Good afternoon we will let john roberts wrap up. Can we go ahead . Try new things. The doctor has me on time today. I will open with the statement from the Brigadier General the white house physician retired military officer was the longestserving in history and earned the trust and confidence and trained under physicians who did the same and then the current position to the president to earn the trust and confidence he said i hired and trained rear admiral jackson that they knew and trusted him it is safe to say mrs. Obama and him trusted him as well because they personally selected him to be there physician. So friday he conducted and supervise the first periodic physical exam as president of the United States. Having the opportunity to review the test and then without considered assessment of the medical fitness for duty now and for the remainder of his term in office. With regard to fridays examination knowing doctor jackson he practiced good medicine however be an error to view that an error of his assessment is an isolated event when it is an ongoing process. Far more important far more meaningful is the doctors evaluation observation conversations and examination doctor jackson and his team have been doing that since donald trump was elected. And to began shadowing the new president elect someone januar january 20 he became the velcro his office is only one of a very few directly across the hall from the private elevator. At any given day the Physicians Office is the first last to see the president. Built an Organization Better than any other in history. More importantly president and mrs. Bush also with obama and every reason to believe that way will discharge the duties of the office. And with that background and information turning it over to doctor jackson as always please keep your questions on topic after he finishes i will address any other questions. Good afternoon. To start with what i will do is read the summary of the president s physical and after im done reading this exactly as i have read it. President Donald J Trump has completed his First Physical examination supervised with appropriate consultation and diagnostic testing conducted january 12 at the Walter Reed National military center. The purpose is to provide the public with the current status to ensure he continues to enjoy all benefits of good health. The examination focus on evidencebased Health Screening and prevention. And then releasing the following health information. The height 75 inches, 239 pound 239 pounds, resting heart rate 68, Blood Pressure 122 over 74. An temperature was 98. 4. Physical examination to include any studies done is uncorrected vision is 2030 with corrected is 2020. Others is normal. Intraocular pressure was normal. Ocular no ocular pathology was discovered. Head ears nose mouth and throat normal. Teeth and gums whether dental findings than was normal thyroid exam. Carotid arteries were normal. Lungs were clear and a screening of the chest and mistreated no pulmonary pathology the cardiac exam part was normal no murmurs or abnormal sounds were noted and his ekg was normal status rhythm on a normal access to have that echocardiogram done that showed normal systolic function with 25 normal chamber size no abnormalities. The light even more right ventricle is normal. And all those are normal. And then to have that above average capacity and with that cardiac output response no evidence of ischemia. Gastrointestinal exam he had a normal optical colonoscopy in 2013 that demonstrated no polyps or abnormal findings because of that the repeat was nonindicated at this time but will be deferred until his next exam. Urine exam was normal. Extremities and musculoskeletal are normal. Full range of motion and good capillary refill in all extremities and no swelling or dema. Neurological the cranial nerves the reflexes and motor function were all normal. And the dermatologic exam knows we miss cell carcinoma or any other german to logical disease. In most providers would be interested to know you can look at the details and with the panel 223 triglycerides up 129 ldl cholesterol 143. Ratio was 3. 3. A complete blood count is hemoglobin and white platelet count were all normal. His extended metabolic pale has fallen and bun is 18 creatinine has good indicators alt was 27. Normal. A1c was 5 and vitamin d was 20, psa 0. 12 thyroid was 1. 76. Ag urinalysis was done that was clear evidence of protein or ketones or glucose or blood. Ipo cholesterol and rosacea and his medical history with family but no past or present use of alcohol or tobacco and medications he takes crestor 10 milligrams daily to lower cholesterol and takes 81 milligrams a day of aspirin and then takes propecia for mel male pattern hair loss and a multivitamin each day for maintenance. During his physical exam to prevent pneumonia and has over two doses to prevent hepatitis a and b. Is vaccinations are up to date and travel vaccinations are up to date. In summary the president s Overall Health is excellent. Cardiac performance was very good and continues to enjoy significant longterm cardiac Overall Health benefits for tobacco and alcohol that could be lost we discussed diet and exercise he would benefit from a diet of her routine exercise regimen with a history of high cholesterol and is on a low doors. We decided to decrease cardiac risk we will lower the dose of the medication he is up to date on all exams all data indicates he is currently very healthy and will remain so for the duration of his presidency. So with that i will take questions i will make one comment. I would like to point out if you know me most likely i will be called to take care of you so ask your questions keep that in mind. [laughter] so they have not been enthusiastic as they are that finite battery. So the president with that reasonable goal over ten or 15 pounds we