News Analysis: For Many, Life in Trump’s Orbit Ends in a Crash Landing

Mr. Trump expressed outrage on Thursday about the toll exacted on some people close to him. Dr. Jackson, the White House physician and rear admiral who withdrew as nominee for secretary of Veterans Affairs after accusations of drinking on official trips and badgering his staff, is “an incredible man” whom Democrats were “trying to destroy,” Mr. Trump said on “Fox & Friends.”

The president attributed it to the toxic atmosphere of the capital, saying he warned Dr. Jackson. “I did say welcome to Washington,” he said. “Welcome to the swamp. Welcome to the world of politics.”

Mr. Trump likewise said that Mr. Cohen, his longtime lawyer who paid $130,000 to Stephanie Clifford, the pornographic film actress known as Stormy Daniels, before the 2016 election and now faces a federal investigation, is “a great guy” who “did absolutely nothing wrong” in that matter.

But as he has with other advisers who have gotten in trouble, the president also distanced himself, suggesting that Mr. Cohen was in trouble for business dealings separate from any legal representation he had done for Mr. Trump. “I’m not involved, and I’ve been told I’m not involved,” he said.

Over many decades, people who have entered Mr. Trump’s circle have discovered that they are bit actors in a movie he sees himself starring in.

“People are not people to him, they are instruments of his ego. And when they serve his ego, they survive, and when they don’t, they pass into the night,” said Tony Schwartz, the ghostwriter on “The Art of the Deal,” Mr. Trump’s first book. “Ultimately, the fate of anyone who casts their lot with Trump is — you are passing through. And I just can’t think of anybody for whom it is not true.”

Jack O’Donnell, the former president of Trump Plaza Hotel and Casino in Atlantic City, and a vocal critic of his former boss, said many people have cycled through his world remarkably quickly without leaving much of an impression on Mr. Trump.

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Hired and Fired: the Unprecedented Turnover of the Trump Administration

Since President Trump’s inauguration, staffers of the White House and federal agencies have left in firings and resignations, one after the other.

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“This is an individual who completely lacks compassion and empathy, and therefore the recycling of people, people crashing and burning, it means nothing to him,” Mr. O’Donnell said. “He might put on a public frown for a day because he’s upset that, in his mind, the admiral got railroaded out. But Trump couldn’t care less about the admiral.”

The president tapped Dr. Jackson because he had come to like him and was impressed by him even though he had little management experience to run the government’s second-largest department. Shortly after his selection, several senior White House officials warned Dr. Jackson that it was a bad idea and that it was likely to end poorly.

But Mr. Trump is a transactional person, and many have made transactional decisions to work for him understanding the risks. For some, it is a sense of public service and duty to country. For others, it is a calculation that the return on investment will be worth it. Indeed, Mr. Cohen has attracted enormous attention over the years as he built business ties because of his affiliation with Mr. Trump.

Some who have come and gone managed to benefit from the experience in their own way despite the ordeal. Sean Spicer, the White House press secretary who was mocked on “Saturday Night Live” and maligned by the president and the news media, nonetheless has received lucrative speaking contracts and has a book coming out in July. Mr. Tillerson and Gary D. Cohn, the former national economics adviser, lost power struggles, but both still have hundreds of millions of dollars to console themselves, and friends say no one should feel sorry for them.

Still, former advisers like Michael T. Flynn, Paul Manafort and Rick Gates have all been charged with or pleaded guilty to crimes and are looking at prison time.

Others worry they may face the same fate. Scott Pruitt, the head of the Environmental Protection Agency whose spending and security practices were spotlighted Thursday at a contentious House hearing, may yet lose his job.

Other presidents have seen associates get caught up in investigations or scandals that were highlighted or magnified because of their closeness. Plenty of advisers, aides and friends of Ronald Reagan and Bill Clinton met untimely ends to their political careers or even went to prison, and critics of both presidents often said they did not seem to care about the consequences to those around them.

The closer someone gets to a president, the harsher the spotlight can be. Many who seek the power and stature of the White House somehow convince themselves that their own foibles or misdeeds will not be exposed, only to learn otherwise, or become intoxicated by their new positions of influence and exercise poor judgment. And Washington can be especially unforgiving. “Here, ruining people is considered sport,” Vincent W. Foster Jr., a longtime Clinton friend and aide, wrote before killing himself in 1993.

