Editor’s Note: Ford Vox is a physician specializing in rehabilitation medicine and a journalist. He is a medical analyst for NPR station WABE-FM 90.1 in Atlanta. He writes frequently for CNN Opinion. Follow him on Twitter @FordVox. The opinions expressed in this commentary are solely those of the author.

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Ford Vox: Donald Trump's doctor issued a statement about the candidate's health that's long on effusiveness and short on details

He says as a doctor, something smells off. Report leaves out mental health assessment; based on Trump's behavior, it may be indicated

CNN  — 

Donald J. Trump appears to have found himself a physician right out of his own mold. Trump has of course built himself up through a true flair for the dramatic, and he’s fond of issuing policy positions full of bombast but little detail.

Similarly he’s selected as his primary physician one Harold N. Bornstein, a gastroenterologist practicing at Manhattan’s tony Lenox Hill Hospital. Bornstein on Monday issued the real estate titan a surprisingly thin letter of medical fitness for the presidency.

That doesn’t mean that Bornstein skimps at all on his weighty conclusion:

“If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.”

I can’t find a record of Dr. Bornstein serving as a personal physician to any of the 43 U.S. presidents. He did obtain his New York medical license back in 1976, so there is the theoretical possibility of his secretly serving every president since Jimmy Carter, but that still leaves out 86% of the individuals ever holding the chief executive position.

Of course, plenty of U.S. presidents have suffered medical calamities – before, during or shortly after serving the office. We do know that Ronald Reagan was eventually diagnosed with Alzheimer’s disease just six years after stepping down from the presidency, and recent analysis of his speech patterns, which became more repetitious and less precise as his presidency progressed, suggests his dementia may have begun well before his term of office ended.

John F. Kennedy assumed the presidency after apparently lying to the American public about not having Addison’s disease, which involves the failure of the hormone secreting adrenal glands positioned atop the kidneys. Addison’s and its treatment can lead to numerous complications.

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Americans probably weren’t too surprised when Bill Clinton underwent quadruple bypass surgery three years after leaving the presidency. This is, of course, the president whose famous appetite and penchant for fast-food was immortalized in a “Saturday Night Live” skit. Just before leaving office, Clinton’s doctors discussed his elevated cholesterol level and their treatment plan while presenting their final detailed medical examination.

Bornstein praises Trump’s low blood pressure (110/65) and specifically cites his low prostate-specific antigen level of 0.15. I suppose that is the number men think about the most.

Bornstein states that other laboratory tests were done but doesn’t specify what they were; instead he effusively declares the numbers were “astonishingly excellent.” While Bornstein is a gastroenterologist, he oddly doesn’t share any GI health details. I will presume that Trump’s colon is “awesome.” Medicalese, this letter is not.

Trump does get high medical marks for his history of abstinence from alcohol and tobacco. President Barack Obama, along with most of our presidents, can make no such claim.

Nobody requires that presidential candidates issue these kinds of health declarations, but they’ve become increasingly common. Trump’s medical statement is unusual in how its author, like the candidate himself, combines vagueness with utter certainty.

Bornstein’s little letter stands in stark contrast to the clear clinical summary Dr. Alberto Mitrani shares about Jeb Bush, for example. In providing relevant medical details about Bush’s health, such as his prior high blood pressure and blood sugars that have improved with lifestyle management, his BMI, his cholesterol numbers and preventative investigations prompted by family history, Mitrani is a bit more convincing.

He concludes, conservatively, that Bush is in “excellent physical and mental condition,” and manages to restrain himself from concluding that the candidate he has just examined should serve as a model for a new statue of David.

In the letter by Mitrani, I recognize a fellow physician communicating in language I understand. In Bornstein’s letter, I smell something a bit off.

I do note that Bornstein says nothing about Trump’s mental health, unlike Bush’s letter.

If I were referred a patient exhibiting the behaviors that we have come to associate with Donald Trump, I wouldn’t be worried so much about his PSA. I’d focus a bit more on the findings of a focused neurological and cognitive examination.

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