Health and Medical History of President

Joseph Biden

President #46: 2021-Present
Lived 1942-Now
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Health and Medical History of President

Joseph Biden

President #46: 2021-Present
Lived 1942-Now
Lived 1942-Now 2023 1776
Revolutionary War
1776-1783
War of 1812
1812-1815
Mexican-American War
1846-1848
Civil War
1861-1865
Spanish-American War
1898-1899
World War 1
1917-1918
World War 2
1941-1945
Korean War
1950-1953
Viet Nam War
1964-1975
Desert Storm
1990-1991
Bush's Wars
2001-2021

Maladies & Conditions  · Family history · Stutter · Exercise asthma · Asbestos exposure · Hair transplant · Cerebral aneurysm · Mirror aneurysm · DVT + pulmonary embolism · Cholecystectomy · Prostatic hypertrophy · Musculoskeletal injuries · Sleep apnea symptoms · Diverticulosis + adenoma · Non-melanoma skin cancer · Seasonal allergies and operations · Fractured foot · Atrial fibrillation · Elevated blood lipids · Gastroesophageal reflux · Root canal

Odds & Ends · Doctors · Resources · Cited Sources

Maladies and Conditions
Family history
Stutter
The anecdotes about Biden's stuttering in Cramer's wonderful book 1 paint a powerful picture of what Biden endured while growing up.
  • "Joe was kind of skinny, and he stuttered, and the kids called him Bye-Bye, for the way he sounded when he tried to say his name." 1a
  • "Joe did not stutter all the time. At home, he almost never stuttered. With his friends, seldom. But when he moved to Delaware, there were no friends. ... [When he] read in class: that's when it always hit -- always always always." 1b
  • "It wasn't quick, it took years. But he learned to game it out. He learned, always, to see himself in the situation to come, to think what he'd say, how he'd sound, what the other guy would say, and what the answer would be." 1c
  • "And in class, he read about Demosthenes, who made himself the greatest orator of his day by putting pebbles in his mouth and declaiming to the sea, above the roar of the waves. So Joey Biden, of Wilson Road, would stand outside at the wall of his house ... and with stones in his mouth, he'd try to read aloud." 1d
But it wasn't just his classmates who mocked him. Almost 70 years after the fact, in 2019, he recalls in an interview 2:
"The paragraph I had to read was: 'Sir Walter Raleigh was a gentleman. He laid his cloak upon the muddy road suh-suh-so the lady wouldn't soil her shoes when she entered the carriage," Biden tells me, slightly and unintentionally tripping up on the word so. "And I said, 'Sir Walter Raleigh was a gentle man who --' and then the nun said, 'Mr. Biden, what is that word?' And it was gentleman that she wanted me to say, not gentle man. And she said, 'Mr. Buh-Buh-Buh-Biden, what's that word?'"

Biden says he rose from his desk and left the classroom in protest, then walked home. The family story is that his mother, Jean, drove him back to school and confronted the nun with the made-for-TV phrase "You do that again, I'll knock your bonnet off your head!"

As he got older, the stinging did not vanish.
  • Although class president and an athlete in high school, he was nicknamed "Dash," referring not to his running speed, but instead: "It was like Morse code -- dot dot dot, dash dash dash dash ... even though by that time I started to overcome it." He was also called "Stutterhead" and "Stut." 2.
  • During the first presidential primary debate in 2020, Biden had a few episodes where his stuttering tripped him up (see below). "Fox News edited these moments into a mini montage. Stifling laughter, the host Steve Hilton narrated: 'As the right words struggled to make that perilous journey from Joe Biden's brain to Joe Biden's mouth, half the time he just seemed to give up with this somewhat tragic and limp admission of defeat.'" 2.
Biden's stuttering is not cured, as of 2019. He must still work to counter it. For example, when reading a speech, his staff will put marks in the teleprompter to help Biden control his vocalizations. To illustrate this technique, which England's King George V also used,
He pulls out a legal pad and begins drawing diagonal lines a few inches apart, as if diagramming invisible sentences: x words, breath, y words, breath. 2
The evidence of Biden's daily work against stuttering is subtle, but seems to be clearly visible to people who themselves stutter.
  • One speech pathologist, who stutters himself, "believes that Biden’s eye movements -- the blinks, the downward glances -- are part of his ongoing efforts to manage his stutter. 'As kids we figure out: Oh, if I move parts of my body not associated with the speech system, sometimes it helps me get through these blocks faster.'" (Eric S. Jackson, assistant professor of communicative sciences and disorders at New York University) 2
  • A communications coach based who stutters and is a friend of Biden's says: "I can’t say it’s a stutter" -- though he noted his friend's habit of abruptly changing directions mid-sentence. "I do hear those little pauses, but I really don’t hear the stuff that you would hear from me or I would hear from you." (Michael Sheehan, who has coached Bill Clinton) 2
  • The author of 2, who also stutters, writes: "In addition to periodically stuttering or blocking on certain sounds, he appears to intentionally not stutter by switching to an alternative word -- a technique called 'circumlocutio' -- which can yield mangled syntax."
  • "During a town hall in August [2019] Biden briefly blocked on Obama, before quickly subbing in my boss. The headlines after the event? 'Biden Forgets Obama's Name.'"
Biden believes that, utlimately, stuttering has been good for him: "Stuttering gave me an insight I don't think I ever would have had into other people’s pain." 2

