For Trump, the Only Medical News Is Good Medical News

WASHINGTON — When Dr. Sean P. Conley stepped in front of the cameras at Walter Reed National Military Medical Center on Saturday, he delivered a briefing that seemed intended less to inform the American public than to satisfy the public relations demands of a famous and famously demanding patient — President Trump.

“He’s doing great,” he said. But moments later, the president’s chief of staff, Mark Meadows, speaking off camera and on the assumption he would not be identified, offered a contradictory assessment, noting “the president’s vitals over the last 24 hours were very concerning, and the next 48 hours will be critical in terms of his care.”

“We’re still not on a clear path to a full recovery,” he added.

The radically different message was stunning, and at first attributed, at Mr. Meadows’s insistence, to “a source familiar with the president’s health” speaking on background, but later identified as the chief of staff.

The discordant statements were a revealing insight into the dynamics behind the Trump White House’s frequent release of misleading information, particularly about the president’s health. Dr. Conley is a Navy doctor and Mr. Trump is not only his patient but his commander in chief. The president is known to be especially interested in presenting his health in the best possible light, and his health has never been an issue the way it is now. It is almost certain he was watching Dr. Conley’s news conference on TV in his hospital room.

For Mr. Meadows, the clarification appeared to be an effort to lay some groundwork for the possibility that Mr. Trump’s condition could worsen, raising the prospect of a potential transfer of power to Vice President Mike Pence under the 25th Amendment. Mr. Meadows, a former congressman from North Carolina, also may have been concerned about his own credibility with journalists in a post-Trump political world.

But the net result of the two conflicting accounts was that in the middle of a pandemic and election that have accentuated the distrust of the government by both left and right, the American public does not have a definitive answer to the condition of the first president to be hospitalized since Ronald Reagan.

While misleading information has been a hallmark of the Trump presidency, the White House physician — Dr. Conley and before him, Dr. Ronny L. Jackson — has been put in a particularly awkward position and provided murky, inaccurate and sometimes inappropriate accounts of Mr. Trump’s health that have included a description, in Dr. Jackson’s case, of the president’s “incredible genes.”

All have been in service of a president who has refused to disclose any details about his physical condition that would undermine the narrative that despite his age, 74, a diet that is heavy on fast food and a deep aversion to exercise, he has the stamina and strength of a man half his age.

Hours after Dr. Conley’s Saturday news conference, during which he dodged questions about whether the president had been on oxygen and inaccurately suggested that Mr. Trump was only “slightly overweight,” Dr. Conley was forced to issue a correction on some of his remarks.

After saying the president had been diagnosed 72 hours before, which would have meant that Mr. Trump continued with a normal schedule of rallies and fund-raisers despite knowing he was ill, Dr. Conley retracted the timeline.

“I incorrectly used the term ‘72 hours’ instead of ‘Day 3’” with regards to Mr. Trump’s diagnosis, he said, adding that the president first tested positive on Thursday night.

It was not the first time Dr. Conley found himself in an awkward position because of his patient.

In May, Dr. Conley — an osteopathic physician — issued a statement announcing that Mr. Trump was taking hydroxychloroquine, the antimalarial drug the president promoted as a measure to fight the coronavirus, despite warnings from the Food and Drug Administration that it can cause heart problems and from the medical community that its use should be discouraged.

“This, perhaps, is a case of the president, not the physician, guiding the course of treatment,” Matthew Algeo, the author of “The President Is a Sick Man,” wrote in The Atlantic. He has described Mr. Trump as less transparent about his health than even other presidents who have hidden serious ailments.

In the statement, Dr. Conley said he had “concluded the potential benefit from treatment outweighed the relative risks” and later said that the president completed the treatment “safely and without side effects.”

The White House doctor has also never provided any explanation for the president’s unannounced trip to Walter Reed in November 2019, when it was recently disclosed in a book by Michael Schmidt, a New York Times reporter, that Mr. Pence was put on standby to take over the powers of the presidency.

In response, Dr. Conley released a statement backing up the president. “I can confirm that President Trump has not experienced nor been evaluated for a cerebrovascular accident (stroke), transient ischemic attack (ministroke) or any acute cardiovascular emergencies, as have been incorrectly reported in the media,” Dr. Conley said.

The White House said at the time that Mr. Trump was simply undergoing a series of “quick exam and labs” as part of his annual physical exam because he was anticipating a “very busy 2020.” Mr. Trump never completed that physical.

Much like the release of a president’s tax returns, releasing the results of an annual physical is a custom, not a legal requirement. (The White House physician’s responsibilities, meanwhile, are to the patient, not the public.) Presidents are not required to tell the public anything about their annual physical exam, or the status or history of their health, although all modern presidents since Richard M. Nixon have chosen to give out some information.

Dr. Conley’s predecessor in the job, Dr. Jackson, had served under the past three presidents. But Dr. Jackson, a retired Navy rear admiral who is now a Republican candidate for Congress in Texas and endorsed by the president, seemed particularly eager to please Mr. Trump.

At a news conference in January 2018, Dr. Jackson said that Mr. Trump was in great health, citing his “incredible genes,” and his assessment that he had done “exceedingly well” on a cognitive test and was “mentally very, very sharp.” He also said that if Mr. Trump had adhered to a better diet over the past 20 years, he “could have lived to 200.”

It was also not clear whether Dr. Jackson fudged the president’s height — he said Mr. Trump was 6 feet 3 inches, when his driver’s license lists him as 6 feet 2 inches. Either way, his body mass index would have defined him as obese.

White House doctors have also refused to provide a full accounting of why the first lady, Melania Trump, visited Walter Reed in 2018 for what they described as a routine embolization procedure “to treat a benign kidney condition.” Her five-day hospital stay for a procedure that is typically completed in one was never accounted for.

The inaccurate and misleading briefing from the White House physician on Saturday was a disappointment to some administration officials, who had pushed for Dr. Conley to take over as the public face of the current news cycle, hoping he would be seen as a more credible source than Kayleigh McEnany, the White House press secretary.

But credibility has never been a strong suit of the doctors that Mr. Trump relies on.

During the Republican primary in 2015, Mr. Trump’s doctor at the time, Dr. Harold N. Bornstein, released a letter stating that Mr. Trump’s health was “excellent” and that “if elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.”

Later, he told CNN how the letter had come about. Mr. Trump, he said, had “dictated that whole letter. I didn’t write that letter.”