

If you are a regular reader of my blog this will be of no surprise to you. In August 2016 when I took Bornstein’s letter apart after it has been given but a cursory glance I made note of his surprisingly low PSA. In fact, I wrote an entire post about it where I reported the probable causes:

  • Low testosterone
  • Medications, such as those for hair loss or drugs that treat an enlarged prostate
  • Prostate surgery

As no other information was reported I was left wondering why? Low testosterone can be age related or it could be from alcohol (unlikely as Trump is widely reported to abstain) or opioids. Who knows, no urine drug screen was provided?


I figured Trump’s ego was so fragile that the thought of people knowing he was taking something for hair loss or for prostate issues would drive him mad, hence the exclusion. His hair is perfect! His hands are large!

And now we have the answer, Trump is on Propecia.

As Dr. Oz the Great and Powerful never let us see the second letter submitted by Dr. Bornstein we don’t know if it was just the first letter that neglected to include a complete list of medications or if both of them did. Dr. Oz gave very little additional information, but he did so very authoritatively.

Dr. Bornstein also forgot to mention that his long-term patient was taking the antibiotic tetracycline for a skin condition. Did he admit this once or twice? Who knows? Why omit it? Who knows?

Propecia can have side effects, primarily issues with ejaculation or sexual function, but it can also lead to depression. Possibly an important side effect for anyone, but especially for the leader of the free world.

So here we are. Trump’s medical letter was a either woefully incomplete on purpose or because of carelessness, neither of which is especially reassuring.

I am just left to wonder what else is missing from Mr. Trump’s medical record and how thorough his health evaluations have truly been? For example, given Trump’s family history of Alzheimer’s disease and the fact that he was planning on being the oldest President perhaps he should have been screened for cognitive impairment? I for one don’t find his sentence structure, given his massive I.Q., or reported behavior on the phone with the Australian Prime Minister comforting, although he may really just be a boor whose grammar hovers around the 6th grade level (according to the Washington Post, I’m no grammar scholar so I needed back up).

What concerns me most about the absence of a cognitive screen is Trump, who claims he is brilliant, would have benefited greatly from a perfect score. He bragged constantly about his strength and stamina while campaigning, so I would have thought he’d have jumped at the chance to shine and boast about his perfect brain.


Did Trump’s doctor simply not think to do a cognitive screen in the same way he didn’t think to spell check his letter or include all of Trump’s medications or is there some other reason? Who knows? With incomplete records and slowly leaked information there are lots of who knows?

What did Dr. Bornstein fail to disclose the Propecia and tetracycline?

What else might be missing and why?

Who knows! Maybe we’ll find out in a series of new revealing interviews after the mid-terms.

Lucky us.







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      1. Clearly, honors graduate and arrogant teacher of USA exceptionalism Dr. Terry Clark is a #Deplorable.

      2. Excellent response, Jen. If things get tough in the US, please come back to Canada. We can use a strong unafraid voice to make sure the Trump admirers here don’t get to downgrade our heath care to American levels(for the average person).

      3. OMG. You fucking rock!!! (Says the 67 year old granny who is also a working RN.) I don’t know when I’ve read anything this good or so on point. Dr. Gunter, I fear we are in a world of hurt, and only just beginning.
        Please keep writing!!

      4. Thank you! As a psychiatrist I can say we are really worried in mental health too. Thank u for your passionate defense of our patients!!

      5. Whoah there! I must have hit an exposed lefty nerve ! Score one for me ! She doth protest too much!

        I stand by my comments and I would like an apology for your crude language in your over-cooked, hyperbolic response; and, of course, for your typical leftard attempt to diminish my expertise. Want to REALLY discuss the Canadian single payer system for openers? I doubt it. You, I hope, realize just how bad it is! Your statement that care is free in Canada is laughable! But I’m sure your gullible groupies will buy it. Maybe you ought to be more ‘genuine’ with your off handed baloney? NO health care is free, certainly not in Canada.

        Why did you leave Canada? Just curious. I do know that ~45% of Canadian doctors would leave for the US if NOT for family considerations! Think about that one.

