In 1891, British medical missionaries from the Church Missionary Society established what they proudly announced as the first modern hospital in Gaza. They promised that their small, 10-bed hospital, called dār ʿabd al-nūr, would replace existing remedies with innovative medical treatments. This paper complicates their claim, and the rise of Western biomedicine in Palestine more broadly, by examining how patients sought medical care in 19th-century Gaza. Reading against the grain of the missionary records reveals a more competitive medical economy in which Palestinian patients received care from a diversity of healers before consulting the missionary hospital as a last resort. Furthermore, the medical treatments offered at the hospital resembled existing practices more than the missionary discourse suggested. In many cases, the medical treatments of Hippocratic-Galenic and Prophetic medicine, interwoven into the Palestinian social fabric, mirrored the prescriptions and treatments found at the hospital. This continuity betrays the role patients played in negotiating the terms of care that shaped the medical landscape in Gaza. A patient-centric approach complements a growing body of scholarship concerned with the social history of Palestine prior to British colonialism. Bringing Palestinian patients to the foreground, however, does not mean ignoring networks that linked Palestinian medicine to global developments. Rather than dismissing the role of British physicians in the medical history of Gaza, this paper untangles the patients' voice from their source material. By placing British missionaries, Palestinian healers and Gazan patients in conversation, this paper challenges the teleology of Western biomedicine in Palestine and highlights the diversity of the 19th-century Palestinian medical economy.