It’s time to talk about Donald Trump’s health (again)

First, before I dive into this week’s column, I wanted to note that on Friday I sent out my roundup of my favorite books of 2025. I know a bunch of you missed it over the holidays, so now that we’re in the midst of it again, I wanted to send a reminder to read it if you wanted to. It’s packed with 25 (actually a lot more than 25!) reading suggestions for your holiday lists or to give as gifts in the weeks ahead.

Onto the news:

Back in September, after Donald Trump disappeared from view for days and the internet went wild with rumors he was dead or hospitalized, I wrote about how the press needed to be leading a more serious conversation about Trump’s health and fitness for the presidency than it was having.

In the months since, the evidence has only grown that something serious is afflicting Trump.

And then last night happened.

Overnight, the President of the United States went on what can only be described as an unhinged social media fever dream. He posted on his social media site Truth Social hundreds of times in a short span — somewhere north of 150 times overnight, a wild mix of conspiracy theories, videos, and memes. It was extreme even for him.

During that end-of-August episode, the major questions were about the president’s physical health — his bruised hands and his swollen ankles — and in the months since, there have been more reasons and evidence that some part of the president is not well:

• He is stumbling, physically, through more of his events. Since August, he appears to be regularly dragging the right side of his body and struggles to walk in a straight line. Just watch this recent video of Trump boarding Marine One, where he appears to be leaning heavily on Melania Trump to stand. And then there was Trump’s Asia trip, where he seemed so lost, wandering aimlessly through a Japanese press event, that the late night shows set it to music.
  

• He appears to have fallen asleep in meetings on multiple recent occasions, including at an Oval Office meeting.
  

• And then there’s the MRI. In October, he went to Walter Reed for his “annual medical exam,” even though it was barely six months after his last “annual medical exam” at Walter Reed, and had a wide range of tests done, including an MRI. In recent days, Trump has gotten into a high-profile tiff with Minnesota Gov. Tim Walz, who pressed him to release the results of that MRI. When asked, Trump couldn’t explain why he had the test.  Finally, yesterday the White House released information saying it was a chest MRI for his cardiovascular and abdominal systems and that, as the White House always says he is, the tests showed everything was “perfectly normal” and in “excellent health.” (Gavin Newsom mocked Trump about the results.)

But that’s not the reason worth having a conversation about Trump’s health today.

Today, we should be having a conversation about Trump’s increasingly clear diminished mental capacity. This is a man, after all, with the sole launch authority for the nation’s nuclear weapons who, on a daily basis, seems increasingly more disconnected from reality, beholden to conspiracy thinking, and — most simply — absent-minded. It is not a recipe for global stability — and deserves more serious conversation than its getting.

Let’s examine some recent evidence, even before last night’s social media feed fever dream:

• Trump has never been what one would call a linear thinker and speaker — he’s always meandered — but anyone who has paid attention to his speeches this fall can sense that something feels less connected and tethered in his mind. During that Asia trip, he rambled in a speech to the Navy through a long digression about magnets and water. At the end of September, his speech to the nation’s assembled generals and admirals went on for some two hours and the word most used to describe it was “rambling.” Rambling. Rambling. Rambling. Rambling.

• He forgot Hakeem Jeffries name. He referred to the House minority leader as “a very nice gentleman” who accompanied Chuck Schumer to the White House for talks during the government shutdown. (There’s an even less charitable interpretation of the clip that Donald Trump didn’t even know who Hakeem Jeffries was in the first place, which would be an even bigger red flag.)

• The president’s “information diet” seems to be getting worse. There are an increasing number of social media posts that bear little resemblance to the real world and that leave US officials scrambling to understand or act upon them. Remember the weird night a month ago where we almost went to war with Nigeria? Or over the weekend, as we lurch toward an unexplained and unnecessary war with Venezuela, Trump announced he was closing the airspace over Venezuela — a power he doesn’t really have and that there was no sign anyone was ready to implement. Or walking into his meeting in Asia with Chinese President Xi Jinping, he made some sort of announcement about nuclear weapons testing that even a month later, no administration figure has really clarified what he meant.

