Donald Trump was on the phone, and he was talking about dying. It was Saturday, October 3, and while his doctor had told the outside world that the presidents symptoms were nothing to worry about, Trump, cocooned in his suite at Walter Reed National Military Medical Center in Bethesda, Maryland, was telling those close to him something very different.

I could be one of the diers, he said.

The person on the other end of the line couldnt forget that unusual word the president used: dier. A seldom-said dictionary standard, it was a classic Trumpism, at once sinister and childlike. If being a loser was bad, being a dier was a lot worse. Losers can become winners again. Diers are losers forever. But arent we all diers in the end? Donald Trump, the least self-reflective man in America, was contemplating his own mortality.

He said it again: I could be one of the diers.

The previous day, at 12:54 a.m., he had announced that he and the First Lady, Melania, had tested positive for COVID-19 in an outbreak that would sideline dozens across the West Wing, the East Wing, the highest levels of the federal government, the military ranks, Trumps 2020 campaign team, and prominent supporters in the religious community. The virus had barreled into the very White House that allowed its spread throughout the United States, where 213,000 were dead and 7.6 million more were infected amid the biggest economic collapse since the Great Depression.

As infections swelled nationwide, the virus made its way inside the president himself an epic security failure with no modern analog. It was over a century ago, amid a pandemic in 1919, that Woodrow Wilson got sick in Paris. His White House blamed what it called a cold and a fever on the dreary weather. But, in fact, Wilson was sick with the virus now known as the Spanish flu, which killed hundreds of thousands of Americans as his administration looked away. One hundred and one years later, the story of Trumps mild symptoms became less and less true as the hours ticked by. His fever crept up. His cough and congestion grew worse. Doctors gave him oxygen and administered a high dose of an experimental antibody treatment unavailable to the ailing masses and made using fetal tissue, a practice his administration opposes, from the drugmaker Regeneron. Still, he resisted going to Walter Reed. I dont need to go, he said, according to a person who spoke to him. Im fine. Im fine. We have everything we need here.

Persuading him to leave the White House required an intervention from his doctors, members of the White House operations staff, the Secret Service, and his son-in-law and senior adviser, Jared Kushner. They had failed to stop the mass deaths of high-risk Americans, but they were going to save Trump, the most important high-risk American of them all. They told him, This isnt just your choice. This really isnt about you. Its about the presidency. Our job is to protect the presidency, and you occupy it. They asked him to think about the military and everyone else whose life would be upended if the state of the countrys leadership was in doubt.

Fine. He agreed to walk across the South Lawn and board Marine One. The White House said the move was made out of an abundance of caution. In a video posted on social media, the president hinted that things werent so great. He put it this way: Im going to Walter Reed hospital. I think Im doing very well, but were going to make sure that things work out.

In the hospital, Trumps world shrank overnight in a way it hadnt since he arrived in Washington from New York to be sworn into office nearly four years ago. Contagious and isolated from his family and closest aides, he was accompanied by Dan Scavino, the social-media director who had first been his caddie and had survived at his side longer than anyone who wasnt blood, and Mark Meadows, his highly emotional chief of staff, who slept in a room nearby, and was attended to by a team of camera-conscious doctors. In this sterilized confinement, he tried to distract himself from his illness. He plotted his escape, planned public-relations stunts, watched TV, and took calls from friends, members of his staff, and Republican lawmakers. But he remained consumed by what the doctors told him about his chances of survival. It wasnt a sure thing.

Nine months into the pandemic and one month away from Election Day, the president considered for the first time that the disease killing him in the polls, threatening his political future, might just kill him, too. On the phone he remarked sarcastically, This change of scenery has been great.

He asked for an update on who else in his circle had contracted the virus, though he expressed no regret, no indication that he understood his own decisions could have led to the infections. Unable to process the irony of his own misfortune, he tried his best to find the Trumpiest spin. Looked at one way, he was having the greatest and most important illness of all time. He had the best care in the world, and he raved about the virtues of the drugs the doctors had him on, including dexamethasone, a steroid pumping up his lungs that can induce euphoria. He was awed by the wonders of modern medicine. He said he was feeling really good, and it didnt sound like he was lying. Then he admitted something scary. That how he felt might not mean much in the end.

This thing could go either way. Its tricky. They told me its tricky, the president said. You can tell it can go either way.

