A Conspiracy Theory About Trump
Terence Lenahan[*]
Copyright 2020 — all rights reserved
ABSTRACT:
Strong circumstantial evidence establishes the overwhelming probability that at his January 2018 physical exam President Trump tested positive for a rare disease, a diagnosis that sheds new light on many enigmas surrounding his persona. Admiral Ronny Jackson assumed operational command of a conspiracy to conceal the truth, his subterfuge so successful that the diagnosis has eluded every media physician. Trump’s two unscheduled four-day absences from sight (March 2018 and November 2019) point to clandestine surgeries. This rare, complex disease cannot be succinctly summarized; the ramifications of its many nuances extend into the body’s every cell and require attention to apprehend, but the time is well spent — the diagnosis is proven beyond reasonable doubt even without medical records.
TEXT:
Introduction:
Supporters of President Trump love conspiracy theories — once tweeted, they exist forever and can never be disproved. Anything can qualify for a presidential re-tweet, the more preposterous the better, the mass dissemination of absurd untruths justified by contorted Orwellian psycho-logic.
This conspiracy theory is one that Trump is sure not to re-tweet because it is about him and, in a bizarre and improbable twist, his extended family. The hypothesis, in a nutshell, is this: As a young man Donald Trump developed a rare disease that over the course of 40+ years transformed him physically and mentally. The dashing young Donald was left behind as he gradually morphed into the man we know today. Obvious symptoms of disease were overlooked by his doctor who never screened him. It was only because he became President, changed doctors, and after a year in office finally allowed himself to be subjected to a full battery of tests that a tumor was discovered. Secret endoscopic surgery was successful, but under the stress of impeachment the tumor recurred, necessitating a second clandestine surgery. True to his nature as history’s most successful mountebank, Trump enlisted military personnel into his conspiracy to conceal the truth, contrary to the public interest. The public’s right to an open political process was not the conspiracy’s only casualty — as his tumor almost certainly resulted from a genetic mutation that other Trumps have also inherited, concealing the truth deprives his relatives of their right to know, precluding them from receiving treatment.
Argument:
Nearly nothing is known about Trump’s health — it is easier to chart the medical history of Henry VIII, even though the king’s skittish doctors left no records. When he unexpectedly traveled to Walter Reed by motorcade last November, cable news was awash in speculation. The absurd cover story of a routine physical only fueled the misdirected media storm, probably pleasing the President greatly.
Experts speculated about acute cardiac or neurological issues, denied by Dr. Sean Conley and former White House physician Admiral Ronny Jackson. Recent revelations that the Vice President was put on notice and that medical personnel were forced to sign confidentiality agreements revived the mystery. Physicians opined that alerting Pence meant that the President was anesthetized, but no one could identify a surgical procedure that could have been completed within the short time that he was behind closed doors. Surprisingly and perhaps shockingly, no medical maven has deciphered the arcane clues pointing to the only possibility that rings true.
Eleven months later, after his sudden hospitalization for Covid, the President’s doctor danced the Trumpian two-step, his avoidance of key questions patent. CNN’s Jonathan Reiner observed that doctors “threw the kitchen sink” at the Covid infection, including Regeneron’s experimental cocktail of monoclonal antibodies, Remdesivir, an unapproved anti-viral, and Dimethasone, a powerful immunosuppressant steroid used to combat pulmonary inflammation, a sign that his lungs were having unusual difficulty coping with the infection.
The President of the United States became a medical experiment — no patient had ever been treated with that combination of therapeutics, each reserved for the sickest cases. Dr. Gupta concluded that something was being hidden; Dr. Reiner wondered why the presidential physicians deployed all their weapons at the onset. Everyone wanted to know what the President’s doctors were hiding. Could his hidden health history be responsible for the elevated level of concern?
With his admission that he believed it appropriate to role play America’s Pollyanna, Dr. Conley joined himself to a long list of physicians who acceded to Trump’s desires. After the January 2018 physical, it was standing room only in the White House Press Room for Jackson’s briefing as listeners worldwide eagerly awaited insight into the American President who many feared could suddenly run amok. Yet not one substantive question was asked, except for Gupta’s inquiry about cardiac calcium, forcing Jackson to admit to mild heart disease he had neglected to mention.
Basic neurological and acuity tests enabled Jackson to brush aside concerns about Trump’s mental fitness, yet tens of millions have long known his behavior to be so outlandishly uncouth that something had to be amiss with a man who long ago was outwardly genteel. Jackson may have assuaged the fears of a few of the millions disconcerted by erratic eruptions of presidential pique, but history teaches that the public has never learned the total truth from any White House physician. Peeking out from behind the cloak of obsequious apologetics and sycophantic humor was an unsettling undercurrent of nervousness, leaving viewers with a sense that the performance had been carefully stage managed, and that Jackson knew more than he was telling.
Twenty months later, media physicians responded to Conley’s evasions with pointed questions: what prompted the sudden decision to go to the hospital?; when did he last test negative and first test positive?; did he have pneumonia?; what is the meaning of “expected findings” in his lung scans?; and, most important, what is the etiology of the lung damage he cryptically referenced? Notably, Conley never described the President’s lung scans as normal. During a phone interview days later, Trump himself admitted that doctors had seen “something” in his lungs.
Conley’s luck held and the most penetrating question remained unasked. The President was at statistically higher risk of death due to his sex, age, and weight, but could his most closely guarded medical secret — the disease that prompted his motorcade to Walter Reed — represent a darker harbinger, a carefully concealed comorbidity that magnified his risk for life-threatening complications from Covid?
