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News Brief: Newsom Survives Recall, New Book About Trump, Pandemic Burnout

NOEL KING, HOST:

California's governor, Gavin Newsom, will keep his job.

A MARTINEZ, HOST:

Newsom fended off a Republican-led recall effort. The Associated Press called the race not long after polls closed.

KING: Nicole Nixon with CapRadio News in Sacramento has been following this one. Hey, Nicole.

NICOLE NIXON, BYLINE: Hi.

KING: So unofficial returns show that about two-thirds of voters in the state chose to keep Newsom in office. What is he saying?

NIXON: Yeah, the governor said he was humbled by the results, and he said that by rejecting the recall, he believes Californians were also saying yes to the coronavirus vaccine, to voting rights and all these other issues that came up in this election. Here he is addressing reporters last night.

(SOUNDBITE OF ARCHIVED RECORDING)

GAVIN NEWSOM: We said yes to all those things that we hold dear as Californians and, I would argue, as Americans - economic justice, social justice, racial justice, environmental justice, our values where California's made so much progress. All of those things were on the ballot.

NIXON: But the governor said he was still concerned with claims by former President Donald Trump and the leading Republican candidate to replace him that the election would be rigged, and he's concerned that these unsubstantiated claims of election fraud are still coming up.

KING: This leading candidate to replace him is a conservative radio host, Larry Elder. What is Larry Elder saying this morning?

NIXON: Elder did not commit to accepting the election results previously, but he did do that last night. He conceded the race.

KING: OK.

NIXON: He told his supporters that they should be gracious in defeat, but some of those supporters didn't really like that. Here's an exchange from his campaign last night in Southern California.

(SOUNDBITE OF ARCHIVED RECORDING)

LARRY ELDER: We may have lost the battle, but we are going to win the war.

(CHEERING)

NIXON: And Newsom is up for reelection next year, and Elder left the door open for another run for governor in 2022.

KING: Nicole, given that this doesn't even seem like it was a particularly close race, can you remind us how this recall effort started and why?

NIXON: Right. This recall was filed in early 2020, before the pandemic, but it quickly became about the pandemic. Newsom's critics didn't like his tough business restrictions. He took a lot of heat because most schools were closed for a full year, and Republicans tried to make this recall a referendum on Gavin Newsom. But Gavin Newsom tried to make it a referendum on Trumpism. He tied it to national fights over reproductive rights and voting rights, and he was able to bring in support from President Joe Biden and other national Democrats to help boost that message. And you know, you're right. Democratic voters outnumber Republicans 2-to-1 in California, and the early results from this recall reflect that. So there aren't too many surprises from this election.

KING: Do you think Newsom will run again in 2022?

NIXON: He didn't look that far ahead in his victory speech last night, but his Democratic allies say that this margin puts him in a very strong position going up - into 2022 when he would run again.

KING: Nicole Nixon of CapRadio in Sacramento. Thank you, Nicole.

NIXON: Thanks.

(SOUNDBITE OF MUSIC)

KING: The U.S. will not attack China.

MARTINEZ: General Mark Milley told his Chinese counterpart this twice in the last days of the Trump presidency. "Peril," a new book by journalist Bob Woodward and Robert Costa of The Washington Post, details these two calls. Milley made one of them four days before the 2020 election and reportedly made the second one days after the January 6 insurrection at the U.S. Capitol.

KING: Now, the book is not out until next week, but Washington Post national political reporter Isaac Stanley-Becker has read it. Good morning, Isaac.

ISAAC STANLEY-BECKER: Good morning.

KING: So this is a big deal. China is a leading U.S. adversary. Why would General Milley have made these calls saying we're not going to attack you?

STANLEY-BECKER: Well, even adversaries share certain interests. And, you know, one of them is preventing nuclear annihilation. And the chairman of the Joint Chiefs, Mark Milley, had reviewed intelligence suggesting that the Chinese believed the U.S. was preparing to attack at that time. And he feared a hair-trigger situation in which there could be miscalculation or a preemptive strike by China in an attempt to fend this off or get ahead of it. And at the time, there were tensions over military exercises in the South China Sea. These tensions were deepened by Trump's belligerent rhetoric toward China on the campaign trail. So he tried to assuage these fears. But you mentioned the first call just before the election, the second two days after January 6. The Chinese general wasn't so easily assuaged. And even though Milley tried to say we're stable; things are steady; we're not going to lash out, it's not clear that that message necessarily had its intended reception.

KING: OK. So China is worried about a U.S. nuclear attack. But then, on the U.S. end, Milley - General Milley also takes steps to prevent former President Trump from ordering a nuclear attack. What was going through Milley's mind?

STANLEY-BECKER: Milley was concerned about checks in the system and ensuring that there wasn't some sort of improper, illegal or immoral action, as he put it to senior officers. So what he does on January 8 is to summon senior officers to review these procedures and to tell them, the president has the authority to decide on action, but there are other steps, and I also have to be made aware of that decision. So whatever happens, clue me in. And it's this remarkable scene in the book where he goes officer by officer, looks them in the eye and asks them to affirm that they understood his directions. And the authors, Bob Woodward and Robert Costa, write that Milley considered this something like an oath.

