To Voice the Unspeakable
On the Fall Equinox 2024, I was out on leave with pay from my faculty position as a Professor of Medicine at the University of California, San Francisco (UCSF) because of my support for the liberation of Palestinians who are suffering genocide. Powerful donors of our public university began another targeted harassment campaign against me which included sending mass emails to people within my institution demanding that I get fired and lose my medical license; I also got waves of death and rape threats, all of this starting in November 2023.
Across the academy in the US, there is a coordinated set of attacks on people of color, our allies and our collective scholarship that centers liberation of all people in all circumstances. In healthcare education, this repression has devastating consequences. The gains of the Civil Rights movement–specifically Title VI–are being weaponized to silence us, defame us and threaten our livelihoods. By framing the demonstration of support for Palestinians or the criticism of Israel as threats to Jewish safety, campuses are effectively silencing advocacy for people of color facing genocide. This weaponization of fragility to silence marginalized people in the academy became evident after the historic response to George Floyd’s murder. We must understand what we are living through to respond in the correct collective manner, to reclaim the ground gained in the Civil Rights struggle. Because we are not going back.
What is most concerning about my particular situation is that those behind the attacks against me appear to work in collaboration with administration in my university, California State Senator Scott Wiener, The Canary Mission—an online doxxing organization with ties to the Israeli state which threatens US academics who support Palestinians —and the largest donor to the university, who supports rightwing anti-Arab individuals and organizations. My suspension follows an eerily similar path of the first tenured professor to be fired in the US for supporting equal rights for Palestinians, Professor of Anthropology at Muhlenberg College, Maura Finkelstein.
Since October 7, 2023, the UCSF administration has become a repressive force against anyone who opposes the genocide against Palestinians or who criticizes Israel. It seeks to quash any critical discussion of its institutional and financial relationships that support this repression. This has resulted in an environment where differing views about violence in the Middle East are suppressed. Those expressing support for Palestinians have been threatened and harmed reputationally and through the loss of livelihood. This pattern of repression is ubiquitous across the University of California and has led to faculty across seven campuses filing Unfair Labor Practices actions, with more joining.
The UCSF’s Chancellor’s office was quick to decry the violence of October 7, and correctly affirmed the value of Israeli lives. Unfortunately, similar condemnations against the killings of Palestinians in Gaza have not been made. Instead, we are met with a chilling silence from the administration, as the genocide in Gaza unfolded, where over two million Palestinians are being starved and well over 40,000 Palestinians have been killed, the vast majority of which comprise women and children. The international peer-reviewed medical journal, The Lancet, has placed the toll of the violence in Gaza since October 7 at just over 180,000 people; a shocking 5 to 7 percent of Gaza’s population. The International Court of Justice has affirmed there is a plausible case of Israel committing genocide in Gaza.
Since October 7, Palestinian paramedics and doctors have been kidnapped, tortured and murdered by the Israeli army and prison guards, and Israel has destroyed almost the entirety of Gaza’s healthcare infrastructure. Today, they are targeting Lebanon’s healthcare system. Over 1,100 of our healthcare colleagues have been killed. Hundreds of letters from faculty, students, trainees, staff and local community have been sent to the university, pleading to take a stand against Israel’s violence in Gaza and affirm the value of Palestinian lives. All of these entreaties have been met with silence and repression.
My role as a physician over the last 22 years, in the communities I serve and at UCSF, has been to speak up for those at the margins of society, whose inferior social position often leads to poor health outcomes. How dynamics of power sediment in the body is the subject of my scholarly work. I raise my voice to uncomfortable truths, highlighting ways in which power entrenches sickness or ensures unnecessarily early disability or deaths for those who lack power. My words at times provoke discomfort and sometimes, embarrassment for some, including my supervisors, the university administration, the City of San Francisco and politicians in California who advance policies that harm the most vulnerable people of our state. My intention has never been to cause harm, but rather, the opposite. I seek to expose the pathology at play, and to invite course correction, so that all may have an opportunity to thrive. The feelings of those who exert power are at times offended by my words, resulting in attempts to police or censor my speech.
The critical connection between protected speech and protected life cannot be overstated. In her foundational essay “Can the Subaltern Speak?” scholar Gayatri Chakravorty Spivak examines the role of the voice in the context of imperialism and colonial capitalist realities. These realities are behind the creation of the University of California, through the brutal dispossession and genocide of the Indigenous people who have lived here for over 10,000 years. These socioeconomic arrangements of power persist today, dictating who lives, how well they live, and who dies. Some California Native people who live an hour away from our health campus still do not have access to running water, which posed challenges as the tribe faced the spread of Covid-19.
