Tuesday, August 19, 2014

Obama's Foreign Policy Makes Medical Sense

In medicine, sometimes we have to wait. “Tincture of time” is a traditional strategy. You have to let the body react, you have to see what is going to happen, you have to resist the temptation to treat right away, because it might not be necessary, and because treatment later on might work better. Yes, it's most often best to catch an ailment early, but when you do, the judgement of the clinician is sometimes just to wait. And when the time comes to act, sometimes the best intervention is not dramatic, but just a well-aimed lance, perhaps; boom boom and it's done.

And sometimes you just don't know what you're dealing with. When I was a senior medical student I made rounds with infectious disease specialist Sam Katz. He would be called in for a case of infection on the wards of Children's Hospital in Boston. Often it wasn't clear what the infection was. So he would say, take the child off all antibiotics and reculture in three days. The housestaff (residents) would protest – this kid's sick! I know, Sam would say, but we need to know what we're dealing with. Take him off all antibiotics (it would take time for the antibiotics to clear from the system so we could get a good culture) and we'll see if we can find the bug after three days. Have some confidence here that the kid is not going to expire – if he gets a lot worse, we can restart early.

Which is a roundabout way of saying that I am one of the apparently few defenders of Obama's foreign policy. Everybody's dumping on the guy with I told you so's. As though it's obvious that an earlier intervention would have prevented the ISIS Syria-Iraqi insurgents from coming this far this fast, and as though it's obvious that this is far too dangerous a place for us to be. Hillary opened her big mouth to distance herself from a sensible policy once again – she claims to have learned the lesson of Iraq, but I doubt it.

Myself, I think Obama, in his very understated way, did the subtly courageous thing to do, he let the infection come to a boil that could be lanced. While doing it, he effectively got rid of the noxious Maliki side infection. Don't want us? Fine, we're out of here. Let's see what will happen. Let's be confident we can handle it in the future. Let's not let ourselves be wagged by the noxious tail.

Now the body has reconstituted itself, we have started to mobilize our forces with a better constituent body to wage the counter-war, and we'll supply some medicine while that tail won't be wagging us any time soon. We also found another functional organ to support in the north, the Kurds. They want us, they have a state that is working (Erbil has a Jaguar dealership), their army will fight. Obama has been quite right to say that they have to want it at least as much as we do – we'll just have to see if the Iraqis do or don't.

Meanwhile, for the situation just a little north of there, Obama refuses to speak out dramatically against the posing-against-the-sky-as-background Putin. Patiently and privately, he says, you don't want to do this. He counters every bishop move with a pawn blocker, and moves his pieces behind the lines of attack to more powerful positions. He has a sense of proportion.

I have been quite critical of Obama in the past, and maybe I'm just the kind of guy who looks for an opportunity to take the other side. Nonetheless, let's see what happens. My sense is that his caution and his subtle risk taking will prove in the end to be admirable and effective.

Budd Shenkin

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