As President Trump’s primary physician, Dr. Sean Barbabella contends with a patient who doesn’t always listen to doctors’ advice.

That was evident during a rally in Ohio this month, where Trump told the audience he takes more than four times the amount of aspirin that his doctors recommend.

“They said, ‘Sir, you don’t need that,’” Trump told the crowd. “I said, ‘Do me a favor, I’ve been doing OK for 35 years, leave me alone.’”Trump continued: “I’ll switch to that tiny little thing and then something bad will happen and I’ll say: ‘You son-of-a-b—doctor.’”It is one of many challenges that come with caring for an 80-year-old president who is the oldest ever inaugurated. Barbabella—or another doctor—is supposed to be no more than three minutes away from the president at all times, according to people familiar with the matter. He is among the few officials with complete knowledge of Trump’s health and one of a handful responsible for what the public knows about it.

Doctors who reviewed Trump’s medical disclosures for The Wall Street Journal say they omit key metrics to gauge his overall fitness. It is Barbabella whose name is attached to these annual reports that have described Trump as being in “excellent health.”The White House has said he has been transparent about Trump’s health.

Eight of the 45 men who have occupied the country’s highest office died during their terms—of them, four were assassinated. Trump was wounded in one assassination attempt and subject to at least two others that were foiled.

Barbabella, 56 years old, served as an emergency medicine physician in the high deserts of Afghanistan, where Navy records show he came under fire. Trump’s top aides say Barbabella’s background caring for soldiers near the front lines made him an obvious pick for a president who has been frequently targeted. He got a boost from one of Trump’s previous physicians, Rep. Ronny Jackson (R., Texas), who knew Barbabella as a young doctor in residency.

“He was a better physician than I was,” Jackson said in an interview.

Barbabella’s style with Trump is low key and direct, according to a person who has seen them interact. Staff regularly leave the room when Trump is talking to his physician, according to the person, a rarity in a freewheeling White House. Officials declined to make Barbabella available for an interview, and he didn’t respond when contacted directly.

Dr. James L. Hancock, who worked with Barbabella in Afghanistan, described him as “introverted, very modest, very confident” and “ice cold under pressure.”“He’s the quiet guy doing the job,” Hancock said.

Barbabella is one of several doctors in the White House Medical Unit—an office that has grown significantly under modern presidents. Like other presidents, Trump’s entourage always includes a medical team.

Before Trump, Joe Biden was the country’s oldest president. He showed signs of mental decline, and shortly after leaving office, was diagnosed with an aggressive stage-4 prostate cancer that had spread to his bone. The presidential medical summaries Biden’s office disclosed didn’t address his cognitive health, or indicate whether he received prostate health screenings.

Trump’s physicians have a history of using superlatives to describe his health. Harold Bornstein, Trump’s longtime personal doctor, wrote in 2015 that his physical strength and stamina were “extraordinary” and his lab results were “astonishingly excellent.”Later Bornstein, who has since died, told CNN that Trump dictated the letter to him.

In his report after Trump’s April 2025 physical, Barbabella said Trump’s health is “excellent” and noted Trump’s “frequent victories in golf events.”In October 2025, after Trump went to Walter Reed National Military Medical Center for advanced imaging, he described Trump’s health as “exceptional.”He has described the persistent bruises on Trump’s hands as the result of frequent hand shaking and his aspirin regimen.

Some physicians have criticized the reports for including extraneous information such as the golf victories, while leaving out key metrics of Trump’s health.

In Trump’s first term, Jackson released the president’s ejection fraction, a measure of how well the heart is pumping. He also described a stress echocardiogram, which checks whether the heart gets enough blood flow when working hard. In Trump’s second term, Barbabella has instead characterized the cardiology results as normal without including data.

James Jones, director of the White House Medical Unit, said that Trump’s physical is an accurate overall assessment of his health and not a comprehensive document with every treatment detail.

Dr. Ludwig M. Deppisch, who wrote a history of White House physicians, says that presidents have a unique responsibility to give a complete and detailed report. “The president does not have immunity from full disclosure of his health because he holds the safety and welfare of the American people in his grasp,” he said.

Barbabella grew up in Birdsboro, Pa., and took to sports including wrestling and running, according to local news accounts from the 1980s. His father was a former Army Ranger who fought and was wounded in Vietnam.

The same year that he graduated from the University of Pittsburgh in 1992, he became an ensign in the Navy, launching a military career that eventually took him to Japan, Germany, Iraq and Afghanistan. But first he went to medical school, graduating in 1996 from the A.T. Still University Kirksville College of Osteopathic Medicine in Missouri, earning a doctorate of osteopathic medicine—or D.O.

The degree is distinct from a doctorate of medicine or M.D., though both confer the same authorities. It is a type of training that focuses on preventive medicine and a holistic approach to care. Barbabella went to the Naval Medical Center Portsmouth, Va., for his residency. The facility produced two of Trump’s other White House physicians: Sean Conley and Jackson, the latter of whom overlapped there with Barbabella.

“He is clinically really good,” said Dr. Andy Johnson, who was the head of the department of emergency medicine at Portsmouth when Barbabella was a young physician. “The president doesn’t need a physician who is coming up with research ideas. He needs someone who doesn’t miss a thing.”Johnson said that Barbabella volunteered for some of the most difficult posts. This included raising his hand to be one of the first doctors assigned to a medical vehicle called the Mobile Trauma Bay, essentially an armored emergency room on wheels. Soldiers referred to it as a “doc in the box.”The idea was to bring a physician as close to the front lines of fighting as possible to save more lives.

In 2009, Barbabella was dispatched to the Now Zad district of Helmand province to treat a group of Marines hurt by an IED (improvised explosive device). When Barbabella arrived, he called out: “I need the most seriously injured!” recalled Josh Sweeney, who had been closest to the bomb.

Sweeney, who lost both of his legs, said: “That’s me.”In the trip out, a Marine was killed in the rescue effort, the Taliban fired mortar rounds at the rescue convoy and multiple vehicles were damaged, Sweeney said. He survived and went on to become a two-time Paralympic gold medalist. Occasionally, as Barbabella rose through the ranks, he would continue to call and check in, Sweeney said.

After serving in Afghanistan, Barbabella was eventually named the commanding officer at the Naval Health Clinic Cherry Point in North Carolina.

During Trump’s transition to a second term, the president-elect tapped Jackson to recommend staff for his medical office and physician. “His direction to me was: Pick somebody that you know and that you trust,” Jackson said. “And if you don’t know them and you can’t personally vouch for them and you don’t trust them, then I don’t want them,” Jackson recalled. He said Barbabella fit all of the criteria and he pushed for him to get the job.

An administration official said that Barbabella secured the position after a competitive process where the Army, Navy and Air Force forwarded up to six candidates to the White House. Ultimately Trump received several options. Trump’s first encounter with Barbabella came just hours after he was inaugurated for his second term, according to people familiar with the exchange.

He has shared war stories with senior staff while riding together on golf carts during the president’s games. When Barbabella was recently promoted to rear admiral, Trump presided over the ceremony, held in the Oval Office.