Experts Raise Concerns Over President's Erratic Behavior

Comparisons drawn to historical case of Phineas Gage and calls to invoke 25th Amendment

Apr. 18, 2026 at 9:35pm

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A cinematic painting of the President sitting alone in the Oval Office, the room bathed in warm, diagonal sunlight and deep shadows, creating a contemplative, melancholy mood that reflects the gravity of the situation.The unsettling parallels between the President's erratic behavior and the historic case of Phineas Gage raise grave concerns about the stability of America's leadership.Tucson Today

A letter to the editor draws parallels between the case of Phineas Gage, a 19th century man who suffered severe frontal lobe damage, and the current behavior of the U.S. President. The authors argue the President's recent actions, including threatening to bomb civilian infrastructure, demonstrate a concerning lack of impulse control and judgment that could have devastating consequences, and call for the 25th Amendment to be invoked to address the issue.

Why it matters

The President's role as commander-in-chief with control over the nuclear codes makes his mental state and decision-making abilities a matter of grave national security concern. Comparisons to historical medical cases like Phineas Gage underscore the potential dangers of a leader exhibiting impulsive, erratic behavior due to potential frontal lobe damage or dysfunction.

The details

The letter cites the case of Phineas Gage, a 19th century railroad worker who suffered severe frontal lobe damage when an iron rod was driven through his head, resulting in dramatic changes to his personality and behavior. The authors draw parallels to the President, who was struck by a bullet in an assassination attempt in 2024, suggesting the transfer of force may have caused similar neurological damage. They point to the President's recent social media threats to bomb another country's civilian infrastructure as evidence of the same kind of impulsive, poor judgment exhibited by Gage after his accident.

  • On July 13, 2024, the President was struck by a bullet from an AR-15-style rifle.
  • On April 5, 2026, the President threatened to bomb another country's civilian infrastructure on social media.

The players

Donald Trump

The current President of the United States.

Chellie Pingree

A U.S. Congresswoman who has called for invoking the 25th Amendment to address the President's behavior.

Phineas Gage

A 19th century railroad worker whose severe frontal lobe injury resulted in dramatic changes to his personality and behavior, serving as a historical medical case study.

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What they’re saying

“It's time to invoke the 25th Amendment after 'openly talking about committing war crimes like he's live-posting a sporting event. This man has the nuclear codes. The Cabinet and Congress must confront the obvious.”

— Chellie Pingree, U.S. Congresswoman

“The damage that a modern-day Phineas Gage sitting in the Oval Office can wreak is inestimable.”

— Peter Pressman, MD, Winter Harbor

“The congresswoman's declaration could not be more timely.”

— Edward A. McCulloch, Ph.D., Tucson, Ariz.

What’s next

The 25th Amendment process to determine the President's fitness for office would need to be initiated by the Cabinet and Congress.

The takeaway

This case highlights the grave national security risks posed by a President exhibiting impulsive, erratic behavior potentially linked to neurological damage, underscoring the importance of robust systems to assess and address mental fitness for the nation's highest office.