Donald Trump has many regrettable qualities, but seldom do they come together in such perfect concert as in his nomination of Dr. Ronny Jackson for secretary of the Department of Veterans Affairs.
If you work for Trump, you have a choice: You can be a shameless toady, or you can try not to let the door hit you on your way out. Jackson, the White House physician, chose the former, and he not only got to keep his job; he got a promotion.
Jackson came to national attention in January, when he appeared in the White House press room to give a report on the president's physical exam. The briefing quickly turned into a festival of idolatry. Trump's health is "excellent," Jackson declared over and over, attesting that the president has "incredible cardiac fitness" and "incredible genes."
Had he eaten "a healthier diet over the last 20 years, he might live to be 200 years old," Jackson gushed. "It's just the way God made him." Michelangelo's David can only gaze with envy on Trump's physical perfection.
The doctor's performance was reminiscent of one time when Soviet dictator Josef Stalin gave a speech. When he finished, applause erupted—and went on and on because everyone was afraid to stop clapping. Jackson had the haunted look and nervous manner of someone standing on a trapdoor above a pit of crocodiles. He was not about to risk the wrath of his boss.
Plenty of physicians took issue with his evaluation of Trump. CNN's Sanjay Gupta, a neurosurgeon, said to Jackson: "He is taking a cholesterol-lowering medication. He has evidence of heart disease. And he's borderline obese. Can you characterize that as excellent health?"
Dr. David Maron, director of preventive cardiology at the Stanford University School of Medicine, said he would "definitely" worry about a patient with Trump's LDL cholesterol reading. Asked by The New York Times whether the president is in perfect health, Maron replied, "God, no."
Jackson thus passed the first test for serving Trump—unabashed servility. He also checks other boxes on the president's list of ridiculous qualifications for vital posts.
Trump loves people with a certain look, and the square-jawed Texan has it. "He's like central casting—like a Hollywood star," he marveled. Trump chose Mike Pence as his running mate partly because "he looks very good." But if appearance were a reliable guide to performance, Warren Harding would have been a great president, and Abraham Lincoln would be forgotten.
Infatuation with the military also figures into Trump's choices, and Jackson is a Navy admiral. Trump has given a number of key jobs to generals—Michael Flynn, James Mattis, H.R. McMaster, and John Kelly. The only thing better than a White House physician who praises him to the heavens is one also bedecked in medals.
Trump has the attention span of a squirrel. It's entirely possible that he got rid of Secretary David Shulkin because he got bored seeing him in the same job for so long. Shaking up personnel and their assignments is something this president needs to hold his interest.
Shulkin reportedly ran afoul of people in the administration who favor privatization of VA medical care. But it's hard to imagine that Trump was motivated by deep convictions on such a dry topic.
Jackson is short on qualifications for running an agency that employs 360,000 people and operates 170 medical centers. The department has long been plagued by scandals and sloppy administration. It needs far greater management skills than Jackson would bring.
But Trump has no appetite for expertise. His Housing and Urban Development secretary, Ben Carson, is a complete novice in the field. The top White House adviser on science has a degree in…political science.
Underlying all these considerations is the president's inability to grasp that his decisions have tangible consequences for actual human beings. He can't focus on the pressing needs of men and women whose military service brought them serious health problems that will require lifelong care.
Jackson is an able physician with a stellar record of service to his country. But his nomination to this office makes him look terribly inadequate, the hapless underling of an incompetent leader.
Serving this president means enabling his reckless conduct and sacrificing one's reputation. Jackson will find what so many others have learned: To be touched by Trump is to be stained forever.