Anne Romatowski noticed a small, soft something in the flesh below her collarbone just before Christmas. She wasn’t concerned. It was a bump on her uppermost ribs, not a lump in her breast. Still, she figured that she might as well schedule the routine mammogram she had been putting off for 10 months.
By the time her appointment came around—on a frigid Thursday afternoon, the day before Valentine’s Day—she had other worries. Donald Trump had returned to office promising to “drain the swamp” and had set up a task force to root out excess and incompetence in Washington. Trump and the Department of Government Efficiency, headed by Elon Musk, were targeting the Consumer Financial Protection Bureau, where she had worked for three years remotely from New York. A few days earlier, Russell Vought, the acting director of the agency, had ordered all of its employees to halt their work.
The CFPB shielded taxpayers from romance scams, Ponzi schemes, excessive fees, unbreakable contracts, and confiscatory interest rates. Romatowski specialized in artificial intelligence. She studied how criminals used deepfaked voices to rip off the elderly and how biased banking algorithms charged Black families more for mortgages than white families.
The bureau didn’t require a single penny of taxpayer resources. It generated some of its budget through fines; the Federal Reserve covered the rest. Yet DOGE fired 70 newly hired or recently promoted employees at the CFPB two days before Romatowski’s mammogram, sending each one an email composed so carelessly that it hadn’t bothered to replace [EmployeeFirstName], [EmployeeLastName], and [JobTitle] with the recipient’s own name and title. “The Agency finds that that you are not fit for continued employment,” the typo-laden email read.
When the mammogram technologist saw the bump below Romatowski’s collarbone, she took the scan, referred her for an ultrasound, and told her to talk to a radiologist across the hall right away. Romatowski did not put her sweater back on, and went into the doctor’s closet-size office wearing shoes and slacks on the bottom and a cloth hospital gown on top.
Two computer screens obscured the radiologist’s face, and a mask muffled his voice. “I’m sorry,” Romatowski said. “Can you repeat that?” He overenunciated: “You have a lump … on your left … breast. It’s extremely … likely that you have breast … cancer.” She needed a biopsy as soon as possible. “Is there any way that we can do it tomorrow?” she asked, choking back tears. “I work for the federal government, and I think Elon Musk is going to fire me.”
When she left the appointment, Romatowski sent a few texts to friends to ask for support before her phone died. She stopped in the lobby of a nearby hotel to plug it in. When she turned it back on, she was bombarded with pings on Signal and Slack. Dozens more of her colleagues had been locked out of their computers that afternoon. Her union had sent her a Zoom invitation to an emergency session for terminated workers. Elon Musk had fired her.
Romatowski joined the meeting from the corner of 23rd Street and Eighth Avenue, and ducked into a Target to get out of the cold. She didn’t have headphones with her, so she listened to the call in the open, pushing an empty cart through the aisles. She couldn’t figure out how to get taken off of mute to ask what would happen to her health insurance.
A biopsy performed a few days later confirmed that she had a rare and aggressive type of breast cancer known as triple-negative. At some point, a cell in the lining of one of her milk ducts had followed the commands of a damaged bit of DNA and started proliferating at an unhinged pace. Her body had failed to kill off the cell and its progeny, which grew into a mass on her chest wall and infiltrated the lymph nodes nearby. Doctors advised that she undergo chemotherapy, immunotherapy, another round of chemotherapy, and a mastectomy or lumpectomy, as well as a potential third round of chemotherapy and radiation, to eradicate the disease.
At the same time, functionaries in Washington were starting to “crush the deep state,” as Trump put it. The “steady creep of government bureaucracy” had sapped “the vitality and wealth of the people,” he had claimed, accusing civil servants of leeching taxpayer resources and subverting the will of the executive. Now he was following through on a promise he’d made on his first day in office: “We’re getting rid of all the cancer.”
I was one of the people Anne texted that afternoon when she left her mammogram. We’ve been friends for 20 years.
