Press Briefing by Press Secretary Sarah Sanders and Dr. Ronny Jackson

James S. Brady Press Briefing Room

3:31 P.M. EST

MS. SANDERS:  Good afternoon.  We’ll let John Roberts wrap up.  (Laughter.)  John, can we go ahead?  Hallie is (inaudible).

Q    You’re reasonably on time for a change.

MS. SANDERS:  Trying new things.  Trying new things.  The good doctor has me on time today.

I’m going to open with a statement from Brigadier General Dr. Richard Tubb.  He is a White House physician emeritus, a retired military officer, and one of the longest-serving White House physicians in history, serving from 1995-2009.

As a physician to the President, he earned the trust and confidence of Presidents from differing parties.  He trained under a physician who did the same, and then trained Dr. Ronny Jackson, the current physician to the President who has also earned the trust and confidence of Presidents from both parties.

Dr. Tubb wrote, “I hired and trained Rear Admiral Dr. Ronny Jackson.  My patients, President and Mrs. Bush, knew and trusted him.  I think it’s safe to assume that President and Mrs. Obama trusted him as well.  After all, they personally selected him to be their physician.

Today, Dr. Jackson will offer his professional assessment of the President’s medical fitness for duty.  Friday, Dr. Jackson conducted and supervised Donald Trump’s first periodic physical exam as President of the United States.

Having had the opportunity to review the tests, consult specialists, thoughtfully analyze the results and discuss them with his patient, he will provide us with his considered assessment of the President’s medical fitness for duty now and for the remainder of his term in office.

With regard to Friday’s examination, knowing Dr. Jackson, I’m confident that he practiced good medicine.  However, it would be an error to view that exam and Dr. Jackson’s exam assessment as an isolated event, when, in practice, it is an ongoing process.  Far more important to a meaningful assessment of the President’s fitness for duty is the doctor’s evaluation, observations, interaction, conversations, examination during the remaining 364 days of the year.

Dr. Jackson and his team have been doing precisely that from the moment Donald J. Trump was elected.  Beginning on November 9, 2016, the members of the White House Medical Unit began shadowing the new President-Elect, figuratively Velcro-ed to his side, 24/7.  On January 20, 2017, Dr. Jackson became that Velcro.  Dr. Jackson’s office is one of only a very few in the White House Residence proper and is located directly across the hall from the President’s private elevator.

On any given day, the “physician’s office,” as it is known, is generally the first and last to see the President.  Dr. Jackson has built and leads an organization that is better than any other in history.  I know that.  I, as physician to the President, was well served by this President’s doctor.

More importantly, President and Mrs. Bush were well served by Dr. Jackson, as were President and Mrs. Obama.  In keeping with his oaths, I have every reason to believe that Dr. Jackson will well and faithfully discharge the duties of his office, and that President and Mrs. Trump, the Office of the Presidency, and the country will be well served because of it.”

Thank you, Brigadier General Dr. Richard Tubb, for that background and that information.  And with that, I will turn it over to Dr. Jackson.  And as always, if you could please keep your questions on topic.  And after Dr. Jackson finishes, I’ll come back up to address any other questions of the day.

DR. JACKSON:  Good afternoon, everyone.  All right, so to start with, what I’m going to do is I’m going to read to you the summary of the President’s physical.  And so I’ll just read through this, and then after I’m done reading this, immediately after the brief, we’ll make this available to everyone exactly as I read it here.  And then I’ll take a few questions.

So to start with:  President Donald J. Trump has completed his first periodic physical examination as President of the United States.  I performed and supervised the examination with appropriate specialty consultations and diagnostic testing.

The exam was conducted January 12, 2018, at the Walter Reed National Military Medical Center.  The purpose of the exam was to provide the public with an update of the President’s current health status and to ensure the President continues to enjoy all the benefits of good health.

This examination focused on evidence-based health screening and disease prevention.  With President Trump’s consent, I release the following health information.

Vitals as follows

Age: 71 years and 7 months at the time of the exam

Height: 75 inches.

Weight: 239 pounds.

Resting heart rate: 68.

Blood pressure: 122/74.

Pulse oximetry: 99 percent on room air.

Temperature was 98.4.

Physical examination, by system, to include any studies that were done, by system:

Eyes: The President’s uncorrected physical acuity is 20/30 bilaterally with corrected visual acuity of 20/20 bilaterally.  His visual fields were normal.  Funduscopic exam was normal bilaterally.  His intraocular pressures were normal, and no ocular pathology was discovered.

Head, ears, nose, and throat:  Normal exam of the head, ears, nose, mouth, and throat.

Dental exam: He has healthy teeth and gums.  There were no other dental findings.

Neck: Normal thyroid exam.  No noted lymphadenopathy.  Auscultation of his carotid arteries were normal.

Pulmonary exam: His lungs were clear to auscultation.  A screening low-dose CT of the chest demonstrated no pulmonary pathology.

Cardiac exam: Heart exam was normal.  Regular rhythm.  No murmurs or other abnormal heart sounds were noted.  His ECG, or commonly EKG, was normal sinus rhythm with a rate of 71, had a normal axis, and no other significant findings.

He had a transthoracic echocardiogram done, which demonstrated normal left ventricular systolic function, an ejected fraction of 60 to 65 percent, normal left ventricular chamber size and wall thickness, no wall motion abnormalities, his right ventricle was normal, his atria were grossly normal, and all valves were normal.

He had an exercise stress echocardiogram done, which demonstrated above-average exercise capacity based on age and sex, and a normal heart rate, blood pressure, and cardiac output response to exercise.  He had no evidence of ischemia, and his wall motion was normal in all images.

Gastrointestinal exam:  He had a normal exam, no masses, no hepatomegaly or splenomegaly.  He had a normal optical colonoscopy done in 2013 — June of 2013 — that demonstrated no polyps or abnormal findings.  And because of that, a repeat colonoscopy was not indicated at this time and will be deferred until his next periodic physical exam.

Genitourinary exam was normal.  Extremities and musculoskeletal — normal throughout.  Full range of motion in all joints.  He had strong distal pulses and good capillary refill in all extremities.  He had no swelling or edema.

Neurological exam: examination of the cranial nerves, cerebellar function, deep tendon reflexes, motor function, and sensory system were all normal.

A cognitive screening exam using the Montreal Cognitive Assessment was normal, with a score of 30 over 30.

Dermatologic exam: normal.  No evidence of melanoma, basal cell carcinoma, squamous cell carcinoma, or any other significant dermatologic diseases.

I’m going to very briefly go over some of the labs here that I feel are most important — most providers would be interested in and then you can look at the details when I put out the written.

But laboratory results summarized: A lipid panel.  He had a total cholesterol of 223.  Triglycerides of 129.  HDL of 67.  An LDL cholesterol of 143.  And his total cholesterol to HDL ratio is 3.3.

His complete blood count, to include his white blood cell count, his hemoglobin, hematocrit, and platelet count were all normal.  And the values are on the written copy you’ll get.

His extended metabolic panel, as follows: His fasting blood glucose was 89.  His BUN was 19.  His creatinine was 0.98; indicators of his renal function.  His liver enzymes: His ALT was 27; his AST was 19 — normal.  His hemoglobin A1c was 5 percent.  His vitamin D was 20.  His PSA was 0.12.  And his thyroid screen with the TSH was 1.76.  He had a urinalysis done that was clear and had no evidence of protein, ketones, glucose, or blood.

His past medical history includes hypercholesterolemia and rosacea.

His past surgical history: had an appendectomy at age 11.

His social history: He has no past or present use of alcohol.  No past or present use of tobacco.

His medications, as follows: He takes Crestor, 10 milligrams daily to lower his cholesterol.  He takes aspirin, 81 milligrams daily, for cardiac health.  He takes Propecia, 1 milligram daily, for prevention of male-pattern hair loss.  He takes Soolantra Cream, as needed, for Rosacea.  And he takes a multivitamin each day for health maintenance.

Immunizations: The President, during his physical exam, had a Prevnar 13 immunization to prevent pneumococcal pneumonia and he had Number 2 dose of his Twinrix to prevent hepatitis A and B.  His routine vaccinations, to include his seasonal influenza are all up to date, and all indicated travel vaccinations are up to date.

In summary: The President’s overall health is excellent.  His cardiac performance during his physical exam was very good.  He continues to enjoy the significant long-term cardiac and overall health benefits that come from a lifetime of abstinence from tobacco and alcohol.

We discussed diet, exercise, and weight-loss.  He would benefit from a diet that is lower in fat and carbohydrates, and from a routine exercise regimen.  He has a history of elevated cholesterol and is currently in a low dose of Crestor.

