The news of Joe Biden’s aggressive prostate cancer diagnosis, complete with bone metastasis and an exceedingly high Gleason score of 9 (a 1-10 system used to grade prostate cancer based on how abnormal the cancer cells look under a microscope), has created an awkward moment for Democrats. Those Right-wing voices who spent years speculating about Biden’s declining health — often dismissed as conspiracy theorists peddling outlandish claims — now find themselves in the position of being partially vindicated.

While we can debate the motives behind their assertions, the central claim that Biden was suffering from a serious health condition beyond normal ageing appears increasingly difficult to deny. Even The New York Times concedes as much.

Take Laura Loomer, the controversial Right-wing provocateur who claimed last July that Biden was in the “terminal stage of his illness,” citing an unnamed “medical source in DC.” At the time, her comments were widely dismissed as baseless fear-mongering. Now, less than a year later, those same assertions have an uncomfortable new resonance. A 2022 gaffe where Biden mentioned having cancer — previously explained away as a reference to minor skin cancers removed in 2021 — suddenly seems less like a verbal slip and more like the accidental disclosure of a more serious underlying condition.

What’s most damning about the current situation isn’t the diagnosis itself but the reaction from medical professionals. Dr. Howard Formman noted in The New York Post that it is “inconceivable” that Biden’s condition wasn’t being monitored before he left office. Dr. Steven Quay went further, suggesting it would constitute “malpractice” for a patient to first be diagnosed at such an advanced stage. Perhaps most pointedly, urologist Dr. David Shusterman compared Biden’s late-stage diagnosis to what he would expect from “a patient who hasn’t had medical attention in 10 years.”

At this point, we aren’t talking about fringe voices — these and others like them are medical professionals expressing genuine bewilderment at how the most closely monitored man in America could have such an advanced cancer diagnosed only after leaving office. The statement from Biden’s team that the diagnosis came after he “started having urinary symptoms” strains credulity. This is especially true when measured against standard medical practice for men over 50, which typically includes routine PSA blood tests capable of detecting prostate cancer long before it reaches such an advanced stage.

This pattern of presidential health concealment has a long and bipartisan history in American politics. When Woodrow Wilson suffered a debilitating stroke in 1919, his wife Edith effectively ran the executive branch for months, keeping the President’s condition hidden from Congress and the public. Franklin D. Roosevelt’s paralysis from polio was carefully managed through staged photo opportunities and press cooperation. John F. Kennedy’s severe back pain and Addison’s disease were concealed with the help of a cocktail of medications and accommodating media.

The difference today is that modern medical expectations and a more aggressive media make such concealment vastly more difficult — and potentially more scandalous. For Democrats, continuing negative disclosures about Biden’s wellbeing undermine trust in future messaging. If voters believe information about Biden’s condition was concealed, they’ll be more sceptical of other claims, from candidates’ health to the integrity of elections and the need to trust government-appointed experts. Meanwhile, for Republicans, it risks reinforcing a troubling pattern where even the most outlandish claims of their wildest provocateurs are entertained on the assumption that some kernel of truth might eventually emerge.

No campaign wants to admit vulnerability — every attempt to question Trump’s health has been met with aggressive pushback — and no administration wants to sow doubt about its leadership. But as Biden’s case shows, concealment can prove far more damaging once exposed. Ultimately, it’s the weakness that does the most damage — not the denial.

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Oliver Bateman is a historian and journalist based in Pittsburgh. He blogs, vlogs, and podcasts at his Substack, Oliver Bateman Does the Work

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