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White House Doctor Shares Results From Trump's First Physical. Aired 3:30-4p ET

Aired January 16, 2018 - 15:30   ET


[15:30:00] ANGELA RYE, CNN POLITICAL COMMENTATOR: He's still a racist today.


STEPHEN MOORE, FORMER ECONOMIC ADVISER TO PRESIDENT DONALD TRUMP: Well, look, I mean, I talk to so many Black Americans myself. And they say what they like about Donald Trump, those who approve of his policies because they think they -- that he is going to make America great again, that he will provide --

RYE: Who did you talk to?

MOORE: -- job opportunities and higher wages. I talk to people all the time when I'm on the street. I talk to people when I'm on the job. I talk to people --


MOORE: And, you know, when I talk to African-Americans and also talk to Hispanics, a lot of times, you -- they don't like his language but they sure like what he's doing for the economy.

And that's the reason I'll bet you -- I'll bet you -- that when he runs for re-election, he gets a higher rate of the Black and Hispanic vote than he did in 2016 because he'll be running on his record, which has been very strong.

RYE: I'm going to take you on that bet.

MOORE: OK, you got it.



MOORE: All right.

RYE: I'm going to take you up on that because here is the thing.

MOORE: You heard it first here, Brooke.

RYE: The only thing that I hear Black and Brown folks and women talking about, and Native American folks, is one word and that's "impeach." I hope he doesn't make it to 2020. Impeach. BALDWIN: OK. OK. Maybe he gets re-elected according to Stephen, and

maybe not so much according to Angela.


BALDWIN: We're going to leave it. I appreciate the healthy conversation.

MOORE: Thank you, Brooke.

BALDWIN: Thank you both so very much.

RYE: Thank you, Brooke.

BALDWIN: We are --

MOORE: Take care.

BALDWIN: Take care yourself.

We are moments away from the White House briefing. We are expecting the doctor who took a look at the President, performed his physical last week at Walter Reed to share those results.

Our chief medical correspondent Dr. Sanjay Gupta is standing by live in the briefing room. We will talk to Sanjay, coming up.





SANDERS: John, can we go ahead? Hallie, we're good to go?

JOHN ROBERTS, FOX NEWS CHIEF WHITE HOUSE CORRESPONDENT: You're reasonably on time for a change, which is good.


SANDERS: Trying new things. Trying new things. The good doctor has got me on-time today.

I'm going to open with a statement from Brigadier General Dr. Richard Tubb, he is a White House physician emeritus, a retired military officer, and one of the longest-serving White House physicians in history, serving from 1995 to 2009. As a physician to the president, he earned the trust and confidence of presidents from differing parties. He trained under a physician who did the same and then trained Dr. Ronny Jackson, the current physician to the president, who has also earned the trust and confidence of presidents from both parties. Dr. Tubb wrote: "I hired and trained Rear Admiral Dr. Ronny Jackson. My patients, President and Mrs. Bush, knew and trusted him. I think it's safe to assume that President and Mrs. Obama trusted him as well, after all, they personally selected him to be their physician."

Today, Dr. Jackson will offer his professional assessment of the president's medical fitness for duty. Friday. Dr. Jackson conducted and supervised Donald Trump's first periodic physical exam as president of the United States. Having had the opportunity to review the tests, consult specialists, thoughtfully analyze the results, and discuss them with his patient, he will provide us with his considered assessment of the president's medical fitness for duty now and for the remainder of his term of office.

With regard to Friday's examination, knowing Dr. Jackson, I am confident that he practiced good medicine. However, it would be an error to view that exam and Dr. Jackson's assessment as an isolated event when in practice it is an ongoing process. Far more important to a meaningful assessment of the president's fitness for duty is a doctors evaluation, observations, interaction, conversations, examination during the remaining 364 days of the year.

SANDERS: Dr. Jackson and his team have been doing precisely that from the moment Donald J. Trump was elected. Beginning on November 9th, 2016, the members of the White House medical unit began shadowing the new president-elect, figuratively Velcro'd to his side 24-seven.

On January 20th, 2017, Dr. Jackson became that Velcro. "Dr. Jackson's office is one of only a very few in the White House residence proper, and is located directly across the hall from the president's private elevator. On any given day, the physician's office, as it is known, is generally the first and last to see the president. Dr. Jackson has built and leads an organization that is better than any other in history. I know that. I, as physician to the president, was well- served by this president's doctor.

