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Four days after former president Donald Trump was shot in the ear at a rally in Pennsylvania, his medical team has yet to release detailed records of his condition or treatment. And while his campaign has pronounced him to be in good health, numerous experts on gunshot trauma and emergency medicine interviewed by STAT said there could still be outstanding questions.

All emphasized that they could not comment specifically about Trumps injury, having not examined him themselves, and added that it did appear that the injury was minor. But they also said that in cases like Trumps, it would be important to rule out any injury to the brain or neck.

It may appear like only a graze to Trumps ear, but a ballistic injury that close to the head/brain isnt trivial, Baylor University Medical Center emergency physician Amy Faith Ho posted on X shortly after the shooting on July 13.

Heres how experts said they would respond to injuries like Trumps and their thoughts on the lingering questions that have not been publicly addressed.

In an interview with STAT, Ho elaborated on how gunshot wounds close to the head are typically treated. Initially, our concern would be things like brain bleeds, arterial bleeds, or other vascular injuries, like something called a dissection. We would also be concerned about bony injuries, so fractures and specifically a skull fracture or a cervical spine fracture if it hit the neck.

Besides the obvious inner and external ear injuries possible, the force of ballistics at that proximity make both skull fractures and head bleeds a very real risk, Ho said. Injuries of this kind would require CT scans of the head and the neck, allowing evaluation of the arteries in both, Ho said. She said shed also check for hearing loss, vertigo, and dizziness.

Nicholas Namias, chief of the division of trauma and acute care surgery at the University of Miami Miller School of Medicine, also noted that the biggest concern with gunshot wounds close to the head is always a brain injury.

These weapons are very high velocity, and you actually can get a brain injury with what looks like a graze, without even a fracture to the skull, Namias said.

Following initial treatment of the local wound and a CT scan to detect potential brain damage, Namias added that he would refer the patient for psychological testing.

Most people dont have it filmed, Namias said of traumatic events like this. He can see it over and over and over, so this has got to be harrowing and so you would screen someone like that for post-traumatic stress disorder.

Any gunshot wound to the head is treated seriously, said Matthew Mostofi, associate chief of emergency medicine at Tufts Medical Center.

Most gunshot victims, he said, are rapidly assessed to make sure their airway is open, their neck is stabilized, and that they are breathing. A quick way to do this is to ask their name. If they say, My name is Donald, you say, Great, youre breathing.

Then we examine you, he said. Wed look at the ear last.

Mostofi emphasized that he could not diagnose Trump from a distance but said that the information he had heard suggested Trump had only sustained an injury to the pinna, or outer ear. Thats not a life-threatening injury, he said.

Ear injuries do have specific potential complications that Trumps medical team would likely be on the lookout for, according to Mostofi, such as cauliflower ear a malady often seen in wrestlers that occurs when the skin and cartilage of the ear become separated by a hematoma and the cartilage does not receive enough oxygen as the wound heals. One remedy is to use a pressure bandage after the injury to make sure the skin and cartilage stay in contact.

The ear is an interesting little appendage, he said. Its skin over cartilage and theres not a lot of blood supply.

He also said perichondritis an infection of the ear cartilage remained a risk and could be more serious than infection of the skin.

Mostofi said patients who had fallen or experienced tenderness in their neck would be sent for further imaging to rule out issues to the head, neck, or spine, especially if they were older, but said if you hadnt fallen or had any tenderness we might not do any imaging. He said he did not think concussion was a potential issue because the bullet had been fired from so far away. While barotrauma, or damage to the eardrum by a pressure change when a gun is fired in a closed car, can be a risk, that was not the case here.

Kenji Inaba, a professor and vice chair of surgery at Keck Medicine of USC and chief of trauma and surgical critical care there, also said there was a low likelihood of brain injury or hearing loss from a ballistic injury to the outer ear, but that close examination was important to look for errant bullet fragments or anything that may have hit the ear and continued into the face or brain.

When were talking about ballistic injuries or gunshot injuries, we want to make sure we discuss all the potential injuries, said Inaba, who is also the medical director for the Los Angeles Police Department.

Inaba said the apparent minimal nature of a gunshot injury that could have been far worse was something he sees often in his own trauma center. We see this all the time, where the head or the body happens to be in a particular space completely impacts the consequences of that bullet, he said.

So far, there has been no release of official medical reports from those who treated Trump and no release of test results or imaging following the shooting. What is known is that after the shooting early Saturday evening, Trump was taken to Butler Memorial Hospital in Pennsylvania, where staff treated his injuries. He was released the same day within a few hours. Trump said Saturday in a post on his social media platform, Truth Social, that he had been shot with a bullet that pierced the upper part of my right ear.