In order to further reduce his cholesterol level and further decrease his cardiac risk, we will increase the dose of this particular medication.  The President is currently up to date on all recommended preventive medicine and screening tests and exams.

All clinical data indicates that the President is currently very healthy and that he will remain so for the duration of his presidency.

Okay.  With that, I’ll take some questions.  Before we get started, let me just make one comment.  I would just like to point out for all of you here in this room — many of you which know me — just, if something should happen to you over the next few months and you should fall ill at some point, that most likely I will be the one called to come to take care of you.  (Laughter.)

So when you ask your questions, please keep that in mind.  (Laughter.)

Yes, sir.

Q    Dr. Jackson, how much weight have you suggested the President lose?  And he has not exactly been enthusiastic about exercising.  The President kind of believes that we all have a finite battery — why waste it on exercising when you can put it toward other pursuits.

What did you counsel him about that?

DR. JACKSON:  Right.  Yeah, that’s right.  So you know, I think the President — you know, he and I talked and he would like to lose over the next — I think a reasonable goal, over the next year or so, is to lose 10-15 pounds.  We talked about diet and exercise a lot.  He’s more enthusiastic about the diet part than the exercise part, but we’re going to do both.

He and I will work together over the next year to incorporate a good plan in so that we can meet those goals.

Q    Thank you.  Dr. Jackson?

DR. JACKSON:  Yes.

Q    Thank you.  Two questions for you.  Number one: There have been some questions as part of your exam — I’m wondering if you talked to the President about this — about the President’s mental fitness.  He has pushed back on that calling —

DR. JACKSON: Right.

Q    — himself a “stable genius”.  Can you assess the President’s mental fitness for office?

DR. JACKSON:  Absolutely.  So, many of you may have picked up on the fact that we did do a cognitive assessment as part of the exam.  And initially, you know, I had no intention of including the cognitive assessment in this exam because, to be honest with you, per all the guidelines that are out there, it’s not indicated at this time.

A lot of the guidelines would suggest that you do cognitive screening questions, and that, if you have a positive or concerning answer in the screening questions, that then you engage with a cognitive screening tool.

So I had no intentions whatsoever doing that, like I said, because I didn’t feel it was clinically indicated.  And part of the reason I didn’t think it was clinically indicated is because I’ve spent almost every day in the President’s presence since January 20 — or, you know, last year, when he got into office.  And I’ve seen him every day.  I’ll see him one, two, sometimes three times a day because of the location of my office.  We have conversations about many things, most don’t revolve around medical issues at all.  But I’ve gotten to know him pretty well and I had absolutely no concerns about his cognitive ability or his neurological functions.

So I was not going to do a cognitive exam, I had no intention of doing one.  The reason that we did the cognitive assessment is, plain and simple, because the President asked me to do it.  He came to me and he said, is there something we can do — a test, or some type of screen that we can do — to assess my cognitive ability?

And so I looked into it, and once again — and my initial question was that I didn’t think it was indicated and I didn’t think we should do it.  After looking at some of the guidelines, there are a few guidelines out there that lean in the direction of potentially doing it.  You know, the Medicare guidelines and some of the NIH, National Institute of Aging — they’ve indicated that it might be a good thing to start doing for most patients in the future.

With that in mind, I went through and I looked at a variety of the cognitive assessments that were available.  Most of them were very simple, very short.  And I think that’s the goal, actually, for primary care providers, in doing this, is to keep it simple.  Keep it short.

We picked one of the ones that was a little bit more involved, it was longer.  It was the more difficult one of all of them.  It took significantly longer to complete, but the President did exceedingly well on it.  So that was not driven at all by any clinical concerns I have; it was driven by the President’s wishes and he did well on it.

Q    So to follow up, the President’s personal doctor memorably said during the campaign that he would be the “healthiest individual ever elected to the presidency.”  Do you agree with that assessment?

DR. JACKSON: I’m not going to comment on that.  My job is to basically give you my assessment of President Trump today, and I’m not going to make any comparisons with Presidents over the last 200 years or anything.

Q    There was an incident recently where the President appeared to slur his words while giving an address.  Did you look into what the cause of that might have been at all?

DR. JACKSON:  I did.  Yeah, we talked about that, and actually one of my ENT consultants was involved in that.  We evaluated him, we checked everything out, and everything was normal.  We even went so far as to do an ultrasound of his parotid glands and a few other things, and there was absolutely no clinical findings that would suggest — I think the reason for that was, quite honestly, and, me being up here right now, I think I need a drink of water.  (Laughter.)

But I think that I had given the President some medication — specifically, some Sudafed over the days previous — and I think that I had, inadvertently, kind of dried up his secretions a little bit more than I intended to and I think that led to — or that precipitated it.

Q    Just to follow up, some people have suggested that could be related to dentures.  Does the President wear dentures?  You mentioned the dental exam.

DR. JACKSON:  He does not.  The President has no partial or any dentures of any kind.

Q    I wanted to ask you two questions, one is about the ejection fraction.  My wife suffers from that so I clued in on the 60 percent.  Is that a concern going forward for him because that, in some cases, indicates low activity in the heart?

DR. JACKSON:  No, not at all.  Sixty to sixty-five percent is a normal ejection fraction.  There’s no concern about that all.

Q    A second follow up on the cholesterol.  Over 220, do you hope to get it under 200?

DR. JACKSON:  Well, we’re not focusing on the total cholesterol as much as we are the LDL.  We’d like to get the LDL down below 120, so that’s what we’ll be shooting for.

Q    Anyway, with the low — I understand that the blood pressure was within norms, but with the high cholesterol, are there any concerns for his heart health?

DR. JACKSON: No, not at all.  I mean, I think that the one good thing that — there are many good things that came from his exam.

I think he had great findings across the board, but the one that stands out more than anything to me is his cardiac health.  His cardiac health is excellent.  And so I think, with all the other things in place — he doesn’t have, really, a family history of premature cardiac disease, he doesn’t smoke, he doesn’t have diabetes — a lot of the traditional risk factors he doesn’t have.  And so I think those things, in combination with the excellent cardiac results that we got from the exercise stress test, I think, are very reassuring.

Q    Dr. Jackson, thank you.  Could you just elaborate, in layman’s terms, if possible — and you’ve been doing a great job of that — what you ruled out in these cognitive tests?

You know, there have been reports that the President has forgotten names, that he’s repeating himself.  Are you ruling out things like early onset Alzheimer’s?  Are you looking at dementia-like symptoms?

And then, a second question: A lot of doctors, at the back end of a physical, like to give their patients tips before they walk out the door — things that they should change in terms of lifestyle or behavior.  What did you tell this President — outside of diet — that he might want to change?

DR. JACKSON:  Yes, so I think that that cognitive test, it’s well respected.  It’s a test that’s used throughout the United States; lots and lots of institutions use that test.  It’s the one that they use at Walter Reed for patients that they feel like they need to do cognitive screens on.

So it’s a universally accepted test.  And, like I said, it’s a little bit more extensive than some of the shorter ones that are in some of the guidelines.  But, yeah, it screens for all those things.  It screens for any type of cognitive issues like Alzheimer’s and all those other things.

So the fact that the President got 30 out of 30 on that exam, I think that there’s no indication whatsoever that he has any cognitive issues.  And on a day-to-day basis, like I said before, it’s been my experience that the President — he’s very sharp, and he’s very articulate when he speaks to me.  And I’ve never known him to repeat himself around me.  He says what he’s got to say, and he speaks his mind.  And I’ve found no reason whatsoever to think that the President has —

Q    He speaks his mind?  (Laughter.)

DR. JACKSON:  Yeah.  I’ve found no reason whatsoever to think that the President has any issues whatsoever with his thought process.

Q    And the tips part?  Did you recommend he make any changes — lifestyle, behavioral, anything?

DR. JACKSON:  No, not really.  I think that the main thing that we focused on, with regards to lifestyle changes, are diet and exercise.  And if we get diet and exercise right, then weight loss will come.  So those are the things that we focused on.

I think that there wasn’t a lot to go on here as far as making him healthier in the year coming other than incorporating an exercise routine, working on his diet, and having him lose — some exercise.  Those things will make him much healthier next year than he is now, although his health is excellent right now.

Dr. Gupta, do you want answer one?  Or do you just want to ask?  (Laughter.)

Q    You ordered some pretty intensive tests, including a CT scan of his chest and a transesophageal echocardiogram.

DR. JACKSON:  No, no, it was a transthoracic.

Q    Transthoracic?

DR. JACKSON:  Yes.

Q    Did he need to be sedated at all?  Was there something you were worried about specifically in giving the CT scan?

