He Just Doesn't Care

From the beginning of this blog, I have written specifically about the impact of the Trump presidency upon our democracy, not about him personally or his underlying emotional reality.  This has become increasingly problematic for me, however, in the face of the President’s increasingly explicit racism, misogyny, dishonesty, ignorance, and so on.  I have been struggling with how best to understand President Trump’s motivations and internal dialog.

Greg Sargent’s recent opinion column in The Washington Post has finally convinced me that I need to write more specifically about the President’s motivations and inner emotional reality as best I can understand them.  Sargent suggests that Trump’s speech and behavior represent more than just ignorance, denial, inability to learn, lack of information, mistrust of experts, antagonism toward science, self-deception and other more benign explanations commentators have proposed.  Sargent writes that it’s rather a much darker “malevolence” that best explains his behavior.

While I appreciate Sargent’s directness and willingness to explore Trump’s cruelty, I don’t think “malevolence” is quite the right term, for it implies a generalized desire to hurt people. Trump, however, seems content to hurt only those who cross him (eg former aides) or those he can exploit for political reasons (eg immigrants).  Trump’s destroys other people not so much from malevolence but from something worse: He simply doesn’t care about what happens to others except as it negatively impacts him.  He isn’t intentionally out to hurt people with his refusals to respond adequately to Covid-19, for instance.  Rather, he doesn’t care about the well-being of others when such concern might get in the way of his own personal objectives; he appears to feel no guilt or remorse for the impacts of his action.  He is what we might commonly call a psychopath.**

His consistently destructive responses to the Covid-19 pandemic are powerful examples.  As the pandemic began in January and February, he rebuffed the advice of the intelligence community, fearful that even acknowledging the potential for serious results from Covid-19 would hurt the economy and thus damage his chances for reelection.  The problem was not his ignorance, for even when the intelligence predictions began materializing, he downplayed the data, repeatedly reassuring the nation that the virus would “simply disappear.”  One might call this “ignorance” or “mistrust of expertise,” but once he had seen the disease and death resulting from his (in)action, those more benign explanations can’t hold.  He just didn’t care.

Although he appointed Vice-President Mike Pence to chair a coronavirus task force, he continued to predict that the coronavirus would disappear “like a miracle.”  Toward the beginning of March, he seemed to take the pandemic more seriously for a while, declaring a National Emergency and invoking the Defense Production Act (to mandate private manufacturers help in producing supplies).  At the same time, however, he downplayed the seriousness of the virus by, for instance, comparing it to the common flu.

By April the President was encouraging sometimes-armed protestors to “LIBERATE MICHGAN” from state-ordered shelter-in-place orders.  In May and June he began to encourage states to re-open, despite increasing rates of new infections and the advice of his own medical experts.  He brought a large political rally to Tulsa despite conditions conducive to spreading the infection, which did indeed spike several weeks later.

Until a July 11 visit to Walter Reed National Military Medical Center, the President had famously never appeared in public wearing a mask.  Sarcastically, he has even criticized states that required masks.  “You have a governor in Maine that won’t let people even look at each other,” he said, adding, in a partisan aside, “I’ve never seen anything like what’s going on with these — it’s really the blue governors, and they haven’t done very well.”

At the beginning of the epidemic, Dr Anthony Fauci, the National Institutes of Health infectious disease expert, appeared almost daily with President Trump.  Beginning in mid-May, however, Fauci almost disappeared.  This has apparently been in response to a May 4 interview in which he said, “I feel I have a moral obligation to give the kind of information that I am giving.”

The President has also demoted the Centers for Disease Control (CDC) — once the world’s premier government health agency.  During previous infectious outbreaks, the CDC had issued almost daily reports.  From April through June in this pandemic, however, it did not issue a single report.  (During other serious outbreaks, the agency issued reports daily.)  Administration officials have criticized the CDC for “undermining” the President.

Up until very recently, only the director of the CDC has been a political appointee.  Four more political appointees have recently been added.

President Trump recently revealed the full extent of his complacency toward American death from the virus.  Against the advice of almost all American medical experts, the President has begun to put enormous pressure on states to completely reopen their schools in the fall, even threatening to withhold funding from schools that do not comply, although, since schools are funded locally, a president has limited power to stop school funding.

It must be said that school openings in Europe have indicated that, especially below the sixth grade, school openings — even without masks or social distancing — have not precipitated` Covid-19 spread.  In Europe, however, the infection rate is not out of control as it is currently in the United States. Even in Europe, upper-level schools are still acting carefully.

The pandemic is reaching unprecedented heights in the United States.  Records for number of new cases are being set every day, which have clearly been driven by the re-opening of many states in response to Trump’s goading.  Compared with all other democracies, most of which have followed appropriate health guidelines, returned to minimal level of disease and now reopened, the US pandemic is still out of control.  It is not clear that Americans will be willing to shut down again even with explicit government regulations.

It should be clear that the only reason the President is ignoring his medical advisors and pushing for the complete re-opening of the schools is to project the appearance of a return to normal to benefit the economy before the November presidential election.  To be sure, as I have written before, there are difficult trade-offs between the strictly medical response to the pandemic and the exigencies of the economy.  These trade-offs, however, are only in the short-term.

While pandemics certainly suppress the economy, treatment protocols that may delay economic opening, surprisingly, do not.

In other words it is not the long-term health of the economy about which Trump is concerned, but the health of the economy before the presidential election.

It is hard to overestimate the practical results of the Trump’s callousness.  Quite literally, thousands of American deaths need to be laid at his feet.  Both his inaction early on and now his current reckless recommendations cannot be understood except as callous disregard for the life of these thousands.

The impact upon the democracy is also critical.  The right-wing media who urge the President on and the members of Congress terrified of Trump’s ire reveal the ugly underbelly of a democracy that has degenerated to the point where the constitutional fail-safes are no longer strong enough.  The opinion attributed (incorrectly) to Winston Churchill — that democracy is the worst form of government, except for all the others — is no longer shared by one-third to one-half (depending on the study) of Americans who would prefer some form of more authoritarian government.

The pandemic threatens more than the lives of millions around the world.  In Trump’s callous hands, it is also threatening our democratic freedoms.

** As a physician, I realize that one cannot make a psychiatric diagnosis without a personal interview and examination.  Nevertheless, the President’s behavior does seem meet the qualifying criteria to fit the psychopath.  In her new book, Trump's psychologist niece calls him a narcissist.  I won’t argue, but the differences are slight.