Britain hasn't been "diminished" by the Syria vote, it has been enhanced

We should feel proud of a Parliament that seeks to be cautious in matters of war and peace, rather than gung-ho.

You can tell things have changed on the global stage when Lord Ashdown, the granddaddy of modern British politics, uses Twitter to profess his latest thoughts: "We are a hugely diminished country this am. MPs cheered last night. Assad, Putin this morning. Farage too as we plunge towards isolationism."

Ashdown’s tweet is something of a weird contradiction: the man has embraced the modern form of communication but not embraced the modern role of Britain in international relations, namely, we just aren’t that big and important anymore.

Moreover, his idea that we are a "diminished" country is something which will be reiterated by hoards of pro-interventionists in the coming days, and yet all of them will proffer no description for why any of us should care. George Osborne followed Ashdown by stating that the House of Commons vote against action in Syria would prompt "national soul-searching" about Britain's role on the world stage.

The question is: why should we care? Why does our inability to enter a foreign country, be it with troops on the ground or bombers in the sky, affect our day-to-day lives? Should we all now have a national conversation about our diminished soul? Are millions of office workers hovering around office water coolers this Friday and not discussing their weekend plans but rather asking themselves, what does it mean to be British?

Just as Polly Toynbee argued in today’s Guardian, this imperialistic undertone to those angry at yesterday’s vote is anachronistic. She called it "a long-delayed acceptance that Britain is less powerful and poorer than it was, weary of wars and no longer proud to punch above its weight. No more pretending, no more posturing."

The individuals who bemoan our falling status ignore that our great status came with greed, bloodshed and racism. We may have ruled a third of the world’s population at one stage, but they really didn’t like having us in charge. An intervention in Syria isn’t going to renew our world status, for we all know China, India, Brazil and others are growing and will soon become the biggest economies, and with it, the greatest militarily.

The pro-interventionists still seem to feel patriotism comes from conflict; the individuals who think Gibraltar and the Falklands – lands they never visit, with people who hardly pay any taxes – are the last bastions of British might. If this Syrian episode diminishes our standing, will we lose these last vestiges of British imperialism? Who cares? We won’t have to spend so much money on defence for two islands that don’t pay for it.

Just as the Iraq war didn’t make us a renewed force on the international stage, a missile strike in Syria won’t show our military strength or rejuvenate our moral standing. This has to be accepted, but it doesn’t need to be met with shame, tears or tantrums. We can all go on with our day-to-day activities; we can even perhaps focus on our own economy, our welfare state, even the NHS. Things carry on when we’re not a superpower. We can rejoice in not punching above our weight, or, as rebel Tory MP Crispin Blunt said, we can "relieve ourselves of some of those imperial pretensions."

This does not mean that the events in Syria are not despicable, nor that intervention may be necessary at some point from the US or from other bodies. But the argument that we are diminished as a nation is absurd. If anything, we in Britain today feel prouder of a Parliament that seeks to be cautious in these matters, rather than gung-ho. Yesterday Parliament won, not Palmerston.

Britannia was mighty when she ruled the waves. But wars aren’t fought on the seas anymore, and I’m okay with that. 

The Houses of Parliament yesterday as MPs debated the possibility of military action against Syria. Photograph: Getty Images.

Kiran Moodley is a freelance journalist at CNBC who has written for GQ, the Atlantic, PBS NewsHour and The Daily Beast.

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The surprising truth about ingrowing toenails (and other medical myths)

Medicine is littered with myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery.

From time to time, I remove patients’ ingrowing toenails. This is done to help – the condition can be intractably painful – but it would be barbaric were it not for anaesthesia. A toe or finger can be rendered completely numb by a ring block – local anaesthetic injected either side of the base of the digit, knocking out the nerves that supply sensation.

The local anaesthetic I use for most surgical procedures is ready-mixed with adrenalin, which constricts the arteries and thereby reduces bleeding in the surgical field, but ever since medical school I’ve had it drummed into me that using adrenalin is a complete no-no when it comes to ring blocks. The adrenalin cuts off the blood supply to the end of the digit (so the story goes), resulting in tissue death and gangrene.

So, before performing any ring block, my practice nurse and I go through an elaborate double-check procedure to ensure that the injection I’m about to use is “plain” local anaesthetic with no adrenalin. This same ritual is observed in hospitals and doctors’ surgeries around the world.

So, imagine my surprise to learn recently that this is a myth. The idea dates back at least a century, to when doctors frequently found digits turning gangrenous after ring blocks. The obvious conclusion – that artery-constricting adrenalin was responsible – dictates practice to this day. In recent years, however, the dogma has been questioned. The effect of adrenalin is partial and short-lived; could it really be causing such catastrophic outcomes?

Retrospective studies of digital gangrene after ring block identified that adrenalin was actually used in less than half of the cases. Rather, other factors, including the drastic measures employed to try to prevent infection in the pre-antibiotic era, seem likely to have been the culprits. Emboldened by these findings, surgeons in America undertook cautious trials to investigate using adrenalin in ring blocks. They found that it caused no tissue damage, and made surgery technically easier.

Those trials date back 15 years yet they’ve only just filtered through, which illustrates how long it takes for new thinking to become disseminated. So far, a few doctors, mainly those in the field of plastic surgery, have changed their practice, but most of us continue to eschew adrenalin.

Medicine is littered with such myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery. Until the mid-1970s, breast cancer was routinely treated with radical mastectomy, a disfiguring operation that removed huge quantities of tissue, in the belief that this produced the greatest chance of cure. These days, we know that conservative surgery is at least as effective, and causes far less psychological trauma. Seizures can happen in young children with feverish illnesses, so for decades we placed great emphasis on keeping the patient’s temperature down. We now know that controlling fever makes no difference: the fits are caused by other chemicals released during an infection.

Myths arise when something appears to make sense according to the best understanding we have at the time. In all cases, practice has run far ahead of objective, repeatable science. It is only years after a myth has taken hold that scientific evaluation shows us to have charged off down a blind alley.

Myths are powerful and hard to uproot, even once the science is established. I operated on a toenail just the other week and still baulked at using adrenalin – partly my own superstition, and partly to save my practice nurse from a heart attack. What would it have been like as a pioneering surgeon in the 1970s, treating breast cancer with a simple lumpectomy while most of your colleagues believed you were being reckless with your patients’ future health? Decades of dire warnings create a hefty weight to overturn.

Only once a good proportion of the medical herd has changed course do most of us feel confident to follow suit. 

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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