(Please forgive the length of the following post. I thought creation of a new feature necessitated a justification. Future DJT Health Watch posts will be considerably shorter.) 

I can’t speak to Donald Trump’s physical condition. There’s little evidence to go on, other than some test results and a letter from his personal physician that followed a December, 2015, Tweet from Trump predicting what the doctor would say. “It will show perfection,” Trump promised. And sure enough, it did, but the wording sounded more like Trump than a highly trained physician. Everything about Mr. Trump was in excellent working order, the doctor reported, and “if elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency,” We can only hope that’s all true.

Donald Trump’s mental condition is a very different matter. We have a great deal of evidence that Donald Trump suffers from serious mental illness that might well require that his Presidential powers be removed. And we the people and our elected representatives bear the responsibility for deciding if and when that must happen, for the President’s sake and the sake of our fellow citizens and the world.

The 25^th Amendment to the US Constitution speaks to the circumstances under which the President’s powers should be removed: Section 3. If the President informs Congressional leaders that he is “unable to discharge the powers and duties of his office,” Section 4. If the Vice President and a majority of the President’s cabinet or “such other body as Congress may by law provide” inform Congressional leaders that the president is “unable to discharge the powers and duties of his office.” In either event, the Vice President assumes the President’s duties and responsibilities (not a happy alternative in the present conditions) until it is clear to Congressional leaders that the President is again fit to serve the nation. I believe the words “such other body as Congress may by law provide” makes us—the people of the United States—responsible to help inform Congress if the President’s mental faculties and his judgment have eroded to the point that his utterances and decisions may endanger not only the Constitution (which he swore to defend) but the well being of every person on the planet.

The DJT Health Watch hopes to contribute to that citizens’ watchdog role. In this posting, we will address two issues—the President’s current, diagnosable mental state, and the most recent evidence of his deteriorating condition.

Thousands of observers have suggested that Donald Trump suffers from narcissistic personality disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition,2013, commonly referred to as DSM-V, of the American Psychiatric Association. Three psychiatrists, having noted Donald Trump’s behavior, wrote an urgent letter to President Obama before he left office, in which they stopped short of making a formal diagnosis, but instead pleaded with Obama to have the President-elect professionally examined before he took office. They wrote:

“Dear President Obama,

We are writing to express our grave concern regarding the mental stability of our President-Elect. Professional standards do not permit us to venture a diagnosis for a public figure whom we have not evaluated personally. Nevertheless, his widely reported symptoms of mental instability — including grandiosity, impulsivity, hypersensitivity to slights or criticism, and an apparent inability to distinguish between fantasy and reality — lead us to question his fitness for the immense responsibilities of the office. We strongly recommend that, in preparation for assuming these responsibilities, he receive a full medical and neuropsychiatric evaluation by an impartial team of investigators.” (http://www.huffingtonpost.com/richard-greene/is-donald-trump-mentally_b_13693174.html)

Of course that did not happen. And it’s not clear that anyone in Congress—Republican or Democrat—is pursuing the concerns raised by these professionals. Journalists have reported them, but they have generally been dismissed by both Donald Trump and his Republican colleagues. That reality, it seems to me, means we, the people of the United States, must pursue this question, before Donald Trump, in his mentally unbalanced state, endangers all of us.

We have already seen the damage Donald Trump can do, simply with ill-chosen, sometimes vicious words. The clearly hurtful insults he hurled at Republican war hero/US Senator John McCain and the Khan family, who lost a son to war, pale by comparison to the consequences of his Tweet against an 18-year old girl who questioned Trump on the campaign trail. The vitriol Trump launched against her unleashed a storm of increasingly ugly messages from Trump faithful that finally led the young woman to say, “I think the worst day was when someone said my address and they said they were coming and they were going to rape me.”

But in the DJT Health Watch, we need to be sure we’re not making partisan mountains out of psychological molehills. In their letter, the three psychiatrists imply that Trump’s “grandiosity, impulsivity, hypersensitivity to slights or criticism, and an apparent inability to distinguish between fantasy and reality” could be a platform for dangerous behavior. A former FBI profiler, who also declined to make a formal diagnosis, nonetheless said this about the condition: “if a person has a preponderance of the major features of a narcissistic personality,” then he “is an emotional, psychological, financial, or physical danger to you or others.” (http://www.alternet.org/election-2016/what-top-fbi-profiler-taught-me-about-extreme-narcissists-donald-trump)If

For those still uncertain whether Donald Trump is a narcissist, here are the primary symptoms of narcisstic Personality Disorder. As you read through them, think about the things you know about Donald Trump, things he’s said and and things he’s done:

From the DSM-5: Evidence of Narcissistic Personality Disorder

• Expecting to be recognized as superior even without achievements that warrant it
• Exaggerating your achievements and talents
• Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
• Believing that you are superior and can only be understood by or associate with equally special people
• Requiring constant admiration
• Having a sense of entitlement
• Expecting special favors and unquestioning compliance with your expectations
• Taking advantage of others to get what you want
• Having an inability or unwillingness to recognize the needs and feelings of others
• Being envious of others and believing others envy you
• Behaving in an arrogant or haughty manner

It seems clear to me that our nation has elected a very sick man to lead us.