KING: It is worth noting that Trump nominated Milley, and he became Joint Chiefs chairman in late 2019. So all of this was going down a little more than a year after that. What happened in that short period of time?

STANLEY-BECKER: That's right. And it's a critical point. He was chosen by the president in 2018 and confirmed in 2019. And there were some immediate events that set this off, including his belief that Trump had suffered a mental decline after the election. This was a view he shared with House Speaker Nancy Pelosi in a phone call on January 8. But there were also some events further back that had led him to believe that he had to ensure that the military wasn't going to be manipulated by this president. And one of those signature events was the walk across Lafayette Square during the protests over the killing of George Floyd when there was that photo op. And Trump brought with him senior members of the military, including Milley. And Milley felt that he had been used for this photo op, and he resolved to not let that happen again.

KING: Does the book say what the words mental decline actually mean?

STANLEY-BECKER: What the book does is it describes what that belief was based on - based on Milley's having watched scenes of Trump just lashing out at aides, him living in this alternative universe of voter fraud and election-related conspiracy theories. And so it describes how this view was formed.

KING: OK. Washington Post political reporter Isaac Stanley-Becker. Thanks for joining us this morning. We appreciate it.

STANLEY-BECKER: Thanks so much for having me.

(SOUNDBITE OF MUSIC)

KING: All right. Consider this fact for a minute - even before the pandemic started, burnout among health care workers was a very big challenge.

MARTINEZ: Now, after treating wave upon wave of COVID-19 patients, burnout is at crisis levels, and many say it could be hurting patient care.

KING: NPR health correspondent Yuki Noguchi has been looking into this. Good morning, Yuki.

YUKI NOGUCHI, BYLINE: Good morning, Noel.

KING: How does burnout present among health care workers?

NOGUCHI: Well, you know, it isn't just an overwhelming amount of work - although it's that, too - it's also demoralization and eroded motivation, loss of purpose. Health care workers tell me its effect is palpable, and they see its impact on patients. Matthew Crecelius really brought that home for me. He's a traveling intensive care nurse, and he's been handling double or triple the usual number of patients and under tougher circumstances. You know, COVID protocols mean industrial fans are blowing, patients are separated and isolated, and so he can't always see or even hear his patients.

MATTHEW CRECELIUS: When you shout out to somebody - hey, can you check on my other people? - like, I can't even see a monitor. I don't know how they're doing.

NOGUCHI: Crecelius says he's lost patients who crash while he's tending to other patients.

KING: Which would suggest to me that staffing shortages are a problem.

NOGUCHI: Oh, that's a huge factor. I mean, people are quitting. Retirement is accelerating. So of course, the people who remain get burnt out even faster. And again, that ripples to patients. Lindsay Moore-Ostby is a primary care doctor in Indianapolis. Every critical care bed in her region is full. One doctor she knows recently called 42 hospitals hoping to transfer a patient, which happens pretty often. So then that doctor complains to her.

LINDSAY MOORE-OSTBY: Now I'm spending time trying to make this transfer happen. So what if I can't provide the care I need to the other patient who needs me? It's really a game of dominoes where the doctor is just emotionally devastated because they can't fix it.

NOGUCHI: And it's frustrating because many patients have COVID and they didn't get vaccinated.

KING: Yes. How much does that frustration over people not getting vaccinated contribute to burnout in this field?

NOGUCHI: You know, a lot because much of today's workload is preventable. Matthew Crecelius, that traveling nurse we heard from earlier, says it's a big reason he plans to switch careers. And he's a fifth-generation nurse. And he's...

KING: Wow.

NOGUCHI: ...Just had enough.

CRECELIUS: Now that there is a vaccine and people aren't getting it, my sense of duty, it's changed for me. Like, no, I'm not interested anymore.

NOGUCHI: And so the staffing problem gets worse, Noel.

KING: Has anybody tried to measure the effect of this on patient care, on what this actually means for people going into hospitals?

NOGUCHI: It's not easy to quantify. You know, plenty of studies show burnout reduces the quality of care, but how much is the bigger question. And it's hard to measure how burnt out a doctor or nurse is or how exactly that affected care. So health care workers say the numbers may never capture the whole picture. There's a woman I talked to who said her father was hospitalized this spring. His doctors were so overwhelmed, she couldn't talk to them. They discontinued his anti-stroke pills, thinking he couldn't swallow them, and then he died of a stroke. So she believes burnout cut her dad's life short. But she also says medicine's a team sport, so you can't pinpoint whose burnout played what role.

KING: Yeah, it makes sense. NPR health correspondent Yuki Noguchi. Thank you, Yuki.

NOGUCHI: Thank you, Noel. Transcript provided by NPR, Copyright NPR.