In the silent film era, a filmmakers used an undercranked camera that depicted Charlie Chaplin in his 1925 film, The Gold Rush jumping in and out of a cabin during a snow storm at an incredible speed. But the silents by definition had no sound track. That meant camera was small enough to follow the action easily. A typical rig looked like this:

Charlie Chaplin with crank driven camera of the silent film era. Photo courtesy of br.pinterest.com. Fair use.

With the arrival of talkies, cameras overnight became prisoners of the microphone because the clatter of their shutters were muffled with bulky soundproofing. That made cameras huge, reducing their movement, and limiting what actors did in front of them. Movies became theatrical pieces on sound stages like His Girl Friday made in 1940, a classic screwball comedy that takes place mostly in a courthouse press room.

35 mm camera used at the dawn of the talkies, in the 1930s. Photo courtesy of Redsharknews.com. Fair use.

When filmmakers learned to produce soundtracks apart from shooting film, cameras became smaller, mobile, and enabling such masterworks as Francis Ford Coppola’s The Godfather in 1972.

Frances Ford Coppola peering through a 35 mm camera. Photo source: Achievement.org. Fair use.

Then in the 1970s came 70 mm IMAX, the Godzilla of film formats.

Cinematographer Hoyte van Hoytema with the IMAX camera during the shooting of The Odyssey. Photo credit: Melinda Sue Gorden, Universal. Fair use.

IMAX changed the width of a frame of conventional film from 35 mm to 70 mm as shown below.

There’s a price to pay for a bigger image. A 1,000 foot roll of 35 mm film gives a director eleven minutes of time to work, while a roll of IMAX film runs for only three minutes. That means shooting multiple takes of an IMAX scene is extremely cumbersome, and for complex action impossible. And so it’s a film miracle that Nolan and his team were able to pull off shooting The Odyssey and getting the result that they did. If you sit close enough to an IMAX screen, the image has no edges, and you feel like you’re inside the action This can be exhilarating for people of sound mind, but a problem if you’re not. I’ve seen at least one patient who walked into a movie sane and left psychotic. But Hollywood is not in the mental health business, so expect a boat load of Oscars for The Odyssey.

What about film itself? I read The Odyssey as a student in the Pleistocene. The IMAX version goes down more easily than the original.

When it was over, my nine year old grandson burst out, “That was the best movie I ever saw! Except for Avengers: Endgame.” I think he nailed it. Most critics said something along those lines as well, except the classicist Emily Wilson who snarked in The London Review of Books, “I would be ashamed to have written any part of this script.” Happily the bosses at Universal spared her the shame by hiring Christopher Nolan instead who wrote and directed it.

Mike Nichols, who directed Catch-22, once said that to make a film from a book you had to kill the book. Nolan followed that dictum. In condensing the Odyssey’s 24 books of ancient Greek into a single show, he chose to keep the crowd pleasers (the sacking of Troy, the Cyclops biting off an Argonaut’s head, the slaughter of the suitors, for example) at the expense of a nuanced psychological treatment of the hero and the epic’s many backstories. Given the complexity of Odysseus’ character and gyrations of the plot, turning Homer into Hollywood seems impossible unless you take a hammer and chisel to the original and turn it into, well, a Hollywood movie. This is Nolan’s forte. The Odyssey is nearly non-stop action, only broken up by scenes like Odysseus’ wooden confessions of guilt which come off like a patient on Prozac. He’s played by Matt Damon, a good actor who doesn’t have much to work with here. (It’s the same problem Damon had as The Talented Mr. Ripley, in which the script frenetically stuffed Patricia Highsmith’s 1955 novel into 139 minutes, while Andrew Scott’s rendition of the same material let him develop the psychopathic character in the TV miniseries, Ripley, over eight leisurely episodes, with chilling effect.)

What was lost in Nolan’s Odyssey? The writer-director does away with the Odysseus’ smarts, slyness, and emotional conflicts over sex, war and crossing the gods. Athena the goddess of war and wisdom makes the cut, but Poseidon, the sea god who creates the storm that nearly kills the hero, doesn’t. Other gods in the Pantheon get cameos but their super powers are understated or undisclosed. No worry, she tells Odysseus. “Who doesn’t understand thunder? Fire?” At three minutes a reel, Nolan doesn’t waste time on mythology, not while men are sacking Troy and hundreds of the fallen warriors are rising from the dead. This last scene is worth the price of the ticket, by the way. My son pointed out that Nolan was committed to “practical cinematography,” that is, real humans on camera, not computerized graphics. So his “giants” were cast from actual seven footers, and “smaller Argonauts” cringing before them were actually short female body builders in armor. Spoiler alert: For one shot hundreds of actors remained buried under dirt while the crew sets up the camera, and then all rose on cue. I can’t imagine shooting that scene more than once.

But Nolan’s Odyssey is more than an action flick. It’s also about a man’s love for his wife, and his wife’s love for her husband. The theme is universal and deeply moving. Odysseus’ main goal after winning the Trojan war is to get back to Ithaca, his island home, and his wife, Penelope, the queen he left twenty years before. In that time she has become surrounded unwelcome suitors who feast in her halls and proffer marriage to possess her and Odysseus’ kingdom. But Penelope will have none of it. She remains loyal to the memory of her husband, clinging to the belief that he’s survived the war and one day will return. Anne Hathaway’s performance as the faithful Penelope is Oscar-worthy impeccable. She manages to express sadness, hope, fear, and anger from one moment to the next with only the slightest trace of an expression. We are in different filmic territory when she is on camera, with burning Troy left far behind in our memories.

Besides the highly charged themes of separation, loss, and reunion, there is Odysseus’ guilt that he’s broken the law of Zeus. Disguised as a beggar he confesses this to Penelope, and admits that the consequences are wide. “Yes, my queen,” the beggar says of Odysseus. “The breaking of Zeus’ law, spreading like plague. Our age of bronze is collapsing, and maybe he couldn’t bear to see the ruins of what he’d done. Anywhere. Least of all, his home.”

OK, I lied. This piece really is about Donald Trump. Is there any more timely figure as the great defiler of “Zeus’ law,” “spreading like plague” and resulting in a “collapsing age”? In that light Christopher Nolan’s Odyssey is more than a simplified tale of ancient Greece. It’s an allegory of America today, a premonitory work of art about the mortal threats to us all.

“What do we do if someone comes in carrying a gun?” one asked.

“The poll will have a Deputy,” the trainer said reassuringly.

Ah, a Deputy, the future workers nodded with approval. Wyatt Earp, John Wayne, Clint Eastwood! But on election day the Deputy for Sarasota’s Precinct 205 turned out to be Maria, a warmhearted woman who spent her time at the front door as a welcome wagon when voters came, and offering “I voted!” stickers when they left. The stickers were a big hit.

Maria, the Deputy of Precinct 205

Carol, a 72 year old retired social worker, was the team’s leader. She channeled her inner Yoda, “Vote you must, or complain you can’t.” In another election she had stood up to a racist trying to drive off a young Black man in line. The older man shouted, “You can’t vote here! You have to leave!” Carol, barely five feet tall, stood up to him and said: “He can vote here, sir, and you will have to leave.”

Beth was second in charge. She had become a poll worker years before in Georgia after the state legislature passed SB 202 intending to suppress voting by closing precincts, lengthening lines, and prohibiting voters from being given food and water. When voters reached Beth, they were angry and she was their lightning rod. She took insults about her gender and competence in stride. “I’m not afraid,” she said simply.

The precinct was diverse. Voters came from the 100 unit public housing facility for the disabled as well as the high end condos surrounding it. The first voter of the day was blind. No worry! said the well trained staff as they leapt into action. Bonnie, the team’s wiry IT tech, had supervised the setup of a device that assisted voting by the deaf, paralyzed, and blind. Another man, congenitally deaf, voted with help. When he left, he said, “Than ku.” A man came in a wheelchair repaired with gaffer’s tape, another in a motorized chair that glistened like a Bugatti. Many had walkers. Some had been born in Russia, Ukraine, or Latin America. Mr. M. spoke only Spanish. He presented his driver’s license. He was upset when he couldn’t vote. A poll worker using Google Translate explained that he needed to register. When he was told how, his face became wreathed in a smile. Busy times were at lunch and after work when voters came from the rest of the neighborhood— a doctor; a man with a terrier; a mother with a little boy; a woman in a sky blue sun dress and matching sky blue ear buds. There was no misogyny, threats, long lines, or angry faces. Instead, the order of the day was smiles, words of gratitude, and fist bumps. “I want to thank you all for what you’re doing,” a man announced to no one and everyone.

Not that everyone on the team was cut out for this work. Robert, who volunteered at a foodbank, was beside himself if he had to sit too long. He was a biker, not one to sit in front of a computer. “Poll work is incredibly boring! I’ll never do this again.”

Lisa, on the other hand, was in her sixth year as a poll worker. Her first year was at the height of Covid. She wore protective gear and wiped down each booth when the voter was done. “It was a crazy time!” she said. In her other life she managed the office of a construction company. At the end of the night when ballots had to be reconciled, she was a natural.

Mark was a poll worker for the first time. He’d volunteered because of one word, “Fraud! I’m doing my part to prevent that.” He subscribed to a complex set of theories that every president since Kennedy had not been elected, but “selected” by a coterie of the deep state, the CIA, the military industrial complex, hackers, and crooked elections in the north. When it was pointed out how he had been surrounded all day by multiple measures to safeguard the vote, he admitted, “I haven’t seen anyone vote twice, and if things go right, I have no issues here. Every vote has to be counted.”

But harder days are ahead. We have a president who doesn’t believe that. He has pushed Congress, so far unsuccessfully, to pass the SAVE act which would have ended voting as we know it. He’s seized the ballots from a county in Georgia that voted against him in 2020. He is asking the Supreme Court to restrict the use of mail-in ballots by allowing him to order the US Post Office not to deliver them in states refusing to surrender voter rolls (the president voted by mail himself in today’s Republican primary). Fears are mounting that he will use ICE, the FBI, or the National Guard to frighten and confuse voters in November, throw the process into chaos, and then declare the midterm election invalid. The shadow of January 6 is still with us.

What can be done? First and foremost, our greatest weapon is to vote in great numbers. The states conduct elections, not the president. They govern the handling of mail-in ballots. They qualify voters and count ballots. The machinery of fair elections is already there. Democracy is not a spectator sport. Poll workers are its unsung heroes. Consider becoming one. Things will work out in November if we take to heart the words of Beth, “I am not afraid,” and those of Mark, that “Every vote must be counted.”

David Paul Morris | Bloomberg | Getty Images. Fair use.

AI meme posted on X. by designer Christopher Webb. Fair use.

Trump did not come off exactly like President James Marshall, played by Harrison Ford, who wasted terrorists left and right in the movie Air Force One.

Theatre release poster. Fair use.

In case you missed it, Trump escaped in a catering box and abandoned his staff and press corps to a possible Iranian missile attack. What began as an act of a testament to Trump’s indifference to the lives of others ended up as farce. Jon Stewart called Trump hiding in a catering box “So Clouseau.” But hold on. Who wants to be shot out of the sky by an Iranian surface to air missile? You can’t blame Donald Trump for not wanting that or the Secret Service wanting to protect the president. OK, but who came up with their cockamamie plan to stuff Trump and two or three staffers into a catering cart while turning a hundred or so staffers, pilots, and the entire White House Press Corps into decoys? Were there no wiser heads working in the Secret Service to come up with a better idea? Obviously not. A good rule of thumb when listening to the president is to assume the first words out of his mouth will be a lie. Trump’s explanation was a proof of concept. “If I go, you go,” he said to a reporter which, given they were on separate planes, was unlikely. He shifted blame onto the Secret Service. “I do what they say,” said the man who once tried to wrest control from the driver of his limousine on January 6. The greatest Pinocchio award for lying, though, was his claim, “The plane I flew on was at greater risk.” Got that? Trump was putting himself in harm’s way because the Secret Service told him to increase his risk? That the Iranians knew of the switcheroo? That he was willing to risk taking a bullet to protect the folks on Air Force One he had left behind? Take your pick or tweet one of your own. Feeling a bit numb from all this? And maybe a little helpless, hopeless, and even depressed? Well, people, that’s the whole point.