DR. JACKSON:  No, not at all.  We got the CT scan just because we were debating — I didn’t have any background information on him at all from a pulmonary standpoint.  I didn’t have old chest X-rays to look at or anything like that.

So I was going to initially just get a chest X-ray and be done with it at that.  But it’s so easy nowadays to just whip in, and it just takes a few — a minute or two — about as much time to get a CAT scan in the way we did as it does to get a chest X-ray.  And it gives you a lot more information about other structures in the chest.  So it just made more sense to get the CT done.

With the regards to the echocardiogram, one of the reasons that I did that was because I wanted to prescribe an exercise program for the President, and so I think that it makes sense to get a good cardiac assessment in a controlled environment like the hospital before you prescribe an exercise program to a patient.  So that was my thinking there.

Q    And he does have heart disease, is that what you said?

DR. JACKSON:  No, he does not have heart disease.

Q    Because he had a CT scan before that showed calcium in his coronary blood vessels.

DR. JACKSON:  He does.  He did.  He had a — so technically, he has nonclinical atherosclerotic coronary — coronary atherosclerosis.  And so that’s been mentioned in previous physical exams he’s had done.

He had a coronary calcium score done in 2009.  It was 34.  He had a coronary calcium score done in 2013 that was 98.  And then we did get a calcium score from this one; I didn’t mention it because I think it was clinically good information.  It wasn’t — but it was 133.

So I had a long conversation with the cardiologist — not only the cardiologist at Walter Reed, but the cardiologist at Cleveland Clinic and several other well-known institutions — and everyone saw that as reassuring that he’s gone this period of time and he’s had that much — or that little of a change in his coronary calcium load.

So that I think, overall, his coronary calcium score is very reassuring and goes along with the rest of his cardiac workup.

Q    Dr. Jackson, if I might ask a question that follows on the philosophy of the fitness of the President —

DR. JACKSON:  Yes.

Q    The 25th Amendment, a lot of people in the country have been talking about it.  It basically contemplates that a group of Senate-confirmed laymen will weigh in on whether the President is able to discharge the duties of the office.  You, as the President’s physician, have certainly given this some thought over the years since you’ve been in your role.

On what basis would you — and this is just a philosophical question — advise the Cabinet that the President is unable to discharge his duties?  How does that bar get met?

DR. JACKSON:  Well, I mean — you know, Section 4 of that amendment doesn’t really, you know, give me a specific duty or role in there.  Like you said, it falls upon the Cabinet and the members of Congress and all.

I think I’m just like any other member of the administration who sees him and talks to him on a regular basis.  If I were to see something that was very concerning and I had concerns about his cognitive ability, or something to that extent, that I would bring that up to the proper people in the chain of command, maybe starting off with the Chief of Staff or something.  And, you know, I think that’s what everyone else in the administration would do.

So I don’t think my role as a physician would be much different than any other member of the President’s administration if they thought something like that were going on.  I just think that, once that happened, if there were someone else in the administration, I would immediately be brought into it to make a clinical assessment and see if I agreed with that assessment.

But, no, I mean, I think at this particular point, based on my exam, and the cognitive testing that we did, and just my day-to-day interactions with the President — you know, the President is mentally very, very sharp; very intact.

Q    Do believe he is fit for duty?

DR. JACKSON:  Absolutely, he’s fit for duty.  I think he will remain fit for duty for the remainder of this term and even for the remainder of another term, if he’s elected.

Q    How can you determine that?

Q    Dr. Jackson, you talked a bit about President Trump and your, kind of, daily dealings with him —

DR. JACKSON:  Hang on, let me — did you say how did I —

Q    Yeah, how can you determine that for the whole — I mean, you can’t determine it for four years out, right?

DR. JACKSON:  Yeah, absolutely.  I don’t have a crystal ball; I can’t look into it.  But based on his cardiac assessment, you can make predictions.  You can make cardiac calculations, and you can see what his risk of having a cardiac or a cerebrovascular event might be.

And so if you look at that stuff — where he falls out on his cardiac assessment — he falls into a category that portends years of event-free living.

So, I mean, sure — I myself could have a big event tomorrow.  I mean, I don’t have that kind of — I’m not making that kind of prediction.  But I’m saying, based on the clinical information that I have right now over the year of me observing him and the few things that have happened with him medically over the year, and in large part on the objective data that we gained from this particular exam, I feel very confident that he has a very strong and a very probable possibility of making it completely through his presidency with no serious medical issues.

Q    Dr. Jackson —

DR. JACKSON:  Yes, I’m sorry.  Go ahead.

Q    So you talked about dealing with President Trump on a daily basis.  Can you talk a bit about him as a patient, like what type of patient he is?  Does he take all of your advice?  And you also talked about — since you were dealing with him on a daily basis, has he had any ongoing illness or anything like that?  You talked about giving him Sudafed.  Sometimes it sounds like he has the sniffles when he’s talking.

DR. JACKSON:  Yeah.

Q    Does he have any allergies or anything like that?

DR. JACKSON:  He doesn’t.  I mean, on occasion, he suffers from the same viral upper respiratory stuff that you and I do, and he gets congestion and things of that nature.

But for the most part, one of the things I found about President Trump is that he’s very independent when it comes to his medical stuff.  And so he’s — I guess, you know — the way he grew up, I guess, he just — he takes care of most of the little stuff himself.  He doesn’t come to me for Band-Aids and things of that nature.  And I’m easily accessible, and a lot of folks will.

So I think he’s a good patient.  Sometimes I have to convince him why I want him to do something.  So he doesn’t just take everything I say and just take at face value and move on.  He’ll ask me questions about, why would I do that or why should I do that, or this, that, and the other.  For the most part, he’s very cooperative.  He follows medical direction.  He’s just like every other President I’ve taken care of.  On occasion, I have to get the First Lady involved — (laughter) — to make sure that he’s doing what he’s supposed to be doing.  But, yeah, he’s a good patient.

Q    Dr. Jackson, just to make sure we’re clear on this — when you analyzed his cognitive ability or neurological functions, that is not the same thing as a psychiatric exam or psychological exam, correct?

DR. JACKSON:  It is not.  No, it’s a screening assessment for cognitive impairment.  Yeah, right.

Q    Dr. Jackson, does the President do anything at all right now in terms of exercise?  What is his daily exercise routine, if there is one?

DR. JACKSON:  So I would say, right now, on a day-to-day basis, he doesn’t have a dedicated, defined exercise program.  So that’s what I’m working on.  The good part is that, you know, we can build on that pretty easily.  (Laughter.)

Q    You said you were discussing that with him.  What are you discussing?  What would you like to see him start doing?

DR. JACKSON:  Well, I mean — like I said, he doesn’t have a daily exercise regimen, and he just — you know, some people exercise, some people don’t.  Some people just haven’t done that as part of their routine.  And I would say that’s the category he falls in right now.

I would say, though, that despite that, one of the things, being with the President on a day-to-day basis, that has been impressive to me is he has a lot of energy — a lot of energy and a lot of stamina.

And I think I first noticed that — we traveled, did some overseas travel last year.  And I was really surprised because I didn’t know the President early on.  And the days — we’d get these 14-, 16-hour days, and the staff is just spent after a while.  And you’re just like, man, when are we going to the hotel?  When are we going down?  Because you have all the issues of different time zones and things of that nature, too.

And I’ll tell you, out of everybody there, the President had more stamina and more energy than just about anybody there.  He was the one that was always like, we’re not going to skip this event, we’re going to do this, we’re going to do that, and stuck to the schedule despite the urging of some of us to let’s just forget the rest of the day.

Q    But can you explain to me how a guy who eats McDonald’s and (inaudible) and all those diet cokes and who never exercises, is in as good as shape as you say he’s in?

DR. JACKSON:  It’s called genetics.  I don’t know.  Some people have just great genes.  I told the President that if he had a healthier diet over the last 20 years, he might live to be 200 years old.  I don’t know.  (Laughter.)  He has incredible genes, I just assume.  I mean, if I didn’t watch what I ate, I wouldn’t have the cardiac and overall health that he has.

So he’s very healthy, despite those things.  And I don’t think that he does that anymore.  I mean, he’s in the White House now.  He’s eating what the chefs are cooking for him now, and they’re cooking a much healthier diet for him now.  And we’re going to continue to work on that and make that even healthier.

But I would say the answer to your question is he has incredibly good genes and it’s just the way God made him.

Right here.  Second row.

Q    Me?

DR. JACKSON:  Yep.

Q    Oh, thank you.  You mentioned that you gave the President a cognitive test.  Was that the Mini-Mental State Examination or the (inaudible) test?  And if not, can you tell us what specific cognitive test you gave him?

