Stop Talking About Biden. Start Talking About Trump.
In an April statement to Congress, 36 medical experts declared Trump mentally unfit and called for use of the 25th Amendment.
The job of President of the United States is not for the faint of heart—or health. After leaving the White House, Bill Clinton made it a mission to eat healthier after developing heart issues. Barack Obama’s hair became noticeably whiter during his years in office.
While Joe Biden was president, bipartisan criticisms of his age and cognition were relentless. They continue to this day. Nearly six months into Donald Trump’s catastrophic second term, Jake Tapper and Alex Thompson wrote a book about how bad Biden’s mental acuity was while president. With the now country in flames, former First Lady Jill Biden just published a memoir setting the record straight about her husband’s disastrous presidential debate, which ended his bid for a second term. She reportedly thought her husband had been drugged or had a stroke, “as if we were watching an A.I. hologram of the man we knew.”
With all respect, there are far more important things to worry about right now than Joe Biden’s debate performance. He isn’t president anymore and never will be again. Unlike the sitting President of the United States, that is. Who is definitely not an A.I. hologram.
Trump, who turned 80 on Sunday, is the oldest-elected President in our nation’s history. In a April 30, 2026 statement, thirty-six top medical professionals—including neurologists, psychiatrists, and specialists in cognitive disorders from the likes of Harvard, Tufts, Columbia, and George Washington University—warned the American people of his “rapidly worsening, reality-untethered, increasingly dangerous decline.”
A February 2026 Reuters-Ipsos poll found that a majority of Americans, including 30 percent of Republicans, agree that Trump has become erratic with age. Yet to a deafening degree, his erratic behavior has been normalized as a personality flaw.
This is a mistake. The thirty-six medical professionals whose statement was entered into the congressional record by Democratic Senators Sheldon Whitehouse and Jack Reed called for use of the 25th Amendment, citing Trump’s access to the nuclear codes. We should pay attention.
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Thank you.
Here’s their courageous statement. It’s worth your time.
Trump’s health is pressing the broader question of what to do when our presidents age. Short of impeachment, the Constitution’s 25th Amendment is all we have. But it is not designed to meet the moment.
I wrote about this for The Hill :
What are the warning signs that Trump is unfit for office?
They predated the 2024 election.
According to speech and language pathologist Michael de Riesthal, during Trump’s 2017 speech in Jerusalem, “there was definitely some imprecise progressive change in articulatory precision and slowing of his speech that is not typical in normal speech.” The White House called it a dry throat.
After Trump’s June 2020 commencement address at West Point, questions arose about apparent signs of unsteadiness, balance problems, and trouble enunciating words.
In the final days of the 2024 campaign, Trump repeatedly and abruptly jumped from teleprompter remarks to nonsensical tangents and back to his prepared speech. Nikki Haley questioned whether Trump was mentally capable of serving as president after he repeatedly seemed to confuse her with former House Speaker Nancy Pelosi in a campaign speech, mistakenly asserting that Haley was in charge of Capitol security on January 6, 2021. Trump confused Biden and Obama eight times during the campaign.
This round, the situation has gotten orders-of-magnitude worse.
After his first physical in April 2025, the White House physician issued a letter with results within 48 hours. For his May 2026 visit, the White House initially said nothing, later sharing a memo from Dr. Sean Barbarbella stating that he was in “excellent health” but recommending that he lose weight and exercise after gaining 14 pounds in the last year. Trump’s latest visit to Walter Reed Hospital was his fourth in the last 13 months.
He has dark, unexplained bruising spanning the back of both of his hands that heavy makeup cannot mask, and visibly swollen ankles. (He’s been diagnosed with chronic venous insufficiency, which occurs when veins become damaged and struggle to send blood back to the heart.) His unusual use of two hands to drink from a water glass has become a documented pattern.
His cognitive decline is equally alarming. When Trump met Russian President Vladimir Putin in August of 2025, he told reporters at the White House “I’m going to see Putin. I’m going to Russia on Friday.” The meeting was scheduled to happen in Alaska, which Trump later confirmed on Truth Social. Trump repeatedly confused Greenland and Iceland in his speech at January’s 2026 World Economic Forum in Davos. In May, for what was reportedly the eighth time, he wrongly attributed the deaths of 13 U.S. officers during the Afghanistan evacuation to Obama, when it actually occurred under Biden’s presidency. He also called the outgoing Hungarian leader Viktor Orbán “the leader of Turkey.”