"More importantly, President and Mrs. Bush were well-served by Dr. Jackson, as were President and Mrs. Obama. In keeping with his oath, I have every reason to believe that Dr. Jackson will well and faithfully discharge the duties of his office, and that President and Mrs. Trump, the office of the presidency, and the country will be well-served because of it."

Thank you, Brigadier General Dr. Richard Tubb, for that background and that information. And with that, I will turn it over to Dr. Jackson. And as always, if you could please keep your questions on-topic. And after Dr. Jackson finishes, I'll come back up to address any questions of the day. Thanks, guys.

NAVY REAR ADM. DR. RONNY JACKSON, THE PRESIDENT'S PHYSICIAN: Good afternoon, everyone. All right. So to start with, what I'm going to do is I am going to read to you the summary of the president's physical. And so I'll just read through this. And then after I'm done reading this, immediately after the brief we'll make this available to everyone exactly as I've read it here. And then I'll take a few questions. So start with: "President Donald J. Trump has completed his first periodic physical examination as president of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The exam was conducted January 12th, 2018, at the Walter Reed National Military Medical Center.

"The purpose of the exam was to provide the public with an update of the president's current health status and to ensure the president continues to enjoy all the benefits of good health. This examination focused on evidence-based health screening and disease prevention. With President Trump's consent, I release the following health information.

"Vitals as follows. Age 71 years and seven months at time of the exam. Height 75 inches. Weight 239 pounds. Resting heart rate 68. Blood pressure 122/74. Pulse oximetry 99 percent on room air. Temperature was 98.4. Physical examination by system to include any studies that were done by system. Eyes, the president's uncorrected visual acuity is 20/30 bilaterally, with corrected visual acuity of 20/20 bilaterally. His visual fields were normal. Fundoscopic exam was normal bilaterally. His intraocular pressures were normal. And no ocular pathology was discovered.

"Head, ears, nose, and throat normal. Exam of the head, ears, nose, mouth, and throat. Dental exam, he has healthy teeth and gums. There are no other dental findings. Neck, normal thyroid exam, no noted lymphadenopathy. Auscultation of his carotid arteries were normal. Pulmonary exam, his lungs were clear to auscultation. A screening low- dose CT of the chest demonstrated no pulmonary pathology.

"Cardiac exam, heart exam was normal, regular rhythm, no murmurs or other abnormal heart sounds were noted. His ECG, or, commonly, EKG, was normal sinus rhythm with a rate of 71, had a normal axis, and no other significant findings. He had a transthoracic echocardiogram done, which demonstrated normal left ventricular systolic function and ejection fraction of 60 to 65 percent. Normal left ventricular chamber size and wall thickness. No wall motion abnormalities. His right ventricle was normal. His atria were grossly normal. And all valves were normal.

JACKSON: "He had an exercise stress echocardiogram done which demonstrated above-average exercise capacity based on age and sex, and a normal heart rate, blood pressure, and cardiac output response to exercise. He had no evidence of ischemia, and his wall of motion (ph) was normal in all images.

Gastrointestinal exam: He had a normal exam, no masses, no hepatomegaly or splenomegaly. He had a normal optical colonoscopy done in 2013, June of 2013, that demonstrated no polyps or abnormal findings, and because of that, a repeat colonoscopy was not indicated at this time, and will be deferred until his next periodic physical exam.

Genitourinary exam was normal. Extremities and musculoskeletal normal throughout. Full range of motion in all joints. He had strong distal pulses and good capillary refill in all extremities. He had no swelling or edema.

Neurological exam: Examination of the cranial nerves, cerebellar function, deep tendon reflexes, motor function and sensory system were all normal. A cognitive screening exam using the Montreal Cognitive Assessment was normal, with a score of 30 over 30.

Dermatologic exam normal. No evidence of melanoma, basal cell carcinoma, squamous cell carcinoma, or any other significant dermatologic diseases.

I'm going to very briefly go over some of the labs here that I feel are most important, and that most providers would be interested in, and then you can look at the details when I put out the written.

But laboratory results summarized: the lipid panel -- he had a total cholesterol of 223; triglycerides are 129; HDL is 67; and LDL cholesterol of 143, and his -- his total cholesterol-to-HDL ratio is 3.3. His complete blood count, to include his white blood cell count, his hemoglobin, hematocrit, and platelet count were all normal, and the values are on the written copy you'll get.

