Well, It’s Now on the Record: Trump is Openly Genocidal

Patrick Koske-McBride
9 min readJul 25, 2024

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I am a minority member in America. More specifically, I am one of that hard-to-find 10–30% of Americans with an “invisible illness.” Specifically; I contracted a benign brain tumor at age 17, and have only been declared “No Evidence of Disease” six years ago. I attended university and graduate school with severe brain damage that impacted me, academically — for those wondering; brain damage destroyed my ability to take standardized tests, but I can write and research academic papers exceptionally well. I do, however, require regular access to MRI scans and neurologists to monitor my cancer, and I’m on several psychiatric drugs correlated with tumor suppression. In my darkest fears, I lose access to affordable modern medicine; my cancer, unmonitored and unchecked, comes back and I become a statistic. This isn’t some sort of far-fetched dystopian scenario, it has already happened to me. That’s right, at age 17, as I was being rolled into the pre-op area of an OR to remove my first (almost benign) brain tumor, my health insurance canceled the operation. The reason? Because I was asymptomatic, and my tumor was found only on scans, neurosurgery was an elective surgery, and, therefore, not covered by my parents’ health insurance. Fortunately, my parents were very fast on their feet, and capably canceled, expanded, and renewed some insurance to arrange my surgery later in the week. Scratch that; we were able to arrange for my elective neurosurgery later that week.

That was my first experience as a minority member in America. And, ever since then, as someone who needs regular but infrequent medical intervention, the clear messag I’ve received from Amerikkka is, “You are a burden to society. You are unwanted. Seek life elsewhere.” If you’ve never felt that way, kudos; you’re operating at full white male privilege in JD Vance’s America. I’ve spent every day since then terrified about my health status and special needs, as compared to the abled populace. I’ve personally watched the Supreme Court and Congress weigh in — several times — on my ability to access life-preserving care. I bring that up in terms of the modern GOP and their horrifying, odious designs on our country, because, as I wrote recently (https://patrickkmc10.medium.com/500-days-of-escobar-is-a-dark-precursor-to-2025-1fe3c64687dc) I am absolutely convinced that a Second Trump Term would be absolutely genocidal, but I honestly don’t believe it would be the sort of organized “top down” genocide we associate with Concentration Camps, Gulags, and other state-administrated genocide. It’s going to look much more like the Darfur, or possibly Pinochet’s Chile — at the closest documented intersection between the Trump Junta and their brown shirted followers, all that will happen is an official will respond to the Proud Boys’ cries for racial segregation with a shrug and a nod. The excitable boys will do the rest.

I’m discussing this in conjunction with my own situation, because the very first step in Trump’s Genocide will be a dark recreation of the Greco-Roman practice of “exposition” in which infants were left in the woods to defend themselves. The woods remain undefeated by the toddler menace. It was a unique form of murder in that it removed the guilt of a crime by commission, and simply replaced it with whatever emotions individuals at the time had regarding letting children freeze and starve to death. At its base, the removal of civilization and its safety benefits is the simplest, easiest, and most effective form of murder. And it paves the way for concentration camps.

How do I know this? As I said, when your connection to the rest of society is the goodwill and kindness of strangers, you start to listen to what those strangers have said, historically. Leaving aside the traditional fate of lepers and other groups with infectious diseases, we can see a direct parallel in the Third Reich. I’ve written a little about Aktion T4, the “pilot program” to the infamous Final Solution before, but, in case you felt like eating, here’s the brief version: In September 1939, Hitler signed an order authorizing Reich medical personnel to begin culling the herd of those who were “deemed incurably sick after most critical medical examination.” That label doesn’t currently apply to me, but it will if the cancer returns. At which point, my entire existence will rest upon the medical resources I can muster. Like most cancer patients, there will be a point in disease progression at which my physicians will say that I am beyond treatment. My greatest life goal is to push that date back as far as I can, and build my life to withstand that time. All of which will be quite unimaginable if my care is left to the whims of private bureaucrats in the Medical Industrial Complex.

