A Yale psychiatrist, Dr. Bandy Lee, is enjoying her fifteen minutes of fame as the editor of the bestseller “The Dangerous Case of Donald Trump.” This book contains the opinions of 27 psychiatrists and psychologists, some of whom believe the President suffers from cognitive dysfunction and mental illness. In doing so, they are damaging a specialty that has struggled to gain respectability among the general public and making it more difficult for those with mental disorders to receive treatment.
Psychiatry is a tough profession. Unlike other medical specialties such as ophthalmology, cardiology and orthopedics, our understanding of the brain is still in the Stone Age. The underlying physiology of the eye, heart and skeletal system is well understood. If a cataract is blurring vision, take it out. If a heart artery is blocked, unblock it. If a bone is broken, set it. But what do you do with a drug addict, an alcoholic, a schizophrenic or a depressed patient? There are no blood tests or radiological studies that give a definitive diagnosis of these entities let alone treatments that are highly successful. Thus, psychiatry constantly struggles to have parity with other medical disciplines as the general public is suspicious of its efficacy.
Dr. Lee’s attack along with a recent book about supposed White House dysfunction Fire and Fury by Michael Wolff have drawn blood. President Trump insisted in his annual physical that his doctor perform the Montreal Cognitive Assessment, which screens for Alzheimer’s and decreased mental functioning. The President obtained a perfect score.
Many psychiatrists – not a group that generally wears MAGA hats – disagree with Dr. Lee’s behavior. The American Psychiatric Association issued the following statement: “Using psychiatry for political or self-aggrandizing purposes is stigmatizing for our patients and negatively impacts our profession.” Dr. Lee’s psychiatric colleagues at Yale noted: “The Department affirms the importance of the ethical standard of conducting an examination of an individual and obtaining proper authorization before publicly stating a professional opinion about that individual.”
One doctor even believes that diagnosing President Trump as mentally ill is an insult to the mentally ill. Dr. Allen Francis, the retired chairman of the Duke University Psychiatry Department stated, “Mentally ill people are almost universally well-meaning, well-behaved, and decent, and Trump is none of these.”
But the true damage is done with the general public. The Trump-supporting truck driver from rural western Pennsylvania suspects that Dr. Lee would never be questioning the President’s mental stability if the President supported open borders, abortion rights, coddling our enemies and free trade. As the recent women’s marches have demonstrated, President Trump’s most fervent opposition consists of upper middle class women who are isolated from the economic chaos afflicting the working class – and Dr. Lee is a card-carrying member of this demographic.
Advances in psychiatry are crucial to decreasing human misery. Someday, psychiatrists will be able to cure opioid addiction, alcoholism and schizophrenia rather than simply manage these entities. But it will take years of expensive research until the complex neural pathways that predispose to these problems are found and sophisticated treatment options involving genetic substitutions or nanotechnology are discovered. Dr. Lee’s grandstanding may delay these efforts.