talked about diet and exercise he is more news yesterday about the diet part and the exercise part but we will Work Together to incorporate a plan to meet the goals. So as part of your questions but conventional fitness he has pushback on that. You may have picked up on the fact we did do a cognitive assessment. I had no intention to include that but to be honest per all the guidelines out there it isnt indicated at this time. But they would suggest you do cognitive screening questions with a positive answer and the screening that you engage with the tool. I had no intention to do that because i did not feel it was clinically indicated and that was because i spent almost every day since january 201 dash 2000 have seen him every day. Because of the location of my office we have conversations about many things. And with absolutely no concerns with his neurological functions but the reason we did that cognitive assessment is because the president asked me to do it. And then to cast a screen but to assess my cognitive ability. So once again my initial question after looking at those guidelines and some of the nih have indicated it could be a good thing for most patients in the future so i looked at a variety of assessments most were very simple and short and to keep it simple and keep it short. And it took longer to complete that wasnt driven by any clinical concern. Do you agree with that assessment . I will not comment i gave you my assessment of president trunk today i will not make any comparison with president s over the last 200 years. That he appeared to slur his words did you look into the cause of that . We talked about that. One of my consultants was involved and we checked everything out and everything was normal we even an ultrasound of his carotid gland there was no findings. I think the reason honestly even up right here now i need a drink of water but with the medication if it was to defend i had inadvertently dried up his secretions more than i intended to. Does the president wear dentures . He does not. My wife suffers from that so is that a concern . Because in some cases that indicates. No no no. No concern at all. But cholesterol to get it under 200 . We are not focusing on total as much as ldl we would like that below 120. So Blood Pressure was normal but high cholesterol any concerns for heart health . No. He had great findings across the board. And now the cardiac health is excellent. He has no history of premature cardiac disease no diabetes or smoking or the traditional risk factors. And with those excellent cardiac results have been very reassuring. And then what about forgetting names or repeating himself . Are you looking at earlyonset alzheimers or dementia . A lot of doctors give them tips when they walk out the door so what did you tell the president outside of diet . It is wellrespected with lots of institutions use that like at walter reed and to do cognitive screens. It is universally accepted with some of those guidelines but any type of cognitive issues. So the fact he got 30 out of 30 there is no indication on a daytoday basis. To be very sharp when he speaks to me he says what he has to say and speaks his mind. And that was no issues whatsoever with the thought process. But the main thing is diet and exercise if you get that right the weight loss will come. That is far as making him healthier. That would make you much healthier. Is there something to avoid that . No. Not to have any Background Information i had no old chest xrays to look at. And as much time to get a cat scan. So with regards to the echocardiogram so it makes sense to get a good cardiac assessmen assessment. So technically non clinical sclerosis and that was a calcium score done at 34 and in 2013 that was 98 and the other i will not even mention it was good information but it was 133. Not only the cardiologist of walter reed but several other wellknown institutions. Everybody thought that was reassuring at this period of time. That little of the change so overall that score is reassuring going along with the rest of his score. Talk about philosophy. And if the president can discharge to give some thought so on what basis would you advise the cabinet he is unable to discharge . But it doesnt really give me a specific duty or role. Im just like any member of the administration talking to him on a regular basis if i had concerns of his cognitive ability to that extent i would bring that up to the proper people in the chain of command. That is just like everybody else in the administration. If they thought that was going on but they thought once that happened mainly i would be brought into that to make an assessment but at this particular point with that cognitive testing mentally he is very sharp and intact he will remain fit for duty at this time is another term if elected. You talked about President Trump. [inaudible] i dont have a crystal ball that based on his cardiac assessment you can make predictions or calculations to see what his risk of having cardiovascular issue so where he falls on his assessment it is a category that portends years of event free living. So sure i could have a big event tomorrow. Im not making predictions but based on the clinical information i have right now over the year of observing him and in large part with the data from this exam i feel very confident he has a very strong and probable possibility to go through his presidency with no issues. Talked about dealing with him on a daily basis does he take your advice . Does he have any ongoing illness or allergies . On occasion with the upper respiratory stuff and gets congestion but for the most part what i found with President Trump is he is very independent with his medical. The way he grew up he takes care of the little stuff himself. He doesnt come to me for bandaids but a lot of people will. He is a good patient. Sometimes