A clinical study of a man in severe cognitive decline
Charles Pierce at Esquire writes that Trump’s conversation with the Times reporter shows that he (Trump) is falling off a cognitive cliff.
In my view, the interview is a clinical study of a man in severe cognitive decline, if not the early stages of outright dementia.
Over the past 30 years, I’ve seen my father and all of his siblings slide into the shadows and fog of Alzheimer’s Disease. (the president’s father developed Alzheimer’s in his 80s.) In 1984, Ronald Reagan debated Walter Mondale in Louisville and plainly had no idea where he was. (Would that someone on the panel had asked him. He’d have been stumped.) Not long afterwards, I was interviewing a prominent Alzheimer’s researcher for a book I was doing, and he said, “I saw the look on his face that I see every day in my clinic.” In the transcript of this interview, I hear in the president*’s words my late aunt’s story about how we all walked home from church in the snow one Christmas morning, an event I don’t recall, but that she remembered so vividly that she told the story every time I saw her for the last three years of her life.
Trump’s obsessive repetition does seem very Alzheimer’s like, and so do some of his blurts of incoherence.
In this interview, the president* is only intermittently coherent. He talks in semi-sentences and is always groping for something that sounds familiar, even if it makes no sense whatsoever and even if it blatantly contradicts something he said two minutes earlier. To my ears, anyway, this is more than the president*’s well-known allergy to the truth. This is a classic coping mechanism employed when language skills are coming apart.
An apparent hope that speed and momentum can conceal the confusion and missing pieces.
There’s a lively discussion on the Esquire Politics page on Facebook. One comment is particularly grim:
Cognitive decline on top of pathological narcissism is extremely dangerous. As a clinician (retired) who specialized in personality disorders, it is obvious to me that Trump’s narcissism is extreme and when he implodes, he will lash out violently which is probably what the rest of the world is worried about. Cognitive decline will only accelerate his lashing out as he will have diminished ability to control his impulses. Simply put, we haven’t seen anything yet in terms of this man’s potential destructiveness.
Like General Jack D. Ripper only a lot worse.
The debate now is not that something is wrong with him but what *specifically* is wrong with him…
Seriously, what is wrong with him?
Well some of what’s wrong with him is what’s always been wrong with him – he’s a bad, mean, greedy, self-obsessed, shallow man. But the profound stupidity – who knows. Apparently he has to get a medical checkup on January 12, and I don’t think they’re allowed to keep the findings secret. Maybe they’ll do it anyway though, and that rule will turn out to be yet another check and balance that isn’t.
Oh. Damn. Sure enough – according to Forbes it’s not a requirement at all, it’s a convention. That of course means he won’t do it.
https://www.forbes.com/sites/quora/2017/11/22/is-the-president-required-to-have-an-annual-physical/#22fae0342397
They’ve already said he’s going to release a “summary” of his checkup, which I am sure will be edited to only say good things and a few token minor issues (like he should lose some weight).
I assume he’s not going to that wacky doctor he used before. If he goes to someone reputable then at least the people around him will presumably be told if serious issues are discovered. There have been plenty of leaks about his erratic behavior in the White House, so I don’t think everyone would be surprised. (And, speaking of leaks, I wouldn’t be surprised if a dementia diagnosis got leaked.)
I have watched family member decline from Alzheimer’s and I know exactly what they mean about the look on their faces. It’s a look of befuddlement, and I see it on Trump a lot, often followed by a look of satisfaction when he switches to one of his go-to lines and seems to think he covered his tracks. I think Trump has just about the perfect personality to hide dementia, as he’s been a big-time fake his whole life, an expert at bluffing, and he’s developed a bunch of mini speeches that he can recite as if by instinct.
I’m more optimistic about the country, though. Trump’s done a lot of real damage, but I think the people around him would stop him from doing anything with truly apocalyptic consequences. They may be OK with taking away people’s healthcare to buy more yachts, but they’re no more eager to die in a nuclear holocaust then anybody else is.
Why do they keep saying “early” stages? If my personal anecdata is valid, Trump is “middle” stage, heading “late” stage. Did he even notice that there was something amiss with his own teeth?
Skeletor:
Why is it I find that so weakly reassuring? My understanding is that the POTUS needs nobody’s permission before he (or notionally she) presses the nuclear button.
