The Greatest Sin of All

Deep background can be useful. In the heat of the moment point to it once again to explain how this moment come to be, the underlying factors at play. So, once again, Politico’s Michael Kruse already took that deep dive:

One day in May of 1918, Donald Trump’s grandfather was walking with Donald Trump’s father along a sidewalk in Queens and said he felt sick. The next day, he was dead… The death certificate said full pneumonia, according to the reporting of the biographer Gwenda Blair, making the elder Trump an early victim of what would come to be known as the Spanish flu.

Fred Trump, twelve at the time, remained stoic, or tried to. “I wasn’t that upset,” he told Blair more than seven decades later. “You know how kids are. But I got upset watching my mother crying and being so sad. It was seeing her that made me feel bad, not my own feelings about what had happened.”

He had no feelings. He saw no need for them:

The boy who lost his father to the last worst pandemic in turn taught his sons to be “killers.” The underlying message, though: “Being a killer was really code for being invulnerable,” as Mary Trump put it in her recent book. “Going forward,” the niece of Donald Trump wrote of Fred Trump, “he refused to acknowledge or feel loss.” The family, in her recollection, never discussed Fred Trump’s father, or his death, or its cause. It was the lesson above all others that Fred Trump passed on to his children – foremost to his middle son, his preeminent heir, the boy who would become the 45th president of the United States.

A president who far more often than not has tried to ignore or downplay or wish away the most devastating global outbreak of illness since the one that ended the life of his grandfather. Who mostly has refused to so much as wear a mask as the spread of sickness has wreaked havoc. Who mocked his opponent during Tuesday’s debate for his face-covering diligence. Whose every word and gesture communicates his priorities to the nation he leads. And for whom any acknowledgment of vulnerability always has seemed to be tantamount in his mind to an impermissible admission of weakness.

“Weakness,” in the Trump family, Mary Trump wrote, “was perhaps the greatest sin of all.”

“Weakness,” Tony Schwartz, co-author of The Art of the Deal, once told me, “is Trump’s greatest fear by far.”

That may be why Trump just bailed out of Walter Reed hospital. He wasn’t weak. He wasn’t a loser or a sucker, so he wasn’t staying. The Washington Post covers the details:

President Trump left an elite medical center Monday evening, even as his doctors acknowledged that they were entering “uncharted territory” and – citing privacy laws – continued to withhold information that could illuminate the president’s prognosis for recovering from covid-19.

Trump’s determination to appear in control in the waning weeks of the presidential race left unclear whether he or his doctors were calling the shots, especially because members of his medical team at Walter Reed National Military Medical Center continued to cherry-pick what they shared with the public. They said his oxygen levels were normal and he had no fever, but refused to answer questions about results from lung scans, his last negative test for the coronavirus or why he is receiving the steroid dexamethasone, typically reserved for patients with severe illness.

But this was simple. He wanted out. And he’s the boss, so that was that. But nothing is quite that simple:

The president returns to the White House at a fraught moment in his recovery – before he has seemingly escaped a period when some patients are known to crash.

“The problem with covid-19 is that people’s condition can deteriorate rapidly, even after days of stability,” said Harlan Krumholz, a cardiologist and health-care researcher at Yale University and Yale New Haven Hospital. “And so we are more accustomed to be cautious with people with high risk.”

But this guy is special:

The president has received care accessible to few other Americans. He was given a brew of laboratory-made antibodies that fewer than 10 other patients have received outside of clinical trials. And for him, returning home means arriving at a place that can be adapted to cater to his needs, Krumholz and others said.

Jonathan Reiner, a George Washington University Hospital cardiologist, said that in an emergency, the White House medical unit “can do what an emergency room can do in the first 15 minutes” – someone could be resuscitated and stabilized during a heart attack, for example, and then transferred to a hospital. Still for ongoing treatment, he said, it would be wise for Trump to remain hospitalized.

“It makes zero sense to move him from Walter Reed,” Reiner said.

