A Palestinian American doctor walked out of a meeting with President Joe Biden before it was over Tuesday evening, underscoring the high tensions, anger and concern from Arab, Palestinian and Muslim American communities amid the Israel-Hamas war.

Dr. Thaer Ahmad, an emergency physician from Chicago who traveled to Gaza earlier this year, told CNN he abruptly left the meeting that included Vice President Kamala Harris, national security adviser Jake Sullivan, other administration officials and a small group of Muslim community leaders.

While the president has often faced protests and interruptions at public events in the last several months, Ahmad’s decision to leave the meeting is perhaps the most intimate moment of protest the president has faced to date since Israel’s campaign in Gaza began following Hamas’ October 7 attack. It’s a stark reminder to the president of the political problem he faces with key parts of his coalition — including Arab and Muslim Americans and progressive voters — as his administration continues to stand by and support Israel’s war in the Palestinian enclave.

CNN previously reported that what was supposed to be an iftar dinner to break the Ramadan fast was changed to a meeting because participants didn’t feel comfortable having a celebratory meal while hundreds of thousands in Gaza are on the brink of famine. It’s another example of the administration’s fraying relationship with the Muslim American community — other attempts at holding meetings in key states have been hampered by declined invitations, and relationships with important community groups have frayed since the war began.

Following the meeting, a White House official said in a statement that “President Biden and Vice President Harris know this is a deeply painful moment for many in the Muslim and Arab communities.”

Biden, the official said, “made clear that he mourns the loss of every innocent life in this conflict” and expressed commitment “to continue working to secure an immediate ceasefire as part of a deal to free the hostages and significantly increase humanitarian aid into Gaza.”

Ahmad traveled to Gaza as part of a delegation of doctors from the NGO MedGlobal, working in the city of Khan Younis as fighting raged around the Nasser Hospital. He discussed his experience there, citing massive numbers of displaced, injured and dying people, and he spoke out against an expected Israeli offensive in Rafah.

“I said it was disappointing I’m the only Palestinian here, and out of respect for my community, I’m going to leave,” Ahmad said he told the president.

Before he left, he handed Biden a letter from an eight-year-old orphaned girl, Hadeel, who is living in Rafah.

“I beg you, President Biden, stop them from entering Rafah,” a translation of the letter shared with CNN says. US officials have warned Israel not to expand its military operations into Rafah without a comprehensive plan to protect civilian lives.

Biden told him he understood that he needed to leave, Ahmad said.

Ahmad said he felt it was important to attend the meeting, though he reiterated he did not feel it was appropriate to talk about death and famine over a dinner. Multiple invited guests declined the invitation.

“I wanted a chance to stand up and walk away from the people making decisions the way they are walking from my people,” Ahmad said.

Ahmad is planning to return to Gaza in the coming weeks.

“There’s this tremendous amount of survivors’ guilt that all Palestinians are feeling right now,” he said. “We are living this and breathing this – our entire lives have been changed. It’s hard to be here and live my life normally thinking about people who are over there suffering – especially having two daughters.”

Ahmad said he also wanted to counter the assertion that Hamas is using hospitals, shelters and schools as bases and command centers.

“We had not seen anything of that nature,” he said.