TOPSHOT – US President Joe Biden looks on as he takes part in the first presidential debate … [+]
As the Biden administration nears its end and moves into its legacy phase, the events surrounding his health and cognitive vitality will undoubtedly leave a lasting impact on the historical narrative.
President Biden’s cognitive decline, first evident during the debates and ultimately costing him the presidential nomination, continues to raise important questions about who he was and who was making the decisions in the White House.
The challenge is that obfuscating President Biden’s age and health represents a potential betrayal of democratic principles, depriving the electorate of the transparency essential to informed governance. Such cover-up consolidates power among unelected operatives, erodes public trust, and undermines the fundamental principles of accountability and constitutional leadership.
Has anything like this ever happened before?
It has – and in even more dramatic circumstances. In 1919, President Woodrow Wilson suffered a catastrophic stroke, a debilitating event meticulously hidden from the American public. The resulting leadership uncertainty profoundly and irrevocably changed the trajectory of United States history in the 20th century.
President Biden’s Age and Hidden Cognitive Decline.
Those who watched the debates witnessed it for themselves – President Biden’s cognitive decline could no longer be hidden. However, efforts to obscure reality were continuing well before June 27, 2024. President Biden had become increasingly unavailable, relied heavily on written commentary, refused meetings and taken a diminished role in governing according to The Wall Street Journal in an article by Annie Linskey. This troubling pattern culminated in a debate show that aired these concerns. Far from mere speculation, these claims are substantiated by a thorough report on The Wall Street Journalrelying on 50 interviews with individuals closely familiar with the administration.
The negative stories were buried. The inner circle blocked the President. Key members of Congress had no contact with Biden. The leading roles were played by unelected staff members. Even now, the Democratic leadership continues to maintain that all was well in Camelot. Senate Minority Leader Charles Schumer asserted last week that Democrats did not fire up the public.
Political leanings can influence whether someone perceives or declares this as a scandal or not. But, fundamentally, the issue left the country facing a potential leadership vacuum. Tangible examples given in The Wall Street Journal parts include the chaotic withdrawal from Afghanistan, where shortened or skipped cabinet meetings highlighted a possible lack of decisive executive direction. The question it raises is inescapable and urgent: who was – and who is – really ruling the country?
This scenario is not without sobering precedent.
Woodrow Wilson’s Secret Strike of 1919
American politician Woodrow Wilson (1856 – 1924), President of the United States from 1913-1921, … [+]
Just over a century ago, the nation faced a president clearly unfit to govern, though this reality was carefully hidden from the American people. The consequences shaped the trajectory of US foreign policy in the 20th century.
In 1919, President Woodrow Wilson, in an exhausting effort to rally public support for US entry into the League of Nations, embarked on a arduous speaking tour. On September 25, 1919, Wilson collapsed, and by October 2, he had suffered a debilitating stroke in his right side. This catastrophic event, his fourth, left him hemiplegic—unable to move his left arm or leg. The president, disabled, became dependent on others for the most basic activities of daily living, such as feeding himself. Even the act of signing his name presented an insurmountable challenge.
This was hidden from the American public and even Congress.
At the center of this unfolding drama was Dr. Cary Grayson, White House physician and Wilson confidant. Grayson, bound by a combination of professional ethics and deep personal loyalty, operated with remarkable secrecy. His relationship with Wilson extended far beyond the clinic; he had introduced Wilson to his second wife, Edith, cared for Wilson’s sister during a medical emergency, and accompanied the president to the Paris Peace Conference in 1919. Grayson had a truly meteoric rise. In a short time, he rose from Assistant Surgeon Lieutenant to Medical Director and eventually to Rear Admiral. This was inextricably linked to his closeness to the president.
Can a man so involved in his patient’s personal and political fortunes really make an objective diagnosis? In 1919, as in 2024, the question of whether loyalty can trump duty to the public takes on an urgent urgency.
This question became acute when, four days after Wilson’s disastrous coup, his cabinet met to discuss the course of the nation. Then-Secretary of State Robert Lansing invoked Article II, Section 1 of the Constitution, which provides that the vice president assumes presidential duties in cases of incapacity. However, Grayson refused to approve or sign any documents attesting to Wilson’s disability, effectively quashing discussions of a transfer of power.
For the next 17 months, the reins of the presidency were practically held by Edith Wilson. Acting as a go-between, she filtered all communication to and from the bedridden president. Its role as de facto custodian of executive power has been the subject of considerable historical debate, yet the fact remains that this extraordinary arrangement kept the true extent of Wilson’s condition hidden from Congress and the public.
What were the consequences of Woodrow Wilson’s secret coup?
The consequences changed the history of the United States. The League of Nations, without US support, weakened into impotence, and only after World War II did the United States begin to approximate Wilson’s vision of a Pax Americana. Yet the ethical questions remain murky: Grayson, as my colleagues and I observed in a Journal of Neurosurgery letter, allowed patient-doctor confidentiality to supersede national security at a critical moment in history. This decision, framed by loyalty and political considerations, obscured the president’s weakness at a moment with key international consequences.
Charitably interpreted, Grayson’s actions spark a debate about the complicated interplay of professional ethics, personal loyalty, and the bonds formed over years of medical care. Less generously, they suggest a destructive combination of political ambition and institutional inertia—a reluctance of those who govern to relinquish power, even when the governed are ill-served.
What are and what will be the consequences of President Biden’s cognitive decline?
History will tell us.
