The White House on Life Support: Power, Panic, and Perception

The physical and mental capacities of the President of the United States and convicted felon Donald Trump has lately been a major subject of online rumour and debate. But this is just the latest in a series of health-related concerns and rumours surrounding the septuagenarian heads of state which have occupied that office in recent years. Both faced at different times major health events or rumours of health events, which in their totality provide a crash course in how to deal with potentially embarrassing crises. We can broadly separate these instances into two categories: occasions which were addressed by the administration, and instances which constituted rumours spread online and by the media without official recognition from the Whitehouse. Through examination of the different strategies used and their efficacy, we can learn how a company can weather concerning public opinion incidents, and how to avoid making a situation worse.

Biden

It is undeniable that health was an everpresent boogeyman for Biden during both presidential campaigns, during his presidency, and even after. What began as a barrage of mockery from the media and the right over the mere fact of his age has matured into extensive and invasive congressional investigations into Biden and participants of his administration concerning his mental acuity and competence. Likewise, the nature of the official responses has undergone a shift in severity. During the 2020 campaign, Biden paradoxically invited criticism over his age and simultaneously insisted that his health was unmarred. During Biden’s term, the official narrative shifted to one of casual self-deprecation in which the administration would treat the issue lightly and even engage in cautious humour. It was during the second presidential campaign that the problems boiled over and Biden’s health became an everpresent matter for debate. The strategy switched to redirection and obfuscation, amounting, in the eyes of some, to a cover-up. To catalogue each and every instance of response to health concerns by Biden’s campaign team or administration would be excessively exhaustive for the purpose of this article. Instead, we will compare three instances where the public relations response differed. First, Biden’s concession of being a “gaffe machine” in 2018 indicates the casual nature of his approach to questions over his age. He invited criticism during the campaign but defended his mental and physical status. This strategy seemed ineffective, and polling from the run-up to the 2020 election shows his age as the primary objection voters had to him, which was seized upon by Donald Trump, who famously coined the phrase, “sleepy Joe”, to great effect.

Moving forward in time to Joe Biden’s term in office, the administration had to contend with not just the vocal gaffes familiar to Biden’s career but increasing instances of stumbling or apparent motor dysfunction. As time went on, Biden was increasingly slow in his speech and began to lose track of sentences rather than merely swap or misplace individual words. The administration, perhaps realising the gravity of concern for his health of the American people, disencouraged reporters from asking questions about it, limited live public appearances and promoted the favourable 2021 doctor’s report which cleared Biden asbeing fit to serve. There was even an instance wherein Biden was interrupted by his own

press secretary, who prematurely ended a press conference while the president was mid-rant. Most damning of all was the report into the withholding of classified documents by Robert Hur, who concluded that the president would not be charged partially on the basis of his forgetfulness and age. The administration was quick to allege that the Hur report was both partisan and excessively personal. The last nail in the coffin of the American confidence in Biden was the disastrous first presidential debate against Trump, an event which rocked the democratic party and paved the way for his abrogation of the candidacy. Insiders and establishment Democrats took the view that it was merely a “bad day”, implying that Biden’s incompetence was an exception, not the rule. This strategy was less effective than the more aggressive stance taken during his actual term, as it legitimised the fears over Biden’s health and revealed an atmosphere of uncertainty and division among the highest levels of the democratic party.

The concerns over Joe Biden’s health and the administration's attitude towards it did not cease with his exit from the Whitehouse. From 2024, reports began by a Wall Street Journal article alleged that considerations had to be taken over Biden’s competence as early as 2021. This has been followed by congressional investigations into the supposed cover-up, at the direction of President Trump. This has been aided by the publishing of Original Sin by democrat Jake Tapper, which alleges Biden was in severe decline during his term, and that administration aides deliberately obscured this fact from the public. Biden, unlike other ex-presidents and candidates, has retreated from public life dramatically, and has not pursued the usual speaking engagements and book deals common to his colleagues, but the evaluation of the public relations behaviour here is entirely dependent upon the truth of the claims. If the claims are true, then we can categorise this as a public relations success, as the administration successfully ensured reporters did not focus on the health of the president to a severe extent as long as possible. Even after the first debate, many democrats still felt comfortable defending Biden’s health, at least until he dropped out of the race. This means that Biden’s PR strategy succeeded in avoiding the worst consequences of his mental state until after it was politically relevant. However, if the claims of a coordinated cover up are false, then this was a significant failure: the administration allowed constant media speculation into Biden’s health, and failed to properly prepare for the end of the electoral cycle.

