HCR -- Overhyping News

Gary Schwitzer's Health News Review reports on and evaluates other reports about health, science and medical topics. This letter from a patient illustrates why their mission is so important. 

Dear Gary: 

Today I read a news release headlined “NIH Study Links Hodgkin Lymphoma Treatment to Possible Risk of Stomach Cancer.” 

After reading the article, I felt like someone punched me in the gut. 

This sentence was most troubling: “Of 17,477 Hodgkin lymphoma cases examined, the researchers identified 89 survivors who later developed stomach cancer.” 

Isn’t that an infinitesimal number? That’s only one-half of one percent. But that wasn’t made clear in the article. 

I’m not a medical professional and don’t pretend to have the background necessary to understand these things, but it seems as though it’s unnecessarily scary. In addition to my primary care provider, I’m seen by my breast surgeon and an oncologist, none of whom have mentioned any concerns about stomach cancer. I’m bright and I’m strong and certainly could have handled such information (although the article does say that most cases occur before age 50, and I’m 71). So my question is, is this really news that we survivors need to know or is the relationship between the radiation (admittedly nasty stuff, especially in the quantities used 40 years ago) and the incidence of stomach cancer a bit sketchy and so rare as to be difficult to establish a cause-and-effect 

Putting such a headline in a publication available to the lay public creates an unnecessary threat of anxiety to patients who’ve already suffered a great deal. 

Certainly the information must be available, but I believe the very slight risk of stomach cancer should be given greater prominence. Bad news doesn’t go away because we wish it would, but neither should we endure worry and fear out of proportion to the facts. 

Many people may not read beyond the headline, or if they do they may not stop to figure the percentage in one sentence of a seven-paragraph article containing lots of numbers. 

Scientific candor is essential, but so is perspective.

Every time I hear yet another of these "possible breakthrough" or "interesting new finding" reports in the media I have the same reaction. Like the recent reports about washing poultry I can't help wondering how much of this reporting is news and how much is just filling air time. Schwitzer responds: 

Carol’s comments are exactly why we have published this website for more than 7 years. Many times in many venues, we are novices in how we communicate about risks. I think there’s often a huge disconnect – a chasm – between those who communicate about health care and their audiences. 

It’s a chasm we try to bridge on this website. Thanks to Carol for sharing her story. I hope we – somebody – can learn from it.

Anyone interested in health care news is invited to visit that site and check it out from time to time. It's not necessary to eagerly gobble up every piece of news, even from Health News Review. But in today's world of information overload, it's easy to get pushed into panic mode when calmly doing more homework is in order.

Mixed Messages About Syrian Rebels -- Updated, Twice

UPDATE:
That terrible video of a group execution by extremists didn't happen recently as the report inferred. It did happen, but the time stamp indicates it was in the Spring of 2012, nearly a year and a half ago. FP has the followup. 
Although Dan Layman, spokesman for the Syrian Support Group, concedes the video was not contemporaneous, other facts of the story are not in question.

"The date of the video has been corrected. The other facts in the article and video are not in dispute," Danielle Rhoades Ha, director of communication at The Times, told The Cable. 

In any event, Layman and other members of the opposition lobby say presenting the year-old video in the middle of the Congressional debate over authorizing war was tendentious. "It really suggests how they're willing to sacrifice truth for their own anti-war sentiments," he said, referring to the newspaper. 

But regardless of when the execution video was made, it still happened, and offers a window into how some rebel groups operate or at least operated at one point in time. It's also just one of many gruesome web videos with unconfirmed origins that have been used by both sides of the war for propaganda purposes. You can bet it won't be the last. 

