Tuesday, June 1, 2010

Medicine's Dark Secret

***WARNING:*** THIS POST MAY BE *HIGHLY* TRIGGERING FOR PEOPLE WHO HAVE EXPERIENCED SEXUAL ASSAULT.  This post discusses sexual assault in medical settings and goes on to explain anesthesia fetishes.

I write this post to educate about an issue, in hopes that it can stop even some of the abuse by criminals in the medical profession and hope dearly that I don’t hurt anyone by bringing back bad memories.  If you or a loved one have experienced sexual abuse and want to talk to someone, you can contact RAINN at rainn.org to speak with a counselor online or on the phone. 

Long ago, I was treated at a university health clinic by a pedophile already convicted of obscenity with a child in another state.  Fortunately for me, his predilection was for young men rather than young women, and he sedated teenagers with cocktails of chocolate syrup and a sedative before raping them.  I shudder to think what might have happened to my husband or my other male friends if they had been treated by him, and I wonder how it was that his colleagues trusted this doctor, if he appeared different or if they noticed some oddities in behavior that didn’t seem right.  More than that, I wondered how he was allowed to practice in our state after being banned from practicing in his own.

While we have all heard of teachers, clergy, neighbors, and scouting officials who have abused children, the medical profession is certainly not immune to abuse.  In fact, if you were an abuser, where best to get access to women or children at their most vulnerable, alone, sometimes overnight, and not completely dressed?  And not just women and children—elderly patients are often raped in nursing homes; according to the Chicago Tribune, there were 86 such reported cases in Chicago from 2007 on.  It's not just doctors and nurses; training programs for surgical techs, CNAs, and other allied positions are pretty readily accessible, short, and affordable. 

You may believe that such cases are extremely rare, that they wouldn’t happen where you work, that none of your co-workers are “like that.”  I am certain that every single non-abusing medical professional has thought this.  But what rate of sexual abuse are you okay with?  Believing that it couldn’t happen “here” is denial and allows criminals to continue doing what they’re doing, often to patient after patient--often hundreds of them--until one person has enough proof to come forward. While certainly no one needs to be making false accusations, every medical professional—and parent or loved one--needs to be appropriately wary, watchful, and protective.

One of the times that patients are most vulnerable is while they are under anesthesia, not just general, but conscious sedation as well.  Not only are patients unlikely to remember, remember completely, or be able to be fight back if assaulted, but those who are normally difficult to sedate and have memories will be questioned and disbelieved since anesthetics can produce sexual hallucinations.  The use of these drugs may actually make abusers feel safe and secure—they can always blame the anesthetic, and patients are likely to have pain and other difficulties in the recovery process that prevent reporting.  Not all hospitals perform the kit exams, thus requiring transfer at a medically vulnerable time.  While most professionals are not abusers and there generally are protocols to keep patients safe, abusers know how to break those protocols.  That’s exactly what’s happened in the cases where there have been convictions.

I was unaware until recently of anesthesia fetishes; I will not provide youtube links but will say that your individual horror movie--or at least my individual horror movie--(being intubated, barfing into a too-small basin, peeing yourself, anesthesia headache, screaming in pain not adequately relieved by fentanyl or morphine, not being able to reposition yourself, ongoing short-term memory loss) is someone else’s fantasy.  These perverts share a lot of commonalities with wheelchair and amputee “devotees”—unable to imagine themselves in a real, equal relationship with a woman, they sexually fantasize about people who are disabled, impaired, or cannot give consent.  Some of them have posted videos from ORs or dental practice rooms with their cell phones.  Erotica or pornography with consenting adults apparently does not hold a candle in their minds to women laid bare on an operating table, unable to move, naked, or more provocatively, under Ioban drapes or being scrubbed with betadine.  And intubation to them is the ultimate blow job.  Perhaps there are many more people with this perversion if you include those willing to date rape someone after drugging them or medical professionals who carry out their medicines, like the university doctor with his chocolate cocktails.  (But who the f* could be attracted to someone while they're in an unconscious state?)

I believe that most medical professionals would not harm others in this way and would go to lengths to protect their patients.  However, sexual abusers are sneaky and not forthright—they can also be risk takers.  They know when others aren’t looking, and the security guards who work at night to keep hospital hallways safe may not realize that they are locking predators in as much as they are keeping predators out.

Patients who have been assaulted may contract sexually transmitted diseases—hepatitis and AIDS among others.  They may become pregnant or awaken with pains they don’t understand. Those who recognize what happened may not come forward because of shock, fear of disbelief, lack of proof, or if there’s been sedation, difficulty with anesthesia or surgery recovery.  If there are no witnesses, as when a radiology tech gropes, it may be particularly difficult to come forward.

Security cameras do no good when people assume that they will not see anything out of the ordinary on them or when they are not reviewed.  Safety protocols are meaningless when someone breaks protocol because of a delay or missing supplies or equipment, leaving patients alone with an abuser who is well aware of where the safety system fails.  Background checks only mean that someone hasn’t been charged or convicted, not that they haven’t or will never abuse another person.  Open your eyes.  Ask questions.

Remember, protocols are guidelines.  People can and will break them.  They know when others aren’t watching.  Protocols don’t make any difference if you don’t blow the whistle when it’s called for.  And it may not just be your patient.  Someday it may be you.  I’ve said it before—never leave your child alone with any medical professional, not even for an x-ray or bloodwork.  If your child stays in the hospital overnight, you must do what you can to stay too--and throughout the day.


Lene Andersen said...

Very important issue. THanks for posting about it.

FridaWrites said...

Thank you, Lene. It took a few weeks for me to be able to write it.

yanub said...

