In Afghanistan, learning the wrong lessons from Bin Laden

Good story in today's Washington Post about whether the Afghanistan war is worth the cost. But even the folks who want to reduce the American footprint there don't seem to have a full grasp of the bigger picture:

Civilian officials argue that recent gains against the Taliban and al-Qaeda have largely been the result of a counterterrorism strategy implemented by Special Operations forces, not the costly, large-footprint counterinsurgency mission that aims to secure the country district by district. Reducing conventional forces, some civilians assert, will not fundamentally alter the calculus that has led to interest among Taliban leaders in exploring peace talks with the Afghan government and U.S. representatives.

“Our mission is to disrupt and dismantle al-Qaeda, and what the bin Laden killing shows us is that you can do that with a small number of highly skilled guys,” the second senior official said. “You don’t need Army and Marine battalions in dozens of districts.”

I think you ought to go a step further and say this: What the bin Laden killing shows us is that you don't need to tie yourself down in Afghanistan if your focus is on Al Qaeda. Bin Laden was killed in Pakistan! Maybe, at this point, America's bases in Afghanistan are designed to prosecute anti-terror operations in Pakistan. But the mission—destroy a small, nimble, stateless group—and the strategy—tie down tens of thousands of troops in a single country—don't fit each other. Per the WaPo story, we probably can't afford to sustain our Afghanistan commitment. But even if we could, that doesn't make it the smart play.

Philadelphia cops want to run the city without living here

I'm not fond of this idea, frankly:

The Fraternal Order of Police Lodge 5 is taking Mayor Nutter and the city's Ethics Board to court.

FOP president John McNesby said the union filed a civil lawsuit against the city last week over a decades-old rule that prohibits cops from making political donations.

The police union is the only one in the city that can't make donations to politicians or to a political-action committee.

"We're treated like second-class citizens," McNesby said. "Enough is enough."

The FOP is clearly one of the city's power-brokers, so maybe it's pointless to complain about the union putting its money where it's mouth is. And certainly, I'm not generally one to oppose unions—even municipal unions—acting in the political realm.

It's just that McNesby's "second-class citizens" comment sticks in my craw a bit. After all, McNesby won for his union the right for cops not to have to live in the city limits. That has always been a bad idea. And the result, when combined with McNesby's new effort, is to create a Philadelphia police force that has sway over the city's politics even if—potentially—a substantial portion of its membership doesn't live here anymore. That bothers me.

It might not bother me so much if the department weren't continually awash in corruption scandals. But it is. From where I sit, it appears that the FOP is seeking to expand its power in the community while continually eluding accountability—both formal, and the informal type that comes from having to live among the people you police. It's a toxic mix, and bad for the rest of us.

David Mamet's conversion to conservatism

Over the weekend, a few of my conservative friends touted this Weekly Standard profile of playwright David Mamet, who is rather famously converting to conservatism. Put aside, for the moment, the spectacle of conservatives who profess to disdain Hollywood high-fiving each other when a celebrity turns out to be Republican. There are hints that Mamet—smart as he is—is motivated more by contrarianism than other factors. You don't have to be dumb to be conservative, but (as represented in the article, anyway) Mamet seems to be guilty of rather shallow thinking.

I'll pluck out two of my favorite examples:

“But I saw the liberals hated George Bush. It was vicious. And I thought about it, and I didn’t get it. He was no worse than the others, was he? And I’d ask my liberal friends, ‘Well, why do you hate him?’ They’d all say: ‘He lied about WMD.’ Okay. You love Kennedy. Kennedy didn’t write Profiles in Courage—he lied about that. ‘Bush is in bed with the Saudis!’ Okay, Kennedy was in bed with the mafia.”

I dunno. Lies are lies, I suppose, but to me there's a vast difference between lying about a best-selling book and, say, misrepresenting and hyping intelligence about non-existent WMDs in order to sell an invasion that will bog your country down in a war for a decade, at great cost and at the expense of thousands of lives. Moreover, while both "lies" might reflect on the character of the particular president, only one seems to have real bearing on governance. That Mamet reduces the two to a kind of equivalency suggests A) an overly simplistic moral imagination and B) a carelessness about what the president actually does.

Next example:

“The question occurs to me quite a lot: What do liberals do when their plans have failed? What did the writers do when their plans led to unemployment, their own and other people’s? One thing they can’t do is admit they failed. Why? To admit failure would endanger their position in the herd.”

This statement comes in a magazine edited by Bill Kristol.

I'm not saying liberals are morally pure, or don't succumb to a herd instinct. But I don't think it's an ideological problem; it's a human nature problem. David Mamet, from what I can tell, is just changing herds. And that's fine. I just wish he'd spare us the sanctimony.

Facebook made my hospital stay less miserable

When the doctors told me they were admitting me to the hospital for surgery, the first thing I did—after calling my wife and parents to let them know how dire things had become—was go to Facebook and Twitter.

