Remote Diagnosis, and the Confession of a Small Man

This essay requires a confession from me. It is necessary to the question before us. It is necessary for the reader is to understand how I know what I am talking about here.

I am not about to confess to some amateur diagnosis of President Trump from afar. That would be both unserious and contrary to the point. The confession is more humiliating than that, as it concerns my own smallness.

But first, we must see to the core problem at hand. Serious-sounding remote diagnosis is not merely sloppy. It is a category error with moral consequences.

When people pretend to be sober and professional as they "remote-diagnose" a public figure’s mental illness from the safe distance of television clips, social media fragments, and partisan disgust, they do more than trespass into territory that real professionals are bound to approach under strict ethical rules. They also teach the public a dangerous and degrading lesson: that wickedness, deceit, vanity, cruelty, corruption, and indulgence are forms of mental illness. They are not. And when we speak as though they are, we further stigmatize millions of people whose mental health struggles are real, serious, and in no way synonymous with evil.

The distinction matters because real psychiatry is not a theatrical accent one adopts when ordinary moral language feels too weak. Professional diagnosis is constrained for a reason. It requires examination, method, consent, and discipline. It is not a costume that television pundits, activists, and aggrieved citizens may put on when they wish to make their contempt sound more scientific than it is.

The rule against such behavior exists not because public men are above judgment, but because diagnosis is not the same thing as judgment. A republic needs citizens capable of judgment. It does not need them pretending to be psychiatrists.

This is where too many people lose the plot. They think that if one refuses the language of remote diagnosis, one must also soften the indictment. Nonsense.

To refuse pseudo-clinical theater is not to become timid. It is to become precise in conception. President Trump does not need to be called clinically insane for the public case against him to be devastating. One may call him dishonest, vain, shameless, cruel, self-exculpating, manipulative, petty, indulgent, and corrupted by a lifetime of insulation from ordinary consequence. One may say that he lies with practiced ease, that he externalizes blame as naturally as breathing, that he treats public office as an extension of self, and that he routinely subordinates truth, law, and national interest to appetite and grievance. All of that is within the civic rights of a free people. And none of it requires a counterfeit medical performance.

In fact, the false medicalization of bad character often weakens one's argument. Once the critic begins pretending to diagnose, he shifts the frame away from choice and toward condition, away from vice and toward pathology, away from responsibility and toward speculation.

The public is then invited to squint at gestures, tics, cadences, and facial expressions as though politics were a diagnostic ward rather than a struggle over power, consequence, and public truth. That is not merely bad reasoning. It is often a disguised form of evasion. It is easier for many people to call a wicked man mad than to admit that a pampered, lawless, self-dramatizing man may simply be what he appears to be.

And here television has done immense damage. Americans did not meet President Trump first and chiefly as a statesman, or even as a businessman in the ordinary sense. They met him as projection. They met him as branding, staging, repetition, camera angle, music cue, set design, and edited authority. They met him as a reality television strongman. Television made him look large. It made him look decisive, commanding, untouchable, and somehow more substantial than he was. It scaled him up.

What many people are experiencing now as "insanity" is often nothing more exotic than the collapse of that amplification. The image is failing. The old aura does not hold as it once did. The strongman projection has thinned, and what shows through it more and more is not some mysterious psychological abyss, but age, petulance, dependency, grievance, vanity, and smallness.

Trump looks old because he is old. He looks small because he is small. He looks erratic in part because the costume no longer conceals the weakness beneath it as effectively as it once did. The disconnect between the remembered projection and the visible man produces a feeling of unreality in the viewer. Many people, lacking a better category, misname that unreality as madness.

But unreality is not diagnosis. Nor is theatricality. Nor is narcissistic display. Nor is shameless lying. We should be wise enough as a people to understand that the camera magnifies as much as it reveals. A man can be made to look larger than life for years, and then in the end appear merely what he always was once the machinery of scale begins to fail him.