Twin studies have shown that genetics contributes 70% to 80% of the risk for stuttering, vs. 20% to 30% for environment 3 4 5. Biden's brother Frank stutters 6, and his maternal uncle "stuttered, hard" 1e -- all his life -- and was known as "Uncle Boo-Boo" 2.

Exercise asthma
During his teenage and young adult years, Biden had exercise-induced asthma. In 2019 his chest x-ray was normal and he was said to have "no lung disease at all" except for a tendency to have bronchospasm during upper respiratory illnesses. 7
Asbestos exposure
In the early 1970s Biden did work on his house that involved weeks in the basement, "in a moon suit, ripping out asbestos" 1f.
Hair transplant
1f.
Cerebral aneurysm
Biden developed a headache and nausea while making a campaign speech in Nashua, NH during his 1988 run for the presidency. He left the speaking podium mid-speech and went to a bathroom where the headache became almost unbearably intense and he dry-heaved. After some minutes, he returned to the podium and completed the speech, though not in his best form. 1g (This must have been before Sept. 1987, when he ended his campaign.)

Some time in early 1988, Biden was "working out on a shoulder press weight machine in the Senate gym when a pain shot through his neck. On the train home to Wilmington, Del., the neck pain returned more severely. His head ached. The right side of his body went numb. A doctor later diagnosed a pinched nerve, and a pain clinic prescribed a neck brace." 8 (In retrospect, this was likely another early symptom of the leaking aneurysm.)

On Feb. 10, 1988, in his hotel room after a campaign appearance in Rochester, NY, Biden suffered a classic "thunderclap headache:" the sudden onset of indescribably severe pain. He lost consciousness (for 5 hours 8), but recovered and went to the bathroom where he again experienced dry heaving before falling asleep for the night. Returning home to Delaware with difficulty the next day, he continued to have pain, but believed he could catch his scheduled afternoon flight. He was convinced to go to the hospital (St. Francis, Wilmington, DE), where a spinal tap disclosed blood in his spinal fluid -- a clear sign of a bleeding in the brain. 1h

Too fragile for a helicopter ride (plus it was too snowy), he was driven by ambulance to Walter Reed Hospital in Washington, though not without getting lost. By dawn the next day he was in the ICU. An angiogram showed an aneurysm in the left side of the brain -- the side that controls speech. Given a 50-50 chance of survival, and the last rights, Dr. Eugene George then operated on him for nine hours. The aneurysm ruptured "the moment they cut into Biden's head." Luckily, the blood jeted toward the wall of his skull, not into his brain. By the next morning, Biden told a staffer, "I'm gonna be all right" 1i. However, his post-operative course was complicated by serious blood clots.

The left side of the brain also controls almost all movements of the right side of the body. After the operation, Biden's right upper eyelid drooped and the right side of his forehead was immobile. Six weeks after the operation, "the muscles in his forehead and cheek began to work again." 9 Biden was away from work (the Senate) for seven months 8.

Biden had ended his presidential campaign in September 1987. Family members believed that he would have died had he still been a candidate on the following Feb. 10 -- because he would have undoubtedly refused to leave the campaign trail and get medical attention 1i.

