OCTOBER 5, 2020
Kuttner on TAP
Thoughts and Prayers
I share Joe Bidens wish for Donald Trumps survival and recovery. He is worth a lot more to this Republic alive than dead.

Trump is now the palpable evidence of his own recklessness. The post-diagnosis polls suggest a Biden landslide to the point where trying to steal the election will be futile.

Despite brave talk, Trump is likely to be sick for a while. COVID often seems to recede only to worsen, especially with symptoms as serious as Trumps. With four weeks to go until Election Day, we should wish him a slow, gentle convalescence.

The alternatives are worse. Should Trump go on a ventilator, his Cabinet would invoke the 25th Amendment, certify that the president is incapacitated, and name Pence acting president—or even president.

We can be sure that Attorney General Bill Barr, the Iago of this drama, has already been on the phone, trying out scenarios. His opportunism knows no bounds.

Barrs loyalty is to the Trumpian project of destroying democracy, not to Trump personally. He would jump to Pence in an oxygen-deprived heartbeat.

Even so, if Trump should expire or be cynically displaced while in a coma, Pence would be eminently beatable. Trump has a feral charisma. Pence is an ordinary hack politician. He took the VP nomination only because he was on the verge of being dumped as governor of Indiana—quite a feat for a Republican.

Should we perhaps worry about the Ghost of Christmas Past scenario, where Trump emerges from his near-death experience a changed man, contrite and compassionate? Not bloody likely. Trumps narcissism is deep in his reptilian brain. Next to Trump, Scrooge is Mother Teresa.

Meanwhile, back at Walter Reed, Sean Conley has served Trump mainly as a spin doctor, not a medical one, even less a specialist in viral diseases or pulmonology. He even spelled one of Trumps drugs wrong and misstated its clinical category.

The doctors have thrown everything at his case, Clorox excepted, in a manner that seems to defy best practice. This is known as the VIP syndrome.

With COVID, the immune system sometimes goes into overdrive and attacks the rest of the body. One drug Trump is getting, remdesivir, boosts the immune system. But he is also receiving a steroid to depress any excess immune response.

The steroid Trump is taking, dexamethasone, sometimes causes psychotic behavior (emulating and exaggerating Trumps normal condition).

This is a drug combination usually reserved for the most severe cases. The sequencing has to be done with great care, requiring inpatient monitoring throughout and beyond the course of treatment.

Trump will be out of action for weeks. Our thoughts and prayers should also be with Trumps doctors.

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