The doctor goes to war

Here's the thing about war: Jerry Bruckheimer and Tom Clancy peacetime fantasies notwithstanding, military force turns out to be quite a blunt instrument. There are few "surgical strikes," smart weapons prove mutton-headed, and slam-dunk intelligence mistakes plain aluminum tubing for uranium-enriching centrifuge parts. The fog of war as bloody miasma: No one knows who is shooting at whom, wedding parties and bomb-making teams are conflated, little girls on bicycles look like vehicle-borne IEDs.

Here's the thing about soldiers: To prosper, to survive, just to maintain their sanity, they must discern certainty within that chaos, even if it must be manufactured. Perceived ambiguities only prolong response times and that delay, to the soldier, may be lethal. Surgeons have a saying: "wrong, sometimes - hesitant, never." It applies equally to war fighters. Thus, the nation's war fighters in Afghanistan have been seeing unmistakable progress for eight years now; the Taliban are in evident disarray, the strategy is working.

War novels and screenplays proceed from this central and organizing tension. But to write insightfully about war, the writer needs to be able to apprehend both realities simultaneously. This is why it takes a decade after a war for the good ones to appear, for that transition to occur in the author's mind. Tim O'Brien's The Things They Carried was published in 1990, fully 15 years after the helicopters pulled away from the roof in Saigon; Jarhead appeared just as Iraq was being invaded, for the second time, 13 years later.

FOB DOC is lodged entirely in the unambiguous present: This non-fiction account by Captain Ray Wiss, a one-time infantry officer, now an emergency medicine physician from Sudbury, recounts his six months in Afghanistan from December, 2006, to May, 2007. The book was vetted by the Canadian Forces public affairs branch prior to publication, and the foreword is by General Rick Hillier. It describes graphically the eviscerations and dismemberments of Afghans and coalition soldiers alike, with full-colour photographs of shattered Afghan children staring hollow-eyed, and of intestines spilling from Afghan abdomens.

Wiss describes himself as happy to see the remains of dead Taliban and he knows that "as long as we are here, the Taliban cannot win, and the Afghan government cannot lose." He keeps two rounds, a 9-mm for his pistol and a 5.56-mm for his rifle, in his pocket, in case he is threatened with capture by the Taliban and needs to dispatch himself. Helpfully, we are provided with a photograph of these too. He enjoys serving as sentry in an LAV out on patrol. He fairly itches for action.

Clearly, however, he is a skilled physician, and fortunately he engages mostly with a scalpel and a suture driver. His resolve and his courage animate him, and his book's importance transcends its bravado-laden aspects, especially in providing such a sobering picture of the carnage there, so far away from all of us.

Although it would be easy to reduce the book to a caricature of jingoistic self-certainty, as with real people and real situations generally, things here are more complex. Weiss has socialist sympathies, he tells us; he is troubled by the Iraq war, and he saw the insurgency in Nicaragua first-hand. Certainly, he is deeply stirred by the plight of the Afghan people. Only the paranoid can impugn the motives of people like Capt. Wiss; all the soldiers one meets there, pretty much, want to help the Afghans.

And yet, we are not; we are losing the war that we started, which is killing them by the thousands. The U.S. generals, including Chairman of the Joint Chiefs of Staff Mike Mullen, can say we are losing (or at least that the situation is "serious and worsening"), so can Gen. Stanley McChrystal, and so can the British. The numbers are familiar: The worst month for coalition casualties since the invasion of Afghanistan was the last one; the next worst was the one before it; eight years of incremental deterioration. George Will can say it, can even call for U.S. withdrawal.

Afghan President Hamid Karzai is weak and compromised, the Taliban control steadily more territory, and Pakistan is imperilled. But we, junior executives of the branch plant, toe the company line, right up until the CEO declares bankruptcy. Joe Biden and Hillary Clinton are duking the point out before President Barack Obama right now. Prime Minister Gordon Brown sees clearly which way the wind is blowing. The answer, he says, is Afghanization; he does not credit Henry Kissinger, but then again, he can't.

Wiss is a valuable lens through which to examine both the war and the self-certainty that has propelled it, so necessary for the soldier, and so disastrous for broader political debate and policy decisions. Notwithstanding that certainty, Wiss is aware of global implications. He discusses his concern for Darfur and Rwanda; he emphasizes the United Nations' approbation of the mission. And he is right about all that. And the worst consequence of our failure in Afghanistan will be all the subsequent Kosovos and East Timors that will go likewise unacted-upon for the next two generations, partly as a consequence of the failure of this adventure.

Wiss's epigram is from Archbishop Desmond Tutu: "If you are neutral in situations of injustice, you have chosen the side of the oppressor. If an elephant has its foot on the tail of the mouse and you say that you are neutral, the mouse will not appreciate your neutrality."

Which is pithy and reminds us all of how we felt at the outset, but does not address the point any more, ultimately, than Wiss or anyone in the Canadian military or government does: We all got so mad. And stopped thinking clearly. Never fight a land war in Asia: It's a simplistic nostrum, but the simplest truths are the most profound. And then we tried, too late, to fix it, and doubled down on a losing hand.

There is another saying that internists repeat sometimes, sometimes about ill-considered surgery: Things are never so bad that, with sufficient effort, they cannot be made worse. FOB DOC is worth reading, but a decade hence, after the withdrawal and after second sight have done their work, the ex-soldiers' novels will be more interesting still.

Kevin Patterson is a physician and writer based on Saltspring Island, B.C. He was co-editor of Outside the Wire: The War in Afghanistan in the Words of Its Participants.