• "Joe was kind of skinny, and he stuttered, and the kids called him Bye-Bye, for the way he sounded when he tried to say his name." 1a
• "Joe did not stutter all the time. At home, he almost never stuttered. With his friends, seldom. But when he moved to Delaware, there were no friends. ... [When he] read in class: that's when it always hit -- always always always." 1b
• "It wasn't quick, it took years. But he learned to game it out. He learned, always, to see himself in the situation to come, to think what he'd say, how he'd sound, what the other guy would say, and what the answer would be." 1c
• "And in class, he read about Demosthenes, who made himself the greatest orator of his day by putting pebbles in his mouth and declaiming to the sea, above the roar of the waves. So Joey Biden, of Wilson Road, would stand outside at the wall of his house ... and with stones in his mouth, he'd try to read aloud." 1d

"The paragraph I had to read was: 'Sir Walter Raleigh was a gentleman. He laid his cloak upon the muddy road suh-suh-so the lady wouldn't soil her shoes when she entered the carriage," Biden tells me, slightly and unintentionally tripping up on the word so. "And I said, 'Sir Walter Raleigh was a gentle man who --' and then the nun said, 'Mr. Biden, what is that word?' And it was gentleman that she wanted me to say, not gentle man. And she said, 'Mr. Buh-Buh-Buh-Biden, what's that word?'"

Biden says he rose from his desk and left the classroom in protest, then walked home. The family story is that his mother, Jean, drove him back to school and confronted the nun with the made-for-TV phrase "You do that again, I'll knock your bonnet off your head!"

• Although class president and an athlete in high school, he was nicknamed "Dash," referring not to his running speed, but instead: "It was like Morse code -- dot dot dot, dash dash dash dash ... even though by that time I started to overcome it." He was also called "Stutterhead" and "Stut." 2.
• During the first presidential primary debate in 2020, Biden had a few episodes where his stuttering tripped him up (see below). "Fox News edited these moments into a mini montage. Stifling laughter, the host Steve Hilton narrated: 'As the right words struggled to make that perilous journey from Joe Biden's brain to Joe Biden's mouth, half the time he just seemed to give up with this somewhat tragic and limp admission of defeat.'" 2.

He pulls out a legal pad and begins drawing diagonal lines a few inches apart, as if diagramming invisible sentences: x words, breath, y words, breath. 2

• One speech pathologist, who stutters himself, "believes that Biden’s eye movements -- the blinks, the downward glances -- are part of his ongoing efforts to manage his stutter. 'As kids we figure out: Oh, if I move parts of my body not associated with the speech system, sometimes it helps me get through these blocks faster.'" (Eric S. Jackson, assistant professor of communicative sciences and disorders at New York University) 2
• A communications coach based who stutters and is a friend of Biden's says: "I can’t say it’s a stutter" -- though he noted his friend's habit of abruptly changing directions mid-sentence. "I do hear those little pauses, but I really don’t hear the stuff that you would hear from me or I would hear from you." (Michael Sheehan, who has coached Bill Clinton) 2
• The author of 2, who also stutters, writes: "In addition to periodically stuttering or blocking on certain sounds, he appears to intentionally not stutter by switching to an alternative word -- a technique called 'circumlocutio' -- which can yield mangled syntax."
• "During a town hall in August [2019] Biden briefly blocked on Obama, before quickly subbing in my boss. The headlines after the event? 'Biden Forgets Obama's Name.'"

Twin studies have shown that genetics contributes 70% to 80% of the risk for stuttering, vs. 20% to 30% for environment 3 4 5. Biden's brother Frank stutters 6, and his maternal uncle "stuttered, hard" 1e -- all his life -- and was known as "Uncle Boo-Boo" 2.

Some time in early 1988, Biden was "working out on a shoulder press weight machine in the Senate gym when a pain shot through his neck. On the train home to Wilmington, Del., the neck pain returned more severely. His head ached. The right side of his body went numb. A doctor later diagnosed a pinched nerve, and a pain clinic prescribed a neck brace." 8 (In retrospect, this was likely another early symptom of the leaking aneurysm.)

