Kamala Harris takes over as the acting US President as Biden undergoes physical

WASHINGTON, Nov 19: Making history, Vice-President Kamala Harris took up the reins of the United States of America as the first woman, first Black American and the first Indian-American, becoming the acting President and Commander-in-Chief for a brief period of 1 hour and 25 minutes on Friday while President Joe Biden was under anaesthesia at the Walter Reed National Military Medical Center in Bethesda, Maryland, for a medical examination called colonoscopy.

So Harris worked from her office in the West Wing of the White House, lit up with her radiating enigmatic smile, as the officiating President of the most powerful country in the world, although for a brief period. It is good reminiscence that she had told cheering supporters in Wilmington, Del, after she had won the Vice-Presidential elections last year, "While I may be the first woman in this office, I won't be the last. Because every little girl watching tonight sees that this is a country of possibilities." And now she has taken a step forward.

Biden's examination came a day before he turns 79 on Saturday. He is the oldest person to hold the office. Biden said while leaving the medical centre, "I had a great physical."

This was Biden's first medical examination as President at the Medical Center. His long-time primary care physician, Dr Kevin O'Connor, declared him to be "fit for duty," after the examination. He gained a few pounds over the years but his cholesterol and blood pressure have improved.

"President Biden remains a healthy, vigorous, 78-year-old male, who is fit to successfully execute the duties of the Presidency," O'Connor wrote in a six- page summary about the hospital visit.

However, a "single, 3 mm, benign appearing polyp" was removed from Biden's colon during the routine colonoscopy for which he was admitted. Evaluation of the polyp is expected to be completed next week. It appears the procedure is a common occurrence with American Presidents. George Bush had it and he likewise transferred his powers to his Vice-President Dick Cheney, but Donald Trump did it secretly lest the waiting media make fun of him. He did not want to transfer the presidential duties to Mike Pence either and therefore he refused anaesthesia.

Of course, Biden has a medical history of two serious brain surgeries (ref: Autobiography, 'Promises to Keep') for aneurysm in the past (1988). He had also undergone surgery for pulmonary embolism. A tiny filter was inserted into the vena cava, a large vein in the abdomen that carries blood to the heart, to avert clotting problems. Recently he also fractured his right foot while playing with his dog in the lawns.

"An extremely detailed neurologic exam was reassuring in that there were no findings which would be consistent with any cerebellar or other central neurological disorder, such as stroke, multiple sclerosis, Parkinson's or ascending lateral sclerosis," Dr O'Connor wrote. "This exam did, however, reveal a mild peripheral neuropathy in both feet," and the President will try out orthotics. About his frequent "throat clearing" during speeches, Dr O'Connor said he experiences occasional symptoms of "gastroesophageal reflux" but no medical issues were found. On the stiffened gait, he said it is due to wear and tear of the spine as also due to the recent foot fracture.

There is persistent atrial fibrillation but it is asymptomatic and ECG is normal. Biden has beeen on Apixaban (Eliquis) for anticoagulation for long. With rosuvastatin (Crestor), his cholesterol level is normal. He does frequent "throat clearing" during speeches, which are symptoms of "gastroesophageal reflux" for which Famotidine (Pepcid) will continue. Even after sinus surgeries, he uses Fluticasone/ azelastine (Dymista) nasal spray and takes Fexofenadine (Allegra).

According to Section 3 of the 25th Amendment of the Constitution, the President must give a written declaration to the president pro-tempore of the Senate and the Speaker of the House that he is unable to discharge the powers and duties of his office and he is transferring his powers as the President to the Vice-President and until he transmits to them a written declaration to the contrary, such powers and duties shall be discharged by the Vice-President as Acting President." So did Biden.