Controversy over the video follows another meta-media story surrounding Elizabeth O'Bagy, an analyst at the Institute for the Study of War cited this week by both Secretary of State John Kerry and Senator John McCain during congressional hearings. In particular, O'Bagy has been cited for her Aug. 30 Wall Street Journal column arguing that "moderate opposition groups make up the majority of actual fighting forces" of the opposition -- a contentious assertion in the debate over whether the U.S. should intervene in Syria. What U.S. officials and the the Journal failed to mention is that O'Bagy is paid by the Syrian Emergency Task Force, a group that lobbies for greater U.S. intervention in Syria on behalf of the rebels.

UPDATE #2: (Sept 11)
Elizabeth O-Bagy has since been fired because her credentials were not in order. She does not have a doctorate. 
A young researcher whose opinions on Syria were cited by both Senator McCain and Secretary of State John Kerry in congressional testimony last week has been fired from the Institute for the Study of War for allegedly faking her academic credentials.

The institute issued a statement on its website concerning the researcher, Elizabeth O’Bagy:

The Institute for the Study of War has learned and confirmed that, contrary to her representations, Ms. Elizabeth O’Bagy does not in fact have a Ph.D. degree from Georgetown University. ISW has accordingly terminated Ms. O’Bagy’s employment, effective immediately.

 LINK and video here.
H/T RT by Sharmine Narwani.

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Two reports this morning differ in now the Syrian "opposition" is depicted. A story in the NY Times, including graphic photo and video, suggests the opposition is a bunch of extremist animals, as ready to kill people as Assad's forces. The other, in the New Yorker, takes a more nuanced position, that the religious ultra-conservatives executing captured enemies, are not Syrians but fighters who have come to the conflict for religious reasons

Brutality of Syrian Rebels Posing Dilemma in West
By C. J. CHIVERS
September 5

The Syrian rebels posed casually, standing over their prisoners with firearms pointed down at the shirtless and terrified men 

The prisoners, seven in all, were captured Syrian soldiers. Five were trussed, their backs marked with red welts. They kept their faces pressed to the dirt as the rebels’ commander recited a bitter revolutionary verse.

“For fifty years, they are companions to corruption,” he said. “We swear to the Lord of the Throne, that this is our oath: We will take revenge.” 

The moment the poem ended, the commander, known as “the Uncle,” fired a bullet into the back of the first prisoner’s head. His gunmen followed suit, promptly killing all the men at their feet. 

This scene, documented in a video smuggled out of Syria a few days ago by a former rebel who grew disgusted by the killings, offers a dark insight into how many rebels have adopted some of the same brutal and ruthless tactics as the regime they are trying to overthrow. 

As the United States debates whether to support the Obama administration’s proposal that Syrian forces should be attacked for using chemical weapons against civilians, this video, shot in April, joins a growing body of evidence of an increasingly criminal environment populated by gangs of highwaymen, kidnappers and killers.

AMONG SYRIA’S ISLAMIST FIGHTERS
BY RANIA ABOUZEID

September 5, 2013

This account, somewhat longer, suggests the local Syrian fighters are not only less extreme, but are regarded with contempt by the extremists like the ones depicted in the previous story. 

More at the link, but this is from the story...

In a freshly dug cemetery in Tartiyah, a small Sunni village near Salma, most of the handwritten names on the forty-eight simple white slabs serving as gravestones belong tomuhajiroun, or emigrants. Locals have dubbed it the “Cemetery of the Muhajiroun.” There’s another larger one in Doreen. The term refers to the early Muslims who migrated with the Prophet Muhammad from Mecca to Medina, but these days it’s applied to Islamist foreign fighters or proselytizers. The names reveal the origins of the men now lying under the grayish, stony soil: Abu Obaida il Tunisi (from Tunisia), Abu Abdullah al-Moghrabi (from North Africa, probably Morocco), Abu Falah il Kuwaiti (from Kuwait). And, of course, the Chechens. 

