The Syrian president isnt the first physician to kill. But there is something galling about someone who is trained to save lives taking them instead

Preparing dinner, I bite my tongue as images of the most recent inhumanity in Syria twinklings on the screen.

Isnt he a doctor too? my daughter asks.

Yes, I grovel at the too and rededicate myself to the carrots.

But she knows that conversations about medication are usually far more animated in our household and immediately sniffs out my reticence.

I dont get it. Arent physicians supposed to aid people?

Since its too late to switch channels, I say something benign. But the footage continues, leaving her to conclude, I guess not all physicians save lives.

The heart-wrenchingly succinct statement goes to the heart of my own dismay at the appalling crisis in Syria. More than 400,000 dead ,~ ATAGEND most recently in a nerve gas strike. Six million citizens internally displaced. Five million refugees fled to neighboring countries. An entire country in spasms. And to add to the unspeakable tragedy, at the hands of a president who used to be a doctor. Not only a theoretical physician , not one of the individuals who enrolled in medical school but never touched a patient. No, Bashar al-Assad was a proper physician who by all accounts was personable and polite.

A doctor who investigated first at the prestigious Damascus University, then committed to post-graduate training and finally went to London to gain farther experience in ophthalmology, a niche medical specialty with many aspirants and limited places. A physician whose boss remembered him as humble and whom nurses guessed exemplary in reassuring anxious patients about to undergo anaesthetic.

To his medical class he was unassuming, seemingly unaffected by his status. Perhaps he had fastened admission in the way of other entitled offspring, through power and privilege, but he seemed to be at ease with the responsibilities of being a doctor.

Some classmates retained their distance, wary of the dictator-fathers long reach. Some suspected he didnt have it in him to be a leader, but then, the world wants good adherents and it would have been quite normal for Assad to have settled in a leafy corner of London and practised his aircraft. Not necessarily groundbreaking stuff, but solid, dependable, everyday medication that alleviated the agony of many. No one thought he would turn out a mass murderer.

Upon becoming president, he returned to London with his glamorous and attained wife, herself a cardiologists daughter, who presumably possessed insight into a medical doctor obligations. At his old eye hospital, he appeared longingly at a slit-lamp and fondly remembered his medical teach.

When he was remembered home, Syria was in the clutches of a uprising, Sunni opposing Shia against a backdrop of roiling tensions in the Middle East. Perhaps Assad, the urbane, London-educated ophthalmologist who spoke of Syrias own democratic experience, would be the peoples of the territories advocate, the agent of change. But alas, the Damascus spring didnt last and Assad the kindly physician transformed into Assad the feared killer.

Revulsion at the horrific abuses perpetrated by the Nazi physicians Josef Mengele most infamous among them led to the development of the Nuremberg Code, which govern the ethics of human experimentation. Radovan Karadiwas a psychiatrist and a poet before being convicted of genocide in the former Yugoslavia. British physician Harold Shipman injected lethal drugs into more than 200 patients, and American cardiologist Conrad Murray was convicted of murder after injecting Michael Jackson with the anaesthetic agent, propofol.

History has witnessed other doctors became rascal but Assads attack on his own people is staggering by any criterion. He has moved from bombing civilians to destroying entire hospitals, and whatever and whoever lies in their wake. Virtually 800 medical personnel have been killed and many others detained and tortured. Four hundred medical facilities lie in ruins, their hapless occupants either dead or badly injured.

Entire cities have been left without medical aid, turning treatable hurts into fatal weaves. The United nations organization has pleaded that even war has regulations but experts say that no previous war has witnessed such deliberate, systematic aimed at providing medical facilities and health professionals.

It defies belief, but in a way it attains appreciation, that a doctor who once felt the pulsing of people, knows that the way to still that pulse is by aiming his strongest weapons at the hospitals that keep people alive and give them hope. It would take a doctor to predict the psychological devastation and desperate resignation of a people robbed of gauze for a bleed weave, antibiotics for a festering sore, surgery for a lodged bullet.

There are interesting opinions on how a person who had once pledged to save lives could so wantonly destroy them. Perhaps he is striving to prove himself to his dead parent who had openly preferred his older son who died in a car accident while Assad was becoming an ophthalmologist. The younger Assad was razzed for being interested in human blood rather than the blood of politics this is the revenge of the bullied.

Or more chillingly, all that medical teach was just a prove and behind the suave expert lay a assassin who ever had the measure of his power. Medical teaching necessarily inures physicians to ache and agony: see how inefficient a doctor would be if he faltered at a patients every tear and wept over every weave. Proportion of becoming a good physician is to learn to stand back enough to help, but most physicians experience a continual tightrope in preserving health professionals boundary while being empathetic. Perhaps Assad only dumped the empathy while fortifying the boundary.

Doctors around the world consider Assads deeds with dismay and horror. They know how many of their colleagues leave medicine for far, far smaller reasons than killing a patient. Most physicians cant bear having a stain on their conscience for “re missing a” diagnosis or misprescribing a drug, never mind that the patient wasnt even hurt. Doctors take their own lives at the mere thought that they did something wrong. It beggars belief that someone who was once one of them could so systematically and remorselessly kill his own classmates and their patients.

History will diagnose Assad one day but in the meantime, when I discover my Syrian patients I cant help wondering whether to only treat their illness or acknowledge their deeper weaves. Their fragility is obvious as is their concern and dishonor.

Assads crimes against humanity seem distant until “they il be” personalised in the form of a son, a mom, a neighbor. The easiest answer is to feel helpless and stay silent but it only doesnt feel right. Another is to express solidarity with our fellow human beings even as they live unrecognisable lives in distant lands. This, too, can feel inadequate in the face of punitive government policies. A third is to support the courageous professionals and the organisations that are determined to stay put in Syria against the odds. Most of us wont going to see Syria because we are not skilled or capable of working in dangerous and impoverished specifies. But we can be effective through donating to believable charities, such as the Red Cross, The White Helmets and Mdecins Sans Frontires, who can channel our aid where it is needed.

Our gestures can seem insignificant in the face of so great a tragedy but I hope it says to the Syrian people that while their own physician president has given up on them, the rest of the world has not.

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