When An American President "Loses It”

When A President "Loses It”

By: James F. Toole, M.D.
Cerebrum, Dana Foundation, 1998

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It has happened, of course—and not infrequently. Just in this century, American presidents who continued to serve in office while seriously neurologically impaired include Woodrow Wilson, Franklin D. Roosevelt, and Dwight D. Eisenhower. In the first two, there is a credible historical case that the results were catastrophic on a world scale. But the real question is: Could it happen again?...

Once officials are elected or appointed, there is no legal requirement for periodic physical, mental, or behavioral examinations while they are serving in office. When the average life span was 60 years, senility was a less common problem. Now, with the graying of America (and soon the world), devastating neurological diseases and other conditions have a much greater likelihood of wreaking havoc on an individual’s mental functioning. Isn’t it time for the law to require health examinations, and public revelation of the results, before election and periodically thereafter while an individual is serving in office—just as there are legal protections of the public in other areas of society? After all, we have laws governing the packaging of foods, construction of automobiles, and periodic inspection for continuing registration and licensing of vehicles and drivers. Why don’t we have similar requirements for public officials (as we have already for aviators)? Unfortunately action is stalled, in part because it contravenes traditions of confidentiality in matters relating to health. Society desperately needs correction of this Achilles’ heel before it is too late.


THE TWENTY-FIFTH AMENDMENT
Why does our nation tolerate this appallingly dangerous flaw in our system? Can there be any brake on this unregulated system— or must we live in danger of catastrophe? A first step was taken in 1965, when Senator Birch Bayh proposed an amement to the U.S. Constitution. On February 10, 1967, Article 25 was ratified by a sufficient number of state legislatures. In it, succession is clearly defined in cases of removal of the president from office by death or resignation. The vice president shall become president, as happened when President Richard M. Nixon was replaced by Vice President Gerald R. Ford.

Section 2 is equally clear on succession to the office of the vice president, as occurred when Ford was appointed vice president after the resignation of Spiro T. Agnew.

Section 3 is straightforward. If the president voluntarily submits a written statement that he is unable to discharge the powers and duties of his office, they shall be discharged by the vice president as acting president until the president submits another document stating that he has recovered. This sequence occurred when President Reagan transferred power to Vice President George Bush in anticipation of undergoing general anesthesia for colon surgery and then resumed office immediately thereafter.

In Section 4, however, there seems the potential for a serious dilemma:

Whenever the vice-president and a majority of either the principal officers of the executive department or of such other body as Congress may by law provide, transmit to the president pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the president is unable to discharge the powers and duties of his office, the vice president shall immediately assume the powers and duties of the office as acting president.

What is the mechanism for determining that the president is unable to serve? How does one inform the president that he is not capable of performing in office? Judging from past experience, it would require the most extreme conditions for the vice president or members of the cabinet to remove their leader. They have a built-in political incentive to maintain the status quo because, if the president is removed, the cabinet that serves him may be replaced as well. Furthermore, these officials are not medical professionals and so cannot have full insight into the dangers of having a mentally impaired leader.

There is an even greater problem in implementation of the next part of Section 4. It states:

Thereafter, when the president transmits to the president pro tempore of the Senate and the Speaker of the House of Representatives his written declaration that no disability exists, he shall resume the powers and duties of his office unless the vice-president and a majority of either the principal officers of the executive department or of any such body as Congress may by law provide, transmit within four days to the president pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the president is unable to discharge the powers and duties of his office. Thereupon Congress shall decide the issue, assembling within 48 hours for that purpose if not in session.

These two clauses conceal potential stumbling blocks. Together, they could enable a cognitively impaired President who lacked insight into his mental deficiency to obstruct governmental procedures for removal from office (or to resume office), despite persistent deficits. Only a specially trained physician has the skills to determine the presence, treatment, and prognosis for neurologic and psychiatric disease.

Learn about the astonishing, complex brain.

FREE Review Copy: Stress, Trauma and Gay Youth

New!