It should by now be obvious that in deconstructing the physical and psychological persona of Donald Trump, everyone must be missing something. A medical degree is not necessary to know that one potential explanation for the November 2019 procedure at Walter Reed has been ignored — an endocrinopathy, a disorder of the endocrine glands, including pineal, hypothalamus, pituitary, thyroid, parathyroids, adrenals, pancreas, and testes/ovaries.
After Trump checked himself out of the hospital, almost certainly against medical advice, media analysts pointed to his manic euphoria as evidence of steroid intoxication. Others observed that his possibly unbalanced mental state was scarcely distinguishable from his mercurial behavior prior to steroid treatment. This seminal insight points to the possibility of a systemic disease producing increasingly toxic levels of steroids throughout his adult life, engendering his progressively outrageous speech and behavior. Consideration of the often-overlooked endocrine system in connection with President Trump’s health raises four key questions.
(1) Is there an endocrinopathy that could explain the enigmas about the President, including his health, his psychology, and even his physical morphology?
(2) Are there persuasive indications that the President has or had such a disease?
(3) Could corrective surgery have been completed in one hour during the November 2019 visit to Walter Reed?
(4) Did his disease damage his lungs, putting him at significantly greater risk of death from Covid?
The secret known to Trump, Jackson, and Conley is that the answer to all four questions is an unqualified “yes.” That is the reason for his shockingly rapid deterioration after testing positive for Covid and his physicians’ panicked reaction.
Acromegaly is a fascinating, complex disease caused by a relatively rare Growth Hormone- secreting tumor called a pituitary adenoma. The disease is protean, having as many as 100 possible symptoms that often manifest in high stress situations. Spikes in Growth Hormone are typically accompanied by emotional instability and impulsive speech and behavior — the acromegalac often seems to act not out of free will but as a pawn of wildly fluctuating pituitary hormones. Practically no one knows of Acromegaly, but thanks to Andre Roussimoff (Andre the Giant) everyone is aware of the childhood variety, or Gigantism. Those cases are rare; for acromegalacs whose disease develops after maturity, the body cannot grow taller, so forced growth occurs in other areas, usually first in one extremity and in the head.
The acromegalac’s body and facial features are deformed so incrementally that even family and physicians fail to recognize the changes during a long progression. Mental and physical manifestations typically emerge as the acromegalac approaches age 50, following several decades of tumor growth when hormonal secretions cross the boundary between tolerable and toxic. Many Trumpian enigmas are explainable by Acromegaly; as with all those afflicted, the hypothesis functions as a Rosetta Stone — only postulate the disease and everything becomes clear.
Despite their characteristic facial disfigurement, acromegalacs are not easy to spot, though they often stand out among others by virtue of a certain edge that gives them an advantage over their peers. Their advantage is amorphous and elusive; its nature cannot be specified nor its source identified. Even the keenest observer never suspects the presence of an unseen element that imbues them with charisma and empowers them to exceed ordinary human limits. Growth Hormone is perhaps the most powerful performance-enhancing substance known to medical science; it works its wonders below the threshold of perception, beyond the ken of those who have never experienced it and those who partake of its benefits, both equally blind to its presence. But it is a Faustian bargain, a devil’s deal with an escalating cost. Indications of the rising price are subtle in the extreme, their evolution so nuanced that decades pass before even the insightful few slowly begin to suspect the source.
Situated at the base of the brain behind the bridge of the nose where the optic nerves cross, the pea-sized pituitary is considered to be the body’s control center because it produces hormones that regulate critical functions, including growth, metabolism, sexuality, emotions, and response to stress. Hormones are the body’s most potent chemicals. A tumor on the pituitary, though not malignant, is a serious disease insofar as it results in excesses of one or more hormones and deficiencies of others. Untreated Acromegaly shortens life by roughly ten years or more, producing a baffling series of intensely painful cascading casualties, most often killing by cardiac or respiratory failure, frequently preceded by loss of sight when the tumor invades the optic nerve.
There are several types of pituitary adenomas. Prolactinoma, the most common, secretes excess female hormones. An adenoma secreting Adrenocorticotropic Hormone (ACTH) is known as Cushing’s disease, in which the adrenal glands secrete toxic levels of cortisol and other steroids. Symptoms of Cushing’s include weight gain restricted to the torso (“central obesity”) with reddening and rounding of the face and emotional instability. President Trump’s face has become rounder; his pigmentation is reddish-orange; he is in a constant state of rage; and his weight gain appears to be restricted to his torso while his arms and legs have remained thin, making Cushing’s a possibility. The rarest pituitary tumor poisons its victims with Growth Hormone and steroids. The unfortunates so afflicted know the horror of both Acromegaly and Cushing’s disease, a hormonal cocktail so noxious that its emotional toll can scarcely be imagined, even by an endocrinologist.
Diagnosis is confirmed by blood testing and an MRI of the brain, but approximately half of all acromegalacs are identifiable by lateral expansion of the torso and characteristic facial changes, including alteration of the shape of the face, expansion of the forehead between the temples (“frontal bossing”), protrusion of the brow ridges and eyebrows, thickening and enlargement of the mandible, and later in the progression general coarsening of the skin and facial features. The changes occur so slowly that they go unnoticed from day to day, but photographs of the acromegalac in his 20’s and in his 50’s or 60’s typically appear to depict different persons. A life photo array often illustrates a progression of deformation such that the acromegalac resembles half a dozen different people over the course a lifetime.
