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H2O Man

(74,320 posts)
Sat Jul 11, 2020, 11:30 AM Jul 2020

Cognition, Orientation & MMSE

Donald Trump has recently bragged that he did surprisingly well on a cognitive test during his unscheduled November 2019 trip to Walter Reed Military Medical Center. As others have pointed out, if this were true, it would be a curious thing to boast about -- "medical professionals were shocked that I could pass a test!" But, of course, Trump never purposely tells the truth.

In researching this over the last 48 hours, I think that I have learned what actually happened on that November day. What is it that Trump has recently twisted and distorted into a really great cognitive test, the with the biggest score ever? Is there actually some connection between Trump's embarrassing fabrication and reality? Perhaps the tiniest of grains of truth?

Trump was upset when he entered Walter Reed, and became more agitated while inside. In such instances, doctors do what is known as a mini-mental status exam. (Some readers are no doubt thinking, "Yes, of course. A Folstein MMSE.&quot This test measures if the person is oriented, able to pay attention, and involves mental and motor skills. The results help the doctors to determine if there may be a phyical or mental issue involved. In a sense, could be called a cognitive test to make the person more at ease if they are agitated.

An MMSE is conducted in a quiet, well-lit room. The doctor asks a series of questions, with three primary focuses: person (what is your name?), time (what is today's date?), and place (where are we?). The full test includes two pages of questions, although in the crisis evaluations with a psychiatrist that I used to sit in on, it was usually an abbreviated version.

When Trump was able to answer the questions he was asked, the doctor did say, "Remarkable! You aced it!" Thus, Trump's hostility melted away, and he was convinced he had done extraordinarily well. In the diseased regions of his mind, this MMSE has morphed into an extensive cognitive test that documented that he is a very stable genius.

If I were to try to place this in context -- and this is merely my opinion -- it fits snuggly into my previously saying on this forum that a sociopath under pressure can experience episodes of psychosis. Trump's more extreme episodes of aggitated hostility and victimhood are something that I asked Dr. Bandy Lee about in my February 2020 interview for DU. The old boy is deteriorating before our very eyes.

Peace,
H2O Man

54 replies = new reply since forum marked as read
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Cognition, Orientation & MMSE (Original Post) H2O Man Jul 2020 OP
Thanks for these details. Of course we all know that tRUMP is nucking futs but it's good to abqtommy Jul 2020 #1
The way he twists H2O Man Jul 2020 #7
Agreed Dawgman49 Jul 2020 #2
Yeah, he'd get really high scores on that one! MoonRiver Jul 2020 #3
Is that the one that asks.... targetpractice Jul 2020 #5
Right! H2O Man Jul 2020 #8
My question is, what was going on that caused him to go to Walter Reed The Velveteen Ocelot Jul 2020 #4
That's the essential H2O Man Jul 2020 #12
Being given a test for cognition isn't part of a routine doctor's visit. The Velveteen Ocelot Jul 2020 #19
I've never been H2O Man Jul 2020 #21
I've had this test 3 times. wnylib Jul 2020 #32
You Mean He Didn't Answer John Barron? Me. Jul 2020 #6
Ha! H2O Man Jul 2020 #13
Yes indeed - The old boy is deteriorating before our very eyes. malaise Jul 2020 #9
Since When Is He Proactive About HIs Health? Me. Jul 2020 #11
His healthy diet? H2O Man Jul 2020 #15
Hahahaha malaise Jul 2020 #17
I keep thinking H2O Man Jul 2020 #14
You are 100% correct malaise Jul 2020 #30
Link update reACTIONary Jul 2020 #27
Thanks malaise Jul 2020 #28
It was part of his physical - in 2018. Ms. Toad Jul 2020 #35
Thanks for the link n/t malaise Jul 2020 #37
I thought it was only a year ago, until I went hunting for it. n/t Ms. Toad Jul 2020 #39
I searched for the WR emergency visit last year malaise Jul 2020 #41
It's sad when you can't tell coeur_de_lion Jul 2020 #10
There have been H2O Man Jul 2020 #16
We are seeing him travel the road map she laid out. malaise Jul 2020 #18
I haven't spoken H2O Man Jul 2020 #20
Nixon, yes. I remember that. wnylib Jul 2020 #36
From reading Dr. Lee's twitter coeur_de_lion Jul 2020 #38
Also Bandy Lee published another link coeur_de_lion Jul 2020 #43
If he's a sociopath, that's one thing. If he's experiencing cognitive failure, that's another. blogslut Jul 2020 #22
Yep. H2O Man Jul 2020 #23
Yes we are :-( OverBurn Jul 2020 #31
Yes. Both conditions. Scary, isn't it? wnylib Jul 2020 #40
Go for the record on live tv. safeinOhio Jul 2020 #24
Oh, hell. I remember doing that when wnylib Jul 2020 #42
Great to see you back posting, H20 Man - and obviously quite congitively competent, also. erronis Jul 2020 #25
Yes, glad you're back. Missed your insights. wnylib Jul 2020 #44
I dealt with head injured patients Warpy Jul 2020 #26
Head injuries are H2O Man Jul 2020 #51
So weird. We're shocked because he's a fucking moron? OverBurn Jul 2020 #29
The only circumstance H2O Man Jul 2020 #48
I like presidents that don't require cognitive pop-quizzes. Nevilledog Jul 2020 #33
I like presidents H2O Man Jul 2020 #47
Well, there that too.....lol Nevilledog Jul 2020 #49
I like both of those things. Iggo Jul 2020 #54
His test was more than two years ago Ms. Toad Jul 2020 #34
Yes, I remember that article. H2O Man Jul 2020 #45
I don't think the two were connected. Ms. Toad Jul 2020 #50
Good call. H2O Man Jul 2020 #52
Well, when you announce your candidacy going DOWN an escalator MagickMuffin Jul 2020 #46
Absolutely! H2O Man Jul 2020 #53

