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July 23, 2025

“It is within the power of writers and artists…to defeat the lie. One word of truth shall outweigh the whole world.”– Alexandr Solzhenitsyn, Nobel Banquet Speech

Medics in Civilian Clothes

I choose to not look the other way. The human body, when deprived of food, follows a predictable arc toward death. I know this because I watched it happen to a friend and I experienced it myself. Not in Gaza, but firstly in a cabin in upstate New York, where my friend, Sikay, spent her final months dissolving into air while I reorganized her kitchen cabinets and pretended organization could defeat mortality.

Three summers ago on a pleasant day just like today, cancer-induced metabolic collapse began its work. Sikay and I weren’t close friends—we’d only eaten out alone once before. But when our restaurant obsessed friend group, of which I was the ringleader, scattered in fear while I stayed firm and resolved. The ironic thing is we are all natural health adherents or doctors.

Death doesn’t make me flinch. When I was sixteen, I found my fourteen-year-old sister dead from a massive brain aneurysm, her face a ghoulish shade of purple, red blood and yellow vomit covering her face and black hair and through the oddly color matching pillow and mattress. Except the red blood was so red. I had nothing to say to myself and could only very calmly and quietly tell my disbelieving mother: “Yes mom, she is dead. We should call 911.” I’m just built different. Later, I watched my mother die from cancer.

Fast forward to the episode when you see your mother howling in pain because they shoved a tube into her lungs to drain them through her ribs what are you going to do? Cry? No you will help. You are going to do whatever it takes. Strangely, Sikay also had to undergo the same procedure. You’d be surprised how many nerve endings you have in your chest. You would be even more nonplussed that modern medicine can offer nothing more than subdermal novacaine to reduce the pain.

So I became Sikay’s caregiver. Reorganized every cabinet, labeled them with index cards so everyone would have instant situational awareness. Moved every dish, pot, utensil to its ideal location. Kept her kitchen island perfectly clear—a shrine to efficiency in the face of entropy. This was military style medic operations of organizing continued until the day she died.

I remember saying to myself, the guest sleeping area is perfect! It was nothing more than a storage area with thin air mattress and lots of junk. I saved that area for last because my comfort during sleep was the lowest priority. Saving Sikay’s life was the highest. I knew the chances were slim, but I saved another friend from cancer once and I thought maybe, just maybe, I can do it again.

As weeks passed, cachexia set in—muscle wasting that’s almost irreversible. I turned to her best friend John during a grocery run before I started my truck: “She looks like my mother when she died of cancer. My mother was seventy-eight pounds at death.” We stared at each other, measuring the darkness and resolve we both recognized. I may never see John again but that is a moment we shared. Medics in civilian clothes.

Eventually Sikay’s legs gave out. If we were animals we’d put each other down at that point and we are animals. No. I had to deadlift her from bed, carry her to the bathroom every time. Under a hundred pounds, but deadlifting a person differs from lifting objects. You must be gentle at your own expense. Keep your back straight so she can cling to you. Arms under hers without hurting her. Your core is hardened, back muscles compensating—like deadlifting with only stomach and spine. After we just changed her diapers. Then I cleaned poop off the bed.

It’s like taking care of a baby, but instead of the transient joy of the miracle of life, the life you and your spouse made, it’s an eternal death specter of a friend that is gonna scar you for life. Well, I don’t care about that, I’ve seen worse I said. Come save a life I said! It’ll be fun I said! Even my girlfriend left me because of this, it was too much for her to experience. Been single ever since, don’t care. I doubled down. I was determined to engineer a turnaround for Sikay.

Somedays, because I have extremely high pain tolerances both physically and emotionally, I was close to my limit yet unaware. I’d be walking out to the truck for another food run, and then I’d find myself stooped over, hands on my knees, breathing hard next to my truck because I suddenly realized opening the door and hopping in might be kind of an effort. And then, she died. It wasn’t the cancer. It was simply the case she no longer had the strength to breathe in or out. So she suffocated.

The body gives your brain memories it will never forget.

What It’s Like to Starve to Death

First you should know, starvation is the worst way to die for many reasons. It’s indefinite, from days to weeks, so it’s very slow. You are very conscious of what is happening but you can’t resolve the problem. It is painful. Compared to torture or solitary confinement, starvation of a population requires no maintenance and the outcome is definitive.