Aging researcher Carolyn Aldwin of Oregon State University told Slate that Trump was a much better speaker in the 1990s, and now “has really severe language problems. He can’t complete sentences. He wanders off topic. He gets very confused …. He clearly has difficulties. How severe those are can really only be established by testing.” During a White House ceremony in February, for example, he incorrectly pronounced the word “undisputed,” saying “undithpuut.”
Trump’s apparent falling asleep during high-level meetings is becoming legendary, reportedly numbering approximately 19 instances so far, including at a December 2025 Cabinet meeting while Secretary of State Marco Rubio was speaking; during dignitaries’ remarks at February’s inaugural “Board of Peace” meeting on Gaza peace negotiations; at an April Oval Office meeting; and during a Memorial Day ceremony at Arlington National Cemetery while Defense Secretary Pete Hegseth delivered remarks. Critics have begun calling him “Sleepy Don”—an unironic echo of the “Sleepy Joe” label Trump used relentlessly against Biden.
What’s the cognitive test Trump has been talking about?
Trump has bragged about acing the Montreal Cognitive Test (MCT), which is “[t]o be used as a screening tool for adults with self or family-reported concerns of cognitive impairment not explained by an alternative medical or psychiatric condition. This score identifies the mild cognitive impairment that may precede various forms of dementia, but does not diagnose specific dementia subtypes.”
To repeat: The MCT test is for people with signs of cognitive impairment. And Trump (disturbingly) has been given the MCT repeatedly while president.
Here’s the president’s take on the experience: “The first question is very easy, and they always show the first question,” he said. “You have a lion, a bear, an alligator, and a…what’s another good…a squirrel…okay? ‘Which is the squirrel?’” Stressing the test is “hard”, he added: “One doctor said, ‘It’s the first time I’ve ever seen anyone get all questions right.’”
Hmmm.
What does the 25th Amendment say about all of this?
Ratified following the assassination of John F. Kennedy, the 25th Amendment established the succession to the presidency in the president’s absence. Undoubtedly, the framers were worried about physical impairment to the point of being unable to function. It wasn’t designed for cognitive decline. Ronald Reagan’s aides reportedly raised its use as a possibility because of his inattentiveness and strange behavior, which later moved into dementia, but that theory of disability has never been tested under the Constitution. Today, that would take aides willing to do the right thing. They don’t exist around Trump.
Could the 25th Amendment be invoked to remove Trump?
Nonetheless, if a majority of either Trump’s Cabinet or either House of Congress determines that he is “unable to discharge the powers and duties of his office,” Vice President JD Vance could take over as “Acting President.”
Section 4 allows Trump to respond with a “written declaration that no inability exists.” At that point, Vance and “a majority of either the principal officers of the executive department” or some other body that Congress creates by law could transmit to the President pro tempore of the Senate (in this moment, Sen. Chuck Grassley) and House Speaker Mike Johnson “their written declaration that the President is unable to discharge the powers and duties of his office.” Congress then has 21 days (after they gather, which they must do within 48 hours) to determine by two-thirds vote of both Houses that he is unfit for office.
Of course, this is a practical impossibility. Trump’s enablers will continue to enable.
Voters should still demand transparency and accountability. The safety of our children could depend on it.
What’s the takeaway?
On April 14, Rep. Jamie Raskin, himself a former constitutional law professor, introduced legislation establishing a bipartisan, independent commission to activate the 25th Amendment, saying:
Public trust in Donald Trump’s ability to meet the duties of his office has dropped to unprecedented lows as he threatens to destroy entire civilizations, unleashes chaos in the Middle East while violating Congressional war powers, aggressively insults the Pope of the Catholic Church, and sends out artistic renderings online likening himself to Jesus Christ. We are at a dangerous precipice, and it is now a matter of national security for Congress to fulfill its responsibilities under the 25th Amendment.
Raskin is right. The public deserves an honest discussion about this sensitive but vitally important issue.
I’m glad you’re here,
KW
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I love your work, but on this I disagree. Until the cult of COB (Clinton Obama Biden) starts acknowledging its failures, and takes a good part of the blame for Trump, we won’t have the tools we need to mount a resistance to his and others fake populism.
Sure, it’s clear Trump is in bad physical health and the cognitive decline is significant. The problem is that his deficiencies morally were well-established and clearly disqualifying prior to both of his elections and enough of the American people chose to put him in office twice anyway. At this point his failings are all baked in and his removal would be characterized as an anti-democratic, politically motivated action by the so-called deep state. And it would elevate JD Vance, who is as talented a debater as he is craven and corrupt, as the incumbent.