Caroline Tan was a studious trainee surgeon working in a large teaching hospital in Melbourne when an unwanted sexual encounter irrevocably derailed her medical career.
Her supervisor, neurosurgeon Dr Chris Xenos, had invited her to his private rooms for some extra tuition after her shift ended. It was late, but having refused previous requests and not wishing to appear unappreciative, Caroline decided to go.
The pair met in the car park and made small talk about artwork inside before entering his room. Caroline’s back was turned when Dr Xenos suddenly came up behind her, spun her around and embraced her. He kissed her on the lips, put his hand on her breast and pinned her against his desk. As Caroline twisted in a bid to free herself from his grasp, she saw his erect penis sticking out of his fly.
“Do you want to go down on this?” he asked, as she escaped his grasp. Heart racing and mortified, she blurted, “How could you?”, and fled the room.
Dr Caroline Tan won a sexual harassment case against Melbourne neurosurgeon Dr Chris Xenos in 2008. PICTURE: Via Caroline Tan Adroit Neurosurgery.
Women have outnumbered men in medical schools in Australia since 1996
TEN YEARS on from the incident and despite winning a high-profile sexual harassment case against Dr Xenos at the Victorian Civil and Administrative Tribunal, Dr Tan says her career has still not recovered. Despite her best efforts, she has never secured a job in the public health system – even on occasions where she’s been the only applicant.
On paper, her credentials are impeccable. She has excellent references, has passed every exam with flying colours and, since 2008, has been a fellow of the Royal Australasian College of Surgeons (RACS) and a registered specialist.
Her case inspired Sydney-based vascular surgeon, Dr Gabrielle McMullin to speak out last month about the rampant sexism allegedly blighting her profession. Citing Caroline’s experience, Dr McMullin claimed she freely advised trainee female surgeons to submit to the unwanted sexual advances of their superiors, rather than lodge a complaint, if they wished to get ahead in their careers.
“[Caroline’s] career was ruined by this one guy asking for sex,” she told the > ABC at the time. “And realistically, she would have been much better to have given him a blow job on that night.
What I tell my trainees is that if you are approached for sex, probably the safest thing to do in terms of your career is to comply with the request.”
So just how sexist are our surgeons? And how typical is the experience of Dr Tan? Is hers an isolated incident or the tip of an iceberg? And how pervasive is the culture of silence that surrounds sexual harassment in the surgical profession?
Moreover, can it really be possible that a handful of male surgeons – arguably among the best educated men in the country – have no more enlightened attitudes towards women than your average nightclub sleaze?
“The woman who speaks up gets a terrible time,” Dr McMullin told The Weekly. “In Caroline [Dr Tan]’s case, the College of Surgeons never gave her any support. They made her continue working with her abuser and he would say things to her like, ‘Just get over it’. They withheld her exams for a year and then she couldn’t get a job.”
Yet the college cast doubt on whether it received a complaint from Caroline at the time. The Weekly invited Dr Tan to take part in this article. Yet, tired of the backlash she receives from male members of her profession whenever she speaks out, she preferred not to go on the record, stating only that previous experience had taught her to have “no confidence that my profession will treat me fairly”.
And it would seem she has a point. Within days of Dr McMullin’s comments to the ABC – and the media storm they created – Perth-based cardiac surgeon Dr Graham Jeffs took to Twitter to accuse
Dr Tan of reviving an unproven slur levelled at all male surgeons. Others have publicly denied there’s a problem, pouring scorn on Dr McMullin’s remarks and undermining Dr Tan’s case.
Dr Chris Xenos, meanwhile, is still working as a neurosurgeon at Monash Medical Centre in Melbourne. Since the tribunal case, he is understood to have served as acting head of his department. In court, he denied Dr Tan’s version of events and accused her of making it up to distract attention from her sub-standard work.
Supported by colleagues and friends, who described him in court as “an exemplary role model and devoted to his wife and children”, Dr Xenos was nevertheless found by the judge to have “deliberately and falsely denied the harassment” and “attempted to completely smear [Dr Tan’s] character”. Media reports have since feted him for his work operating on sick kids.