Several people who have been close to Mr. Trump over the years say that he is exceptionally good at rationalizing his own behavior to himself, and compartmentalizing the types of personal catastrophes that would leave other people emotionally ravaged.

“I think that loyalty has always been a one-way street with Trump, and he doesn’t really care about the wreckages he engenders as long as he comes out where he wants to be,” said Tim O’Brien, a biographer who was sued by Mr. Trump over a book reporting that Mr. Trump had inflated his net worth.

“Ronny Jackson’s reputation would never have been in play had the president not put him up for this job,” Mr. O’Brien said, adding that in Mr. Trump’s mind, the issue is, “Ronny was great, but Washington is a snake pit.”

Michael D’Antonio, another Trump biographer, said, “Anyone who engages with the president and, before that, with him as a business person, had to practice self-defense even if they were his allies.”

“All that matters to him,” he added, “is what you say and do in the moment in front of him.”

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Investigators Focus on Another Trump Ally: The National Enquirer

Now the tabloid company has been drawn into a sweeping federal investigation of Mr. Cohen’s activities, including efforts to head off potentially damaging stories about Mr. Trump during his run for the White House. In one instance, The Enquirer bought but did not publish a story about an alleged extramarital relationship years earlier with the presidential candidate, an unusual decision for a scandal sheet.

The federal inquiry could pose serious legal implications for the president and his campaign committee. It also presents thorny questions about A.M.I.’s First Amendment protections, and whether its record in supporting Mr. Trump somehow opens the door to scrutiny usually reserved for political organizations.

A search warrant federal prosecutors in New York served to Mr. Cohen this week requests, among other things, all communications between him, Mr. Pecker and Dylan Howard, the business’s chief content officer. The company was in touch with Mr. Cohen, The New York Times previously reported, as it pursued its deal to acquire the rights to a former Playboy model’s story about an affair with Mr. Trump.


Donald J. Trump in 2014 with his close friend David J. Pecker, chairman of American Media Inc., which publishes The Enquirer.

Patrick McMullan/

The company is also facing a Federal Election Commission complaint claiming that the $150,000 payment to the woman, Karen McDougal, represented an illegal campaign contribution. A.M.I. is in the process of responding.

A.M.I. has denied any wrongdoing while also saying its cooperation with investigators will not extend beyond its constitutionally protected status as a news organization.

“It’s easy to look down at the work product of celebrity magazines and assume they are not entitled to same protections as the mainstream media,” said Cameron Stracher, a lawyer for A.M.I. “But the First Amendment was designed to protect all speech against government intrusion.”

In A.M.I., Mr. Trump has had an unusually powerful media backer, one that complements the supportive prime-time slate at Fox News.

The Enquirer had an average paid circulation of about 260,000 copies weekly in the second half of last year. That was a 13 percent drop from the previous six-month average, according to publisher data provided to the Alliance for Audited Media that was obtained by The Times.


Mr. Trump with Karen McDougal, a former Playboy model who claims they had an affair. Mr. Pecker’s company suppressed the story during the presidential campaign.

But most of its sales come over the counter at $4.99 a copy. The Enquirer provides a useful platform for a politician seeking votes from average Americans, in a place candidates have gone to show their familiarity with everyday life: the supermarket checkout lane.

The family that controlled A.M.I. before Mr. Pecker took it over in 1999, the Popes, moved early on to secure prime placement for The Enquirer in magazine racks at grocery store cash registers. The company now also owns The Globe, Us Weekly, OK! and other titles that benefit from that arrangement.

In a statement, the company said, “If A.M.I. was ‘helpful’ to the president during the campaign, it was because the audience of The National Enquirer was one of the most supportive of his candidacy during the campaign.” It added that Enquirer covers featuring Mr. Trump increased sales.

“We covered him for a business reason,” the statement said.

Mr. Pecker, a Bronx native who has reveled in upsetting the Manhattan magazine establishment since the early 1990s, has been open about his view that A.M.I. has good reason to connect itself to Mr. Trump. As he told The New Yorker last year, he considered an attack on Mr. Trump an attack on A.M.I. — implying they were one in the same.

