How Joe Biden Identified As Fit For Office

A review of 'Original Sin: President Biden's Decline, Its Cover-Up, and His Disastrous Choice to Run Again'

Joe Biden’s cognitive decline has been gradual, punctuated with episodes of high stress, starting with the death of his son. Beau Biden had collapsed during a family vacation in 2013 and then had a glioblastoma tumor removed, but he continued to deteriorate even as he announced his intention to run for governor of Delaware. Beau never bothered to suspend his campaign for governor before he died in May 2015.

According to the authors of Original Sin: President Biden's Decline, Its Cover-Up, and His Disastrous Choice to Run Again, Vice President Biden was already decieving the press about his flights to Houston to visit with Beau while he was in treatment. Worse, his son Hunter was already in the throes of the drug addiction spiral that would lead to his divorce from Kathleen Buhle, a close friend of Michelle Obama, driving a wedge between the First Lady and the Bidens.

Biden already sounded “old and diminished” during interviews with his ghostwriter in 2017. Federal prosecutor Robert Hur obtained those recordings as part of his investigation into classified materials that Joe Biden had illegally kept upon leaving office. Voters still did not get to see this side of him, however, for his public appearances were still energetic. His long history of verbal gaffes also disarmed the unwary. Any time he said something ridiculous, it was just Biden being Biden, again.

Biden reportedly slid downhill during his bus tour of Iowa in December and January of 2020. Iowans were not impressed by his appearances. After the caucus, his “aides privately noted that voters were seeing a diminished man who was not as he had been just two months earlier.” Months later, “they couldn’t rely on him to stay on message, and he often had a very short attention span.” As the campaign approached the nominating convention, a series of video interviews with constituents had to be edited down, from hours to minutes in length, because Biden was performing so poorly.

Biden’s decline was of course visible to those around him during his campaign and presidency, but the closest people were the least likely to notice the dramatic changes over time, for they saw him all the time. Those changes were most visible of all to people who met Biden again after not speaking with him for over a year, for then the difference was stark. They were all reminded of their own elderly parents slipping downhill in the last months of life, shocked at how thin and frail Biden had become, unable to follow his meandering, slurred speech.

And yet Biden won in 2020, for his opponent was Donald Trump. Biden described his intention to be a “transitional” president, but the midterm election results fooled Biden and his team into thinking they could win again in 2024, too, even though all the polling showed Americans thought Biden was too old. Ron Klain, known to White House staff as “the prime minister,” browbeat David Axelrod over his doubts: “Who’s going to beat Trump?” he demanded. Klain always deferred to Anthony Bernal, the top aide to Jill Biden as well as the deputy campaign manager. Bernal was known to staff as the “loyalty police.”

The excuses of 2020 became the excuses for 2024. “Harris made plenty of mistakes,” they write, “but no decision that she and her campaign made was anywhere near as consequential as his decision to run for reelection and pretend he wasn’t mentally melting before our eyes.” The authors of Original Sin write that “for those who tried to justify the behavior decribed here because of the threat of a second Trump term, those fears should have shocked them into reality, not away from it.”

Indeed, the shocking reality of the second Trump presidency has made many former close supporters angry, disillusioned: “they’ve been gaslighting us.”

Our most important sources were Democrats inside and outside the White house who were grappling with how so many of them had been so focused on convincing voters that Donald Trump was a true existential threat ot the nation that they put blinders on, participating in a charade that delivered the election directly into Trump’s hands.

Whereas Biden had been declining as he arrived in the White House, his decline accelerated once he was in office. Under COVID isolation protocols, he began mistaking strangers for friends. It was during this first year of the Biden presidency that mere excuses gave way to cover-up.

Biden’s electoral reputation — always coming back after every stumble, despite the odds, over decades in politics — now worked against him. “To family and close aides, the mythology became almost a theology, a near-religious faith in Biden’s ability to rise again.,” the authors explain. “And as with any theology, skepticism was forbidden.” The cult of Biden admitted no doubts. According to sources close to the Bidens, the unofficial family motto, “never call a fat person fat,” was not “just about politesse; it was about ignoring ugly facts,” avoiding “mean truths.” As one unnamed source tells the authors: “The Bidens’ greatest strength is living in their own reality.”

Reading that statement, I was struck by its broader application to Democratic Party politics more generally. The greatest strength that alphabetical organizations (‘The Groups’) have is that they live in their own reality: put Lia Thomas on the trophy stand with women, and Americans will learn to accept Lia Thomas as a literal woman, they tell Democrats. This will lead to broader social acceptance of ‘transgender people’ as a class, goes the theory.

The real world does not obey the magical formula, however. Actual, real, not-imaginary American voters reject the Lia Thomas program by wide margins in opinion polls — in fact, the margins have consistently grown, year-on-year, as the phenomenon of males cheating at female sports has grown. The party activists (often misconstrued as ‘the base’) actively reject this polling reality for a different, imaginary one that they believe is inevitable (“right side of history”).