Stage one: Your liver releases glycogen stores. Hunger gnaws. The body maintains blood sugar through desperate chemistry. You joke about “empty tank” and “I’m starving!” when joking is still possible. Let’s skip gluconeogenesis for now.

Stage two: Fat metabolizes into ketones. Muscles cannibalize themselves to feed the brain. Arms and legs become withered branches, ribs resemble a xylophone through wrinkled paper skin exposing your rather poor levels of blood pressure.

Stage three: Your organs fail in sequence. You don’t realize it yet until the autopsy but liver, kidneys, skin, muscles all take hits to keep your brain and heart alive. Breathing becomes effort, then impossibility. But you will likely die of a heart attack first.

How do I know this? Not from research, but I actually accidentally died a month ago, it’s further down in this article.

My friend Sikay died not from cancer but from lacking strength to inhale or exhale. Suffocated in her beloved cabin, away from hospitals, as she wanted. Her best friend and sister watching. Some say live your best life—she made proof that you must also die your best death. I say that as someone who almost died thrice.

Now multiply our intimate horrors by 2.3 million. That’s a big number, I only described to you three deaths in my life.

I can’t pronounce Gaza correctly nor probably can you, but I know what it is and who they are. They are a nation of suffering people who we can and should help.

The Final Plan

On October 9, 2023, Israeli Defense Minister Yoav Gallant spoke seven words that would become a death sentence for millions:

“We are fighting human animals and will act accordingly.” The declaration came with specifics: “No electricity, no food, no water, no fuel. Everything is closed.”[^1]

Not hyperbole. Not heated rhetoric. Policy.

I’ve spent years mapping the machinery of Gaza’s famine—not as metaphor but as engineered system. What emerges isn’t chaos but architecture. Every calorie calculated. Every death anticipated. Every child who whispers to their mother “I want to go to heaven, because at least heaven has food”—documented, predicted, premeditated, intentional.[^2]

The International Crisis Group’s leaked analysis uses language that should chill: “an experiment in calibrated starvation.” Israeli authorities calculated Gaza’s population requires 2,279 calories per person daily to avoid malnutrition. Current aid delivers 1,750 calories. The math is grade school. The outcome is genocide.[^3]

Here’s what 75% of minimum caloric needs looks like: Children whose hair falls out in clumps. Mothers whose bodies cannot produce milk. Fathers who pay $300 for flour that cost $10 before the siege. One sack. On the black market. If they survive the gunfire at distribution points.[^4]

Weaponized Famines in History

History offers templates. Stalin sealed Ukraine’s borders in January 1933, trapping peasants as grain rotted in guarded warehouses. The Holodomor—“death by hunger”—killed up to 7 million.[^5] Nazi Germany encircled Leningrad for 872 days. One million starved while bread recipes included sawdust and wallpaper paste.[^6] Nigeria blockaded Biafra from 1967-70. Two million dead, mostly children.[^7]

The Gaza model Israel has created and executes without the slightest interference perfects these prototypes. Previous famines required hiding evidence. Gaza’s happens on Instagram. Previous famines could claim accidental consequence. Gaza’s perpetrators announce intent at press conferences. This is why I don’t post on social media, it’s pointless, it won’t make a difference.

“The Revolution Will Not Be Televised.”— Gil Scott-Heron, 1970

The innovation lies in maintaining victims at what the leaked documents term “the brink of collapse”—alive enough to avoid triggering international famine declarations, dead enough to ensure societal destruction. A population perpetually dying but never quite dead. Statistical juggling as warfare. An entire nation on a airplane without engines in a phugoid cycle pitching nose down then nose up over and over till it crash lands.