But still, we can look on the bright side. As an Alzheimers case, he will probably be unable to find that button amongst the junk undoubtedly all over the top of his desk: which his underlings will have every reason to add to, and precious few to clear up.
(And please don’t point to some propaganda photo of him sitting at a tidy desk in the Oval Office. Fake news.)
On the other hand, he is a deeply stupid know-nothing, who has always been incapable of admitting he doesn’t know something, now in a position where people expect him to know stuff about things he’d never even thought to think about a year ago, all the time.
Given that, I’d expect a “state of befuddlement” and being “only intermittently coherent” to be his current default operating mode.
Well, there isn’t actually a button, is there? A nuclear strike would depend on lots of people doing lots of things to make it happen. Presumably these things are not on a hair trigger and will need some preparation before popping off like firecrackers. And presumably there’d be lots of running around by technicians and double-checking targets and fiddling with knobs and so on.
Well, I say “presumably”. I’m basing this entirely on my experience of how complicated systems tend to work in practrice. For all I know, there actually *is* a Scorched Earth button.
Let’s hope there isn’t and let’s hope – regardless of who is in charge – some of the people in the pipeline choose to disobey orders.
Let’s just hope he doesn’t take the physical at the same doctor who certified him to be fit for president.
It’s fairly clear at this stage that he’ll go to whatever doctor tells him he’s the fittest. wellest specimen of humanity that has ever existed. He’s basically Wolverine, they’ll tell him, and that’s what the White House will report.
It’s difficult to make actual diagnoses based on public knowledge… but whatever is up with him, he’s clearly decompensating.
I’ve said before that my own opinion is that Trump is a narcissistic sociopath. As for the nuclear button… well, narcissistic sociopaths are behind most family annihilations. In that scenario the (usually) Dad ends up failing in some way that is unspinnable. Rather than face his family as a failure he kills them all then himself.
It’s the sort of thing I can see Donnie doing on a much bigger scale. The country doesn’t respect him any more (OK, it’s only his perception that “the country” ever felt like that, but his perceptions are what matter here) and he can’t deal with having “failed” so he takes the country with him.
I’m not saying that’s going to happen, but it’s within the psychology of the kind of man Trump is. What worries me is that he’s been stuffing his administration with yes-men or leaving posts unfilled so the chances of there being someone, you know, sane who will refuse an order is a good deal less likely than it has been in previous regimes.
The main problem I have with the idea of cognitive decline is that nearly everyone I know speaks the same way, with the same type of vocabulary (and that goes even for the educated ones). It is a way of speaking familiar to those of us in the rural midwest, and it is possible that at some point Donnie decided (consciously or unconsciously) to emulate it to please his base (after all, he first discussed running for president in the 90s; that would give him ample time to reduce his vocabulary to nearly nothing). I haven’t noticed his eyes; I can’t bring myself to watch him with any degree of concentration.
Still, the idea that he is in the throes of Alzheimer’s would mean that most of my co-workers, family, and students are also showing symptoms (at very young ages for many of them). For quite a few of these people, the level of ignorance and poor vocabulary has a certain deliberateness to it, because the anti-intellectual vibe is so important here (and apparently everywhere these days, even in the halls of academia). I also had family members with Alzheimer’s, and I don’t see the same things in Donald that I saw in them. Of course, it could be a reasonably early stage, but still…these people could not have held the sort of grudges that Trump holds, or remembered the people they hated, let alone the stupid nicknames.
At this point, I would think that calling Donnie anything clinical should be avoided without comprehensive examination – and I maintain once again that many people need to get out of their sheltered world and move around in the areas where middle America lives, and long enough to blast away their illusions.
Omar @6, latsot@8,
This appears to be another of those “we don’t really know, because it’s never happened before” scenarios.
On paper, the president has the authority to order a first nuclear strike. In practice, that order has to go through a few people, any of whom might decide that the order is unlawful and refuse to carry it out. But then, the president could just fire that person and order his or her replacement or second-in-command to do it, and so on until he finds someone compliant.
From an article discussing recent Congressional hearings on the subject:
iknklast – jesus that’s depressing.
I hate anti-intellectualism with the heat of a thousand suns.
