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Gaza

Middle East

1 October 2024

5 min read

The human cost of the Israel-Gaza war

A veteran volunteer surgeon laments a well lived life.

Tim Goodacre

Tim Goodacre is a reconstructive plastic surgeon, and volunteer at a hospital in Gaza.

AbdulRahman at work.

Tim Goodacre.

The Israel-Gaza war rages on. Every few days a new tragedy hits our dulled senses. The West Bank and now Lebanon are getting dragged into the conflict. Palestinians and hostages continue to die, and hunger and disease threaten Gaza's displaced people as autumn and winter approach.

Yet what is often lost is the human face of this conflict. This is the story of one such life.

AbdulRahman was an intelligent, gentle and diligent young third year medical student in his early twenties, with judgement well beyond his peers. Towards the end of 2023, as the war spread more viciously towards southern Gaza, he was one a group of around 10 students who volunteered to join the team of health care workers at the European Gaza Hospital (EGH). I was volunteering there as a reconstructive plastic surgeon and and met him in the hospital.

Both medical schools in Gaza before the war began were in the north alongside their parent universities. They had been destroyed during the onslaught in the early months of fighting. In the southern town of Khan Younis, the EGH was the sole surviving operational facility to which the wounded could be transferred. It was overwhelmed by the vast numbers of families also taking refuge in what was deemed a safer space than most of the surrounding war zone.

Many of the senior medical staff and surgeons had retreated to scattered parts of the strip, displaced frequently by the ever-moving conflict and driven by the need to support their families and stay together. ‘Live together-die together’ is an understandable feature in the horror show of war. Students, frequently left with no money or resources, started to volunteer to serve in hospitals in exchange for a little food and a sense of worth in the work they could offer. Any functioning hospital, if briefly ‘deconflicted’ so they could provide relatively safe care, found itself staffed by a disparate crew of local staff, displaced students, and an indeterminate number of more senior surgeons from both Gaza and humanitarian agencies.

His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.

It was into this chaotic mix that young AbdulRahman walked having fled his family home in the east of Khan Younis in November 2023. A bright young man, with great aspirations to qualify as a surgeon and serve his community, he had spent the first six weeks of the war at home, unable to attend his medical school in Gaza City to the north, but working hard at his studies regardless, using every online and library resource available to him.

At some point in late November, the battle zone moved south, and his family home was shelled along with many dwellings in the vicinity. Caught in crossfire, he sheltered in his neighbouring relative’s house after his parents and other close family had escaped to Rafah.

Abdulrahman told me the dramatic story of his escape into the house in which he survived for a week alongside his relative’s family when I spoke to him in late January 2024. This young man not only survived an ordeal of indescribable fear and potential slaughter, but he was then arrested and interrogated in brutal fashion by IDF forces.

On his release after a harrowing week, he made his way barefoot to the nearest hospital, which happened to be the EGH. In that place of safety, he was given food and water and after recuperation, volunteered to work alongside a reconstructive plastic and burns surgeon who had recently returned to Gaza after training in the UK.

Although his family were still all alive in Rafah in displaced makeshift shelters, he opted to stay and throw his weight into whatever he could do to support the hospital whilst continuing to learn his profession as a doctor. Travelling occasionally at great personal risk to see and support his family, he devoted all his waking hours to surgical work in EGH operating theatres and wards. His excellent command of English made him immensely valuable to any visiting surgeons who managed to access Gaza during the war months. He was always cheerful, always willing to respond to requests for his time, however stressful the surrounding clamour from desperate patients and relatives might become.

When his working day was done, in the middle of the night he would arrange for his fellow students to have informal teaching seminars from whoever he could cajole to deliver them, and would absorb knowledge and ideas about best practice like a sponge. His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.

I had every intention of supporting this fine young man in achieving his professional aspirations by whatever means I could once a ceasefire arose and he could be brought safely to Europe to continue his training.

In the last week of August, AbdulRahman was sheltering in a relative’s house in Khan Younis. In the small hours of the morning an Israeli attack was launched on the neighbourhood and the house took a direct hit. AbdulRahman was killed instantly.