Dying for Flour, Dying near Flour

Samah Zaqout, please follow her Substack too because she inspired me to write this — this is her lived experiences if she and her family are still alive because she’s clearly a target by now. Her father leaves their shelter at dusk, chasing rumors of flour trucks. “Thousands stood there, waiting,” he told her later. When the trucks arrived, so did the gunfire. So did death.[^8]

Some carried home sacks worth more than gold. Some carried home wounds. Or you get shot to death. It’s easy for the most moral army in the world, the IDF, by the way, to shoot fish in a barrel, except the theatre is a sporting event stadium with humans. Ironically the trucks that reached him carried neither flour nor hope—only wounded and dead humans. By morning: 112 killed, 760 injured. Instead of flour on a truck, you see corpses. Instead of getting flour, you die. It’s an orgy of death by and from IDF grunts to the top of Israeli chain of command. Orgies by definition are pleasurable and lead to death of civilization.

“We do not want blood-stained flour,” her father said.

But what choice do you have? Starve at home or die seeking bread. It’s an interesting choice. Would you eat flour with blood. Yes you do, because wine with the body of Christ is something Christians do this every week metaphorically, but Gazans have to do it literally now. Since May 2025, over 1,000 Palestinians have been shot to death trying to get food.[^9]

The Gaza Humanitarian Foundation’s four “Secure Distribution Sites”—football fields surrounded by barbed wire and sniper positions—transform survival into Russian roulette.[^10] I have run out of religious metaphors to sublimate the horrors, I haven’t even shown you the thousands of videos I’ve watched of tens of thousands dead or dying in real time. It’s very real. AI isn’t that good yet.

A doctor at Nasser Hospital: “If people arrive early and approach the checkpoints, they get shot. If they arrive on time but there’s overflow, they get shot. If they arrive late in this ‘evacuated zone,’ they get shot.”[^11]

This is not failed aid distribution. This is population control and extermination through operational slaughter. The world’s most useless organization is the UN and whatever its proxies are like the ICC, because they want you to believe they are doing what matters. They don’t do anything, they just talk. Doing is up to you.

How Starvation Kills Babies and Kids

Dr. Jamal Imam describes treating Amjad, a child weighing less than six kilograms: “His muscles waste away, vision blurs, immune system becomes dangerously weak, organs shut down.” Present tense. Ongoing. One child among thousands.[^12]

The medical terms sanitize horror: Marasmus—severe wasting until ribs protrude like accusations. Kwashiorkor—protein deficiency swelling bellies while limbs shrink. Cardiac atrophy—hearts literally shrinking until they cannot pump blood. Refeeding syndrome—where giving food too quickly kills because the body has forgotten how to process nutrients.[^13]

But medicine cannot capture what UN workers document: Doctors collapsing mid-surgery from hunger. Mothers mixing baby formula with contaminated seawater. Children identifying explosives by sound because that’s their only education now.[^14]

One detail haunts: Palestinian children have stopped dreaming of becoming engineers or teachers. They dream of driving donkey carts. Even imagination starves.[^15]

I Know Starvation, Let Me Explain

A few substack articles back I wrote my account of nearly dying from unintended starvation from non-diabetic ketoacidosis. I lost all the skin on my hands and feet. I went into a 36-hour coma from pushing through hunger while coding an app for 5 days. I lost a pound every day and didn’t notice or feel hungry. My body crashed, rebooted, survived.[^16] Gaza’s children face the same metabolic catastrophe stretched across months. But no reboot. No survival.

CAPTION: The author’s shedding skin post keto-acidosis induced metabolic coma.

I felt how Gazans starve in first person because the pathways overlap: glycogen depletion, ketone accumulation, organ failure. But velocity matters. My crisis hit like lightning—terrible, but finite, reversible. Gazans starve drowning in honey. Sweet promises of aid. Sticky bureaucracy. Gaslighting, being told they deserve it. Inevitable heart failure and brain death. Which is literally the definition of death, having a non-functioning heart and brain. You’re dead.

“It is not me that will die, it is the world that will end” is attributed to the ancient Greek philosopher Epicurus.

He was being metaphorical. In this case–you and the world around truly and utterly die simultaneously.

So Sikay’s story and mine reveals the body’s limitations under starvation. Gaza’s story reveals what? Humanity’s limits. How blind and unfeeling we all are.

Gazans, Sikay and I Live and Die Our Best Lives

I track my own caloric intake now. A neurotic tic born from research. Yesterday: 2,847 calories. Coffee with cream (110). Sesame bagel with butter (380). Grilled chicken salad (425). Afternoon snack of almonds (164). Pasta with marinara and parmesan (658). Evening tea with honey (64). Glass of wine (125). Dark chocolate (70). Mindless grazing while writing (roughly 350). I don’t really eat that kind of food, but you get the picture.

