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Culture War Roundup for the week of October 14, 2024

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The NYT proposes an interesting metric to gauge Israeli misconduct in Gaza: the amount of one-shotted Palestinian children.

65 Doctors, Nurses and Paramedics: What We Saw in Gaza

I worked as a trauma surgeon in Gaza from March 25 to April 8. I’ve volunteered in Ukraine and Haiti, and I grew up in Flint, Mich. I’ve seen violence and worked in conflict zones. But of the many things that stood out about working in a hospital in Gaza, one got to me: Nearly every day I was there, I saw a new young child who had been shot in the head or the chest, virtually all of whom went on to die. Thirteen in total. At the time, I assumed this had to be the work of a particularly sadistic soldier located nearby. But after returning home, I met an emergency medicine physician who had worked in a different hospital in Gaza two months before me. “I couldn’t believe the number of kids I saw shot in the head,” I told him. To my surprise, he responded: “Yeah, me, too. Every single day.”

Using questions based on my own observations and my conversations with fellow doctors and nurses, I worked with Times Opinion to poll 65 health care workers about what they had seen in Gaza. Fifty-seven, including myself, were willing to share their experiences on the record. The other eight participated anonymously, either because they have family in Gaza or the West Bank, or because they fear workplace retaliation.

44 health care workers saw multiple cases of preteen children who had been shot in the head or chest in Gaza. 9 did not. 12 did not regularly treat children in an emergency context.

Quotes from the doctors:

“One night in the emergency department, over the course of four hours, I saw six children between the ages of 5 and 12, all with single gunshot wounds to the skull.”

“I saw several children shot with high velocity bullet wounds, in both the head and chest.”

“Our team cared for about four or five children, ages 5 to 8 years old, that were all shot with single shots to the head. They all presented to the emergency room at the same time. They all died.”

“One day, while in the E.R., I saw a 3-year-old and 5-year-old, each with a single bullet hole to their head. When asked what happened, their father and brother said they had been told that Israel was backing out of Khan Younis. So they returned to see if anything was left of their house. There was, they said, a sniper waiting who shot both children.”

I think this is a brilliant bit of journalism. First, they specify preteen children who are killed, a hugely important qualifier for a conflict which may see 16-year-old boys plant IEDS. Second, they queried a range of doctors, some of whom have no association with Palestinians or even Arabs (or even Muslims for that matter). Third, the data uniquely sheds light on possible Israeli misconduct. Blankly informing us about the number of dead Palestinian children tells us very little: are these combatant-aged? Did they die because of a nearby explosion targeting a combatant? The metric they chose is as beautiful as Abraham Wald’s famous WWII survivorship bias statistical work.

Looking specifically at the number of one-shotted children relative to the number of total shot children is an amazing way to determine intent on behalf of the Israeli soldiers. We should expect that, if these children are shot because they have caught stray bullets aimed elsewhere, that most of the children would be shot in places other than their head and chest. We should similarly expect a higher number of cases of multiple bullet wounds, as in the case of their being shot due to crossfire fighting. In gang-related shootings in America, we don’t see a high number of one-shotted adolescents, but wounds on arms and legs, abdomens, and multiple punctures. (Think 50 cent). Note that any Palestinian child shot or grazed by a bullet is going to be sent to the hospital, so there is no survivorship bias in the presentation of children to the hospital. These doctors have been presented with all bullet-wounded preteen Palestinians, and they are shocked at the high rate of one-shot critical hits — including the author who “volunteered in Ukraine and Haiti and grew up in Flint, Michigan.”

So, why are Israeli soldiers one-shotting children in Gaza? IMO, the most likely answer is that they want to. Israeli culture is not Western culture, neither is Israeli military culture identical to Israeli culture at large. There is an undercurrent of supremacism and extremism in Israeli military culture. When Israeli soldiers were found to be sexually torturing Hamas prisoners, extremists gathered to protest the soldiers’ arrests. These extremists included an Israeli politician, and the current national security minister publicly condemned the arrest of the soldiers. A Rabbi who specifically teaches orthodox military recruits alongside Talmud studied has specifically advocated for the killing of women and children in Gaza.