On Feb. 10, 1988, in his hotel room after a campaign appearance in Rochester, NY, Biden suffered a classic "thunderclap headache:" the sudden onset of indescribably severe pain. He lost consciousness (for 5 hours 8), but recovered and went to the bathroom where he again experienced dry heaving before falling asleep for the night. Returning home to Delaware with difficulty the next day, he continued to have pain, but believed he could catch his scheduled afternoon flight. He was convinced to go to the hospital (St. Francis, Wilmington, DE), where a spinal tap disclosed blood in his spinal fluid -- a clear sign of a bleeding in the brain. 1h

Too fragile for a helicopter ride (plus it was too snowy), he was driven by ambulance to Walter Reed Hospital in Washington, though not without getting lost. By dawn the next day he was in the ICU. An angiogram showed an aneurysm in the left side of the brain -- the side that controls speech. Given a 50-50 chance of survival, and the last rights, Dr. Eugene George then operated on him for nine hours. The aneurysm ruptured "the moment they cut into Biden's head." Luckily, the blood jeted toward the wall of his skull, not into his brain. By the next morning, Biden told a staffer, "I'm gonna be all right" 1i. However, his post-operative course was complicated by serious blood clots.

The left side of the brain also controls almost all movements of the right side of the body. After the operation, Biden's right upper eyelid drooped and the right side of his forehead was immobile. Six weeks after the operation, "the muscles in his forehead and cheek began to work again." 9 Biden was away from work (the Senate) for seven months 8.

Biden had ended his presidential campaign in September 1987. Family members believed that he would have died had he still been a candidate on the following Feb. 10 -- because he would have undoubtedly refused to leave the campaign trail and get medical attention 1i.

No aneurysm has "recurred" since this operation, as demonstrated most recently by a CT angiogram in 2014 7. (This statement, however, is ambiguous regarding the development of any new aneurysm.)

The procedures on Biden's cerebral arteries left metallic clips in place 10. It is therefore unsafe for him to undergo an MRI scan, as the intense magnetic field of the MRI could tug on the clips, with potentially serious consequences.

An evaluation for clotting disorders was negative, so the clots were ascribed to his immobility after the operation -- an unfortunately common complication of surgery. He was treated with oral anti-coagulant medication for "several months," and a filter was placed into his inferior vena cava. 7. (Placing the filter seems to be the "third operation" Cramer refers to 1j.)

Comment: Because medical science has discovered new clotting disorders since 1988, it is eminently possible that re-evaluating Biden would today disclose a diagnosable clotting disorder. In some sense, however, it doesn't matter, because Biden is now taking an anti-coagulatant medication (for his atrial fibrillation) and this would likely be the treatment for any hyper-clotting disorder found.
Comment: Because of the seriousness of a pulmonary embolism, it was common practice in PE patients in the 1980s to insert a vena caval filter to prevent recurrences. Unfortunately, these devices themselves turned out to cause complications, hence they are used much less frequently now.

Biden fell asleep during President Obama's speech on debt reduction, on April 14, 2011. 11

Illustrating the power of the presidency, Biden was not only able to get an appointment with an orthopedist the next day, a Sunday, but the consultation lasted two hours. 12 13 14

At first intermittent, as of 2019 his heart rhythm was "persistent (more constant) a-fib, with a normal ventricular response." Physical exam in 2019 showed an irregularly irregular heart rate of 72 beats per minute. An echocardiogram circa 2019 showed normal contractility of his left ventricle. 7 Comment: This much-abbreviated report of the echocardiogram omits the size of the left atrium, which is an important prognostic factor in atrial fibrillation.

Because of the risk of blood clots associated with atrial fibrillation, Biden takes an oral anticoagulant medication: apixaban (Eliquis). 7

By December 2019, he was taking rosuvastatin (Crestor), the dose being unspecified. His lipid levels that month were: total cholesterol = 126 mg/dl; HDL cholesterol = 26 mg/dl; LDL cholesterol = 69 mg/dl; VLDL cholesterol = 21 mg/dl; triglycerides = 106 mg/dl. His cardiac C-reactive protein was 0.29 mg/L and homocysteine = 12.1 µmol/L. 7

The main risk of GERD is cancer of the lower esophagus -- because years and years of stomach acid washing over this area can change the tissue from normal to abnormal and then to cancer. Biden has, at some unspecified time, had endoscopy to look at his lower esophagus. The December 2019 note from his physician implies that nothing serious was found, but (a) this is imprecise, and (b) the note does not actually say that nothing serious was found. 7

Biden was not placed under general anesthesia, and the 25th Amendment was not invoked. The White House basement has a dental facility. 16