The White House has offered shifting descriptions of President Donald Trump's medical exam in the days since he made an unscheduled Saturday visit to Walter Reed National Military Medical Center.
Trump and White House press secretary Stephanie Grisham initially billed Trump's visit as the first part of the President's annual physical. But two days later, the President's doctor described the hospital visit as an "interim checkup," a term physicians told CNN implies a separate visit that is not part of an annual physical.
In a bid to quell concerns and speculation surrounding the visit, the White House released a memo from Dr. Sean Conley, the President's physician, describing the visit as "a routine, planned interim checkup as part of the regular, primary preventative care he receives throughout the year."
Despite speculation otherwise, he said Trump "has not had any chest pain, nor was he evaluated or treated for any urgent or acute issues."
The immediate effect of Conley's memo was to bolster the White House's claims that Trump was not being treated for an urgent medical issue. But the memo also revealed a shift in the White House's explanations for the purpose of Trump's visit to Walter Reed.
Meanwhile, Senate Minority Leader Chuck Schumer, a New York Democrat, said Tuesday he wishes the President "well" from "whatever he's recovering from."
While the White House has maintained since Saturday that Trump's visit to Walter Reed was "routine" and that Trump had no symptoms that prompted the visit, Grisham initially claimed that Trump was getting a head start on "portions of his routine annual physical exam."
"Anticipating a very busy 2020, the President is taking advantage of a free weekend here in Washington, D.C., to begin portions of his routine annual physical exam at Walter Reed," Grisham said in a statement on Saturday.
Trump made the same claim in a tweet late Saturday night, calling the visit "phase one of my yearly physical" and saying he would complete his physical "next year."
But on Monday, while Grisham continued to insist that Trump's visit was "routine," she called it a "checkup" and made no mention of it being part of Trump's "annual physical." And then came Conley's memo.
Trump on Tuesday continued to refer to the visit as a "very routine physical," despite the new language used by Grisham and Conley's memo.
Dr. Jonathan Reiner, former Vice President Dick Cheney's longtime cardiologist, said he remains "very skeptical" of the White House's explanation, particularly because the White House did not disclose what exam Trump underwent beyond having blood drawn.
"The President has a physician with him every day and access to 24/7/360 care," said Reiner, who was in touch with the White House on Monday about Trump's visit to Walter Reed. "I have no doubt he was taken to Walter Reed to do something specific and separate from 'a quick exam and some bloodwork.' All that can be done at the White House."
Dr. Jennifer Peña, who served as physician to Vice President Mike Pence until May 2018, called the "interim checkup" and "annual physical" characterizations "very" different.
"Routine annual is where we do a comprehensive history and physical exam, with any necessary labs and studies," she said, while noting that an "interim checkup" suggests a "follow up" visit for a condition or medication that is being monitored.
Dr. John Sotos, a cardiologist who studies the medical history of US presidents, said he was reassured by the memo on Trump's health and that "the most serious concerns are largely eliminated."
He said the need for an "interim checkup" between annual physical exams nonetheless raised questions.
"He described this as a routine, planned interim checkup ... the question is why would they plan an interim checkup? In other words, if his state of health in February is so good, why would there be the need for an interim?" said Sotos, who is currently the CEO of Expertscape. "We obviously haven't had a full explanation of the decision-making that went into this."
It's still not clear exactly what testing Trump underwent on Saturday and why he was unable to get the exam done at the White House, which has a clinic that can handle most preventive care needs.
Conley only said that the medical portion of Trump's visit to Walter Reed lasted "a little more than an hour" and that he "did not undergo any specialized cardiac or neurologic evaluations."
Sotos noted that certain cardiac exams, such as an electrocardiogram, are not considered specialized. Trump has a common form of heart disease.
Conley also disclosed that Trump got a blood test, revealing a decrease in his cholesterol levels after his doctors earlier this year increased the dosage of his cholesterol-lowering medication.
Multiple sources and experts have said that the President's trip to Walter Reed was abnormal or outside of the protocol for routine visits to Walter Reed. The White House has not denied this, but Conley claimed "due to scheduling uncertainties, the trip was kept off the record."