The First Casualty of War

The Global  fight to control Corona virus has now been referred to by many as a War. It is easy to understand why. The destruction it has already caused to millions of people is hard to fully fathom or estimate. At the current time, the death toll remains extremely small, it compared to any other cause of death. The tool of human suffering on the many had millions who have lost their livelihood, freedom and sense of security is impossible to estimate.

Oliver Stone, in the famous movie Platoon told us that innocence was the first casualty of war. The movie was a powerful political critique of the Vietnam War and perhaps wars in general. The conflict was a perhaps histories first televised example  of how easily ethical human beings could lose their moral compass and even common sense during  times of crisis.

The Vietnam, we may recall, was had initially been a war to protect the people of Vietnam from communist oppression and at least initially, to return them to their French colonial benefactors and while also protecting the West from communist expansion.

The dominant belief at the time was The Domino theory, which suggested that if Vietnam fell to communism, other countries would fall like dominoes. Communism was seen in many ways like a virus, at risk of infecting all of us if the free world did not take a stand. The initial goals of the war was to protect the freedom and human rights of both the Vietnamese people and the West.

As the war progressed however, despite good intentions, the American’s and their allies drifted steadily went down a path of strategic folly and wide spread human rights abuses. With conventional warfare, generals turned steadily turned to more radical  and extreme solutions. It was a slippery slope of gradually increasing ferocity and human rights abuses.  By the early 70’s Americans were using napalm, exfoliant, and large scale carpet bombings on an unprecedented scale.  It would become the greatest  war time humanitarian apocalypse since world war two breaking virtually every rule of the Geneva conventions on the grandest of scales.

There would have been many times in the early parts of the conflict where our leaders should well have seen that the war was lost, but once people commit to an action it can be almost impossible to change course until  complete catastrophe is reached. In poker this is referred to as being pot committed. It is a situation where you know that you are probably beaten but you have already committed so much to the pot, that the drop out impossible. Instead you are now committed to following the pot to the likely conclusion- you will lose the whole game. So it is in often in warfare.

By the early 1960,s though it was clear by most military analysts that victory was not possible.  The Americans, having already committed billions to the war could not change tactics and retreat. They were committed to following the war through to the bitter end. From the last 1963.s to 1969 the Americans, under Lynden Johnston, would paradoxically escalate the aggression partake in the greatest bombing campaign in history.

Eventually public protests and disobedience brought and end to the madness but it would takes until 1972 for the Americans to finally concede defeat.  By the time The last American troops left Vietnam, 7 millions tons of bombs had been dropped on the peoples of Indochina, three times more bombs that had been dropped  by America during world war two. Millions of cluster bombs and mines would continue to mane and kill Vietnamese and Cambodian children for decades to come. Large areas of the countryside where poisoned with millions if tons of defoliant, resulting in deaths from chemical poisoning and malnutrition. It has been estimated that there were 4,000,000 victims of dioxin poisoning in Vietnam.

Estimates of Vietnamese casualties vary, but it goes into the millions, the majority of whom were civilians and children. For the American and other allied troops involved the emotional scars would lead to untold suffering and the formal recognition of post-traumatic stress disorder as a real psychiatric disorder

The irony of the gross atrocities of the Vietnam War  is that the whole raisson detre for the war had been to protect the Vietnamese peoples from Communist oppression. When humans are caught in the fog of war and the human casualties start to mount it can be easy to lose our moral compass and to forget what we are fighting for. Sometimes the cure can indeed be much worse than the disease.

As we now embrace for our fight against Corona virus, I wonder if we will learn  past lessons of if we are destined to repeat histories mistake an embark on folly of a global proportion.

Our fight against Corona began with the goal of protecting us from the spectre and fear of a viral pandemic. It was begun with the nobel goals of protect the quality, value and freedom of human life. As we continue to  increasingly extreme actions we risk drifting into an ideological position and losing sight of our real goals.,  The indeed is the role of doctors- to help people and of course to no do harm. “First do no harm” remains a core principal of the Hypocratic oath.

As however we have been unable to control the spread, we have as a groups moved to gradually more extreme measures.  Easily we have slid down a slippery slope of what some might call human rights violations.

Systematically we have seen people around the globe denied basic human freedoms- many millions have been placed under house arrest. Rights to travel have been taken. In places people have lost the right to congregate, to practice their religion, protest,exercise free speech and to earn a living. As a society we have isolated ourselves and become gripped with fear with an infective xenophobia. We have demonised and imprisoned those we see as potential carriers and in doing so,perhaps we have lost some of our humanity

People have seen their life savings crumble and their way of life destroyed. During peace times our moral compass would show outrage, but during times of crisis people steadily and easily move to greater extremes.

We no see millions of people who will lose their livelihoods. Unemployment may reach unfathomable proportions, and social upheaval is of an unprecedented scale. Over coming months the economic disaster that unfolds will bringer hunger, suffering depression, suicide and death in many forms .

Yet in the midst of such a crisis leaders are pot committed- to acknowledge that the measures are not working and to repeal them would be like retreat in a time of war- unacceptable. Instead most likely leader will move to greater extremism- even now countries scramble to institute the most draconian measures, hoping that their last-ditch carpet-bombing efforts will subdue the subversive coronavirus, where conventional weapons have not worker.

Perhaps we are seeing what the German political scientist Elisabeth Noelle-Neumann termed The spiral of silence theory. It is a form of pluralistic ignorance sometimes a specific type of which is the Abelene Paradox. It is a drift to extremism which goes against where a vocal minority takes the majority down a path an all to often of

During the fog of the corona virus our moral compass and even our most basic common sense is at risk of deviating. We are at risk of going down a path of greater and greater human suffering and human rights violations as we have tended to do during other times of hysteria.

We can forget to ask ourselves why are we really doing this, does it make sense and are we really reducing human suffering through our actions   adding to it.

What the final death toll attributed to Corona Will be is still uncertain.  Lessons from War teach us if anything, that there  are worse things than death. Sometimes maintaining your values and humanity in the face of tragedy is the most important thing

humans we have fought and died for our values and out freedom. Even in times of crisis or war it is better to maintain or ethical compass, even if it means more lives are lost, that to sacrifice our core values.

It is sobering to recall that after the end of  the Vietnam war not a single country in South East Asia became communist. The Domino theory and the associated Mcarthyist hysteria over communism died a quick and ignominious death. The Berlin wall came down, Soviet union collapsed, and China moved to a free market style economy.

With the benefit of hindsight it is hard to imagine how the The Domino theory and The Vietnam war could have ever have made sense to anyone, yet alone the wisest leaders of the free world.

When the hysteria of corona settles, we will need to look back on our actions and hold ourselves accountable. The reflective mirror of hindsight can be unkind even to the best intentioned. The road to hell, as it is said, is paved with good intentions

Role of the medical profession is to help people, to protect the quality of their lives and their dignity and freedom. When it is time to reflect on how we have as a society managed this crisis I hope that we can look back and say we stuck to our principles. We can forget that as doctors this first and over-riding rule is primo non nocere- First do no harm