ABSTRACT
If one of my patients frequently said one thing and did another, I would want to know why. If I found that he often used words that hid their true meaning and affected a persona that obscured the nature of his actions, I would grow more concerned. If he presented an inflexible worldview characterized by an oversimplified distinction between right and wrong, good and evil, allies and enemies, I would question his ability to grasp reality. And if his actions revealed an unacknowledged-even sadisticindifference to human suffering, wrapped in pious claims of compassion, I would worry about the safety of the people whose lives he touched. For the past three years, I have observed with increasing alarm the inconsistencies and denials of such an individual. But he is not one of my patients. He is our president.1
