Taking Dictation

 

Two months in, Donald Trump is not acting like a dictator. He’s become one. He’s assumed every trait he’s admired in the world’s worst: capricious, insulting, boastful, striking at enemies perceived and real, threatening, suppressing art, banning words, hiding history, bullying, raving like a lunatic. Fulfilling dreams born of a life of failures masquerading, he knows, as success. Hurting the weak, to feel strong. Punishing people and places that show concern for racial and religious minorities, unwinding protections for Americans of different sexual orientation, gutting departments that serve people about whom he couldn’t care less, including his enstupened MAGAs – people and things he considers useful only as ways to flash see-me power.

NOAA and the National Weather Service? Cancer research? Promising more “clean” coal (which doesn’t exist) plants to stick it to “lunatic” environmentalists. Is it all retribution for when, as a shady businessman and social pretender in NYC, his peers ridiculed him? For which he made up by sexual predation?

But why such an ugly start to this column? Maybe because I’ve just returned from NYC, where my brother, intubated in an ICU and unresponsive, faces uncertain recovery. While there, news didn’t stop. Each day, already emotionally taut, brought a new outrage from Trump and his coven of unqualified but willingly subservient people. Plans to undo climate-related and pollution-preventing regulations, hurting everyone but his grateful bankrollers, who slather him with flattery. Attorney General Pam Bondi promising, enthusiastically, to weaponize her department for Trump. 

Trump calling non-slavish news organizations criminal. Overt attacks on free speech, ho-hummed by the “patriotic” right. Ten Senate Democrats caving to Republican budget blackmail; House Democrats stood firm against it, a plan that cut social spending, increased it for the Pentagon, and granted more power to Trump and Musk to do their worst. That’s what ugly is.

We picked a good time to be with my brother. As a physician, I could provide context and translation of his situation to my sister-in-law, whose strength has been stretched to its limits. Always an optimist, she imagines him returning home. I can’t, but it’s too soon to say.

The chance of America returning home, however, is less than my brother’s. Because of the unhealthy mind of one man (not counting supra-president Musk) in a position and disposition to destroy everything that makes America what it is, we’re in real trouble. It’s governance by intimidation. Trump must imagine himself alongside Hitler, Mussolini, Putin, Stalin, Kim Jong Un, Viktor Orban, Saddam Hussain; arm in arm, grinning his signature, plasticized thumbs-up. 

To whom can we turn to undo the madness? Cowardly and avaricious elected Republicans, whose party once eschewed authoritarianism, have forsaken America’s foundational principle of separation of powers. Once outraged by President Barack Obama’s executive orders, they’re now mum as the word at Trump’s, who, in his first four years, issued as many as President Obama did in eight. The pace, now, is furious. In both meanings. Including helping to curtail free speech around the world.

Every day, there’s something worse. Even as their rights disappear along with those of the people they hate, MAGA voters revel in it. Their sources of what passes for news blind them to the implications if Trump achieves the total control he desires, facilitated by surrender of those who could stop him. Right-side submission is already complete. From the left, podcasters and YouTubers are issuing fighting words; but words (like these here ones) aren’t action.

Courts? Trump’s control of them, personified by Aileen Cannon, isn’t yet total, but he’s filled them enough to make them unlikely rescuers. One brave judge just took a stand against Trump’s ominous use of an antique act for extralegal deportation of alleged Venezuelan gang members. Forcing the ultimate showdown, he ordered planes carrying them to turn around. They didn’t. Trump continues deportations, ignoring judicial injunctions, attacking judges personally after being ordered to follow the law. Time was, Republicans would denounce such dictatorial lawlessness. Not MAGAs. They wished for a mad king and got one.

Until he retired, my brother was a nationally recognized lawyer. Despite Trump’s vindictive, okay-by-Republicans attacks on lawyers who dared to defy him, he’d have stood up, too. My dad was an appellate judge who scrupulously followed the law even when he disagreed with it, leaving legislating to legislators, unlike Trump’s Cannonade. Ironically, when my dad was in a similar medical situation to my brother’s, I was our family’s physician-guide for painful decisions. For my brother, it’ll be his wife’s and daughter’s role, for which I’m grateful.

Bereft of feck, Democratic leadership is useless. The Republican party has thrown in with global enemies and, worse, home-grown ones, the ones rising to Trump’s occasion, willingly, anti-constitutionally, turning every strand of government into a bullwhip in his hand. Unable to tell Reich from wrong, nearly half of Americans appear glad for Trump’s corrupt goose-step to despotism.

Once, I believed America could protect itself from that, and would.

DOGE Ball

 

When I was a surgical intern, we had a patient, a young girl, maybe eight years old, who’d had a severe infection in her leg, necessitating removing much of the skin of her thigh. Her bandages required regular changing; because of the pain and her young age, it was being done in the OR, under general anesthesia.

A new drug had just been approved, considered safe to use outside the OR, because it provided analgesia and anesthesia without suppressing breathing. We tried it, in her room. The dressing change proceeded without evident awareness or pain by the girl.

That was half a century ago, and I still can hear her fearful howl as she awoke, an unearthly wail, as if she’d been forced to look through open gates of Hell. It was horrifying. If she didn’t remember, it had to remain in her somewhere.

The drug was ketamine.

Elon Musk admits – brags of – using ketamine recreationally, frequently. The man supervising a post-adolescent team of tech nerds is canceling people and programs without applying anything close to cost/benefit analysis, firing thousands of government workers via boilerplate emails. The man claiming he’s uncovered massive fraud, without producing a single example, shows all the signs of ketamine abuse.

Quoting: “Frequent, heavy recreational use—say, several times a week—has been linked to cognitive effects that last beyond the high, including impaired memory, delusional thinking, superstitious beliefs, and a sense of specialness and importance...” Like barging into world politics, planning to colonize Mars, taking a chainsaw to US government. And calling Senator Mark Kelly, R-AZ, a traitor for supporting Ukraine. If, in his chemically-addled brain, Musk thinks he’s finding “waste, fraud, and abuse,” he’s not. It’s irrational, wholesale firings followed by serial re-hirings when the essential nature of the employees is realized.

Waste, fraud, and abuse exist in the federal government. In Trump’s administration, it’s everywhere. His golfing weekends waste millions of taxpayer dollars each time he takes one. DOGE itself is a fraud; so is his bitcoin scam. Abuse is the operating premise of Trump’s and Bondi’s DOJ. No one except Trump, who’s dismantling the means to investigate his own corruption, is against finding and weeding it out. But it wouldn’t be Musk’s version, which lacks meaningful scrutiny of targeted departments or the importance of their work.