The most detailed medical information yet has come from Trumps former White House doctor, Rep. Ronny Jackson of Texas, who said he examined Trump shortly before the start of the Republican National Convention and said on a podcast that the bullet had taken off a chunk of Trumps ear.

He was lucky, Jackson said on The Benny Show. I mean, it was far enough away from his head that there was no concussive effect from the bullet, and it just took the top of his ear off. Jackson said Trumps wound was initially bleeding heavily but that he will be OK.

Jackson told The New York Times he had changed the bandage on Trumps ear and that it was large because you need a bit of absorbent and you dont want to be walking around with bloody gauze.

Trump told Jackson that had he not pulled his head back just a microsecond before the shooting to gesture toward a graphic behind him, that bullet would have entered his head, according to Jackson. He added that Trump told him: That chart that I was going over saved my life.

Trumps son Eric told CBS News this morning that his father did not receive stitches but had a nice flesh wound and was doing well.

In the aftermath of the attempted assassination, more detailed information from official medical sources has yet to be released a cause of concern for some observers.

Nick Mark, an intensivist in Seattle, said that he was frustrated more information was not being released or reported by the media.

Did he have a head CT? What did it show? Did he have stitches? Tetanus shot?, Mark asked Tuesday in a post on X.

Speaking with STAT, Mark said that he didnt want to fearmonger and that the wound could be minimal. That said, Id want to know as a doctor that the person running for the highest office hasnt been cognitively impaired by a high velocity bullet.

Theres been so much attention rightfully given to President Bidens health, and almost nothing about this, Mark said. Its frustrating.

Steven Beschloss, who wrote a book about presidential assassin Lee Harvey Oswald, said he was concerned about the information vacuum surrounding the shooting. I find it stunning Trump is the only sourcedid a bullet hit him, graze him, or was it something else, he posted.

Its been three days going on four since this horrific event occurred [] yet we have not received a medical report from the hospital nor have we received a medical report from the campaign or the Trump organization about the damage to his ear, said former Republican National Committee chair Michael Steele in an interview with MSNBC. There are a lot of questions about that ear.

The consensus, however, is that Trump got lucky.

It certainly would seem former President Trump should make a full recovery, said Thomas Scalea, the physician-in-chief of the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center. In terms of his ability to function and recover, it seems it wont be a problem.

Scalea said his thoughts went beyond the medical issues involved. The real story to me is you cant run for president without someone trying to kill you, he said.

It was close three or four inches away and this is a completely different story, he said. Its a matter of inches.

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Physicians weigh in on potential impact of Trumps ear wound: Its a matter of inches - STAT

MILWAUKEE Former president Donald Trump is trying to present a more worker-friendly vision of the Republican Party at this weeks convention, but he has continued to make clear in private that he views himself as the best choice for billionaires and big business, according to donors who have attended fundraising events.

Even as Trump leans into populist themes that make some Republicans wary, he has told corporate leaders and major donors that he is the only bulwark against Democratic plans to raise taxes. Trump has even told wealthy backers that he needs their help to counter the financial heft of the unions that he is simultaneously trying to court. The convention has also showcased voices friendly to the nations business elite.

The two conflicting versions of the GOPs future leave unsettled exactly how the former president would try to balance his partys factions if he wins in November, probably setting up a reprise of the tensions over economic policy that characterized his first term.

Maybe we are living through a political realignment. Maybe in 2028, Wall Street and the Chamber of Commerce will be solidly Democrat and labor unions will be solidly Republican, but I wouldnt bet on it, said Michael Strain, director of economic policy studies at the conservative American Enterprise Institute.

A speech Monday by Teamsters President Sean OBrien was the most tangible sign yet of Trumps attempt to cast the party in a different light when it comes to the economy.

When did you think you would see that at the Republican National Convention? Trump campaign senior adviser Chris LaCivita asked reporters in Milwaukee on Tuesday, referring to OBriens speech.

Trump had been courting the Teamsters before the convention. At a fundraiser this year at the Pierre hotel in New York, Trump told a room of billionaires, real estate executives and others that the Teamsters really like me. He said he had used Teamsters all my life because of the concrete, all the concrete guys here are the Teamsters.

Im going to get their vote anyway, Trump told the guests. The workers are going to vote for me. Theyre not voting for that guy.

But most unions have endorsed President Biden for reelection this fall. Biden has also advanced populist economic themes while simultaneously raising huge sums of money from billionaire donors and other financial elites, although his policy agenda is much more in line with that of the union movement.

OBrien didnt endorse Trump on Monday; the Teamsters have yet to back a candidate. One prominent Republican strategist close to some of the partys top donors, speaking on the condition of anonymity to provide a candid assessment, said that there was considerable grumbling about OBriens convention speech. But those people were loath to say it publicly because they know Trump is looking to court the unions and win their voters, the strategist said.

Trumps rhetoric among business elites, though, hasnt been as labor-friendly.