have to convince him why i want to do something he doesnt just take everything i say at face value. So for the most part he is very cooperative following medical attention just like every other president of taking care of you have to get the first lady involved. [laughter] just to make sure we are clear exercising the cognitive ability that is not the same as a psychiatric or psychological exam. No it is a screening assessment for Cognitive Impairment. Does the president do anything right now in terms of exercise . Right now he does not have a day today defined exercise program. That is what i am working on but the good part is we can build on that pretty easily. [laughter] what were you discussing . He doesnt have a daily exercise regimen. Some people dont or havent done that as part of their routine. But i would say that despite that being with the president on a day to day basis he has a lot of energy and a lot of stamina. I first noticed that traveling overseas last year. I was really surprised i noticed that early on todays that were 14 or 16 hour days and the staff is saying when do we go to the hotel . With the different time zones but the president had more stamina and energy than anybody there. He always said were not going to give this and would stick to the schedule despite the urging of some of us. So he eats mcdonalds and never exercises . Some people have great genes. I told him if he had a healthier diet the last 20 years he lived at 200 years old. If i didnt watch what i would eat he is very healthy despite that i dont think he does that anymore he is been in the white house and eats what the chefs cooking cooking for him which is a much healthier diet we will continue to make that event healthier but it is just good genes that is how god made him. You mentioned you gave a cognitive test. It was to monitor assessment you can find it online. Do you have a Life Expectancy range . Do you have the elliptical machine . Do you see any evidence of bone spurs . No. We did not examine that. He has not come to me complaining of that. We were pretty cap crunched for time so we didnt look at those issues. But with Life Expectancy he probably will not live 200 but i would have to say every other american male but certainly no less. What about the diet and exercise plan . Be medically able get a nutrition nationalist to meet with the chef going over the preparation just to be sure cutting calories and the fat and carbohydrates is much as we can. With exercise that is something myself or mrs. Trump will work with him upstairs and we will have that set up to his specifications. I dont limit his diet i just made recommendations. Anything a part of the president s Health Record overall physical fitness or medication you are not permitted to tell us or keeping from us for privacy restatement reasons . And of those lists is handsdown more information with any other assessment to date. It makes it much easier. And theres nothing that is concerning to me. And so can you say what that scrutiny and then at a later date. Do you exclude any of those . So at this time. I dont know president reagan medical condition but lets just assume they had some evidence of Cognitive Impairment toward the end of his presidency, i can reliably say the community would back me up if he had some type of mental or cognitive issue this test would pick up on it. He would not get 30 out of 30 so i have very confident there is nothing like that going on. With my personal experience he has absolutely no cognitive or mental issues at all. He is very sharp. With his Prostate Health you cited the low psa could that be Something Else . It could be but it is very low but we have no indication based on previous psa numbers that there is no issues going on. A lot of people dont even do that anymore but we have a long history with the medical record. If we had seen a big bump it would be concerning but we didnt so we are not going down that path. You said his weight was 239 just shy of obesity. We do height and weight with the bmi calculator. There isnt a lot of point at this point he acknowledged she could lose a few pounds. So to get some other form of calculation and then to continue those physicals in the future. That is totally up to the president like i said before i will continue to monitor the president over the next year and spend lots of time with them if i have any indication that clinically indicates he should do that that short of that if he wants to get one next year. What about the hepatitis c . He had one i did find that his past medical record. Talk about the diet can you flesh that out like chicken or fish or white meat . So i will have more information on that next year. What was the other question . We all do this on overseas travel so when we travel from one time zone to another on the other side of the planet, i recommend everyone on the plane take a sleep aid so that we can try our best to get on the schedule of our destination. So, he has on occasion done that. Its only during travel. I would say that this is just my guess, so i could be wrong but he sleeps four to five hours a night, and i think hes probably been that way a lot and one of the reasons hes been successful because personally i need more sleep than that but he doesnt require a lot of sleep. What is your prediction if the president doesnt make changes and can you tell us how many people were involved . Its going to depend because this Time Next Year we will do a lot of the same tests, cardiac assessments and everything else. When we get the data we will recalibrate and if hes made a lot of changes, i assume he will be in better shape than he is right now if he is eating better and lost a few pounds but even if he hasnt i wont make that assessment without giving the object of testing that we did this time. The other question . Speak to it lasted