Marshall Took an Oath to His Patients. He Has Used It to Bind Them.

Senator Roger Marshall, an OB/GYN by training, has used his medical credentials to lend legitimacy to a Republican Party apparatus that harms the Kansas women he once swore to serve. That is the sentence I have to write first, and it is the one I have to mean. Let me show you what I mean by it.

Marshall is a physician. He spent two decades delivering babies in Great Bend before he went to Washington. He won a House seat in 2016 representing western Kansas, then won his Senate seat in 2020 — the year Donald Trump carried the state. He knows, the way any physician knows, what a wanted pregnancy looks like at twenty weeks and what an unwanted one looks like at eight. He knows what methotrexate does to an ectopic pregnancy and what misoprostol does to a miscarriage the body cannot complete on its own. He knows that the worst moment of his old professional life was the patient who hemorrhaged while the lawyer on the phone asked whether the legal clock had run out.

He also, in 2020, embraced Donald Trump’s debunked claims that the presidential election had been stolen. He did this after taking an oath to defend the Constitution of the United States against all enemies, foreign and domestic. The oath does not say “except when my party’s candidate claims he lost.” It says domestic enemies too. By its plain words, the man who loses the count loses the office, and the man who wins the count wins it, and no Senator gets to substitute his preferred verdict for the canvassed one.

He also left a town hall early last year after constituents pressed him about the Trump administration’s funding cuts and federal layoffs. Senators are not paid to leave when the questions get hard. They are paid to take the questions, and to answer them, and to be seen answering them.

But the medical credential is the one I want to hold up to the light. Because the medical credential is the one the apparatus most needs to borrow. The Republican Party’s post-Dobbs abortion-restriction project cannot be sold to the public as “letting women die on the table to vindicate our theology.” It has to be sold as “reasonable regulation that doctors support.” And for that sale to work, the doctors who support it have to look like doctors who have looked at the evidence. Marshall has been the most useful doctor the project has had in the Senate.

He has voted, year after year, for the appropriations riders and the conscience-clause protections and the defunding mechanisms that have, since the Supreme Court overturned Roe v. Wade on June 24, 2022, emptied OB/GYN ranks in the restriction states. The Hyde Amendment rider, renewed annually since 1976, bars federal Medicaid funds for abortion except in cases of rape, incest, or life of the mother. Marshall has voted for that rider every year he has held the seat. The Weldon Amendment, attached to Labor-HHS appropriations since 2005, strips federal funds from any state or locality that discriminates against health-care entities for declining to provide or refer for abortion. Marshall has voted for that rider too. The Church Amendments of 1973 and the Coats-Snowe Amendment of 1996 — these are the instruments through which the captured operation has built the architecture of refusal in the states where it has the votes.

The documented effects are not theoretical. Idaho, which has enforced the nation’s most aggressive post-Dobbs ban since 2022, has lost roughly one in five practicing OB-GYNs since the law took effect — a figure tracked by Idaho Medical Board records and reported by the Association of American Medical Colleges. Hospital obstetric programs have closed in the state’s rural counties. Residency applications to restriction-state OB/GYN programs have declined, per ACGME match data, year over year. Marshall has voted for fewer physicians. He is a physician who has voted for fewer physicians.

The medical credential is the whitewash. The apparatus is the bones.

Let me show you what scripture has to say about that. Matthew 23, the seven woes against the scribes and Pharisees — the most religiously credentialed people of Jesus’ day. Verse 27: “Woe to you, scribes and Pharisees, hypocrites! For you are like whitewashed tombs, which outwardly look beautiful, but within are full of dead people’s bones and all uncleanness.” Verse 28: “So you also outwardly appear righteous to others, but within you are full of hypocrisy and lawlessness.”

Jesus did not say that to people who failed to be religious. He said it to the most outwardly religious people of his day — the people whose credentials were most impressive, whose tithing was most meticulous, whose public observance was most impeccable. He said it because the credentials were the cover. The tomb looked beautiful from the road. Inside, the bones.

That is what Marshall’s medical credential has become. Outwardly beautiful — a physician, an OB/GYN, the man who delivered the babies. Within, full of dead people’s bones — the apparatus he serves, the votes he casts, the women in his own state who cannot get a methotrexate prescription on a Friday afternoon because the pharmacist pulled it from the formulary pending legal review, the ectopic pregnancy that gets watched one more hour because the lawyer on call is not sure the clock has run out. The credential is the whitewash. The apparatus is the bones.

I taught that passage for years without seeing what it was actually about. I know who pays for the cover.

And I want to name who else pays. Adam Hamilton, the sixty-two-year-old Methodist pastor and founder of the Church of the Resurrection outside Kansas City, is the Democrat trying to take Marshall’s seat. Hamilton won his primary with thirty-five percent of the vote in an eleven-candidate field and broke a quarterly fundraising record in the state. He is currently the object of the most revealing attack ad of the cycle, from Main Street Fund — a Massachusetts-based Super PAC whose treasurer has worked for Republican campaigns — which has spent more than six hundred thousand dollars this month hammering Hamilton as a “megachurch pastor that’s too woke for Kansas.” The Kansas City Star found the ads rely on sermon snippets taken out of context.

The captured operation works on the credential from the other side, too. The white coat gets used. The clerical collar gets used. The instrument is the same in both hands. Mocking the operation is permitted; mocking the believer is not.

But the asymmetry matters. Marshall has the institutional power. He sits in the chamber that confirms the justices and ratifies the apparatus. Hamilton is the candidate trying to unseat him. The captured operation that uses Marshall’s credential is in power. The captured operation that uses Hamilton’s credential against him is, at the moment, an out-of-state Super PAC. Those are not the same.

So does the column let Marshall off because the captured operation is bipartisan? No. The captured operation works on credentials in general. Marshall lent his to the apparatus that is killing his patients. He did so as a physician, which is the credential the apparatus most needed. He did so after taking an oath that asks physicians to do no harm and asks Senators to defend the Constitution against all enemies, foreign and domestic. He did so while the women of his own state were the ones whose pregnancies his votes had made legally unvisitable.

The verse has not been edited. The oath has not been retired. The whitewash has not been removed. The bones are still inside.