Surgeon Gabrielle McMullin stands by her recent remarks claiming sexism is rampant within the surgical community. PICTURE: Alana Landsberry
A MONTH on from her “blow job” comment, Dr McMullin acknowledges that her remarks were > intentionally provocative. They quickly made national headlines, sparked debate and ruffled many feathers in the surgical community. Looking back, she says she has no regrets, as her actions drew much-needed attention to the issue at stake. “It’s unacceptable that people turn a blind eye to sexual harassment,” she says.
At first, the RACS – the organisation responsible for the training of surgeons – went on the offence, with President Michael Grigg describing Dr McMullin’s comments as “appalling” and insulting to male surgeons. Within a few days, however, the college changed its tune. It announced it had “moved swiftly to establish an expert advisory group to deal with concerns of bullying, harassment and discrimination”. And now that the dust is settling, Professor Grigg’s view on the controversy appears to have softened. “To be honest, I think shining a light on this issue isn’t a bad thing,” he tells The Weekly. “[Dr McMullin’s comments] certainly got the attention of the entire profession.”
That is an understatement: her comments made for animated water cooler conversation across the nation, from school gates and HR departments, to financial institutions and law firms. And they reignited conversations about experiences of sexual harassment in all workplaces.
Dr Helen Szoke, CEO of Oxfam, has agreed to be deputy chair of the College of Surgeons’ new independent expert advisory group. As former Victorian Equal Opportunity and Human Rights Commissioner, she is aware of the obstacles that women face in reporting sexual harassment and denies it is a tokenistic response. “I’ve gone into this and, in a sense, put my own name and reputation into it, with a strong view that this isn’t just about getting this issue off the front page,” she tells The Weekly.
RACS President Professor Grigg concedes there is work to be done, but argues some surgeons are not even aware their behaviour constitutes sexual harassment. “People say silly little things like, ‘Don’t be a princess’,” he says. “I don’t think they are aware they are engaging in sexual harassment. I think awareness of things people say may be one of the positive things that comes out of this.”
According to Melbourne medical registrar Dr Ashleigh Witt, the culture of silence over harassment in medicine is corrosive. “Let’s consider the hundreds of other cases [aside from Dr Tan’s],” she writes in her personal blog. “The ones who didn’t make the news. The ones who, excuse my vulgarity, ‘got on their knees’ because it was easier. The ones who were too scared to tell anyone their boss made a pass at them. Or the ones who did confide in another doctor, only to be told, ‘Keep your mouth shut and you’ll be fine’.”
Dr Witt, who recounts being told by a surgical registrar to dye her hair dark if she wanted to be taken seriously, told of her frustration at being objectified at work. “Sexual harassment is every time you call me ‘blondie’ or ‘Barbie’, every time you make a joke about my choice to wear a skirt not pants, every time you comment on my appearance rather than my skill-set, every time you call me a ‘lady doctor’ instead of a ‘doctor’,” she said.
Across the city from Dr Witt’s workplace, an unnamed surgeon quit a major Melbourne hospital last month amid concerns over his performance and allegations of sexual harassment. It didn’t take medical students long to figure out who he was. “Everyone who has been a female med student there in the past 10 [years] can work out who it is,” said one. “During a surgery ‘tute’ when I was in third year [he said to one female student], ‘Sorry, I couldn’t hear your answer because I was staring at your breasts’.”
NOT ALL women, however, agree that there’s a significant problem. One well-respected female surgeon, who did not wish to be named, told The Weekly she had enjoyed a “very positive” experience as one of only a handful of women in her speciality. “If anything, I’ve seen the complete opposite,” she says. “No one has ever tried to inappropriately deal with me. I’ve been lucky to be around professional kind of people. When I worked in [another hospital], one of our junior doctors was assaulted by a patient and the hospital administration didn’t handle it well. But > my head of department took it extremely seriously, responded very professionally and showed great leadership.”
