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Our Complacent Commander in Chief
When I served in Afghanistan, we had to walk single file through Taliban-controlled territory laden with mines, hoping to stay on the thin, invisible path that the point man had cleared with the squad’s lone metal detector. None of us had any illusions about the danger we were in; we knew we had to remain vigilant. “Complacency kills” was a common mantra. America is in one of the most vulnerable phases of the war in Afghanistan—with a resurgent Taliban, few combat forces on the ground, and mostly Afghan allies for protection. And we have a complacent commander in chief.I served under Barack Obama and George W. Bush, and I trusted that each one would uphold their end of the bargain with the military: We go into harm’s way, and they wage the war honorably and responsibly. This president is different. This past week I learned that Donald Trump potentially ignored—or simply did not read—intelligence that Russia had allegedly placed bounties on American soldiers in Afghanistan.According to The New York Times, three marines were murdered last year possibly by Taliban fighters seeking Russian bounties. Yet Trump did nothing, then or now. Failing to act on this new information declares to our enemies that it’s open season on those still deployed and sends a message to U.S. soldiers and our Afghan allies that nobody has their back.[Elizabeth Warren: We can end our endless wars]The refusal to protect American soldiers from Russian attempts to murder them is only Trump’s latest dismissal of the dangers facing troops abroad. After Iranian missile strikes against U.S. bases in Iraq earlier this year, he claimed that “we suffered no casualties.” Later, after 100 soldiers were diagnosed with traumatic brain injuries, he said, “I heard that they had headaches and a couple of other things, but I would say, and I can report, it is not very serious.”This same injury rightly warranted a Purple Heart when I was in Afghanistan. After a rocket-propelled grenade exploded near one of my sergeants, he was left concussed and unable to form coherent sentences for days. Concussions plague many soldiers for years, causing cognitive and emotional impairments. Just as some injuries require amputation, a traumatic brain injury also takes a part of the person it wounds.When the president downplays the risks to our soldiers or fails to act on new information—or simply doesn’t read the briefings and take our lives seriously—he neglects his crucial duty to counter threats far above the paygrade of the average service member, who is only trying to safely accomplish the mission to which he’s assigned.Russian bounties are especially dangerous because they drive a wedge between our military and the Afghan people by encouraging treachery in an already-impoverished country. When I was there, almost a decade ago, one of the most challenging threats we faced was attacks by Afghan soldiers and police on coalition forces, known as green-on-blue attacks. Yet because we needed to build trust with our allies, we had no way to mitigate this vulnerability, which the Taliban—now aided by Russia—have long sought to exploit.The Afghan War is an intimate conflict, built on trust with the Afghan people. My company’s mission was to partner with an Afghan National Army unit on a small patrol base in the northern Helmand River Valley. Then as now, American troops were outnumbered in the deserts and valleys of Afghanistan, in close quarters with an unfamiliar culture. The marines were nervous at first, but we lived and patrolled together with the Afghans. Our goal was to train the Afghan soldiers so that they could take over the fight that both groups knew would eventually be theirs alone.[Read: The U.S. once wanted peace in Afghanistan]Many of us developed close relationships while we were there. On Eid-al-Fitr, the holiday marking the end of Ramadan, American and Afghan soldiers slaughtered sheep, as is customary, and broke bread together. I found myself up late with the Afghan commander smoking cheap Pine cigarettes and eating melon-size pomegranates cross-legged on his rug-covered dirt floor. He showed me old videos of mujahideen fighting the Soviets during their occupation in the 1980s.When I later had to tell him that one of his men had been killed, I saw this perpetually stoic man’s eyes redden and water, just as my lieutenant’s had a few moments before when I told him the same news about one of his marines. Our men fought and died together, building partnerships over decades across battalion after battalion.In the village I sat at shuras, or meetings, debating