        And how long did you guys wait for your surgeries? ( be honest now; somehow I don’t trust you to be straight with me). The reason most Canadians just love their care is because they don’t know what they’re missing. FYI, bypass surgery at the U. of Toronto is carried roughly 10-18 months later than it would in the US, under the same clinical setting. I talked to a fella in NOTL who had a documented MI, was admitted to the hospital and his MI was documented perfectly ( enzymes, etc). He told me that he was sent home and scheduled for a heart cath in 6 months !! I was stunned!. In the US a person with NO insurance, if admitted with a documented MI, would have that cath within days!

        I want to point out that the main issue with a single payer system, as it is with the British NHS, is that it’s a ”closed’ system. That is, by definition, services and access are limited. For example, the amount of money the system has to play with is fixed ( unless your taxes are raised) each year. Any expenditure, let’s say for a state of the art MRI scanner, is a ‘loss’ to the system. You can’t charge patients for the new and better service it provides. Therefore the system has to restrict the equipment it buys and the services it offers, which leads to reduced access, more morbidity and poorer outcomes ( due to delayed treatment and sub-standard equipment). Docs are also paid less/ visit/ procedure, etc towards the end of the year, resulting in less access, again. They simply see less patients.

        Is it your contention that Canadian HC is better than that in the US? Honesty required. Try hard.

        I will await your response. BTW, for your own sake and reputation, please dispense with the work fuck! It only erodes your credibility as a physician! It is never becoming to address another physician the way you did me.

      6. Terry, it seems you know as much about the Internet as you do international health care, empathy and debate. Also, it’s generally best if the first word of your smartypants reply is spelled correctly. It’s whoa! not “whoah.” Who taught you spelling at school, Betsy DeVos?

        This is a blog, so that means it’s my house. I put out interesting information to read and people read it or not. A comment is like a letter on my doorstep or a knock at my door and I reply how I want because it’s my house.

        Sometimes I just fucking swear for fun, but mostly my ire is directed at people who are pompous, rude and uninformed and who should really know better. Also, anyone who thinks a man who leered at naked teenagers backstage during a pageant is worthy of anything but psychiatric help is on my shit list too.

        You are very bad at debate, because you ignored everyone of my scenarios. That’s not how it works. You answer my questions before you move on. Tsk tsk. You also ignored everything I wrote about women dying from unsafe abortions and why that scares me under Trump and His Serene Highness Bannon. No cherry picking here Dr. Dude. Which one of my kids gets brain damaged if I can afford the oxygen or get Medicaid? Tick tock, their tanks are running low.

        I’m going to let you in on a secret. There is a thing called Google that allows you to look stuff up, like we used to with a card catalogue at the library! You claim to be an honors student so I’m going to assume at one point in your life you have looked something up. Why don’t you look at the WHO and Commonwealth Fund’s ranking, the U.S. is consistently below Canada. Like I said, Canada has issues and it isn’t #1 on any list, but the U.S. is worse and more expensive. Do some fucking research man, it’s not hard information to find. Even under the ACA 10% of people are uninsured, that’s about 29 million people. If you think that’s something to brag about then you are more of a heartless bastard than I thought.

        As for a retired doctor bragging about his honors in medical school? That, my friend, is not a measure of knowledge or empathy or wisdom. In my medical school there was no honors, just pass/fail. You know why? Our professors felt honors and a gold medal made students competitive about winning and creative about gaming the system, not learning how to be a good doctor.

        Dr. Dude Bro my reputation is just fine, so no need to mansplain me on my conduct. Everyone on the Internets knows me and exactly what I stand for. I’m also not interested in your replies based on your n of 3 or the 2 months you lived in the U.K.

        If you find that the WHO moves the U.S. health care system up from 37th in the world (they rank Canada at 30th) after we have all experienced Trumplestiltskin Care then please come back, otherwise I will assume you are waiting for the call to co host the Miss Teen White House pageant with your pal.

      7. yeah i am one of those applauding you jen. terry is an ass and a typical white privileged male dr. ugh.