In addition to producing crippling skeletal and joint symptoms, Growth Hormone degrades vital organs asymptomatically for decades before the severity of the cumulative damage becomes perceptible. An acromegalic attack against the respiratory tract typically begins with sleep apnea, affecting an estimated 50 to 80% of acromegalacs. There are two types of apnea, constrictive and obstructive, but in Acromegaly, growth of new tissue and excess fluid synergize, giving the apnea both constrictive and obstructive characteristics. Growth of the mandible and maxilla combine with soft tissue swelling of the tongue, palate, uvula, nasal passages, laryngeal and pharyngeal mucosal tissues, sinuses, and lungs to narrow the airway. Elongation and spreading of the ribs degrades the inspiratory muscles and alters the geometry of the rib cage, contributing to hypoventilation, or increasingly frequent respirations of shorter duration. Most insidiously, Growth Hormone triggers the deposition of spongiform bony tissue on the inner surfaces of the lungs, gradually burying the alveoli under “lung overgrowth.”
These anatomical changes result in serious complications including emphysema and bronchiectasis. Bronchiectasis, a shortness of breath due to hardening of lung tissue, ends in death from respiratory failure — when sclerosis renders the alveoli incapable of performing gaseous exchange, even a ventilator on maximum pressure is futile. Lung disease/respiratory failure is the cause of death for about 25% of all acromegalacs.
The pituitary secretes primarily at night. As the level of performance-enhancing chemical increases, the acromegalac awakes earlier and earlier, often after no more than three or four hours of sleep. The increasing hormone level forces the body to create new cells at an accelerated rate, resulting in increased appetite beginning around age 50. As the hormone creates a very bad feeling, binging on comfort food to increase endorphins is common, as is alcoholism.
Even the foregoing very brief description of a complex pathology is sufficient to identify President Trump as a possible candidate. The inference becomes increasingly persuasive when the evidence is scrutinized, and no known fact is contraindicative. The overwhelming probability is that Acromegaly is the secret he has conspired to conceal — there is no tenable alternative explanation.
1. A frequent signpost is provided by a photo array that permits comparison of the subject’s physiognomy at different ages, as described on The Mayo Clinic webpage. With an acromegalac, it is often difficult to believe that a photo taken at age 25 is the youthful version of the mature individual rather than an altogether different person. Not surprisingly, President Trump’s appearance bears little resemblance to Donald Trump at age 30 or even age 50 — outside of the Twilight Zone, there are few if any alternative explanations for that.
2. The clearest, most conclusive evidence of President Trump’s Acromegaly is provided by the photographs taken by TASS during his May 10, 2017 Oval Office meeting with Russian diplomats. The President did not expect to be photographed and was furious at the publication — never again did he skip his mandatory makeup session. The photos revealed his acromegalic disfigurement to be quite florid, reflecting the severe hormonal imbalance typical of later stages of the disease. His pattern of facial transmogrification resembled that of Pio Pico, the last Mexican governor of California, famous for his florid acromegalic disfigurement, definitively diagnosed from an 1852 daguerreotype.
3. Acromegaly degrades targeted organs, and the body’s largest organ, the skin, is a frequent focus. As Trump neared age 50, orange spots began to erupt on his face and ultimately transformed his fair Caucasian complexion, now a dim memory. It is probable that he damaged his skin under the unnaturally intense ultraviolet light of a tanning bed, and Acromegaly targeted the damaged organ, creating his unique deformity. He is now prepared for public appearances by a master cosmetologist, but the orange tint cannot be concealed, though it appears to have faded greatly in the last eighteen months. The conspiracy here is that political and medical mavens never mention his pigmentation, even though no one has ever seen another human being like him; they never question how he came to be that way, and never wonder why he is now less orange than when he was elected, questions pondered by tens of millions but never openly discussed in the media.
4. A comparison of contemporary photos with earlier images reveals that the shape of Trump’s head and face have changed completely. His cranium is unique, having grown into a distinctive box shape, almost a cube. His mandible has become less angular, significantly more rounded, and has markedly thickened, as have his mastoid, temporal, and cheek bones. Subcutaneous osteophytes (bone spurs) are visible on his checks and jaw. His facial skin has coarsened markedly, a textbook acromegalic symptom. It is as if the handsome, debonair man once known to the world as “The Donald” had been replaced by an alien doppelganger with Neanderthal DNA.
5. The aged Trump’s personal habits became so abnormal that after the first presidential checkup, Jackson felt compelled to explain that the President “has a lot of stamina,” a facile, seemingly offhand comment that succeeded in shutting the door on discussion of Trump’s troublesome symptoms. The benefit of a good night’s sleep is a self-evident truth and the torment of sleep deprivation is well known to those conducting “enhanced interrogations,” yet in Jackson’s Orwellian newspeak chronic insomnia was not disdained as a torture technique but was touted as an asset, the product of superb genes. After three years in office, the Surgeon General joined the chorus, pointing to his minimal sleep time as a sign of superiority, vehemently averring that “the President is healthier than I am,” even though he is not the President’s doctor, and that he “needs less sleep than I do,” as if a grumpy old man’s insomnia was cause to boast. Trump often bragged about his ability to function on four hours or less of sleep, but the stamina characteristic of the earlier phase of Acromegaly has been replaced by fatigue as he now spends hours in his bedroom obsessively tweeting in response to cable news.
The President often displays classic symptoms of sleep deprivation, including irritability, bad moods, and errors in judgment as during the 2018 trip to France when he refused to go out in the rain; upon his return, at Arlington Cemetery he made a completely unnecessary and extremely damaging remark at the grave of General John Kelly’s son. His inability to get a good night’s sleep is not an asset — it is a potentially serious symptom that demands investigation. Given the importance of sleep to the human body and mind, a person who brags that he doesn’t require sleep is a deluded fool, as is a Surgeon General who agrees with him.
6. His fast food binges are well known. Jackson’s oft-quoted fawning that Trump might have lived to be 200, if he could just have “controlled his appetite over the last twenty years!” has never been properly deconstructed. The weak attempt at jocularity unwittingly revealed something previously unknown — his overeating had progressed for two decades, leaving the audience pondering why a slim man with normal appetite developed a mid-life craving for junk food.
