After a period of silence, Dr. Bandy Lee and her committee of mental-health “experts” have again burst onto the scene, angling to participate in the impeachment of President Trump. They are defying the Goldwater Rule, which holds that it is unethical for physicians to diagnose patients they have not personally examined. They claim that President Trump is a such a serious threat to the nation that they are allowed to violate rules.
“We don’t believe there is the need for any further evaluation, and we are making ourselves available for the impeachment hearing because we believe that mental health issues will become critical as pressures from the impeachment hearings mount,” Dr. Lee told the Washington Examiner. “In other words, the more successful the impeachment proceedings become, the more dangerous the psychological factors of the president will become.”
Obviously, the thing to do is to increase the psychological pressure on a person you declare to be unstable.
Dr. Lee’s “medical assessment” of the President’s “mental capacity to fulfill the duties of his office” includes the examination of tweets, public appearances, and the 448-page Mueller report. “There is very little that a personal examination will add,” Lee said.
She denies that she is actually making a diagnosis. Indeed, “unfitness for office” is an opinion, a conclusion that is not in the DSM, the Diagnostic and Statistical Manual of currently defined psychiatric diagnoses.
Regardless of one’s opinion about President Trump, this self-appointed “Independent Expert Panel for Presidential Fitness” should concern all Americans. Where does a group of academic experts get the ability or the authority to determine whether the President is “capable of keeping the country safe”?
The U.S. Constitution provides several methods of “regime change,” which is what Congressional Democrats, the mainstream news media, and this Panel seem
determined to achieve. The first is elections. In 2016, Americans voted for a change from the policies of Obama and Clinton and the imbedded bureaucracy. Ever since then, the losers have been seeking to nullify this result. Attacks on the President by the press have been unrelenting. Unlike Abraham Lincoln or Woodrow Wilson, this President has not imprisoned any journalists or shut down any newspapers. But he does make sarcastic remarks—and his opponents would like to deny him the forum of social media.
Second is the 25th Amendment, which provides for the removal of a President for incapacity. This might have removed Woodrow Wilson after a devastating stroke had it been in existence at the time. It requires action by the Vice President and a majority of executive officers or a body appointed by Congress—not a few activist academics. This has so far been a non-starter.
Finally, there is impeachment, for “high crimes and misdemeanors.” In American jurisprudence, proceedings are supposed to be triggered by a crime—not by the Soviet KGB method of “show me the man, and I will name his crime.” Or worse, “KGB Plus”—show me the man, and I will invent his crime.
In a world where there are so many ever-changing rules that everyone might be inadvertently committing “three felonies a day,” anyone could be prosecuted. But one is at least supposed to have certain rights: confronting the accuser, assistance of counsel, access to all the evidence, the right to call and cross-examine witnesses. And knowing exactly what the charges are.
Why should psychiatrists be intruding themselves into this legal process? Are there Thought Crimes that they have a special ability to discern?
Ordinary Americans should be very concerned. If this can happen to the President, it can happen to them. And it does.
One alarming example is the “fitness for duty” evaluations to which physicians may be subjected by people who for some reason want to destroy them. There are virtually no due-process rights. The examiner has the status of a physician, but no obligation to act in the “patient’s” (target’s) best interest. Some psychiatrists may presume to have god-like power to judge a person’s emotions, intentions, and capacity—asserted in the name of safety or “security.” “Red flag” laws are another example.
President Trump may be right in saying: “They’re not coming for me. They are coming for you. I’m just in the way.”
Bandy Lee and associates are showing us a method to remove undesirables if legal process fails.
Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. Her views are her own. This is an edited version of her column that originally appeared in pennypress.com. Reprinted with permission.
White House Physician, Navy Rear Adm. Dr. Ronny Jackson, performed President Donald Trump’s annual physical last week are released the following results:
President Donald J. Trump has completed his first periodic physical examination as President of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The exam was conducted January 12, 2018 at the Walter Reed National Military Medical Center.
The purpose of this exam was to provide the public with an update of the President’s current health status and to ensure the President continues to enjoy all the benefits of good health. This examination focused on evidence-based health screening and disease prevention.
With President Trump's consent, I release the following health information:
Age: 71 years, 7 months
Height: 75 inches
Weight: 239 pounds
Resting heart rate: 68 bpm
Blood pressure: 122/74 mm
Hg Pulse-oximetry: 99% room air
Temperature: 98.4 degrees F
Physical Examination by System (to include studies)
Eyes: Uncorrected visual acuity was 20/30 bilaterally, with corrected visual acuity of 20/20 bilaterally. Visual fields were normal. Fundoscopic exam was normal bilaterally. Intraocular pressures were normal bilaterally. No ocular pathology was discovered.
