The cognitive health of a nation’s leader can have far-reaching consequences that extend beyond their term in office. A striking example of this is the case of President Woodrow Wilson, whose impairment during crucial post-World War I negotiations may have indirectly contributed to the conditions that led to World War II.

In 1918, Wilson contracted influenza during the global pandemic. This illness, coupled with a severe stroke in October 1919, left him significantly impaired during the final year of his presidency[1]. This period coincided with critical negotiations for the Treaty of Versailles, which would shape the post-war world order.

Wilson’s diminished capacity meant he was unable to effectively advocate for his “Fourteen Points” plan, which aimed for a more balanced peace[2]. Instead, harsher terms were imposed on Germany, creating economic hardship and national resentment that would later be exploited by extremist political movements[3].

The consequences of these decisions were catastrophic. World War II resulted in an estimated 70-85 million deaths worldwide[4], a scale of loss that might have been preventable had the post-WWI peace process been handled differently.

This historical example underscores the critical importance of a president’s cognitive function. Executive functions such as decision-making, problem-solving, and communication are essential for effective leadership, particularly in times of crisis or complex international negotiations[5].

One aspect of cognitive function that plays a crucial role in leadership is prosody – the rhythm, stress, and intonation of speech. Prosody is not merely about eloquence; it significantly impacts how messages are received and interpreted. Research has shown that prosodic features of speech can influence listeners’ comprehension, emotional response, and even decision-making[6].

In the context of presidential communication, prosody can affect a leader’s ability to motivate a nation, provide hope in times of crisis, and effectively convey complex policy decisions. Presidents who have been noted for their strong oratorical skills, such as Franklin D. Roosevelt and John F. Kennedy, used prosody effectively to rally public support and communicate their vision[7].

The implications of this are significant for the democratic process. When electing a president, voters are not just choosing a set of policies, but also a communicator-in-chief who must be able to lead effectively in times of national and global crisis. The cognitive health of candidates should be a key consideration in the electoral process.

It’s important to note that cognitive health is a complex issue influenced by many factors, and simplistic or discriminatory approaches should be avoided. However, given the potential long-term consequences of presidential decision-making, it is crucial that voters have accurate information about candidates’ cognitive capabilities and that robust systems are in place to ensure continuity of effective governance under all circumstances.

[1] Cooper, J. M. (2009). Woodrow Wilson: A Biography. Knopf.
[2] MacMillan, M. (2001). Paris 1919: Six Months That Changed the World. Random House.
[3] Keynes, J. M. (1920). The Economic Consequences of the Peace. Harcourt, Brace and Howe.
[4] Weinberg, G. L. (2005). A World at Arms: A Global History of World War II. Cambridge University Press.
[5] Goldstein, K. (2015). The Executive Brain: Frontal Lobes and the Civilized Mind. Oxford University Press.
[6] Scherer, K. R., & Bänziger, T. (2004). Emotional Expression in Prosody: A Review and an Agenda for Future Research. Speech Communication, 46(1-2), 180-203.
[7] Leanne, S. (2016). Say It Like Obama and Win!: The Power of Speaking with Purpose and Vision. McGraw Hill Professional.

It is troubling that his closest allies dismissed this as just a “bad night.” This situation is reminiscent of Monty Python’s Black Knight, who, after losing all his limbs after a duel with King Arthur, insists it is “only a flesh wound.” Such deflection ignores the serious implications of what we witnessed.

While I am not a neurologist, but just a humble retired GI doc, I have observed patients and family with neurologic symptoms and signs, taught mental status exams  for 5 years to  medical students and watched 10 seasons of ER. While watching the debate, terms like “abnormal prosody” and “paraphrasing errors” came to mind.. Coupled with a noticeably slowed, narrow gait, vascular Parkinson’s disease may be the disease process we are witnessing. This can mimic neurodegenerative disorders and  often follows a progressive course.

