It’s not photoshop it’s slop.

Which part? The entire image, with the exception of the patient, is just the AI image Trump posted last week. The patient’s face is just the photograph of that Israeli settler from the cover of some magazine.

Combining two images with Photoshop is a pretty normal way to use Photoshop. Complaining that a particular source image is AI ignores the actual reason why it was posted, and why there was an editorial reason to want to post an otherwise faithful copy of the original, modified in a specific way.