“The Sad Case of Dr. Deborah Birx” – and how it endangers us.

Much has been written about President Trump’s fragile ego in the context of his malignant narcissism; in fact, I have expressed my opinion that the extent of his psychopathology is a topic that the mainstream media is deliberately and inexcusably avoiding. I believe that a word now is in order about the ego of Dr. Deborah Birx, the coordinator and now de facto chief scientific spokesperson for Trump’s pandemic task force.

Pundits have conjectured that Dr. Birx’s awkward excuses for and obsequiousness toward Trump are tactical in nature, that she is heroically sacrificing our own reputation to preserve a relationship to Trump so that she can steer him away from his most destructive impulses. Maybe in part, and maybe it started that way, but she has gone way too far and is now one of Trump’s enablers.

Somewhere inside she must realize that she is now doing more harm than good. There is more to her relationship with Trump than just tactics.

I believe that Dr. Birx’s own ego may not be strong enough to withstand the thought of being summarily dismissed by Trump. There is nothing obvious in her life that would prepare her for that kind of rejection and disapproval; in fact, the contrary is true. Dr. Birx’s life story has been one success after the next, following a steady uphill course.

She carries herself with dignity and pride, clearly conscious of the image that she presents to the public, down to the fashionable scarves. I emphasize that I am not saying that there is anything wrong with that; far be it from me to take issue with someone as genuinely accomplished as Dr. Birx. I am saying, however, that she may be vulnerable to being exploited by a powerful and malignant narcissist like Trump.

Dr. Birx’s military background conditions her to a certain deference to authority. That deference simply makes it more difficult to contemplate being punished unfairly by someone in authority, especially by being publicly kicked to the curb and humiliated.

I want to also stress that this discussion is appropriate only for one, important reason: Dr. Birx is allowing herself to be used by Trump and in my opinion, despite what she may believe, she is helping to endanger lives. She is lending credibility to Trump’s leadership of the pandemic response, and that troubles me for a particular reason right now: Her tacit support of Trump’s self-serving refusal to embrace the idea that an expanded regime of testing must be implemented before society can safely be reopened.

My training and experience as a psychiatric social worker are helpful in understanding human behavior. On the other hand, I have applied my lawyerly training to evaluating expert opinions on the need for a much more expansive program of testing for COVID-19, including testing of potential symptomatic carriers, as a precondition for restarting the economy. What the research reveals is that, although opinions vary as to the scope, all credible experts believe that a comprehensive regime of testing and contact tracing is necessary to identify and isolate carriers, and to protect vulnerable places like hospitals and nursing homes.

Trump repeatedly has pushed back on this idea, for the obvious reasons described in another post. Dr. Birx has been non-committal about such testing, refusing against all prudence to be more specific – or to tell us if or when the CDC will be issuing its own guidance on a testing program, which the CDC should have done by now.

As a consequence, many states are drifting toward restarting their economies without such programs, or even without any ideas what such programs should look like. It is the next big storm cloud/pandemic screw-up on the horizon, and Dr. Birx has not prevented it. She is helping to enable it.

I hope that friends, family members, or respected colleagues will have a heart-to-heart with Dr. Birx, explaining to her what she is doing to herself – and to the country. Tell her that we appreciate her efforts, but that a constructive relationship with a malignant narcissist on the order of Donald Trump is not possible. Ask her to give you an example of one such relationship in Trump’s life. And have her read the recent interview with Dr. John Gartner in Salon.

Plead with her to follow the example set by her older colleague, Dr. Fauci, and maintain an arms-length professional relationship with the president. Implore her to stop the fawning. And if she gets fired for doing and saying the right things, so be it. She will have nothing to be ashamed about and will feel much better about herself in the end. And the rest of us will be safer.

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