His extended metabolic panel as follows: His fasting blood glucose was 89. His BUN was 19. His creatinine was 0.98, indicators of his renal function. His liver enzymes, his ALT, was 27. His AST was 19, normal. His hemoglobin A-1 C was five percent. His Vitamin D was 20. His PSA was 0.12, and his thyroid screen with a TSH was 1.76. He had a urinalysis done that was clear, and had no evidence of protein, ketones, glucose or blood.

His past medical history includes hypercholesterolemia and rosacea. His past surgical history -- he had an appendectomy at age 11. His social history: He has no past or present use of alcohol; no past or present use of tobacco.

His medications as follows: He takes Crestor, 10 mg daily to lower his cholesterol. He takes aspirin, 81 mg daily for cardiac health. He takes Propecia, one mg daily, for prevention of male pattern hair loss. He takes Soolantra Cream as needed for rosacea, and he takes a multivitamin each day for health maintenance.

Immunizations: The president during his physical exam had a Prevnar 13 immunization to prevent pneumococcal pneumonia, and he had number two dose of his Twinrix to prevent hepatitis A and B. His routine vaccinations, to include his seasonal influenza, are all up-to-date, and all indicated travel vaccinations are up to date.

In summary, the president's overall health is excellent. His cardiac performance during his physical exam was very good. He continues to enjoy the significant long-term cardiac and overall health benefits that come from a lifetime of abstinence from tobacco and alcohol. We discussed diet, exercise and weight loss. He would benefit from a diet that is lower in fat and carbohydrates, and from a routine exercise regimen. He has a history of elevated cholesterol, and is currently on a low dose of Crestor. In order to further reduce his cholesterol level and further decreases his cardiac risk, we will increase the dose of this particular medication. JACKSON: The president is currently up to date on all recommended preventive medicine, and screening tests and exams. All clinical data indicates that the president is currently up to date on all recommended preventive medicine and screening tests and exams.

All clinical data indicates that the president is currently very healthy, and that he will remain so for the duration of his presidency.

OK. With that, I'll take some questions.

Before we get started, let me just make one comment, I'd just like to point out for all of you here in this room, many of you which know me, just if something should happen to you over the next few months and you should fall ill at some point, that most likely I will be the one called to come take care of you.


JACKSON: So when you ask your questions, please keep that in mind.


QUESTION: Dr. Jackson, how much weight have you suggested the president lose, and he -- he has not exactly been enthusiastic about exercising. The president kind of believes that we all have the finite batteries, why waste it on exercise when we can put it toward other pursuits. What did you counsel him about that?

JACKSON: Right. That's right. So you know, I think the president, you know, he and I talked and he would -- he would like to lose over the next -- I think a reasonable goal over the next year or so is to lose 10 to 15 pounds. We talked about diet and exercise a lot.

He's more enthusiastic about the diet part than the exercise part, but we're going to do both. He -- he and I will work together over the next year to incorporate a -- a good plan so that we can -- we can meet those goals.

QUESTION: Thank you. Two questions for you. Number one, there've been some questions as part of your exam. I'm wondering if you talked to the president about this, about the president's mental fitness. He has pushed back on that calling (inaudible) a stable genius. Can you assess the president's mental fitness for office?

JACKSON: Absolutely. So you -- many of you may have picked up on the fact that we did do a cognitive assessment as part of the exam. And initially, you know, I had no intention of including a cognitive assessment in this exam, because to be honest with you, per all the guidelines that are out there, it just -- it's not indicated at this time.

A lot of the guidelines would suggest that you do -- that you do cognitive screening questions, and that if you have a positive or concerning answer in the screening questions that then you engage with a cognitive-screening tool. So I had no intentions what so ever of doing that, like I said, because I didn't feel it was clinically indicated.

And part of the reason I didn't think it was clinically indicated is because I've spent almost every day in the -- in the president's presence since January 20 2000 -- or you know, last year when he -- when he got into office. And I've seen him every day, I see him one, two, sometimes three times a day, because of the location of my office.

We have conversations about many things, most if not -- most don't revolve around medical issues at all. But I've got to know him pretty well. And I had absolutely no concerns about his cognitive ability or his -- you know, his neurological function.

So I was not going to do a cognitive exam. I had no intention of doing one. The -- the -- the reason that we did the cognitive assessment is, plain and simple, because the president asked me to do it. He came to me and he said, is there something we can do, a test or some type of screen that we can do to assess my -- you know, my cognitive ability.