Elsewhere in Syria, and abroad, a fair proportion of Assad’s opponents view the foreign fighters with suspicion and disdain for their ultraconservative views. They also know the accounts, some captured on amateur video, of summary executions of prisoners—sometimes with a simple shot to the head, and sometimes through beheadings or slit throats. These reports are not limited to the foreign fighters—they’ve been ascribed to some among the Syrian rebels, too. Others say that they need them now to help topple Assad, and that their ideas about a future ultraconservative Islamic state, and their reputation for brutality, can be put aside and dealt with later. Some rebels, however, aren’t waiting until the fall of the regime, and have openly clashed with some of the more hardline Islamist groups like Jabhat al-Nusra. (All of this is a confounding problem for the United States as Congress debates military action.) 

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The men were openly disdainful of the Free Syrian Army units, saying they were engaged in “tourism” well behind the front, and were also openly hostile to the Alawites, or Nusayris, as they called them. “Even the Shiites have declared them kuffar[nonbelievers],” said one. “They are all the same. They view us Sunnis as the enemy; they are all involved in the war against us,” said another. “They won’t want to stay here after this,” said a third, meaning after they’d swept through the villages. The men also mocked the Muslim Brotherhood as inadequately committed to its faith. 

“We call the Muslim Brotherhood ‘whatever the audience wants,’ ” said Mohammad, the Syrian Islamist fighter. He wore green military camouflage pants and a black T-shirt bearing the Islamic shahada in white script. “If the people say they want Sharia, they say they want it. If the people say they want democracy, they say they want it. They just want power.”

HCR -- Poultry Washing Rant

I started by day with a rant in a Facebook timeline. 

That "don't wash your chicken" meme is multiplying like somebody dripped raw chicken into gravy and didn't replace the gravy. I saw it again on NBC last night, and that Julia Child video snip is repeated endlessly by writers without imagination using it to fill air time. It finally got on my last nerve. One of my Facebook friends very sensibly posted this:

Another stupid fear mongering about germs. If splattering and misting is the problem, wash the damned chicken in a bowl! I wonder how many people will now cook their chicken unwashed.

And she's correct. This paranoia about germs is getting out of hand. The irony is that genetically modified food products and ubiquitous chemical sprays (many of which are forbidden in much of the modern world outside the US) are getting a pass while locally produced food products have to fight local ordinances and zoning restrictions that make it hard for someone to even feed themselves, much less -- God forbid -- share something with a neighbor or sell it to a stranger in a local farmers market. But back to my rant. The comment thread went like this...

Hostess -- And then clean the bowl and the sink thoroughly with warm water and detergent.
Comment -- Brining is good!
Comment -- Carnivore problems, heh. [*I liked this one.*]
Comment -- You're supposed to cook it unwashed :-(
Comment -- I don't see the point of washing chicken, unless there's visible schmutz on it. You get rid of the bacteria by cooking the chicken thoroughly, not by washing it off. The article is the opposite of fear mongering, it's telling people to relax and accept the fact that their chicken skin is far from sterile when they put it in the oven.
Hostess --  I make chicken curry mostly, not roast chicken. Indian cooking calls for removing the skin and then cutting it up. No way is it safer to handle unwashed chicken to which fecal matter and other stuff is sticking and then hoping that it will all get "cooked." I am sorry, I call this unnecessary and stupid. If splashing contaminated water is the problem, there are ways to avoid it. Meat handling requires care. As Bill said, it is a carnivore problem.
Comment -- Also assumes your water supply is basically clean. Bacteriology is never absolute, just managing populations.

That was enough for me. I've been waiting for years to get this out. 

John Ballard "Managing populations." Good point. I was fortunate in the early days of being in the food business to go to food handling classes required by a local health department. (This was in Florida but could have been anywhere in the Sixties.) There were three classes less than hour, a week apart. During the first class someone took potential contaminants into plastic lab dishes with a growing medium -- a little piece of something from the floor, strand of hair, fingernail cleanings. I can't recall if anyone spit or coughed into one or not, but the lesson was to see what they looked like after being incubated until the last class, two weeks later. We got to see what all these bacteria-covered contaminants looked like, which was, of course, pretty disgusting.

