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I’m A Doctor. Here’s What I Find Most Concerning About Trump’s Medical Letter
INFORM • INSPIRE • ENTERTAIN • EMPOWER
TRENDING
I’m A Doctor. Here’s What I Find Most Concerning About Trump’s Medical Letter
Carlo Allegri / Reuters
Donald Trump is talking about Hillary Clinton’s health, as are two doctors who have never evaluated Clinton. They have apparently diagnosed her with all kinds of ailments using the long disproven Fox-Drudge equation.
This attention on Clinton has renewed some interest in the letter Donald Trump released last year from his personal physician.
Many outlets
have picked it apart, but I want to tell you as a doctor exactly how bad
it is. I would never write anything this terrible for a jury duty
excuse or a back to work note, never mind something that half the
country (and possibly half the world) might see or could possibly end up
one day in a presidential library!
There are so many issues with the letter I’m going to just start at the beginning:
1. The header has a non-working web address, and doctors don’t include e-mail addresses in letters.
It is
incredibly rare for doctors to include an e-mail address in this kind of
correspondence because we don’t want the person receiving the letter
(e.g. the entire press corps or the place of work or the disability
insurance company) to e-mail back with questions about our patient’s
health. This could lead to a HIPAA (privacy) violation. Also, gmail is
not a secure method of communication, so most doctors don’t want to use
it for medical information. We doctors also don’t put our e-mail address
in letters because we don’t want patients using unsecured methods of
contact. I’m happy to have my patients e-mail me, they just need to do
it through our secure server. The e-mail address is really odd, but then
again it could be a fancy concierge doctor thing.
Except a fancy
concierge doctor would probably have a working website. Really, you’re
writing a letter for someone who wants to be President and this is what
we get at http://www.haroldbornsteinmd.com, a weird website with a name and links to other services?
2. Lennox Hill has a Division of Gastroenterology, not a “Section,” and Dr. Bornstein isn’t listed on the website as a member.
Dr. Bornstein is affiliated with Lennox Hill, but he is not part of their Division of Gastroenterology.
There also isn’t a Department of Medicine there is a Division of
General Internal Medicine and Dr. Bornstein isn’t a member of that
either. Having admitting privileges and being a division member are not
the same thing. Many hospitals allow doctors to have admitting
privileges and not be department or division members. And what’s with
this made up “Section”?
It is also very
odd for a doctor in a private practice to use their admitting
privileges address under their signature if it is not the same as their
practice address.
3. The letter starts with a typo.
I’m the typo
queen so I’m not really one to judge, but if a patient of mine were
running for president and needed a letter, I’d make damn sure it was
typo-free.
4. No doctor describes tests as “only positive results” or “astonishingly excellent.”
“Only positive
results” is gibberish. Some tests are good if they are positive and some
are bad if they are positive. Some results are just not binary. For
example, a hemoglobin (blood count) is a number and not positive or
negative.
What are
“astonishingly excellent” laboratory test results? I’m a doctor, and I
don’t know. Is it astonishing that a 70-year-old man has normal results?
Are his results all exactly average which is good — but wait, I thought
his tests are all positive?
And while we’re at it, doctors just don’t say “laboratory test results” that sounds like something on a soap opera.
5. Doctors don’t say “test score” — we just give the results.
The
conventional way to reference PSA would be PSA 0.81 ng/ml (normal < 4
ng/ml). A test score is something that happens at the DMV.
6. How did Dr. Bornstein test Donald Trump’s strength and stamina?
Did he have him
bench press in the office? Do a treadmill test? Doctor’s just don’t
typically write vague, quasi-medical things in letters. I’ve also never
heard of a stamina test.
An internist might test muscle strength as part of a physical exam, but the results are graded 0-5 and 5 is not secret code for extraordinary it’s code for normal.
7. “The healthiest individual ever elected to the presidency.”
Every news site
has pointed out how ridiculous this is. Dr. Bornstein is not a medical
historian who runs a presidential health archives and obviously
Washington and Lincoln never had their PSA checked for comparison. The
first blood pressure cuff was invented in 1881, so yeah.
8. There isn’t any useful health information.
Someone with
Parkinson’s or Alzheimer’s could have a normal blood pressure, normal
PSA, take 81 mg aspirin and be on a “low dose” (we don’t know the exact
dose or type) statin — so could someone with diabetes or someone who had
a heart stent placed last year or who had a stroke four years ago.
Things I don’t find concerning:
That Dr.
Bornstein is a gastroenterologist. Often when internal medicine
specialists start out, they accept both general medicine and specialty
patients. As the years go by, they stop accepting general patients, but
often hang on to a few favorites or high-profile patients. It’s done
less now, but in the ‘70s and ‘80s, it was more common. Bornstein may
very well have been seeing Trump in that capacity. But yes, a healthy
man would not need to see a gastroenterologist until the age of 50.
Newsweek pointed out
the letter was made on Microsoft Word, but the header on my work
letters is generated in the same type as the letter. Sadly, many doctors
don’t use lovely heavy bond paper with nice letterhead anymore. But you
know when I would? If I were writing a letter for someone who is
running for president.
The signature. I hit return a lot for my huge signature and still sometimes scrawl all over the address. Hey, I’m a doctor.
It’s a terrible letter.
Did Dr.
Bornstein write it? If so he should be embarrassed. It’s medically
illiterate. If he doesn’t know his website doesn’t work or if that he’s
not in the Division of Gastroenterology, that’s an issue.
Did Trump write
it? He’ll never tell. It certainly reads like a letter written by
someone with close to no knowledge of Dr. Bornstein’s practice or
medicine.
All I can say
is, typos and weird links and mentions of non-existent sections of
gastroenterology and nonsensical medical information aside the letter
provides essentially no medical information.
***
After this was originally posted someone mentioned that Dr. Jacob Bornstein died in 2010.
Was an old
doctor’s letter used as a template with the person copying the
letterhead not knowing or remembering that the elder Dr. Bornstein had
passed away? Is this Dickensian six-year-old letterhead with the name of
the deceased still at the top?
A version of this post originally appeared on DrJenGunter.wordpress.com.
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