The stakes are too high to ignore these signs. Ensuring that the most powerful position in the world is held by someone who is neurologically and psychologically sound is not just a matter of political strategy—it is a matter of national and global security. If we are to avoid potential tragedy, we must confront these issues with the seriousness they deserve.

The recent debate should prompt a thorough and transparent evaluation of President Biden’s capacity to fulfill the demands of his office. Anything less risks dooming not just our nation, but the world, to the consequences of impaired leadership. The time for empathy and decisive action is now, for the sake of all our futures.

Hey there fellow time-travelers! Yesterday I embarked on a journey that took me from the bustling streets of Manhattan straight back to the days of quill pens and steam engines. Perhaps, not that far back to the Gilded Age, but to an encounter that Vanderbilt and Astor would have recognized.

It all began innocently enough when I decided to hop on a NJ Transit train from Manhattan to Princeton, armed with nothing but my trusty iPhone and the NJ Transit app for my digital ticket needs. Modern, efficient, and oh-so-21st-century, right? No sooner than you could hum “Chattanooga Choo-Choo” things were about to take a whimsical turn.

Upon boarding the train, I eagerly flashed my digital ticket to the conductor, expecting a nod of approval or perhaps a high-tech validation dance. Instead, what I got was a surprising twist straight out of a Dickens novel. The conductor, with a flourish that would make any Victorian-era trainmaster proud, whipped out a single-hole punch and transformed my digital ticket into a bona fide analogue relic.

I stood there, iPhone in hand, marveling at the retro transformation unfolding before my eyes. It was like watching a black-and-white movie suddenly burst into Technicolor. From cutting-edge tech to mid-19th-century simplicity in the blink of an eye – who knew train travel could be such a delightful blend of old and new?

But this unexpected trip down memory lane didn’t stop there. As the conductor wielded his trusty hole punch, I found myself reminiscing about my first encounter with this humble office tool back in grade school. Ah yes, the days of diligently punching holes in my assignments to fit neatly into those ring binders. And the excitement of upgrading to the multipunch device that liberated me from the tyranny of measuring hole spacing! Who knew hole punches could spark such nostalgia?

And speaking of technological marvels, let’s not forget the great pen revolution of the 1960s. Out went the old fountain pens with their inky splatters, and in came the sleek, crystal-clear Bic ballpoint pens. It was a time of bold innovation and perhaps a few ink-stained pocket protectors left in the dust.

Yet here we are, in the 21st century, marveling at the circular dance of hole punches and the timeless charm of analog tickets. It’s a curious thing, isn’t it? How we cycle through the ages, rediscovering and reimagining what worked in the past.

So, next time you find yourself on a journey through time and space aboard a NJ Transit train, remember to keep your digital ticket handy. Who knows, you might just end up with a charming souvenir from the days of yore – courtesy of a single-hole punch and a conductor with a flair for the dramatic.

And as for me? Well, I’ll be here, eagerly awaiting the resurgence of steam-powered espresso machines and top hats in everyday fashion. Because why not embrace the whimsy of it all? After all, in this delightful dance between past and present, there’s always room for a good punchline.

Protest movements start with a belief and idea, challenged and changed by special interests and ultimately hardened by money, mobs and weaponry.

In the 1970s, I was actively involved in protests against U.S. Foreign Policy during the Vietnam War. At that time, like many others, my understanding of the conflict was shaped by what I was taught in high school and what I saw in the media. The prevailing narrative portrayed Communist Vietnam as a dire threat to Southeast Asia and the American way of life, invoking the Domino Theory to justify U.S. intervention.

However, my perspective shifted when I entered college and was exposed to different viewpoints, particularly through the teachings of professors at New York University. They challenged the credibility of the Domino Theory, pointing to evidence that contradicted the official narrative. This newfound knowledge had profound implications, especially for those of us who were of draft age, as it exposed the true motivations behind U.S. involvement in Vietnam: financial gain for military manufacturers and the perpetuation of the military-industrial complex. 