But it made all the sense in the world to Donald Trump. Like those dead American Marines in that cemetery in France, or his cohorts back in the sixties who ended up dying in Vietnam, those suckers and losers who didn’t have the drive and the smarts to get out of going off to die for nothing in return, only suckers and losers hide in hospitals, so he fixed that:

At a Monday news conference, White House physician Sean P. Conley said doctors were “cautiously optimistic and on guard” about Trump’s discharge. But he said the benefits of returning to the White House outweighed the risks.

“Every day a patient stays in the hospital unnecessarily is a risk to themselves,” Conley said. “And right now there’s nothing that’s being done upstairs here that we can’t safely conduct down home.”

But Conley acknowledged that the medical team is in “uncharted territory” with the mix of medications the president has been given and that the dangerous period for the infection is not over. He’s “looking to this weekend” for assurance that Trump has cleared rough waters.

“If we can get through to Monday” of next week, he said, doctors will “take that final deep sigh of relief.”

Trump doesn’t care. He laughs at that kind of thinking. That’s only wimpy medical talk:

Daniel Kaul, an infectious-diseases expert at the University of Michigan, said people of Trump’s age and with similar severity of illness – to the extent that is known – “usually have a pretty slow recovery, with weeks and sometimes months of cognitive difficulties, shortness of breath, severe fatigue.”

Like other experts, Kaul said it is highly likely that Trump had covid pneumonia.

That’s only what medical people say, and no one will ever know:

At the briefing, Conley selectively invoked health privacy laws known as HIPAA – the Health Insurance Portability and Accountability Act – when questions arose about the president’s respiratory-system scans or whether he remained infectious.

Asked when Trump last tested negative for the coronavirus, Conley replied, “HIPAA precludes me from going into too much depth.”

That’s the rule. The patient owns his or her medical records and, by law, can keep them private. No one will know if Trump is still highly contagious. All covid patients are at this stage, but no one will know in Trump’s case. That’s private. And any cognitive difficulties are private too. But he’ll be fine:

Trump returns to a White House complex with two medical clinics, according to people familiar with the facilities: a small one on the ground floor available to the first family and others working in the building, and a larger one in the Executive Office Building. The latter unit is equipped to stabilize patients needing urgent care following incidents ranging from an accident to a heart attack or stroke. The goal is to stabilize patients before transferring them to a hospital.

For a scheduled procedure, presidents typically go to Walter Reed; for trauma, they go to George Washington University Hospital, where Ronald Reagan was treated after being shot almost four decades ago.

Health officials from current and past administrations agreed that the White House medical unit can bulk up on staffing and equipment to ensure that it can care for and at least stabilize a patient who takes a turn for the worse.

“But it’s really inefficient and risky compared to being on site in a hospital” with Walter Reed’s capability, said a health official from a previous administration who spoke on the condition of anonymity to freely discuss the topic.

So what if it’s really inefficient and risky? He’s not a wimp, but again, this isn’t that simple:

One significant question Trump’s doctors have not addressed is how long they plan to continue giving him the steroid and a cocktail of disease-fighting antibodies, said John W. Mellors, chief of the division of infectious diseases at the University of Pittsburgh School of Medicine.

Mellors said some patients with symptoms similar to those described by the president’s doctors achieve a full recovery. Others feel unwell for weeks or even months, with symptoms that can include fatigue, body aches, and shortness of breath, low-grade fever, and mental fogginess.

In other cases, the virus can be suppressed temporarily but then come back to cause major damage in the lungs or the heart, or by developing blood clots. Which trajectory any given patient takes “is all emerging” in terms of medical research findings.

The president probably is still contagious, experts said.

But beyond that, no one knows. Trump might drop dead at any time now. But at least he’s not weak.

He proved that. Robin Givhan explains how he did:

President Trump walked out of the double brass doors at Walter Reed National Military Medical Center wearing a disposable mask and surrounded by security. He paused for the cameras. He gave a thumbs-up for the benefit of the pictures. And he climbed aboard Marine One.