The Acromegaly hypothesis perfectly explains his addiction to comfort food and his inability to control his appetite beginning at about age 50, when his disease would have been progressing for two decades or more. Increased, uncontrollable appetite has a physiological basis in the body’s demand for protein and minerals needed to create new tissue at an accelerated rate, often resulting in obesity. If he ate like a teenager at a buffet, it was in a sense because he was still growing, but he would not get taller and in fact has lost height as his lumbar vertebrae eroded (another common acromegalic symptom). His weight gain was not primarily abdominal fat — his torso expanded laterally as anabolic hormones built a progressively wider body. The irony is that increased food intake raises serum levels of IGF-1, which stimulates increased hunger — the more the acromegalac eats, the hungrier he feels.
7. Just as his appearance was totally transformed, so too his personality. The young Donald Trump was considered to be charming, but no one has used that term to describe him for many years. In those distant days he presented as a man with a balanced outlook expressing thoughtful observations, scarcely resembling the persona he projects today; there was no hint of the perpetual scowl, chronic ire, gratuitous invective, or dark ideation that became his hallmarks. There had been early signs of explosive temper after his purchase of The Plaza when his tantrum lasted many hours as he railed about every scratch on every furnishing, but the public was first exposed to it during his senseless vendetta against Alicia Machado, then Miss Universe, who he branded as “Miss Piggy.”
His temperament became more volatile than quicksilver. He is perpetually ready to fight, responding to even petty annoyances with cruel remarks that erupt without inhibition or the filter of forethought. The most shocking manifestation of his mercurial mentality during the 2016 campaign was his eagerness to throw down the gauntlet with Pope Francis. The candidate reacted defiantly to a third-hand paraphrase of a lurid tabloid headline mischaracterizing the Pope’s words, when he could have easily temporized. Given a choice between dispassionate circumspection and a knee-jerk reaction, without a moment’s hesitation he threw a counterpunch at the Pope. Rather than appearing reasoned and restrained, like a person temperamentally suited to control the world’s largest nuclear arsenal, Trump reacted like a hothead primed to go off half-cocked, like a man who might react to an accidental nudge with a punch in the nose, like a man with Acromegaly.
His emotional dysfunction, the eruption of orange spots on his formerly fair face, and his increased appetite manifested as he neared age 50, pointing to the possibility that all three originated from increasingly toxic hormonal imbalances produced by a pituitary tumor.
8. High stress can trigger a hormonal spike such that previously repressed symptoms suddenly manifest, a progression that was apparent during the final weeks of the 2016 campaign. The release of the Access Hollywood videotape thrust Trump into the greatest crisis of his political life. The tension was palpable — he was under emotional pressure like never before. He had always sailed through adversity as if protected by Providence, but even he must have questioned his ability to survive this crisis.
Perceptible signs of the intensified stress were not confined to his shaky voice when he emerged from seclusion on October 7, 2016. Media commentators ignored the obvious upshot — his skin suddenly darkened to a shade of bronze, as if a bit of burnt umber had been blended into his standard makeup. It was a hue seen only twice more, during the third debate and again amidst the elation of his election night victory celebration, another probable hormonal peak. Throughout the campaign his facial skin tone had been a mixture of orange, pink, and red, but on these occasions it transformed into a tawdry bronze resembling cheap artificial tanning creams. Scrutiny of his iconography during the campaign reveals a constantly shifting palette of skin tones, edema, and a variable degree of puffiness around his cheeks, nose, forehead, and lower eyelids, the daily variations so subtle that they passed unnoticed except to an eye focused on the nuances of his appearance. These external manifestations of pituitary fluctuations again point to his head, including soft tissues and all cranial bones, as a primary target of acromegalic attack.
9. Critically relevant to President Trump’s recent Covid crisis was the effect of stress on his breathing following release of the Access Hollywood tape. On multiple occasions during the third debate, a strange sniffing sound emanated from his nostrils during inhalation, as if he was experiencing sleep apnea while awake. The phenomenon recurred multiple times as he struggled to inhale. The ears of every viewer perked up and took note of the strange sound. Even to a layman, the anomaly pointed to the possibility of a serious medical condition but doctors took it in stride.
Trump’s anomalous breathing could have posed an interesting challenge in differential diagnosis, and perhaps even led to discovery of the true root cause, but, incredibly, not a single journalist or media physician deemed repeated dysfunctional inhalations in a presidential candidate to be worthy of analysis. One hates to think that they were accessories to Trump’s conspiracy of silence, but no one questioned the candidate, his surrogates, or his physician about the strange sniffing sound he could not suppress, the spasmodic breathing he could not control, or his suddenly darker skin. Trump’s odd breathing was not ignored by viewers — the following weekend it was poorly satirized by a loudly sniffing Alec Baldwin on SNL.
The dysfunctional inhalations evidenced a degraded ability to intake sufficient oxygen through an increasingly constricted airway. It was as if he needed stents between his nostrils and lungs because the mucosa had suddenly swelled to double or triple normal size. The puffiness of his face and his remarkably swollen lower eyelids were external manifestations of soft tissue hypertrophy — his labored breathing signified that the same process was occurring internally, constricting and obstructing the airway, his tumor secreting at increasingly dangerous levels in response to the most stressful situation of his life.
Ten weeks later, on January 11, 2017 during his pre-inauguration press conference, another high stress situation arose with release of the Steele Dossier, and the bizarre inhalations reemerged. Dysfunctional breathing manifested for the third time during an hour-long interview with David Muir. Six months later, he could be heard sniffing loudly for air during a telephone interview as he struggled to sell the lame explanation that his son met with Russians only as a benefactor of orphans.
