Respectful Insolence

Doctors and terror

One of the things that I found most disturbing about the recent failed bombing attempts in London and the car attack in Glasgow, aside from the terrorism and potential for huge losses of life, is this:

GLASGOW, Scotland (AP) — British police focused Tuesday on at least four physicians with roots outside Britain – including a doctor seized at an Australian airport with a one-way ticket – in the investigation into failed car bombings in Glasgow and London.

At least four of the eight suspects were identified as doctors from Iraq, Jordan and India. One of the doctors from India, 27-year-old Muhammad Haneef, was arrested late Monday at the international airport in the Australian city of Brisbane, where he was trying to board a flight with a one-way ticket late Monday, the Australian attorney general said.

Prime Minister John Howard said a second doctor was being interviewed in Australia, and British media reported that at least two of the others detained were trainee physicians.

Mark Shone, a spokesman for Halton Hospital in England, said Haneef worked there in 2005 as a temporary doctor, coming in when needed. He also confirmed a 26-year-old man arrested in Liverpool late Saturday – also Indian – practiced at the hospital but he would not provide the man’s name or further details.

Amid increased security at British airports, train stations and on city streets, a bomb disposal team carried out a controlled explosion on a suspicious car parked outside a mosque in Glasgow.


That’s right. A large percentage of the terror suspects arrested thus far are physicians or physician trainees. It bothered me enough that Ayman Muhammad Rabaie al-Zawahiri is a high-ranking member of al Qaeda. Radio reports that I heard early this morning were claiming that as many as six of the suspects were physicians or physician trainees. Attention is now focusing on the large number of physicians who have of late immigrated to the U.K., many of whom work in the National Health Service from Muslim countries.

It just boggles my mind that physicians can become terrorists like this. It is antithetical to the very core of our purpose in becoming physicians: To relieve suffering and to help the sick and wounded. We’re not supposed to produce more sick and wounded. A more disturbing implication than how those sworn to heal could so easily be drawn into planning and executing the mass killings of innocent human beings is the possibility that some of these physicians, rather than being involved in bombing plots, might turn their skills to terror, either through chemical or biologic attacks.

Make no mistake about it, any physician who leaves the path of healing and becomes an accomplice to mass murder and terrorism has committed an even worse betrayal than the run-of-the-mill terrorist because he or she will have abandoned everything that the profession stands for, even if they do not use their special skills in the attack itself. It just goes to show how powerful ideology and religion can be, corrupting even those who should normally be very resistant to killing in the name of God.

ADDENDUM: More on “Britain’s medical terrorists.”

Comments

  1. #1 Drat
    July 3, 2007

    The attraction of medical practice for many is power over people’s lives that provides a path to wealth and more power. Once you’ve had experience being a god, playing god comes easily.

    I know of a doctor in San Bernardino County who was famous for killing patients he didn’t like. When he died of a massive heart attack, many EMTs cheered.

  2. #2 Matt Penfold
    July 3, 2007

    Orac,

    One thing to bear in mind is that the vast majority of people arrested under terrorism laws in the UK do not end up being charged with anything, and of those that do get charge most are for non terrorism relates offences such as visa violations.

  3. #3 HCN
    July 3, 2007

    Weird radio commentary I heard this morning: On a previous day over a discussion of Michael Moore’s “Sicko”, one talk show guest suggested that health care in the USA should be subject to free-market, and needed health care professionals be recruited from all over including the Middle East.

    Then this morning the talk show host summarized that discussion, and then played the news feed from the UK where they had arrested more medical doctors from Jordan, and other parts of the Middle East.

  4. #4 Joseph j7uy5
    July 3, 2007

    I cannot agree with Drat’s comment that “many” physicians enter medical practice in order to gain power over other people’s lives.

    In order to know what is behind this spate of medical practitioners being implicated in terrorism, it would be necessary to know if they were recruited as terrorists first, then went to medical school, or if they decided to become terrorists after entering medical school.

    It would be less troubling if they were terrorists first, who then decided to become physicians specifically to gain mobility, financial resources, and to avoid suspicion.

