The practice of triage in dealing with medical patients especially under emergency conditions was first formalized by French doctors during World War I. Patients are divided (hence, trier, to separate or sort) into one of three categories:
- patients who are likely to live, regardless of whether they receive immediate treatment
- patients who are likely to die, even if they receive immediate treatment
- patients for whom immediate treatment can improve their likelihood of recovery
I’m sure my physician readers will correct my diction.
The practice of triage requires two related skills: you’ve got to be able to assess a patient’s condition quickly and accurately and you’ve got to be able to assess realistically and accurately the effects of likely treatment.
In his column this morning Bob Herbert takes note of the Obama Administration’s problems in determining the relative importance of their priorities:
If I were a close adviser of President Obamaâ€™s, I would say to him, â€œMr. President, you have two urgent and overwhelming tasks in front of you: to put Americans trapped in this terrible employment crisis back to work and to put the brakes on your potentially disastrous plan to escalate the war in Afghanistan.â€
While I may not agree with Mr. Herbert’s prescriptions, I agree with his priorities. But I think that the Administration has a problem with triage.
I have sympathy for their predicament. They have an enormous number of very grave problems on their plate. They’re eager to blame their immediate predecessors for many of them but I think that in fact many of the problems, e.g. the financial crisis, the looming crisis in healthcare, global warming, and so on, have their roots in bad policy decisions made over a period of twenty, thirty, or more years by Republican presidents and Democratic presidents, under Republican Congresses and Democratic Congresses. Additionally, I think that it’s fairly retorted that President Obama sought these challenges.
The economy is the fundamental problem of problems. Need I repeat It’s the economy, stupid!? If the economy continues to weaken over the next three years as it has done for the first year of President Obama’s term, he will have no second term in which to tackle the pressing problems. That what the Administration can do may be very limited or even counter-productive does not absolve President Obama from the appearance of taking determined action. If the economy does not recover at least somewhat during his administration, his successor may have the luxury of blaming his predecessor for the country’s economic woes while taking credit for an inevitable recovery.
While Afghanistan has no strategic importance (so long as Al Qaeda isn’t there), what we do there does. If our allies leave due to flagging American support, it will place the future of NATO in serious doubt and with it the heart of our foreign policy. If we simply leave Afghanistan, it will provide more evidence to our enemies that America is a weak foe and a worse friend. If we escalate our efforts in Afghanistan, we run the risk of sinking vast sums, lives, and energies into the potentially hopeless task of making a nation out of a group of none too friendly tribes.
They say that impending doom does wonders to concentrate the mind. So far that doesn’t seem to be the case with the Obama Administration. From that I speculate that either they don’t see these conditions as being as serious as I do (and Bob Herbert does) or they don’t have the ability to establish relative priorities.
Whether they have the ability to assess the effects of their prescriptions realistically and accurately is the subject of another post.