DR. JACKSON:  It was.  It was the Montreal Cognitive Assessment, sometimes referred to as the MoCA, and you can find it online.

Q    Thanks very much.  Just a couple of things.  Do you have a life-expectancy range for him based on his results?  (Laughter.)

Number two, what exactly does the exercise and eating plan look like?  Is it you’re going to put an elliptical machine next to the bedroom and he’s going to use it?  What does that look like?

And then, also, number three, did you see any evidence of bone spurs, which the President said that he suffered from?

DR. JACKSON:  None of that stuff has been bothering him recently, so we didn’t examine him for bone spurs right now.  He’s not come to me complaining of that, so there was no reason in this particular assessment.  We were pretty crunched for time with everything we had done, so we didn’t look at issues like that.  So I didn’t assess that, no.

As far as life expectancy, I’ll say he probably won’t live to be 200.  But I don’t know, I think his life expectancy is — I would just have to say it’s the same as every other American male right now, but it’s certainly no less.

Q    And then the specifics of the dietary and exercise plan — what’s in store?

DR. JACKSON:  We’re working it out right now.  Actually, what I’m doing is I’m — one of the things is I’m getting a nutrition specialist to come up here and meet with the chefs that we have here.  And they’re going to go over the preparation of the President’s food just to make sure that we’re cutting the calories and the fats and the carbohydrates as much as we possibly can and still making good meals for him.

With regards to the exercise, that’s something that myself and, potentially, Mrs. Trump will work with him upstairs — you know, there’s a gym upstairs, and we’ll get that set up to his specifications.  And we’ll see how that goes.

Q    Is he limited to one scoop of ice cream now?

DR. JACKSON:  I don’t limit his diet at all.  I just make recommendations.

Q    Dr. Jackson, one follow-up question.  There isn’t anything that’s a part of the President’s health records or his overall physical fitness, or any medications that he’s taking that you’re not permitted to tell us?  Is there anything you’re keeping from us for privacy reasons?

DR. JACKSON:  I can promise you there’s absolutely nothing that I’m withholding from this.  And I can tell you that I’ve done the last four or five of these — I’ve been involved in probably the last six or seven of these — and this is hands-down more information than that’s been put forth by any other assessment to date.

Friday was a good day for me.  Friday made today exceptionally easy for me.  So when we left Friday, it was good for me.  It made this much, much easier for me today.  So no, I’m not withholding anything, and I have reviewed the President’s past medical records to the extent that they’ve been made available to me and there’s nothing at all that’s concerning to me.

Q    Doctor, can you say — given the President’s age, he’s somewhat of a peer to where President Reagan was at this time in his presidency.  Can you say — given that there is scrutiny of what was overlooked at the time with President Reagan, in terms of Alzheimer’s and things he was then known to suffer from at a later date, can you say whether the test that you ran would exclude any of those things and what the possibility of overlooking something like that would be?  You know, how can you tell the American people that this time you’re certain?

DR. JACKSON:  I can say that that test — and I don’t know President Reagan’s actual medical condition and I don’t know what his condition was like toward the end of his presidency.  I’ve read things and seen the documentaries and stuff, just like everybody here.

But let’s just assume that he did have some evidence of cognitive impairment toward the end of his presidency.  I think that I can reliably say, and I think that the folks in the mental health community out there would back me up on the fact that, if he had some type of mental cognitive issue, that this test is sensitive enough — it would pick up on it.  He would not have got 30 out of 30 on the test.

So I’m very confident, at this particular stage, that he has nothing like that going on.  And like I said, my personal experience has been that he has absolutely no cognitive or mental issues whatsoever, that he is very sharp.

Q    Can I ask a quick question about PSAs?  Are you confident of his prostate health?  You recited a very low PSA.  Are you certain that’s not a product of finasteride masking?

DR. JACKSON:  It may be.  And that is probably why his PSA is as low as it is, because it’s very low.  But we have no indication whatsoever on the prostate exam and based on his previous PSAs that he has any prostate issue going on.

I mean, a lot of people recommend that you don’t even do a PSA anymore.  I did one because we had a long history of PSAs on previous exams when I reviewed his past medical record, and so I thought it made sense to go ahead and do one

And had I seen a large bump in his PSA or something, then it would have been concerning.  But I didn’t, so we’re not going down that path.

Q    Dr. Jackson, did you take a waist measurement for the President?  His weight — I think you said 239, right?  That seems — I think that’s just shy of obesity, right?

DR. JACKSON:  He is, yeah.

Q    So you’re confident of that number, and did you do any measurements?

DR. JACKSON:  We don’t do any measurements.  We do height and weight, and then you can put them in the BMI calculator and you know, whatever.  But we’ve never done measurements.  There’s not a lot of point in it at this point.  I mean, the President has acknowledged that he’d be healthier if he lost a few pounds, and that’s what we’re going to try to do.

So doing measurements and getting some other form of calculation wouldn’t have really changed anything clinically for us.

Q    Because of his age, will you conduct cognitive testing in the future?

DR. JACKSON:  Excuse me?

Q    Because of his age, in continuing his physicals in the future, will you also continue the cognitive testing?

DR. JACKSON:  That’s going be totally up to the President.  Because, like I said before, I didn’t feel it was clinically indicated on this round.  So I will continue to monitor the President over the next year.  I’ll talk to him on a regular basis.  I’ll visit with him every opportunity.  I’ll spend lots and lots of time with him over the next year, and if I have any indication that we need to do it or if I come up with anything on any of his exams that clinically indicates we should do that, then, yes, I will recommend doing that.

Short of that, if the President wants to get one done next year, then we’ll do another one next year.

Q    Dr. Jackson, it’s recommended that most baby boomers get screened for hepatitis C.  Did you do a hep C test, or has he had one previously?

DR. JACKSON:  He has had a hep C test remotely.  I did find that in his past medical record, but I did not do one this time.

Q    Doctor, thank you.  You talked a little bit about his diet here at the White House.  Can you flesh that out a little bit?  What specifically is he eating?  Is he eating lots of chicken and fishes and white meat?  And also, does he take any sleep aids?

DR. JACKSON:  First, I have to admit to you that I see what he eats on the plane, and that he eats the same food that we eat on the plane, which is usually fairly healthy meals, minus the desserts that we get.  But I have not been as actively involved in his diet as I will be in the year to come, so I don’t have a lot of information on that right now.  But he’s asked me to get the nutritionist involved, which basically has given me permission to become involved in that, and I will.  So I’ll have more information on that next year.

And then what was the other question?

Q    (Inaudible) sleep aids.

DR. JACKSON:  Oh, sleep aids.  The President does take some Ambien on occasion, like we all do, on overseas travel.  So when we travel from one time zone to another time zone on the other side of the planet, I recommend that everyone on the plane take a sleep aid at certain times so that we can try our best to get on the schedule of our destination.  So he has, on those occasions, done that.

Q    What about here at the White House?

DR. JACKSON:  Here at the White House?

Q    Just when he travels?

DR. JACKSON:  No, not — only during travel.

Q    How much sleep does he get, on average?

DR. JACKSON:  He doesn’t sleep much.  I mean, I would say that — you know, this is just my guess based on being around him.  I didn’t ask him this question, so I could be wrong on this, but I would say he sleeps four to five hours a night.  And I think he’s probably been that way his whole life.  That’s probably one of the reasons why he’s been successful, I don’t know.  Because, me personally, I need a lot more sleep than that.  But he’s just one of those people, I think, that just does not require a lot of sleep.

Q    Dr. Jackson, can you say whether your prediction of good health and no serious events for years to come still holds if the President does not make changes to his diet and starts to exercise?  Is that still your professional medical opinion?  And then, also, can you just tell us how long the examination was, sort of, start to finish, and how many people were involved?

DR. JACKSON:  Yeah.  So, I don’t know.  I mean, I guess it’s going to depend, because this time next year we’ll do a lot of the same tests.  We’ll do cardiac assessments and everything else.  When we get the objective data next year, we’ll look at it and we’ll recalibrate.  And if he’s made a lot of changes, I assume that he’ll be in even better shape than he is right now, if he’s eaten better and he’s lost a few pounds.

But even if he hasn’t, I won’t make that assessment without doing a lot of the objective testing that we just did this time.

So — and then the other question was?

Q    How long was the entire — the entirety of the exam?  And how many people were involved?