the problems facing the Afghan people. We learned one another’s names and faces. On patrols, we’d visit compounds to follow up on a well we’d helped build, only to be invited in for chai. I looked at children, the young boys rowdy and smiling, the girls with curious eyes not yet covered by a burka, and I wondered what kind of life they dreamt about and whether our work would someday help them realize it.In 2015, a few years after my tour of duty, the Taliban overran the district where I’d served. I have no way of knowing what happened to the army commander or the children who’d followed us on patrol begging for pencils. But I’m certain that the American troops still deployed are our last hope of leaving the rest of the country with a fighting chance to hold out against Taliban rule, which remains as oppressive today as it was in 2001. We owe the Afghan soldiers and people and the U.S. troops still deployed the support and respect needed to finally end this war.Every single man and woman who fought in the Afghan campaign would sleep easier, or tell their story to their children with more pride, or stand before the graves of long-dead friends with less heartbreak, if the war were to end in victory—but I know that’s not possible. We can still, however, end this war with honor.[Jim Golby and Peter Feaver: It matters if Americans call Afghanistan a defeat]As we reduce our footprint, the risk grows greater to the few troops who remain. Our retreat must be done thoughtfully and systematically to minimize bloodshed in a war we no longer intend to win. And yet the president is managing it with careless disregard for the 12,000 service members currently deployed, by eroding the trust developed with our Afghan allies over decades, and by betraying the sacrifices that so many of us made during this costly American tragedy. Instead he should note the standard of care that the soldiers he leads devote to their fallen comrades.In Afghanistan, when an improvised explosive device killed marines in my company, the blast often tore apart their body. After a Navy corpsman made a heroic but futile attempt to save their life, a medic on a casualty-evacuation helicopter took custody of the body, the next in a long line of soldiers, sailors, airmen, and marines who solemnly delivered the remains home to their family. But our job on the ground still wasn’t over.Despite the danger from Taliban fighters and other IEDs, a squad would search the scene to try to collect additional body parts. We didn’t always succeed. One man’s ring finger with his wedding band was never found and returned to his widow. But honoring their sacrifice demanded follow-through and every possible effort to the end.When the president treats the conclusion of this war as unimportant, his behavior squanders whatever honor the men and women currently deployed may yet salvage from this terrible ordeal. They’re risking their life for the same cause as all of us who served: peace. More than 2,300 Americans have been killed in action; in these final moments of the war, we cannot let their sacrifices be in vain.
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Trump supporters displaying QAnon posters appeared at a Trump rally in Tampa, Florida, on July 31, 2018. | Thomas O’Neill/NurPhoto via Getty Images QAnon started on an obscure internet forum. Now its supporters are running for Congress. “Where we go one, we go all” is a frequent slogan of adherents to QAnon, a fringe conspiracy theory that posits the existence of a pedophilic “deep state” working against President Donald Trump. Now, it looks like at least a couple of them could be going to Washington. On Tuesday, restaurateur Lauren Boebert defeated five-term incumbent Rep. Scott Tipton for the GOP nomination in Colorado’s Third District. Boebert is a conservative gun rights activist who touts her support for Trump, as well as her belief in “personal freedom, citizen rights, and upholding the Constitution of the United States,” on her campaign website. She’s seemingly also on board with QAnon: In May, she told far-right personality and QAnon supporter Ann Vandersteel that the theory isn’t really her “thing,” but then later added, “I hope that [Q] is real, because it only means America is getting stronger and better and people are returning to conservative values.” And in the traditionally Republican Colorado Third District — Tipton won by about 8 points in 2018 — Boebert is also the favorite to win in November. If she does, odds are good she won’t be alone in her familiarity with QAnon when she gets to Congress. Marjorie Taylor Greene, a Georgia Republican, almost won her primary outright