Why Is Bernie Sanders Hiding His Medical Records?

Donald Trump claims to be in "perfect" health - something his age and level of significant obesity make suspect at best.  Meanwhile, Bernie Sanders had a heart attack in October and has yet to fully release his medical records to disclose the true state of his health (originally, Sanders said he would release his medical records.  He has now backtracked on doing so). In both instances, Trump and Sanders are potentially misleading voters who have a right to know the state of their health since it impacts their ability to perform the duties of the presidency and may also  impact their decision making ability.  A column in the Washington Post by a cardiologist argues that there need to be mandatory standards of disclosure for both sitting presidents and presidential candidates.  Without such standards, voters are left without critical information and it can only be assumed that individuals who do not release comprehensive medical information have something to hide.  When candidates refuse to release full information on their health, it is appropriate for voters to ask "what are they hiding/".Here are column highlights:

Coming off victories in Iowa and New Hampshire, Sen. Bernie Sanders (I-Vt.) is increasingly described as the front-runner for the Democratic presidential nomination. Inevitably, questions will arise about the health of the 78-year-old senator as well as that of the 73-year-old incumbent, President Trump.

But the public reports on the two men’s recent health-related episodes, written by their primary-care military physicians, do not serve voters well. The fault, however, is not with the physicians but with the absence of explicit standards for disclosing health records of presidents and presidential candidates — an eminently rectifiable situation.

Both medical reports omit critically pertinent prognostic data that the physicians certainly know. Sanders had a heart attack in October, but his report is silent about the extent of disease in his coronary arteries, which is the most important factor in determining his risk for another heart attack. The report on Trump’s abrupt, unscheduled visit to Walter Reed National Military Medical Center in November listed several key cardiovascular symptoms the president did not have, but failed to say whether he was free from the sensations of chest squeezing and left arm discomfort that patients classically experience during heart attack and its precursors.

Voters need and deserve health information from candidates because a vote is fundamentally a bet on the future, reflecting the voter’s estimate of the candidate’s ability to lead the nation toward the voter’s desired endpoint. . . . illness physically impedes exercise of the office.

Medical conditions that might significantly impair these functions over the next four years should be disclosed to voters. All others are no business of the public.

The rub is defining “significantly.” Fortunately, military medicine has long experience doing exactly this, by defining medical standards for specific jobs — pilot, parachutist, cook, etc. Among these, in my experience, the mental and physical demands on air traffic controllers most closely track the four essential “presidential” functions. The Air Force lists hundreds of medical conditions that disqualify air traffic controllers by threatening the four functions, including heart attack, psychosis and non-trivial cancers. Subtract from this list the musculoskeletal requirements of general military service (the campaign trail’s rigors can substitute as a stamina test), and the remaining conditions well describe the medical threats to the exercise of the presidency. Military physicians work with such lists daily.

Thus, as a first cut, I would propose a policy (better, a law) requiring presidential and vice presidential candidates to publicly disclose complete information on every non-musculoskeletal medical condition they have that would disqualify them from being an air traffic controller in the Air Force.

The report on Sanders was incomplete by Air Force standards because appeals for reinstatement after a heart attack must include a full description of coronary artery anatomy.

With explicit standards the country would know exactly what the physician means by “fit for duty,” thereby avoiding adversarial speculations such as those surrounding Trump’s visit to Walter Reed.

It is important to emphasize that any medical standard for the presidency would only be a standard for disclosure. In no case would the standard bar someone from holding office because of a medical condition. That would be up to the voters, as it has been every four years since 1788.

Trump’s Physical Revealed Serious Heart Concerns

Like almost everything else that Donald Trump and his minions say, the claims that Trump's recent physical showed him  to be in "excellent health."  Having watched the press conference by White House physician, Dr. Ronny L. Jackson, Jackson's body language and demeanor suggested that he was very uncomfortable with what he was saying, indicating that he is not as good of a lair as Trump or Sarah Huckabee Sanders, perhaps the most dishonest woman in Washington.  Now, as the New York Times, is reporting, a number of cardiologists believe that Trump is at significant risk of a heart attack.   No doubt Mike Pence is smiling behind the scenes.  As for Trump's golfing counting as "exercise," not really since he rides in a golf cart constantly.  Here are article highlights:

Cardiologists not associated with the White House said Wednesday that President Trump’s physical exam revealed serious heart concerns, including very high levels of so-called bad cholesterol, which raises the risk that Mr. Trump could have a heart attack while in office.

Dr. Ronny L. Jackson, a rear admiral and the White House physician, said Tuesday in his report on the president’s medical condition that Mr. Trump was in “excellent” cardiac health despite having an LDL cholesterol level of 143, well above the desired level of 100 or less.

Dr. David Maron, the director of preventive cardiology at Stanford University’s medical school, said Wednesday that it was alarming that the president’s LDL levels remain above 140 even though he is taking 10 milligrams of Crestor, a powerful drug that is used to lower cholesterol levels to well below 100.

Dr. Maron said he would “definitely” be worried about Mr. Trump’s risk for having a heart attack if the president were one of his patients. Asked if Mr. Trump is in perfect health, Dr. Maron offered a blunt reply: “God, no.”

Other cardiologists also disputed Dr. Jackson’s rosy assessment of the president’s heart health. Several said Mr. Trump’s goal should be to get his LDL below 100, or even under 70. He has a real risk of having a heart attack or stroke, especially considering his weight and lack of exercise, they said.

