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.