about four plus hours, about four hours i think. I have 12 consultants in it. I dont execute these physicals in a vacuum. I have a vote of specialists available to me and just like on a daytoday basis, im somewhat of a quarterback with regards to his care, so i spent weeks consulting his care and his exam appropriately and what was appropriate to his exam so it was a team effort with the above positions at walter reed did a great job taking care of him. Was there anything the president or any one else said that wasnt mentioned today . Theres a lot of things here. Som some of the president s friends have told reporters he washes his hands obsessively and things like that. Did you see any indication of that type of behavior [inaudible] he washes his hands frequently uses puerile. As many hands as he shakes in a day, he would be a fool not to. I am encouraging that so im not going to say that isnt anything he shouldnt be doing. I would like him to continue to be a bit of a germ of go and make my job easier along the way. [inaudible] that is in me speaking, that is objective datbut thesubjective t the data that is collected and he will definitely fall into that category. Hes 71yearsold and he can drive if he wants to without glasses. A lot of people his age cant do that, so if you look at a lot of things acrosstheboard, hes very healthy. His Overall Health is a excellent. Hes tracking that and we are working on that but overall, he has very good in excellent health. [inaudible] based on the study his heart is very healthy and these are what youre looking at. We are focusing on the cardiac Health Indicator with the rest. He has no evidence of this. His heart was within the excellent category. The dose of his cholesterol medicine is very low, a very low dose and we have a lot of room to increase that. If will pull even more if we do the diet and exercise i dont think hes got much room to do anything else. I understand hes asking questions about Vascular Health including the stroke and things so we are looking at the Health Overall and it looks good right now. [inaudible] that is always a possibility. Right now he has no evidence of that at all so it will be a routine thing we do if it becomes a problem. I didnt have enough time to give it in this particular exam. We have to make some conscious decisions about what we did and didnt want to do and its something i can do at any given point so we will do that and i will get a baseline test. [inaudible] you can do virtual. Im a big fan of the optical colonoscopy so i will recommend that he be sedated and get an optical colonoscopy. [inaudible] probably making recommendations on that. I wont make that decision but i will be part of the discussion. It wasnt necessarily needed for someone did he tell you why she wanted it done . Theres been a lot of speculation. Was he upset and what were some of the discussions from what he told you . This has been done narrative for quite a while and i think that it was an opportunity to put some of that to rest. Is there any one incident but said this is what i want to do or is this just a collection of voices of criticisms . By reason it came up in discussing all the other things in a run down of what we were going to do on that date he asked could i include this in the assessment and so it wasnt driven by anything that just happened. He said can we do this and so we did. [inaudible] did he express any change as a result of becoming president . I think it is my job to bring that up on occasion and with other members of the administration. One thing that is unique and this has nothing to do with my medical assessment. Ive seen it before in the next day would build on the day before. He has the unique ability to push the button and i think overall that has helped him with his stress level and make them healthier from a stress standpoint. You said youve had these conversations with him, can you take him through with a specific exercises as you look at this routine . I dont want to do something that will cause the president to have joint issues and things like that so i will look at how we can do something aerobically and with a minimal impact [inaudible] im not going to comment on that. If it were my 5yearold i might say dont watch so much tv but he can do as much as he wants. Thats just not something im going to comment on. He might be in the office. He spends as much time in a secondary role. What is your take of all of the doctors have said they see the symptoms of this . The American Psychiatric association has said so that we shouldnt be making this kind of assessment unless theyve had the opportunity to get to know him and examine him and in my opinion that its just tabloid psychiatry and im not going to address it. The president before january 20, i never saw him before january 20 so i had no information on that. You said you would assume its within four to five hours. I think most would be helpful but it doesnt concern me because it is his nature and i just think it works for him. If he could get more sleep that would be great but i dont know that its likely to happen. Does this president asked about how he can follow the example and do you keep a tally of how much he plays that repeatedly doesnt tell us do you keep a tally . I do not keep a tally. There is a certain amount of exercise involved in that. Next question . E. Doesnt take any medications at all. What is the exam involved . Can look online and see what it all about. If you do well on it, anything about the 26 is normally and if you get a 30 out of 30 i think you can confidently assume that you are done for now. The president is the first [inaudible] you say but has extended his life in any way and makes him unusually healthy . He has incredible cardiac fitness at this point in his life and a large part of that is due to the fact hes had a life of abstinence