Editor’s Note: Jonathan Reiner, MD, is a CNN medical analyst and Professor of Medicine and Surgery at George Washington University. The views expressed in this commentary belong to the author. View more opinion at CNN.

CNN  — 

Although it’s said that Washington, DC, is a city where secrets go to die, the explanation for why President Donald Trump was hurried to a hospital last fall remains a well-guarded mystery.

jonathan reiner aug 8

White House press pool video from the afternoon of Saturday, November 16, 2019 shows the President getting into a black Secret Service Suburban with his physician, Dr. Sean Conley, for the short motorcade procession to Walter Reed National Military Medical Center. The visit – which, unusually, occurred without announcement – deviated from usual White House protocol that calls for the President, and potential first responders, such as medical staff, to travel in separate vehicles.

At the time, the White House unconvincingly asserted that the President simply had some time on his hands and wanted to begin portions of his routine annual physical exam. According to a new book from New York Times reporter Michael Schmidt, Vice President Mike Pence was placed on standby should he need to assume the powers of the presidency temporarily, in case Trump had to be anesthetized (Trump denies this). That claim, coupled with the President’s unprompted denial this week that he did not have “mini-strokes,” only deepens the mystery. (Trump asserted that his “mini-strokes” tweet was intended to refute an August 31 tweet by a former White House press secretary – and CNN contributor – Joe Lockhart, which read “Did @realDonaldTrump have a stroke which he is hiding from the American public?”)

While it’s entirely possible there’s an innocuous reason for Trump’s Walter Reed visit, the event is reminiscent of other times in American history when important information concerning the medical fitness of the president, or a candidate for that office, was withheld from the public.

In the spring of 1944, the Allied forces were preparing to invade Europe, Franklin Delano Roosevelt was nearing the end of his third term, and his health was failing.

On April 4, amid rising public concern about the president’s condition, White House physician Admiral Ross McIntire held a news conference and assured the country that FDR simply had the flu.

There were, however, a handful of physicians who had examined the President a week earlier who knew that McIntire was not being truthful. The President, in fact, was suffering from advanced congestive heart failure. The American public was never told the truth, and although Roosevelt easily won reelection in November 1944, his health continued to slide. On April 12, 1945, just a few months after his fourth inauguration, the 32nd President of the United States died at age 63 from a cerebral hemorrhage, likely precipitated by his uncontrolled high blood pressure.

During the close election of 1960, John F. Kennedy and his doctors vehemently denied his long-rumored Addison’s disease. Kennedy told the historian Arthur Schlesinger Jr., “No one who has the real Addison’s disease should run for the presidency, but I do not have it.” Kennedy would go on to win by a razor thin margin, conceivably aided by the concealment of a disease that in 1960 was sometimes fatal. A post-mortem following Kennedy’s assassination in 1963 confirmed that he did, in fact, have the chronic adrenal condition.

In 1992, Paul Tsongas and his physicians touted the candidate’s victory over lymphoma during his bid for the Democratic presidential nomination. In March of that year, Tsongas’s doctor, Dr. Tak Takvorian stated, “At the moment, it would appear to be clear sailing.” Unfortunately, Tsongas and his oncologists did not disclose that he suffered a recurrence of lymphoma in 1987, less than a year after his bone marrow transplant. The senator’s lymphoma would soon return again, and he died in 1997.

In 2015, Dr. Harold Bornstein, vouching for Trump’s health, released a statement asserting that a recent medical examination revealed “only positive results,” that the candidate’s physical strength and stamina were “extraordinary,” that Mr. Trump’s vital signs were “astonishingly excellent,” and if elected, the patient unequivocally would be “the healthiest individual ever elected to the presidency.” Dr. Bornstein later acknowledged that Mr. Trump had dictated the letter himself.

While voters hold the ultimate power to determine who will serve as president, the public must have an accurate representation of the health of the candidates in order to make an informed decision. If Sen. Tsongas had been elected president in 1992, he quickly would have become too sick to serve. In December 1992, acknowledging mistakes concerning the disclosure of his medical history, Tsongas proposed the creation of a national commission to examine the issue.

Would FDR still have won his final election if the public knew what his doctors knew? Would voters have tasked a dying man with the daunting job of ending the war, rebuilding Europe, and containing the Soviet Union? It’s impossible to know with certainty, but voters deserved to know the truth.

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The public should be told what really happened at Walter Reed last November, and both candidates should release comprehensive medical reports before the first debate. As President Roosevelt said, “Democracy cannot succeed unless those who express their choice are prepared to choose wisely.” Having an accurate assessment of the health of those who seek the presidency is an essential component of such a singular choice.