Something has provoked me to write this essay several times
since I left Congress. In this instance,
it was the response of medical experts on the Task Force on COVID19 to the
president’s “musing” that the internal use of disinfectants might be helpful to
those who had or were fearful of having COVID19. That comes on the heels of the
”game-changer,” Hydro chloroquine.
Professionals who serve in government are perpetually faced
with choices between what their profession has taught them and what is
politically expedient. No one in government is exempt from these painful
choices. My own experience came to this
choice point in 1968. Should I enter the
US Navy as a psychiatrist during the War in Vietnam? I struggled with this Question and decide to
explore other routes to fulfill my obligation to my country. I tried to
transfer to the Peace Corps, but I was refused that route.
I wrote to the Norwegian government about the possibility to
go to Norway and work in a Mental Hospital. They told me of the possibility in
Tromso which is above the Arctic circle. There was a regional hospital opening there.
I wrestled with the idea for a long time and decided to go
into the Navy with my passport in my pocket, hoping to serve my time and come
out to work to change my country. That was always the underlying force in my service
in government. That is all history now. I tell this to say that I have a deep
feeling about the internal struggle any doctor feels about his decisions. With each patient I saw I had 3 options: !.
fit for duty, 2. To the Naval Hospital for treatment or 3. Recommend an
Administrative discharge due to unfitness for service. I saw 8-10 patients per
day for two years.
On some occasions I was so upset by what I saw that I wrote
the Chief of Naval operations or the Medical Chief of operations. I irritated
my superiors at the Naval Station so much that I was put on the list to go to
Vietnam despite having one child and a second on the way. I was saved from that
fate by my local Medical commander who wanted me to run his alcoholic Rehab
clinic. The other day I felt like I was standing next to Captain Crosier on the
deck of the Teddy Roosevelt when he was cashiered off his ship because dared to contact people outside the chain of command.
I was enraged by mental health professionals who enabled Vice
President Cheney to torture Iraqis with a patina of humanity in the process. The
step to Dr. Mengele is too close and I felt they should resign from the CIA. I tried
to enact President Obama’s Executive Order into law, but I failed.
President Trump presents a whole set of problems. First and
foremost is whether he is fit to be president.
The American Psychiatric Association has an ethics rule that prohibits
members from diagnosing a person whom the professional has not seen
personally. It is a good rule, but times
have changed since that rule was written in the 1960’s. Today telemedicine makes it possible for
professionals, including mental health professionals, to work with patients at
a remote site. Drugs are prescribed and
treatments are recommended based on television observation.
Over the last 3 ½ years we have had adequate opportunity to
observe the president’s state of mind. Paranoia, narcissism, obsessive lying and
disregard of establish health precautions are in evidence on a daily
basis.
The refusal of the US Senate to impeach him was evidence that
the political process has failed to hold him to the Constitutional Standards. So
he now feels vindicated and free to do anything.
This puts medical professionals in the position of being the
last protectors of the people from his irrational behavior. All that matters to him is his TV ratings and
reelection.
Those who stay with him are simply caught in the vice
between doing what they know is right and trying not to offend a vindictive
tyrant so that they can influence him in his decision-making process. The flaw
here is that he has no decision-making process.
His decisions are coming from a childish and immature intuition. He
really consults no one except the approval polls.
Elliot Richardson and Bill Ruckelshaus stood up to Nixon in October
1973. Robert Bork caved to the president
and fired Archibald Cox and 10 days later the Impeachment of Nixon began.
There are several Medical professionals who are enabling the
president to spread dangerous and potentially lethal medical misinformation. They all need to stand up with the
Hippocratic oath in hand and resign.
Some say let’s wait and get him in the election in 190
days. Consider for a second, all the
damage, delay, obstruction and chaos he can create in 6 months and 10 days. Is
a foolish attack on Iran or a confrontation with China in our best interest? His warped sense of intuition may make those
seem like good political moves to help his reelection. You don’t have to work your imagination too
hard to see the damage he can do.
None of those professionals will have any impact. But their
public stand will show the American public what they can expect from this
rudderless leader. Trump is talking about a housecleaning at HHS and replacing
Secretary Azar with one of the medical professionals. He will have co-opted all
their professional integrity by one move.
A Faustian bargain has never worked and never will.
A Faustian bargain has never worked and never will.
