President Donald Trump could have avoided the firestorm over Ronny Jackson’s nomination if he’d taken Johnny Isakson’s advice to begin with.

In a private conversation with Trump last month, the Senate Veterans’ Affairs chairman mounted a strong defense of then-VA Secretary David Shulkin. But despite Isakson’s guidance, Shulkin was canned a few days later, and Jackson, the White House physician, was quickly nominated to take his place.


Jackson was chosen with little vetting, angering several White House aides, including chief of staff John Kelly. And now a whisper campaign of allegations threatens to tank his nomination.

The episode offers a window into how the president’s impulsive decision-making has created problems for GOP senators as well as his own aides. On Tuesday, Senate Republicans were left to field questions about unsubstantiated allegations of misconduct against Jackson brought to the Veterans‘ Affairs Committee. One GOP senator, who requested anonymity, said the hope is that Trump withdraws the nomination sooner rather than later to avoid prolonging the pain.

Instead, the president sent mixed signals about the nomination as Jackson fought to keep his prospects alive. In a private meeting with Sen. Jerry Moran (R-Kansas), Jackson said the allegations are false and that he wants a hearing to make his case. At the same time, Trump was telling reporters that he “personally” didn’t think Jackson should fight on but it was “totally” Jackson’s decision.

“The president says, ‘Oh yeah, I wouldn’t move forward with it.’ I mean, what does that say? If the president is going to put forward somebody’s name, he needs to have the confidence in that individual,” said Sen. Lisa Murkowski (R-Alaska). “And if it’s just like kind of a knee-jerk, here’s a warm body? Then his team needs to work to make sure that the president sees the short-sightedness of that.”

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Jackson’s trouble may also signal a new front in the war inside the White House. Aides who‘ve come to realize they can’t control the president have taken to leaking negative information about advisers, Cabinet members and Cabinet nominees in hopes they can shape the president's personnel decisions — or torpedo them entirely — through the news media.

A handful of White House insiders speculated that such a leaking campaign was afoot against Jackson, whose nomination rattled West Wing advisers and was opposed by nearly every senior White House staffer.

Senate Republicans were skeptical of Jackson from the beginning, given his lack of experience managing a large organization. The weak reception left Jackson with no base of support from which to mount a campaign for the job — and that was before reporters starting asking about allegations that he drank on the job at the White House or over-prescribed pills.

“I had my doubts from the beginning,” said Sen. Jeff Flake (R-Ariz.), a frequent critic of Trump. When a nominee is tapped “to run an agency this big, with so much responsibility, you want to make sure you vet it properly … I’m not sure that was done here.”

Jackson had previously been in the running for a job as undersecretary of veterans’ health at the veterans affairs department, but turned it down, according to two people familiar with the issue. He likely received only a cursory vetting during that negotiation, leaving the White House with little idea of whether he could survive the Senate’s brutal confirmation process.

When the nomination hit turbulence, the White House initially had no coordinated response for defending Jackson or undercutting the allegations against him. Late Tuesday, the White House released inspector general reports about Jackson and highlighted positive remarks that had been made about him by his subordinates.

But a much larger document dump has been requested by senators in both parties, and lawmakers said they had no idea what information about Jackson could be out there, given the seriousness of the charges leveled against him.

“This is one of the most important secretary positions for men and women across the country. And it is unacceptable to me that the White House did not apparently vet him,” said Sen. Patty Murray of Washington, the No. 3 Democratic leader and a VA committee member. “Because they don’t, our committees end up having to do it. And these are serious issues.”

A number of people over the past week have come forward to Sen. Jon Tester (D-Mont.) with potentially damaging information about Jackson. As with all White House employees, the FBI had a file on Jackson. Tester said it “looked OK” when he reviewed it.

But new allegations against Jackson are “coming from people the FBI didn’t interview,” Tester said on Tuesday. Those claims, Tester confirmed on NPR, include misconduct at work, excessive prescriptions of medication and drinking on the job. A person who travels with Jackson, however, said he’s never seen the White House doctor drink at work.

Tester said the nomination could “definitely” go forward if Jackson is cleared of wrongdoing. But it will be at least two weeks before Jackson’s confirmation hearing, originally planned for Wednesday, is rescheduled.

Republican senators started hearing rumors about Jackson over the weekend. In response, Isakson scheduled a conference call on Sunday with GOP members of the committee to discuss the possibility of delaying Jackson’s confirmation hearing, according to senators and aides.

Republicans agreed, and Isakson and Tester demanded 12 years worth of documents on Jackson’s history from the White House on Tuesday.

White House officials were scrambling to find out whether the allegations are true; some of the officials had heard about them only from Capitol Hill aides. Even if the accusations end up not amounting to much, the challenge of proving his innocence in the midst of the congressional and media maelstrom could be too much for Jackson to pull off.

“They haven’t vetted the guy. They’re vetting while trying to confirm him and they honestly don’t know: is there substance to the allegations?” said Darin Selnick, a former Veterans Affairs adviser for the White House Domestic Policy Council under Trump.

Though some of Jackson’s one-on-one meetings with senators were canceled on Tuesday, he made a point of meeting with Moran and telling reporters that he was “looking forward to the hearing so I can sit down and explain everything.”

Moran said afterward that Jackson was “impressive” in making his case that none of the alleged misdeeds are true. And the senator seemed skeptical that Jackson could conduct himself as poorly as has been alleged, given his long history of public service in the White House.

“Someone in the military in a leadership position has an annual review. The proper thing to do is to not reach any conclusions,” Moran said. “He’d like to respond to the allegations, but my impression is he doesn’t know what they are, either.”

A 2012 inspector general report found that tension between Jackson and another doctor on the White House medical staff helped create a "tense, fractured, dysfunctional, and demoralizing" work environment, with "unprofessional behaviors" evidenced by both men. A follow-up report in 2013 found morale had improved, but some people in the White House medical unit still supported Jackson's removal. Both were released by the White House, along with past positive performance reviews from former President Barack Obama, including the handwritten note: "He has earned my complete trust and respect."

But Republicans said Tuesday that if the additional information they‘re hearing about Jackson is substantiated by documents and witnesses, Jackson’s nomination is in trouble.

"if it is true, then that is a vetting miss," said Sen. Thom Tillis (R-N.C.) of the allegations.

“The White House knows that we’re all going to do our job over here on the Senate side, do deep dives” on Jackson, said Sen. Joe Manchin (D-W.Va.), a member of the veterans’ affairs committee who frequently votes for Trump nominees. “The White House has to be aware of [concerns over vetting], and problems with that, and do their job.”

Of course, if the nomination is scuttled and the White House has to hit reset, the biggest loser will be the Department of Veterans Affairs, which has had two confirmed leaders and three interim leaders in less than four years as a result of constant turmoil. The department has been dogged by tales of poor care for veterans for years.

Republicans and White House officials wish the president had taken more time before unceremoniously axing Shulkin with a surprise tweet last month.

“Sometimes it’s like: ‘Gotta fill it, gotta fill it, gotta fill it right away,’” Murkowski said. “If the president wasn’t satisfied with Shulkin, he could have put someone in as acting [secretary] and done a more fulsome vetting.”

Arthur Allen, Lorraine Woellert and Andrew Restuccia contributed to this report.