DR. JACKSON:  The exam lasted about four-plus hours.  So I think we were there — well, about four hours, I think.  And I had a total of, I believe, 12 consultants involved in it.  I don’t execute these physicals in a vacuum.  I have a lot of specialists available to me.  And just like on a day-to-day basis, I’m somewhat of a quarterback with regards to his care, so I spent weeks speaking with consultants and trying to figure out how to plan his exam appropriately and what was appropriate for his exams.

So it was a team effort with a lot of the physicians at Walter Reed who did a great job helping me take care of him.

Q    Thank you, Dr. Jackson.  Was there anything that the President or anyone else specifically said for you not to mention today

DR. JACKSON:  Absolutely not.  As a matter of fact, there’s a lot of things here — I was like, are you okay with me mentioning this?  He’s like, absolutely, I don’t care.

So I — yeah, go ahead

Q    And just to follow up on that, some of the President’s friends have told reporters in the past that they think he’s a germophobe, that he washes his hands obsessively and is concerned about that.  Have you seen any indication of that type of behavior being around the President?

DR. JACKSON:  No.  I mean, he washes his hands frequently.  He uses Purell.  And as many hands as he shakes in a day, he’d be a fool not to.  So I think the more he can wash his hands and use Purell, I’m encouraging that.  So I’m never going to say that’s anything that he shouldn’t be doing.  So I would like for him to continue to be a bit of a germophobe and make my job a little bit easier along the way.

Q    How would you characterize the President’s health to an average 71-year-old American male?

DR. JACKSON:  I’d say, based on his cardiac assessment, hands down, there’s no question that he is in the excellent range, from a cardiac standpoint.  And that’s not me speaking; that’s objective data.  You can look at the data that was collected, and he will definitely fall into that category.

Q    Is that just cardiac, or is it everything?

DR. JACKSON:  Well, it’s cardiac.  And, I mean, look at his vision — I mean, he’s 71 years old and his bilateral uncorrected vision is 20/30.  I mean, he can drive, if he wants to, without glasses.  A lot of people his age can’t do that.  So I think if you look at a lot of things across the board, he’s very healthy.

 

So that’s why I put out in the statement that the President’s health is excellent, because his overall health is excellent.  Are there a few things he could do to make himself a little healthier with the diet and exercise?  Absolutely.  And he’s tracking that, I’m tracking that, and we’re working on that.

 

But, overall, he has very, very good health.  Excellent health.

 

Q    Just to be clear, though, Dr. Jackson, he is taking a cholesterol-lowering medication, he has evidence of heart disease, and he’s borderline obese.  Can you characterize that as excellent health?

 

DR. JACKSON:  I mean, I think based on his current cardiac study, I mean, his heart is very healthy.  Those are all things that we’re looking at with regards — well, you know, you’re a neurosurgeon — there’s stroke issues there too.  But we’re focusing on his cardiac health and, you know, as an indicator of what the risk of his vascular health might be like.  He has very — he has no evidence of peripheral vascular disease.  His heart exam, like I said, I think was in the excellent category for his age and sex.

So, I think that despite that, that you’ve mentioned, I think that we’re doing a decent job with his cholesterol.  I would say that the dose of his cholesterol medicine is very low.  He takes a very low dose of his cholesterol medicine right now, so we have a lot of room to increase that.

Most cardiologists would put a patient on a larger dose of cholesterol medicine in that to start with, so we’re going to up that.  And I suspect that when we do that, his cholesterol — his LDL will fall even more.  And then like I said, if we do the diet and exercise — I mean, I just don’t think that he’s got much room to do anything else.

Q    You said there were some stroke concerns

DR. JACKSON:  Excuse me?

Q    You just said there were stroke concerns as well?

DR. JACKSON:  No, no, I said — I was talking to Dr. Gupta saying that it’s not just the heart that he’s asking questions about — I understand that he’s asking questions about vascular health, including heart disease and stroke and stuff.  So I’m saying that we’re looking at that.  We’re looking at his vascular health overall, and it looks very good right now.

Q    What about potential diabetic changes as a result of his weight?

DR JACKSON:  He has no — it’s great.

Q    I know his pressure is real good, but what about potential because of the weight as he gets older?

DR. JACKSON:  I mean, yeah, sure.  That’s always a possibility.  We’ll monitor that.  But right now, his hemoglobin A1c was normal, and his fasting blood glucose is normal, so right now he has no evidence of diabetes at all.

So we’ll continue — it will be a routine thing that we do every year with fasting blood glucose and hemoglobin A1c.  If that becomes a problem, we’ll address it.

Q    Did you test his hearing?

DR. JACKSON:  I did not test his hearing.  I will test his hearing.  The only reason I didn’t test his hearing was because I didn’t have enough time to do it in this particular exam.  We had the exam pretty packed, and we had to make some conscious decisions about what we did and didn’t want to do.  And hearing seemed low on the priority list right now.  And it’s something I can do at any given point.  So we will do that, though.  I will get a baseline hearing test on him just because I generally do that.

Q    Does the President — when the President has his colonoscopy at the next physical, will he be sedated?

DR. JACKSON:  That’s going to be up to the President.  You know, I will recommend that he is because just — you can do virtual colonoscopies where you’re not sedated.  I’ve had patients do both.  I’m a big fan of the optical colonoscopy.  I just like — so I will recommend, if he does it next year, that he be sedated in an optical colonoscopy.

Q    And when that happens, are you a part of the decision-making process on handing over power to the Vice President or whoever while he’s sedated?

DR. JACKSON:  I’ll be making recommendations on that with the Chief of Staff and the National Security Council and everybody else.  I won’t make that decision, but I will be a part of that discussion

Q    Dr. Jackson, thank you.  You say that the President was the one who requested the cognitive test, that it wasn’t necessarily needed for someone of his age.  Did you — did he tell you why he wanted it done?  There’s been a lot of speculation out there about his cognitive state.  Was he upset with some of that talk?  What were the discussions that you had from when he told you, “this is why I want to do it”?  Why did he say he wanted to do it?

DR JACKSON:  I don’t think he — he wasn’t upset with it, but that did draw up part of the process.  I think this has been the narrative for a while, and I think he saw doing the physical as an opportunity to put some of that to rest.  And I think he wasn’t obviously the least bit concerned that he had anything to hide, and so he saw — he actively asked me to include that in it, so we did.  So I think —

Q    Was there any one incident that kind of made him say, hey, this is something I want to do, or was it just a collection of voices of criticisms or —

DR. JACKSON:  Not that I’m aware of.  I mean, he didn’t mention any one particular incident to me.  And the reason it came up is, I was going over his physical exam with him and discussing all the other things that we were going to do, and I was giving him a rundown of what we were going to do on that day.  And he asked me, at that point, could I include this in the assessment.  And so it wasn’t driven by anything that had just happened or anything he had just heard or seen.

Q    No, I mean, like outside criticisms.  There was no —

DR. JACKSON:  I have no idea.  He didn’t discuss any of that stuff with me.  He just asked me — he said, hey, can we do this.  And so we did.

Q    On the President’s stress level, in your conversations in your examinations, did he express any change in how stressful this job, or lack of stress that he has experienced as a result of becoming President?

DR. JACKSON:  No, no.  I talk to him sometimes about stress just because I think it’s my job as his physician to bring that up on occasion, as I do with many other members of the administration.  I’ve never seen the President stressed out about too much.

I think the one thing that I’ve noticed about him that I think is unique and I think — and this is just my personal opinion; this has nothing to do with my medical assessment — but I think one of the things he has that’s unique that I think is probably — I would just assume has led to some of his success over the years — he has a very unique ability to just get up in the morning and reset.

And I’ve seen it before, where things are going on.  And I think a lot of people around him, and myself if I were in that situation, I would get up in the next morning and the next day would build on the day before and I would start getting more and more stressed.  He has a unique ability to somewhat set — to push the reset button.  And he gets up and he just starts a new day.  And I think that, overall, that has helped him with his stress level and made him healthier from a stress standpoint.

Q    And if I could follow up on the questions of a few of my colleagues regarding an exercise routine for the President.  You said you’ve had these conversations with him.  Could you take us through some specific exercises that you and the President are considering as you look at this routine?

DR. JACKSON:  No, I mean, I think any — there’s a variety of ways to do this.  You can do stationary bike.  You can do an elliptical.  You can do treadmill.  I want to do something that’s low-impact.  I don’t want to do something that’s going to cause the President to have joint issues and things of that nature.

So what I’ll do is I’ll look at how we can do something aerobically and how we can do it with minimum impact on his joints, and then that’s what I’ll approach him with as the best option.

 

Q    Does he watch too much TV?  From a sedentary lifestyle sort of perspective, should he cut back on that?

