diagnosis via video - why I'm taking it seriously in this particular case.

[cab67]

We've all seen commentaries, written or video, by psychologists, psychiatrists, and other medical professionals explaining that Old Colostomy's obvious decline is caused either by Alzheimer's disease or frontotemporal dementia. All sort of evidence is lined up - his frequent confabulation, his declining sense of decorum (which was never substantial to begin with), bruising on his hands, his posture, and so on.

It's often said that psychiatric diagnoses based on anything other than direct evaluation of the subject in person are guesswork and shouldn't carry much weight. And for the most part, I agree entirely with that.

In fact, there's an ongoing real-life example of how uninformed diagnoses can cause harm - the Vaccine Adverse Event Reporting System (VAERS). This is a system run by HHS to monitor adverse reactions from vaccines. Or at least, that's the intent. In reality, it's worthless. Reactions can be reported by anyone. This means a lot of them are from parents convinced that a vaccine gave their child autism. But beyond the reports by people without medical training, and the reports that are obviously fake (e.g. there are several reports of penises growing out of people's foreheads following vaccination), the person reporting the reaction need not be someone working with or related to the person with the alleged reaction. It could be a "concerned" neighbor who thinks the kid down the block was harmed by a vaccine. Did this person ever really interact with the child? No, but they saw a change in the child's behavior, and that must have been because of a vaccine.

Some have compared the practice to what happened during the Terri Schiavo case, in which videos of a young woman in a vegetative state were used by politicians and commentators (nearly all on the political right) to argue that she might not be in a deep vegetative state after all, that she might improve, and that her feeding tube shouldn't be removed. The videos had been edited to make it look as though the young woman was interacting with people and objects in ways someone in a permanent vegetative state would not be able to do. It was a disgusting display of partisan misuse of media to promote an agenda.

So I don't have much use for psychiatric diagnoses based on video evidence.

But in the case of the current president, I'm more inclined to take them seriously. Why?

Two reasons - first, it's not just a handful of medical experts speaking up. A lot of them are. And we're not necessarily talking about internists and OB-GYN's - these are people specifically trained in psychiatry or clinical psychology with extensive experience on the subject of dementia.

But the second, which I regard as more important, is the sheer volume of the evidence. With Terri Schiavo, we had a modest amount of video, and it had been cleverly edited. With the Orange One, we have years' worth of video, much of it shot live and not edited, going back to when he first became a public figure in the 1980's. It's not just that we're seeing a plainly obvious decline; we're seeing very specific changes in his behavior, and these symptoms show up repeatedly.

I'm not a psychologist myself. My wife is, and I might have absorbed some knowledge of the subject osmotically from her, and I saw what my mom and uncle went through with my grandfather, but neither of these renders me qualified to make any kind of diagnosis. But when so many experts are converging on one or a few diagnoses based on impartial evidence anyone can see, my willingness to accept the claims grows.

None of the claims made in the media are conclusive. They can't be - these people have never examined the president in person, nor have they given any of the tests used to generate a diagnosis. (They might have been done and not released to the public; if so, that would be a Watergate- or Iran-Contra-level scandal.) But they're not on par with someone down the street thinking I must have been compromised by a vaccine because was once seen tripping on my front lawn.

My thoughts, anyway.

[travelingthrulife]

1. VAERS is not worthless. It is a tool to capture drug issues not seen prior to approval.

It captures anything from anyone, so that, ideally, nothing is missed, but it is data that is reviewed by scientists after collection for relevance.

MAGA never understood it. They thought anything reported was real and accurate and relevant. But it had not been reviewed yet. So if they typed in that the vaccine caused them to grow a penis on their forehead, it became true. If they typed in that it caused their kid's autism, it became true and the data was quoted as scientific fact.

Just because it is one more tool MAGA has broken does not mean it is useless.

[cab67]

7. true, but...

Last edited Sat Dec 20, 2025, 05:34 PM - Edit history (1)

...given how easy it is to make a fake report, even a trained scientist would have to give low weight to anything on VAERS.

The is something I deal with all the time, albeit not with health care. There are web sites that list reported fossil occurrences. The problem? Many of the reports are made by people with expertise in one particular group (e.g. primates), but who are also reporting fossils from other groups found at the same site (e.g., rodents, ruminants, turtles, crocodiles, horses). One's expertise drops the further away one moves from the point of expertise. I'm reasonably good with bird, lizard, and turtle material, though I'm not qualified to identify them beyond "bird," "lizard,": or "turtle." My error rate would be higher if you asked me to identify a bunch of mammal fossils. And when it comes to fish, any identification I might make should be ignored.

Since these web sites are based on literature reports and haven't been vetted by people who actually work on the groups found in the report, they can yield misleading results. I've reviewed manuscripts on research based entirely on some of these data sets, and the authors are always surprised at the number of mistakes in their work that arose from data base error.

[usonian]

2. I try not to overthink it. Sick is as sick does.

In his last days in the White House, Nixon reportedly wandered around the halls speaking to portraits of past presidents.

Trump defaces them.

So, not only deranged but malignantly deranged.

Sherlock Holmes, amateur psychiatrist.

[Intractable]

3. Sherlock Holmes, amateur psychiatrist.

He prescribed for himself a seven percent solution of cocaine to deal with his ennui.

noun: ennui

a feeling of listlessness and dissatisfaction arising from a lack of occupation or excitement.


Ah, the good ole days.

[usonian]

4. I should change that. The character was weirder than me, and yes, that's possible.

In fiction.
No ennui here. I am flat out busy, especially with DU lately.

Enjoy a cocaine-free day!

[cab67]

6. yes, but....

...different kinds of dementia can have different effects on one's behavior.

In one sense, you're right - it doesn't matter. His inability to function as president is as obvious as an egret on a black-sand beach. He needs to be 25thed out of office immediately, whether it's Alzheimer's or a form of FTD is irrelevant. He has to go.

But in another sense, it matters a great deal. That's because there won't be support in the cabinet to 25th him. Barring unforeseen circumstances, we're stuck with him until he end of his term. Impacts on impulse control, for example, are far worse with some forms of dementia compared with others. If it's one of these, we need to set up additional safeguards too limit his ability to order a nuclear strike.

This is the article that prompted my comment. It was posted by Amaryllis, and there was a substantial discussion in the ensuing thread.

https://frankgeorge8675309.substack.com/p/dammit-its-not-alzheimers-heres-why-c9f

[Trust_Reality]

5. Sometimes the symptoms are pretty obvious even to a low level mental health aide.

On the other hand, it seems like quite a few people with serious intent are missed by high level doctors who declare them to be rehabilitated and safe following in-person evaluation.

[cab67]

8. I actually know a little about your last point!

My wife's a clinical psychologist, and her work focuses on developing therapies to prevent recidivism among people convicted of domestic violence-related crimes.

She was once working for a DOC. I will name neither the county nor the state. I travelled with her to keep an eye on our daughter, who was a toddler at the time. My aunt called, and I had to explain that I was on my way jail to pick up my wife. It took some explanation.

Not disagreeing with your point at all - just adding a useless piece of trivia.

[PatSeg]

9. There is probably no person today who has been

photographed, videotaped, and broadcast live as much as Donald Trump. I think it is very likely that a good mental health professional can diagnose him without seeing him in person. There is just so much evidence to work with, more possibly than could be ascertained by a few in person evaluations.

The recent assessment that was posted here a few days ago sounded very probable to me. Meanwhile of course, there are doctors who HAVE treated him in person and have run numerous tests, but cannot reveal their findings to the public.