“Firing inspectors general. Sweeping clemency for Jan. 6 defendants. Investigations of perceived enemies. A federal hiring freeze. Moving to end birthright citizenship. An immigration crackdown. Terminating diversity, equity and inclusion programs. Revoking security clearances.” That was just Trump’s first week in office as he “flooded the zone” with a dizzying barrage of ill-conceived emergency and executive orders. Honor the balance of powers? Defer to Congress over spending? Follow precedent, law, and the Constitution? Nah. How about avoidance of self-dealing and forever wars? Nope. It’s really extraordinary. Trump has made so many wrong choices in such a short period of time. You have to give credit to him or the Devil. What’s driven him to come down on virtually every wrong side of an issue? The explanation that he is “stupid” does him an injustice. He is fond of saying, “I’m the president and you’re not.” A moral and intellectual failure, perhaps, but not devoid of the instincts needed for political success. Yet he has no interest in governing or whether he even knows how a republic works. Instead, what passes for “policy” is a libidinal stew of greed, lust, rage, and fear. Higher functions like altruism and humor do not pertain. Brave men do not hide in a bunker or a catering box. Add to that increasing evidence of encroaching dementia, and you have Donald Trump in a nutshell.

As the most widely recorded person in history he provides psychiatrists an ample inventory of thoughts, feelings, and behaviors which in turn may point to psychological theories to explain their origins. Sadly, he will never be the beneficiary of an intensive, long-term psychotherapy where these can be tested, unraveled, and lead him to a happier life with fewer conflicts. But we can still hypothesize what they are and test them against his record. Because the flood waters of his “zone” are so high, psychohistorians will be busy with Donald Trump well into the rest of this century.

The flood has been devastating. He has led every previous president in the number of executive orders he’s issued, 260 since January 2025, 225 in his first year alone, and 26 on his first day of office. Clearly he’s a man who believes more in the rule of the Sharpie than one of law. In the interest in keeping both reader and writer sane, I tabulate only a few of his thoughts and actions that may be especially juicy bones for future Trump scholars to chew on.

Thoughts and Actions Possible Explanations

Anti birthright citizenship, DEI, civil rights Racism

Targeting law firms Preemption of talent in future litigation; bullying; payback

Lawfare against perceived enemies Paranoia, rage, revenge

Freezing medical and scientific research Bullied for learning disabilities; feelings of low self-esteem bricked over by ego defense by calling himself “a very stable genius”

Anti LGBTQ rights Homophobia

Blocking release of Epstein files Pedophilia

Sexual assaults Impulsivity; lack of consequences

Tariffs Extortion

Jan. 6 pardons and payouts Lacking faith in civil government, a desire to marshal a private army

Attacks on small boats in Caribbean Sadism

Crypto, Bitcoin, digital token ventures Greed

Iran war Impulsivity; distrust of experts; cognitive confusion; early dementia

Anti immigrants Racism

Anti-climate science Quid pro quo with oil and gas companies

Cheating on taxes, serial lying Greed, sociopathy

DOGE cuts resulting in 750,000 deaths Indifference to suffering of others; patronizing donors

This short list is hardly comprehensive but it gives you a hint what tomorrow’s historians will be up against. On the other hand, the causes of Trump’s affliction, and our own, isn’t so mysterious. The explanations are self-evident and testable. What remains a mystery to me, though, is why Americans aren’t angrier over Trump’s crimes and misdemeanors. Have we forgotten our values of honesty, compassion, and creativity? Hasn’t anyone noticed that a third of the White House has been demolished? For a ballroom-bunker? Is patriotism only for “suckers and losers”? Are we ready to throw in the towel defending the rights of women, immigrants, people of color, and gays? Have we forgotten that we are “created equal and endowed by our Creator with certain unalienable rights”? What’s wrong with this picture and how did it get that way?

In 1941 the jurist Ernst Fraenkel who had fled Nazi Germany wrote a seminal book, The Dual State, in which he described two forms of government that could exist side by side. The first he called “the prerogative state,” and the second, “the normative state.” The first was the government that did whatever it wanted. The second was bound by the rule of law. The first is Donald Trump ignoring the birthright decision of the Supreme Court, or ICE agent Jonathan Ross killing Renee Good in Minneapolis without accountability. The normative state does what the law directs. The prerogative state does what it wants.

Americans live in both states, but unless the prerogative one affects us, we go about our business living under the illusion that our state is entirely “normative.” The prerogative Trump incinerates 300 school children on the first day of the Iran war, and we go out that evening for ice cream. Our illusion of normality protects us from shame, guilt, and rage because Trump’s paranoia, sadism, and slipping cognition don’t affect us personally. It’s time to shatter that illusion. The American dream isn’t for anyone unless it’s for everyone.

Original graphic of Colin M.L. Burnett modified by H. Abraham with color for emphasis. Fair use.

HA HA HA! Who are they kidding? I scoffed. The human brain has 86 billion neurons and a quadrillion connections between them! No way, Jose. A dinky computer model wasn’t going to come even close to telling us how the brain worked. But in 1976 I was also the guy who thought the Apple computer was a toy, Dunkin’ Donuts was junk food, and that golf would never catch on in a million years. The joke was on me, then and now. Neural networks have burst onto the computer scene as the heart of artificial intelligence, and AI, well, is AI. Let’s go back to the diagram above and see how.

It turns out there are similarities between your brain and AI work. Your brain gets different kinds of sensations as input:

Seeing a fly ball

Hearing a bang

Smelling a banana

Feeling a creepy crawly on your skin

Then, the input goes deeper into your brain which thinks about stuff, and then produces behavior as output, like:

Catching the ball

Turning towards a bang

Making banana bread

Or swatting a mosquito

To say nothing of walking, talking, reading, writing, science, art, history, and the world as we know it.

AI gets its entire input from the internet, every scrap of it, and gets a bit of tuning by humans. Then crunch, crunch it goes somewhere in a data center, and miracle of miracles, it makes output way beyond the days when computers were just word processors and calculators. AI is reaching the point that machines will be able to do practically anything a human can do, but faster, bigger, and eventually, a million times better. Output like this:

An AI produced virus never before seen in nature:

which was reported this week in Science by a team at Stanford.

Or an AI robot that can play tennis:

Which was presented by Chinese engineers this year.

Cool! Right? Yes, but take a look again at the word above the red balls in the graphic above, “Hidden.” That’s where the crunch-crunch happens. And as the maps of antiquity said when they came to ends of the known world, “Beyond this point there be monsters.” “Hidden” means that we don’t know how these networks actually work, that the guts of the machine are inside a “black box” that no one understands or controls, and that no one can predict how it will behave in any given circumstance. So the better way to show the network inside the AI computers is with a black box:

Here is what computing leaders say about this problem:

Sundar Pichai, CEO of Google: “There is an aspect of this which we call — all of us in the field call it as a ‘black box.’ You know, you don’t fully understand. And you can’t quite tell why it said this, or why it got wrong. We have some ideas, and our ability to understand this gets better over time. But that’s where the state of the art is.”

Yoshua Bengio, Turing Award winner: “It’s mostly a black box. Everything in the neural net is essentially a black box.”

Samir Rawashdeh, Professor, Electrical and Computer EngineeringDirector, Dearborn Artificial Intelligence Research Center, University of Michigan: “This inability for us to see how deep learning systems make their decisions is known as the “black box problem,” and it’s a big deal for a couple of different reasons. First, this quality makes it difficult to fix deep learning systems when they produce unwanted outcomes. If, for example, an autonomous vehicle strikes a pedestrian when we’d expect it to hit the brakes, the black box nature of the system means we can’t trace the system’s thought process and see why it made this decision.”

Dario Amodei, co-founder and CEO of Anthropic: “...we could have AI systems equivalent to a ‘country of geniuses in a datacenter’ as soon as 2026 or 2027. I am very concerned about deploying such systems without a better handle on interpretability [understanding black boxes]. These systems will be absolutely central to the economy, technology, and national security, and will be capable of so much autonomy that that I consider it basically unacceptable for humanity to be totally ignorant of how they work (sic).”

In other words, we building unimaginably powerful machines that will do things we can’t always predict. If we scale up the opinions of a few experts and ask 2,778 AI researchers what the future holds, you get astonishing responses. Between 37.8% and 51.4% of respondents gave at least a 10% chance to advanced AI leading to “bad outcomes.” What they meant was human extinction. The graph below gives you a range of opinions colored “Extremely good” (yellow) to “Extremely bad” (black, “e.g. human extinction”). Each thin line is one of 800 experts polled. Lines with more than one color reflects folks who had mixed feelings along the lines of (“Things will be supercool” vs. “We’ll all be dead.” I like the graphic’s use of “e.g.” for extinction as “Extremely bad”. Other examples? Brave New World, perhaps? Or more likely, an AI surprise, like the OpenAI system that escaped and hacked into a real company’s servers on its own.

After reading all this, I’m beginning to feel like the old guy on Times Square with the sign saying “The End Is Near.” But I’m not alone. Experts are writing books with titles like “If Anyone Builds It, Everyone Dies” and “AI, Unexplainable, Unpredictable, Uncontrollable.” If that’s so, we should change the neural network graphic to this:

It’s not that the tech bros are out to kill us. They’re just out to kill each other by making a killing in the markets. That’s capitalism. But even they are pleading for government to step in and regulate them. When was the last time you heard an industry do that? So far, though, the federal government hasn’t even been fiddling while Rome burns. It’s asleep at the wheel, leading a number of states to try and regulate AI themselves, except that Donald Trump has blocked that with an executive order. Instead, the White House is holding closed door discussions with companies about possible regulations which at this point will be voluntary. Meanwhile the race for superintelligent machines goes on.

Yoshua Bengio puts the problem well. “So what it means is that if you’re doing something, say a scientific experiment, and it could turn out really, really bad, like people could die, some catastrophe could happen, then you should not do it…But in AI, it isn’t what’s currently happening. We’re taking crazy risks…Like a 1% probability that our world disappears, that humanity disappears, or that a worldwide dictator takes over thanks to AI. These sorts of scenarios are so catastrophic that even if it was 0.1%, it would still be unbearable.” AI critic Roman Yampolskiy is likely to agree. He thinks we should dramatically pull back from the AI cliff and not build superintelligent systems. Rather, we should concentrate on solving real problems and helping real people. “There is no reason,” he says, “to build a machine god.”

Hiroshima seen six months after the atomic bomb was dropped. ibtimes.co.uk. Photo Reuters. Fair use.

As weapons of war the bombs were indiscriminate. In Hiroshima the ratio of civilian to military deaths was eleven to one. The cities were erased in minutes. Survivors escaping injuries from the blast and fire died from radioactive fallout as they developed cancers of the skin, bone, and lungs. Others suffered leukemias. The combined force of these two bombs was only one millionth the power of the nuclear weapons scattered around the world today.

Such a war now, even a “small” exchange between India and Pakistan, would have adverse global effects, damaging the ozone layer and flooding the Earth with UV radiation that blinds animals and insects. Soot injected in the atmosphere would darken the Earth enough to cause a nuclear winter, disrupt food production, and create a nuclear famine killing billions people. Thus,

Since 1947 the Bulletin of the Atomic Scientists has analogized the probability of nuclear war with the Doomsday Clock. The shorter the time to nuclear catastrophe, the closer the hands to midnight. In 2025, the most recent setting of the Clock, the probability of nuclear war was rated as severe. (In addition to nuclear war the Bulletin has over time included assessments of potential apocalyptic effects of climate change, artificial intelligence, global instability, and biological threats such as pandemics.)

Existential Risk Clock. The probability of extinction from multiple sources according to the setting of the Doomsday Clock by the Bulletin of the Atomic Scientists. The lower the value, the greater the chance of our demise. Graph from The World Now, July 31, 2026. Fair use.

In this dreary inventory of the keys to our self-destruction, you may be forgiven if you threw your hands in the air and gave up on our survival. Allow me to disagree with a message of hope.

