Biden's cancer diagnosis is very strange, and a medical cover-up is the least of it

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Yesterday evening, Joe Biden’s office announced that the former president had been diagnosed “with an aggressive form of prostate cancer that has spread to his bones.” Biden must have had this cancer for a long time for it to have spread that far, and thus it seems very strange that someone receiving presidential levels of medical care should have been diagnosed only just last week. Many in our circles posit that insiders have known about Biden’s illness for years, but that they have kept his diagnosis and treatment under wraps for political reasons. Among other things, they argue that this explains a July 2022 gaffe in which Biden complained that environmental pollution is “why I and so damn many other people I grew up with have cancer.”¹

In fact, I think a simple cover-up is the most harmless possibility here. It’s likely that doctors have diagnosed Biden’s cancer so late because the former president was subject to a high degree of isolation and medical neglect while in office. Perhaps family and close advisers carefully managed Biden’s annual physicals to avoid any inconvenient findings as part of a broader campaign to hide his dementia. Alternatively, it’s possible that signs of cancer were discovered at some point, but that Biden’s inner circle avoided confirming the diagnosis or pursuing treatment. Either way, the late diagnosis and the advanced cancer together suggest that Biden has been left sick and untreated for a long time.

As I wrote last year, Biden’s presidency was an informal and unacknowledged regency. Biden himself did not have the mental capacity to rule on his own, and so a confined circle of close advisers and family effectively directed the actions of the presidential office on his behalf.

Importantly, this regency was not “the White House” or “Biden’s staff” or “the Democratic Party” in general. It was much smaller than all of those things. The regents worked hard to obscure Biden’s dementia from Congress, from large parts of Biden’s own campaign, from the Democratic Party and from many others within Biden’s White House. They ensured that even internal meetings unfolded in highly scripted and predetermined ways, so that cabinet and other officials could not gain a clear idea of Biden’s mental state. They berated and intimidated anyone voicing concern about the president’s health behind the scenes. And they had very simple reasons for doing all of this: If Biden’s dementia were to become common knowledge and not merely an object of private suspicion (however widespread), the regency would be shown up as illegitimate and potentially broken.

Regents exercise power by restricting access to their charge and restricting their charge’s access to information and the outside world. It is thus unsurprising to find that Biden’s regents subjected him to strict social isolation, particularly towards the end of his term:

… [T]he men and women around [Biden] … have kept him more and more under wraps. He is a captive … I have been hearing for months about the increasing isolation of the president, from his one-time pals in the Senate, who find that he is unable to return their calls. Another old family friend, whose help has been sought by Biden on key issues since his days as vice president, told me of a plaintive call from the president many months ago. Biden said the White House was in chaos and he needed his friend’s help. The friend said he begged off and then told me, with a laugh: “I would rather have a root canal procedure every day than go to work there.” A long retired Senate colleague was invited by Biden to join him on a foreign trip, and the two played cards and shared a drink or two on the Air Force One flight going out. The senator was barred by Biden’s staff from joining the return flight home.

The necessity of isolating Biden in itself might be sufficient to explain his medical neglect. Either way, a small regency of the kind that managed Biden’s presidency would have been on the one hand highly motivated to broadcast an image of presidential health, while on the other hand having limited options as far as covering up medical issues.

The regents were in no position to hide serious diagnoses, which would have rapidly drawn all manner of doctors, experts and outsiders into the inner circle. Perhaps Biden’s cancer could be kept out of the press for a time, but knowledge would spread beyond the regents’ tight-knit ranks to their rivals, sceptics and enemies in the palace. Still worse, others would suddenly gain access to the president and form their own opinions about such tabu topics as his mental state. Their best and perhaps only strategy would have been to limit care and keep any signs of disease secret – if necessary also from the president himself.

1. The White House clarified that Biden was referencing his earlier diagnoses for non-melanoma skin cancer.