Democrats have therefore responded to Donald Trump’s incredibly-popular executive order against males in female sports by letting even more boys and men cheat at female sports just to own the chuds. It will all resolve as expensive litigation which Democrats will absolutely lose because they are on the wrong side of Title IX law. These are expensive virtue signals, and they derive from pure belief, not polling.

Democrats who dare to point out this obvious political suicide pact, such as Massachusetts Rep. Seth Moulton, are subject to cancelation for expressing their wrongthink. Likewise, Moulton met Biden during his term and observed his evident decline, becoming the second Democrat to call for Biden to step aside after the disastrous debate performance against Trump. He was excoriated for this, too.

Dean Phillips tried to primary Biden. He wanted to force a debate that would expose the president’s decline, so that the party would stop sleepwalking into defeat. He never got his debate, withdrawing after intense ballot opposition by the party organization.

George Clooney had seen his friend Joe Biden fading away when they met at a celebrity fundraiser. After the debate disaster, Clooney argued with Jeffrey Katzenberg over the wording of his New York Times op-ed calling for Biden to step aside.

Convinced that Biden just needed Hollywood magic, Katzenberg had Steven Spielberg personally coach Biden. It had even worked to the degree that Biden, who rejected efforts at cognitive assistance as personal humiliations, had put up with being coached, for once.

But it was painfully clear that Biden could not make it to November. “One of the great lessons from 2024” is that “never again can we as a party suggest to people that what they’re seeing is not true,” David Plouffe tells the authors. Apply that statement more broadly to Democratic issue-organizing: Americans look at Lia Thomas and see a man cheating at women’s sports. Americans can be shamed and threatened into silence, but not into un-seeing what they see. Then those Americans vote without a DEI consultant looking over their shoulder.

It’s not just ‘gender identity’ issues. Look at immigration. Americans felt an immigration crisis, but Democrats told them there was no crisis, and anyway it’s a good thing to have so many new immigrants, how dare you, you racist. Americans also felt inflation, but saw Joe Biden celebrating the Biden economy. Cognitive dissonance resolves in privacy of the ballot box, the confessional of democracy. A voter who feels gaslit will reward Democrats with defeat. Voters live in actual reality, not Biden’s reality, or Lia Thomas’s reality, or some other imaginary place. They did not identify with the world according to Biden, or Democrats.

Biden’s 19 November 2021 physical by his longtime personal physician, Dr. Kevin O’Connor, did not include a cognitive examination. Without an examination, there could be no diagnosis. Without a diagnosis, no one could even discuss Biden stepping aside from the race, let alone invoke the 25th Amendment. O’Connor continued to exclude cognitive testing from Biden’s physicals in 2022 and 2023 even as he described the advancing physical decline of the president in great detail. After Biden’s last physical in February 2024, Press Secretary Karine Jean-Pierre responded to a press question about the missing cognitive test with dismissal: “He passes a cognitive test every day.”

This was clearly false. Alex Thompson and Jake Tapper write that “since at least 2022, he has had moments where he cannot recall the names of top aides whom he sees every day.” Over the second half of his term, “Biden’s gait grew stiffer, his voice softer.” From 2022, his meetings became fewer and more scripted. Cabinet officials began to see less and less of him, recieving their briefings from those cabinet officials who did see him. The president used notecards and teleprompters during these meetings, yet his thought-train always derailed, so that he never addressed the topic at hand. Biden would leave important caucus meetings without ever making the ask for a vote. Democrats were in fact leaderless.

Washington has always given senile politicians a certain amount of protection. The authors cite Kay Granger, Mitch McConnell, John Conyers, Thad Chochran, Robert Byrd, Strom Thurmond, and Woodrow Wilson as examples. Franklin Roosevelt used a wheelchair due to polio, but reporters respectfully avoided mentioning it or publishing photographs. John F. Kennedy famously lied to reporters that he did not have Addison’s disease. “We still don’t know when Ronald Reagan’s Alzheimer’s truly began,” the authors note. While Biden’s cognitive decline and the public cover-up are not unique, “it is arguably the most consequential” such scandal in American history.

Let us not argue: this was the biggest health scandal in American political history, for it resulted in the catastrophe of November. As implied in the title Original Sin, Joe Biden chose Kamala Harris as his running-mate out of exhaustion; it was the act of a man in serious decline. Distrust of Harris within the shrunken circle of trust around Biden led to mutual antagonism. She had no real political strengths or merits, nor did they ever develop any in her, for she was never supposed to matter except as an identity category. Harris was, in essence, a DEI hire. Biden had ‘identified’ as fit for office, however, and now so did Harris.

Administrations always experience some turnouver and this is perhaps the richest vein of potential culpability outside the Biden inner circle. Klein, who is almost two decades younger than Biden, left in 2023 after a health crisis. “This is a fucking disaster,” Jen Psaki said aloud as she watched the debate. One wonders how Klein expected Biden to do what he could not. According to the ratings, MSNBC viewers seem to wonder whether Psaki is being truthful that she had “never met” the Joe Biden who appeared on the debate stage in 2024 before she left the White House in 2022. Viewers are instead left to wonder if Psaki left the White House because she did meet that Joe Biden.