The subaltern are the people who are pushed to the margins of society. They include the Natives in the colonial context and the people who receive orders, but do not give them. In summary, those on the losing end of power. To allow them a voice is to endow them with subjectivity, which complicates the project of exerting power over them. In order to bypass innate human qualities of empathy and care, their subjectivity must be denied. It is easier to subjugate, displace and murder people when you do not have to consider their humanity.
This dehumanization is a prelude to all sorts of debased human behavior, exemplified by genocide. Dehumanization has characterized the Israeli government’s treatment of Palestinians since 1948 and in government public communication since October 8, 2023. Israeli genocide scholar and former Israeli soldier Omer Bartov expresses alarm about the societal devolution in Israel, where most Israelis lack the ability to feel empathy for Palestinians, and today, the people of Lebanon too. To speak up for the rights of Palestinians at this moment is to humanize them; to insist upon their subjectivity. This upends a logic where the founders of Israel framed Palestine as “a land without a people for a people without a land,” in one statement rendering Palestinians not only speechless, but also nonexistent. Instead of examining this narrative of erasure, my university took part in it by ensuring that those who speak out against the genocide of Palestinians will be met with censorship and repression.
At UCSF, those who are marginalized include students, staff, faculty and patients from marginalized communities and identities: working class Arabs, Muslims, SWANA, Palestinians, Asians, including South Asians, Sikhs, Indigenous people, Black people, Irish people, women, transgender people, people with disabilities, Anti-Zionist Jews, Queers, Pinay people, neurodivergent/autistic people, allies and more. In my two decades of working at this institution, I have never seen so many different people afraid to speak. And it makes sense, because when you peruse the 581-page Unfair Labor Practices filing you can see the whole suite of repressive tactics that are making people expressing support for Palestinians scared to speak up.
Staff at my university have been disciplined and even stalked for displaying visible support for Palestinians. Nurses have been instructed to remove cultural articles of clothing, or sent home for wearing watermelon pins, symbols of support for Palestinian liberation. Some who refused have been suspended. A chief resident who presents as white revealed his Palestinian heritage during his Grand Rounds lecture, where he spoke on the health crisis in Gaza. Following this lecture, pro-Israeli faculty attempted to have him fired, a few weeks from completing a grueling seven-year residency program. His crime? “Pro-Israel faculty said they felt the resident was calling them baby killers,” reports one who was present at the lecture and who chooses to remain anonymous, for fear of repercussions. This chief resident was bringing attention to the health circumstances of his people during a genocide. At our institution, some faculty and staff have lost 60 family members. Others have lost almost 100. Their grief is rendered invisible and unspeakable at UCSF.
Physicians who have spoken on the harm to children in Gaza–where over 16,750 children have been killed since October 7–have been threatened, shamed or have had their rights to make educational content banned. Health Equity scholars have had their roles limited when mentioning the impact of violence in Palestine, with salary support removed from their activities that were once lauded as critical to the advancement of equity in medicine. Leaked emails show leadership at the Office of Diversity and Outreach harassing people advocating for Palestinians. These so-called ambassadors for diversity shut down all support for anti-Zionist Jewish students who screened Israelism, a documentary by two Jewish directors who expose the indoctrination of American Jews to the supremacist and apartheid ideology of the Israeli state. This same diversity leadership has fired staff advocating for critical dialogue around the impact of Jewish supremacy.
For my advocacy, I have been harassed online, slandered and defamed as a racist, as I said above, bombarded with racist death and rape threats through my social media accounts and work email, have had a plain clothes police officer show up to my lecture where he intimidated students who came to hear me speak, have been placed under investigation, and now, have been suspended indefinitely. What they seem to want is silence, reputational damage and career destruction. This week our only Palestinian faculty member was silenced; the lecture he planned for six months–at the request of students–was abruptly canceled.
These acts occur at the same time that the UC police department received approval for military grade weapons they requested. Students nervously watch as their tuition and our tax dollars are used to buy weapons to be deployed against them for protesting the university’s complicity with Israel’s genocide. This comes in tandem with the university’s increasingly repressive policies. UCLA students understand these weapons are not to protect them, because police stood by and let a violent pro-Israeli mob assault them for hours on campus in April, sending dozens to the hospital. The students understand their safety is not considered by both the police and the university. Their safety and right to protest have been systematically denied.
It is in this context that I wish to share the concerns of those who are afraid and silenced at every level in our institution. I do not claim my words are perfect, but maintain they are never to harass, target, exclude or discriminate. I voice the impact of these patterns of repressive harm and to ask questions of their origins, reach and their long-lasting traces. Every institutional avenue to raise concerns has been turned against us, or removed, since October 2023. There is nowhere for us to go. So we speak and attempt to describe this repression, and the uncomfortable and unsafe positions we are placed in because of these gaps. The administration’s gross negligence to secure the safety of all members is harmful to everyone. My questions seek to correct our course, so we can be in an environment where everyone’s voice and experience is honored.
