Article
Comment
Gaza
Middle East
5 min read

The human cost of the Israel-Gaza war

A veteran volunteer surgeon laments a well lived life.

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

A young doctor wearing scrubs smiles.
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.

Explainer
Comment
Economics
Leading
Politics
Wisdom
5 min read

When someone makes a claim, ask yourself these questions

How stories, statistics, and studies exploit our biases.

Alex is a professor of finance, and an expert in the use and misuse of data and evidence.

A member of an audience makes a point while gesturing.
On the other hand...
Antenna on Unsplash.

“Check the facts.”  

“Examine the evidence.”  

“Correlation is not causation.”  

We’ve heard these phrases enough times that they should be in our DNA. If true, misinformation would never get out of the starting block. But countless examples abound of misinformation spreading like wildfire. 

This is because our internal, often subconscious, biases cause us to accept incorrect statements at face value. Nobel Laureate Daniel Kahneman refers to our rational, slow thought process – which has mastered the above three phrases – as System 2, and our impulsive, fast thought process – distorted by our biases – as System 1. In the cold light of day, we know that we shouldn’t take claims at face value, but when our System 1 is in overdrive, the red mist of anger clouds our vision. 

Confirmation bias 

One culprit is confirmation bias – the temptation to accept evidence uncritically if it confirms what we’d like to be true, and to reject a claim out of hand if it clashes with our worldview. Importantly, these biases can be subtle; they’re not limited to topics such as immigration or gun control where emotions run high. It’s widely claimed that breastfeeding increases child IQ, even though correlation is not causation because parental factors drive both. But, because many of us would trust natural breastmilk over the artificial formula of a giant corporation, we lap this claim up. 

Confirmation bias is hard to shake. In a study, three neuroscientists took students with liberal political views and hooked them up to a functional magnetic resonance imaging scanner. The researchers read out statements the participants previously said they agreed with, then gave contradictory evidence and measured the students’ brain activity. There was no effect when non-political claims were challenged, but countering political positions triggered their amygdala. That’s the same part of the brain that’s activated when a tiger attacks you, inducing a ‘fight-or-flight’ response. The amygdala drives our System 1, and drowns out the prefrontal cortex which operates our System 2. 

Confirmation bias looms large for issues where we have a pre-existing opinion. But for many topics, we have no prior view. If there’s nothing to confirm, there’s no confirmation bias, so we’d hope we can approach these issues with a clear head. 

Black-and-white thinking 

Unfortunately, another bias can kick in: black-and-white thinking. This bias means that we view the world in binary terms. Something is either always good or always bad, with no shades of grey. 

To pen a bestseller, Atkins didn’t need to be right. He just needed to be extreme. 

The bestselling weight-loss book in history, Dr Atkins’ New Diet Revolution, benefited from this bias. Before Atkins, people may not have had strong views on whether carbs were good or bad. But as long as they think it has to be one or the other, with no middle ground, they’ll latch onto a one-way recommendation. That’s what the Atkins diet did. It had one rule: Avoid all carbs. Not just refined sugar, not just simple carbs, but all carbs. You can decide whether to eat something by looking at the “Carbohydrate” line on the nutrition label, without worrying whether the carbs are complex or simple, natural or processed. This simple rule played into black-and-white thinking and made it easy to follow. 

To pen a bestseller, Atkins didn’t need to be right. He just needed to be extreme. 

Overcoming Our biases 

So, what do we do about it? The first step is to recognize our own biases. If a statement sparks our emotions and we’re raring to share or trash it, or if it’s extreme and gives a one-size-fit-all prescription, we need to proceed with caution. 

The second step is to ask questions, particularly if it’s a claim we’re eager to accept. One is to “consider the opposite”. If a study had reached the opposite conclusion, what holes would you poke in it? Then, ask yourself whether these concerns still apply even though it gives you the results you want. 

Take the plethora of studies claiming that sustainability improves company performance. What if a paper had found that sustainability worsens performance? Sustainability supporters would throw up a host of objections. First, how did the researchers actually measure sustainability? Was it a company’s sustainability claims rather than its actual delivery? Second, how large a sample did they analyse? If it was a handful of firms over just one year, the underperformance could be due to randomness; there’s not enough data to draw strong conclusions. Third, is it causation or just correlation? Perhaps high sustainability doesn’t cause low performance, but something else, such as heavy regulation, drives both. Now that you’ve opened your eyes to potential problems, ask yourselves if they plague the study you’re eager to trumpet. 

A second question is to “consider the authors”. Think about who wrote the study and what their incentives are to make the claim that they did. Many reports are produced by organizations whose goal is advocacy rather than scientific inquiry. Ask “would the authors have published the paper if it had found the opposite result?” — if not, they may have cherry-picked their data or methodology. 

In addition to bias, another key attribute is the authors’ expertise in conducting scientific research. Leading CEOs and investors have substantial experience, and there’s nobody more qualified to write an account of the companies they’ve run or the investments they’ve made. However, some move beyond telling war stories to proclaiming a universal set of rules for success – but without scientific research we don’t know whether these principles work in general. A simple question is “If the same study was written by the same authors, with the same credentials, but found the opposite results, would you still believe it?” 

Today, anyone can make a claim, start a conspiracy theory or post a statistic. If people want it to be true it will go viral. But we have the tools to combat it. We know how to show discernment, ask questions and conduct due diligence if we don’t like a finding. The trick is to tame our biases and exercise the same scrutiny when we see something we’re raring to accept. 

 

This article is adapted from May Contain Lies: How Stories, Statistics, and Studies Exploit Our Biases – and What We Can Do About It
(Penguin Random House, 2024)
Reproduced by kind permission of the author.

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