How a Simple Trip to Nashville Became a Missed Opportunity for Melania Trump

First Lady Melania Trump sat down without speaking when she joined a roundtable discussion on Tuesday inside a room decorated like a movie theater at a children’s hospital in Nashville.

As medical experts described the challenges faced by babies born to mothers struggling with the effects of heroin and prescription drug abuse, Trump listened attentively, nodding, sometimes showing her concern with an earnest squint, and occasionally mouthing “thank you.”

The event had all the stagecraft deployed for decades by First Ladies wanting to bring attention to a heartbreaking social ill — in this case the intractable opioid crisis gripping the country. But there would be no sound bite of the First Lady addressing the epidemic for the evening news. Before the cameras could record the First Lady addressing the group, reporters traveling with her were hustled out of the room.

It was a small moment, but one that set in relief the challenge the First Lady has faced in balancing her own personal reticence to engage with the press with her desire to bring attention to her “Be Best” initiative focused on children’s health and happiness.

Melania Trump’s spokeswoman, Stephanie Grisham, told TIME that reporters had to leave the room to protect the privacy of patients at the facility, and she later provided quotes from the discussion that took place afterward for print and online reporters to use.

The First Lady told the room that her passion is to shine a light on the opioid crisis, Grisham said, and she believes in starting early to educate young mothers and children about the dangers of drugs. “I believe the more we talk about this, the shame and guilt will go away,” the First Lady said.

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Later in the afternoon, reporters watched as the First Lady blew bubbles and crouched down to hug and play trains with children in a playroom at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. She complimented 4-year-old patient Essence Overton on her painted nails and showed the charmed little girl her own nails. “Yours are all different colors. I like that,” Trump told the girl.

But any chance that Melania Trump’s message could reach the public was hurt when her husband took the stage to address the annual Veterans of Foreign Wars convention in Kansas City, Missouri, on Tuesday.

Treating the event more like a campaign rally, Donald Trump criticized the “fake news,” claiming that “what you’re seeing and what you’re reading is not what’s happening.” The remark drew widespread comparisons to a quote from George Orwell, and the VFW later apologized for the fact that some in attendance had booed journalists.

Later in the day, an audio recording of Donald Trump talking with former personal lawyer Michael Cohen about making a payment to a Playboy model surfaced and the New York Times published a story about how the president was upset on a recent trip on Air Force One when he saw the First Lady’s TV was tuned to CNN instead of Fox News, which led Grisham to issue a statement that Melania Trump watches “any channel she wants.”

Melania Trump is popular. Her approval ratings are consistently above 50 percent. And her husband, whose ratings hover in the low 40s and high 30s, might benefit from some of her reflected glow. The First Lady is planning to ramp up her public appearances in the fall. But she won’t break through unless her voice is heard.

Grisham argued that she’s not necessarily trying to draw attention with her public activities.

“Mrs. Trump is not one to seek out attention and does not do things simply for a photo op,” she told TIME in an email. “Her focus is to help children in every way that she can, and use her role as FLOTUS for good — she remains focused on her efforts and that will not change.”