Head/Ears/Nose/Throat: Normal exam of the head, ears, nose, mouth, and throat.
Dental: Healthy teeth and gums.
Neck: Normal thyroid exam. No noted lymphadenopathy. Auscultation of the carotid arteries normal.
Pulmonary: Lungs clear to auscultation. A screening Low Dose CT of the chest demonstrated no pulmonary pathology.
Cardiac: Heart exam normal. Regular rhythm. No murmurs or other abnormal heart sounds noted. ECG with normal sinus rhythm, rate of 71, normal axis, and no other significant findings. Transthoracic Echocardiogram demonstrated normal LV systolic function, EF 60-65%, normal LV chamber size and wall thickness, no wall motion abnormalities. RV normal, atria grossly normal, all valves normal. Exercise Stress Echocardiogram demonstrated above average exercise capacity based on age and sex, and normal heart rate, blood pressure, and cardiac output response to exercise. No evidence of ischemia noted and wall motion was normal in all images.
Gastrointestinal: Normal exam. No masses, hepatomegaly or splenomegaly noted. Normal optical colonoscopy with no polyps or abnormal findings completed June 2013. Repeat colonoscopy not indicated and was deferred until next periodic physical exam.
Genitourinary: Normal exam.
Extremities/Musculoskeletal: Normal throughout. Full range of motion in all joints. Strong distal pulses and good capillary refill in all extremities. No swelling or edema noted.
Neurological: Examination of cranial nerves, cerebellar function, deep tendon reflexes, motor function, and sensory system all normal. Cognitive Screening Exam using the Montreal Cognitive Assessment was normal with a score of 30/30.
Dermatologic: Normal exam. No evidence of melanoma , basal cell carcinoma, squamous cell carcinoma, or any other significant dermatologic disease.
Total cholesterol: 223 (mg/dL)
Triglycerides: 129 (mg/dL)
HDL cholesterol: 67 (mg/dL)
LDL cholesterol: 143 (mg/dL)
Cholesterol to HDL ratio: 3.3\
Complete Blood Count:
WBC: 5.5 (K/UL)
HGB: 16.1 (g/dL)
HCT: 48.7 (%)
PLT: 241 (K/UL)
Extended Metabolic Panel:
Fasting Blood Glucose: 89 (mg/dL)
BUN: 19.0 (mg/dL)
CREAT: 0.98 (mg/dL)
ALT: 27 (U/L)
AST: 19 (U/L)
Hemoglobin AlC: 5.0 (%)
Vitamin D: 20.0 (ng/ml)
PSA: 0.12 (ng/ml)
TSH: 1.76 (ulU/ml)
Past Medical History
Past Surgical History
Appendectomy (age 11)
• No past or present use of alcohol.
• No past or present use of tobacco.
Rosuvastatin (Crestor), 10 mg daily to lower cholesterol.
Acetylsalicylic Acid (Aspirin), 81mg daily for cardiac health.
Finasteride (Propecia), 1 mg daily for prevention of male pattern hair loss.
Ivermectin Cream (Soolantra), As needed for treatment of Rosacea
Multivitamin (Centrum Silver), Daily for overall health maintenance.
The President’s overall health is excellent. His cardiac performance during his physical exam was very good. He continues to enjoy the significant long term cardiac and overall health benefits that come from a lifetime of abstinence from tobacco and alcohol. We discussed diet, exercise and weight loss. He would benefit from a diet that is lower in fat and carbohydrates and from a routine exercise regimen. He has a history of elevated cholesterol and is currently on a low dose of Rosuvastatin. In order to further reduce his cholesterol level and further decrease his cardiac risk, we will increase the dose of this particular medication. The President is currently up to date on all recommended preventive medicine screening tests and exams.
All clinical data indicates that the President is currently very healthy and that he will remain so for the duration of his Presidency.
At the above height and weight, Donald Trump’s BMI is 29.9 placing him in the overweight category just shy of the 30 BMI cut off for obesity.
His blood pressure and heart rate are excellent for his age, especially in the absence of a blood pressure medication.
His pulse oximetry demonstrating the oxygenation of his blood is excellent as well.