He said that after A.M.I. bought Ms. McDougal’s story and agreed to feature her in health and fitness columns in non-gossip magazines like Hers and Flex, it expected her loyalty to the company and Mr. Trump. “Once she’s part of the company, then on the outside she can’t be bashing Trump and American Media,” he said.


The president’s lawyer Michael D. Cohen. A search warrant served to him this week requested, among other things, communications involving A.M.I.

Amir Levy/Reuters

Mr. Pecker has been supportive of Mr. Trump’s presidential aspirations since his run as a Reform Party candidate in 2000, when George magazine — part of the company Mr. Pecker ran then, Hachette — featured a friendly profile. The Enquirer was early to promote Mr. Trump’s potential bid in 2011.

As Mr. Trump ramped up his campaign in 2015, he, Mr. Cohen, Mr. Howard and Mr. Pecker engaged in more serious discussions about how A.M.I. could be helpful, according to several people familiar with the efforts.

In one early interaction, Mr. Cohen helped arrange an ultimately abandoned attempt to buy and bury a potentially damaging photograph of Mr. Trump at an event with a topless woman — what is known in the tabloid world as a “catch and kill” operation.

One person close to the campaign at the time recalled a meeting at Trump Tower in February 2015 between Mr. Pecker and Mr. Trump about how A.M.I. could help surface embarrassing information about Bill and Hillary Clinton, his Democratic rival, during a general election. The person, who requested anonymity to discuss private matters, said Mr. Cohen was also present. A.M.I. declined to say whether the meeting took place, and Mr. Cohen did not respond to a request for comment.

There are several intersections between Mr. Trump’s world and Mr. Pecker’s. The former casino executive, David R. Hughes, joined A.M.I.’s board in 2013, when he was the chief financial officer of Trump Entertainment Resorts (he is no longer a Trump employee). After the 2016 campaign ended, a media adviser, Justin McConney, landed at A.M.I. as its audience development director (he has since left).


Dylan Howard, A.M.I.’s chief content officer, was involved in the effort to buy and bury Ms. McDougal’s story.

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One of A.M.I.’s top financiers, the billionaire Leon G. Cooperman, was critical of Mr. Trump during the campaign but has more recently compared him favorably to Ronald Reagan. Last July, he accompanied Mr. Pecker to a White House dinner with Mr. Trump, along with another A.M.I. financial backer, Anthony Melchiorre, of Chatham Asset Management.

At the center of the campaign finance inquiries will be whether the ties between Mr. Cohen, Mr. Howard, Mr. Pecker, Mr. Trump and others led A.M.I. to act more like a political supporter than a news organization.

The group that brought the federal election complaint, Common Cause, claims the payment for Ms. McDougal’s story was not a “legitimate press function” and therefore was not protected by rules exempting news organizations from campaign finance regulations.

The question represents tricky terrain for federal officials, given the protection journalists have under the First Amendment. “We always worry when investigators are making those judgment calls about whether your editorial process is legitimate or not, or is this legitimate journalism or not,” said Alexandra Ellerbeck, the North America program coordinator for the Committee to Protect Journalists.

Yet even the staunchest defenders of the press say fraudulent activity is not protected by journalistic freedoms.

“We are not, as media organizations, immune from the civil and criminal laws of the country,” said Sandra S. Baron, a senior fellow at Yale Law School and the former executive director of the Media Law Resource Center.

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Veterans Affairs Shake-Up Stirs New Fears of Privatized Care

He said that a middle path that he had tried to pursue — investing in the department’s own health care system while offering veterans more, though not unfettered, access to private doctors — had been rejected by Trump administration officials interested in rewarding private individuals and companies with a windfall in government money.

“They saw me as an obstacle to privatization who had to be removed,” he wrote in one of the most forceful statements offered yet by a fired Trump administration official.

Senior White House officials offered a different rationale for his firing that was based more on a damaging report about Dr. Shulkin’s use of government funds on a trip to Europe released last month than on a dispute over policy.

Lindsey Walters, a deputy White House press secretary, told reporters aboard Air Force One on Thursday that the nomination of Dr. Jackson should not be interpreted as a signal that Mr. Trump wants to privatize veterans’ health care.

But Mr. Trump seemed to renew those concerns just a short time later, promising in a speech in Ohio that he was going to ensure that veterans “have choice,” harkening back to a campaign promise to enact something like the Koch-backed plan.