My extermination won’t be as dramatic as a forced death march, firing squad, or Zyklon B chamber. All that is required for my grisly, gruesome end is a withdrawal of support. That’s it; just another person in power flinches when I discuss my personal history, and the physicians, meds, and doctors go away and it’s me against Zeus.

For everyone wondering, yes, a scant few chronic disease survivors lasted long enough to make it to the death camps. Here’s an account of a Diabetic who survived the Holocaust (https://www.diabetes.co.uk/blog/2015/03/surviving-the-holocaust-with-type-one-diabetes-the-story-of-ernest-sterzer/). Some readers will use that man’s harrowing survival as an excuse to invalidate my own personal fears. To which I can only say; if your fundamental argument can be reduced to, “Yeah, but Auschwitz didn’t kill him, you’ll be okay,” I would urge you to hide Grandma’s insulin and blood tests for a few weeks, so someone you allegedly love can receive the exact same level of care he did. Again, given that glioma survivors’ life expectancy is measured in months, I don’t think I would last long. And, make no mistake, The Donald is absolutely gearing up to Aktion T4. How do I know?

He fucking said so. To a distant family member, to be sure (as detailed here: https://time.com/7002003/donald-trump-disabled-americans-all-in-the-family/) The critical quote attributed to Our Lumpiest President?

“Those people . . . ” Donald said, trailing off. “The shape they’re in, all the expenses, maybe those kinds of people should just die.”

Now, I would be the first person to admit that I am regularly deluged with — and ignore — pleas for funds to end genocides elsewhere in the world, or sponsor Medicins Sans Frontiers, and I regularly ignore them, like most of you do.

Here’s where I, a chronically ill person, distinguish between Trump’s overt malevolence in advocating euthanasia for a distant family member, and me deleting an e-mail from an advocacy group: That man went and personally advocated and begged for The Donald’s help in advocating for his developmentally-disabled son. And Trump told him to literally fuck off and die. To his face.

That is beyond monstrously callous, it’s murderous and dangerous. I’ve told my story of institutional cruelty that barred me from life-saving surgery to a handful of people. I will be the first to admit that Miss Manners does not prepare you for that story, and, in the moment, it’s hard to know what to say or do. I understand that; as a young adult cancer survivor; I’ve seen that blank look on many a face. There is, however, a beyond-wrong response to that story that I’ve now heard of exactly twice: “I hope the disease wins.” Nobody has ever said that, to my face, but responses like, “Well, I’m sorry that happened to you, but…” is meant to paper over the sentiment, “I just don’t see why you, personally, should be alive.” In defense of the GOP, that is not a response I’ve ever received from someone I’d associate with intelligence or compassion, so, it’s quite possible that Mitt Romney or Nikki Haley would make the usual soft “tut-tutting” noises I’ve come to expect when someone is invested in a genocidal status quo, but know that admitting that is a social faux pas.

The GOP did not nominate Mitt Romney or Nikki Haley to be their standard-bearer. They did not nominate a saner, kinder person. They somehow went with the second person I’ve ever heard of who saw someone in a dangerous place, and consciously sided with Death. The first was, horribly, a Grade A asshole I met in graduate school, who is still allowed to menace society, as far as I know.

The second person I’ve heard of is now just a point or two behind the DNC nominee. And he delights in cruelty, malice, and death. Project 2025 outlines that it wants to put a lifetime cap on Medicare, Medicaid, and Disability benefits. I’m sure I used those up six months into cancer. On Day 1 of Gilead — and that is a “when,” not an “if,” if we allow this disturbing rot to remain in the Body Politic — I will lose those life-preserving benefits. I may make it long enough to see women being grabbed off the street for immodest dress, but I certainly won’t have a home or much time, at that point. And that goes for every single chronically ill member of your family. It will, quite literally and deliberately, start with your diabetic grandmother. Joe Biden’s signature legislation on healthcare was capping insulin costs. Trump will not only remove those protections, he’ll provide some sort of inducement for providers and hospitals to deny access to insulin, because Trump is always exclusively about revenge, and his signature vengeance is to destroy and upend any of his forebears’ contributions to society.