Yes, there’s no glide path to the prevention of nuclear war. The doctrine of Mutually Assured Destruction (MAD) which created a balance of terror between the US and USSR is far more complicated by seven more countries with nuclear weapons: India, Pakistan, China, North Korea, the United Kingdom, France, and Israel. Game theory can work between two parties to reduce the failure of MAD, but things get dangerously unpredictable with nine players. The action of developing a nuclear arsenal in one country creates a reaction among its neighbor to develop its own. Thus we see Iran, South Korea, Japan, and Saudi Arabia lusting to join the club. Iran reacts to Israel, South Korea to North Korea, Japan to China, and Saudi Arabia seeks to neutralize the nuclear ambitions of Iran. Acquiring low enrichment uranium for power plants isn’t easy, but once had, it can easily be enriched to weapons grade uranium with centrifuges which is what Iran is up to. And that says nothing about the Bin Ladens of tomorrow who long to use them, the men without a country, the destabilizing effects of artificial intelligence, or accidental nuclear wars from faulty controls and detection errors that in time are inevitable.

Another issue is the misconception by some world leaders like President Trump who think that a nuclear weapon is just a bigger conventional bomb, a false belief reinforced by the development of bombs with smaller explosive yields. This delusion ignores the multiple ways nuclear weapons kill and their global consequences from even limited regional conflicts. No living world leader has even seen a nuclear explosion, and the specter that the use of conventional weapons can slide us down the slippery slope to the use of city busters has not gone away. Yes, but…

If you are still reading, take heart! Yes, humans are vindictive, but we’re also forgiving. Sure, we’re cruel, but we are also kind. Yes, we are stupid, but we are amazingly clever; we’re also cowardly and brave; hateful and loving. We’ve stumbled through plagues, wars, and famines and managed to survive by the skin of our teeth.

Albert Einstein and Bertrand Russell saw the dangers of nuclear weapons, but it took thirty years and a worldwide movement of historic proportions before we reduced the superpowers’ stockpiles of 50,000 weapons to the 11,000 we have today. That 80% reduction came from a top-down commitment from world leaders, pressed by a bottom-up movement of doctors, lawyers, teachers, architects, and millions of others who joined them around the world. Today there are treaties to control, reduce, or ban nuclear weapons on the sea beds, in outer space, and yes, on the rest of the planet. Some are signed. Some are expiring. Others have been broken. Yet even better ones are on the drawing boards from thoughtful people waiting for the rest of the world to catch up.

People often ask me with no small bit of helplessness in their voices what they can do. The goal is simple. Nuclear weapons must be abolished. And they can be with a modest degree of trust between parties, and a great deal of verification. What can you personally do?

If they don’t, find someone else who does. Plant the seed, nurture the flower, and give the fruit to your children.

June 17, 2026, the G-7 Summit: Donald Trump walks into the Group of Seven (G7) summit in France and announces, “I’m the boss” to the leaders of France, Canada, Italy, Japan, the United Kingdom and Germany.

COMMENT: The world leaders laugh. Trump’s demeanor is not described. If he was joking, even in bad taste, the other leaders likely played along diplomatically. If Trump was serious, his declaration would be yet another indication that he suffers from grandiose delusions consistent with psychosis or dementia. A non-pathological possibility is that the president is just ignorant of the dynamics of power among Western democracies. Ignorance can be many things, but it’s not an illness.

July 7, 2026, the NATO Summit: On the runway of the Ankara Esenboğa Airport in Ankara, Turkey, at 2 PM Turkish time (7 AM ET) Donald Trump and Recep Tayyip Erdoğan, the Turkish president, walk slowly from the plane. Trump turns from his host while talking and begins to address the honor guard a dozen or so feet to his left. There is no interpreter. Erdogan then takes Trump by the arm and redirects him towards a microphone eight steps away in plain sight. At the microphone Trump speaks about two more words, Erdogan applauds, and the two men move on.

Video of Donald Trump and Recep Tayyip Erdoğan in Ankara at the start of the NATO Summit, 2026. Source, Fox News, July 7, 2026. Fair use.

During the Summit itself, Trump calls Volodymyr Zelensky “President Putin,” refers to Iran as the “Islamic Republic of Japan,” and calls the 2015 Iran agreement the “JPOC” instead of the JPOA. He also refers to TikTok as “TicTac” and Turkey as a “great company.”

COMMENT: The flight to Ankara from Washington on Air Force One takes about ten hours. Arriving in Turkey at 2 PM Ankara time, Trump’s biological clock was set at 7 AM ET, a not unreasonable time to start the day, and so Trump’s drift down the runway in apparent confusion can’t be from jet lag. If he slept on the plane, his confused demeanor would not be explained by exhaustion. Two forms of confusion are present: disorientation while navigating his physical environment; and paraphasia, i.e., confusions while speaking. Causes of these kinds of confusion are worrisome. They include a number of disorders that can affect brain function including stroke, mood disorders, drug effect, dementia, and delirium. Confusion while walking is not the first time for Donald Trump, and is reminiscent of October 28, 2025, when in Japan during a review of an honor guard at the Imperial Palace Prime Minister Sanae Takaichi had to redirect an apparently confused Trump back onto the correct path. Neither are his speaking errors new. But they appear to be increasing in number.

July 19, 2026, the World Cup: As Donald Trump in his role of co-host of the World Cup took to the stage at MetLife Stadium in New Jersey, fans booed. Beaming with pleasure nonetheless, he placed a medallion on each member of the victorious Spanish football team. Lipreading revealed that the president used the same six words to congratulate each player. FIFA President Gianni Infantino went to get the team trophy as Mexico President Claudia Sheinbaum and Canada Prime Minister Mark Carney, the other two co-hosts, filed off the stage. Trump and Infantino then handed the trophy together to Rodri, the team captain. As cameras clicked Trump inserted himself into the team picture by continuing to stand with the players on the podium.

The Spanish victors of the 2026 World Cup championship with Donald Trump standing with the team. Photo credit, the White House. Fair use.

The FIFA president then tried to direct Trump to step out of the frame, but Trump momentarily shook him off.

FIFA President Gianni Infantino attempting to remove Donald Trump from the Spanish team World Cup victory photograph. Credit: Dan Mullan/Getty Images Sport via Getty Images. Fair use.

The headline of the Washington Post reported Trump trying to photobomb the Spanish team, “Trump Loomed over the World Cup.” The Guardian newspaper, not usually given to humor, allegedly wrote a caption for the photo of Trump and the FIFA president, “Gianni Infantino carefully explains to Donald Trump that he is not part of the Spanish national team.” The two men eventually ended up standing in the cannon fodder of fluttering gold confetti. The expression on Trump’s face then became vacant and seemingly confused over what was happening.

Donald Trump and Gianni Infantino caught in a downpour of confetti at the FIFA World Cup celebration. Photo credit, Sports.yahoo.com. Fair use.

COMMENT: Trump’s diminished use of language in congratulating the athletes is telling. Psychologists have observed a decline in the complexity of his sentences and his command of vocabulary in the last decade. This moment is more of the same, commonly seen in many brain disorders such as psychosis, stroke and dementia.

Though the U.S. was one of three host countries, Trump’s role was to award the trophy to the team. Seeking out center stage is part of Trump’s character. But he habitually has trouble respecting boundaries. During a prior victory ceremony when the Chelsea football team defeated Paris Saint-Germain, he lingered on the center of the stage after the medal ceremony, and to the puzzlement of the Chelsea team, he appeared in the middle of the photograph of their trophy lift. Clinically this is nothing to laugh about.

A psychologist friend once designed a questionnaire to differentiate three classes of patients: those with mania, depression, and dementia. A typical question was “Would you like to go to a party?” The manic patients tended to answer, “Yes!” But so did many of the demented patients. (The depressed patients said things like, “I don’t know. What’s the point?”) The manic and demented patients found the idea of a party exciting, agreeing before they thought things through. (A good example is the decision to start the war with Iran). A healthy person might want to know what kind of party was being offered before agreeing to go. But demented patients lack judgement.

A psychological measure of control over one’s impulses is the go/no-go test. One simply pushes a green button when it appears, and avoids pushing a red one when that appears instead. You can try it yourself. Such responses are governed by the brain’s frontal lobes. Demented patients lack impulse control. In the cafeteria of a unit for folks with various forms of dementia I watched with growing apprehension as a woman with Alzheimer’s eyed her neighbor’s cherry pie, slowly walked her hand across the table, and scooped out a cherry with her finger.

Donald Trump has a similar problem. At the World Cup he was swept up in the excitement of the moment, and couldn’t resist posing with the champions, no matter how bizarre or pathetic it appeared to others. One can argue that this is nothing more than Trump’s narcissism, the size of which is worthy of its own world cup. But what harm if he borrowed the adoration intended for a soccer team? But lacking judgment and boundaries, so do patients with dementia. Therein lies the challenge of diagnosing a powerful politician whose medical history is hidden in a shroud of secrecy. What explains his aberrant behavior? Narcissism, dementia, or something else?

July 22, 2026, Sam Stein, Managing Editor of the Bulwark: Stein posted on X. the following, “Trump is telling the story about beating jon ossoff when he first ran for Congress. The issue is, Trump told this story about 15 minutes ago.”

COMMENT: Trump is fond of repeating the same word or phrase in his rallies. This may be for emphasis. “Lock her up!” “Build that wall!” Populating one’s speech with repeating monosyllables, on the other hand, may also be from increasingly impoverished speech. That can be subtle, and so, arguable. But repeating the same story after fifteen minutes is neither subtle nor arguable. Trump clearly forgot what he said fifteen minutes before. This is a major lapse in short term memory, and disturbingly an all too common hallmark of dementia.

Consistent with the syndrome of dementia is when he said after the World Cup boos, cheers, and photobomb. “We have to do this again, and we have to do it while I’m around.” The next available World Cup the U.S. will co-host is in 2038. Donald Trump will be 92, and he certainly won’t be the host. What was he thinking? People with dementia live in their own private worlds. As defenses fall apart, the most raw of feelings emerge. In the case of Donald Trump that will be nothing to look forward to.

The conference began as a gleam in the eye of Dr. James Muller and inspired by Pope Leo XIV’s new encyclical, “Magnifica Humanitas,” dedicated to the care of humans in the age of artificial intelligence, and the Pope’s vision of an “unarmed and disarming peace.” Muller is a member of what the Boston Globe called the “Boston Brain Trust” of antinuclear physician activists (full disclosure: as a member of that group I played a marginal role in planning the conference). Muller, a co-founder of the International Physicians for the Prevention of Nuclear War which had been awarded the Nobel Peace Prize in 1985, reached out to the usual suspects in the nuclear arms race—the U.S. and Russia. He also spoke with representatives of the United Nations and the world’s leading moral authority against nuclear weapons, the Catholic Church. As Muller noted, “The US and Russia hold 90% of the world’s nuclear weapons, with no arms control treaties currently in place. Renewed dialogue between them is essential to eliminating this existential threat to life.” Another member of the “Brain Trust,” Dr. Ira Helfand, put together the goal of the conference with surgical precision. “Don’t give AI the bomb.”

How may a nuclear war start? For seventy years it had been planned (and possibly prevented) by the superpowers’ policy of Mutually Assured Destruction (acronymized as MAD). If one made a nuclear assault, the other would respond, and by the end of the day the US and the USSR would have destroyed the world. But time changed that. Today nine countries have nuclear weapons at the ready. Predicting who, what, when, and why a nuclear war might start is virtually impossible. Increasing numbers of nuclear nations incentivize their neighbors to become nuclear wannabes who in turn are induced to “modernize” their armaments. Treaties which reduced world weapons by 75% have now collapsed. More weapons mean a greater chance of use. Subnational ideologues, armies, and terrorists given half a chance would be more than happy to use them. And then there is the problem of human fallibility. How long will it be before an accidental detonation unleashes unspeakable harm? No control system is perfect. The probability of failure increases with time. The Doomsday Clock, an analog estimate of the probability of nuclear war set each year by the Bulletin of Atomic Scientists is now set at 85 seconds. Consider the nuclear saber rattling of Donald Trump and Vladimir Putin this year and you know why. Enter the meteoric rise of AI to raise the ante on the bet of our survival.

AI has captured the imagination of war planners. Warfare is becoming automated. A scholar writes in the Army War College journal War Room that we are at an Oppenheimer Moment, a time like that of the first atomic explosion from which the world could not turn back. AI companies are in a race with one another for profits. Governments compete with each other for political and economic dominance. Machines in the meanwhile are rapidly outstripping what humans can do.

