Dr. Mark Perlmutter (Orthopedic Surgeon, North Carolina)
Appearances
This American Life
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At the same time that Froese was starting to document this, Mark, working with his patients, he was seeing the same thing. He vividly remembered the day he saw two kids brought in who had both been shot in the head and the chest.
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These weren't kids injured by collapsing buildings. They were kids who'd been shot, direct gunshot wounds into 12-year-olds, 8-year-olds, even toddlers.
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13 children in 14 days. Even with all the other traumatic injuries and deaths they saw, the kids who were shot really stuck with Mark. It was haunting him.
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That's as far as Mark thought about it at the time. The detail of 13 kids, all with gunshot wounds to the head and chest, it just got added to the long list of things they saw in Gaza and couldn't fully understand. It didn't come back to Feroz until they were back home and got invited to speak at a conference in Dearborn, Michigan.
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The panel had another American doctor who also volunteered in Gaza. He worked in two different hospitals a couple months before Feroz and Mark arrived.
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Because of Adam's specialty, he would have only seen children who survived a gunshot to the head long enough to make it to reconstructive surgery. Not many did. He saw one. It was still shocking to him. Adam had served in Iraq as a surgeon in the U.S. Army. He treated lots of injured people, but what he was seeing in Gaza was different.
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There were documented cases where Americans did kill Iraqi children, but nothing near the scale that these doctors saw in Gaza. As somebody with U.S. military experience, do you have a perspective that could explain the circumstances that lead to a kid getting shot? How do you answer that?
This American Life
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The medical worker I spoke with who spent the most time in Gaza also saw the most kids shot, 50. She showed me a picture she took of a scan of a five or six year old skull. There's a bullet in the middle of it. She was told this child was playing with their friends when an armed quadcopter drone came overhead and shot the child. Dr. Alia Kattan also responded to Froese's call out.
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She's an anesthesiologist from Southern California. She went with her husband and between the two of them saw 15 kids who had been shot in the head or chest. The one that really stuck with her also happened to be the youngest case I'd heard of.
This American Life
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Feroz reached out to as many American medical workers as he could. Doctors, nurses, paramedics. He created a survey to send out and compiled all the answers. The results stunned him.
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Out of the 53 American medical workers surveyed who did emergency care for children in Gaza, 44 said they saw kids shot in the head or chest. Here's Mark.
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Feroz published an op-ed in the New York Times with the results of the survey. A group of the doctors wrote two letters to then-President Biden outlining what they saw. Froese thought that would mean two things. They'd get a call from the White House and there'd be an investigation.
This American Life
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I talked with three people who worked at the U.S. State Department and reviewed allegations like this, including the person who until recently was the Ambassador-at-Large for Global Criminal Justice, a position that used to be called the War Crimes Ambassador. They all agreed the doctor's report sounded credible and significant enough to investigate.
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Each of them said the next step should be asking Israel for answers. One who was involved in vetting U.S. weapons transfers told me if this had been another country other than Israel, this is what would have happened. A few years ago, a senior member of the House Foreign Affairs Committee received reports that Mexican Marine units were executing and disappearing people. The U.S.
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stopped a shipment of machine guns for more than two years while they investigated the allegations. Eventually, Mexico agreed that American weapons wouldn't go to those units. But that isn't what happened here. The Biden administration never met with Rosenmark. They didn't investigate these claims or make any public statements asking Israel to stop shooting kids in Gaza.
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They didn't try to get to the bottom of these allegations. I read these doctors' accounts and had the same question they asked in one of their letters to President Biden. How could this be a series of accidents, such widespread shooting of so many young children over the course of an entire year? But I've also reported on war crimes before.
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And I know that cases that seem, to a bystander or even a doctor on the ground, like clear acts of atrocity, they can be explained as a tragic but expected part of war, allowable under the rules of war. The Gaza Strip is a small, densely populated place. It's nearly 50% children. Hamas is hiding inside that population.
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Any fighting between Hamas and Israel will have civilian casualties, including children. So we asked the Israel Defense Forces how they explained the reports from American medical workers. They declined both my interview requests but sent a statement saying, the IDF does not target minors and takes extensive measures to prevent harm to civilians, including children.
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The IDF is committed to mitigating civilian harm and operates in full compliance with international legal obligations. For security reasons, we cannot elaborate on operational policies. Which doesn't explain why so many kids were getting shot. So I went looking for an Israeli soldier who'd served in Gaza.
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who could tell me what it was like on the ground and what the rules were on who they could shoot in what circumstances. And we found one who would talk with us. He's a reservist in his early 30s, a grad student whose unit got called up at the beginning of the war. He asked us to just call him M. He was worried about retribution, so we had an actor read his responses to my questions.
