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Feels like it has become a weekly ritual - firings and resignations from the Trump administration. But last night, the firing of Veterans Affairs Secretary David Shulkin still came as a bit of a shock.


Yeah, I mean, consider what happened last summer. President Trump was praising Shulkin at a bill signing. As the audience was clapping, Trump mouthed his famous catchphrase, you're fired. And then he said...


PRESIDENT DONALD TRUMP: We'll never have to use those words. We'll never have to use those words on our David.

GREENE: All right, well, fast-forward eight months, and the president took to Twitter to announce that Shulkin is out and that the current White House physician, Dr. Ronny Jackson, is in as his nominee to take over at the VA. So what is behind the timing of this change? And what does it mean for the embattled agency and also for veterans?

KING: NPR's Quil Lawrence covers Veterans Affairs. He's with us now.

Good morning, Quil.


KING: All right, so Dr. Shulkin came on during the Obama administration. He was tasked with overhauling the troubled VA health network. He had bipartisan support, and as we just heard, it seemed like President Trump really liked him. And then his last six weeks got rocky. What actually led to his departure?

LAWRENCE: There were two things. An ethics investigation by the inspector general at VA came out saying that Shulkin had taken an official trip to Europe last year but that he improperly brought his wife along, spent several days on tourism. He had to end - he ended up paying back several thousand dollars of improperly spent VA funds. So that was not very popular among rank-and-file veterans. Congress ended up supporting him on - after that ethics investigation. But what was even more interesting were emails exchanged between other political appointees within the Trump administration who were actively planning to use this investigation to push out Shulkin and his top deputies because they didn't think he was moving fast enough to increase the use of private care at the VA.

KING: OK, so there are a couple backstories here. What do you know about his replacement nominee, Dr. Ronny Jackson?

LAWRENCE: He's got a great reputation as a physician. He's a combat doc. He was in Iraq. But he was last in the public eye in January when he gave President Trump a clean bill of health. Other than that, no one really knows his qualifications to run such a huge organization. VA has more than 300,000 staff.

KING: And a lot of actual veterans really liked Dr. Shulkin, right? How are veterans' organizations reacting to all this?

LAWRENCE: The big organizations had been pulling for Shulkin. They thought he was pragmatic, a technocrat. They don't know much about Jackson. Shulkin wasn't a vet. Jackson is. But other than that, they're sort of saying, we're going to wait and see; we want to get to know him.

KING: Do you think that Dr. Jackson is going to have an easy time getting confirmed?

LAWRENCE: Well, there's already some noise, particularly among Democrats as they heard the news last night - they think Shulkin was pushed out by an agenda that wants to privatize the VA. And for all its warts, vets like the care they get at the VA once they get in the door. And the VA does pretty well with its outcomes, even compared to the private sector. So we may see in this confirmation hearing an effort to extract some pledges from Jackson that he'll resist the agenda - the same agenda that may have just gotten his predecessor fired.

KING: That is really interesting. NPR's Quil Lawrence. Thank you so much, Quil.

LAWRENCE: Thanks, Noel.


KING: Last week, Russia's president, Vladimir Putin, won an election that puts him in power for the next six years. But now Putin is up against one of the biggest crises of his 18-year presidency.

GREENE: Yeah, a couple things to look at here - he's facing anger right now at home over a fire in a shopping mall in Siberia that killed 64 people. And abroad, the country is facing unprecedented isolation after the U.S. and (inaudible) other countries kicked out dozens of Russian diplomats.

KING: NPR's Lucian Kim is on the line from Moscow to talk about how Putin is dealing with all of this.

Good morning, Lucian.

LUCIAN KIM, BYLINE: Good morning.

KING: So Putin has this landslide victory in the presidential election, which we all expected. How are these two simultaneous disasters - the fire and the diplomatic crisis - affecting his popularity?

KIM: Well, surprisingly, both fit the Kremlin narrative quite well, that Putin is the only leader for Russia. From the Kremlin's point of view, these mass expulsions of diplomats just prove that the rest of the world is ganging up on Russia, and this horrible fire shows people that Putin is a good czar who just has a lot of bad ministers, advisers and governors around him.

