Over the past eight months, COVID-19 has spared no one — including the rich and famous.
In early March, actor Tom Hanks was one of the first public figures to test positive. In spring and summer, Amanda Kloots utilized Instagram to document her four-month illness and decline of her husband, the Broadway actor Nick Cordero.
Arguably the most prominent case in recent weeks has been that of U.S. President Donald Trump and his associates. The president’s case prompted the same white-coated press conferences outside of Walter Reed that have prevailed in other high-profile medical cases, but in this instance media coverage was supplemented with talk of conspiracy theories and experimental treatments. Dr. Brian Garibaldi, a Hopkins physician, is among Trump’s medical providers.
Dr. Barron Lerner, a physician and historian at New York University Grossman School of Medicine, wrote a book describing the distinct impact of celebrity cases on the health-care system and the physicians who treat them. When Illness Goes Public: Celebrity Patients and How We Look at Medicine was published through the Hopkins University Press nearly 14 years ago. Lerner spoke about a physician’s role in a celebrity case in an interview with The News-Letter.
“Many doctors love to treat celebrity patients,” Lerner said.
According to Lerner, treating a famous patient can improve a physician’s prestige and increase the chances of receiving research funding. However, there is a certain amount of risk to reputation should a case go awry. Michael Jackson’s physician was unable to practice medicine after providing the entertainer with a deadly amount of propofol. One of Joan Rivers’ physicians resigned from his clinic after participating in the endoscopy that led to her death.
The risks don’t stop hospitals from vying for celebrity attention; prestigious hospitals offer medical suites for the one percent at rates more expensive than most luxury hotels.
The Marburg Pavilion at Hopkins Hospital is a local example; these rooms come equipped with fresh floral arrangements, a family room and custom-made meals. The staff interacting with such high-profile patients have been trained by contractors from the Ritz-Carlton and Disney. Trump spent his stay at Walter Reed in Ward 71, a six-room suite complete with a full dining room and two offices.
However, such very-important-person (VIP) treatment rarely promises improved medical outcomes. Lerner mentioned the phenomenon known as VIP syndrome.
“Because [the patient] is a famous person, [doctors] do things they wouldn’t usually do, and the patient suffers as a result,” Lerner said. “Ironically, in past cases famous patients have received worse care.”
Doctors often choose not to take on family or friends as patients for a reason; emotional attachment can cloud one’s judgment and make one eager to please. A similar eagerness to please with high-profile patients may lead a physician to perform excessive medical tests or withhold troubling news.
While it is hard to make any concrete claim about the state of the president’s health, VIP syndrome may explain why Trump was prescribed the steroid dexamethasone, which is typically reserved for serious cases. Jonah Goldberg, an author and syndicated columnist, wrote an op-ed for The Baltimore Sun speculating on this topic.
“[The president] might be getting the health care he wants rather than the treatment he needs,” he wrote.
The course of a celebrity illness also has an impact on potential patients across the country. A major point in Lerner’s book is how the media tends to oversimplify a celebrity’s treatment regimen and outcomes. This can lead the public to believe that an experimental treatment is effective or ineffective based on an informal study where the sample size is one star. After Trump cited an untested antibody cocktail from Regeneron as the source of his improvement, the pharmaceutical company’s stock surged in the past week.
Physicians are obligated to keep health information private during interactions with the press. A recent example of this was when White House physician Dr. Sean Conley invoked the Health Insurance Portability and Accountability Act to decline to fully answer questions about the president’s health. In the case of a public figure such as the president, Conley can only disclose what Trump authorizes him to.
When asked about how media relations related to Trump’s medical case, Lerner conceded that a balance in information sharing is necessary should a political leader fall ill.
“If it's a significant illness that is likely to impact their ability to carry out their jobs, the public deserves to know,” he said. “While they are under some obligation to discuss their illness, they are under no obligation to tell you every single thing about their illness.”
As the COVID-19 pandemic continues, we can expect to learn more about celebrities and their uneven standards of care. When it comes to health, a VIP pass may continue to be a double-edged sword.
Correction: This article originally stated that Barron Lerner is a physician in the NYU Langone School of Medicine. He is a physician in the NYU Grossman School of Medicine. The News-Letter regrets this error.
