I wonder if Shulkin got a courtesy call beforehand (while he was on the toilet?) or if he found out about this with the rest of us, via Twittergram.

The writing’s been on the wall for weeks. It couldn’t have come as a surprise either way.

https://twitter.com/realDonaldTrump/status/979108846408003584

WaPo wrote this morning about the long days Shulkin has spent in Trump purgatory lately. If you think his predicament was tough, imagine Jeff Sessions’s. He’s been living this for upwards of a year:

The uncertainty has left the leader of the federal government’s second-largest agency, its employees, and even senior White House officials wondering if Shulkin still officially speaks for VA. It has raised questions, too, about what’s being done to restore order at the agency after weeks of turmoil have left little doubt that Shulkin, the lone Obama administration holdover in Trump’s Cabinet, is next to go in what’s become a pronounced leadership shake-up.

What’s befallen Shulkin is a favorite tactic of Trump’s, who followed a similar approach with Secretary of State Rex Tillerson and, to a lesser degree, national security adviser H.R. McMaster. The president emasculates those who fall from favor, humiliating them through media leaks and in disparaging comments to friends. The mixed signals often leave even senior White House officials guessing who will be fired and when.

Waaaaay too many bad headlines for Shulkin lately. Some reeked of swampiness: Six weeks ago he was dinged by the VA’s inspector general for accepting Wimbledon tickets and airfare for his wife during a trip to Europe last year — and then trying to cover it up. Others smelled of bureaucratic failures for which the VA remains the federal government’s gold standard: Just three weeks ago the IG hit the department again by noting that the VA’s D.C. medical center has for years “suffered a series of systemic and programmatic failures to consistently deliver timely and quality patient care.” That’s poison for a populist president who said he’d clean up Washington and make America — particularly its military — great again. Can’t blame him for dropping the axe.

The replacement is a surprise, though. Initially it looked like Fox News host Pete Hegseth, a veteran, was in line for the job. His name had come up during the transition and he talks to Trump by phone sporadically. But Hegseth got nuked a few days ago with a report alleging that he’d had affairs at work and had his own ethical problem via a nonprofit he runs. Anti-Trumpers snarked that infidelity and ethical questions made him a perfect fit for the administration but it would have made it difficult to get him confirmed. So instead POTUS threw a curveball by naming Ronny Jackson as Shulkin’s successor. Remember him? He’s the White House physician who delivered an ultra-rosy assessment of Trump’s health early this year, leading to more scoffing from Trump critics. But Jackson is no partisan: He was Obama’s White House physician too and is admired as a terrific doctor and person by some of the biggest names in Obama’s administration.

And he’s not just a doctor, he’s a Navy admiral. If you want someone to lead an agency responsible for medical care for veterans, you might logically turn to someone who specializes in medical care and is himself a veteran. The open question, sure to be asked at his confirmation, is whether he has the management background needed to reform a bureaucracy as hellacious as the VA’s. Evidently POTUS thinks he does. Or maybe POTUS is at the point where he’s prioritizing his comfort level with appointees above all else. He knows Jackson personally. He obviously trusts him. Jackson’s served in the White House for 12 years without scandal. Maybe that’s good enough?

Update: Not all Obama alumni are hyped to see Jackson in this role, it seems.

Dr. Jackson is a wonderful man and always came across as the consummate professional as the President's physician (who would tend to any of us when needed).

But it's hard to separate this nomination from his glowing public assessment of Trump's heath. I suspect Trump didn't. https://t.co/mrcOIopHj9

— Ned Price (@nedprice) March 28, 2018

Dr. Jackson is a good and honorable person, fine doctor and career military but you do get the sense that this has as much to do with his boffo press conference on the president’s physical as anything else. https://t.co/uEbm7dPz1d

— David Axelrod (@davidaxelrod) March 28, 2018

Update: Meanwhile, on Capitol Hill, Mitch McConnell suddenly has a very full plate:

Checked in with Senate GOP sources. The gist: they'd like the president to cool off on the Cabinet reshuffling. Describe Pompeo/Haspel process as enough of a challenge with midterms just months away. But, of course, they're not sure if the WH is listening.

— Robert Costa (@costareports) March 28, 2018

Good thing the GOP wasn’t planning to pass any legislation of significance this year!