A few days later, I brought a bottle of wine to her apartment and ordered us Thai food. Anne picked at her noodles, preoccupied not with her misfortune, but with planning and logistics. She had already set up consultations with multiple physicians and networked with fellow breast-cancer patients. At the same time, she was figuring out how to pass on her work to her colleagues who remained employed at the CFPB and scouring job listings for those who did not. Others had it worse than she did, she said. “A lot of people get fired when they get sick. A lot of people get fired because they are sick.”
I am biased, but Anne really is selfless and levelheaded, dry-witted and good. She worked in what bloodless McKinsey types might call “financial inclusion,” but what she describes as “policy work, close to people.” She had helped low-income mothers in Washington, D.C., find safe housing and good jobs. She had assessed anti-poverty programs while living in Kenya. She had directed philanthropic investment in distressed communities in the Bronx and Houston and protected New Yorkers from financial swindles. Getting hired by the CFPB was “a dream,” she said.
The agency is the only financial regulator specializing in direct support to the public. Over the past decade and a half, it has capped the late fees charged to 45 million credit-card holders, scrubbed medical debt from 15 million credit reports, managed as many as 50,000 complaints a week, returned $19.7 billion to consumers, and fined firms and individuals $5 billion.
Financial businesses require this kind of exacting, assertive oversight, Anne believes. They power the economy. But their tendency to engage in predatory lending and frothy speculation risks pitching individuals into bankruptcy and the whole world into recession. (Indeed, fraud is a leading indicator of downturns; flailing firms sometimes try to scam and swindle their way back into the black.) The agency gave Washington unique insight into household finances, and acted as an early-warning service for the country’s systemic regulators, including the Treasury and the Federal Reserve. Anne began her career during the 2008 financial crisis. She’d seen how it devastated people’s lives. The CFPB, she told me, existed to “prevent it from happening again.”
But banks had long argued that the CFPB stymied good financial products instead of stamping out bad ones. The American Bankers Association cast it as a “regulator gone rogue.” The Chamber of Commerce accused it of “hurting consumers by limiting choice and diminishing competition.” And Republicans on Capitol Hill had always felt that the CFPB was so independent as to be unaccountable, because Congress has no control over its budget and little control of its operations.
The Trump administration went further. Vought, the CFPB’s acting director, described the agency as “woke & weaponized.” Musk posted, “CFPB RIP” on X in his first weeks in Washington. Trump called it a “very important thing to get rid of.” (Notably, the CFPB has regulatory authority over the president’s crypto token, X’s forthcoming payment system, and Tesla’s auto-lending arm.)
Anne thought her job might be reinstated, she told me that night in her apartment. The administration hadn’t gone through the legal steps required for mass reductions in force. Plus, the Constitution obligates the president to “take Care that the Laws be faithfully executed.” A law Congress passed in 2010, the Dodd-Frank Act, had created the CFPB and tasked it with protecting Americans from “unfair, deceptive, or abusive” financial contracts. Trump was supposed to act as a faithful executor of the agency and its mission, whether he wanted to or not.
The day she was fired, a legal team representing her and her colleagues made that argument to a judge, accusing Vought and Trump of “the unlawful dismantling” of a government agency. “This a tragedy for American consumers, and it is lawless,” Deepak Gupta, an attorney, argued. DOGE was planning to fire nearly all of the CFPB’s remaining employees. The plan was put on hold as the case started to work its way through the courts.
In early March, Anne joined a call to discuss her union’s legal strategy, then went to Memorial Sloan Kettering for an MRI of her tumor. A similar rush of appointments and meetings and paperwork consumed the rest of the month. She had a painful ultrasound-guided biopsy of her axillary lymph nodes and consulted with advocates for the Community Development Financial Institutions Fund, which Trump was also trying to shut down. She had an echocardiogram and applied for unemployment insurance. She finished packing up her apartment in New York and moved back into her childhood bedroom in McLean, Virginia, then had a chest port put in for IV infusions.