from tobacco and alcohol is there anyone such as a psychiatrist or psychologist whose job it is to monitor the president emotional state or watch potential psychiatric problems were indicators . Spinnaker both civilian and military including psychiatry but that is my job as the primary care doctor in the sense that i see him on a regular basis every day so i think that polls upon me to do that [inaudible] where do you stand on that . Education and mindfulness, where do you stand on that . Many can get involved in that and find that they are helpful so i am not opposed to him being involved in those kind of things in the future what do you think you will get in terms of exercise . We are going to make some progress. I am not worried about it. Its going to be some aerobic exercise. And like i said its going to be something that is healthy for him so we are going to work on that. [inaudible] like i said to this point i will become much more involved in that relationship from this point forward in the second term but their specific request to make that payment from anyone it is a natural extension in the assessment. Answering questions here which i think is extraordinary is that an indication of these rumors and questions . The president encouraged me to come out and told me i want you to get out there and talk to them and answer every single question they have. [inaudible] absolutely. They are not good at finding early stages as mentioned. Hes very specific at finding subtle cognitive changes. The psychologists that utilize this will tell you that they will pick stuff up and even the patient is sometimes not aware of so i think there are great tools. I wouldnt recommend doing anything beyond that. Are the issues about the cognitive testing [inaudible] i am totally unaware of this being done before. No president ever had a cognitive assessment as the president of the United States is this the first time that its happened. I look pretty extensively not to mention the fact i know most of the physicians and its never been done. The ability to run or start an n office but its really not my call. [inaudible] it is a good way for stressing that is what he enjoys doing he said he doesnt drink and smoke and does he have any other addictions . He has no drug addiction encouraging him to step up on that [inaudible] his daughter and mrs. Trump are both proponents of eating healthier and exercising so they will be partners of mine in working this out so they are involved in it absolutely. Going forward, would you recommend the president undergo that type of testing . Im comfortable with the algorithms that are out there. The physician and the patient and the family go over the screening questions and they go to a screening Assessment Tool and then they go on to other types of testing so i think there is a healthy algorithm in place and that should be a distinction between the president and a physician and i would have no problem in the future if someone takes my place and theres another following that particular algorithm i think we followed it and we couldnt have done this test specifically because the president added to his physical exam. That was informative. I think we covered just about everything that we can possibly think of when it comes to the president s health because it is late in the afternoon and weve been in the room for an hour and i know you all have stories to write and things to follow so we will keep this short and i will take a few questions but we are going to keep today pretty short and dive right in. [inaudible] any details around that event and what that would look like. Widely reported yesterday in contrast to the past predecessors the president didnt take place in memorials for doctor Martin Luther king jr. Or appear [inaudible] any reason . He participated on friday to honor the life and service of Martin Luther king jr. And we would like to continue to do projects throughout the year have not just one day through the event on friday and we will continue to be involved in efforts and opportunities moving forward over the course of the year. [inaudible] up to two hours on the meeting on thursday so if something happened between ten and 12, what happened in those two hours and whats changed . To be very clear, the president is running the show at the white house and i was part of this process and the conversations that went on. As he looked at the deal he wants the right deal and lead out witout with his priority ise and needed to be included in the legislation and simply failed to address the things laid out. One of the areas that fell short was the funding for Border Security. They put in about one tenth that the department of Homeland Security needed, not what they wanted that wha but what they nd this was a complete failure in terms of a good deal based on what the president laid out and wanted to see any piece of legislation. Hopefully we get there. We are still working with members, house and Senate Members to try to make a deal and make sure that we include those compliments the president has very clearly laid out a. Does a good deal include white immigrants and it is the opposite because by definition, the meritbased system is colorblind. Its not based on any of that criteria or race or religion or country of origin, it is on the merits of whether this person will be contributed to society so get the races all those things and makes it a more fair system instead of picking and choosing to meet different quote us into Different Things and frankly its a system that most democrats supported and voted four years ago but now that this president is champion of that i think they are showing absolute signs and definitions of what hypocrisy looks like. The bottom line is we want a deal on daca, they want a deal on Border Security. Theyve said in the past they support the meritbased