People who recycled into the 2024 campaign from within the administration would have, or else should have, known that he was in serious decline, but they still worked to elect him. When Biden called for South Carolina to be the first primary state, the party dutifully changed its calendar without a debate.

During his trip to Ukraine for the anniversary of the Russian invasion in 2023, Biden’s overall decline became too obvious to ignore or deny anymore. After that, his “verve and physical abilities…would decline significantly over the final two years of his presidency — at a rate far exceeding that of the first two years, according to top aides” (emphasis added).

The worse he got, the angrier the denials became. People did ask questions about his fitness for office, but they all met with denunciations. Presidential aides did apparently approach at least one reporter, but they killed the story out of fear.

After Biden announced his candidacy for 2024, Alex Thompson reported that “the White House is basically hiding Biden as he auditions for another term.” Based on his reporting at Axios, In June 2023 the New York Times noted that “Mr. Obama was twice as likely to do public events after 6 p.m. compared with Mr. Biden.” On 4 June 2025, the Wall Street Journal published the headline: “Behind Closed Doors, Biden Shows Signs of Slipping.” It was never sufficient reporting, nor was it ever as loud or sustained as the contrary chorus of angry denial emanating from the White House. Yet the controversy was public for a year before the debate.

Biden’s state of the union performance in March 2024 fooled everyone. Thanks to the oppositional energy from the GOP, it was one of the best public appearances of his presidency. Lucid, charming, Biden seemed to be back. If anything, the attacks on his cognitive capacity from the right — the deepfakes, “Sleepy Joe,” etc. — had immunized Biden from public examination. Most voters do not feel threatened by the dotage of an elder male. That threat simply does not work as a negative political communication.

Prosecutors made the same calculation. “People in the room laughed” when Biden told Robert Hur his bizarre anecdote about shooting a bow in Mongolia. The prosecution team worried that jurors “might be overcome with sympathy. And even those who were impatient would be reluctant to convict this man of a federal crime and send him to prison.” Hur declined to prosecute Biden for “a serious felony that requires a mental state of willfulness” because jurors would not see that mental state in Biden. They would instead see, and moreover feel, a senile old man.

Even the exposure of debate was not enough, in the end. Covid put additional pressure on Biden when he was diagnosed shortly after the debate. Nancy Pelosi met with him in person and urged him to step aside. Ultimately, however, fundraisers cut off the campaign and forced Joe Biden to quit, or he would not have been able to make payroll the next month. Those same political investors then turned around and funded Kamala Harris’s losing campaign.

As the post-debate reality sank in, Democrats defaulted to their ‘decorum’ setting. “The shortest presidential primary in modern history” was the result. Politics being the domain of tremendous egos, there were silent clashes. “Privately, Barack Obama and Nancy Pelosi favored some sort of process” for a primary that would let Democrats run a field of candidates past voters, but this was “viewed by the Harris camp as skepticism of Harris’s political abilities.” Given that she had no political abilities, this proved to be the correct view.

Identity politics were the original sin of the Biden administration. Joe Biden identified as fit for office when he was not. Kamala Harris identified as fit for office when she was not. Democrats identify as the party of women, but also insist that any man can identify as a woman; they identify as the party of the working class while rejecting working class values. Voters see through this, including a large number of Democratic(?) voters, now, which is why the Democrats continue to struggle, no matter how bad Trump gets.

They are a party of elites holding luxury beliefs who nevertheless identify themselves as a popular resistance. Americans are exhausted by identity politics, and by Democrats, and by their denialism. They have lost trust in media institutions which participate in identity politics. They demand authenticity over identity.

Distrust runs deep now: If they will lie to us about this, what else have they lied to us about? Biden’s prostate cancer announcement on the eve of the book’s release is raising new suspicions that the medical cover-up involved more than his cognitive decline. At least one prominent oncologist, Ezekiel Emanuel, says that Biden “probably” had cancer at the start of his presidency. If such screening was not usual for his age group, then Biden was not the usual man, being President of the United States, the commander-in-chief, the guy with the nuclear codes.

The diagnosis is not hard to discern. It is a pattern of presidential medical care based on political considerations rather than evidence. Congress must act. Presidential families must lose a certain amount of control over presidential health information. The era of presidents’ personal physicians making up their own country-bumpkin standards of care must end. Presidents should be subject to statutes that require rigorous, regular health monitoring regimes carried out by doctors who are not subject to conflicts of interest. Congresscritters should be included as well, if for no other reason than fairness. Excuses are no longer acceptable.

The book is an easy read. I leave it to others to decide whether Jake Tapper was aggressive enough before the debate, or what the shortcomings of Alex Thompson might be. They have given us an essential beginning, an indictment of sorts, from which to understand the timeline of Biden’s decline and the consequent cover-up.