President Biden met with a small group of Muslims at the White House on Tuesday — a conversation that became another sign of how contentious his relationship with Arab Americans and Muslims has become because of the war in Gaza.

Dr. Thaer Ahmad was one of the people at the meeting. But the emergency medicine physician walked out of the meeting before it was over. He told NPR he left out of respect for his fellow Palestinians and as a signal that he believes the White House needs to do more to end the war and to get humanitarian aid into the region.

Ahmad recently returned to the United States from Gaza, where he was treating patients in Nasser Hospital in Khan Younis before it became inoperable due to fighting.

He told NPR he wanted to share what he had witnessed first-hand with the president, and speak out against potential Israel military action in Rafah.

"We've been on the ground, we've seen just how overcrowded Rafah is — just how little aid is getting in — and that any sort of military activity there would be catastrophic," Ahmad said.

He said he handed Biden a letter from an 8-year-old orphaned Palestinian girl who begged Biden to stop Israeli troops from entering the city.

"It was tough, you know — I wanted to communicate that message, but at the same time, I also wanted it to be clear that up until now — what the White House has done is not sufficient enough," Ahmad said.

The White House declined comment on the discussions during the private meeting. Press secretary Karine Jean-Pierre said Biden respects the right to peaceful protest. "We understand it's a very painful time," she told reporters.

Another doctor showed Biden photos of the suffering

Dr. Nahreen Ahmed also attended the meeting. The medical director of aid group MedGlobal, who has been to Gaza twice since the war started, said she felt Biden was "somewhat dismissive" during the meeting when she showed photos of the suffering that she had witnessed.

"Maybe he didn't mean it that way, but you're the president of the United States, you cannot sit there and be this dismissive of individual pictures of people suffering that are being put in front of you and then tell us all, 'Well, I've seen these before,'" she told NPR.

"Even if you have — that's not the right response to a community of people that are hurting from what's happening in Palestine and are trying to express to you their hurt and their pain and their frustration."

Ahmed said she felt the meeting was "a way to manage the community, to say that we are trying our best, that we hear you," and did not feel like the president was empathetic to their concerns.

The meeting was held ahead of a scaled-down iftar

The White House had planned to invite some Muslim leaders to an iftar to mark Ramadan, but scaled those plans back when some people said they did not feel comfortable with the plans.

"This is the holy month of Ramadan and these are the last 10 most holiest days of the month, and it would be inappropriate to be breaking fast at the White House — given our policies that are enabling a famine in Palestine," said Wa'el Alzayat, who runs Emgage USA, the largest get-out-the-vote organization in the country.

Alzayat and others pushed the White House for a meeting with Biden instead of a dinner, though Alzayat still declined the invitation altogether. The president did host a small group of Muslim officials who work in his administration for an iftar.

Biden last met with a group of Muslim leaders at the White House in October — a group that included Alzayat and Rami Nashashibi, a Palestinian American community organizer from Chicago.

Nashashibi said he feels the White House is not genuinely listening to Muslim and Palestinian perspectives.

"The reality is we have not seen, in the last five months, the president take any responsibility for the fact that perhaps his inability to reign in (Israeli Prime Minister Benjamin) Netanyahu much earlier has contributed to some of the catastrophic loss of life," Nashashibi said.

The White House says it is pushing back

Biden routinely encounters protesters upset with his support for Israel's war in Gaza — even during a star-studded fundraiser in New York City last month. Democratic voters in a string of states have organized protest votes during primary elections to register their disapproval.

The White House has urged Israel to do more to prevent civilian deaths in Gaza — and has said it opposes a major ground operation in Rafah.

"We have said there have been too many civilians killed. We have talked about the civilian infrastructure that's been destroyed. We have been very clear about our concerns and objections over some obstacles that have been put in the way of getting additional humanitarian assistance in," John Kirby, a spokesperson for the National Security Council, said on Wednesday.

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