President Trump has always been a snake oil salesman. But now we know he's not just selling the stuff, he's taking it himself.

At least, that's what we're supposed to think. Trump on Monday told reporters that he was taking hydroxychloroquine, the anti-malarial drug he has pushed for months — against the advice and wisdom of government experts — as a possible "game changing" treatment for the COVID-19 disease that has shut down much of the world.

"I'm not going to get hurt by it," Trump said, despite evidence that the drug can produce serious side effects — including death — and has little or no benefit to patients suffering from the coronavirus.

The backlash and confusion was swift. Even Fox News' Neil Cavuto was so alarmed by the president's statement that he went on air to plead with viewers not to follow Trump's example. "If you are in a risky population here, and you are taking this as a preventative treatment ... it will kill you," Cavuto said. "I cannot stress enough. This will kill you." Speaker of the House Nancy Pelosi (D-Calif.) went a step further, expressing concern on CNN that Trump was endangering his health because he is already "morbidly obese."

Trump infamously can never admit when he is wrong — the government purchased more than 29 million doses of the drug, a presidential "accomplishment" that turned sour as the negative studies started to stack up — but it seems unlikely he would risk his own life to make a point. So what's going on? To contemplate this question is to dive into Trump's tricky relationship with the truth and the power of his own self-regard. Here are three possibilities.

Maybe he's lying. There is always a reason to approach Trump's claims with skepticism. After all, this president lies about everything. Yes, the White House on Monday furnished a note from his doctor saying the two had agreed that "the potential benefit from treatment outweighed the risks." But Trump's doctors — like their patient — haven't always been reliable interpreters of reality.

On the surface, Monday's revelation simply seems unbelievable. "Trump is either unnecessarily taking hydroxychloroquine, a drug which can cause hallucinations and heart failure," Vox's Aaron Rupar noted on Twitter, "or he's irresponsibly lying about it." The president has frequently warned — in an economic context — that cures should not be worse than the disease. Trump is notoriously inconsistent, but taking chloroquine would show serious disregard for his own advice, particularly if (as we have been told) he hasn't even tested positive for the virus.

And Trump is not above creating a diversion. Until he revealed his alleged drug regimen on Monday, the top story of the day was his announced firing of the State Department's inspector general — a clear attack on the systems designed to curb executive branch corruption and waste. Suddenly, the president's choice of pharmaceuticals dominated the airwaves and headlines. Pretty convenient.

Maybe he believes his own bull. My colleague Damon Linker last year noted the tendency of Trumpist Republicans to create their own reality, and I have wondered at times if this president, rather than try to keep his lies straight, simply believes that whatever he says in a particular moment is the truth, even if it's at odds with facts and his own previous statements. In this scenario, Trump's use of hydroxychloroquine makes a little more sense. Coronavirus has invaded the White House, after all, and the president would certainly want to protect himself from illness. If he really is using the drug, it might be because he believes — despite everything — that it works.

That doesn't really make him sympathetic. All it means is that Trump trusts his gut — or his rich guy friends — more than he does the observations and expertise of people who study these kinds of things for a living. Once again, he has disregarded science for magical thinking, this time at the possible risk of his own health. That's extremely dangerous.

Maybe he's just a narcissist. The president seems to regard all of reality in terms of whether it is "pro-Trump" or "anti-Trump." And when reality collides with his worldview, he decides it is "anti-Trump." So if studies show that a drug he touted is dangerous or ineffective, it must be because someone, somewhere is out to get him. And if that's the case, he can simply disregard the inconvenient facts.

"Here's my evidence: I get a lot of positive calls about it," Trump said Monday. "The only negative I've heard was the study where they gave it — was it the VA? — with people that aren't big Trump fans."

This is conspiracy thinking at its most shallow and elemental. To embrace this line of thought is to believe there are people across government and society who would reject a coronavirus cure because they would rather thousands of people die and the economy go to shambles just to make the president look bad. This isn't true, but it might be enough to push Trump into taking a drug he probably shouldn't.

Trump's unnecessary use of the drug — and his willingness to encourage others to do so — causes harm to others, like lupus patients, who really need hydroxychloroquine and have faced shortages because of his obsession. And generally speaking, it isn't great to have a head of state playing a chemistry-based version of Russian roulette on the job. The president is treating governance and the lives of others with selfish, stupid disregard.

Perhaps one last possibility is that Trump, like so many others, wants desperately to believe there exists a magical elixir that will act as a swift cure-all for the deadly pandemic ravaging America and the world. Hanging the nation's hopes on hydroxychloroquine is certainly easier than overseeing the widespread testing, tracing, and social distancing policies that are really needed to address the crisis. Let's just hope America has the common sense to see Trump's hydroxychloroquine sales pitch for what it is: a sham.

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