"The Hippocratic oath is null and void for practicing Muslims [because] when a call for jihad is made by the emir [Osama bin Laden] everyone must answer including doctors and surgeons." That's Khalid Kelly, a radical Irish convert to Islam, responding to my question about how doctors, sworn to protect human life, could possibly have sought to kill innocent civilians in a London nightclub and Glasgow airport last weekend.

The revelation that six out of the eight suspects arrested in relation to the most recent U.K plot were doctors should actually cause little surprise. Al Qaeda's Egyptian number two, Ayman Al Zawahiri, is a qualified surgeon who, according to some reports, even today practices medicine in the tribal regions of western Pakistan. Zawahiri was no ordinary surgeon according to his uncle, whom I spoke to in Cairo earlier this year, but was regarded as a "genius" by his peers at a Red Crescent hospital in Peshawar, Pakistan where he did stints during the 1980s. In fact Zawahiri was not even the only surgeon-jihadist in that hospital. Its director, Dr. Sayyid Imam (also known as Dr. Fadl), founded the Peshawar wing of the terrorist group Egyptian Islamic Jihad and was a key mentor to Zawahiri and other future al Qaeda leaders.

Jihadist groups such as Al Qaeda have particularly focused their recruiting efforts on attracting highly skilled individuals, like doctors, as operatives. Such recruits are more likely to have the technical skills needed in assembling explosive devices and the discipline required to carry off an operation. Al Qaeda's standardized application form, discovered by the U.S. military in Afghanistan after the fall of the Taliban, required candidates to specify their precise educational achievements and to list their "intellectual" and "professional skills." This helped Al Qaeda recruit only the most promising operatives from the thousands of jihadists present in Afghanistan.

Al Qaeda's preference for skilled recruits was borne out by a 2006 Washington Quarterly study by Peter Bergen and Swati Pandey of the academic backgrounds of the 79 jihadist terrorists responsible for five of Al Qaeda's largest anti-western attacks. They found that more than half had had at least some higher education. Fifty-eight percent of those had attained a degree in a scientific or technical subject, and engineering was the most popular choice of degree followed by medicine. (These findings and the fact that doctors were involved in the most recent terrorist plot debunk theories that jihadist recruitment is socio-economically driven.)

Although no definitive conclusions about those ultimately responsible for last weekend's attacks can yet be made, the involvement of doctors could point to an Al Qaeda hand. Doctors would certainly have made perfect recruits for a terrorist organization trying to infiltrate operatives into the U.K. because of a fast-track immigration route for doctors. Until April 2006 doctors taking training posts in the UK to achieve specialist qualifications did not need to apply for a visa. Additionally a senior Anglican priest working in Baghdad has said that he was told by a senior Al Qaeda operative this April to expect attacks on Britain and the United States and that "those who cure you are going to kill you."

U.S. intelligence sources believe that some of the doctors, mostly of Middle Eastern origin, may well have been recruited by Al Qaeda in Iraq according to CBS News. Additionally, Iraq's National Security Advisor told CBS that Al Qaeda in Iraq had in the last 18 months "changed its recruiting strategy [toward] targeting highly educated and highly intelligent people" and had been "systematically infiltrating operatives into Europe." (Given that the U.N. High Commission on Refugees estimates that the number of Iraqi refugees to Europe will double to 40,000 in 2007, this diagnosis should be deeply concerning to European counter-terrorism officials.)


Whatever the level of Al Qaeda direction, the involvement of so many doctors in last weekend's plot, raises new concerns about the damage jihadists could inflict on western countries. Medical professionals have access to all sorts of drugs and chemicals that could be used to harm the general population. And some medical staff have access to agents (for example harmful viruses) that could be used to launch a biological attack.

More concerning still is the fact that many hospitals have stocks of radioactive materials used to sterilize medical equipment and for some cancer treatments. These include the radioactive isotopoes Cesium-137 and Cobalt-60, listed by the U.S. government as dangerous isotopes because they have relatively long half lives and could be used by terrorists to construct a radiological device or "dirty bomb," essentially a conventional bomb with radioactive materials packed inside. Although U.S. government scientific reports make clear that such a device would kill few people, the potential for such an attack to sow panic in the public could create serious economic consequences.

Michael Sheehan, the New York Police Department's counter-terrorism commissioner after 9/11, says that, because of this, the doctors' involvement in the U.K. plot is somewhat troubling. Sheehan told me that "during my time at NYPD a dirty bomb attack was a major concern and we developed a number of programs to increase security at hospitals and other companies that handled radioactive materials."

Al Qaeda leaders have themselves made no secret of their desire to launch an attack using a radiological device. In 2004 Al Qaeda ideologue Mustafa Setmariam Nasar argued in an online tract that such an approach was the best way to inflict severe damage on the United States, even inventing the slogan "dirty bombs for a dirty nation." That same year Al Qaeda operative Dhiren Barot was arrested in the U.K., along with a veritable "Ocean's 11" team of accomplices skilled in various technical areas from engineering to building design, for plotting attacks against Britain and America. One of Barot's schemes was to extract the radioactive isotope americium from smoke detectors to launch a dirty bomb attack in the U.K. Abu Ayyub Al Masri, Abu Musab Al Zarqawi's successor as leader of Al Qaeda in Iraq has also made developing such capabilities a priority, stating on a jihadist website in 2006 that there was "a dire need" for experts to be recruited into the organization to help develop "unconventional weapons whether biological or dirty as they call them."


It does not seem as if the doctors involved in last weekend's plot would have held back from such forms of attack. The two doctors that drove their SUV into Glasgow airport last weekend appeared to want to do everything they could to fan the flames and maximize human casualties once their car did not blow up. That brings me to why it was to Khalid Kelly, the pro Al Qaeda Islamist, that I turned to find out more about how doctors could also be terrorists.

It's because until recently Kelly was employed as an intensive care nurse in a London area hospital, working to save lives, all the while speaking out in favor of beheadings of Western citizens in Iraq and supporting Al Qaeda terrorist strikes in the U.K. Kelly who has now left the U.K. permanently because of the government's crackdown on those who incite terrorism, told me this week that "the time for talking is over."

By Paul Cruickshank