The Acromegaly hypothesis perfectly explains the puzzling phenomenon of Trump’s breathing. The disease has dual aspects — tissue growth and swelling in targeted areas of the body. One of the most frequently targeted organs is the respiratory tract, usually first manifesting as sleep apnea, almost certainly to be found in the medical records that Trump ordered seized from his doctor following his election. After release of the embarrassing video and in anticipation of the third debate, under the most extreme stress he ever faced, Trump’s pituitary tumor went into overdrive. Growth Hormone had already damaged his respiratory system, but the damage remained imperceptible until extreme stress provoked increased mucosal edema. The distinctive sound emerged as atrophied chest muscles strained to pull air past nasal passages and sinuses swollen to the point of occlusion. The third 2016 debate revealed that Trump’s most dangerous comorbidity had passed the tipping point — the damage to his respiratory system had suddenly crossed the boundary between imperceptible and perceptible At that point, his lung damage was no longer completely reversible.
If Acromegaly was responsible for the degradation of his respiratory system as evidenced in the third 2016 debate, there would have been subtle early warning signs — probably ignored — of an incipient problem, and in fact Trump had shown indications of hypoventilation before entering politics. During the years when he disputed President Obama’s citizenship, the act of speaking publicly seemed to make his chest constrict, his whole body tightening as his enthusiasm pushed him to the edge of his seat, a breathless quasi-croak emerging from his throat. The phenomenon was puzzling because as an experienced public personality he would not be expected to tense up in such situations. If that subtle shortness of breath was an early sign of Acromegaly attacking his respiratory system, the deterioration would be expected to progress and ultimately become acute. The eyes of America were focused on him when that occurred in October 2016.
The circumstantial evidence is overwhelming that President Trump suffered from Acromegaly for more than four decades. His entire cranium has expanded and changed shape; his face has become rounder; his original angular jaw morphed into a broad, thicker mandible; osteophytes grew on his facial bones; his features have coarsened markedly; his pigmentation has undergone a drastic metamorphosis; his airway has become constricted; his personality has changed dramatically; his sleep time has progressively diminished as his craving for comfort food became uncontrollable; his voice transformed over a five year period spanning his late 40’s and early 50’s, progressing from a relatively mellifluous tenor to baritone and finally to rough, raspy bass, the result of thickening vocal chords; even his ears have grown. These factors all point to Acromegaly as a unified theory of causation. No other disease can produce that panoply of diverse symptoms.
Is it possible that President Trump does not have Acromegaly? His hands are not enlarged, and whether he has an enlarged foot or left leg cannot be determined. But about one-third of acromegalacs do not develop an enlarged extremity. The fact that a given individual lacks a specific symptom does not exclude Acromegaly; the disease is highly individualized, different for each person, and medical science cannot yet explain why it attacks a given part of the body while bypassing other parts in different individuals. In Trump’s unique case, his head is a primary affected extremity, and the targeted organs are his skin and respiratory tract. Acromegaly is the only disease in which a hormonal spike can affect both respiration and skin color.
His progressively rounder face, his orange skin, and his obese torso with spindly extremities could point toward Cushing’s disease. Insomnia is not common with Cushing’s, but it does occur. Cushing’s, however, would not explain his thickened mandible, his protruding brow, his dysfunctional breathing, or the changes to his speaking voice. But a mixed tumor potentially explains it all — his cranial deformations, his pathological skin pigmentation, and his penchant for fulminatory outbursts support the inference that he was afflicted with the rarest, most destructive tumor, a complex adenoma producing both Growth Hormone and steroid-stimulating ACTH, the most toxic hormonal cocktail.
Skeptics will respond that even granting the circumstantial evidence that the President has or had Acromegaly, Cushing’s disease, or both, only a little research on the UCLA Pituitary Tumor Center website is required to ascertain that the average time required for endoscopic resection of the pituitary is 3½ to 4 hours, apparently making it impossible for the surgery to have been performed during the brief November 2019 Walter Reed visit.
That time estimate is for the initial operation, typically excising a tumor growing for 30+ years. But one surgery is often not enough — it is not uncommon for a resected pituitary adenoma to regrow during the first year or two after surgery. The pathology begins with division of a single cell, so a redeveloping tumor initially consists of only a small salient easily excised in less than hour, even allowing 15 minutes for a preoperative MRI.
Is it possible that President Trump’s November 2019 conspiracy was not his first, that he had an earlier secret surgery? Endoscopic resection of the pituitary leaves no scar, raising the question of whether perceptible signs of a secret operation could be detected in his head, skin, and physique, the external focal points of acromegalic attack.
Successful endoscopic surgery results in rapid reduction in soft tissue swelling, noticeable after 48 hours. For Trump, that would be appear as reduced hypertrophy of his face and cheeks. Longer term, without the pressure of anabolic hormones, he might begin to lose weight, and that could continue for eighteen months. Beginning about nine months after surgery, his hyperpigmented skin should begin to fade, probably in irregular, mottled splotches. Any regression of symptoms in his facial skin would be slow and subtle, but if his coloration is due to toxic levels of cortisol, with normal hormonal balance restored at some point the orange pigment in his skin should diminish.
As early as summer of 2016 when I first discerned Donald Trump as a probable acromegalac, I reasoned that if he were ever to appear with subtly reduced puffiness in his brow, cheeks, and lower eyelids, then began slimming down, and the orange tint to his skin faded, the inference would be that he was surgically treated for a pituitary tumor. That indeed occurred on March 29, 2018.