abqtommy

(14,118 posts)
1. Thanks for these details. Of course we all know that tRUMP is nucking futs but it's good to
Sat Jul 11, 2020, 11:34 AM
Jul 2020

understand the process...

H2O Man

(74,320 posts)
7. The way he twists
Sat Jul 11, 2020, 12:20 PM
Jul 2020

things is diagnostic in and of itself. Both people I spoke with said it is important to understand that Trump has convinced himself that he actually aced a cognitive test. I said that he has never hesitated to outright lie. Both said that while true, it is equally true that he has a limited capacity to grasp the trith. One pointed out that he fully believes in the most pathetic of conspiracy theories.

Dawgman49

(243 posts)
2. Agreed
Sat Jul 11, 2020, 11:38 AM
Jul 2020

would love to see his results on the MMPI, Minnesota multiphase personality inventory, would probably be off the chart

targetpractice

(4,919 posts)
5. Is that the one that asks....
Sat Jul 11, 2020, 11:50 AM
Jul 2020

"Are your stools black and tarry?" multiple times in the set of 500 questions?

H2O Man

(74,320 posts)
8. Right!
Sat Jul 11, 2020, 12:21 PM
Jul 2020

I'm thinking the exact same thing. Trump wouldn't even have to study for it to get high marks.

The Velveteen Ocelot

(117,805 posts)
4. My question is, what was going on that caused him to go to Walter Reed
Sat Jul 11, 2020, 11:49 AM
Jul 2020

(suddenly, on a Saturday) in the first place, and when he got there, why, exactly, did the doctors think it was necessary to give him any kind of cognitive test? Why was he upset, and why was he so agitated and possibly confused? Did they think he might have had a stroke, or was he decompensating psychologically for some reason? Just being oriented as to time and place and being able to draw a clock and identify a camel still leaves a lot of possible pathologies. Their excuse that the visit was just an early start on his annual physical was obvious bullshit. What was really going on?

H2O Man

(74,320 posts)
12. That's the essential
Sat Jul 11, 2020, 12:38 PM
Jul 2020

question, isn't it? While I think HIPAA is a good thing, it would seem that there should be an exception in this case. I've tried to find out, but even people at MSNBC and the NYT only have unconfirmed speculation.