      8. First of all, Terry, you bitch about the word “fuck” yet, in the same comment, use the lovely wors “libtard”? While the word fuck may not be professional, using a personal disparaging word like libtard is offensive. That alone removes any ounce of your credibility for me.

        Second – have you ever been sick, and I mean REALLY sick? I was diagnosed with recalcitrant CNS lupus in 2005, and my family’s world changed forever. Remember, this was before ANA. I was challenged by my insurance company nearly every step of the way, even though it was a group plan through my husband’s employer AND in California, which has some of the best patient protection legislation in the country. I just don’t find having to go to war with your insurance while fighting a life threatening illness all that indicative of a great healthcare system…at least from a patients point of view. And you know all those fancy high end treatments and medications? The vast majority aren’t even covered. Yeah – the US health care system is awesome – if you are Donald Trump or a Saudi prince. For the rest of us? Not so much.

        By 2011 I had nearly reached my lifetime cap for insurance (and ours was remarkably high, which we paid dearly for). I was actually considering stopping all treatment – a death sentence by all accounts. I was left with the option of depriving my daughter of a mom or making my family homeless.

        By ending all lifetime caps, ACA saved my life. If those caps come back I am fucked.

        Oh, and planned parenthood probably saved my life many years ago. They detected an arrhythmia when I went for a physical there when I was self employed and could not afford healthcare. A couple of years later my brother dropped dead after experiencing an arrhythmia. Planned Parenthood does so much more than abotions and handing out the day after pill. Defunding them, especially after taking away healthcare from millions of women, is a crime. Just saying.

    2. I can’t speak for Jen, but I’m going to complain, bitch, and do everything I can to protect myself, my grandkids, and our country, for the next 4 years.

    3. I suspect Dr Clark is a pseudonym and the author is joking to get a rise from Dr Gunter. There is no way an MD (presupposed educated) would say “US health Care …. bar none”. Clearly, we have good health care in the US, but there are significant issues with affordability, access and quality. Problems that have been mostly overcome in other western social democracies. If I recall, based upon objective metrics, US health care was ranked 10th in the world (I might be off a bit, be we are certainly no where near first). If Dr Clark is a real person and is serious……wow…. that post certainly reflects a willful disregard of the evidence.

    4. The only thing I like about His Orangeness is that he has no interest in my little corner of New England. I’m not going anywhere, especially not to hell in the handbasket he’s offering. If King Philip’s people couldn’t force us out back in the day, it’d be a shame to let that little puffed up German-American do it. it’d be a slight to the Wampanoags’ skills as fighters.

      1. It is sad, but somewhat amusing ( especially for someone who has studied all of the world’s healthcare systems for over 16 years) to see uninformed people spew crap about the US health care system, while at the same time burying their heads in the sand (deep) and attacking ( with low life aplomb) anybody who disagrees with their narrative. It’s even more amusing to see the ‘fuck this, fuck that’ posts. It really does define you. Share with your friends and your children, please.

        Now, let’s get to it. How many of you US citizens would be glad to leave the US and go to another country for, let’s say, major neurosurgery or cardiac bypass surgery or whatever?

        Before you answer, consider this: the US leads the world ( be happy now, it’s YOUR country) in treating: heart disease, stroke, hypertension, cancer, psychiatric disease and ‘responsiveness’, which is treating all patients with respect and in a timely fashion. Our wait times are the envy of the world, bar none ( don’t you just love that ‘bar none’ thingy of mine?). We also lead the world in developing new drugs and cutting edge treatment models and life saving devices. The number ONE facility for cardiac surgery in the world is in the US ( Cleveland Clinic). I can assure you that it’s NOT in Canada, France, the UK ,Germany or Scandinavia!! We’re also number one in cancer research across the globe.