Moreover, my involvement in protests during that time exposed me to the harsh reality of government suppression and violence. Instances like the infamous clashes in Chicago and Washington D.C.(where I had a serving of tear gas)  served as stark reminders of the lengths to which those in power would go to quell dissent.

Fast forward to today’s protests on college campuses, and I can’t help but draw parallels and differences to what is occurring now.  As a former student of USC Medical School and a prior employee at Columbia University, I know and experienced the historical Jewish influences in both institutions. Given this background, it is disquieting, witnessing the alarming rise of anti-Semitic rhetoric and the uncritical support for the Palestinian cause, often coupled with indirect endorsements of Hamas, a terrorist group defined by the U.S. and neighboring Arab nations.

This shift in discourse is puzzling, especially given the historical significance of Judaism in intellectual and collegiate life. It seems that the true history of Zionism, born out of a response to European colonialism and centuries of Jewish persecution, has been conveniently overlooked or distorted. Similarly, the violence perpetrated against Jewish communities in Palestine during British rule has been swept under the rug, along with Israel’s defensive actions against relentless attacks by neighboring Arab states.

One cannot ignore the role of financial interests in shaping these narratives. Arab states, particularly Qatar, have poured significant funds into academic institutions, influencing discourse and faculty appointments and fostering pro-Palestinian sentiments as well as funding the underground tunnels and offensive weapons used by Hamas against the State of Israel.. As a result, Israel, once seen as a beacon of hope born out of the ashes of the Holocaust, is now portrayed as an oppressive state in the eyes of many on college campuses.

Yet amidst the rhetoric and polarization, it’s important to remember the human cost of the conflict. Innocent Palestinians suffer due to their leadership’s prioritization of weaponry over education and development, while Israel faces constant threats to its existence and is forced to adopt a more conservative approach, including rejecting the two-state solution.

Ultimately, what’s needed is rational governance and a commitment to dialogue and compromise from all sides. Only then can we hope to pave the way for lasting peace in the Middle East, where the safety and well-being of all its inhabitants are prioritized above all else.

For decades, I have harbored a profound respect for bison. From childhood encounters at the Bronx Zoo to thrilling wildlife sightings in Yellowstone National Park, I have always been captivated by their strength and resilience. However, their journey in America has been fraught with hardship. Once roaming the Great Plains in millions, their numbers dwindled to near extinction by the late 19th century due to excessive hunting and habitat loss.

Fortunately, the 20th century witnessed a concerted effort towards bison conservation, leading to their gradual resurgence. Yet, California was not typically considered part of their natural range. This is where the story of Camp Pendleton’s bison takes an unexpected turn.

In the 1970’s the San Diego Zoo partnered with Camp Pendleton to establish a breeding program with the introduction of Adam and Eve, a pair of bison. Despite the seemingly incongruous setting of a military base, this program proved immensely successful. Over the years, the herd has flourished, with over 150 bison now roaming the hills and mesas of Camp Pendleton.

Their primary habitat lies near the artillery range, offering a stark contrast to the sounds of military exercises. As a Marine soldier and fellow golfer shared, “We often have to stop shooting practice while the bison graze through the area. They have no natural predators here, except for the occasional golf ball or shell fragment.”

This observation resonated deeply. Witnessing these majestic creatures thrive under the protection of the very institutions that once played a role in their historical decline served as a powerful reminder of our evolving relationship with nature. The story of the Camp Pendleton bison serves as a beacon for hope, reminding us that even in the midst of human activity, nature can find a way to adapt and thrive.

Among the residents were Sabras, Israeli-born natives, who had recently completed their service in the Air Force during the 1967 war when Israel was attacked by Syria, Egypt, and Jordan. A year later, a similar conflict erupted, claiming lives both in the kibbutz and beyond.