Healing the Brain: Stress, Trauma and LGBT/Q Youth

CONTACT: A Thousand Moms,

2367 Curry Road, Schenectady NY 12303

518 952-1257; athousandmoms@yahoo.com

Available on Amazon.com

And at www.HealingTheBrainBooks.com

(Includes video), 172 pp, illustrated, 8 1/2 x 11

From the author of the acclaimed Dana Sourcebook

of Brain Science, an easy-to-read layman’s guide to understanding the brain and health.  Praise for Healing the Brain:

Click for e-book, PDF format

Purchase directly (paperback or Kindle) at Amazon.com or www.HealingTheBrainBooks.com

“Well researched, fleshed out with relevant case histories, this book packs a lot of solid information into its 152 pages. Written in an engaging style for the layman, it covers a wide range of topics. One learns a great deal about the biology of stress, particularly the vulnerability of the brain in the pre-adult years. This book also provides a glossary of key brain science terms and a listing of organizations serving the LGBT /Q community and resources on the brain. Brief summaries of Erik Erickson's Stages of Development and Abraham Maslow's 12 Characteristics of a Self-Actualized Person lead into a detailed examination of the brain's structure and functions. Although the basic wiring structure is present at birth, there are several critical stages of brain development. Nurture, experience and stimulation are essential to proper brain growth and to the fine tuning of its communications structure. Notably, PTSD is not just an issue for veterans, but can also develop in children and teens who are going through a traumatic situation such as child abuse.”--Gary Bordzuk, Librarian, Rockville, NY

“David Balog takes a subject fraught with difficulty and makes it simple and accessible to everyone. The book goes a long way in helping one understand how and why and in what ways stress affects how we live and cope. Invaluable.”--Jessica Watson-Crosby, former president, National Association of Former Foster Children

“...[A] book for educators (or anyone working with youth) that explains the complicated workings of the brain in an easy-to-understand manner. The author goes on to discuss various types of trauma and how the adolescent brain responds to trauma such as depression, stress, addiction, risk taking, PTSD, etc. LGBT/Q youth may experience….I highly recommend this book!--Carol Dopp, M.Ed.

"An invaluable resource for those working in the trenches with LGBTQ youth in foster/adoptive care but equally important serves as a primer for those in the community at large who are largely unaware of this subset in our population who are in such desperate need!"--Dr. Ray Werking, professor, GLSEN educator and host, WRPI Radio

“David Balog understands the strain of alienation, so he tackles this subject with compassion and concern. Mr. Balog draws on his knowledge of brain science to give readers insight into what happens to young people under tremendous stress….”--Gary L. Cottle, author

“Easy to read. Difficult to put down.”--Micheal J. Colucciello, Jr., NY State pharmaceutical researcher, retired.

Also available in the series: Addiction; Development; Domestic Violence and TBI; Memory; Fetal Alcohol Spectrum Disorders; Stress & Money.

Purchase directly (paperback or Kindle) at Amazon.com or www.HealingTheBrainBooks.com

Free e-book: Concussions, CTE and Football

From the Introduction:

When You Watch Your Next Football Game...

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From high school to college to professional levels, football dominates American sports and exposes millions to head traumas on practically every play.

It is a paradox of wide proportions. From opening day in September to the Super Bowl in February, the National Football League (NFL) dominates American sports and wins television ratings far beyond any other program--sports or otherwise.

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Increasingly, though, discussions of football (and other sports) include the medical terms concussion and chronic traumatic encephalopathy (CTE), a long-term degenerative and incurable brain disease. Although military personnel and others are vulnerable to the disease, the highest risk is among athletes involved in contact sports in which hits to the head are considered “part of the game.”

Ten years ago, few would have predicted that the movie “Concussion” starring Will Smith would be made. Fewer would have predicted that brain injuries would one day dominate the sports headlines. When former NFL star Junior Seau committed suicide in May 2012, the media focused almost entirely on whether the thousands of head blows he endured during his 19-year career as a middle linebacker were a contributing factor.

More than 3,000 former NFL players sued the league for allegedly misleading them about the risks of brain injury. The players and the league settled for more than $1 billion in damages. New policies and studies aimed at protecting the brains of athletes seem to be announced every week. But it’s not just professional athletes who are the focus of attention. No fewer than 40 states have passed laws requiring athletes in schools and recreational programs to schedule a doctor’s appointment when a concussion is suspected.

A progressive, degenerative brain disease, CTE can present itself  in athletes and others with a history of repetitive brain trauma months, years, or even decades after injury. Memory loss, confusion, depression, aggression, impaired judgment or impulse control, and, eventually, progressive dementia may result.