 

DR. JACKSON:  I’m not going to comment on that.  I might comment on that if that were my five-year-old; I might tell you they watch too much TV.  But I’m not going to — the President, he can watch as much TV as he wants.  And I don’t know how much TV he watches, so I’m not going to — that’s something I just can’t comment on.  So —

 

Q    But you get why I’m asking, because of the seated sort of aspect of television-watching versus the active lifestyle part of it.

 

DR. JACKSON:  I don’t know.  I mean, I don’t know what he’s doing when he’s watching TV most of the time.  He might be in the office.  He might be seated.  I just don’t know.

I think he spends probably as much time seated in a sedentary role as a lot of us do that have office jobs and things of that nature.  I don’t think that the TV — watching TV really contributes to that that much, in my opinion.

Q    Doctor, you’ve examined him and performed a cognitive assessment.

DR. JACKSON:  Right.

Q    What is your take of all the doctors and clinicians all across the country who have said that, in this President, they see symptoms of this, that, and the other?

DR. JACKSON:  Symptoms in what way?

Q    Well, symptoms of dementia, symptoms of —

DR. JACKSON:  I would say that — you know, the American Psychiatric Association has said so, too — I think that people shouldn’t be making those kinds of assessments about the President unless they’ve had the opportunity to get to know him and examine him.

And in my opinion, that’s just tabloid psychiatry, and I just don’t — I’m not going to address it or fall into responding to those kinds of questions or accusations.

Q    How would you describe his diet before he became President?  A lot has been said about too much McDonald’s, too many burgers.  Do you think it was problematic?

DR. JACKSON:  To be honest with you, I have no idea.  I just have the same information you have.  I didn’t know the President before January 20th, so I never saw him eat a meal before January 20th.  So I have no information on that.

Q    Thank you.  You said you’re not sure how much sleep he gets a night, but you assume it’s between four to five hours.  Does that concern you?  Would you recommend him to try to get more sleep?

DR. JACKSON:  I mean, sure.  I think more sleep for all of us would be helpful, but it doesn’t really concern me because I think it’s just his nature.  I think he’s always been that way, and I just think that it works for him.  It wouldn’t for me, but it works for him.  And so, sure, if he could get more sleep, that would be great.  But I just don’t think that that’s likely to happen.  That’s just the way he’s wired.

In the back.

Q    Did you tell the current President about his predecessor’s exercise routine?  And does this President ask you about how he could follow his predecessor’s example to be as fit as Barack Obama was?

And a second question, do you keep a tally of how much golf the U.S. President plays?  That is something the press office repeatedly does not tell us.  Do you keep a tally?  And do you consider that exercise?

DR. JACKSON:  No, I’ve not had that conversation.  No, I don’t keep a tally.  And, yes, like everything else, being on the golf course, there is a certain amount of exercise involved in that.

Next question.

Q    Dr. Jackson, does the President take any medications that you haven’t disclosed here today?

DR. JACKSON:  He does not.  He doesn’t take any medications at all that I’ve not disclosed here.

Q    Can you give us an idea of exactly what that cognitive exam involved over that half hour?  And does that conclusively rule out any further psychological exam?

DR. JACKSON:  Yeah, like I said, it does.  You can look online and see what it’s all about.  It’s easy to — just pull it up online — the Montreal Cognitive Assessment.  You’ll see it right there, and you can see what all it entails.

It does rule out the need to do any other cognitive testing.  That’s the reason you do it.  It’s a screening tool.  If you do well on it, I think anything above 26 is normal.  If you do — certainly, if you get a 30 out of 30, I think you can confidently assume that you’re done on the cognitive workup for now.

Q    Do you have any concerns about the President’s use of Twitter?

DR. JACKSON:  No, I don’t — yeah, Twitter doesn’t involve me as a doctor.  I don’t have any concern on that.

Q    Thank you, Dr. Jackson.  The President is the first lifelong teetotaler and nonsmoker to sit in the Oval Office since President Jimmy Carter.  Can you say that that’s extended his life in any way and makes him unusually healthier for his age?

DR. JACKSON:  I would say that, in my opinion, it’s had a big impact, especially the smoking part of it.  So, like I said,

he has incredible cardiac fitness at this point in his life, and I think a large part of that is probably due to the fact that he has had a life of abstinence from tobacco and alcohol, in particular tobacco.

Q    Thank you.  You mentioned a whole bunch of doctors that participated in Friday’s exam.  And there are other questions that were asked today about the President’s emotional health.  Is there anyone on the President’s medical team, such as a psychiatrist or psychologist, whose job it is to monitor the President’s emotional state or watch for potential psychiatric problems or indicators of those?

DR. JACKSON:  No, that’s not — that’s not anyone’s official duty.  I have all specialists at my disposal, both civilian and military, including psychiatry should I need them.  But that’s really my job as his primary care doctor, and I’m pretty suited for it in the sense that I’m — that I see him on a regular basis every day.  So I think that that falls upon me to do that.

Q    Did you make any wellness recommendations to the President against the burnout — mental burnout, first and foremost, like meditation, or mindfulness?  Where do you stand on that?

DR. JACKSON:  Say it again?  The question is, would I recommend any type of alternative medicine?

Q    No.  No.  No.  (Inaudible) wellness recommendation against the burnout —

DR. JACKSON:  Like?

Q    Like meditation or mindfulness.  Where do you stand on that?

DR. JACKSON:  Sure, I mean, I think those are all, you know, relaxation methods.  I think that, in general, any of us that can get involved in that — that can find the time for that, I think that those are helpful and that they make you healthier.  So, yeah.  I mean, I’m not opposed to him being involved in those kinds of things in the future.

Q    Realistically, what do you think you’re going to get him to do as far as exercise?  Tell him I’ll be his exercise buddy if he needs one.  But what —

DR. JACKSON:  I’m going to get him to do some stuff.  We’re going to make some progress.  I’m not worried about it.

Q    Like what?

DR. JACKSON:  I don’t know.  We’ll see.  I mean, but it’s going to be some aerobic exercise.  And like I said, it’s going to be something that spares his joints and is healthy for him.

So we’re going to work on that.

Q    Yes.  Thank you, Doctor.  Will your office be working with the White House Chef at all, (inaudible) in terms of formulating what kind of diet he’s going to need?

DR. JACKSON:  Am I working with them?

Q    Yeah, is there some sort of like set plan as to —

DR. JACKSON:  Right.  Yeah, like I said —

Q    (Inaudible.)

DR. JACKSON:  Right, like I said, to this point, I haven’t been as involved in that as I want to be.  But I’m getting — I will become much more involved in that relationship from this point forward since the President has given direction to do so.

Q    You made a statement saying that you expect the President to be in good health for the duration of his term, or even a second term, if he gets it.

Was there a specific request from the President to make that statement, or from anyone in the administration or from anyone in the White House?

DR. JACKSON:  No, absolutely not.  I think someone asked a question regarding fitness for duty, and it’s a natural extension of the fitness-for-duty assessment now and for the remainder of his presidency.  And so I just followed that up with one term or two terms.  So no one had prompted me or prepped me to ask any — or to answer in any such way.

Q    You’ve been answering questions here for more than 50 minutes, by my take, which I think is really extraordinary.  Is that an indication of the President’s desire to put all these rumors and questions to rest, once and for all?

DR. JACKSON:  Absolutely.  I think the President encouraged me to come out and he said specifically told me, he said, “I want you to get there and I want you to talk to them, and I want you answer every single question they have.” (Laughter.)

He called Sarah and he told Sarah, “I do not want you pulling him off that stage.  You leave him up there until he’s ready to come off.”

And so, yeah, I think that two reasons.  One is because the President wants me up here.  And two, because as of Friday, I was pretty excited about getting up here and talking about his health because Friday was a good day.  And he gave me a lot of — it made me enthusiastic about being up here today.  So that’s really — really, where we’re going.

Q    Will you commit to doing this next year?

DR. JACKSON:  Absolutely.

Yeah.

Q    Dr. Jackson, just one more question about the Montreal exam and other, sort of, mini mental status exams.  They’re pretty good but they’re not really sensitive to someone who’s already high-functioning.  They’re not really good at finding early stages of dementia.  If the President is worried about it, would you recommend more sophisticated exams?

DR. JACKSON:  Yeah, if he’s worried about it, which he’s not.  But I think you know —

Q    But he asked for it.

DR. JACKSON:  Right.  I think that they are actually pretty specific at finding subtle cognitive changes.  At least everything I’ve read about them, they’ll tell you — the psychiatrists and psychologists that utilize these things will tell you that they will pick up stuff that even the patient is sometimes not aware of.  So I think that they’re great screening tools.  And I think short of having any type of issue with a cognitive screening tool, I wouldn’t recommend doing anything beyond that.