Last night, in an attempt to measure his decline, my son and I watched the second 2016 presidential debate again.For context, my son reminded me that Clinton was one of the most capale debaters of this era. As oddly as Trump behaved, his ability to think and speak in an extended period of time in the fall of 2016 wass starkly difference than his presentation today.

The presidency can take a toll on the most qualified of persons. Keeping in mind that Trump is at best a part-time president in terms of his efforts, things have increased the pace of his decline. I suspect that, at the time he went to Walter Reed, it was the investigation of his Ukraine "policy" that troubled his sick mind.

For the good of the country, those who got him to Walter Reed should recognize an obligation to tell the public what factors motivated them to get him to an unscheduled appointment. But the good of the country isn't a factor for them ....unless one thinks that Kellyanne's heading a small group effort that rsulted in George's NYT op-ed and book by "Anonymous" is noble.

The Velveteen Ocelot

(117,805 posts)
19. Being given a test for cognition isn't part of a routine doctor's visit.
Sat Jul 11, 2020, 12:53 PM
Jul 2020

I've never been given one, even at my relatively old age - not for a sprained knee or bronchitis or a broken toe or anything else I've been treated for lately. That's because none of those visits were to check up on symptoms suggesting a condition that would cause me to be confused or suffering from dementia (some people think I'm confused all the time, but that's a different issue ). There had to be some reason why they wanted to know whether the hamster was dead even if the wheel was still spinning (and the answer to that is kind of obvious; the wheel can still spin even if the hamster can't tell a camel from a rhinoceros). Fat Nixon evidently was able to "pass" that basic evaluation but that doesn't mean there isn't something wrong with him, or that the Walter Reed doctors suspected as much.

H2O Man

(74,320 posts)
21. I've never been
Sat Jul 11, 2020, 01:02 PM
Jul 2020

given one, and I've had many medical issues over the past three decades. I've only seen them in one of two contexts: when an individual was brought in on a crisis call to be evaluated by a psychiatrist, or during a "med review" when the psychiatrist sees the person is not doing well and likely is non-compliant in taking their medication as prescribed. I cannot think of a single other example.

I suspect that the current pressures -- the upcoming election, the Russian bounties he ignored, corona virus, and the BLM demonstrations -- have not made for a stable White House environment, or a very stable genius. The next few months are high-risk.

wnylib

(22,991 posts)
32. I've had this test 3 times.
Sat Jul 11, 2020, 02:58 PM
Jul 2020

The first time was for a specific disorder. I told my doctor for 2 years that I had occasional memory lapses. He laughed it off as normal aging (I was 60 at the time). But when I had some dizzy spells and thought lights were dimming when people told me they weren't, I feared I was having tia's and demanded that my doctor take it seriously. He sent me to a neuroligist.

The neurologist did that test with me. It covered the date, then giving me a sequence of five random words that he said he would ask me for later. Then I had to draw a clock face. The test felt embarrassingly juvenile to me. I am not a genius, but I do have a normal IQ. I repeated the words when he asked for them. I had made associations in my mind for them as a recall technique. Then I had to name a certain number of words beginning with the letter "h" (20? Not sure now how many since this was several years ago). And a few other questions

He did a blood test which showed a very severe vitamin D deficiency. He said that could cause tia's and ordered a brain MRI which confirmed several tia's. He also noted that my BP was too high considering that I was on BP medication. He was very blunt and direct about my regular doctor being negligent in not following up on my complaints for the previous 2 years, not changing my BP med, and not monitoring my vitamin D level because I have a physical disorder that can cause lowered D levels.

The neurologist put me on a prescription dose of 50,000 units a week of Vitamin D for a few months. He contacted my doctor about changing my BP med. Once the D levels were normal again, I started taking daily maintenance doses of D. No more incidents of tia's (knock on wood).

I changed doctors for primary care, too.

(And I passed the cognitive test despite my lowered D and tia's.)