There is also a religious component to the Jewish extremism of the Israeli military, which I think is difficult for a naive Westerner to wrap their head around. When a Christian or post-Christian Westerner thinks about Judaism in Israel, they assume they must be worshipping something that is approximately the moral equivalent of Christ. “Sure, they don’t have our Jesus dude, but they recognize the same attributes and moral conduct in other ways”. But this is really not the case. With the same attention that Christians allot to Christ, Judaism allots to the practice of ritual rule-following. When Christians look at their God being tortured by sinners like themselves, Jews look solipstically at their own torturous history by outside threats. The attentional focus of the religion is different, and the moral focus is different. These are qualitative differences. When you combine this phenomenon with the independence of Rabbinical academies, you are going to see some extremist branches rise up in some Jewish academies, especially among the conservative and non-ultra orthodox. These extremist branches are most likely to pour out students onto the Israeli military. In other words, the Israeli military selects for the extremists which are raised up within the de-centralized schools of Israel. Don’t forget that it’s Israel under attack, not “secular country I happen to be citizen of”. They pray to Israel daily, it is their Christ, so for a Zionist extremism it is as if their deepest value is being terrorized.

I think this is a brilliant bit of journalism. First, they specify preteen children who are killed, a hugely important qualifier for a conflict which may see 16-year-old boys plant IEDS.

...because the spiritual purity of 15-and-younger boys disarms explosives?

You may feel this is brilliant journalism, but nothing in it really addresses child soldiers, which have a sordid history in islamic extremism even without touching on Hamas' deathcult tendencies. Child soldiers aren't merely 'are they big enough to carry a gun', which can be well below 10, but 'are they old enough to throw stone-heavy grenades,' which is even less. A preteen can easily be a child soldier, and even a cutoff of 6 is being arbitrary in terms of 'can they provide militarily-useful tasks.'

Nor does anything in the article address the nature of Hamas's influence in the information space, which is not only in the form of influence on intermediaries (by controlling access to Gaza) but also on the locals reporting to those intermediaries (by threats of retaliation).

Nor does the article- or you- make any effort to clear for selection bias on head/body shot children. For the article, there's only 8 cited speakers and the doctors who have the internal medicine specialty to be spending time on children shot in the head are, by the nature of their specialty, not going to be the medical experts handling walking-wounded children who got shot in the arm or non-critical parts of the leg but who don't rise to their need.

You say this...

Third, the data uniquely sheds light on possible Israeli misconduct.

...but the data doesn't uniquely shed light on possible Israeli misconduct. The data doesn't uniquely shed light on any misconduct. The data doesn't even demonstrate a pattern, because the data is depicted without time, context, or even attribution.

Heck, the data doesn't even provide an actual number of children shot.

Most of the article- the vast majority of the article- isn't even about gunshots. It's about malnutrition, psychological harm, baby mortality, and other things.

There are only 8 speakers cited with stories of children being shot. Given the relative range differentials between the Israeli small arms users and Palestinians, it would seem reasonable that a 'the Israelis are deliberately targeting children' to rely on snipers (shooting individual targets from range with precision), rather than closer-range options (pistol-executions) or mid-range-but-less-accurate fires.

On a very basic breakdown of -Attribution of who done it -Attribution of child-soldier era child -Characterized as single shot -Characterized as a sniper (single shot, single targets)

We have

Claim 1: 6 children, ages 6-12, single shots to skull

Attribution: None Child-soldier age: Yes Characterized as single shot: Yes Sniper characterized: No (no claim of a sniper context, or how a sniper would be responsible for a singular group)

Claim 2: Pediatric gunshot-wound patients

Attribution: None Child-solder Age: Unclear Characterized as single shot: No (gunshot-wound patients is plural patients, not claiming all patients had a single gunshot wound) Sniper characterized: No

Claim 3: Several children with high-velocity bullet wounds in head and chest

Attribution: None Child-soldier age: Unclear Characterized as single shot: No Sniper characterized: No ('high-velocity bullet' does not imply sniper, and no basis of what this means is provided)

Claim 4: 4-5 year old children, all shot in head with single shot, all delivered at once

Attribution: None Child-soldier age: No Characterized as single shot: Yes Sniper characterized: No (Additionally, group delivery implies no risk in taking the time to load all individuals, supporting a close-killing, not snipers)

