In San Francisco, Doctors Feud Over ‘Do No Harm’ When It Comes to War Protests

It looked like any other pro-Palestinian encampment at a college campus in the United States. The tents, the flags, the banners calling for a cease-fire in the Israel-Hamas war.

But this was at the University of California, San Francisco, one of the nation’s pre-eminent medical schools and teaching hospitals. The protesters were medical students and doctors. And the chants of “intifada, intifada, long live intifada!” could be heard by patients in their hospital rooms at the U.C.S.F. Medical Center.

The Israel-Hamas war has frayed social ties around the world, undermining family gatherings and school classrooms. But rarely has it fractured a medical community the way it has at U.C.S.F., where a staff known for celebrating diversity has fallen into an atmosphere of backbiting and distrust.

The university and the medical center are uniquely intertwined, both overseen by the same administration and thought of locally as one premier institution. Unlike other University of California campuses, U.C.S.F. does not have undergraduates and focuses only on health sciences. And for decades, it has built a national reputation for caring for a broad array of patients in the city, from those addicted to fentanyl on the streets to tech billionaires seeking world-class services.

But many say the spirit of camaraderie and inclusion has dissipated since the Oct. 7 Hamas-led attack against Israel. Doctors there have feuded over whether it is appropriate to openly express feelings about the war within the healing confines of a hospital. In interviews, several Jewish doctors said they had taken an oath to “do no harm,” and that meant keeping politics separate from the care of their patients.

But some doctors said they interpreted “do no harm” in a different way, feeling a moral obligation to speak out against the killing of doctors and patients in Gaza where Israeli strikes have struck hospitals. And they said that as a medical community, it was important for U.C.S.F. to take a stand against the war and call for a cease-fire.

Over the past several months, doctors, medical students and patients have filed hundreds of complaints with the university administration. Some have alleged instances of antisemitism on campus. Others have said they were inappropriately silenced when they tried to express pro-Palestinian points of view.

Jonathan Terdiman, a Jewish gastroenterologist, said the behavior that might be tolerated on an undergraduate campus — such as the “intifada” chant — hits differently at a hospital.

“People are coming here for chemotherapy. They have dire illnesses,” Dr. Terdiman said. “When that chant goes up and is heard in the patient care rooms, which it clearly was, it’s a violation of our professional obligations as health care providers.”

Some Jewish doctors said they have darted into side rooms when they have seen staunch Israel critics approaching. Others said they have tried to keep their Jewish identity a secret. Matthew Smith, a doctoral student in biophysics who is Jewish and wears a skullcap, said he has been told by a lab technician that Israel deserved what happened on Oct. 7 and by another student that “Jews control the banks.”

“It kind of staggers me honestly,” said Gil Rabinovici, an Israeli neurologist who directs the Alzheimer’s disease research center at U.C.S.F. “There is a lot of intimidation going on trying to silence the Jewish voice and Zionist voices.”

Jess Ghannam also said he cannot believe what U.C.S.F. has become, given its well-known history as a place of diversity.

He has been at U.C.S.F. for 30 years, specializing in chronic illnesses, including post-traumatic stress disorder. His parents are Palestinian, and he joined protests at the encampment and has worn a watermelon pin, a symbol of solidarity with Palestinians.

Patients have thanked him for wearing the pin, he said, because it acknowledged their horror at the destruction in Gaza. But he said that while he has freely worn the pin, some of his colleagues have been instructed by their supervisors to remove their pins and kaffiyeh.

U.C.S.F. has a dress code prohibiting political symbols in patient care settings, but Dr. Ghannam said staff members for years have worn pins supporting abortion rights, Black Lives Matter and the L.G.B.T.Q. community without repercussions.

“It’s become extremely difficult and painful to walk into buildings now at U.C.S.F.,” Dr. Ghannam said. “There is a fear and a sense of intimidation.”

Some Jewish doctors said they felt the outward displays of support for Palestinians were inappropriate to wear while treating patients. They said that some Jewish patients at a fertility clinic were rebuffed when they asked that the symbols be removed.

“I wouldn’t wear an Israeli flag pin in a patient encounter,” Dr. Terdiman said. “Absolutely not.”