Likewise, Kate Drummond, a Melbourne-based neurosurgeon and deputy chair of the RACS’ Women in Surgery committee, claimed her experience had been one “overwhelmingly of collegiality, satisfaction and friendship” in an online piece for the Medical Journal of Australia. She suggested Dr McMullin’s comments would deter women from becoming surgeons and the suggestion that abuse was endemic was “untrue, unhelpful and damaging”.
It is clear, nonetheless, that Dr McMullin’s comments have left many rattled and uncomfortable. When The Weekly phoned the office of Dr Chris Xenos at the Monash Medical Centre in Melbourne to offer him the opportunity to tell his side of the story, a staff member informed us he was on leave, refused to pass on a message and hung up. When we contacted the media unit of South Eastern Sydney Local Health District to ask for permission to photograph Dr McMullin at Sutherland Hospital, which is down the road from her office, we were refused. Normally, it would be okay, the media officer told us, but because of whom we were photographing and her recent comments, it was a no.
While opinions and responses may be divided, statistics paint a clear picture. One in four women has been sexually harassed in the workplace in the past five years, according to research led by the Sex Discrimination Commissioner Elizabeth Broderick, and a third of us have experienced sexual harassment in our lifetimes. The most commonly reported forms are sexually suggestive comments, offensive jokes or intrusive questions and inappropriate leering. Almost one in six women says they’ve received inappropriate, sexually explicit emails or text messages in the workplace.
“Sexual harassment can occur in all types of workplaces – regardless of industry or workplace size,” says Elizabeth Broderick. “Ensuring women occupy positions of power equally with men is key to creating a safe and inclusive culture for both women and men.”
And therein lies a problem: supervising surgeons wield enormous influence over the progression of their trainees and the vast majority of supervisors are men. As Judge Marilyn Harbison noted in
her judgement on Dr Caroline Tan’s case: “It was not just that [Dr Xenos] was senior to her in the hospital. He was in a position of great influence as to her qualifications and future career.”
Hospital administrators also turn a blind eye to sexist surgeons, according to Dr McMullin. “Hospitals don’t take [surgeons] on because they are bringing in tonnes of money,” she says. “So you have these guys who are very powerful. Every hospital has policies [around discrimination and harassment] that they trot out, but it’s meaningless unless you put them into action.”
The RACS says it provides “a lot of opportunities for people to complain,” says Professor Grigg but then admits, “Not many people avail themselves of those opportunities.” He adds, “Maybe we are not doing enough to make people come forward. [That’s why] we think the time has come to expose ourselves to review.”
Dr Szoke is confident there’s now an appetite for real change at the 88-year-old college. “I “I think if the Royal Australasian College of Surgeons accepts there is enough of a case to set up an expert group, it has to accept then that we’ve got a really important job to > do,” Dr Szoke says. “This could be a really important opportunity for the college to be quite groundbreaking in what it does.”
Professor Grigg says the College is prepared to make significant changes and will spend hundreds of thousands of dollars funding the expert advisory group’s work. “We hope there will be change,” he says.
MAKE NO mistake, The Weekly is not suggesting sexism is confined to or even necessarily worse in the surgical profession. Where there’s a culture that permits, encourages or fails to recognise and penalise sexism, it will keep happening.
Clearly, higher education doesn’t preclude it. It has been argued that top footballers, for example, who disrespect or abuse women, should be explicitly taught about equal rights because they may have gone straight from school into a glorified profession where women are seen as playthings or a perk of the job.
Yet surgeons represent the academic elite in this country. Surely these men know women are their equals in intelligence and ability? Indeed, if they needed any further reminder, most would have studied alongside women (who now make up more than half of medical students).
Some argue that the Royal Australasian College of Surgeons needs to undergo a cultural shift. Dr Tan told The Age newspaper it was “an Anglo-Saxon old boys’ club” that favours men. Professor Grigg insists the description is “unfair”. “In the past, it was very much a male-dominated career,” he says. “In part, that’s because it was seen as a demanding, time-intensive type of avenue; it was a career that just wasn’t attractive to people who were going to be involved in bringing up a family.”
Fifteen years ago, says Professor Grigg, just 5 per cent of surgeons were female. Today, it is 10 per cent. And 27 per cent of the next generation of trainees are women. “Times are changing,” he says. “Women are disproportionately [over]represented in leadership.”
