Trump’s Life Could Rest in This Military Surgeon’s Hands - OZY | A Modern Media Company
White House physician Sean Conley during an update on the condition of US President Donald Trump, on October 3, 2020, at Walter Reed Medical Center in Bethesda, Maryland.
SourceBRENDAN SMIALOWSKI/AFP via Getty

WHY YOU SHOULD CARE

Because as a celebrated Navy surgeon tries to treat Donald Trump, it may be more than the virus that he has to fight.

By Nick Fouriezos

Sean Conley knows pressure. While in Afghanistan, the U.S. Navy surgeon once saved the life of a Romanian soldier who was hit by an IED; he led a team that cracked open the patient’s chest and literally squeezed his heart to keep it pumping. His leadership won the trauma department head, and six other colleagues, a Romanian medal of honor. And yet even that whirlwind of an experience didn’t prepare the president’s physician for the gale force he experienced Saturday, charged with navigating a 74-year-old obese president through a virus known for killing seniors with preconditions and doing so under the most intense scrutiny perhaps any American doctor has ever faced.

Flanked by nine fellow medical team members, Conley gave a news conference to update the public on the president’s condition Saturday — and delivered a dose of confusion instead. “This morning, the president is doing very well,” he began, benignly enough, but then dropped that it was now “just 72 hours into the diagnosis” … a number that defied the official narrative from the White House, and which he later had to correct as Thursday night. When asked whether the president had received oxygen, Conley seemed to be dodging the question, insisting repeatedly that Trump was not on it “right now,” before finally giving a timeline that ruled out Thursday and Saturday but seemed to suggest Trump may have received oxygen at the White House on Friday.

At one point, Conley said the president is “doing so well,” downplayed Trump’s obesity as being “a little overweight” and declared that while the president originally had “a mild cough, some nasal congestion and fatigue,” all of those symptoms “are now resolving or improving.” But that optimism was contradicted moments later, when Trump’s chief of staff Mark Meadows told reporters that the president’s vitals “over the last 24 hours were very concerning,” that “the next 48 hours will be critical,” and that the president was “still not on a clear path to a full recovery.”

It’s amazing what you can do when you have the right tools and the team that works with efficiency to make it happen.

Dr. Sean Conley, on trauma surgery in Afghanistan

So either Conley stretched the truth with his rosy diagnosis, or the White House wants to push a more dire narrative — or the truth lies somewhere in between. Either way though, the mixed messaging doesn’t reflect well on Conley, whose role should be to to provide clarity in a moment rife with national concern. As Conley himself said after that fateful day in Afghanistan where his team saved that Romanian’s life despite numerous obstacles: “It’s amazing what you can do when you have the right tools and the team that works with efficiency to make it happen.” The former Navy lieutenant commander has access to whatever tools he could ever need, and a team full of experts at his disposal — but can he rise to the occasion?

The famously bullish president will present unique challenges to Conley’s medical team. After all, Trump has downplayed the virus on multiple occasions and has also suggested a number of nonscientific cures against expert recommendations. He also faces pressure to get back on the campaign trail, with just a month left before Election Day. And it’s quickly becoming clear that Trump is willing to take aggressive, risky measures to fight the disease.

On Friday afternoon, the White House released a statement from Conley, announcing that Trump had received an 8-gram infusion from an experimental coronavirus treatment developed by Regeneron. The New York biotech company began clinical trials of the antibody cocktail in June and has not yet completed them. After receiving the infusion, Trump decamped from the White House to Walter Reed Medical Center in Bethesda, Maryland, for a multiday stay on the advice of Conley and others.

Trump has pushed doctors to prescribe hydroxychloroquine to either prevent or treat the virus — he even announced in May that he was taking it himself, despite numerous studies refuting the drug’s efficacy and listing potential negative side effects. That led Conley to send a memo, released by White House press secretary Kayleigh McEnany, explaining the decision. “After numerous discussions he and I had regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from treatment outweighed the relative risk,” the memo read.

Conley’s memo is potentially a troubling indication of his blind spots when it comes to pushing back against the commander in chief, suggests Gustavo Ferrer, a veteran pulmonologist who has run two ICUs in the Miami area since the outbreak began. “Every organization in the whole world has supported research into hydroxychloroquine and there is still no evidence it works, neither for treatment nor prevention,” Ferrer says, adding that those studies existed earlier this summer. “[Conley] should have cautioned and advised [Trump] that the president should not take this, period. The evidence doesn’t support it.” To be fair, this time around Conley says he has not put the president on hydroxychloroquine, despite Trump having asked about it.

A native of the Philadelphia suburb of Doylestown, Conley earned an undergraduate degree from Notre Dame in 2002, graduated from the Philadelphia College of Osteopathic Medicine in 2006 and completed a Navy emergency medicine residency program in Portsmouth, Virginia, in 2013. He assumed the White House physician job in May 2018, replacing the controversial Ronny Jackson, who is now running for Congress as a Republican and is heavily favored to win a seat in Texas. Jackson was known for his sycophantic hyperbole — in one memo he said that if Trump had had a healthier diet the last 20 years, he “might live to be 200 years old.”

NBC News reported Saturday that Conley was Jackson’s pick for the job, and others in the White House Medical Unit believe Conley wasn’t vetted well enough. White House spokesman Judd Deere told NBC: “This type of reporting is grossly irresponsible because Dr. Conley is an imminently [sic] qualified talented physician with a wealth of experience well-suited to serve President Trump and ensure he remains very healthy to continue his work on behalf of the American people.”

Conley has been more measured than Jackson in his assessments of the president’s health. After a physical in January 2019 showed that Trump had gained four pounds while his cholesterol had gone down, Conley wrote that Trump was “in very good health and I anticipate he will remain so for the duration of his presidency, and beyond.” When Trump visited Walter Reed last November, in a weekend trip that didn’t follow typical protocol for a routine exam, Conley reported that the president “has not had any chest pain” and “did not undergo any specialized cardiac or neurologic evaluations.”

While Trump is exhibiting only mild symptoms so far, the worst effects should be seen approximately one week in, says Ferrer. It will be crucial for Conley and his team to monitor blood tests for inflammatory markers, which can help forecast the severity of the virus. For someone of Trump’s age, the disease could last two weeks if there aren’t complications — and three weeks or longer if things worsen. “They need to follow the evidence as things come up day by day, and above all, be on top of his clinical and laboratory blood tests, how they evolve,” Ferrer says. On Saturday, Conley said the team was taking daily tests and that he wouldn’t put a timeline on releasing Trump because “with the known course of the illness, from days 7 to 10 we get really concerned about the inflammatory phase.”

Given that his experience is centered around trauma surgery, Conley is relying on a number of viral and cardiovascular disease experts — on Saturday, he introduced three pulmonary doctors, two infectious disease experts, an anesthesiologist and a clinical pharmacist, plus a number of nurses. Still, given the Trump administration’s reticence to take the advice of experts in the past, Ferrer cautions that Conley will need to be more assertive with Trump. “My hope is they are bringing in people who have been involved in this process, and leave pride at the door,” Ferrer says. “Anything outside the box they may attempt to use has to be supported by evidence.”

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