Is the President losing it?

First it was presenile dementia. Now, it's a stroke.

A rash of armchair-diagnosis speculation about President Bush's health, based on his faltering speech
in the first debate to his drooling and drooping Wednesday night, is
flying around the Web. And there's nothing to feed
"is-he-really-fit-to-lead?" grousing among Democratic partisans in the
blogosphere like the fact that President Bush, who was pronounced
healthy at his annual check-up in August 2003, has refused to get his annual physical this year before the 2004 election.

A letter by one Dr. Joseph Price of Carsonville, Mich., to the Atlantic Monthly in response to James Fallows' July/August cover story on Bush and Kerry's debating styles, first raised the idea that Bush's mental faculties might be in decline.

But it was Bush's less-than-lucid performance in the first presidential
debate against Senator John Kerry that sparked the creation of a short video montage
juxtaposing footage from that debate with video from George W. Bush
sparring with then-Texas Governor Ann Richards, ten years ago. (You can
see more footage of the younger Bush's debating prowess here.)

"In the 1994 video he was going along and having no trouble having a
nice flow of language. But now he's so faulting and labored and
limited," says Robert McInerney, a retired internist in Pittsfield,
Mass. "He's getting as inarticulate as I am, and I'm in my senior
years," adding this caveat: "[But] I think it would be foolish to make
a diagnosis over a one-minute video clip."

Bush's insistence on tightly-controlled appearances has other doctors
wondering, too. "I think he's deteriorated in terms of his problem with
word-finding, repetition of phrases and understanding what other people
are saying," said Dr. Justin Frank, a professor in the Department of
Psychiatry at George Washington University Medical Center, who is the
author of "Bush on the Couch."
But Dr. Frank also stressed: "He would need to be tested to see if he
has dementia. This is all speculation without testing. He could just be
extremely acutely anxious. Anyone can get anxious and sound
disorganized."

Still, Dr. Frank said that during his book tour this summer from L.A.
to Philadelphia, seven or eight different physicians and psychologists
came up to him at readings to discuss their concerns about the
President's mental health: " Four people said they thought he reminded
them of their patients in the early state of Alzheimer's. Several
people wondered if there is a gradual deterioration from chronic substance abuse.

But Bush's improved performance in the latter debates made others doubt
that there's anything organic amiss: "In someone who has got a
developing dementia, they have good days and they have bad days. But it
isn't 90 minutes of bad debate one day, and 90 minutes of good debate
one day. It's much more subtle than that," says Dr. Raymond A. Wertheim
of Bethesda, Md.

After Bush's performance in the third debate, Dr. Frank changed his own
at-arm's-length diagnosis: " I think that the reason he looked demented
in the past debates is that Kerry figured out how to make him anxious.
And when he's anxious he gets disorganized. But Kerry did not make him
anxious this time. So, the issue for him is trying to manage anxiety.
That's his main concern."

Now, that still doesn't explain Wednesday night's spitting.