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Today’s DJT Health Watch: Hopes that Trump had enough control of his faculties to assume the Presidency with at least a little grace, humility, and invitation to inclusiveness were dashed when he made time to fume over journalistic estimates of his inaugural crowd, at the same time as he began signing orders to dismantle critical programs like the Affordable Care Act. He was reacting to these photographs(below), published by the New York Times, showing the relative size of the crowds that gathered on the National Mall for Trump’s swearing in and Barack Obama’s first inaugural in 2009. (Trump crowd is at bottom, Obama, 2009, at the top)

(The New York Times)

With many, many government positions still unfilled and responsibilities piling up for his new administration, he allowed the crowd question to distract him and lashed out at news media about the photos during a visit to the CIA. Before hundreds of CIA employees, Trump began by accusing journalists of falsely reporting that he was at odds with the intelligence community (despite the fact that he had likened them to Nazis barely a week before), and he, again falsely, accused news media of deliberately underestimating the size of his inaugural crowd. Apparently unable to recall his criticism of the intelligence community or unwilling to take responsibility for it, Trump told the crowd at the CIA, “I just want to let you know, I am so behind you.” After telling the workers he was at war with the media, Trump told them, “The reason you’re the No.1 stop is, it is exactly the opposite. I love you. I respect you, there’s nobody I respect more.” A week earlier, Trump had condemned intelligence officials for releasing details from an intelligence dossier alleging that Russia had compiled incriminating personal information about Trump gathered during his visits to that country. If Trump remembered his earlier remarks during his visit to the CIA, he was engaging in an audacious bout of lying as he stood before them. That would be cause for significant concern in itself. If he honestly had no memory of his earlier statements about the intelligence community, it could be evidence of a larger problem, perhaps advancing dementia, which, like a narcissistic personality disorder, would potentially require removing him from the line of duty.

Referring to the news media and their reporting on the inaugural crowds, Trump accused journalists of publishing a photo of an empty field to suggest he drew a smaller crowd to his swearing in. His next comment carried more than a hint of threat, “We caught them in a beauty and I think they’re going to pay a big price.” What price any reporter could be expected to pay for publishing news and information under the First Amendment was unclear. But Trump apparently continued to obsess about the reportage and shared his anger with his staff.

When press secretary Sean Spicer held his first official Trump administration press briefing in the White House, he tore into the assembled reporters for their reporting and claimed—falsely—that Trump’s audience was “the largest audience to ever witness an inauguration.” Spicer accused the New York Times reporter of manipulating framing of the photographs to “minimize the enormous support that had gathered on the National Mall.” He also claimed—again falsely—that ridership on Washington’s subway system was higher for Trump’s inauguration than for Obama’s in 2013. It is cause for deep concern that the most powerful leader in the world is spending his time, and his staff members’ time, angrily obsessing about the number of people who stood before him as he took the oath of office. I’m not an MD and I’ve never played one on TV, but I am a PhD and I can think analytically, and what we’re seeing and hearing from this President certainly sounds a lot like extreme narcissism, and perhaps other destabilizing conditions, to me.

For the purposes of the DJT Health Watch, we should note that the New York Times also reported that, during his CIA visit, Trump engaged in somewhat unusual “stream-of-consciousness” comments that also sound a lot like a troubling narcissism disorder or advancing dementia. He’s reported to have informed the assembled crowd that he felt no older than 39 (he’s 70). According to the Times, he sought to reassure anyone who questioned his intelligence by saying, “I’m, like, a smart person,” and mused aloud, as he stood before the CIA workers, about how many intelligence workers backed his candidacy. (New York Times, Jan. 22, 2017, p. A1) (Much of Trump’s behavior bears comparison to Humphrey Bogart’s portrayal of the distracted and ultimately demented Captain Queeg in the film, The Caine Mutiny.) 

Trump’s staff is being forced to absurd, nonsensical extremes to defend the erratic behavior and thought of the President of the United States. When the host of NBC’s Sunday morning political show asked Presidential counselor, Kellyanne Conway, why Trump sent his press secretary before reporters to “utter a provable falsehood,” [about the inaugural crowds] Conway responded, “You’re saying it’s a falsehood, and they’re giving—our press secretary, Sean Spicer, gave alternative facts to that.” (Washington Post, Jan. 22, 2017, retrieved from https://www.washingtonpost.com/news/the-fix/wp/2017/01/22/kellyanne-conway-says-donald-trumps-team-has-alternate-facts-which-pretty-much-says-it-all/?utm_term=.2f3c909ca235 on Jan. 23, 2017) The host, Chuck Todd, was so exasperated by Conway’s deceitful invention, he responded, to one of the closest counselors to the President of the United States, indirectly about the President of the United States, “Alternative facts are not facts; they’re falsehoods.” 

It just goes on and on So many bizarre moments, driven by the increasingly delusional man at the center of the storm, a man who may be so psychologically debilitated that he will come to pose a threat to all of us. That’s why the DJT Health Watch has begun. And, if you’re still reading, I invite you to respond to these posts with any additional information that would be useful to those who eventually carry out the duty of the people and the Congress in making the case for relieving Donald Trump of his responsibilities. And we need to keep all of our elected officials, state and national, informed of our progress, so they can add the gravity of their offices to the call for action that may not be far off. Surely no American—of any political stripe—would oppose this project for the sake of mere political or pecuniary gain. For Donald Trump’s sake and for the sake of our nation, the world, ourselves and our future generations, we must keep watch and be ready to issue the call for action by our elected officials.