With this increasing awareness about the dangers of concussion, parents face tough choices about which sports their children should be allowed to play. Some of the more

New rules have since been designed to lessen brain trauma; but with every new horror story that emerges on the sports pages, parents worry even more.

dangerous sports for the brain, such as football, soccer, ice hockey, and lacrosse, are also the most popular. Although everyone agrees that brain trauma may have lasting and debilitating effects, and science continues to make slow progress toward understanding the disease, we cannot yet entirely quantify those effects. As a result, parents and even medical professionals are left to search their hearts and scour Web sites for answers. But a decade’s worth of research has made one thing clear: We need to find better ways to protect the brains of athletes.

Difficult to Measure

Concussions suffer from a perception problem. On the surface, they might not seem to have a lasting, serious impact. (In fact, sports programs and commentators continue to celebrate the most impactful “hits,” using euphemisms such as “getting your bell rung.”) They are an invisible injury: There is no blood, there are no displaced bones, and the patient rarely complains. Even when an athlete is knocked unconscious and observers react with panic, the concern quickly fades. Ninety-nine percent of concussed athletes wake up in seconds or minutes and then seem fine. When symptoms persist beyond the day of injury, in the vast majority of cases they dissipate within a month. The injury seems as if it is gone forever, leaving no scars or overt indication that it ever happened.

Children at Risk

Most brain trauma in the industrialized world occurs in children playing sports. Since participation is voluntary, and the rules of recreational sports are malleable, it seems reasonable to make every effort to reform each individual sport....

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Foods to prevent obesity, Alzheimer's, stroke

Source: Penn State

Summary:

The reason why some people find it so hard to resist finishing an entire bag of chips or bowl of candy may lie with how their brain responds to food rewards, according to researchers who found that when certain regions of the brain reacted more strongly to being rewarded with food than being rewarded with money, those people were more likely to overeat.

 Learn about your brain and food.    

FULL STORY

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The reason why some people find it so hard to resist finishing an entire bag of chips or bowl of candy may lie with how their brain responds to food rewards, leaving them more vulnerable to overeating.

In a study with children, researchers found that when certain regions of the brain reacted more strongly to being rewarded with food than being rewarded with money, those children were more likely to overeat, even when the child wasn't hungry and regardless of if they were overweight or not.

Shana Adise, a postdoctoral fellow at the University of Vermont who led the study while earning her doctorate at Penn State, said the results give insight into why some people may be more prone to overeating than others. The findings may also give clues on how to help prevent obesity at a younger age.

"If we can learn more about how the brain responds to food and how that relates to what you eat, maybe we can learn how to change those responses and behavior," Adise said. "This also makes children an interesting population to work with, because if we can stop overeating and obesity at an earlier age, that could be really beneficial."

"Until we know the root cause of overeating and other food-related behaviors, it's hard to give good advice on fixing those behaviors," Keller said. "Once patterns take over and you overeat for a long time, it becomes more difficult to break those habits. Ideally, we'd like to prevent them from becoming habits in the first place."

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Story Source:

Materials provided by Penn State

How Quitting Smoking Improves Your Health

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Quitting smoking can help most of the major parts of your body: from your brain to your DNA.

 Brain

Broken Addiction Cycle

Quitting smoking can re-wire your brain and help break the cycle of addiction. The large number of nicotine receptors in your brain will return to normal levels after about a month of being quit.

Head and Face

Sharp Hearing

Quitting smoking will keep your hearing sharp. Remember, even mild hearing loss can cause problems (like not hearing directions correctly and doing a task wrong).

Better Vision

Quitting smoking will improve your night vision and help preserve your overall vision by stopping the damage that smoking does to your eyes.

Clean Mouth

Nobody likes a dirty mouth. After a few days without cigarettes, your smile will be brighter. Quitting smoking now will keep your mouth healthy for years to come.

Clear Skin

Quitting smoking is better than anti-aging lotion. Quitting can help clear up blemishes and protect your skin from premature aging and wrinkling.

Heart

Decreased Heart Risks

Smoking is the leading cause of heart attacks and heart disease. But many of these heart risks can be reversed simply by quitting smoking. Quitting can lower your blood pressure and heart rate almost immediately. Your risk of a heart attack declines within 24 hours.

Thin Blood

When you quit smoking, your blood will become thinner and less likely to form dangerous blood clots. Your heart will also have less work to do, because it will be able to move the blood around your body more easily.

Lower Cholesterol

Quitting smoking will not get rid of the fatty deposits that are already there. But it will lower the levels of cholesterol and fats circulating in your blood, which will help to slow the buildup of new fatty deposits in your arteries.