“That’s a really high LDL,” Dr. Topol said. “We’re talking about a 70-plus-year-old man who is obese and doesn’t exercise. Just looking at the lab value, you would raise a big red flag.”

He added: “I would never use the words ‘excellent health.’ How you could take these indices and say excellent health? That is completely contradicted.”

Asked whether Mr. Trump has heart disease, Dr. Jackson said he did not. “Technically, he has nonclinical coronary atherosclerosis,” Dr. Jackson told reporters.

Outside doctors — who have not directly examined Mr. Trump — questioned that conclusion, saying that the combination of Mr. Trump’s weight and the cardiac test results raised more concerns than Dr. Jackson’s comments would reflect.

The cardiologists said the president’s weight and diet were a serious problem that probably contributed to his high LDL level and increased his risk for heart problems. Dr. Topol dismissed as irrelevant the debate about whether the president technically met the definition of obese.

“Here the issue is, does he have abdominal obesity?” Dr. Topol said. “I don’t care what his height is. All you have to do is look at his abdomen. Abdominal obesity, that’s the machinery for inflammation for the heart.”

Scalia's Death Ruled to Due to Heart Attack

I know it is bad form to speak ill of the dead, but with the news that Antonin Scalia's unexpected death was due to a heart attack, it is difficult to refrain from pointing out that while the obese Scalia relished in pointing out the sins of others, he apparently was blind to his own sin of gluttony. WFAA 8-TV has details on the cause of death:

United States Supreme Court Justice Antonin Scalia’s heart stopped beating during his sleep, Presidio County Judge Cinderela Guevara told WFAA on Sunday.

Guevara officially pronounced him dead at 1:52 p.m. on Saturday. She will be the local official who signs his death certificate.

Hours earlier, the county judge told WFAA that myocardial infarction — or a heart attack — would likely be the cause of death listed. Guevara later said she would confer with the Justice’s personal physician on what specifically to show as the cause of death.

While Scalia died of natural causes and possible because of his own obesity, the right wing conspiracy crowd is claiming that Barack Obama had Scalia murdered in order to open a seat on the Supreme Court.  Contrary to this utter lunacy, WFAA 8 TV reported as follows:

“As part of my investigation one of the things I did ask the sheriff and the U.S. Marshal: 'Were there any signs of foul play? And they said, ‘Absolutely not.’ At that time, I still wanted to be careful and asked them if [Scalia’s] physician would call me.”

The justice’s personal doctor called Guevara at 8 p.m. Saturday night.

“When [the physician] explained [Scalia] had just visited on Wednesday and Thursday, and [the doctor] had done an MRI, then I felt comfortable what I knew was going on with him physically,” she said.

Guevara said Scalia went to his doctor for a shoulder injury last week, but the justice also suffered from several chronic ailments.

 Bottom line: Scalia was 79 years old and grossly over weight.  His bad lifestyle choices caught up with him.  All I can feel is good riddance.

NBC's Tim Russert Dies of Heart Attack

While more recently I had not agreed with some of his reporting - e.g., beating the Rev. Wright story to death and in my view catering to Hillary Clinton during the primaries - I nonetheless was sad to learn that Tim Russert died this afternoon of a heart attack. I had watched him on "Meet the Press" just recently. It's perhaps even more of a shock now that I have realized that he was only a little more than two years older than me (I had thought he was older than 58 and I guess I don't look so bad for my age after all). I can certainly think of numerous people much more deserving of death than Russert. His unexpected death should be another wake up call to all of us that we truly do not know how much time we have in this life, so we need to enjoy the moment and find some magic and wonder in every passing day. My thoughts and condolences go out to his wife and son. I am glad that Russert had been able to vacation with his family just days ago. Here are some highlights from MSNBC:

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WASHINGTON - Tim Russert, NBC News’ Washington bureau chief and the moderator of “Meet the Press,” died Friday after a sudden heart attack at the bureau, NBC News said Friday. He was 58. Russert was recording voiceovers for Sunday’s “Meet the Press” program when he collapsed, the network said. He and his family had recently returned from Italy, where they celebrated the graduation of Russert’s son, Luke, from Boston College.

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Russert was best known as host of “Meet the Press,” which he took over in December 1991. Now in its 60th year, “Meet the Press” is the longest-running program in the history of television. But he was also a vice president of NBC News and head of its overall Washington operations, a nearly round-the-clock presence on NBC and MSNBC on election nights.

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Survivors include Russert’s wife, Maureen Orth, a writer for Vanity Fair magazine, whom he met at the 1976 Democratic National Convention; and their son, Luke.

Sevilla midfielder Antonio Puerta dies

This is a strange and sad story. How and why he had a heart attack at age 22 has yet to be explained. My thoughts and condolences go out to his family and expectant girl friend. Here's a part of the International Herald Tribune's coverage:

SEVILLE, Spain: Sevilla midfielder Antonio Puerta died Tuesday, three days after collapsing on the field during his team's Spanish league match against Getafe. Puerta died of "multiple organ failure stemming from prolonged cardiac arrest" and subsequent coronary problems, Virgen del Rocio Hospital director Gimeno Guerrero said in a statement.

The 22-year-old Puerta had been in an intensive care unit since Saturday and had been given assisted ventilation but his condition worsened Tuesday, the hospital said. Puerta lost consciousness and fell near his own goal Saturday in the 31st minute, but was able to walk off minutes later after being treated by team doctors. But doctors said he had a heart attack in the locker room, and at least one more in the emergency room of the Seville hospital where he was taken.