Posted tagged ‘Iraq’

More Tragedy: Brain and Mind, Iraq Suicides edition.

July 8, 2008

In this post, published here and over at Cosmic Variance, I looked through the story of Iraq veteran suicides to speculate on the implications of the spread from the neuroscience profession to the public of the idea that what we perceive as mind, as our selves, is actually a phenomenon of our material brains.

That’s an important notion, one taken as a commonplace by just about every neuro researcher I know that will, I still think, have a profound cultural impact, potentially as great as that of the concept of the descent of man from prior forms.

But then this story appears. Another man gone, to remind me and anyone who reads this of fact of tragedy that is the reality, the hard ground of fact and loss.

I have no deeper scientific argument that I want to pursue here, and I am not going to express any of the political thoughts that this story does evoke in me.

This is just a pause, to think about Joseph Patrick Dwyer, and those whose loss should not simply be aggregated into the accumulating totals — both the official count of war dead, and those, like Dwyer who have paid such a terrible price outside the neat categories of conflict caualties.

My deepest sympathy to the family and friends of PFC Dwyer.

Image: Francisco de Goya, “Desastre de la Guerra (Disasters of War)” 1810-11. Source: Wikimedia Commons.

Program Notes: Iraq disaster/NY Times does good edition…

July 1, 2008

Read this on the fate of wounded Iraqi soldiers. (h/t TPM)

Weep, then think.

Two issues related to the themes of this blog come to mind. The first is that this is an example of the kinds of issues that lie behind the broad point I tried to make in this post about why we have alreadly lost whatever was worth “winning” in Iraq.

There, I used the most simple minded of quantitative arguments to assert that the destruction of life in Iraq had already topped the threshold that other experiences — the Civil War, World War I — suggested produced lasting, conflict-perpetuating damage to the societies that suffer them.

Behind the blunt statistics — the fact that 2 percent or more of the Iraqi population have died as a direct or indirect result of the conflict — lie the individual stories that produce their individual quanta of grief, shame and rage. Today’s New York Times article, the well written and wrenching work of Michael Kamber, does what good journalism should do: tell particular stories that provide the specific human experience that drives the larger trend of events.

What does it do to an army to know that it’s wounded are left on the heap? What does it do to a society if the best organized and armed group assumes its polity and its generals are willing to abandon them? Nothing good. If you are looking for places where the seeds of future conflict sprout, this is a good place to start, IMHO.

The second point is the one that should be obvious by now within our public discourse, but strangely isn’t. Kamber writes that “In the United States, the issue of war injuries has revolved almost entirely around the care received by the 30,000 wounded American veterans.” That’s true — but what has been missing from that coverage is the issue that lies at the heart of this account of Iraqi problems: the ongoing cost of caring for the novel populations of wounded soldiers in modern war. It happens for American soldiers more than for Iraqis, I believe, but broadly, more seriously wounded soldiers survive now than did in previous wars due to advances in frontline and later medical care.

As Linda Bilmes and Joseph Stiglitz have documented in their insufficiently well publicized studies, the cost of caring for US wounded is going to drain hundreds of billions of dollars from the Treasury for decades.

That cost, of course, is the reason wounded Iraqi vets are receiving such a poor shake; it helps explain at least some of the disgraceful lapses in care US soldiers have endured. It also leads directly to the bigger story that Stiglitz and Bilmes have tried to tell: the true cost of major modern conflict is a disastrous burden for any society to bear.

When they actually added up all the numbers, the indirect cost of the war to the US economy turned out to by conservative reasoning to double the direct costs — on the order of 1.5 trillion dollars over time.

That’s about 11 percent of the total output of the US economy in current dollars — and while that seemingly devastating cut in our wealth is eased by the decades-long schedule over which the money will be fed to the maw of war, ask any economist what compounding does to seemingly small cuts (or gains) in output. Again, nothing good in this case.

This post could go any number of directions from here. One stray thought: all that missing US money could have done a lot of good in taking care of the Iraqis we arguably most need to think well of our presence in their country.

But there is a much more important point to be made than yet one more plaint about tthe venality and corruption of the war here and there: Governments — and empires — fall when the economic cost of maintaining control over resistant or even indifferent satrapies rises too high.

