With the recent agreement between the Biden and Trump presidential campaigns on debates, the top of the list of outcomes to watch for from those debates will be voter perceptions of the physical and mental state of the candidates. It will be heightened this year in large part due to the relatively advanced ages of both major party candidates.

Such perceptions, while widespread and generally accepted are not always accurate. 

That was the case when the first televised presidential election debates between John Kennedy and Richard Nixon were held in 1960.
 
Going into the debates both candidates had sterling credentials. Both were young — Nixon was forty-seven and Kennedy was forty-three. Nixon served as a member of the U.S. House of Representatives, as a U.S Senator, and as a two term Vice President. Kennedy also served as a as a member of the U.S. House of Representatives and as a U.S. Senator. Both were World War II veterans. Kennedy was also a war hero who saved the crew of a Navy PT Boat after it was attacked and sunk. 

Regarding their credentials on personal health conditions, they were polar opposites.

To address chronic and debilitating back pain, Kennedy regularly took codeine, demerol, methadone, barbiturates, anti-anxiety medication, prednisone, and ritalin. He also suffered from Addison’s disease, a thyroid condition which required regular injections of steroids. None of this was evident on the debates especially on the first one watched by an estimated 60 to 70 percent of the voting universe then.

In post-debate surveys after the first debate, many viewers perceived Kennedy as vigorous, healthy, and robust. Many also viewed Nixon as tired, ill, and lethargic. 

Some suggest Kennedy’s long-term affliction with of Addison’s disease and long-term use of steroids resulted in hyperpigmentation which gave him a healthy tanned appearance on the debates. Nixon’s haggard appearance likely resulted from a bout with the flu and a painful knee injury that he suffered while climbing out of a car. Neither were chronic or serious. 

In any event, as is often the case in the political arena, initial perceptions become permanent.

Ultimately Kennedy defeated Nixon by a very thin margin. 

Presidents with serious medical and cognitive conditions that were downplayed, not publicly acknowledged, or discussed openly occurred well before the 1960 presidential debates. 

Grover Cleveland underwent surgery to remove a cancerous tumor in his mouth. William McKinley suffered from depression, phlebitis, and epilepsy. Woodrow Wilson had a debilitating stroke after which his wife was the de facto president. 

Franklin Roosevelt’s physical in 1944 revealed advanced arteriosclerosis, cardiac weakness, and acute bronchitis. Ignoring recommendations from his medical team to retire, FDR ran for and won an unprecedented fourth presidential term. Five months later he had a stroke and died. 

Dwight Eisenhower had a massive heart attack in 1955 and a stroke in 1957. Ronald Reagan was diagnosed with Alzheimer’s disease five years after leaving office. There were indications of it in his second term, but it was not confirmed until after he left office. 

There are common threads to all the above medical situations. The public was not made fully aware of them or fully informed just how serious they were. That lack of openness and transparency resulted from intensive efforts by presidential staff, campaign advisors, family members, and the media to shield the President from concerns about fitness to serve.

It is ironic that John F. Kennedy once responded to a question about how he addressed the enormous amounts of information provided to him by advisors and staff. JFK said “Before making a decision, I always ask… what am I not being told?”

That is a question voters should demand answers to going forward. Voters and the media on both sides of the current ideological divide in America must embrace a uniform process to get and share those answers. The purpose is not to influence voters but to help them reach informed decisions.

I suggest every presidential candidate and every vice-presidential candidate be examined by a bi-partisan team of independent medical professionals, and their observations be made readily available to every American prior to elections.

I further suggest that post-election and annually while in office, every sitting President and Vice President be required to be examined by a bi-partisan team of independent medical professionals whose observations are shared with  Congress and every American. 

This is not a huge request. It is a best practice for every organization committed to excellence in leadership performance. As a CEO of a wide range of not-for-profit organizations, I got regular comprehensive annual physical and cognitive exams. The reason was simple. It assured those whom I served that I was able to perform my assigned duties and responsibilities.

Surely, we deserve and can expect no less for those who seek election to and serving in what is universally acknowledged to be the most demanding jobs in the world. Next up should be the same for those in high levels in the legislative and judicial branches of government.

David Reel is a public affairs and public relations consultant who lives in Easton.