Case in point: firing National Park and Forest Service workers. National parks add billions of dollars to the US economy. Maybe Elon doesn’t like trees or bison; but they more than pay for themselves. The daughter of a friend had her dream job as a park ranger, for which her education made her highly qualified. Her performance had received laudatory accolades. Yet she was fired via one of those impersonal, cruel emails, accusing her, without specifics, of poor performance and lack of qualifications. Clearly no one had bothered to look. Like most of the touted firings, it was seemingly only to impress impressionable MAGAs.

If Musk’s narcissistic grandiosity and lack of empathy (he considers it a weakness) might be drug-induced, Trump came by his honestly. Which is the only context in which that word can be applied to him. Nature or nurture, it’s who he’s always been. But, even notwithstanding his multiple business failures and scams, his current disastrous behavior beggars understanding.

Since re-assuming office, his domestic actions seem to have in common only “because I can.” After his empty praise of veterans, gutting the Veterans’ Administration is an unexpected example. Killing cancer research; censoring science; destroying the EPA and the Department of Education: those were expected, but no less disastrous and irrational. Promises to the contrary, it appears Medicaid is also on the block. Social Security, too? 

As to his on-again, off-again tariffs, the effects of which he’s never understood, were his “advisers” afraid to contradict him? Vengeful authoritarians have a way of throttling dissent. Example: The oft-professed holiness of Mike Johnson, Speaker of the House and God, would, you’d think, render him reluctant to lie as blatantly as he does. As the stock market continued its freefall, as prices rise and jobs disappear, Holy Mike shifted blame by saying it will take time to repair the damage caused by President Biden’s terrible economy. As if Trump’s bizarre bungling has nothing to do with it. As if historic job creation, unprecedented corporate profits, taming the pandemic, enormous stock market gains, and rebuilding rotting infrastructure equate to “terrible.” “Envy of the world,” people said. Because it was.

Gaslighting enough for a million hot-air balloons, Fox “news” is referring to the upcoming “Biden recession.”

When MAGA voters are convinced by Foxotrumpic disinformation that Trump is playing four-dimensional chess with our economy, when they prefer authoritarianism over democracy and are okay with weakening the US to the benefit of Russia, it’s hard to foresee a way out. If there were an obvious, brilliant plan behind all of this, stock markets would be rising, not tanking. Mismanagement does the opposite. 

Betrayal

 

From my never-ending reach for common ground comes a fact so incontrovertible that we'll all agree: under Trump, America has sided with Russia and others of our adversaries. Supporting facts: The Oval Office encounter with Volodymir Zelensky, in which both Trump and Vance attacked him aggressively and angrily. (That the ambush was pre-planned seems obvious; admittedly, that invites disagreement.) Also: the UN resolution that Russia was the aggressor when it invaded Ukraine. In voting "no," America joined Russia, China, Hungary, and fifteen other retro nations. Despite US opposition, the resolution passed overwhelmingly. Such is the respect for the US that Trump has engendered.

Those events occurred; on that much we agree. We can also agree, because it's true, that Russia was delighted with the Trump/Vance vituperation of the man leading a country bravely defending itself, under relentless, deadly siege. Reflecting the exhausting disconnect that now characterizes American politics, some see those events as disturbing, depressing, embarrassing, and indicative of the end of America standing for good in the world; for democracy, for morality, for generosity. They recall that, in getting Ukraine to relinquish its prodigious arsenal of nuclear weapons several years ago, America agreed to protect it thenceforth. They dislike seeing their country renege on such a critical commitment.

Others see it as peachy.

What happened is on record. The question is, is it good or bad? Putin is a ruthless dictator. He imprisons his political enemies, except when he has them killed. His unprovoked invasion of Ukraine is cruel and immoral, bombing shopping malls and hospitals, deliberately. Children's hospitals. Kidnapping thousands of Ukrainian children, removed to Russia for who-knows-what purpose? Either you revile Putin for those horrors or, like Trump, you admire him. Either you see him as a continuing threat to cyber security and election meddling, for another example, or, like Trump, you're fine with turning him loose.

Your choice: It's a free country. For how long it remains so depends, at least in part, on whether a voting majority of Americans finds siding with Russia good for our country and morally superior to helping Ukraine in its fight to maintain democracy and independence.

In response to a statement that we're witnessing the collapse of the American ideal, Garry Kasparov, Russian world chess champion and courageous critic of Russia, replied (paraphrasing), "We're not seeing the collapse of the American ideal; we're seeing its betrayal." It's a significant, if subtle, difference.

"Collapse" suggests it was inevitable; that our democratic republic was impermanent from its founding. "Betrayal" accurately implies it's been forsaken; in this case, by a man who never understood or valued American ideals. Though it depends on reasonably well-informed voters, democracy isn't intrinsically flawed. With its election lies and so much more, Trumpism is making it so. As rapidly as it's happening, it ought to be reversible, which is why Trump and his destructors are trying so hard to prevent its resurrection. By lies, dishonest media, vote suppression, and a weaponized DOJ. Plus a blatantly dishonest SOTU speech. During which, it must be said, the Democrats' response was stupid.

Trump sees the world not in terms of right and wrong, but whether transactions enrich himself: material; land; aggregation of wealth. Hotels in Gaza. Kingly tributes. Bitcoin. "You hold no cards," Trump bloated to President Zelensky. There's no clearer confirmation of who Trump is. For him, "cards" are tangible items of value. Such ephemera as being right, heroically defending against a brutal aggressor, undergoing horrendous sacrifices to save their country? To Trump, not playable cards.

Until a few weeks ago, the American ideal had meaning; was, at least in part, central to our international presence. It was reasonable to believe it had staying power. Instead, Republican leaders of all pronouns are praising Trump's and Vance's crude attack as courageous, great for America. Manly. They disparage President Zelensky as ungrateful, greedy, incompetent; lie that he's never thanked America, which he has, many times. But, unlike the adulators with whom Trump surrounds himself, the Ukrainian president refused to grovel.

