Rockin’ pneumonia: A unifying diagnosis

A prominent internist writes with admittedly speculative comments on the diagnosis of pneumonia made public today regarding Hillary Clinton. He writes:

During my 19 years as a board certified internist I have taken care of many hundreds of patients with pneumonia. The story about Hillary Clinton being diagnosed with pneumonia raises a red flag as to the cause. It could simply have been a community acquired pneumonia, which means she contracted it as a healthy person living her usual life. This happens occasionally, even to healthy people. If this is the case the timing certainly is unfortunate for her given where we are in the election cycle though it doesn’t portend anything ominous.

Another more worrisome possibility comes to mind. I raise this second possibility because of Hillary’s history of neurological illnesses (blood clot in brain, concussion), hints raised on the internet in Wikileaks documents and by others that she may have a neurological disease like Parkinson’s, and her by now well documented history of recurrent coughing fits. This second possibility is that she has an aspiration pneumonia.

Aspiration pneumonia occurs when fluids and food particles that normally enter the esophagus instead enter the windpipe and lungs. It is commonly seen in neurological conditions like strokes and Parkinson’s disease or similar diseases where the nerves to the swallowing mechanism are not working properly. This is especially worrisome because it is likely to recur given the underlying, usually incurable disease process and because it can be a life-threatening event.

I consider aspiration pneumonia to be the more likely cause because it unifies all the pieces of disparate information that are available on Hillary’s medical condition. A diagnosis of aspiration pneumonia raises profoundly troubling implications for her possible election as president.

Someone should demand full and immediate disclosure of her medical records. She should also be the subject of a swallow study to confirm that she can swallow normally (if one hasn’t been done already). Every voter should know what’s at stake.

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