Tuesday, January 18, 2011

A Partial Defense of Ron Jr

In his new book, Ron Reagan Jr. makes some claims about what he believes were early signs of Alzheimer's disease seen in his father.  Generally speaking I have little respect for Ron Jr., and some of his claims warrant further inspection, but the vehement denials from some of the former President's allies also seem a bit overwrought.

Allahpundit cites this WaPo medical Q-and-A as evidence that Reagan did not have Alzheimer's while in office.  Read it and judge for yourself.  Here is a quote from it, bold added for emphasis:
Wallace, N.C.: Do you think that Ronald Reagan had Alzheimer's during his term as president?

David Shenk: Everyone wants to know that about Reagan, understandably. The short answer is no -- he did not have diagnosable Alzheimer's in the White House.

Alzheimer's is a progressive disease that creeps up very very slowly, and it was certainly creeping up on him during the late years of his Presidency. He knew that better than anyone, and joked frequently in speeches and with his White House doctors. But it's clear from looking at the evidence that his memory troubles in the White House were much too slight to be considered Alzheimer's.

I'd say that's at least a little ambiguous.

A few points pro and con-Ron Jr.--

Pro:
  • Family members can often know when something is wrong, even when others are not as perceptive.  Numerous times I was told that my grandfather "seemed fine" when he had been symptomatic for a while -- even after diagnosis.  And no, I don't think these individuals were all just being polite.
  • After consulting with a MD friend of mine, it is possible that a visual inspection of the brain as described in Ron Jr.'s book might have revealed hints of the disease, though certainly not a diagnosis. 
  • By the time Reagan was diagnosed in 1994 he was probably in the "moderate" stage of the disease given the motor deterioration evident in his handwritten letter. It is entirely reasonable to presume that pathological origin of the disease had begun during his Presidency.
  • Even if the disease had begun during his Presidency (as I feel was likely), there is little reason to doubt the sound judgment of President Reagan on policy matters in the earliest stages.  It's not like he was going to forget what the little red button did and accidentally nuke anybody, or do anything idiotic like try to take over health care.  We joke about Zombie Reagan coming back to restore conservatism, but in all seriousness I'll take a 95% capacity Reagan over a 110% capacity Obama.
  • Reagan had a significant cognitive reserve, and would have adapted and performed rather well during the early stages of the disease.
  • While many Americans are emotionally and ideologically attached to Reagan and his legacy, he was, after all, a mere human, subject to human ailments. We should be concerned with the historical facts, not political posturing.


Con:
  • Reagan was diagnosed in 1994. Ron Jr.'s claims of symptoms in President Reagan's first term are stretching the believable boundaries of perception of the disease.  Late second term sounds more reasonable to me.
  • Ron Jr. has already had to walk-back part of the story about the surgery to relieve pressure from his brain.  He initially claimed that Reagan was treated in San Diego, then later at the Mayo Clinic, but has revised his story to claim that the initial treatment for the fall happened in Tuscon, and the skull pressure treatment happened two months after the incident of being thrown from his horse.  
  • In revising his story, Ron Jr.'s initial account of "[opening] the President's skull" became "[burrowing] a hole".  This should diminish the likelihood that anything significant was seen.
  • Ron is an idiot with a book to sell.

My doc friend (-who is a Democrat, for what it's worth) called Ron Jr's story (as cited in the above-linked Salon article) "a mix of both plausible and less plausible elements..."  

That sounds about right to me.

1 comment:

Anonymous said...

How about the part where robin Williams did a stand up routine about how "there's something missing up there!" with many parallels to alzheimers *during* reagan's presidency?

Also, there's a large group of people who remember Reagan less-than-fondly. He is hated slightly less than Nixon by several members of this household, for example...

Mja