Learn about your brain and addiction.

Lungs

Stop Lung Damage

Scarring of the lungs is not reversible. That is why it is important to quit smoking before you do permanent damage to your lungs. Within two weeks of quitting, you might notice it’s easier to walk up the stairs because you may be less short of breath. Don’t wait until later; quit today!

Prevent Emphysema

There is no cure for emphysema. But quitting when you are young, before you have done years of damage to the delicate air sacs in your lungs, will help protect you from developing emphysema later.

Return of Cilia

Cilia (The fine hairlike projections from certain cells such as those in the respiratory tract that sweep in unison and help to sweep away fluids and particles) start to regrow and regain normal function very quickly after you quit smoking. They are one of the first things in your body to heal. People sometimes notice that they cough more than usual when they first quit smoking. This is a sign that the cilia are coming back to life. But you’re more likely to fight off colds and infections when you’re cilia are working properly.

DNA

Lower Cancer Risk

Quitting smoking will prevent new DNA damage from happening and can even help repair the damage that has already been done. Quitting smoking immediately is the best way to lower your risk of getting cancer.

Stomach and Hormones

Smaller Belly

Quitting smoking will reduce your belly fat and lower your risk of diabetes. If you already have diabetes, quitting can help you keep your blood sugar levels in check.

Normal Estrogen Levels

If you’re a woman, your estrogen levels will gradually return to normal after you quit smoking. And if you hope to have children someday, quitting smoking right now will increase your chances of a healthy pregnancy in the future.

Erectile Dysfunction

Sexual Healing

If you quit smoking now, you can lower your chances of erectile dysfunction and improve your chances of having a healthy sexual life.

"The nicotine was making me dead, inside and out. Now I feel free, vibrant, energetic, focused, and so alive!"

-Smokefree Arwen

 

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Blood and the Immune System

Normal White Blood Cell Count

When you quit smoking, your body will begin to heal from the injuries that smoking caused. Eventually, your white blood cell counts will return to normal and will no longer be on the defensive.

Proper Healing

Quitting smoking will improve blood flow to wounds, allowing important nutrients, minerals, and oxygen to reach the wound and help it heal properly.

Stronger Immune System

When you quit smoking, your immune system is no longer exposed to tar and nicotine. It will become stronger, and you will be less likely to get sick.

Muscles and Bones

Strong Muscles

Quitting smoking will help increase the availability of oxygen in your blood, and your muscles will become stronger and healthier.

Stronger Bones

Quitting smoking can reduce your risk of fractures, both now and later in life. Keep your bones strong and healthy by quitting now.

SmokeFree.gov

Expanding buprenorphine treatment could curb opioid overdoses

Expanding primary care buprenorphine treatment could curb opioid overdose crisis7

Brain basics in jargon-free language.

Expanding the availability of medication treatment for opioid use disorder in primary care settings would be a major step toward reducing overdose deaths, write two physicians specializing in addiction medicine and health care delivery in the July 5 issue of New England Journal of Medicine. In their Perspectives article entitled "Primary Care and the Opioid-Overdose Crisis - Buprenorphine Myths and Realities," Sarah Wakeman, MD, medical director of the Massachusetts General Hospital Substance Use Disorders Initiative and Michael Barnett, MD, of the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, describe current barriers to expanded delivery of buprenorphine treatment and outline possible solutions.

"One of the tragic ironies is that with well-established medical treatment, opioid use disorder can have an excellent prognosis," they write, noting that almost 80 percent of Americans with opioid use disorder are unable to receive treatment and that the growth in distribution of buprenorphine - one of three FDA-approved medications for the treatment of opioid use disorder - has been slowing rather than increasing in recent years. "To have any hope of stemming the overdose tide, we have to make it easier to obtain buprenorphine than to get heroin and fentanyl."

The authors describe 5 persistent but inaccurate myths that they believe prevent buprenorphine from being more widely adopted:

O That is more dangerous that other common health care interventions,
O That buprenorphine treatment is just replacing one addition for another,
O That abstinence-based treatment - short-term detoxification and rehabilitation - is more effective than medication-based treatment,
O That providing buprenorphine treatment is particularly onerous and time consuming for primary care physicians (PCPs),
O That physicians should just reduce opioid prescriptions to address the overdose epidemic

Most outpatient buprenorphine treatment is already provided by PCPs, and expanding the availability of office-based buprenorphine treatment, as several other countries have done, presents a realistic solution to addressing the overdose crisis, the authors note. They write, "We are in the midst of a historic public health crisis that demands action from every physician. Without dramatic intervention, life expectancy in the United States will continue to decline. Mobilizing the PCP workforce to offer office-based buprenorphine treatment is a plausible, practical, and scalable intervention that could be implemented immediately."


