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Other Features: Teaching and Learning Moments

Call It What It Is: Sexual Harassment

Mattke, Angela; Schmitz, John Joseph MD; Zink, Therese MD, MPH

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doi: 10.1097/01.ACM.0000345394.25069.61
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“You always wear tight sweaters so I notice your boobs,” Dr. B announced as I stepped into the doctors’ lounge. I hadn’t yet noticed the other two 60-something male physicians sitting with him. As a third-year medical student, I was on an elective rotation in a small town hospital for nine months. I didn’t respond. I froze. What should I do? What could I do?

In an apparent attempt to change the subject, one of the other doctors mentioned that he’d learned that I was getting married and inquired about the date. “It’s in five weeks,“ I stammered while darting towards door. Ashamed of my breasts, I tried to cover them as I swallowed back tears. I was startled by the nurses who were waiting outside the door to accompany me to a lecture. Maybe they had heard some of it.

For two full days I let this incident eat at me. It wasn’t the first time Dr. B had said something like that to me, but that didn’t make it any easier. I didn’t tell anyone, not even my fiancé. I spent hours replaying the incident in my mind. I tried to make sense of the situation in my journal. My rational side told me that I was not to blame, but still I had an aching, sinking feeling about the situation.

I had fallen into the victim’s mentality—the same mentality I had witnessed, and strived to change during my college years while working with victims of domestic violence at the local shelter. I was furious with myself for letting this happen. To compound the insult, all three of the doctors who were present had daughters close to my age and in medical residencies.

A few days later, I shared what had happened with my preceptor. From that point, everything worked as it should have, more or less. The hospital was understanding, caring, quick to act, and private. But why did this happen?

Although the hospital has a policy for dealing with sexual harassment, we have a culture that permits it. We as a society do not like to confront these ugly situations—“We are taking every action to deal with this unfortunate incident….” Incident? No, assault; for that’s what it was. An assault upon my being. An assault upon all the long hours I’ve worked to get this far. A demeaning jab delivered in a house of healing that shattered my sense of security and self-worth.

One of the roots of this cultural problem is fear. Fear of reprisal. Fear of sticking out. Fear of not getting that good review. Fear of being labeled and distanced from colleagues. Even fear of what ill might befall the perpetrator!

Another root of our problem is tolerance. “That’s just the way he is” or “Dr. X is just from a different time” or “but he’s a great doc” are not excuses that we should accept. We have worked too hard to approach gender equality in professional life to still paradoxically tolerate other, more gross inequalities.

Sexual harassment occurs in the medical world. Fear of the repercussions of reporting are real. It is comfortable to believe that in our lofty profession, we have moved beyond it. We have not.

Later in the month my fiancé and I went to a party. I walked up when a group of friends were talking about the new cardiologist at their hospital. “She’s a real looker; I’d like to get into that skirt,” one of our friends said. That evening, my fiancé and I discussed how I had higher expectations of our generation of male physicians in terms of viewing females as equal peers. And while we may have developed an appropriate intolerance of the more overt forms of sexual harassment and discrimination, the subtler, more insidious forms that we tolerate (and even expect) are just as damaging.

Angela Mattke

John Joseph Schmitz, MD

Therese Zink, MD, MPH

Ms. Mattke is a fourth-year medical student, University of Minnesota Medical School, Minneapolis, Minnesota.

Dr. Schmitz is a second-year resident, Mayo Clinic, Rochester, Minnesota.

Dr. Zink is professor, Department of Family and Community Medicine, University of Minnesota Medical School, Minneapolis, Minnesota; email: ([email protected]).

© 2009 Association of American Medical Colleges