Mirror aneurysm
Three months after his near-catastrophic brain aneurysm, Biden underwent surgery for a second aneurysm, on May 4, 1988. Unlike the first one, this aneurysm was on the right side of the brain 10 -- a so-called "mirror aneurysm" to the first 1j. This second aneurysm had not bled 7 and was "much smaller" than the first 10. The procedure took 4.5 hours and resulted in a hospital stay of about 10 days 10.

No aneurysm has "recurred" since this operation, as demonstrated most recently by a CT angiogram in 2014 7. (This statement, however, is ambiguous regarding the development of any new aneurysm.)

The procedures on Biden's cerebral arteries left metallic clips in place 10. It is therefore unsafe for him to undergo an MRI scan, as the intense magnetic field of the MRI could tug on the clips, with potentially serious consequences.

DVT + pulmonary embolism
After his February 1988 aneurysm operation, Biden developed a deep vein thrombosis (blood clot) in a leg, which led to a pulmonary embolism (blood clot in the lungs) 8. This is a potentially fatal disorder.

An evaluation for clotting disorders was negative, so the clots were ascribed to his immobility after the operation -- an unfortunately common complication of surgery. He was treated with oral anti-coagulant medication for "several months," and a filter was placed into his inferior vena cava. 7. (Placing the filter seems to be the "third operation" Cramer refers to 1j.)

Comment: Because medical science has discovered new clotting disorders since 1988, it is eminently possible that re-evaluating Biden would today disclose a diagnosable clotting disorder. In some sense, however, it doesn't matter, because Biden is now taking an anti-coagulatant medication (for his atrial fibrillation) and this would likely be the treatment for any hyper-clotting disorder found.
Comment: Because of the seriousness of a pulmonary embolism, it was common practice in PE patients in the 1980s to insert a vena caval filter to prevent recurrences. Unfortunately, these devices themselves turned out to cause complications, hence they are used much less frequently now.

Cholecystectomy
Gallbladder removed 2003, for reasons unstated 7.
Prostatic hypertrophy
Sometime before 2008, Biden developed an enlarged prostate; biopsy showed no cancer 8. At an unspecified time before 2019, he took medication to counter what was diagnosed as benign prostatic hypertrophy (BPH). Eventually he was "definitively treated with surgery." He has never had cancer of the prostate. 7
Musculoskeletal injuries
For various "sports medicine and orthopedic injuries," Biden has undergone "multiple physical therapy treatments and surgeries." 7
Sleep apnea symptoms
Biden's physician wrote, in 2019: "Obstructive sleep apena (OSA) has been considered, but his symptoms have improved significantly after his sinus and nasal passage surgeries." 7 Comment: Though not explicitly stated, this sentence implies that Biden had symptoms of sleep apnea and that they were significant (because his symptoms could not otherwise have improved "significantly"). At best, the symptoms would have been snoring and nothing else. More substantially, he could have been sleepy or mentally dulled. Atrial fibrillation can also be caused by sleep apnea. The physician's sentence additionally implies that he was not formally tested for the disorder.

Biden fell asleep during President Obama's speech on debt reduction, on April 14, 2011. 11

Diverticulosis + adenoma
Biden had mild diverticulosis discovered during a routine screening colonoscopy at an unspecified date. A 2008 colonoscopy disclosed a single non-cancerous tubular adenoma, with no recurrence in later colonoscopies. 7 Comment: Biden has never had colon cancer, but a tubular adenoma is a step toward colon cancer, hence the physician's explicit statement about no recurrence.
Non-melanoma skin cancer
He has had "several localized, non-melanoma skin cancers" completely excised by Mohs surgery, with clear margins, and receives "close dermatologic surveillance." Skin examination in 2019 showed "several areas of lentigo and actinic changes." Biden spent a great deal of time in the sun in youth. 7
Seasonal allergies and operations
Biden has had "seasonal allergies and sinus congestion for most of his life," leading to "several" operations on his "sinus and nasal passages" at unspecified dates. These operations improved his symptoms, but he still uses two over-the-counter medications: fluticasone/azelastine (Dymist) and fexofenadine (Allegra). 7
Fractured foot
In playing with one of his dogs on Nov. 28, 2020 (the Saturday after Thanksgiving) 12, Biden incurred "hairline fractures" in one of his feet. Sources did not report which foot. His physician reported that fractures in the "lateral and intermediate cuneiform bones, which are in the midfoot," were diagnosed by CT scan after plain X-ray films failed to show a break. The fractures would "likely require a walking boot for several weeks." 12 13 14

