If you begin with the baseline assumption that Donald Trump must be somewhat intelligent to have been so successful in business — or, if you prefer, so crafty a con artist — then you might be left wondering why the president often sounds like a tongue-tied middle-schooler who didn't study for a test, or a beauty-pageant contestant trying and failing to elaborate on her platform of "world peace."

Comparing Trump's recent syntax (garbled, unfocused, repetitive) to extemporaneous answers he gave in interviews in the 1980s and early '90s (relatively fluent and felicitous), the health-and-medicine news site STAT provocatively asks whether Trump is suffering from cognitive decline:

For decades, studies have found that deterioration in the fluency, complexity, and vocabulary level of spontaneous speech can indicate slipping brain function due to normal aging or neurodegenerative disease. STAT and the experts therefore considered only unscripted utterances, not planned speeches and statements, since only the former tap the neural networks that offer a window into brain function.

The experts noted clear changes from Trump's unscripted answers 30 years ago to those in 2017, in some cases stark enough to raise questions about his brain health. They noted, however, that the same sort of linguistic decline can also reflect stress, frustration, anger, or just plain fatigue. [STAT]

That "however" is such a buzzkill, isn't it?

This kind of speculation is no doubt fun and emotionally satisfying. We've engaged in it here at The Week. Even seasoned pros like cognitive scientist Steven Pinker can't resist it:

But make no mistake: This is nothing more than speculation. And we're far more likely to engage in it when the subject is verbally challenged in the first place. Google the words "George W. Bush" and "cognitive decline" to see what I mean. At the top of those search results, you'll find this YouTube video, in which then-Gov. Bush sounded sharp and surefooted in a debate, as compared to the halting 2004 sitting-president version (who, it can scarcely be doubted, was under considerable wartime "stress, frustration, anger, or just plain fatigue").

That Bush was in the throes of "pre-senile dementia" was catnip for the left-wing blogosphere. The former president doesn't often speak in public these days, but does anyone still believe he is suffering from dementia? Bush was said to have come away from Trump's inaugural address thinking "that was some weird shit" — pithy proof, if you ask me, that 43 is compos mentis.

When it comes to Trump, there is a temptation to medicalize his many deficiencies of character and intellect. I entertain these theories myself, especially the quite compelling theory that he is a pathological narcissist. But none of us can know for sure. As a practical matter, yes, it does seem like Trump could speak more fluently as a younger man than he does today. But in those interviews with Larry King, Oprah Winfrey, David Letterman, and Charlie Rose, he evinces the same basic worldview that he does today; there may be more words per minute and the occasional pleasing turn of phrase, but there is no deeper knowledge of policy, no subtler grasp of international affairs. At bottom, it's the same simplistic shtick about America not winning anymore. (Back then, it was Japan screwing us, not China.)

The temptation to medicalize Trump is the political equivalent of euthanasia. We can pull the plug on his presidency and peacefully end the suffering. This is the crux of Ross Douthat's intriguing but ultimately unpersuasive argument for removing Trump via the 25th Amendment:

The Trump situation is not exactly the sort that the amendment's Cold War-era designers were envisioning. He has not endured an assassination attempt or suffered a stroke or fallen prey to Alzheimer's. But his incapacity to really govern, to truly execute the serious duties that fall to him to carry out, is nevertheless testified to daily — not by his enemies or external critics, but by precisely the men and women whom the Constitution asks to stand in judgment on him, the men and women who serve around him in the White House and the Cabinet. [The New York Times]

Resorting to the 25th Amendment is a comforting deflection from the fact that we, as a country, knowingly did what we did. Not most of us, but a plurality large enough to lawfully elect him. Trump is what he's always been. He did not hide his essence, his wickedness and stupidity, during the campaign. He flaunted it. He dared us to elect him, and elect him we did.

And if we're going to correct the mistake before 2020, we're going to have to do it the hard way — through the painful political process of impeachment. To paraphrase Michael Douglas in Wall Street, this is your wake-up call, pal; go to work. Trump never sleeps.