The Value of Expertise

As readers of these pages know (and know extremely well…), I write about Trump having early dementia (which is dementia, but where the person is still able to function).  I’ll often get replies from people who disagree, which is fine and understandable – I’m not even remotely a doctor.  However, what I always say is that when I say Trump has dementia, it’s not my opinion, but I’m passing along with many psychologists say and write.  And not just write articles, but even a book, The Dangerous Case of Donald Trump,  published during Trump’s first term when 37 psychologists  and psychologists wrote articles on cognitive issues that showed symptoms of early dementia.

​One of those 37 was Dr. John Gartner -- a psychologist, psychotherapist, and former assistant professor at Johns Hopkins University Medical School – who’s been among the most outspoken in his field, including as founder of the “Duty to Warn” podcast, who I’ve quoted at length here.
 
There are two important, general points that Dr. Gartner makes.
 
The first is that unlike other fields of medicine where doctors make their diagnoses based on direct consultation with their patients, when psychologist diagnose dementia, it’s often (if not usually) done from afar.  That’s because, as he explains, dementia patients are often very effective in telling stories that are pure fiction when asked, but which (because of their condition) they fully believe, making a close-up diagnosis more challenging.  This is why they will instead look at a distance for signs that are common in dementia patients.
 
And the second is that psychologists who are experts in the field of dementia see things in a person that are those signs of dementia which, to laymen, seem perfectly normal.  The way a person stands, their facial expressions, how sentences are placed in conversation, for instance.  Or when stumbling over a word and instead making up a new one in its place – to most people, that’s just a glitch, but to a psychologists, it’s paraphasia, which is a sign of dementia.
 
I mention all this because last Sunday on his podcast, RawStory reported about how Dr. Gartner addressed recent signs that – to an expert – suggested that Trump may be showing a "serious cognitive problem."
 
When Trump snapped at a reporter to “Be quiet, piggy,” it was covered by the press and in public as being incredibly rude and sexist.  But to Dr. Gartner, the behavior was more questionable and overlapped with concerns of Trump’s cognitive health.  That’s because in the same exchange on Air Force One, Trump acknowledged not only taking multiple cognitive tests, but also an MRI. And while to most people in the public those examinations returned to jokes about Trump’s past simplistic tests where he had to remember the words “Person Woman Man Camera TV” in order and identify animals, and so two examinations appear unrelated – they aren’t unrelated at all to a psychologist and speak to Trump’s mental state and a larger problem.
"They said they did advanced imaging," Dr. Gartner explained. "Okay, well, Trump said not once, not twice, but three times that he had taken cognitive tests. Plural. Okay, so not just a screening exam...They gave him multiple tests. We do not give people multiple cognitive tests unless we suspect there's a serious cognitive problem."

"We also never, ever...give someone an MRI unless we suspect or need to rule out a serious problem," he continued. "So, we know his doctors gave him multiple cognitive tests and an MRI. They didn't say explicitly because of the brain, but we can certainly be sure they scanned his brain. If they're giving him a neuropsychological battery, they're scanning his brain."

None of this got reported in the press when discussing Trump’s exchange with the press on Air Force One, including him snapping “Quiet, piggy” to a female reporter.  It didn’t get reported because journalists are not expert psychologists who know these things and are able to make connections that those in the public can’t.

"If Donald Trump were just an ordinary patient and you saw these kinds of serious signs of dementia,” Dr. Gartner added, “a responsible doctor would give him both a neuropsychological battery and an MRI. Of course, they're not telling us why they gave those tests.  They're not telling us the results.”

This is just one example of a great many that are the reason why, when I say that I believe Trump has dementia, it’s because of what expert psychologists say.  Not because it’s just my unqualified opinion.  Professionals see and know and understand details of their field.  Details that the rest of see look at as normal.
 
But if there’s one thing most everyone knows at this point about him, what Trump does is not normal.