in Georgia’s 14th District, which lacks an incumbent, and she’s on track to win again in the August runoff. Greene is even more open in her support for the conspiracy theory: In a 2017 video discussing it — one of several first uncovered by Politico — she told supporters that “there’s a once-in-a-lifetime opportunity to take this global cabal of Satan-worshipping pedophiles out, and I think we have the president to do it.” Boebert and Greene are the two QAnon-supporting candidates most likely to make it to Congress this November, but they’re not the only ones who have a shot. According to Media Matters, there are at least eight other QAnon-friendly candidates for Congress who have already won their primaries, as well as one more (in addition to Greene) who’s headed for a runoff. It’s a surprising number of people to have successfully running for office while embracing an objectively wild conspiracy theory. But maybe not that surprising — after all, one of the president’s sons posted a QAnon graphic on Instagram just last month. Candidates don’t need to explicitly endorse conspiracy theories to elevate them According to Travis View, a QAnon expert and co-host of the podcast QAnon Anonymous, part of it is just politics, albeit a particularly Faustian variety. The fanatical dedication to QAnon that characterizes many of the conspiracy’s acolytes turns out to be very effective when it comes to spreading a particular candidate’s message — or, at least, it is if they think a candidate is on their side. Of Boebert, View says, “I feel like she’s being very crafty in that she seems aware of what she needs to say in order to give enough wink and acknowledgment to the QAnon community without out-and-out endorsing it.” We can now add Lauren Boebert to the ever-growing list of QAnon supporters who are running for Congress.— Right Wing Watch (@RightWingWatch) May 18, 2020 Boebert has continued to walk that fine line since her win on Tuesday. “I’m glad the [inspector general] and the [attorney general] are investigating deep state activities that undermine the President,” she said in a statement to Vox. “I don’t follow QAnon.” But Graham Brookie, an expert on disinformation and the director of the Atlantic Council’s Digital Forensic Research Lab, says that whether candidates like Boebert officially lay claim to the conspiracy theory doesn’t matter too much. “She may not identify as an adherent of QAnon conspiracy theories,” Brookie, a native of Colorado’s Third District, said in an interview with Vox, “but she has certainly amplified them provably, and the impact is the same on the audience.” I was born & raised in #CO03. This is my home. I also happen to run a nonpartisan center dedicated to identifying & explaining disinformation. So let me explain this: Lauren Boebert is an unabashed conspiracy theorist, who spreads QAnon & is unfit for elected office.— Graham Brookie (@GrahamBrookie) July 1, 2020 QAnon supporters — and believers of other conspiracies — are “primed to believe in code words and secrets,” as Vox’s Jane Coaston explained: Conspiracy theories create order out of chaos, attempting to make sense of events that don’t make sense. And researchers have found that fact-based arguments against them only serve to reinforce them in the minds of believers. That’s what makes QAnon or Sandy Hook trutherism or any other conspiracy theory so difficult to combat: Because conspiracy theories aren’t based on facts, conspiracy theorists aren’t receptive to them either. Not all QAnon-friendly candidates are like Boebert, though: Some exist much closer to the Greene end of the spectrum. Specifically, View describes some QAnon supporters as “pragmatic” in their embrace of the conspiracy theory: “cynical grifters who see the QAnon community as a bunch of people who can be exploited for money or online audiences,” or even to win a Republican primary. But in other cases, he says, “you see people who are genuinely radicalized by the QAnon story.” For example, View says, Jo Rae Perkins, who won the Republican nomination for Senate in Oregon, appears to be a “true believer”; she even made explicit reference to Q in her victory speech this May. Tacit support for QAnon makes sense for some candidates in today’s GOP When it comes to the recent surge in QAnon-supporting candidates, most of their voters — and there are about 600,000 of them, according to a calculation by the Washington Post — aren’t voting for Q directly. In fact, just over three-quarters of Americans have never heard of QAnon. But while QAnon encompasses a lot of truly wild conspiracies, at its heart, View says, is “pervasive institutional distrust”: a belief that “the whole of mainstream media, the whole of the political system is entirely, irredeemably corrupt.” And in the era of Donald Trump, that kind of populist messaging plays really, really well with the Republican primary electorate. (Not only with Republicans — as the Atlantic’s David A. Graham points out, voters of all stripes can be conspiracy-prone, and our current political environment isn’t helping. But the Satanic-pedophilia stuff is basically only a thing in on the extreme fringes of the GOP.) Tipton, the Republican incumbent Boebert defeated, was endorsed by Trump — but Brookie argues that that endorsement was in name only. “From an ideological standpoint, candidates like Boebert tend to play to the kind of basest parts of Trump’s base, which his rhetoric has consistently promoted, endorsed, amplified,” Brookie said. “So a victory of a candidate like Boebert can’t be seen as anything other than an extension of Donald Trump’s influence on the Republican Party.” In other words, elements of the worldview underpinning QAnon don’t look all that different from what’s coming from the top of the ticket — which would explain the prevalence of QAnon signs at Trump rallies. just some extremely normal people at an extremely normal political rally for an extremely normal president— Andrew Kirell (@AndrewKirell) July 31, 2018 The result is a fairly widespread acceptance of — or at least an openness to — it and other conspiracy theories. For example, a Yahoo News/YouGov poll in late May found that “half of all Americans who name Fox News as their primary TV news source believe the conspiracy theory (that Bill Gates wants to use mass vaccination to implant microchips), and 44 percent of voters who cast ballots for Trump in 2016 do as well.” "Half of all Americans who name Fox News as their primary TV news source believe the conspiracy theory (that Bill Gates wants to use mass vaccination to implant microchips), and 44 percent of voters who cast ballots for Trump in 2016 do as well."— Ben Collins (@oneunderscore__) May 22, 2020 As NBC’s Ben Collins points out, that’s not a theory that Fox ever boosted. But the channel has “spent the pandemic sowing constant distrust in disease experts, leaving a gaping hole for answers that’s been filled by opportunistic, algorithm-gaming grifters online.” And it’s not too much of a jump from a conspiracy theory about Bill Gates and vaccines to QAnon. According to View, QAnon functions as “a meta-conspiracy theory that can connect with every other sort of conspiratorial narrative,” however out there it might be. Republicans also haven’t been especially proactive in condemning QAnon when it crops up in candidates. After Boebert’s win, the National Republican Congressional Committee reiterated its support for her. When asked by the Democratic Congressional Campaign Committee if it intended to disavow Boebert, the NRCC said in a statement shared on Twitter by Huffington Post reporter Kevin Robillard that “we’ll get back to you when Cheri Bustos and the DCCC disavow dangerous conspiracy theorists like Nancy Pelosi and Adam Schiff.” View says that failure to forcefully condemn the conspiracy theory means that QAnon is likely to stick around in the Republican Party: “Anything short of a clear, forceful repudiation,” he said, “they will take as acceptance.” It’s unclear how Boebert’s hardline populism and flirtations with QAnon might hold up come November, though. It worked out well for her in the primary — she becomes one of just a small handful of candidates to successfully oust an incumbent of their own party this cycle — but Anand Sokhey, a professor of political science at the University of Colorado Boulder, isn’t so sure the same will be true in the general election. “I think it’s very competitive now,” Sokhey said. “It looks like it’s certainly possible for the Democratic candidate, Diane Mitsch Bush, to run strong in that district where we normally wouldn’t have thought it would have been possible.” Support Vox’s explanatory journalism Every day at Vox, we aim to answer your most important questions and provide you, and our audience around the world, with information that has the power to save lives. Our mission has never been more vital than it is in this moment: to empower you through understanding. Vox’s work is reaching more people than ever, but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn. Your financial contribution will not constitute a donation, but it will enable our staff to continue to offer free articles, videos, and podcasts at the quality and volume that this moment requires. Please consider making a contribution to Vox today.
