UC San Francisco fired me for speaking out against genocide, but as a physician I could not remain silent

Rupa Marya*
Jun 16, 2025

After 23 years of service, I was fired from my position as a Professor of Medicine at the University of California, San Francisco, for being critical of Israel’s violence in Gaza and speaking out against the racism that leads to genocide.

In May 2025, after 23 years of service, I was fired from my position as a Professor of Medicine at the University of California, San Francisco (UCSF). As healthcare workers were being targeted, tortured, and killed in Gaza by Israel’s US-backed genocide, I could not remain quiet. I spoke out as Gaza’s hospitals were bombed. I brought everything I had as a physician dedicated to building a world of health for all, as a scholar of colonialism and health, as an activist who has stood with Indigenous grandmothers at Standing Rock and survivors of racist police violence in San Francisco, and as a mother who cares for my own children and as a corollary, all children. For my protected speech, which was supportive of Palestinian rights and critical of Israel’s violence and the racism that leads to genocide, I was maligned, attacked, and ultimately fired.

But my university’s attacks on me started long before October 7th. For several years, when I would advocate for hospitalized Black or poor patients who were not getting the standard of care, UCSF leadership would call me into the office and chastise me. When I advocated outside the hospital walls for unhoused and other marginalized people who were shot by the police in San Francisco, university lawyers would call me, attempting to harass me into silence.

I have been targeted because the stories I share challenge the powers that be. I am attacked because of my worldview that all beings deserve health–including Palestinians–and because my scholarship reveals that health for all is impossible under colonial dynamics of power, which will always entrench a supremacist logic, thereby relegating certain classes of people to sickness. Our duty as healthcare workers is to put a finger on what ails us and to speak up when we have come to an understanding that can help prevent illness and death. In order to do that, healthcare workers need our voices to be protected and unfettered.

The narrative battlefield

While I endured years of harassment at UCSF when advocating for Black patients’ healthcare, the university’s attacks on me escalated sharply after I started articulating the health impacts of settler colonialism in Palestine. Settler colonialism is a form of colonization where a group of settlers takes over land from a native population, establishing long-term occupation, denying the native group basic rights. Ireland used to be a settler colony, but achieved its liberation in 1922, after over 700 years of brutal British colonization. The U.S., Canada, and Australia are ongoing settler colonial nations. Settler colonial states require systems of supremacy to enforce their legitimacy. Racism is a founding principle of their origin and is a requisite component for their continuity. While the British went around the world characterizing the Black and brown people whose land they stole as “savage,” that racist epithet was first used on the Irish.

When I asked questions about the impact of a supremacist logic in medicine–a worldview that has led to more than 77 years of apartheid, ethnic cleansing, and now genocide–California State Senator Scott Wiener vilified me and then my university followed suit, both twisting my words to cast me as “antisemitic.” The same “reality bending” attacks happened when I spoke publicly about concerns raised by UCSF medical students who were uncomfortable when a new student arrived, announcing they had come from a country with mandatory service in a military that is actively committing genocide. I asked urgent questions of medical ethics: how do we, as a profession, handle situations in which medical schools admit students from a country with mandatory military service that is actively committing genocide?

Although State Senator Wiener framed me as “targeting a 1st year med student for harassment b/c he’s Israeli,” what my questions probed was not about a specific nationality. Israel has mandatory military service and allows people of multiple nationalities to serve in its military. There are currently over 23,000 U.S. citizens participating in the Israeli military, and by extension its war crimes. My concern was neither the student’s nationality, and certainly not their religion, but rather the context of genocide and the action: possible participation in perpetrating genocide. The urgent issue at hand is not my job or the particulars of what I said. It is about our ability to speak out about the brutal genocide in Palestine, which is funded by our taxes. The broader issue is the way settler colonialism creates narratives that justify oppression and silence those who resist.

Distorting and mischaracterizing my words as State Senator Wiener did led to threats to rape or murder me that continued for months. Sponsors cancelled speaking opportunities, and the press repeatedly smeared me. UCSF suspended me, attacked my medical license, and then fired me without due process. No one with a public voice is immune from this treatment. In the most bizarre twist of my case, UCSF’s investigative report, which they compiled with the disgraced Paul Weiss law firm to build a case to fire me, states that there is no first-year Israeli medical student. I was suspended and fired, in part for allegedly harassing someone who may not exist. This twist led my legal team to consider, in the free speech lawsuits filed in state and federal court, the manner in which the overblown reaction to my words was manufactured to silence me. The legitimate ethical concerns I raised about medical professionals being involved in committing acts of genocide remain unaddressed. And the genocide still rages in Gaza.

Shared histories, shared resistance

Settler colonial realities are, by definition, authoritarian. Under the current Trump administration, we see its teeth laid bare, with judges arrested, students abducted, immigrants deported, and doctors fired. The brutal processes we are witnessing in Palestine are not too distant history in the U.S. In 1862, Abraham Lincoln signed the Morrill Act Land Grant College Act, which gave an estimated 11 million acres of land stolen through violent dispossession of Indigenous people to universities across the US. California received 150,000 acres, which was used to start the University of California.

UCSF has its own specific colonial role towards California’s Indigenous people. When Ishi walked out of the woods in Oroville in 1911, the last surviving member of his tribe who was massacred by the State of California’s genocide to clear land for American/European settlers, he was brought to UCSF for care. That care included putting him on display as a “living artifact,” and when he died, stealing his brain and sending it to the Smithsonian. Organ theft and trafficking, morbidly, are other hallmarks of settler colonial violence. Indigenous resistance to these and other gross indignities is criminalized as the stories of our outrage are silenced.

