San Francisco’s Biggest Hospital System: Don’t Talk About Palestine

In December, Bridget Rochios, a nurse practitioner and midwife at the University of California, San Francisco, showed up to work wearing a keffiyeh. 

Later, she and other co-workers started coming to work wearing “Free Palestine” pins, as well as hospital ID badges shaped like a watermelon, a pro-Palestine symbol. 

Rochios, whose work includes addressing health disparities within reproductive health care, had been moved by reports of Israel’s targeting and destruction of Gaza’s hospitals and health care system, and started wearing the items as a show of solidarity with Palestinian women and babies, as well as her medical colleagues in Gaza. 

Supervisors ordered Rochios and her colleagues to remove the pins, threatening them with suspension or termination. Most complied, but Rochios refused. 

In April, she traveled to Gaza where she spent a month delivering babies at a maternity hospital in Rafah and the al-Aqsa Hospital in Deir al-Balah. She saw some of the many delivering mothers who have suffered under dire conditions in Gaza.

“The people who are really ‘unsafe’ are the women who I was supporting in labor as literally bombs were dropping.”

A week after she returned to the U.S., her supervisors at the UCSF Mission Bay campus, one of the graduate school and hospital system’s 10 campuses, placed Rochios on a three-month paid administrative leave for “insubordination.” Her suspension was renewed in September after she again refused to remove her watermelon pin. She may still face further sanctions, including termination. University representatives have told her that several colleagues and patients said the pin made them feel “unsafe.”

“The people who are really ‘unsafe’ are the women who I was supporting in labor as literally bombs were dropping and shaking the walls of our hospital,” Rochios told The Intercept, recalling moments during Israel’s invasion of Rafah. “Women who have not had prenatal care at all; women who went to walk to the hospital in labor and have a baby, and then two hours later, walk back home to their tent where they did not have running water, where they don’t have enough food or hydration to breastfeed, no clean water, or money to buy formula for their kids.”

Medical professionals, especially those who have treated patients in Gaza’s and Lebanon’s hospitals over the past year, have spoken out about atrocities carried out by the Israeli military. Doing so at UCSF, one of the country’s most elite medical institutions, may come at a price. 

Rochios is one of nine health care workers at UCSF who spoke with The Intercept about their experiences of censorship and punishment after speaking out about human rights for Palestinians as a part of their research and medical work.

UCSF declined to comment or respond to a detailed list of questions or multiple phone calls over the course of a week. A UCSF spokesperson said they were concerned that the accounts of UCSF employees were being “taken out of context.”

Rupa Marya, an internal medicine physician and professor at UCSF, is perhaps the most notable and vocal among those who have received pushback. In her social media posts in January, Marya, an expert in decolonial theory, questioned the impacts of Zionism as “a supremacist, racist ideology” on health care and drew immediate criticism from pro-Israel colleagues and Democratic state Sen. Scott Wiener.

The university then published a statement across its social media accounts addressing the posts without naming Marya, disavowing her statements as “antisemitic attacks.” Wiener thanked UCSF for the statement. A flurry of online attacks against Marya followed, including racist and sexist attacks and threats of death and sexual violence. Wiener has continued to single out Marya on social media.

In September, Marya wrote a new post on social media that UCSF students were concerned that a first-year student from Israel may have served in the Israeli military in the prior year, then asked, “How do we address this in our professional ranks?”

The following month, the university placed her on paid leave and suspended her ability to practice medicine pending an investigation into the post. The university has since reinstated her ability to give clinical care, but she remains banned from campus, including the hospital where she worked.

“I wanted to protect people who have lost family members,” Marya said. “People are being murdered, doctors are being disappeared, hospitals are being bombed — you have this traumatized community in UCSF. I’ve been trying to give voice to the experience of the Muslim, Indigenous, Black, SWANA” — Southwest Asian and North African — “students who are afraid, like deeply afraid.” 