He visited the site on Tuesday. He was trying to put himself on the side of the people, and there, he said criminal negligence was to blame. Just yesterday, one of his top advisers said rabble-rousers from the opposition are trying to exploit this tragedy for their own political purposes. Of course, the real problem here isn't that Russians don't know how to put out fires. Of course, they do.

KING: Right.

KIM: The problem is corruption among officials and the willingness of businesspeople to play along with that.

KING: And so when people in Russia are outraged about the fire but not at Putin, what are they outraged about exactly? Was the building's code not up to - was the building not up to code?

KIM: Well, the building was definitely not up to code. There were also reports that the - there was a cinema at the top of - on the top floor of this shopping center. There were reports that the doors were locked from outside so people couldn't get in without paying. And just the combination of this and the slow government reaction has caused a lot of outrage here.

KING: Let's talk about these diplomatic expulsions, more than 20 countries booting out Russian diplomats. How is Putin reacting to that right now?

KIM: Well, Putin himself has not reacted. He's really been preoccupied with the fire. But his spokesman said that any response will be, in his words, reciprocal. What's quite - kind of interesting is that a lot of the rhetorical reaction here in Moscow is directed at Britain. Yesterday, the Foreign Ministry issued a statement and said, Britain has shown that it can't predict - protect the lives of Russian citizens on British soil and that Britain actually needs to prove that it didn't poison this double agent - former double agent, Sergei Skripal. The attitudes towards the U.S. seems actually more tempered - at least, coming from the Putin - from Putin's administration. His spokesman said Russia wants good relations with all countries. And it seems that Putin is still very interested in a summit meeting with Donald Trump.

KING: NPR's Lucian Kim from Moscow. Thank you so much, Lucian.

KIM: Thanks.


KING: All right, it seems like barely a day goes by without a new installment in the crisis that is unfolding in Venezuela.

GREENE: Yeah. I mean, the economy there has collapsed. The country is desperately short of food and also medicine. And now we have news of another tragedy - a fire in a police station that officials say has killed at least 68 people.

KING: NPR's Philip Reeves reports on South America, and he joins us now.

Phil, good morning.


KING: So what do we know about this fire last night?

REEVES: Well, this happened in the prison cells of a police station in Valencia. That's a city about a hundred miles west of the capital, Caracas. And reports say that disturbances broke out inside the cells. Some prisoners set fire to their mattresses. The fire spread. And at one point, rescuers had to punch a hole in the wall of the building to try to get people out.

KING: Wow.

REEVES: Venezuela's chief prosecutor says on Twitter that nearly all of the 68 who died were prisoners, although the victims also include two women who were visiting.

KING: Phil, what are Venezuela's prisons like? Are they overcrowded? Are they violent? Is this the kind of thing you expect?

REEVES: Yes, indeed. I mean, human rights groups have for ages been warning about the dire dysfunctionality of the Venezuelan penal system - overcrowded, awash with disease, malnutrition, not to mention drugs and guns. And this situation has an added twist, which is that, you know, the relatives of the people who were the victims of this weren't getting any news. They gathered outside the building, desperate for information. No one was telling what was going on. They got angry, and there were clashes with security forces, who used tear gas to try to bring the situation under control.

KING: What's the status of that now? Is it under control outside of the prison?

REEVES: We're hearing it is under control, yes.

KING: Venezuela is obviously deeply volatile in a lot of different ways. What does this incident mean for the government of Nicolas Maduro?

REEVES: Well, it's another reminder of the desperate situation there. I mean, the currency has crashed. This - the inflation rate is running into - well into four figures. Millions of Venezuelans have left the country. As you mentioned, there's a dire shortage of food, medicine and other basics. It puts more pressure on President Nicolas Maduro and the ruling socialist party. They're already unpopular. Maduro's organizing an election in an attempt to get a second term in May, and that is being boycotted by most of the mainstream opposition, who regard it as fraudulent, a view that is also held by much of the international community.

KING: Is he likely to get a second term if this election goes ahead?

REEVES: He is likely to get a second term, although he is being challenged by one figure on the opposition side who is coming - performing very well in the polls. But Venezuela and Maduro have a reputation of rigging elections, and there is a widespread expectation that that will happen again.

KING: NPR's Philip Reeves. Thank you so much, Phil.

REEVES: You're welcome.

(SOUNDBITE OF FAIT'S "SURRENDER TO") Transcript provided by NPR, Copyright NPR.