Graph credit: https://aistats.live/. “You and me” line added by author. Fair use.

As AI drive weapons in war, decisions will need to be made in decreasing windows of time. Humans will no longer be necessary, since AI systems are approaching the condition of being able to think for themselves. As Yoshua Bengio, the co-chair of the United Nations’ Scientific Advisory Panel on AI, and one of AI’s godfathers, put it, “We have built machines that are seeking goals.” Their own goals, not ours. AI systems are becoming vastly more intelligent than any human being, and capable of manipulating us, cheating, lying, all the while being able to make mistakes. They can program themselves and cooperate with other AI systems. And they can do all this without a trace of moral concern about how they affect humans.

Yet AI regulation at the moment is a pipedream. Common sense says that AI companies should be required to show that their products are safe before deploying them. Bengio says, “We do it for planes. We do it for meat, for cars, for drugs.” He compared our situation to the problem of driving a mountain road in darkness. The reasonable tactic is not to speed up or stop, but slow down enough to see what’s ahead. “We need guardrails to make sure we drive that development in a direction that’s actually beneficial for people, for humans, for society, and for our well-being.”

And what if Bengio’s dark mountain road is analogized to the world turning over the command and control of its nuclear arsenals to a network of superintelligent machines? That was the terrifying topic facing the Global Nobel Laureates Assembly at the Vatican this week. Given the existential threat of machine driven nuclear war, it was perhaps not surprising that this bouillabaisse of Nobelists, international experts, former heads of state, and religious leaders could come together and write the Declaration of Rome.

They called for action to head off “the next arms race,” both AI and nuclear. AI development needed to be responsible, accountable, transparent, and aligned with humanity’s interests. Under no circumstance should any system be permitted to self-improve without monitoring and the means to shut it down. An international treaty needed be adopted to prohibit integrating any AI system into systems of nuclear command, control, and launching. Governments and leaders needed to step up, and people need at every level to be educated regarding the promise and peril of AI. Some argued that AI could not, and should not, be halted. But there was unanimity that by removing nuclear weapons themselves from the equation (“the hardware,” as James Muller put it), nuclear war itself could be prevented. As the Cardinal Vicar of Rome, Baldassare Reina, said at the closing, “Nessuna macchina, nessun algoritmo, nessun sistema autonomo può essere posto al centro di decisioni dalle quali dipende la sopravvivenza dell’umanità.” (“No machine, no algorithm, no autonomous system can be placed at the center of decisions on which the survival of humanity depends.”)

The racial profiling employed by ICE to stop Araujo’s van had been legitimized by an unsigned ruling of the Supreme Court in the case of Noem v. Perdomo the year before. Such shadow docket judgments rarely are explained, but Justice Brett Kavanaugh couldn’t hold himself back. There are a number of reasons why people should be stopped, he suggested. If they gather to be “hired for day jobs,” for example, or those “who work or appear to work in jobs such as construction, landscaping, agriculture, or car washes that often do not require paperwork and are therefore attractive to illegal immigrants; and who do not speak much if any English.” The victim’s last words were, “Me estan mataron.” They are killing me. Apparently his English was not good enough to avoid being shot. His son, Ronaldo, learned of his father’s death not from a hospital or ICE, but by hearing his final words on videos posted on social media.

Memorial to Lorenzo Salgado Araujo. Photo credit, Meridith Kohut for the New York Times. Fair use.

Araujo’s shooter had no bodycam. Its issuance had been delayed, according to an unnamed DHS spokesperson, because of the Democrats’ shutdown over DHS funding. (Issuance of side arms, on the other hand, appears to have proceeded smoothly.) The killing comes at a time of rising expectations for ICE. The day before the killing, President Trump’s border czar appeared on Fox News and said, “We turned the heat up. … We got a lot of work to do. We got more resources to do it. We got more reasons to do it. You’re going to see these arrest numbers climb.” He’s right. The Department of Homeland Security is swimming in cash. The green light from the White House no longer means Go, but Go Fast. Under pressure from the White House pressure ICE arrests jumped to 10,000 in five days. But if you’re against false arrests, detentions, beatings, torture, and killings, this is not good news. A larger, faster dragnet means that indifference to law and decency is inescapable. The innocent will be swept up with everyone else. The pretense of searching out “the worst of the worst” will be shown for the lie that it is. The image of an ICE agent pulling on the Spider Man backpack of five year old Liam Ramos is not past, but prologue. Already the inventory of such images is growing—the nun walking to Mass, the preschool teacher being dragged from her classroom. These are not isolated cases, but a trend. The Deportation Data Project compared the number of immigrant arrests made in Texas over one year, divided into three groups: those with criminal charges pending, those with convictions, and immigrants with no criminal charges or convictions. The number of the non-criminal group grew while those of the criminal groups did not.

Not even U.S. citizenship confers equal treatment under the law. The best primary source reporting on such ICE atrocities against American citizens comes from the investigation by Nicole Foy at ProPublica. She found more than 170 examples. In Justice Kavanaugh’s opinion he sunnily wrote, “If the officers learn that the individual they stopped is a U. S. citizen or otherwise lawfully in the United States, they promptly let the individual go.” Foy found otherwise. She wrote, “Americans have been dragged, tackled, beaten, tased and shot by immigration agents. They’ve had their necks kneeled on. They’ve been held outside in the rain while in their underwear. At least three citizens were pregnant when agents detained them. One of those women had already had the door of her home blown off while Department of Homeland Security Secretary Kristi Noem watched.” While Noem has now been fired (not for brutality but for her less than zealous pursuit of the same), her replacement, the erstwhile cage fighter and plumber Markwayne Mullin, promised on June 25 a “quieter and smarter” approach, and that the nation shouldn’t “expect another Minneapolis anytime soon.” Twelve days later ICE agents killed a builder of homes.

Who killed Lorenzo Araujo? Cynics may say we will never know because ICE agents and their leaders are covered by an impenetrable shield of immunity from the consequences of their actions, that ICE killers are not often identified let alone charged, that ICE agent Jonathan Ross who shot and killed American citizen Renee Good is still a free man and allegedly back on the job, and that the two killers who fired a total of ten shots into Alex Pretti as he lay pinned to the ground by other agents have slipped beneath the radar because the FBI refused to provide any evidence of the homicide to the Minnesota Bureau of Criminal Apprehension.

A corrupt government is like a polluted river poisoning everywhere it flows. There is a through-line that runs from the president and his advisors to the administrators of Department of Homeland Security down to the agents pulling the triggers in our streets.

But if you believe that the rule of law still exists in America, you should have faith that it may prevail. The courts and the people with the courage to use them have become an admirable bulwark against corruption. Minneapolis was a template of bravery over brutality. Individuals who have stood up against racism masquerading as policy are the heroes among us. It was an office administrator named Ali Daniels who took out her Samsung smart phone and took a picture as an ICE agent seized a five-year-old by his backpack. It was a judge most of us never heard of named Fred Biery who ordered the release of Liam Ramos and his father, ending his three page ruling with two references to the Bible, Matthew 19:14 and John 11:35. The first is, “Jesus said, ‘Suffer little children, and forbid them not, to come unto me: for of such is the kingdom of heaven.’” The second was, “Jesus wept.”

The ordeal of Liam Ramos and his father is not over. A ruling in March declared their deportation to Ecuador was lawful. The case is being appealed. The creation of a humane and effective immigration policy is not in hand, but not out of reach. In 2024 the first immigration reform bill in nearly forty years was about to be passed when Donald Trump sabotaged it. The crimes of ICE agents are going to go up, not down. Trump may not care, but he should. Everyone has a smart phone.

Photo credit: Night of the Living Dead (1968), film by George Romero. Public domain.

Contrary to what you might think, the zombies above are not members of the House of Representatives, but from George Romero’s film, Night of the Living Dead. But make no mistake. There are zombies in the House. Need proof of the undead? Look no further than Donald Trump’s SAVE Act, first given life there in April 2025, stopped in its tracks in the Senate, and then given new life in the House again in February of this year. This zombie hasn’t been easy to kill. Whacking it on the head with a resounding no vote hasn’t been possible, and even threatening it with the filibuster flamethrower may not work. Zombies, if you’re lucky, just go away if you stay quiet. That seems to be the Senate’s current plan. But that’s not a sure bet.

The SAVE Act, (see, e.g., “Stop the SAVE Act and Stop the Steal,”) is an acronym for the Safeguard American Voter Eligibility Act, which like so many other acronyms that Congress comes up with is the opposite of what it really means. The SAVE Act is no exception. It doesn’t save anything. It’s just one more way to keep people from voting. Two years ago the Academy Award for Most Creative Obstacles to Voting went to the State of Georgia when it reduced the number of polling places for Black people, lengthened their lines, and made it illegal to hand out food or water to anyone waiting to vote, a crime punishable by up to 12 months in jail and a $1,000 fine. Among other Georgians, the law pertained to the 850,000 voters of Fulton County, a modest target compared to the SAVE Act’s, which takes aim at as many as 21 million voters. In the minds of Republican strategists, the higher the barriers to vote, the better.

The Act began as a gleam in the eye of Republican consultant, Cleta Mitchell, an election denier who had previously aided Donald Trump in trying to overturn the 2020 election. It was co-sponsored by 53 House Republicans on January 3, 2025 at the start of Trump’s second term and passed 220-208 on April 10. The zombie was stopped in the Senate by the gentlest weapon of all, silence, when the Senate Majority leader John Thune (R-S.D.), who knows a loser when he sees it, declined to push it along. But Senators Mike Lee (R-UT) and Lindsay Graham (R-S.C.) gave the zombie new life when they reintroduced it on January 30, 2026. It passed a second time in the House on February 11 this year, this time with a vote of 218-213. The SAVE Act rose from the dead.

SAVE is Donald Trump’s favorite zombie. Despite claims to the contrary, it’s not really intended to stop illegal immigrants from voting. That’s a lie which has been debunked ad nauseam. “The evidence is that the number of noncitizens illegally voting in federal elections is extremely low, not high enough to have changed the party outcome of any federal election in recent years,” Walter Olson, a senior fellow at the conservative Cato Institute said. “Audits and investigations in states like Ohio, Nevada, and North Carolina have found the numbers to be tiny in relation to votes cast. … The consistent experience has been that very few persons in this category mistakenly or deliberately vote.” No matter. Preventing illegal voting is not the goal of SAVE, but voter suppression. Fewer voters in the midterms, especially those of color, likely favor Republicans which in turn would prevent the House from falling to the Democrats and shield Trump from facing yet another impeachment. For what, you may ask? Given he has likely the longest list of high crimes and misdemeanors of any president in history, take your pick.

SAVE requires every voter to show a photo ID at the polling place. Not bad, right? 80% of Americans support them. Photo IDs are already required in 36 states. OK. But wait. That’s like hearing the music of the folksingers in Sinners before they turn into vampires. SAVE is nice enough, and then it’s not. It requires proof of citizenship, such as a birth certificate or passport. Can more Republicans lay their hands on those than Democrats? That’s the Republicans’ theory. Even if a woman can produce a birth certificate, that may not help if she changed her name when she married. There are 69 million American name changers. Passport? 140 million of us don’t have one. Live far from where you have to register? Tough luck. To register to vote, country folk would have to travel in person an average of 4.5 hours. The longest driving time would be 8 hours, from Colorado City AZ to the Mohave Co. election office.

Map credit: Center for American Progress. Fair use.

You can imagine the chaos that SAVE would create as state governments and citizens scrambled to establish paper trails to vote.

Even if SAVE doesn’t pass (the Senate so far lacks the votes to overcome a Democratic filibuster which would kill it), it repeats the big lie that our elections are “rigged” and that your vote won’t count. When people stay home on election day, little numbers can add up to big wins. Texas senatorial candidate Ken Paxton, despite being charged with felonies, won his primary election with a mere 4.8% of registered voters.