I don’t give long odds for an Iraqi administration that cannot take care of its army; if the kind of indifference Kamber documents in today’s piece persists, I’d bet that power will fragment, flowing to those people and groups that promise and deliver the kind of social web that have so aided Hezbollah and Hamas in their ascents — not a good prospect for all kinds of reasons.

And as for us: whether or not we meet our moral obligation to take care of our own soldiers and those Iraqis who we led into in the conflict we initiated, the American imperial adventure in Iraq has already demonstrably weakened us within a world with rapidly shifting centers of influence, wealth and power. It has done so in all kinds of ways, as Andrew Bacevich expertly and efficiently documents in today’s Boston Globe. (Again, h/t TPM).

One of the most obvious ways that this is taking place, one which is (as Bacevich points out) strangely absent from our politics right now, is that the kind of cold-eyed quantitative analysis provided by the likes of Bilmes and Stiglitz strongly suggests that the Iraq war could be the kind of pure econmic drain that kills empires. Derangement of state finances and overextended military adventures have afflicted empires both old and new.

For a cartoon tour through the controversial history of imperial decline, think the Syracusan fiasco that doomed the Athenian empire, the fate of the Qing dynasty after half a century or more of devastating internal rebellion and sustained external conflict, and then the collapse of the European empires under the weight of the material and moral costs of wars large and small. Go on one step more, and ponder the impact of the twin costs of the mostly cold conflict the Soviets waged to retain control of their western provinces — the Warsaw Pact nations — and the hot one fought and lost in Afghanistan.

The US weathered Vietnam with its global position largely unchanged, perhaps even strengthened, given what happened to its leading rival for power.

The world is different now.  To draw out the political point that I hope is obvious even unstated:  the cost of John McCain’s vision of indefinite war in Iraq  may well turn this conflict into our Somme.  Even if we “win” in Iraq, in the sense that we retain a compliant client in power, basing rights and contractual control of that nation’s oil, we are well on our way to losing the larger and much more important conflict.

How do I know? The fact that we cannot, or will not pay for the proper care of soldiers who fought on our behalf tells me so.

Images:  Francisco Goya, “The Disasters of War (Los Desatres de la Guerra),” plate 56, c. 1810.  Source Wikimedia Commons.

John Singer Sargent “Gassed,” 1918. Location:  Imperial War Museum, London.  (The painting is huge, and no internet reproduction can create the effect of seeing the real thing.  IOW:  Stop in to the IWM if you have the chance.)  Source, Wikimedia Commons.

Thinking Like a Scientist: Surge/John McCain edition

June 11, 2008

How do scientists think?  Lots of ways, of course, as any human being does, drawing on intuition, visual reasoning, leaps of analogy, hard, slogging calculation, day dreaming…anything that works.

But what distinguishes scientific habits of mind from the everyday interpretation of experience is that there are certain rules scientists learn to follow to transform initial ideas into reliable conclusions.  Among them is the notion of a metric, a standard of measurement that you can use to compare one state of a system with another.  Absent some reliable set of measuring sticks it is impossible to draw more than impression, a feeling out of any observation.  Instead of data, you have anecdotes, and the dangerous license to draw any lesson you want from that absence of solid information.

All of which leads to today’s back-and-forth on the campaign trail.

Much has been made around both the campaigns and the blogosphere about John McCain’s Today interview in which he said that the timing of US troops homecoming from Iraq was “not too important.

The furor has mostly raged around the question of what exactly McCain meant by that eye-popping remark.  But I think that the more important claim McCain made has been missed, and it is, IMHO, the key both to his campaign and to one of the most significant problems with the idea of a McCain presidency.

Just before the “not too important” line, McCain repeated what’s becoming common “wisdom,” that the surge is working.  In his words, he said “anyone who knows the facts on the ground says that” [the surge is working].

In order for McCain to have any hope of winning the presidency, that has to be true — there have to be “facts” throughout the hard ground of Iraq that tell us the surge has been and continues to be effective.

But the phrase “the surge is working” is meaningless without a metric.  Working how?  By what standard?  What does it mean to “work” in the context not just of the facts on the ground, but intended goals of the policy, the baseline metrics established before the surge took place?

