With only marginal exceptions, everyone in Gaza is sick, injured, or both. This includes every national aid worker, every international volunteer, and probably every Israeli hostage: every man, woman, and child. While working in Gaza we saw widespread malnutrition in our patients and our Palestinian healthcare colleagues. Every one of us lost weight rapidly in Gaza despite having privileged access to food and having taken our own supplementary nutrient-dense food with us. We have photographic evidence of life-threatening malnutrition in our patients, especially children, that we are eager to share with you.

Virtually every child under the age of five whom we encountered, both inside and outside of the hospital, had both a cough and watery diarrhea. We found cases of jaundice (indicating hepatitis A infection under such conditions) in nearly every room of the hospitals in which we served, and in many of our healthcare colleagues in Gaza. An astonishingly high percentage of our surgical incisions became infected from the combination of malnutrition, impossible operating conditions, lack of basic sanitation supplies such as soap, and lack of surgical supplies and medications, including antibiotics.

Malnutrition led to widespread spontaneous abortions, underweight newborns, and an inability of new mothers to breastfeed. This left their newborns at high risk of death given the lack of access to potable water anywhere in Gaza. Many of those infants died. In Gaza we watched malnourished mothers feed their underweight newborns infant formula made with poisonous water. We can never forget that the world abandoned these innocent women and babies.

We urge you to realize that epidemics are raging in Gaza. Israel’s continued, repeated displacement of the malnourished and sick population of Gaza, half of whom are children, to areas without running water or even toilets available is absolutely shocking. It was and remains guaranteed to result in widespread death from viral and bacterial diarrheal diseases and pneumonias, particularly in children under the age of five. Indeed, even the dreaded polio virus has reemerged in Gaza due to a combination of systematic destruction of the sanitation infrastructure, widespread malnutrition weakening immune systems, and young children having missed routine vaccinations for nearly an entire year. We worry that unknown thousands have already died from the lethal combination of malnutrition and disease, and that tens of thousands more will die in the coming months, especially with the onset of the winter rains in Gaza. Most of them will be young children.

Children are universally considered innocents in armed conflict. However, every single signatory to this letter saw children in Gaza who suffered violence that must have been deliberately directed at them. Specifically, every one of us who worked in an emergency, intensive care, or surgical setting treated pre-teen children who were shot in the head or chest on a regular or even a daily basis. It is impossible that such widespread shooting of young children throughout Gaza, sustained over the course of an entire year is accidental or unknown to the highest Israeli civilian and military authorities.

Intro

For reasons this subject has recently become very relevant to me. I would like to discuss the nature of parental abuse through the lens of Dnd so that… our dnd games will be more realistic and emotionally cathartic. It's a pretty thin veil over what I'm actually talking about so those unfamiliar with Dnd will find this perfectly understandable. As your cptsd buddy who gets it, this is your literal trigger warning before choosing to continue and I don’t want to hear any crap about it from anyone who doesn’t know why it’s necessary to include this sentence. Without further ado, these are my tips and guidelines for understanding how to run a player character who has an evil-aligned parent who left them with cptsd:

Terms

Abuse, neglect, and exploitation are the tools of evil-aligned parents, but there are differences in manifestation of these tools whether the parent is chaotic evil, a demon, or lawful evil, a devil. The evil carried out by demon or devil parents has similar effects on the victim (feelings of worthlessness, anxiety, unresolved latent rage, depression, unrelenting stress, suicidality, etc.).

• Abuse is inappropriate treatment of an individual. It includes physical, psychological, emotional and sexual abuse.

• Neglect is the refusal or failure of a caregiver to provide for the needs of a child or vulnerable adult.

• Exploitation is taking improper advantage of an individual. It can involve finances, material, labor or activity.

Demon Parents

The destruction of the demon parent is obvious to most people and this is the kind of parent who is commonly described as a “monster.” The demon parent behaves like an unpredictable greedy animal who takes what they wish from their family as they please, including the satisfaction of their suffering. They disregard all ethics and morality in the pursuit of physical pleasure that they can never quite satisfy. The anger of feeling this lacking is relieved by using family members for target practice. Everyone in the family is consciously afraid of the demon parent because the demon parent will do whatever they want to vulnerable people to fulfill their sick desires without reservations or justification. The needs of others can not be conceived of by individuals depraved in this way and they use threats to coerce others into behaviors which benefit the demon. Demon parents, when discovered, receive deserved universal condemnation and in many cases criminal punishment.

• Abuse: Physically harm family members at any time for any reason.

• Neglect: Family focused on keeping demon parent placid, wouldn’t dream of provoking the demon-parent with expressions of need.

• Exploitation: Demon parent makes demands and use violence or the threat of violence to coerce their victims into performing services for them.

