Dr. David Macpherson: The president must step aside

Last week’s presidential debate left a very hollow feeling in my gut. I am a lifelong Democrat and have been an ardent supporter of President Biden. I believe he’s done a great job. But as much as I’d like to tout his past accomplishments, the focus must be on the future. What will Biden be like in a year? Or four? His performance during the debate seemed anything but presidential. He appeared a diminished old man.

As a retired physician I can’t help but wonder if we’re witnessing some type of neurodegenerative disease in the president. But physicians should never make armchair diagnoses — the president should be seen by a geriatrician or neurologist for further evaluation. Should these assessments prove negative, there’s nothing to celebrate.

We then would have to conclude that our president is simply aging and has lost reserve. Under stressful times his mind and body no longer can rise to the occasion. Sadly, there is no known way to reliably regain reserve. Further, we can anticipate more events like his debate performance as the years progress.

Those with diminished reserve certainly can rise on occasions (as the president did in the State of the Union address and the rallies post-debate). But he was unable to perform at an arguably more important event, the debate which he and Democratic leadership pushed for, hoping to show that he retains the vibrancy needed to be president. The image of him walking like a robot on stage and speaking gibberish cannot be tossed off as just a bad day.

I’ve also heard conjecture that he was given cold medication for his purported upper respiratory infection. While that may be true, his impaired cognition and stiff movements that may have resulted from the medication is another sign of diminished reserve. Normal adults function normally after taking cold medication.

These and other explanations represent denial with potentially catastrophic consequences. This was not simply a poor debate performance. His performance should be regarded as a strong signal of the years catching up with him, and much as we want, he cannot reliably return to his former vigor. The sooner the president decides to step aside, the sooner the nation can identify another leader capable of coherently denouncing the ridiculous lies former President Trump repeats.

Biden can step aside and retire as a patriotic hero and rest on his past record. If he refuses to step down now, I suspect polling numbers and contribution figures will suffer badly, and he’ll be forced to step down later, perhaps too late to identify and promote a worthy replacement. Worse, he will argue he can once again fight through the obstacles.

Sadly, these challenges, the challenges we all face as we age, are insurmountable. The years Biden has served as president have taken a severe toll on him. The trajectory of his functional decline seems steep, too steep to justify continuing to run for another term. His choice is to pass the baton now and depart a hero or attempt to cling to power and leave a loser whose own ego may jeopardize his past accomplishments and our future.

Dr. David Macpherson is a retired internal medicine physician living in Upper Burrell.