In the late spring and early summer of 1776 delegates from the thirteen British colonies in North America met in Philadelphia to discuss the formation of a new nation. Despite the oppressive heat, they maintained the secrecy of the proceedings as much as possible by closing all the doors and windows. The discussions that followed were never made public, except for what little can be garnered from letters exchanged between John Adams and Thomas Jefferson decades later. What is known is that there was considerable discussion of whether the government that would be established to replace the British monarchy would have a Chief Executive with powers extending over all of the soon to be thirteen sovereign states. Most of the delegates were concerned that this ‘President’ would establish himself as a King and re-institute the very system of government they were trying to get rid of.
Arguing against this ‘Imperial Presidency’ was the absence of a leader all the delegates trusted and had confidence in aside from one man. No, it was not George Washington. He had yet to demonstrate his reliability and selflessness as a commander in the field. It was Benjamin Franklin. Franklin was respected on two continents for his work as a diplomat, inventor, and scientist. Even the British, his enemies, were in awe of him. He had a loyalist son, William, who ignored Franklin’s advice to oppose the British crown, but this ‘family problem’ did not diminish Franklin’s stature. The delegates in Philadelphia allegedly floated the idea of Franklin as the wise and trustworthy Chief Executive for the newly established nation, and Franklin responded, “I am too old.” He was eighty years old at the time of this second meeting of the Continental Congress.
What Franklin recognized and our current Presidential candidates do not realize or perhaps care to acknowledge is that with age comes an inability to recognize your own infirmity. In the recent Presidential debate, Biden babbled incoherently, and Trump lied prolifically. It was a demonstration of what old men resort to when the only thing they can remember clearly is their golf handicaps, and even that was disputed in this debate.
We all have blindspots, literally and figuratively. If you map out your vision in each of your eyes, you will discover a small area just lateral to your central vision in which you see nothing. This is because there is a spot on your retina, the part of your eye that processes light focused on the back of your eye, that is devoid of light receptors. This is where the nerve carrying messages from tens of thousands of light receptors exits the eye on its way to the brain. You do not realize you have this blindspot because your brain processes out this defect in your vision. It does not have you see a black spot to the side of your sharpest vision. In effect, you cannot see what you cannot see.
A similar phenomenon happens when there is damage to specific areas of the brain. You may be paralyzed but argue that you can move the paralyzed limb. You may be blind in a quarter or a half of your visual field but still insist that your vision is intact was asked. This happens with strokes, infections, tumors, and other causes of brain damage. It is broadly referred to as ‘neglect’ or ‘denial,’ and it involves part of your brain not recognizing disturbed function or loss of function in another part of your brain. This condition is especially problematic when an individual insists on making decisions he or she is no longer competent to make. Equally problematic is when people in a position to make decisions for the impaired individual insist on deferring to the compromised person. Rather than helping the person with deficits, they aggravate his or her situation by not stepping in and assuming responsibility.
Currently, we are faced with a monumental national dilemma. We have two candidates for the most demanding job on the planet who are both demonstrably incompetent and in denial. The Trump campaign promotes a man who will follow the blueprint for Constitutional shredding outlined in the authoritarian instruction manual called Project 2025. Under this plan, he will establish a virtual dictatorship, suppress all dissent, create ‘tribunals’ to jail political opponents, and abandon democratic allies around the world. I am not extrapolating: I am quoting.
Biden, on the other hand, assures us that he will continue to pursue agendas he has supported in the past, but the past is not an indicator of what he can accomplish as his abilities to think and speak and argue continue to deteriorate. The vision of this man trailing off incoherently as he negotiates with Putin or Xi is horrifying.
Neither man is fit for the job, and both insist that they are ready to ‘hit the ground running.’ In truth, both will stumble and hurt innumerable people as they fall. We shall have a President unacceptably dependent on his ‘caregiver’ assistants and obstinately denying his own limitations. To physicians working with old people, this is a familiar scenario. The insistence that the impaired individual is the only one who can decide the course of action that should be adopted, a refrain parroted by both political parties, is nonsense. That America is asked to choose between a twice impeached, convicted felon and an octogenarian in obvious cognitive decline is absurd. We must do better. We need a man or woman with vision, integrity, determination and the wisdom of a Benjamin Franklin. Ben knew when to step aside.
Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan. He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the U.S., as well as in England, Germany, and France.