Mirroring the counterfactual Trumpian claim that Ukraine started the war, Marco Rubio intoned, as his soul departed his body centripetally, that President Zelensky owed an apology for "antagonizing" Trump. Are there no MAGAs who find that outrageous, who recognize in that reality-reversing statement the disdain with which Trump and his osculators see their voters? "America First" is their second-biggest deception: For Trump, it means "Trump first, America last."

Here's another proposal on which we should agree. Let's judge Trump's and Musk's and their cabinet members' actions thus: Are they helping average Americans? Have they fortified America's standing and influence in the world? Conversely, to what extent are they benefitting Trump, Musk, polluters, and/or Putin but not the rest of us?

My answers: in no way; the opposite; a whole lot. Convincing arguments to the contrary welcomed. This might help. Or this. And this.

Conning The Conned

Notwithstanding its faults - slavery, native American genocide, Japanese internment, misogyny, persisting racism, favoring the wealthy, the Electoral College - I've always believed America was a respected and trustworthy force for good in the world. By votes of its people, it made efforts to correct those faults, showing the world that, unlike dictatorships, democracy's ills can be self-healing.

Trump's first election challenged those beliefs, but he'd lost the popular vote and, four years later, was rejected and ejected: beliefs restored. Then, despite January 6 and his election lies, threats, mishandling Covid-19, and promises to punish anyone who'd challenged him, he was elected again, though more votes were cast against than for him. Now, only weeks into his second term, Trump's America is, observably, no longer a force for good. Predictable from how he campaigned, America is siding with enemies, forsaking friends and the health of our planet. Once-true beliefs have become untenable. It's hard to take.

Amidst a brave war for democracy in a land murderously invaded by a dictator whose political opponents tend to become dead, America has switched sides. If it still existed, Trump would have us join the Warsaw Pact; his kind of people.

Knowing it can no longer count on us to stand for and protect freedom, the free world recoils. Trump's besotted party, which once condemned Russia's criminal dictator, now praises him. For reasons about which there's speculation but -- not yet -- no revelation, Trump has always done Putin's will. Confirming the obvious, Russian state television's Vladimir Soloviev just said it's "no coincidence" that, after his conversation with Putin, "the phrases [Trump] is saying are so deep and so correct. They are in total alignment with the way we see things."

MAGA is Trump's most dangerous con job. Pretending to make America "great," he's blinded millions of gulliblized voters from seeing that he's eliminating every aspect of its greatness, including standing for freedom around the world. People who've never understood or accepted the value of America's founding principles see what's happening and love it; trying to descale those eyes is wasted effort. But we're approaching the point at which the machinery to bring the world's greatest democracy back into being will have been dismantled forever. More people need to join those speaking out. The need isn't subtle.

Dictators have in common controlling all centers of power: first, the military and law enforcement, to make good on threats. Then the press, legislators, investigators, and judges. With no resistance from Republicans and willing capitulation by others, Trump is remaking all of those entities, purging people who've stood for the Constitution, replacing them with his most loyal sycophants, guaranteed to do his bidding. Which they already are. The latest example: selecting as FBI deputy director former Foxer and current right-wing screamer Dan Bongino, who describes himself as "all about owning the libs." For MAGAs, that's all a resumé needs.

Thanks to America's most hypocritical senator, Trump has our Supreme Court mostly in hand, too. And he's been removing from office everyone whose job it is to keep the government from illegal overreach. JAGs, there to keep the military within legal constraints; inspectors general, ethics overseers, and US Attorneys who'd been investigating him. Moving us further toward autocracy comes his delusional executive order granting interpretation of laws only to himself and his Attorney Genuflector. In their silence, Republicans, other than Alaska's Senator Murkowski, have purged themselves. 

MAGAs hear Trump refer to himself as "the King," see the White House officially picturing him wearing a crown and rejoice. "Command us, Your Majesty. We believe your promises, even as they go unfulfilled. Attack those we fear or hate and we'll ignore the harm you're doing, including to ourselves." (Sick, but not sic.)

Ironically, the victim of the biggest con of all is Trump. The Project 2025 creators he's hired have convinced him he's in charge, encouraging his monarchical madness. Meanwhile, they're getting him to implement their true agenda: erasing the vision of America's founders, in which they've never believed, that individual freedom, defended by the law and by separation of powers, should be paramount in a democratic republic; that ultimate power resides with the people.

It's starting to feel like this: Following Project 2025 page by page, the Projectors are securing their anti-American dream of a Christian Nationalist theocracy, by and for only straight, white, native-born, wealthy males; limiting the vote, if they could, only to them. So certain they were of Trump's malleability, they published their plan pre-election. With no pushback from them, free to use the presidency as an ego-fondling, tribute-providing ATM, Trump ceded to them the real power. Especially Elon Musk: boastfully, recklessly ruining lives, barely denting the federal budget, lying about reasons and results; convincing MAGAs they're seeing patriotism at work. 

Time is short. Watch this speech by Illinois Governor Pritzker. Its truths are self-evident, its warnings a cri du couer. Stay for what begins at 4.00.

King Me

 

If I were to discover that any thought I had or any demand I were to make would be actualized, I wouldn’t use that power to rename bodies of water. Because I’m not a psychopathic narcissist, I wouldn’t decide to take over a national artistic institution and declare, like “Soviet Realism” back in the day, what art is and is not acceptable. Or threaten to shut down news agencies; not even Fox.

I wouldn’t stop sending food to starving people around the world or issue edicts intended to harm LGBT people. Or, for that matter, anyone. Nor would I ban words. I wouldn’t demand that critical information about diseases and science be removed from circulation. Because my grandchildren’s future concerns me above all, I wouldn’t denude the Environmental Protection Agency or push for more pollution or end support for renewable energy. No one who’s not a walking ICD-10 would do any of those things.

In the wake of a sudden spate of airplane disasters, firing hundreds of people at the FAA responsible for maintaining air traffic control infrastructure wouldn’t happen. Same with nuclear safety workers, meat inspectors, forest rangers, federal inspectors general, and ethics watchdogs. Given the rapid rise of influenza, bird flu, RSV, and who knows the next one, I wouldn’t gut the CDC. Only a lunatic would.

Because consumers benefit from protection from usurious banks, I wouldn’t defenestrate the CFPB. I wouldn’t threaten to end FEMA or dismember the IRS as a favor to my rich, tax-avoiding friends if I had any, which I don’t. Close to last on my list would be imposing inflationary, economy-killing tariffs and lying about how they work. None of those things would make me feel good about myself.

