Post #845: On medicine versus panic: The Presidential Suite at Walter Reed

Posted on October 2, 2020

Walter Reed.  Source:  Wikipedia.

I’m going to point out something that I think is obvious, regarding the President’s move Walter Reed hospital today.  I’m only doing this because the news media merely seem to be echoing what they’ve been told by the White House.  And not really giving it much thought.  Moving the President to Walter Reed now may be as much for the purpose of controlling information as it is for providing health care.

Normally, you don’t put someone in a hospital unless they need to be hospitalized.  The term-of-art is that they require “an inpatient level of care”.  That’s a little hard to define exactly, but it’s one of those things that doctors know when they see it.  And that term is how the Medicare program determines whether it will or won’t pay for an inpatient hospital stay.

For this move to Walter Reed, the White House was quoted using one of those bland “out of an abundance of caution” phrases.  At the same time, they tried to make it clear that the president currently has only mild symptoms.  That is, they are making it clear that the President doesn’t require an inpatient level of care.

And we end up with this unique situation where the President is in the hospital, but not hospitalized.  He’s physically staying full time at Walter Reed, but has symptoms that do not require “an inpatient level of care”.

That’s quite unusual, I think.  So unusual that in everyday language, there is no difference between “in the hospital” and “hospitalized”.

The White House is a few minutes’ helicopter ride from Water Reed.  And COVID-19 symptoms progress steadily enough that the President’s medical staff would have plenty of time to get him to Water Reed, should his condition worsen.  And I’m fairly confident that White House medical staff can provide any sort of ambulatory medicine.

(And, in fact, CNN reporting notes that: “It remains extremely rare for a president to overnight in hospital, given the extensive medical facilities available at the White House.”)

And yet, the President is in the hospital.  But not hospitalized.  Normally, a White House focused on projecting an image of strength, and minimizing any medical issues, would do anything BUT put the President in a hospital.

My guess is that the main reason for this pre-emptive move is to hide his actual hospitalization status.  This way, no one will know if or when he reaches the point of actually requiring hospitalization.  E.g., if his condition worsens, they’ll quietly wheel him down the hall to the ICU, and no on need know, least of all the American public.

Whereas a helicopter ride from the White House to Walter Reed would draw attention.  That would be a pretty big red flag that the President was in serious condition, if that were to occur.

And so, maybe a little ironically, after all that nonsensical talk about “not panicking” the public, we are finally at a point where that’s true.  Moving the President to Walter Reed now, rather than if needed, is a hedge against a significant decline in the President’s health.  Not a medical hedge — a way to provide better care.  But an information hedge — a way to be able to conceal the fact of a worsening condition, if it comes to that.  A way to prevent panic.