By Cory Franklin

November 4, 2022

Consider these sentences:

I plead guilty. I plead not guilty.

I am going to kill you. I am not going to kill you.

You are under arrest. You are not under arrest.

In each example, one word – “not” – changes the meaning of the sentence completely. “Not” is doing some heavy lifting – especially if you are in court, facing someone with a gun, or being detained by the police. Which is why someone who cannot process a specific word properly, that is, he or she misses occasional words, might not be the optimal candidate for a job with a lot of responsibility, like being a US senator. You don’t want to miss “not.”

As the result of a recent stroke, this is the situation John Fetterman finds himself in as candidate for the Senate from Pennsylvania. Partisans of both stripes, don’t worry – this is not a political screed about Mr. Fetterman or his opponent, Dr. Mehmet Oz. Their qualifications and policy proposals are well-trod ground, available elsewhere.

No, this is about Dr. Clifford Chen. Who is he? Dr. Chen is the physician who wrote the medical report released to the public about Mr. Fetterman’s condition. The key passages in his report referring to Fetterman, “Occasional words he will ‘miss’ which seems like he doesn’t hear the word, but it is actually not processed properly…. He has no work restrictions and can work full duty in public office. “

Normally, it is considered bad form and a breach of professional ethics for us doctors to question the report of another physician who has examined a patient whom we have not. (This etiquette doesn’t stop physicians from commenting publicly on the mental or physical status of Presidents Trump or Biden.)

The “no exam, no comment” rule is far less compelling when we’ve all become accustomed to watching politicians perform under pressure on our TV, phone and computer screens. Doctors, like everyone else, now have more leeway to opine, even if formal diagnosis without an exam is still frowned upon.

In this case, Fetterman and Oz engaged in an hour-long public debate, which served as a sort of mini examination of the candidate’s speaking and comprehension. Fetterman was permitted a sophisticated closed-captioning system to allow him to read questions posed by the moderator.

Despite this and other accommodations, Fetterman stumbled badly. His speech was halting and on occasion he couldn’t pivot from one thought to another. By itself, this was merely concerning, but his answers were occasionally nonsensical and in some instances non sequitur. It was quite apparent the processing problem was significant and the conclusion of “no work restrictions and can work full duty in public office” was somewhere between overly optimistic and unrealistic. The workload in question is demanding, ceaseless and, in the national security realm, resolves matters of life and death.

Fetterman’s deficiency — his lack of versatility as the conversation darted this way and that — was obvious to any viewer, us physicians included. This wasn’t entirely surprising. NBC reporter Dasha Burns had said, several days before the debate, that when Fetterman spoke to her without the aid of a captioning device, “it wasn’t clear he was understanding our conversation.”

Circling back to Dr. Chen, why did he write a report giving Mr. Fetterman carte blanche to return to work with no restrictions, when the debate demonstrated that assessment was dubious at best? Doctors write “return to work” statements routinely and one of the tricks of the trade in problematic situations like this, when it is hard to commit one way or another, is to hedge or use ambiguous language. Leave it to the employer/reader to decide the patient’s fitness for work or let future events dictate the patient’s status. Dr. Chen could have done that, but he chose a “damn the torpedoes, full speed ahead” approach. He doesn’t see any problem.

You don’t have to be a brain surgeon (sorry) to understand his motivation. Dr. Chen is an active Democratic supporter. According to Federal Election Commission Records, Dr. Chen has made four contributions to the Fetterman campaign in the past year and a half, totaling $1,330. He has also made contributions to the Democratic National Committee, the Democratic Senatorial Campaign Committee, and several Democratic candidates of almost $3,000 altogether.

Dr. Chen has every right to support candidates of his choice and donate money as part of that support. He crosses the line when he commingles professional judgment with political support. Before the debate, Fetterman campaign spokesman Joe Calvello told The Washington Free Beacon, the doctor’s report was not about politics. Subsequent facts proved otherwise. (And before you skip to the comment section, yes, Donald Trump cherrypicked his doctor for a glowing health report; this is not a partisan issue).

The problem is that by letting his politics intervene, Dr. Chen uses his professional status to mislead the public. We are entitled to an honest assessment of how a candidate’s health status might affect his ability and performance in crucial situations; Dr, Chen failed to give us that, providing instead a campaign talking point.

Compounding this problem is something even more serious from a professional standpoint. This is one more breach of trust between the medical profession and the public, at a time – the COVID pandemic – when that foundation of trust, is at a new low. It takes a long time to create a cornerstone between doctors and the public. For nothing more than parochial interests, Dr. Chen’s letter is one more damaging chip to that cornerstone. When I am asked why someone should believe doctors, things like this make it hard to answer.

Some in Mr. Fetterman’s camp, including his wife, would have you believe commenting on his debate debacle is about discrimination against those with disabilities – ableism, another noxious new term that seems to consider all disabilities in one class. This is arrant nonsense. People who wear glasses can serve in office, people in wheelchairs can serve in office (a certain president comes to mind). Someone who misses the word “not” in a sentence because of processing disability is not in the same category. If there is any discrimination going on, it is by those who don’t want to recognize people as individuals, with different abilities – and disabilities

The origin of the word “profession” comes from the Middle Ages for those who professed an oath to use their learning to serve the public. The original professions were the clergy, law, military, and medicine. The definition has since expanded and much has changed but serving the public with your learning remains constant. By that measure, Dr. Chen’s actions were not professional.

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Cory Franklin is frequent and valued contributor here at johnkassnews.com.

He is a doctor who was director of medical intensive care at Cook County Hospital in Chicago for over 25 years. An editorial board contributor to the Chicago Tribune op-ed page, he writes freelance medical and non-medical articles.

His work has also appeared in the New York Times, Jerusalem Post, Chicago Sun-Times, New York Post, Guardian, Washington Post and has been excerpted in the New York Review of Books. Cory was also Harrison Ford’s technical adviser and one of the role models for the character Ford played in the 1993 movie, “The Fugitive.” His YouTube podcast Rememberingthepassed has received 900,000 hits to date. He published Chicago Flashbulbs in 2013, Cook County ICU: 30 Years Of Unforgettable Patients And Odd Cases in 2015, and most recently coauthored, A Guide to Writing College Admission Essays: Practical Advice for Students and Parents in 2021.

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