Devil Parents

Devil parents are most interested in conducting their evil within the bounds of established rules or through the arbitrary interpretation of those sometimes recently invented rules. Although their methods are different than the demon parent’s, the desire to exert control and be served is the same regardless of the kind of evil methods the parents employ. While demon parents’ chaotic nature prevents them from fully integrating into society or holding any kind of wealth or power therein, devil parents are experts in manipulation and exploitation who often find themselves in positions of leadership in society, equipping them with servants to use against their victims. They can convince a person who they are abusing and exploiting to be thankful for being tolerated. Their specialty is for their victims and onlookers to view their abuse as fair, justified, or mundane because individual incidents appear, especially to the victim, to be non-abuse as the abuse isn’t demonic in nature. The devil makes their victims feel indebted to them so that they continue to serve. Family members are used up until they are totally consumed, which frustrates the devil parent because they demand to be served regardless of the mental or physical condition of their victims, so they shame their victims to work through any amount of pain or disability. Their victims, conditioned by their own parent to believe that this is a natural parent-child relationship, is ashamed of the anger and frustration they feel and learn to suppress their ideas, their desires, and their emotions because all could be used as tools by the devil parent to demean and shame. Devil parents, when discovered, become attractive to potential victims and repulsive but acceptable to most healthy people who do not understand the nature of psychological torment as they have never experienced it, who don’t believe in psychology altogether, or are themselves openly practicing devil-parents as the techniques of devil parents are often celebrated in conservative circles. Shame and plausible deniability keeps victims from admitting that they could have been abused.

• Abuse: Devil parent will systematically deconstruct the egos of their victims so that they believe they are less than human therefore needing to work to earn their place in the family which is framed as a refuge from a society which is even less accepting (which appears to the victim to be true because cptsd victims of any kind of evil-aligned parent were deprived of the skills they needed to be taught to have healthy relationships of any kind). They will punish failure and accept any amount of success neutrally as if it were the minimum possible standard. Demean and shame family members to enforce hierarchy that children exist to serve their parents and be thankful their parents allow them to live. Anything to shatter confidence and self-respect is on the table unless some rule forbids it.

• Neglect: React to expressions of need or emotions with shaming and condemnation. Make victims feel embarrassed for having physical and emotional needs from their parent. Criticize the lacking nature of the child’s self-taught attempts to take care of themselves so that they feel incompetent and worthless. Ignore health problems caused by neglect, convince victims they are not having health problems since they weren’t neglected. Tell the victim they are not experiencing the emotions they are experiencing and by faking them are not living up to their obligations to the devil parent. Children of devil parents view death as a welcome retirement from the required service of their devil parent’s domain which would be selfish to indulge in while the parent “needs them”, and feel guilty for wanting to die despite having a such an extraordinary and “loving” devil-parent.

• Exploitation: The Devil’s primary purpose is to enthrall their victims, family and beyond. They believe others to be opportunities or obstacles. They will use systemic psychological torment techniques (which they likely learned from their own devil parents and chose to perpetuate) to make their victims feel that their only purpose is to serve the devil parent and be ashamed by any thought that is not oriented to benefiting the devil parent.

Neutrally Evil Parents

It is also possible for a parent to be aligned neutral-evil and have a mix of the above distinguishing characteristics, as a parent my PC is familiar with. The neutral evil parent is a resentful ticking timebomb who will perform their evil lawfully when calm and chaotically when enraged.

Roll a d4

• Evens the neutral evil parent is calm and practices evil lawfully, use devil guidelines.

• Odds the neutral evil parent is enraged and practices evil chaotically, use demon guidelines.

PC Background Skills

PCs with cptsd, while debuffed from a panicked and disorderly survival mind, do have some unique abilities. PCs with Cptsd have an inflated perception skill because for their own safety they learned to never stop scanning their environment for potential threats ever. They tend to be excellent at identifying others by the sound of their footsteps and are themselves gifted at stealth and deception. They have skill in insight due to constantly monitoring the emotional state of the evil parent so they can hide when they identify the evil parent is becoming dangerous. PCs may have some skill in nature, survival, and medicine due to the practical experience of having to figure out how to care for themselves as children.

Depending on the nature of the abuse and the personality of the Player character, the PC could attain the Narcissist or Sociopath attributes. Unlimited ego from oneself and a disregard for all others may allow one to survive a chaotic and deprived environment, however applying this solution will shift the PC's alignment to evil.

Conclusion

Hopefully someone will get some use out of this… for their Dnd game. For anyone who has a player character who feels nothing but pain and knows their loving parents are related to that somehow but feel too guilty to explore that emotion, have your player character explore and radically accept the validity of that emotion in a controlled environment. The character will feel more acute emotional pain than they ever had before because it had accumulated over a lifetime and the body keeps the score, but the character will feel some relief from the constant ambient pain which had to be suppressed before. When they accept their own emotions and their own inherent worth, they can re-contextualize their experiences, learn the skills they were deprived of, and go on to lead a happy and fulfilling life at any age. That’s what I’m hoping for my PC. I'd like to hear from anyone who has a personal interest in this topic. For characterization purposes, do you think a PC in these circumstances might forgive their evil parent since they came from an evil background they are incapable of overcoming or condemn their evil parent for never being critical about how their behavior affects themselves and others in their entire life?

“What has happened in Gaza over the past nine months is devastating. The images of dead children and desperate, hungry people fleeing for safety, sometimes displaced for the second, third or fourth time,” Harris said. “We cannot look away in the face of these tragedies. We cannot allow ourselves to become numb to the suffering. And I will not be silent.”

Speaks for itself. We've been beyond satire for a long time but this one still got me.

The reason I choose to continue living is that I only have one chance to inhabit a mortal body in this world so I’d like to see it through for as long as I can. What’s yours?