Illustrating the power of the presidency, Biden was not only able to get an appointment with an orthopedist the next day, a Sunday, but the consultation lasted two hours. 12 13 14

Atrial fibrillation
Atrial fibrillation, which is an abnormal rhythym of the heart, was unexpectedly discovered during a routine pre-operative electrocardiogram at the time of Biden's gall bladder removal in 2003. He is said to be completely asymptomatic from this rhythm, never requiring an electrical intervention nor medication to control the rate of the ventricle. 7

At first intermittent, as of 2019 his heart rhythm was "persistent (more constant) a-fib, with a normal ventricular response." Physical exam in 2019 showed an irregularly irregular heart rate of 72 beats per minute. An echocardiogram circa 2019 showed normal contractility of his left ventricle. 7 Comment: This much-abbreviated report of the echocardiogram omits the size of the left atrium, which is an important prognostic factor in atrial fibrillation.

Because of the risk of blood clots associated with atrial fibrillation, Biden takes an oral anticoagulant medication: apixaban (Eliquis). 7

Elevated blood lipids
At some point before 2008 Biden began taking a "statin" type of cholesterol-lowering drug 8. His lipid levels that year were: total cholesterol = 173 mg/dl; HDL cholesterol = 47 mg/dl; LDL cholesterol = 98 mg/dl; triglycerides = 133 mg/dl 8.

By December 2019, he was taking rosuvastatin (Crestor), the dose being unspecified. His lipid levels that month were: total cholesterol = 126 mg/dl; HDL cholesterol = 26 mg/dl; LDL cholesterol = 69 mg/dl; VLDL cholesterol = 21 mg/dl; triglycerides = 106 mg/dl. His cardiac C-reactive protein was 0.29 mg/L and homocysteine = 12.1 µmol/L. 7

Gastroesophageal reflux
Biden takes an over-the-counter medication, esomeprazole (Nexium), for symptoms of gastroesophageal reflux disease (GERD). His primary symptom is an "occastional" need to "clear his throat more often." It is unclear whether occasional cough and sinus congestion are also symptoms of GERD. 7

The main risk of GERD is cancer of the lower esophagus -- because years and years of stomach acid washing over this area can change the tissue from normal to abnormal and then to cancer. Biden has, at some unspecified time, had endoscopy to look at his lower esophagus. The December 2019 note from his physician implies that nothing serious was found, but (a) this is imprecise, and (b) the note does not actually say that nothing serious was found. 7

Root canal
On June 11, 2023 Biden identified that he was experiencing pain related to his lower right premolar (tooth 29). Dentists at Walter Reed saw him on the 12th, took x-rays, and performed a root canal over two days, initially at Walter Reed, and then at the White House the next day. 15

Biden was not placed under general anesthesia, and the 25th Amendment was not invoked. The White House basement has a dental facility. 16

Odds and Ends
Doctors
Resources
Cited Sources
  1. Cramer, Richard Ben. What It Takes: The Way to the White House. New York: Random House, 1992.
    a  p.252  b  pp.301-302  c  p.304  d  p.306  e  p.265  f  p.249  g  pp.371-373  h  pp.905-907  i  pp.907-910  j  p.1036

    Comment: This book -- an immersive biography of six contenders for the 1988 Presidential election -- is simply tremendous. One thousand pages, and you really don't want it to end. Makes it clear that success or failure in running for President ultimately rests on the personality of the candidate. The victor in this particular campaign, Bush41, was at all times willing to do "what it takes" to win the Presidency. There is no better book to discover what makes people at this level tick.

  2. Hendrickson, John. What Joe Biden Can't Bring Himself to Say. The Atlantic. 2020; Jan./Feb..   Available on the web at: https://www.theatlantic.com/magazine/archive/2020/01/joe-biden-stutter-profile/602401/

    Comment: Essential reading to understand Biden's stuttering.