The speculation on Thursday about a possible policy shift was mostly fed by the lack of information about Dr. Jackson, whose only prominent public statements have been about Mr. Trump’s health.

Veterans advocates are especially concerned that Dr. Jackson, a rear admiral in the Navy who has no real management or political experience in a large bureaucracy, will be pushed around or, worse, simply co-opted by officials in the administration set on drastically expanding private care.

“We don’t know what his agenda is. We don’t know what his views are,” said Verna L. Jones, the executive director of the American Legion. “No one has had an opportunity to talk to him.”

“Of course we are nervous,” she added.

Leaders of the older, congressionally chartered veterans groups like the Legion are not categorically opposed to easing restrictions on private care, particularly in cases where veterans are facing long wait times and subpar facilities. About 30 percent of veterans’ appointments are currently made with private health providers for those reasons.

But the groups prefer tweaking programs already in place while at the same time addressing the problems that made private care necessary.

John Hoellwarth, the communications director for Amvets, said he thought the first response of most veterans groups to Dr. Jackson was to search for him online.

Dr. Shulkin said that he had been friendly with Dr. Jackson for several years — both men also served in the Obama administration — and encouraged him to go through the interview process to lead the department’s health system this year. Still, he said that he thought concerns about Dr. Jackson’s résumé were justified.

“There is no question about it, but I can’t imagine any job that prepares you for this type of job,” Dr. Shulkin said.

By most accounts, Dr. Shulkin’s rapid fall began as he increasingly butted heads with other Trump administration official over how to approach the expansion of private care. The officials — who included the department’s press secretary and assistant secretary for communications — came to consider Dr. Shulkin as an obstacle and repeatedly tried to have him removed.

Many of those officials, several of whom have ties to the Concerned Veterans group, are still in the administration and are likely to have increased sway in the department. But the ultimate decision about the structure of the department’s health care most likely resides on Capitol Hill, where lawmakers have been struggling for almost a year with the issue.

“I think that there was a miscalculation that if you could get rid of the secretary who is a moderate that things will fall in place, and I just don’t think that is going to happen,” Dr. Shulkin said.


David J. Shulkin testifying this month before the House Appropriations Committee.

Erin Schaff for The New York Times

Dan Caldwell, the executive director of Concerned Veterans for America, strenuously disputed Dr. Shulkin’s analysis and said the secretary was using privatization as a “straw man” to distract from his own ethical lapses.

“The president has said he supports full V.A. choice,” Mr. Caldwell said. “The president would not have selected Admiral Jackson if he did not believe he supports his full agenda.”

Mr. Caldwell was referring to a damning report released in February by the department’s inspector general that found “serious derelictions” related to a trip Dr. Shulkin took last year to Britain and Denmark. It concluded that he had spent much of the trip, which cost more than $122,000, sightseeing and that he had improperly accepted Wimbledon tickets as a gift.

Dr. Shulkin has continued to deny any wrongdoing, and on Thursday blamed his political opponents in the department for the investigation itself.

“This is 100 percent about the politics and this is the way that people fight their battles in Washington rather than having intellectually honest discussions,” he said.

The White House did not view it that way. Senior officials came to believe that Dr. Shulkin had misled them in the run-up to the report’s release. His public declarations of innocence only further aggravated top officials, who felt he had too openly aired internal politics with news outlets and had repeatedly opened the White House to criticism.

The exact circumstances surrounding Dr. Shulkin’s firing, and exactly how much the White House chief of staff, John F. Kelly, was aware of it, remained unclear.

One person with direct knowledge of the events said Dr. Shulkin had called Mr. Kelly around 10:30 a.m. Wednesday, asking if he were about to be fired. Mr. Kelly told that him he did not know, and that he would get back to him.

A White House official would not discuss the details of what took place, beyond saying that Mr. Kelly had called Dr. Shulkin to accept his resignation, and that the secretary gave it.

Dr. Shulkin declined to discuss the episode in detail, but said he did speak on the phone with Mr. Trump on Wednesday about the progress of various policy initiatives at the department and implied that his job status did not come up.

A few hours later, he was at home on the phone with his wife when she broke the news: the president had fired him in a tweet.