I watched a documentary (hagiographic) on Jane Goodall, in which she explained that the reason she was perfect for the job was that she had no scientific training, and in fact, hadn’t gone to university at all. So she wasn’t ruined by scientific expectations – which may be why, when I was watching it, I had a lot of moments like “Why the hell did she do that? Why didn’t she question that finding? What was she thinking?” But I suppose that’s because my doctorate in science has spoiled me for the real thing…meanwhile, everyone kept referring to her as Dr. Goodall in interviews and the like.
Then I went home and was finishing up a novel written by leftists, where the line “but then, aren’t all scientists basically criminals?” was used in a non-ironic way, and where the scientists were all doing genetic modification to make monsters that would destroy the rest of us because…science does things like that. There seemed to be no other motivation.
Right and left, left and right, alike have a real disdain and hatred for science. Yes, science has made mistakes. Yes, science has had bad people. Yes, science has been used for scary bad things, and things that have lacked ethics. Yes, big bad bomb. Yes, Tuskegee. Yes, Henrietta Lacks. But…these are the aberrations, and these are the reasons we have so many ethics procedures now, procedures that get people like Andrew Wakefield unseated from his license.
Sorry, bit of a deviation from the OP there…it seems lately like one thing always leads to another…and another…and sooner or later, it all leads back to the anti-intellectualism that got Trump elected.
NP, that’s not really a deviation.
Goodall did go on to get a PhD though, at Cambridge, so calling her Doctor isn’t actually a mistake.
That was never noted in the film; they continued to talk about her lack of university education. They probably should have made that clearer…
Good grief, how bizarre.
Actually, ‘science’ is just a collection of facts that have been found out and of ideas about them. And according to the philosopher Daniel C. Dennett, Charles Darwin was the greatest scientist who ever lived: “greater than Newton; greater than Einstein.”
And what was Darwin’s undergraduate training in? Theology!
Which only goes to show IMHO that one can make an entry into science at any of its windows, and at any level.
If Donald Trump has Alzheimer’s disease, as he likely does, he must still be in the disease’s earlier stages. He seems like he can find his way around the places he lives in and goes to, and he is still half-competent in language. In later stages, he would stop recognizing people, stop using language, start wandering around and then become bedridden, etc. He doesn’t seem to have gotten that far, however.
True, and the early stage can last for some years.
iknklast, are we talking about just the vocabulary? Or the seemingly confused speech as well?
I’ve lived sort of on the outskirts of the rural Midwest (between suburban and true rural) and have not heard healthy people talk like this:
“I’m always moving. I’m moving in both directions. We have to get rid of chainlike immigration, we have to get rid of the chain. The chain is the last guy that killed. … [Talking with guests.] … The last guy that killed the eight people. … [Inaudible.] … So badly wounded people. … Twenty-two people came in through chain migration. Chain migration and the lottery system. They have a lottery in these countries. They take the worst people in the country, they put ‘em into the lottery, then they have a handful of bad, worse ones, and they put them out. ‘Oh, these are the people the United States. …’ … We’re gonna get rid of the lottery, and by the way, the Democrats agree with me on that. On chain migration, they pretty much agree with me.”
Trump has walked off, forgetting to sign bills, at signing ceremonies. He got off a plane and wandered around for a while chatting with people before someone pointed to the limo he’d walked right past on his way off the plane.
Then we have the confusion like him saying people pay $15 a month to eventually build up good health insurance for themselves when they’re older, as well as the general rambling speech.
So, no, he’s not forgetting who people are or where he lives, but this very concerning. The “unfit to be president” stage is well before he’d have to be placed in a care facility.
Yeah I’m not really buying the dementia theory for Trump…at least not just yet. Some articles touting this insist on how different he was in interviews from the 80s and 90s, but I when I see those interviews, he seems much the same to me as he is now. The only story that gave me pause is the one about him supposedly telling people that the voice on that Hollywood Access tape was not his, since that suggests a rather disturbing level of delusion that’s beyond his usual gaslighting.
Skeletor, I wish I could say I don’t hear healthy people talking like that…but maybe they’re not healthy and just manage to somehow get along? I don’t know, since I don’t pry into the medical histories of people I don’t know all that well. It just seems to be a…thing.
And some of it sounds like ADHD, which actually isn’t that great in a president, either, frankly.
