We rise every morning in this apocalyptic now, touch our screens or jab at our remotes, and receive the incoming: 65,000 new cases a day, 139,000 deaths. The order of magnitude of our loss of human life and looming economic carnage is staggering: we have 4% of the world’s population, but over 25% of global deaths from Covid-19. The international community is aghast at how America has responded to the crisis. We are viewed as a pitiful and failed state. For the 70% of Americans who live outside of the cult of the President, the current predicament is maddening, if not soul-crushing. We can’t help but la-ment ‘ Did it all have to unfold in this disastrous manner?’

The answer is “yes”.

Yes, it was inevitable that the President would display a shiftless and shambling response to the crisis; that he would be unable to collaborate with public health professionals and would subvert policy to divisive culture wars; and that he would take no responsibility for his dysfunc-tional leadership and the damage that flowed from it.

Inevitable because the President is at the mercy of a severe personality disorder that is defined by three unforgiving and unyielding traits: impulsivity, a drive to dominate others, and remorselessness.

Inevitable because the President, for the first time in his tenure, had to face a crisis that could not be spun, intimidated, vanquished by disinformation, or re-branded away. This crisis has laid bare the pathology of his personality disorder. One could be forgiven for thinking that, with the stakes so high, he could have transcended the pull of these destructive traits. After all, it cer-tainly would have been to his political advantage. But he was a fly caught in the web of his condi-tion. We never had a chance.

How the President’s condition dictated our fate can be understood through the lens of these three ruinous traits.

Impulsivity is one of the core traits of psychopathy. It appears to be associated with an underlying brain abnormality, probably in the area of the prefrontal cortex that integrates reason with rapid-fire impulses. As a result, the psychopath is wired to be disinhibited, reckless, undisci-plined, unruly, easily bored, disorganized and undependable.

This cluster of traits has been on full display since we first heard of the virus in January. We know Donald Trump has contempt for the kind of nose-to-the-grindstone planning that was necessary to generate a competent and coherent response to the Coronavirus. He brags about not reading briefing papers and scoffs about diving into the quotidian details of any project.

His disdain over the details of governance masks his incapacity to solve problems that require discipline, deliberateness and focus. A head of state described a 60 minute meeting with Trump as “60 one minute meetings.” The recent spate of insider books on what it was like to work with Trump highlight his distractibility (“attention span of a gnat”); and paint a picture of a man who, while he clearly has skills in the political arts, exudes incompetency when confronted with a complex or thorny issue.

And dereliction. He didn’t attend coronavirus task force meetings, and became bored with the daily press conferences as soon as it became clear they were hurting his poll numbers. As we look back over the past seven months, it is clear there was never even a plan of a plan. There was chaos and neglect all the way through.

The set of skills needed in a President to develop a detailed and comprehensive response – a response that would not leave the rest of the civilized world aghast – was simply not there. He was overmatched. We are the global leader in data science. We have the most advanced and certainly the most expensive health care system in the world. Yet, we never had a chance.

The psychopath is unable to connect with others in a loving manner, which appears to be related to deficits in the limbic area of the brain. He can only relate to others through the gear of domination. “Winning,” as Trump endlessly repeats, is everything. Nestled within this cluster of traits are arrogance, deceitfulness, and attention-seeking.

In theory, just because Trump doesn’t have the temperament to delve into the complex challenges presented by the pandemic, just because he has been utterly indifferent to running the federal government, doesn’t mean he couldn’t have delegated authority to others who were capable; or collaborated with public health officials or any number of think tanks that had detailed plans on how to manage a pandemic. After all, it would have made him look good.

But it was never going to happen. Collaboration is anathema to the psychopath. The psy-chopath is like a leopard who eschews traveling in a pack and relies solely on their cunning to seek out their prey.

From the outset, Trump treated the crisis as a media spectacle that he was driven to dominate. By instinct, he did not view the crisis as a threat to the country, but rather to his brand of “stable genius” and “I’d give myself a 10.” His basic mode was to tell a story about the crisis that made him look good, rather than actually manage it. Trump relied on the skills that have served him so well in the political arena, “skills” that can be discovered in any textbook on clinical psychopathy. These include:

1. Denial – “It will disappear…like a miracle…it will fade away”
2. Disinformation – “anybody who needs a test, will get a test,” “99%” of COVID cases are “totally harmless.”
3. Blame – Obama, Democratic governors, World Health Organization
4. Undermine expertise – attack the credibility of the CDC, muzzle Dr. Fauci
5. Foment divisiveness – “liberate Michigan!”, characterize Blue America as evil.
6. Demand fealty – stack the White House and Cabinet with feckless plutocrats and sycophants.
7. Dismantle – the pandemic task force in the White House established by President Obama.
8. Smear and taunt – Daily Twitter rages that trash a long list of perceived enemies (“sleepy Joe,” “nervous Nancy”)

This crisis demanded collaboration and truth-telling. Trump’s unyielding drive to dominate, fueled by his arrogance and deceitfulness, gave us the opposite.

We all can act against our nature, at least occasionally. Introverts can act like extroverts in some situations. Someone who is not conscientious can – particularly if the stakes are high – rise to the occasion and get the job done. And so Donald Trump, after seeing the devastation brought about by his indifference to governing and divisive politicization of the virus, would cer-tainly course correct. Surely he would. All he would need is a modicum of conscience and con-cern.

It is difficult for us to grasp that someone could be devoid of this basic humanizing ten-dency. And yet there appears to be a small percentage among us (1%) who do not struggle with their conscience at all. Psychopaths appear to have an inherited, neuro-developmental abnor-mality whereby they simply cannot experience much, it at all, of three emotional states: fear, shame and guilt. Psychologists call these states “inhibitory” emotions because they guide us to be sensitive to and cautious toward threat situations; and lead us to have an appropriate concern for the effects our actions might have on others, and thus curb our selfish or immoral tendencies.

Trump’s diminished capacity to experience fear and thus apprehend the presence of a threat no doubt contributed to his sluggish response to COVID-19. He seemed oblivious to the scale of the risk. Even into March he was describing it as a “hoax”, although Asia and Europe were already undertaking massive mobilization efforts.

Is there any better, that is more odious example of absence of shame or a moral heart-beat than his doling out of ventilators and protective equipment to governors based on their politi-cal leanings and sycophancy to him. Well, perhaps holding rallies in Tulsa and Arizona which ap-pear to have contributed to spikes in the virus in those locales.

Trump’s refusal to take responsibility for harm his actions may have produced also flows from this deficit in conscience and empathy. A psychopath does not have the emotional infra-structure to care about children in cages or overflowing morgues. Clever psychopaths can at least generate “the words if not the music” of empathy. Trump doesn’t even try for that.

The fatalities mount. Trump is at the mercy of his condition, and we are at the mercy of him. We should expect incoherence, divisiveness and callousness all the way to the end.