In 1999, I returned to Israel with my family and had the opportunity to explore the region with an Israeli guide named Gaddy, who had Palestinian friends. We visited various Islamic sites, including the Dome of the Rock, where a Palestinian caretaker pointed out the shared historical origins of Judaism and Islam. We also ventured into Hebron in the West Bank, dining at a Palestinian restaurant adorned with a portrait of Yasir Arafat. The owner spoke of ambitious plans for Hebron, envisioning a bustling town with hotels, casinos, and religious sites to attract millions of tourists from around the world.I calculated the short distances to Hebron from the population centers of Europe, Asia and the Middle East and the billions of people across the planet that identified with the great religions: Christianity, Islam and Judaism and nodded my head that his predictions were likely to be true. Sadly, these dreams were shattered by the eruption of the second intifada a year later, resulting in loss and suffering on both sides.

A decade after that, my son pursued medical education in Tel Aviv, and we endured tense moments during Scud missile attacks by Hamas from Gaza. By then, Hamas had solidified its control over Gaza and continued to threaten Israel, particularly the areas near Bror Chayill.

I find it ironic that Palestinians and the American Left lay claim to the moral high ground of repatriation against Jewry without acknowledging the persecution Jews have endured over two millennia. the Persian and Roman exile from Israel, the deportation of Jews from England in the 14th century, the Inquisition, murder and displacement of Jews from Spain and the Iberian Peninsula in the 15th century, the pogroms, forced servitude and murders in Russia and the Austrian-Hungarian Empire in the 18th and 19th century and the Holocaust in the 20th century. The story repeats itself ad nauseum: a minority (Jewry) confronting a majority who needs a scapegoat (i.e. reason for the Black Death in Europe in the 14th century, loss of World War I and runaway inflation in Germany in the 1920’s) who can intimidate, suppress, murder and steal their culture and physical goods without repercussion. 

 The cycle of minority persecution, scapegoating, and violence against Jews repeats throughout history, from ancient exiles to the Holocaust. It’s a sad reality that in the face of radical religious factions driven by zealotry, defense of Israel becomes a necessary course of action.

My heart aches for the innocent lives lost on both sides of this enduring conflict. As a student of history, I believe that countering religious zealotry, which seeks the annihilation of Jews, necessitates defending Israel. I remain hopeful that one day, reasonable minds will prevail, allowing Hebron to thrive as a peaceful and prosperous destination for people of all religions to enjoy.

But wait, as the years stack up like pancakes, so do the struggles at the other end of life’s conveyor belt. Enter the geriatric experience – where once-easy skills now play hide and seek with our memories. Picture me, preparing to enlighten some young medical students about the art of “falls in the elderly.” Little did I know, my own walking escapades would become the star of the show.

“Decreased proprioception,” I declaimed, feeling quite the wise sage. “Ankles that flex like uncooperative door hinges and a big toe clearance that screams ‘trip me if you dare’.” But that wasn’t the end of my aging acrobatics; oh no, there’s more. Numbness, tingling, and muscles that have taken a sabbatical joined the party, making sure my gait resembled a comedy skit more than a dignified strut.

Still, I fancied myself quite the septuagenarian athlete. Treadmill trekking, skiing (albeit a bit more ‘controlled falling’ these days), hiking, and golfing – I had a fitness arsenal that could make even a personal trainer raise an eyebrow. Then came the showdown in the Utah golfing arena. Another septuagenarian, a golfing legend in his own right, launched a golf ball into the stratosphere while mine stuttered like a reluctant rocket. My ball decided to take a scenic route through rocks and pine trees, like it was on a woodland adventure.

“Lost ball,” I mumbled in defeat, dropping another on the fairway. But behold, my fellow septuagenarian turned out to be a real-life action hero. With the agility of a mountain goat and the fearlessness of a squirrel on caffeine, he bounded up the hill, leaping over boulders and obstacles with the grace of a ballet dancer. “How do you stay so spry?” I gasped, amazed. His answer? A casual, “Oh, just thirty years on the search and rescue team in Salt Lake City.” In other words, decades of extreme skiing, hiking to the moon (or at least 10,000 feet), and kayaking through rapids that could give a roller coaster a run for its money.

