WASHINGTON - President Donald Trump's impromptu weekend visit to a doctor prompted renewed questions about the status of his health after the White House released a memo late Monday denying "speculation" that he had been treated for a medical emergency.
Trump, 73, made an unscheduled trip to Walter Reed National Military Medical Center in Bethesda, Maryland, on Saturday, a visit that remained shrouded in secrecy for two days as Trump stayed away from the public eye and the White House dodged questions about his health.
In a memo released by the White House late Monday, Trump's doctor, Sean Conley, wrote that Trump's "interim checkup" over the weekend had been "routine," and was only kept secret because of "scheduling uncertainties."
"Despite some speculation, the President has not had any chest pain, nor was he evaluated or treated for any urgent or acute issues," Conley wrote in the memo. "Specifically, he did not undergo any specialized cardiac or neurologic evaluations."
While Trump claimed that he had begun "phase one" of his annual physical, Conley said Trump would have a "more comprehensive examination" next year. While Trump described his condition on Twitter as "very good (great!)," Conley's memo did not characterize the president's overall health. It did include cholesterol figures that had reduced since Trump's last physical exam in February.
It is unusual for a president to do a physical exam in multiple stages months apart, and the circumstances surrounding Trump's visit renewed questions about the White House's handling of his medical information, according to several experts.
In a statement Saturday, White House press secretary Stephanie Grisham said that Trump had undergone a "quick exam and labs" and that he "remains healthy and energetic without complaints." Grisham also said Trump had taken advantage of a "free weekend" in Washington to "begin portions of his routine annual physical exam."
Two people who interacted with Trump late last week said that he seemed to be hoarse and have signs of a cold but that nothing serious seemed amiss.
Trump's voice was occasionally subdued and raspy during a news conference Wednesday with Turkish President Recep Tayyip Erdogan. But Trump also spoke for more than an hour Thursday at a political rally, the latest in a string of campaign events that the White House has pointed to as signs of his energy and vigor.
On Monday, he remained out of public view, holding his meetings behind closed doors. He met with Federal Reserve Chairman Jerome Powell inside the White House residence rather than the Oval Office, according to a White House official familiar with the matter who was not authorized to speak publicly and requested anonymity.
A common cold would normally not be enough to prompt a visit to Walter Reed, because the White House has adequate equipment and facilities to treat most minor illnesses and conduct routine tests. More comprehensive testing can be performed at Walter Reed.
The White House medical unit has the ability to perform many medical procedures on-site, including most that can be done in outpatient settings, said Jennifer Peña, a doctor who served as Vice President Mike Pence's physician until May 2018.
"The most informative question to ask about the current situation is: What is available at Walter Reed that is not available in the West Wing medical unit?" said John Sotos, a cardiologist who has studied the health records of previous presidents.
Conley's memo did not specify which tests he performed on Trump that required the president to physically visit Walter Reed, only saying that the checkup was "part of the regular, primary preventative care he receives throughout the year."
Several medical experts have questioned why Trump would begin his annual physical in November, just nine months after his last exam, and not complete it until 2020. Leaving a months-long gap between beginning and completing the exam is unusual and potentially counterproductive, said Sotos, who has served as a physician for the Air National Guard.
"When they complete the physical in six months, the information they got on Saturday would be six months old," he said. "I haven't seen such a thing by presidents in the recent past."
There are other reasons Trump's visit to Walter Reed was out of the ordinary.
During Trump's previous medical examinations, the White House has announced the visit in advance and the president has taken the presidential helicopter, Marine One. On Saturday, Trump's visit was not announced beforehand and the president used a motorcade, which is equipped with an ambulance.
"That's one of the unusual things about the whole situation," Peña said. "Not just the mode of transportation but also, traditionally the physicals are announced and put on their public schedule. That's why it doesn't quite fit the profile."
While there are other plausible explanations for the decision to forego Marine One, the White House has not adequately communicated the circumstances around Trump's visit, said Jonathan Wackrow, a former Secret Service agent.
"The way that this was messaged from the White House just was poor," he said Monday on CNN.
Previous presidents have also faced scrutiny for a lack of transparency about their health.
President Grover Cleveland secretly had surgery on a yacht in New York to remove a tumor from his mouth, and Franklin Delano Roosevelt, who was diagnosed with polio, hid much of the impacts of the disease from the public. President John F. Kennedy kept his Addison's disease a secret until after his inauguration.
Sen. Bernie Sanders, I-Vt., faced criticism earlier this year after his campaign took several days to report that he had suffered a heart attack, initially describing his condition as a "a myocardial infarction."
During his campaign in 2016, Trump repeatedly brought up the health of his Democratic opponent, Hillary Clinton, describing her as not physically up to the task of being president. When Clinton fell ill at a memorial event in September 2016, Trump's allies highlighted video showing her collapsing. Clinton's campaign eventually disclosed that the candidate had suffered a bout of pneumonia.
On Monday, Trump's campaign pushed back against speculation that there was anything wrong with the president's health, branding the news coverage over the hospital visit as "hysteria."
"BREAKING: An X-Ray image has been released from President @realDonaldTrump's visit to Walter Reed," the campaign posted on Twitter, with an image of an X-ray of a caped man with a Superman logo across his chest. "Surely @CNN can stop the hysteria now!"
Speaking on Fox News on Saturday, Grisham said Trump's visit to Walter Reed had been "routine" and dismissed "rumors" that there was a more troubling explanation for the impromptu trip.
"He is healthy as can be," she said. "He's got more energy than anybody in the White House. That man works from 6 a.m. until, you know, very, very late at night. He's doing just fine."
Trump had his first physical as president at Walter Reed in January 2018. His second was in February 2019. Trump's doctors hailed his health as "excellent" and "very good" after those exams.
Sotos said he viewed those "rosy" reports skeptically, in part because of questions about the reported height and weight in the first report, which placed Trump just one pound below being officially obese. Both his reported height of 6-foot-3 and weight of 239 pounds from that first visit faced scrutiny from outside observers.
"There's pretty good reporting that the president has not been forthcoming about something as simple and innocuous as his height," Sotos said. "I find it very hard to have confidence that the information being released is high quality."
Peña said advantages of going to Walter Reed include the fact that it is the president's home hospital and there is a dedicated facility for his care. In addition, because it is a military base, it is more secure and officials are better able to maintain privacy than at a hospital open to the public.
Trump praised the doctors in a tweet Saturday, adding that he had visited a wounded service member during his trip.
"Those are truly some of the best doctors anywhere in the world," he wrote.
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The Washington Post's Josh Dawsey and Seung Min Kim contributed to this report.