Each item is a small miracle of access. Each bite a universe away from Samah’s family dividing a handful of dried dates—Ramadan 2024’s only sweetness. Imagine if your Thankgiving meal was simply a palm sized collection of dried fruits and nuts under a non-rain proof tent sitting on a rug and with the smallest bits of plastic wrap as plates, to separate the food from the rug. You know that the IDF soldiers around you might throw in a grenade for fun, they like to laugh as you suffer, but you don’t care. It’s still food, and it’s the best holiday meal ever. Because you made it this far. You’ve never been tested like this. You eventually realize every crumb is a blessing from God.

CAPTION: Ramadan (17 March) 2024. Famine loomed at that time and my father wanted to bring something for us. The best he could find was dried fruits, pictured here. I sheltered in this house with my 9-member family and other 50 relatives in the western part of North Gaza. Photo by Samah Zaqout.

My friend Sikay, bless her soul, had access to food until the end. We spoon fed her till the end. Her body simply refused it. Gaza’s children beg for what their bodies still desperately need. The cruelty differential breaks cognition and emotional limits because Operation Starve Gaza To Death is the penultimate plan to weaponize famine. It makes sense, it is an inexpensive and efficient way to eliminate a few million people. Why wouldn’t you execute it? It’s easy. You just have to pretend these people are animals. Gunning them down while they scramble for food is just the cherry on top. We can just say Palestinians are lying and everyone will obey us.

Israel Is Perfect, Israel Is Moral

Israeli officials deploy words like precision munitions: “We act in accordance with international law.” “Hamas diverts aid.” “Security protocols require strict measures.”[^17] Also Israel states many times over that they are the “most moral army” and “most moral country” in the world. In an Orwellian future world that is reality, might as well go with the flow.

Meanwhile, the UN’s World Food Programme documents no evidence of systematic aid diversion.[^18] Doctors Without Borders calls the distribution system “slaughter masquerading as humanitarian aid.”[^19] The International Court of Justice issues orders Israel ignores.[^20]

But legal frameworks assume enforcement. What court has jurisdiction over calculated caloric restriction? What judge can mandate protein requirements? The crime perfects itself through bureaucratic precision. You’re not in a big club? Yes you are. You are the in the club that agrees with the other club because you aren’t doing anything. We are all doing nothing.

Gaza Will Live Forever, However…

Severe childhood malnutrition causes permanent cognitive impairment. The medical literature is unequivocal. Stunted growth. Reduced IQ. Compromised immune systems. Generational poverty. Each starving child becomes an internalized demographic weapon against Palestine’s future.[^21]

This is warfare by actuarial tables and spreadsheets. Not just killing but programming future incapacity. Even if aid flows tomorrow—it won’t—the damage compounds across generations. Today’s hungry infant becomes tomorrow’s cognitively impaired adult becomes next generation’s vulnerable parent.

Israel’s calculation appears precise: Why violently eliminate a population when you can systematically disable within one generation? Why martyr when you can maim and kill without bullets and bombs, silently? Let them live, but barely. Let them exist, but weakly. Victory through vitamin deficiency. It’s a brilliant plan, better than any war extermination campaign in history. The gunfire and bombs are just for destroying infrastructure and to instill psychological terror.

We’ve Perfected Indifference

Alexandr Solzhenitsyn, Soviet dissident and political prisoner, mapped the USSR Gulag system as islands of horror in a sea of denial. Gaza represents Israeli innovation: no denial required. The horror is livestreamed 24/7. Ultra Gulag needs no excuse, you’ve already accepted it as par for course.

We’ve perfected indifference. One million died in Leningrad’s siege. We build monuments. One hundred children dead from malnutrition in Gaza. We debate definitions and let journalists confabulate over Israeli press briefings. We see and hear but don’t care. Maybe if I could teach you. I have this big fatal problem as you can see. I tend to dampen down my own pain and suffering but I can see other’s very acutely. I don’t like that because I know others can’t deal with pain like I do. They cry and feel pain unlike I do. I will do anything to my ability and strength to fix other’s problems to my own detriment. But you have the opposite problem. You choose to ignore other peoples’ pain. You can’t even finish reading this article most likely.