    Either way, though, Orac’s point stands. It is a huge betrayal of centuries of tradition, of all the thousands of practitioners who came before us, making the field into what it is today.

  5. #5 Jon
    July 3, 2007

    Your opinion that physicians have high ideals is nonsense. They’re neither better nor worse than non-physicians. And of the reasons for going into medicine, ‘helping people’ was probably not at the top of the list for the majority of physicians I know.

  6. #6 MartinC
    July 3, 2007

    I agree with Matt, while the two perpetrators of the Glasgow (and according to reports, the London attempts too) seem to be medics I wouldn’t jump to the conclusion that everyone who has been arrested is necessarily involved.
    As others on the blogosphere have commented, are Al-Qaeda down to their last terrorists ? They really must be scraping the barrel to have to use these incompetents.
    http://tinyurl.com/2t54s6

  7. #7 Warren
    July 3, 2007

    This unsettled me as well, but then I remembered the number of US physicians who let their religious beliefs get in the way of providing the best care, especially to women who are or might be pregnant and want either an abortion or Plan B.

    Religious indoctrination short-circiuts intelligence.

    Every time.

  8. #8 Jacob Wintersmith
    July 3, 2007

    The notion that doctors do or should follow a different code of ethics from everyone else is very strange. Why should doctors be strict pacifists if we don’t expect the same ethical stance from everyone else?

    I think most doctors have the same basic ethical perspective as non-doctors: it’s usually good to heal people and bad to harm them, but in certain situations it is morally appropriate to attack/harm/kill others. For example, I suspect that doctors supported the war in Afghanistan at rates similar to the general US population (alas, I don’t have any survey data on hand).

    Of course, anyone who thinks that the actions of these terrorists were justified has a thoroughly fucked up ethical code. But whether the terrorists were doctors is irrelevant.

  9. #9 IanR
    July 3, 2007

    I have no idea if my experience applies in Arab countries, but it definitely applies to Indians.

    There is immense pressure for people who do well in school to go into one of a handful of prestigious professions – medicine, engineering, and (in the case of Trinidad, but less so in India) law. Studying medicine isn’t a choice – rather, it’s a choice (if not an act of outright rebellion) to choose something other than medicine. Becoming a doctor isn’t fun – it’s far worse if you are doing it out of obligation to your family.

    It’s bad enough to be stuck in a career you don’t like, but medicine is an especially demanding master. It’s almost impossible to walk away after investing that many years of your life into something. But when walking away means disrespecting your father and your family…it’s almost impossible. While radicalisation tends to be seen as a phenomenon of disaffected youth, a doctor isn’t as far away from it as you might think. In addition, the story says: Haneef worked there in 2005 as a temporary doctor, coming in when needed. So you have a doctor who is unable to find full-time employment. And while they seem very young, in the British system you can graduate from medical school at 22 or 23. Opportunities for advancement are also limited for foreign doctors in the UK.

    I am not defending their actions, but it is a lot less shocking than it might seem at first glance.

  10. #10 dc
    July 3, 2007

    No-one seems willing to admit that these attacks are a reaction to the ongoing murder campaign against Iraqi civilians. To condemn attacks on western nations whilst ignoring the killing (on a far greater scale) of Iraqis is gross hypocrisy. It is nothing to do with them being doctors. These doctors presumably have friends and family who are victims of the murderous US occupation too. The scapegoating of ordinary Iraqis (and Afghanistanis) for the attacks of 9/11 (for which they had no responsibility) is the reason for these attacks. They believe that if we in the west have a little taste of the terror which they have to live with every day perhaps we may tell our politicians that this injustice must end.

  11. #11 MartinC
    July 3, 2007

    dc, if it was the US or the British who were the ones setting off bombs and killing dozens of ordinary Iraqi citizens every day then perhaps you might have a point. The reality is that it is religious fundamentalists who are carrying out the murder of their fellow Iraqis for the crime of being a slightly different religious sect than themselves.

  12. #12 ParanoidMarvin
    July 3, 2007

    dc

    While not condoning the US occupation of Iraq, which was done on a false basis, I must say that you’re extremely ignorant.

