“Institutional betrayal”

Just over a decade ago, I fell and broke my arm. Badly. The treatment I received was almost funny in its incompetence, but that’s a story for another day.

While I was in the hospital emergency department, I had an experience that was not remotely funny. I had been there for several hours, seeing one medical professional after another, being x-rayed and, mostly, waiting. During all of this time, I was in intense pain but was told I could not be given anything for pain because it (the pain) assisted in making a proper diagnosis. Seemed odd to me at the time. After all, we were not dealing with something abstract here: I had a broken bone that was, surely, clearly visible through an x-ray. Help me manage the pain, for heaven’s sake!

However, as I quickly learned that day, when you are flat on your back, wearing nothing but a hospital gown, and in pain, you have no power.

Poking about

When two irritatingly enthusiastic male residents descended on me after I had been at the hospital for several hours, I was not at my sharpest. They began by telling me that I had very large breasts, which would make it harder for them to properly strap my arm. One of them then insisted that he needed to do an anal exam because the nature of my break was something seen in people with colon cancer.

Surely not?!?! But, I was exhausted and not thinking entirely clearly, so I “consented” to the exam. However, when I, painfully, rolled over on to my side and he unceremoniously pulled up my skimpy hospital gown, it was not my anus into which he inserted his fingers but my vagina. I yelled something like “Hey, wrong hole,” and he quickly removed his fingers, said something like “Whoops!” and that was the end of any internal exam.

By this time, I was a mess. I was still in a huge amount of pain. I felt judged and insulted by the doc’s comments about my breasts and was shaken by this so-called anal exam. I just wanted to go home and crawl into bed.

Sounds of silence

The next morning, I woke up furious. I knew that what had happened to me constituted sexual abuse, but I was much more focused on my need for ongoing medical attention for my arm. I had to return to the hospital a few days later to be seen by the orthopaedic surgeon and, sure enough, this same resident was lurking about. My partner managed to get his name and write it down, but I was afraid that if I said anything it might affect the medical care I needed.

So, I did nothing. For more than a decade I did nothing, other than to tell one or two close friends. I kept the slip of paper with the doctor’s name on it and looked at it from time to time. I sometimes berated myself – a privileged, white woman; a lawyer – for not reporting the doctor who sexually abused me. But I remained silent.

Who’s paying attention?

In 2015, then-Health Minister Eric Hoskins established a task force (not the first in Ontario) to examine the sexual abuse of patients, which was chaired by now-Senator Marilou McPhedran.

The task force’s report made a number of recommendations focused on transparency and accountability. It urged the government to reform the self-regulatory model of investigating sexual abuse of patients and called for true adherence to a zero tolerance approach to this serious issue.

A recent investigation conducted by the Globe and Mail tells a tale that makes it easy to understand why so many women, like me, don’t want to report to the College when they have been sexually abused by a doctor.

The Globe used the case of Allan Gordon as an example of the ways in which the College of Physicians and Surgeons continues to fail patients who lodge complaints against physicians who harm them.

Gordon, a neurologist accused by many women of serious sexual improprieties, was allowed by the College’s discipline committee to enter a “no contest” plea and resign, and the women’s cases were closed with no public acknowledgement of their allegations.

As one woman, a lawyer, told the Globe:

“I never got to look at him and say, ‘You abused my trust.’”

The College’s registrar, Nancy Whitmore stands by the committee’s handling of the case:

“I think what we’ve done very well is we have protected the public interest.”

“It felt gross and wrong”

Really? Over the past six years, the College has dropped one out of four allegations of sexual abuse made against doctors, instead entering findings that the doctors have engaged in disgraceful, dishonourable or unprofessional conduct. Sometimes, but not always, the doctor resigns.

MacPhedran, who worked on this issue for decades before being appointed to the Senate, is critical of allowing doctors to resign in the midst of a sexual abuse complaint:

“This kind of secrecy and silence protects perpetrators.”

The Globe noted that a number of the women with whom they spoke were “reluctant to complain to the college.” They were afraid they would not be believed and they did not want to compromise their medical care:

“It was me against this world-renowned doctor.”

“I thought I’ve got to let this doctor do what he’s got to do because I’m desperate for a solution to what’s wrong with me.”

Not only does the College seem to make it easy for docs to sidestep any formal accountability for their sexual abuse of patients, in at least some cases it replaces the documentation on the public record to erase any mention of sexual abuse. It no longer posts information on its website, which allowed members of the public to know about any past complaints against physicians and their outcomes, replacing that information with a news release that remains on the site for just 90 days.

“Completely unacceptable”

Even though zero-tolerance of the sexual abuse of patients has been enshrined in Ontario legislation since 1994, as the task force found, many patients lack confidence in the system that is supposed to protect us, so don’t make a report. Those who do are often disappointed in the outcome. And, unlike the doctors whose legal fees are covered by the Canadian Medical Protective Association, complainants who need legal assistance must pay for it themselves.

No wonder University of Oregon psychologist Jennifer Freyd has coined the term “institutional betrayal” to describe systemic responses to patient sexual abuse.

As for me? In my work, I tell survivors of sexual violence:

“It’s not your fault. It is never your fault. Whatever you do – report, don’t report – is up to you and is okay. You need to do what is right for you to do.”

I made a written submission to the 2015 Task Force, minus the doc’s name (somewhere along the way I had lost that slip of paper where my partner had written it down). I know on every level that what happened to me is not my fault.

But, still, I feel shame: shame at having to hear that man’s comments about my breasts, shame at the feeling of his fingers in my body where they did not belong and shame that I did not tell and, maybe, stop him from doing it to someone else.

2 thoughts on ““Institutional betrayal”

  1. I remember you telling me about the sexual abuse Pamela – we were both working at NAWL at the time and you had just gone through that awful “examination”. The thought of that still makes me so angry I could spit! But mostly, I’m so very sorry that the repercussions of that abuse and the guilt of not having reported it, still cause you shame. No woman should have to carry the weight of shame and guilt for being victimized by sexual predators, and that is exactly what that doctor was. I have no magic words, just to say that I hope some day you are free of those feelings that you do not deserve to carry. Hugs.

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