America’s Gerontocracy Needs a Public Physician

Aside from some brief written statements, the public has not heard directly from 84-year-old Senator Mitch McConnell since he fell at his home in Washington, D.C., and was taken away by an ambulance two months ago.

Why he fell, what has happened since, and how he’s doing now remain unclear.

His absence has inspired conspiracy theories, memes, and morbid speculation that a couple of awkwardly staged proof-of-life photos have done little to assuage.

If Americans are doubtful that McConnell will ever return to the Senate floor, it’s understandable: This is not the country’s first encounter with a frail or ailing representative.

Six elderly members of Congress have died just this term, and others have demonstrated mental decline.

Younger members have also had episodes of incapacity, as when Representative Tom Kean of New Jersey missed months of work this past spring while hospitalized for depression.

Our previous president suffered obvious but under-disclosed deterioration while in office; our current leader, who will leave office the oldest president we’ve ever had, is under constant scrutiny for signs of impairment .

Historically, our elected leaders have argued, for plenty of good reasons, that they are entitled to privacy regarding their health and discretion about when they leave.

Congressional norms tie power to seniority, which discourages early retirement; airing the health status of our leaders risks creating national-security concerns.

But letting politicians judge their own capacity to serve has simply not worked in the public’s interest.

I’m a physician—a geriatrician, in fact—and I know from countless encounters with frail, aging patients that many have difficulty admitting when their capacity has started to slip.

Many people struggle to recognize, too, when a new impairment means a permanent change in conditions, not just a temporary setback.

The United States needs a system to oversee its leaders’ fitness to serve.

Currently, no independent entity assesses and publicly reports on the health of the president or members of Congress.