And when he arrived at the White House, he walked up the steps, stood in front of four American flags. And removed his mask. He removed his mask in a show of what? Ego. Recklessness. Selfishness.

He is still convalescing from covid-19, a highly unpredictable and deadly disease. He remains contagious. His doctor has noted that he may not be “entirely out of the woods.” And since he has been at Walter Reed, the White House has become a coronavirus hot spot. Press secretary Kayleigh McEnany on Monday added her name to the list of staff, residents and recent visitors who have tested positive in the past week, which also includes the first lady.

But no matter. Image is Donald Trump’s everything.

This was staged carefully. He was strong. He was Mussolini or at least Silvio Berlusconi strong, and he tweeted too:

Trump announced his return in a victorious tweet in which he described covid-19 as nothing to worry about despite the fact that more than 209,000 people have died in the United States. After receiving treatment unavailable to the average American, he declared himself feeling better than he did 20 years ago, as if he had just spent a few days at a spa: “Feeling really good! Don’t be afraid of Covid. Don’t let it dominate your life. We have developed, under the Trump Administration, some really great drugs & knowledge. I feel better than I did 20 years ago!”

The fact of his discharge was reiterated by his physician, Sean Conley, who in a news conference said, “He’s back!” All that was missing was the roar of the crowd.

Givhan was not impressed:

The man who fancies himself the ultimate showman has proved to be terrible at choreographing these bids for attention. His law-and-order posturing in front of St. John’s Church this summer had him looking like a confused would-be strongman manhandling a Bible. And over the weekend, as Trump waved to his devoted followers from behind the tinted windows of the black Chevy Suburban, he looked like the caged ringmaster in a circus of his own creation.

He did not look tough; he looked trapped.

He looked desperate. He looked pathetic. He looked weak – not because he was ill or because he was finally wearing a mask but because instead of doing the hard work of accepting his own vulnerabilities in the face of sickness, he’d propped himself up on the strength and professionalism of Secret Service agents. Instead of focusing on the humbling task of getting better, he was consumed by the desire to simply look good.

But that’s not his choice:

The president has surrounded himself with a host of people who acquiesce to his every whim. He is their means to an end, whether it be a paycheck or a place in the history books. They may be true believers in his politics; they may bathe in the sea of grievance he has unleashed. But they are invested in the character he has created. Everything is in service to it. He has crafted an image of himself as infallible and invincible. And he is abetted by a doctor who publicly describes Trump’s progress through covid-19 as though he is recounting the legend of Superman.

In this White House, there are few candid, behind-the-scenes photographs of Trump in the residence or in the Oval Office. There are few images that remind the public that while he may be an inordinately confident man, he is, nonetheless, just a man. His supporters bear placards suggesting he has been sent by God. He does all that he can to invest himself with lordly power — from affixing his signature to stimulus checks to declaring that he alone is the fixer of what troubles America.

Trump has surrounded himself with people who have put their faith in his image. They minister to it and worship it. The man himself, as witnessed by his own deeds, is expendable.

That may be a bit over the top, but Dana Milbank is simply direct:

Americans of all political stripes wished President Trump well in his battle with covid-19. Now he is repaying our compassion with reckless disregard and callous contempt for the well-being of anybody but himself.

Trump, announcing via Twitter on Monday afternoon that he was ending his hospitalization at Walter Reed National Military Medical Center after three days, told Americans that the pandemic is no big deal…

A more selfish man has never occupied his high office. He received a cutting-edge treatment, monoclonal antibodies, unavailable to virtually all other Americans. He received an antiviral, remdesivir, which is rationed for ordinary Americans. He required oxygen and steroids.

Yet Trump has the audacity to tell Americans the virus is no biggie. No doubt the families of the 209,000 dead are greatly reassured.

He told those families that they were suckers and losers, identifying a new class of total losers – those who took this Covid thing seriously – those wimps and fools who were afraid of this little virus. Look at him! He beat this thing! America cheered. Look at them! They wimped-out and died! America sneered. Maybe these people should die.