The lesson was that bacteria, which are on virtually everything in our environment, need three conditions to multiply -- moisture, a growing medium and proper temperature. Take away any of these three and the population will not reach the danger level. That's why we can enjoy dried fruits and beef jerky (dried), pickles and preserves without refrigeration (pH levels either kill or render reproduction) or insure food is in a "safe temperature range." Very hot kills bacteria, and very cold renders them unable to multiply.

Over the years I have seen the "safe temperatures" get adjusted one way or another (like the ratio of external heart compressions and breaths in CPR) but the main idea has not changed: limit the number of germs and you are not taking chances.

This is why for years food workers were allowed to handle both food and money. The amount of germs getting passed around was not considered to be enough to cause a foodborne illness outbreak. (I always worry about bank tellers, especially during flu season. And as every mother knows, sending kids to daycare or school is certain to make them sick, especially when the school year starts. And babies that spread poop are the main vectors of cholera and dysentery in places where the water may not be potable but people take reasonable precautions when they prepare food.)

So I'm with the Hostess on this one. And I'm also an advocate of the "ten-second rule" as long as your gonna eat whatever hit the floor and it didn't land buttered side down or clearly in or on something nasty. I'm really glad I retired before all this rubber glove obsession got started. I'm glad they use them (now that others have that job) but when I was in the business I only saw them when the product was too nasty to touch, or stank, or some OCD boss made everybody do it, typically one who was also so cost-conscious that there were limits on the number of gloves allowed per shift, resulted in people not replacing them after a smoke break. I have seen plenty of hand washing but never saw anyone sanitizing a contaminated glove.

Trivia factoid--the main reason for not allowing food, drink, smoking or gum in food production areas is keeping hands away from eyes, noses, lips and pockets. (Not to mention spitting.)

And while I'm ranting, next time you hear this conversation, it's a good time to point out that sick food service workers who are the most poorly paid service people in the economy, also never have paid PTO which they might take advantage of when they are sick. Just know and accept that every time you eat out you are being served by a population that could be working with something you may not want to catch, and it sure as heck ain't gonna be a moisture particle from a package of poultry.

I don't want to come across as a curmudgeon, but straightforward candor is one of the benefits of getting older. In the same way that unpopular social movements are the responsibility of young people, speaking truth to power is the responsibility of old people. When you have responsibilities to family and employers advocating unpopular  ideas is not smart. It can get you fired or shunned.

This principle is related to the idea expressed by James Baldwin when he said "The most dangerous product of any society is the man who has nothing to lose."  We have seen it most recently in movements in the Middle East. The Syrian tragedy is a painful example. And at least one contemporary thinker suggests that Syria has been brought to civil war in no small way by a series of climate disasters resulting in the existential crisis we are now witnessing.  But I digress.

Before leaving the food discussion I have two additional items to add.

First -- and this gets back to that "population control" point -- I heard another horror story from a more recent food handler's training class than the one I mentioned in the Sixties. Since then standards of safety have really improved (despite the tenor of my complaining) and most of the country is now moving to something called ServSafe, an industry-wide program of best practices that has been rolling out nationally for the last ten or fifteen years. When it came to the place where I last worked I was privileged to attend one of the inaugural series of classes.

The instructor, an experienced sanitarian with years on the job, told a story about a family that got sick one Sunday after lunch. The mother was planning corn on the cob for lunch, so to save time (a pot of water takes a long time to come to a boil) she cooked it while they were getting ready for church and left it on the stove, covered, until they had it for lunch. After they ate they got sick with what was later determined to be botulism poisoning.  One person died, one didn't get sick who had not eaten corn, but the baby, who didn't have corn but ate something cut by a fork someone else had used, got sick enough for a fatal dose of botulism. The problem was a combination of time and temperature. Corn taken directly from boiling water is safe, but a tiny amount of the bacteria in what turned out to be a perfect incubation temperature multiplied to a fatal level over a period of hours.

