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28 October 2020updated 29 Oct 2020 6:58am

America and the politics of pain

Gravely ill in hospital with sepsis, our writer had a revelation on how Donald Trump transformed the US’s inequalities into a suicidal tribalism.

By Timothy Snyder

Why has the American government acted in a way that has left more than 200,000 of its citizens dead? Coronavirus has killed more Americans than the Wehrmacht, or the Japanese imperial army, or indeed any other battlefield foe. We endure the equivalent of 9/11 every few days. This time, though, Americans took decisions that killed horrendous numbers of other Americans. Like famines, plagues are political; this one is, above all, tribal.

In 2019, when I was near death, I faced the logic of the tribe, and could think of little else. As a result of medical mistakes made in December, I had a liver infection and had fallen into sepsis. As I sought to be admitted to an emergency room for the fourth time that month, bacteria was taking over my blood. A physician friend met me in the lobby. The nurses there did not appear to take the case seriously. I had a fever, a headache, was trembling, had entered in a wheelchair, and could barely move. At the edge of life, waiting for something to happen, I couldn’t think well, but my American sensibility grasped what the problem was: my friend was black.

In that moment (exceptionally), I was in a predicament that black people face all their lives. After the better part of an hour, I was admitted to the emergency room where, again, nothing much happened, and for quite a while. My friend stayed with me the entire night (it was 17 hours before I was diagnosed), huddling in her fleece. If the nurses and doctors could not see the hospital badge she wore around her neck, I feared, no one would listen to her. The nurses from the lobby walked by, talking: “Who did she say she was?” “She said she was a physician.” Laughter.

Four years earlier, I had been in the same American hospital with a Ukrainian rock star friend who seemed to be having heart trouble. My friend told me then that if I was ever sick in Ukraine I should call him. I knew what he meant. Ukraine is a country of extreme inequality and oligarchical patron-client relationships; he would make sure that I was looked after.

Last December, after surgery and my admission to a hospital ward, some of my US colleagues began to chide me and my wife. We should have called powerful patrons, they said, to make sure that I was treated well in the hospital. Despite having written a book in 2018 called The Road to Unfreedom, about how the US was becoming more like an east European oligarchy, I was a little shocked by this.

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When I was facing death, race intruded itself immediately into my thoughts and worries; class required that little prod a couple of days later. In American public health, as in public life, it is racism that enables economic inequality. As the great social thinker WEB Du Bois argued in Black Reconstruction (1935), a tribalism built upon skin colour and the memory of slavery makes some poorer white people willing to sacrifice themselves for some richer white people. The consequent politics of pain is visible in healthcare and in public services, or rather in their absence. Donald Trump did not create this, but he relies upon it, and during the pandemic he has made it much worse.

Pain points: Timothy Snyder believes inequality in the US will soon “render democracy impossible”. Credit: Andrew Sullivan/The New York T​im es/ eyevine


The American politics of pain has three levels: the sadistic, the sadomasochistic and the sadopopulist. Our commercial medicine is sadistic. Everyone is supposed to have private insurance, but some 30 million Americans have no insurance at all. People who have insurance expect precedence over those without it. People with more expensive insurance expect better treatment than those with less expensive insurance. Americans cannot help but be pleased when they receive, or imagine they are receiving, better treatment than other Americans. This pleasure, at the pain of others, deadens critique. Relative privilege blinds wealthier Americans to the reality that the whole healthcare system is shambolic – that they, too, can pointlessly die, as I almost did. Trapped in an economy of pain, it does not occur to them that everyone’s level of care, including their own, should and could be much higher.

At the point where healthcare meets public services, some Americans take pain upon themselves for the sake of inflicting greater pain upon others; sadism becomes sadomasochism. Ronald Reagan popularised the racist critique of the welfare state in the 1980s: that benefits would be exploited by dark-skinned free riders. Along with this comes an appeal to white pride: we, the real Americans, are rugged individualists who do not need government handouts. White Americans who accept this reasoning are choosing to suffer for the pleasurable thought that others will suffer more. The suffering is real; the rollback of the welfare state since Reagan’s administration chiefly hurts white people, and it is the decline in white life expectancy that has caused American life expectancy – 78.6 years – to plateau.

Sadomasochism becomes sadopopulism when a charismatic politician emerges who explicitly articulates this tribal order, and apportions the pain. Trump is not a populist; populists think the state can be used to transfer wealth and power from the elite to some version of the people. Trump does the opposite: his policies involve transferring wealth to the wealthy.