There is another reason the insanity language spreads so easily. Most of us still possess, however damaged, a civic conscience that expects the presidency to impose some discipline upon the man who holds it. We expect adulthood. We expect some relationship to shame. We expect some capacity for restraint. We expect consequence, duty, and at least the appearance of moral proportion.

When those expectations collide with a public figure who seems instead to have been pampered by wealth, protected by celebrity, and insulated from normal correction for so long that he experiences impulse as entitlement, the civic mind recoils. It sees a man in high office behaving beneath the office. It sees appetite where it expects judgment. It sees grievance where it expects duty. It sees a giant institution inhabited by a stunted character.

That recoil is often mislabeled. It is not really a diagnosis. It is a moral revulsion produced by the spectacle of smallness enthroned.

And now the confession.

I do not hear the note of deceit in President Trump because I am a great man. I hear it because I am not. There are some readers who will think less of me for saying so. They may be right to do so. But honesty requires the admission.

I know the smaller forms of evasion, self-justification, vanity, and bad faith well enough to recognize their enlarged public form. I know what it is to flatter oneself. I know what it is to reach for a lie because it is easier than standing naked before truth. I know what it is to indulge an inner ugliness if only for a moment, to commit in miniature what one condemns in another at scale.

I do not say this to collapse all distinction between private frailty and public corruption. That would be absurd. A petty lie in ordinary life is not the same thing as organized deception from a seat of power. My point is not equivalence. My point is recognition. We do not always spot vice because we are pure. Sometimes we spot it because we have heard its lesser music in ourselves. Not as a governing principle. Not as a permanent dwelling. But enough to know the smell of the place.

That is the confession of a small man. I am small enough to know how smallness sounds.

And sure, I too have at times used words like narcissistic, insane, sociopathic, or psychopathic rhetorically. We may use such words in ordinary moral and civic language. We may use them to describe what a pattern of conduct looks like to us, what kind of soul it suggests, what kind of public danger it resembles, and how profoundly it departs from ordinary decency.

The language itself is not prohibited. What is prohibited, for actual professionals, is the pretense of diagnosis without examination and authorization. What is corrupting, for the rest of us, is the imitation of that posture.

I do not use such terms as medical diagnoses, and they should never be mistaken for that. I use them as civic language, shorthand for a public pattern of grandiosity, instrumental dishonesty, callousness, self-regard, appetite without remorse, theatrical instability, and indifference to the harms inflicted on others. The citizen is permitted to judge. The writer is permitted to use severe moral language. What neither should do is put on the white coat from afar and pretend to have crossed from rhetoric into medicine.

That border must remain clear. The mentally ill are not the moral refuse heap into which a frightened republic may dump the conduct of its worst public men. The sick are our fellow citizens. Many of them struggle nobly, quietly, and without harming anyone. To use their conditions as a metaphor for public wickedness is not compassion. It is slander with a clinical accent.

So let us say what needs saying in plain language. President Trump is not beyond judgment because we decline to pathologize him from afar. He is more squarely subject to judgment for precisely that reason. We do not need to guess at hidden diagnoses. We have his record. We have his words. We have the pattern of lies, cruelties, humiliations, evasions, betrayals, and indulgences. We have the spectacle of a television-made giant shrinking into the dimensions of the man beneath the production. We have enough.

Call vice vice. Call corruption corruption. Call selfishness selfishness. Call cruelty cruelty. Call deceit deceit. Reserve diagnosis for doctors. Reserve professional ethics for professions. Reserve civic judgment for the citizen and for the republic that cannot survive without it.

The danger before us is not that we have encountered some inscrutable mad king beyond human comprehension. The danger is more humiliating than that. A media-amplified culture mistook a small man for a large one, and too many of us now seek refuge from that embarrassment in the language of illness. We should not.

The country does not need counterfeit diagnosis. It needs clearer sight. And if I am fit to say that, it is not because I stand above the thing. It is because I know, too well, the lesser shape of it from below.

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