Opinion: RFK Jr.’s brain worm reignites this perennial debate

Opinion by Julian Zelizer, CNN

(CNN) — News that third-party presidential candidate Robert Kennedy Jr. suffered from a parasitic worm in his brain prompted a wide range of responses this week — from shock to disbelief — in what has already been one of the most unusual presidential races in recent history. But more important than the details of the parasite was the conversation it sparked about presidents and health. Kennedy, President Joe Biden and former President Donald Trump should all disclose their health records. 

Some of Kennedy’s health issues were revealed in a 2012 deposition during divorce proceedings from his second wife, and while his campaign declined to share his health records, the presidential candidate provided more details to The New York Times and in the podcast “Pushing the Limits with Brian Shapiro” this week. Kennedy said he had recovered from the brain fog and memory loss brought on by the parasite, as well as a bout of mercury poisoning he said occurred around the same time, with his spokesperson brushing off questions about whether his health issues could compromise his fitness for the presidency.

While the two major candidates have not released extensive health records this campaign cycle, a six-page summary from the White House in February concluded Biden is “fit for duty.” Trump’s doctor released a three-paragraph statement in November saying he was in “excellent health.”

Many critics claim this is not enough. The majority of voters think both Biden and Trump are too old for another term, and there are always concerns that the physicians signing off on these statements are more eager to protect the public image of the candidate than to share the full and unvarnished truth about how that person is doing.

There is no requirement for disclosing a candidate’s health records in the Constitution. Nor are there any other legal requirements that candidates running for the highest office in the land need to share this information. In the second half of the 20th century, however, candidates have set a precedent of doing so, gradually succumbing to the pressure to provide a greater amount of information to voters. This has been a positive development, and one that the 2024 presidential candidates should continue. 

Some of the pressure came from the realization that many past presidents suffered serious conditions without ever telling the public. President Chester A. Arthur never disclosed that he had Bright’s disease, a kidney condition, during his bid for the Republican nomination in 1884. President Woodrow Wilson famously suffered a debilitating stroke in 1919 that affected him for the rest of his presidency. In 1944, the physician Frank Lahey produced a dire secret memo after examining Franklin Roosevelt, predicting that the president, who suffered from severe heart problems, would not make it through another term (Roosevelt ended up dying of a cerebral hemorrhage just 11 weeks into his fourth term). In 1955, President Dwight Eisenhower downplayed the severity of a heart attack. And the list goes on.

Occasionally, when candidates were forced to publicly contend with their health issues, they became the source of scandal and controversy. This was the case with Sen. Thomas Eagleton, Democratic presidential candidate George McGovern’s running mate when he challenged President Richard Nixon in 1972. Revelations that Eagleton had undergone shock treatment for depression, which he had not told McGovern about, led him to withdraw from the race.

In contrast, in 1976 almost every candidate voluntarily provided reporters with summaries of their medical history. Independent candidate Eugene McCarthy, who believed they should not be public, was the exception; he argued that presidents should be elected on “the basis of his or her record of service, of thought about the issues and programs to deal with them, and not on the basis of any private status such as that of patient.”

So, what changed? Before the Eagleton saga, the ratification of the 25th Amendment in 1967 outlined a clear path of succession should the president be removed from or die in office. Passed in the aftermath of President John Kennedy’s tragic assassination, the debate over the amendment put concerns about the physical longevity of candidates front and center.

During the 1960s and 1970s, as scholar Michael Schudson has written, the notion of disclosure and transparency became a powerful norm throughout American society. The sentiment that the public was better off with more information was partly a response to the secrecy that had dominated American politics in the early days of the Cold War.

In 1992, Democratic candidate Paul Tsongas, a former senator from Massachusetts, advanced the drive for transparency. He had discovered a lump in his groin nearly a decade earlier and was eventually diagnosed with non-Hodgkin lymphoma. By the time he ran for president in 1992, however, physicians had confirmed that he was cancer-free. Tsongas emphasized his fitness during the primaries, with the campaign releasing a video of him swimming. He ended up dropping out of the campaign, unable to defeat Bill Clinton, and in December of that year, he announced that he had a cancerous growth in his abdomen. Many voters couldn’t help but wonder what would have happened if he had been elected president.

Health concerns have been a recurring issue among presidential candidates in recent decades. In 2008, there were questions about Republican nominee John McCain’s history of skin cancer, and in 2016, rumors swirled about Hillary Clinton’s health when she stumbled into a van (her doctor had diagnosed her with pneumonia just days before and said the incident was a combination of that illness, dehydration and overheating).

The key, ultimately, is to weigh not whether a candidate has a health issue, as Jacob Appel, a physician at the Mt. Sinai Medical School has argued, but whether that condition would impair his or her ability to govern effectively.

The more that politicians are honest about their medical issues, the less others are likely to feel a stigma surrounding their own problems. Nearly everyone deals with some combination of health problems and there is no reason this should be a source of embarrassment or shame. Candidates have the opportunity to model a different kind of mentality by being transparent.

Finally, in an age of disinformation, more accurate information is a good thing. With rumors and misrepresentations often swirling out there on the internet, it would be better to just come out with the truth with a controlled and straightforward announcement.

Health issues are one universal phenomenon in our age of polarization and division. Whether someone is rich or poor, powerful or marginalized, White or Black, we all contend with the health of our bodies and minds. Those who have chosen to run for the highest office in the land should be open and honest about their medical histories. Doing so would only bolster the health of our democracy.

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