In fact, McCain is or ought to be aware that the surge has not worked by those original metrics.

There were two established at the beginning of the policy:  to create a security environment in which normal life could resume;  and with that cessation of violence, to create a  window of opportunity during which the incumbent Maliki government could achieve the political reconciliation that would ensure that improvements in security would outlive the surge.

Of those two, the first, the military goal of quelling violence, was instrumental; the second, more fundamental one of establishing a stable polity, was the essential, ultimate purpose of the surge.

So far, only the military one has been partially achieved; the political one, the one that actually counts, remains a mess — perhaps growing yet worse as the Maliki government’s army has confronted the Sadrist’s political and armed power bases in what has at times verged on a full internecine civil war.

The only way to say that the surge is working as established fact is to ignore the more important of the two metrics and to give the best possible gloss on the ongoing violence in Iraq.

Now — none of this matters in the first order politics of McCain’s statement.  He’s trying to say that a policy he has championed is the right one, and at the same time to make the barely coded claim that his opponent who has yet to visit a Baghdad marketplace in the usual kind of street clothes one wears to go shopping, doesn’t know what’s going on.  All that is going to get lost anyway in the back and forth on the homecoming gaffe.  (I know — Josh Marshall argues that this wasn’t a gaffe, and he’s right.)

But one of the features of an endless campaign is that over time you get a sense of how the candidates competing for the job actually think — how their minds work.

Here McCain is losing the long war. One of the most basic tasks of a leader is to set goals and then recognize whether or not the actions taken to achieve such ends have done so.  You have to set your metrics and pay attention to the data as they are, not as you wish them to be.

If, however, you choose to shift the goalposts so that any outcome is a success — you may have a smile on your face, but you don’t become a president worth having.

PS:  Shame on the Today interviewer who uncritically put to Senator McCain the unqualified claim that the surge is working.

Image:  Ford Maddox Brown “The Proclamation Regarding Weights and Measures 1566 A. D.” Source:  Wikimedia Commons.

Talking the Mental Illness Talk–OK. Walking the Walk?…

June 10, 2008

…Not so much, according to Michelle S.

Responding to my recent post on the Iraq War suicides and what they can tell us about the question of brains-and-minds, one of my favorite commenters (and a former student, much admired and much missed) weighs in from a position of much greater knowledge than I possess on issues of brains and mental illness. Michelle knows what she’s talking about and says it better than I could — so here is what she has to say:

_______________________________

I would love to think that some hope is justified here. Unfortunately, I don’t think that’s the case.

While it’s a major development (no pun intended) that the military is finally starting to take PTSD and other brain-related maladies seriously, I don’t think they’re anywhere near the level of understanding or action that is necessary to make any real progress. It’s one thing to admit that something exists–or at least sort of admit that it exists–but another to really do something about it. Admittedly, some of the military leaders seem to be trying. On the other hand, a lot of soldiers are still afraid to admit that they might be suffering from a mental illness.

Hell, plain old civilians are afraid to admit it, and for good reason in some cases, I might add. Stigma is far from gone in the US. As a country we offer sympathy and support for anyone suffering from an illness of the heart, the lungs, the kidneys, whatever, but the brain is still different to us somehow. We manage to forget that it is still an organ, albeit a really darned complicated one.

Then there’s the problem of mental illness in general–in fact, nearly any brain-related problem–being grossly misunderstood. I actually had a young mother say to me once, in regard to her two year old, “He’s so moody! I’m just terrified that he might be bipolar!” Dear, your child is not bipolar. He’s two. His “mental illness” is that he is a two year old. (And, I’m sure, by the time he’s five she’ll have him on ritalin–but NO ONE wants me to get started down that road.)

The public needs good, solid information about what mental illness is. The MSM has yet to provide that, in my opinion. Meanwhile, schizophrenics in particular continue to be demonized, even while they’re forced to live in a society that only treats mental illness as an afterthought. Have you heard even one Presidential candidate address the near-crisis that is geriatric mental health in the US? Ok, I’m preaching on a topic that is dear to my heart here, I know, but come ON–experts in that field are shouting at the top of their lungs about this problem. They have been for years. Why is no one listening? Why is insurance coverage for mental health such a joke?

