Doctors can be monsters, too

If anyone still has the naive belief that doctors are somehow immune to sexual arousal from interaction with their patients, they need to pay attention to what went on in a courtroom in Michigan this month when more than 150 young women testified against Larry Nassar and the sexual abuse he perpetuated against them over two decades. (Coverage of trial) A lot of the attention on this case has focused on the gymnasts who were victimized and the role of the Michigan State, the Olympic Committee and other governing boards that didn't address the complaints years and years ago. But there is a wider lesson for all, not just for those involved in sports, which isn't getting enough attention.

This respected doctor had obviously seen a lot of young women throughout his career and obviously, unlike what the medical community likes to tell us, it did not become old hat to him. It didn't all look the same and not arouse him. Doctors are not automatically asexual beings in the exam room and some are even sexual predators that use their position and "expertise" to manipulate their patients and abuse them.

If you read the accounts of what the victims experienced, you see examples of claiming that sexual abuse was a needed medical treatment and of the confusion and doubt this caused in a patient who must in many regards trust their doctor and his education to determine best treatment. (Victim impact statements) In so many aspects of medicine, the patient is treated as hopelessly uneducated, incapable of understanding what is wrong with them or the treatment except in the most general, oversimplified terms. Patients are kept at arm's distance from their own health decisions. Think about when you have a health problem. You are supposed to go to your primary care physician who then decides whether to refer you to a specialist. If you have tests done, the results go to your physician who then shares them with you. The physician is set up as the complete authority figure.

I can't tell you how many times I've heard, "My doctor won't let me get in the pool for two weeks" or "My doctor has told me I must have a colonoscopy every six months now." And the majority of people follow the commands, whether they like them or not, without even thinking about questioning them. While there might be good medical logic for these type of commands, it would be healthier if it was presented as, "Getting in a pool before your incision heals will increase your risk of infection" and "You seem to have increased risk of ______. One way you could chose to deal with that is by testing more often. Here are the risks and benefits of a colonoscopy." This would place the power and responsibility with the patient.

If the Nasser case shows us anything, it is the huge danger of assigning a fallible person with such authority and control over other people's bodies and lives. These girls felt uncomfortable, but they were told he was the best doctor around so they second guessed themselves. And when they did complain they were told, "He is a respected doctor. He knows best not you. He knows better than you do what is best for your body." That is the medical culture that we all live in and it is not a safe one.

Related posts:
Patient Modesty
Take it All Off
How to Protect Your Modesty in a Medical Setting