As President Donald Trump finishes his first year in office, Ayad reflects on his family’s long-standing connection to him and the man’s impact on his father Sikander. Like Trump (prior to his presidency), Sikander spends the better part of the 1980s mired in debt, “uncertain about his financial future” (4). However, while Trump’s investments involve multimillion dollar deals and bailouts from his rich family, Sikander gambles the family’s meager savings on a series of “haphazard purchases” (5): gas stations, a strip mall, a campground, and a trout farm. While he thinks ownership of these entities makes him the equivalent of a “true” American, they instead lead to bankruptcy after the Reagan presidency, forcing Ayad to take out student loans or drop out of college. It is Sikander’s return to clinical cardiology that leads to his initial meeting with Donald Trump in 1993 due to Trump’s potentially fatal heart arrhythmia.

Balancing a high-profile divorce from his first wife Ivana and the pregnancy of his then-mistress, Marla Maples, Trump suffers heart palpitations at a golf course and then, during dinner a few nights later. On his way home, he collapses in the back of a limo. After a series of hospital visits and testing, doctors send Trump to New York, where he is referred to Sikander in Milwaukee—a leading specialist on the newly-discovered Brugada arrhythmia.