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Soon, Peter Orszag was sitting in the Oval Office.

Obama said he didn't want him to leave his job as director of the Office of Management and Budget. Orszag discussed his concerns that they'd left themselves in a budgetary vise – that delaying the pain of real fiscal rigour, and Orszag's sense that they'd be ducking the tough choices again – meant he'd "have trouble selling" the coming year's budget. The President looked at him skeptically. He knew Orszag was displeased where things were going on the budget, but, Obama said, "we can work those things out, it's still early."

Then Orszag took it down one more step. "I come in every day with a lump in my chest," he told the President. The tension, the chaos, the infighting, especially the battles with National Economic Council director Larry Summers – it had all made life hard to tolerate in the White House, Orszag said. It wasn't that he was unfamiliar with a high-pressure, high-stakes effort, after six years in the Clinton administration. But this was different. "I think there are going to be some changes coming in terms of personnel that'll be helpful with all that," Obama said.

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Without giving Orszag the specifics, he wanted to let his OMB director know that there might be some departures among the senior staff that might provide relief. "I don't want you to feel that way, Peter," Obama said, genuinely concerned. "I really don't."

Sitting with Obama, Orszag couldn't help but think of what the President might have accomplished if, as Orszag said, he had a "proper process to fill his needs."

And thinking of the President's fortunes brought him back to Summers's assessment – expressed in many ways until this spring – that they were "home alone."

"I mean it," Summers had told him. "We're home alone. There's no adult in charge. Clinton would never have made these mistakes."

Orszag had thought about it, and turned it over in his head countless times, in the tumultuous year and a half since joining the administration.

He felt the President had great "raw ability," but was stymied by a process that Summers, for the most part, oversaw, like "someone stealing gas from your gas tank and then criticizing you for not being able to drive your car."

In economic policy meetings without the President, Summers would joke that they were all caught in "relitigation roulette," where the outcomes of important policies – like a spinning roulette wheel – were left to blind chance.

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But Orszag and others said that the quip was something of a misdirection on Summers's part, as Larry stood in a central role in determining those outcomes.

How did he do it? "By willfully ignoring the President's wishes and relitigating again and again decisions the President had made because Larry didn't think they were well-informed or this or that. And instead of actually coming back to him with more information, he came back to him with the same information, just repackaged a little."

What issues? Orszag, like others, can tick off a long list. Obama wanted to move forward on tough climate-change legislation; Summers was opposed, telling Orszag, at one point, "We have to derail this!" It was derailed. A financial transactions tax on banks and financial institutions, to try to tame the trading emphasis that has swept those industries and, along the way, raise money: Obama said, in one meeting, "We are going to do this!" Summers disagreed; it never materialized. The list goes on.

"Larry just didn't think the President knew what he was deciding," Orszag said. Sometimes, the result was just long delay. The President was, from early in the administration, pushing for discretionary freeze on spending. Orszag favoured that as well and wanted to make a presentation on the matter. Summers said to him, "You can't just march in and make that argument and then have him make a decision because he doesn't know what he's deciding." In that instance, after long delays, the President did champion the discretionary freeze. But either delay or defeat of the President's wishes generally defined the course of events.

"The fundamental question is did the President want a check on his decisions ex post facto? Did he actually want the relitigation roulette, because he recognized that his instincts weren't correct? Or was this outright and willful" on Summers's part, that "I know more than the President, flat-out. That strikes me as more likely."

Even as Orszag sat with the President on that spring day in the Oval Office, he was perplexed, and all but exhausted with frustration.

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"The question is why didn't [Obama]stop it? People knew. People realized the process wasn't working, and they kept saying it. By spring of 2010, when I was saying I just don't want to do this any more, they kept saying they would fix it. And they set deadlines that were, of course, missed … but, the President didn't say, 'Goddammit!'

"He didn't demand that it be changed," Orszag said, reflecting, a year later, on his tenure in the White House. "And that can't be healthy."

Which is why sitting with Obama, in this exit meeting, Orszag felt a kind of sadness. The promise of the inauguration, of all those grand plans. It now seemed so far away.

"Peter, thanks for your hard work," the President said. "I want you to stay in touch with me."

"Of course, Mr. President."

Excerpted from Confidence Men: Wall Street, Washington, and the Education of a President, by Ron Suskind. Reprinted with permission from HarperCollins.

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