A little alt-history

It’s been a year since Joe Biden revealed that he had been diagnosed with aggressively metastatic prostate cancer that had spread to his bones. This is currently incurable, although major advances in treatment now make it possible for men with this diagnosis to often live for several years, or even a decade. Still, the five-year survival rate is only 30%.

I was reading an article about revamping the Democratic primary process, and in the midst of it I began to contemplate what would have happened if, for instance, Biden hadn’t debated Trump in the summer of 2024, and had remained in the race. The polls for Biden even before the debate catastrophe were quite grim, which is ultimately why there was so much pressure on him to withdraw, but Trump is a completely bizarre person/candidate/president, so it’s far from impossible to construct an alternative scenario in which Biden would have gotten re-elected if he had stayed in the race, especially without the debate disaster. I think this alternative scenario was always pretty unlikely, but it well could have happened if things had broken right.

Now if that had happened, Biden would have had to disclose four months into his second term that he had an incurable cancer, that required aggressive and enervating treatments to extend his life. At that point, no matter what he did going forward, we would have been sucked into a maelstrom of political and cultural madness, with Trump raving 24/7 about the the Biggest Coverup and Scandal in American History, the rest of the scream machine talking about nothing else ever, and the elite media handling the situation in . . . well I’m sure you can imagine.

One further note before we kick this around: I don’t think there’s any evidence at all that Biden knew about his cancer prior to last May. It’s in fact routine for men of Biden’s age not to get diagnostic PSA tests for prostate cancer, because for a bunch of reasons the cost/benefit analysis doesn’t warrant doing so. So this just would have been some strikingly bad luck, although in another sense the odds of an eightysomething president having a health catastrophe of some type are very high (Trump turns 80 in three weeks in case Jake Tapper has mislaid his calendar).

Anyway it’s interesting to think about how this scenario might have played out, and you are invited to do so.

. . . I should have noted that any possible outcome in the alternative scenario of President Biden discovering had advanced incurable cancer in May of 2025 would be vastly superior to what actually happened, i.e. the Trump catastrophe. Nothing in the post was intended to suggest otherwise.

I also should have considered something that a few commenters raised, which is the counter-factual in which Biden had found out in say May of 2024. In some ways that’s the more interesting counter-factual.