Donald Trump's campaign released an update on the former president's health Saturday, one week after he survived an attempted assassination at a rally in Butler, Pennsylvania.
The memo, from Rep. Ronny Jackson, MD (R-Texas), a staunch supporter who served as Trump's White House physician, offers new details on the nature of the GOP nominee's injuries and the treatment he received in the immediate aftermath of the attack.
It is the most thorough accounting to date of the former president's condition since the night of the shooting, which also left one rally-goer dead and injured two others.
According to Jackson, Trump sustained a gunshot wound to the right ear that came "less than a quarter of an inch from entering his head, and struck the top of his right ear."
The bullet track, he said, "produced a 2 cm-wide wound that extended down to the cartilaginous surface of the ear. There was initially significant bleeding, followed by marked swelling of the entire upper ear."
While the swelling has resolved and the wound "is beginning to granulate and heal properly," he said Trump is still experiencing intermittent bleeding, requiring the dressing that was on display at last week's Republican National Convention.
"Given the broad and blunt nature of the wound itself, no sutures were required," Jackson wrote.
Trump was initially treated by medical staff at Butler Memorial Hospital. According to Jackson, doctors "provided a thorough evaluation for additional injuries that included a CT of his head."
Trump, he said, "will have further evaluations, including a comprehensive hearing exam, as needed. He will follow up with his primary care physician, as directed by the doctors that initially evaluated him," he wrote.
"In summary, former President Trump is doing well, and he is recovering as expected from the gunshot wound sustained last Saturday afternoon," he added.
Jackson said in the letter that, as Trump's former doctor, he was worried and traveled to Bedminster, New Jersey, where Trump had flown late Saturday after he returned from Pennsylvania, "to personally check on him, and offer my assistance in any way possible."
He said he has been with Trump since that time, evaluating and treating his wound daily, and would remain with Trump through the weekend, including traveling to Michigan, where Trump held his first rally since the shooting, joined by his new running mate, Sen. JD Vance (R-Ohio). At Saturday's rally, the white gauze on Trump's ear was replaced by a skin-colored bandage.
Jackson appears to be licensed to practice medicine in Florida, according to a state health department database. that Jackson has a certification in Emergency Medicine, valid through the end of 2025.
A spokesperson for the congressman did not immediately provide a response when asked about the status of his license, and Trump campaign's did not immediately respond to questions.
Jackson has come under considerable scrutiny. After administering a physical to Trump in 2018, he drew headlines for extolling the then-president's "incredibly good genes" and suggesting that "if he had a healthier diet over the last 20 years he might live to be 200 years old."
In 2021, the Department of Defense inspector general that found Jackson had made "sexual and denigrating" comments about a female subordinate, violated the policy on drinking alcohol on a presidential trip and took prescription-strength sleeping medication that prompted worries from his colleagues about his ability to provide proper medical care.
Jackson denied the allegations, claiming he was the victim of a "political hit job" because of his close ties to the former Republican president.
Last year, Trump's campaign released a letter on President Joe Biden's 81st birthday from Bruce A. Aronwald, MD, a New Jersey physician, who said he had been the former president's doctor since 2021.
Trump's campaign and federal law enforcement had released little information on his condition or treatment in the days after the attack, declining to disclose medical records or hold briefings with the doctors who treated him at the hospital.
After a would-be assassin shot and gravely wounded President Ronald Reagan in 1981, the Washington, D.C., hospital where he was treated gave regular, detailed public updates about his condition and treatment.
Trauma surgeon Babak Sarani, MD, who said he has been treating more patients with wounds from AR-15-style assault rifles, said the description in the letter was "exactly in line with what you would expect from a bullet wound."
While the indirect damage is still usually minor, he said the risk of extensive damage is greater than if another gun were used.
"If a bullet whizzes by your ear from a low-caliber handgun, it's not a big deal. ... You get a headache or feel dizzy like a bad concussion," said Sarani, chief of trauma at George Washington Hospital in Washington, D.C. "But if the bullet is from an assault rifle, the energy is bigger, broader, and you're more likely to develop bruises."
He added, "in Trump's case, he got very lucky. The majority of the energy was released in the air. If it had hit him in the head, we would be having a completely different conversation."
Former Secret Service agent Rich Staropoli said the AR-15-style rifle used by the gunman fires a 5.56 millimeter bullet at such high speeds -- over 2,000 miles an hour -- that just the air pressure as it passes can cause extensive damage.
"The shock wave alone could have ripped his ear off," Staropoli said of Trump. "It's amazing the bullet nipped him" and didn't do any other damage.
"It's a one in a billion type of thing," he added. A fraction of a millimeter closer, "and this would be a different story. It really is incredible the thin line here between just a nick and devastating bodily damage."
Kenji Inaba, MD, chief of trauma and surgical critical care at the University of Southern California, said a follow-up by Trump's physician was appropriate, including a mental health evaluation.
"Clearly any injury, no matter how minor, when there is intent, will be associated with some degree of post-traumatic stress, so this would also be a consideration for his medical team," said Inaba in an email.