Chaos swirling since Biden’s debate flub is causing cracks in a White House known for discipline

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By COLLEEN LONG

WASHINGTON (AP) — Internal drama. Leaks. Second-guessing. The pressure and chaos swirling since Joe Biden’s disastrous debate performance is causing cracks in a White House that until now had been marked by discipline and loyalty.

For three-plus years, the Biden administration has been mostly a restrained and staid operation, defined more by an insistence on showcasing policy and an avoidance of palace intrigue. Aides generally kept any criticism of their boss or their jobs out of the public eye. Not lately, though.

White House press secretary Karine Jean-Pierre reflected Tuesday on the extraordinary moment for the president and his team, as questions about the 81-year-old’s age and mental capacity threaten to torpedo his reelection dreams. “It has been an unprecedented time,” she said of scrutiny of the president. “We are meeting a new moment that has never really existed before.”

Biden’s shaky June 27 debate performance has led to an unusually public blame game, leaks of private phone calls between the president and Democrats and questions about his son Hunter Biden’s presence at the White House. It has prompted current White House officials to anonymously vent their concerns about Biden’s ability to do the job and even led to the departure of a radio journalist after details emerged the Biden campaign had fed her and another reporter interview questions.

Not to mention all the drama playing out on Capitol Hill, where a handful of House Democrats have publicly called for Biden to step aside and there is closed-door hand-wringing by others over whether to publicly come out against the president as party leaders try to bring members to heel.

Biden has been adamant that he is not leaving the race, and the chorus of criticism may be dying down, but it’s not clear yet whether the White House drama has been a momentary lapse or will continue as the nation barrels toward the 2024 election.

Andrew Bates, a senior deputy press secretary, said Biden had “restored compassion, honesty, and competence to the Oval Office” and built the most diverse administration in history.

“As President Biden has fought for and delivered the strongest record of any modern administration, there wasn’t a single week that Washington didn’t doubt him and his team,” Bates said. “The staff are deeply proud of him and each other and know the key is to focus on the work and the American people, not the noise.”

The buttoned-up vibe at the White House under Biden has been intentional — he wanted his administration to be viewed as a return to normal governing operations after the leaky Trump White House, when half-baked policies ended up on the front pages and details of private meetings appeared in public sometimes while they were still underway.

It was also reflective of the deep loyalty of Biden’s inner circle, where many top advisers have worked with the president for decades.

Biden’s debate performance prompted a surprising amount of public criticism from some of his biggest fans, including former White House communications director Kate Bedingfield, who was on a cable TV panel immediately after the faceoff.

“It was a really disappointing debate performance from Joe Biden. I don’t think there’s any other way to slice it. His biggest issue was to prove to the American people that he had the energy, the stamina — and he didn’t do that,” she said on CNN.

After Biden’s interview on ABC, meant in part to show he can talk off the cuff, former White House communications official Michael LaRosa posted withering public criticism: “Just when you thought the President’s communications teams had lost all of their credibility …. they are racing to the bottom and determined to continue humiliating the President and First Family with misguided and BAD media relations practices that erode his standing day by day.”

In private, aides and allies were quietly shaken over how Biden performed in the debate, and wondered whether the campaign was salvageable, particularly as the negative reviews kept pouring in.

At Camp David the weekend after the debate, Biden’s family — in particular Hunter Biden and first lady Jill Biden — encouraged the president to stay in the race, and questioned whether his staff had prepared him properly. (Biden, for his part, has said firmly the debate disaster was “nobody’s fault but mine.”)

Not long after, the presence of Hunter Biden — awaiting sentencing on three felony convictions in a gun case — at the White House was unsettling to some people, who worried about his influence with his father, according to two Democrats close to the White House who spoke to The Associated Press on condition of anonymity to discuss the sensitive matter.

And there’s been the second-guessing over the long-term strategy to limit Biden’s public interactions, especially with journalists, under a mandate led by senior aides. Biden has granted fewer interviews than his modern predecessors, and he’s held fewer news conferences than any president since Ronald Reagan.

Bates said the strategy “is and has been for the American people to hear directly from Joe Biden.” He noted Biden gave an interview Monday to MSNBC’s “Morning Joe,” has taken questions from reporters more than 580 times and travels the country speaking to people directly.

White House officials recently vented their concerns about the president and his abilities in stories spread across national media. One official who raised alarms on The New York Times sounded a little like “Anonymous,” the Trump staffer who signaled discontent about the Trump presidency in a New York Times op-ed and later went public with his grievances.

“This is not like the last administration where we try to find out who is speaking or leaking, that’s not something we do here,” Jean-Pierre said when asked about the official’s comments. “Everybody has their opinion.”

She said she had not heard anyone voice criticisms like those appearing in publications.

In an effort to boost staff morale, Biden chief of staff Jeff Zients urged White House aides last week during an all-staff meeting to tune out the “noise” and focus on the task of governing.

There have also been public missteps. Jean-Pierre told reporters Biden had not been seen by his doctor since his physical, but the president later told campaign workers on a private call that he had been seen by his doctor after he felt sick returning from grueling back-to-back foreign trips.

