Healthcare professionals, whether retired or practising, should possess the ability to look at their fellow men and women and derive a considerable amount of information merely by observation. My wife, Pat, a retired physiotherapist, is an ace at spotting quirks of posture and gait. incidentally, her extensive riding experience enabled her to make useful observations about horses as well. My granddaughter, Mackenzie, a newly minted psychologist, is revelling in the skills that her recently completed training have given her in spotting abnormalities of behaviour and outlook. When I was employed as a teacher of medical students in Australia a few years ago I used to introduce them to a game I devised that I shall call 'farmers and horses'. I would take a small group of students to the wards and look out for a jovial, male patient and ask him if he objected to the students and me talking about him in his presence as if he were the horse and we were the farmers proposing to buy him. I would then ask the students to observe and tell me what they saw: did his stated age matches appearance? what could they tell from looking at his hands? and so on, all while re reassuring the patient that he could bail out if he found it all too personal and uncomfortable. It is a remarkable truth that the vast majority of patients faced with students remark, “They’ve got to learn somehow, Doc.” Then, they patiently submit themselves to the inexpert manoeuvres of the trainees. The underlying purpose of this game was to teach medical students that the clinical examination began the moment the patient’s nose crossed the threshold of the doctor's office. Now, this long digression leads to the subject of this piece: President Donald Trump.
Donald Trump is a strange cat by any standards. He lurks at one or other of the very far ends of the normal distribution curve of human behaviour. During his election campaign he exhibited several extraordinary traits and has carried many of these over to his early presidency. He is an exhibitionist, extraordinarily thin-skinned, combative, aggressive and patronising. He appears to have a very warped view of women and non-Caucasians. He has made many well reported remarks about women and Muslims that appear not to have affected his standing in the minds of many Americans. I must admit that I have been eerily fascinated by his steady, remorseless march from candidate to president and along the way I have made a few clinical observations.
Several more qualified commentators than me have likened his behaviour to that of a toddler and have suggested that he will run a toddler presidency. I am not sure whether adults are thought to suffer from oppositional defiant disorder (ODD) but Mr Trump does seem to exhibit common traits with those children who do. The Mayo Clinic regards those who often lose their temper, are touchy and easily annoyed by others, who are angry and resentful, argumentative and who deliberately annoy other people, to be suffering from ODD. Sound familiar?
I wonder if our Donald does not exhibit mild signs of satyriasis or hypersexuality. After all, he is on his third wife and boasts openly of grabbing women ‘by the pussy ‘. He surrounds himself with glossy, big breasted and otherwise scrawny females. He goes out of his way to tell the world how much he admires the female sex without going into details about what it is that he admires. During his campaign he was at pains to let us all know that his relatively small hands did not mean that he is external genitalia should not be taken seriously. There are some urban myths that suggest small hands in a man equate to a short penis. Those who would like more information on the topic should go to: http://www.livescience.com/53946-hand-size-penis-size.html
My last little thought about President Trump is that he exhibits signs of borderline personality disorder (BDS.) After all, he does seem to be emotionally labile and to exhibit instability of mood and behaviour. He is prone to impulsive actions and incapable of forming stable relationships. He is quick to anger. He has a very short attention span and likes to conduct his business through the medium of 'tweets', messages constrained to one hundred and forty characters.
My playing the amateur psychiatrist inclines me to consider that Donald Trump is not quite a real grown-up. There have been so many instances of quixotic behaviour during the last year that it is hard to know where to begin. Using social media, especially Twitter, while on the election campaign, seemed to work in his favour. On several occasions, most notably after the debates with Hillary Clinton, he fired off an angry little ‘tweets’ about points that she had appeared to score over him. One imagined and hoped, that the gravity surrounding the office he so remarkably won, would curb his enthusiasm for this mode of communication. It does not seem to have done so. He has been obviously annoyed by the legal challenges put up against his executive order banning the immigration of citizens of six or seven mainly Muslim countries. He has gone so far as to asperse a senior judge who issued an injunction against his order. He is now faced with probable defeat if the matter gets as far as the Supreme Court or tearing up his original order and starting again. Either way he has not behaved with much grace. He continues to abuse both Muslims and Latinos. He threatens to walk away from long established trade deals and is generally behaving in a truculent fashion to all he considers to be the other. As well, he has made threats to all and sundry e.g. China and Japan, but when faced with leaders of such countries he behaves in a much more muted fashion.
The President of the United States of America is probably the most powerful single individual on earth. The constitution of the United States was very carefully crafted by the founding fathers to organise, as far as it was foreseeable, a mechanism whereby no branch of the government had unfettered powers. The system of checks and balances has worked very well in the past. The new president, if his early form is anything to go by, gives the impression of being irked by the very mention of the word fettered in connection with himself. He is quixotic, mercurial and quite unpredictable. He also has his fingers on the nuclear button. His personality, allied to his total lack of previous experience in government, could amount to a dangerous and explosive mixture. His background is that of business where he can hire and fire on a whim. It looks as if he hopes to translate that background into the fields of government and international diplomacy. The next year or two will show us all if he can make a successful translation. Cracks are starting to appear in his inner circle. Mike Flynn, his newly appointed national security advisor has handed in his cards after the Washington Post revealed some dodgy dealings with the Russian authorities during the transition period. His counsellor, Kellyanne Conway, looks to be on shaky ground after telling the world that the President has every confidence in Mike Flynn, hours before he packed his briefcase and left to return to obscurity. There are reports about other cracks appearing in the new White House team.
I fear that this whole enterprise is going to end in tears. A spectacularly unqualified and unstable man, surrounded by yes-men will discover that simple answers to complex situations are usually wrong. The rest of us must sit by and see how the toddler president manages. We are in for an exciting ride.
February 15 2017