At a Business Roundtable event in June, Trump told CEOs that he would cut their corporate taxes again, pleasing people in the room, according to donors, who spoke on the condition of anonymity to discuss private remarks. In several fundraisers this year, Trump encouraged the richest CEOs to write large checks to him because unions were giving so much to Democrats. At another fundraiser in Texas, he urged the richest donors to give because the Democrats get the money from the unions, millions and millions of dollars.

He told them explicitly they needed to support him because he would lower their corporate taxes.

Some mainstream party leaders say theyre fine with this weeks framing. Virginia Gov. Glenn Youngkin, a former private equity executive, is firmly rooted in the GOPs business-friendly traditions. But in an interview with The Washington Post in Milwaukee, he praised the choice of Sen. J.D. Vance (Ohio) as the vice-presidential candidate, pointing to his military service and up-by-the-bootstraps biography. Vance is viewed as closer to the partys populist wing.

Youngkin said he does not see Vances selection as a signal that the GOP is turning toward more populist economic policies primarily because its the president who sets the agenda, one that Youngkin expects to be an extension of the first Trump administration, featuring more tax cuts and pared-back regulations.

President Trump is going to set the direction of the country, and hes going to build a rip-roaring economy, Youngkin said. Hes done it before; hes going to do it again.

Zoomed out, the convention had plenty of room for corporate executives, too. Gary Cohn, a former Goldman Sachs executive who was one of Trumps top economic advisers in the White House, was seen milling about. Large corporations host nightly parties.

In an interview with Bloomberg published Tuesday, Trump also called for cutting the corporate tax rate to 15 percent from 21 percent something some of his advisers have said he would not try to do while suggesting he could pick JP Morgan CEO Jamie Dimon, a billionaire, for treasury secretary.

Many corporate interest groups, like the Chamber of Commerce and the Business Roundtable, have long been wary of parts of Trumps bedrock economic agenda, including ramping up the aggressive trade policy of his first term and cracking down on undocumented immigrants. On those points, Trump and Vance were already united before Vance joined the GOP ticket.

And some corporate-minded Republicans fear that their ability to check Trumps most disruptive policies could wane. That might mean Trump does less to pursue initiatives such as repealing the Affordable Care Act or cutting food stamps that were priorities of the last generation of GOP policymakers. Meanwhile, a second Trump White House would also probably take steps that are anathema to Wall Street-aligned Republicans, such as escalating a global trade war and implementing mass deportations.

Trump put language in the Republican Partys platform that the GOP now supports tariffs, according to people familiar with the drafting.

Hes all big government, big government move beyond Reaganism, all that stuff, one Trump adviser, speaking on the condition of anonymity to share candid opinions, said of Vance. And now hes the heir apparent.

Trumps first term was characterized by frequent disputes between two factions of the administration over economic policy: business-friendly Republicans, such as Treasury Secretary Steven Mnuchin and Larry Kudlow, Trumps top economic aide; and economic populists, such as strategist Stephen K. Bannon and trade advisers Peter Navarro and Bob Lighthizer, who pushed for greater confrontation with China.

Trump liked to play the camps off each other, and he took some populist steps, including through higher tariffs on U.S. trade partners. But tariffs aside, his policies overwhelmingly reflected the priorities of Mnuchin or Kudlow, on everything from cutting corporate taxes, to appointing regulators friendly to Wall Street, to attempting to slash government spending on social programs.

Both sides have jockeyed for influence since Trump left office, hoping for prime position in a potential second administration. But Vances elevation may be the clearest signal that the economic populists are likely to have a greater say in the second term than they did in the first.

Sen. Josh Hawley (R-Mo.) told The Post that Vance is an articulate spokesperson for what I call economic nationalism, economic populism, which is really about rebuilding American industry and protecting American jobs.

Hawley said he was optimistic that Trump would pursue this policy agenda if reelected, including by significantly expanding tariffs and even by embracing labor legislation that Republicans have traditionally opposed.

Thats been nowhere in the Republican Party of my lifetime to date, so its very significant, Hawley said. If the Republican Party is going to be a true majority party not just win an election here and there, but become a majority party theyre going to have to be the party of working people and blue-collar folks. And youre starting to see that reality sink in.

OBriens call for Republicans to shift policies to better support blue-collar workers went over well with at least one delegate: Ed Cox, an attorney with expertise in finance law, who also is chairman of the New York State Republican Party. Cox described himself as probably one of the people in that convention center who negotiated a union contract. He said OBrien echoed the paradigm shift that Trump has signaled he wants to see.

Trump has been very consistent, Cox said. This is not a small change.

Isaac Arnsdorf and Azi Paybarah contributed to this report.

