Donald Trump all but clinched the Republican Party nomination after his decisive win in Indiana. The post mortems have begun. Blame, recrimination, and threats, particularly from those who failed to secure the nomination for themselves or their favored candidate.

The headline of the week has been the death of the Grand Old Party. The Atlantic proclaimed, “The Day the Republican Party Died.” Perhaps Don McLean can be plucked from the shelves of the Rock and Roll Museum, dusted off, and tasked with writing a new song. “The three men I admired most, Jeb, Ted, and Mitt, caught the last #NeverTrump train for the coast.” Mr. McLean can work on the rhyming bit.

“RIP, GOP” wrote the Boston Globe. As did the NY Daily News, pronouncing the GOP dead in 2016. You get the idea. Did the Republican Party truly drop dead on the first Tuesday of May 2016? Or has the party suffered a long, terminal illness, sustained by extraordinary life support measures for the past few years, only to have Republican voters finally pull the plug during this election cycle?

I contend that the Republican Party was diagnosed with a terminal disease way back in 1988, almost thirty years ago. One might argue that when Ronald Reagan, on his last day in office, boarded his “last train for the coast”, was the day the GOP’s “music died.”

Think of other chronic medical diseases, such as Alzheimer’s, Parkinson’s, or cancer. The mind or body slowly fail, not typically in a linear fashion, but always in a long term unrelenting downward trajectory. There are improvements along the way, providing hope to those afflicted and their loved ones, but the hope is short lived, and the disease, despite a short pause, picks up where it left off.

The first sign of illness post Reagan was George HW Bush, in his acceptance speech at the RNC convention, calling for “a kinder and gentler nation.” Kinder and gentler than what? Obviously a repudiation of Reagan’s brand of conservatism, which candidate Bush once called “voodoo economics.” Perhaps HW looked back on eight years of Reagan and said to himself, “Bad news on the doorstep, I couldn’t take one more step.”

Next was George HW Bush’s famous pledge, “Read my lips. No new taxes.” Right out of the Republican Party playbook. Music to conservative ears. Cancer in remission. Until he turned his back on his pledge and raised taxes. Kicking the Republican Party in the teeth.

This paved the way for eight years of Bill and Hillary Clinton. “While the king was looking down, the jester stole his thorny crown.” King George HW Bush looked down with contempt at the Republican base and Bubba the jester not only stole the crown, but used Bush’s “no new taxes” words against him in the 1992 presidential campaign.

The patient was not dead however. Signs of life appeared as Newt Gingrich’s Contract with America in 1994 infused the GOP with lifesaving doses of “accountability, responsibility, and opportunity.“ New life, GOP control of Congress, and hope that the demise of the Republican Party had been arrested.

Enter a new era for the Republican Party in 2002 with George W Bush and his promise of “compassionate conservatism.” Just as with his father before him, more compassionate than what? Reagan’s conservatism? Newt’s Contract with America? Did this help or hurt the Republican Party?

“I went down to the sacred store, where I'd heard the music years before. But the man there said the music wouldn't play.” Republicans heard the music of Reagan years before but Bush proclaimed the song was over. No conservative was George W Bush. Foolhardy and misguided military follies in the Middle East. Expansion of the federal education bureaucracy with Ted Kennedy via No Child Left Behind. Medicare Part D expansion increasing government control of healthcare. Promotion of open borders via amnesty. And a massive increase in government spending.

Enough to make voters wonder whether President George W Bush was a Republican or a Democrat. Republican voters “sang dirges in the dark,” staying home in 2006, handing Congress back to the Democrats. Quite the legacy for Bush and another turn for the worse in the health of the GOP.

In 2008, “a generation lost in space” saw the Republican Party on life support and voted for President Hope and Change. And change is what we got. But not for the better. In 2010 the GOP cancer went into remission, again in 2014, with two landslide midterm elections handing control of the House and Senate back to Republicans.

Was this the road to recovery for the Republican Party or just a brief pause in the GOP death rattle? Republican voters asked their party “for some happy news, but she just smiled and turned away.” The GOP-controlled Congress turned abruptly from its campaign promises. Spending continues unabated. Obamacare and Planned Parenthood remain fully funded. The IRS remains unpunished. Executive amnesty proceeds according to Obama’s wishes. Iran got its nuke deal. Endless executive orders mocking the separation of powers. Everything playing out as if Harry Reid and Nancy Pelosi were still in charge.

The EKG showed the Republican Party with a flat line, no pulse, no blood pressure, and no brain activity. “The day the music died.”

Along came Donald Trump. Not a conservative. Not even a politician. But a pragmatist able to identify the disease killing the Republican Party, offering a brash, politically incorrect, yet popular set of solutions for injecting life back into the party.  Sixteen other candidates, all extremely accomplished in their own right, methodically destroyed and removed from the nomination race. The media and the GOP elites unable to respond or stop the Trump train. “No angel born in Hell could break that Satan's spell.”

The candidates and the entire Republican establishment were perplexed and frustrated. “Oh and as I watched him on the stage, my hands were clenched in fists of rage.” They said #NeverTrump and promised to either vote for Hillary Clinton or sit out the presidential election entirely. The same party elites who told us to hold our noses and vote for McCain and Romney for the sake of “party unity” are now kicking sand and running home with all of their toys.

Yet they blame Donald Trump for the demise of the Republican Party, not realizing that all Trump did was act as the coroner, examining the GOP corpse, declaring it dead, and signing the death certificate. The Republican Party elites are, “Them good ole boys drinking whiskey and rye, singin' this'll be the day that I die.” Not realizing that they died decades ago.

Brian C Joondeph, MD, MPS, a Denver based retina surgeon, radio personality, and writer. Follow him on Facebook  and Twitter.