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Ex-VA Chief's Book Describes Chaos And Confusion Inside The White House

RACHEL MARTIN, HOST:

What's it like to be fired by a tweet from the president? Former Secretary of Veterans Affairs David Shulkin has written a book that answers that question. Shulkin describes chaos and confusion inside the White House during his year as the head of the VA. NPR's Quil Lawrence sat down with Shulkin to talk about all of it.

QUIL LAWRENCE, BYLINE: The book is called "It Shouldn't Be This Hard To Serve Your Country." The title has two meanings, Shulkin says.

DAVID SHULKIN: It's really about veterans, and it's about those that have served our country and the responsibility that I think all of us as Americans feel to making sure that they have the services and the care that they need, should they need it.

LAWRENCE: But the second meaning is hard to miss. Shulkin's own service as VA secretary was rough. He clashed repeatedly with President Trump's other political appointees in the department. They claimed Shulkin was slow-walking the president's plan to expand the use of private health care by VA. Shulkin was pushed out after 13 months. His tenure was strange from the start. It all began in Trump Tower with what Shulkin called a job interview unlike any other.

SHULKIN: He would ask a question, and I would start to answer - he would finish the sentence.

LAWRENCE: Trump then nominated him to lead the VA. The president also named half a dozen other political appointees who would later work to undermine Shulkin. That didn't happen right away. At first, Shulkin helped push a raft of bipartisan VA legislation through to the president's desk. At the signing ceremony of one of those bills, Trump joked that he'd never have to use his reality TV show catchphrase, you're fired, for the VA secretary.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: We'll never have to use those words on our David. We will never use those words on you, that's for sure.

LAWRENCE: Shulkin paints Trump as utterly unfamiliar with how the Department of Veterans Affairs works. Shulkin says he had to dissuade the president from trying to close some VA hospitals by executive order. Throughout his tenure, the president insisted Shulkin was in good standing; meanwhile, the half-dozen political appointees at the VA, Shulkin says, were working against him.

SHULKIN: It was very hard for me to navigate between these two worlds.

LAWRENCE: Things started to look bad, especially because some of the appointees were in the VA's press office.

SHULKIN: There was a group that was clearly providing him information, saying that things were actually different than what I was telling him. And I didn't spend a lot of time trying to manage that relationship. I felt that there are too many urgent issues happening for veterans for me to spend my time on the politics of it.

LAWRENCE: But the politics would soon eclipse those urgent issues. An email between two political appointees was leaked to The Washington Post. It detailed a plan to push Shulkin out, based on charges of improper spending on a VA trip to Europe and misusing his security detail. Shulkin devotes a lot of the book to defending himself. He quotes from a previously unpublished VA report, he says - concluded he did nothing improper.

SHULKIN: I wasn't that good at the politics, obviously.

LAWRENCE: Shulkin was fired by tweet on March 28, 2018. The next morning, he told NPR that he had been pushed out by people who intend to privatize VA health care. Weeks later, Congress passed a major expansion of the VA's use of private care, VA Choice. Shulkin says it's too soon to say whether that's going to open the door to privatization.

SHULKIN: But I do not believe that the forces at work to dismantle the VA have gone away.

LAWRENCE: VA officials say the new law hasn't resulted in major flight from VA care to the private sector; Shulkin says it's too soon to tell. The VA did not respond to a request for comment on former Secretary Shulkin's book.

Quil Lawrence, NPR News.

(SOUNDBITE OF NORMAN NODGE'S "EMBODIMENT") Transcript provided by NPR, Copyright NPR.

Quil Lawrence is a New York-based correspondent for NPR News, covering veterans' issues nationwide. He won a Robert F. Kennedy Award for his coverage of American veterans and a Gracie Award for coverage of female combat veterans. In 2019 Iraq and Afghanistan Veterans of America honored Quil with its IAVA Salutes Award for Leadership in Journalism.