If Donald Trump Was Incapacitated, Would We Know? 

The president disappeared just long enough for the speculation to begin, and for the press to start asking questions. The year was 1893, and Grover Cleveland had a tumor on the roof of his mouth. Fearing that news of his illness would make him seem weak, Cleveland arranged to have it secretly removed on a friend’s boat during what his administration publicly described as a four-day fishing trip. The ruse held until a journalist learned about the surgery and published a story. The president’s office denied it, branding the journalist a liar. 

Times may change, but suspicions often don’t. Leading into Labor Day weekend, Donald Trump’s public schedule was unusually empty and he didn’t appear before the press, spurring a rousing round of speculation—and, to be real, more than a few jokes—about whether the president was ill, incapacitated, or maybe even dead. (Slightly hampering the theory that he was unconscious, Trump posted endlessly on TruthSocial throughout the weekend, including, on Sunday, “NEVER FELT BETTER IN MY LIFE,” adding, in a trademark non sequitur, “Also, DC IS A CRIME FREE ZONE!”)

The internet had its fun, and Trump reemerged, looking just about as healthy as he usually does. Afterward though, a new question arose: if Trump ever actually is incapacitated, will the American public know right away?

History is not particularly reassuring on this point. Presidential secrecy around serious health matters is the rule, rather than the exception, says Kathryn Olmsted, whose book Real Enemies examines governmental secrecy and the citizen paranoia it helps create.

“There have been many cases of presidents or their aides covering up health crises,” says Olmsted, a historian at the University of California, Davis. The full truth of Grover Cleveland’s surgery—which removed part of his jawbone and impacted his speech—would not be revealed until after his death. Besides Cleveland, there’s Woodrow Wilson, who was effectively incapacitated after a stroke during his second term, and whose wife Edith all but ran the country, even as she later insisted in her memoirs that she’d only acted as a “steward.” In the case of FDR, Olmstead says, “the extent of his disability wasn’t known to the public. He couldn’t walk on his own, but his administration hid that for many years.” (It’s also been speculated, Olmsted said, that a spot above his eyebrow was a melanoma that was quietly removed during his presidency.) Ronald Reagan was believed by some to be suffering from dementia as early as 1984—leading to, among other things, jokes about him being secretly hyper-competent on Saturday Night Live—although he didn’t publicly disclose an Alzheimer’s diagnosis until 1994.

Perhaps the most infamous example is JFK, she adds, who despite his appearance of youthful vigor, had numerous medical issues, including Addison’s disease; the steroids he took for it gave him osteoporosis.

Reticence over his health would become an issue when he was assassinated, Olmsted points out. “JFK’s autopsy was done very quickly, astonishingly so,” she says. “That was done at the request of the Kennedy family. The speculation was that they were afraid that too much would be revealed about his various ailments.” The speed of the autopsy and perceptions about the secrecy of its results inspired decades of controversy; the two Navy medical officers who carried out the postmortem exam eventually defended their work in a 1992 interview with a medical journal, by which time conspiracy theories about the procedure were already firmly cemented.

Concerns that a president may not really be in charge, are Olmsted says, “a version of a deep state conspiracy theory. We think he’s the president but actually there are these shadowy actors that are controlling him. That’s an anxiety that goes back to the Declaration of the Independence and this concern that the king was being controlled by evil actors.” 

We’re a country ruled by astonishingly old people, many of whom are not always forthcoming about their mental or physical struggles. Most of the American public didn’t know the full extent of President Joe Biden’s apparent cognitive decline until his disastrous debate performance against Donald Trump. Outside the presidency, the advanced age of members of Congress has often become an issue when it begins to seem like they’re no longer fully able to serve, including Dianne Feinstein (D-Calif.), and infamous segregationist Strom Thurmond (R-S.C.), who served for so long that he was able to vote against the Civil Right Act in 1957 before retiring in 2003 after 47 years in the Senate. Most recently, concern has centered around Eleanor Holmes Norton (D-D.C.), who at 88 years old, has refused to step down despite some of her colleagues expressing concern that she’s experiencing cognitive decline.

When it comes to Trump, the issue becomes more concerning given the administration’s high concentration of aggressive, hyper-loyal flacks who say things that aren’t true and do so with a remarkable level of force. It’s difficult to envision them being immediately forthcoming if Trump were to experience a real health crisis. The Trump camp’s truthfulness on this issue has been a concern going back to his first candidacy in 2015, when his physical results were released by his personal doctor Harold Bornstein. The release was full of glowing adjectives and light on details—because, Bornstein later revealed to CNN, Trump himself wrote it.

If the United States is becoming less of a representative democracy with every passing day, as it sometimes appears, Trump and those who surround him can draw on plenty of precedent from various autocrats to handle any future health crises. As Radio Free Europe once pointed out, when autocratic leaders become seriously ill or pass away, their declines tend to be shrouded in secrecy, obfuscation, and lies. The death of an autocrat creates a power vacuum, the outlet added, and, “if not managed properly, it could undermine how a country’s citizenry, and the world, perceive the leader and sow doubts about a regime’s viability.” Such was the case, for instance, with Uzbek leader Islam Karimov, whose 2016 death took days to even be conclusively confirmed. 

There is one key distinction between Trump and the presidents, members of Congress, and autocrats who came before him, Olmsted points out. While most conspiracy theories about a world leader secretly being dead or dying posit that the leader’s death would be a bad thing—either because of genuine fondness, or because of the chaos and power vacuum it would create—the false notion that Trump had passed into a gilded boardroom in the sky over Labor Day weekend was greeted quite differently.

“What’s more unusual about these conspiracy theories about Trump,” Olmsted says dryly, “is that they seem to be wish fulfillment for a lot of people.”