  3. Corrado Fagnani, Steen Fibiger, Axel Skytthe, Jacob V. B. Hjelmborg. Heritability and environmental effects for self-reported periods with stuttering: A twin study from Denmark. Logopedics Phoniatrics Vocology. 2011; 36: 114-120. DOI: https://doi.org/10.3109/14015439.2010.534503
  4. Rautakoski P, Hannus T, Simberg S, Sandnabba NK, Santtila P. Genetic and environmental effects on stuttering: A twin study from Finland. Journal of Fluency Disorders. 2012; 37: 202-210. DOI: https://doi.org/10.1016/j.jfludis.2011.12.003
  5. Kraft SJ, Yairi E. Genetic Bases of Stuttering: The State of the Art, 2011. Folia Phoniatrica Logopaedica. 2012; 64: 34-47. DOI: https://doi.org/10.1159/000331073
  6. Parry, Ryan; Butterfield, Alan; Boswell, Josh. Joe Biden's brother Frank owes dead man's family $1 MILLION for 80mph car crash -- but has never paid a cent in 20 years and the Democratic candidate did NOTHING to help. (Published 6 Feb. 2020. Downloaded on 2021-01-23.) Available on the web: https://www.dailymail.co.uk/news/article-7908559/Joe-Bidens-brother-Frank-owes-1-million-dead-mans-family-2020-Democrat-did-help.html
  7. O'Connor, Kevin C. [Report of Joseph Biden's medical history and physical examination]. (Published 15 Dec. 2019. Downloaded on 2021-01-18.) Available on the web: https://go.joebiden.com/page/-/CiU2iAa4Ig_%20j5EQzueoad.pdf

    Comment: Screen shots are archived here: MORE

  8. Altman, Lawrence K. Many Holes in Disclosure of Nominees' Health. New York Times. Oct. 19, 2008.   Available on the web at: https://www.nytimes.com/2008/10/20/us/politics/20health.html
  9. Newman, Meredith. What Joe Biden learned from his life- threatening brain aneurysms. (Published Mar. 18, 2019 (updated Aug. 14, 2020). Downloaded on 2021-01-23.) Available on the web: https://www.delawareonline.com/story/news/politics/joe-biden/2019/03/18/joe-biden-2020-how-then-senator-overcame-life-threatening-brain-aneurysms/3002961002/
  10. Associated Press. Biden Resting After Surgery For Second Brain Aneurysm. New York Times. May 4, 1988.   Available on the web at: https://www.nytimes.com/1988/05/04/us/biden-resting-after-surgery-for-second-brain-aneurysm.html
  11. Allen, Jane E. A snoozing VP and sleeping air traffic controllers suggest we're dangerously sleep deprived. (Published April 14, 2011. Downloaded on 2023-08-13.) Available on the web: https://abcnews.go.com/Health/Sleep/napping-nation/story?id=13378488
  12. Karnie, Annie. Biden's doctor says he has hairline fractures after twisting his ankle playing with his dog. (Published 29 Nov. 2020 (updated 30 Nov.). Downloaded on 2021-01-23.) Available on the web: https://www.nytimes.com/2020/11/29/us/politics/biden-ankle-sprain.html
  13. Associated Press. Doctor says Biden fractured foot while playing with his dog. (Published November 29, 2020 8:31 pm. Downloaded on 2021-01-23.) Available on the web: https://www.newsday.com/news/nation/biden-sprain-foot-dog-1.50077873
  14. Grindley, Stephanie. President-elect Joe Biden suffers hairline fractures after fall on Sunday. (Published 29 Nov. 2020 (updated 30 Nov.). Downloaded on 2021-01-23.) Available on the web: https://www.wtrf.com/top-stories/president-elect-joe-biden-suffers-hairline-fractures-after-fall-on-sunday/
  15. O'Connor, Kevin C. President Biden's current dental work. (Published 12 June 2023. Downloaded on 2023-06-16.) Available on the web: https://www.whitehouse.gov/wp-content/uploads/2023/06/Letter-6.12.pdf

    Comment: Screen shot is archived here: MORE

  16. Ward, Myah. The tooth is out there: Biden gets a root canal. (Published 12 June 2023. Downloaded on 2023-06-16.) Available on the web: https://www.politico.com/news/2023/06/12/joe-biden-root-canal-00101523
Other Sources
Pubmed Search   (0 matches when checked in March 2013)

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