Overall, Biden’s public relations suffered massively as a consequence of poor communication around his health. It is an unfortunate fact that the most effective strategies on his part were also the most deceitful: limit live public exposure and restrict speculation by disencouraging media discussion. Therefore, if a company suffers a PR disaster anywhere near this scale, withdrawing from events which could spawn controversy, while doing everything to downplay whatever problem is at issue will allow it to weather the storm. At the same time, companies should try not to appear secretive, and try to redirect onto successes when confronted.

Trump

Although the two men are similar in age, Trump has mostly evaded political ramifications as a result of questions about his age, and his supporters are mostly content to believe that heis physically fit and mentally capable. However, Trump’s health has been the subject of considerable journalistic and academic debate since he first became President. Unlike Biden, Trump has been consistently defensive regarding his physical condition, and has ensured his physicians consistently support this view. With regards to his mental health, Trump has been the object of intensive study due to allegations of a myriad of mental disorders levied by academics. Lately, Trump’s health has come under more public scrutiny than ever, and his administration has adopted a fascinating tactic of controlled transparency to combat it.

During the first Trump administration, concerns about Trump’s health primarily focused on his mental state, culminating in the anthological book The Dangerous Case of Donald Trump, which described Trump as presenting a “clear and present” danger to the nation. This academic movement was largely dismissed as paranoid by the media, and had a negligible impact on the election, although most Americans believed that Trump was both too old and dishonest. IT was therefore facile for Trump’s media team to deny all accusations and manipulate them to depict the accusers as obsessed and irrational. As Trump’s second campaign and presidential term progressed, public concerns over his health mounted. The New York Times assessed this campaign as being very different from his first: his speeches are less frequent and darker in subject and language, displaying more tangential thought and less accurate details. It has been attested that the assassination attempt in Butler, Pennsylvania has had a profound impact on his psychology, with his attitude turning increasingly angry and fearful. More monumentally, despite reassuring examinations from doctors, Trump is widely suspected of having severe long term illnesses including ischemic strokes or severe cardiological issues. This is based on bruising on his hand which suggests injections, and swollen legs, and apparent face drooping and motor instability. Karoline Leavitt has almost entirely dominated the narrative regarding Trump’s health, disinviting speculation by conceding to lesser health issues than have been suspected, and refusing to give clear details beyond that official story. This has been an excellent strategy, and has confined severe speculation considerably. Note that other representatives, like physician Sean Barbabella, have been ridiculed for giving poor answers to questions regarding his health, such as suggesting that bruises in his hands were from frequent hand-shaking rather than any medical issue.

Trump’s management of public relations regarding his health is a masterclass in deflection, containment, and media management. Where Biden faced daily criticism for an ill-defined cover-up, Trump, who has a history of exaggerating his health and faculties, has faced much reduced criticism from mainstream media. This is because rather than ignoring issues, Trump and his representatives either aggressively deny, or concede to a lesser issue. It is worth mentioning that this is effective because of Trump’s broader media policy which includes pursuing legal action against critical media, and excluding mainstream media from the Whitehouse press corps if their coverage is too critical

Corporate representatives have much to learn from Trump’s success. Too often, firms feel that they must speak to the media on their terms, in case the coverage is negative, but by tactically targeting high-viewership sources who are willing to be complementary in exchange for access, this effect can be mitigated. Likewise, when addressing an issue it is important to deflect criticism by admitting to a lesser problem, then diverting attention to thealleged corruption of accusers. If the choice is made to deny the allegations made, then it must be done in the most extreme and vitriolic method possible. Ideally, attention will divert onto the manner of your statement rather than its content. The more cantankerous and controlling the media strategy, the more that media will be apprehensive of producing negative content.