See the article here:
Economic nationalism at the RNC clashes with Trumps pitch to donors - The Washington Post

Good evening from Milwaukee, where I had a relish tray last night. Today, Im looking at how the Republican National Convention has become a conversion story. Then, we zoom into a light-blue state where Republicans think they have a shot in November.

When Senator J.D. Vance of Ohio takes the stage in Milwaukee tonight to accept his partys nomination to be vice president, he will complete the final stage in his transformation from foil to acolyte of former President Donald Trump.

His long history of disparaging Trump, whom he has called an idiot and cultural heroin, does not make him less suited for elevation within his party. Rather, it makes him a better avatar for the tale Trump wants to tell.

Vance is a political convert, whose remaking of himself and his political image in order to thrive in Trumps Republican Party proves and reinforces Trumps power. And he will serve as a capstone for a convention that has been a conversion story unto itself.

Conversion is a defining feature of todays Republican Party, given how full it is of Republicans who did not much like Trump when he cannonballed into politics in 2016, and how far it has moved from the Reaganesque tenets that once defined it. The intraparty unity on display here is possible only because a lot of people have changed their minds about the former president over the past eight years. Trump himself, a former Democrat, has changed his politics, too.

Trump cares little about whether his converts are doing so for pragmatic reasons or moral ones, just as long as their fealty is public, and over the course of this week, Trump has paraded his converts for all the country to see.

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Theres No Zealot Like a Trump Convert - The New York Times

Every act of political violence yields instant reactions that cant be supported by the available facts.

A single assassination attempt by a loner with a rifle doesnt necessarily tell us anything about whether America is poised to plunge into a political abyss. Nor do the motives of would-be assassins necessarily map onto a given eras partisan divisions. Nor can we say definitively that this assassination attempt has sealed up the 2024 election for Donald Trump and his running mate, J.D. Vance surely the wild twists and turns of the Trump era should disabuse us of that kind of confidence.

Having lived through eight years of that era, though, I feel comfortable making one sweeping statement about the moments when Trump shifted his head fractionally and literally dodged a bullet, fell bleeding and then rose with his fist raised in an iconic image of defiance. The scene on Saturday night in Pennsylvania was the ultimate confirmation of his status as a man of destiny, a character out of Hegel or Thomas Carlyle or some other verbose 19th-century philosopher of history, a figure touched by the gods of fortune in a way that transcends the normal rules of politics.

In Hegels work, the great man of history is understood as a figure whose own particular aims involve those large issues which are the will of the World Spirit. Hegels paradigm was Napoleon, the Corsican adventurer whose quest for personal power and military glory spread the ideas of the French Revolution, shattered the old regimes of Europe and ushered in the modern age.

For Hegel the great mans role is a fundamentally progressive one. He is developing or revealing some heretofore hidden truth, pushing civilization toward its next stage of development, sometimes committing crimes or trampling sacred things but always in service to a higher aim, the unfolding intentions of a divine process.

In different ways in my own lifetime, American conservatism and liberalism placed Hegelian hopes in Ronald Reagan and Barack Obama, both figures who seemed to embody a grand optimistic vision of how the global future would unfold.

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Opinion | Donald Trump, Man of Destiny - The New York Times

In November 2022, after the Republicans lackluster showing in the midterms, I wrote a column titled Donald Trump Is Finally Finished. I keep a printed copy on my desk as a humbling reminder of how wrong I can be.

How did Trump go from a disgraced has-been even Fox Newss Laura Ingraham implied he was putting his own grudges ahead of whats good for the country to the man of destiny he had become even before he dodged that bullet on Saturday?

A simple explanation goes something like this: The G.O.P. ceased to be a normal political party in 2016 and became a cult of personality, less interested in winning elections than in burnishing the savior-victim myth of its charismatic leader. As a cult, the party could never realistically allow any other Republican to successfully challenge Trump for the nomination. And as a nominee, Trump would only gain strength once the extent of President Bidens mental decline became obvious.

But this analysis, true to a point, falls short in at least three respects. It doesnt give Trump the political credit he deserves. It fails to reckon with the Biden administrations political blunders. And it reduces the Democrats problem to a Biden problem. Their problem is bigger than that.

First, Trump. Just as Barack Obama knew that he stood for hope, Trump knows that he stands for defiance. Defiance of what, or whom? Of the gatekeepers to cultural respectability in todays America. And who, in the minds of Trump supporters, are they?

They are the reporters who said it was a conspiracy theory to suggest Covid emerged from a Chinese lab. Or the academic deans who insist every job applicant write D.E.I. statements and refuse to hire those who criticize them. Or the do-gooders who charge that Americans who want better control of the southern border are motivated by racism. Or the pundits who say, as one NBC contributor put it in 2016, that 100 percent of Trump voters are deplorable. Or the journalists who claimed that inflation is good for you.

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Opinion | The Secret of Trumps Resurrection - The New York Times