The Center for Protest Law and Litigation, a First Amendment group, is assisting Marya in obtaining public records of possible communications about her social media posts between UCSF, Wiener, and the Helen Diller Family Foundation, the school’s largest donor that has in the past donated to pro-Israel propaganda groups. The center filed suit for the records after the university failed to produce documents after nine months of back and forth, during which the school claimed such records are exempt from freedom of information laws. 

In a statement sent to The Intercept, Wiener said Marya’s social media posts “crossed a line,” accusing her of using “an antisemitic conspiracy theory targeting Jewish doctors” and an Israeli medical student. He said concerned UCSF faculty and students brought the January and October posts to his attention. “I then called out those posts as antisemitic, just as I have called out homophobic, transphobic, racist, and Islamophobic statements by various individuals,” he wrote. 

Wiener, as a part of the legislature’s Jewish Caucus, previously targeted K-12 school districts for teaching history lessons that were critical of Israel, dismissing them as “bigoted, inaccurate, discriminatory, and deeply offensive anti-Jewish and anti-Israel propaganda,” according to a January letter to state lawmakers. He decried the online threats against Marya, calling for an investigation. 

The school’s crackdown has been broad, targeting professors, doctors, and medical staff.

Doctors have had their lectures mentioning Gaza scrubbed from the internet or canceled outright. They have been accused of antisemitism and creating an unsafe work environment, and banned from lecturing entirely. Staffers, nurses, and students have been suspended for speaking out in solidarity or for acts as simple as wearing a watermelon pin or hanging a pro-Palestine symbol in their offices. Dozens of employees have criticized the ongoing silence from UCSF and its failure to condemn Israel’s war on Gaza, accusing the school of favoring pro-Israel views.

“This is really unprecedented where this university in particular has stepped in and taken such a strong stand in support of some speech and opposition to other speech,” said Dan Siegel, a longtime Bay Area civil rights attorney who is representing several UCSF employees facing discipline. “It’s really remarkable to me that there is so much content-based discrimination here.” 

For the past 30 years, Siegel has represented faculty and staff across the UC system in employment and workplace issues. Before October 7, he had never seen such a widespread effort to punish employees for speaking out about a specific issue.

“Look, I don’t want to make people feel uncomfortable, but aren’t people made uncomfortable by 40,000 dead in Gaza?”

“Among the supporters of the Israeli government, this is a cynical and manipulative effort to limit debate,” he said. “They’ve promoted an atmosphere where you’re a student at the university or a patient at the hospital, and it becomes perfectly normalized for you to say or for someone to champion your saying, ‘I feel uncomfortable as a Jew because of people saying these things,” said Siegel, who is Jewish. 

“Look, I don’t want to make people feel uncomfortable, but aren’t people made uncomfortable by 40,000 dead in Gaza or the efforts taking place in the West Bank to steal Palestinian land?” Siegel asked. “Those things make me feel uncomfortable — so now we’re all going to be censoring each other’s speech because it makes us uncomfortable, and that really can’t be the criteria for limiting speech.”

In late July, a group of House Republicans, including House Energy and Commerce Committee Chair Cathy McMorris Rodgers, R-Wash., told UCSF they would investigate allegations of antisemitism made by employees and patients at the institution. The members of Congress threatened to withhold all federal funding, including Medicare and Medicaid payments, from the school and health care system. Their investigation is a part of a larger partisan effort, led by House Speaker Mike Johnson, R-La., targeting universities whose students and faculty have been vocal critics of Israel. 

Three UCSF physicians have been banned from giving lectures after mentioning the negative health impacts of Israel’s war on Gaza or the apartheid health system in the Occupied Territories. 

Jess Ghannam had received pushback for his scholarship in the past. In 2012, an attendee of one of his lectures about Gaza at UCSF called the police on him, saying they didn’t feel safe with him on campus, Ghannam recalled. Later that year, a student burst into tears and ran out of a lecture Ghannam was delivering at UC Davis and later filed a complaint alleging that Ghannam had created an unsafe learning environment. (UC Davis launched a formal investigation, which eventually saw the complaint dismissed.)