As President Trump approached the end of his first year in office, the question arose as to whether Dr. Bornstein’s shortcomings would be corrected by a different doctor. As noted on The Mayo Clinic website, Acromegaly often goes unrecognized until a new physician enters the case. A full endocrinal panel was undoubtedly completed during the presidential physical on January 12, 2018. Acromegaly was not discovered because Jackson is a brilliant diagnostician who suspected it from Trump’s appearance or his explosions of uncontrollable rage; rather, it was simple military medical procedure that detected high levels of Growth Hormone, cortisol, and IGF‑1 (Insulin-like Growth Factor‑1), an anabolic helper hormone that can produce ravenous hunger and binge eating.
Standard treatment protocol is that after diagnosis the patient receives an injection of Ocreotide, suppressing secretion of Growth Hormone for one month. A second injection carried him through mid March. The unpleasantness of the injections quickly resolves any reservations about surgery. There was a window on Sunday evening, March 25, 2018, after his return from a Palm Beach weekend, when clandestine surgery could have been performed at Walter Reed or even in the White House with imported equipment. Trump remained in seclusion on March 26, 27, and 28, the first three day period of his entire presidency when he was completely shielded from sight, his unexplained invisibility ignored by seemingly oblivious reporters.
On Thursday, March 29, he flew to the Midwest for a rally, but as he walked to Marine One, the cameras were kept far back. No explanation was given for holding the press corps at a distance, but he clearly had some reason for avoiding close scrutiny. Only after his return to Washington was normal access restored.
As he stood at the podium to address his rally four days after his presumptive surgery, there was a subtle but distinct difference in his appearance. An unmistakable decrease in the puffiness of his forehead and cheeks, especially around the right eye, was tangible evidence of reduced swelling as fluid was no longer being forced into the targeted tissues. The sudden diminution in the soft tissue hypertrophy that had long suffused his face is explicable only by surgical removal of a pituitary tumor.
Up to that point, President Trump averaged eleven tweets per day. On Saturday, March 24, 2018, he spent the day golfing in Florida and tweeted only once. As he returned to Washington on March 25, true to form he tweeted nine times. On March 26, when he would have been recovering from surgery, he issued only four tweets, probably drafted in advance in contemplation of his convalescence. On March 27, he tweeted only once — on his second post‑op day he may have felt shakier than he anticipated. On March 28, when his recovery was well underway, he was back to nine tweets. This progression is consistent with surgery on Sunday, March 25, 2018, and gradual recovery over three days.
Eighteen months after his secret surgery President Trump’s appearance continued to evolve, and four observations made during that period confirm the Acromegaly hypothesis First, one year after his secret surgery, the orange tint to his face began to fade, implying that his unique skin color was primarily due to excess cortisol. The fading of his orange pigmentation was almost miraculous, raising the possibility that his pituitary could slowly recover and the skin color of his youth could return over a period of seven years or more. Second, after surgery he was able for the first time to lose some of the excess weight he formerly could not shed. As he walked away from Marine One on August 21, 2019, he buttoned his jacket for the first time in years, and having accomplished that feat twice tugged proudly on the lapels with smiling but short-lived satisfaction — by year end he regained the weight he had lost. Third, he now sleeps two hours more than before surgery, awakening at 6:00 am, not at 4:00 as he did during his first year in office. Fourth, there have been no further public episodes of dysfunctional breathing prior to his contracting the Covid virus.
Though his skin has become pastier and coarsened significantly in the last two years, his face and lower eyelids lack their pre-surgery puffiness. The diminution in facial edema, the gradual fading of his orange pigmentation, his weight loss, his increased sleep time, and the absence of respiratory symptoms prior to his Covid infection are strong confirmations of clandestine surgery to excise his pituitary tumor, the only possible explanation for the fourfold regression. Trump credited Jackson with two accomplishments unknown to the public: diagnosis of his rare disease, and masterminding the conspiracy to keep it secret. Such was his gratitude that he nominated Jackson for a Cabinet post, and when that failed sought to reward him with a second star.
Postoperative patients are counseled that a surgical cure does not mean that they are out of the woods. There is always the possibility of recurrence of the tumor, especially in the first two years after surgery. President Trump’s stress-filled life transformed that possibility into a probability.
When on November 16, 2019, not coincidentally amidst the tremendous stress of impeachment hearings, Trump unexpectedly drove to Walter Reed and remained for less than two hours, questions about his health finally attracted media attention. The motorcade trip was highly unorthodox. Walter Reed medical staff typically receives advance warning of presidential visits, notifying them of certain security closures, he would normally travel by helicopter, and there would be photo ops with military personnel; but none of those things occurred. Press Secretary Stephanie Grisham floated a lame cover story: “Anticipating a very busy 2020, the President is taking advantage of a free weekend here in Washington, D.C., to begin portions of his routine annual physical exam at Walter Reed.” The President, responding to the skeptics who sensed a conspiracy, echoed her claim in a late night tweet, justifying the unusual trip as “phase one of my yearly physical” to be completed “next year.”
No one believed that the President traveled to Walter Reed for a blood draw. After returning from the hospital, he remained out of sight all Saturday afternoon, Sunday, Monday, and Tuesday, only the second time in his presidency that he was not seen for such an extended time period. Senator Schumer wished him well with “whatever he is recovering from.”
The White House has a sophisticated medical unit, and doctors immediately questioned what necessitated a trip to Walter Reed. Media coverage was so intense that Dr. Conley issued a late night statement in an effort to quell speculation: “This past Saturday afternoon the President traveled up to Walter Reed National Military Medical Center for a routine, planned interim checkup as part of the regular, primary preventative care he receives throughout the year. Due to scheduling uncertainties, the trip was kept off the record. The President has not had any chest pain, nor was he evaluated or treated for any urgent or acute issues. Specifically, he did not undergo any specialized cardiac or neurologic evaluations.” While Conley denied “specialized cardiac or neurologic evaluations,” he did not state that the President had not undergone any other treatments.