And so I looked into it, and once again, my initial question was that I didn't think it was indicated, and I didn't think we should do it. After looking at some of the guidelines, there are a few guidelines out there that lean in the direction of potentially doing it. You know, the Medicare guidelines and some of the NIA, National Institute of Aging, they've indicated that it might be a good thing to start doing for most patients in the future.

With that in mind, I went through and I looked at a variety of the cognitive assessments that were available. Most of them were very simple, very short, and I think that's -- that's the goal actually for primary care providers in doing this, is to keep it simple, keep it short.

We picked one of the ones that was a little bit more involved. It was longer. It was -- it was the more difficult one of all of them. It took significantly longer to complete, but the president did exceedingly well on it. So that was not driven at all by any clinical concerns I have. It was driven by the presidents wishes, and he -- he did well on it.

QUESTION: So to follow up, the president's personal doctor memorably said during the campaign that he would be the healthiest individual ever elected to the presidency. Do you agree with that assessment?

JACKSON: I'm not going to comment on that. My job is to -- is to basically give you my assessment of President Trump today. And I'm not going to make any comparisons with presidents over the last 200 years or anything.

QUESTION: Yes, there was an incident recently where the president appeared to slur his words while giving an address. Did you look into what the cause of that might have been at all?

JACKSON: I did. Yes, we talked about that. And actually one of my ENT consultants was involved in that. We evaluated him. We checked everything out. And everything was normal. We even went so far as to do an ultrasound of his (INAUDIBLE) glands and a few other things. And there was absolutely no, you know, clinical findings that would suggest -- I think the reason for that was, quite honestly, me being up here right now, I think I need a drink of water.


But I think that -- I had given the president some medication, it was specifically some Sudafed over the days previous. And I think that I had inadvertently kind of dried up his secretions a little bit more than I intended to. And I think that led to -- or that precipitated it.

QUESTION: Some people have suggested that could be related to dentures. Does the president wear dentures...


JACKSON: He does not. The president has no partial or any dentures of any kind.

QUESTION: Dr. Jackson...


QUESTION: ... ask you two questions. One is about the ejection fraction. My wife suffers from -- (INAUDIBLE) 60 percent, is that a concern going forward for him? Because that, in some cases, indicates low activity...


JACKSON: No, not at all, 60 to 65 percent is a normal ejection fraction. That's not -- there's no concern about that at all.

QUESTION: Second follow-up on cholesterol. Over 220, do you hope he'll get it under 200?

JACKSON: Well, we're not focusing on the total cholesterol as much as we are the LDL. We would like to get the LDL down below 120. So that's what we'll be shooting for.

QUESTION: And is in any way with the low -- I understand that the blood pressure was within norms, but with the high cholesterol, were there any concerns for his heart health?

JACKSON: No, not at all. I mean, I think that, you know, the one good thing that -- or, you know, there are many good things that came from his exam. I think he had great findings across the board. But the one that stands out more than anything to me is his cardiac health. His cardiac health is excellent. And so I think, you know, with all the other things in place, he doesn't have really a family history of premature cardiac disease. He doesn't smoke. He doesn't have diabetes.

A lot of the traditional risk factors he doesn't have. And so I think that those things in combination with the excellent cardiac results that we got from the exercise stress test I think are very reassuring. QUESTION: Thank you. Could you just elaborate in layman's terms if possible, (INAUDIBLE) great job at that, what you ruled out in these cognitive tests? You know, there have been reports that the president has forgotten names, that he is repeating himself. Are you ruling out things like early onset Alzheimer's? Are you looking at dementia-like symptoms?

And then a second question. A lot of doctors at the back end of a physical like to give their patients tips before they walk out the door, things that they should change in terms of lifestyle or behavior. What did you tell this president, outside of diet, that he might want to change?

JACKSON: Yes, so I think that the cognitive test, you know, it's well- respected. It is a test that's used throughout the United States. Lots and lots of institutions use that test. It's the one that they use at Walter Reed for patients that they feel like they need to do cognitive screens on. So it's a universally accepted test. And like I said, it's a little bit more extensive than some of the shorter ones that are in some of the guidelines.

