In the Kandahar Air Field Hospital intensive care unit, the battle-wounded generally experienced their trouble in two phases. At first the problem was usually bleeding, and the solution for this was surgery. In subsequent days, when trouble reasserted itself it did so in the company of fever and sheet-soaking sweats. Since Thucydides at least, battle wounds have festered with the relentlessness of civilizing missions foundering in alien lands. For those who survive the first few hours, sepsis has long been the most lethal danger.
When an infection becomes severe, physicians call it septic shock, but usually it is not the infection itself that shuts down kidneys and lowers blood pressure – it is an over-vigorous inflammatory response provoked by the infecting microbes, often continuing long after the organisms are eradicated. This process is what usually kills people in septic shock: not bacteria consuming the flesh of the infected person, but the withering of the body under the sterilizing effect of its own response to that infection.
It's the over-response that trips humans up.
I was in Kandahar because, in the months prior to 9/11, al-Qaeda spent about five hundred thousand dollars getting men trained to steer airplanes into buildings. In response, the west overreacted catastrophically: the invasion and occupation of Afghanistan and Iraq and an embrace of torture; rendition; Gitmo; and spies reading and listening to much of what we do. A trillion and a half dollars was spent, to much worse than no effect.
In response to that enormous consequent and secondary injury, we risk over-reacting yet again. The sentiment among western publics is so leery now of military adventurism that even one hundred thousand dead in Syria has not been sufficient to stir us to act. And now Bashar al-Assad has used sarin, an organophosphate nerve gas to kill a thousand civilians, among them 400 children.
Organophosphates don't attack anything directly, the way bacteria or shrapnel might. They work by abruptly releasing muscle and nerve cells' own potential electric energy, making them fire as hard as they can continuously, until they can't anymore. The poisoning victim shudders and, depleted, stops breathing and moving.
Even after viewing images of children grown still in this manner, the western public remains stalled on the subject of how to respond. We remember hearing about Saddam's use of nerve gas, when we were being worked up into war fever.
Clearly, an intervention of the Afghanistan-Iraq sort is not useful or would even be possible anymore, in Syria, in 2013. Equally, a few cruise missiles lobbed for a few days into the middle of the fight will achieve nothing except the death of more people, including innocents. It is the right thing that must be done, not those sorts of bellicose impetuousness. But the right thing is not nothing. Not after one hundred thousand dead.
There is something that could be done, cheaper than invading, and more effective than missile strikes, and we've done it before, in the Cold War. Millions of Syrians are on the move, fleeing the carnage. We could evacuate Syrians who wish it – just as we did for refugees from insurrections in Hungary and Czechoslovakia, and for the Vietnamese 'boat people'. While resettlement efforts were being prepared, safe havens could be created and actually defended, if necessary. The bitterness of that phrase post-Srebenica might finally be expunged.
It would be expensive, but it would show that Role To Protect means something other than another excuse to attack when WMDs, or whatever other excuse, has not sufficed. If Barack Obama needs to make a point to Mr. Assad and to the larger world, let this be it: we will counter your evil, as best – and, better – as gently as we can.
And when Syrian families begin settling in among us as our neighbours and friends we might also look at them and back away from some of the ways of thinking that permitted the gruesome excesses of the last dozen years. It is only those ways of thinking that have stopped a conversation about mass evacuation from being discussed. One hundred thousand dead, and climbing. That number will double and triple while we worry about extremists who might cross our borders as refugees. But how many extremists are being born in the cauldron of Syria, in the face of western indifference, now?
The public is resolved not to be duped into war again and this requires that it thinks in a complicated way about the range of options before it. But for the last two years, we, the western public, have not done that. We've just written off the whole subject. We were excessive in our action, and now, depleted, we are excessive in our inaction. Just like the poisoned nerves and muscles of a thousand dying Damascenes in August, 2013, only a few weeks ago.
Kevin Patterson is a Canadian novelist and internist.