Perhaps things are starting to improve. Perhaps the brain as a whole, with all of its complex subtleties, capabilities and limitations, will get the attention it needs and deserves. I hope that your hope is justified. But I think (and therefore I am–maybe) we’re a long way off.

——————————

Image:  Francisco de Goya, detail from No. 62 in the series Los Caprichos, 1799. Source:  Wikimedia Commons.

Burrowing into tragedy: a story behind the story of the Iraq War Suicides.

June 5, 2008

Cross Posted at Cosmic Variance (thanks Sean).

My thanks to all here who gave me such a warm welcome on Monday (and, again, to Sean for asking me here in the first place).

This post emerges out of this sad story of a week or so ago.

Over Memorial Day weekend this year there was a flurry of media coverage about the devastating psychological toll of the Iraq and Afghanistan wars. The single most awful paragraph in the round-up:

“According to the Army, more than 2,000 active-duty soldiers attempted suicide or suffered serious self-inflicted injuries in 2007, compared to fewer than 500 such cases in 2002, the year before the United States invaded Iraq. A recent study by the nonprofit Rand Corp. found that 300,000 of the nearly 1.7 million soldiers who’ve served in Iraq or Afghanistan suffer from PTSD or a major mental illness, conditions that are worsened by lengthy deployments and, if left untreated, can lead to suicide.”

(For details and a link to a PDF of the Army report – go here.)

This report, obviously, is the simply the quantitative background to a surfeit of individual tragedy – but my point here is not that war produces terrible consequences.

Rather, the accounts of the Iraq War suicides — 115 current or former servicemen and women in 2007 – struck me for what was implied, but as far as I could find, not discussed in the mass media: the subtle and almost surreptitious way in which the brain-mind dichotomy is breaking down, both as science and as popular culture.

How so? It is, thankfully, becoming much more broadly understood within the military and beyond that “shell shock” is not malingering, or evidence of an essential weakness of moral fiber. PTSD is now understood as a disease, and as one that involves physical changes in the brain.

The cause and effect chain between the sight of horror and feelings of despair cannot, given this knowledge, omit the crucial link of the material substrate in which the altered and destructive emotions can emerge. PTSD becomes thus a medical, and not a spiritual pathology.

(This idea still faces some resistance, certainly. I launched my blog with a discussion of the attempt to court martial a soldier for the circumstances surrounding her suicide attempt. But even so, the Army is vastly further along in this area that it was in the Vietnam era and before.)

Similarly, depression is clearly understood as a disease with a physical pathology that underlies the malign sadness of the condition. (H/t the biologist Louis Wolpert for the term and his somewhat oddly detached but fascinating memoir of depression.)

This notion of the material basis of things we experience as our mental selves is not just confined to pathology. So-called smart drugs let us know how chemically malleable our selves can be.

More broadly, the study of neuroplasticity provides a physiological basis for the common sense notion that experience changes who we perceive ourselves to be.

All this seems to me to be a good thing, in the sense that (a) the study of the brain is yielding significant results that now or will soon greatly advance human well being; and (b) that the public seems to be taking on board some of the essential messages. The abuses (overmedication, anyone?) are certainly there. But to me, it is an unalloyed good thing that we have left the age of shell shock mostly behind us.

At the same time, I’m a bit surprised that the implications of this increasingly public expression of an essentially materialist view of mind haven’t flared up as a major battle in the science culture wars.

Just to rehearse the obvious: the problem with cosmology for the other side in the culture war is that it conflicts with the idea of the omnipresent omnipotence of God. The embarrassment of evolutionary biology is that it denies humankind a special place in that God’s creation, destroying the unique status of the human species as distinct from all the rest of the living world.

Now along comes neuroscience to make the powerful case that our most intimate sense of participating in the numinous is an illusion.

Instead, the trend of current neuroscience seems to argue that the enormously powerful sense each of us has of a self as distinct from the matter of which we are made is false. Our minds, our selves may be real—but they are the outcome of a purely material process taking place in the liter or so of grey stuff between our ears.

(There are dissenters to be sure, those that argue against the imperial materialism they see in contemporary neuroscience. See this essay for a forceful expression of that view.)

