by Jon Sopel
Dr Jackson made clear that he had never had any doubts about the President’s cognitive abilities. ‘I didn’t think it was clinically indicated because I’ve spent almost every day in the President’s presence since January 20 – or, you know, last year, when he got into office. And I’ve seen him every day … We have conversations about many things, most don’t revolve around medical issues at all. But I’ve gotten to know him pretty well and I had absolutely no concerns about his cognitive ability or his neurological functions.’
All of which begged a very obvious question – why carry out such a test if you think there is no medical justification for it? Because, Dr Jackson explained, the President had insisted on it. Donald Trump, in a memorable series of tweets had described himself as a ‘very stable genius’. In fact, these tweets are too good not to quote in full.
‘… Actually, throughout my life, my two greatest assets have been mental stability and being, like, really smart. Crooked Hillary Clinton also played these cards very hard and, as everyone knows, went down in flames. I went from VERY successful businessman, to top T.V. Star … to President of the United States (on my first try). I think that would qualify as not smart, but genius … and a very stable genius at that!’
But with his mental faculties being called into question the President recognised this was an issue that needed dealing with. And while Dr Jackson neither called the President a genius, nor stable – he managed effectively to put the whole issue of whether the 45th president was mentally impaired, unable to carry out the functions of his office properly, to bed. Among the Trump haters you could almost sense the sadness and disappointment – the air had been let out of their most promising balloon. You could perhaps question Harold Bornstein, but Rear-Admiral Ronny Jackson – the man who had treated George W. Bush and Barack Obama before with distinction? The trauma specialist who had served his nation, seeing service on the front line in Iraq with the marines? Not a chance.
The news headlines that evening online and on TV and radio, and in the newspapers the next morning, were as good as the President could have hoped for. ‘White House doctor: Trump “has absolutely no cognitive or mental issues”,’ said Vox. The CNN headline was ‘Dr Jackson’s glowing bill of health for Trump’. NBC had ‘White House doctor declares Trump mentally “very sharp” and in “excellent health”’. For Time magazine it was ‘The White House Doctor Called President Trump’s Health “Excellent”’.
It was mission accomplished, job done. And shares in Dr Jackson were soaring through the White House roof. The President as part of his daily briefing has the headlines cut out of newspapers and presented to him in a folder. It was hard not to picture him purring with rare delight at the newspaper coverage he was receiving, like a proud actor reading his reviews after the press night, where the critics declare him the next Olivier.
However, the sugar rush brought about by good headlines doesn’t last long in the White House. The next battle, the next media onslaught, the next presidential counter-attack is never far away. The Jackson cameo in the story of this presidency was soon starting to fade.
But then came a tweet from the President a couple of months later that would cause a serious outbreak of acute jaw drop syndrome among the Washington political class and journalists alike, which Dr Jackson really should have spent more time finding a treatment for. There had been a lot of it about. Donald Trump’s tweet was brief and to the point: ‘I am pleased to announce that I intend to nominate highly respected Admiral Ronny L. Jackson, MD, as the new Secretary of Veterans Affairs …’
Woah. Back up. The VA? Are you kidding? To call this a bit of a step up in the managerial and political experience of this physician would be to put it at its very mildest. In the White House he managed a team of around 30 doctors and nurses, tops. The Veterans Affairs department employs, well roughly 12,000 times that number. The VA has 370,000 staff and has an annual budget of $180 billion. It is a sprawling behemoth, with the second biggest federal budget – only the Department of Defense receives more taxpayer dollars.
The VA’s motto is ‘To care for him who shall have borne the battle and for his widow and his orphan.’ In a country with no national health service, this is the nearest thing to it. There are VA hospitals and health centres across the country whose mission is to provide healthcare for servicemen and women, military veterans and their families. It covers millions of people, has a noble ambition but has been badly managed for years, is racked by scandal – and is one of the hottest of hot potatoes in Washington.
Donald Trump had homed in on the subject with laser-like precision during the election campaign. ‘We will take care of our great veterans like they have never been taken care of before,’ he told the Republican National Convention, in 2016. Once in the White House he claimed that his administration was following through on that promise. David Shulkin – whose firing from the VA I wrote about earlier – was ostensibly forced out after an official investigation found that he had not declared corporate gifts, and taking his wife with him on a taxpayer funded trip to Europe. There was, though, another more compelling theory about what really lay behind his dismissal.
Shulkin knew his subject, having been the number two in the VA during the final years of the Obama administration. And before that he had become a seasoned and respected hospital administrator, having run New York’s Mount Sinai Beth Israel Medical Centre. But the ideological hawks around Donald Trump – and in particular, a couple of wealthy right-wing conservatives – had been making disobliging noises in the President’s ear. They were annoyed at Shulkin’s resistance to the privatisation agenda that free-market think tanks and Republican donors (with interests in providing healthcare themselves) had been pushing for years.
