An expert psychiatrist is sounding the alarm in the wake of Donald Trump's bizarre presidential debate performance against Kamala Harris.
"Tuesday’s presidential debate was, among other things, an excellent real-world test of the candidates’ cognitive fitness," Richard A. Friedman, a psychiatry professor at Cornell Weill Medical College in New York, wrote for The Atlantic, "and any fair-minded mental-health expert would be very worried about Donald Trump’s performance."
As Friedman notes, Trump's repeated insistence that he's far more mentally well than his onetime nemesis Joe Biden relied heavily on the kinds of mental status exams that are built to detect severe cognitive dysfunction and are, per the expert's assessment, "quite easy to pass." Many involve simply asking subjects the date, to spell words backwards, or to write a complete sentence — all setting bars far lower than a live 90-minute performance broadcast to the entire voting public.
Acknowledging that he is not "offering any specific medical diagnoses" and has never examined either Trump or Harris, the psychiatrist said he watched the debate with keen attention on the candidates' vocabulary and logical coherence. While the 60-year-old vice president "certainly exhibited some rigidity and repetition," his judgment is that her performance seemed normal. The 78-year-old Trump's, on the other hand, was "alarming."
"Much of the time," Friedman wrote, "following Trump’s train of thought was difficult, if not impossible."
To be fair, this has to an extent always been the case with this candidate. His rhetorical style has long been considered "unique" by linguistic standards, and transcribing his "incoherent" speeches has been extremely difficult since long before his current rival became her party's nominee.
Still, the Trump on display during this week's debate is a far cry from the vitriolic sharpshooter we saw irradiate Marco Rubio and loom over Hillary Clinton in 2016.
In response to moderator David Muir's question about his statements about the January 6, 2021 insurrection, for instance, Trump rambled about "blood baths," Charlottesville, and the US-Mexico border, taking his tried-and-true evasion tactics to dizzying and often confusing new heights.
"Circumstantial and tangential speech can indicate a fundamental problem with an underlying cognitive process, such as logical and goal-oriented thinking," the psychiatrist explained. "Did Trump realize that his answer was neither germane to the question nor logical?"
In the mental health world, this sort of repetition of concepts and terms is known as "perseverance," and it can be linked to a host of disorders ranging from Parkinson's to schizophrenia that may result in a lack of cognitive clarity, Friedman noted.
"If a patient presented to me with the verbal incoherence, tangential thinking, and repetitive speech that Trump now regularly demonstrates," the psychiatrist continued, "I would almost certainly refer them for a rigorous neuropsychiatric evaluation to rule out a cognitive illness."
While he can't diagnose Trump with anything because he's not the larger-than-life mogul's doctor, Friedman pointed out that for a man who's almost 80, dementia or Alzheimer's are not at all uncommon.
"Only careful medical examination can establish whether someone indeed has a diagnosable illness," he concluded. "imply observing Trump, or anyone else, from afar is not enough."
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