Trump held a press conference on September 26 in the Rose Garden to announce Amy Coney Barretts nomination to the Supreme Court. Photo: Carlos Barria/REUTERS

Statistically, the coronavirus is more likely to cost Donald Trump the White House than his life, though the threat to the latter isnt helping the former. A little more than three weeks before the election, potentially contagious and freaking everybody out, Trump faces what looks like the end of his presidency. Hes mishandled the coronavirus, hes never been popular, and hes gonna lose badly. I think its pretty simple, a senior Republican official said. Of course he was going to say, Oh look, I feel great! Look how badly I beat this puny little virus! Meanwhile, it touches every Americans life every day in multiple different ways, and hes handled it badly and people dont forget that. Or, as exTrump adviser Sam Nunberg put it, Everything has just completely gone to shit.

The polls suggest not just that the president will lose to Joe Biden but that he might lose bigly, in a landslide.

When the coronavirus came to America, the president was preoccupied with more obvious threats. The first positive case was confirmed in Washington State on January 21, and that same day, as he landed in Davos, the Senate was debating an organizing resolution for the presidents impeachment trial. In the Alps, he dismissed the news about the virus at home. We have it totally under control, he said. In fact, the president soon thought that things could hardly be going better.

After three years of crisis, the election year had begun with his acquittal on charges of abuse of power and obstruction of justice brought by the House under Articles of Impeachment. At the same time, the economy was booming. In the Democratic primary, which would select his opponent for the general election, the candidate he most feared, Joe Biden, seemed to be choking. And Michael Bloomberg was threatening to blow the whole thing up anyway. Trump thought about the last campaign and, ever superstitious, how to replicate its magic. He was relieved when Hope Hicks, his closest aide, returned to the White House after two years in exile in Los Angeles. Around the same time, he welcomed back Johnny McEntee, a former aide he believed to be a MAGA whisperer, capable of knowing exactly what would appeal to his base. He didnt think about the coronavirus much. And then the deaths began.

If the president had his way, hed be back in February, Newt Gingrich told me. The former Speaker of the House is an opportunist, and in the era of Donald Trump, that means he must be an optimist. In 2016, Gingrich supported Trumps campaign in the hope that hed be asked to be the vice-president. Instead, Trump repaid his loyalty not with power or higher status in history but with the cushiest gig in Europe: He made Gingrich the husband of the United States ambassador to the Vatican, based in Rome. Before the pandemic, whenever youd call the guy, he was in a loud restaurant Hi! Yeah?! This is Newt! having the time of his life. So one might understand why hes invested in keeping this whole thing going.

Gingrich grasps better than most how to stick to a message, and he keeps a straight face on Trumps behalf even as he argues things he knows cannot be true. That voter surveys are skewed by the left-wing media. I think the election is not quite like the public-opinion polls, he says. That the presidents illness is a political asset. It gives him a better understanding of what people are going through, he says. Or that the president doesnt mean to imply those killed by the virus were weak when he says hell beat it because hes strong. I think hes talking about a national attitude. Should it be Hunker down in the basement or Reopen the schools? he says. Still, he cannot help but break character to admit the obvious: If the president had his way, thered be no virus. Thered be historically high employment among Blacks and Latinos. But you dont get to pick the circumstances in which you run.

And the circumstances have grown less pickable each day. I think some of this is sad to watch, Nunberg said. Its getting to the point where hes almost turning into a laughingstock. What Im worried about is whether he wants to completely self-destruct and take everything down with him vis--vis the election and the Republican Party. He added, This is a guy whos not gonna lose joyfully.

It does appear at times as though self-destruction may be the point. How else could you explain the Plague Parade circling Walter Reed, in which a very sick Trump boarded a tightly sealed SUV with his Secret Service agents so he could wave at the supporters who had come to fly their flags on the street? Or the Evita-inspired return to the White House, in which a still very sick Trump ascended the staircase to the balcony, ripped off his face mask, and saluted to no one as his photographer snapped away? Or calling in to the Fox Business Channel to suggest his infection may be the fault of the Gold Star military families, since they were always asking to hug him? This is what it looks like when the president knows hes losing, but its also close to what it looked like when he won after all, he thought he was losing in 2016, too. We all did. Youre never as smart as you look when you win, and never as dumb as you look when you lose, according to David Axelrod. In Trumps case, it may be more like this: What seems like genius when he manages to survive is the very madness that threatens his survival in the first place.