        And here is something to consider: one of the main reasons our per capita costs are so high is that the US develops the most cutting edge drugs and treatments on the globe. And if WE don’t pony up and pay through the nose for those blessings, those companies doing the research will indeed stop doing just that. In effect, we subsidize the rest of the world in this regard. That’s why you can buy expensive US drugs in the UK, Canada, etc for a fraction of what we pay. And there are advanced treatments (ie. proton therapy for cancer) that you will NEVER, or rarely, see in abundance in Europe, Canada, etc. As I pointed out earlier, those socialized systems are ‘closed’ and cannot afford to offer such treatments. We are also inefficient in the administration of our HC–too much bureaucracy and gov. regulations ! That certainly contributes to our per capita costs and must be addressed.

        Also, FWIW, I’m just as fearful of Trump as you guys are. However, he’s our guy for four years and we would all do well to accept that fact and hope that he shines, as opposed to trashing him at every whip-stich! It only undermines our country. Makes YOU feel good, but it undermines our country.

        As I may have pointed out earlier, the WHO ( World Health Organization) report from 2000 actually ranked France as the best HC system in the world! And the US as about 37th! Are you kidding me?! I’ve lived in France for a few years and, trust me, you don’t want to be there IF you are really sick. No way. That WHO report was long ago debunked, big time. Totally invalid parameters and assumptions were used. It was an attempt to falsely build up other HC systems and paint the US system as just so-so. You know, the old,’ we hate winners’ approach and the US is just a big bully! And, BTW, when was the last time you heard about an Arab sheik flying into France to have his abdominal aortic aneurysm repaired? How about NEVER!

        I welcome your thoughts and ANY evidence to prove me wrong, but let’s cut the ‘fucks’ out of it. No, I’m not a prude, but I do put a premium on civility! Hope you do too. Please present any valid evidence you have to contradict me, not just disagreeing and slamming me for the sake of whatever !

        I’m hoping Jen is putting together a hyperbolic response! I look forward to it.

        Oh, an interesting article from a few years ago strongly suggested that if ANY other HC system in the world took care of the US population, our HC stats would be at least 40% worse ! We are NOT a healthy population by any metric: obesity, smoking, drugs, unhealthy life styles, poor pre-natal care, gun deaths and so on!

    5. Between your discursive style and your passion for exclamation points, not to mention your quivering distaste at swear words and overuse of adjectives, are you sure you are not the Orange One himself?

    6. Well I don’t know – I’m in Australia and our health care is probably better than US and it’s FREE, yep FREE!!!

  2. Terry Clark is a typical RWNJ, with the arrogance to believe he, a visitor to Dr. Gunter’s blog, can demand she not use words of HER choice on HER blog.

    Further, he demands an apology, and suggests it’s not “becoming” for her to speak to him that way. As if she’s somehow less of a physician than he is.

    Bless his shriveled little South Carolinian heart. If y’all decide to go to his Facebook page and tell him what you think of him, be sure to use politically correct language. /s

      1. Well, then, Terry, perhaps you should provide verifiable links to your credentials. You state you have studied international health care systems and are therefore an expert yet don’t list any publications. You state you teach a course and offer an invitation to take the course, but don’t state where, when and how. You claim much about your supposed superiority but provide no support. You demand someone on her own blog should behave according to your own delicate sensibilities losing sight of the fact that any valid points you may have are completely invalidated by your lack of bedside manner. You are a boor. Until you display some, you are a mere little brother to the Bully-in-Chief. I pity your patients and students, if any truly exist.

  3. The absurdity of a male MD preaching to others to be civil and not curse is mind boggling. Any RN, like me, who has actually worked in the presence of male MDs, has been cursed at, belittled, condescended to, and blamed by the doctors. Based on your comments, Dr. Clark, you’re an elitist, who has probably never had to worry about how to pay for medical bills. That theoretical patient you mentioned, with no insurance, who needs a heart cath? He may or may not get it, depending on whether he CHOOSES to bankrupt himself for the procedure. Sure, he CAN have the procedure done, but WILL he? Your arguments are condescending and irritating, but woefully lacking in fact. Have you not heard of the trend of Americans going to other countries for surgery, because they can’t afford it here? Like most elitists, you probably ignore those facts that don’t fit into your narrow minded belief system. Go away, and leave the compassionate realists alone.

    Jen, you’re post and responses to him are awesome. Keep it up.

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