On Tuesday Trump tweeted that the visit was a “very routine physical,” but he again remained out of sight in his quarters, unwilling to put speculation to rest. Only late on Wednesday afternoon did he finally show himself, looking somewhat the worse for wear as he might well have following the trauma to his sinuses from trans-nasal endoscopic base brain surgery.
By interviewing cardiologists and neurologists, cable news chose the wrong type of specialist — an endocrinologist or a neurosurgeon might have proved more fruitful. The best explanation for the visit to Walter Reed was that the “condition being monitored” was his pituitary disease. When blood tests revealed that his tumor had begun to regrow, a second surgery became necessary, one that could easily be completed in less than an hour.
A second clandestine surgery also explains traveling by limo, allowing him to reenter the White House unseen, rather than by helicopter, exposing his shaky gait as he traversed the White House grounds. His schedule was completely clear and he did not appear for three days after surgery, recovering out of sight from prying eyes, reprising the strategy used after the presumptive March 2018 surgery. Though brief, the second surgery may have taken an unexpectedly high toll, necessitating four days out of sight to recuperate — that would not be surprising as he did not jump back up from the first surgery in a day or two as many patients do.
The Acromegaly hypothesis holds that everything in Conley’s statement was true. The President wasn’t evaluated or treated for cardiac, neurological, or acute issues. Regular preventative care for his pituitary disease would be prompt removal of a tumor as soon as it recurred. Conley must have earned increased presidential respect for his adept use of a shroud of truth to conceal the facts.
In virtually every case, Acromegaly accounts for an unusual occurrence in the history that no other diagnosis can explain. For President Trump, the singular symptom that dovetails only with Acromegaly was the episode that occurred while announcing the relocation of the U.S. Embassy in Israel. His speech suddenly became unintelligible — the President was babbling gibberish on live television, broadcast throughout the Middle East. Aides immediately shut him down and pushed him out of the room. Media medical mavens were predictably vague, providing the viewer with no insight into the phenomenon beyond conjectures such as dry mouth, loose denture, or stroke. A nonplussed Dr. Gupta commented only that there were “clearly some abnormalities of his speech.”
Unintelligible speech is an infrequent but well known manifestation of Acromegaly caused by hyponatremia, or low sodium, which often accompanies the disease and manifests under stressful conditions. The acromegalac believes he is making sense, but the bewildered expression on the face of the hearer clues him that the words he spoke were not language but jabberwocky. As with many aspects of this disease, I am aware of it because it happened to me, twice, without warning at age 63. When the President’s physicians deny the Acromegaly hypothesis, as is expected, they should be pressed to provide an explanation for this unusual episode.
Donald Trump’s lifelong hormonal imbalance permanently altered the thickness of his cranial bones, the shape of his torso and face, his features, his pigmentation, and the pitch of his voice, raising the question of how much his mentality and emotions were affected. Surgical resection of the pituitary does not rapidly restore normal emotional balance, just as it cannot quickly resolve longstanding physical deformations. Decades of toxic levels of Growth Hormone and steroids inevitably leave their mark, producing a long-lasting but unquantifiable impact on personality and emotions, leading to impulsive decision-making and explosive eruptions of rage.
Trump’s mental processes as manifested in his speech have clearly deteriorated, but that is not the effect of Acromegaly. Nor was Acromegaly the wellspring of his craving for adulation, his egotism, greed, bullying, megalomania, or other undesirable personality traits. Seen through the eyes of his sister as revealed by his niece, these qualities had been evident since childhood when he was molded by his father’s warped personality and heartless child-rearing practices. Growth Hormone and steroids did not cause Donald Trump’s less admirable qualities; the powerful performance-enhancing hormones simply intensified his innate traits and brought them to the fore.
To doctors, Acromegaly is an impersonal disease found toward the front of the Merck Manual, far removed from viruses toward the end. But it does share one commonality with Covid, an uncanny ability to ferret out and attack its victims’ weakest points, their greatest vulnerabilities. To those who have suffered from toxic levels of Growth Hormone, Acromegaly is more than a disease — it is a consciousness, a presence, an evil entity, a demon bent on torture and destruction. Neurosurgery saved President Trump from that demon, but after the recent life-threatening assault against already damaged lungs, his future prognosis is much more problematic. During his circumnavigation of Walter Reed to wave at fans, his orange pigmentation had vanished in a day and his skin was ashen, indicating the gravity of his condition. If his refusal to convalesce results in relapse or ire-infection, his physicians have already used their most potent drugs, and those weapons may not prove so efficacious the second time around.
When my doctor first proposed the diagnosis, I turned to Wikipedia to research the disease I had only hours previously learned to pronounce. It was both a shock and a relief to see myself on that webpage, but the truly stunning revelation was seeing my father too. I was instantly transported to the past, awash in memories of 25 years of painful cascading casualties, including blindness, as a prelude to his agonizing death. At least twenty doctors had consulted and failed to diagnose him. Later, after finding a photo of his siblings, an idea began to germinate — it slowly dawned on me that my uncle, two of my aunts, and probably their mother were all victims of Acromegaly, but without understanding how that could be possible.
My doctor, an assistant professor at the school of medicine, was shocked by my story — the disease was thought to be strictly idiopathic. Subsequent research led to a New England Journal article on familial Acromegaly, discovered when researchers retrieved DNA from the 7 foot 7½ inch skeleton of Charles Byrne, a late 18th century London celebrity known as the Irish Giant. Byrne’s corpse had been stolen after his death and his bones exhibited in a museum against his express wishes. The researchers isolated a mutation on the “gene encoding the aryl hydrocarbon-interacting protein,” conveying a propensity to develop Acromegaly. Returning to Byrne’s roots, they traced the history of four families with the AIP mutation in two Counties of Northern Ireland over three centuries. The four families had developed Acromegaly at a predictable rate and, much more rarely, Gigantism. One of the Counties where the mutation was endemic was Armagh, birthplace of my grandmother. It was my fate to develop Acromegaly as a result of a genetic defect she carried, said to have first arisen 57 to 66 generations earlier, between 350 and 525 A.D.