For Trump, the state is not about governing people, but about magnifying a personality. If “my people” (his words) are suffering, the point is not to heal them, but to make sure other Americans are suffering more. The pain of his followers has meaning if they believe that it serves the greater suffering of others, and thereby unifies them with the chieftain.

Trump is not a populist but a sadopopulist, and has created a visible and powerful union around the idea that politics is about sacrifice rather than about achievement. The sacrifice is meaningful if it is meaningful to Trump; sacrifice for fellow citizens, or for the country, is meaningless. Those who die on the battlefield are, for the president, “losers” and “suckers”.

It is a common error to judge Trump for what he is not rather than what he is: an exemplar of charismatic leadership as described by the German sociologist Max Weber. His leadership is about according symbolic favour to his followers by defining their enemy. This can be understood quite literally. Followers of the internet conspiracy QAnon, such as the Republican congressional candidate Marjorie Taylor Greene, regard Trump as a heroic lone warrior battling a global Satanic organisation that kidnaps and abuses small children. (And why would Americans be vulnerable to such a thought? Lacking meaningful sick leave, parental leave and vacation, Americans hand their children over to strangers when they are days or weeks old, and feel profoundly guilty about it.)

It is misleading to think of Trump as a liar, since only someone who understands truth as a value can lie. It is not that he fails to tell the truth; it is that he resists seeing factuality and consistency as constraints, and is ready to change the line at any moment.

If you are outside the tribe, this can seem comical, like any unfamiliar ritual. But if you are inside the tribe, it works. Although we are experiencing plague and depression at the same time, Trump’s approval rating is around 40 per cent, and will remain so. That is a stunning victory of tribalism over the individualism that Americans believe is at the heart of politics.

In December 2019 I entered an American hospital just as the coronavirus outbreak was discovered in China. One might have guessed then that the US would not be the best place to spend an epidemic. Our pre-existing condition, in the insurance company jargon, was our politics of pain.

According to a nationwide survey, one-third of Americans admit they avoid medical treatment for fear of expense. Lacking sick leave, people who are ill still have to go to work, as they did when Covid-19 struck. The epidemic brought with it unemployment, and so separated about five million more Americans from insurance. A different president and a different Senate might have seen the epidemic as reason to address the problem of healthcare. But under Trump and his allies, we have mass death, or, perhaps, mass killing.

A tribal chieftain must adapt external reality to a language of “us and them”. His power depends on the ability to conjure and apportion emotion. The more reality resists, the harder he has to work.

A virus is tough to manipulate because it follows a mathematical logic of transmission, can be traced empirically through testing, and attracts the attention of experts. Trump made it clear that he did not like testing, and testing was negligible at the crucial moment (one test per million Americans by the end of February). Trump repeatedly claimed that without tests there would be no disease, and that the virus would simply disappear. As treatment he recommended ultraviolet light inside the body and the consumption of disinfectants. He praised as an “important voice” a doctor – Stella Immanuel – who says that illnesses are caused by “demon sperm” and have been treated with alien DNA.


In enlightened or liberal politics, the body is a site of freedom and space a zone of reason. In tribal politics, space is marked out symbolically and the human body is a site of loyalty. Hygienic practices such as the wearing of masks or participation in shutdowns were tribal from the beginning. Trump initially refused to wear a mask, and encouraged his supporters to overthrow state authorities that tried to enforce quarantines and lockdowns. These protesters were mostly white, and often people who had not actually lost their jobs. The idea was not so much that they needed to work as that other people – black and brown people – needed to work for them. When Trump himself caught the disease in October, he used the occasion for a virility performance in which he removed his mask in front of the television cameras while still infectious.

In the 2016 election, the Trump campaign tried to “deter” black people from voting. In the American politics of pain, they are the anointed victims. The pandemic confirms and intensifies this. Adjusted for age, black people are dying from Covid-19 at just over three times the rate of white people, which makes the pandemic seem like two diseases. The economic collapse associated with the disease hits black people especially hard, since they are less likely to own homes or have reserves of wealth. The near absence of federal assistance for the unemployed hurts more white people than black people, but as a community it is the latter group that faces the existential threat.

The president expects his tribe to take a hit so that others can suffer more. The national press reported on the racial disparities in coronavirus infection and death rates, but this sadly did not have the expected effect. Once it became clear that black and Hispanic people were suffering disproportionately from the disease, the sadism got out of hand.

