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Is it fair that the American media is obsessing over the fact that Hillary Clinton has a minor medical condition, one that thousands of people contract and are cured of every day? No, it's not fair at all. But blood sports never are.

Ms. Clinton has high disapproval ratings, nearly as high as Donald Trump. That's largely because many people have come to believe that she's a serial truth-stretcher, and is never entirely on the up and up. Republicans have spent decades feeding this idea, and the Trump campaign has recently been insinuating that the latest thing she's covering up is her health.

Then one day last week she had a coughing fit on stage. A few days later she seemed to almost faint leaving a 9/11 commemoration; now it turns out she has pneumonia. To some Americans, this is no big deal – the condition is slightly worse than the common cold, but, all things considered, not quite as bad as promising to erect a wall along the Mexican border. To many other voters, however, it's yet more proof of their conviction that Ms. Clinton can't be trusted. What else is she hiding?

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Democracy is a funny creature. Platforms matter. A candidate's record matters. But voters also cast their ballots based on a feeling of visceral connection to, or repulsion from, the candidate. An impression about a politician's fundamental nature can, fairly or not, become attached to him or her – and images or incidents reinforcing that notion may find more acceptance than those challenging it.

Remember the picture of former Progressive Conservative leader Robert Stanfield dropping the football in the 1974 election? The awkwardness of his body, and the look of almost senile confusion on his face contrasted badly with the youthful and suave Pierre Trudeau. That one split second, caught on film, played into the narrative of him as some old fuddy-duddy. It wasn't fair. Politics isn't.

Or consider President Gerald Ford, who in the public mind had a reputation as a bit of dolt, and an unathletic klutz. When he tripped and fell on the stairs of Air Force One in 1975, it reinforced the impression. In fact, Mr. Ford was the most successful athlete ever to occupy the White House. As a college football star, he once played against the Chicago Bears; after graduation, both the Detroit Lions and Green Bay Packers offered him a contract. (He turned them down to go to Yale Law School.)

Or what about George H.W. Bush? In 1987, Newsweek magazine ran a picture of the then-vice-president on its cover, with the headline "Fighting the 'Wimp Factor.' " It was a widespread charge, but a strange one, given his record. He'd been a fighter pilot, and a decorated Second World War veteran. He'd been shot down and had survived. His predecessor as President was Ronald Reagan – who had the face of a hero. But he was not actually a war hero. While Mr. Bush was fighting the Japanese in the Pacific, Mr. Reagan was stateside, making movies. No, not fair.

But in the 1988 election, Mr. Bush crushed Democratic challenger Michael Dukakis in part by painting his opponent as a wimp, and finding a single image to encapsulate that Republican narrative. On Sept. 13 of that year, Mr. Dukakis took a ride in an M1 battle tank. The GOP had been attacking him as weak on national defence, so the Democratic campaign decided to stage a photo op that they thought would look tough and martial. Big mistake.

Dukakis In A Tank became an Internet meme before there was an Internet or memes. With his head poking out of a turret and his tiny, elfin skull dwarfed by an oversized helmet that, almost too perfectly, even had his name on it, he looked like an infant, not a president.

The Bush campaign created an exceptionally successful attack ad out of it, in which a voice-over listed all sorts of reasons why Mr. Dukakis was allegedly weak on national defence – but the visual of him in a tank said it all. The pictures "proved" he wasn't qualified to be commander-in-chief.

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Of course, the quality of one's defence policy is not measured by one's ability to successfully model a helmet. But when voters already have an idea in their heads, and the image fits, watch out.

And proving that Election 2016 is nothing new under the sun, the Bush '88 campaign insinuated that Mr. Dukakis had health problems – in particular, mental-health problems.

When outgoing President Reagan was asked about this, he demurred with this zinger: "Look, I'm not going to pick on an invalid." Then he smiled. Politics is not a game for the faint of heart – or those who make the mistake of getting caught on camera, fainting.

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