US elections 2024

Warning signs of Joe Biden’s decline were hiding in plain sight well before last month’s calamitous US presidential debate performance against Donald Trump.But Biden had the perfect cover: a long history of verbal slips and other blunders that made it hard to blame his age alone. “I am a gaffe machine,” he admitted in December 2018 when asked about potential liabilities of his election campaign.He also medical experts on his side. In 2021 Dr Kevin O’Connor, the president’s physician, pronounced Biden “a healthy, vigorous 78-year-old male who is fit to successfully execute the duties of the presidency”.Critics say there was a conspiracy of silence at the White House, however. The 36 press conferences that Biden had given by the end of June were fewer than any president in the same timeframe since Ronald Reagan.Biden’s team came down hard on reporters who questioned whether the oldest president in American history – now 81 – was still fully capable of doing the job. Journalists also wanted to avoid the accusation of ageism or that they were helping to elect Trump.“It is simply astounding for the entire country, including its most seasoned reporters, to be as shocked as everyone was by the ugly and painful reality of Biden’s debate performance,” Jill Abramson, former executive editor of the New York Times, wrote on the Semafor website this week.While it was a “super hard story to report”, she said it could have been done. Instead, Abramson said, the American press failed in its duty to hold those in power accountable. Here are some of the dots that, with the benefit of hindsight, could have been joined sooner:19 March 2021: Biden stumbled three times as he climbed red carpeted stairs to Air Force One to board a flight to Atlanta. A White House spokesperson blamed windy weather.1 March 2022: At his State of the Union address on Capitol Hill, Biden said “Iranian” when he meant “Ukrainian,” “America” when he meant “Delaware” and “profits” when he meant “prices”.26 March 2022: Biden upended a carefully crafted speech in Warsaw, Poland, by ad libbing about the Russian president, Vladimir Putin: “For God’s sake, this man cannot remain in power.” White House aides were forced to hastily clean up the remark.18 June 2022: Biden fell off a bicycle near his Delaware beach home, moments after greeting reporters with a wave and a cheery “Good morning!” Asked what caused the fall, Biden said the “toe cages” on his bike got caught.28 September 2022: Biden sought out Jackie Walorski, an Indiana congresswoman who died in a car accident in the previous month, during a conference on food insecurity. Biden thanked other conference organisers then asked: “Jackie are you here? Where’s Jackie?” He later apologised.7 October 2022: Biden began an economy speech in Hagerstown, Maryland, by saying: “Let me start with two words: ‘Made in America.’”1 November 2022: At a campaign rally in Hallandale Beach, Florida, Biden blamed inflation on “a war in Iraq” when he meant Ukraine. In correcting himself, he made another mistake: “I think of Iraq because that’s where my son died” – in fact Beau Biden returned home in 2009 and died of brain cancer in the US in 2015.12 April 2023: During a visit to Ireland, Biden called New Zealand’s All Blacks rugby team the “Black and Tans”, which is the name of British recruits to the Irish military in the 1920s.21 May 2023: At the G7 conference in Japan, Biden said he has “spoken at length with President Loon of South Korea”, meaning the South Korean president, Yoon Suk Yeol.1 June 2023: Biden tripped and fell over a small black sandbag on stage at the US Air Force Academy graduation in Colorado Springs. He later quipped that he got “sandbagged”.8 June 2023: Biden referred to as British prime minister Rishi Sunak as “president”, then corrected himself with a joke: “I just promoted you.”16 June 2023: At a speech about gun safety in Connecticut, Biden closed with the baffling line: “God save the queen, man.”27 June 2023: Speaking about Nato’s support for Ukraine, Biden referred to Russia’s attacks as an “onslaught on Iraq”. He described the Indian prime minister, Narendra Modi, as the leader “of a little country that’s now the largest in the world, China”, before correcting himself.28 June 2023: Biden told reporters at the White House that Putin is “clearly losing the war in Iraq” when he meant to say Ukraine.10 September 2023: Biden was rambling mid-sentence in Hanoi when Karine Jean-Pierre, the White House press secretary, intervened and told reporters: “Thank you everybody, this ends the press conference.” Moments earlier, the president had quipped: “I don’t know about you, but I’m going to go to bed.”11 September 2023: During a speech marking the anniversary of the September 11, 2001 terrorist attacks, Biden told US troops in Alaska he remembered “standing there the next day” and looking at Ground Zero in New York. In fact Biden, then a senator, did not visit the site until nine days after the atrocity.26 September 2023: Biden briefly lost his footing while walking down the stairs of Air Force One after landing in Michigan. The Axios website reported that, to avoid such incidents, Biden was using a shorter stairway, wearing tennis shoes more often and working on his balance with a physical therapist.22 January 2024: At a White House meeting on reproductive health, Biden directed the audience’s attention to the health secretary, Xavier Becerra, “sitting” in the room. It was in fact the homeland security secretary, Alejandro Mayorkas.4 February 2024: At a campaign event in Las Vegas, Biden said: “I sat down and I said, ‘America is back.’ And Mitterrand, from Germany – I mean, from France looked at me …” He meant to say Emmanuel Macron.8 February 2024: Special counsel Robert Hur determined that Biden would not face criminal charges over his handling of highly classified documents but opined the president “would likely present himself to a jury, as he did during our interview of him, as a sympathetic, well-meaning, elderly man with a poor memory”. Responding to Hur’s report, Biden mixed up the presidents of Egypt and Mexico.11 February 2024: Biden passed up an interview in the Super Bowl pre-game show, a relatively new presidential tradition that offers an audience of tens of millions of people.13 June 2024: Biden stood very still during a Juneteenth musical performance at the White House, leading to speculation that he had “frozen”.18 June 2024: Biden seemed to temporarily forget the name of Mayorkas at an immigration event but managed to recover.27 June 2024: Biden was hoarse, lost his train of thought and stumbled through the first presidential debate against Trump. He later blamed a cold and jetlag. His campaign plunged into crisis as he faced questions over whether he should carry on.Charlie Sykes, a conservative political commentator, said: “What happened was the Democrats had created this alternative reality bubble in which Biden was fine. Millions of voters sat down on Thursday and they expected Joe Biden to come out strong, vigorous and really take it to this notoriously unprepared demagogue. Instead, what did they see? Joe Biden comes shuffling out and he’s incoherent, confused and often inaudible.“They were shocked by it but I guess the big question is, why should they have been so shocked? The answer is because they had been in a Biden bubble. We all talk about the alternative reality bubbles on the right but what we saw was the Democrats had created one of their own around this question of Joe Biden’s age and his fitness.” More

Fallout from Joe Biden’s disastrous debate performance last week continues to draw calls for health exams and clinical testing for the US president, and speculation.High-profile neurosurgeon Dr Sanjay Gupta called on Biden Friday to undergo neurological testing and release the results to the public, saying he and other brain specialists believe a detailed cognitive exam is warranted.“From a neurological standpoint, we were concerned with his confused rambling; sudden loss of concentration in the middle of a sentence; halting speech and absence of facial animation, resulting at times in a flat, open-mouthed expression,” Gupta wrote for CNN.Gupta qualified that his suggestion was based on “only observations, not in any way diagnostic of something deeper”. He continued that “the president should be encouraged to undergo detailed cognitive and movement disorder testing, and those results should be made available to the public”.Gupta’s article followed a recent New York Times story, based largely on anonymous sources, that people in contact with Biden reportedly had recently noticed the president making more factual errors and losing concentration.The same story raised the specter of Parkinson’s disease, although publicly available medical records show no evidence that the president has the disease. Parkinson’s is a neurodegenerative disease associated with a stiff gait, changes in motor skills and lack of facial expression. Some people also experience cognitive decline.The president’s primary care physician, Dr Kevin C O’Connor, told the New York Times that he observed “no findings which would be consistent with” Parkinson’s disease in his most recent physical of the president.The president’s most recent physician’s examination, from February, attributed his stiff gait to a healed foot fracture and peripheral neuropathy. Peripheral neuropathy is nerve damage that, in the president, resulted in a deficit in sensing hot and cold in his feet. O’Connor reported the president “continues to be fit for duty” with “no new concerns”.Biden’s age, 81, has been a locus of concern for voters. Those concerns were piqued by a debate performance that was widely considered jumbled and disjointed. Trump is only three years Biden’s junior, at 78.Notably, voters don’t particularly like either candidate. In a survey released by the Wall Street Journal two days after the debate, about half of voters said they were not enthusiastic about either candidate on the ticket and would like to replace them both.Biden and his team have defended his debate performance and batted back calls to step aside by saying the president had a cold and was tired after international travel. Biden told Democratic governors that he needed to listen to his team’s warnings about his schedule, and get more sleep.skip past newsletter promotionafter newsletter promotionGupta’s warning also draws on a tension in medicine that has been especially animated in the last two presidential administrations: between professionals’ “duty to warn” Americans about the fitness of their leaders and the potentially high degree of error inherent in “armchair” medicine.During the Trump administration, a group of psychiatrists authored a book warning that the former president could be perhaps dangerously mad and a narcissist. The warning prompted the American Psychological Association to reiterate its commitment to the “Goldwater rule” against “armchair psychiatry”.Cardiologists also questioned whether the former president was at risk of a heart attack because of high cholesterol levels reported by the White House physician, Dr Ronny L Jackson. At that time, Jackson reported the former president was in “excellent” cardiac health.Amid pronounced concerns about Biden’s age, Trump’s rally speeches have been criticized as rambling, bizarre, incoherent and fascistic. For instance, Trump once described Israel’s Iron Dome missile defense system as: “Ding, ding, ding, ding, ding, ding. They’ve only got 17 seconds to figure this whole thing out. Boom. OK. Missile launch. Whoosh. Boom.” Trump, like Biden, has lapsed when trying to recall specific facts. More