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Wooing Saudi Business, Tabloid Mogul Had a Powerful Friend: Trump

It was an opportune moment for Mr. Pecker to showcase his White House connections. He was considering expanding his media and events businesses into Saudi Arabia and also was hunting for moneyed partners in acquisitions.


Mr. Pecker’s company, American Media Inc., published a 97-page glossy magazine that is essentially a promotional brochure for Saudi Arabia and the crown prince.

The intersection of the tabloid publisher with the Saudis, enhanced by the White House visit, is a previously untold chapter in the long, symbiotic relationship between the president and Mr. Pecker, which was forged in the 1990s. At the time, Mr. Trump was celebrating a real estate comeback after his casino bankruptcies and was both the subject and the source of much gossip in New York.

Mr. Pecker, who had known Mr. Grine only for a few months, invited him to the dinner to thank him for advice he had provided about investing in the Middle East, according to someone who knew of the invitation.

Word soon traveled back to Saudi Arabia about the dinner: It signaled Mr. Pecker’s powerful status in Washington.

Two months later, he was in Saudi Arabia, meeting with Mr. Grine and the crown prince about business opportunities there, according to A.M.I.

And by January, Mr. Pecker was confident enough about his growing rapport with Saudi investors that he sought their help bankrolling a possible acquisition of Time magazine, which he had long coveted, according to two people with direct knowledge of the talks. A.M.I. disputed that.

The White House did not respond to a request for comment.

The people briefed on the interactions between A.M.I. and Saudi Arabia requested anonymity because they were not authorized to speak publicly.


François Hollande, right, then president of France, shaking hands with Saudi Prince Alwaleed bin Talal in Paris in 2016. At left is Kacy Grine, a businessman with Saudi connections who joined Mr. Pecker at the White House dinner.

Bertrand Guay/Agence France-Presse — Getty Images

The outcome of Mr. Pecker’s efforts to do business with the Saudis remains unclear. But he is still working to cultivate ties. This week, he and Mr. Grine both attended events in New York featuring Prince Mohammed, who is on a tour across the United States.

Ahead of that visit, A.M.I. published a 97-page glossy magazine that is essentially a promotional brochure for Saudi Arabia and the crown prince. It makes no mention of anything troubling, like the Saudi-led military campaign in Yemen, human rights concerns or the crown prince’s arrest last fall of many extended royals, including Prince Alwaleed bin Talal, an influential client of Mr. Grine’s.

The magazine — which refers to Saudi Arabia throughout as “the Magic Kingdom” — includes an interview with Mr. Grine, accompanied by a photo of him posing with Mr. Trump in the Oval Office, taken during his visit with Mr. Pecker. It talks up the relationship between Mr. Trump and the Saudis, noting that Mr. Trump “endorsed the crown prince’s high profile anticorruption” crackdown.

A.M.I. has said it produced the magazine to “capitalize” on interest in the crown prince, who is next in line to the throne, and has been careful to say it received no input or guidance from Saudi officials. That carries important legal implications: Foreign direction or control of such a purely promotional publication would require disclosure to the Justice Department. The Saudi government did not respond to a request for comment.

The magazine — 200,000 copies distributed in Walmart and other outlets, with a cover price of $13.99 and no advertising — provided a unique welcome mat for the prince, whose visit comes as the Trump administration is trying to establish tighter ties with the kingdom. Both countries are touting cross-border investment opportunities, including a pledge by the Saudi government to put $20 billion into a fund that will invest in American infrastructure projects. The kingdom is also nearing a deal to buy American-made missiles and other military equipment.

Mr. Grine, a 30-year-old French citizen, has helped broker deals between Saudi investors and companies in France, Senegal and the United States. He and Mr. Pecker were introduced last spring by Ari Emanuel, chief executive of Endeavor, the huge talent, entertainment and sports company based in Beverly Hills, Calif.


Mr. Trump with Karen McDougal, a former Playboy model who claims they had an affair. Mr. Pecker’s company suppressed the story during the presidential campaign.

Mr. Grine and Mr. Pecker soon had a series of discussions about the investment landscape in Saudi Arabia, according to a person briefed on the talks. Mr. Pecker extended the White House dinner invitation shortly afterward.

