Since medical issues may explain both W's poor performance in debate #1 and -- as we shall see -- the improvement of debate #2, let us allow ourselves some room to speculate. Consider what follows our very own home-grown version of Kremlinology.
A correspondent sent me the following:
The argument for President Bush having Wernicke-Korsakoff's syndromeIs this likely? I hope someone knowledgeable in this area can comment -- sans anonymity, preferably.
(WKS).
It has recently been suggested that President Bush is suffering from pre-senile dementia or early Alzheimer's as a way of explaining his apparent decline in verbal skills over the past decade. If only for partisan reasons, some are inclined to believe this diagnosis, however it does not really fit with the signs seen in the president.
One main point made in argument that he has pre-senile dementia is the supposed confabulation observed by Dr. Price. While the Presidents fumbles do seem to fit the description of confabulation, that symptom is almost pathognomic (clinically defining as) Korsakoffs psychosis, a condition normally paired with Wernicke's encepholopathy. Wernicke-Korsakoff syndrome is seen in alcoholics thought to be brought on by a resulting thiamine deficiency. How strong the symptoms appear to be depends on how quickly the alcoholic quits drinking in relation to the onset of the symptoms. In the case of the President he seems to have stops just as things began to get bad.
Furthermore, the symptoms can regress with treatment using thiamine. The two most persisting signs that resist thiamine treatment are memory problems (that cause confabulation) and ataxia, the clumsiness associated with heavy drinkers. In fact the loss of coordination is one of the complications of the disease in that the patients are more prone to falls. As many had noted during the Bush presidency he had a tendency to fall and hurt himself scratching his face on at least two occasions.
Dr. N [name withheld]
Researcher in cognitive neurology.
At any rate, thiamine can alleviate the symptoms of Wernicke-Korsakoff's syndrome. Which would explain why Bush has good days and bad days.
Another correspondent (who also asks to go unnamed) offers the following:
Did he *really* stop drinking? If not, or if he has done some significant relapse bingeing in the past few years, alcohol-induced persisting dementia is a possibility. Look in the DSM-IV (the Diagnostic and Statistical Manual used by psychiatrists and neuropsychologists, among others, to formulate diagnoses based on available evidence).. this book is found in any large bookstore.Yes, we are operating in a speculative mode here. If speculation be the food for thought, let us feast!
Briefly, this diagnosis requires the development of multiple cognitive deficiencies manifested by both (1) memory impairment--impaired ability to learn new information or to recall previously learned information) and (2) one or more of the following cognitive disturbances...
Among the possible cognitive disturbances we find: (a) aphasia (language disturbance) and (d) disturbances in executive functioning (i.e., planning, organizing, sequencing, abstracting).
5 comments:
He might just be stupid.
I will admit off the bat I am a Bush supporter, but this story has caught my interest and Ive tried to keep up with your analysis. I will also confess that I was beginning to think the president did in fact use some sort of audio device to recieve cues from aides, but not because of the bulk of "evidence" cited here.
The pictures of Bush from both debates definitely prove that there was indeed something under Bush's coat. Also, Bush's constant blinking had me thinking he was listening in on something. I based this on the fact that when I listen to my "Learn to Speak French" CD's on the bus, I do the exact same thing; perhaps people subconciously blink repeatidly when processing information based enitrely on audio-sensory.
Having said that, however, I think all this talk of dymentia is a load of hooey, and only weakens your argument by adding the "tin-foil-hat" perception that seems to dog many bloggers who attempt to tackle these types of theories. I believe the president is mentaly fit for 2 reasons:
1) I think he has actually become a better speaker over the last 3.5 years. I'm sure some of the change in my perception of the president's speaking abilitys are have been effected by 3.5 years of getting used to him, but I honestly believe he has improved dramatically. It used to be that when the president spoke I felt as though I were watching a fat man walk accross an icey street - not feeling comfortable until the ordeal was over with. Now he is more fluid and cogent in his communication.
2) It seems that these doctors who have tried to imply that the president may be ill are pushing their evidence instead of letting it speak for itself. Also, their is a certain degree to which they have framed their facts to fit their argument. For example, the doctor you cited wrote the following as part of his case: "As many had noted during the Bush presidency he had a tendency to fall and hurt himself scratching his face on at least two occasions." Had the president been experiencing these accidents in his day-to-day activities that would have been one matter, but he had these accidents while mountain biking in dangerous terrain. Sure, someone could cite the inability of the president to operate a bicycle as a valid point by this doctor. But the fact he doesnt mention the context of these accidents, leaving an impression that these accidents could have taken place during normal circumstances, leaves me very suspect of this particular doctor's motives.
My conclusion? I think the president has injured his back. It makes sense when you consider other behaviors that attributed to the president poor showing in the first debate. The fact he slouched, and even leaned on his podium, for almost the entire duration of the debate.
Additionally, if you'll review the tape you'll notice the president turned his body at the hips to look over at Kerry. Normally one would turn at the mid-section/shoulder region, but to anyone who has suffered from a bad back it is understandable why he would turn at the hips instead. The president's lack of motivation and slowed rythym (a problem he has never has in the past - you can call the man an imbecille, but you cannot deny he is a peppy imbecille) would have most likely been caused by pain killers, or more likely muscle relaxers.
Finally, I dont think the president wore an audio device because Karl Rove is no idiot. Alot of noise was made about the bulg in the presidents back after the first debate, enough to make me believe they wouldnt be stupid enough to let it be visible in the second. If the president were dependent on this system they would have mounted the transmitter at his belt line and ran the wire up his side - not up his back.
Most likely both bulges were caused by two different types of back braces. Having realized people were talking about the bulg after the first debate they probably just replaced that brace with one that would not stand out as much. Also, I dont think they would admit the president needed the brace because it would turn into another barb the pundits could use to harangue the president with (ie: "wimp factor").
I have noticed something about Bush in just the past week or so. I noticed it during the second debate and never noticed it before. He is doing something strange with his jaw--wiggling it side to side or jutting it out quickly. It looks like a nervous tic, but I wonder if it's the symptom of anything else? Now I see it all the time, when he's speaking at campaign appearances etc. It's very weird. Any ideas? Maybe he has a toothache or TMJ or something, or is it the sign of something else more serious?
As to the wriggling back and forth of his jaw, that could be to adjust the apparatus in his ear, which would at least appear to be some sort of cochlear device, the better to hear the middleman between himself and his brain. Sort of like what you do in airplanes to make your ears pop . . .
I've written about Wernicke-Korsakoff's and have treated a number of patients. The disorder is indeed due to a deficiency of thiamine, and is found in alcoholism, nutritional deficiencies, and malabsorption syndromes (which of course lead to failure to absorb thiamine (vitamin B1). Thiamine acts as an essential coenzyme in at least two vital brain metabolic pathways.
Wernicke's is characterized by a gait disturbance, mental status changes, and ophthalmoplegia (which means a disorder of eye muscles leading to uncoordinated eye movemements and/or nystagmus, which is a rapid eye movement when the eyes attempt to gaze laterally).
The late stage of this syndrome (Korsakoff's) is when further deterioration takes place and there is confabulation, which of course means making up fantastical stories and believing them. It is irreversible, that is, not affected by thiamine.
If the subject continues to drink alcohol, and Wernicke's is present, then there is usually progression to the late (Korsakoff's) stage.
Thiamine, by the way, to be effective must be given parenterally (intramuscular or intravenous) as most of these patients don't absorb it until they're improved. It's important to assess magnesium levels as well, as this substance is important to assist in utilization of thiamine.
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