At the center of this drive to silence me since November 2023 is State Senator Scott Wiener, who regularly surveils my social media posts and amplifies ones he can cast as antisemitic because they mention words like “Zionist” or “Israeli.” He shares my posts with his twist of words and tags UCSF. An onslaught of online vitriol from trolls ensues in addition to the usual university disciplinary proceedings. What has been highly unusual though was the university putting out an online post in response to Wiener’s prodding that triggered UCSF’s anti-abuse advocate Denise Caramagno to speak up for me. This chain of events led to her getting fired.
While Wiener is working to attack a public university professor, he is also busy working to dismantle California’s ethnic studies curriculum. That curriculum is based on scholarly work that gives voice to the subaltern here in California, including California’s Native communities, Japanese Americans who had their farmland expropriated while interned in concentration camps across California’s Central Valley, undocumented immigrants who keep our economy running, and refugees of the Nakba in 1948, who fled here after Israel ethnically-cleansed hundreds of Palestinian villages. Policing voices of the marginalized in the field of ethnic studies is how Wiener hopes to bolster the dominant structures that reinforce his position, while perpetuating dynamics of harm, and consequently, poor health outcomes for marginalized people.
I am not the only Asian women who Wiener cynically cast as racist. During the 2018 senate race, Wiener smeared the Asian candidate Jane Kim as disrespectful of the Chinese community in San Francisco. Kim positioned her platform against the interests of Wiener’s biggest donors; corporate real estate developers such as UCSF’s largest donor, the pro-Israeli Diller Foundation, which has funded multiple rightwing and Islamophobic organizations.
The Dillers are also the largest donor to the entire UC system. They grow their wealth through the for profit Prometheus Real Estate Group, a corporate landlord that inflates local rents, displacing poor and working people in the process. In a case of unfortunate symmetry, the Dillers had also donated to Regavim, a rightwing Israeli nonprofit that funds Jewish settlers working to evict Palestinians from their homes in the West Bank; their donations to Regavin reportedly stopped after those details were revealed. This family is also behind the latest round of enclosing People’s Park in Berkeley, sending sheltering unhoused people packing. They literally put people in tents from Frisco to Palestine. The family’s toxic behavior has earned them the ire of California rapper No$hu–Wiener gets a special shout out “Even politicians do get bought/You can ask that f**king wiener, Scott”–and the status of a boycott target by local Jewish artists and allied activists.
What is so threatening to Wiener that he launches his internet attack-dogs on me? Is he really concerned that a physician and public university professor who dedicates her life to anti-racism and ensuring good care of all members of our communities–including the dispossessed–is a closet hater of the Jewish people? The progressive Jewish community in the Bay Area contested his framing vehemently, and repeatedly. This issue is about power, not identity, ancestry or heritage.
In Wiener’s January 2024 attack on me, he publicly targeted me, framed me as a Jew hater, tagged UCSF and later thanked them when they amplified his words in their coordinated social media posts. In a flurry of tweets and online death threats spurred by Wiener’s posts, the Canary Mission was tagged, after which I was placed on their website, leading to months of online harassment. The Canary Mission is also funded by the Diller Foundation. In January 2024, The Center for Protest Law and Litigation (CPLL) took notice of this public communication between a state senator, a university and the Canary Mission and issued a Public Records Act request for the email communications between these groups. UCSF failed to produce the emails and in August, the CPLL sued UCSF to get access to them.
This is not the first time my university has collaborated with politicians, the media and even lawyers in an attempt to silence me. The first time was after Bay Area Rapid Transit (BART) police shot and killed my former patient, Charles Hill, on July 3rd, 2011. I had taken care of Hill in my medical training, when I rotated as a resident in the San Francisco General Hospital Emergency Room. Over the years of training, I would run into Hill on the sidewalks of the Mission on my walks home from the hospital after overnight shifts. I would check if he had his medications and made sure he was as good as he could be in the challenging circumstances of being poor and unhoused in San Francisco.
I saw the brutal footage showing police gunning down Hill–who was clearly in a mental crisis—within two minutes of the cop stepping onto the train platform. Shocked, I wrote an open letter to my city decrying police brutality. The letter was circulated by the “hacktivist” group, Anonymous, and reached tens of thousands of people. It gained such attention because as protests erupted to denounce Charles Hills’ murder, cell phone use in the area was cut so protestors could not communicate with each other, or to the outside world. Silencing is how power maintains its violence, uninterrogated.
