Comment: Before howling at Dr. Zebra for publicizing Presidential piles, consider: (1) "The data are the data." The hemorrhoid is clearly documented. It is medical. Thus, there is no reason to omit it. (2) A hemorrhoid is not always as lowly or as insignificant as you are may think. Hemorrhoids are often associated with fiber-poor diets (as are colonic polyps, which Bush has had). Hemorrhoids may be a sign of abnormal blood circulation in the liver (although Bush has admitted abusing alcohol, there is no other evidence he has suffered liver complications). Hemorrhoids can sometimes lead to severe complications: liver abscesses are rare, but severe bleeding from hemorrhoids is less so. Because of his bleeding hemorrhoids in 1941, Franklin Roosevelt lost almost two-thirds of all the hemoglobin in his body.

Thus, when Bush was ordered on May 4, 1972 to undergo a flight physical, this would most likely have been the routine start of the 3 month physical exam window. On May 19, Bush asked his superiors how to "get out of coming to drill from now through November" 3. Flying examinations are normally given only at drill.

On August 1, Bush was grounded, in part (?wholly) because he had failed to complete his flight physical 3.

Comment: Failure to complete a flight physical is a serious matter in the military flying community. Because failure grounds the pilot, the overall readiness of the flying unit decreases. Readiness is the Air National Guard's primary mission.

It is unclear whether the DUI mentioned above is the same as the following incident: In late 1972 Bush took his then-16-year-old brother Marvin out drinking. On the way home Bush ran his car over a neighbor's garbage cans. Confronted by his father, George W. challenged elder Bush to go "mano a mano" outside 5 6.

Bush told his doctors in August 2001 that he currently abstains from alcohol. In 1999 he released a three-page statement from doctors saying he had "totally abstained from alcohol during the past 13 years" 2.

Comment: Dr. Zebra concludes Bush used cocaine in his 20s. (Should someone protest that there is no smoking gun, Dr. Zebra reminds them that medicine has its own standards of proof. Consider, for example, a 60 year old smoker with one hour of unrelenting squeezing midline chest discomfort, plus nausea and EKG changes. That is not "an alleged heart attack," it is a heart attack unless proven otherwise. Same thing here.) Cocaine use has clear medical implications. For example, it is associated with elevated risk of acquiring chronic diseases, such as viral hepatitis and sexually transmitted disease. Acutely, it can trigger cardiac or cerebro-vascular catastrophe.

As of November 2003 he could lift as much as 215 pounds, but due to a torn meniscus he has decreased his running, with a consequent increase in his per-mile time from 7 minutes to 9 minutes 10.

Comment: While no one would ever discourage physical fitness, it is telling that all of Bush' fitness did not prevent the development of coronary artery disease that led to a coronary artery stent just four years after leaving office, at the comparatively early age of 67. This may represent Bush's hard-living young adulthood catching up with him.

USA Today, however, says that Bush is 5 feet, 11 and 3/4 inches tall 11 and Bush's much-discussed National Guard records list him as 5 feet 11 inches tall while in his mid-20s.

Comment: There is no medical reason to measure body fat to a precision of .01%, and it is probably not even possible to do so with any known technique. Consequently, there is certainly no medical reason to report body fat to that degree of precision, unless the aim is to enhance the President's image of fitness by touting a body fat below 20%. Similarly, it is no stretch (pun intended) to imagine that his height was rounded up to the more macho-sounding six feet. All this gives a new meaning to the phrase "Spin Doctors."

Bush's father, George H. W. Bush, had a similar procedure 8 months later.

Interestingly, his father George H. W. Bush also suffered a syncopal episode while President.

Bush underwent follow-up colonoscopy on June 29, 2002, at Camp David. He denied signs or symptoms of colorectal cancer, but underwent the procedure to be "super-cautious" about his health 14. The results of the examination were reported to be normal. Supposedly, another of the reasons Bush underwent the procedure was "to underscore its importance for people over 50 who are at risk" 15.

Before the 20-minute procedure, Bush invoked section 3 of the 25th Amendment, temporarily transferring Presidential powers to Vice President Cheney MORE -- the first time an official transfer of power had been made under that provision of the Constitution. Bush commented: "I'm the first president to have done so (transferred power) under this type of procedure and/or physical examination. I did so because we're at war" 15.
Comment: It is often written that Ronald Reagan used section 3 of the 25th Amendment to transfer power to his Vice President on July 13, 1985 before undergoing surgery for colon cancer. However, Reagan did not explicitly invoke the 25th Amendement 4b.

Details of the procedure were released MORE. Bush will likely undergo repeat colonoscopy in 5 years 15.

Bush had no ill effects from the vaccine 19, unlike the experience of John Adams. Bush's public smallpox vaccination follows the example of Harry Truman.

The Time Magazine cover of Dec. 1, 2003 confirms an ear lobe crease on the right and suggests the presence of hair in the ear canal. The combination of and ear lobe crease and hair in the ear canal has been reported as more predictive of coronary artery disease than either alone 22 23.

On July 7, 2005 Bush was bicycling fast in Scotland, about 45 minutes into his usual one-hour ride, when his mountain bike skidded out from under him on slick pavement. Bush (and/or the bicycle) hit a member of the local security detail. Bush was wearing a helmet. He suffered minor scrapes and bruises of the left hand and arm. Dr. Richard Tubb, the President's physician, bandaged the hand, and was sent to look after the Scottish officer. 24 25

Most of the proposed causes are ill-informed zebra hunting. Instead, consider this simple recollection Bush had about the final weeks of 2002, when the decision to invade Iraq was looming ever larger:

There was a lot of stress. Yeah, I felt stressed. My jaw muscles got so tight. And it was not because I was smiling and shaking so many hands. There was a lot of tension during that last holiday season. 26a

Though without symptoms, an obstruction in at least one of his coronary arteries was discovered during his annual physical the day before. The physical included a stress test and an electrocardiogram. Those results prompted a CT coronary angiogram (i.e. an angiogram of the coronary arteries performed via a CT scan), and the results of that led to the stent. The procedure was performed at Texas Health Presbyterian Hospital in Dallas, Texas, as an inpatient. 28.

The procedure was controversial in medical circles, as the benefits of stenting in asymptomatic persons is unclear. Comment: That may be true in general, but without knowing the precise coronary anatomay, it is not possible to comment about the advisability of the procedure in an individual.