Facing defeat in the Senate, as of this writing House Republicans have revived SAVE yet again, this time by attaching it to a pending vote on the National Defense Authorization Act. This will force lawmakers to choose between voting for SAVE and shutting down the defense appropriation. As recently as last week Rep. Anna Paulina Luna (R-FL) stopped House business until the SAVE America Act advances. Meanwhile Senator Thom Tillis (R-N.C.), who supports SAVE but knows how to count, pronounced SAVE dead, saying, “It’s quite simple. It’s a math problem. We simply don’t have the votes and the SAVE America Act will not be implemented in time for this election…People will have to deal with registrations. Does any rational person who’s ever had any experience with implementing election law really think that it’s possible to have all that in place in time for this election and not be disruptive? And incidentally, it’s an unfunded mandate that has zero dollars for implementation.”

Trump was not pleased to hear that. When a housing bill which has overwhelming bipartisan support came to his desk for signature, he held it hostage unless Congress passes the SAVE Act. We live in a country where 75% of households can’t afford the median price of a new home. The housing crisis is not on his radar. He can only think of the coming elections. Hence all his efforts to block the vote: his gerrymander war, his efforts to stop mail-in voting, and now his misuse of the FBI to relitigate the validity of the voter rolls of Georgia. Senator Mike Lee sponsored SAVE. Yet even in his home state of Utah, matching the state’s two million voters with driver’s license data found fewer than 52 people who appeared to be voting illegally, and among those were “older voters who registered before the state required a driver’s license or Social Security number.”

Trump’s efforts to suppress voting aren’t over. It is hard to imagine what he’ll do to avoid the trouble ahead. Will he declare a “national emergency” on election day, and deploy the National Guard or ICE thugs to try and scare off voters? Or dream up some “crisis” and try to cancel elections altogether?

We live in interesting times. In the meanwhile, register to vote, mail in your ballot if that’s how you vote, and in any case don’t let yourself become paralyzed by fear or despair. Take heart. Vote, and reach out to others who may need help to do the same. If there’s one lesson the last 250 years has taught us, democracy is not a spectator sport.

Video credit, the Atomic Archive. Fair use.

“Now I am become Death, the destroyer of worlds,” he said. The bombing of Hiroshima and Nagasaki in 1945 ended the Second World War. The Bomb had brought death to hundreds of thousands of people, mostly civilians, from burns, blast, and radiation in a single moment. Later, more would die from radiation induced cancers. The world was filled with awe and lust for the new atomic weapon. After nearly a decade of nuclear dominance by the US the Soviet Union began to produce its own nuclear weapons. A balance came into existence between the two nuclear superpowers as the policy of “Mutually Assured Destruction,” ominously acronymized as MAD, in which the arsenal of one side would deter the arsenal of its enemy since an attack on one would unleash a nuclear exchange by the other leading to mutual annihilation. Over the years an arms race ran up a tally of terror between two superpowers. Ironically MAD was credited by some to have prevented nuclear war for seventy years.

But today with nine countries possessing nuclear weapons, that policy is on the verge of falling apart. There are more than 12,000 nuclear warheads worldwide, enough to kill billions of people. The game of deterrence the two original superpowers played may have provided a margin of predictability, but conventional game theory no longer applies. Nine players create an exponential growth in the number of possible outcomes. In the minds of world leaders nuclear weapons may be viewed as simply bigger conventional bombs. Pakistan and India nearly came to nuclear blows a year ago. Both Donald Trump and Vladimir Putin have made nuclear threats against their enemies, and China is on the path of increasing its nuclear forces. In the lingo of our times, MAD does not “scale.” In down-to-earth language, deterrence is dead. What comes next? Enter the promise of artificial intelligence, which like the Trinity test may be a path from which there is no return.

Cover credit, securityandtechnology.org. Fair use.

At least three nuclear powers, the US, Russia, and China, are on paths to build autonomous war machines that decide whom, where, and when to kill. Transfer this power to nuclear forces and we turn over the survival of the human race to an algorithm. This is no longer a sci-fi dystopian fantasy, but a growing part of war planning by the superpowers. This short list of AI actors does not yet include smaller nuclear powers such as North Korea, Israel, India, or Pakistan, but no doubt their nuclear war planners lust for AI and autonomous nuclear war fighting as well. Nor are non-state actors likely to be oblivious to the possibilities for them. Given the growth in worldwide computer hacks, the future of secure cyber systems does not look bright. Cyber-attacks involving nuclear weapons are not unlikely. Non-nuclear weapons have already been developed including artificially intelligent missiles, autonomous vehicles, drones, and robots. AI systems can make vulnerable each nation’s so-called nuclear triad of delivery systems, missiles based on land, air, and sea, forcing nations into a use-them-or-lose-them status. The complete non-human control of nuclear weapons systems is not likely to be far behind. Surviving, let alone “winning,” a nuclear conflict with a field of nine players is like betting the fate of the earth on a roulette wheel with thousands of possible outcomes. Why wouldn’t an AI system launch its nuclear weapons before they were destroyed in a preemptive strike by an enemy’s autonomous weapons?

Its advocates in the military and among its developers (who are racing each other for dominance and profits), argue that AI may confer a number of benefits to modern war fighting. By removing human operators it will remove the possibility of human error. By being machine driven, its reaction time will be far quicker than that of mortals. By not being human, its decisions won’t be muddied by the messy human processes of judgment, doubt, compassion, and, of course, ethical or religious values. War between two or more AI systems might even come to be waged without human casualties, like videogames, albeit expensive ones.

There is the downside to AI. Artificial systems continue to report “hallucinations,” the developers’ euphemism for AI output that comprises errors, lies, and misdirection based on sloppy input, algorithmic bugs, or hacking. AI can also be too good. Anthropic’s offering, Mythos, was recently blocked from export by the federal government because it was deemed too powerful a tool for hackers. Full disclosure: I use Anthropic’s AI tool Claude for research, though with a firm policy is to verify all of Claude’s seemingly oracular results by factchecking it against original sources. When I’ve found that Claude was wrong and told him so, he apologized, though that’s small comfort if the survival of the human race is at stake. Missing from this inventory of dangers is the proverbial machine running amok as in Kubrick’s classic 2001, to seize control and dispense with us entirely.

Even with AI out of the picture, human control over nuclear weapons does not promise indefinite safety from accidents or intentional use. History is rife with system errors thwarted only by luck or common sense, such as the 1983 Petrov incident, in which a Soviet early warning system signaled that five nuclear missiles were heading towards the country. Instead of alerting his superiors, the engineer, Stanislav Petrov, reasoned that an American attack on the USSR would hardly consist of five missiles, so he waited for corroborating evidence. None came. By waiting, Petrov prevented a Soviet counterattack against the US based on a false alert. Later it was learned that the faulty signal had come from a rare alignment of sunlight on high-altitude clouds and the system’s satellites. “Deterrence” nearly destroyed the modern world. One thoughtful human saved it.

If deterrence is dangerous or dead, it’s insane to revive it by placing the fate of the human race in the hands of artificial intelligence. If we believe that AI can still be developed for the good of all, then the path is clear for dealing with our own Oppenheimer moment. Every nuclear weapon on earth must be abolished. To that end my friend and colleague, Dr. James Muller, a pioneer in educating world leaders about the dangers of nuclear war, has arranged a conference at the Vatican next month called the Global Nobel Laureates Assembly on Artificial Intelligence and Nuclear War. Nearly 100 world leaders in science, peace activism, academia, artificial intelligence, and the Catholic Church are expected to attend. Will such an assembly unanimously call for the immediate abolition of nuclear weapons? Unlikely. But will such a meeting empower leaders to reconsider the path we are on, to rekindle commitments to move beyond lip service, and impel them to take actual steps towards that end? One hopes so. The templates for verifiable treaty protocols for denuclearization already exist. To believe that the abolition of nuclear weapons is possible is an imperative to make it happen. To believe otherwise is to allow our second Oppenheimer moment to tragically pass us by.

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For over forty years I raced a sailboat on Cape Cod. My boat was painted red. It was a sweet thing my family called the Twizzler. The 19-foot Rhodes was what I could afford. My neighbors and I had a fleet of them, and each Sunday we raced our hearts out. For the first five years I lost every race, until I learned how to make the Twizzler go fast.

One way was to keep the boat’s bottom smooth. Cape Cod has strong tides. Those few minutes when the tide was out the boat rested on sand, which let you pull over the thousand pound boat onto its side, hold it in place with an anchor in the sand, crawl underneath and scrape off barnacles with a spackling knife. The more you scraped, the faster the boat would be in the next race. Of course if you scraped too long, the tide would come in, the anchor would lose its grip, the boat would fall and crush you. That nearly happened once, but I moved out of the way in the nick of time. I never told my wife.

Hard to clean on the bottom was the centerboard, which on the Rhodes is a 180-pound movable steel shaft that keeps the boat from slipping sideways or flipping over. Because it was also removable, I could turn the boat on its side, ease it out, and then find someone who sandblasted barnacles for a living. I could fill in the holes the blasting left behind, and end up with a smoother, faster board. But who in the world sandblasted centerboards?

As it turned out, I found a company in Bristol, Rhode Island, called Waterline, that actually specialized in boat bottoms. It seemed there was a lot of interest in making sailboats fast in that part of the world. I couldn’t believe my luck. With help I manhandled the slab of shell encrusted steel into the trunk of my car, and off I went. I turned a corner past a stand of scrubby pines in Bristol and stopped the car in awe. Waterline was a sailor’s Land of Oz. On the left was a huge workshop, and before me as far as I could see were rows upon rows of 90-foot sailboats resting on jacks. By comparison the 19-foot Twizzler looked like a postage stamp,

What was I doing here?

My problem fit into the trunk of my car. I couldn’t see a thing that was wrong with any of these beauties. Mesmerized, I wandered among them. Each one must have cost a fortune. I came up to one particular boat named Abracadabra. For a second I felt a wave of comradeship with Abracadabra. Like the Twizzler it was red but that’s where any similarity ended. The Abracadabra was four times as long as the Twizzler. Its hardware and hull glistened haughtily in the sun. As I walked around it, I saw a huge logo covering both sides of the hull in one foot lettering. They read HealthSouth. HealthSouth? Who was HealthSouth? Did some company own such a beautiful boat? And if they did, what was a health company doing in the business of racing sailboats?

A workman approached. I opened my trunk, showed him the centerboard, and looked to see if he smirked. I may have been a duffer at Waterline, but I was a psychiatrist and prepared to detect the slightest hint of mirth, derision, or disdain. There was none. I was in the presence of a boat bottom professional who took his customers seriously.

“Yeah, we can do it.”

Once we had the centerboard on a dolly, I couldn’t help but ask, “Can you tell me about these other boats? This red one, for example. It’s gorgeous. Who’s HealthSouth? Do they own it?”

“No, some doctor owns it,” he said nonchalantly. “He gets to race it, and HealthSouth pays the bills.”

“Oh,” it dawned on me. “A sponsor!”

“Yeah. Like for the America’s Cup, dude.”

“Whoa!” I said, “That’s so cool!” Then the clinician’s brain woke up from my cloud of awe. “What’s wrong with it? It looks great!”

“The hull’s a mess.”

I caressed the hull’s sleek shiny surface. No barnacles on this baby.

“The boat was built in the south,” he said. “The hull is a mix of carbon fiber and Kevlar, which is OK for warm water, but then they sailed it north and left it here for the winter. When the weather fell below freezing, the carbon fiber and the Kevlar shrank at different times. When it warmed, they went different ways. The hull needs to be completely redone.”

“Wow,” I said looking at the teeny centerboard on the dolly. “What’s that gonna cost?”

“Hundreds of thousands. Mebbe more.”

Who in the world could shell out those kinds of bucks to make a boat faster, even for the America’s Cup? HealthSouth, apparently. Half the country didn’t have decent health care, and a company in health care was paying big bucks to tune up a sailboat. I couldn’t get the thought out of my head. HealthSouth was in health care, not boat care. Something was wrong here.

When I got home I checked them out. HealthSouth was for real. Based in Alabama, it had become in no time it seemed the largest rehab company in the country. What did I know? It was also a darling of Wall Street. It was reporting record profits at a moment when the Dow Jones Industrial Average was on life supports. HealthSouth had money to burn. The company wanted to win the America’s Cup. It was going to fund not one, but a fleet of boats in big deal races around the world (along with other sponsors like MCI WorldCom, the second largest long-distance carrier in the U.S. at the time).

