We must respect Bill Cassidy’s right to abandon his medical ethics for absolutely no political gain

Last month, as I shuffled through the subterranean corridor connecting lawmakers’ offices to the Capitol—a route I know intimately, having walked it with everyone from John McCain to the CEO of Raytheon—I found myself walking alongside Senator Bill Cassidy.

The Republican from Louisiana was walking with the brisk, determined cadence of a man who desperately hopes that if he moves fast enough, reality will fail to catch up. A gaggle of reporters was trailing him, lobbing rapid-fire questions about drug pricing and college sports. Cassidy eagerly engaged with these topics, clinging to them the way a drowning sailor clings to a piece of driftwood. He would much rather discuss whether LSU’s offensive line is adequately compensated through NIL deals than talk about the actual crisis at hand, because unlike epidemiology, college football is a science his constituents actually respect.

But then someone asked him the question he least wanted to hear: Did he regret voting to confirm Robert F. Kennedy Jr. as Health Secretary?

I watched Cassidy’s face tighten. And in that moment, I felt a profound, overwhelming wave of sympathy for him. I have decided that we, as a nation, are being incredibly unfair to Bill Cassidy, and by extension, we are threatening the very fabric of how Washington operates.

Cassidy is a medical doctor. He is a gastroenterologist who spent decades practicing medicine. He is openly pro-vaccine. He understands the germ theory of disease. He knows what a virus is, he knows what mRNA does, and he knows that the polio vaccine is not a covert operation funded by the deep state to alter our DNA.

Yet, when the time came, he bravely threw all of that into the Potomac River. He looked at a nominee who believes that Wi-Fi is leaking our brain-blood barriers, who suggests that antidepressants cause school shootings, and who thinks raw milk is a viable substitute for pediatric care, and Cassidy voted "yea." He handed the keys of America’s immunization policy to one of the nation’s most prominent vaccine skeptics.

He did this for one simple, noble, time-honored reason: to survive a Republican primary election in Louisiana.

And now, polling indicates he is headed into this weekend’s election and is going to lose anyway.

This is a devastating breach of the American political contract, and I will not stand for it.

We need to talk about the total collapse of the soul-selling economy in modern politics. I have been covering Washington for three decades. I have sat at Cafe Milano and watched men trade their most deeply held personal convictions for a subcommittee chairmanship before the appetizers even arrived. It used to be a highly reliable market. You swallow your pride, you endorse the lunatic, you nod solemnly while someone suggests injecting bleach into the human body, and in return, the political base lets you keep your job.

It was a beautiful, elegant, transactional system that kept this city running. It allowed for a healthy balance of private sanity and public madness.

What is happening to Senator Cassidy is, frankly, un-American. He did his part. He performed the ritual debasement. When Kennedy sat before the Senate Health, Education, Labor, and Pensions Committee, Cassidy had to sit there, a medical professional with a license to practice, and listen to a man explain that tap water is calcifying our pineal glands.

Cassidy swallowed hard, pushed down whatever vestigial medical ethics he had retained from the Hippocratic Oath, and fell in line. He sacrificed his historical legacy! He alienated his former medical colleagues! And for what? So some MAGA primary challenger can edge him out by three points anyway?

I tried to explain this tragedy to a prominent Democratic strategist over a $112 Niçoise salad at the Hay-Adams last Tuesday. The strategist, entirely oblivious to the delicate nuances of Republican primary dynamics, argued that Cassidy deserved to lose for endangering public health and elevating a conspiracy theorist to the highest medical office in the land.

I practically choked on my seared tuna. "You're completely missing the point," I told him, dabbing my mouth with a linen napkin. "Public health is irrelevant here. What's at stake is the basic transactional integrity of the United States Senate."

The problem with the modern MAGA and MAHA voter is that they have become greedy. They no longer accept the performative capitulation of a terrified establishment Republican. They want authentic madness.

It is no longer enough for a doctor like Cassidy to hold his nose and vote for the anti-vaxxer; they want Cassidy to personally go to a local CVS and smash vials of the MMR vaccine with a bespoke wooden mallet. They want him to denounce Louis Pasteur on the Senate floor. They want him to look into a television camera and swear that he has personally seen a child turn into a 5G antenna after a flu shot.

Cassidy’s fatal mistake, which I warned him about when we crossed paths at the Aspen Institute last summer, was the "initial balk."

When Kennedy was first floated for the position, Cassidy expressed skepticism. He was one of the few Republicans to initially balk at the idea. He let his medical background show for a brief, terrifying second. He hesitated.

In the modern Republican party, hesitating before you kiss the ring is a worse crime than refusing to kiss it entirely. The base smelled the science on him. They sensed that deep down, in the darkest recesses of his heart, Bill Cassidy still believes that the scientific method is a valid way to observe the natural world. And for that, they will never forgive him.

But think about the chilling effect this will have on future generations of lawmakers. If a sitting senator knows that completely abandoning their lifelong convictions won't even guarantee their reelection, why would they ever abandon them?

We risk creating a Washington where politicians just stubbornly vote according to their conscience because there is no market value in selling out. That is a terrifying prospect. The entire ecosystem of this town relies on the fundamental understanding that a politician's principles are always for sale, provided the price is right. If the currency of MAGA loyalty is completely decoupled from the act of legislative surrender, the market will crash.

I look at Bill Cassidy, a man who has spent 11 years in the Senate, and I see a victim of a changing economy. He is a Blockbuster Video in the age of streaming. He offered a perfectly good, traditional product—hollow, cynical appeasement—but the consumer base has moved on to wanting bespoke, artisanal derangement.

Louisiana voters, I am begging you to look at the bigger picture. When you head to the polls this weekend, consider the sheer emotional labor Senator Cassidy put into betraying his own profession for you.

He looked at a man who thinks the FDA is a criminal syndicate suppressing the healing power of sunshine and dirt, and he handed him the keys to the NIH, all so you would like him. He violated the core tenet of "first, do no harm" just to do a little harm to his own dignity, entirely for your benefit.

If we do not reward this kind of transactional cowardice, the entire ecosystem of Washington D.C. will collapse. We have to honor the bargain. You demanded he trade his spine for a primary victory, and he handed it over on a silver platter. Give the man his votes. It’s simply the polite thing to do.