The reported slurring of Trump’s speech during his conversation with Elon Musk Monday reminded me of a previous time this sort of thing happened.
Gerald Ford, who was President from 1974 to 1977, was an ex-athlete who exercised regularly. Although he had knee replacements in 1990 and 1992 when he was in his late 70s, this was due to his old football injuries and he was otherwise a healthy man. Ford didn’t suffer his first major illness until 2000, when he was 87.
Just before the 2000 Republican National Convention in Philadelphia, Ford had pain in his face and tongue and saw a doctor. However, no diagnosis was made and he was not treated before flying that day to Philadelphia for the convention, during which he was celebrated along with the other Republican ex-presidents Ronald Reagan and George H.W. Bush.
That evening, August 1, 2000, Ford had interviews on NBC News and on C-SPAN, and among other things reminisced about the first time he went to a Republican National Convention in Philadelphia in 1940 and helped Wendell Willkie become the Republican nominee over the objections of the Republican old guard. However, if you watch the C-SPAN interview of Ford, you’ll immediately see when he starts speaking (at 0:44) that he was badly slurring his speech. Ford also seemed tired and confused.
The events of the next few days are extensively documented. I am relying on the following (paywalled) review of Ford’s medical emergency and treatment, a review that gives many more details than my brief overview:
Lee J, Pappas TN. ”The President's Syndrome”: The Diagnosis and Treatment of Gerald Ford's Lingual Actinomycosis. Am Surg. 2023 Nov;89(11):5057–5061.
Ford’s children watched his TV interviews and were so concerned about his slurring that they urged that he be taken to the emergency room. This prompted his visit just after midnight to the ER of Hahnemann University Hospital, which the Secret Service had selected in advance as the hospital to take Ford if he had stroke symptoms. Ford complained to the ER doctors of head and tongue pain, which he attributed to a sinus infection. The ER docs were concerned about a possible stroke and recommended a CT scan, but Ford was adamant on simply getting pain relief and going back to his hotel, which he did.
The next morning, August 2, Ford’s speech got worse and his left side got weaker. He was taken back to the ER at 9am. By this point his symptoms included slurring of speech, weakness in his left arm, dizziness, balance issues, and continued pain in his tongue. A CT scan revealed a posterior circulation stroke, i.e., a stroke due to reduced blood flow to the back of the brain.
Ford was put into the hospital’s neurointensive care unit and placed on intravenous heparin to inhibit blood coagulation, and his symptoms went away within 24 hours …
… except for two things: the tongue pain and the slurring of speech. Not only did the speech slurring not get better — it got worse.
The next day, August 3, Ford was examined by Dr Richard Hayden, the hospital’s head of otolaryngology (the ears, nose and throat specialty). Hayden found a mass on Ford’s tongue that evidently was causing his pain. An MRI on August 4 confirmed the mass, though its cause was still not known. The morning of August 5, Ford was taken to the operating room to biopsy the tongue, and Hayden found an abscess, which he drained through a one-centimeter incision. A biopsy confirmed that there was no cancer but there was an infection of Actinomyces bacteria, so Ford’s initial and main complaint was due to what doctors call lingual actinomycosis, or Actinomyces infection of the tongue. Actinomyces is common; you and I both surely have it in our bodies, but luckily it’s usually innocuous.
After the abscess was drained Ford rapidly improved, and he was discharged on August 9 with a prescription of the antibiotics clindamycin and levofloxacin for the infection and the anticoagulant warfarin to prevent another stroke.
Afterwards, Ford remained relatively healthy until 2006, the last year of his life.
Here are some of the differences between Ford’s slurring episode in 2000 and Trump’s on Monday:
- Ford (then 87) was nine years older than Trump is today (78).
- Despite his extra age Ford, who exercised and was reasonably trim, was quite possibly in better physical shape than today’s Trump, who gets little exercise and who is obese.
- Ford’s medical problems causing slurred speech are extensively documented. We don’t know Trump’s medical problems, if any. Trump has been reticent about releasing information about his health.
- Ford initially declined treatment despite his medical emergency. We don’t know whether Trump has been offered treatment for a condition that would cause slurred speech, or whether he has declined it.
- Ford had family members who cared about his health and insisted that he be treated, even over his objections. It’s not clear Trump has that.
- Ford was not running for President. Trump is.
- Ford’s medical condition in 2000 was not of significant importance to the potential safety and well-being of all Americans. Trump’s is.
Lots of things can cause speech to be slurred or appear to be slurred in a mass-media interview. With Ford, surprisingly enough it was not the stroke — it was the abscess in his tongue. One wonders whether that abscess saved Ford’s life, by prompting him to get timely treatment for a stroke he didn’t know he had.
We don’t know the cause of the slurring evident to people who heard Trump’s conversation with Musk on Monday. Possibly it was merely an artifact of technical problems during his interview, something I suggested in a comment here yesterday. However, Trump’s slurred speech has been evident at other times, such a rally in February, a rally in May where he said “fake infrastrucker, ershure para”, a campaign event last month, and so forth. Even if this latest slurring is merely Musk’s flawed technology it’s still a reminder that Trump has for some time had a speech-slurring problem that could indicate medical issues.
Given his symptoms, it would be helpful for Trump to release enough of his medical records to explain the slurring of his speech. The cause could be innocuous; for example, perhaps Trump has a dental implant that damaged the lingual nerve; although this can cause slurred speech, loss of taste, and altered salivary secretion it should not affect decision-making. Or it could be something more serious.
Whatever it is, American voters deserve to know.