But, yes, it screens for all those things. It screens for any type of cognitive issues, you know, Alzheimer's and all those other things. And so, you know, the fact that the president got 30 out of 30 on that exam, I think that, you know, there is no indication whatsoever that he has any cognitive issues. And, you know, on a day-to-day basis, like I said before, it has been my experience that the president -- you know, he is very sharp, and, you know, know he is very articulate when he speaks to me. And, you know, I have never known him to repeat himself around me.

He says what he has got to say. And he speaks his mind. And I found no reason whatsoever to think that the president has...

QUESTION: He's fine?

JACKSON: I found no reason whatsoever to think that the president has any issues whatsoever with his thought process, so.

QUESTION: And the tips part, did you -- did you recommend he make any changes, lifestyle, behavioral?

JACKSON: Well, not really. I mean, I think the main thing that we would be focused on with regards to lifestyle changes are diet and exercise. And you know, if -- if we get diet and exercise right, then weight loss will come. So those are the things that we focused on. I think that there -- there wasn't a lot to go on here as far as giving, you know, making him healthier in the -- in the year -- in the year coming, other than incorporating an exercise routine, working on his diet and having some exercise.

Those things will make him much healthier next year than he is now, although his health is excellent right now.

Dr. Gupta, do you want to answer one or do you just want to...


QUESTION: You ordered some intensive testing, including a CT scan of his chest and a transesophageal echocardiogram...

JACKSON: No, it was a transthoracic.

QUESTION: Transthoracic. Did he need to be sedated at all? Was there something you were worried about specifically when you ordered the CT scan?

JACKSON: No, not at all. We -- we got the CT scan just because we were debating -- I mean, I didn't have any -- any background information on him at all from a pulmonary standpoint. You know, I didn't have old chest x-rays to look at or anything like that. So I was going to initially just get a chest x-ray and be done with it at that. But it's so easy nowadays to just whip in and it just takes a few -- you know, a minute or two -- about as much time to get a CAT scan in the way we did, as it does to get a chest x-ray and it gives you a lot more information about other structures in the chest.

So it just made more sense to get the CT done. With regards to the echocardiogram, one of the reasons that I did that was because I wanted to prescribe an exercise program for the president and so I think that it makes sense to get a good cardiac assessment in a controlled environment like the hospital before you prescribe an exercise program to a patient. So that was my thinking there.

QUESTION: He does have heart disease, is that what you said?

JACKSON: He does not have heart disease.

QUESTION: He had a CT scan before that showed calcium in his coronary blood vessels.

JACKSON: He does -- he did. He had a -- so I think -- so technically he has nonclinical atherosclerotic coronary -- coronary atherosclerosis. And so that's been mentioned in previous physical exams he's had done. He had a coronary calcium score done in 2009, it was 34. He had a coronary calcium score done in 2013 that was 98.

And then we did get a calcium score from this, I didn't mention it because I think it was clinically good information. It wasn't -- I -- but it was 133. So I had a long conversation with the cardiologist, not only the cardiologist at Walter Reed but the cardiologist at Cleveland Clinic and several other well-known institutions. And everyone saw that as reassuring that he's gone this period of time and he's had that much -- that little of a change in his coronary calcium load.

So I think overall, his coronary calcium score is very reassuring. It goes along with the rest of his cardiac workup.

QUESTION: Dr. Jackson, if I might ask a question that follows on the philosophy of the fitness of the president?

JACKSON: Yes. QUESTION: The 25th amendment, a lot of people in the country have been talking about it, it basically contemplates that a group of Senate- confirmed laymen will weigh in on whether the president's able to discharge the duties of the office. In the U.S. the president's position (ph) certainly given this some thought over the years that you've been in your role. On -- on what basis would you, and this is just a philosophical question, advise the cabinet that the president is unable to discharge his duties? How does that bar get met?

JACKSON: Well, I mean, you know, section four of the -- of that amendment doesn't really, you know, give me a specific duty or role in there. Like you said, it falls upon the cabinet and the members of Congress and all. You know, I think I'm just like any other member of the administration who sees him and talks to him on a regular basis. If I were to see something that was very concerning and I had concerns about his cognitive ability or, you know -- you know, something to -- to that extent that I would bring that up to the -- to the proper people in the chain of command, maybe starting off with the chief of staff or something.

And I think that's what everyone else in -- in the administration would do. So I don't think my role as a physician would be much different than any other member of the president's administration if they thought something like that were going on. I just think that once that happened, if it were someone else in the administration, I would immediately be brought into it to make a clinical assessment and see if I agreed with that assessment.

