Column: Here’s why Biden should get tested and the results made public

President Biden keeps pushing back.

He’s not going anywhere, he defiantly insists, and claims he feels just fine.

But I’ve been hearing from doctors who saw Biden muddle through the June 27 debate and think he’s anything but fine. One of them told me he’s certain Biden is suffering from a movement disorder for which there is no cure.

A diagnosis by someone who has not examined a patient is speculative. But the shared view among the doctors who contacted me is that we are not looking at a man who’s simply getting older. We’re looking at a man with a serious medical condition.

California is about to be hit by an aging population wave, and Steve Lopez is riding it. His column focuses on the blessings and burdens of advancing age — and how some folks are challenging the stigma associated with older adults.

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In a recent column, I wrote that no one can accurately diagnose dementia from afar. But doctors tell me neurological movement disorders can be easier to detect.

“Every physician I have spoken to agrees that Biden has classic symptoms of Parkinson’s,” one of the doctors said.

Another noted the “masked face, blank expression, stopping as he shuffles along, soft, hoarse speech and stiff arms as he walks — all Parkinson’s.”

Two additional responses were of particular interest because they came from neurologists with decades of experience. So on Monday, just after the New York Times reported that a Parkinson’s specialist visited the White House eight times in eight months, I called them.

“When I was watching the debate,” said Dr. Michael Mahler, who’s on the UCLA faculty, “there were clues to me” that Biden, 81, was probably dealing with more than the normal challenges of aging.

The first sign for Mahler was “the way he walked onto the stage, with a very stiff gait. Normally, the way people walk, they swing their arms, and he didn’t have much arm swing. Then, watching and listening to him, he had … almost no facial expression…. His blink rate was really, really low, and he had very few other movements.”

Mahler noted Biden’s muffled speech as well. He said he couldn’t make a definitive diagnosis without a full physical, lab work, medication history and a five- to six-hour neurological battery of tests. But he said that what he saw were symptoms in the “Parkinsonian” paradigm.

Dr. Jack Florin, a Fullerton neurologist who’s been practicing medicine for 50 years, told me he has noticed signs of an advancing movement disorder in Biden for several years, and they were accentuated during the debate.

For Florin, there’s no doubt what’s going on: He thinks Biden has a Parkinson’s variant called progressive supranuclear palsy (PSP). He noted that singer Linda Ronstadt has the same condition, as did the late actor Dudley Moore.

“When you have PSP, your eye movements are not normal,” Florin said. “You’re looking down and you have difficulty moving your eyes from side to side. People with PSP have what’s called a fixed stare, and it looked like he was just staring, because his eyes were not moving.”

Over the course of his career, Florin said, he’s had hundreds of PSP patients. In Biden, he said, other telling symptoms included “low volume and rapid speech with loss of normal rhythm,” as well as “episodes of sudden forced eye closure,” also known as blepharospasm.

Dr. Michael Mahler, a UCLA faculty member, said that during the June 27 debate, shown in a screenshot from “L.A. Times Today,” he saw “clues” that President Biden might be dealing with more than the normal challenges of aging.

In Biden’s stiff gait, Florin saw another clue.

“He doesn’t have idiopathic Parkinson’s. That’s the most common type. People are stooped, often they have a tremor, and usually it’s on one side more than another. He doesn’t have that,” Florin said.

In his opinion, Biden has PSP, which is “progressive, incurable and untreatable…. As it gets worse, postural instability is the main problem, and there’s a risk of falls. After a while, patients cannot safely walk. A cane or walker won’t really help, because you can fall over backwards. As the disease gets severely worse, you’re mainly confined to a wheelchair.”

Two other doctors who contacted me did not rule out the possibility that Biden’s problems during the debate could have been caused — at least partially — by the side effects of medication.

“I certainly couldn’t diagnose him,” said Dr. Laura Mosqueda, a USC geriatrician who worries that people will incorrectly make the diagnosis that the president’s problem is his age, even though the world has no shortage of fully functioning people far older than Biden. “I don’t care if it’s 81, 61 or 41. I don’t think this is about his age. It’s about — does he have a medical problem we ought to be aware of?”

And that’s the right question.

Just four months shy of election day, the presidential election comes down to a choice between someone we know and someone we don’t know.

Trump, we know, and many people consider him the greater threat to the republic. And it’s no surprise that readers keep asking me why he’s not the candidate whose party wants to put him out to pasture.

Biden, we used to know, but a stranger is now wearing his suits.

He owes it to voters and his own party to undergo a full physical, cognitive and neurological workup and to make the results public. If there’s a problem, it needs to be addressed, with courage and transparency.

For his sake, and ours.

steve.lopez@latimes.com