When Physician to the President Dr. Sean Conley addressed the media today at Walter Reed National Military Medical Center in Bethesda, his responses to questions raised more questions with media and those watching on television.

For example, why would he not say definitively that President Trump has not used supplemental oxygen?

As a former vice president of a health care company–and an ongoing coronavirus patient–let me try to shine a little light on the reason I’m taking the statements from the White House physician with a grain of salt. 

First off, you’ve got to remember one thing:  while Conley is a public servant and on the government payroll, he is Trump’s personal physician.  You can make a strong argument that the medical condition of the person who has his finger on the largest nuclear arsenal in the world is an issue the electorate should have access to.

But as Trump’s personal physician, Conley is limited on the amount of information he can release by HIPAA, the federal Health Insurance Portability and Accountability Act of 1996.  That law, which protects every patient in the US, bars doctors from publicly disclosing a patient’s health information.

There’s one time when a doctor can talk about that patient:  when the patient him/herself allows disclosure of specific information.

In other words, Trump gets to decide what Conley can tell the press.  In this case, based on the hoops Conley jumped through to avoid saying Trump was on supplemental oxygen, Trump likely instructed Conley that he could not release that he had been on supplemental oxygen.

If you look at the releases Conley sends through the White House Press Secretary, they start with, “I release the following information with the permission of President Donald J. Trump.”  Conley’s acknowledging that he’s not giving all Trump’s health information; he’s only giving the information Trump has permitted him to release.

In a normal presidency, the President has understood that it’s in the public interest for Americans to know the health of the president, but as we know, this was not always the case.  Reagan had early onset Alzheimer’s in his final years in office, and his wife reportedly took over Executive duties.  FDR never publicly acknowledged he had polio, but it never impacted his ability to govern.  Wilson had a stroke and his wife took over Executive duties.

Trump is, and has been, hiding his medical condition from the public.  Conley is handcuffed by law on what he can say, and his statements should be examined for as much as what he doesn’t say as much as for what he does.

What we should listen for

There is some information the media should ask the doctors.  When I first got diagnosed with coronavirus, my doc told me to monitor two stats:  my temperature and my PulseOx, or pulse oximetry.

Temperature is an obvious way to tell someone is sick, or getting sicker.  However, coronavirus patients don’t always spike a fever (I didn’t), so using that as a sole metric is flawed.

PulseOx, however, is a more important measurement.  It’s the oxygen saturation level of your blood, and it tells you how efficiently your cardiopulmonary system is working.  Normally, your PulseOx–measured by a non-invasive monitor clipped to your finger; you can buy one on Amazon for $25–should be 97 or higher.  The max measurement is 100.

If your PulseOx goes under 95 consistently, it’s a danger sign, but not a critical one.  If it drops below 90 consistently, as my doctor told me, you should be hospitalized.  Some people in the medical field have told me about coronavirus patients whose PulseOx was in the 70s when they first sought help.

When I was in the depths of my coronavirus case, my PulseOx was regularly under 95, but only two or three times in the two weeks went below 90.  Now, 90 days after first being diagnosed, my PulseOx only drops below 95 a few times a day; it’s usually 95 to 97.

Conley was asked about Trump’s PulseOx by a reporter. He responded that (paraphrasing) Trump’s PulseOx was 97.  He did not say if that was a one-time measurement or a consistent one.

Trump’s walk to the helicopter and his “proof of life” video from the White House, therefore, are less than impressive to me.  Those were bursts of energy that a person with mild to moderate coronavirus would be able to do; it’s the after-effect of the burst where the exhaustion hits.  When I had an active virus, I could shower and shave; afterward, however, I would be so exhausted I would have to rest for hours.

What the media should be asking

If I were a member of the media questioning Conley, I’d get him on the record for a few things:

• Are you giving us only information Trump allowed you to present, or is this a complete and uncensored case review of the President?
• Has Trump instructed you not to tell us specific details about his health?
• What is the daily range of Trump’s PulseOx readings, how much does it vary each day, and what the low he’s hit?
• How is Trump’s stamina impacted?  Would he be able to walk for five minutes without being fatigued or out of breath?
• Does Trump feel winded after talking?  Can he have a 10 minute phone call without impacting his energy?

The obvious disclaimer:  I’m not a medical professional or a lawyer.  I’m relating information and insight from my own personal experience.