When a coronavirus policy did emerge from the White House, it had more than a whiff of ethnic cleansing about it. In March, Trump announced there would be no federal plan, but rather a competition among the 50 states for necessary resources. They would be expected to waste their own limited budgets in bidding wars with one another. Their governors were instructed to display fealty to the chieftain if they wished for ventilators or other equipment from the federal government.

States governed by Republicans (“red states”), such as Florida, were given equipment whether they asked for it or not; states governed by Democrats (“blue states”), such as Washington and New York, were treated with contempt and disdain. In Trump tribalism, “red states” is an acceptable way to say “white people”, whereas “blue states” means “black people, immigrants, turncoats”.

In April, New York City was the centre of the virus, and the White House concluded that the disease would be limited to “blue states”. The notion was to allow people in those states to die and blame the Democratic governors. Within the tribal logic of us and them, of “real Americans” and others, this made sense. Of course, the absence of testing allowed the virus to spread unseen. People who refused to wear masks or obey shutdown orders infected others. By summer, New York and the rest of the American north-east was safe, while states such as Florida, with Republican governors, were raging with Covid. In July, Trump’s advisers tried to warn him that “our people” were now getting the disease. It is a telling phrase: so long as the Americans dying were not “our people”, nothing was to be done.


The victims of the mass death were individuals, each had a name, and one name will be remembered more than most. Like many black men, the Minneapolis resident George Floyd caught the disease and lost his job. On 25 May, a clerk in the city called the police, thinking that Floyd had passed him a counterfeit $20 bill. Whether or not this had happened, it is certainly the kind of crime that would be far less likely had the American response to coronavirus not been so disastrous. One of the policemen used his knee to hold Floyd’s neck to the pavement for nearly nine minutes at the scene. Floyd died not long after, and protests, almost entirely peaceful, spread throughout the country.

In tribalism the chieftain defines right and wrong. Six days later, with cameras rolling, the White House stage-managed the violent clearing of a peaceful Black Lives Matter protest nearby, so that Trump could walk to a church and wave a Bible. In the tribal telling, it was the protesters, the outsiders, who were to blame. On 26 June, Trump ordered the protection of monuments and statues from “anarchists and left-wing extremists”. The conspiracy theory of his executive order featured villains who denied the “fundamental truth that America is good, her people are virtuous, and that justice prevails in this country to a far greater extent than anywhere else in the world”. The monuments that most concern Trump are those of Confederate defenders of slavery.

In July, Trump dispatched a new American secret police force to Portland. Overseen by Chad Wolf, the acting Homeland Security secretary, this paramilitary force tear-gassed, assaulted and illegally detained protesters. This had the effect of making the Black Lives Matter gatherings there (on the scale of hundreds) look like riots. Trump’s fundraising emails used the televisual spectre of racial disorder to win donations. The composition of this new secret police recalls elements of the history of authoritarianism and political atrocity. The men brought to Portland had served on the border, and quite possibly in the hundreds of lawless detention centres in the US. Some of the largest of these are near the southern border with Mexico, but they are scattered throughout the country. In Nazi Germany, the SS were the first prison guards in the concentration camps. As Hannah Arendt argued in Origins of Totalitarianism (1951), men trained at a frontier and returned to the interior bring with them practices they applied to people regarded as aliens.

On 2 September, Trump designated Portland, along with Seattle and New York, as “anarchist jurisdictions”. The executive order, which referred to no law and provided no authority for these designations, was justified only by the claim that these cities were “permitting anarchy, violence and destruction”. The essential idea is that places where people protest for the rights of black people and social justice are the enemy; the presumable aim is the preparation for some kind of exceptional action. But what cannot be a coincidence is that all three cities are within 100 miles of the coast, and are thus within a “border zone” where Homeland Security claims special authority to harass Americans.


Generating a crisis that Trump could manage was better than allowing people to pay attention to the one he couldn’t. Trump needs a fake emergency to displace the real one. Throughout his slow-motion Reichstag Fire, an epidemic was raging across the country and his supporters were dying. Before an in-person indoor rally in Tulsa on 20 June, the Trump campaign removed stickers from seats that were there to remind people to keep a social distance. A prominent supporter who attended the rally caught Covid and died.

Like other forms of ethnic cleansing, attempts to direct the virus spiralled out of control. Most of those suffering and dying now are in “red states”. Republicans were expected to look away from dead friends and family members, and focus on ostensibly disloyal blacks and their supporters. Rather than a disease that was killing Americans, the issue was supposed to be the rebellion of crime-ridden cities. If black people got their way and he lost office, Trump warned, the safety of “suburban housewives” would be at risk. In a country where black men were lynched over accusations of sexual assault, Trump’s message was explicit and impossible to misunderstand.

