A Sadist walks into a Pandemic

3 min readNov 1, 2020

On October 30, CNN reported that in his recent rallies Trump made a series of baseless claims that doctors were inflating the coronavirus death count for their own monetary gain, despite the fact that COVID cases and deaths are rapidly surging across our country. At a rally in Michigan’s Waterford Township, Trump said, “Our doctors get more money if someone dies from COVID. You know that, right? I mean our doctors are very smart people. So, what they do is they say, ‘I’m sorry but everybody dies of COVID.’”

The President of the American Medical Association, Dr. Susan Bailey, called Trump’s comments “malicious.” She was right that Trump’s attacks on doctors are born out of unconscious sadism. Pundits called Trump’s attacks on doctors bizarre, not understanding that he views the virus as something that is attacking him, literally and figuratively: in his view, doctors are on the side of the virus in their insistence on making it the headline. Trump believes that he should be the only headline, lauded for his heroic defeat of COVID at Walter Reed.

But more important, his ignoring of the crisis altogether — not giving it much thought because he didn’t want to “panic” the American people” — was also a sadistic act. He expresses this sadism with cowardice. It isn’t just that Trump sat on what he knew about the dangerous virus in January, despite Bob Woodward reporting it that way. He didn’t fully connect with the information he possessed, because over time sadism has destroyed not only Trump’s compassion but also his curiosity and ultimately, his ability to think. This results from the sadist’s need to dehumanize victims, in order to protect the sadist from feeling guilt. First, the sadist discounts any possible suffering they endure. Soon all capacity for compassion disappears, followed by a loss of competence to deal with a situation that no longer has any meaning to the sadist.

I see Trump’s attitude toward the pandemic as malignant neglect. Trump’s brand of sadism is passive; lethal while less overtly obvious. What is the relationship of malign neglect to sadism? In psychoanalytic terms, sadism involves pleasure at inflicting cruelty. What Trump has done is disguise that sadism. He downplayed and ignored the danger of COVID while simultaneously claiming to be a wartime president who would conquer the virus. His promise was essentially sadistic, cruelly teasing us with a pledge of concerned action when he was in fact uninterested, uncaring and incapable of creating a plan, much less…


Dr. Justin A. Frank MD is a psychiatrist and psychoanalyst best known as the quintessential expert in the psychology of the 21st-century American presidents.