The last dentist office I went to had open cubicles, separated only by supply shelves from the other work areas. And the wall was a huge window looking out over the parking lot and neighborhood. I could see right away the advantages to a system like that. No one does anything they aren't supposed to, since nothing can be hidden. The chiropractor I used to see had a similar set-up (she was more a massage therapist than a chiropractor), as did my daughter's orthodontist. I think maybe such floor plans for health practices would be a good thing, generally. I mean, no one wants to be naked and in a vulnerable position where just anyone can see, but perhaps less expectation of privacy would reduce the incidence of abuse?

FridaWrites said...

Our dentist/orthodontist/chiro are the same way and it works. There is something to be said for the practices where nurses will walk in at any time, though that can also be annoying. The difficulty I guess is trying to balance patient privacy/modesty for procedures and uncomfortable exams and patient safety; also protecting patients' medical information from being overheard (I've often had people I know at the same dr.'s office).

I was relieved to see that women employees would always check in on residents who had visitors at my husband's grandmother's nursing home.

Suzy Furno-Maricle said...

Interesting topic....however I must caution against the idea of
"less expectation of privacy".
It is already a legal concept being debated in the courts, and should we as patients accept the idea, then all expectations of privacy can ( and will)be violated.
I can say that my male family members (who see a male dr.) would be horrified if a female nurse just "walked in"...as I would with a male nurse or tech. There has to be a better way to mitigate the circumstances.
And do not count too much on staff monitoring.....violations are passed over everyday.
Thanx FW for the interesting debate!

FridaWrites said...

Thank you, swf. I wonder if staff are also reluctant to report because that will in some circumstances cause them to get fired by people who have more power in the organization.

Elizabeth McClung said...

A disturbing fetish, not unlike necrophilia, or the fetish found in male orderlies of raping coma patients.

I go to a female only dental practice and I transfered from a dentist who I told the staff WAS a sadist, and I believe enjoyed the emotional as well as physical aspects of fear.

How to stop or even lessen. I don't know, except that the Royal College, the Canadian College and whatever groups in the US have to open the books - which I think will, when finally opened look like the Catholic 'admission' of tens of thousands of sexual abuse cases (which caused no effect in the way, protocols or treatment of children and those who dealt with children and women alone in churches in Evangelical and Protestant churches).

Shipton, the mass murderer of the UK who killed at least 105 individuals, ONLY got caught because he started changing wills to have the people he killed give them all their money...after they died. He may have killed 300+.

It is well known and you can look at the BC college of Physicians and Surgeons to see who THIS MONTH has 'supervision' for the many sexual acts they have already done. If you want to be a pedophile, a serial sex abuser, then get a doctor's degree because even once they catch you - you can still keep on doing it - the question wasn't "Why was he still allowed to practice in another state" but like all the ones here and in the UK, "WHY AREN'T THEY IN PRISON?" - in the US you can't vote, you can't do many things, and I am sure setting up a doctors office for a post prison publically registered sex offender on parole would be impossible. But they don't go to jail.

Much like the epidemic of physical abuse in senior centers which has the same style as old police stations, 'they give you trouble, rough them up some so they quiet down'. As you say, hard to get evidence, those who experience it have compounded shame regarding testifying and doctors, RN's, medical staff, medical administrators, rehab therapists are SO USED to being able to do what they want with no oversight that even if caught they would do as they always do - blame the patient. For example, we KNOW that some rehab therapist work people until they cry or scream, and with vets coming home, that kind of rehab will only increase - we KNOW IT, and yet we never ask, "Is this person a sadist? Have they cross a line?" - because there is no line.

Thank you for sharing this. My solution would be public raids on hospitals, in front of Cameras, so that people could say, "That's my doctor...wait, he did something like that to me." - it is already well known that HMO's will cover up deaths, abuse, and much more to avoid lawsuits, so will hospitals and other institutions. It is the 'thin white line' which sticks together.

I remember reading the blog of a nursing student who worked at an all female wing of low risk mental health facility and when she had a bad day, she would intentionally push individual buttons and then call for a four point restraint, order them doused with water or leave them all shift until they wet or shit themselves. Since she went through a lot of boyfriends and had some issues with parents, she had a lot of 'bad days' and detailed what she did. Last I could stand reading her, she was not in prison, but going to work another day, the institute collecting insurance money for the care of people's children, her care.

The fetish of helplessness, it isn't just men. It really is all about domination and power, not the sex - turns out my therapist was right.

What ARE the lines? Who inspects? Who enforces? - who of us hasn't had an angry tech with a needle? Or a pissed off doctor talk in a way would be inappropriate in any other setting or profession. And if a dentist wants to start telling you wacko theories when helpless, I for one would just nod, yes, terrified.

Elizabeth McClung said...

Youtube: where stalking and dubious/illegal fetishs' come into public sharing and creepy bonding and google tries to sell ad space on it.

FridaWrites said...

Elizabeth, your comment is very astute in many ways.

I had not made the direct connection to what's happened in the Roman Catholic Church, but the dynamic is very similar. One doctor in our state was convicted of molesting an adult woman...and still has not had his licensed stripped away, is still in practice under supervision.

Something's got to change, something's got to give, someone's got to blow the whistle. Many someones. They're relying on our silence, just the clergy. Even once is too much.

And yeah, sadists, I've seen a few--they clearly get off when hurting someone or intentionally inflict more pain than is necessary, while most care providers are cautious and concerned.

Youtube: yeah, you're right about the stalking. I've watched a number of the devo videos, half-paranoid that I'm someone's joke or fetish (I don't know that is paranoia--it happens to enough people that it's a matter of chance). I've also reported a number of these videos. The advantage is alerting us that there are people like this.

FridaWrites said...

PS, I know there are many others in our state--I just happened to run across a news alert.