The inconvenient stories I share counter the narrative attempts by my university to brand itself as “Redefining Possible” in health. But what can actually be possible for Black and brown patients from a university that is actively involved in harming them? UCSF lab workers claim they were exposed to harmful radiation at its animal lab located on the Hunters Point Shipyard EPA Superfund site. While expanding the health campus into historically Black neighborhoods upending longtime residents, UCSF offers to study homelessness in Black communities, instead of securing their right to remain. From the Right to Remain to Right to Return, these rights get at the heart of dynamics of power in a world structured through Western imperialism and ultimately dictate who gets to be healthy and who gets to be sick.

The questions I asked that triggered my university to illegally fire me shed light on a patterned trifecta made up of billionaire donors, their lackeys in government and university administrators who work together to target students and academics for their free speech across the U.S., because they do not like the narrative we are speaking, which right now is calling to stop the genocide in Gaza and liberate Palestine. This unholy alliance of oppression, designed to crush support for Palestinians, has been violating the U.S. Constitution by denying our rights to free speech on university campuses and in public across the U.S.. Their activity is not to stop racism. Their goal, in fact, is to reinforce it.

To demonstrate this bias, in the face of glaring racism, UCSF was not inspired to fire Dr. Howard Maibach, after it was publicly revealed that he injected and exposed over 2600 Black and brown imprisoned people to industrial chemicals, without informed consent, while on faculty. These occurred just years after the Nuremberg Doctors’ Trials, which established the field of medical ethics. When this horror came to light in the wake of George Floyd’s murder, UCSF responded with a “mi culpa” and suggested an oral history project as remediation. As of 2022, Maibach was still receiving a $211,417 paycheck as a professor at UCSF. He is represented by “Israel’s lawyer,” Alan Dershowitz, who tried to pressure my university to stop me from speaking at the American Medical Association’s National Health Equity’s Grand Rounds in February 2023, where we explored Maibach’s illegal and unethical behavior through the lens of the legacy of racism in medicine. These are the kinds of stories they hope to silence, because these narratives expose dynamics of history and power alive today that relegate marginalized people to poor health. To make health possible for all, power must be shared, which is exactly what the people invested in settler colonialism fear.

Silencing as genocide enablement

The effect of silencing doctors and other healthcare workers has a particularly grave impact. Because when doctors are silenced, people die. In fact, silencing doctors is a key tactical aspect of how the US-sponsored Israeli genocide has unfolded and accelerated. For six weeks starting in October 2023, I was in daily contact with Palestinian-British surgeon Dr. Ghassan Abu-Sittah, who was operating in Gaza’s hospitals under a state of complete Israeli siege and continued bombardment. He relayed the horrors of operating by phone light after Israel cut the electricity, of amputating without adequate anesthesia because Israel blocked the entry of medicines into Gaza, and of caring for children that Israeli soldiers had deliberately shot in the head.

I shared these reports with colleagues, editors, and organizations across the U.S. and was stunned to see the immediacy of silencing. No one wanted to broadcast the doctor’s alarms about these evolving war crimes. One academic physician said, “I’m afraid to speak up because of my racist boss. He has to sign off on my grant application.” Leadership in medicine across the West made it clear that sharing the suffering and deaths of Palestinians was considered a direct affront to the feelings of people who support Israel. What a callous and depraved arithmetic.

Later in 2024, Dr. Abu Sittah was working in Beirut and throughout southern Lebanon, caring for some of the thousands of people injured in Israel’s synchronised pager attacks, which wounded and killed civilians and children. We observed that as Dr. Abu Sittah worked amid attacks that threatened his life and the lives of thousands of others, I and many others faced attacks on our livelihoods, with suspensions, threats to professional accreditation, along with character smear campaigns launched by our own institutions. Recognizing this pattern, Dr. Abu-Sittah coined the phrase “Genocide Enablement Apparatus,” which we and a dozen other physicians and human rights advocates detailed in a report submitted to the UN and now published on their website.

The “Genocide Enablement Apparatus” framework outlines how healthcare workers are targeted and killed and healthcare infrastructure destroyed in Gaza, while healthcare workers across the West are intimidated and silenced in professional and civic spaces–in hospitals, clinics, professional associations, and in the pages of medical journals. Together these attacks on healthcare workers–one on our bodies, and the other on our voices–have accelerated the annihilation of the Palestinian people. There are fewer people left to provide care, and fewer people willing or able to speak up. This two-pronged effort functioned to undermine the “avalanche of solidarity” that is needed to stop the genocide, as Dr. Mads Gilbert, a physician and advocate of solidarity medicine, has remarked.

If my employer wants to fire me for saying ‘Stop Bombing Hospitals,’ then they cannot claim to be a place in which medicine is truly practiced. My duty as a physician is to speak up for the health of all people. If a job requires me to stay quiet as children are killed, that’s not a job worth having. Healthcare workers have an obligation to speak up–now more than ever. We must not be silent when our words and actions together can resist the erasure of the people of Palestine. To deny healthcare workers the right to speech is to deny our very humanity, as Israel and the US deny Palestinians theirs.

When liberal institutions slide towards authoritarianism, we must walk away from them. We must refuse to legitimize their immorality with our presence and our brilliance.  It should be clear to us all that our labor and talents should not be rendered in places that enable genocide, especially as healthcare workers. We must instead put our efforts into building a new kind of medicine, one that liberates through the act of healing, one that centers love for humankind in our care, one that teaches the practice of principled solidarity, and one that requires that we speak up in the face of injustice and violence. This is the medicine of the future borne out of our collective stories that insist on a world of care. It is the only kind of medicine that can truly achieve health for all.

*Rupa Marya is a physician, writer, composer and activist whose work sits at the intersection of climate, health and racial justice. She is the co-author with Raj Patel of Inflamed: Deep Medicine and the Anatomy of Injustice. Follow her on Substack @RupaMarya.