In a normal presidential campaign, such language would be unorthodox. Were Trump thinking about winning a majority of votes, or even about winning a plausible coalition of states, he would be tamping down the rhetoric, slowing the spread of the disease, and aiming for the centre. Instead, he increases the pain and the fear. Despite the pandemic, he works to eliminate the Affordable Care Act, which would mean denying health insurance to some 20 million Americans. The Republican National Convention, which was held at the end of August, was not at all about policy, but about conspiracy; it was about enraging the already committed, rather than reaching out to the undecided. This makes sense if we think of the event as a rally in preparation for the chaos of a spoiled election. Given that Trump has repeatedly expressed his affection for dictators such as Vladimir Putin, and proclaimed his indifference to election results, there is little reason to think he is trying to win in the conventional sense. He realises he has little chance against Joe Biden. His tweet on 30 July, in which he pleaded for the election to be delayed, is a recognition of that, and it began a series of such admissions that has lasted months.

When Trump says the election is rigged against him, or that the Supreme Court must intervene, or that he has the right not to acknowledge the results, he is saying two things at once: he cannot win an election, and those who support him should act to keep him in power anyway. Trump is aiming to create so much chaos around the election that he will somehow be able to cling to his office. He cannot change the date of the election, but he can undermine public confidence by claiming it will be fraudulent. Having spread a pandemic that necessitates mail-in voting, he opposed additional funding for the United States Postal Service, making it more difficult to deliver those ballots.

Trump can intensify the tribal rhetoric in the hope that his supporters will turn to violence and intimidation when the time comes. In Ohio in August, he raged that Biden will take away Americans’ guns and “hurt God”. After another black man was shot by police in Kenosha, Wisconsin, Trump defended a white man charged with shooting and killing two protesters. The young man was one of his supporters, which is all that matters. On 29 September, the first presidential debate, Trump then refused to condemn white supremacy, and instead called out by name one group (the Proud Boys) and asked for their support.


Trump’s posture that his own survival from Covid-19 means others should disregard the disease is a call for further self-sacrifice. Those who follow Trump’s lead are willingly risking their lives and, as they know, risking the lives of others. This is our sadopopulism. White people accept poor care and the risk of death, provided black people and others endure worse care and greater risk. Republicans who choose to die for the tribal chieftain are making a meaningful sacrifice. Only if Americans continue to die can Trump’s survival serve as proof of his manhood. And they will continue to die. The city of Washington, DC has trouble controlling the disease because the federal government refuses to obey municipal rules. Thus the White House itself has become a Covid-19 hot zone.

The other sacrifice Trump calls for is the sacrifice of our democracy. The president has conceded the majority, so he needs members of his minority to act outside of the rules and the law. Rather than running a normal campaign, he has chosen to prepare a coup. Indeed, it is hard to think of a coup that has been advertised in advance like this one. The tribe knows what it is supposed to do, but this does not mean the coup will work. Biden’s popularity makes possible the landslide that is needed to demoralise those who would spoil an election. Americans are more aware of the risks and more mobilised than in 2016. The scenarios of a spoiled election, from Putin to pitchforks, are all known and are subject to counterplanning by citizens, NGOs, lawyers and the Biden campaign.

The tribe is real, but it is a minority, and can be defeated. What then? The status quo was already unsustainable. The pain in the system can only be released by changing the system. American inequalities are so staggering that, with or without Trump, they will soon render anything like democracy impossible. From Plato through to George Orwell and Raymond Aron, political thinkers have warned that drastic inequality makes a republic impossible. To recover from our plague of tribalism, we will need something new; a politics of responsibility, a serious attempt to name and resolve racial and economic inequality simultaneously. It can begin with universal healthcare.

I have been out of treatment for three months now, and I feel better. But I am scarred by that moment, brief though it was, when I was exposed to our politics of pain. I am very privileged, and even so I almost died of inequality. But my friend stayed close, and I got better, and I see a few things differently now. Recovery is not about going back, but about going forward, into something better.

Timothy Snyder is the Levin Professor of History at Yale University. His most recent book, “Our Malady: Lessons in Liberty and Solidarity”, is published by Vintage

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This article appears in the 28 Oct 2020 issue of the New Statesman, The Great Reckoning