On Truth Social, day after day, out of sight of most Americans and news coverage, he’s ranting about conspiracies that are just fundamentally untrue. Remember when he posted an AI-slop video of himself dropping poop on the American people? As one USA Today Opinion piece in September summarized: “An unhinged rant about Tylenol. Baffling conspiracies about an escalator. Deluded self-praise. Two-decade-old gripes over losing a construction project bid, droned about on the world stage as if nothing could be more important. That all came from President Donald Trump in one week, a week that should alarm us and spotlight one simple fact: He is desperate and declining.”

Indeed. Back in August, I wrote, “Put all of this together, and it’s clear that there’s enough smoke coming from the White House to warrant at least a major story in a major outlet investigating whether there’s fire.”

The first of those pieces came just before Thanksgiving: The New York Times ran a front-page investigation that concluded Trump is slowing down: “Still, nearly a year into his second term, Americans see Mr. Trump less than they used to, according to a New York Times analysis of his schedule. Mr. Trump has fewer public events on his schedule and is traveling domestically much less than he did by this point during his first year in office, in 2017, although he is taking more foreign trips. He also keeps a shorter public schedule than he used to. Most of his public appearances fall between noon and 5 p.m., on average.”

It was a useful piece, in part because it was data driven: Among other findings, the Times investigation found that the average public start of his scheduled events has slipped from 10:31 a.m. in 2017 to 12:08 p.m. today.

Trump responded with a Truth Social post: “There will be a day when I run low on Energy, it happens to everyone, but with a PERFECT PHYSICAL EXAM AND A COMPREHENSIVE COGNITIVE TEST (“That was aced”) JUST RECENTLY TAKEN, it certainly is not now!”

But the Times story last week still feels like it should be the start — not the end — of the conversation. In fact, if anything, Trump himself is opening the door for more inquiries with his continual attacks on the mental fitness of Joe Biden in the White House last year. Many of Trump’s latest social media posts, including a host of them overnight, focus on the Biden autopen — and he even trolled his predecessor on his garish new line of presidential portraits in the West Wing by putting up a picture of the Biden autopen rather than Joe Biden himself.

The very least the press corps could do is report as extensively on Donald Trump’s mental fitness NOW as it has this year investigated the mental fitness of Joe Biden THEN.

Part of what bothers me here is that reporters are clearly paying more attention than their coverage makes clear: Get into almost any circle of Washington reporters and you’ll hear about reporters who are carefully tracking the roughly monthly recurrence of the strange bruising on his hands, which often seems to coincide with a few days out of public view.

What is going on?

I’m a longtime student of presidential succession and “continuity of government” protocols and one of the big questions I think about is that in the personality cult of MAGA would any set of Cabinet officers ever be willing to move to invoke the 25^th Amendment in the event of a major health episode of the president? Think Marco Rubio and JD Vance would be the profiles in courage to declare the president incapacitated, even if he was? Would Pete Hegseth, Kristi Noem, and Pam Bondi take away the nuclear keys if they had to?

I have my doubts.

In an administration and political movement that was always prized loyalty, you can imagine not declaring the president incapacitated being seen as the ultimate loyalty test. And yet we all can recognize the signs of aging in Donald Trump — this is a grandparent where his family would be starting to have the conversation about whether he was safe to drive anymore, let alone control the nation’s nuclear weapons.

It’s long past time for this to be a sustained front-page story in the US. One of my consistent refrains this year has been that the US media knows how to provide wall-to-wall coverage and how to elevate a “news story” to a “news event.” (Think Hunter Biden or Hillary’s emails.) It’s clear that the media hasn’t yet decided that the president’s health and fitness is worthy of a “news event.” But it should be.

There is no bigger, more consequential topic in the world than this: Is the President of the United States mentally fit to serve?

We need to start this conversation with this simple set of facts: Donald Trump is the oldest person ever elected to the presidency, and yet we know less reliable information about his health than we have known about any modern presidency.

We don’t even appear to know his actual weight — right now, the White House is claiming that at 224 pounds, he’s twenty pounds lighter than he was during his first presidency, when he was officially listed at 244 pounds.

GMG

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