With his presidency in a perpetual state of crisis, Donald Trump spun a mesmerizing alternative reality in an impromptu press conference with Mitch McConnell on Monday, inaccurately characterizing his accomplishments as historic, Obamacare as dead, and the Republican Party as united. But as ever in the Trump White House, no public-relations campaign survives a full news cycle before self-negation. Hours after Trump and McConnell feigned friendship in the Rose Garden, the president received a brutal wake-up call from John McCain, whose fatal opposition to Obamacare repeal exacerbated the schism between the thinly smiling duo. Standing before a crowd in Philadelphia to receive an award from the National Constitution Center, McCain launched a furious attack on the president’s nativist agenda, condemning “people who would rather find scapegoats than solve problems.”

McCain didn’t mention Trump by name. But his words struck with the clarity of a senator in his sunset years with nothing to lose. “To fear the world we have organized and led for three-quarters of a century, to abandon the ideals we have advanced around the globe, to refuse the obligations of international leadership and our duty to remain ‘the last best hope of Earth’ for the sake of some half-baked, spurious nationalism cooked up by people who would rather find scapegoats than solve problems, is as unpatriotic as an attachment to any other tired dogma of the past that Americans consigned to the ash heap of history,” McCain said, at times emotional. “We live in a land made of ideals, not blood and soil.”

“We have done great good in the world,” he continued, fueling a long-standing ideological battle with Trump, who has argued that the United States has no moral authority in the world and has done his best to prove it. “We will not thrive in a world where our leadership and ideals are absent. We wouldn’t deserve to.”

McCain has never hesitated to speak his mind about Trump, who famously said on the campaign trail that the senator was “not a war hero” because he was captured in Vietnam. (McCain, the son of a Navy admiral, refused to be freed until other prisoners of war were released, and was permanently disabled by the torture his captors inflicted; Trump received five deferrals from the draft, including one for bad feet.) The relationship soured further in July when McCain flew back to Washington, shortly after having brain surgery related to his cancer, only to vote against a Trump-McConnell bill to repeal Obamacare. Bemoaning the tone of modern politics, he delivered a blistering speech from the Senate floor, arguing that partisanship was paralyzing lawmaking institutions. “Stop listening to the bombastic loudmouths on the radio and television and the Internet. To hell with them,” he said. “We are an important check on the powers of the Executive. Our consent is necessary for the president to appoint jurists and powerful government officials and in many respects to conduct foreign policy. Whether or not we are of the same party, we are not the president’s subordinates. We are his equal!”