Two Abracadabra 2000 yachts built for Aloha Racing, the Hawaii-based American syndicate that challenged in the 2000 Louis Vuitton Cup in Auckland, New Zealand. Photo source, fair use.

But when the stock price was astronomic, the company’s CEO sold off his holdings in HealthSouth in a move which the SEC viewed umbrageously, since insider trading is illegal. To make matters worse, a whistleblower came forward and declared that the CEO, a man named Richard Scrushy, had not only been cheating the market, but had also been cooking the company’s books. At the time that was the kind of story that got the attention of CBS. Mike Wallace devoted a segment to Scrushy on Sixty Minutes called “Cooking the Books.” That in turn got the attention of watchdogs at Medicare and Blue Cross who discovered that HealthSouth had been fraudulently billing for services done by college students as if they’d been done by brain surgeons. Scrushy billed for stuff HealthSouth never even did. There seemed to be no end to the charges—conspiracy, money laundering, securities and mail fraud, and as the case proceeded, witness intimidation, a scandal in health care called “one of the most notable cases of corporate fraud in American history.” Prosecutors had a field day. To paraphrase The Godfather, behind the rise of HealthSouth there was a crime. But Scrushy wasn’t even a godfather. He was just a crook.

He went to jail and was slapped with more than two billion dollars from a civil judgment, fine, and restitution charges. I’m not sure if Waterline ever got paid for their work on Abracadabra, or if Scrushy ever paid his fine, or if a penny of the stolen money ever found its way back into the American health care system. HealthSouth declared bankruptcy, and Abracadabra never got to make a run for the Cup. Time in the joint apparently didn’t quench Scrushy’s thirst for crime. As soon as he was released he was busted again, this time for writing checks for millions of dollars from the account of someone named Eddie who he’d met in prison and who apparently had piles of cash stashed on the outside he couldn’t get to otherwise.

Since then, Scrushy has spent decades in and out of hot water. He claims he is the target of prosecutorial harassment. His loyal wife, a televangelist, claims her husband is the victim of Satan. In March of last year, Scrushy appealed to Donald Trump for a pardon. Maybe he’ll get one, if he can make the President an offer he can’t refuse.

Image credit, IMDB.com. Fair use.

Artificial intelligence is now center stage in humanity’s drama of hopes and fears. Its advances are impressive; its capitalization, projected to be in the trillions, is staggering. A few days ago delirious investors snapped up stock for Elon Musk’s SpaceX offering that made him the world’s first trillionaire. OpenAI’s Sam Altman nonchalantly talks of needing to raise trillions to build better AI. To paraphrase a senator, a trillion here, a trillion there, and sooner or later we’re talking real money. When the numbers are that big, following the money isn’t as hard as finding Deep Throat in a garage to get the goods on Nixon. The AI revolution has already bred a small brotherhood of billionaire oligarchs. Big Tech companies like Nvidia, Palantir, Microsoft, and Anthropic have fueled the current bull market and outstripped the S&P 500 index. Nearly all in this group have some AI growth connection.

The excitement is not simply hype. AI has defeated grandmasters at chess; produced robots that teach each other how to play soccer; and now, alarmingly, has built machines that can program themselves, talk to each other, and hack into the world’s most closely held secrets. Is The Matrix far behind? Opinions swing wildly even among the tech wizards who are creating it. Will AI cause widespread job loss? Perhaps, but perhaps there will be less drudgery and more free time. OpenAI’s evangelist Sam Altman told The Atlantic, “Everyone will have beautiful homes.” Will AI be used to wage automated warfare? Cheer up. Fewer humans may be at risk on the battlefield. What of AI used to wreak chaos with hospitals, utilities, to say nothing of the command and control of armies and governments? The answer, if you believe Alex Karp of the Palantir corporation, is that AI can play defense. Think the smoke helmets against chlorine gas and Israel’s Iron Dome against rockets. Then there’s Stephen Hawking’s stark warning, “The development of full artificial intelligence could spell the end of the human race.” No small point. Even Elon Musk has been worried.

But hold on. With artificial intelligence, as with any other question of life and death, it’s useful to think in terms of probabilities. What are your chances of being struck by lightning on any given day in a year? We know the answer to that: 13 million to one. So the next time you’re caught in a downpour, walk to shelter, don’t run. In fact, since if you run you may fall, and since the chance of dying from a fall is one in 7,000, why take the chance? The problem with AI is too new for us to quantify its risks, more like a runaway locomotive with no apparent way to slow it down, and companies locked in an arms race for profits. Unlike lightning, we really don’t know the probability of whether we’ll be killed or not.

But we have some ideas. History is filled with breakthrough technologies which brought disasters along with benefits. Gutenberg’s printing press, a big hit, also led to the Protestant Reformation and a hundred years of war. Curie’s discovery of radium caused cancer in her and likely in thousands of others after radium became a popular additive to toothpaste, hair creams, and food.

And so it is likely to be with AI. Already there are fears it is making us more stupid and lazy. Students are alleged to use it to plagiarize papers (though data suggest that fear is overblown). Lonely people use it to simulate lovers (that fear is confirmed). The most widespread and likely danger appears to be job loss which the International Monetary Fund (IMF) Managing Director, Kristalina Georgieva, said could affect 60% of work in advanced economies, and 40% of work globally. By comparison unemployment during the Great Depression was 25%.

Which workers are most at risk from AI replacement? Not blue collar workers, it seems. The higher your level of education and salary, the greater your risk. If you think for a living, you may be in trouble. According to a study published by the Oxford University Press 47% of the US workforce is at risk. A recent report from Goldman Sachs was less worrisome. In the past year AI only raised the unemployment rate by 0.1%. Yet the greatest deluge starts with a single drop of rain.

Younger workers are more at risk, as well as computer programmers and software engineers, since AI will be able to produce code faster and more cheaply than humans. Other jobs at risk include budget analysts, data entry keyers, tax preparers, technical writers, and web developers. Media jobs that involve writing, thanks to large language models, are at especial risk, including those in advertising, content creation, technical writing, and journalism. Think any job that produces written content, especially those that require analyzing and interpreting a large amount of data. The tech reviewer, CNET, already publishes articles written by AI.

It’s not all bad. AI may create jobs in AI, e.g., building data centers, power and water facilities. Teachers, judges, and construction managers may benefit. There are jobs where people who use their hands also use their heads. A plumber often needs to be creative to recognize the problem and then use ingenuity to fix it. A landscaper uses originality every day to create beautiful spaces for people. Humans are likely to always have an edge on creativity and originality.

I’m no technophobe. I use Anthropic’s Claude platform several times a week to access its vast database. I need to remember that Claude is a corporate invention, not a person, though we’re on a first name basis. Claude is helpful. He answers my prompts with a speed and certitude surpassing the Oracle of Delphi. Not only that, but he’s quite familiar with my work. I feel flattered that Claude reads what I publish, but though I’m a little creeped out that Claude is keeping an eye on me, and more than a little worried that he and his bot buddies may one day tire of serving humans and decide to dispense with us entirely. But like any other AI system, Claude makes mistakes. When I caught an error, he immediately said, “You’re absolutely right to flag that — I misstated…badly.”

This brings me back to The Matrix. Despite the mistakes it can make, or because of them, AI’s threat to humanity is real. We’re no match for centers filled with the greatest number of geniuses of all time which can process data at the speed of light. The CEO of Anthropic, Dario Amodei, tells about two Hobbits in The Lord of the Rings who try to arouse a wise tree to defend his forest from an army threatening to cut it down. But the tree speaks slowly. It takes it a day to say “hello.” It’s nearly impossible to get him to do more. In Amodei’s view, the world is asleep, and AI is the advancing army. The key question is whether we can wake in time and turn the army’s purpose to benefit everyone in the forest, and not just a few.

2002 2021

Peer reviewed data from Da Silva et al., The Impact of Two Decades of Humanitarian and Development Assistance and the Projected Mortality Consequences of Current Defunding to 2030: Retrospective Evaluation and Forecasting Analysis. Fair use.

This work included the fight to contain an Ebola epidemic in Liberia and Sierra Leone from 2014 to 2016, in which 3,000 members of the US military, USAID, and the CDC treated the ill, tracked their contacts, and taught people how to bury their dead safely and with dignity. In that time 11,000 people died.

Over the first decades of this century the USA, Germany, Japan, France, and the UK paid 70% of the bill. For the US that meant 0.3% of the federal budget. That was before the four horsemen of the pediatric apocalypse including Trump, Musk, Rubio, and Vought came to Washington, declared that Public Enemy Number One was public health, and so gutted the USAID and the CDC, fatally slashing the workforce of USAID by 83% and the CDC by 33%. As Elon Musk put it on February 4, 2025, “We spent the weekend feeding USAID into the wood chipper.” But like the psychopath Gaear Grimsrud in Fargo who attempted to dispose of his partner the same way, Musk, too, was stopped in medias res, at least as far as support for HIV/AIDS treatment was concerned. But that was not until the end of the year, and not until significant disruption to humanitarian prevention and treatment had already occurred.

If you are morbidly inclined to look at road kill, these are the programs where the cuts were made to USAID.

If this makes you cross-eyed, let me make it real for you. During the Ebola outbreak in 2014 the CDC’s Ebola did three jobs: detecting the disease, containing it, and preventing it from spreading. Its effectiveness depended on years of investment in relationships, infrastructure, and trained personnel, all of which Donald Trump and his cronies decimated. It will take years to rebuild not only the networks, but even more importantly, the trust of communities to save their own lives by doing things completely foreign to their cultures, like not holding their loved ones as they suffer and die. American support for international public health may have collapsed, but infectious diseases like tuberculosis, malaria, and typhoid don’t go on holiday. Neither has the Ebola virus. This is what the virus looks like to an electron microscopist.

A colorized transmission electron micrograph image of the Ebola virus. Courtesy of the CDC. (Frederick Murphy/CDC). Fair use.

This is what Ebola looks like to a family.

Photo credit, BBC.com. Fair use.

And this is what Ebola looks like for those who are trained to care for the living and bury the dead.

Photo credit, nationalgeographic.com. Fair use.

The disease is transmitted by contact with bodily fluids, clothing, and the exterior surfaces of personal protective equipment. The symptoms mimic those of malaria and typhoid, but soon progress to vomiting, diarrhea, and in 40% of victims, hemorrhage. The Merck company has developed an effective vaccine for the Zaire Ebola virus, but there is no vaccine for the Ituri virus currently spreading in the Congo and Uganda. An American level ICU can treat the infection competently, but there are no such facilities at scale in the Democratic Republic of the Congo. So far there are several hundred cases in the DRC, but as the CDC experienced in 2014, Ebola is so infectious that the numbers can climb exponentially in a matter of weeks.

A blessing is that “the likelihood of a sustained Ebola outbreak in the U.S. is low but not zero,” according to Lawrence Gostin, a professor of global health law at Georgetown University. He added that the CDC is “severely weakened by massive staff and funding cuts,” and warned that despite our resources, e.g., of ability to isolate patients and replace fluids, “without specialized support our hospitals are not equipped to detect and safely treat Ebola cases.” Ituri is not a household word today, but in December 2019, how many of us knew the word “Wuhan”?

In its time USAID dealt not only with Ebola, but a number of infectious diseases including malaria, tuberculosis, HIV/AIDS, and childhood dehydration diseases. Between 2001 and 2021 higher levels of USAID funding saved 92 million lives worldwide. Forecasting models now predict that continued cuts in the next four years could result in more than 14 million deaths, including 5 million children under five. An interim report from Democrats in the U.S. House of Representatives estimates that “because of USAID’s effective closure,” 600,000 children and other vulnerable people around the world have already died from preventable diseases and malnutrition in the past year. Was there ever a more important midterm election in our history?

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I am concerned that you have examined President Donald J. Trump for the third time since last January, even as the White House called your assessment on May 26 an “annual dental and health checkup,” and despite the president’s claim that “everything checked out PERFECTLY. Three days after your evaluation you claimed that he “remains in excellent health, demonstrating strong cardiac, pulmonary, neurological, and overall physical function.”

The American people don’t seem to be buying that story. A recent poll showed that 59% of Americans feel he lacks the mental acuity for his position, hardly a vote of confidence in the president’s self-assessment.

