For all the chaos of the past 14 months, one of the few constants in the West Wing has been Donald Trump’s flair for appointing Cabinet members who are not just wildly unqualified for their jobs, but in fact uniquely ill-equipped to do anything but dismantle the agencies they’ve been tasked with leading. Obviously, the original cast is filled with classics, such as Education Secretary Betsy “What‘s a school?” DeVos, Energy Secretary Rick “I think I made a wrong turn” Perry, and HUD chief Ben “Poverty is a state of mind” Carson. Now, however, as the president scrambles to replace the first-string officials he’s unceremoniously fired—or tormented until they quit—he is having to get creative. And so, yesterday, in a one-two punch of incompetence, he announced the appointment of his personal physician, Dr. Ronny Jackson, to run the Department of Veterans Affairs, replacing David Shulkin, whom he fired via tweet.

Even in a White House used to unhinged three A.M. tweets and children as senior advisers, Trump’s decision to appoint Jackson was said to come as a shock to close aides. Jackson is, by all accounts, a capable doctor, who served both George W. Bush and Barack Obama after returning from Iraq. He also has no apparent management experience that would qualify him to run a 360,000-person, nearly $200 billion federal agency. “Nobody in the White House that Jonathan Swan has spoken to can satisfactorily answer the question of how his personal White House physician is qualified to run the second-largest agency in the federal government, and one of the most consequential and dysfunctional institutions in America,” reported Axios. The best anyone in the White House can come up with is that Trump thinks he’s “great” because the doc told the world, with a straight face, that the president has “incredibly good genes” and “if he had a healthier diet over the last 20 years, he might live to be 200 years old.”

Weirdly, Jackson’s supreme confidence in Trump’s physical and mental health hasn’t convinced veterans who rely on the V.A. for their own health services. Per Stars and Stripes:

“We’re highly concerned,” AMVETS Director Joe Chenelly said. “We don’t know this guy.”

John Rowan, who leads Vietnam Veterans of America, described Jackson as an “unknown quantity.”

“The only good thing is, he’s a veteran and experienced with dealing in warfare,” Rowan said. “That’s good. Whether he has administrative experience or not, I don’t know. Hardly anybody knows.”

On Capitol Hill, one Republican aide told The Washington Post that appointing Jackson “could be a disaster for vets,” adding, “What has this guy ever managed? Can he really take on one of the toughest jobs in government?” Carl Blake, executive director of Paralyzed Veterans of America, offered ominously: “We are all headed into the deep unknown now.” One former V.A. official was more blunt, telling Politico that his “first reaction was O.M.G. That’s still my reaction. . . . The V.A. is the hardest department to manage as it is so political.”

Trump supporters have their own, predictable justifications for cheerleading the president’s pick. “Obviously, as the White House physician, Admiral Jackson has the president’s trust, which will be vital in bridging the final barriers to getting real V.A. health-care choice enacted into law,” Sarah Verardo of the conservative Independence Fund told Army Times. “Who is or is not the secretary is not important when this president has laid out such a clear and compelling vision for the V.A.”

More grounded observers, however, suspect ole Ronny may not pass a smell test. As one longtime Republican lobbyist put it to Axios, referring to Jackson’s chances of being confirmed by the Senate: “Harriet Miers.”