An uncorrected vision test of 20/30 means that without glasses, the president has near perfect vision.
A low dose CT of the chest is not routine during annual physicals in non-smokers, but is reassuring that he most likely doesn’t suffer from lung cancer, the number one cancer killer in America.
His EKG, which evaluates electrical abnormalities of the heart secondary to disease or heart attack, confirmed the ideal heart rate.
His echocardiogram, and ultrasound evaluating heart structures and pump activity, demonstrated no heart failure or issues with the filling or pumping of blood, as well as confirming normal anatomy (valves, wall thickness, etc).
A stress test evaluates for cardiac ischemia, or loss of blood flow to heart muscle during rest and exercise, and was normal as well.
A normal colonoscopy in 2013 suggests his next screening colonoscopy wouldn’t be performed until 2023 unless he had pain, rectal bleed, changes in his stool, or any risk factors for colon cancer.
The Montreal Cognitive Assessment was given to evaluate cognitive function and is not routinely done during annual physicals. This was performed and passed with a 30/30 score. The test evaluates memory, orientation, visuospatial and executive brain function, recall, concentration and language fluency. An example is shown here.
His cholesterol is elevated but his good cholesterol is strong and his ratio of cholesterol to HDL is well within goal.
The remaining blood tests looked very good, especially his HBA1C and blood glucose evaluating for diabetes.
Of note is his Vitamin D level which appears low-normal and could put him at risk for osteoporosis. It does not appear a bone density test, Dexa scan, was performed.
A PSA of 0.12 is reassuring as well although is not recommended as a screening test for prostate cancer.
It's been suggested that President Trump loses 10-15 lbs and increases his exercise activity.
My opinion, for a 71-year-old man with high cholesterol, President Trump is way ahead of the curve. I’m a fan of Crestor, his cholesterol lowering medication, and credit his lipid profile numbers to his use of the statin. His weight is an issue but I think the White House has a bowling alley, chefs who could make asparagus taste like meat, and secret service who wear fitbits. I think he’ll be just fine.
This is a developing story.
Investigators believe the Las Vegas Route 91 Harvest Concert shooter, Stephen Paddock, suffered from severe mental illness that was never diagnosed. This seems obvious to us, as anyone who would kill 59 innocent people and wound hundreds more could never be of sound mind.
However, one would think a person this mentally unstable would leave a pattern of behavior footprints that would have been picked up earlier in his life.
Although no motive has been established in the shooting, investigators have interviewed multiple acquaintances who knew the 64-year-old real estate investor and were told he was disconnected, stand-offish, and lacked multiple social interactions. However, he easily flew under the radar as he had a girlfriend, appeared to be close to his mother, and had successful real estate dealings that funded his gambling habits.
Most mass shootings are committed not by those who spent time in mental institutions but by those who dined, shopped, and lived near their victims. And many have been under the care of medical providers, being prescribed medications that address psychological symptoms. So how do mass shooters evade proper diagnosis?
To the layman, the average person with severe mental illness appears highly erratic, confused, unpredictable. To a trained medical professional, the same symptoms would trigger their suspicions as well.
But the average killer may be a psychopath, being impulsive, antisocial, and exhibiting violent behavior. If they don’t act violent or violently impulsive, they can elude the interviewer.
A mass shooter will plan their attack, may stake out locations, and but will overall remain isolated to avoid arousing suspicions. And a psychopath, may exhibit antisocial behavior. So as they stay remain isolated and introverted, they allow less opportunity to be “made.”
As in Stephen Paddock’s case, he flew under the radar as he did not avoid the public. He would drink, gamble, frequent casinos and appear to be very successful in his business/real estate dealings. With lack of a criminal record and violent interactions, the average person wouldn’t deem him suspicious of committing such a heinous act.
Many people with mental illness may have symptoms they wish to control, but will stop short of admitting they have a medical condition that needs treatment. Those who suffer from delusions or psychosis may believe others are exhibiting the abnormal behavior, so why would they want to undergo treatment themselves?
Moreover, if they fear being “turned in” by the medical provider interviewing them and revealing homicidal ideation, they will be less inclined to seek medical help.
If an individual with severe mental illness has difficulty maintaining a job, he/she most likely will be without employer-paid health insurance. This limits access to seeking medical help all the more.
The chilling truth is we have killers who live among us who may plot and plan right under our noses. Let’s pray they leave enough clues that they get caught before they carry out their plans.
Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD, FAAFP and a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.