I wouldn’t prevent people from using whatever pronouns they like. Arresting migrants, documented or not, who’ve been here for decades, working, paying taxes, raising American children, wouldn’t happen. I wouldn’t pretend I could rewrite the US Constitution by declaration; or claim to be for free speech while shutting it down, coming from people who disagreed with me.

There’s no way I’d hire an unimaginably wealthy megalomaniac, paranoid, nasty, and conspiratorial pusher of blatant lies, to bring disarray to every agency, like a can in a kidney store, firing people willy-nilly, for show, often mistakenly and without justification, with no evident plan for the aftermath. Nor would I turn my office into an ATM. 

For a day or two, I might relish knowing that no matter what I did, no one in my house or in power at the other end of the street would raise alarms; instead, they’d toss their integrity like a used Kleenex, heaping praise on me like the Second Coming. Propose my birthday as a national holiday, want my head on Mount Rushmore, when, if I did those things, the proper place would be on a plate. But it wouldn’t last. It’d be embarrassing. If people compared me to Jesus I’d demand they pray for forgiveness and never blaspheme again.

Like any decent American given that power, I’d seek ways to improve lives rather than shatter them; bring together people of all backgrounds, establish gatherings in every city to air differences and find paths to common ground. Having appointed competent, dedicated department heads, I’d insist that their purpose is to serve all Americans, not themselves. Rather than cutting funds for education, Head Start, healthcare, food, and research, I’d increase them, because, directly and indirectly, we all count on them. To pay for it, I’d end subsidies to oil companies and several corporate tax breaks, and return rates to where they were during President Obama’s booming economy. Or Clinton’s, when they produced a surplus. And I'd do the same as Trump

with the Pentagon's budget. Imagine that.

So here we are. In Earth's greatest putative democracy, a pathological, vengeful liar, having spent a lifetime bullying the powerless, was again handed the world’s most powerful office when there was no mistaking his lust for unbridled power. Given, in effect, unlimited wishes by a genie, having the opportunity to do enormous good, he chose unchecked harm, and not just at home. Via VPJD, he insulted NATO, all but cutting it loose; praised European fascists; sold out Ukraine to secure Vladimir Putin’s territorial aims, handing the “most powerful” title to him and China's Xi.

Knowing Trump as we did, even those who voted for him because they relished “sticking it” to people they dislike, it was obvious that giving him that kind of power would be sending a shark to swimmers wearing chum suits. Cruelty isn’t unintended: it’s the point and purpose. Making life so miserable for so many people, I couldn’t live with myself. No moral human could. For Trump and Musk, though, and Stephen Miller and Russell Vought and Kash Patel, et awful, it’s their raison d’etre.

RFK, Jr is too delusional to be doing it on purpose, but the suffering he’ll inflict could be even worse.

Is Enough Enough?

 

If a dictatorophilic “president” refuses to obey the law, and when his party in Congress doesn’t care, who’ll stop him? The Constitution is but a piece of parchment. What can believers in democracy do? Roll it up and smack him with it? The weakness of constitutional democracy is “Consent of the Governed.” It works only when citizens and their leaders willingly submit to its laws.

When our government, established by men who escaped tyranny and sought to prevent it here, ignores it, who’s there to enforce it? The Supreme Court? The body that granted Trump nearly unlimited immunity, gutted the Voting Rights Act, and grafted words onto the parchment saying that unlimited, unaccountable political donations are free speech? That decided corporations are people? Ignores Justices Thomas and Alito’s corruption?

If the Court were to declare any of Trump’s or President Musk’s actions unconstitutional, Musk, Vance, and Holy Mike Johnson have been clear: they don’t care. SCOTUS can direct US Marshals to arrest people who ignore its rulings, but they’re under the aegis of Attorney General Bondi, whose first actions were to do Trump’s bidding in going after prosecutors who lawfully targeted his crimes. We’ll find out soon enough whether Trump will uphold the Constitution. And whether Trump’s foresight-deficient voters will rejoice if he doesn’t. 

Until Republicans restrict it to Republicans, the ultimate restraint on leaderly lawlessness is the vote. But, following successful, long-term efforts by rightwing media, that’s failed, too. Which leaves only the slimmest of hopes that the taken-in will take back out; something toward which the Foxified have shown no inclination. They need to understand how democracy protects them, which they don’t. They need to realize and care what’s happening to it, which they can’t. They need to seek sources of accurate information, which they won’t. If Trump, who just opined that CBS and 60 Minutes should be abolished, deplatforms all but Foxoid media, they never will. Free speech, which Rs once claimed Ds were against, is in the eyes of the office-holder.

I’ve mentioned The Bulwark previously, a group of former Republicans boldly calling out Trump’s unfitness and the dangers he represents. Among them is Bill Kristol, founder of the conservative Weekly Standard, former Fox “news” contributor. Presumably to silence him, Elon lied that he’s on USAID’s payroll, using that as a reason to take it down. Swallowing the lies like seals do salmon, mixing and neologizing metaphors, Muskovites jumped on the slandwagon. 

To complaints about Musk’s illegal neutering of USAID, Trump has assured us that Elon gets nothing out of it. Well, except that he happened to be under investigation by USAID’s inspector general. And that, by diminishing its benefits to America’s image abroad, he enhances China’s. Which might have something to do with the fact that Elon does billions of dollars of business there and hopes to keep doing so.

Yale Law School grad Veep Vance’s response to a judge enjoining Musk’s illegal incursions was that it should be ignored. Musk called for the judge’s impeachment. The response of Congressional Republicans to this anti-constitutionalism can be summarized in no words. MAGA voters? Even fewer. “Ominous” would be mine.

MAGA was founded on xenophobia, homophobia, and anti-diversity. Because Trump is making good on it, his supporters find damage anywhere else irrelevant, if, jubilant about deportations and anti-trans actions, they notice or care.

They may soon, though, if any of them experiences credit card or banking fraud. Immediately after confirmation, Russ Vought, Trump’s head of the Office of Management and Budget and Project 2025 mainliner, disbanded the Consumer Fraud and Protection Bureau. Of the four million people to whom it has refunded over $1.8 billion fraudulently taken, surely many are Trumpic. Who benefits from killing it? Banks. Republican donors.

