Baquer Namazi is an urgent American foreign policy crisis, even if his case isn’t in the headlines yet. On January 28th, the 81-year-old Namazi, who is a US citizen and a former high-ranking official with UNICEF, was granted a temporary medical release from Tehran’s Evin prison, where he has been held without even the pretense of due process since February of 2016. On February 6th, just four days into his furlough, Namazi’s son, a Dubai-based lawyer named Babak Namazi, called a press conference in Washington, DC to announce that his father had been forced to return to prison despite a recommendation from a government medical examiner that he be allowed out for a minimum of three months. The decision to release a frail elderly man from prison simply to recall him four days later was “a spectacular display of cruelty,” Babak said. Jared Genser, the Namazi family’s US lawyer, called the the elder Namazi’s return to Evin “a stunning development, tantamount to a death sentence that will be imposed quickly.”

The Iranian regime intends to push an 81-year-old right to the brink of death, and possibly over it. That’s hardly where the depravity of this story ends. In October of 2015, Baquer’s other son, Siamak Namazi, a Dubai-based consultant and advocate of closer relations between the US and Iran as well as a US citizen himself, was arrested in Tehran and charged with espionage. Both father and son have been sentenced to ten years in prison. Siamak had advocated for the relaxing of international sanctions that he claimed were limiting the importation of medicine into the country. At the February 6th press conference, Babak revealed that his brother has been tortured in prison, and “subjected to very cruel treatment, which he has only shared recently.” In a statement from Baquer Namazi that Babak read at the press conference, the elderly man wrote, “My son Siamak has suffered far more than myself.”

Baquer continued that Siamak “pays the price for standing up for the right of Iranian people to life-saving medicine, previously denied by sanctions.” This alludes to the standard theory that Siamak is being punished for trying to foster closer relations between the US and Iran, a development which more hardline factions and centers of power in the regime supposedly view as a threat to their political and economic position. When I met Babak Namazi and Genser in New York last Friday, Babak said he had no idea why his family was being persecuted. “The only reason that they have been detained is to be used as part of some complex web or game or whatever it is that the Iranian government has come up with, and it is victimizing my family as part of it.”

But Tehran’s motives matter less than its actions. On Friday, Babak told me that on his father’s first day back in prison last week, his heart rate plunged and he had to be rushed to the prison infirmary on a stretcher. “This is literally fighting for my father’s life,” he said. Genser added that a resolution “has to happen very quickly.” The Iranians, however, are not treating the situation as a short-term crisis. At last week’s press conference, Genser emphasized that the Iranians have shown no willingness to even negotiate for the Namazis’ release. “The resistance here is on the side of the Government of Iran and not the side of the US in getting these cases resolved,” Genser said. 

On Friday, Babak reiterated that the regime in Tehran “did not see this as an emergency.” This could turn out to be a grave miscalculation on the regime’s part. Relations are cooling between the US and Iran, and affecting the grotesquely cruel death of an elderly and arbitrarily imprisoned American citizen will undoubtedly undermine some of the remaining logic for the US continuing its current policies with the regime. The death of college student Otto Warmbier after being released from custody in North Korea last year likely reduced America’s appetite for allowing hostile foreign regimes to ransom US citizens. Baquer’s death would further expose this tactic as a means of humiliating the US and testing the country’s resolve, as well as a fairly blunt form of blackmail.

With additional sanctions against Iran percolating in Congress and the nuclear deal’s future uncertain, Baquer’s death could threaten an already tense status quo. Then again, Iran’s resistance to even negotiating over the Namazis raises the question of how much that status quo is really worth. As the Wall Street Journal reported last week, the US offered Iran a channel to discuss possible prisoner releases last in December, but has not gotten a response from Tehran yet.

Iran doesn’t view Baquer Namazi’s imprisonment as the unfolding and impending crisis that it is. Then again, it’s unclear that the Trump administration views it that way either. On Friday, Genser emphasized that US has remained engaged on the issue, and it’s clear that the Namazi family has gotten through to decision makers in both the executive and legislative branch, as well as to high-ranking officials at the UN, Baquer’s former employer. But as Genser explained, there’s no White House war room aimed at formulating and executing a plan for ending Baquer and Siamak’s imprisonment. “They have been working this issue diligently over the last year in a whole range of ways both public and private,” Genser said of the Trump administration. “What we’ve complained about and are continuing to be concerned about is the lack of a clear leader of the team responsible for bringing the American citizen hostages home, which we just have not had.” Genser added that there were “lots of things happening in lots of different directions,” but without “a coherent strategy” to free US hostages.

Even this represents an improvement of sorts. Whatever the shortcomings of the Trump administration’s approach, at least the White House has created conditions in which the Namazis are comfortable advocating for their family in public. That, Babak Namazi recalled, wasn’t the case under Obama. “I was advised very strongly, in the strongest terms possible, that I should not take a public profile,” Namazi said. “I put my entire trust and confidence in the Obama administration and the person of Secretary [of state John] Kerry who advised me that any publicity would undermine the release of my family.”

Babak’s trust was poorly repaid. On January 16, 2016, the US secured the release of five American citizens detained held in Iran, in return for dropping charges against several Iranian citizens and releasing a $400 million payment that the US technically owed to Iran under an earlier court decision but which a succession of US presidents had declined to send to the Islamic Republic regime. Siamak Namazis wasn’t part of the deal. Babak says he found out on television the day the release was announced that his brother would remain in prison. “I was not informed ahead of time. I also had a difficult time talking to someone within the first 24 hours and I got a very strong sense that I’m being avoided.”

Namazi says that he doesn’t know why his brother wasn’t part of the prisoner exchange, and that it’s a question he’s “been tormented by every day.” But one explanation he’s heard is that Kerry “had the assurance of [Iranian foreign minister Javad] Zarif that my brother would be released imminently, and that therefore it’s not an issue. Of course I was astonished that that promise was sufficient…My brother was intentionally and recklessly left behind—and on mere promises from people that have never had a successful history of living up to those promises.” Instead of releasing his brother, the next month the regime arrested Siamak’s father Baquer Namazi. Zarif even falsely claimed that Baquer wasn’t being held in prison during a July 2017 interview with CBS News.

Freeing the Namazis means making an unlikely deal with a regime whose actions now seem calibrated for maximal cruelty and recklessness. On February 10th, Israel shot down an Iranian drone that had penetrated its airspace . The aircraft had been launched from a base in Syria, and in response Israel claimed it took out half of the Iran-allied Assad-regime’s air defenses. The incident, like Baquer’s return to Evin prison, may be part of an emerging trend of even greater confrontation between Iran and its perceived enemies. Breaking through to the Iranians under these circumstances will be a steep challenge for the Trump administration, but at least one U.S. citizen’s life my depend on it.