    Most terrorists attacks in Iraq, at least up until two months ago, were performed by Suni Moslems. El-Qaeda, or the world Jihad, is Suni Moslems. Those that attacked the US on 9/11 were mostly Wahabi, againt a sect of Suni Islam.

    Assuming that the last attempted terrorist attacks was again pat of the world Jihad, similar to all major terrorist attacks since 9/11, you’re actually saying that the world Jihad is trying to give the west a little taste of the terror it itself is responsible for in Iraq.

    Yes, the US handled Iraq incredibly ineptly. However, they never forced Suni terrorists squads to target Shiite mosques. They never forced those same groups to attack Iraqis going to vote, and they never once forced them to attack the food markets. It’s hard to attack army bases, an action which while still an act of war, can be justified against an occupying force, but most of us, and most moslems, wouldn’t consider that a license to blow up our own people.

    I see no reason to assume that these attacks are any different from 9/11, and I don’t think you think that those attacks were justified by the war that came after them.

  13. #13 SN
    July 3, 2007

    When I first heard the story, my thought was not that doctors are turning into terrorists, but that the terrorists are becoming doctors (possibly to get easier access to work visas?) Dont you think it’s possible that they were terrorists first, and then decided that becoming a “skilled worker” was a good idea? I know becoming a doctor is hard work, but you can’t deny a lot of terrorists are very dedicated.

  14. #14 AE
    July 3, 2007

    The idea that doctors can be “evil” is not new.

    As Dr Ben Goldacre coincidentally pointed out in his Bad Science column in the Guardian newspaper last Saturday, Doctors had been active participants in the Nazi project, and joined Hitler’s National Socialist party in greater numbers than any other profession (45% were party members, compared with 20% of teachers).

    Just because someone has had an education, it doesn’t make them automatically good, rational and humane.

  15. #15 Orac
    July 3, 2007

    Bit of a straw man there.

    I never said that it did. However, doctors may be venal and greedy and have many other failings, some spectacular, but most of us nonetheless did enter the profession to help people, contrary to the claims otherwise. That’s why, when doctors start intentionally killing and harming innocent people (or planning to do so), be it Nazi doctors or doctors participating in terrorism, I view it as a betrayal.

  16. #16 JS
    July 3, 2007

    I see no reason to assume that these attacks are any different from 9/11

    I do. You can say what you will about Al Qaeda, but they are not bumbling amateurs. These bozos set three or four bombs. Only one – one – of them actually went off, and that one only hurt two people – the two people who were setting it off.

    Compare and contrast this with the Madrid attack, where not only most or all of the bombs actually detonated – the attackers even managed to escape.

    Colour me skeptical of the Al Qaeda angle on that story.

    - JS

  17. #17 derek
    July 3, 2007

    If being a doctor paid little more than being any other profession, then altruism would be everybody’s reason for being a doctor, I’m sure. But a doctor’s job pays very well indeed if you’re in some countries; or if you can use your medical training to immigrate to a country where it pays better than any job at home.

    Terrorists tend to be highly educated, sensitive, and energetic people, rather than your average schmoe mowing the lawn. It would be no surprise to me to learn that most people who are both foreign immigrants and terrorists, are disproportionately working in their host country’s medical services. It’s a good gig for an upper middle class boy.

  18. #18 daedalus2u
    July 3, 2007

    It is perfectly obvious what happened. Those doctors learned about evolution in medical school, that warped their fundamentalist religious beliefs and values, and so they became murderous terrorists.

  19. #19 Tegumai Bopsulai, FCD
    July 3, 2007

    I find the utter incompetence to be unsettling. These douchebags couldn’t even set off a car bomb properly; I can only imagine how much difficulty they would have with something like transplant surgery.

  20. #20 sailor
    July 3, 2007

    “find the utter incompetence to be unsettling. These douchebags couldn’t even set off a car bomb properly; I can only imagine how much difficulty they would have with something like transplant surgery.”
    Absolutely, this stunt makes you wonder about the competence of the medical profession. If they were terrorists first, how the hell did they ever make doctors?