Nothing is more confirmatory that Project 2025, whose playbook Trump (“I never heard of it”) and his appointees are following page by page, is about enriching the rich and ignoring or intentionally hurting everyone else. Likewise, defunding the National Institutes of Health. Even people who reject science and distrust allopathic healthcare will be hurt. Losing access to its publications harms physicians and their patients. Research funding is being limited, threatening progress in cancer treatments, among others. It’s inexplicable and malicious. For countless Americans, including Trump’s idolizers, it could be fatal. 

So what is it, MAGAs? Are you okay with Trump’s march toward plutocratic autocracy because you think you’ll be fine? You know the aphorism, right?

If not, you should.

Let Me Count The Ways

 

The US Agency for International Development is a “criminal organization,” says President Musk, so, illegally bypassing Congress, he’s ending it. Cowed Republican members say nothing.

USAID represents about one percent of the federal budget. It’s the world’s largest provider of food to the hungry. It distributes schoolbooks and vaccines, promotes democracy and good will toward America. In ending it, Trump, ceder of the free world, passes leadership to our adversaries.

It’s what happens when a “president” who knows little and cares less, hands our government to the world’s richest man, unelected, given no powers by Congress. A man who, like Trump, loves dictators and seems to enjoy hurting the powerless.

It’s not only Musk whom Trump loosed upon us. He’s putting in charge, if Republican Senators forsake their duty, people who should never run important agencies, who’ll weaponize them for Trump, as opposed to President Biden’s non-weaponization about which Trump’s cadre of liars lied endlessly instead of legislating.

It’s not as bad as predicted, though. It’s worse. And, like the cliché about drinking from a firehose, it’s impossible to take it all in. Intentional, most likely. Having limited space, we’ll mention only a few transgressions with which we’re being hosed.

Most consequential is what’s happening at the DOJ and FBI. At Trump’s bidding, those critical law enforcement agencies are being turned into Soviet-style tools of repression; agents and prosecutors who did their Constitutional duty are being replaced with ones who won’t. They’ll destroy the lives of innocent citizens while lessening America’s ability to confront terrorism, home-grown and foreign, endangering us all. It’s rule by threat and intimidation.

When federal crimes are suspected, the FBI investigates. If suspects lie or refuse to cooperate, this may include obtaining search warrants. When evidence of crime is uncovered, the DOJ prosecutes; if they make their case, a jury of citizens, chosen by both sides, convicts. It’s how American jurisprudence, till now, has worked. For Trump’s multiple crimes, those steps were followed. People who did their sworn duty are being fired; many will be “investigated.” It’s conceivable that Trump’s minions threaten jurors, too.

If approved, his disingenuous testimony to the contrary, Kashyap Patel will recast the FBI as KGB. (Maybe not the juror thing.) Nothing coming from Republican members of The World’s Greatest Deliberative Body suggests he’ll be rejected, so thorough is their surrender of integrity and respect for the law.

As Florida’s Attorney General, Pam Bondi’s refusal to prosecute Trump’s pre-presidential crimes, after which her campaign received a generous donation from him, means it’s naive to believe she won’t do the same with the DOJ. In fact, hot off the presses, she already is.

While the FBI and DOJ focus on serving Trump’s pathologies, what will happen to their central mission of protecting America from threats within and without, and prosecuting actual criminals? From the once and former “party of law and order,” their silence is profound. But expected.

A sampling of other transgressions deserving mention, for none of which is there space to do justice:  

Like the abortive rollout of curtailing practically all government spending, which lasted about one day before Trump was made aware of the predictable consequences, his tariffs on Mexico and Canada went on hold before they happened. Trumpists, of course, assign it to Trump’s cosmic superpowers. Or was it that the markets crashed, his pals lost lots of money, and his benefactors screamed about the negative effects on their businesses? Whatever the reason, Trump’s justifications changed approximately hourly. Which is uncharacteristic of well-reasoned, purposeful plans.

No concession, the 10,000 touted troops Mexico will send to the border are fewer than it sent in previous years. For the interested, here’s an expert’s discussion of the tariffic dangers.

Trump’s heartless, fact-free accusation and purely political response to the air tragedy over D.C. has been hashed aplenty. Was it intended to forestall mention of his scrapping the Aviation Safety Committee? In any case, his lack of empathy for the victims was the opposite of presidential. But pure Trump.

Whatever one thinks of gender pronoun use, Trump’s banning them from government communications seems to violate the First Amendment. Same with LGBT-related words. As opposed to, say, Facebook banning Trump, about which Trumpists continually connipted.

If briefly and clumsily, Trump banned distribution of life-saving HIV drugs. This harbings life (or death) under RFK, Jr, who’s one step away from confirmation.

Removing security details from Milley, Bolton, and other intended targets of assassination by Iran, is just short of doing it himself. But they weren’t nice to him.

Banning public communication from the CDC will harm all Americans, even MAGAs. Same with shutting down the Consumer Financial Protection Agency. Samer with purging helpful information from other government sites.

His “turning on the water” in California accomplished only badness.

When his hotels are built in Gaza, will the Mediterranean become "The Sea of Trump"?

Though incomplete, this list makes clear: Trump’s ego and donors are top priorities. Lawfulness is at the bottom. The public weal has no ranking at all.

Bought any eggs lately?

Brick By Brick

 

             Image source: anntelnaes.com

After an exhausting week of stamping out human decency in his government, Trump spent the weekend taking the Miami golf cure. I spent it getting over not being confirmed as Secretary of Defense. I thought I had a shot; my resumé is on a par with Pete Hegseth’s, if not greater. We both served in the military in war zones, but, unlike me, he didn’t receive a Purple Heart. We both provide weekend opination via public media; and whereas mine is mine only, he shares his platform as a mere co-host. In managing huge bureaucracies, we’re identical. What put me out of the running, I think, is that I’m not a problem drinker or a sexual miscreant, both of which are touchstones in the upper echelons of today’s Republican Party.

Choosing Hegseth over me made Trump the only president who’s had two cabinet nominees requiring a Vice-Presidential tiebreak after a 50–50 vote. No other president has had even one. Which says everything about the quality of his choices. 

For those who believe Democrats’ unanimity in voting no was purely political, votes for the previous SecDef nominees, Democrats and Republicans, were as follows: Lloyd Austin, 93–2; Mark Esper 90–8; James Mattis 98–1. Ashton Carter 93–5; Leon Panetta 100–0. Robert Gates 95–2. The difference: credentials. If not all R senators are stupid enough to think Hegseth is qualified (?), only 3 had the guts to vote no, one of whose cynical hypocrisy put us where we are. It’s shameful and cowardly.

