Watching that noble doctor Bill Frist make his TV rounds last weekend — I know he's a saint because he keeps telling us so — I began to think I was going under general anesthesia. Here's a guy who dispenses bromides and palliatives for every troublesome topic, dishing out the spin so smoothly that you have to question your own grasp on reality. A spoonful of sugar makes the medicine go down? Dr. Frist, as he insists that we call him, gives us the whole bowl. "He's perfected that earnest, focused look that people want when they go to the doctor," one of his former medical colleagues told me this week. "It's as if you are the only person in the world."

It's a sham, of course, because the client who always comes first is Senator Frist's role model and patron in compassionate conservatism, George W. Bush. And so the good doctor congratulates himself for his good work on "H.I.V./AIDS in Africa," an admirable record indeed were it not for the unmentioned footnote that he knocked down his own Senate legislation earmarking $500 million for that cause by 60 percent after the White House jerked his chain. He promises to open up Medicare to private health plans without mentioning that much of his own fortune (in a blind trust, of course) derived from the for-profit Hospital Corporation of America (HCA), the medical giant founded by his father and brother.

Dr. Frist further suggests that that little Trent Lott nastiness is behind us now because Republicans are going to have "a dialogue on race . . . in a more visible, a more open way." The dialogue, we later learn, consists of (1) highly visible photo ops for Dr. Frist with black conservatives; (2) a spirited defense of the judicial nominee Charles Pickering's strenuous effort to reduce the sentence of a convicted cross-burning hoodlum; and (3) the White House intervention in the Supreme Court case challenging the University of Michigan's affirmative action program. (Will the administration also weigh in on the affirmative action programs for alumni children that have given every Bush family applicant a leg up at Yale?)

The doctor is very good at this game, but not yet nearly so sophisticated as the master. The White House has the bait-and-switch routine down to a science. As The Associated Press reported on Wednesday, Ari Fleischer just happened to announce that Mr. Bush would increase aid to Africa just before declaring the president's intention to intervene in the Michigan case — much as he had announced at the height of the Lott embarrassment that the president was looking forward to a trip to Africa. (That safari was quietly "rescheduled" to no fixed date when Mr. Lott stepped down three days later.) The Africa card is the Republicans' answer to the Democrats' race card, and once it had been played, the stage was set for Mr. Bush's "statement on affirmative action."

That statement contained so many sound bites lauding "diversity" — the word turned up as many as three times in a single breath — that the casual channel surfer might think the president was joining the Rainbow Coalition. Or forget that he presides over a party whose Congressional majority contains not a single black member, even in the House, where "diversity" could easily have been put into action, affirmative or otherwise, by recruiting a minority candidate for one of the many safe Republican districts.

The Bush rhetorical technique — of implying one thing while doing quite another — was first honed to perfection in the speech handing down the great stem-cell "compromise" of summer 2001. In his new and mostly worshipful memoir about Mr. Bush, "The Right Man," his former speechwriter David Frum describes the president's sleight-of-hand technique from the inside: "Because Bush summarized all points of view so sympathetically, he was able to win the support of his viewers for his own not at all middle-of-the-road position." What the speech did, in other words, was persuade inattentive listeners that the president was so sympathetic to scientific research and the ill that he couldn't possibly be throwing roadblocks in the way of potential cures for cancer, juvenile diabetes and Alzheimer's (as in fact he was).

It was only a few weeks after the stem-cell speech that 9/11 was upon us. Although that cataclysmic event is said to have changed George W. Bush as much as it supposedly changed so much else, it has not altered his brazen style. If anything, the midterm election has emboldened the White House to use fictional rhetoric to paper over harsher reality in almost every policy area it can.

Mr. Bush rolls out an economic plan that he says will help address joblessness, now at an eight-year high and growing, when in fact it's mainly a payday for those who collect dividend checks. Promising to speed the cleanup of corporate corruption, he accepts the resignation of Harvey Pitt, but two months-plus later Mr. Pitt is still on the job, working his will as the S.E.C. does some of its most crucial "reform" rule-making. Mr. Bush thumps as a hallmark of his education vision the No Child Left Behind Act, but his tight budget will leave states struggling to fulfill its alleged goals. Even Marvin Olasky, the Bush sycophant who wrote the book that inspired compassionate conservatism, said last month that while he awards the president an "A" for "setting the message" he gives him an "F" for his legislative follow-through.

But Mr. Olasky may not be the only one who is waking up to the ruse. The drop in Mr. Bush's poll numbers this week reminds us that anesthesia, no matter how well administered, eventually wears off. Affirmative action, judicial nominations, Enron and the rest are passionate issues for some, but war is a wake-up call for all. As the president keeps stamping his foot about Saddam Hussein, there is a dawning sensation that America is being held hostage by the administration idée fixe that is Iraq. It's a sword of Damocles hanging over our foreign policy, economy and national security alike.

The White House wants us to believe, as Dr. Frist reassured us last weekend, that North Korea is "an entirely, entirely different situation" from Iraq. Yes it is, not least because North Korea does not produce oil. But the two situations are now inseparable. Kim Jong Il may be crazy but he's not stupid. He bet the bank that Mr. Bush, for all his promises not to respond to nuclear blackmail, would do exactly that to avoid a distraction from Iraq. And so he called the president's bluff and will soon get his ransom. Mr. Bush's retreat all but invites other rogues to push us around, or worse, in this interregnum of vulnerability that his verbal bluster and tactical blundering has created.

Iraq's hammerlock on the economy is just as tight. We increasingly realize that no matter what Mr. Bush's tax-cutting plan, or any Democratic alternative, the economic issue du jour is not so much class warfare as warfare, period. No one believes the economy is going to expand as long as war clouds dampen the business environment. If the war drags on for months, recession could well follow.

Nor does anyone know what vanquishing Saddam and then governing Iraq will cost in either dollars or lives. Lawrence Lindsey, the chief White House economic adviser, was fired after he put the bill at $100 billion to $200 billion. But William Nordhaus, the Yale economist, puts the Lindsey estimate at the low end, with the high end being $1.6 trillion over a decade. Whatever the number, the cost of the war isn't being factored at all into the budget proposal the White House will send to Congress, according to USA Today. Yet even with that huge sum unaccounted for, the tax cuts and deficits are already so out of control that budgetary allotments for homeland security are being cut back. As for the American troops to be thrown at Saddam, remember those leaked Pentagon war plans from last summer that capped the total at 250,000? This week ABC's John McWethy reported that the number had escalated to 350,000 before the battle is even joined.

Mr. Bush's rhetoric says we can have it all — lower taxes, better schools, a war or two or three, civil defense — without pain. But the numbers don't add up, and when the expanded war becomes a reality, we'll see a bottom line that not even the smoothest politician's bedside manner can obscure.

While we wait, an anxious nation whiles away the time with "Joe Millionaire," a "reality" TV show in which a sweet-talking con man charms a bevy of credulous women into believing he will give them a fairy-tale ending. And why not? It's a perfect reflection of the reality of this moment, right down to its predictable, all too inevitable, denouement.

E-mail: frankrich@nytimes.com