Texas Representative Ronny Jackson, who served as White House physician from 2013 to 2018, has become one of the more vocal Republicans echoing Donald Trump’s argument that Joe Biden is suffering from cognitive decline and is likely using drugs to hide his condition. Speaking on Maria Bartiromo’s show on Fox on Sunday, Jackson said, “It’s really embarrassing as former White House physician to have to do something like this but I’m gonna be demanding on behalf of many millions of concerned Americans right now that he submit to a drug test before and after this debate, specifically looking for performance-enhancing drugs.”

Jackson is right to say that what he’s doing is embarrassing, but the shame reflects on him and Trump, not Biden. At best, Trump and Jackson reflect the worry on the part of Republicans that Joe Biden is likely to perform well in the debate scheduled on Thursday, as he tends to do in debates. This will give lie to one of the major arguments the GOP has been making in the presidential race, that Biden is possibly suffering from dementia.

No wonder Trump keeps harping on the notion that Biden will cheat during the debate. On Saturday in Philadelphia, the former president said, “So a little before debate time he gets a shot in the ass and that’s—they want to strengthen him up. So he comes out, he’ll come out—OK. I say he’ll come out all jacked up, right?” Trump also suggested Biden might be using cocaine, asking the same crowd, “Whatever happened to all that cocaine that was missing a month ago from the White House?”

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On one level, these accusations are just weird. Debating is not an Olympic sport that you can win by juicing. It’s unlikely that either cocaine or any other drug would really help a poor debater. Aside from being typical Trumpian mudslinging, these accusations are almost certainly motivated by the fact that support for Trump has shown a marked tendency to go down whenever he debates a Democrat (as political analyst Josh A. Cohen has documented, this happened in both 2016 and 2020). Trump’s erratic behavior doesn’t play well to a national audience, although it has strong appeal to the MAGA base that dominates the GOP.

The bad faith of Trump and Jackson is deepened by their hypocrisy. There are credible allegations that during his tenure as a White House physician Jackson was a pill pusher. In January of this year, the inspector general of the Department of Defense made public a report that, as The Washington Post summarized, “faulted previous White House medical teams for widely dispensing sedatives and stimulants, failing to maintain records on potent drugs including fentanyl, providing care to potentially hundreds of ineligible White House staff and contractors, and flouting other federal regulations.”

The newspaper added: “Former staffers said those practices were shaped by Ronny Jackson, an emergency medicine physician who led the team under President Barack Obama, continued to exert control over it as President Donald Trump’s personal doctor, and ultimately spent nearly 14 years in the White House.”

Jackson’s behavior as White House physician, which included allegations of sexually inappropriate comments, led to his being quietly demoted from the rank of admiral to retired captain in 2022 (although the Navy didn’t go public with this fact until 2024).

Even before the inspector general’s report, Jackson’s tenure as White House physician was controversial. As NBC News reports, in 2018: “Jackson withdrew his nomination to be the head of the Department of Veterans Affairs after allegations surfaced that he was sometimes drunk on duty and that he was known as the ‘candy man’ among staff for handing out prescription drugs without paperwork.”

If Jackson was known as the “candy man,” it’s reasonable to ask how much candy Trump has eaten—before, during, and after Jackson’s years in the White House. It’s also worth noting that since Jackson and Trump have revealed themselves to be strong political allies, there’s little reason to trust Jackson’s diagnosis of Trump’s cognitive health.

In October 2020, Trump started to tweet even more erratically than usual, upsetting both the political and business elite. At the time, The New York Times reported: “Some White House staff members wondered whether Mr. Trump’s behavior was spurred by a cocktail of drugs he has been taking to treat the coronavirus, including dexamethasone, a steroid that can cause mood swings and can give a false level of energy and a sense of euphoria.”

On the point of cognitive decline, Trump offers more cause for concern than Biden. It’s undeniable that Biden, age 81, has lost a step. He’s often faltering and slow in speech, at times given to bouts of forgetfulness or confusion (in a recent Time interview, Biden confused Russian President Vladimir Putin with Chinese President Xi Jinping).

Yet Biden at his worst pales into insignificance as the maker of minor verbal slips against the incoherent babble that regularly issues from the mouth of Donald Trump, himself no spring chicken at age 78. As Talia Jane of The New Republic notes, “Trump’s cognitive decline has been notable for years, as he frequently rambles incoherently in a word-association whirlwind of nonsense about sharks, slurring his words, freezing—even forgetting his own son’s name.”

One of the Trump’s many verbal slips is particularly notable. As NBC reported on June 16, “Former President Donald Trump on Saturday confused the name of his former White House physician just moments after he said President Joe Biden should take a cognitive test.”

Speaking to supporters, Trump boasted, “I took a cognitive test, and I aced it. Doc Ronny—Doc Ronny Johnson. Does everyone know Ronny Johnson, congressman from Texas? He was the White House doctor.”

If they were capable of contrition, both Trump and “Doc Ronny Johnson” would have ample reason to be blushing bright red. But we all know that won’t happen. Instead, they will likely continue their shameless hypocrisy until Election Day, if not beyond.

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Jeet Heer

Jeet Heer is a national affairs correspondent for The Nation and host of the weekly Nation podcast, The Time of Monsters. He also pens the monthly column “Morbid Symptoms.” The author of In Love with Art: Francoise Mouly’s Adventures in Comics with Art Spiegelman (2013) and Sweet Lechery: Reviews, Essays and Profiles (2014), Heer has written for numerous publications, including The New Yorker, The Paris Review, Virginia Quarterly Review, The American Prospect, The Guardian, The New Republic, and The Boston Globe.