He may be wrong about who is cheering and who’s sneering. Not everyone shares his contempt for weakness. Compassion isn’t stupidity. That’s a MAGA Fox News talk radio thing.

Megan McArdle has a few things to say about this:

Trump’s message is only a supercharged version of what his remaining supporters had already settled on: “Sure, Trump got covid because he didn’t take standard precautions, but only cowards do that. We of the right do not cower in our bedrooms, hiding from a virus – we bare our faces and dare covid to infect us.”

I’m afraid this message has fallen flat with me. I lean more right than left, but I also spent five weeks last spring at my father’s house in Massachusetts, after he caught the coronavirus at his cardiac rehab facility. When he came home, still covid-19 positive, I literally cowered in a bedroom with all of its windows open to the 35-degree New England “spring.”

I guess I’m supposed to be embarrassed that I isolated myself rather than frolicking through the potentially virus-laden air of the common areas, the way a real righty would have – sans peur et sans masque.

But she’s not embarrassed:

Of course, I did venture out to help my dad, who had just spent a month locked in his room by a nursing home that was – get this – afraid of letting the virus spread among its vulnerable patients. While he recovered his strength, my sister and I ran errands and did housework, protected by masks and nigh-obsessive hand-washing. The rest of the time, we stayed in our rooms while my dad occupied the main part of the house.

I would have gravely disappointed our president because I felt a deep, sick fear every time I wondered whether I had caught the virus. I was afraid for me, with my history of lung problems and hypertension. I was afraid for my sister, because who knew what this disease might do to her. And I was also afraid for my dad, because if we caught it, he’d end up with two patients instead of two helpers.

In retrospect, I probably could have relaxed; it now appears that covid-19 patients are mostly contagious in the first few weeks, which dad had spent in the rehab facility. But while we might have been mistaken about our personal danger, I’m quite sure we weren’t wrong to be afraid of covid-19.

So, for her, it comes down to this:

What we need – beside clear priorities and aggressive risk management – is some actual courage – the kind that does the right thing despite real danger, not the false fearlessness that imagines away true threats. Unfortunately, instead of showing us what genuine bravery looks like, Trump keeps trying to manufacture the ersatz variety, out of equal parts feckless belligerence and sheer pigheaded denial.

There’s a lot of that going around. The New York Times’ Gina Kolata and Roni Caryn Rabin report this:

Scientists, ethicists and doctors were outraged by the president’s comments about a disease that has killed nearly 210,000 people in the United States.

“I am struggling for words – this is crazy,” said Harald Schmidt, assistant professor of medical ethics and health policy at the University of Pennsylvania. “It is just utterly irresponsible.”

Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical School, called the president’s message “dangerous” because it encouraged his followers to ignore basic recommendations to keep themselves safe.

“It will lead to more casual behavior, which will lead to more transmission of the virus, which will lead to more illness, and more illness will lead to more deaths,” Dr. Schaffner said.

That makes Trump a killer:

Mr. Trump’s tweet may lead some people to believe that Covid is on the decline, when in reality, it’s still largely uncontrolled in the United States, and numbers have been rising, experts said. Over the past week, there has been an average of 43,586 new cases a day, a 6 percent increase from two weeks earlier, and 720 deaths a day.

Experts pointed out that Covid-19 has “dominated” the lives of millions of Americans, particularly Black and Latino people who have been hit with devastating force by the virus. The death rate for Black Americans diagnosed with Covid-19 is more than twice the rate for white Americans.

“When you speak to families in those communities, I’m sure there will be a difference of opinion in regards to whether this is to be thought of as insignificant,” said Dr. Leon McDougle, president of the National Medical Association.

Yeah, but those Black and Latino people always vote for Democrats, and once dead, they don’t, so this may be a good thing, but personal stories always matter more:

Unlike average Americans, many of whom were unable to get tested for the virus or who got care in hospitals overwhelmed by patients sick with Covid, Mr. Trump has had a full team of specialists devoted to his needs at the Walter Reed medical center. His home, the White House, has a medical unit that his physician, Dr. Sean P. Conley, said on Monday was “staffed 24/7.”