  21. #21 revere
    July 3, 2007

    I don’t disagree. You might add that American psychologists have been implicated in aiding torture.

  22. #22 Doc Bill
    July 3, 2007

    I really hope there is another explanation for these events other than doctors setting off car bombs.

    However, if that’s the case then Dawkins is not only correct but the God delusion takes on a deadly dimension.

    All it will take is an insanity outrageous enough and a willing dupe with his/her finger on the button to trigger a massive response against the innocent. In justified revenge, of course.

  23. #23 Cam
    July 4, 2007

    I’ve always decried how some branches of the media seem to portray Muslim immigrants as an implicit danger to Western societies. Fortunately, I’ve always had many Muslim colleagues in medicine to point to, and show how they’re contributing to their new countries in an extremely positive fashion.

    I don’t know if I’ll be able to make that argument anymore.

  24. #24 Dianne
    July 4, 2007

    The attraction of medical practice for many is power over people’s lives that provides a path to wealth and more power.

    Maybe. But what is power? Successfully recessitating someone who was clinically dead is power. Giving someone chemotherapy and watching their tumor melt away, their pain disappear, and their lives return is power. Supporting someone through a bout of Neisseria meningititis meningitis and seeing them walk out of the hospital, brain and body intact, is power. Being the first person to know something about how the body works, even if it is just a minor detail, is power. Destruction is for amateurs and ficking incompetents who can’t manage any of the above.

    (And, yes, I know: Sometimes-frequently-the patient stays dead, the tumor grows anyway, the bacteria wins, the results are a complete and uninterpretable mess…any MD who thinks that he or she is god is quickly disabused of that idea by reality. But even one success is power beyond that which any terrorist will ever know.)

  25. #25 Dunc
    July 4, 2007

    I find the utter incompetence to be unsettling.

    Yep, that’s what worries me – we’re employing doctors who apparently don’t know enough chemistry to know the difference between a fuel and an explosive.

    And can we stop calling them “car bombs” please? Bombs contain explosives. They didn’t have any explosives. They had fuel. All cars contain fuel.

  26. #26 Dianne
    July 4, 2007

    It is antithetical to the very core of our purpose in becoming physicians: To relieve suffering and to help the sick and wounded. We’re not supposed to produce more sick and wounded.

    I agree. A doctor who commits an act of violence is breaking not just the general laws and rules of his or her society, but also the promise he or she has made to help people who are vulnerable: sick or hurt. An additional betrayal, much as a spouse who abuses his or her spouse or a parent who abuses his or her child is committing not just violence but also a betraying a trust, breaking a promise.

    However, I would question whether most physicians–including you–consider this statement to be absolutely true in all circumstances. For example, should no doctor join the military because, even if their part is limited to healing those hurt by the war, they are a part of an institution whose whole point is to create more sick, wounded and dead? (I’d say yes, incidently. Doctors should not be part of the military.) Should doctors never participate in any physical assault on another person under any circumstances–i.e. self-defense, defense of another person, etc.

    Before you roll your eyes and accuse me of taking the statement to its illogical extreme, consider whether doctors involved in terrorist acts might not see their acts as acts of self-defense, defense of the homeland, etc. This would not excuse them–they should be bright enough and educated enough to know better–but it might make things more explicable.

    One final, pedantic note: Several doctors have been arrested as part of the investigation. None have been charged, muchless convicted. Let’s not get too carried away with condemning them for something they may not have done.

  27. #27 MartinC
    July 4, 2007

    Dunc, a fuel, in sufficient quantities, can be an explosive so long as it is detonated in the correct way. The previous incompetent London bombers also failed in this part of their plan. Thank goodness fundamentalists hate science.

  28. #28 Dunc
    July 4, 2007

    MartinC: A fuel, mixed with an oxidizer, in sufficient quantities can be an explosive. No oxidizer, no explosion. And you can’t tell me that these idiots were trying to create a properly optimisied fuel-air explosion.