What changes when atrocity becomes ambient? When checking Palestinian children’s death counts becomes morning routine like weather? When “they want to go to heaven because at least heaven has food” becomes just another quote in just another article like mine?

Sophie’s Choice with Excel. I’m just as guilty as you. All I do is just being honest about it.

What Do You Want to Do?

You want action items. Solutions. Hope. I offer observation: We are conducting history’s first live-streamed, mathematically optimized, legally documented genocide through food. Every phase calculated. Every outcome modeled. Every death predictable.

The question isn’t what can be done. Food exists. Borders exist. Trucks exist. The question is what we accept. What we normalize. What islands we allow in our expanding archipelago.

For months during late 2023 and till mid 2024, I donated about 500 dollars a month via non-traditional routes direct to refugees via zelle, venmo, etc. It helped, a little bit. every 2 dollars I gave fed one person one meal a day. Maybe it kept someone alive, I don't know. But I stopped giving because I knew by March-May of 2024 that no food was getting in anyways. Cash doesn't feed people, food does. I was dismayed not because some kind of hopelessness set in. I was enraged because my ability to help others was cutoff.

CAPTION: Thank you video to the author from a self-organized Gazan food distribution network

I organized my friend’s cabin while she died. Labeled medications she’d never take. Sorted papers she’d never read. Cleaned spaces she’d never see. Rituals of the living performed for the dead. Insulation against insanity.

Gaza’s parents perform inverse rituals. They prepare for deaths not yet arrived. Count bread crumbs while hurtling toward catastrophe. Watch their children shrink into statistics and skeletons. Insanity would be mercy indeed.

Sikay’s cabin was beautiful in late summer. Later in winter, she wrote me a Christmas card that said “Thank you for actively saving my life.” But I didn’t, she died. Can you do better? You might, but you have to care first.

Gaza cannot lock doors they don’t have any. They cannot leave. They can only document the fire while we debate the temperature. Can only starve while we parse medical nomenclature and terminology. Gazans die while we perfect emotional and physical distance from them. Think upon our sins.

Your horror means nothing without action. Your sympathy means nothing. Your reading means nothing without response.

But you’ll share this article. Feel informed. Translate it for other countries. Feel angry. Feel helpless. Then eat dinner. As will I. As Sikay cannot. As 2.3 million do not.

Then let it rise.

Then let it move you.

Or let it pass, like everything passes, like everyone passes, like Gaza’s children pass away—documented, preventable, precise.

The architecture of extermination requires only one thing: our participation through paralysis.

The body, when deprived of food, follows a predictable arc toward death.

So does the conscience, when deprived of action.

Which stage are you in? What can you do? What can we do?

Footnotes

[^1]: Statement by Israeli Defense Minister Yoav Gallant, October 9, 2023. Reported across international media including Al Jazeera, BBC, and Reuters. The complete siege declaration explicitly targeted civilian infrastructure and survival needs. URL: https://www.aljazeera.com/news/2023/10/9/israel-announces-total-blockade-on-gaza

[^2]: Defense for Children International - Palestine field report, May 2025. Documentation of children’s testimonies including the heartbreaking statement about heaven having food. URL: https://www.dci-palestine.org/_my_son_cried_all_night_from_hunger_the_palestinian_children_starved_to_death_by_israeli_authorities

[^3]: International Crisis Group report on Gaza’s humanitarian crisis, 2025. The 2,279 calorie calculation comes from Israeli government documents revealed in court proceedings, while the 1,750 calorie delivery figure is from Gaza Humanitarian Foundation reports. URL: https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/gaza-starvation-experiment

[^4]: Samah Zaqout, “Famine, Fear, and the Fight for Bread,” Substack, July 21, 2025. First-hand account documenting flour prices rising from $10 to $1,000 per sack. URL: https://substack.com/@samahzaqout