A.M.I. would not say who else was among the “select group of friends” Mr. Pecker took to the White House at the president’s invitation. During the evening, the Middle East and the recent French elections came up. In a statement, A.M.I. said, “The entire conversation was social, with the exception of a couple very brief mentions of current events.”

Mr. Pecker is best known for The Enquirer, but his media empire is wide-ranging. A.M.I.’s titles include Men’s Journal, Hers, Flex and Muscle & Fitness.

The publisher has used the company at times to protect close friends, including Mr. Trump. Karen McDougal, a former Playboy model, recently filed a lawsuit alleging that Mr. Trump’s lawyer was secretly involved when A.M.I. tried to bury her story about an affair with Mr. Trump. A.M.I. bought the rights to her story during the presidential campaign for $150,000 but never published it. In the world of gossip media, such a maneuver is known as a “catch and kill” operation.

Mr. Trump’s lawyer Michael D. Cohen and A.M.I. have denied the allegations. Mr. Trump’s representatives say the affair never happened.

During the campaign, The Enquirer also published scathing articles about Mr. Trump’s rivals, as well as perceived antagonists like the television host Megyn Kelly. In promoting Mr. Trump, The Enquirer endorsed a candidate for the first time in its history.


A page from A.M.I.’s magazine on Saudi Arabia showing Mr. Grine at the White House with Mr. Trump.

Since he entered the White House, A.M.I. titles have run articles alleging a “deep state” plot to undermine Mr. Trump. As scandals engulfed the White House, a recent Enquirer cover blared: “Donald & Melania Fight Back! Exposing the Lies, Leaks and Intimidation. How They’ll Crush Their Enemies!”

The support appears mutual. Mr. Trump at times has praised Mr. Pecker’s stewardship of A.M.I. He once endorsed Mr. Pecker to run Time magazine, whose cover, Mr. Trump has incorrectly asserted, has featured him more than anyone else.

“David Pecker would be a brilliant choice as CEO of TIME Magazine — nobody could bring it back like David!” Mr. Trump wrote in a Tweet in 2013.

A.M.I. has struggled financially. It went through a series of restructurings in the last decade, including a bankruptcy in 2010 in which the company reported up to $1 billion in debts, before being acquired four years ago by two private equity funds.

The company said in a statement that it was “in an incredibly stable financial position.”

Mr. Pecker has continued to hunt for new acquisitions. Last year, he bought Us Weekly from Wenner Media. But money remained scarce, according to A.M.I.’s financial advisers. When Mr. Pecker’s friend Harvey Weinstein suggested last fall that they team up to purchase Rolling Stone, Mr. Pecker expressed little interest. “I can not contribute any cash,” he wrote in an email obtained by The New York Times.

In that same Sept. 28 exchange, Mr. Pecker wrote Mr. Weinstein: “I am in Saudi Arabia on business. Can’t call from here.”

In a statement to The Times, A.M.I.’s chief content officer, Dylan Howard, said, “Any media executive worth his or her salt must look at any acquisition opportunity in today’s media climate.”

During the visit to Saudi Arabia, Mr. Grine arranged for himself and Mr. Pecker to meet with Prince Mohammed, who is the chairman of the kingdom’s deep-pocketed Public Investment Fund. At the meeting, Mr. Pecker described his vision for expanding his events business, which includes the Mr. Olympia bodybuilding competition, into Saudi Arabia.

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Veterans Affairs Secretary Is Latest to Go as Trump Shakes Up Cabinet

Mr. Trump, who made veterans issues and overhauling the scandal-ridden department a focal point of his campaign, showered Dr. Shulkin with praise. At a bill-signing ceremony in June, Mr. Trump teased that the secretary need never worry about hearing his “Apprentice”-era catchphrase, “You’re fired.”


Dr. Ronny L. Jackson, the White House physician, discussed the results of President Trump’s medical exam in January.

Doug Mills/The New York Times

“We’ll never have to use those words on our David,” the president said. “We will never use those words on you, that’s for sure.”

But in recent months, a group of conservative Trump administration appointees at the White House and the department began to break with the secretary and plot his ouster. At issue was how far and how fast to privatize health care under the department’s health system, a long-sought goal for conservatives.

The officials — who included Dr. Shulkin’s press secretary and assistant secretary for communications, along with a top White House domestic policy aide — came to consider Dr. Shulkin, who had run the health program under President Barack Obama, and his top deputy as obstacles to one of the administration’s policy goals.

