What Elvis, Michael Jackson and Trump have in common

WELL, well.US President Donald Trump says he has spent the last week and a half enjoying his hydroxychloroquine, presumably neat. It is impossible to say whether it is true; as doctors on Twitter were quick to note, Sean Conley, the White House physician, said in a memo that he had discussed the drug with Mr Trump, not prescribed it - although together he and the president concluded it was worth the risk.

But if you take the president at his word - something I admittedly almost never do, but let us just say - it does make perfect sense. In Donald Trump, you have the patient perfect storm: a science denier, a devotee of medical quackery, and - above all else, I cannot emphasise this part enough - a powerful and narcissistic celebrity. This is what happens when your rich and famous VIP client (think Michael Jackson, but with nuclear codes) also has a nutty perspective on medicine and an even nuttier one on facts. You get a statin-taking, extravagantly overweight man demanding a drug that increases the risk of cardiac arrest.

We already know a great deal about Mr Trump's science-denialism and fondness for snake oil. So I would like to focus mainly on the most under-discussed variable in this equation: the fact that the president is rich and powerful and very famous. People like him often seek out doctors who will follow their patients' egos, not science and data.

We saw this quite clearly during the presidential election, when Mr Trump's personal physician, Harold Bornstein, wrote a letter saying Mr Trump's lab work was "astonishingly excellent"; that his "physical strength and stamina are extraordinary"; and that, if voters chose him, he would be "the healthiest individual ever elected to the presidency".

It then turned out Dr Bornstein did not write it. "He dictated that whole letter," the doctor told CNN. "I just made it up as I went along."

Time and time again, we have seen it: celebrities nagging their physicians to administer questionable and risky therapies, sometimes with tragic consequences. (Elvis Presley being the most obvious example, but also, yes, Michael Jackson). In 1964, a Maryland psychiatrist named Walter Weintraub even coined a term for this problem: VIP Syndrome.

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"I often say that celebrities get the worst treatment," Richard Friedman, a psychiatrist at Weill Cornell Medical College, told me. "One, they often are not properly diagnosed, because doctors don't want to ask embarrassing questions - about substance abuse and sexual histories, for instance. And two, celebrities are often driven by fads, not data, and while doctors want to do what's right, they also know that celebrities have the power to make their lives very difficult."

I had my reasons for phoning Dr Friedman. He treated Philip Roth - a fact I never learned from Dr Friedman, obviously, but came out after the author died, in a memoir by a friend. It led me to conclude that Dr Friedman has probably cared for his share of famous patients. He demurred when I asked, but told me his own solution, when his patients are being unreasonable, is to say yes, they are extraordinary, but that they are not immune to the laws of physics. "And I tell my residents: 'You are not a 7-Eleven'," he added.

So now, consider the case of Donald Trump. He is already a germaphobe. He has no grasp of science, singing the praises of bleach elixirs for Covid-19. He rejects or cherry-picks his facts, at best viewing them through a political prism: He said the data showing the hazards of hydroxychloroquine came from his detractors - "it was a Trump enemy statement" - when in fact they came from his own Food and Drug Administration.

To bolster his case, his campaign manager, Brad Parscale, tweeted an endorsement of the drug by the Association of American Physicians and Surgeons. It sounds like an unbiased professional organisation. The name is deceptive. It is decidedly partisan. It opposes abortion. It opposes Obamacare. It opposes, of all things, mandatory vaccines.

Until 2019, Mr Trump himself recycled the dangerous canard that vaccines were linked to autism, only recanting his views after a measles outbreak.

He is now in charge of a country in a quest for a vaccine during a pandemic. One shudders to think of it.

This happens against a larger backdrop still, in which radical individualism has been extended to our health, with Americans often deciding they know better than doctors what is best for them. Our trust in mainstream medicine has eroded right along with our trust in the media, government, and our fellow countrymen. You see it with alternative medicine on the left (Gwyneth Paltrow, sigh). You see it with the hawking of nutritional supplements by Alex Jones and Mike Cernovich on the right. You see it in the Oval Office.

You must pity the doctors who try to care for our president. They have the world's most powerful patient on their hands, and very likely its most impossible. He is not powerful enough to destroy facts. But he is more than influential and narcissistic enough to make sure they never get in the way. NYTIMES