My unfounded theory about Trump's cognitive test

[unblock]

22. cognitive tests are different.

i can't speak to the protocols of the moca test specifically, but as a former emt, i frequently tested patients for alertness and orientation, which tries to get a some of the same things the moca test does (and in fact, a portion of the moca test is exactly that).

it's not an exact science, for instance, consider orientation to date. the test asks if you know today's date. but what the emergency happened near midnight and they get it on the wrong side? moreover, if the person doesn't have a steady job or school or something else that demands knowing exactly what date it is, people often don't know.

i can't tell you how many times during this pandemic mrs. unblock or mini-unblock have asked by what day of the week it was. they're not cognitively impaired, they're alert and oriented times three just fine, it's just that knowing the exact date or day of the week is simply not an important part of their current lives such that they should know it of the top of their heads.


so as an emt, i often had to prompt or ask a different follow-up question or gauge the response. for instance:

"what? date? um, i was married on a sunday in 1956, it was a beautiful spring day!" -- not alert and oriented to date

"what's the date? what's that got to do with the pain in my chest? i don't know! i got a package on monday, that was 2 or 3 days ago, so maybe it's thursday. or wednesday. who gives a crap! i'm retired! just get me in the truck and drive me to the hospital!" -- alert and oriented to date, even if it's saturday.

i'd be surprised if the moca test protocol didn't provide for some degree of prompting.


as for the ethics involved, we'll probably never know what the doctors wrote on his test results or what they informed donnie, his handlers, and his family. i'd assume they did their job ethically, but were then barred from telling the public the truth (well privacy laws do this anyway).