Claim 5: Child shot in the jaw

Attribution: None Child-solder age: Unclear Characterized as single shot: Yes Sniper characterized: No (Not in nature of delivery or precision)

Claim 6 Father + Brother claiming children (3 and 5) were shot by snipers in house after rumored Israeli pullout

Attribution: None (Israeli attribution is of the rumor of an Israeli pullout from a neighborhood; the sniper is not attributed) Child-soldier Age: No Characterized as single shot: Yes Sniper characterized: Yes

Claim 7 18-month little girl with gunshot wound to the head

Attribution: none Child-soldier age: No Characterized as single shot: Yes Sniper characterized: No

Claim 8 (Dr. 'Many' children, on almost daily occurrence, with nonfatal gunshot wounds to head

Attribution: none Child-solder age: Unclear Characterization as single-shot: No Snipe characterized: No (Not in nature of delivery or precision)

So of our 8 claims- claims that are clearly selected for shock impact to print and thus are probably at the bounds of what even the NYT would consider worth reporting- we have...

8 Claims

Attributions to Israeli Shooters: 0

Characterization of Non-Child Soldier Age Victims: 3

Characterization of single shots: 5

Sniper characterized: 1

So when you say this...

So, why are Israeli soldiers one-shotting children in Gaza?

This is assuming a conclusion not supported by the data.

No evidence, or even claim, is made that it was Israelis in particular shooting the children. That may be the insinuation, but nothing in the article elevates the Israelis over other factors or actors, including...

-Revenge killings / crimes of passion targeting a family

-Armed criminals attempting to silence witnesses of a crime

-Suicide by traumatized children (see lower article on psychological trauma)

-Resource-shortage/'mercy' murders by caretakers unable to afford the children (see lower article on inability to care for children)

-Cross fire from other combatants

-Deliberate fire by other combatants*

*This is the due reminder that Hamas deliberately works to get Palestinians killed, uses human shields for military positions, and done the shooting themselves on occasion... and that the current conflict wouldn't be occuring if they weren't willingness to plan and execute theatrical murder of children for propaganda effects

And this is if the claims made are to be taken at face value, and not reflective of other data compromise issues such as selection bias (if Dr. Farah is the sort of doctor who can help children shot in the head, he's not going to be given the children who were shot less severely who other, less specialized, people can care for) or other issues of unintentional or intentional bias, or examples of outright deception.

(This is the due reminder that any Gazan medical center data that relies on the Gazan ministries is using Hamas-approved and provided data. This includes conflating gazan civilian and gazan combatant casualties, and exagerating claimed losses.)

And this doesn't even approach whether incidents which would be Israel were results of laws-of-war-acceptable action, which the article doesn't even try to address from any perspective. Naturally the Hamas-institutional data would not exactly be publicizing how many children who have been shot were shot in the context of being belligerents in the current conflict.

And this doesn't go into data collection issues, such as how the relevant medical authorities were picked, the lack of cross-reference to any sort of objective data sets (or even unobjective data sets), and the rather blunt use of emotive language and framings for what ends with a rather direct policy advocacy stance which itself would imply the selection of data was driven to justify the policy rather than the other way around.

So, as far as brilliant research goes, nah. Not really.

A preteen can easily be a child soldier

That Hamas is utilizing 8 year old child soldiers to lob grenades is a level of propaganda that the IDF hasn’t even reached yet. There has been no information coming out of Israel that Hamas is using preteen child soldiers in their operations, neither is there drone or other footage which would immediately shift public opinion in favor of Israel. This isn’t happening.

the doctors who have the internal medicine specialty to be spending time on children shot in the head are, by the nature of their specialty, not going to be the medical experts handling walking-wounded children who got shot in the arm or non-critical parts of the leg but who don't rise to their need

This is not true. Emergency nurses will deal with children shot in all places. As would surgeons, parademics, and critical care doctors. Any child shot is going to see these professionals. There’s not some “child shot in the head super-specialist” at these clinics. I mean, maybe neurosurgeon, but that’s not even a listed specialty in the article. Who do you believe is the lower specialty on whom they drop off the children only merely shot in the abdomen or thigh?

