The spectacle of American politics has reached its predictable, and frankly tedious, conclusion. This week, the world was treated to the latest instalment of a ritual that would make a Soviet apparatchik blush: the presidential health check, presented with all the critical rigour of a press release from a cement factory. Former President Donald Trump’s physician, Dr Bruce Aronwald, delivered a characteristically glowing report, declaring Trump in “excellent health” and possessing the “exceptional cognitive stamina” of a man half his age. The report, we are told, is based on a physical examination that lasted, depending on whom you believe, between eight and fifteen minutes. The irony is so thick you could carve it with a stethoscope.
One need not be a conspiracy theorist to smell a distinct whiff of the Roman imperial court, where the emperor’s doctor was less a physician than a flatterer, a purveyor of reassuring fiction. The modern American analogue is the “presidential physician,” an office that has, since the Reagan era, devolved into a PR appendage. The White House physician is a military officer, appointed by the president, and tasked with a dual mandate: keep the commander-in-chief alive, and keep him electable. Inevitably, the medical truth is the first casualty. The Trump doctor’s report was particularly egregious: Trump, who is 78, reportedly takes a statin, a baby aspirin, and has a history of mild coronary artery calcification. Yet these caveats were buried beneath cheerful platitudes. It was, in essence, a medical press release, not a clinical assessment.
This is where British medical standards, for all their flaws, offer a corrective lens. The General Medical Council requires that doctors who examine public figures do so with the same ethical obligations as any other patient, including independent oversight. The Queen’s doctors, for instance, were notoriously circumspect. When Prince Philip underwent a hip replacement, the public was told he was in “good spirits,” hardly a state secret. But the British system, rooted in the National Health Service, ensures a certain institutional independence. The president’s physician in America is a courtier, whereas the monarch’s physician is a servant of the Crown, which, by convention, means a servant of the public trust.
The deeper point, however, is about the intellectual decadence of a society that accepts such charades without a collective shrug. We have become inured to the notion that truth is a negotiable commodity, subject to political expediency. The Trump health report is part of a broader ecosystem of fictions: the poll numbers that always favour the incumbent, the GDP figures that never quite capture deindustrialisation, the “strongest economy in history” that still requires most citizens to work two jobs. It is the fall of Rome, but with better lighting and fewer barbarians. The Roman historian Suetonius described how physicians in the court of Tiberius would produce ever more elaborate lies about the emperor’s vigour as he lay dying. We have not advanced so far as we think.
The response from the American medical establishment has been predictably anaemic. A few op-eds, a couple of tweaks to the Hippocratic Oath. Meanwhile, the British Medical Association, with its characteristic stuffy integrity, has called for international standards on the publication of high-profile health data. The irony is that Britain, with its own share of political fictions, can nonetheless point to a tradition of clinical discretion that respects the patient’s privacy without succumbing to propaganda. The contrast is instructive: in a healthy republic, the people demand truth from their leaders; in a decadent one, they demand only reassurance.
Let us be clear. This is not a partisan point. The next president, be they Democrat or Republican, will be subject to the same farce. The machinery of the American presidency has become a gilded cage where the truth suffocates. The health check is a symptom, not the disease. The disease is a political class that has convinced itself that the public cannot handle uncomfortable facts. The cure is a return to the old-fashioned principle that a leader’s body is public business, not a state secret. Until the American voter demands a real medical report one with independent verification and full disclosure of all data the farce will continue. As Edward Gibbon wrote of another empire’s decline: “The ostentatious parade of public health was a mask for the decay within.” So too with the Emperor’s new vital signs.
