President Donald Trump either weighs 239 pounds — or he doesn't.
He either personally dictated the clean bill of health that his longtime personal physician, Harold Bornstein, released during the 2016 presidential campaign — or he didn't.
And he either approved a "raid" of Bornstein's office last year to retrieve his medical files that left the doctor feeling violated — or he simply signed off on what the White House described this week as "standard operating procedure."
A full 16 months into his presidency, Trump's health, like many other personal details, remains shrouded in mystery and has become another political controversy facing the president. Trump and his White House have only compounded the confusion by insisting on near-secrecy about his health and refusing to answer basic questions that predecessors have commonly addressed.
The irony is also not lost on the president's detractors that Trump — who at 70 became the oldest person elected president and who repeatedly attacked Hillary Clinton's health and "stamina" during the 2016 campaign — may have misled the American public about his own physical well-being.
"When it comes to Donald Trump, this fits a pattern of him not wanting to disclose the truth about everything from his tax returns and his health records to his visitor logs to his weight," said Jesse Ferguson, a Democratic strategist who worked on Clinton's 2016 bid. "It has become clear in the first year and a half that anything he attacked Hillary Clinton for, he was guilty of doing far worse, whether that was financial scandals, whether that was medical questions, and the list goes on."
The latest health brouhaha began Tuesday, when NBC News published an interview with Bornstein in which the president's former doctor described a morning "raid" in February 2017 in which three men arrived at his office and seized all of Trump's medical records. The men included Keith Schiller, Trump's longtime bodyguard who at the time worked in the White House, and Alan Garten, the Trump Organization's top lawyer, Bornstein said, adding that the roughly 30-minute incident left him feeling "raped, frightened and sad."
White House press secretary Sarah Huckabee Sanders told reporters Tuesday it was "standard operating procedure" for the White House Medical Unit to take possession of the president's medical records, and a spokesman for Garten similarly defended the process.
"At the request of the White House, Dr. Bornstein voluntarily turned over the medical records to Mr. Schiller," a Garten spokesman said. "The handoff, which occurred well over a year ago, was peaceful, cooperative and cordial. Before turning over the records, Dr. Bornstein was informed of the reasons for the request and willingly complied."
Later Tuesday, Bornstein told CNN that Trump had personally dictated the 2015 letter the doctor released on the then-candidate's behalf, praising him in hyperbolic and florid language.
"He dictated that whole letter. I didn't write that letter," Bornstein said. "I just made it up as I went along."
The letter did sound Trumpian, describing Trump's blood pressure and laboratory results as "astonishingly excellent," his physical strength and stamina as "extraordinary," and concluding that he would be "the healthiest individual ever elected to the presidency."
The White House denied several requests for comment on whether Trump had directed Bornstein on what to write.
Some White House officials weighed pushing back on Bornstein by painting him as loony, one White House official said. But aides abandoned that argument since the doctor had served as Trump's personal physician for over three decades, the official said.
Bornstein himself — already a colorful figure with graying shoulder-length locks — has further deepened the mystery by behaving erratically. He seems to have willingly spoken with some reporters while shutting down others — including one he ordered to "go back and report on how your toilet bowl works."
On Tuesday, he politely declined to comment before hanging up on a Washington Post reporter who called his office. On Wednesday, a woman who picked up the phone at his office said he had "no comment" and also hung up.
The ensuing muddle also comes as another Trump doctor is facing credibility questions. Four months ago, Ronny Jackson, then the White House physician, issued a clean bill of health for the president that was so over-the-top in its superlatives that it was questioned by many, from medical experts to people who have simply watched Trump on television.
Jackson declared that Trump's "overall health is excellent" and predicted he "has a very strong and a very probable possibility of making it completely through his presidency with no serious medical issues."
"Some people have just great genes," Jackson added. "I told the president that if he had a healthier diet over the last 20 years, he might live to be 200 years old."
Jackson, nominated last month by Trump to head Veterans Affairs, was forced to withdraw his name over allegations that he handed out drugs without prescriptions and presided over a hostile work environment in the White House Medical Unit. He is not returning to his job as Trump's White House physician.
The episode marks just the latest example of Trump managing to transform something as innocuous as an annual physical into a political maelstrom.
"We all laugh it off, but Trump is neither young nor particularly healthy," said Dan Pfeiffer, a former senior adviser to President Barack Obama and a host of "Pod Save America." "He's the president and yet another norm that informs how we make our most serious political decisions as a country has broken down."
The potential ramifications extend beyond the president. If Trump did dictate the letter to Bornstein, Bornstein's license to practice medicine should be revoked, said Jonathan Moreno, an ethics professor at the University of Pennsylvania's Perelman School of Medicine.
"He has said that he lied, that he signed something under duress. Well, that's tough," Moreno said. "As a doctor, your obligation is to the well-being of the patient, which includes the ongoing care of the patient. And if he felt he couldn't go along with it, he didn't need to sign it."
Inaccurate medical records could complicate care for Trump's current health-care providers and erode public trust in his health, experts said.
"The public relies on professionals to be giving honest, accurate and candid assessments that they can rely on," said Robert Truog, director of the Harvard Center for Bioethics. "When those assessments have been dictated by someone, it is none of those things."
The American Medical Association has a code of ethics, but there is no single list of standards to which all physicians should adhere.
Enforcement is often difficult. State medical boards need complaints before they act, but doctors are notoriously reluctant to criticize each other. Legal liability is the other enforcement mechanism.
Yet when their patients are celebrities or people who wield enormous power, some doctors can lose their way. Several experts noted pop star Michael Jackson's ability to get his doctor to prescribe the powerful sedative propofol.
With "athletes, movie stars or the president, sometimes the balance gets tipped," said Chris Winter, a neurologist at Charlottesville Neurology and Sleep Medicine in Virginia and author of "The Sleep Solution."
Said Truog: "I believe, in working with celebrities or politically powerful people, it can be very difficult to hold that line. But it's critical that we do hold that line because the trust of the public is at stake."