That Hamas is utilizing 8 year old child soldiers to lob grenades is a level of propaganda that the IDF hasn’t even reached yet.

You seem to have misunderstood the point of the opening, which was to contest your characterization of the limit of child soldiers, which itself wasn't limited to Hamas. A child soldier is not a 16 year old. A child soldier is a child who is used in the function of war, regardless of their age, and as such age alone does not disprove someone from being a combatant unless the age is so low that they physically cannot.

There has been no information coming out of Israel that Hamas is using preteen child soldiers in their operations, neither is there drone or other footage which would immediately shift public opinion in favor of Israel. This isn’t happening.

Sure it is. It's denied and disparaged as Israeli propaganda or otherwise that it shouldn't matter because children, but it is in no way hard to find information of Hamas using pre-teen children as human shields to military operations, of using preteens as messengers or conveyers of military goods, of Hamas opening fire into crowds of civilians which would involve pre-teens, of stealing and depriving the Gazan population of resources which lead to murder over or due to a lack of resources, of Hamas deliberately murdering families of dissidents for the purpose of intimidating the populace, and otherwise setting conditions in a warzone in which people are regularly shot for less-than-maximally-nefarious-reasons by maximally-nefarious jews.

This is not true. Emergency nurses will deal with children shot in all places.

There are two problems with this contestation, both demonstrating separate logical errors leading to data issues.

First is a dynamic which can be summarized as 'tell me you didn't think about triage without telling me you didn't think about triage.' Triage itself is screening function when medical issues over overwhelming and resources- included the doctors themselves- are limited. Not all injuries are emergencies to a triage, and in turn not all injuries will go to emergency treatment in the first place. If you then cite numbers of medical emergency cases, you are starting to count after triage has already filtered relevant contextual numbers.

Second, the NYT isn't citing a representative sample of emergency nurses- or even exclusively emergency nurses- in the first place. It was specifically citing people who were willing to claim observation of children being shot, which is itself a selection bias. '100% of the people I cited claimed cases of X' means nothing on a statistical when you are not citing people who do not support X, and that's if you had a representative survey basis in the first place, which the NYT opinion presenter does not.

As would surgeons, parademics, and critical care doctors. Any child shot is going to see these professionals. There’s not some “child shot in the head super-specialist” at these clinics. I mean, maybe neurosurgeon, but that’s not even a listed specialty in the article.

Thank you for admitting another issue in the article's data base, I was hoping to lead you to that point.

Yes, the lack of professional characterization is a separate issue for the brilliance of the research, as it conflates the medical supporters who might have a more representative understanding of general child injuries as part of the triage process (who, in the article, aren't even claiming Israeli snipers or the such in the first place) from more specialized medical experts whose expertise in specific things- like, say, chest surgeries- who would only be under a significant selective survivorship bias of what they are exposed to (both the nature of the injury, but also operating on people who survive long enough to get to them).

This conflation of category of medical experts, in turn, can be and is used to conflate the different viewpoints to distorting effect. As the viewpoints of people with wider-but-less-serious issues are presented in equal ground with more narrow perspective that are narrower-but-more-severe (because the person in question is primarily dealing with the most severe cases). This is a technique to shape audience perception by insinuating that the equivalence of the reports suggests that the conflated categories are a single category that is both more common and more severe on average than the spread actually is.

But since relevant medical and surgical specialties do exist, and the volunteers of any previous or accumulated experience will be allocated those cases as a matter of course, we can infer from organizational practicalities (and some parts of the article itself) that there is a relevant degree of case selection filtering going on.

Who do you believe is the lower specialty on whom they drop off the children only merely shot in the abdomen or thigh?

Or the hand or the foot or the arm?

The person with clearly vestigial wounds is clearly the lower priority and will receive more limited care by less trained or specialized people. A surgeon who specializes in opening up chest cavities to remove things that can kill people is not going to spend their time resetting dislocated joints or applying splints, when that level of care can be provided by a more-numerous non-surgeon whose use in that role can free up the surgeon to do surgeries.

Now, if you wish to make the argument that the Gazan medical situation is not so dire such that there is no need to triage and thus more specialized medical professionals see a representative selection of wounded children...