It’s time to talk seriously about Donald Trump’s health.

The day he returned from India, the president held his first news conference in the White House Brady briefing room and took questions for nearly an hour. This came after an early morning tweet wherein he seemed to blame the Democrats for the falling stock market and for making the “Caronavirus [sic] look as bad as possible.”

Some thought the president had popped his cork.

In the middle of November he broke his normal weekend routine to travel to Walter Reed for an undisclosed reason.

The visit prompted a rare written statement from Press Secretary Stephanie Grisham on November 16. “Anticipating a very busy 2020, the President is taking advantage of a free weekend here in Washington, D.C., to begin portions of his routine annual physical exam at Walter Reed,” she said.

Three days later the president’s doctor issued his own statement. “This past Saturday afternoon the President traveled up to Walter Reed National Military Medical Center for a routine, planned interim checkup as part of the regular, primary preventative care he receives throughout the year,” Physician to the President Dr. Sean Conley said. “Due to scheduling uncertainties, the trip was kept off the record.” And, “despite some of the speculation, the President has not had any chest pain, nor was he evaluated or treated for any urgent or acute issues.”

”Specifically, he did not undergo any specialized cardiac or neurologic evaluations,” Dr. Conley said.

While the president has had many free weekends since his sudden visit to the hospital in November, he has not finished his physical—and the White House has remained silent about it. They have issued no on-the-record statements or anything that can be used on background.

The issue of Trump’s health keeps cropping up not only because of his age, diet and signs of heart disease—plus the stress caused by impeachment and the fact he operates the office of the presidency in a constant state of chaos—but specifically because of things people have noted during some of his public appearances. Slurring words, a strange look to his gait and appearing befuddled in public all have ramped up questions about Trump’s health.

When he replaced the head of the DNI with a loyalist who had no background in intelligence, some said Trump was crazy. When Richard Grenell, the former German ambassador who got the assignment, said we didn’t need intelligence agents on the ground in foreign countries since we can get what we need from the Internet, some thought Grenell and Trump were both crazy.

But those actions are typical Trump.

When he claimed at a rally that he’s now the country’s “chief law-enforcement officer” and then meddled in the Roger Stone case, again the cry arose that he’d lost his mind. Trump’s interference came after Judge Jackson sentenced Stone to 40 months in prison and said, “He was not prosecuted, as some have claimed, for standing up for the president; he was prosecuted for covering up for the president.”

Trump? He immediately considered a pardon for his old friend who has a tattoo of Richard Nixon on his back. “I want the process to play out,” he told reporters. “I think that’s the best thing to do. Because I’d love to see Roger exonerated. I personally think he was treated unfairly. They talk about witness tampering but that man that he was tampering didn’t seem to have much of a problem with it.”

The statement betrays a total lack of understanding of the law, but it is also typical Trump. The question, however, has become this: Is “typical Trump” indicative of a physical, emotional or neurological malady that is hampering his ability to carry out the Constitutional duties of his office?

This is independent of whether or not he’s failing to carry out his Constitutional duties simply because he doesn’t give a flying fickle finger of fate about the Constitution. While it is easy to believe someone who doesn’t respect the Constitution must have a mental problem, it doesn’t necessarily mean Trump is mentally ill.

Still, many pundits, readers and voters have noted other Trump peculiarities. He denies people he obviously knows when they get into trouble: When he was accused of having former congressman Dana Rohrabacher offer a pardon to Julian Assange in exchange for saying Russia didn’t hack the DNC in 2016, his press secretary said it was a “absolutely and completely false” and Trump “barely knows” Rohrabacher. This despite documented proof Rohrabacher spent 45 minutes in a meeting with Trump, Reince Priebus and Steve Bannon in 2017 and numerous other circumstances in which Trump and Rohrabacher spent time together.

At a campaign stop last week in Colorado, Trump attacked the Academy Awards. “And the winner is a movie from South Korea,” he told the adoring throng. “What the hell was that all about? We’ve got enough problems with South Korea, with trade. And after all that they give them best movie of the year?” He added, “Can we get like Gone With the Wind back please?” Where does one even begin?

To be fair, if you’re going to question the president’s sanity, then you also have to question Congressman Matt Gaetz, who appeared on ABC last weekend and said in effect that the American people love a sovereign and it’s okay for Trump to pardon Roger Stone.

You also have to loop in Senate Majority Leader Mitch McConnell, who said Attorney General William Barr is a man of “unquestionable integrity.”

But like Lawrence O’Donnell, who called Trump a “Russian operative” on television, we have to remember it isn’t necessarily Trump, Gaetz or McConnell’s mental condition that needs to be questioned, though it could be. Trump might be nuts and worship Russia—and he may just merely be a Russian puppet.

There are a growing number of people concerned it may be both. Many have compared video of Trump when he first got in office to more recent video. They’ve looked at the way he’s walked to the helicopter on the South Lawn. They’ve examined his rallies, speeches, infrequent news conferences and pool sprays. They comment on the way he dresses, speaks and looks about furtively, and they comment on his makeup and the way he leans forward when he’s standing in front of people.

Dr. Ronny Jackson, who performed Trump’s first medical exam as president, declared him “fit for duty” physically and mentally in 2018. When I asked about his health, I was told in the White House briefing that Trump had such good genes he could live to be 200. Dr. Jackson also reported the president performed a “difficult” cognitive test (the Montreal Cognitive Assessment) and scored 30 out of 30.

But since Dr. Jackson trumpeted Trump’s health from the James Brady Briefing Room, the administration has fallen silent on the matter. Last year the White House said little more than “eh, he’s fine.” It didn’t help that buried in that first health report were signs of heart disease—a fact upon which several physicians later commented.

It is the lack of comment from the White House that is most alarming. And while it may be Trump’s desire to sweep any concerns about his health under a rug, it just won’t happen.

In the last week he has traveled to Los Angeles, Las Vegas, Colorado and India. He’s appeared at rallies and had to deal with crowds, hotel rooms, aircraft travel and more. He’s a septuagenarian showing early symptoms of heart disease and his health is important to all of us because of the huge federal apparatus he commands. His recent actions, hobbling Congress and the judicial system, mean he even has more power at his command than most other presidents. His health, therefore, is of paramount importance.

But it doesn’t stop there. President Trump, 73, Bernie Sanders (who recently suffered a heart attack), 78, Michael Bloomberg (who has two stents), 78, former Vice President Joe Biden 77, Elizabeth Warren, 70, are all close to the end of the average lifespan, so voters need to know how healthy these people are.

Everyone but Trump, who is the oldest person to be sworn in for his first term as president, is merely vying for the job he already has. And the amount of stress that normally occurs with this job, combined with the self-induced stress brought about by Trump’s ability to operate untethered to reality and by his divisive antics, undoubtedly is causing more stress than normal on the president—just as it has produced more stress on the country at large. Taking all of this into consideration makes any rational person question the president’s physical and mental wellbeing.

During his campaign he produced a letter that said he would be the “healthiest individual ever elected to the presidency.” But the doctor named as its author, Dr. Harold Bornstein, later said Trump wrote the letter himself.

The man who made 16,000 false or misleading statements in his first three years as president does himself no favors when it comes to his health because he cannot tell the truth about anything. He attacked CNN and Jim Acosta in India: “Your record on telling the truth is so bad, you ought to be ashamed,” he said. To which Acosta responded, “Our record on delivering the truth is a lot better than yours.”

For all of the above reasons, the president’s health remains one of the most underreported yet urgent issues we face as we head into the 2020 election.

That’s a fact. And Donald Trump needs to tell the truth about it.