Stand Up

The vast majorityoif people in this world are decent, normal people who want nothing more than a peaceful and stable life for themselves and their families.

I will say it again.

The vast majority of people in this world are decent, normal people who want nothing more than a peaceful and stable life for themselves and their families.

If you can accept this premise, there may be something of further interest to you in this post.  If you cannot, then I thank you for your honesty and wish you well as you journey to your next internet destination.

I don’t normally make political posts.  In fact, I think one of the things that is destroying civil politics as we know it is the internet.  However, I have become so increasingly disturbed by the situation in Syria that I finally felt compelled to put a few thoughts to paper.

I suppose another premise that I must also ask you to accept is that we all have biases.  Biases based on upbringing, politics, religion, friends, and so forth.  And in the interest of full disclosure, I will first share my biases with you.

1)I have an interest in global health, particularly refugee health.  I think the monumental task of triaging, treating, and housing/re-settling refugees is one of the greatest public health challenges of our time.  The UNHCR recently estimated that of the 2 million Syrian refugees now living in neighboring countries, half are children; the majority of which are under the age of 11.

2)I subscribe to the MSF (Doctors Without Borders) field bulletins.  I love MSF.  They are a gutsy, apolitical organization that works where literally no one else will go.  Frequently overwhelmed, constantly undersupplied, often in mortal danger, their doctors, nurses, and field personnel are among the bravest human beings on the planet.

MSF recently released a statement that on August 21^st, three of its Damascus-area supported hospitals had treated approximately 3600 patients presenting with neurotoxic symptoms in a three-hour time period.  Read the original press release here.

3)As a medical student rotating through the ER, I was involved in the stabilization and treatment of a patient with organophosphate (pesticide) poisoning, the symptoms of which are essentially identical to those of someone exposed to a chemical nerve agent such as sarin gas. To the point, it was horrible.  Extreme respiratory distress, inability to control bowel and bladder functions, extreme salivation, seizures, coma… I will never forget the experience.  It was watching someone die in the most gruesome way possible right in front of my eyes.  And this was just one patient.  I can’t imagine the horror of a hospital full of patients in such distress.  Like Hell on Earth.

4)Since 2004, I have been privileged to work in an academic medical setting, which by its very nature is diverse, even in Indiana.  I have coworkers, acquaintances, and friends of friends who are either Syrian or of Syrian descent.  Hopefully it won’t surprise you to know that they are decent, normal people, wonderful physicians, and unimaginably sick at heart at what has been happening in Syria since 2011.

Chemical weapons were used against civilians in Syria.  This is no longer conjecture, but an undeniable fact.  I cannot say for certain by whom they were used, though increasingly the U.S./Kerry camp asserts evidence that they were used by Assad against rebels and civilians. 

Why is this such a big deal, you might ask?  Because chemical weapons are a horrific weapon of mass murder that affect any and all in their path (similar to all other classes of WMDs).  They kill indiscriminately, brutally, and not always quickly.  They are relatively easy to conceal, disperse; and compared to other WMDs, also relatively easy to manufacture.  Those who survive will often have permanent deficits.  They are truly terrible, some of the worst products of human ingenuity.  We are, of course, not the first generation to realize this, which is why a prohibition against the use of any and all chemical weapons was established at the 1925 Geneva Convention.

What about the other tens of thousands of Syrians killed by more “conventional” means?  Assad has been brutally murdering his own citizens since early 2011, he’s now just added a more vicious weapon to his dictator arsenal, right?  This is a fair point.  However, this is how I look at it: As a pediatrician, I frequently find myself counseling parents regarding discipline as such – “pick your battles.”  The small, or even sometimes moderate transgressions can be overlooked, but there comes a time in every household where a line is crossed.  In my opinion, Syria’s use of banned chemical weapons against citizens is like your teenager stealing your wallet, your car, and staying out until 4AM drinking and smoking with his friends.  In most households, this would not simply be ignored.