Surgery for sure. Apparently this is quite serious and disturbing. This account may be dark awhile.

And I meant it. I assumed that if I wasn't too overcome with pain to care about social networking, then I'd at least choose to be stoic and not inflict the details of my illness upon my friends.

Who was I kidding? I'm not one to endure pain silently—or, really, anything silently. It's why I blog. I'm a compulsive oversharer. Indeed, my first update to Facebook—dictated to my wife, apparently, through a morphine haze—came just a couple of hours after surgery.

Surgery done. Colostomy! Diverticulitis! Pain! (sec:jcm)

And over the next 24 hours, there were 26 comments appended.

Here's the thing: Surgery is an isolating thing. You're taken away from the people you love, drugged and cut open. After that you have days spent watching TV, giving blood, and drifting in and out of consciousness. The pain was the worst thing about surgery; the colostomy bag was the second. The loneliness could've ranked right up there with it.

But it didn't, quite. Because I kept posting, three and four times a day, to both Facebook and Twitter—and, thank God, folks kept posting right back at me.

Just a few hours after my first update, in fact, President Obama took the airwaves to announce the death of Osama bin Laden. Slightly more alert this time—and leaving the TV on around-the-clock to reduce my sense of dislocation—I posted this at 12:40 a.m.:

News flash: Osama bin Laden was hiding in my gut.

Probably not that funny, I realize. But I'd realized that I'd probably be giving folks regular updates on my recovery. And I'm not an optimist. But I didn't want to scare people away. So I figured a few jokes sprinkled in amongst the self-pity might be helpful.

I wrote about the food. I wrote about my roommates. I wrote about feeling sorry for myself. I wrote about the bad TV. And people kept responding. It was absolutely what I needed.

Social networking's limitations were also helpful. I've been writing longer blog posts this week, but while I was in the hospital I could barely stay awake or concentrate for five minutes at a time. (There were a couple of times I actually did fall asleep while updating my social networks, only to snap awake when I dropped my iPhone in my lap.) One-hundred-forty characters allowed me to communicate without spending the kind of energy required from an actual hospital visit. I could dip in and out of the communications stream as I was able.

Does this mean anything? I don't know. I Googled around to see if there was any link between a patient's social networking practices and their health outcomes, but it doesn't look like the kind of thing that's been researched. (Yet.) All I know is that I've had a love-hate relationship with Facebook and Twitter. It's why I invented "Single-Tasking Sundays" for myself.(Suspended for the duration.) But when I went into the hospital, I was able to take all my living relationships with me, staying in conversation and feeling the love. It was great.

So I hate my fucking colostomy

Warning: This is really gross.

When the doctors came to me that Saturday afternoon and told me I was probably going to need surgery, I got weepy. It wasn't the surgery itself that brought tears to my eyes—though knowing that my belly was about to be sliced open wasn't exactly comforting—but what the docs told me was waiting on the other side: a colostomy bag.

Surgery scared me. The colostomy offended me.

There was my vanity, first off all. Who gets colostomies after all? Old guys, that's who, grampas who've had their sexual day in the sun and don't have to worry about looking good and being attractive to the opposite sex. (I'm married and faithful, but I don't want to be repulsive to other women; this made me feel like I'd be repulsive to both my wife and other women.) Young, virile men don't have colostomies. I'm not young exactly—I'm 38—but I suspected the surgery was a too-early arrival in the precincts of the elderly.

Beyond that, though, the problem was literally visceral: Part of my insides would be hanging outside. I'd be carrying a bag of shit on my gut. It would be like walking around as an extra from a zombie movie, only all the time. Or all the time until it's reversed, which I'm told will happen in the first couple of months.

Truth be told, I didn't do very well the first couple of times the nurses emptied the colostomy bag while I was in the hospital. The fact of clearing out my guts through my gut made me lightheaded; the smell made it worse. The nurses told me that I'd have to start emptying my own bag; even more, I'd have to change it myself once I went home—actually wiping my intestines clean before adhering a new bag to myself.

I felt ... petulant.

Complicating matters was the fact that the colostomy wasn't the only hole in my gut. When I went into the hospital—and here is where I might be guilty of oversharing—I hadn't pooped for two weeks. I was distended, my entire gastrointestinal system inflamed to the point of cutting off the blood supply to vital organs. I was so distended, in fact, that when surgeons tried to make the first colostomy hole in me—at the top of my belly, just under my sternum—it didn't work: they couldn't access my intestine. So they tried again an inch down from there, and managed to open up the pipes. I'm told I popped like a zit, two weeks of pressure buildup in my insides suddenly finding a quick, messy release.

The result of the first incision, though, is that I have two holes in my gut: the colostomy, and what I like to call the "superfluous wound." It's about an inch deep and an inch wide, and requires daily dressing. And the nurses told me that this, too, would require my personal care. The prospect filled me with dread.