Maybe Donald Trump had calculated that by appointing Jackson he would have a more malleable and accommodating VA Secretary. Maybe he genuinely thought it was a small step from running a team of 30 to a team of 370,000. Maybe not that much thought was given to it, except for the fact that the President wanted to reward a man who had done him a massive favour with the briefing he gave the press.
An important thing to understand is that there could be precious little interaction between the political staff at the White House and those who are part of the military command structure, such as Jackson. As a physician he did not report to the President’s chief of staff, nor was he answerable to the White House lawyer; he reported to his military superiors at the little-known White House Military Office – and although the two different teams saw each other daily, would eat lunch in the same canteen and travelled the world together when the President was on the move, they didn’t really interact much. That is why it was such a leap for Jackson to transfer into such a politically exposed position, having only ever known the armed forces chain of command. And building a set of relationships in the political domain, it was recognised, would be important, crucial even to navigating a path to his nomination.
Standard operating procedure when you are seeking to make an appointment like this is that you do full and thorough background checks on the candidate. The only cabinet level job that doesn’t require a congressional confirmation hearing is the Chief of Staff. Anyone else has to go through the rigours of detailed questioning before committees, and the de rigueur solicitous schmoozing of the senators and House of Representatives members who will decide the nominee’s fate. So, the White House – typically – wants to know what skeletons there may be in closets. Has the nominee ever employed an illegal immigrant as a maid or gardener? Have they ever had any disciplinary run-ins at work? Are there people out there who have scores to settle? In other words, is there anything that might derail the process?
In fairness, the White House might have thought such investigation superfluous. Jackson already enjoyed the highest security clearance as the personal physician to the President. And who else in the White House, apart from the First Lady, is going to have such an intimate and personal relationship with him? He is one of the few pe
ople entitled to go from his surgery in the East Wing up the staircase that leads to the President’s private quarters, without being escorted by a secret service agent.
Not much was done. After the tweet announcing that Dr Jackson would be the nominee, the bureaucracy kicked in – a timetable for hearings; meetings scheduled with key stakeholders; appointments for the doctor to widen his political network.
But then things started to go awry. A few barely perceptible murmurs at first, that got louder and would eventually become a deafening clamour. If the White House wasn’t going to do background checks on their candidate, then the Senate and House committees would.
All the people who worked for the Rear-Admiral were also drawn from the US military, so if they had concerns they had – until the moment of his nomination – either to keep their counsel, or watch as their complaints were swept under the carpet. But a little-known Democratic Party senator on the Veterans Affairs committee, Jon Tester, was contacted by a number of either current or former staff who had served under Jackson.
Senator Tester painted a devastating picture: it seems he was known as the ‘Candy Man’. ‘On overseas trips, the admiral would go down the aisleway of the airplane and say, “All right, who wants to go to sleep?” And hand out the prescription drugs like they were candy and put them to sleep, and then give them the drugs to wake them back up again,’ he said, claiming this was the evidence from 20 or more people who had contacted him. ‘This doctor has a problem because he hands out prescriptions like candy. In fact, in the White House they call him the Candy Man.’ The drugs he was talking about were Ambien, a popular sleeping pill; and the ‘uppers’ were Provigil, a drug to increase wakefulness. Staff members on presidential trips would be given these in plastic bags when they boarded Air Force One. The picture conveyed was that this was as routine and unremarkable as the hot face towel and the printed menu being handed out by the cabin crew with whatever was for dinner on the flight.
It was alleged that Dr Jackson didn’t keep proper records of what drugs had been handed out and to whom. And in some cases, it wasn’t just sleeping tablets that were dished out, but highly addictive and powerful opioids, such as Percocet. Co-workers would allege that he privately kept large quantities of these controlled substances in his office.
Senator Tester also cited allegations that Jackson was drunk on duty during his time working for the administration of the former president, Barack Obama. A summary report handed out by Democrats on the committee claimed that on a number of occasions according to co-workers Jackson was drunk while on call – at times when he was expected to be able to report to duty at a moment’s notice in case the President had a health issue. At least once, Jackson couldn’t be reached, the senators reported, because he was ‘passed out drunk in his hotel room’. These co-workers told senators that Jackson got drunk at a Secret Service going-away party and wrecked a government vehicle. Although those claims have now been thrown into doubt, with both the White House and the Secret Service denying them.
The clean-cut, impeccably turned-out, charming Doctor Jackson was picking up a number of ugly scuff marks, as he found himself in a spotlight he could never have imagined, or planned for. Then came the bullying claims. He used his senior officer rank to push around those beneath him. They also portrayed Jackson as power-hungry. In the summary, co-workers are quoted as saying that he was ‘abusive’, ‘explosive’, ‘dishonest’ and ‘vindictive’. He allegedly had ‘screaming fits’ or ‘tantrums’ and was ‘intolerable’ as he gained power in the White House Medical Unit. On overseas trips staff were ordered to leave a bottle of rum and a bottle of Diet Coke in his room, it was claimed.
