I have not had the opportunity to examine the president personally, but warning signs abound. What if I had reliable outside information that Airman Trump displayed erratic emotions? That I saw very clearly that he was engaging in cyberbullying on Twitter? That he had repeatedly made untruthful or highly distorted statements? That his language implied he engaged in sexually abusive behavior? That he appeared paranoid about being surveilled or persecuted by others, that he frequently disregarded or violated the rights of others?

These are the sorts of things that set off alarms for Air Force psychiatrists. I certainly could not certify him as “P.R.P. ready” without more extensive psychological evaluation.

It does not take a former Air Force psychiatrist to point out that our country finds itself in a place unlike any we’ve ever been before. Saturday morning’s alarm in Hawaii, as residents read alerts that incoming ballistic missiles were on their way, is a wakeup call to the very real danger we’re facing. Global tension and angst are significantly heightened.

We’ve been here a few times before, but unlike those other times our commander-in-chief adds, without equivocation, to this angst almost daily with his words and actions. We have always assumed that the person at the top has the mental fitness to meet whatever standards the Air Force set for the rest of the chain of command. What keeps me up at night? The realization that, at the worst possible time, we have a chief executive who I believe would probably fail the P.R.P.

The topic of presidential fitness and cognitive decline has always been a legitimate issue. The ability for the Executive Office to function effectively and without exposing the American people to undue danger relies on the mental faculties of the one person inhabiting its walls. Former President Jimmy Carter pointed this out in an article he wrote for The Journal of the American Medical Association in 1994, in which he warned that our country is in “continuing danger” from the possibility that a president could become disabled “particularly by a neurological illness.” Revelations that President Ronald Reagan may have had early-stage Alzheimer’s while he was president add to these concerns.