On the last Saturday in March, she received an email at 9:28 p.m. Judge Amy Berman Jackson had issued a 112-page opinion excoriating the Trump administration, whose intent, a sworn affidavit revealed, was to turn the CFPB into a “room at Treasury, White House, or Federal Reserve with five men and a phone.” The president was acting in “complete disregard of the decision Congress made,” Jackson wrote—the decision that the CFPB “must exist.”
Anne had her job back. On Monday, she read the financial papers. On Tuesday, she went to Georgetown University Hospital for her first round of chemo.
It took two weeks for the CFPB to reissue Anne a laptop. She went to the agency’s headquarters near the White House to pick it up, and spent three hours waiting in the lobby. The Trump administration had banned her and most other CFPB employees from entering the building. When she finally got the computer, it would not boot up.
Vought had ordered the agency’s civil servants to stop what they were doing, but he had not given them any instructions on what to do instead. Anne wasn’t sure what her job entailed anymore. Still, if she was drawing a salary, she was going to work. She was not allowed to hold any meetings with industry representatives. So she pulled up data on mergers and acquisitions. She could not provide technical assistance to other agencies, such as the Securities and Exchange Commission. So she went to as many internal meetings as she could and performed “statutory” tasks specifically required by Dodd-Frank, such as monitoring fintech companies’ public financial statements. Each Monday, as DOGE required, she sent an email to the Office of Personnel Management with five bullet points explaining what she had done over the past week.
Getting fired again might be a “silver lining,” her oncologist told her; that way, she could focus on her treatment. But she would lose her insurance and her income. “The whole silver-lining thing wasn’t convincing,” she told me. She did wonder if she should tell her boss that she was sick. She decided against it. She felt fine. She might not later. The chemotherapy’s side effects—nausea, exhaustion, anemia, brain fog, digestive problems—would intensify over time. The summer would be worse than the spring, the fall worse than the summer, the winter worse than the fall.
On April 17, she received an email with the subject line “Specific Notice of Reduction in Force.” She would lose access to her computer and email account again at the end of the following business day, DOGE told her, and she would be placed on administrative leave for two months. Then she would be let go.
That night, she joined a virtual town hall with hundreds of other laid-off employees. The CFPB had 1,700 workers when Trump came into office, and now had only 200 left. Even if the court gave Anne and her colleagues their jobs back, the agency was disintegrating. Scores of skilled civil servants had retired or taken positions outside government. The Trump administration had canceled contracts for user research and testing, financial management, “internal controls,” and “identity access software.” The remaining employees did not have the skills or capacity necessary to do the work required by law, let alone the novel work the agency had undertaken in recent years.
When I visited Anne in Virginia in late April, she told me that she worried about scammers stealing grandparents’ retirement savings, thieves hacking people’s bank accounts, sports-betting apps bleeding young men dry, and “buy now, pay later” companies targeting poor consumers. I worried about her. She had dyed her hair pink, but little of it remained. She moved slowly. I kept asking how she was doing. Losing your job, getting cancer, and moving back in with your parents—it was a heck of a punch line, she told me, as well as a gut punch. The thing that really upset her was the way Vought talked about his own colleagues in government. In a leaked video, he’d said he wanted “bureaucrats to be traumatically affected.” He wanted them “to not want to go to work because they are increasingly viewed as the villains.” He wanted to “put them in trauma.”
After I saw Anne, I reached out to Rohit Chopra, who had led the CFPB from 2021 until Trump fired him in February. In private, Chopra told me, many elected Republicans supported the agency. It had done a lot for their constituents, even if few would say that out loud. Trump was not only destroying the agency, he believed, but destroying state capacity and “the human capital that really powers” the government. He could not quite articulate what it would take for the system to heal.
Chopra has known Anne for a long time and he admires her work, he told me, though he hesitated to linger on her contributions to the agency. He worried about focusing on the plight of civil servants rather than the people they serve. And he worried about his comments sounding “almost obituary,” given her health status. The issue is personal for him. Chopra was diagnosed with thyroid cancer days after Trump won his first presidential contest. He was undergoing treatment while leading the CFPB. “You never want to feel like it’s over,” he said.