In his 25 years at the university, Ghannam never had any of his lectures canceled outright. He is a well-known speaker who has shared his research on the consequences of war on displaced communities, such as Palestinians, in many venues over the past two decades. And he helped establish mental health and medical clinics for Palestinians, interviewing Palestinian torture survivors who were incarcerated in Israeli prisons. 

In September, he was scheduled to speak to first-year medical students, after a group of medical students had met with the university’s deans to push for more education around Palestine. 

Then, four days before the scheduled talk, Ghannam heard from the course instructor that his lecture was being canceled. The instructor said there wasn’t enough time to provide “wraparound services” for students, or peer support or support services, for those who may be distressed by the topic, Ghannam said. 

Students responded with outrage. Ninety-five medical students signed a letter addressed to school officials, calling the cancellation “an act of intentional erasure of historical harms that continue to affect our communities and our profession” and alleging that it was part of “a pattern of suppression that seemingly targets any element of acknowledgement or advocacy for the health of Palestinians, despite UCSF’s claimed position as a bastion of social justice.” The students went on to host Ghannam independently, allowing him to give his lecture in front of about 100 people.

“That’s the clear message: You can’t talk about Palestine, you can’t talk about genocide.”

“If you talk about Palestine,” Ghannam said of his critics’ perspective, “if you talk about the health consequences of genocide, and the negative impact of genocide and settler colonialism, it’s OK to talk about it in any other people except Palestinians — and then if you do try to talk about it in the Palestinian context, we’re going to shut you down.”

“I mean, that’s the clear message: You can’t talk about Palestine, you can’t talk about genocide.” 

Leigh Kimberg had a similar experience. Kimberg, a medical school professor, primary care doctor, and leader in the field of violence prevention and trauma-informed care, had lectured at UCSF’s continuing education program several times in the past decade.

In April, she gave a 50-minute lecture and dedicated six of those minutes to a discussion of the health of Palestinians in Gaza. She argued that you cannot speak on trauma-informed care without mentioning the genocide in Gaza and described the connections between the liberation of Black, Palestinian, and Jewish people. She also decried antisemitism during her lecture.

Still, the following month, administrators told Kimberg that they had received complaints from attendees who called her speech “biased and antisemitic,” which prompted the school to remove the recording of her talk from the school’s website. When she protested the video’s removal, she said the school barred her from giving lectures at the program.

The ban was lifted after multiple emails from Kimberg and Siegel, who is representing her, but she was told that her future talks must comply with the program’s rules. She also received pushback from her division at the school of medicine, where colleagues have referred to her as “inflammatory” or “not trauma-informed.”

Kimberg began to speak out about Palestine publicly last October, and her Palestinian colleagues welcomed her perspective as a person of Jewish ancestry. Her grandparents had fled antisemitic violence in Poland and Lithuania, and three of her relatives died in the Holocaust. But her colleagues also cautioned her of the backlash to come. 

“We do want to warn you that the second you advocate for Palestine, you will be called ‘antisemitic,’” Kimberg recalled from earlier conversations with Palestinian colleagues. “It doesn’t matter that you’re Jewish — in some ways, it will be worse — but you will definitely be called ‘antisemitic’ if you say anything to value Palestinian life.”

“And that has been my experience.”

Such discrimination is what led Keith Hansen, a former chief resident of surgery at UCSF, to conceal his Palestinian heritage throughout his career. As chief resident in the fall of 2023, Hansen would send daily emails to his co-workers at the trauma surgery department at San Francisco General Hospital, highlighting updates across their field. In one of those emails in October, as reports of Israeli strikes on hospitals in Gaza began to compile, he skipped the updates and instead asked his colleagues “to take a moment to acknowledge that doctors and surgeons and patients, just like us, were being bombed by the Israeli government.”

Hansen received positive feedback for the email from his co-workers, but in his monthly review to assess his performance as a resident, an attending physician referred to Hansen as “a polarizing figure” because of the email. 

In May, as student activists continued to occupy a protest encampment at the school’s Parnassus Heights campus, Hansen gave a lecture as chief resident about his work in organ transplantation along with health inequities of Palestinians in Gaza and the West Bank under Israeli occupation. 

