On Bearing Witness

 

On Bearing Witness

Author: Samer Attar, M.D. 

Published October 3, 2025

DOI: 10.1056/NEJMp2511323

Copyright © 2025

Why should we bear witness to others’ suffering, knowing that it may scar our minds or stain our conscience? In part, it’s because when we meet someone in distress or read in the news about victims of a bomb, a flood, or an illness, they’re all us. The space between us connects us more than it separates us. That’s why the Talmud and the Quran both teach that saving one life is like saving the whole world — their scriptural meaning is both literal and symbolic.

I’m an American surgeon, and I have worked in Syria, Ukraine, and Gaza. I have been to Gaza six times since December 2023, and I’ve operated at seven hospitals — all of which have since been sieged, bombed, or demolished. Several of my Palestinian colleagues have been injured or killed working on ambulances or in medical centers. I have no bullet or shrapnel wounds, but the scars that are hardest to heal can’t be seen. What did I witness? What did all of it teach me?

In Gaza last year, we operated on 11 blast-induced traumatic amputations in a single day — not including all the pus-filled and maggot-infested wounds. I stopped counting after that.

I spent many nights packing bits and pieces of blown-up little kids into body bags. They’d get dropped off — only skin and bone — in blood-soaked rags and pajamas. No amount of surgical education could ever have prepared me for that.

Parents routinely returned their children — recently declared dead after a bombing — back to the emergency room. They tore at our scrubs. They were horrified that they might have buried their child alive. Sometimes the kids were in fact still alive — borderline clinging to life — but had been declared dead during the overwhelming chaos of mass-casualty triage. Most of the time they were dead. Parents had seen a gas bubble blow from the nostrils, or they swore that they’d seen an arm move. An ultrasound showing a dead heart was unequivocal.

One night we had 60 dead and 200 injured — or what Palestinians call “just another Tuesday.” People died on the floor waiting for care. One 5-year-old child lay on the ground. His intestines spilled out of his belly. His older brother begged me to help. I grabbed his hand and joined it with the child’s. I wanted to say, “I’m sorry. He’s gonna die. Just hold his hand until he does.” Instead, I just stared at him — and then left him there to pound the floor in grief as I took an undignified leap over a father grieving over his daughter’s mangled body to help triage the scores of wounded people still lying on the blood-smeared floor.

One child showed up barely holding on. An explosive blast had shattered her head open. A chunk of shrapnel stuck out of her skull. Fragments of gelatinous brain trickled out and stained her flowered shirt. She was somehow still alive, gasping for breath, blood foaming and bubbling through her mouth and nostrils — one of many cases deemed “hopeless.” We could not waste resources trying to save her, but we didn’t want her to die alone. So we took turns holding her hand until she died.

We shrouded her and took her to the morgue. The white shroud had turned entirely red by the time we got there. Each body bag on the floor told a story. “Show him!” the morgue workers told one of their colleagues. I didn’t need to see the bodies, but they insisted on proving they weren’t lying. One of them opened a bag and pulled out an infant by the legs. He held the body upside down — sliced in half at the abdomen, the shredded insides dangling and flailing from the belly — no torso, arms, or head. The father’s decapitated body lay here — they could not find his head in the rubble. The mother’s body lay there, along with three of her children blended into one bag — a jumbled, twisted, inseparable mass of charred bones and blackened muscle fused together by the energy of the explosion. I can still smell the burnt flesh. One of the security guards spun around and vomited. It was too much for him, too.

We did about 20 surgeries nonstop another day — predominantly on women and children. The first patient that morning was a 25-year-old woman whose breasts had been explosively avulsed from her chest, and her left arm traumatically amputated through the shoulder. Her arm hung by tangled threads of cooked muscle and bone shards. Her two teenage sisters had similar wounds. My Palestinian cosurgeon broke down in tears. He has five daughters, and they reminded him of his children. It was one day for me. It had been 18 months for him and 2 million of his fellow Palestinians. His fear and grief could no longer be caged or compartmentalized.

I would see starving people clawing their way over their neighbors for scraps of potatoes that tumbled off an aid truck onto demolished roads in the rubble of East Gaza. I counseled a father carrying the remains of his daughter in a burlap rice bag — all he had recovered was her head, her hand, and her leg after a bomb had obliterated his home. He couldn’t find any other container to bury her in.

Somehow, I would find myself back in Chicago in the West Loop, queuing patiently with a civil crowd waiting for a seat at the bar at Au Cheval to have a cheeseburger. That kind of reentry jolts the body and scrambles the mind, as any warrior returning from battle can attest. So why keep going back?

As with physical wounds, constantly digging into and picking at psychic scars can infect one’s soul and make one’s mind brittle, rigid, and breakable. But with appropriate care, and if we give our bodies the space and stillness to breathe and heal, our scars can be humble reminders. They can give us the courage and the resilience to stay standing. To build an open mind, a soft heart, and steeled nerves — a balance that takes daily practice against the weight of the world.

As I write this essay, there are still Israeli hostages in Gaza, and hundreds of thousands of Palestinians are homeless, suffering, starving, and dying. Maybe we can’t save the world. Maybe we can’t stop bombs or massacres. Maybe we can’t stop criminals from taking hostages or governments from slaughtering civilians.

But nurses and doctors in Gaza taught me this lesson: I can at least show up and do what I’m good at. I can serve a community, bear witness to its suffering, and then make some noise about it. It’s not much, but it sure beats the hatred, violence, and madness of angry men with their fingers pulling 

October , 2025