Arriving at the Pentagon, Pete went to work implementing Project Trump 2025: his first communiqué was about ending DEI, because any military member not straight, male, white, and Christian is inferior. Then, calling them “dishonorable” and “liars,” he banned trans people who, because they had the courage to be public about who they are, are braver than most; and about whom there’ve been fewer deportment issues than non-trans members. And he announced plans to interview top general officers to see which will kowtow and which won’t. Shoot protestors in the legs. 

Beyond turning the military into his domestic enforcers, Trump is eliminating people and programs that would keep him in check. He fired inspectors general of virtually all government agencies. His Department of “Justice” ousted every prosecutor who worked with Jack Smith and will subject them to “investigations,” and it just ended further pursuit of Trump’s crimes. The firing of the IGs was clearly illegal because the law requires thirty days’ notice. The message: Whatcha gonna do about it?

Same with the TikTok law passed by Congress, signed by President Biden, and approved in a rare 9–0 ruling by the Supreme Court. Trump ignored it. Likewise, his demented attempt to rewrite the Constitution by executive order. He’s convinced he’s above the law, which, thanks to congressional pusillanimity and judicial corruption, it turns out he is. Then, because they’d get in his way, he rescinded the ethics rules ordered by President Biden. 

In a silent coup, our country has been captured by a group of very wealthy men, Christian nationalists who are anything but Christian, whose aim is to remove from government all institutions that have, till now, protected us from people like them; that stand in the way of unchecked power and unregulated self-enrichment; that let people not like them retain the power of the vote. And they’ve put in place enough judges and justices to clear their path.

It’s been a concerted effort for years. In Trump, they recognized the perfect stooge, one they could convince he’s in charge because he so desperately needs to be; a frontman willing, for his needy gratification, to keep public eyes off what’s happening; to cede the agenda to Project 2025. It’s not Greenland or Panama or Canada. It’s in the backrooms of the White House, into which they’ve charmed and threatened unimaginably rich oligarchs to bankroll their efforts. Trump gives them what they want because they give him what he needs.

Trump was elected by a minority of voters, strategically convinced it was about eggs and immigrants. People who look worshipfully at his self-pity and rejoice as he strikes at the vulnerable, who will include, before long, themselves. When they realize that, it’ll be too late.

It’s hard to accept, to know whether to tune out or scream into the night. Trump has the limelight. For him, vengeance is the goal; that, and validating his neediness. He’s president of people who see the cruelty and love it. And of the string-pullers. The more distracting outrage he engenders, the more he lies and pounds his chest, the more he fools the media into focusing on the hole rather than the donut, the more easily the Project-iles can take down our democracy, all but unreported, brick by brick.

For those who still believe in democracy and kindness, it’s hard to watch and harder to know what to do.

God Help Us

 

We’ve just returned from visiting my brother and his family in NYC, which we hadn’t done for several years. Between getting up at 4:30 a.m. for both flights, long and sleepless, staying in one of the smallest hotel rooms anywhere, I’m still uncombobbled. This offering, therefore, will lack my usual cohesive brilliance.

Even if back to “normal” it’d be hard to process Trump’s inaugural speech and its sequelae. I still haven’t, dark as it was and dully delivered. Bravado and bull. Claiming a mandate where none exists, but joyously received by the select crowd.

Sidebar: why is the Vice-Presidential Oath so much longer than the Presidential? Perhaps the Founders anticipated the current short attention span and difficulty reading. But he managed to articulate the lies and contradictions. 

Trump swore that he would faithfully execute the office of president of the United States and would, to the best of his ability, preserve, protect, and defend the Constitution of the United States. It might not have been a lie. “To the best of my ability” is the escape clause. He’s made it clear he has no inclination to preserve, protect, and defend. But ability? Based on the last eight years, four in, four out, not much. So, no matter how bad, it’ll be the best he can do. Plus, he’s been granted immunity by the SCOTUS Five.

His speech was surprisingly listless, even when he described the past four years, in which a pandemic ended, employment and markets soared, businesses were created at a record pace, infrastructure finally began long overdue rebuilding, as the most bleak in all of history. And took credit for the (three) Israeli hostages being released.

As soon as circumstances were unpomped, he headed downstairs, where he unloosed a more typical tirade, the usual disproved untruths, the self-pity, the threats. It was far more nefandous and much more in character. 

Later, sitting behind the Resolute Desk, he signed out of the Paris Climate Accords, benefitting fossil fuelers and harming everyone else, especially those alive in twenty years or so. Same with abandoning the World Health Organization, saving a few nickels, potentially costing many lives. Also, making JD Vance look like an idiot for saying he wouldn’t, he pardoned or commuted all of the anti-constitutional actors of J6, including the most violent and those convicted of seditious conspiracy. There’s no clearer evidence of his disdain for the law and love of those who share that disdain in his favor. Has any Congressional R criticized the pardons? Does a bear fly in the sky? 

This is the lesson to be learned from his pardons and commutations of the J6 criminals: the rule of law no longer applies. It impedes his agenda and he has no intention of following it. Now he has 1,500 grateful foot soldiers ready to be the core he’ll call upon, to threaten lawmakers, federal and local. Scare them into falling into line. Fear worked during his two impeachments, even without an army of directed mobsters.

This time, the Proud Boys and their ilk, the “militias,” the racists and anti-Semites know they’ll not have prosecutions to worry about, whatever they do. They’ll be the core of Trump’s Gestapo, his SS, and he’ll use them to cow every Republican in office. Am I over the top? No. I got the message, is all. He made it clear: The era of Constitutional government is over. It had a good run, though. Will any of those who voted for him care? Before the election, he couldn’t have made it clearer. They saw it and voted him in. 

15,000 trans people are serving in the military, honorably. Trump has banned them. As usual, cruelty, not the best interests of anyone but himself, is the point. Same with his banning of further refugee admissions, which includes Afghan citizens and their families who aided Americans during the Afghanistan war.

Nor can I ignore the “my-chance-in-the-spotlight,” hyperbolic praise of Trump, the least religious, most un-Christian man ever to occupy the White House, by the inaugural clergy, including the Rabbi, virtually anointing him God’s avatar on Earth. To any but the most besotted, Franklin Graham’s elegiac effusiveness and prayerful praise, barely short of equating Trump with God, was borborygmic.

