When President Donald Trump’s doctors release a summary of the physical exam he is scheduled to undergo Tuesday, the document is almost certain to conclude he remains in excellent health, if his previous assessments offer any indication.

But that is likely to do little to quiet questions about Trump’s health. And even the president himself has begun making tacit acknowledgement of his own mortality — albeit often in the context of security — as he reflects periodically on his limited time left on Earth and wonders aloud whether he would make it into heaven.

“I don’t know how long I’ll be around,” he mused during an event in the East Room earlier this year. “I have a lot of people gunning for me.”

Trump’s visit to Walter Reed National Military Medical Center will be the third time he’s visited the facility for a medical exam since becoming the oldest president ever inaugurated last year. The White House said the check-up would include “routine annual dental and medical assessments,” despite him having already visited a dentist in Florida twice this year.

Trump and his team eagerly describe him as a leader with boundless energy and unmatched acuity, shrugging off his visible signs of age and the moments when he appears to doze off during meetings. But even the rosy appraisals offered by his physician after frequent exams have done little to dampen questions about Trump’s health. Presidents are not legally obligated to release anything about their health, so everything they do disclose is by choice. Several presidents before Trump were found afterward to have concealed medical issues in office.

Trump, whose political brand is built on an image of strength and vigor, is famously loathe to concede any physical fault. He makes near-daily comparisons to a predecessor he calls “Sleepy Joe.” His aides are quick to point out when he is working late — as they did this weekend, when a communications aide announced the president was in the Oval Office at 9:30 p.m.

“I don’t happen to be a senior. I’m much younger than you,” Trump insisted at a retirement community in Florida this month. “I’m a much younger man than you.”

Yet even though Trump is a louder and more visible presence than Joe Biden was during his presidency, he still travels less often than he did during his first term and has on multiple occasions closed his eyes for long stretches during on-camera events.

Repeated attempts on Trump’s life by would-be assassins and his advancing age appear to be reminders that everything could change in an instant. Even as he and his aides downplay any physical deterioration, like bruising on his hands and swelling in his legs, the president has allowed brief glimpses into his thoughts on earthliness.

A stray comment as he welcomed King Charles III to the White House last month offered a revealing window. Referencing his own parents’ 63-year-long marriage, he turned to his own wife, who he wed 21 years ago.

“That’s a record we won’t be able to match, darling,” said the 79-year-old president. “Sorry, just not going to work out that way.”

In public, the president has maintained remarkable sangfroid around repeated threats on his life. When he emerged wearing a tuxedo into the White House briefing room last month after a panic-ridden press dinner, his demeanor was remarkably serene.

“It’s a dangerous life,” he shrugged, reflecting on whether he would change any of his habits an hour or so after a gunman tried to enter the ballroom where he was preparing to dine on steak and lobster.

Yet people who have spoken to Trump say his personal safety is never far from mind, even as he attempts to avoid it becoming a debilitating fixation. Iran, the country he is at war with, has previously plotted to assassinate him. And two people close to him — the Japanese Prime Minister Shinzo Abe and the conservative activist Charlie Kirk — have been killed by lone gunmen during outdoor events in recent years. On Saturday, the Secret Service shot and killed a man who the agency said fired at officers at a checkpoint near the White House while Trump was inside — a reminder of the security danger the president faces.

Questions about Trump’s physical and mental fitness have existed since before he entered office. A letter from his then-personal physician in 2015, during his first run, declared: “If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.” The doctor who wrote it, Harold Bornstein, later told CNN that Trump had dictated the statement himself.

Medical episodes peppered Trump’s first term, including a sudden and unexplained visit to Walter Reed that an aide later appeared to reveal was for a colonoscopy, and a bout of Covid that White House officials at the time failed to disclose the severity of.

Since returning to the White House, visible ailments have prompted the White House into divulging new details of the president’s physical condition.

The White House said swelling in his ankles that was revealed last summer​ was a result of chronic venous insufficiency, a common issue related to age. Trump attempted wearing compression socks, but found them uncomfortable.

The bruises on Trump’s hands, which he attempts to conceal with thick makeup, occur because he takes a large dose of aspirin — higher than his doctors recommend — and shakes many hands, the White House said.

And, officials insist, the heavy eyelids during meetings are simply long blinks.

After Trump visited Walter Reed in October, he revealed to reporters he’d undergone an MRI. But he refused to say why, or even what part of his body was imaged. It wasn’t until several months later that officials confirmed the procedure was actually a CT scan, and was intended “to definitively rule out any cardiovascular issues,” according to the White House physician, Dr. Sean Barbabella.

In his report on Trump’s physical a year ago, Barbabella praised the president’s “active lifestyle” and his “frequent victories in golf events.” Since then, however, Trump has conceded he rarely works out, quipping during an event on the new presidential fitness test that he spends “about one minute a day max” on exercise.

Even the most health-minded figures in his administration accept his diet is terrible.

“I don’t know how he’s alive, but he is,” Health and Human Services Secretary Robert F. Kennedy Jr. said on a podcast this year, citing Trump’s intake of McDonald’s, candy and Diet Coke.

Perhaps no health topic is more fraught than Trump’s cognitive abilities. In his second term, his public events often veer wildly from topic to topic — none related to the stated reason for his being there. He calls his winding way of speaking a “weave,” but his critics question whether he’s mentally sound.

The three cognitive tests Trump says he’s taken under a doctor’s supervision have become recurring features of his political events, though he declared this month he may forgo them in the future.

“I think I’m done with those days. I’m tired of taking that test,” Trump said during a speech at an event celebrating small business owners at the White House.