During the talk, he also disclosed his Palestinian heritage, something he had never done in his career. He shared that he was born in Jordan to Palestinian refugees, his mother from Ramallah and his father from Jenin. After running through data showing health disparities between Palestinians living under occupation and Israeli citizens, as well as the targeting of physicians in Gaza, he called on the university to do more to address such issues. He referenced other UCSF initiatives, such as fundraising to protect doctors and scholars in Afghanistan and Ukraine. He went on to call for an academic boycott of institutions “complicit in the genocide and medical apartheid.” 

Following his talk, several colleagues lodged complaints against him that he was creating an unsafe working environment. The chair of his department also directed him and other speakers not to mention “anything political or anything that didn’t have to do with graduation.” At graduation, he said people he had previously gotten along with avoided him. 

“Everyone kind of shows their true colors once they find out your background.”

“There’s that term — ‘liberal except for Palestine’ or ‘humanitarian except for Palestine’ — and a lot of people as soon as they hear you’re Palestinian just change their entire view of you,” Hansen said. “And it has changed my relationship — I mean, there were people at graduation who didn’t talk to me, who I had known for years and always got along with really well. Everyone kind of shows their true colors once they find out your background.” 

At the same time, pro-Israel speakers have been invited to campus while Palestinian voices have been opposed. Among those speakers were Elan Carr, a U.S. Army veteran and CEO of the Israeli American Council, an influential pro-Israel lobbying and advocacy group. UCSF’s Office of Diversity and Outreach invited him to speak during May’s Jewish American Heritage Month.

Nearly 100 faculty, medical workers, and students wrote to the diversity office, protesting Carr’s talk, citing his role at a counterprotest against student encampments at UCLA that turned violent a month earlier, as well as his endorsement of transphobic comments on social media. Carr’s speech on “the persistence of anti-Zionism, anti-Israel discrimination, and campus antisemitism” went on as planned.

The same office declined to sponsor and publicize an official screening of documentary “Israelism,” which was hosted by the school’s chapter of Jewish Voice for Peace. The film centers on the advocacy of anti-Zionist Jewish activists. 

Some staffers have been disciplined for a speech act as quiet as wearing a pin. 

Shortly after October 7, Rosita, a nurse at UCSF who gave only her first name out of fear of being doxxed by pro-Israel activists, started hand-making watermelon pins for her co-workers to attach to their hospital ID cards, green glittery resin disks with a small rubber watermelon glued on top.

A slice of the fruit has been a symbol of Palestinian liberation since the 1980s, when Palestinian artists started to use the depictions of the watermelon, with its red flesh, green rind, and black seeds, as a way to circumvent an Israeli ban on public displays of the Palestinian flag in Gaza and the West Bank. Rosita passed her pins out to interested colleagues at work and to others during pro-Palestine protests.

In a relatively uniform work environment such as a hospital floor or clinic, custom badge pins are typical ways for medical workers to express themselves. At UCSF, such displays are often political, with many wearing pins that advocate for LGBTQ rights or the Black Lives Matter movement. In the past, UCSF even gave away its own uterus pins meant to affirm reproductive rights, said Rosita, who also helped found the school’s faculty and staff pro-Palestinian group. 

“I can tell what type of person you are by the pins that you have on your badge,” she said. “So it’s a sense of pride and solidarity and acknowledgment.”

In all, Rosita said she has made and given away 500 pins. And while many workers received compliments from colleagues and patients, those who wore the pins started to get approached by their managers, telling them the pins were antisemitic and ordering them to remove them under threat of suspension or termination. 

In September, Rosita’s manager called her in for a “counseling” session where she was told to remove the pin because a staff member said it made them feel “uncomfortable.” She refused and responded with an email, calling the manager’s request “discrimination and denial of the Palestinian people.”

“My niece is Palestinian,” she wrote in the email. “She is 10 years old. She enjoys collecting Polly Pockets and does jujitsu on Saturdays, studies Arabic on Sundays.”

“She exists!” Rosita added. “I wear the watermelon because she exists!”