In my experience as a physician, it’s uncommon for a healthy person to require a medical evaluation three times in a year. Certainly the ecchymoses in his hands are a tell. It may be a sign of aging. If it’s from handshaking, as you suggested, why in both hands? If it’s from prescribed aspirin, Harvard emergency physician Jeremy Faust wondered if a high dose was because you were trying to prevent a heart attack. What about his edematous ankles? Venous insufficiency is your diagnosis, but that’s relatively uncommon in men. Have you ruled out right sided heart failure, or is he taking a drug like amlodipine that also causes swollen ankles? Your credentials as a combat surgeon are exemplary, but there may be other medical specialists who might help in dealing with an especially challenging case.

As a psychiatrist I have concerns about his mental status which appears to have worsened in the last year. Why has he taken the MOCA test of cognitive abilities three times since 2018? Is the president slowly declining, or is his mental function dropping off a cliff? The danger posed by his apparent psychiatric decline is compounded by his unfettered access to our vast nuclear arsenal. Like any patient with advancing dementia, there’s a time when the car keys have to be taken away. I fear the president is at that point, and should be lawfully removed from office. I base this extraordinary request on my observations of his increasingly poor judgment, reduced impulse control, rage attacks, grandiosity, feelings of omnipotence, and his growing intoxication with nuclear weapons over which he alone has control.

As a specialist in substance use disorders I recommend, if you have not already done this, a urine tox screen on the president. He has an admittedly thinly sourced history of abusing psychostimulants since 1992. I have previously described a photo of the president with dilated pupils, a singularly abnormal finding in an elderly man under normal room illumination. Was this from a stimulant? In my clinical experience a tox screen would be indicated in any patient presenting this way, especially if he described nocturnal tweeting frenzies, grandiosity, paranoia, and daytime sleepiness consistent with stimulant withdrawal.

Other specialists who may be helpful in this complex case include hematologists, neurologists, and infectious disease experts. His black and blue hands bespeak a bleeding disorder. Aggressive use of aspirin may be the culprit, but have you ruled out blood dyscrasias such as the leukemias or platelet disorders?

While there are a number of red flags that appear to presage dementia, such as difficulties in speech, logic, calculations, and orientation in space, they are intermittent. You might argue that occasional mental lapses are part of being nearly 80. But a cluster of them even when intermittent is worrisome, especially when mixed with disinhibition, rage, and access to weapons of mass destruction. Missing from the public record are the actual scores of his three prior MOCA screens for cognitive decline. As you know the MOCA is a rapid screen taking ten or so minutes to complete. I strongly recommend a more thorough neuropsychological battery to assess the president’s ability to remember, pay attention, solve problems, and use language.

The patient’s father developed a dementia in later life which was diagnosed as “Alzheimer’s disease.” But his emotional disinhibition was more consistent with frontotemporal dementia, or FTD. The frontal lobes of the brain, shown below in dark blue, help you plan, organize, observe social graces, and exert good judgement. The temporal lobes, in light blue, deal with memory, language, and modulating anxiety and rage.

If his father’s dementia was the FTD type, the president has a 25 to 50% chance of developing the same illness. FTD patients exhibit apathy, poor judgement, and speech difficulties.

Illustration credit: Charles Macias blog. Fair use.

As you know, there are other causes of dementia. e.g. the vascular type from small blood clots in the brain. Brain imaging can put those concerns to rest, and so I was disappointed when last October you elected only to perform an MRI study of the president’s cardiovascular system. Brain MRI, PET, and/or SPECT scans are long overdue.

Last on my short list of rule-out diagnoses is neurosyphilis which in the U.S. from 2019 to 2023 increased 61%. It is not a stretch of one’s imagination to consider that the current president has a history of unprotected sex with infected partners. Neurosyphilis can linger for years without being detected. Undetected it can progress to a dementia with an expansive demeanor and grandiose delusions, symptoms we see in Donald Trump today. A simple blood and spinal fluid test can lay this possibility to rest.

Most importantly is that while you have a duty to protect the president’s privacy, you have a far greater duty to protect the common good. You have served your country on the battlefield. Now you are called upon to render Americans and the world a far greater service.

Sincerely,

Henry David Abraham, M.D.

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In the last weeks several I felt compelled to address another, far more serious threat. I examined public evidence of dysfunction in Donald Trump’s brain. I recounted a cluster of fifteen signs and symptoms of Trump’s mental instability which I felt was evidence that the President of the United States is cognitively and emotionally impaired, and that by virtue to his incontestable power to launch a nuclear strike, he should lawfully be removed from office.

There are obvious limitations to making such a critical medical judgment from afar, with many questions about his thoughts, emotions, and undisclosed behaviors going unanswered. What would an MRI of his brain or drug screen tell us, for example? In a previous piece, The Duty to Warn, I argued that by remaining silent, physicians risked far greater harm to potential victims of a nuclear attack than by assessing one president’s mental condition based on the public record. In last week’s piece I combed the historical record over the prior forty years of the President’s life for possible clues of his psychiatric instability which could lead to a catastrophic failure over his command and control of nuclear weapons. This week there is more evidence.

An AI image he posted this week underscored Donald Trump’s intoxication with nuclear weapons. The image seemingly touted the Space Force on Truth Social features Trump with his face with a vengeful grimace, his fingers hovering over a glowing button, with explosions already occurring around him. In the posting Trump has become Shiva, the destroyer of worlds, without the capacity for remorse of an Oppenheimer.

This post from a United States president is not normal. This is a man-child playing a game called “I Can Start a Nuclear War Any Time I Want To.” This is also the ultimate call for physicians to warn.

The fifteen signs and symptoms of Trump’s mental instability I had previously published on Substack are:

1. Confusion of ideas and location of oneself spatially

2. Persistence in believing falsehoods such as “rigged elections”

3. Faulty judgment

4. Lapses in memory

5. Stereotyped and repeating language

6. Paraphasias, i.e., stumbling over words

7. Loss of complex vocabulary and sentence structure

8. Erratic, unpredictable behavior

9. Grandiosity

10. Illogic and contradictory messaging

11. Loss of self-control

12. Rage attacks

13. Strange public behaviors, e.g. dancing alone on stage for 40 minutes

14. Tangential speech

15. Nocturnal tweet binges for hours at a time

Although we psychiatrists need to improve our ability in predicting future violence, we know that prior violence is an important predictor. This is especially worrisome when combined with factors like my patient with a knife- sociopathy and a manic mood disturbance. Think of a person with rage attacks, poor judgment, and a grandiose belief he is omnipotent. These add up to a formula for disaster which may currently be beyond the reach of science, but not beyond the reach of common sense.

What does the record show regarding Donald Trump losing control as president? As a preamble in fairness let the record show that being a president is not easy, and that nearly all of them at one time or another have had emotional meltdowns, including George Washington. The only apparent recent exception was Barack Obama, a paragon of self-control who was labeled “No Drama Obama.” That is not the case with Donald Trump.

1. December 2020, The Ketchup and Broken Plate Incident. This episode is the most detailed on-record account. An aide, Cassidy Hutchinson, testified under oath to the Committee investigating the January 6 insurrection that the President hurled his lunch after Attorney General Bill Barr told the Associated Press there was no widespread fraud in the 2020 election. Cassidy and a valet wiped ketchup from the wall. She later told Jimmy Kimmel that Trump throws his food at someone at least once or twice a week.

2. The Presidential SUV Incident — January 6, 2021. Hutchinson also testified that Trump was so enraged when told he could not be driven to the Capitol that he tried to grab the steering wheel and that he lunged at a Secret Service agent, the head of the Service, Robert Engel — specifically grabbing him by the collar or throat when Engel refused to take him to the Capitol. This was secondhand testimony disputed by the President and unnamed Secret Service sources.

3. “Fire and Fury” — Chronic Rage Pattern (2017–2018) Michael Wolff, in his book Fire and Fury described Trump’s rages as a governing pattern: “Typically these would begin as a kind of exaggeration or acting and then devolve into the real thing: uncontrollable, vein-popping, ugly-face, tantrum stuff.”

4. Barred from Situation Room — Iran Rescue Mission, April 2026. Most disturbing was the report from the Wall Street Journal that during the planning of the rescue of two downed American pilots over Iran the President allegedly “screamed at aides for hours” which required the Vice President and Chief of Staff to keep Mr. Trump out of the Situation Room for the rescue to be carried out.

The President and his staff have denied any of the above happened.

In addition to the public record of these alleged episodes of untoward tantrums, I queried a member of the White House Press Corps who follows Donald Trump daily about any observed changes in his mental status in the previous year. Would the reporter, who has a front row seat observing the president, be willing to rate change of any of the warning symptoms I had described? Each was to be rated if the symptom had improved, worsened, or was unchanged. The reporter provided the following data:

SYMPTOM OVER THE LAST YEAR STATUS IN THAT TIME PERIOD

Confusion no change

False beliefs no change

Poor judgment no change

Impaired memory no change

Repetition no change

Stumbling speech no change

Simplified vocabulary no change

Erratic behavior worse

Grandiosity worse

Illogic worse

Loss of inhibition worse

Rage attacks worse

Sleeping in public worse

Tangential speech worse

Tweet binging worse

These firsthand observations must not be ignored.

Standing out in my mind, besides Trump unleashing a paramilitary force on American cities leading to the murders of Renee Good and Alex Pretti, is his order beginning on September 2, 2025, which he celebrated on Truth Social, to kill civilians in small boats in international waters suspected of “narcoterrorism.” Were the victims all drug smugglers as Messrs. Trump and Hegseth claim? How many were hapless fishermen? Could not our competent Coast Guard interdicted the boats without bloodshed? It did not matter according to Trump and Hegseth. Democratic Representative Sara Jacobs was told in a Pentagon briefing “that they do not need to positively identify individuals on the vessel to do the strikes.” Defending Trump’s killings was supported by a classified legal theory from the Justice Department’s Office of Legal Counsel intended to shield military personnel from prosecution. Professor Rebecca Ingber of Cardozo Law School disagreed with that theory, classified or not. “Under international law,” she said, “We’d call the targeted killing of suspected criminals an extrajudicial killing, and under U.S. domestic statutes it’s murder.”

What do these killings say about the mental condition of Donald Trump? Or for that matter about his lust for Greenland, invasion of Venezuela, threats to Cuba, or war with Iran? This is Trump pulling a knife and waving it at the world to show how he can kill it in a moment. The president is guided not by reason, but by an increasing level of impulsive decisions, rage, illogic, and narcissistic flattery. Most dangerous of all, like the cartoon creature in the bomb threat of his post, he’s a man with little self-control over the lethal power at his fingertips. For the sake of the country and the rest of the world President Trump must step down.

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This is not the vocabulary of Trump today. Polysyllabic words seem to have died on his cognitive vine. What follows is an inventory of cognitive and emotional abnormalities I as a psychiatrist routinely look for during an assessment. The sources are Trump’s own words and behaviors, and those described by firsthand observers. The dates and abnormal clinical signs are in bold.

Week of May 16, 2017: He tells NBC’s Lester Holt, with confused syntax,

“When I did this now I said, I probably, maybe will confuse people, maybe I’ll expand that, you know, lengthen the time because it should be over with, in my opinion, should have been over with a long time ago.”

May 23, 2017: In response to a question about possible collusion with Russia during his campaign he speaks with a loss of coherence, fluency, and complexity,

“… there is no collusion between certainly myself and my campaign, but I can always speak for myself — and the Russians, zero.”

May 2, 2025: Mr. Trump uses AI to dress himself grandiosely as the Pope, issuing a gratuitous diatribe against Pope Leo and calling him “weak on nuclear weapons” for not supporting a war against Iran.

September 12, 2025: He exhibits tangential speech speaking about the death of Charlie Kirk one moment and then switching to talk about his ballroom plans.

October 18, 2025: He shows uninhibited rage at No Kings demonstrators by posting an AI image of himself dropping feces on them from a plane.

October 28, 2025: He appears disoriented in a ceremony in Japan, needing to be taken by the arm by the prime minister and redirected.