immigration. I dont see what is complicated. We want the same thing. They need to quit playing politics and do what they were elected to do and come to the table with a deal based on the parameters discussed and lets try to get something done for the American People [inaudible] the president has laid out what he wants to see in the process and i think in the meritbased system you cant argue that priority laid out and what that looks for and how it levels the Playing Field as the opposite of what you are suggesting. He didnt say bring me any deal to people agree to, he said im confident that you will come together to address the situation and concerns laid out and they will answer the call that has been made and that simply didnt answer this field. We want to see the meritbased immigration so those are the components that weve laid out. The president viewpoint has been consistent but it is and what is laid out the did they tell him not to answer questions for the committee today . Touching upon the white house prior to the confidential material this is part of the judicially recognized process that goes back decades that weve been cooperating fully in his investigations and encourage the committees to find an inappropriate accommodation to ensure congress obtains information necessary to its legitimate interest. He wants immigrants to come in everywhere but through a meritbased system. Does that mean so the u. S. Would no longer provide a safe haven or civil unrest . One of the things to remind people of his looking at the name of the program it is temporary and not meant to be permanent. We are looking to find permanent solutions. We want to fix the problem and that is why doing one piece of this isnt enough. It has to be responsible and that is what this administration will continue to push for. [inaudible] it doesnt seem like an open question to me. [inaudible] he had a large group of people and the president wanted multiple people that had been part of the conversation and the foundation that they had worked on in the room as a part of the discussion and i guess i am lost on why the two senators in the midst of this entire discussion continue to be part of the discussion. There are several others as well. Why not encourage them to be completely transparent [inaudible] there is a process of what that looks like and should go throu through. I cant speak to that. I would prefer to attorneys on that. We have been completely cooperative in this process and we will continue to be but we will also maintain the executive privileges at the white house that have been practiced for decades and that need to be maintained. The president said this has all but as wellbut a number of peope administration said it is strong language. Can you clear up what the president did say . He said of the term wasnt used. No one is going to pretend like the president is always politically correct. One is in the oval office today because he isnt a scripted robot. Sometimes he does use tough language. The point hes trying to make that should be focused on is the issue at hand. We wasted five days fighting over one word when we should be fighting over the people involved in the program. If democrats want to protect these individuals thats who they should be fighting for and about is finding a permanent solution and not a quick fix is. Figuring out how to end the migration and the lottery system they are wasting time and complaining about the fact the president isnt doing enough when hes the only one engaging in this process and hopefully they will get onboard and start doing their job [inaudible] does the president support this . We dont want the government to shut down but we would like to see a budget deal. We hope democrats will not hold the government hostage and stop military spending and will not stop allowing our country and our nation to be protected because they failed to stop using the political poise and started actually governing and that is what we are hoping for. Can you clarify what has been denied here. You said weve been spending five days talking about one word. Is that the only thing here is which profanity the president used to deny the general characterization . I go back to the fact sometimes the president does use tough language. I can only rely on the individuals that were and those that have come out and spoken about this said they didnt recall the specifics but the bottom line is the president wants to see a deal done and make sure we have increased Border Security and see the end to the chain migration and those are the priorities and that is the focus we are talking about whether you are talking about that or not. [inaudible] i know weve laid out with the priority is look like. I cant speak to just one piece that may or may not exist. [inaudible] is that something that bothers the president at all . You would have to be more specific. I dont think again that that is the basis for the focus of the white house. What the white housthe white hof there was a derogatory language in haiti or africa anything similar to that specifically im talking more generally that sometimes the president can be politically incorrect and i wasnt speaking to that moment exactly. I was talking more generally that i havent heard him make a reference like that. The constitution is madisons monument and in that way its all around you when you come to washington, d. C. And the whole threepart structure of government and the way people speak to each other and exercise their free speech so it was the same case in st. Paul where they said if you seek the monument look around you similarly look around and you will see it everywhere. Posted a form that looked at a variety of issues including the economy, access to health care and national security. Everyone can find a seat. I want to welcome everyone. Im the director of the coalition