President Joe Biden welcomes Nato leaders to Washington on Tuesday for a summit which has become key to demonstrating he is capable of meeting the demands of the presidency for four more years.
Heads of state gathering to shore up transatlantic support for Ukraine in its battle against Russia are confronting the prospect of the return of Nato sceptic Donald Trump as Mr Biden tries to save his re-election campaign, which has been in a tailspin following a disastrous debate performance.
The president said his work at the summit, where Nato is celebrating 75 years, would be a good way to judge his continued ability to do the job.
He points to his work rallying Nato members in its stiff response to Russia’s invasion of Ukraine as a prime example of his steady leadership and among the reasons he deserves another four years in the White House.
“Our allies are looking for US leadership,” Mr Biden said in an MSNBC interview. “Who else do you think can step in here and do this?
“I expanded Nato. I solidified Nato. I made sure that we’re in a position where we have a coalition of… nations around the world to deal with China, with Russia, with everything that’s going on in the world. We’re making real progress.”
Dr Kevin O’Connor, Mr Biden’s physician, issued his first comment since the debate after White House press secretary Karine Jean-Pierre struggled to address questions about the president’s health at Monday’s news briefing.
Ms Jean-Pierre said Mr Biden has extensive yearly physical exams.
“A couple times a week,” Mr Biden does a “verbal check-in with his doctor while he’s exercising,” Ms Jean-Pierre said, adding that he had a check-in on Monday.
There has been confusion about whether Mr Biden saw his doctor about his cold after the presidential debate on June 27.
The White House initially said there was no medical exam, but it later said there was a “short verbal check-in” and it was determined that no exam was needed.
“He has seen a neurologist three times,” said Ms Jean-Pierre. “Not more than that.”
She stressed that all three meetings with a neurologist were tied to the president’s annual physical exams.
But Ms Jean-Pierre declined to say where Mr Biden had seen the neurologist — whether the visits were at Walter Reed National Military Medical Center or elsewhere.
She cited the report of the president’s most recent physical, issued in February, which said, “an extremely detailed neurologic exam was again reassuring” in that there were no findings consistent with a stroke, multiple sclerosis, Parkinson’s or ascending lateral sclerosis.
The letter added that no tremors or “motor weakness” were detected.
Written by Mr Biden’s physician, Dr O’Connor, the letter added that Mr Biden “demonstrates excellent fine motor dexterity.”
Visitor logs show that Dr Kevin Cannard, a neurologist who has conducted research into Parkinson’s, went to the White House eight times between July 2023 and March.
Ms Jean-Pierre declined to confirm the doctor’s name or explain why he was going to the White House. She told reporters this was due to security reasons and noted that the White House medical unit treats more people than just the president.
“There are thousands of military personnel who come on to this White House,” Ms Jean-Pierre said.
“Many of them get the care from the White House medical unit and so we need to be super careful.”
Later on Monday, Dr O’Connor released a letter with the permission of both Mr Biden and Dr Cannard who he confirmed had been the neurologist who evaluated the president at each of his three physicals since he took office.
But Dr O’Connor said most of Dr Cannard’s visits to the White House were pursuant to his role as a specialist attached to the White House Medical Unit, where he treated patients for a wide array of neurological issues over a dozen years.
According to visitor logs, Dr Cannard made similar trips to the White House during the Obama administration and during the Trump administration – which did not publish visitor logs – according to a person familiar with the matter who spoke on condition of anonymity.
Dr Cannard did have one visit with Mr Biden’s personal physician this January in the White House Residence clinic, weeks before the president’s physical in February.
Dr O’Connor repeated that the findings of that physical did not detect signs of any neurological disorder.
“President Mr Biden has not seen a neurologist outside of his annual physical,” Dr O’Connor said in his letter.