White House aides declined for days to explain a neurologist’s repeated visits to the White House that had sparked speculation that Biden was getting treatment, and Jean-Pierre misspoke when talking about the issue Tuesday.

On Sunday, a radio host departed her job after news that she and another interviewer at a different station had asked questions of Biden that had been fed to them by the campaign.

The interviews were meant to be part of an effort to restore faith in Biden’s ability not just to govern over the next four years but to successfully campaign, but the revelation only added to criticism that he couldn’t handle unscripted questioning.

___

Associated Press Writers Aamer Madhani and Zeke Miller contributed to this report.

Amtrak Borealis topped 18,500 passengers between St. Paul and Chicago in first month

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The Borealis, a mid-day Amtrak train from the downtown St. Paul Union Depot to Chicago, launched in late May following decades of advocacy by rail fans eager to see a second train roll out daily after the storied, but often delayed, Empire Builder. The Twin Cities-Milwaukee-Chicago corridor has proven popular, with preliminary figures showing more than 18,500 riders hopping aboard in the first month alone.

That’s an average of about 300 daily passengers in each direction, which Amtrak officials called a promising showing given that peak summer travel season is still to come. Nationally, Amtrak is on track, so to speak, to set a new all-time passenger record, with more travelers embracing rail in the post-pandemic era.

“With strong college and university markets on this route, we are confident Borealis will continue to perform well when students and staff travel in greater numbers this fall,” said Ray Lang, vice president with Amtrak State Supported Service, in a written statement.

Shorter trips

Ramsey County Commissioner Rafael Ortega, the longstanding chair of the county’s Regional Railroad Authority, said Monday that he’s received interest from far afield in copying the initial success of the Borealis with additional rail lines, though he would not disclose from where.

“People are already interested in coming into the Union Depot from different parts of the country,” Ortega said. “I think we’re going to get a third train after a while. They called me. I’ve already attended a meeting. It’s so preliminary, it’s just kind of talk now, but it’s good talk.”

As for ridership on the Borealis, “based on the very first day’s numbers, I’m not surprised,” Ortega said. “I think it’s going to go higher. A lot of people are taking these shorter trips to see family or a jazz festival in Red Wing and LaCrosse, (Wis.).”

A 39-route vision

In May 2021, Amtrak issued a 13-page “corridor vision” report that called for introducing new stations in over half of all U.S. states within 10 to 15 years. The report called for increasing rail service to 47 out of the country’s top 50 metropolitan areas and improving 25 existing routes, while adding 39 new routes. In addition to the Borealis, rail fans have advocated for the Northern Lights Express (NLX), a proposed higher-than-normal speed passenger rail project that would connect Minneapolis and Duluth, though Duluth would be a much smaller population site than Chicago.

Passengers have expressed excitement about the long-awaited Borealis, which leaves St. Paul at 11:50 a.m. and arrives in the Windy City around 7:15 p.m., with tickets starting at $41 one-way. A return trip from Chicago drops passengers in St. Paul at 6:30 p.m.

That said, rail fans have noted that the corridor skips a key destination — Madison, Wis.

Built in the late 1980s, the state-leased Horizon trains require stairway boarding and offer limited business seating and no baggage car, so bicycles are not yet allowed. Minnesota officials have called the possibility of leasing or buying newer train cars a strong possibility as service matures.

It is unclear what percentage of Borealis ridership travels between Chicago and Milwaukee, where the Borealis has replaced one of the Hiawatha’s daily round-trips, as opposed to the St. Paul-to-Milwaukee segment, where the Borealis mirrors the route of the Empire Builder.

Some rail fans have speculated that Borealis ridership may get the occasional boost heading eastbound due to the frequent lateness of the Empire Builder, which is scheduled to depart from the St. Paul Union Depot at 8:50 a.m. daily but has been known to roll out as many as five hours late due to congestion on freight tracks.

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What cognitive tests can show — and what they can’t

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By LAURAN NEERGAARD

WASHINGTON (AP) — It’s the new chant in Washington politics: “Get a cognitive test!”

Political opponents, armchair pundits and even nervous supporters are demanding that President Joe Biden undergo such testing after his dismal debate performance – even though his physician says he gets, and passes, an annual neurologic exam.

Former President Donald Trump, who’s only a few years younger, makes his own gaffes. He recently bragged about passing a 2018 cognitive test – while calling the doctor who administered it by the wrong name.

With all the concern, what can cognitive testing actually tell about a person’s brain health – and what can’t they answer? And presidents aside, does the average older adult need one?

What are cognitive tests?

They’re brief screening tools, a 10-minute series of questions to assess different brain functions. Two of the most common are called the MMSE, Mini-Mental State Exam, and the MoCA, Montreal Cognitive Assessment.

Recalling a list of five unrelated nouns or seeing how many words beginning with F you can say in a minute can assess short-term memory and language. Counting backward by 7s tests attention and concentration. Drawing a clock with the correct time is a clue to spatial awareness.

How reliable are cognitive screenings?

