The deepening troubles of Ronny Jackson, President Trump Donald John TrumpOmar fires back at Trump over rally remarks: 'This is my country' Pelosi: Trump hurrying to fill SCOTUS seat so he can repeal ObamaCare Trump mocks Biden appearance, mask use ahead of first debate MORE’s pick to lead the Department of Veterans Affairs (VA), have left Republican insiders shaking their heads.

Their ire is directed not only at Jackson but at what they perceive to be an egregious failure in the White House vetting process.

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“It’s an absolute fiasco,” one GOP strategist with ties to the White House told The Hill on Wednesday afternoon, as Jackson’s nomination appeared to careen off the tracks amid allegations of excessive drinking, toxic work environments and lax prescription practices.

“The president chose his personal physician because he thought he was a good guy. And they had no idea how much work it takes on the back end,” the strategist added, referring to the process of getting someone confirmed for a major position by the Senate. “It’s a lesson in how it works.”

Tobe Berkovitz, a Boston University professor who specializes in political communications, said, “It’s one more bit of proof, as if any were needed, that the Trump White House are not exactly the best vetters in the world when it comes to any kind of position.”

The White House has defended its work in nominating Jackson, with press secretary Sarah Huckabee Sanders pushing back during Wednesday’s media briefing against suggestions that the problems now haunting the nominee should have been discovered at an earlier stage.

Sanders noted that Jackson had served both of Trump’s immediate predecessors, President Obama and President George W. Bush, in a medical capacity.

“Because Dr. Jackson has worked within arm’s reach of three presidents, he has received more vetting than most nominees,” she said.

In relation to the specific allegations, Sanders said “a very thorough investigation and vetting process has taken place. None of those things had come up.”

But Jackson, already on the ropes, received another body blow just a few hours after Sanders’s remarks when The New York Times published a report detailing new allegations.

Those allegations, based on a document from the staff of Senate Veterans’ Affairs Committee ranking member Jon Tester Jonathan (Jon) TesterPence seeks to boost Daines in critical Montana Senate race This World Suicide Prevention Day, let's recommit to protecting the lives of our veterans Filibuster fight looms if Democrats retake Senate MORE (D-Mont.) that was circulated to reporters more widely within minutes of the Times’s report, included the charge that missing Percocet tablets on one occasion threw the White House Medical Unit “into a panic.”

Jackson is also alleged to have gotten drunk at a Secret Service going away party and wrecked a government vehicle. Jackson denies this. “I never wrecked a car,” he told reporters.

A former official in a previous Republican administration told The Hill that the Trump White House was not in a unique situation with Jackson, despite the lurid allegations that are now threatening to sink his nomination.

“The adage for this White House I think rings true for previous White Houses as well,” this source said. “Sometimes these appointments are made out of a sense of loyalty and friendship rather than out of competency for the job.”

This person cited the example of Harriet Miers, who was nominated to the Supreme Court by Bush.

Miers was a friend of the president and had also served as his personal lawyer. But her 2005 nomination to the high court was met with consternation even in conservative circles, where she was widely perceived to lack the kind of outstanding résumé that would be expected in a Supreme Court nominee.

She withdrew from consideration less than a month later.

The former White House official said that the Miers example was one that Jackson would be well-advised to copy.

“You have to fish or cut bait,” the source said. “Harriet was not given a hearing because her name would have been sullied if the [confirmation] hearing had gone on. It would really have done damage to her because the Democrats and some Republicans would have eviscerated her. If you go forward, your whole career could be overshadowed by a fiasco.”

The president appeared to offer Jackson an exit on Tuesday, during a news conference with French President Emmanuel Macron.

Trump said he had told Jackson that he did not need the trouble of the confirmation process.

“I don’t want to put a man through [that process] who’s not a political person,” Trump said. “I don’t want to put a man through a process like this. It’s too ugly and too disgusting.”

But the president reiterated that the final decision would rest with Jackson.

Even those who are critical of the White House’s handling of the matter are not totally without sympathy, however.

The GOP strategist with White House ties said that Sanders’s argument — that Jackson had been cleared to serve three presidents as a physician — had almost certainly played into the White House’s calculations.

“When other presidents and staff have given the guy solid reviews, [the current administration] would never think there was an issue. Until there was one — and then it’s too late,” the source said.

It is also true that, for all the chaos that has afflicted the White House on other matters, its processes for getting its major nominees confirmed have not gone awry often.

With the exception of businessman Andy Puzder, who withdrew from consideration as Labor secretary, Trump’s Cabinet was confirmed without major incident. One source with knowledge credited the Trump transition team with doing much of the hard work that helped ease that process.

A number of lower-level nominees have withdrawn, however. That, together with the unusual levels of churn in the administration, has created a reputation for turbulence in personnel matters.

Whether such turbulence hurts Trump is a different question.

Rows over nominees seem almost quaint in a time when the president uses his Twitter account to assail a former FBI director as a “slime ball,” as he did with James Comey James Brien ComeyDemocrats fear Russia interference could spoil bid to retake Senate Book: FBI sex crimes investigator helped trigger October 2016 public probe of Clinton emails Trump jabs at FBI director over testimony on Russia, antifa MORE last week, or to highlight praise from a hip-hop star, as he did with Kanye West, twice, on Wednesday.

There have also been many more serious debates than the nomination fights, as Berkovitz noted.

“It doesn’t do Trump any good,” he said of the Jackson controversy. “But considering the world of hurt that is put on Trump pretty much on a daily basis, how much worse can this hurt him?”

The Memo is a reported column by Niall Stanage, primarily focused on Donald Trump’s presidency.