Aging Experts Don’t Really Want to Talk About the Election

Every day, my inbox is filled with opinions on everything from poop transplants to climate change. When news breaks in medicine, inevitably someone sends me an email offering me an opinion piece.

Except on one issue: the health of the main presidential candidates. Almost no one wants to touch it.

This first became clear to me last year, shortly after starting my job as editor of First Opinion. Even in the spring and summer of 2023, the speech questioned whether President Joe Biden and former President Donald Trump were too old to occupy the White House for another term. Around the same time, Sen. Mitch McConnell had frozen as he spoke, while then-Sen. Dianne Feinstein had died after several years of concerns about her ability to perform her duties.

I thought STAT readers would want to hear from an expert on health and aging, so I contacted probably dozens of gerontologists and geriatricians. (It took me longer than it should have to realize the difference between those specialties: gerontologists study aging, geriatricians treat older patients.)

I started with those who had written previous First Opinions, but they all objected or simply did not respond. When someone refused, I would ask them to suggest someone else who might be willing or able to write. I would then chain my way through a university’s gerontology department until I was four or five degrees away from the original person I had communicated with.

Many of those who refused said they were too busy. But others were frank: They simply didn’t want (or weren’t allowed) to weigh in on such a controversial topic. Of course, there are plenty of people offering opinions and even diagnoses on cable TV and online, but they are generally not the measured experts STAT readers want and deserve to hear.

I finally found an author who was willing to write. something: Anna Chodos, associate professor of clinical medicine in the UCSF Division of Geriatrics and practicing geriatrician. Quite rightly, he did not want to comment directly on Biden or Trump’s health. Instead, he wrote a thoughtful opinion piece arguing that age limits for politicians are a terrible idea. “Aging is a heterogeneous and unpredictable process mitigated by old advantages in life and luck,” he wrote.

But as an opinion editor, I still wanted to find someone who could make a compelling argument: The candidates were too old! They weren’t too old! Trump was clearly going senile, but Biden was fine! Biden was clearly going senile, but Trump was fine! Everyone is worried about the wrong aspects of aging!

Since then, I have tried again and again this month.

Fortunately, First Opinion has published a few other articles on the candidates’ health, notably by Lawrence K. Altman, a doctor and reporter who has been covering the issue since the 1970s for the New York Times. In February he wrote a measured testfilled with anecdotes from his previous reports, arguing that candidates should share more information. Like Chodos, he urged people not to give in to stereotypes: “Studies have shown that 17% of Americans aged 75 to 84 and 32% of those aged 85 and older have dementia. But that means more than two-thirds do. No “I have dementia.”

In July, he was more forceful, arguing that Biden needed to release records from a complete medical evaluation. And this week highlighted an important point: When Vice President Kamala Harris and Trump began insulting each other about cognitive health, they overlooked the suffering of millions of Americans with mental illness.

Last week, STAT also reported that ethicist George J. Annas makes a surprising argument: that the president and the candidates deserve doctor-patient confidentiality. He notes that the public needs the president to be able to freely discuss embarrassing conditions with his doctor, rather than hiding them. (It does say that the president has an ethical responsibility to share any conditions that may interfere with his ability to perform his duties.)

But none of those essays, despite being packed with information, completely scratched my itch. It’s always difficult to find experts (trained to weigh nuances and write 30-page academic papers) who are willing to make the kind of argument that fits into a Google-friendly headline. But I have discovered that this, without a doubt, is the most difficult topic on which to assign opinion pieces in my almost 20 years of working in opinion journalism.

The question is: Why?

The reasons the experts gave me seem to fall into three groups.

First, it is too complicated to judge from afar whether someone has Parkinson’s, cognitive impairment, or mental illness. Fair.

Second, they don’t want to upset their colleagues. They worry that a simplistic argument will cause their peers to look down on them, perhaps damaging their professional reputation. Also fair. The stigma of engaging with a popular audience is real, although it is disappearing. Institutions increasingly encourage this type of writing, with some serious caveats.

Third, and most worrying: they are afraid of angering readers.

These are, to put it mildly, a controversial election. As a voter living in the Philadelphia suburbs, one of those “swing communities,” I see it in practice, literally. No matter how well supported it is, experts worry that sharing an aggressive opinion could expose them to harassment online or offline. It is something that all medical experts have become. more cautious about in it Covid wake. What might once have seemed like a public service, even an ethical imperative, now feels physically dangerous.

That means knowledgeable people are less inclined than ever to offer informed opinions. Good opinion writing is about helping readers think about the world, preparing them to understand the strengths and limits of opposing arguments. When the climate has made sharing a good faith argument seem dangerous, we all lose.

I would never want someone to present an argument that they are uncomfortable with or, worse yet, one that could expose them to harm. But I hope things change and we can recapture both the joy and usefulness of making a bold, exciting op-ed that makes people angry in a good way.

As always, if you have a surprising and surprising idea for an op-ed, send me an email: (email protected). You can find our guidelines here.