President Biden continues to fight back.
“It's not going anywhere,” he insists defiantly, saying he feels fine.
But I have heard from doctors who saw Biden emerge victorious from the June 27 debate and think he is not doing well at all. One of them told me he is certain Biden suffers from a movement disorder for which there is no cure.
The diagnosis of someone who has not examined a patient is speculative, but the opinion shared by the doctors who contacted me is that we are not dealing with a man who is simply aging, but rather with a man with a serious illness.
California is about to be hit by a wave of aging, and Steve Lopez is taking advantage of it. His column focuses on the advantages and disadvantages of advancing age, and how some people are challenging the stigma associated with older adults.
In a recent column, I wrote that no one can accurately diagnose dementia from a distance, but doctors tell me that neurological movement disorders may be easier to detect.
“Every doctor I’ve spoken to agrees that Biden has classic Parkinson’s symptoms,” one said.
Another noted the “masked face, the expressionless expression, the stopping when walking, the soft, hoarse speech and the stiff arms when walking: all this is Parkinson’s.”
Two additional responses were particularly interesting to me because they came from neurologists with decades of experience. So on Monday, just after the New York Times reported that a Parkinson’s specialist had visited the White House eight times in eight months, I called them.
“When I was watching the debate,” said Dr. Michael Mahler, a UCLA faculty member, “I had inklings” that Biden, 81, was probably dealing with more than the normal challenges of aging.
The first sign of Mahler was “the way he walked on stage, with a very stiff step. Normally, the way people walk, they swing their arms, and he didn’t have much arm movement. Then, watching him and listening to him, he had… almost no facial expression… His blinking frequency was very, very low, and he had very few other movements.”
Mahler also singled out Biden's tone-deaf speech. He said he couldn't make a definitive diagnosis without a full physical exam, lab work, medication history and a five- to six-hour battery of neurological tests. But he said what he saw were symptoms of the “Parkinsonian” paradigm.
Dr. Jack Florin, a Fullerton neurologist who has been practicing medicine for 50 years, told me he has noticed signs of an advanced movement disorder in Biden for several years, and that they became more pronounced during the debate.
For Florin, there is no doubt about what is happening: He believes Biden has a form of Parkinson's called progressive supranuclear palsy (PSP). He noted that singer Linda Ronstadt has the same condition, as does the late actor Dudley Moore.
“When you have PSP, your eye movements are not normal,” Florin said. “You look down and you have difficulty moving your eyes from side to side. People with PSP have what’s called a stare, and it looked like you were just staring, because your eyes weren’t moving.”
Over the course of his career, Florin said he has treated hundreds of patients with PSP. In Biden’s case, he said, other telltale symptoms included “low volume and rapid speech with loss of normal rhythm,” as well as “episodes of sudden, forceful eye closure,” also known as blepharospasm.
UCLA faculty member Dr. Michael Mahler said that during the June 27 debate, shown in a screenshot from LA Times Today, he saw “clues” that President Biden might be dealing with more than the normal challenges of aging.
In Biden's stiff gait, Florin saw another clue.
“He doesn’t have idiopathic Parkinson’s, which is the most common type. People are hunched over, they often have tremors, and they’re usually more on one side than the other. He doesn’t have that,” Florin said.
In his view, Biden suffers from PSP, a “progressive, incurable and untreatable disease… As it worsens, postural instability is the main problem and there is a risk of falls. After a while, patients cannot walk safely. A cane or walker does not help much, because they can fall backwards. As the disease worsens severely, one is mostly confined to a wheelchair.”
Two other doctors who contacted me did not rule out the possibility that Biden's problems during the debate could have been caused, at least in part, by side effects from the medication.
“I certainly couldn’t diagnose him,” said Dr. Laura Mosqueda, a USC geriatrician who worries that people will misdiagnose the president’s problem as his age, even though there are plenty of fully functioning people in the world far older than Biden. “I don’t care if he’s 81, 61 or 41. I don’t think it’s about his age. It’s about whether he has a medical problem that we should be aware of.”
And that is the right question.
With just four months until Election Day, the presidential election comes down to a choice between someone we know and someone we don't know.
We know who Trump is, and many people consider him the greatest threat to the republic. And it's no wonder readers keep asking me why he's not the candidate whose party wants to feed him.
We already knew Biden, but now a stranger is wearing his suits.
He has an obligation to voters and to his own party to undergo a full physical, cognitive and neurological examination and to make the results public. If there is a problem, it must be addressed with courage and transparency.
For their sake and ours.