The secretary’s troubles only grew when what had been an internal power struggle burst into the open in February, after the department’s inspector general issued a scathing report describing “serious derelictions” related to a trip Dr. Shulkin took last year to Britain and Denmark. The report found that the secretary had spent much of the trip sightseeing and improperly accepted Wimbledon tickets as a gift.

Critics of the secretary seized on the report to try to hasten his removal. Dr. Shulkin, fearing a coup, went public with a warning about officials “trying to undermine the department from within” and cut off those he saw as disloyal.

The efforts backfired. At the White House, senior officials came to believe that Dr. Shulkin had misled them about the contents of the report. And the secretary’s public declarations only further aggravated top officials, who felt Dr. Shulkin had gone too far in commenting on internal politics with news outlets and had opened the administration to sharp criticism over his trip to Europe, which the report said cost more than $122,000.

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Turnover at a Constant Clip: The Trump Administration’s Major Departures

Since President Trump’s inauguration, staffers of the White House and federal agencies have left in firings and resignations, one after the other.

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As recently as early March, after meetings with John F. Kelly, the White House chief of staff, Dr. Shulkin publicly claimed victory, signaling that he had the White House’s support to remove officials opposing him.

But the victory seemed short-lived. In short order, Dr. Shulkin began markedly curtailing his public profile, cutting off communications with reporters and isolating himself from top deputies he viewed as disloyal. People who have spoken with the secretary in recent days said he was determined to keep his post, even as it became increasingly clear his time was up. He was set to meet with leaders from the nation’s largest veterans groups on Thursday.

Dr. Shulkin remained overwhelmingly popular on Capitol Hill, where the Senate unanimously confirmed him last year, and among the veterans groups that have traditionally held outsize influence in Washington. In recent weeks, leaders from both parties publicly and privately signaled their support, even as rumors of his replacement appeared in news reports.

But Mr. Trump had had enough. He began to discuss successors in recent weeks, even considering Energy Secretary Rick Perry as a possibility. He told friends last weekend that he would fire Dr. Shulkin, it was just a question of when.

Dr. Shulkin’s departure could clear the way for a more aggressive push for government-subsidized private care at the department. Dr. Jackson and his policy views are little known on Capitol Hill, where lawmakers will have the final say on the matter.

Representative Phil Roe of Tennessee, the Republican chairman of the House Veterans Affairs Committee, said Wednesday that he considered Dr. Shulkin a friend and regretted his departure.

“I think he’s done a fantastic job and I hate to see him go,” Mr. Roe said. “That said, I respect President Trump’s decision, support the president’s agenda and remain willing to work with anyone committed to doing the right thing on behalf of our nation’s veterans.”

Correction: March 28, 2018

Because of an editing error, an earlier version of this article misstated the rank of Dr. Ronny L. Jackson. He is a rear admiral, not an admiral.

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Former Playboy Model Karen McDougal Sues to Break Silence on Trump

“The lawsuit filed today aims to restore her right to her own voice,” he said, adding, “We intend to invalidate the so-called contract that American Media Inc. imposed on Karen so she can move forward with the private life she deserves.”

Ms. McDougal filed her suit just days before Ms. Clifford was to appear on “60 Minutes” to discuss her relationship with Mr. Trump and the efforts Mr. Cohen undertook on his client’s behalf to pay for her silence.

Mr. Trump joined a legal effort last week seeking some $20 million in penalties tied to Ms. Clifford’s agreement.


The lawsuit claims that Michael D. Cohen, Mr. Trump’s personal lawyer, was secretly involved in Ms. McDougal’s talks with the company.

The court dispute has drawn public attention to an issue that was previously sidelined. And both women’s suits could provide more fodder for federal complaints from the watchdog group Common Cause that the payoffs were, effectively, illegal campaign contributions.

Ms. Clifford and Ms. McDougal tell strikingly similar stories about their experiences with Mr. Trump, which included alleged trysts at the same Lake Tahoe golf tournament in 2006, dates at the same Beverly Hills hotel and promises of apartments as gifts. Their stories first surfaced in the The Wall Street Journal four days before the election, but got little traction in the swirl of news that followed Mr. Trump’s victory. The women even shared the same Los Angeles lawyer, Keith Davidson, who has long worked for clients who sell their stories to the tabloids.

