When Trump makes palpably false statements, all the insider accounts — Michael Wolff’s book, Bob Woodward’s book, the anonymous op-ed in the New York Times — gain credibility. In fact, when insiders use sweeping generalities (“impetuous, adversarial, petty and ineffective,” the anonymous insider wrote to describe Trump’s governing style), they fail to convey the depth of Trump’s capacity for self-delusion and his inability to recognize how crazy he sounds to others. (A paranoid but reality-based individual might think the death toll numbers were cooked, but he would recognize that he’d sound like a lunatic if he said so.)

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Trump’s outburst should remind us of several troubling facts. First, whether he is lying (or is simply a victim of his own self-delusion that he is incapable of error) is beside the point. He’s not functioning as a president or any other officeholder should. He cannot comprehend facts, process them and take appropriate action. He is, in a word, non-functional.

Second, the “senior officials in his own administration … working diligently from within to frustrate parts of his agenda and his worst inclinations” (as recounted in the anonymous Times op-ed) are kidding themselves. They are enabling someone with a weak grasp on reality to maintain the pretense of normalcy. Our allies see through the act; our foes do, too. When cogent decision-making is required by the chief executive, we are at the mercy of his whims and factors beyond our control (e.g. the forbearance of aggressors, the vicissitudes of the business cycle).

Third, the problem is getting worse and more cringe-worthy. When the president falsifies the crowd size at his inauguration, no one gets physically or economically harmed. When he denies that his inattentiveness and sloth have contributed to thousands of deaths, problems don’t get fixed, more Americans are put at risk and the danger of future error increases dramatically.

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Fourth, Republicans’ inability to check or challenge the president and their insistence on rubber-stamping his decisions while ignoring his outbursts pose more than a constitutional and moral challenge. They, too, are responsible for confirmed Cabinet officials who are incompetent or corrupt, for lack of serious governance, for failure to hold officials accountable, and for the suffering and deaths (e.g. separated families, dead Puerto Ricans) that come about by virtue of a president who is never forced to confront reality.

Finally, Vice President Pence, the only member of the administration that Trump cannot fire, is culpable for this state of affairs as well. His continual apple-polishing, excuse-making and fact-free excuse-mongering only encourage Trump’s behavior. And his dishonest shilling for the president (everything from walking out of a football game to supporting Trump’s conduct of foreign policy) raises real doubts as to whether, if Trump were ever removed or left office early, a trustworthy chief executive would be taking his place.