Rosita, who is Rochios’s union steward and has been representing her in disciplinary hearings, said she worried she would be met with similar punishment. 

Another staff member faced similar pushback for displaying pro-Palestine symbols. A researcher at UCSF, who declined to give their name due to fear of workplace retaliation, was told by supervisors to remove a sign from their office that said “Queer as in Free Palestine” with a red and pink triangle. The staff member, who is queer, said the sign was meant to express solidarity between the LGBTQ community and Palestinians. They noted that their Mexican LGBTQ flag had been accepted. Leading up to the ban, the researcher had received an online death threat for displaying the symbol, and one community member confronted them inside their office, accusing them of supporting Hamas. 

The school told them the red triangle was a Nazi symbol that is being used to promote violence against Jewish people. The ban remains on the staff member’s employee file. Since reporting the death threat, the school has yet to offer a safety plan for the staff member, who as a result has been working remotely since September.

“It’s been really tough. I’ve had to take time off, my mental and physical health is just shot at this point from the stress and anxiety, not knowing whether I’m going to lose my job,” they said.

“My mental and physical health is just shot at this point from the stress and anxiety, not knowing whether I’m going to lose my job.”

Another staffer received a notice of intent to fire her just for discussing accusations lodged against them with colleagues. In January, UCSF therapist Denise Caramagno quote tweeted, to her modest following of 500 users on X, the school’s public rebuke of Marya with the following: “@UCSF is coordinating an attack on its own faculty of color who are asking legitimate questions about social determinants of health. This is a violation of academic speech. How are we to achieve health equity if we cannot ask important questions about systems of supremacy?” 

Several months later in May, Caramagno’s supervisor sent an email, flagging that a physician at UCSF sent a complaint about Caramagno’s post to school officials and a complaint officer in the diversity office, calling the tweet antisemitic and questioning Caramagno’s ability to “offer psychological support to Jewish and Israeli faculty and staff.” 

Over the past decade, Caramagno helped build the school’s CARE program, which provides resources and support to those on campus who have experienced discrimination, harassment, or abuse. As the co-director, she had remained the point of contact for students to reach out to confidentially and become a trusted source of support to students during difficult moments, including amid protests during the #MeToo and Black Lives Matter movements. She’s regularly called out systemic racism as a part of her role. 

“When I see what’s happening in Palestine, it just looks like the most extreme form of racism,” Caramagno said, referring to the genocide in Gaza. “We’re a public health care system, so when we see the dismantling of the public health care system [in Gaza], we have an obligation to call that out.”

While the complaint did not lead to any discipline, she was barred from serving as a point of contact for individuals with reports of antisemitism.

In June, her supervisors caught wind that Caramagno had shared the email from her supervisor that included the complaint with close friends and colleagues, seeking guidance and support on how to proceed. Supervisors told her that she was not allowed to share the email, which they considered confidential. Caramagno and her attorney, Siegel, insist the email was not confidential, which she dismissed as “defamatory.” Even so, by August she was suspended and then received notice of the school’s intent to fire her. She is barred from campus and from contacting her clients. 

“I’m a trained clinician in this; I know the laws about confidentiality,” Caramagno said. “I know I had never breached confidentiality, and I never will.”

Last week, a group of faculty staff and students, including Kimberg and Ghannam, gathered for the first session of the UC People’s Tribunal, a group that aims to hold UC leaders accountable for the school system’s complicity with Israel’s genocidal war in Gaza and the ongoing displacement of Palestinians.

In addition to the violent crackdown on student encampments across the UC system last spring, school leaders have long shown a pro-Israel bias in their longstanding opposition to attempts by student and faculty groups to join academic boycotts of institutions with ties to Israel. The tactic is part of the Boycott, Divestment, and Sanctions movement, or BDS, which aims to achieve Palestinian statehood.

The People’s group, which presented the tribunal charges at La Peña Cultural Center in Berkeley, focused on the UC’s investments in Israeli companies and the other activities of UCSF’s largest private donor, the Diller family. A collection of foundations created by the Bay Area real estate billionaire Sanford Diller, who died in 2018, gave a massive $1 billion to the school in 2017 and 2018, after giving $150 million over the previous 15 years. 