Next day, in his presence, a brave lady bishop preached love and charity. He’s demanding an apology. Too Christ-like, evidently. I can’t define “evil,” but I know it when I see it.

So let’s end happier: Importantly, people speculated about Melania’s hat. Some pointed to the similarity to the Pizza Hut logo; or the Hamburgler; or Spy vs Spy. Clearly, though, the purpose was to fend off any attempt by Trump to kiss her. It mostly worked. So there’s that.

Also, far as I can tell, day one has passed. Did the war in Ukraine end?

Oh, The Inhumanity

 

Upon learning of the horrific fires in Los Angeles, death, destruction and suffering by his fellow human beings, President-elect Trump wrote, “What’s happening in Southern California is an indescribable tragedy. When in office, I will continue President Biden’s skillful efforts at guiding federal resources to their aid. My government will do everything possible to succor the suffering and rebuild that great city.”

This was in a parallel universe in which Donald Trump and his political party are known for their generosity and concern for those in need, and in which Schrodinger’s cats roam free while Newton’s apples rise into trees.

In ours, as is well-known, if under-repulsed, he and his sycophantic similars chose to attack and blame Gavin Newsom, DEI, liberals, Joe Biden, and Ukraine, expressing zero sympathy, affording no comfort. It’s consistent with previously withholding aid for places where he thought people hadn’t satisfactorily kissed an anatomic ring, the location of which we care not to mention.

Across America, decent people are offering help and sympathy. Not Trump. Because it’s who he is: nasty, brutish, and short. On humanity. For which MAGA loves him all the more.

Trump’s nastiness has been accompanied by his signature disinterest in facts, and lies. Falling in line, avoiding any mention of climate change as a factor, his team piled lies upon lies. It’s worth noting how many Republicans offering effortless thoughts and prayers for LA residents and meaningless praise for the firefighters voted against a bill addressing wildfire prevention just months ago. 

Except for providing help or not, Trump’s lies are of little importance to people affected by the fires. But they reveal what’s to come for the next four years. People suffering from the true “Trump Derangement Syndrome,” MAGAs who believe that, like Jesus, he can do no wrong, will forever fail to see that, for Trump, it’s never about the people he’s sworn to serve: it’s about him, always and only. And his fragile ego, need for praise, resentment of those who fail to provide it, and his desire for vengeance against them. If his reaction to the fires hasn’t convinced his supporters, nothing will. Assuming they care.

And why is that? A tsunami of bad information and outright lies consumed online have made it impossible for reality to find a way in. Even someone with resources the rest of us don’t have has given up trying: outgoing HHS Secretary, Xavier Becerra, said, in describing the impossible task of providing accurate information and having it accepted, “I can’t go toe to toe with social media.” In addition to which, Republican leaders like Holy Mike Johnson and hole-y Ron Johnson threaten to withhold aid until California Democrats change those policies about which R Congress-dwellers, holding their Johnsons dear, continue to lie.

Social media misinformation targets voters ill-equipped to recognize lies and uninterested in dispelling them. It’s unlikely, though, that Mike and Ron and their fellow spouters are too dull to know the facts. (Hannity, Waters, Ingraham, et al., on the other hand, do seem too dumb to know, and definitely don’t care.) Which makes the battle against willfully dishonest social media and rightwing propagandists even more difficult, as they force their knowing untruths into their listeners like an un-lubed colonoscope.

And so it is that MAGAs soak up Trump’s lies ever more eagerly, even as he breaks one promise after another. He’d build an impenetrable wall and Mexico will pay for it; balance the budget; wipe out the national debt. Promises forgotten or denied. This time it was ending the war in Ukraine within 24 hours of inauguration. Now it’s “try for 100 days.” Bringing down prices will be easy and immediate, he said. Now it’s “very difficult.” "Temper your expectations," said his incoming border czar, about "mass deportation of millions." But it got him elected.

Elon Musk said trimming “at least two trillion dollars” from the annual budget would be no problem. Now, “there might be a good shot at one trillion.” He’s lying about the LA fires, too. Steve Bannon hates him and, for once, is right. Poor Elon had no idea how the federal budget works and he’s beginning to realize it. Expect he’ll find a few billion; then see how he manages to get it through Congress.

Trump, though, deserves no such deference. He never fulfilled his false promises, but, because his acolytes have no memory and will believe anything, keeps making them. Annexing Canada and Greenland is purely performative (though many MAGAs are taking it seriously), distracting from the impact of tariffs and deportations, assuming he follows through. Retaking the Panama Canal, though, is about revenge for refusing his planned hotel there, accusing him of money laundering and fraud. Business as usual, in other words.

Comments on Jack Smith’s report just released and, more importantly, the one not, wait for another time. And the hearings. The ridiculous, embarrassing hearings.

Capitulants

 

The above cartoon was created by Pulitzer Prize-winning Ann Telnaes, then spiked by Jeff Bezos' Washington Post. So she resigned. The worst is yet to come.

Last time round, Trump lost the popular vote by millions, but the antiquated Electoral College, disinformation from Russia and others, and a rightwing media conglomerate devoted to replacing truth with fiction put him in the White House. He proceeded to run up massive debt, mishandle the pandemic to the tune of hundreds of thousands of unnecessary deaths, and gift world leadership to our adversaries. Then, at the end, he lied about losing a free, fair, multiply-adjudicated election and instigated an attempt to overthrow it. The lie lives on.

This time, all memory erased, Americans gave him more votes than Vice President Kamala Harris; though, as in both prior elections, more voted against than for him. Baseless claims of receiving a “mandate” notwithstanding, it was one of the narrowest margins of victory in history. But they gave him both houses of Congress, too, Republican members of which are more MAGAfied than ever. The Supreme Court was already his. It’s a four-fecta. How quickly we forget.

Well, not forget, so much as succumb to four years of concentrated whitewashing. Because they know their agenda depends on obsequious acquiescence by Congress and voters, along with the press and social media, it’s been an all-out effort by Project Trump 2025. Who remembers Trump’s words on January 7, 2021, when he said that “the demonstrators who infiltrated the Capitol have defiled the seat of American democracy”? He doesn’t. He never meant it in the first place. Now he agrees with Rep Mike Collins (R-GA), who said this week, evidently without irony, “On this day in history in 2021, thousands of peaceful grandmothers gathered in Washington, D.C., to take a self-guided, albeit unauthorized, tour of the U.S. Capitol building.” And if he was being ironic, his colleagues and voters nevertheless buy the rewrite like Trump Bibles.

