Right-wing shock jock Rush Limbaugh announced Monday that he has been diagnosed with cancer. On Tuesday, Donald Trump told reporters that he was considering awarding Limbaugh the Presidential Medal of Freedom. On Tuesday night, Trump followed through on this tease, calling on his wife, Melania, to award the medal to Limbaugh during the State of the Union as she sat with him in the House of Representatives gallery. Said (Donald) Trump:

Here tonight is a special man, beloved by millions of Americans, who just received a Stage 4, advanced cancer diagnosis. This is not good news, but what is good news is that he is the greatest fighter and winner that you will ever meet, Rush Limbaugh. Thank you for your decades of devotion to our country. And Rush, in recognition of all you have done for our nation—the millions of people today that you speak to and that you inspire and all of the incredible work you have done for charity—I am proud to announce tonight you will be receiving our country’s highest civilian honor, the Presidential Medal of Freedom.

The medal, which is given at the discretion of the president for “especially meritorious contributions” to society, has previously been awarded to such individuals as Georgia O’Keeffe, Duke Ellington, Jonas Salk, Helen* Keller, Neil Armstrong, and Mr. Rogers (and, to be fair, also to a bunch of random politicians). Now Rush Limbaugh has one too!

In a strictly anthropological sense, this is appropriate. As the increasingly prominent voice of sour, sarcastic, nasty white-male contempt, Limbaugh did contribute a great deal to our changing American society. Thirty-five years ago, he was a small-time radio host on a station in Sacramento, California. Twenty-five years ago, he was being cited as an inspiration by hard-line Republican congressmen and radio imitators like Indianapolis-area personality Mike Pence. (Pence would go on to write, in a Rush-style 2001 “reality check” column, that connections between smoking and fatal disease are overblown by nanny state politicians and “the media.” Limbaugh, an ostentatious cigar smoker, has lung cancer.) Now Mike Pence is vice president under Donald Trump, who went from being a onetime registered Democrat who often didn’t even vote to being the leader of the Republican Party while consuming immense, almost hard-to-believe quantities of the boorish mass-market right-wing media that Limbaugh inspired.

The watchdog group Media Matters has been documenting the ways Limbaugh’s “devotion to our country” manifests itself for years and years. Here’s a recent example, in case you were wondering whether seeing his worldview take control of the White House had tempered him any.

In 2010, Limbaugh suggested that black Democratic South Carolina Rep. Jim Clyburn—who was present in the chamber on Tuesday—should take a job as Nancy Pelosi’s driver, describing his idea as “Driving Miss Nancy.” In 2011, here’s how he summed up a speech by Chinese President* Hu Jintao:

“Ching cha. Ching chang cho chow. Cha Chow. Ching Cho. Chi ba ba ba. Kwo kwa kwa kee. Cha ga ga. Ching chee chay. Ching zha bo ba. Chang cha. Chang cho chi che. Cha dee. Ooooh chee bada ba. Jee jee cho ba.”

Inspiring stuff, indeed! As in inspiring me to combine whiskey and Sudafed in an attempt to sleep until January 2021 and/or January 2025.

When Limbaugh was presented with the Medal of Freedom on Tuesday night, he affected an expression of shock and gratitude, as if emotionally overwhelmed and surprised. But it would be strange if he had actually been surprised to receive the medal, given that he was in D.C. sitting next to the president’s wife at an event being held on the same day that the New York Times reported he was in line to get one. It was a reminder that Limbaugh and others like him have always been entertainers—he started his career as a regular DJ, introducing records—and have sometimes passed off their more offensive remarks as humorous, good-natured ballbusting that liberals and Feminazis take too seriously. But as Trump followed his testimonial to Limbaugh with a grim, fascism-adjacent passage about taking revenge on illegal immigrant criminals and foreign “barbarians,” he was referring to border fortifications and military strikes that are as real as it gets. These days the show never ends.

Correction, Feb. 5, 2020: This post originally misspelled Helen Keller’s first name. It also misidentified Hu Jintao as the former premier of China; he was president.