Either “malpractice” or “criminal”: Dr. Justin Frank on power, drugs and Trump’s White House

Donald Trump has repeatedly shown that he is a lawless person — but his malign influence extends far beyond himself.

Trump’s “dangerous charisma” attracts already corrupt and ethically compromised people into his orbit. He also exerts a malignant perfidious influence over people who are vulnerable to such energy and temptations, but for whatever reason have not yet fully surrendered to them. This is a defining feature of dangerous leaders. 

On this, political scientist Brian Klaas warns in his book “Corruptible: Who Gets Power and How It Changes Us”: “Whatever specific interventions are adopted, a big part of the battle is acknowledging a core problem: those who shouldn’t be in power are more likely to seek it. We need to design every system to try to screen out the corruptible, power-hungry candidates.”

New reporting about the inner workings of the White House during the Trump administration sheds even more light on the ex-president’s (and now criminal defendant facing 91 felonies and hundreds of years in prison) corrupting power and influence over the people around him and the type of toxic environment he created and enabled while in office. From Rolling Stone:

White House pharmacists reportedly distributed uppers and downers like candy to Trump administration officials during his time in office, according to a new report from the Department of Defense Inspector General. 

The 80-page document, which was released on Jan. 8, found that “all phases of the White House Medical Unit’s pharmacy operations had severe and systemic problems due to the unit’s reliance on ineffective internal controls to ensure compliance with pharmacy safety standards.” …

While Trump lived under the White House roof, the pharmacy reportedly kept messy, handwritten records, spent lavishly on brand-name medications, and failed to comply with a slew of federal law and Department of Defense regulations governing the handling, distribution, and disposal of prescription medication. 

Through in-person inspections and interviews with over 120 officials, the report concluded “that the White House Medical Unit provided a wide range of health care and pharmaceutical services to ineligible White House staff in violation of Federal law and regulation and DoD policy. Additionally, the White House Medical Unit dispensed prescription medications, including controlled substances, to ineligible White House staff.” 

In an attempt to better understand the Trump White House pharmacy scandal, I recently spoke with Dr. Justin Frank. He is a former clinical professor of psychiatry at the George Washington University Medical Center and the author of “Trump on the Couch: Inside the Mind of the President.”

In this conversation, Dr. Frank shares his professional insights about the Trump White House pharmacy and why it was so dangerous. He also discusses the specific drugs and narcotics that were apparently being given out there with few or any controls of limits and how they could impact people’s behavior and moods – which includes the possibility of fatal outcomes.

Dr. Frank also continues to warn about Trump’s extremely dangerous mind and overall pattern of behavior and why as seen with the second E. Jean Carroll court case for defamation, and escalating threats of violence and retribution against his “enemies”, that the corrupt ex-president will not be stopped by “the walls closing in.” Instead, Dr. Frank predicts that Trump is a malignant narcissist who will go down in a blaze of glory before he ever surrenders or is otherwise made to yield in his assaults on society, human decency, and the rule of law.

How are you feeling given what has happened since our last conversation a month or so ago? Trump is winning in the primaries and is about to become the Republican Party’s presidential nominee. He is being forced by a civil court to pay even more money to E. Jean Carroll for attacking her reputation. Trump is only continuing to escalate his threats of violence and mayhem and being a god-like dictator. And how do you think the American people are doing emotionally right now?

Your question is very broad, pertaining both to my individual reactions as well as assessing the American people in general. So there is a bifurcation in my own feelings. The tension is between rage and resignation. And then somewhere in the middle is a wish to expose the criminals who are part of Trump’s orbit, and more generally who are inspired by his behavior. There is a part of most people’s personalities that gets a thrill from breaking the rules and engaging in the types of misdemeanors that kids indulge in such as taking candy from a store without paying. But there are people who are far more dangerous than that. Trump is one of them. He unconsciously declares himself a psychopath by saying that he is above the law. He is also a cruel man who enjoys destroying anyone who disagrees with him.

As for the American people? We are a society more divided than united. Many of us are anti-intellectual and don’t want to think. That makes such people attracted to strongmen and bullies like Trump. Trump has made his followers reject the truth for alternate facts – and that makes most of us insecure and uncertain about what to believe. As November approaches there will be more uncertainty and anxiety about who and what to believe. That can only lead to people making choices and then sticking to them for their own safety sake. To me, cruelty is the biggest change that is happening, and it is getting worse on a daily basis.

During the second E. Jean Carroll civil trial, Trump was disruptive. He got angry and stormed out of court while it was in session. He continued to attack her character, literally, while being involved in a second trial for defamation. You are an expert on Trump’s mind and behavior. What did you see as you watched Trump’s antics?

From the time Trump was five years old, he hated rules and couldn’t control himself. If Trump didn’t like something, he would convert feelings into immediate action. He threw rocks at a toddler who lived next door when he was five. He punched out his second-grade teacher because he got mad at him. As a father, Trump knocked out his son, Don Jr., when he was in high school because he wasn’t dressed appropriately. Trump has always been like this. As people age, they generally do not change; they instead become more of their true selves.  His capacity for self-restraint is becoming a thinner veneer over fundamental destructiveness. He is increasingly no longer able to fake it. This is why Trump is in court acting out, mumbling, being angry and disruptive. 