The 2 other occasions I have had the test were in routine wellness checks that United Healthcare does once a year on seniors when they have one of their doctors do a home visit. (Passed those, too, of course.) And no more memory gaps or dizzy spells.




malaise

(272,279 posts)
9. Yes indeed - The old boy is deteriorating before our very eyes.
Sat Jul 11, 2020, 12:25 PM
Jul 2020

I watched an expert in the field in a state of stunned incredulity at the Con's claims about this MMSe test. He had a hard time keeping a straight face but was very curious to know why the Con was taken to WR in the first place.

Remember when and his goons told us it was part of his medical. Clearly it was not.

https://www.vox.com/policy-and-politics/2019/11/18/2097-explained
<snip>
President Donald Trump made a trip to Walter Reed National Military Medical Center in Bethesda, Maryland, as White House press secretary Stephanie Grisham put it, to “begin portions of his routine annual physical exam” on Saturday. But there are indications the trip wasn’t as routine as the White House would have the public believe.

To be clear, there’s no hard evidence that Trump’s trip to the hospital was anything more more than a 73-year-old man being proactive about his health. But the White House’s complete lack of credibility on issues from crowd size to foreign affairs makes it disconcertingly easy to disbelieve what officials say.

While there would likely be fewer questions surrounding Trump’s health if the White House hadn’t long established a reputation for lying about everything, there are a number of indicators that something out of the norm went down on Saturday afternoon.
-------------------------

The Con so wanted to raise this cognitive nonsense that he forgot the lies associated with the trip to the hospital last year. We have a saying here - mouth open, story jump out.

H2O Man

(74,320 posts)
14. I keep thinking
Sat Jul 11, 2020, 12:43 PM
Jul 2020

of the old saying, "You couldn't make this shit up." If some person had authored a novel describing this before 2016, no publisher would have thought it worthy of being printed. Far too unrealistic.

At best, the script for a C-grade drive-in movie.

H2O Man

(74,320 posts)
16. There have been
Sat Jul 11, 2020, 12:46 PM
Jul 2020

two other presidents in my lifetime who had episodes that involved breaks from reality: LBJ and Nixon. But nothing like this. He is exactly as dangerous as Dr. Lee has been warning that he is. We are seeing him travel the road map she laid out.

malaise

(272,279 posts)
18. We are seeing him travel the road map she laid out.
Sat Jul 11, 2020, 12:49 PM
Jul 2020

THIS

I hope his enablers also pay for this literal and figurative madness

H2O Man

(74,320 posts)
20. I haven't spoken
Sat Jul 11, 2020, 12:53 PM
Jul 2020

with her in over a month now. But I think there is a "Part 3" interview coming up. Events are happening so rapidly that it's hard to keep pace.

wnylib

(22,991 posts)
36. Nixon, yes. I remember that.
Sat Jul 11, 2020, 03:08 PM
Jul 2020

But LBJ? When? I don't recall him having a reality break. But I do remember that he looked ragged and worn out when he announced that he would not run for another term.

coeur_de_lion

(3,745 posts)
38. From reading Dr. Lee's twitter
Sat Jul 11, 2020, 03:12 PM
Jul 2020

it looks like she has a new consulting thing going with the Biden campaign and other groups of concerned government officials. She's doing it pro bono.

See here:

[link:


?s=20|

blogslut

(38,224 posts)
22. If he's a sociopath, that's one thing. If he's experiencing cognitive failure, that's another.
Sat Jul 11, 2020, 01:03 PM
Jul 2020

If he's a sociopath experiencing cognitive failure, hoo boy.

wnylib

(22,991 posts)
40. Yes. Both conditions. Scary, isn't it?
Sat Jul 11, 2020, 03:18 PM
Jul 2020

It makes me think of ancient Rome when insane emperors ruled.

Or Medieval Europe when incompetent, insane kings remained on thrones in the belief that they were God's annointed ones by blood descent. But at least then there were blood relatives who often deposed those kings.

Our system was supposed to prevent that nonsense by letting the people choose a competent person and providing for impeachment and removal if he/she proved incompetent or corrupt.