Ms. McDougal negotiated with the country’s leading tabloid news provider, A.M.I., which is known to buy and bury stories that might damage friends and allies of its chief executive, David J. Pecker — a practice known as “catch and kill.”

Ms. McDougal’s legal complaint alleges that she did not know about the practice, or about Mr. Pecker’s friendship with Mr. Trump, when she began talking to company representatives in spring 2016, shortly after Mr. Trump locked up the Republican nomination.

A.M.I. has previously acknowledged that Mr. Trump had been friends with Mr. Pecker, but said that he had never tried to influence coverage at the company’s publications.

Ms. McDougal has said that she was ambivalent about selling her story on the tabloid news market, but felt that her hand was forced after a hint of the alleged affair appeared in May 2016 on social media. Convinced something more would come out, she was determined to tell her story on her terms, her suit says.

A mutual friend connected her to Mr. Davidson, who, she said, told her the story could be worth millions. He arranged an interview with Dylan Howard, A.M.I.’s chief content officer, in Los Angeles. Mr. Davidson told her before the interview that A.M.I. would put $500,000 in an escrow account for her, and that “a seven-figure publishing contract awaited her,” the complaint reads.

Mr. Howard spent several hours pressing Ms. McDougal on the details of her story. But several days later, the media company declined to buy it, the complaint reads, and “Mr. Davidson revealed that, in fact, there was no money in escrow.”

A spokesman for Mr. Davidson said on Tuesday that the lawyer “fulfilled his obligations and zealously advocated for Ms. McDougal to accomplish her stated goals at that time,” but that commenting further would “violate attorney-client privilege.”

A.M.I. told The Times last month that it decided not to print Ms. McDougal’s story because it could not verify important details, though it acknowledged discussing her allegations with Mr. Cohen, the president’s lawyer, saying it did so as part of its reporting process.

The tabloid company showed renewed interest in the story in summer 2016, when Ms. McDougal began talks with ABC News. This time, A.M.I. offered a different deal.

Mr. Davidson informed her that A.M.I. would buy her story but not publish it because of Mr. Pecker’s relationship with Mr. Trump, the suit says. The payment would be $150,000, with Mr. Davidson and others involved on her behalf taking 45 percent. More alluring to Ms. McDougal, who is now a fitness specialist, was that the media company would feature her on its covers and in regular health and fitness columns, the complaint says.

As A.M.I. and Mr. Davidson pushed her to sign the deal on Aug. 5, Ms. McDougal expressed misgivings. But, her suit says, Mr. Davidson and Mr. Howard argued in an urgent Skype call that the deal to promote her would “kick start and revitalize” her career, given that she was “old now.” She was 45.

In all, they said, the contract would obligate A.M.I. to run more than 100 columns or articles and at least two covers featuring her. When she asked Mr. Davidson what she should do if her story leaked, he responded in an email, “IF YOU DENY YOU ARE SAFE,” and urged her to sign as soon as possible, according to the court documents.

The Times reported last month that Mr. Davidson sent Mr. Cohen an email on Aug. 5, 2016, asking him to call. Mr. Davidson then told Mr. Cohen over the phone that the deal had been completed, according to a person familiar with the conversation.

The timeline provided in the lawsuit shows that Mr. Davidson’s email came as he and A.M.I. were still hashing out the terms of the deal, which Ms. McDougal did not sign until the following day, Aug. 6. Mr. Cohen told The Times last month that he did not recall the communications.

After signing the contract, Ms. McDougal grew frustrated when she did not hear about columns or cover shoots for several weeks. She later figured out why. Though the agreement explicitly mentioned “a monthly column” on aging and fitness for OK! and Star, and “four posts each month” on Radar Online, it only gave A.M.I. “the right” to print them. It was not an obligation.

“She was tricked into signing it while being misled as to its contents (including by her own lawyer, on whose advice she was entitled to rely),” the lawsuit reads. So far, A.M.I. has run one cover and roughly two dozen columns or posts featuring her. The company later amended her contract to let her respond to “legitimate press inquiries” about Mr. Trump.

Mr. Stris contends that his client was misled and that the contract was executed under fraudulent circumstances, giving her the right to sue in court rather than proceed in arbitration.

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