I don’t know if he’s got dementia, or if he’s always been like this. I do know that people spent a lot of time trying to diagnose Dubya, and Ford, and everyone else, and all the Repubs were out there trying to give Hillary some sort of debilitating disease. I think such speculation is not a great idea because it can become a self-propagating, truth eating monster. Once the talk gets started, it becomes “true”. Later information that refutes it cannot be dispersed as widely, because everyone knows the truth already. This is the same media monster that ate Hillary and tried to eat Obama…I think we need to be more responsible than that.
Speculation is one thing, but this is moving beyond speculation into people asserting things with great confidence that they should not at this point have.
Omar #20
No, “science” is not just a collection of facts. Science is a collection of methods for determining “facts,” or, at least, for determining as best we can what’s going on and why.
It’s not an encyclopedia.
I wonder if Trump now knows what the “nuclear triad” is? He didn’t in the campaign to become Republican nominee, which is something that should have killed his chances then and there (even over and above his racism, misogyny, ignorance and boorishness). Command of the nuclear arsenal is one of the things Presidenting IS. Such a lack of fundamental knowledge would not endear him to military personnel whose lives are very much affected by presidential decisions. I would hope this inexcusable and indefensible ignorance would be remembered by people at all levels of the US armed forces. I would hope that there would be some in the military chain of command who would disobey orders from him. At least some in the military (as in intelligence and law enforcement), who take the welfare of the US seriously must be fully aware of Trump’s carelessness and cluelessness about the genuine security and safety of their country. There are probably some (undoubtedly too many) who would reflexively follow any presidential order regardless of content simply because it is “presidential.”
I’d bet that Trump was disappointed the nuclear “football” was not actually a football…
iknklast #15
When Goodall started out, the dominant paradigm among naturalists was a hidebound behaviorism that discounted the idea that non-human animals were capable of cognition (any such idea was “anthropomorphism,” which was anathema.) She was able to observe her subjects with a fresh eye, free of a lot of assumptions and prejudices that would likely have inhibited her, even if she’d rejected them.
No doubt it’s usually a good thing for a beginner to have a thorough grounding in their chosen field. But there are exceptions to everything.
I think it was Jane Goodall I heard on the radio once explaining that when she documented her observations she didn’t write ‘x animal was angry’ or whatever, but rather ‘x animal behaved in such a way that a human behaving in this way would be interpreted as expressing anger’–this was, she explained, how she ‘got away with’ her descriptions.
I have a text document on my memory stick with notes for an essay I’d like to write someday about Jean Laidloff, Dian Fossey and Jane Goodall (if anyone here can think of any other women I should add to this particular list, please share). Each was put on track for what turned out to be an important scientific career because they were young, pretty, and pleasant, and happened to draw the attention of older established men who promoted their interests and put them into positions where they could develop their work. I think there’s some significance in that, if only that during this period it was really the only way for women to get ‘patronage’ of that sort. I don’t know what I think about this; I haven’t written the essay yet….
Guest, one woman you might want to take a look at is the late Stella Brewer Marsden, author of The Forest Dwellers, who did terrific work with wild chimpanzees in the Gambia. She initially worked with Goodall before going on to do her own work.
Lady M. @#27:
Agreed. But I include all that in the phrase “ideas about them [ie the facts]”.
Hi Acolyte of Sagan–thanks for that. What I’m interested in, with respect to the three women I mentioned, is the fact that their entry into the academic fields in which they did worthwhile research was through older established men who supported them because they were young, pretty and pliable rather than because they were promising scholars. I won’t argue that established male academics never support female protégés, but in my experience the situation can be very fraught (and based on what I’ve been reading over the past few months it’s even worse than I thought). Men support younger men who they can see themselves in, or whose work they feel will raise their own reputations; the dynamic with younger women can be different. I have no idea if these women experienced the kind of sexual abuse we’ve been reading about lately, or if they felt they needed to comply with some kind of feminine template to gain the patronage that allowed them to establish their own reputations, but their initial career paths were certainly ‘unconventional’ by male standards–and not available to women who don’t match the attractiveness template. On the other hand, though, as iknklast pointed out, they may never have had a chance at all if they’d had to ‘go through appropriate channels’. I think that’s what I want to explore by highlighting Laidloff, Fossey and Goodall (and anyone else who fits this pattern that anyone identifies).