When one talks to a physician, we will often identify ourselves as “advocates.” In fact, we will often insist that we advocate for our patients every day as we call insurance companies to get expensive drugs approved and to call in favors to get scans expedited.

We insist that our advocacy stretches beyond the confines of the hospital too. As first-hand witnesses of social injustices, some of us feel compelled to speak up for those facing housing insecurity in our emergency departments, and others refuse to ignore the children who die from gun violence in our trauma bays. Heck, we have Black Lives Matter posters hanging in our residents’ lounges! But even under our grand performance of championing, one topic we physicians have remained intentionally silent on has been the killing of thousands of Palestinian civilians in Gaza. And for that silence, our Hippocratic oath weeps in hypocrisy. 

We may not have a degree in regional conflict, but our education teaches us well about the intricacies of death and suffering. We understand the internal injuries that tend to occur when hundreds of pounds of concrete collapse onto an exposed chest. We know the mechanism behind severe dehydration and how to prevent it (i.e., access to clean drinking water). We constantly remind each other to “wash our hands” and “scrub in” to prevent contamination and infection. And yet, even knowing these horrors, we look away as innocents endure these torturous conditions in Gaza without water, sanitation or medical attention.

Not only have we stayed silent as Palestinian men, women and children have been killed, but we have stayed quiet as our physician colleagues have begged for reinforcements and support. Doctors Without Borders and the World Health Organization have been clear: There is a humanitarian catastrophe occurring in Gaza they are unable to staunch. They have explained in detail the public health crisis unfolding as access to anesthesia, antibiotics, and fuel for hospital generators runs short. 

We should be fundraising for their medical efforts throughout our residencies. Our voices should ring hoarse from the passion of our protests supported by our academic medical centers. Yet we do not feel this conflict directly applies to our definition of physician advocacy, so we avoid the discomfort and carry on. Our powerlessness spirals as we become isolated observers.

As a medical community, what are we saying with our institutionalized silence? 

Why is it so difficult to stand by our medical ethics that state it is imperative to protect the wounded and sick, without discrimination? 

When will we say, enough is enough and advocate, as physicians, for a ceasefire? 

Time is running short, and our white coats are stained with the blood of the patients we never felt the need to speak up for.

DR. TERESA ELMORE is a resident at Yale New Haven Hospital. Contact her at teresa.elmore@yale.edu.