This leads to the second point. Just about any food that humans can eat is a perfect place for germs to grow that can make us sick. The only protections we have are the ones we know about and learn about over time. We know, for example, that the alcohol in wine kills germs, so wine at room temperature is not dangerous. In fact, it often turns sour, indicating that the acidity level (like that of preserves or pickles) is sufficient to kill bacteria.  But who would suspect corn? Or potatoes, for that matter? It turns out that a baked potato is a potentially hazardous food, especially if the skin is broken. It is a perfect breeding ground for anything that will make us sick. One famous case of mass food poisoning was an event that served barbecue-stuffed baked potatoes to several hundred people. The problem was not that combination, but the time that lapsed between when those two ingredients were put together and when they were actually eaten. Critical hours passed as the potatoes were prepped, stored, transported, stored again, distributed and finally eaten.  

Another case of foodborne illness involved a local buffet. I was discussing it with the sanitarian who happened to be in that territory, suggesting that they may have had a problem with improper storage and handling. He said the place was clean as a pin and always had good reports. The investigation was still incomplete and they still had not discovered the source of the problem, but they were looking at the spices used in the kitchen. It never occurred to me until then, but herbs, spices and teas are not customarily handled in a strictly safe manner. We are protected from sickness by the small amounts typically used as well as cooking. (Nobody I know either washes or irradiates herbs or spices.) It is for this reason that the "sun tea" fashionable a few years ago was not a good idea, since teas, unlike coffee beans, are not subject to a level of germ-killing heat until they hit the scalding water used to make tea.

As we enter another holiday season it's good to be reminded about safe food handling practices, especially involving time and temperature. But this foolishness about washing chicken has less to do with food safety than with well-meaning people way up the food chain trying to get attention.

Pie in the Sky -- Chinese Drone Cake Delivery

Here's a link to the story.
Thanks, John Robb

The news broke yesterday morning, after a Sina Weibo user noticed what looked like a UFO hovering above a street in Dongguang, in southern China, and after noticing a SF Express logo, posted images online.

In July, a Shanghai bakery launched aerial cake delivery—or “pie in the sky,” as the Telegraph put it (video below). However, as an anonymous government official told the Shanghai Daily at the time, businesses that want to use drones must be granted approval from the local civil aviation authorities first. The bakers forgot to do that, apparently. 

However, the Dongguan police said that, except during certain sensitive times, commercial operators who receive permission from the civil aviation regulator and air traffic control are allowed to fly drones (links in Chinese). SF Express says it's strictly complying with the policies.

Morning Reading -- September 3

Get bookmarks ready. 

Too many long reads this morning for one sitting. 

Lots to read & think about. Subjects all over the place. 

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How does US stance on #Syria impact its #Iran policy? http://t.co/HDiGLNFLcz
— Vali Nasr (@vali_nasr) September 3, 2013

This puzzles together with my speculation that the president is playing for time with his gambit for Congressional approval.  Key word --> back-channel. 

Steve Coll on how Should Obama Respond to #Syria with lesson of #Iraq's use of CW in mind http://t.co/CXdyYhlcXH via @NewYorker
— Vali Nasr (@vali_nasr) September 3, 2013

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.@NewYorker on the new neuroskeptics.Neobumpology http://t.co/c1ZwvZ5c4X
— James C.Coyne (@CoyneoftheRealm) September 3, 2013

Entertaining read. Not too long.
I was hooked by a reference to phrenology, recalling a conversation I had years ago with my grandmother. She was a daughter of the South, sent to college in Ohio by her father (who had lost any shot at hereditary wealth when he sold his Kentucky farm for Confederate money). I came across a reference to Blind Tom, a black savant, born into slavery, whose home was near Columbus, Georgia where we lived. My grandmother told me her father once saw Blind Tom while traveling by train. He was not performing, but her father met the man who was his master. With his permission he was allowed to feel Tom's head, looking for bumps or ridges across the skull that might indicate unusual development. Apparently none were reported but the story made a good anecdote.
So much for trivia.

