Medicine at the Edge of Annihilation

A medical staff member prays in a room designated for sterilizing surgical tools, which also serves as a rest and prayer space for doctors and staff, at Shifa Hospital in Gaza City, July 4, 2025. (AP Photo/Jehad Alshrafi, File)

What is the role of practitioners of medicine under occupation? A genocide? In a system of settler colonialism? Under the shadow of a bomb edging toward the hospital or clinic that holds together what remains of Gaza? I ask because the current iteration of the genocide has stripped bare the facades and the double standards of those who treat Palestine as spectacle, as tragedy, as endless conflict. In the face of their lies and evasions, it is medicine that remains unmasked. Doctors, nurses, ambulance drivers, and all who bind wounds and repair shattered bodies have become the only truth left standing: the last layer of a society under siege. Through horrors and unspeakable crimes, Gaza has engraved the fact that when every stratum of life is torn away, those committed to healing become the final bulwark against annihilation.

That exposure of medicine as the last line of survival raises a second question. If, in acute crisis, practitioners become the fuel of survival, what is their role in the residue of violence, when the gunfire recedes and slow, structural violence advances to secure the political aims of a settler-colonial project? It would be a mistake to assume this is a niche question, as the same frame travels to Canada, the United States, Australia, Argentina, South Africa, and – televised today – Occupied Palestine. The answer I offer calls for an alignment of medicine against what is upheld by the liberal international order: not the humanitarian medicine of neutrality, depoliticization, and bandages that keep bodies alive for another round of dispossession, but a people-centric medicine that is openly political and not confined to the sterile towers of Western medical institutions. I speak of medicine that stands ontologically against individualism and its fixation on the isolated patient as the unit of concern. What is needed is holism, that is, medicine that refuses to separate the body from the land it is rooted in, the clinic from the community that sustains it, and the wound from the politics that produced it. Holism insists that healing is inseparable from liberation, and that health is not only the absence of illness, but the presence of justice, restitution, and reconciliation on the terms of the marginalized.

Translating these words into action requires a fight not just with medicine but with science as a structure of knowledge that has long been co-opted by capitalism to drive the development of modernity, thereby neutralizing its practitioners into being mere agents of (C)apital and its apparatuses. Science, as inherited through the liberal international order, carries the illusion of neutrality, dressing itself in the garb of universality and progress, presenting its methods as for the sake of “development,” while in practice serving the political economy of those who monopolize power and resources, of those who maintain empire. Contrary to popular assumptions, the laboratory, the clinic, the university lecture hall are not untouched spaces; they are sites of power that have, time and again, disciplined populations into compliance, categorized bodies into hierarchies, and produced knowledge that justified conquest, domination, and dispossession. To speak of medicine outside this order is therefore to speak of disobedience: of doctors and nurses and healers who go beyond simply patching wounds and toward actively refusing the epistemologies that define health as productivity, illness as deviance, and life as disposable under the calculations of empire.

If we are to imagine holism as the ground of a liberatory medicine, then it demands more than a critique of humanitarian bandages or the sterile neutrality of Western institutions. To embody liberation medicine, it requires dismantling the very logics that confine health to metrics and numbers abstracted from the lives they claim to measure. It demands that we recognize the violence of occupation not only in the bombs dropped from the sky but in the bureaucratic forms that withhold permits, in the checkpoints that delay ambulances, in the algorithms that decide which medical supplies cross a border and which are denied. For far too long, we have become accustomed to such violence, recording it, reporting it, normalizing it, until it slips into the background as one violation among many in Israel’s expanding catalogue. But this normalization has given Israel the room—one can say the legitimacy and the cover—to refine its structural weapons: tools greater than the destruction of individual bodies and more tailored to the erasure of Palestinian presence itself, the slow attempt to uproot us from the land that the world continues to name, in diplomatic jargon, as the “Palestinian Territories.”

We are mistaken if we think the remedy to this problem is simply scheming for “de-normalization” of the Palestinian condition in academic halls or NGO workshops. We must recognize that such a process requires elevating our medical practices themselves into weapons of struggle – arming the Palestinian people not only to live resiliently but to stand strong, to organize, and to defeat a genocidal army with the mind but, importantly, with the sword. Just as Israel treats our doctors, nurses, and their institutions as combatants, so must we, in the sense that they are not labourers of care but vanguards of mobility, of communal security, of the fragile but enduring thread of a future that Israel attempts to sever daily. Their words, their actions, and the authority they hold within our communities carry the capacity to galvanize us to mobilize for one another and, crucially, to dream of what a future of freedom should look like.

For it is true that the freest person is often the educated person, and I do not mean it in the romanticized sense of education as salvation, but because knowledge – knowledge grounded in the experience of the oppressed and the dispossessed – is the toolkit that transforms dreams into structured processes, visions into strategies, and goals into horizons we can reach. To speak of liberatory medicine, then, is to speak of a pedagogy of healing that refuses neutrality, that arms communities with both the scalpel and the idea, with both the practice of saving a life today and the vision of creating the conditions where life itself can flourish tomorrow.