This Olympic-level gaslighting has been furthered by relentless attacks on big- and small- “ell” liberalism as hatred of America. Holy Mike Johnson, whose ear, by his own report, God has, just referred to Democrats as “the enemy.” Newly-elected MAGA Congressmen Brandon Gill of Texas and Riley Moore of West Virginia, on the occasion of their swearing-in, unlimbered themselves of their demagogic Trumpist bona-fides:

Gill: “We want to end the woke chaos that they have unleashed on this country, that boys can become girls and girls can become boys, and that boys should be in girls’ sports and boys should be in girls’ locker rooms.”

Moore: “My constituents have sent me here to this town not to work with Democrats but to destroy their agenda over the last four years that has crushed the American Dream and the American worker.”

After Vice-President Harris swore in three-time Senator Deb Fischer (R-NE), the senator’s husband shook off Harris’ proffered hand. Placing themselves on the side of the lawbreakers and against its defenders, Republican leaders have refused to install an authorized plaque in the capitol honoring the police who fought to stave off the riot. Thus is the division and hate Trump has stoked within his party and among his voters.

There are consequences to accepting this totalitarian repetition of lies and rejection of legitimate dissent. Before blowing up himself and a rented Tesla in front of Trump’s Las Vegas hotel, the deceased had written: “Try peaceful means first, but be prepared to fight to get the Dems out of the fed government and military by any means necessary. They all must go and a hard reset must occur for our country to avoid collapse.” It’s all but a direct quote from Trump at every one of his rallies.

The perpetrator of the terrorist attack in New Orleans was immediately hyped on Fox “news” and the rest of rightwing dissemblers as an illegal immigrant rather than the US-born Texan he was. The truth hasn’t stopped Trump from continuing to blame it on President Biden’s so-called “open borders.”

The political inversion of America is nearly complete: an incoming administration promises to lie to us, suppress truth, and punish those who dare tell it. While claiming to be protectors of free speech. Rather than taking a principled stand, self-serving media oligarchs are pre-capitulating, donating millions to Trump’s inauguration, which, for lack of regulation, may as well have been slipped directly into his pocket. Because they knew President Biden and Democrats weren’t a threat, those same moguls gave nothing, or next to it, to his. 

Let’s assume not all Trump voters are happy with what they’re seeing now, that they’re not as enthusiastically destructive as those legislators and people like these. But, having been willing to overlook the obvious and believe the lies, they’re complicit. If it’s not already too late, they should consider Abraham Lincoln’s 1862 message to Congress as Civil War approached: 

"The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew. We must disenthrall ourselves, and then we shall save our country."

Healers

 

To start 2025 on the right foot, and because America has rejected the left for now, I’ll begin the year with a non-political column. Also, in the waning days of a nasty, flu-like illness, I don’t have the psychic wherewithal to address the prospects of another Trump “presidency,” even as it seems to be self-destructing like a “Mission Impossible” tape, which deserves a fun-filled column. Too bad.

I will, however, mention the passing of Jimmy Carter, whose post-presidency, in terms of integrity and righteousness, compares to Trump’s as light does to darkness. No matter what one thinks of his years in the White House, few can disagree that the life President Carter lived for decades after was exemplary.

Nor, though it’s not original with me, can I resist pointing out what might be Carter’s most fitting legacy of all: after the death of a president, flags on federal buildings and locations, by tradition and executive order, fly at half-staff for thirty days. Which means that, during Trump’s inauguration, American flags we and the world will see will be in the mourning position. What could be more appropriate? Thanks for that and for so much more, Jimmy. Also, think how much better off we’d be today if Ronald Reagan hadn’t reversed all of Carter’s green energy initiatives forty-three years ago.

And now, apropos of nothing and of only particular significance, here’s something I wrote, long ago, in my “Surgeonsblog” days: 

In no way is it false modesty to say that physicians are not healers. At best, what we do is clear the way, making conditions as favorable as possible for the body to heal itself. For without the body's amazing powers of defense and repair, nothing we do -- especially we surgeons -- would be lasting at all. The most immediate and palpable evidence of this is watching what happens after an operation. If healing within the abdomen evolves in secret, the incision itself is a biology classroom available to all.

Wound healing is a complex process, and it would be folly for me to attempt explanation in detail; mainly because, so long after medical school, I've forgotten the pathways, the kinins and the prostaglandins involved, and I'm not inclined to look them up again.  Anyone who's had an operation, from minor to a big deal, has had the opportunity to witness it themselves.

Despite having explained it in advance, I’d often get calls of concern about redness of an incision. Of course, it's necessary to separate the natural from the infected (nowadays, digital photography and email can save an office visit); but all incisions get red for a small distance out from the cut. The process of bringing the building materials into the work site is a form of inflammation: capillaries dilate and proliferate, blood flow increases, making a visible Red Zone. Of millimeters, though, not twenty yards.

That, and much more, goes on under the surface as well. Attracted by "injury chemicals," various cell types arrive and unload their cargo, set up lattice work, induce structural changes. The result of this cellular influx is a gradual thickening and hardening of the area for an inch wide or more, and which carries the unofficial-official name "healing ridge." When the ridge isn't there, trouble lies ahead. In the chronically ill, in people on high-dose steroids, in the malnourished, a soft and non-pink incision is an unwelcome and unhappy harbinger.

As much as feeling the swelling and firmness of the healing ridge can alarm the unexpecting, it's a sign of health, indicating that help is on the way, that the work of healing is carrying on. I'd warn people to expect and welcome it. To hernia patients, I'd say, "In a few days it's going to feel like a sausage under there. You might think the hernia is back." Or, after removing a lump of some kind from some place, "In a couple of weeks, you'll think I didn't remove it at all."

It takes months for the ridge to disappear. While the zone of redness dims, the incision itself gets increasingly red, and doesn't simmer down for a year or more. It's a living monitor of how long healing is active. Recipients of an operation get a ridge-side seat from which to watch the body do its work.

A corollary is the tiredness that most everyone feels after surgery. There's lots of work going on, I'd tell them. While you're feeling lazy, your body is doing the equivalent of walking around all day. So, if you’re recovering from surgery, give yourself a break. Watch and feel your body do its amazing work, rising to the occasion and making us surgeons seem like the wizards we aren’t.