Writers on the brain and the mind tend to divide into Spocks and Kirks, either embracing the idea that consciousness can be located in a web of brain tissue or debunking it. For the past decade, at least, the Spocks have been running the Enterprise: there are books on your brain and music, books on your brain and storytelling, books that tell you why your brain makes you want to join the Army, and books that explain why you wish that Bar Refaeli were in the barracks with you. The neurological turn has become what the “cultural” turn was a few decades ago: the all-purpose non-explanation explanation of everything. Thirty years ago, you could feel loftily significant by attaching the word “culture” to anything you wanted to inspect: we didn’t live in a violent country, we lived in a “culture of violence”; we didn’t have sharp political differences, we lived in a “culture of complaint”; and so on. In those days, Time, taking up the American pursuit of pleasure, praised Christopher Lasch’s “The Culture of Narcissism”; now Time has a cover story on happiness and asks whether we are “hardwired” to pursue it.

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Useful post by @zeinobia on the 45 men and 5 women who will write yet another constitution for Egypt http://t.co/ZTCkuew2Kp
— Evan Hill (@evanchill) September 3, 2013

This link will be of interest to those following Egyptian developments. A committee has been appointed to draft yet another constitution for the next chapter of Egyptian political growth. Critics should be reminded that our own efforts at representative democracy were a famous failure with the Articles of Confederation and the US Constitution (which has since had plenty of changes) was not contemporaneous with the Declaration of Independence but was ratified more than a decade later.

Zenobia is one of Egypt's smartest bloggers and political analysts. She was on the scene long before the Arab Spring. Her knowledge of the players is easy to see in her straightforward descriptions. The reader will not remember them all, but I reading her thumbnail sketches made me optimistic about what might happen next in Egypt.

Egypt closes Al Jazeera affiliate, Brotherhood TV http://t.co/BcImCuSVQR via @FRANCE24
— Diane Al-Habieli (@al_habieli) September 3, 2013

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Religious Israeli schools censoring human reproduction from textbooks http://t.co/MBa2nCoAKV
— joseph dana (@ibnezra) September 3, 2013

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Get ready for a paradigm shift. 

This next read is serious. 

Is there a Syria-climate change link? http://t.co/59eaElAPiD
— Peter Daou (@peterdaou) September 3, 2013

If you want to understand what's happening in Syria ...
by digby

Please read this important post by James Fallows:

Many times I've mentioned the foreign-policy assessments of William R. Polk, at right, who first wrote for the Atlantic (about Iraq) during Dwight Eisenhower's administration, back in 1958, and served on the State Department's Policy Planning staff during the Kennedy years. He now has sent in a detailed analysis about Syria.

Polk wrote this just before President Obama switched from his go-it-alone policy and decided to seek Congressional approval for a Syrian strike. It remains relevant for the choices Congress, the public, and the president have to make. It is very long, but it is systematically laid out as a series of 13 questions, with answers. If you're in a rush, you could skip ahead to question #7, on the history and use of chemical weapons. But please consider the whole thing when you have the time to sit down for a real immersion in the implications of Congress's upcoming decision. It wouldn't hurt if Senators and Representatives read it too.
Read the whole thing here. It is the most cogent recitation and analysis of the Syrian crisis that I've seen. While my opposition to this intervention is rooted in global concerns which are unrelated to this set of circumstances, these particulars bolster my instincts and my fundamental skepticism about the wisdom of this action.

Here's just one interesting insight that should make us all step back and ask ourselves whether our long term interest might be better served by concentrating on a different issue that really does require American "intervention":

Syria has been convulsed by civil war since climate change came to Syria with a vengeance. Drought devastated the country from 2006 to 2011. Rainfall in most of the country fell below eight inches (20 cm) a year, the absolute minimum needed to sustain un-irrigated farming. Desperate for water, farmers began to tap aquifers with tens of thousands of new well. But, as they did, the water table quickly dropped to a level below which their pumps could lift it.