I do know that this line of thought leads down a very convoluted rabbit hole, and that’s not where I am trying to go just now.

Instead, the reports of the Iraq suicides demonstrated for me that the way the news of the materiality of mind is is slipping into our public culture without actually daring (or needing) to speaking its name.

That the problem of consciousness is still truly unsolved matters less in this arena than the fact of fMRI experiments that demonstrate the alterations in brain structure and metabolism associated with the stresses of war or the easing of the blank, black hole of depression. The very piecemeal state of the field helps mask its potentially inflammatory cultural implications.

To me this suggests two possibilities. One is that it is conceivable that when the penny finally drops, we might see backlash against technological interventions into the self like that which has impeded stem cell research in the U.S.

On the other hand, I don’t think that the public can be motivated or even bamboozled into blocking the basic science in this field. Too much rests on the work; any family that has experienced Alzheimers knows just how urgent the field may be — not to mention anyone with a loved one in harms way.

This actually gives me hope for a shift in the culture war. For all the time and energy wasted over the last several years defending the idea of science against attacks on evolution, with the cosmologists taking their lumps too – the science of mind could force a shift in the terms of engagement decisively in the right direction.

Or I could be guilty of another bout of wishful thinking. Thoughts?

Image: Brain in a Vat, article illustration. Offered in homage to my friend and source of wisdom, Hilary Putnam, who introduced the brain-in-a-vat thought experiment in this book. Source: Wikimedia Commons.

What’s Wrong With This Broadcast: NPR Edition

March 15, 2008

I’m listening to my local NPR station’s broadcast of Scott Simon’s Saturday Morning Edition as I write this, and the host introduced a discussion of the upcoming fifth anniversary of the war in Iraq by talking about casualties: the 3,975 American servicemen and women killed to date, and, as the host put it, Iraqi casualties estimated from some 40,000 to over 100,000.

Apparently Scott simply forgot about two separate studies published in the fifteen months, each of which concluded that excess Iraqi deaths since the American invasion topped half a million. The Johns Hopkins, Lancet group published their result first: they see about 650,000 deaths as the most likely number as of the end of 2006. As discussed in this post below, a later WHO led study led to the number Simon quoted, an estimate of 151,000 Iraqis dead by violence since the start of the war as of late 2007. Though that number is often cited as a definitive refutation of the Hopkins work, the WHO survey identified 151,000 deaths by violence among 400,000 excess deaths total. As a Hopkins researcher pointed out while methodological differences led him to trust the higher number more, the two estimates were in broad agreement.

Simon also ignored another major study suggesting even higher totals: a British independent surveying company’s estimate of over one million deaths. (To paraphrase a famous West End comedy, perhaps NPR’s motto has become “No Data, Please. We’re American.”)

In other words: Simon simply spoke falsely when he introduced histwo guests, Senators James Webb and John Kyl to discuss the current state of the war. The misstatement, to put the kindest gloss on it, framed the subsequent interviews.

That error (see — kind) materiallly affected what came next. By drastically understating the upper bounds to the cost of the war to the Iraqis, he allowed Senator Kyl’s claims of the likelihood of a political and strategic success of the occupation to stand essentially unchallenged. Those claims have to be understood against the background the sectarian devastation that has taken place already. The real question, one that Simon never thought or had the gumption to ask is not “is the surge working?” but “is the reduction of violence of the last several months meaningful?” — given the lack of the political change the surge was supposed to nurture.

All of which is to echo, once again, Brad DeLong’s cri de coeur.  Like he said:  Why, oh why can’t we have a better press corps?

Image: Francisco Goya, Los Desatres de la Guerra, plate 79, captioned “Murio la Verdad” — “The Truth has Died,” c. 1820. Source: Wikimedia Commons.

The half a percent solution: More on why we are losing/have lost the war in Iraq

February 22, 2008

Congressman Patrick Murphy of Pennsylvania gave a brutally clear interview on NPR’s On Point program yesterday. The whole thing is worth a listen, but a key comment came fairly early on.

Murphy was promoting his new memoir and talking about his experience as a member of a unit of the 82nd Airborne in the immediate aftermath of the invasion. As the occupation was beginning, a total of 3,500 soldiers from that division had responsibility for a district of Baghdad that was home to about 1.5 million Iraqis.