Ah, let’s talk about the great divide in our mastery levels – I, the illustrious explorer of New York City sidewalks and conqueror of Florida bar stool acrobatics, and he, the daring daredevil of Wasatch Mountain’s icy slopes and altitude-extraordinaire. It’s like comparing a slightly mischievous squirrel to a high-altitude superhero with extra red blood cells for added oomph. Yes, I was grounded at sea level, while he practically lived in the clouds.

So, the big question arose – could practicing the fine art of pedestrianism in quirky situations bring back the glory days? Armed with my trusty hiking poles, I embarked on an epic quest: the Stewart Cascade Trail in Sundance, Utah. A mere 3 ½ miles, you say? A paltry 617-foot elevation gain? Well, let me regale you with tales of fallen Norway Spruce that wanted to trip me, streams that seemed to play tag with my feet, and mud that had a vendetta. Each step was a calculated gamble – like a dance with destiny. Will the limestone rock be a solid partner, can my hip flexors outsmart this tree branch’s sneak attack, should I leap like a gazelle or wade like a water buffalo through that stream?

Three hours later, I emerged – battered, not broken, weary as a sloth on a Monday morning, and feeling like a 21st-century version of Kit Carson (minus the wild frontier, plus the determination to conquer nature’s hurdles). And guess what? A few more trails later, I discovered that maneuvering stairs, sauntering on sidewalks, and even the most mundane urban escapades were suddenly a breeze. I had transformed from pavement pauper to sidewalk swashbuckler!

So here’s the grand revelation: practice, my friends, is the enchanted elixir of youth. Venture to the mountains, ponder each step like it’s a piece of a grand puzzle, and who knows? Someday you might just be the sprightly counterpart to your gravity-defying grandson. Until then, let the sidewalks tremble at the approach of your rejuvenated footsteps!

A taste that transcends time, an American emblem.

In Times Square’s bustling scene, I savored you,

Nathan’s masterpiece, as I toiled on Broadway’s stage.

As a part-time employee in that bustling space,

Where documents flew and deadlines gave chase,

Amidst the chorus of keys and whirring machines,

I found solace in your presence, your flavors serene.

But it was on July 4th, in Dobbs Ferry, I recall,

My first encounter with you, a revelation, overall.

At my uncle’s house, laughter filled the air,

As I sank my teeth into a grilled Hebrew National, rare.

I listened to Mel Allen’s voice on a transistor radio,

His iconic commentary filled the air with a vibrant glow.

As the hot dog sizzled on the grill, a symphony of flavors,

His voice painted the scene, enhancing the savors.

Amidst family and friends, laughter filled the space,

The transistor radio playing, a joyful embrace.

Dobbs Ferry’s charm, the hot dog’s savory bliss,

A symphony of summer, a moment not to miss.

In the sweet voice of Mel Allen, the stadium would sway,

As he announced a Mantle home run, “going, going, gone,” he’d say.

Toasted buns, untoasted buns, a debate so grand,

A choice that divides, across this great land.

Yet, as I bit into your warmth, the bun held you close,

A perfect union, each flavor enhancing the other’s dose.

Oh, hot dog, your history we must embrace,

From street carts to ballparks, a cherished place.

A symbol of immigrants’ dreams and endeavors,

Your origins intertwined with American treasures.

From German immigrants’ humble sausages, they say,

You were born in the streets of New York, they portray.

From Coney Island’s Nathan’s to Times Square’s allure,

You’ve become a culinary icon, timeless and pure.

So, let us raise a bun, a condiment-laden cheer,

To the hot dog, beloved, let its legacy be clear.

In each bite we take, a taste of history is found,

A culinary masterpiece, forever renowned.

Blooming Wildflowers: As I set foot on the trail, my eyes widened with delight. The recent snows and rains had cast a spell, and the wildflowers responded by bursting into bloom with such enthusiasm that even the most seasoned botanists would be envious. Golden Columbine, Woods’ rose, Common Pacific Pea, Sticky Geranium, Wasatch Penstemon, and Pacific Ninebark paraded their colors, turning the trail into a living tapestry. Thankfully, I had my trusty sidekick, the Picture This app, to help me identify each flower. With a snap and a click, I became a botanist extraordinaire. Move over, Fremont and Ogden!