Q    Are you saying — this is my ignorance — but are we saying that, because of Reagan — all right, we had some of the issues with Reagan — and the issues about this President, cognitive testing, mental acuity testing, is not commonly part of an annual physical with the President of the United States?

DR. JACKSON:  I’m saying I’m totally unaware of this ever being done before.  As far as I know, no President has ever had a cognitive assessment as President of the United States.  This is the very first time it’s ever happened.  If anybody is aware of it happening before, then they have information I don’t have, because I looked pretty extensively, not to mention the fact that I know most of the physicians that are alive that have taken care of the last three, four, and maybe five Presidents, and it’s never been done.

Q    With the power that he wields, should it not be?

DR. JACKSON:  In my opinion, as his physician, no.  If the American public somehow thinks that that’s part of an assessment for a President, then I suppose they can incorporate that into your ability to run for President or serve in office.  But that’s really not my call.

I approach the President like I would any other patient, and he has gone above and beyond what I would consider a requirement to demonstrate his cognitive abilities.

Q    So with the questions that have been answered —

DR. JACKSON:  Next question.

Q    The President playing golf a lot, almost every weekend.  Is that helpful for his health?

DR. JACKSON:  Is it healthy for him?

Q    Yeah.

DR. JACKSON:   I think so.  Be outside, and — you know, it’s a good way to relieve a little stress.  So I think if that’s what he enjoys doing, I think it’s healthy for him to do it.

Q    Dr. Jackson, thank you.  You said he doesn’t drink and he doesn’t smoke, and other than the diet issue, did you address drug addiction?

DR. JACKSON:  Drug addiction?

Q    I mean, any other drugs?

DR. JACKSON:  Yeah, no, no.  He has no drug addiction.  Absolutely not.

Q    Thank you for your time, Dr. Jackson.  (Laughter.)

DR. JACKSON:  Okay, Sarah is telling me to wrap it up, so I’m going to — I’m going to take one question but from somebody else, because — one more question.

Back there.

Q    Thanks.  So could you give a sense on how involved the First Family is in this — the First Lady, his daughter, others — in encouraging him to be — step up on the exercise?

DR. JACKSON:  Sure.  Yeah, they’re involved in it.  His daughter, Ivanka, and Mrs. Trump are both proponents of eating healthier and exercising.  So they’ll be partners of mine in working this out.  So they’re involved in it, absolutely.

Sorry, I wasn’t trying to be disrespectful; I was just trying to spread the wealth.

Yeah.

Q    My question was, with all the questions that have been asked, going back to that issue, everyone has asked about mental acuity.  Those questions have been in the public.  And he told Sarah to tell you to stay up here until those questions are answered.  Going forward, would you recommend that Presidents undergo that type of testing?

DR. JACKSON:  No, I don’t think so.  Because, like I said, I think that — I’m comfortable with the algorithms that are out there.  Most of the algorithms out there start with personal observation and observation of the physician and the patient, and the family and the patient.  And then they go to screening questions after that.  And then, after screening questions, they go to a screening assessment tool, like the one we used.  And then if that’s abnormal in some way, then they go on to other types of more detailed cognitive testing.

So I think there’s a healthy algorithm in place, and I think that — in the future, that should be a decision between the President and their physician.  And I would have no problem in the future if someone comes in and takes my place and there’s another President here, and then following that particular algorithm.  I’m comfortable with that algorithm.  I think we followed that algorithm.  I think had I followed that algorithm to a T, we would not have even done this test.  We did this test specifically because the President added it to his physical exam.

So that’s it, guys.  That’s all the questions I’ve taken.  Thank you for your time.  I appreciate it.

Q    See you next year.  Thank you very much.

MS. SANDERS:  Well, that was informative.  I think we covered just about everything that we could possibly think of when it comes to the President’s health.

Because it’s late in the afternoon and we’ve been in the room for an hour, and I know you all have probably stories to write and things to file, we’re going to keep this last little bit pretty short.  I’ll take a few questions, but we’re going to keep today pretty short.  But we’ll go ahead and dive right in.

Go ahead.

Q    Sarah, the President, is he still scheduled to release the “fake news” awards tomorrow?  And when and how is that going to be done?

MS. SANDERS:  We’ll keep you posted on any details around that potential event and what that would look like.

John.

Q    Thank you, Sarah.  It was widely reported yesterday that, in contrast to his past three predecessors, the President did not take any part in any memorials to Dr. Martin Luther King, Jr. or appear at any public functions on that.  Any reason why?

MS. SANDERS:  The President participated in an event on Friday to honor the life of service of Martin Luther King, Jr.  And we would like to continue to do projects and events throughout the year and not just have one day, but certainly wanted to recognize that here at the White House through the event on Friday, and will continue to be involved in efforts and opportunities moving forward over the course of the year and over the course of the President’s term.

Hallie.

Q    Sarah, Senator Graham said today on the immigration discussions that he thought that the President was on track to come to a deal with him and Senator Durbin up to two hours before last week’s immigration Oval Office meeting on Thursday.  He said, “Something happened between 10:00 and 12:00.”  He says the President got bad advice from his staff members, potentially including Stephen Miller, potentially including John Kelly.  What happened in those two hours?  What changed?  Is Stephen Miller running the show now?  What’s going on?

MS. SANDERS:  Hardly.  So, to be very clear, the President is running the show here at the White House.  Look, I was part of this process and part of the conversations that went on.  The President simply, as he looked at the deal, he wants a good deal and he wants the right deal.  He laid out what his priorities were, what needed to be included in any piece of legislation.  And this simply failed to address the things that were laid out.

Specifically, one of the areas that really, really fell short was the funding for border security.  They only put in about one-tenth of what the Department of Homeland Security said they needed — not what they said they wanted, but what they said they needed.  And this was simply a complete failure in terms of a good deal, based on what the President had laid out and based on what he wanted to see in a piece of legislation.

Hopefully, we get there.  We’re still going to continue working with members of both Republicans and Democrats, House and Senate members, to try to make a deal on DACA and make sure that we include those components that the President very clearly has laid out.Cecilia.

Q    (Inaudible) merit-based, Sarah?

MS. SANDERS:  Sorry, I’m going to pop around today since we’re on a short timeframe.

Q    Just picking up on what you just left off on — so does a good deal include, then, preferring white immigrants from Norway than black and brown immigrants from Haiti or African nations?

MS. SANDERS:  Not at all.  In fact, it’s actually the opposite, because by definition, a merit-based system is colorblind.  It’s not basing it on any of that criteria.  It’s not based on race, it’s not based on religion, it’s not based on country of origin, it’s actually based on the merits of whether or not this person is going to be contributing to society.

So, actually, it erases all of those things and makes it a much more fair system instead of picking and choosing from trying to meet different quotas of different things.  It’s a merit-based system, and frankly, it’s a system that most Democrats supported and voted for just years ago.  But now that this President is championing it, they are, I think, showing just absolute signs and definitions of what hypocrisy looks like.

Look, the bottom line is: We want a deal on DACA.  They want a deal on DACA.  We want a deal on border security.  They want a deal on border security.  They’ve said that they support these things.  They’ve also said in the past that they support merit-based immigration.  I don’t see what is complicated here.  We all want the same things.  Democrats need to quit playing politics and start doing what they were elected to do, and that is governing.  And they need to come to the table with a real deal based on the parameters that were discussed in the meeting that most of you saw, and let’s try to get something done for the American people.

Q    But the President did mention it.  But he did mention country of origin.  And the fact of the matter is, the countries that he mentioned, one is very white, and the others are very not white.  So that is about race, is it not?

MS. SANDERS:  No, it’s not.  And again, the President has laid out what he wants to see in an immigration process and that is a merit-based system.  You cannot argue with the priority that he has laid out and what that looks like and how it actually levels the playing field and is the opposite of what you’re suggesting.

Blake.

Q    Sarah, thanks.  To pick up from what Hallie had asked.  Something clearly had changed between Tuesday, when the President said, bring me any deal you agree to, and —

MS. SANDERS:  To be clear, he said — he didn’t say bring me any deal that two people agree to.  He said to the people at this table, I’m confident that you will come together and address the situation and the concerns that we have laid out, and that you will answer the call that has been made.  And that simply didn’t happen with this deal.

Q    So is it simply if you say that that they came here with one-tenth of the border wall funding, that if more money comes to the wall, you’ve got a DACA deal?

MS. SANDERS:  We also want to see an end to chain migration, we want to see an end to the visa lottery system, and we want to see merit-based immigration.