After the letter reached over 10,000 shares, the university’s lawyers called me, telling me I was in big trouble for violating HIPAA patient privacy laws by publicly stating Charles had been a patient of mine and for disclosing his mental health issues. I asked who would press charges against me. The lawyer said, “Well, technically the family.” I replied, “We don’t know his family. He is unhoused and has been living on the streets for years. Do you think his family would be upset that I disclosed my relationship and his vulnerable status as I publicly advocated for him to not get shot by the police?” We now know Charles’ brother tried and failed to get justice for the homicide.
In that moment, the lawyer replied, “I guess not.” I continued, “Was I adhering to my duty as a physician to advocate for my patient who experienced harm and to advocate for vulnerable people like him in our community?”
“I guess so.”
“So, please help me understand the problem.”
The lawyer responded that I was mandated to refresh my knowledge of HIPAA law and retake a training module. So I did. And I continued to speak out. Each time I spoke, I came closer to articulating and exposing how structures of power in medicine—and in society at large—predetermine health outcomes for our patients and ourselves, the marginalized people working in a field whose limits of healing are circumscribed by the power that seeks to silence us.
Since 2011, whenever I have spoken up for my patients neglected within the institution, I have been accused of being “a bully,” “unprofessional” and “aggressive” by the university’s internal reporting processes. When I was called to the office with a faculty coach, the coach reflected that each instance involved me advocating for a Black patient, as a woman of color. They invited the question: who is aggressive? Me, or the system where such practices of harm were occurring? Me, or the system attempting to silence me for speaking up? The naming of the problem was couched as the problem. It continues to be the focus, where statutes around protection at the university are used to silence real concern about vulnerable people’s safety and wellness.
When naming dynamics of power that harm are viewed as more harmful than the dynamics of power causing the harm, we see power entrench itself in an attempt to render marginalized people silent. To evolve our society into one where all may have the opportunity to be healthy, we must confront and discredit this manipulation. We must insist on the right of all to speak freely about repression, oppression and violence, so that we can move to stop violence against all people.
I can introspect on my words, perhaps the awkwardness of them, that inability to convey depth and nuance on social media, or the foolishness of attempting to reduce what has now taken me some 3400 words down to 120 characters. While my language may invite criticism, it does not detract from the impetus that compels me to speak.
I have been a witness and support for countless faculty, staff, students and patients from marginalized backgrounds over the past 20 years at UCSF. Repression against us has never been as oppressive as over the past year. Instead of shifting the approach, the university continues to barrel down this path of harm. Many members of our community express a lack of safety in an institution that seeks to silence us, while characterizing our defense of Palestinian human rights and criticism of Israel’s violation of them, as racist, threatening, harassment and harmful. Defending the rights of Palestinians to live in dignity and with equality is none of these things. I do not excuse my language, but seek to humanize myself, as someone serving a system not built for me, a system which today, harms people like me for standing with the oppressed.
When a woman from a marginalized background speaks, if she can be heard, it is only through the noise of obfuscation. Thus, her concerns are sidelined or rendered moot. The dynamics of power that created the violent separation of humanity, expressed through colonial domination, are intact and unwilling to be contested. But when there is a genocide, we must redouble our efforts and discover the courage we did not know we possessed. To push against the silencing is a struggle we all must carry. This struggle is not only for the people harmed by genocide but also for the offenders who must be invited back from the edge of human depravity to a place of seeing and experiencing our shared humanity.
Recognizing the impact of this strain, I am reminded of the most common question I have been asked by medical students over the last two decades. After considered hesitation, those who have found their voice manage to eek out:
“How do you survive in such a racist institution?”
I have survived because I struggle against the racist structures seeking to silence me, and others like me. I struggle against those who want to hide the voices of those who say NEVER AGAIN, and who–most cynically –defame us as racist or harmful as we speak up for those experiencing racialized harm, including ourselves. The tools that were developed during the Civil Rights era are being manipulated by people of great privilege to silence marginalized people here as those around the world are murdered. Our struggle must be understood through the lens of power–not simply identity–which is what defines this as a decolonial struggle. Our scope has always been global, because these projects of colonial terror have always been global. I engage in this struggle with people from similar backgrounds, because I know it is fundamental in our duty as healthcare workers, as we collectively strive to achieve health for all. For all.
To progress as a community sharing a university and planet together, we must find the courage to resist the reactionary forces that seek to silence us and insist on the humanity of those deprived of it. We must demand our right to speak against these forces that seek to repress us, and for our concerns to be addressed, now more than ever. When doctors do not speak in times such as these, people die. It is a matter of life and death that we must continue to raise our voices. We must take up the collective burden from the elders who moved the needle forward in the 1960s and push forward in this next chapter of Civil Rights to secure the possibility of all people to live a life of health.