Opinion

A Second Opinion On Hillary’s Health

(BRENDAN SMIALOWSKI/AFP/Getty Images)

Gerard Gianoli Co-Founder, Ear & Balance Institute

As a physician, I have long thought it fair game to ask questions about the health of presidential candidates. I thought it was fair when Bob Dole’s health became a topic of media speculation in 1996. I felt the same way when John McCain entered the media-medical spotlight in 2008. And I certainly have no problems with the sudden focus on Donald Trump and Hillary Clinton following her abrupt health-related departure from a September 11 memorial, her subsequent trouble walking, and her campaign’s belated announcement that she has been diagnosed with pneumonia.

In fact, I think this focus is long overdue.

I have spent the past three decades practicing a field of medicine that directly bears on Mrs. Clinton: Neuro-otology, which focuses on the segments of the skull and brain that influence the workings of the human ear. More specifically, I’ve focused on working with patients who have inner ear effects from elevated pressure in the skull. In this capacity, I have worked with thousands of patients from all over the country and have even contributed to NASA’s research on the medical challenges facing astronauts.

One medical issue I deal with is “transverse venous sinus thrombosis” – the fancy way of saying “blood clotting in a major vein in the brain.” Mrs. Clinton, of course, was famously diagnosed with such a blood clot in late 2012; it was discovered after she fainted and sustained a concussion. Her blood clot was in a part of the brain that directly influences the pressure in her skull and the workings of the human ear, hence my familiarity with her situation.

A blood clot near the brain is unlike many other common blood clots. If a leg clot, for instance, ends up blocking a vein, there are almost always other veins that can pick up the slack. The brain is another matter. There are no alternative veins large enough to bypass it. The result is the accumulation of extra fluid in the skull, which in turn puts pressure on the brain and the nerves coming from it.

The result is increased intracranial pressure – a serious issue with a host of serious side effects, from headaches to dizziness to vision problems and more.

Many people assume that blood clots simply disappear once you begin taking medication, but this is simply not true. About half of patients will continue to have a blocked vein, and half will have partial reopening. Either way, the result is the constant threat of increased intracranial pressure and its attendant effects.

This bears directly on Mrs. Clinton. It is a medical certainty that she experienced some degree of increased intracranial pressure before her blood clot was, thankfully, discovered. It is also a certainty that she is at a significantly elevated risk of such pressure returning and spiking. Her predisposition for blood clots makes this even more likely. In light of these facts, the symptoms that she manifested on September 11, to say nothing of several other documented events before that, raise serious questions about whether the blood clot identified three years ago continues to cause problems with Mrs. Clinton’s health.

I recognize the limits of my analysis. It is an educated guess based on my training, my work with patients with similar diagnoses, and the extremely limited medical information that Mrs. Clinton has so far released. But in my opinion as a medical professional, this warrants serious investigation, not just by other physicians, but also by the media, who have so far largely dismissed questions of Mrs. Clinton’s health as conservative fear-mongering.

This journalistic inquiry would be greatly aided if Hillary Clinton released her full medical records. (I also believe Donald Trump should release his full records; the brief “doctor’s note” his campaign released several months ago is equal parts laughable and insulting.) Absent that, it is incumbent for the media to do what it has done with every other candidate, especially Republicans, whose histories raise questions about their health: Ask questions, the answers to which the American people have a right to know.

As a physician – and a voter – I expect nothing less.