Trump continues to claim, contrary to all the evidence, that he didn’t know E. Jean Carroll. Based on what we know about his personality and mind, does Trump really believe this? Is he just lying and/or delusional?

In my opinion, Donald Trump is a “segmental thinker”. He lives in the moment and is attracted by a shiny object and forgets everything else. Trump sees an attractive woman and she becomes the focus of his attention. That is who Trump is. Trump was caught bragging on that recording admitting that he grabs women in their genitals whenever he wants to. So, when Trump says that he didn’t really know E. Jean Carroll, he is not simply denying having known her. But the real meaning goes much deeper: Women are interchangeable for Trump. So of course, Trump didn’t know E. Jean Carroll. When Trump says he doesn’t know a woman, or anyone else, he is really letting you know that he has no concern or care about anyone other than himself.  

During her interview on Monday with MSNBC, E. Jean Carroll said that she is not afraid of Trump anymore and that he is like a “walrus” making noises. Many people ran with Carroll’s comment about Trump and then proceeded to make fun of him. As you know, I have repeatedly warned that there is nothing funny about Trump. Donald Trump and what he represents is terrifying. That laughter is defensive and a function of deep existential terror and denial. In the end, all these people laughing at Trump are engaging in gallows humor.  

E. Jean Carroll was not simply making fun of Trump. She was speaking her truth, that when she saw Trump in the court, she suddenly realized he was like the emperor without clothes. She is saying that to her Trump is nothing. To be afraid of this man is ludicrous as she now sees him. Trump has a lot of money, but he really is unremarkable. Sure, he bullies weak Republican congressmen but he is nothing at his core. E. Jean Carroll called Trump a hollow man. That is what E. Jean Carroll is saying.

Moreover, E. Jean Carroll and Liz Cheney and Hillary Clinton and the other women who have stood up to Trump show, at least as I see it, that women are less afraid of Trump than most men are. Lots of men – both in Congress and his MAGA followers in general – are terrified of Trump and are afraid of being emasculated by him. That fear of Trump also paralyzes many among the opposition. When Trump says “jump!” there are so many men who say, “how high?” and then do whatever Trump wants.  

It is now being reported, which is not at all surprising, that the White House pharmacy under Trump’s regime was giving out prescription medication, including powerful narcotics, with few oversights or limits. It was basically candy and it was being doled out like Dr. Feel Good was running the pharmacy. You are a highly respected physician who has worked at some of the country’s leading medical facilities, what was your initial reaction when you learned about the Trump White House pharmacy? 

Trump basically gave the people in his White House permission to not obey the law, since the law doesn’t matter to him. There was no regulation in Trump’s White House as seen with the pharmacy — and more generally. Drugs were basically being given away to anyone who asked for them. Under Trump, the White House pharmacy was basically lawless and like something out of the Wild West. As for specifics, two of the drugs that are prominent in the reporting on that pharmacy are Ambien, which is a common sleeping pill, and Provigil, a psychological stimulant that makes the brain more alert. It doesn’t work like amphetamines and was first used to treat narcolepsy.  Provigil is also used by people to help them concentrate.

The Department of Defense’s investigative report into the Trump White House pharmacy lists many different drugs. Here are some drugs that stood out to me: morphine, ketamine, and fentanyl.

Those drugs are really dangerous, and they’re controlled substances. I cannot prescribe codeine or morphine unless I have a special license that allows me to do it. My medical license alone will not allow me to prescribe those drugs.  I have a special license from the Bureau of Narcotics and Dangerous Drugs so I can prescribe some of those medicines. Not only that, but I also can’t even call in a script over the phone. The patient has to bring in a written prescription in order to get it filled. I’m really struck by the amounts that were given out and the poor record keeping. Many of these drugs are addictive narcotics. They are also sedatives and depressants. These drugs make you disconnected and calm. You feel no pain. These drugs numb you.

What about the ketamine and fentanyl? 

Ketamine is used to treat severe depression, but under controlled circumstances where it’s administered intravenously, and the person goes into a special ketamine practice where it is administered via an IV. Ketamine is also used as a recreational drug. It is a very powerful drug that is dangerous and needs to be monitored. Fentanyl is a sedative that people take who just want to zone out. But Fentanyl can kill you really fast; if a person takes too much Fentanyl they will die.

If a physician was giving out drugs in the ways these government audits and investigations are indicating it is malpractice. If someone who is not a physician is giving out these drugs in the manner detailed in the report on the Trump White House pharmacy it is, in my opinion, criminal. They should all be prosecuted.

What do you think is going to happen with Trump’s behavior as the election approaches and his criminal trials, fingers crossed, finally begin in earnest? What do you want to prepare the American people for?

The main thing that I am worried about is the complacency of the public and specifically the country’s leaders and law enforcement and other people in positions of authority and power who are still letting Trump run wild. Trump is extremely dangerous. Trump does not believe in laws and rules. He wants to be a lawless dictator. This is why I continue to share my conclusion, based on the evidence, that Donald Trump appears to be psychotic. He is a person who is detached from reality. Even with the trials and other pressures, Trump is not capable of breaking down, of being cowed and/or broken. If anything, Trump will go down in flames if he goes down at all. Trump is an extreme narcissist who will destroy anyone who has ever done anything to hurt him, to oppose him, or defy him.