Male surgeons earn an average of $378,000 a year while female surgeons earn an average of $200,000 a year
BACK AT her private practice in Melbourne, Dr Caroline Tan is taking shelter from the storm of controversy around her case. She would love to work in the public sector as she has “always wanted to be able to treat the sick regardless of their financial situation”, but knows from bitter experience that this is unlikely to happen. In 2008, for example, Dr Tan claims that she was stonewalled by the Royal Hobart Hospital for a six-month locum position in circumstances where she says there were repeated advertisements stating that the neurosurgery unit was in urgent need.
Despite the furore her comments caused, Dr McMullin continues to stand by what she said and supports Dr Tan as well as other women who have shared their stories. She says there are many good male surgeons, but rejects suggestions which have arisen that the issues of bullying and harassment are gender neutral. “If someone drags a trainee into their room and says [perform a sexual act on me],” she says, “that’s not gender neutral.”
While her comments may seem shocking, it may be that Dr McMullin’s stance has been a necessary antecedent for meaningful change. A more anodyne comment about sexism would probably not, after all, have led to an independent inquiry.
Yet is it not unfortunate that this was the price of action in a profession dominated by some of the greatest minds in Australia? “Yes,” replies Dr Helen Szoke, who is otherwise careful to reserve judgement on the issue she’s now investigating. “In a word, yes.”
A BROKEN SYSTEM
Caroline [Tan] did exactly what we hope our sisters and daughters would do, should – God forbid – they find themselves in this situation. However, in an awful but not that surprising twist, reporting her sexual assault cost Caroline her career. Dr McMullin is not the problem here. She is simply the messenger. The problem here is a system where reporting sexual harassment is vehemently discouraged. A system where a young doctor successfully takes her assailant to court and is never employed by that system again. A system where big names have stood up this week and said sexual harassment is not a problem in medicine.
Dr Ashleigh Witt, Melbourne.
I AM CRYING
I am the mother of a “Caroline”. What Dr Gabrielle McMullin says is absolutely true. It is overwhelmingly apparent that the medical establishment punishes victims of sexual harassment if they dare to speak up. The recurring theme that the victims only have themselves to blame for not reporting these matters is sickening in its stupidity. I am crying as I am writing this as I am just so angry. I thank [Dr McMullin] from the bottom of my heart for igniting this debate so publicly. I know my “Caroline” would not be comfortable if there was any prospect of her being identified so I can only give my first name.
Ruth.
INDECENT PHOTOS
I work in a regional health service and a surgeon is well-known for harassment of the younger and more inexperienced nurses. His behaviour includes taking photos of his own genitals on his phone and asking young nurses to scroll through and find something so that they are sure to see the photos. When in surgery, he also likes to make comments comparing the bodies of the people on the operating table to the bodies of the young nurses in theatre. Everybody knows this, including hospital management, but nobody will address the issue. Theatres are all about making surgeons happy and that includes not calling them out on their behaviour. The older and more experienced scrub nurses will address the behaviour as a joke, boiling on the inside, to let the younger nurses know that they are aware of the issue, but that’s as far as it is addressed.
Nurse, NSW.
I WAS BULLIED
In 1990, as a very young intern and about 28 weeks pregnant during my orthopedics term, the surgeon I worked for bullied me relentlessly, made me stand for hours without any breaks, made lewd jokes to his registrar about how I had clearly spent “too much time on my back” rather than studying and gave me a terrible report, despite my having worked harder than ever to try and “make up” for being pregnant. He humiliated me and yet it never occurred once to anyone in that operating room, least of all myself, to voice any sort of complaint. The recent stories brought back these unforgettable, horrible weeks I spent in hospital training. Yet it seems many have endured much worse, braver women than me. I left for family medicine training as soon as I could. I have no regrets in that choice, but I do regret I didn’t stand up against that surgeon then because 25 years later it doesn’t sound like very much has changed.
Anonymous GP.
A version of this article originally appeared in the May 2014 issue of The Australian Women’s Weekly magazine. All dates and names mentioned were accurate when going to print.