He knew, as does every Gazan in these troubled times, that nowhere was safe, and all lives in that tragic zone are at risk. His is a story of a life tragically cut short, of the randomness and destructiveness of war. His death strikes right at the heart of my hopes for the remnant of the fine young population of such a desperately sad nation state. He, and those like him, could have been at the heart of the re-building of Gaza, able to live in what now feels a far-off peace. I cannot translate this into anger, as AbdulRahman himself had a passionate concern for peace and reconciliation, and never once spoke to me in many conversations of support for Hamas, or of hatred for those who had destroyed his country.

What can be done however, is to honour his life and commitment with similar tenacity in supporting the pursuit of peace, justice for his people, learning and education for the remnant of the nation, and reconstruction of a Palestine that can proudly and honourably reflect the finest values it possesses. AbdulRahman was a great Palestinian, and his all too short life was one which I want to celebrate as one of the finest I have seen in many students of the next generation of doctors. May he rest in peace, and may a lasting peace come quickly to Gaza, to all of Palestine and the whole of the Middle East.

Review

Comment

Morality

23 November 2023

7 min read

Sam Bankman-Fried: doing the math on morality

The calculated character and philanthropy of crypto-criminal Sam Bankman-Fried is analysed by Krish Kandiah, who finds it doesn’t to add up.

Krish Kandiah

Krish is a social entrepreneur partnering across civil society, faith communities, government and philanthropy. He founded The Sanctuary Foundation.

Sam Bankman-Fried at a crypto-conference, 2021.

Cointelegraph, CC BY 3.0, via Wikimedia Commons.

Going Infinite, Michael Lewis’ biography of Sam Bankman-Fried, the world’s youngest self-made billionaire is quite the compelling read.

For a start Lewis has an incredible ability to explain complex economic and business scenarios in a way that is not only accessible, but also gripping. It is no wonder his previous books have been turned into Hollywood blockbusters.

Lewis also has a knack for finding the humanity in almost any given situation. Whether he is writing about the system for picking a world-beating baseball team, the global economic crisis or, in this case, the rise and fall of a cryptocurrency exchange, he delves deep into the characters at the heart of the stories, exposing their strengths and weaknesses, their struggles and values.

The publication of Going Infinite last month also coincided with Bankman-Fried’s real time court case, ending in a guilty verdict for, in the words of US attorney Damian Williams, “one of the biggest financial frauds in American history – a multibillion-dollar scheme designed to make him the king of crypto.”

This fraud centred on Sam Bankman-Fried’s company FTX, a cryptocurrency exchange. It emerged as one of the largest in the world with billions in deposits. All helping Bankman-Fried, aged just 29, to become recognised by Forbes magazine as the 41st richest American.

For all Bankman-Fried’s (and his friends’) talk of altruism, they weren’t very good at being nice to each other.

My personal interest in the man behind the fraud was shaped by three things. Firstly, as an adoptive and foster parent of two children who are on the autistic spectrum, I was interested in what Lewis would say about the common speculation that Bankman-Fried is also on the autistic spectrum.

I was also intrigued by Bankman-Fried’s philosophical approach to philanthropy and how Lewis would present the problems with the movement known as Effective Altruism.

Finally, I was interested in just to what extent Bankman-Fried’s commitment to mathematical algorithms overshadowed his moral awareness, given that it may well ultimately result in a sentence of 100 years behind bars.

Autism

Lewis invites us into as much of the inner world of Bankman-Fried as he can. He writes about his loneliness in childhood and his struggles with social conventions, for example. One particularly powerful moment is when we are allowed to eavesdrop on a video call with Vogue editor Anna Wintour. Bankman-Fried cannot do the call without simultaneously playing a video game. He doesn’t want to see Ms Wintour’s face while she is speaking and only looks at her when he is speaking.

While Lewis readily points to traits that are commonly associated with people on the autistic spectrum – Bankman-Fried’s struggle to comply with social norms and difficulties understanding facial expressions, for example – he avoids using the term “autism”.

It seems that Bankman-Fried himself is aware of his neurodivergent traits and is not afraid to talk about the way they impact his emotional and existential intelligence.

At one point he writes to his girlfriend:

“I don't feel happiness. What's the point in dating someone who you physically can't make happy?"

He went on to say:

“In a lot of ways I don’t really have a soul”

I found statements like these hard to read, but insightful. As a culture we are growing in our understanding and appreciation of a range of areas of diversity, however this has yet to be robustly applied to enable both widespread social acceptance and self-acceptance. The fact that Lewis chooses not to use the term autism may be a symptom of this.