In some areas, all agriculture ceased. In others crop failures reached 75%. And generally as much as 85% of livestock died of thirst or hunger. Hundreds of thousands of Syria’s farmers gave up, abandoned their farms and fled to the cities and towns in search of almost non-existent jobs and severely short food supplies. Outside observers including UN experts estimated that between 2 and 3 million of Syria’s 10 million rural inhabitants were reduced to “extreme poverty.”
The domestic Syrian refugees immediately found that they had to compete not only with one another for scarce food, water and jobs, but also with the already existing foreign refugee population. Syria already was a refuge for quarter of a million Palestinians and about a hundred thousand people who had fled the war and occupation of Iraq. Formerly prosperous farmers were lucky to get jobs as hawkers or street sweepers. And in the desperation of the times, hostilities erupted among groups that were competing just to survive. 

Survival was the key issue. The senior UN Food and Agriculture Organization (FAO) representative in Syria turned to the USAID program for help. Terming the situation “a perfect storm,” in November 2008, he warned that Syria faced “social destruction.” He noted that the Syrian Minister of Agriculture had “stated publicly that [the] economic and social fallout from the drought was ‘beyond our capacity as a country to deal with.’” But, his appeal fell on deaf ears: the USAID director commented that “we question whether limited USG resources should be directed toward this appeal at this time.” (reported on November 26, 2008 in cable 08DAMASCUS847_a to Washington and “leaked” to Wikileaks ) 

Whether or not this was a wise decision, we now know that the Syrian government made the situation much worse by its next action. Lured by the high price of wheat on the world market, it sold its reserves. In 2006, according to the US Department of Agriculture, it sold 1,500,000 metric tons or twice as much as in the previous year. The next year it had little left to export; in 2008 and for the rest of the drought years it had to import enough wheat to keep its citizens alive. 

So tens of thousands of frightened, angry, hungry and impoverished former farmers flooded constituted a “tinder” that was ready to catch fire. The spark was struck on March 15, 2011 when a relatively small group gathered in the town of Daraa to protest against government failure to help them. Instead of meeting with the protestors and at least hearing their complaints, the government cracked down on them as subversives. The Assads, who had ruled the country since 1971, were not known for political openness or popular sensitivity. And their action backfired. Riots broke out all over the country, and as they did, the Assads attempted to quell them with military force. They failed to do so and, as outside help – money from the Gulf states and Muslim “freedom fighters” from the rest of the world – poured into the country, the government lost control of over 30% of the country’s rural areas and perhaps half of its population. By the spring of 2013, according to the United Nations High Commission for Refugees (UNHCR), upwards of 100,000 people had been killed in the fighting, perhaps 2 million have lost their homes and upwards of 2 million have fled abroad. Additionally, vast amounts of infrastructure, virtually whole cities like Aleppo, have been destroyed.

If that doesn't sound like a premonition of many more crises to come, I don't know what does. Perhaps we should stop blowing things up for a little while and concentrate on being a global leader on the real existential crisis of our time: climate change. Tomahawk missiles aren't going to solve it, that's for sure.

I know it's long but please read this entire article. If you are persuaded, send it to your Representative, particularly if he or she is a progressive Democrat who is likely to be arm twisted by the Syria hawks in the Democratic leadership. It's vitally important that we break this cycle of military intervention to solve problems that can't be solved by military intervention. There are much bigger, long term challenges underlying all of this this that are papered over by America's status as the world's policeman and it's not serving any of us well.

It's not that the US has no leading role to play in the world. It's just that we are playing the wrong one.

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I ask digby and Fallows forgiveness in advance for stealing this post entirely without parsing or indicating quotes. The subject in this case is more important than editorial protocol. I cannot overemphasize what they say: read what Polk wrote. I think he's correct.