If the war in Iraq were a disease, it would be diabetes, the chronic illness that slowly ravages the health while causing relatively little pain. Past the headlines of the war and the devastating losses suffered by the wounded and the dead, much of the other damage and costs to this nation are largely painless and hidden from view. This is the same catastrophe of hidden consequences that also characterizes diabetes, and as diabetes does to its victims, the war is slowly and quietly eating away at the health of this nation.

It is easy to underestimate the cost of the war in Iraq because it is a small war. American troops have suffered fewer casualties there in five years than they suffered on Iwo Jima in four weeks during World War II. Like diabetes, however, once you get down to the microscopic level, or in the war’s case, past the headlines, the damage from the Iraq war is tremendous.

The impact on the American military, for example, is approaching unbearable. Despite the valor of its men and women and its successes, even its generals say the Army is being ground down in Iraq and the military has lost its ability to fight another war anywhere else at the same time. More than 29,000 military personnel have been physically wounded, and at least one in five of those who have returned suffer from depression or other mental illness brought on by repeated tours of duty in Iraq. Among those injured are more than 600 with limb amputations, another parallel to diabetes as it is the most common reason for limb amputation in America.

The war is consuming billions of taxpayer dollars desperately needed elsewhere, including dollars for the repair of old roads and bridges, military equipment and training, health insurance for children, food stamps for the poor, research and development, health care for veterans, and much more.

These costs are a striking parallel between the war and the disease; both cost the American economy about $12 billion a month and at least $150 billion a year. Despite the magnitude of those financial costs we barely feel them much because they are spread out for all to pay, and are hidden among other costs. Moreover, there are no new taxes being raised to fight the war or diabetes, so there is no easily identified financial pain associated with the costs.

The war is not just consuming money we need; it is consuming our political attention and capital at a time when we need our political leaders to be focused on soaring energy costs, a tanking economy and dollar, global warming, unconstrained health care costs, and job losses in a changing world economy, to name a few things. Every discussion we have about the war means a conversation we did not have about some other important issue.

This all points out another striking parallel: Both the war and diabetes cause huge amounts of silent damage. Because it damages blood vessels everywhere, diabetes silently damages eyes, the kidneys, the limbs, the heart, and much more. Nerve damage it causes results in numbness in hands and feet, blood vessel damage causes atherosclerosis of arteries to the heart and elsewhere, and retina damage causes blindness. It is a kind of creeping death that only in its later stages causes great pain and misery. It is so silent that some 6 million Americans have diabetes and don’t know it.

The relative silent character of the damage wrought by the war on the nation, and by diabetes on the body, contributes to our ability to ignore the harm being done. If there is no crisis, there is no need to change what we are doing. If we do not have to pay for the war now, and can simply put off other needs or add the cost to the national debt, our leaders don’t need to raise taxes on us to pay for the war. If hundreds of thousands of mentally ill soldiers just go home and disappear from view, our armed forces appear to suffer fewer casualties than they really do and the public does not recognize the need to substantially curtail an unsustainable troop level in Iraq. If diabetes is a painless disease that does not seem to be harming us right now, we do not need to diet, exercise or lose weight.

None of this is to argue for or against the war. Wars such as that in Iraq are fought in the moment but are ultimately judged by history. Indeed, as I have said in this column, we may be stuck there now regardless of the consequences because leaving may cause more harm than staying.

It is to say, however, that in arguing about whether the war is worth the cost we must recognize its true cost. Otherwise, similar to diabetes, when we finally recognize the full extent of the damage the war is quietly doing to us, it will be too late. Our feet will be too numb to walk abroad with confidence in these troubled times, our economy will be sclerotic, our vision will be too hazy to see clearly in a chaotic world, and our national heart will ache for a lifetime.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region.