Which brings us to the heart of the matter.  Use of chemical weapons, cannot stand.  It MUST NOT be allowed to happen unchecked.  The consequences for the future are too horrible to contemplate.  I have been disappointed, yet unsurprised at the unwillingness of the UN and western allies to take action on the situation.  In their defense, there are exactly zero good options.  Become embroiled in yet another impossibly complex religious geopolitical war in the Middle East? I don’t think so.  Send arms and support to jihadist- backed rebel groups so Syria can be the next Afghanistan in 20 years?  Bad idea.  Diplomacy? Impotent and ineffective (see also: Russia).  Bomb the daylights out of the whole country? Inhumane and probably also ineffective.  So-called “tactical strikes” against military installations? Maybe, but with a high probability of either being too much or too little.  Embargo? Again, maybe, but with the knowledge that that embargos universally make living conditions even worse for civilians in war-torn countries.

Any action undertaken by the U.S. and its allies will have serious, far-reaching political consequences; both foreseen and unforeseen; immediate and long-term.  But to me, personally, these consequences are more palatable that the consequences of doing nothing.  It is said that those who do not study history are doomed to repeat it; should we then ignore the edict of our forefathers, fresh from the horrors of World War I, that chemical weapons have no place in modern warfare?  To me the answer is unequivocally no.

So what to do about Syria? In his speech yesterday, President Obama surprisingly, but I think perhaps wisely punted the question back to Congress.  Any action taken in such a complex situation with potentially widespread consequences cannot and should not be decided unilaterally.  Political, diplomatic, and military voices should all have the chance to weigh in.  And even more importantly, the voice of the people.  U.S. citizens deserve, and have been given, the chance to help decide what our country will do about Syria.  It may very well be that I hold the minority opinion that the U.S. should take any action at all, and that's ok.  If any action or inaction that we undertake as a nation is driven by the wishes of the majority, I can accept it even if it runs contrary to my own.  Is this not the point of democracy?  If the U.S. is to move forward into the quagmire, it must be by majority consent.  We must share in the decision, for we will surely share in the consequences.

So stand up.  Speak up.  Be counted.  Let your Senator or Representative know what YOU think should be done about Syria.  Do not say “I haven’t been following closely enough,” “I don’t have an opinion,” or “I didn’t get around to it.”  We have a week before Congress is back in session, which is enough time to read and form an opinion. (And please do not use this post as your only source of information.  My favorite article on Syria so far is here; the New York Times has had a good series of reporting on Syria, as well as CNN and The Huffington Post).

Even saying “I care, but I have no idea what to do” is a viable opinion to express.  Our elected leaders need to know that we are paying attention, lest they forget the gravity of the decision they have been tasked to make.  And, who knows?  America is full of smart people, maybe someone out there has a workable idea that hasn’t been discussed yet.

But for the love of mercy and human decency, do not remain silent.  Or know that if you do, you relinquish any future claims on complaining, lamenting, or criticizing the inevitable political fallout whatever our action or inaction.  Do not say “we should have done something” if you will not say it now.  Do not say “we should have stayed out of it” if it’s not important enough to say now.

For many of us this is a long holiday weekend, time to spend with family, friends, and loved ones celebrating the end of summer.  I hope you enjoy the weekend, but I also hope you will take some time to think about Syria and consider… What if you, your loved ones, your friends had the simple chance or (mis)fortune of being born in a different country?  What if you were as you are now, a decent, normal human being who wanted nothing more than a peaceful and stable life for you and your family?  What if you suddenly found yourself the subject of a brutal dictator, the citizen of a country embroiled in civil war, the parent who must choose between fleeing to abject conditions in an alien refugee camp or risk your lives staying where you are?  Imagine, that for the past two years your life had been utter hell and horror, worse than you could have ever believed… and then you watched as your family, your friends, your neighbors, your parents, even your children, were brutally murdered by guns, bombs, and then one of the worst weapons of warfare known to man?  What if you were counting on strangers halfway around the world to decide if there would be any sort of justice for you and your loved ones?  What would you have them decide?

I pray to a merciful God that we will never have to know such things, but we cannot ignore that this is a reality for many of our fellow human beings.  Other people who, while far away, we might find are not so different from us.