Bit of background here: Murphy’s dad was (is?) a Philadelphia cop. Murphy had expected to be one himself, but the twists and turns of a somewhat hellraising youth led him to ROTC and a career in the US Army. But he knew from policing, and he’s got Phillie in his bones. The key fact that Murphy gave his listeners is that from a policing point of view, Philadelphia is just about the same size as his area of operation in Baghdad.

How many cops does Philadelphia use to police its 1.5 million residents? 7,000. Oh — and a couple of other things: Police officers in Philadelphia speak the local language, live in neighborhoods in (and, to be sure, around) the city, and many if not most have family roots that go back one or more generations into that community. The 82nd Airborne in Bagdad…not so much.

To Murphy this was just one more example of how badly conceived and led the Iraq operation was from the beginning. That’s certainly true, and the more important meaning of the comparison.

But to me what stood out from that couple of sentences in an almost hour long interview, was the importance of scientific –and more precisely — quantitative reasoning in every day life.

One of the great things about real quantitative reasoning is that it is a very efficient way to think about appropriate problems. Individual military engagements, of course, are all different; there are procedures, training and plans you can make to improve your odds of success, but there is no simple algorithm that is going to get your platoon through every contact with the enemy.

Warfare, however, does have some quantitative approaches that make individual successes more likely and minimize both the liklihood and the consequences of single set backs. That’s the point behind the old cliche often attributed to Omar Bradley: “Amateurs study tactics, professionals study logistics.” (The quote turns up all over — see this for example.)

That is, actually getting right the calculation for the number of spare parts you need to keep a tank running across Russia makes a big difference to your chances of success — see Richard Overy’s excellent Why the Allies Won for details.

Coming back to Murphy’s anecdote, the other virtue of quantitative reasoning as applied to Iraq, (besides being essential — i.e. we see what happens when our leaders ignore it), is that it is efficient.

It enables you to learn a lot about different courses of action, retrospectively or in prospect. And it does so very quickly. It turns out that in many situations you don’t need much knowledge to be able to infer a great deal more, with great confidence. Simple models based on relatively simple and easy to get data actually can do a lot of heavy lifting.

(As an aside — the PBS kids show Cyberchase takes this as its core theme. My seven year old son is addicted, and I’m glad.)

Try this one on for size: what are minimums for policing large urban populations during an occupation? You could start by looking at a few large cities already at peace — Philadelphia for example. We know, thanks to Captain-turned-Congressman Murphy that Philly runs out about one cop for about every 200 citizens.

You can take that as a working average for cities with a diverse populaton with some identity divisions between them, a working civil government, an established rule of law, and a common language, shared history, and a fair number of common civic symbolic unifiers — a disdain for Santa Claus at Eagles games and so on.

In other words, 1/200 is your starting approximation for policing requirements when you begin to think about taking over the responsibility for order in an unfamiliar territory.

You would, if you were the least bit prudent (or if your own skin and those of soldiers under your command were at stake), probably try to work out some of the factors that might alter that number: things like ethnic/sectarian divisions more intense than you were used to; language barriers; the absence of existing civil institutions; the lack of a history of rule of law and so on.

The bottom line is that there is no rational way to come up with a number smaller than that required to police a city at peace whose police force patrols with the active consent of the overwhelming majority of the policed.

Hence, the decision to station just 3,500 soldiers whose duties included but were not limited to maintaining civil order in an occupied city neighborhood as large as Philadelphia was an obvious error — one of a pattern of blunders that has cost so much for so long.

And the key lesson to draw out of all this belaboring of the obvious? It took only two numerical facts to reach that conclusion: the number of police in Phillie; the number of troops in the neighborhoods of Baghdad. You don’t have to be brilliant to think clearly.

You just have to choose to do so, and to employ the intellectual tools human beings have spent millenia developing to do so.

I want a President that can count beyond “one, two, three, many.”

Image: Etienne Jeurat, “Prostitutes transported by the Police,” 1755. Source: (via Wikimedia Commons) The Yorck Project: 10.000 Meisterwerke der Malerei. DVD-ROM, 2002. Licensed under a GNU Free Documentation License.