The Pandemic Should Change the Way We Talk About Dying
I am a resident emergency physician in New York City, and I’ve lost count of the number of times I’ve had to pick up the phone to inform the family of a patient with the coronavirus that their loved one was close to death. Recently, when an elderly woman arrived with what my colleagues and I identified as severe COVID-19, her prognosis was grave. I went to the ambulance bay, away from the cacophony of the emergency department, to call her relatives to tell them that even our most advanced interventions would not help her. The news was understandably difficult to absorb. The family reflexively asked us to “do everything,” rather than heeding the gentle recommendation that we focus on preserving her comfort.We placed a tube in her throat to connect her to a ventilator, inserted catheters in her veins to administer medications that would sustain her heart, and performed chest compressions to temporarily supply blood to her vital organs. Our team tried for 45 minutes to resuscitate the patient as her lungs and heart gave out.[Amitha Kalaichandran: We’re not ready for this kind of grief]The number of coronavirus cases in New York City has declined, but COVID-19 is on the rise in many other states. Doctors across the country are in the same situation I was in just a few weeks ago—overwhelmed by a large number of patients whose conditions deteriorate rapidly, and responsible for guiding relatives who must make incredibly important decisions over the phone. I wonder whether people are receiving the type of care they truly wish for in their final moments of life and what can be done to preserve a dying patient’s autonomy during this pandemic. Advance directives are one of the most important gifts people can give to their loved ones before they die. But few people actually have them in place.Discussing our own death with those we love and with health-care providers, let alone confronting it ourselves, is difficult. Yet death is a part of life, and planning for it can help those you love.My family’s confrontations with unexpected death inform the way I think about caring for critically ill patients. When I was 9, complications from a perforated intestine, sudden lung failure, and multiple strokes nearly killed my father. In the face of tremendous odds, he survived to lead a semi-independent life, before dying from a heart attack 15 years later.[Listen to Social Distance: You should have an advance directive]That experience shaped how my mother and I approached her own advancing liver disease as I entered adulthood. We took time to discuss what it meant to her to be alive: to laugh with others, share a drink or meal together, and meaningfully interact with the world. She decided that, if her condition was irreparable, she wouldn’t want to be kept alive on life support. Days before she was supposed to board a flight to New York City for specialist care, she suffered a massive stroke. A helicopter transported her to a hospital with neurosurgical capabilities as I rushed to be with her.When I arrived, she was different, not “there”—dependent on the same machine to breathe and medications that my COVID-19 patients are now on. Even so, her heart kept pumping as her breathing was maintained by the ventilator.I was an emergency medical technician at the time, able to grasp the reality of her dire condition, and yet I still doubted myself. As her only child and legal next of kin, was I to allow her to die when there was even an infinitesimal chance that things could be different? Could she survive like my dad did years before?[Steven McDonald: No one is supporting the doctors]I didn’t have to make any of these heart-wrenching decisions. My mom had prepared me for the worst day of my life. I was equipped with her advance directive, stating that after a short trial of invasive measures, she did not wish to remain on life support. She was made comfortable with medications. After the machines were disconnected and her heart stopped beating naturally, doctors did not perform chest compressions or any further interventions. For the rest of my life, I’ll live in gratitude for her last, invaluable gift—readying us both for her death before it happened.Six years later, my patients and their families are facing the sudden decline that can occur in people with COVID-19, and many are not prepared. Before the pandemic, my colleagues and I conducted end-of-life conversations or delivered bad news over the phone only in very rare circumstances. I would take a patient’s family to a quiet room, sit face-to-face with them, and offer a hand to hold. Now the comfort I can offer the family, in some cases living mere blocks away, is limited, since relatives are rarely allowed in the hospital during coronavirus surges. Such restrictions exist for everyone’s safety, but they can make end-of-life decisions that much more difficult. When family members see the physical condition of their loved one, that’s often when the gravity of an acute situation truly sinks in. Without witnessing this reality, disbelief is common. “You can’t be talking about my dad,” one family member said to me over the phone. “There’s no way you have the right person. Please tell me this is a mistake.” No one should be making decisions about end-of-life care under such stressful circumstances.In the absence of an advance directive, physicians always “do everything” to save someone’s life; it is our ethical and legal mandate. But in the final days or hours of an illness, when the body is permanently failing, disrupting the dying process without an advance directive in place can feel especially troubling. CPR is not like it is in the movies. Effective chest compressions, for instance, regularly break ribs. Invasive measures are justified when a patient has decided that they want them—and many patients choose that route. But they aren’t what everyone might wish for as they lie dying. When I know a patient’s wishes, I can work with a family to achieve them, even over the phone. In the end, I want my patients to die with dignity, whatever that means to them.End-of-life conversations are hard. Yet the coronavirus is with us, and we should use this period of collective grief and suffering to reflect and plan. A patient’s wishes, written in the form of an advance directive and made known to those who would make decisions for her in the event she’s unable to, can empower those she loves most and offer some certainty during one of the most challenging times in their life.
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