The subject of this article is President Trump, but the author’s personal history is most relevant — even the very little that is known about his relatives points to the probability that Donald Trump too is a familial acromegalac. The President’s grandfather, Frederick, emigrated to America from Kallstadt. Not coincidentally, national screening in Germany revealed a shocking number of possible positives for Acromegaly, more than 1 in 1,000, at least 250 times higher than had been expected, indicating that the AIP mutation is also endemic in the President’s grandfather’s ancestral land. There is only one photo online, making it impossible to tell if the Trump patriarch developed the disease or only carried the genetic defect.
When Mary Trump, the daughter of the president’s deceased older brother, became a public figure, the media understandably focused on the psychologist’s portrayal of her uncle, but something significant went unmentioned — her appearance. When her book began to be discussed, Ms. Trump was under a gag order — the public saw only the book jacket photo of a slim woman aged about 35 with a normally proportioned face and attractive but unremarkable features.
When the 55-year-old appeared in person, it was clear that over two decades her appearance had changed. She was no longer slim, but the weight gain was not the acquisition of a middle-age paunch — like her uncle, her girth had expanded laterally and her chest size had increased. Her face was elongated, with thick cheek bones and a thickened jawbone. The symmetrical chin that graced her earlier image had become prominent and rounded. These are all textbook acromegalic deformations.
Mary’s father, Fred Jr., died at age 42 of a heart attack ascribed to depressive alcoholism. Death at such an early age from heart failure is very unusual even in an incorrigible alcoholic, unless impacted by an additional factor; Growth Hormone attacking the cardiac muscle makes it understandable. His early death makes it difficult to identify acromegalic changes, but he did have a broad forehead and prominent brow ridges. Drinking to excess is common among acromegalacs, whether as a result of the need to self-medicate the indescribable pain, or because the AIP mutation also conveys a propensity to alcoholism, or both. Like the unknown number of deaths by suicide among depressives, premature deaths caused by acromegalic alcoholism are never connected to the underlying disease.
Donald and Fred Jr. inherited the gene from their father. Photos of Fred Trump Sr. available online reveal that his forehead broadened, expanding between the temples, while his brow ridges increased in prominence, clear signs of “frontal bossing” and textbook indications of Acromegaly. Fred Sr. is said to have possessed the cold, unfeeling personality acromegalacs often develop after years of toxic hormonal imbalance, consistent with the disease.
Fred Sr.’s case is particularly unusual and initially baffling — like Pio Pico, he lived to age 93. Given the destructive power of Growth Hormone, acromegalacs rarely enjoy long life. There is one possible explanation for his longevity — like Pico, he must have experienced a spontaneous remission due to pituitary tumor apoplexy. The rupture of an apoplectic adenoma fills the pituitary’s protective fossa with blood and tissue, sometimes resulting in an infarct that disrupts the adenoma’s blood supply. In layman’s terms, the tumor ruptures and kills itself; the acromegalac is cured, able to live a normal life during which his acromegalic changes regress.
Finally, all America has noticed that the President’s youngest son experienced an unusual growth spurt and now towers over his father. If he inherited the AIP mutation, a 50–50 proposition, it is entirely possible that the extreme stress associated with being a presidential child activated a pituitary tumor, causing the accelerated growth. An adenoma may have been secreting excess Growth Hormone for some time, targeting his hip joints, based on an ataxic element to his gait which has been noticeable for several years. He could be reprising the case of Tony Robbins, the author and motivational speaker, who was diagnosed with acromegalic gigantism in high school after growing eleven inches in one year. Robbins developed the disease decades prior to the introduction of endoscopic surgery, when the trauma involved in accessing the pituitary could prove fatal. Robbins, like Pio Pico, was one of the very rare acromegalacs who apparently experienced a spontaneous remission following an episode of pituitary tumor apoplexy (approximately one case per year in the US). Fortunately, with the perfection of endoscopic base brain surgery, what was once a sentence to a short, brutish life is now completely curable. Presumably White House physicians are monitoring the son’s hormones as they are his father’s.
Occam’s razor prefers Acromegaly to any other diagnosis for President Trump because it provides the simplest explanation for the widest spectrum of facts, and there are no facts that directly disprove it. If President Trump did undergo secret surgeries for Acromegaly, it is unfortunate that he conspired to conceal them, especially now that his human frailty is on full display. One estimate is that for every diagnosed case of Acromegaly, thirteen others are never found. It has been my hope that when his disease came to light, President Trump would spearhead the effort to increase knowledge of this strange affliction with a view toward reducing human suffering. The increased awareness only President Trump could create would produce an enormous public health benefit that would continue in perpetuity, accruing to innumerable thousands in generations yet unborn. It would be a unique event in world history — if the criterion were the number of people helped, simply acknowledging his Acromegaly should win him a nomination for the Nobel Prize for Medicine, a mind-boggling thought to contemplate.
The lives shaped by this fascinating pathology are often distinguished by paradoxes, ironies, and mysteries. Trump’s paradox: the man who avoided military service in his youth by complaining of phantom bone spurs in old age has osteophytes visible on his face and an probably many others elsewhere. Trump’s irony: the man who breathed life into the most preposterous of conspiracy theories became the focus of his own conspiracy, executed by his co-conspirators for the purpose of deceiving the American public. Trump’s mystery: when will we know the truth?
[*] Terence Lenahan is the author of the forthcoming book Avatars of Acromegaly: Handel, Henry, Trump, and the deadly fraternity.
