Hillary Clinton’s recent “medical episode” on 9/11/2016 added fuel to the political debate over her state of health. Even skeptics such as Washington Post writer Chris Cillizza went from pleading, “Can we just stop talking about Hillary Clinton’s health now?” (9/6/2016) to arguing that, “Hillary Clinton’s health just became a real issue in the presidential campaign” (9/11/2016).
In response to the renewed questions, Clinton’s physician Dr. Lisa Bardack released a public letter on 9/14/2016 giving an update on Clinton’s health. This letter, in turn, has sparked further public discussion. I just want to discuss two issues that have been part of the current controversy:
1) Clinton’s diagnosis of non-contagious pneumonia
Some Clinton foes have questioned the diagnosis of pneumonia, asking if it was appropriate for to have hugged a young child at a campaign appearance when she knew she had pneumonia. This was one of many typical online comments: “Pneumonia is contagious. Why was Clinton hugging a child in a staged photo op after her episode? Either she is an idiot or she is lying.”
Dr. Bardack’s letter stated the Clinton had a “mild non-contagious bacterial pneumonia” — a diagnosis also questioned by skeptics.
Although I’m not an infectious disease expert, Dr. Amesh Adalja is. In a recent article, he noted:
Bacterial pneumonia is not ordinarily contagious like the flu, said Dr. Amesh Adalja, a board-certified infectious disease physician at the University of Pittsburgh. “Most bacterial pneumonias begin with bacteria colonizing the upper airway — at this stage nasal colonizing bacteria can be passed from person-to-person but don’t always necessarily lead to pneumonia. Viral pneumonia, on the other hand, can be contagious as the respiratory viruses that cause it can spread through coughs and sneezes.”
2) An apparent inconsistency in the description of Clinton’s CT scan
This is an area I feel more qualified to discuss, because I am a board certified diagnostic radiologist. Dr. Bardack’s letter also mentioned that:
A non-contrast chest CT scan, including a CTA calcium score, was performed. This test allowed for specific imaging of her lungs while also following up on cardiac risk stratification from 2010 given her family history of heart disease. The results of the CT scan revealed a small right middle-lobe pneumonia; her coronary calcium score was again zero.
Again, some have questioned the accuracy of that comment. A “CTA” is an abbreviation for a radiology test known as a “computed tomography angiogram.” By definition, this requires the injection of intravenous contrast (or “dye”) into the blood stream. So there is a contradiction between the description of the study as “non-contrast” and the named test, “CTA.”
However, the “calcium score” exam mentioned is typically performed without IV contrast and the rest of Bardack’s paragraph makes sense if one assumes that she meant to say “CT” (without the “A”) rather than “CTA.” In other words, her use of the term “CTA” may have been a typo, which would not surprising coming from a physician who isn’t necessarily familiar with all the nuances of radiology terminology. However, only Dr. Bardack knows whether she meant to say “CT” rather than “CTA” and I hope she chooses to address this point publicly.
For what it’s worth, I’m not a supporter of Hillary Clinton. I oppose the vast majority of her political positions including her views on economics, health care, foreign policy, gun rights, free speech, and domestic surveillance. I think she would make a terrible President of the United States. However, attacking Clinton due to apparent dishonesty in her physician’s descriptions of “non-contagious bacterial pneumonia” or a “CTA” test without IV contrast is counter-productive. Such attacks are too easily refuted, and will merely discredit those on the political Right who oppose Clinton’s candidacy. I’d much rather her opponents focus their energies against her public policy positions.
There are a lot of reasons to oppose Hillary Clinton. But arguments over “non-contagious bacterial pneumonia” and “CTA” are merely a distraction that don’t serve the American public.
(Note: I am not a supporter of GOP nominee Donald Trump either.)