But you know, I mean, I think -- at this particular point, based on my exam and the cognitive testing that we did and just my day-to-day interactions with the president, you know, the president is mentally very -- very sharp, very intact.

QUESTION: Do you believe he is fit for duty?

JACKSON: Absolutely he's fit for duty. I think he'll remain fit for duty for the remainder of this term and even for the remainder of another term if he's elected.

QUESTION: How can you determine that (ph)?

QUESTION: Dr. Jackson, you talked a bit about President Trump in your own -- your kind of daily dealings with him...

JACKSON: Hang on, let me -- did you say how?

QUESTION: How can you determine that for the whole -- I mean, you can't determine four years out, right?

JACKSON: Yeah, absolutely. I -- I don't have a crystal ball, I can't look into it. But you know, based on his cardiac assessment, you can make predictions, you know, you can -- you can make cardiac calculations and you can see what his risk of having a cardiac or a cerebrovascular event might be. And so if you look at that stuff where he falls out on his cardiac assessment, he falls into a category that portends, you know, years of, you know, event-free, you know, living. So I mean, sure, you know, I myself could have a big event tomorrow. I mean, I -- I don't have that kind of -- I'm not making that kind of prediction. But I'm saying based on the clinical information that I have right now over the year of me observing him and the few things that have happened with him medically over the year, and in large part on the -- on the objective data that we gained from this particular exam, I feel very confident that he has a very strong and a very probably possibility of making it completely through his presidency with no serious medical issues.

QUESTION: Dr. Jackson?

JACKSON: Yes, I'm sorry, go ahead.

QUESTION: So you talked about dealing with President Trump on a daily basis. Can you talk a bit about him as a patient, like what type of patient he is? Does he take all of your advice? And you also talked about -- since you were dealing with him on a daily basis, has he had any ongoing ailments or anything like that? You talked about giving him Sudafed, sometimes it sounds like he has the sniffles when he's talking. Like, does he have any allergies or anything like that?

JACKSON: He doesn't. I mean, on occasion, he suffers from the same, you know, viral, you know, upper respiratory stuff that you and I do and he gets congestion and things of that nature. But for the most part, you know, one of the things I found about President Trump is that he's very independent when it comes to his medical stuff. And so, you know, he's -- I guess, you know -- you know, the way he grew up, I guess he takes care of most of the little stuff his self.

He doesn't come to me for band-aids and things of that nature, you know. And you know, I'm easily accessible and, you know, a lot of folks will. So, you know, I think, you know, he -- he's a good patient. He sometimes, you know, I have to, you know, convince him why I want him to do something, so, you know, he doesn't just take everything I say and just, you know, just take it, you know, at face value and move on.

He'll ask me questions about why would I do that or why should I do that, this, that and the other. For the most part, he's very cooperative. He follows, you know, medical direction. He's just like every other president I've taken care of. On occasion, I have to get the first lady involved to make sure that...


...That he's taking -- that he's doing what he's supposed to be doing. But yes, he's a good patient.

QUESTION: Just to make sure we're clear on this, when you analyze his cognitive ability or do neurological functions, that is not the same as a psychiatric exam or a psychological (inaudible)?

JACKSON: It is not. No, it's a -- it's a screening assessment for cognitive impairment. Right, yes, right. QUESTION: Dr. Jackson, does the president do anything at all right now in terms of exercise? What is his daily exercise routine, if there is one?

JACKSON: So, I would say right now on a day-to-day basis, he doesn't have a dedicated, defined exercise program. And so that -- you know, that's what I'm working on. The good part is that, you know, we can -- we can build on that pretty easily.


QUESTION: So you said you were discussing that with him. What are you discussing? What would you like to see him start doing?

JACKSON: Well, I mean, like I said, he doesn't -- he doesn't have a daily exercise, you know, regimen and he just -- you know, some people exercise, some people -- you know, don't. Some people just didn't -- you know, didn't -- you know, haven't done that, you know, as part of their routine. And I would say that's the category he falls in right now.

I would say though that -- you know, despite that, one of the things, being with the President on a day-to-day basis, that has been impressive to me is he has a lot -- a lot of energy, a lot of energy and a lot of stamina. And I think I first noticed that, you know, we traveled -- we did some overseas travel last year. And I was really surprised because I didn't know the president early on. You know, when -


the days we'd get these 14, 16-hour days, and you -- the staff is just spent after a while. And you're just like, man, when are we going to the hotel?