Symphony of Bird Calls: As I ventured deeper into the trail, a delightful cacophony of bird songs enveloped me. The Yellow Warbler, Chipping Sparrow, Western Tanager, and Black-Headed Grosbeak took center stage, performing their avian concert with gusto. How did I know who was who? Well, I whipped out my virtual maestro, the Merlin Bird ID app, which analyzed their melodious tunes and provided me with front-row seats to the avian symphony. I couldn’t help but imagine President Theodore Roosevelt himself tapping his foot to the beat, although I doubt he had access to such technology back then.

Tech Guides the Way: Amidst the lush scenery and melodious serenade, I realized that staying on track was crucial. Enter AllTrails, my digital hiking guru. With its comprehensive maps, trail descriptions, and weather updates, it kept me from getting lost and even warned me about the occasional lightning risks. AllTrails had my back, ensuring I wouldn’t end up as a character in a survival reality show. So, armed with my smartphone and a good sense of humor, I embraced the harmony of nature and tech.

Conclusion: The Dawn to Armstrong Trail is a testament to the beauty of nature, but it’s also a shining example of how technology can enhance our experiences. As I strolled along, Picture This transformed me into a wildflower expert, Merlin Bird ID made me a bird whisperer, and AllTrails guided me with the wisdom of a seasoned explorer. Who knew that 19th-century explorers and President Roosevelt could be upstaged by the likes of an app?

So, dear hiker, don’t hesitate to embrace the wonders of technology while immersing yourself in the wonders of the Dawn to Armstrong Trail. Let modern-day explorers like you use apps to become botanists, ornithologists, and expert navigators. Laugh, learn, and indulge in the perfect harmony between nature and tech as you create your own unforgettable adventure on this enchanting trail. Happy hiking!

Timing, tempo, and rhythm – three little words that can mean the difference between life and death. In the twisted game of existence, they’re the cogs that turn the wheels, propelling us forward or leaving us behind in a trail of dust.

In sports, timing can be the difference between winning and losing, between victory and defeat. But it’s not just about being in the right place at the right time. As basketball coach John Wooden once said, “Be quick, but don’t hurry.” It’s about knowing when to make your move, when to strike, and when to hold back. Elvin Hayes, who played for the Houston Rockets in the 1970s, was known for listening to Smokey Robinson’s “Second That Emotion” before games. Hayes believed that the song’s upbeat tempo helped him get into the right mindset for the game. The late, great Kobe Bryant listened to Jay-Z, Beethoven and Journey to syncopate his court skills. 

Timing is a key ingredient that makes the jokes of Seinfeld, Chris Rock and George Carlin hilarious and transform a sigh into a belly laugh.

Tempo, on the other hand, is the heart of music. It’s the pulse that drives the beat, the speed at which we move through life. And just like a well-crafted melody, the tempo can evoke emotions we never knew existed. The faster the beat, the more frenzied we become. The slower the tempo, the more melancholic we feel. It’s a delicate balance, and one that can be manipulated to great effect.

But rhythm is the true master of our fate. It’s the pattern that underpins everything we do, the driving force that gives us purpose and direction. Whether it’s the rhythm of our breathing or the rhythm of our footsteps, it’s the metronome that keeps us moving forward. As writer Maya Angelou once said, “Everything in the universe has a rhythm, everything dances.”

Timing, tempo and rhythm are the foundations of our existence, the elements that shape the mysterious maze of life. Whether we’re making jokes or scoring points, playing music or dealing with our feelings, it’s these three little words that can lift us up or drag us down. So let’s harness the power of timing, the core of tempo and the master of rhythm. For by doing so, we’ll find the groove that leads us to success and keep us forever young!