Two days after my visit, Anne received an email with the subject line “Recission of Specific Notice in Reduction in Force.” (The email misspelled the word rescission.) DOGE had ignored a court order requiring it to perform a “particularized assessment” of each employee it fired, a whistleblower had testified: “All that mattered was the numbers.” Judge Jackson forced the Trump administration to reinstate Anne and her colleagues again.
At the beginning of June, I went back to Virginia to take Anne to immunotherapy and chemo. The night before the appointment, at her parents’ house, we talked for hours. She showed me an email she had gotten from the Treasury’s human-resources office that day, informing her that she had been overpaid and owed $11,292.50 to the government. (By her own calculations, the Treasury actually owed her interest on back wages.) I watched as she sent her weekly email, distilling her labor into DOGE-mandated bullet points.
A few weeks earlier, I had put her in touch with my friend Allison Rockey, who had just completed treatment for the same kind of aggressive breast cancer Anne has, and at the same hospital. Allison had given Anne special mitts to hold cold packs against her hands and feet during chemo, to mitigate the nerve damage the medication can cause. Anne had been meaning to reach back out to Allison so they could catch up, she told me.
I sputtered. Allison had thought she was in remission, but the cancer had metastasized to her brain. She had died at home two days before. Anne hadn’t heard yet. “I’m sorry, I’m so sorry,” I said half a dozen times. Anne interrupted me. “I’m sorry,” she said.
The next morning, I showed up with an N95 mask on. We loaded the car and commuted across the Potomac River. At the hospital, Anne met with a nurse practitioner to discuss some gastrointestinal symptoms she had been having. The nurse ordered a CT scan of her abdomen; if it showed excessive inflammation, she would recommend that Anne skip a week of chemo. The phlebotomist struggled to find a vein to administer the contrast fluid for the scan. Anne had to go to a different part of the hospital to have another provider access the port in her chest. It took hours to get the test and the go-ahead.
In the mid-afternoon, we finally got settled at the infusion center. I persuaded her to let me get us lunch. “Literally anything,” I told her. “Literally anything you want to eat.” Why not lobster and champagne? She settled on crab cakes, which arrived in a comically fancy box. As she ate, I yapped, trying to cheer her up.
Nurses hooked her up to a pump, and I helped strap Allison’s cold mitts onto her hands and feet. They did not just protect against neuropathy, but also reduced the chance that she would lose a fingernail or toenail and end up with an infection, Anne told me. “If you get sick while you have cancer, you can die,” she said. “You can get an infection that your body can’t fight, and then you could die.”
As the life-destroying, lifesaving medication flowed into her, Anne drifted off. I wondered what she would be like the next time I saw her. I kept thinking about Susan Sontag’s 1978 meditation on cancer, a disease she described as “spectacularly” caught in the “trappings of metaphor.” At the time, writers used cancer as an allegory for emotional repression and encumbered it with idioms of shame. In 2025, the predominant metaphors involve cancer’s endogeneity. It is the sickness that comes from within.
The night before, Anne had told me how moving she’d found it to take the oath of office. Her grandfathers had enlisted in the military and fought for this country; her mother had worked on the Hill and her father for the Justice Department. She felt proud to be a public employee, sworn to “support and defend the Constitution against all enemies, foreign and domestic.” When she woke up the next day, she would log on to her computer and do her job. She would try to protect consumers, as her doctors would try to protect her, as her union would try to protect the CFPB, as financial regulators would try to protect the markets, as the courts and the bureaucrats would try to protect the Constitution and the country—human beings in human systems trying to heal human faults.
For his part, Elon Musk has given up on trying to administer his radical treatment to the civil servants Trump had described as a metastatic disease. After falling out with the president and failing to make the government more efficient, Musk had fired himself from DOGE.
*Illustration by Akshita Chandra / The Atlantic. Sources: Courtesy of Anne Romatowski; Peter Dazeley / Getty.
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