Fast forward to this morning. I woke up at 6:16 am and—as has become my habit—felt under my shirt to see if the bag had filled overnight and needed emptying. Something worse had happened: It ruptured on the top side; waste was pooling on my chest and around my wound.

We called the nurse's office. One would be coming at 9, my wife was told. But I might want to clean up and dress everything myself before she got there, if I could.

The choice was to replace my colostomy bag and wound dressing, or sit around a couple of hours and let filth leak into my wound. It didn't seem like a real choice.

So I did what I had to do, with the assistance of my wife. First I cleaned my wound, extracting soupy gauze from the hole and packing fresh stuff in, then covering it up with medical tape. Then we found a fresh colostomy bag and cut a hole in it to match the size of my stoma. It was gross. But I was clear-headed—I even took a photo of the whole mess to show the nurse, just in case some visual help was needed later on.

So I'm proud that I could handle situations I'd dreaded. Sometimes you find you're capable of more than you realized because you're forced to do more than you want to.

On the other hand, the incident only exacerbated my anger about parts of the surgery that no doubt saved my life. I hate my fucking colostomy, and I can't wait for it to be fixed.

Notes from surgery: Pain, then the sponge bath

There are almost no visual components to the memories of my first waking moments after surgery. Mostly, I suspect, this is because I was still pretty doped up—and thus mostly unable to open my eyes. What's left is a mishmash of sound and pain.

Pain. I knew before I was even told that the doctor had made two holes in my body, because I could feel them both, individually, one on top of the other on my abdomen, two fingers of fire—no, something worse than fire, because fire can be extinguished and there was nothing to the intensity of agony in my belly that suggested a temporary nature. I screamed—or tried to at least. Most likely I grunted angrily.

It was going to get worse: I still needed to be transferred from the operating table to a recuperation bed. I could hear the nurses around me talking–male and female voices mixing together in a kind of urgent incoherence—and then the sheet below me tighten in a one-two-three! movement to lift me to my new repose. It squeezed my wounds a little. I screamed. "YOU'RE HURTING ME!" I wanted to say, but I don't think I managed actual speech.

And then: blackness.

Soon after, though, a new sensation emerged. I still hurt, still hurt too much to want to endure or survive. But then the sponge touched my skin: someone was cleaning me, a soothing touch in the midst of misery. Along my left leg, up the calf and thigh. And then, finally, up from there. The post-surgical moment when I first thought I might survive occurred when a nurse—whose face I've still never seen, I don't think—oh-so-briefly washed my balls.

There's nothing erotic to this. But the pain had been so thorough, so penetrating—and the warm, sudsy sponge against my testacles made me feel ... loved. And then, blackness again.

Something similar would happen over my next few days in the hospital. Young men wiped my ass. Older women washed me all over. A beautiful young Indian woman showed me how to empty the shit from the bag on my stomach. At one point on my last day—seriously, I'm not making this up—a woman washed my feet while singing Negro spirituals. It was a resonant moment—possibly slightly absurd, but it felt resonant—that did not get me to return to the Christianity of my youth. But that's as clean a shot as anybody will get, most likely.

Losing control over these basic functions, I guess, should make me angry on some level. But for whatever reason, I resigned myself pretty quickly to the idea that I didn't have control of this situation. And so I accepted it: Every ass-wipe was a gift, a step closer to home and recovery.

Where I've been

At the moment, I have a hole in my belly where I do most—but not all!—of my pooping and farting. It's a colostomy. It's also temporary, knock on wood. And it's why I've been absent from my own blog the last two weeks.

There is no official diagnosis: the main suspect is diverticulitis. The surgery that gave me the hole in my belly wasn't trying to fix any underlying problems—it was simply trying to ease the pressure on a gastrointestinal system that was so distended that the blood supply to critical organs was in jeopardy. A colonoscopy and two more surgeries await me. I've been in such pain, post-surgery, that I'm not really happy at the prospect. Gotta get fixed, though.

Absent an official diagnosis, I'm full of self-recrimination, suspecting that a lifetime of bad decisions about my health and life have led inexorably to this moment. I am being judged. And I am judging myself. My uncertainty—and I'm self-aware enough to know this is all probably just post-op depression talking—is wide enough to encompass nearly all the choices I've made the last two decades. I have a loving wife, and a beautiful son, both of whom are burdened by my circumstances. I feel this keenly.

So I don't know what this blog will be for the next couple of months, given A) that my life will be dominated by medical events and B) I've not been able to sustain the attention span for an entire Sports Illustrated article lately, much less keep up with the nuances of politics. And beyond this, I'm not sure what the blog will be anymore because I'm not certain who I will be anymore. This is re-evaluation time: I must ensure that I am living a creditable life. Anything that doesn't add to the balance probably goes by the wayside.