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His company started in the north of Gaza, not near the hospital where Feroz and Mark and most of the doctors were. He said there was a humanitarian road running north and south. And near the humanitarian road, the rules of engagement were, don't shoot unless there's an immediate threat.
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He says there was one incident where his unit did see two young people they thought might be a threat. One day, when two teenagers, 14 or 15, were part of a convoy going south, they sprinted away and ran into a building. A Hummer and a tank followed them and ordered them to come out. The army thought the teens might be luring them into a trap.
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When the teens didn't come out, they fired at the building, killing them. He says his unit never fired on any other teenagers or little kids. But, he says, different units operate differently.
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So, according to M., the broad permission to fire and the types of units led by more aggressive company commanders, he can see how that could result in soldiers shooting Palestinian children. He didn't see this himself. This is just his opinion, he told me. But he believes that Israeli soldiers have probably shot some children on purpose.
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I could just tell you, based on the dozen conversations I've had, they're talking about children who are as young as, this is hard to say, but 18 months who have been shot.
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I asked M for other possible explanations. What if the soldiers didn't know they were kids? It's a chaotic, tense environment full of people and places to hide. That could happen. But he and another IDF soldier I spoke with, someone who didn't serve in Gaza, but whose job was to identify targets for snipers, said it wasn't hard to distinguish a child from an adult.
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It wouldn't explain an 18-month-old being precisely shot in the head, or toddlers, or other grade school age kids. Or the kids being used as human shields by Hamas, or even victims of Hamas in a false flag operation to blame Israel and draw sympathy. M hadn't heard of that happening in Gaza, and hadn't seen it.
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He says when he tries to make sense of what happened, there's been a societal shift in Israel that he thinks is a factor.
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The Israeli army has not announced any investigations into the shooting of children in Gaza. In the meantime, the Trump administration just authorized another $12 billion in arms sales to Israel. That's in addition to the reported $17.9 billion the US has given Israel in military aid since the war began. The kids getting shot like this are a tiny part of the large number of casualties in Gaza.
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At least 65,000 people have been killed, more than 15,000 of them children. An expert who investigates war crimes described it as a haystack of needles. Most of these allegations will never find their way to court.
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So sometimes, in cases like these, war crimes investigators look for emblematic crimes, clear instances of violence outside of the rules of war that tell us something about the war, like the My Lai Massacre, Srebrenica, the chemical weapons attacks in Syria. What do these deaths tell us? The hundreds of kids American medical workers saw shot in the head and chest. What are they emblematic of?
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They tell us it's likely that an Israeli soldier can shoot a child in Gaza on purpose, with no consequence, and the U.S. isn't going to try to stop it.
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Dr. Mark Perlmutter had been on about 40 medical missions all over the developing world before he went to Gaza. He's a white guy, almost 70, a hand surgeon in rural North Carolina when he's not doing humanitarian work. And when he found out patients in Gaza needed an orthopedic specialist like himself, he signed up and flew there in March of 2024.
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He'd worked in some pretty violent places, but never an active war zone, and only knew the basics about the conflict between Israelis and Palestinians.
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Intifada is the word for Palestinian uprising against Israeli occupation. But Mark was about to get a crash course from one of his fellow doctors.
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Dr. Feroz Sidwa, a trauma surgeon from the U.S. He's also volunteered as a doctor in the war in Ukraine and with Palestinians in the West Bank. He's closely studied the Israeli-Palestinian conflict, though his family's from a small ethnic minority in what is now Pakistan.
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So Mark sat next to Feroz. And when they arrived at the European hospital, that's the name of the hospital, in Han Yunis, in Gaza, their team dropped off their thousands of pounds of supplies. European Hospital was built for just over 200 beds, but is taking care of over a thousand people. And families are living in every corner of the hospital. Mark hadn't seen anything like it.
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Froze hadn't either, but he told me he didn't linger on that long. A nurse took them on a quick tour, let them know where everything was.
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This is like minutes into your initial tour of the hospital. You see two kids with gunshots to the head and then two more kids with gunshots to the head.
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Froese works at a hospital near Stockton, California, which has higher rates of violent crime than most of the country.
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I mean, it was a war zone, but still, this was a lot. And then he moved on. There were so many people that needed medical attention, the only way he could keep track of his patients was to make notes on his iPhone. Just to warn you here, the details are graphic.
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He pulled up an entry from a random day just to give me a sense of what it was like.
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90 minutes. It's intense. But in that endless stream of traumatic injuries, there's one that jumped out at him every time. Kids getting shot in the head. Whenever he saw this, he'd make a note of it on his phone.