But even the most cursory enquiries by the political side of the White House would have revealed that the nomination of Dr Jackson was going to hit the buffers. The White House Medical Unit had been investigated before. Years before Donald Trump became president, the working atmosphere had become so contentious within the unit that the Navy’s inspector general stepped in. His judgement in 2012 was that the environment was ‘toxic’ and that one or both of the top two doctors, including Dr Jackson, should go. But no action was taken.
In light of all these disclosures, the Senate committee deferred the hearing to look at Dr Jackson’s nomination for the Veterans Affairs Department, and the White House went into damage limitation mode, trying to shore up the President’s ill-advised nomination.
But then the inevitable happened. I was in the East Room of the White House for the news conference to mark the state visit of Emmanuel Macron. Ronny Jackson was still the plat du jour for the journalists attending. President Trump had two messages about him. One was that Jackson was a top guy, fantastic doctor, man of unimpeachable integrity, how unfair it was that his family was being put through this, and he backed him totally to become VA Secretary. The other was – the game’s up. Move out of the way. You are roadkill. Yes, I hear you say, aren’t those contradictory messages? Well, indeed they are, but that is broadly what the President had to say.
‘He’s an admiral, he’s a great leader, and they question him for every little thing,’ said Trump, suggesting that what these Democratic senators on Capitol Hill were doing was nothing more than muck-raking. But then he carried on at this packed news conference: ‘I told Admiral Jackson just a little while ago, what do you need this for?’ recounting his conversation with the White House physician. ‘This is a vicious group of people, they malign … what do you need it for?’ And just in case Dr Jackson hadn’t got the message loud and clear, the President went on: ‘I don’t want to put a man through a process like this. It’s too ugly and too disgusting … If I were him, I wouldn’t do it.’
His nomination was now on life-support. Shares in Ronny Jackson were diving just as fast as they had risen. And though this was never publicly admitted, there were other anxieties about the VA nominee. There had been concern among some White House staff about Jackson having to give evidence before a Senate committee. Specifically, would the evidence he had given to the press on the state of the President’s health withstand proper scrutiny? In particular, the worry that Dr Jackson had borrowed too heavily from another doctor, Candide’s Dr Pangloss – with his ever optimistic and rosy-eyed view of the world. When Jackson reported that Trump was six feet three inches tall and weighed 239 pounds, that is – miraculously – one pound under the weight where you would be declared obese. And six foot three? He’s tall, but the president is not six three; nowhere near. As one commentator noted, if you are a super-fit and toned quarter-back for a pro NFL team you might have that height and weight – but this is a 71-year-old man who lives on Big Macs, fries and pizzas – and takes no exercise.
After the Trump/Macron news conference, word went out that Jackson wanted to soldier on. He was not giving up. For a couple of days, the White House tried to circle the wagons and protect their man. But as anyone with any political nous knew, this was a forlorn operation. This nomination was clinically dead. It was time to pull the plug, as Jackson himself eventually recognised.
He issued a furious statement, denouncing the allegations of improper behaviour that had been levelled against him. They were ‘completely false and fabricated’, he declared. ‘If they had any merit, I would not have been selected, promoted and entrusted to serve in such a sensitive and important role as physician to three presidents over the past 12 years,’ Jackson said. ‘Going into this process, I expected tough questions about how to best care for our veterans, but I did not expect to have to dignify baseless and anonymous attacks on my character and integrity.’ Jackson explained that he had decided to withdraw because the allegations against him had ‘become a distraction’ for Trump and his agenda.
The allegations were never proved and never tested. That said, an awful lot of people who had worked with him contacted the Senate committee to raise their concerns. And maybe one looks at this whole episode and thinks this is the congressional confirmation process working in exactly the way that it should.
A man against whom question marks had been raised is not confirmed to a job.
But Ronny Jackson – surely – should have never ever been considered for the post. He had zero qualifications for it. Yet, off the back of one televised news conference where he flattered the President, Donald Trump wanted to reward his new flavour of the month with a job that was way beyond his skill set. His name was thrown out into the public domain without even the most cursory of enquiries about his suitability by the White House, or about his background. In a private organisation this would be seen as a failure of duty of care towards an employee. There had been warning signs aplenty which had been carelessly ignored.
And so it came to pass that a man who had been a physician to three presidents, had served his country – and survived – in the toughest of war zones, was now torn to shreds under the unsparing and withering fire from senators and the media. And when the going got tough, the White House did what it deemed it had to do, politically – it cut the naval officer adrift.
Dr Robert G. Darling, a former White House physician to President Bill Clinton and a retired emergency medicine doctor in the navy, said, ‘This is a guy who served this country, who is in this job pretty reluctantly, and now he’s getting hung out to dry.’
The one thing you didn’t get is a mea culpa from Donald Trump. There was no misjudgement on his part. It was the media who were to blame, egged on by irresponsible Democratic senators who wanted to score political points. They were the ones who had hurt Dr Jackson.