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Harvard T.H. Chan School of Public Health. EurekAlert

Autism and homelessness

The first peer-reviewed study into autism and homelessness has been published, in the journal Autism.

The researchers* found evidence suggesting that autistic adults are over-represented among the homeless population. They have called for more research to understand the links between autism and homelessness, to help prevent autistic people becoming homeless and to improve support for those who are already homeless.

Existing research & method

Anecdotal reports from autism clinicians and keyworkers, as well as two small studies from a few years ago, have suggested that there may be high numbers of autistic people in the homeless population. But this is the first academic research looking at this issue properly.

The researchers attempted to fill this gap by gathering initial evidence about the prevalence of autistic traits in homeless people. They worked with one homeless outreach team is the UK and screened 106 people they support to see if they could be autistic.

Results & discussion

12.3% of homeless people had a range of autistic 'traits' in line with diagnostic criteria. This is substantially higher than the general population autism prevalence of 1%. It is not clear that this 12% were actually autistic, but the screening suggested that they could be.

Writing in the journal, Autism, the researchers said: "If autistic difficulties are common among homeless populations, then this has important implications. Many people are homeless in the United Kingdom; the most recent estimate is that there are almost 5000 rough sleepers at any one point (Ministry of Housing, Communities and Local Government, 2017), and there is a much larger group of people with no stable accommodation who are termed the 'hidden homeless' (Crisis, 2017). There may therefore be a considerable number of homeless autistic adults who are not having their needs met and who are in an extremely vulnerable position."

Learn about the brain in clear language.

Alasdair Churchard has a doctorate in Clinical Psychology from University College London and worked on this study alongside Morag Ryder, William Mandy and Andrew Greenhill. He said: "Our research shows that autistic people may be at higher risk of becoming homeless than the general population.

"It is well-known that life for homeless people is extremely mentally and physically hard, and those who are autistic are likely to have additional vulnerabilities which would only make their lives more difficult.

"Further research is required in this area, and we have been working with professionals in the homelessness field to raise awareness about the potential links between autism and homelessness."

Sarah Lambert, Head of Policy at the National Autistic Society, said: "This is an important and robust study, which suggests that there could be a significant number of autistic adults who are homeless - and potentially living without an understanding of their needs or appropriate support.

"It's well established that many autistic people struggle to get the support they need and face huge difficulties throughout their lives, including high rates of mental health problems, underemployment and social isolation. We've heard anecdotal reports of autistic adults falling through gaps in support and into homelessness but there's very little research into this or awareness of this as an issue.

"This is the first peer-reviewed study to provide initial evidence of a link between autism and homelessness and provides an important platform to get to grips with this issue. We now need further research to investigate this link, and to develop the right support for homeless autistic people and to prevent those at risk from falling into homelessness in the first place."

"Homeless autistic people have gone unrecognised and unsupported for far too long."

Case study

Dr. Andrew Greenhill, a clinical psychologist also involved in the research, said: "One person that stands out for me is an older man who had lived on the street for 45 years, in an inner city.

"He ran away from his family home because his relationship with his father was so poor and physically abusive. He then survived by following a regular routine and sleeping in the same place every night, relying on the food made available at day-centres and drop ins. He refused all professional help or contact, and existed in a 'bubble' whereby he refused all attempts to engage. It was clear that he found social engagement of any kind very distressing and was highly motivated to avoid this.

"Eventually he was admitted to hospital after it appeared he'd had a stroke, and was unable to care for himself. He eventually accepted a room in a low intensity 'cottage hotel' hostel, where there were few, if any expectations about things like form filling, attending meetings or assessments. He has since managed to maintain his preference for privacy and solitude whilst having his basic needs met, with support workers around to keep an eye on him and to help out if any difficulties arise."

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Read an article about the research on the Conversation website and access the full research paper in the Autism Journal.

*The research was carried out by Alasdair Churchard, alongside Morag Ryder and William Mandy from University College London and Andrew Greenhill from Kensington & Chelsea Learning Disability Service.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.