    They were obviously woriking on the Hollywood idea that fuel + ignition = big boom. They weren’t going for incendiary, they were going for fragmentation, hence the nails. There is no way in hell you can get that sort of explosion by setting light to petrol and sticking some propane cylinders on the fire. Kids do that sort of thing every Nov 5th.

    Heck, they could’ve done a better job with OTC fireworks.

  29. #29 sailor
    July 4, 2007

    OH OH, Brain surgery takes another hit. First Egnor, a creationist brain surgeon, who does not understand evolution and logical thinking makes them look dumb.
    Now it turns out one of the terrorists in that group in the UK was A BRAIN SURGEON. I am willing to make a prediction he, like Egnor was a creationist with a strong belief in a single god.
    And they tell us atheists are morally unhinged!

  30. #30 Justin Moretti
    July 4, 2007

    Dianne, if you think doctors should not be part of the military, then who do you propose should take care of the wounded?

  31. #31 medrecgal
    July 4, 2007

    Yes, I, too, was unsettled by the notion that there are physicians out there who could be involved in something so utterly evil and antisocial. However, once I stopped to think about it, there have been others in this usually noble profession with such tendencies also. My first thought was of the likes of Dr. Josef Mengele (familiar, I’m sure, since you have so many links regarding the Holocaust). As for the Muslim connection, I think part of the problem is an underlying lack of understanding regarding this particular religion. Most Muslims do not condone the kinds of actions perpetrated by terrorists, and most don’t believe it is an acceptable expression of their beliefs. It is the extremists that are the real problem, and striking fear into the hearts of “nonbelievers” is their primary objective. Whether they are physicians or not is likely to be secondary, which is a shame. People supposedly dedicated to healing and preserving life should not be involved in actions that clearly cause untold degrees of human suffering.

  32. #32 Dianne
    July 4, 2007

    if you think doctors should not be part of the military, then who do you propose should take care of the wounded?

    It’s a problem. Particularly if there were a draft, that is, if the people actually getting hurt had no choice in the matter. But the fact remains that the purpose of the military is to kill people and that medicine in the context of the military is really weapons repair. Who is the first priority for medical care in a battle? Not the worst off, but the ones most likely to be able to go back out and kill some more if they are treated. This seems inconsistent with the goal of preserving life and helping those in need. But I agree that its an imperfect solution at best.

  33. #33 Dr Aust
    July 4, 2007

    For those that haven’t read the stories in detail, the people arrested in the UK were fairly junior doctors, 2-3 yrs post med school graduation (taking medicine as a bachelor/ first degree) so maybe only 1-2 yrs post-registration, working at grades equivalent to US junior resident level.

    Given the level of Islamist death-cult radicalism among certain Muslim groups I guess we shouldn’t be that much more surprised by doctor would-be suicide bombers than by the previous crops of Univ-educated suicide bombers like the 9/11 lot. Educated people are clearly not immune from indoctrination.

    Agree with Orac that there is “something extra” with seeing doctors do this stuff, though – specifically the disconnect between training for and working in a job whose primary purpose is to relieve human suffering, and then planning to INFLICT random studdering on blameless people. Of course, there are plenty of historical precedents for this sort of mental dissociation. Remember the Nazis infamously congratulating themselves on “remaining decent fellows” while carrying out genocide? There is nothing like a mad legitimizing ideology, plus the categorizing of particular religious, ethnic or political groups as “inferior” or ultimately “valueless”, to allow people to disconnect the different bits of their minds and behave in inhuman ways.

    On a different subject, interesting comment higher up from IanR about the pressure in some cultures and social classes for high achievers at school to go into a very limited range of “prestige” professions, of which medicine is one (and law another). This is occasionally debated in the UK, where medical school entry is typically at 18-19, so very young. The countries the doctors in the news stories come from would also typically have medical school entry at this stage, i.e. straight from high school.

    It is certainly widely believed by people who teach NON-medical B.Sc. students in the UK that the brightest middle-class kids who do well in science subjects at high school are effectively “herded” towards medicine by teachers and parents. Personally I would say that too many medical students in the UK are driven largely by “proving I am top of the class”. When teaching them you have to keep banging in the mantra “It’s NOT about you – it’s about the patients”.

