Calvin Coolidge, who presented a “quiet, boring, dour” image to the public, became president in 1923 when president Warren G. Harding died of heart attack. He was elected to the presidency in 1924 and practiced what might be called a minimalist style of governing and personal behavior. He would sleep for about 11 hours a night and also manage to get in a nap during the day lasting from two to four hours. He would speak as little as possible, advising his successor Herbert Hoover that he “could rid himself of long-winded visitors by simply sitting still and in silence until the visitor stopped talking.”

This public image (which was different from the private man who had a fun-loving side), was what caused the acerbic writer Dorothy Parker of the New Yorker, when told of Coolidge’s death in quiet retirement in 1933, to respond, “How can they tell?”

I was reminded of this when I read this article about the side effects associated with the steroid dexamethasone that Trump is being treated with.

Some of the more common side effects can affect a patient’s mental state, such as aggression, agitation, anxiety, irritability, depression, changes to mood, and nervousness. Trouble thinking, speaking or walking can also occur. Other common side effects include blurred vision, producing less urine, dizziness, an irregular heartbeat or pulse, headaches, and noisy breathing. Patients may also experience numbness or tingling in the limbs, swollen fingers, hands, feet or lower legs, pounding in the ears, difficulty breathing at rest, and weight gain.

There are a range of less common side effects, too, like stomach cramps, back ache, and bloody or tarry stools. Dexamethasone has also been linked to rare reports of grandiose delusions, psychosis, delirium, and hallucinations.

Aggression? Agitation? Irritability? Changes to mood? Trouble thinking and speaking? Noisy breathing? Grandiose delusions? Psychosis? Delirium? Hallucinations?

How can doctors say that a patient is having side effects when he exhibits all these behaviors even before being given the drug? As Parker would say, “How can they tell?”

For example, what does one make of the all-caps rant of around 15 tweets that Trump sent out within the space of an hour or so starting at 4:00am yesterday dealing with all manner of random topics. Commenters are calling that display of manic behavior ‘roid rage’ and suggest that his doctors may have been overdoing the steroid dose.