How the Horrible Hospital Explosion in Gaza Changed the Trajectory of Biden’s Emergency Israel Trip

President Biden was taking chances when he decided to become the first American president to visit Israel while a war was going on. There were concerns about his physical safety and about the political risk of trying to make an impact but coming home with nothing.

But no one could have predicted that his trip would be thrown for a loop by an explosion at a Gaza hospital that may have killed hundreds. The blast was initially blamed on Israel but was more likely a terrible accident caused, it now seems, by an errant rocket fired by Islamic Jihad, an Iranian-backed militia that occasionally allies with Hamas.

No matter. In the hours between the initial charge and the release of evidence to the contrary, thousands of enraged protesters across the Middle East took to the streets, and even moderate Arab heads of state were compelled to denounce Israel for the heinous act. A summit in Jordan—which Biden was scheduled to attend with the leaders of Egypt and the Palestinian Authority—was called off.

The summit—which hadn’t been publicly announced until Jordan’s King Abdullah canceled it—would have outlined plans to bring humanitarian aid into Gaza but may also have broached proposals for releasing hostages and preventing the war from widening. It would have bolstered Biden’s image as an effective diplomat—and even could have improved Israel’s security and the well-being of Palestinians in Gaza.

The explosion at the hospital ended those prospects—ended the very possibility of any Arab leader so much as meeting with Biden, whose first order of business was reiterating his support for Israel. Even if definitive proof absolves Israel of blame for the explosion, protesters across the Middle East will not believe it—and the Arab leaders aren’t likely to take the risk of trying to change their minds.

The incident could also broadly damage relations between Israel and the region’s Sunni Arab nations, which had been improving in recent years as a result of their common enmity toward Iran. In particular, it is almost certain to set back the prospects for normalizing relations with Saudi Arabia. Serious talks normalizing Israeli-Saudi relations—along with the growing sense that both Israel and the Arab nations were ignoring the Palestinians’ plight—may well have spurred Hamas terrorists to mount their Oct. 7 attack on Israel, killing 1,300 people, most of them civilians, including 31 Americans.

In that sense, Hamas’ attack has so far been a success. Normalization has been, for the moment, derailed. Even the United Arab Emirates—one of the only Arab countries to condemn Hamas for its attack without criticizing Israel for its occupation of Gaza—issued a statement on Tuesday denouncing Israel for the explosion and deaths at the hospital.

Meanwhile, Biden carried on with the Israeli leg of his mission, meeting with its cabinet and delivering a strong, emotional public speech pledging America’s continued support. “Israel must again be a safe place for the Jewish people,” he said, adding, “We’re going to stand by your side.” As he has done before, he issued a warning to countries that are thinking about joining the armed attacks on Israel (“Don’t, don’t, don’t”), noting that he has deployed two aircraft carriers and that 2,000 rapid response force Marines are now within striking range.

At the same time, Biden emphasized—as he has in previous speeches, but more pointedly here—that Israel must obey the rule of law and the laws of war. Living by these laws, which require minimizing civilian casualties, is a hallmark of democracies. It’s what “distinguishes you from terrorists,” he told his Israeli audience. If you give that up, he said, “the terrorists win.”

In that light, he said, “we mourn the loss of innocent Palestinian lives,” including those lost at the hospital (which, he said, citing U.S. intelligence, had not been caused by Israel). He announced that the U.S. would provide $100 million in humanitarian aid for Palestinians in Gaza and the West Bank.

Finally, Biden said, “hard as it is, you must continue to pursue peace.” He said he understood the “all-consuming rage” that Israelis feel about Hamas’ attack and hostage-taking, but he cautioned, “Don’t be consumed by it.” The U.S. “made mistakes” after the terrorist attacks of Sept. 11, 2001, he said. Responding effectively “requires being deliberate, asking very hard questions,” outlining the objectives of a response, and providing “an honest assessment of whether the path you’re on will achieve these objectives.”

It’s unclear what an Israeli—or Israel’s wartime unity cabinet—might take away from the speech. On the one hand, Biden said, justice must be done against Hamas; do what you need to do; we’re sending you more weapons to protect yourselves; we’ll be with you. On the other hand, he warned them not to get carried away, and to avoid killing lots of civilians.

Biden also reportedly urged the cabinet to consider the fate of the hostages, which are believed to number 199, including 13 Americans, as their top priority. This too could make an Israeli military response more problematic—and possibly, if the cabinet heeds Biden’s words, less likely.

More than 360,000 Israeli reservists have been called to active duty. Many of them are poised on Gaza’s northern border, awaiting the order to invade and wipe out Hamas as a terrorist group and political force that can ever do Israel harm again. In recent days, Israel has warned the residents of northern Gaza to move south in order to avoid the coming battles. Many have left, but many have stayed; in some cases, Hamas has blocked them from leaving—wanting them to stay as human shields, either to deter Israel from invading or to compound the casualties for which the group and its allies can blame Israel.

The fallout from the hospital bombing complicates Israel’s military plans as well. The military strategist Lawrence Freedman wrote in his Substack column Wednesday, “There is nothing Israel can do to degrade Hamas as a military entity—siege, air strikes, ground attack—that will not affect ordinary Gazans,” whose lives are “already miserable enough.” This was always understood, but after the hospital bombing, the world’s eyes will be even more trained on civilian casualties—on Israel’s damage to ordinary Gazans—and some of Israel’s foes might be still more enticed to retaliate, believing they’ll be praised for doing so.

If Israel goes through with a ground invasion, the death toll will climb—among Israeli soldiers as well as Gaza’s civilians. Again, Freedman: “I cannot think of a recent example of a properly defended built-up area falling quickly to an offensive, even one relatively well-executed. … In this case the Hamas fighters, numbering about 30,000, can operate out of a labyrinth of underground tunnels.” Israeli troops could rush in quickly—in which case casualties will be high. Or they could move more methodically, slowly picking off the defenses—though the longer the invasion takes, the more international pressure will mount to stop.

Ethan Bronner, the Jerusalem bureau chief for Bloomberg News and a veteran Middle East correspondent, wrote on Wednesday that Israelis are still determined to rout out Hamas. He quoted military spokesman Daniel Hagari as saying, “We have to fight—we cannot live next to our borders with Hamas ISIS governance that threatens our civilians and do massacres where you rape women, behead bodies, kidnap babies.”

Still, as Biden asked, how does Israel achieve its objectives without foiling them in the long run? The summit in Jordan might have made it a little easier to deal with these dilemmas. Now the issues and dangers are more complicated than ever.