A senior White House official told me there has been an ongoing effort to persuade the president not to do any of this, as there always is during his episodes of advanced mania. Asked what the effort looked like this time, with Trump physically removed from most of the people who might try to calm him down, the official said, Well, for starters, its unsuccessful.

One former White House official said that stopping Trump from doing something stupid that he really wants to do is possible only if youre actually sitting in front of him. Sick themselves or trying to avoid a sick president, the people he trusts and respects who would be barriers to that behavior dont seem to be around, this person said. It just looks so chaotic. Duh.

On October 5, the night Trump returned, a member of the White House cleaning staff sprayed the press briefing room. Photo: Erin Scott/Reuters/REUTERS

A second former White House official said the problem is now people are so broken down, to the point where everyones been in Jesus, take the wheel mode for the last couple years, and fighting against him is only gonna get them burned. Why even try? The presidents staff, this person said, have no ability to think strategically because the presidents behavior poses new threats to survival every five minutes. I dont think theyre even considering what happens if hes back in the White House and he needs oxygen or a ventilator. Their view is If it happens, well, well fucking figure it out when it happens!

Like Gingrich, they have to stay optimistic. They arent even considering what happens when hes feeling worse than hes feeling now, when hes hopped up full of steroids and other performance enhancers. Hes on the sort of drugs youd see with a Tour de France rider in the mid-90s! Another way to say this, the former White House official said, was that the president is hopped up on more drugs than a Belgian racing pigeon. In keeping with the bird theme, this person said the presidents illness was proof that the chickens are coming home to roost.

Going back to 2016, this person added, you always had these warnings from the Clinton camp and Democrats and the Never-Trump Republicans that, if he takes office and if a crisis hits, its gonna be a mess. But people dont really vote on that when theres not a crisis. People think, A crisis isnt gonna happen! May as well vote for the guy with a good tax policy. Suddenly, this happens, and you always assume it wont happen to you, but when you act like that, bad things happen!

One theory of Trumps self-immolation campaign is that its about gaining a sense of control. I dont think he wants to lose. I think he wants to have excuses for why he did lose, a third former White House official said. If its the ballot, the China virus, if its Nancy Pelosi. I just think he wants an excuse.

As he considers the end, he fakes his way through a performance of political possibility. One person who publicly supports Trump and considers him a friend said that, in conversations with White House and campaign officials following the presidents release from the hospital, it became clear that no one who was supposed to know seemed sure when he would be okay. Theyre putting out a big Oh, everythings fine! face. But I dont think they know how much stamina hes gonna have, this person said. I didnt like the way he looked on that balcony. Last week, I wouldve said that he was definitely going to win. Now, I dont know.

Trump spoke from outside the Oval Office on October 7 about having COVID and the vaccine. Photo: @realdonaldtrump/Twitter

Donald Trump does not often get sick. The philosophy of Fred Trump decreed that sickness was weakness, Mary Trump told me, which obviously Donald has adhered to, which is a big part of the reason were in this horrible mess were in.

Mary Trump is the presidents niece as well as a psychologist, whose best seller, Too Much and Never Enough, analyzes her uncle through the dysfunctional family he came from. In her view, the president is best understood as a self-unaware Tin Man, abandoned as a small child by his sick mother and rejected by his sociopath father until he became useful to him, whose endless search for love and approval plays out as mental warfare on the Free World he improbably represents. In order to deal with the terror and the loneliness he experienced, he developed these defense mechanisms that essentially made him unlovable, Mary said. Over time, they hardened into character traits that my grandfather came to value. When youre somebody who craves love but doesnt understand what it means he just knows he misses it and needs it, but hell never have it because hes somebody nobody loves thats fucking tragic. He still needs to go to prison for the rest of his life. Its not a defense. But its sad.

For two weeks before he died, Fred Trump was hospitalized at Long Island Jewish Medical Center in what Mary remembers as a very beautiful corner room with lots of sunlight. With her uncle at his fathers bedside, she said, everyone just stood around chitchatting, making small talk they just dont understand how to be human. When his mother was in the hospital, often for osteoporosis and once after a brutal mugging, Trump visited with an attitude of Why the fuck do I have to be here? she said. It was of no use to him whatsoever. When Marys father, Fred Jr., was dying in the hospital, her uncle Donald didnt even visit. He went to the movies.