The foundations, named for Diller’s late wife Helen, also donated $100,000 in 2016 to the Canary Mission, a group that aims to blacklist students and professors at universities who are found to be critical of Israel. Once an individual is listed on the Canary Mission site, a flood of cyberbullying messages often follow in an attempt to ruin the person’s reputation. The site has a profile for Ghannam and Marya, accusing both of supporting terrorism and antisemitism. Ghannam jokingly called himself one of the site’s “inaugural” members, or a “first-gen Canary Mission.” The group also recently celebrated Marya’s suspension on social media.

In 2016, the Diller Foundation also donated $25,000 to Regavim, an Israeli NGO that sues Palestinians who try to build homes in the occupied West Bank; $100,000 to Reservists on Duty, a group that pays for Israeli reserve soldiers to travel to U.S. universities to work with students on projects that challenge BDS; and $25,000 to Turning Point USA “for US campus efforts against BDS.” And the foundation has donated to Islamophobic groups American Freedom Law Center and Stop Islamization of America, along with American right-wing conservative groups, Project Veritas and the David Horowitz Freedom Center.   

Jackie Safier, Sanford Diller’s daughter, who now runs the Diller Foundation, has dismissed connections between the foundation and the far-right Zionist and conservative groups in the U.S. and Israel. Given the foundation’s close ties with UCSF, however, faculty and staff who have faced punishment for their pro-Palestine speech have questioned whether the relationship was a factor. 

“You can’t walk anywhere at UCSF without seeing Helen Diller’s name somewhere,” Ghannam said. “The foundation’s name is in the front of UCSF, the main entrance, they’ve endowed chairs and faculty positions.”

Ghannam had hoped to travel to Gaza to assist patients there during this past year, but has been barred due to Israeli travel restrictions into the territory for individuals with Palestinian ancestry. He instead has been forced to watch the conflict from afar, doing what he can with organizing at UCSF, while Israeli strikes kill people he’s close with.

“There’s this awesomeness of feeling the solidarity; people are finally understanding Palestine in ways that they never understood before,” Ghannam said. “But at the same time, the amount of fucking grief and pain that I feel every day with knowing that my colleagues have been killed, that all clinics that we helped build and all the programs we help build and all of the people whose kids I’ve seen grown up over the years and get married — they’re all dead, so there’s this profound sense of grief and guilt.”

Rochios’s advocacy on the health inequality experienced by Palestinians in Gaza began by speaking out at home, both at the workplace and at rallies in the Bay Area. When Rochios, who was allowed to travel to Gaza, was working in Rafah in April, she began to share what she was witnessing on television news for outlets such as Al Jazeera. 

“While the West seems to not give any weight or validation to Palestinian reporters on the ground, these health care workers have become the journalists, the storytellers, all this information, and it became very clear to me to that it was my duty to try and be a voice to that,” she said.

UCSF escalated its punishment against Rochios this week, moving her from a paid suspension to three days unpaid. She will be allowed to return to work for the first time since June on November 21, but was again ordered not to wear her keffiyeh or watermelon badge. If she continues to wear the items, the school said, she would be in violation of UCSF’s PRIDE policies and Principles of Community, which are among several codes meant to reinforce diversity and inclusion within the institution. She expects to be fired, given the climate of repression she and her colleagues have experienced at UCSF.

Through conversations with colleagues in the OBGYN department at the nearby city-run San Francisco General Hospital, Rochios knows that this outcome is not the norm in her profession, even within the same city. Unlike at UCSF, the hospital workers have been able to display their support for Palestine, with some openly wearing sweatshirts that read “Healthcare workers for Palestine.” 

“I’ve become such a pariah in this way within UCSF,” she said. “Whereas it exists without issue in a sister hospital in the same city.” 

Correction: November 19, 2024, 11:23 a.m. ET
This article originally referred to Rupa Marya as a lecturer at UCSF. She is a professor of medicine.