But now we've seen that system fail and need to fight to re-establish it.

safeinOhio

(33,242 posts)
24. Go for the record on live tv.
Sat Jul 11, 2020, 01:15 PM
Jul 2020

Reporters, start you stop watches. Ok, Donny count backwards from 100 by 7. GO.

wnylib

(22,991 posts)
42. Oh, hell. I remember doing that when
Sat Jul 11, 2020, 03:24 PM
Jul 2020

i was only 6 years old and being knocked out with ether for a tonsillectomy.

The nurse first checked that I could count to 100, then told me to do it backwards. But when I got groggy and made mistakes, I started over to correct myself. LOL.

The nurse cursed and told the anesthesiologist to increase the dose.

Warpy

(112,232 posts)
26. I dealt with head injured patients
Sat Jul 11, 2020, 01:51 PM
Jul 2020

for quite a bit of my career, people who can turn on a dime, so I've had occasion to do the quick and dirty rundown of gross cognitive functioning, myself. His conflation of that with a praiseworthy performance on a math test is nothing short of astonishing, but the real nugget of truth here is that he was given one, at all.

That suggests his visit was a precaution to rule out a CVA.

There is a great deal of overlap between antisocial personality disorders and malignant narcissism, but I do agree with your last sentence: under pressure, he's losing the plot quickly. The problem is that pressure or no pressure, he will be a destructive force until he is removed one way or another.

Personally, I'm in favor of keeping the pressure on. I knew in November 2016 that either the office would destroy him or he'd destroy us, and I vastly prefer the former.

H2O Man

(74,320 posts)
51. Head injuries are
Sat Jul 11, 2020, 03:47 PM
Jul 2020

so complicated. Things such as if the injury was to the front or back of the head cause a wide variety of symptoms. My interest in the topic started as a result of its connection with boxing. It grew, of course, two years ago when I had a brain injury resulting from a fall. Then a cousin had a motorcycle accident, and was in a coma for about a week or so.They change your life.

I vote with you. Let's destroy him in November.

OverBurn

(1,017 posts)
29. So weird. We're shocked because he's a fucking moron?
Sat Jul 11, 2020, 02:15 PM
Jul 2020

So weird. When would medical professionals make comments like that, ever. Was it a fucking Mensa Test he aced? Yes that would be shocking. Or were the medical professionals shocked he passed a simple test, because he's a fucking moron that can hardly string a sentence together.

H2O Man

(74,320 posts)
48. The only circumstance
Sat Jul 11, 2020, 03:41 PM
Jul 2020

that I can think of that might result in a doctor saying something like that is if they were dealing with a brat.

Nevilledog

(52,146 posts)
49. Well, there that too.....lol
Sat Jul 11, 2020, 03:42 PM
Jul 2020

Imagine all the books to be written about his sociopathy and malignant narcissism.

H2O Man

(74,320 posts)
45. Yes, I remember that article.
Sat Jul 11, 2020, 03:38 PM
Jul 2020

I can't connect to it now, and thus am depending on my memory -- which admittedly isn't what it once was. But if I do remember correctly, it was based on a summary, and did not involve any reporter etc access to the actual medical records. Again, I recognize that my memory is not always the best. And I appreciate yournoting it was the Montreal test, as another person had described.

Indeed, it may be all that Trump has been yapping about. However, it is still different than the information I've been told about his unscheduled appointment at Walter Reed.

Ms. Toad

(34,863 posts)
50. I don't think the two were connected.
Sat Jul 11, 2020, 03:44 PM
Jul 2020

He's been yammering recently about the cognitive assessment - as a way of attacking Biden's mental acuity.

From the 1/2018 article:

During President Trump’s medical exam this week, he was given a cognitive test and passed with a perfect score.

“I’ve found no reason whatsoever to think the president has any issues whatsoever with his thought processes,” said the president’s physician, Dr. Ronny L. Jackson, a rear admiral in the Navy.


Most people don't remember the test 2+ years ago and are thinking that when he said "recently" that he was referring to the Walter Reed visit.

MagickMuffin

(16,343 posts)
46. Well, when you announce your candidacy going DOWN an escalator
Sat Jul 11, 2020, 03:39 PM
Jul 2020

Everything is downhill from there!

Mental health DOWNHILL

Physical health DOWNHILL

Mental Health of the Nation DOWNHILL



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