Exclusive: Biden aides discussed wheelchair use if he were re-elected, new book says

This story is adapted from the forthcoming book "Original Sin: President Biden's Decline, Its Cover-Up, and His Disastrous Choice to Run Again," by CNN's Jake Tapper and Axios' Alex Thompson.Joe Biden's physical deterioration was so severe in 2023 and 2024 that advisers privately discussed the possibility he'd need to use a wheelchair if he won re-election, CNN's Jake Tapper and Axios' Alex Thompson write in their new book, "Original Sin," out May 20.Why it matters: The discussions reflected the extent of the president's declining health — particularly the significant degeneration of his spine — and his aides' alarm over it as Biden sought a second term at age 81.The conversations also reveal the White House's determination to conceal the reality of Biden's condition, at the risk of his own health, while he faced a tough re-election bid against Donald Trump.The book is based on interviews with more than 200 people, mostly Democratic insiders, with knowledge of the events that unfolded during the final two years of Biden's presidency. Almost all of the interviews took place after the 2024 election.Driving the news: "Biden's physical deterioration — most apparent in his halting walk — had become so severe that there were internal discussions about putting the president in a wheelchair, but they couldn't do so until after the election," the authors write.Biden aides believed it was politically untenable to have Biden use a wheelchair during his re-election campaign."Given Biden's age, [his physician Kevin O'Connor] also privately said that if he had another bad fall, a wheelchair might be necessary for what could be a difficult recovery," the authors report.Biden's team had increasing fears of a fall after he tripped over a sandbag at the Air Force Academy in June 2023. Aides then began taking many more precautions to avoid a repeat before the November 2024 election. They tried to figure out shorter walking paths, began insisting on handrails for steps up to the stage at his appearances, had him wear sneakers more often, changed his visual briefings before events to ensure he knew every step he was expected to take, and guided him more carefully through the movements. The intrigue: O'Connor had long privately expressed concern about the toll the presidency was taking on Biden's health. The doctor often argued with Biden's political officials to get more rest time into the president's schedule.O'Connor sometimes quipped that Biden's staff members were trying to kill him, while he was trying to keep him alive.Zoom in: Throughout 2024, Biden aides told reporters that the president's halting walk was partly the result of him fracturing his foot in November 2020, and then refusing to consistently wear his walking boot. In short, they said, Biden was being undone by his own vigor.But that contradicted what O'Connor had publicly reported at the time.After Biden wore a walking boot for 10 weeks in late 2020 and early 2021, O'Connor noted that "both small fractures of his foot are completely healed" and that "this injury has healed as expected."O'Connor repeated in his public health summaries that Biden had "mild post-fracture foot arthritis," but focused largely on "significant spinal arthritis" to explain the changes in the president's gait. Zoom out: Biden, his family, and senior White House officials pushed forward with the president's re-election campaign despite seeing signs of physical and mental decline over the course of his administration, the authors write.But Biden's disastrous debate performance against Trump last June stunned Democratic leaders, who began pushing for the president to drop his re-election bid. He did so three weeks later and quickly endorsed Vice President Harris, paving the way for her to be the party's new nominee for president.What they're saying: Asked about the book's reporting, a Biden spokesperson who declined to be identified said in a statement to Axios that Biden's "medical exam made clear that he had a stiffened gait caused, in part, by wear and tear to his spine — but that no special treatment was necessary and that it had not worsened.""He was transparent about this, and it was far from 'severe,'" the statement added. "Yes, there were physical changes as he got older, but evidence of aging is not evidence of mental incapacity.""And so far," the statement continued, "we are still waiting for someone, anyone, to point out where Joe Biden had to make a presidential decision or make a presidential address where he was unable to do his job because of mental decline. In fact, the evidence points to the opposite — he was a very effective president."

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