Altruism

Sam Bankman-Fried was a very visible member of the Effective Altruism (EA) movement. EA is a fascinating philosophical approach to philanthropy which challenges individuals to consider their lives in terms of maximising their resources for the benefit of the world. Bankman-Fried’s answer to the question “How can I do most good with my life?” was to plan to earn a very large sum of money, ideally an infinite sum of money, that could then be used to help solve huge global issues such as the threat of nuclear war or another global pandemic.

There are many criticisms of the EA movement, and, Lewis explores several of them during the course of the book. Perhaps most obviously, for all Bankman-Fried’s (and his friends’) talk of altruism, they weren’t very good at being nice to each other. In fact, there was a major falling out between the effective altruists at his first company Alameda Research where half of the employees left because of his leadership style. Charity, it seems, did not begin at home.
It is also unclear how much money Bankman-Fried actually gave away to philanthropic causes. And it is alleged that just a month after FTX collapsed, the company even began trying to claw back the charitable donations it made. According to direct messages on X with journalist Kelsey Piper, Bankman-Fried agreed his ethically-driven approach was "mostly a front".

"Some of this decade's greatest heroes will never be known," he wrote to Piper, "and some of its most beloved people are basically shams."

The quest to do good in the world seemed to have become more like a gambling obsession with Bankman-Fried, a game in which the ends justified the means.

They say the road to hell is paved with good intentions. It is uncertain whether Bankman-Fried had good intentions at all or whether the lure of billions of dollars became so irresistible that whatever virtue once existed was sacrificed to vice.

There was another dark side to Bankman-Fried’s EA philosophy. He seemed to be fascinated by the question of just how far he could go in his calculations of trade-offs and risks in the supposed cause of saving the future of humanity? What was the highest risk he would take? What boundaries would he cross for financial gain? What would need to be sacrificed on the way? The quest to do good in the world seemed to have become more like a gambling obsession with Bankman-Fried, a game in which the ends justified the means.

Automatism

Sam Bankman-Fried was not afraid to be honest about his struggles to process and express empathy in socially acceptable ways. He once said:

"There's a pretty decent argument that my empathy is fake, my feelings are fake, my facial reactions are fake.”

However, what he seemed to struggle with in empathy, he apparently tried to make up for in logic. The following example is helpful.

Lewis records that Bankman-Fried saw Donald Trump as an “existential risk” to democracy and good governance and decided the best way to remove the threat was to offer to pay him not to run for president—an idea Trump was reportedly open to.

“His team had somehow created a back channel into the Trump operation and returned with the not terribly Earth-shattering news that Donald Trump might indeed have his price: $5bn. Or so Sam was told by his team,” Lewis writes.

I have some admiration for Bankman-Fried’s out-of-the-box thinking. He was speaking Trump’s language. He was trying to save the world. He was trying to solve a problem. Logically it was sound. But his $5,000,000,000 calculation was fundamentally flawed. It took no account of democratic values, of the consequences of feeding an ‘existential threat’ billions of dollars, or the illegality of bribery and corruption on that scale.

The same miscalculation haunts the EA movement. While earning infinite amounts of money to save the world or prevent the climate emergency sounds logical, it fails to factor in the dark side of humanity: greed, lust, pride or gluttony, or whichever vice stopped Bankman-Fried from giving away his promised sizeable sum of money and led him rather to committing one of the largest frauds in history. The tech-bro altruistic movement also doesn’t factor in the bright side of humanity: compassion, humility, generosity, sacrifice. It doesn’t account for the human things that keep us going as we pursue justice - proximity to the people we are serving, faith or beauty.

The verdict against Bankman-Fried shows us that hard logic, like lofty ideals, is not enough to protect us from the bad we might do or propel us unswervingly towards the good we should do. The equations are flawed. We are more than machines. We are not social or biological robots. Our emotions and reactions can never be completely predictable or automatic because we are human beings, each of us with our unique strengths and weaknesses.

Ultimately, this is what I liked about Lewis’ book – his portrayal of Sam Bankman-Fried not in terms of how much money he made, or how many years he will spend behind bars, not as Crypto-King or Lord of Frauds, but as a uniquely talented and flawed individual who wrestles with some of the biggest existential paradoxes, and who is still, by the way, only 31 years old.