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when he was in his prime, those who saw him every day came to understand that his amiable exterior cloaked an inner complexion that was detached, remote, and ultimately unknowable. He was uninterested in details. He was prone throughout his life to mixing up facts and fuzzy at remembering names.

There is no bright line to define where these characteristics turned into something more serious than the ordinary slippage that comes with getting older. Hutton and the three other doctors who served as Ronnie’s White House physician are on record saying that they do not believe Ronnie’s mental capacities dropped sharply until after his presidency. “His behavior was so absolutely the same, day after day, his punctuality, his habits, his method of speech, etc. It never gave me any cause for alarm at all,” Hutton recounted in an oral history for the University of Virginia’s Miller Center. Lawrence K. Altman, a physician who was the leading medical writer for the New York Times, heard pretty much the same from Hutton’s predecessors. “They saw and spoke with him daily in the White House, they said, and beyond the natural failings of age never found his memory, reasoning, or judgment to be significantly impaired,” Altman wrote in 1997.

Biographer Edmund Morris was also adamant that, in his research and observation, he saw no signs that Ronnie suffered cognitive decline while in the White House. “I’ve read every word of the Reagan diaries,” Morris told me in a 2017 interview. He insisted that although Ronnie “became a very old man at the end,” the president’s sentences continued to be “structurally perfect,” and his handwriting remained uniform throughout the eight years in which he recorded near-daily entries in his journals. In Morris’s massive biography of Ronnie, he posited that the president’s diaries offered “no hint of mental deterioration beyond occasional repetitions and non sequiturs; and if those were suggestive of early dementia, many diarists including myself would have reason to worry.”

Much of the conjecture about the disease’s onset centers around Ronnie’s performance leading up to and during the most serious crisis of his presidency, the Iran-contra scandal. Would the misconduct have been allowed to happen if the president had been more on top of things? Did his fumbling as it unfolded show that he was already losing his faculties? David Abshire, who helped steer the president through the rough waters of Iran-contra, insisted he never saw signs of dementia. Ronnie was confused about names and dates, and his testimony before the Tower Board had been a disaster. But Abshire always felt he had the president’s full attention when they spent time together. He wrote: “Of course, I also cannot compare this Ronald Reagan with the younger one who was governor of California or who was president before the assassination attempt early in his first term. But for me the speculation about when Alzheimer’s set in has never been a real issue. I never saw him faltering or failing, except in the egregious and stunning case of the second Tower Board hearing.… True, there was this horrendous Reagan naiveté on arms-for-hostages deals. He could also compartmentalize out bad news and not face it. However, I reminded myself almost daily that this was a president in his midseventies, recuperating from an operation [for a prostate problem], with a confusing crisis on his hands. Yes, he was depressed. Although the flame burned low, he was a bit frail but still a president in command of himself.”

Peter Wallison, who was White House counsel during that stressful period, told me much the same. “I don’t think there was any slippage. He was not a detail person. He never was a detail person. He was a person who had principles, and so he structured his policies or insisted on certain policies based on some principles that he thought were important. The details were not something that he needed to know about,” Wallison said. “I was only there for a year, from April of ’86 to April of ’87. I was in many meetings with him, and I never saw any change. Now, maybe from 1981 to 1985, there was a slippage, but when I was there in that year, I never saw anything like that. He was always alert to what people around him were thinking and doing.”

However, the president’s own son Ron caused a sensation in 2011 when he seemed to imply otherwise. In his book My Father at 100: A Memoir, Ron wrote of feeling “shivers of concern” during the first term that “something beyond mellowing was affecting my father.” As Ron watched his father stumble through that initial debate with Walter Mondale in 1984, the younger Reagan began to experience what he described as “the nausea of a bad dream coming true.” When I pressed him on the subject for this volume, Ron insisted that passage of his book has been blown out of proportion to its significance. “I simply acknowledged the medical reality. My father’s own neurologist, Ronald Petersen at the Mayo Clinic, was the man who led the team that discovered that late-onset Alzheimer’s develops over at least ten years, maybe twenty years. [It takes] years and years in order to reach the stage where you begin to suffer from dementia,” Ron said. “The question of whether he had the disease in its early stages during the presidency more or less answers itself.”

But, Ron added, “It is unfair and unwise to judge a presidency based on some ailment that a president might have had. We don’t judge Lincoln’s presidency by his depression. We don’t judge FDR’s presidency by his polio, or anything like that. You judge a president by what he has done, what he did, his actions in office. Judge him that way. The fact that the disease was working away in him is all but irrelevant, unless you can point to something where, oh my God, he was clearly out of his mind.” Had the president or his doctors had so much as an inkling

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