Time for them to turn off the lights and head out the door....

Health questions around McConnell and Feinstein raise a critical concern

Opinion by Julian Zelizer

On Wednesday, Senate Minority Leader Mitch McConnell caused quite a scare when he froze during a press conference and was led away by an aide. Though he returned a few minutes later, telling reporters he was “fine,” the incident – coupled with multiple reported falls he has taken this year – raised new questions about the 81-year-old Republican’s health.

But McConnell is just one example of a senator whose physical or mental health has come under scrutiny in recent months.

Democratic Sen. Dianne Feinstein of California took an extended absence from the Senate after her shingles diagnosis early this year. Her temporary departure impeded Senate Democrats’ ability to move forward on crucial judicial nominations for several months. Even when Feinstein returned, there were still doubts about whether she had fully recovered – most recently, on Thursday, when she appeared confused and had to be prodded to cast a vote in a Senate Appropriations Committee hearing.

And then there is Democratic Sen. John Fetterman of Pennsylvania, who suffered a stroke during his campaign, and was admitted to the hospital for clinical depression in February. His spokesperson at the time said he had struggled with depression “off and on throughout his life, [though] it only became severe in recent weeks.” Once in treatment, he began to talk quite candidly about his mental health struggles. He returned to the Senate in April, saying it was “great to be back.”

In presidential politics, health has also been a major concern, particularly given the age of the leading 2024 presidential candidates – President Joe Biden, who is 80, and former President Donald Trump, who is 77. And while the age of politicians should not be a determining factor for voters – given that many older officials have proven to still be up to the job, and many younger politicians have proven they are not – health is a legitimate issue.

Politicians should disclose to voters any major medical issues that could impede their ability to perform their tasks in office, so that voters can account for those issues when casting their ballots.

Just think about it: We evaluate candidates and incumbents based on a whole host of qualifications – intelligence, charisma, ethics, political prowess, experience – and more. Why should their health, particularly where it pertains to their ability to perform their jobs, not be included in that list? Moreover, if politicians were more transparent about their health, the public might be less concerned about the question of their age and agility.

Voters also deserve to know the full extent of relevant health problems among those already serving, even if they are not running for reelection, since medical complications that arise while in office can impact their ability to perform their roles in government.

Of course, if politicians began to disclose more about their medical conditions, that would be a departure from historical norms.

Most famously, then-President Woodrow Wilson suffered from a devastating stroke in 1919 as he was negotiating the Treaty of Versailles and planning for the League of Nations. His wife, Edith Bolling Galt Wilson, took the reins, running much of his administration in his absence. The public did not begin to learn the details of his disability until 1920, and even then, they did not know the extent of his health issues or the significant role his wife had taken to keep the executive wing running.

Although much of our historical memory centers on how much the public knew about former President Franklin D. Roosevelt’s use of a wheelchair – a consequence of his battle with polio – more relevant to his ability to govern were his struggles with hypertension and heart disease, particularly as he ran for a fourth term in 1944. He notably died in office from a cerebral hemorrhage, just months into his fourth term.

White House officials downplayed the severity of then-President Dwight Eisenhower’s heart attack in 1955, and did the same for former President John F. Kennedy, who struggled with a number of medical issues, including back pain and Addison’s disease. For all his ailments, he took a cocktail of drugs, including painkillers, anti-anxiety medication, stimulants and more.

Mental illness has received even less attention. A Duke University Medical Center study has shown that many presidents likely suffered from depression, anxiety and even alcoholism, all of which could greatly have impacted their ability to serve and yet which almost never became part of the public conversation. Historians have uncovered, for instance, how much then- President Richard Nixon was drinking in 1973, sometimes leaving him incapacitated in key moments, such as during the Yom Kippur War – when Israel found itself at war with multiple Arab nations and needed US aid.

Keeping significant health problems from the public also does not serve our democracy well. Medical privacy is important, of course, but so too is the right of voters to know the physical and/or mental limitations of the leaders who are running to represent them or currently representing them.

Since the 1970s, investigative journalists have been more dogged in covering this issue. One turning point was when the press reported that Sen. Thomas Eagleton of Missouri, Democratic nominee George McGovern’s 1972 running mate, had been hospitalized for depression and had received electro-shock treatment – a revelation which forced Eagleton to drop out.

The most significant written change took place with the Twenty Fifth Amendment, adopted in 1967, which authorized the vice president and a majority of the Cabinet or Congress to declare that the president was “unable to discharge the powers and duties of his office,” thereby allowing the vice president to assume the power of the acting president. The amendment, however, did not specify what those disabilities would be.

Changing norms have improved the ability of voters to gain access to the medical records of presidential candidates and sitting presidents. Incumbent presidents have agreed to share medical records, though sometimes reluctantly and without full details. There is a perennial fear among politicians of looking “weak.” And candidates for office have been less forthcoming in what they share.

By treating health concerns — physical and psychological — as something that should be hidden, politicians also play a part in perpetuating stigmas around the many health issues that millions of Americans contend with every day. If our leaders were more candid, we might respond to our own ailments differently – opting to treat, rather than to hide them, and recognizing that not all of them inhibit us from leading full lives or working full time.

Health issues do not recognize political divides. They impact the bodies and mind of every family — red, blue and purple — in communities that are rich, middle class and poor. It’s time to finally break free from the old taboos that surround this issue. Politicians, including Biden, have the opportunity to help us see how we can be more mature and honest when contending with this universal experience.