They don’t diagnose health problems. A bad score is just a red flag that indicates a need for further testing to see if there is a health problem and uncover what kind, said Dr. James Galvin, a neurologist at the University of Miami.

A good score usually is good news. But the highly educated especially tend to be good test-takers even if cognitive trouble is starting to brew. So if someone scores OK yet they, a family member or the doctor sees some day-to-day concern, more testing still could be warranted.

“We simply use it as a benchmark to determine our suspicion level,” Galvin said.

When and how often should cognitive screenings be done?

“A screening test is exactly a snapshot in time. So it tells you in that moment how someone does on that test,” Galvin stressed. “It doesn’t tell you how a person is functioning in their everyday life.”

Simply reporting a concern is reason enough for a primary care doctor to perform one. But it’s also supposed to be part of the annual Medicare wellness visit for those 65 and older.

Galvin wouldn’t discuss Biden or Trump because he hasn’t examined them — but said that generally it’s a good idea for seniors to get checked yearly to spot changes. It’s much like how doctors don’t assume your blood pressure’s still fine, they measure it.

How is a cognitive test different from a neurologic exam?

Cognitive screenings are “pencil and paper tests” usually handled by primary care doctors, while neurologic exams generally are performed by a specialist, Galvin said.

It’s a very detailed physical exam. Doctors watch the patient’s speech patterns and behavior, test how key nerves are functioning, check reflexes that can signal brain diseases and assess muscle tone and function.

If either kind of test signals real cognitive concerns, the next step may be more intensive neuropsychological testing — an exam that often lasts up to three hours.

After an exhaustive interview of the patient and any accompanying family members, the neuropsychologist goes through tests and tasks designed to check specific brain functions – intelligence, memory, verbal ability, problem-solving and reasoning skills, visual and auditory responses, emotion and mood. They may use puzzles, objects to rearrange, or drawing and writing tests.

Blood tests and brain scans also may be ordered. Special types of PET scans can detect Alzheimer’s hallmark amyloid plaques and tau tangles in the brain. An MRI can detect past strokes, helpful in diagnosing vascular dementia.

How can you tell if cognitive concerns are a disease or just getting older?

“Age makes us do things a lot slower,” Galvin said. “We move slower. We think slower. But we’re still moving correctly and we’re still thinking correctly – it just takes us longer.”

Examples of slower cognitive “processing” might be difficulty remembering a name, numbers or specific details under pressure – but they come back to you later.

Galvin noted that sometimes, reversible health problems mimic cognitive trouble. For example, urinary tract infections are notorious for causing sudden confusion in older people. Certain medications affect memory, as can thyroid problems, depression, even poorly controlled diabetes.

Anyone who’s worried about their memory should talk to their doctor, or seek a specialist, “who can reassure you that everything’s OK or develop a treatment plan that’s specific for you,” he said.

—-

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Al Sharpton to deliver eulogy for Black man who died after being held down by Milwaukee hotel guards

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MILWAUKEE (AP) — The Rev. Al Sharpton is scheduled deliver a eulogy for a Black man who died last month after being pinned to the ground by hotel security guards in Milwaukee, his office said Tuesday.

The death of Dvontaye Mitchell has drawn comparisons to the murder of George Floyd, a Black man killed in 2020 after a white police officer in Minneapolis knelt on his neck.

Sharpton, a longtime activist and leader who serves on the U.S. Commission on Civil Rights, said in a news release that he’ll speak at Mitchell’s funeral Thursday. The Republican National Convention opens just days later, on July 15, and law enforcement agencies are bracing for political protests around the convention arena in Wisconsin’s biggest city.

Sharpton said convention-goers need to know about Mitchell’s death.

“We cannot watch Dvontaye Mitchell’s murder be washed out by the RNC coming to town, where they will solidify a nominee whose view of justice is pure brute force,” Sharpton said, referring to former President Donald Trump.

Mitchell, 43, died on June 30 at the Hyatt Regency after four security guards held him down on his stomach, media outlets have reported. Police have said Mitchell entered the hotel, caused a disturbance and fought with the guards as they were escorting him out.

Mitchell’s family has hired civil rights attorney Ben Crump, who represented Floyd’s family. His death spurred worldwide protests against racial violence and police brutality.

It’s unclear why Mitchell was at the hotel or what happened before the guards pinned him down. The Milwaukee County medical examiner’s initial report said Mitchell was homeless, but his family told the Milwaukee Journal Sentinel that’s not correct. Sharpton said in a news release announcing his Milwaukee visit that Mitchell’s mother said her son was suffering a “mental health episode.”

Police officials were still investigating Mitchell’s death on Tuesday, the Journal Sentinel reported. The police department responded to an Associated Press request for an update by emailing a statement saying that an unidentified individual had fought with security guards at the hotel on June 30 and was unresponsive when officers arrived.

The medical examiner’s office has said the preliminary cause of death was homicide but the cause remains under investigation. No one had been charged criminally as of Tuesday.

A spokesperson for Aimbridge Hospitality, which runs the Hyatt Regency in Milwaukee, told the Washington Post that the company extends its condolences to Mitchell’s family and supports the ongoing investigation.