Dr. Ghannam said that he has told some of his fellow protesters to remove signs that he felt were inappropriate, such as one at the encampment that declared “UCSF Kills Doctors,” a reference to the demonstrators’ belief that university investments were supporting the war in Gaza.

But he said that he did not have a problem with the “intifada” chant, which pro-Palestinian activists say symbolizes resistance against Israel in Gaza, but many Jews consider a genocidal call against their people.

“People who are screaming that they don’t feel safe are sometimes conflating feeling unsafe with feeling uncomfortable,” he said.

In December, a task force of hospital doctors focused on antiracism discussed via email whether to issue a statement calling for a cease-fire.

Avromi Kanal, a hospitalist and assistant professor of medicine, responded that while he was “horrified by every innocent death,” he worried that a cease-fire would empower Hamas and encourage kidnapping for ransom.

Dr. Kanal has dozens of relatives living in Israel, including one who hid from Hamas for hours at a music festival on the day of the attack and another who works in forensics and had to identify the bodies of dead children. His grandfather survived the Auschwitz concentration camp, with his forearm branded by the Nazis.

Soon after he sent the email questioning a cease-fire resolution, Dr. Kanal learned that someone had forwarded it to another U.C.S.F. doctor, Rupa Marya, who practices internal medicine and said she focuses on how history and power affect health. She criticized his email on X multiple times over several months without naming him.

But later, in a Substack post, Dr. Marya did refer to him by name and called his email an “expression of anti-Arab hate” that prompted doctors of South Asian and North African descent “to say they do not feel safe in his presence.”

Dr. Kanal said that he was shocked a colleague with whom he had never spoken had blasted him so publicly. He met with university leaders multiple times, but he said they took no action. He then filed a complaint with the school’s Office for the Prevention of Harassment and Discrimination, which responded that Dr. Marya’s speech was protected and closed the complaint.

“It’s not the words of my colleague that leave me feeling unwelcome and frankly unsafe here at work,” Dr. Kanal said. “It’s the persistent unwillingness of my leaders to clearly denounce them and ensure my inclusion in this broad community here at U.C.S.F.”

The university did respond to a different post by Dr. Marya. In January, she said on X that “the presence of Zionism in U.S. medicine should be examined as a structural impediment to health equity” as she shared another person’s post about being “terrified” for “Palestinian, Arab, Muslim, South Asian and Black patients” being treated by Zionist doctors and nurses.

The university, without naming Dr. Marya or quoting her post, said in a statement that the notion that Zionist doctors are a threat to their patients was both antisemitic and “a tired and familiar racist conspiracy theory.”

In a written response, Dr. Marya said the statement by U.C.S.F. that addressed her post was “a disingenuous attempt to silence perspectives they don’t like” and that she has never felt, in her 22 years on the job, “the kind of repression” that she has since Oct. 7.

She said she called out Dr. Kanal because his email was the first time she had heard “a doctor put forward an argument to continue the killing of innocent people.”

“It shocked me to see this and it is a violation of a fundamental ethical cornerstone of our profession to do no harm,” she wrote.

If the doctors can agree on anything, it is that the university administrators have done too little to quell tensions and address complaints.

A U.C.S.F. spokeswoman, Kristen Bole, said the university and medical center are working hard to ensure a healing environment for its patients and respect the free speech rights of its employees. She said that Sam Hawgood, the chancellor who oversees both the school and hospital, has convened meetings with faculty to hear their concerns and has issued public statements denouncing intolerance several times.

She declined to address the specifics of how U.C.S.F. has addressed particular complaints. Mr. Hawgood declined a request for an interview.

Rick Sheinfield, a Jewish lawyer who has seen doctors at U.C.S.F. for 30 years, said that he filed a complaint with U.C.S.F. in January over Dr. Marya’s posts. He was told in April that his case was closed with no action taken.

He said that he and his family have received excellent medical care there — from heart surgery to the births of his two children. He is unsure if he will remain a patient, but said he was certain of one thing: If he was starting to look for medical care in San Francisco now, he would strike U.C.S.F. from his list.

It was not so much the posts of one doctor that bothered him, he said, but what he saw as indifference from the larger community.

“I don’t think they would tolerate this if it were medical conspiracy theories alleging such hateful things about other groups,” he said. “But they are tolerating this.”