At a rally in Cleveland on Monday, presidential nominee Hillary Clinton coughed several times. She reached under the podium and grabbed a glass of water, excusing the cough as a consequence of having talked so much. When the cough didn’t immediately go away, she laughed it off as an allergy to thinking about Donald Trump. The episode lasted around 20 seconds.
NBC published the clip of Clinton coughing as a Labor Day news story, under the headline “Hillary Clinton Fights Back Coughing Attack.” From there, conservative pundits took a hard turn into the shadows. Matt Drudge emblazoned the top of his still tremendously popular blog: “GETTING WORSE: CLINTON COUGH VIOLENTLY RETURNS. HEALTH STATUS UP IN THE AIR.”
The coughing spell played into a narrative that Drudge and some other media outlets have attempted to construct—and conservative politicians like Rudy Giuliani have encouraged—in which Clinton is physically unfit for the presidency. This morning, Drudge links to an article wherein “10 Prominent Doctors Question Hillary Clinton’s Health.”
Among doctors there is sometimes an inverse relationship between prominence and credibility. At Fox News, physicians can become prominent by fueling conservative narratives like the one where Clinton is covertly unwell. Their medical correspondent Marc Siegel raised ardent concerns about Clinton’s blood: “In 2012, she has a severe concussion … then she ends up with a blood-clot in the brain, she’s on a lifetime of blood thinners. If she’s prone to falling … guess what, if she falls and hits her head? She’ll get a blood clot on her brain.”
Of course, when a person falls while taking blood thinners, they’re not as likely to suffer a clot as a hemorrhage. And either would be unlikely. Among the least relevant considerations in an election year might be “How well would this candidate fare after a blow to the head?”
In Clinton’s case, though, she has a documented medical history of faring well. To prevent further blood clots, her physician, Lisa Bardack, writes that Clinton still takes the blood-thinning medication coumadin (along with more than 25 million other Americans). And after the incident, she did temporarily require special eyeglasses that included a type of lens called a Fresnel prism. (This prism is still today fodder for implication of conspiracy, including from television personality Drew “Dr. Drew” Pinsky just last week: “When she hit her head, she had to wear these prism glasses when she came out …. That is brain damage, and it’s affecting her balance. Now clearly, it hasn’t affected her cognition, but tell us a little more about that. That’s profound.”)
Having a blood clot in a vein adjacent to one’s brain can be significant, of course. Or it can dissolve (as Clinton’s has, according to Bardack), and the person can continue serving as Secretary of State. The Clinton campaign has indicated it will not be releasing further medical documentation, and the coughing episode yesterday was the result of allergies. That—or an upper respiratory virus—would be the vast statistical likelihood for any person coughing. Clinton also has a documented history of a pollen allergy and, as NBC notes, “Allergens were high in Northeast Ohio on Monday, according to pollen.com.”
Special attention may have been warranted if Clinton had lost consciousness during the spell, if she had coughed blood onto the podium, or if she had coughed to the point of becoming so lightheaded that she suggested Mexico will fund construction of a tremendous wall along our southern border.
I don’t say that lightly, but to make the point that a candidate’s health is relevant only insofar as it might influence or allude to their ability to govern. If there were reason to discuss Clinton’s cough, it would traditionally be as a story of resolution and determination—a public servant who refuses to be sidelined by some infirmity. Bob Dole persevered despite paralysis of his arm and hand to earn the Republican nomination in 1996. Ronald Reagan was praised for his resilience and re-elected to the presidency after a gunshot wound left him with an area of dead tissue and blood in his left lung that he had to forcibly cough out. And at another end of the coughing hero narrative, the fact that Michael Jordan played through “the flu” in 1997 turned a standard 38-point performance into one of the most legendary games in his career. (He later said, “I was scared; I didn’t know what was happening to me. … I felt partially paralyzed.”)
If constituents are sincerely concerned about the health of these candidates, then it’s worthwhile to remember that Donald Trump has shared only a bizarre bit of support from a gastroenterologist in duress, while Clinton has shared a moderately thorough medical appraisal. Both were largely subjective, but we have more hard evidence about Clinton than Trump. In The New York Times, Robert Lahita, professor of medicine at Rutgers University, suggested recently that these doctors may, under such circumstances, lack objectivity: “I don’t want to say that they’re coerced into saying that they’re in good shape, but I think it would be much fairer to their personal physicians if their medical data were available to a neutral panel of physicians, a bipartisan panel who could review their data.”
That might be good. At the same time, other physicians will say that data analysis gives an incomplete picture. There is no way to assess a person’s health without an ongoing, face-to-face patient-doctor relationship, and the most valuable information is a good doctor’s analysis.
As an outside observer, what would be concerning is a person who never coughs. And what is concerning is the standard through which this cough, in this particular person, is read as weakness.