  34. #34 S. Rivlin
    July 4, 2007

    This is not a new trend in the world of terrorism that physicians have played a major role in mass killing. Ahmed Jibril (I think that is his name), one of the masterminds behind the slaughter of the Israeli athletes in the Munich Olympic Games (1972) is a physician who for years resided in Iraq as a guest of Saddam. Several members of Hamas are physicians; number 2 in Al-Qaida (Al Zahawiri) is a physician and a New York physician named Baruch Goldstein emigrated to Israel and had slaughtered 29 Palestinians in Hebron several years ago.

    What is common to all these physicians? Religious orthodoxy!!! They all deeply believe that they are carrying out God’s will. Physicians are not immune from religious brain-washing.

  35. #35 Dr Aust
    July 4, 2007

    Anyone know any studies about rates of religious belief in physicians by comparison to the general population? I guess it would be very different for different countries.

    Would have to be carefully “controlled” for social class and ethnicity, I suspect.

    Perhaps I should run this as a student project next year – investigate the levels of religious belief in medical students and in a matched sample of science bachelors degree students.

  36. #36 Dr Aust
    July 4, 2007

    Hmm

    Like all research ideas (well, nearly all) someone else has got there first…

    According to a 2005 national survey 91% of US doctors are religious. Wow.

    http://thyroid.about.com/b/a/180174.htm

    - the full references (free) is here:

    http://www.blackwell-synergy.com/toc/jgi/20/7

  37. #37 Justin Moretti
    July 4, 2007

    Who is the first priority for medical care in a battle? Not the worst off, but the ones most likely to be able to go back out and kill some more if they are treated.

    Dianne, I think you should go and do some reading about how trauma victims are triaged, i.e. sorted out according to priorities. The damage done and the immediacy of any threat to life dictate priority, not the rapidity of post-treatment return to function.

  38. #38 TheProbe
    July 5, 2007

    Diane said” “Who is the first priority for medical care in a battle? Not the worst off, but the ones most likely to be able to go back out and kill some more if they are treated.”

    Incorrect. Having been a beneficiary of field triage, I can assure you that the first evacueee is the one who is bleeding the most, even if survival is not likely. I waited nearly two hours for a dust off after the first evac of a friend with a serious head wound (he did survive, but with substantial neurological and cognitive sequelae) because ground fire was too intense to allow another helicopter into the LZ. I was able to function during that time, as we had a superb medic who knew his business. Two others merely waited, simply because our medic would not allow them to stand with their leg wounds and risk further blood loss. All three of us returned to duty within three weeks. The first out never returned to duty.

  39. #39 trrll
    July 5, 2007

    I can’t speak for doctors in the UK, but from my vantage as medical school faculty, I’ve been very impressed with US medical students. I’ve detected a distinct change over the years. 25 years ago or so, I encountered a lot of medical students who were arrogant and self-centered, and really seemed to be in it for the money, but I’ve hardly seen anybody like that in recent years. Back then, an MD degree was virtually a license to print money. Modern medical students invest a huge amount of time and money in their education, and given modern issues with insurance compensation and the like, they have little idea how much they’ll be making by the time that they finish. The students that I meet today seem to have a genuine calling and to be motivated by a desire to help people.

    That being said, however, I’m inclined to doubt whether such motivation provides reliable immunization against the kind of political fanaticism that enables people to ignore the humanity of others and commit terrorist crimes.

  40. #40 Inquisitive Raven
    July 5, 2007

    Dianne: “Who is the first priority for medical care in a battle? Not the worst off, but the ones most likely to be able to go back out and kill some more if they are treated.”

    Chiming in on the triage discussion, I would point out that the first priority for medical care in any mass casualty situation is the patient who’ll get the most benefit from it. Depending on the circumstances, that may not be the worst off. The basic issue is limited resources available for treatment. You can’t afford to waste them, so the patient who’ll probably die no matter what you do has a lower priority than the patient who can be saved with treatment but won’t make it without. FTM, the patient who’ll probably make it without treatment also gets bumped to a lower priority.

    I was taught that in a civilian EMT class.

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