Trump will start by denying healthcare to Americans. This won’t be a campaign promise or bumper sticker, because being the Deathcamp Party isn’t popular. It will start with a series of aggressive “cost cutting” measures “designed to increase government efficiency and reduce costs to citizens,” but that will entail a very quiet genocide of denying people healthcare. This will be, like Aktion T4, a test of the American Public’s tolerance for low-level genocide. There won’t be a backlash. I know that because, when I was denied care (quite legally, BTW, which also shattered my faith in the American legal system), nobody from the hospital’s legal office showed up to discuss the legal repercussions Blue Cross might face for endorsing malpractice and negligence; it was a very sympathetic social worker who showed me the door. Then everyone in that facility went back to work. That will be America’s response — millions of us will immediately lose medical coverage, and, because it will take weeks or months for us to succumb to our individual diseases, we’ll be sung out of this world to a resounding chorus of, “It won’t be so bad.” That will be the first 6–18 months. After all of us useless eaters depart, Stephens Bannon and Miller will gleefully look to the other traditional enemies of fascism: humans.

We need to be firm, we need to be clear-eyed, so; fascists are not, ever, to be considered human. They rely upon that basic shared humanity to operate in society, and it’s time to stop this paradox of tolerance bullshit that leads to Auschwitz. The basic test is this: Does the person in front of you openly advocate killing innocent people? I’ll be generous and give assholes like Raygun and Nixon the benefit of the doubt and limit this policy exclusively to “Statements of intent made by the individual,” rather than “potentially dangerous policies or actions pursue by the individual.” We’ll let the Death Kamp Krew off for the half-dozen times they attempted to end the ACA, for the multiple Supreme Court cases that coldly decided my fate, and for other times they’ve needlessly and cruelly endangered me, and limit it simply to “Openly genocidal statements made in front of humans.” Read it again:

“Those people . . . ” Donald said, trailing off. “The shape they’re in, all the expenses, maybe those kinds of people should just die.”

Today, “Those people” is me and my tribe. Tomorrow, it’s Black and Brown people. Then registered members of the Democratic Party. Again, Aktion T4 started in 1939; the Nazis are still with us, and running a major political party.

The solution to our fash problem? As I said, whenever someone boasts about killing someone — as Trump promised to in 2016:

I could stand in the middle of Fifth Avenue and shoot somebody, and I wouldn’t lose any voters, OK?

Again, nobody forced him to say that into a microphone, it wasn’t caught on an invasive wiretap, that is a statement made by subhuman scumbag, Donald Trump in an Iowa campaign stop in 2016. That should have been the moment when we all recoiled, brought out the “He’s a murderer just waiting for an opportunity,” and then banished him to Wasilla. Again, society becomes murderous when it consciously tolerates murderers, and, if we simply want to rely on public statements made by Ted Bundy, that seems like a good enough determination system to me. The punishment for fascist statements should be fairly humane and easy to navigate, namely, the complete and total disenfranchisement of anyone who makes openly genocidal statements. No voting, running for office, campaign contributions, or even interacting with any elected officials. If Trump is cool with the idea of from something that provides me with life, but he can not see the value in; I simply advocate treating him and all the Death Kampers identically: I do not see the value in them having a voice in politics, and I believe that the shape they’re in, and all the social expenses… maybe those kinds of people should just move to Hungary, or Turkey, or Russia. They already have their own ethnostates for white idiots with substance abuse issues and an overwhelming predilection for blood sports. They can move there and leave humanity to deal with actual, real political questions that don’t posit a society that has a surplus population.

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Patrick Koske-McBride
Patrick Koske-McBride

Written by Patrick Koske-McBride

Science journalist, cancer survivor, biomedical consultant, the “Wednesday Addams of travel writers.”

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