In his 2007 book Think Big, the future president recalled how, a decade before, he unexpectedly came down with a wicked case of the flu in the middle of his negotiations to buy a newspaper (he didnt say which one). I felt terrible. It was so bad that I called the sellers and told them we would have to postpone the closing until I was better, he said, which was very unusual because I never get the flu. Its been ten years and I havent been sick a day since then. Trump didnt share the story of this freak illness to reveal his humanity but to add to his myth. He lost out to another buyer in the end, he said, and he was happy he did because, he claimed, the unnamed paper turned out to be a bad investment that was some other suckers problem. Catching the flu was a lucky break that saved me from ruin, he said. Sometimes luck makes better deals than talent. In other words, the idea that sickness is weakness, except for when it happens to him, took root a quarter-century before he made it his case for reelection.

Trump is aware that he isnt healthy. His wife, an Eastern European former model who eats salmon and greens, lengthens her muscles on a Pilates reformer, and glows as if cast in bronze, is healthy. As a 74-year-old who takes the unscientific position that human beings have a finite amount of energy that exercise needlessly drains, and who thus never engages in any physical activity more strenuous than golf or tweeting, and whose vices include red meat, French fries, ice cream, Oreos, and Diet Coke, he knows he is very much not that.

And he understood that with age and weight comes heightened risk in the coronavirus pandemic. But he couldnt accept that he wouldnt be fine, that he was part of the at-risk seniors his advisers kept telling him he should think about since they were an important voting demographic and they were literally dying by the thousands. What he could accept even less than not being fine was not seeming fine. His supporters like to imagine him as a cartoonish representation of his vigorous, manly spirit, a joke directed at anyone who doesnt find it funny. In memes, he body-slams his enemies. A video from the Trump campaign, released the week of his COVID-19 diagnosis, shows him body-slamming the virus. When I stopped by the home of Willard and Dolly Smith in New Hampshire last month, the flag on the couples front lawn showed Trumps fleshy face on Rambos ripped body. Im back because Im a perfect physical specimen and Im very young, the president joked on Fox Business on Thursday. But the stabs at self-deprecation, more necessary at this moment than ever before, do little to mask deep insecurity. Since his illness, the makeup the president applies himself has gotten so heavy and so dark that rather than obscure his pale coloring, it emphasizes the contrast between his unnatural face and the bare skin of his ears and hands. (All those years spent judging beauty pageants, and he never learned from the contestants the value of body makeup.)

Personality is policy in the Trump administration, and the presidents insecurity has made the uncertainty about the countrys leadership unavoidable when any chief executive falls ill even worse. His unwillingness to admit human frailty has led the White House and its doctors to keep information about his illness not only from the public and the press (three members of which have, so far, been infected at the White House too) but from his own staff. After Hope Hicks began experiencing symptoms at the Minnesota MAGA rally on Wednesday, forcing her to isolate in the back of the plane on the trip home, officials with whom shed had contact remained in the dark. After she tested positive on Thursday afternoon, the White House failed to notify others who would soon test positive themselves. They learned about it when the world did, not with an official disclosure but with a leak to the media. The president couldve given it to her, one of those people told me, in fairness, but I wouldve done things different that day, had I known.

Trump did know, but he didnt change his plans. At 1 p.m. on Thursday, he flew to his Bedminster, New Jersey, golf club, for a fund-raiser with hundreds of his supporters, some of whom he spoke with indoors. Later that night, he tweeted about Hicks being sick. Terrible! he said. The First Lady and I are waiting for our test results. In the meantime, we will begin our quarantining process.

Reading the message, the person said, Iassumed he mustve had a preliminary positive one. The lack of transparency, this person added, is symptomatic about how people I work with always keep the wrong things secret. Suicidal in all senses, this is the Trumpian madness that threatens the presidents political and earthly future as it puts at risk everyone around him.

As one White House official put it: Everybody at the top should be fired.

*This article appears in the October 12, 2020, issue ofNew York Magazine. Subscribe Now!

An earlier version of this article incorrectly stated that Donald Trump didnt attend his brother Fred Jr.s funeral. Its been updated to reflect that he didnt visit him when he was dying in the hospital and instead went to the movies.

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The Entire Presidency Is a Superspreading Event - New York Magazine