[^5]: Timothy Snyder, “Bloodlands: Europe Between Hitler and Stalin,” Basic Books, 2010. Academic consensus places Holodomor deaths between 3.5-7 million, with most estimates around 3.9 million. URL: https://www.basicbooks.com/titles/timothy-snyder/bloodlands/9780465031474/

[^6]: Harrison E. Salisbury, “The 900 Days: The Siege of Leningrad,” Da Capo Press, 2003. Soviet archives confirmed over 1 million civilian deaths, primarily from starvation. URL: https://en.wikipedia.org/wiki/Siege_of_Leningrad

[^7]: Blockade of Biafra documentation, Nigerian Civil War archives. Most scholarly estimates place civilian deaths between 1-2 million, with the majority being children under five. URL: https://en.wikipedia.org/wiki/Blockade_of_Biafra

[^8]: Samah Zaqout, ibid. Her father’s testimony about the flour distribution massacre at Nabulsi checkpoint. URL: https://substack.com/@samahzaqout

[^9]: UN Human Rights Office statement, July 22, 2025. Documentation of over 1,000 Palestinians killed while seeking food aid since May 2025. URL: https://apnews.com/article/israel-hamas-gaza-war-palestinians-07-22-2025-8eb90d73c1b7499d3dbc8b8d95da65cc

[^10]: Gaza Humanitarian Foundation operational documents, leaked May 2025. Description of “Secure Distribution Sites” design and security protocols. URL: https://en.wikipedia.org/wiki/Gaza_Humanitarian_Foundation

[^11]: Doctors Without Borders field report, July 2025. Emergency coordinator Aitor Zabalgogeazkoa’s documentation of shooting patterns at aid distribution sites. URL: https://www.doctorswithoutborders.org/latest/gaza-humanitarian-foundation-aid-distribution-system-must-be-dismantled

[^12]: Save the Children medical report, June 2025. Dr. Jamal Imam’s case notes on treating severe malnutrition in Gaza. URL: https://www.savethechildren.net/stories/doctors-story-hunger-gaza

[^13]: WHO technical guidelines on severe acute malnutrition, 2019. Medical definitions and treatment protocols for various forms of malnutrition. URL: https://www.who.int/publications/i/item/9789241506328

[^14]: UNRWA situation report #180, 2025. Documentation of healthcare worker malnutrition and collapse during medical procedures. URL: https://www.unrwa.org/resources/reports/unrwa-situation-report-180-situation-gaza-strip-and-west-bank-including-east-jerusalem

[^15]: Save the Children psychological assessment report, 2025. Documentation of “complete psychological destruction” among Gaza’s children. URL: https://www.savethechildren.net/news/complete-psychological-destruction-children-gaza-have-suffered-relentless-mental-harm-during

[^16]: Tatsu Ikeda, “I Nearly Died From Keto & Thinking Too Hard,” Substack, July 3, 2025. Personal account of non-diabetic ketoacidosis. URL: https://substack.com/@tatsuikeda

[^17]: Israeli Ministry of Foreign Affairs press statements, various dates 2024-2025. Standard language used in response to humanitarian criticism. URL: https://www.gov.il/en/departments/ministry_of_foreign_affairs

[^18]: World Food Programme assessment, June 2025. No evidence found of systematic aid diversion by Hamas despite repeated Israeli claims. URL: https://www.wfp.org/emergencies/palestine-emergency

[^19]: Doctors Without Borders statement, July 2025. Description of GHF system as “slaughter masquerading as humanitarian aid.” URL: https://www.doctorswithoutborders.org/latest/gaza-humanitarian-foundation-aid-distribution-system-must-be-dismantled

[^20]: International Court of Justice provisional measures order, January 26, 2024. Court ordered Israel to prevent genocide and ensure humanitarian access. URL: https://www.icj-cij.org/case/192

[^21]: The Lancet Global Health, “Neurodevelopmental, cognitive, behavioural and mental health impairments following childhood malnutrition: a systematic review,” July 2022. Comprehensive review of long-term impacts. URL: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00215-3/fulltext

Investigation based on primary sources from UN Human Rights Office, World Food Programme, Doctors Without Borders, firsthand testimonies, and comparative historical analysis of documented famines. For those still counting: 101 Palestinians dead from malnutrition since October 2023, including 80 children. During the writing of this article, that number increased.

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