To patients who were not as fortunate as the president, his message was distressing. Many, like Jennifer English, who is still grappling with the long-term effects of an infection she contracted in April, were unable to get medical care when they needed it.

“It makes me irritated – he can check himself in and has a team of 14 doctors; most of us couldn’t find one doctor to listen to us,” said Ms. English, a 46-year-old mother of three and restaurant manager from Oregon City, Ore., who called the president’s message “reckless.”

Ms. English still has fatigue, bouts of nausea and vomiting, blurry vision and brain fog. She used to run marathons. Now she gets short of breath when she walks her dog around the block, she said, and takes two naps a day.

“You’d think with him contracting it, he’d gain a little empathy, and a little knowledge, but apparently not,” Ms. English said. “He’s still downplaying it, and saying ‘don’t let it dominate your life.’ It dominates my life. Every minute of my life is dominated by it.”

She thought he’d gain a little empathy? He’s still a killer, but not because he’s highly contagious at the moment. His father taught him that there are “Killers” in this world, and losers, and no one else, so be a killer. All else is shame. And do not shame the family. Weakness really is the greatest sin of all.

And here we are.

About Alan

The editor is a former systems manager for a large California-based HMO, and a former senior systems manager for Northrop, Hughes-Raytheon, Computer Sciences Corporation, Perot Systems and other such organizations. One position was managing the financial and payroll systems for a large hospital chain. And somewhere in there was a two-year stint in Canada running the systems shop at a General Motors locomotive factory - in London, Ontario. That explains Canadian matters scattered through these pages. Otherwise, think large-scale HR, payroll, financial and manufacturing systems. A résumé is available if you wish. The editor has a graduate degree in Eighteenth-Century British Literature from Duke University where he was a National Woodrow Wilson Fellow, and taught English and music in upstate New York in the seventies, and then in the early eighties moved to California and left teaching. The editor currently resides in Hollywood California, a block north of the Sunset Strip.
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1 Response to The Greatest Sin of All

  1. Deborah Vatcher says:

    When the president spoke of feeling incredibly well after receiving steroid therapy, saying, “I feel better than I did 20 years ago!” I chalked that up to the dexamethasone talking, and his “steroid euphoria.” Many people get hyped-up on these meds, and some even become overtly manic and psychotic. Steroids can really mess up your mind. I’m also concerned about his steroid treatment at this time, because I have a hunch that Trump hasn’t taken them before, unlike JFK, who had been on cortisone for years to treat his Addison’s. So who knows how Trump’s mind will function while on these drugs. I took a peek at his twitter feed this morning, and it freaked me out (more than usual). All caps, one after another and another. Nuts!

    These are a few excerpts from the article I linked to below:

    Corticosteroid-related central nervous system side effects

    “Emotional lability and irritability are common symptoms sometimes accompanied by auditory hallucinations and paranoia.[22] Rarely, altered consciousness and disorientation may be observed. The mechanism by which the corticosteroid induces symptoms such as mania, depression, and psychosis is not clear.

    “In some cases, cognitive deficits, difficulty to maintain concentration, and poor memory, especially after prolonged treatment with high doses of corticosteroids, were observed.

    “The cognitive effects of corticosteroids appear to be occasional and include disorders, which consist of dementia or delirium.

    “A small percentage (2-4%) of patients develop depression, anxiety, or becomes apathetic.[26] While another small percentage (3%) shows psychosis with hallucinations.

    “The beginning of the appearance of symptoms induced by corticosteroids is variable. They may arise in the first phases of treatment, during, or even at the end of therapy.[30] In most cases (86%), they occur within the first 5 days of treatment.

    “Many scientific and literature evidences highlight how the administration of corticosteroids results in a high incidence of mood elevation, satisfaction, and optimism.[39] Less frequently, euphoria, insomnia, and increase in motor activity may occur.

    “Psychiatric adverse reactions are under-estimated and therefore it is not always possible to identify the effective dose and at the same time the most secure.”

    ~ Dr. Debby MD FACP

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