Congress continues to rank dead-last in the most recent Gallup poll of public confidence in institutions. It’s no surprise: when representatives and senators aren’t squabbling, posturing, and at one another’s throats, such as during Brett Kavanaugh’s Supreme Court confirmation hearings, they’re saying and doing things that strain credulity. It’s no coincidence that insulting the intelligence of members of Congress is such a staple of American folk wisdom. “Suppose you were an idiot, and suppose you were a member of Congress. But I repeat myself,” quipped Mark Twain. “When Congress makes a joke it’s a law, and when they make a law, it’s a joke,” said Will Rogers.

Too often, though, the joke is on us. A friend of mine was seated at a banquet table with the family of a then-congressman from Kansas. Family members expressed relief at the congressman’s career in politics because none of them thought that he was smart enough to enter the family business—processing scrap metal. “When I was debating what became the 2008 Farm Bill,” said Colorado congressman John Salazar, “I had a member of the Agriculture Committee actually ask me if chocolate milk really comes from brown cows. I asked if he was joking and he assured me he wasn’t.” That’s in the same category as the concern of Representative Hank Johnson that stationing 8,000 U.S. military personnel on Guam would cause the island to “become so overly populated that it will tip over and capsize.”

Congresswoman Sheila Jackson Lee of Texas once proclaimed that the U.S. Constitution was 400 years old. And as a member of the House Science Committee, Lee, during a visit to the Mars Pathfinder Operations Center, asked a NASA scientist whether the Pathfinder probe had photographed the flag that astronaut Neil Armstrong left behind in 1969. Armstrong had, of course, left the flag on the moon. In 2010, Lee proclaimed on the House floor that “victory had been achieved” by the United States in the Vietnam War and that “today, we have two Vietnams: side-by-side, north and south, exchanging and working.” Lee was a member of the House Foreign Affairs Committee when she made that statement.

I once attended a conference at which Representative Tom Bliley of Virginia— then-chairman of the powerful House Commerce Committee—spoke by teleconference. As he read from a prepared statement, he included the instructions—such as “pause for emphasis”—that had been inserted by his speechwriter. Where one line had been inadvertently duplicated, Bliley read it a second time. Carelessness? Intoxication? Senility? Don’t voters have a right to know?

Former senator Pete Domenici of New Mexico was sufficiently forthright to reveal in 2007 that he had been diagnosed with frontotemporal lobar degeneration—an inexorably progressive, incurable disease characterized by the wasting away of the frontal and temporal lobes of the brain. Because of the behavioral changes and dementia that accompany this condition, Domenici announced that he would not seek reelection the following year. I had great sympathy for Domenici, but he should have resigned at the time his illness was diagnosed; his constituents deserved that.

Speaking of brain pathology and dementia, House Minority Leader Nancy Pelosi has been slurring her speech and having difficulty pronouncing words. It was especially evident during a press briefing in June but has been noticeable since at least April of last year. This is not normal. As a voter and taxpayer, but also as a physician, I worry about whether people in such condition are fit to serve.

Perhaps we should ask candidates (and incumbents), including the president and vice president, to volunteer for periodic testing of intelligence, mental status, and psychopathology. After all, we often demand to know whether a candidate has recovered from open-heart surgery, cancer, or strokes, and many states require elderly drivers to get relicensed. Testing could answer speculations about mental fitness, one way or the other.

A mental-status exam offers an assessment of cognitive abilities, memory, and thought processes. It includes assessments of alertness, speech, behavior, awareness of environment, mood, affect, rationality of thought processes, appropriateness of thought content (presence of delusions, hallucinations, or phobias), memory, ability to perform simple calculations, judgment (“If you found a letter on the ground in front of a mailbox, what would you do with it?”), and higher reasoning, such as the ability to interpret proverbs (such as “a stitch in time saves nine”). A useful adjunct would be the Minnesota Multiphasic Personality Inventory, or MMPI, a standardized test of personality traits and psychopathology commonly used by psychologists.

An intelligence test measures various parameters thought to correlate with academic or financial achievement. Every politician need not be a genius, but I’d like the ones who represent me to know that islands don’t capsize with the arrival of a few thousand military personnel.

“Congress consists of one-third, more or less, scoundrels; two-thirds, more or less, idiots; and three-thirds, more or less, poltroons,” H.L. Mencken observed. Testing might help us weed out a few idiots. Getting rid of the scoundrels and poltroons will have to wait.

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