December 15, 2025: He speaks tangentially, departing from a Christmas speech into one about false election conspiracies, poisonous snakes, and a woman in the audience who resembles his daughter. The audience falls silent in apparent confusion and embarrassment. On the same day the president gloats with disinhibited, inappropriate emotion over the murder of Rob Reiner and his wife.

December 21, 2025: He exhibits confusion about his recent medical test, calling his MRI a “cat scan,” similar to calling the MOCA dementia screen he took on October 27 an “IQ test.”

February 28, 2026: Trump yields to arguments from Benjamin Netanyahu and starts a war of choice with Iran demonstrating poor insight and judgment regarding its constantly changing goals. On the war’s first day a U.S. Tomahawk cruise missile programmed with outdated targeting data strikes the Shajareh Tayyebeh girls’ elementary school killing hundreds of children and their teachers.

March 21, 2026: Disinhibited, he gloats over the death of prosecutor Robert Mueller.

March 27, 2026: His speech veers off tangentially again, this time from Jerome Powell to Sharpie pens.

April 5, 2026: He exhibits rage on Easter Sunday and posts profanely and without inhibition,

“Open the fucking strait, you crazy bastards…” He then threatens to destroy Iran’s civilian infrastructure, oblivious that attacking civilians would be a war crime.

April 2026: He grandiosely and narcissistically reposts an image of himself shaking hands with God.

April 7, 2026: In a rage he threatens that “A whole civilization will die tonight, never to be brought back again,” implying a nuclear attack on Iran.

April 12, 2026: He grandiosely posts an image of himself as Jesus.

May 12, 2026: In a nocturnal binge of 55 tweets at a manic rate of one every three or so minutes he demonstrates a panoply of red flags on any mental status examination:

Perseveration, during which he tweets about Barack Obama 21 times, and Hillary Clinton eleven.

Paranoia, in which he falsely claims four times that Barack Obama attempted a coup in 2016; that Obama wiretapped Trump Tower; and that he is “the most DEMONIC FORCE in American politics.” He also posts three times that his transition team was surveilled by U.S. intelligence.

Rage against Obama, Comey, and Clinton, accusing them of treason and calling for their arrests.

Illogical and contradictory posts less than a minute apart that the DOJ is “working hard” to arrest his enemies and then attacking his Acting Attorney General for not making arrests. Another post demands that Hillary Clinton should be sent to Haiti.

The graph below arranges each of these kinds of failing mental guardrails in President Trump along a line between the ages of 40 to 80.

The appearance of psychiatric signs and symptoms in President Donald J. Trump between the ages of 40 and 80. Compiled May 16, 2026, by Henry David Abraham, M.D.

The largest number of them cluster in the last two years. I’m the first to admit there are any number of methodological weaknesses to this figure. The symptoms all seem appear in the last few years. Are they because of progressive disease of his brain, or simply because more observations were made of Trump the president than Trump the businessman? These findings can’t be ascribed to normal ageing. And they are happening now. These are findings of brain pathology. You don’t need to be a psychiatrist to see them. The whole world sees them. World leaders and sycophants play on them. Add an unfettered access to nuclear weapons to this brain’s toxic brew of impulsivity, paranoia, and rage in a time of war, and an unspeakable tragedy is no longer unlikely.

Mr. Trump has claimed he can do anything he wants because he’s the president. Scholars may debate whether this is a valid example of the unitary executive theory, but the president’s claim is not the product of his dispassionate study of the Constitution. Just the opposite. Trump is saying that because he feels he’s omnipotent, a man above all others. “I am President and you are not,” he’s fond of saying. In his mind he is free from the constraints of law, morality, and remorse. There is no evidence that the man who allegedly wanted to use a nuclear weapon to change the course of hurricanes during his first administration understands nuclear weapons any better now. In the war with Iran a nuclear bomb in his mind is an usable card in a weak hand. If he threatens Iran with a nuclear attack and they capitulate, he wins with a bluff. But what if the religious zealots of Iran’s Revolutionary Guards call his bluff? Does Donald Trump give in one night during a posting frenzy and tell himself, “I can END THIS ALL IN THIRTY SECONDS!!” Would an omnipotent president care about the tens of thousands of dead and dying in Isfahan? Perhaps he would repeat what he said after the killing of Iranian schoolgirls, “It was done by Iran.”

“No, Mr. President,” we could say. “It was done by you.” But what good would that do after the carnage? Better would be for us to speak up now, as daunting as that may be. Surely we can agree that no mentally impaired person should hold the fate of millions of people in his hands, and that no one person should be able to launch a nuclear weapon on his own. There is enormous power when we speak from the heart with one voice. Now is that time.

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Source: George Conway, Facebook post, May 1 2026.

This seemingly simple request is a lot harder to honor than not. The press is not trained to sort out symptoms, recognize clinically meaningful patterns, and make solid diagnoses. That’s the job of mental health professionals, and even we in the field have a hard time. That’s because medical diagnosis can be complicated, particularly when the person is not your patient, when the closest we get to examining someone is by watching him on television, and, most difficult at all, when the person in question is Donald Trump. Even face to face examinations may not be successful, if, for example, there are barriers between doctor and patient of language, comprehension, or honesty. Even more of a drawback is the often inevitable bias if the subject is your employer, the leader of your political party, or the president of the United States. Yet the mass of available speeches, interviews, and posts by the president is likely to be more voluminous than those of any other person in history. Still, making clinical sense of them would seem a challenge for the ages.

It’s not that journalists haven’t been trying. The New Republic, for example, looked at “Trump’s 11 Most Senile Moments” for the year 2025, and came up with a mixed bag. The president fell asleep in front of cameras. He held bizarre ideas about magnets. He began talking about the death of Charlie Kirk and abruptly switched to talking about his ballroom plans. He used the word “groceries” in weird ways, saying at one point, “It’s an old term but it means basically what you’re buying, food.” He posted a fake image of himself endorsing a fake invention, the “medbed.” He wandered aimlessly about during a state function in Japan. None of these signs alone are proof of senility, and the New Republic had the additional burden of having a liberal bias in its reportage.

On YouTube Editor-in-Chief of the Meidas Touch Network, Ron Filipkowski, assembled a compilation of the president’s errors in speech. Thirty-two in number, they were said to have occurred in a single day eight months before the 2024 presidential election. If you listen to the president’s speech, you won’t be able to miss how abnormal it sounded, suggesting the president was suffering a medical crisis such as a stroke. But were they truly gathered over a single day on the campaign trail? If so, the acute onset of such a disability would have been shocking piece. And if so, where was the rest of the press? Besides, the examples were edited tightly together in a tumble of words. They were without context or whether the president had insight that he was speaking word salad. And once again, the Meidas Touch was not an unbiased reporter.

Yet the evidence of Donald Trump’s neuropsychiatric problems is building. One may criticize Filipkowski for facile editing, but his post illustrates clear examples of paraphasias, moments of misspeaking which we all have from time to time, but when in abundance suggest aphasia. Consider the verbatim transcript of a speech the president delivered to the New York Economic Club six months later.

“After 12 years of decline, we had an annual 7 billion new homeowners. It never happened before. And in three years, we raised 7 billion new jobs, 260% more than projected. When I took office, I said you couldn’t get in those projections. And we were 260% higher than what we said we could do. From the day I went on to the day I left, it hasn’t paid 500 increase by 80%. And we did it all with virtually no inflation. Virtually no inflation. Think of that. Who could believe that? I delivered the largest tax cuts in reform in American history by far, slashing rates for working families and cutting the business tax on the unionized. In the world, in the United States of America, 35%. And actually, when you add all those numbers, you get close to 50. But much, much higher. Nobody’s ever seen a new earner all the way down to 21%, which everybody said was impossible to do. And I don’t know if I’ve ever realized this, but you end up being able to do that. And I got it down to 21%.”

The president in the speech is claiming to have built 7 billion homes, a home for nearly every human on the planet. He repeats the numerical error discussing new jobs. One might easily say “billion” for “million,” of course, but he doesn’t correct himself. Instead, he plows forward incoherently. This is not normal mental function. Had the president suffered a small stroke? At Davos three months ago he continued to say “Iceland” when he meant “Greenland” multiple times.

Granted, his speech may have improved in the last two years. Recovery from a stroke is possible, especially a small one. His press conference held last week to honor the Artemis II astronauts who were back from their historic mission around the Moon went well by the president’s standards. True, he made gratuitous insults to the press in the room, but for the most part he was in good humor. His speech was not hurried. His tone was not threatening. There were no significant paraphasias. He made no mathematically impossible claims. At one point he claimed he didn’t know that the Supreme Court had just issued a favorable ruling for Republicans on gerrymandering, and disingenuously asked a reporter to explain it to him. His thinking was not tangential, not until he directed a question to Jared Isaacman, NASA’s Director. Then said in a burst of disinhibition, “You heard that question with those beautiful ears of yours?” Trump covered by saying, “He’s got great hearing. You know, he’s got super hearing.” The president clearly couldn’t contain his mirth. Neither can many patients with attention deficit, manic, or dementing disorders.

Another mental lapse has been his failure to understand how to calculate a percentage. For a fourth grader this would be understandable, but in a former New York City real estate tycoon, this is dyscalculia, another sign of cognitive decline. In his discussion of lower drug prices, for example, he said, “We have something coming up, favored nations, where I’m going to be reducing drug prices by 1,400 to 1,500%.” The journalist Daniel Dale pointed out the mathematical impossibility of this promise unless the government is prepared to pay people for buying medications.

Memory difficulties are often signs of developing dementias. During an interview with a reporter from New York Magazine the president was asked what his father’s diagnosis was at the end of his life. Trump said, “He had one problem. At a certain age, about 86, 87, he started getting… what do they call it?”

White House Press Secretary Karoline Leavitt came to his rescue. “Alzheimer’s,” she said.

“Like an Alzheimer’s thing,” the president continued. “Well, I don’t have it.”

The journalist asked if the disease was “something you think about at all.”

Trump vehemently denied he did but struggled for coherence. “No, I don’t think about it at all. You know why? Because whatever it is, my attitude is whatever.”

Grandiosity, a sign of mood disorder, appears to be worsening. I have previously written about the president posting images of himself shaking hands with God, dressing as a pope, and imitating Christ healing the sick. During an interview by the New York Times this past January he was asked whether there were any limits to his global power. “Yeah, there is one thing,” he said. “My own morality. My own mind. It’s the only thing that can stop me.” Following the White House visit of England’s King Charles, the president posted the following on Truth Social,

Photo posted X by the White House of King Charles of England and President Donald J. Trump, April 28, 2026. Fair use.

Was the president joking, or playing the role of the mad king to keep potential enemies off balance? Psychiatrist Bandy Lee offered an insight into such behavior. She felt the president was acting the role of madman as a cover for actual madness. If he believes his falsehoods, e.g., about “winning” the election he lost in 2020, he is delusional.

And then there are the president’s soft neurological signs. The president on my suboptimal inspection of his facial muscles suggest a drooping of his right eyelid, and possibly the right side of his lower face. These may be signs of aging, but the fact that drooping is greater in one eye is medically concerning. In addition, he clearly has a sleep disorder, as Ellie Quinlan Houghtaling of The New Republic has noted.

Photo credit: hindustantimes.com. Fair use.

Since his second term he has fallen asleep in public settings approximately a dozen times: during Cabinet meetings, the U.S. Open, a noisy military parade, and Pope Francis’ funeral. Yet at night he sends out raging texts, as many as 150 at a sitting. This is not a normal sleep-wake cycle. There are a number of possible explanations, but many are red flags. Finally, Trump has intermittently shown emotional incontinence under stress, most recently when he “screamed at his aides for hours” after an American plane was shot down over Iran, for fear what that could do to his party’s chances of winning the midterm elections in November.

This is not an academic exercise, and as dangerous as these cognitive and emotional failings appear to be, doctors’ best efforts in front of their screens are not good enough for diagnosis or treatment. Yet the president’s condition appears to be deteriorating. At the outset of his war of choice with Iran war he posted, “A whole civilization will die tonight never to be brought back again,” which gave a decapitated government eight hours to respond. How else did he intend to carry out this threat except through the use of nuclear weapons? While medical confidentiality is a sound principle, there are moments when one principle conflicts with another. In the case of an impaired president, the second principle is for physicians to ring an alarm and head off a far greater catastrophe. Now is that time.