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TOPSHOT – US President Joe Biden looks on as he takes part in the first presidential debate of the … [+]
As the Biden administration nears its conclusion and transitions into the legacy phase, the events surrounding his health and cognitive vitality will undoubtedly leave a lasting impact on the historical narrative.
President Biden’s cognitive decline, which initially became apparent during the debates and ultimately cost him the presidential nomination, continues to raise important questions about who that is and who made the decisions in the White House.
The challenge is that the misappropriation of President Biden’s age and health represents a potential betrayal of democratic principles, depriving the electorate of the transparency essential to informed governance. Such cover-up consolidates power among unelected agents, undermines public trust, and shakes basic principles of accountability and constitutional leadership.
Has something like this ever happened before?
That happened – and under even more dramatic circumstances. In 1919, President Woodrow Wilson suffered a catastrophic stroke, a debilitating event carefully hidden from the American public. The resulting opacity in leadership profoundly and irreversibly changed the trajectory of United States history in the 20th century.
Those who watched the debates witnessed it firsthand: President Biden’s cognitive decline could no longer be hidden. Yet efforts to cover up the reality were underway well before June 27, 2024. President Biden had become increasingly unavailable, relying heavily on scripted remarks, refusing meetings and taking what he said was a diminishing role in the administration. The Wall Street Journal in an article led by Annie Linskey. This disturbing pattern culminated in a debate performance that exposed these concerns. Far from being mere speculation, these claims are substantiated by thorough reporting The Wall Street Journalbased on fifty interviews with people closely familiar with the administration.
Negative stories were buried. The inner circle blocked the president. Key members of Congress had no contact with Biden. A crucial role was played by non-elected staff members. Even now, the Democratic leadership continues to claim that all was well in Camelot. Senate Minority Leader Charles Schumer claimed last week that Democrats were not doing so gaslight the public.
Political preferences can influence whether or not this is considered or labeled a scandal. But at its core, this issue left the nation facing a potential leadership vacuum. Tangible examples in the The Wall Street Journal The piece includes the chaotic withdrawal from Afghanistan, where truncated or skipped cabinet meetings highlighted the potential absence of decisive executive leadership. The question it raises is both inevitable and urgent: who really ruled – and who is – the country?
This scenario is not without sobering precedent.
Woodrow Wilson’s 1919 Hidden Stroke
American politician Woodrow Wilson (1856 – 1924), President of the United States from 1913-1921, … [+]
Just over a century ago, the nation faced a president who was demonstrably unfit to govern, although this reality was diligently hidden from the American people. The consequences shaped the trajectory of American foreign policy in the 20th century.
In 1919, President Woodrow Wilson, in an exhaustive effort to gain public support for America’s entry into the League of Nations, embarked on an arduous speech tour. On September 25, 1919, Wilson collapsed, and by October 2 he had suffered a debilitating stroke on the right side. This catastrophic event, his fourth, left him hemiplegic, leaving him unable to move his left hand or leg. The president, incapacitated, became dependent on others for the most basic activities of daily life, such as feeding himself. Even signing his name posed an insurmountable challenge.
This was hidden from the American public and even from Congress.
At the center of this unfolding drama was Dr. Cary Grayson, Wilson’s doctor and White House confidant. Grayson, bound by a combination of professional ethics and deep personal loyalty, acted with extraordinary secrecy. His relationship with Wilson extended far beyond the clinical; he had introduced Wilson to his second wife, Edith, cared for Wilson’s sister during a medical emergency and accompanied the president to the Paris Peace Conference in 1919. Grayson had a truly rapid rise. In a short time he rose from assistant surgeon lieutenant to medical director and ultimately vice admiral. This had inextricable ties to his proximity to the president.
Can a man so enmeshed in his patient’s personal and political fate really make an objective diagnosis? In 1919, as in 2024, the question of whether loyalty can transcend duty to the public becomes a pressing urgency.
That question became acute when, four days after Wilson’s catastrophic stroke, his cabinet met to deliberate the country’s direction. Then-Secretary of State Robert Lansing invoked Article II, Section 1 of the Constitution, which allows the vice president to assume presidential duties in the event of incapacitation. Yet Grayson refused to endorse or sign any documentation proving Wilson’s disability, effectively quashing discussions of a transfer of power.
For the next seventeen months, the reins of the presidency were effectively in the hands of Edith Wilson. As an intermediary, she filtered all communications to and from the bedridden president. Her role as de facto steward of the executive branch has been the subject of much historical debate, but the fact remains that this extraordinary arrangement hid the true extent of Wilson’s plight from Congress and the public.
The consequences changed the history of the United States. The League of Nations, deprived of American support, languished in impotence, and it was not until the aftermath of World War II that the United States began to approach Wilson’s vision of a Pax Americana. Yet the ethical questions remain stark: Grayson, as my colleagues and I noted in a Journal of Neurosurgery paperallowed patient and physician confidentiality to transcend national security at a crucial moment in history. This decision, motivated by loyalty and political considerations, concealed the president’s weakness at a time of crucial international importance.
Interpreted charitably, Grayson’s actions ignite a debate about the complicated interplay of professional ethics, personal loyalty, and the bonds forged through years of medical care. Less generously, they suggest a pernicious entanglement of political ambition and institutional inertia – an unwillingness on the part of those who govern to relinquish power even when the governed are poorly served.
What are and what will be the consequences of President Biden’s cognitive decline?
History will tell us.