So those are the components that we’ve laid out.  The President’s viewpoint on this has been consistent.  It hasn’t changed.  But what was reflected in that deal isn’t what the President laid out.

Jordan.

Q    Thanks, Sarah.  Is the President concerned about what Steve Bannon might tell the Mueller grand jury?

MS. SANDERS:  Not that I’m aware of, no.

Trey.

Q    Sarah, two questions for you.  Did the White House tell Steve Bannon not to answer certain questions before the House Intelligence Committee today?

MS. SANDERS:  There’s a statement that I’ll read:  As with all congressional inquiries touching upon the White House, Congress must consult with the White House prior to obtaining confidential material.  This is part of a judicially recognized process that goes back decades.  We’ve been cooperating fully with these ongoing investigations, and encourage the committees to work with us to find an appropriate accommodation in order to ensure congress obtains information necessary to its legitimate interests.

Q    Sarah, in the Oval Office today, the President said that he wants immigrants to come in from everywhere.  Does everywhere include those six countries that were on the travel ban list?

MS. SANDERS:  Look, like the President said, he wants immigrants to come in from everywhere, but he wants to do that through a merit-based system.

Shannon.

Q    So does that merit-based system mean ending the TPS program so the U.S. would no longer provide a safe haven to countries having a natural disaster, a civil unrest?

MS. SANDERS:  I think that’s a different part of the conversation, and I think one of the things to remind people of, the TPS program — again, look at the name of the program.  It’s temporary.  It’s not meant to be permanent.  We are looking to find permanent solutions.  We’re not just trying to put a Band-Aid on the situation, we want to actually fix the problem, and that’s why simply doing one piece of this immigration reform isn’t enough.  It has to be responsible immigration reform, and that’s what this administration is going to continue to push for.

Q    Can you explain, because I think this is still an open question, how did Senators Cotton and Perdue get here to the White House on Thursday?  Who invited them?

MS. SANDERS:  The President.

Q    Why?

MS. SANDERS:  Doesn’t seem like an open question to me.

Q    Well, so why did he invite them?  I mean, Senators Durbin and Graham wanted to come and present their proposal.  Why did the President feel he needed other people in the room?

MS. SANDERS:  As the President did — I guess, what, a few days prior when he had a large group of people here — the President wanted to have multiple people that had been part of this conversation, that had been part of the foundation that they had worked on the days prior to that in the room as part of the discussion.

It was a decision he made, and I guess I’m lost on why the President having two Republican senators, who have been in the midst of this entire discussion, continue to be part of the discussion.  If anything, I think he should be celebrated for including more voices.  Instead of limiting it to two, he broadened the field and brought additional people into the room — not just those two members, but several others, as well.

Kristen.

Q    Sarah, thanks.  The President again today called the Russian probe a hoax.  So why not encourage Steve Bannon to be completely transparent today on Capitol Hill to help (inaudible).

MS. SANDERS:  No one has encouraged him to be anything but transparent.  But there is a process of what that looks like and what that process should go through.  And that —

Q    (Inaudible) not answering some questions, right?

MS. SANDERS:  Look, I can’t speak to that.  That’s something that I would refer to attorneys on that matter, and specifically Steve Bannon’s attorneys.

Look, we’ve been completely cooperative throughout this entire process.  We’re going to continue to be cooperative.  But we’re also going to maintain some of the executive privileges here at the White House that have been practiced for decades and that need to be maintained.

Q    And is there any reaction to Steve Bannon being subpoenaed by Mueller?

Sorry, Kristen, I have — Ashley.  Go ahead.

Q    In that meeting, the President reportedly used vulgarity.  The White House has said he did not use that specific word.  The President has said that, as well.  But a number of people in the administration said he used “tough language,” “rough language,” “strong language.”  Can you clear up once and for all what the President did say?

MS. SANDERS:  Look, I wasn’t in that room, so I can go only off of what the individuals who were.  They said that term wasn’t used but that tough language was.

Look, no one here is going to pretend like the President is always politically correct.  He isn’t.  I think that’s one of the reasons the American people love him.  One of the reasons that he won and is sitting in the Oval Office today is because he isn’t a scripted robot.  He’s somebody who tells things like they are sometimes, and sometimes he does use tough language.

The point that he’s trying to make, the point that the entire conversation, frankly, should be focused on is the issue at hand.  We’ve wasted five days fighting over one word when we should be fighting over the people that are involved in the DACA program.

If Democrats really want to protect these individuals, that’s who they should be fighting for and that’s what they should be fighting about, is figuring out a permanent solution to DACA, not a quick fix; figuring out how to secure our border and increase border security; figuring out how to end chain migration; figuring out how to end the visa lottery system.  They’re wasting time, yet complaining about the fact that this President isn’t doing enough when he’s the only one that’s really engaging in this process.  And hopefully, they’ll get on board, get out of the way, and start actually doing their job.

Anita.

Q    I have two quick questions.  One, since a deal does not look like it’s in sight — now we’re three days until the federal government doesn’t have any more money — does the President —

MS. SANDERS:  Sorry, a deal on what?  I just want to be clear if we’re talking about the budget or DACA.

Q    A deal on immigration.

MS. SANDERS:  Okay.

Q    And so right now there’s no deal.  Does the President support a short-term CR to get us through the next few weeks to keep the government open?

MS. SANDERS:  Look, we certainly don’t want the government to shut down, but we’d still like to see a budget deal that is a two-year budget deal that is a clean budget deal.  We haven’t given up on that, and we hope that Democrats will not hold our government hostage, and will not stop military spending, and will not stop allowing our country and our nation to be protected because they failed to stop using political ploys, and they’ve started actually governing.  And that’s what we’re hoping for.

Jonathan.

Q    Sarah, I said I had a second question.

MS. SANDERS:  Sorry, we’re tight on time, so I’m going to hop.  Jonathan.

Q    Sarah, can you clarify exactly what has been denied here?  Because the day of that meeting, Thursday night, the White House put out a statement that did not deny the President said what was widely reported.  You now said we’ve been spending five days talking about one word.  Is that the only thing that’s being disputed here in this denial is which profanity the President used?  Do you deny the general characterization?  Do you deny that he said —

MS. SANDERS:  I certainly deny the general characterization.  Again, I go back to the fact that sometimes the President does use tough language.  I wasn’t in the room, so I can only rely off of the individuals that were.  And those that have come out and publicly spoken about said they didn’t recall those specific phrases being used.

Look, the bottom line is the President wants to see a deal done.  He wants to protect DACA.  He wants to make sure we have increased border security.  He wants to see an end to chain migration, an end to the visa lottery system.  Those are the priorities.  That’s our focus, and that’s what we’re talking about whether you guys are talking about that or not.

I’m going to take one more question.  Jill.

Q    I wanted to follow up on Shannon’s question there first, and I’ve got another one.  Does the President — will he agree to some type of deal that traded the diversity lottery for making permanent the TPS protections?

MS. SANDERS:  I’m not aware of that specific agreement.  I’d have to check.

Q    Would he be open, though, to that kind of trade-off?

MS. SANDERS:  I’d have to check.  I know we’ve laid out what our priorities look like, and I think it would depend on the entire piece of legislation.  I can’t speak to just one piece of something that may or may not exist.

Q    And then, Secretary Nielsen today was testifying on the Hill.  And at one point, she said that she was in that meeting, and she said she was surprised by the fact that the folks in that meeting were using such profane language.  Is that something that bothers the President at all?  And how often does he use that kind of language that we’re all talking about?

MS. SANDERS:  You’d have to be more specific in terms of —

Q    Profanities, how often does he —

MS. SANDERS:  Has he ever used a word?  Probably so.  Yes.  But I don’t think, again, that that is the basis of what the focus of the meeting was and certainly not what the focus of the White House has been.

I’m going to take one last one because Ayesha has been patient.

Q    Thank you.

MS. SANDERS:  Welcome back.

Q    Thank you.  I just want to kind of pinpoint.  I know this has been talked about, but when you say that the President, he’s not politically correct — so would the White House then consider, if there was some type of derogatory language used to describe Haiti or Africa or the countries of Africa, to say that these are not good countries to come from — that that’s an issue of being politically incorrect?  Or is that —

MS. SANDERS:  I certainly can speak to my experience.  I’ve never heard him say anything like that or similar to that specifically.  I’m talking more generally that sometimes the President can be politically incorrect.  I think sometimes you guys have heard him.  I wasn’t speaking to that moment exactly.  I was talking more generally.

But I’ve never heard him make a reference like that, and so, certainly, can’t speak to anything beyond that at this point.

Thanks so much, guys.  Have a good day.

END

4:42 P.M. EST