Medical Examiner

Medical Records Won’t Tell Us Anything Useful About the Candidates’ Health

The “concern” over Clinton’s pneumonia is about politics, not medical precision.

Hillary Clinton leaves her daughter’s home in New York City on Sunday.

Brian Snyder/Reuters

Hillary Clinton and Donald Trump are two of the oldest and most despised presidential aspirants in American history. These twin facts, dropped into the ghoulish antagonism of an election’s stretch run, have mixed together to produce a national conversation that’s essentially about whether either of the candidates is going to die anytime soon.

Somewhere in all the partisan anger and lurid conspiracy theorizing surrounding that question is a legitimate worry: As a nation, we are considering two presidential candidates who are 68 and 70 years old for an office that requires at least four years—and possibly eight—of grueling work. Regardless of whom you support, it would be nice to know that the president will survive his or her tenure in office.

Which is why the video of Clinton appearing to wobble as she exited the 9/11 memorial ceremony on Sunday afternoon was a jarring moment. It at once frightened the worriers and fed the ghouls, and it redoubled calls, even from a surprisingly restrained Trump, for more disclosure about each candidate’s health. But there is no medical record or doctor’s note of any kind whose release would defuse the issue. These documents are opaque even to other doctors, and it’s hard to imagine Clinton’s nastiest foes being satisfied by anything short of a handwritten note from God himself, co-signed by Louis Pasteur and Hippocrates. Everything in this election has been politicized. Why not the candidates’ white blood cell counts, too?

Clinton’s campaign released a statement on Sunday explaining that she had been diagnosed with walking pneumonia on Friday afternoon and had become dehydrated at the 9/11 event. While some people paired this with her coughing fit the previous weekend as indication that it actually is time to worry about Clinton’s health, the diagnosis likely explains both incidents. Her campaign staff has also been sick—pneumonia is an infection that is easily spread among people.

Unsurprisingly, the incident has renewed calls for Clinton to be more upfront about her health, led by Trump himself, as he promised to release “very specific numbers” from his own medical tests.

Trump can release these numbers if he wants to. But they won’t tell us much about how his body would respond if pneumonia broke out at his campaign headquarters. Nor does the fact that Clinton came down with the disease tell us much about her health overall, about her health over the next several years if she serves as president, or even about her life expectancy.

A medical record is not as useful as we might like it to be. For one thing, it’s not a singular document with a discoverable reveal, like a tax return. As Margot Sanger-Katz pointed out in the New York Times late last week, medical records are extremely hard to gather and do not offer clear takeaways. There will be years of information spread across different doctors’ offices that will be incomprehensible to many—even doctors. Beyond the logistical challenges of gathering a complete set, Sanger-Katz writes:

Good luck reading those records when you get them: pages of lab readings, check-box answers, billing codes and illegible handwriting. Few patients can understand the records, and neither can many physicians. That’s why, even in the most wired of medical offices, receptionists still hand you a clipboard and ask you to write your medical history before the doctor will see you.

Yes, your own recounting of your medical history is just as valuable to your doctor in getting an indication of your current state of health as any independent assessment of medical records. Maybe more so. That’s in part because health is unpredictable—a bout of pneumonia could happen to anyone. Cancer can strike at random. Medical records won’t solve that. And yet we’re still clamoring for the paperwork.

There’s hope that a release of medical records would quiet the unfounded reports that either candidate is hiding a major medical scandal. In a smart piece in Politico several weeks back, Dan Diamond argued that voters have the right to know as much as they can about the candidates, and having an independent medical team review each could offer an unbiased assessment.   

The idea itself is fine (if difficult to enforce, given privacy rights around medical information). But there’s no real reason to believe it will depoliticize the issue. It would just shift the locus of criticism. Were the doctors truly independent? Was all information released to the public?

Trump and Clinton have lived in the public eye for so long it’s unlikely that either has experienced an undisclosed major health issue—one that would hinder his or her ability to serve as president. It’s equally unlikely that submitting to an independent physician’s assessment or releasing a data dump of medical records or test results would quell the politicized conversation about how fit they are to serve.

The life expectancy calculator offered by the Social Security Administration gives Trump another 15.2 years to live, while Clinton has 18.4 years. This is because Clinton is both a little younger and is female (the calculator takes only age and gender into account). But even a more nuanced prediction of each candidate’s likelihood of getting different diseases would not really be helpful in assessing his or her fitness to serve. How would voters weigh a 23 percent chance of developing cancer against a 16 percent chance of, say, Alzheimer’s?

They would probably still vote for the candidate whose positions they actually agree with.  While further public assessment might provide a fuller picture of either candidate’s risk profile, all the knowledge in the world can’t yield a promise of good health going forward—the only thing that might have a hope of stopping the whisper campaigns.

Just look at what’s happening today. Though the conspiracy theory around Clinton is related to a supposed neurological condition, something completely unrelated to pneumonia, the exponents of that theory are jumping on this minor illness as evidence supporting their crusade. And if they’re not doing that, they’re calling the pneumonia diagnosis a media hoax. Sometimes they’re doing both things at once. “Pneumonia, incidentally, is a complication of Parkinson’s disease,” one of the paranoiacs wrote, under the headline “Media Hoax! Sick Hillary Clinton Does Not Have Pneumonia.” This is about politics, not wellness.

Read more of Slate’s campaign coverage.