Open Secrets: #MeToo in the Med School

Open Secrets:
#MeToo in the Med School

Published on November 5, 2018

This article contains sexually explicit language.

On Feb. 12, 2010, Michael Simons, a cardiology professor at the Yale School of Medicine, penned a letter to Annarita Di Lorenzo, an Italian postdoctoral associate at the time. The single note, handwritten in effortful Italian, soon became a series of emails, conversations and letters, in which the accomplished doctor professed his desire for the younger researcher.

“I want to kiss your lips on the coast of Liguria … and every part of your body in every continent and city in the world,” he wrote in one of the letters. “I want to see you in evening dress at La Scala … and naked on the beach of Jamaica.”

Di Lorenzo made her lack of romantic interest in him clear and told him that the letter was insulting to her, her boyfriend and Simons’ wife. But Simons continued to harass her, telling Di Lorenzo that she was choosing the wrong man: Unlike her boyfriend, Simons promised Di Lorenzo that he could “open the world of science” to her.

When Di Lorenzo left Yale to pursue a career at Cornell University in 2011, Simons repeatedly made derogatory comments about Frank Giordano — her then boyfriend and now husband — who remained at Yale.

In 2013, the University-Wide Committee on Sexual Misconduct found Simons guilty of sexually harassing Di Lorenzo and creating a hostile work environment for Giordano. The Yale Daily News obtained a report from an outside fact finder, as well as two reports from the UWC, which outline new details about this allegation against Simons. A faculty member at the School of Medicine who leaked the documents to the News requested anonymity for fear of retribution. The News has chosen to identify the victims of the case because their names were previously disclosed in a 2014 New York Times report. Simons did not respond to multiple requests for comment.

Five years after the UWC’s decision, Simons made headlines again. After the University transferred him from the Robert W. Berliner chair to the Waldemar von Zedtwitz chair at the end of July, Yale medical faculty rallied against the new title. Typically, endowed chairs are reserved for senior faculty members and often include supplementary funding. By September, more than 1,000 students, alumni and faculty members across the School of Medicine had signed an open letter to University President Peter Salovey condemning the decision. Amid the controversy, on Sept. 18 at 3 p.m., executive board members of the Committee on the Status of Women in Medicine gathered in the Steiner Room of the Yale School of Medicine to discuss this decision with School of Medicine Dean Robert Alpern and Chief Diversity Officer Darin Latimore.

According to two SWIM executive board members who werepresent, Alpern began the meeting by defending the University’s decision. He argued that Yale did not intend to confer a new honor on Simons with the transfer of chairs. And at one point during the meeting, as Alpern fielded questions and justified the University’s decision, he claimed that he had an obligation to speak for Simons.

“I have to defend the defenseless,” Alpern said. Two SWIM executive board members at the meeting — who were interviewed on separate occasions — confirmed Alpern’s words. Two other members of the executive board, including Epidemiology professor Nancy Ruddle, said they couldn’t remember the exact phrase Alpern used but recalled him describing Simons as “defenseless.” When asked about the context in which he described Simons as “defenseless,” Alpern declined to comment.

“I was just shocked,” Ruddle said. “I was zeroing in on the ‘defenseless’ because I was thinking of all the other people who are defenseless at the medical school, just like the women who experience sexual misconduct.”

For many faculty members at the School of Medicine, Simons’ new professorship represents the culmination of a long-festering wound from the University’s failure to properly address cases of sexual misconduct. New revelations about Simons’ case, as well as two cases of sexual misconduct that are open secrets at the School of Medicine, highlight an institutional culture that prioritizes prestige over the safety of its faculty, students and staff. In the face of continuing advocacy by students, faculty and alumni to end workplace sexual misconduct, Alpern’s characterization of Simons raises the question — who holds power at the Yale School of Medicine, and who is left defenseless?

“AND SHE WOULD NEVER KNOW”

Despite Simons’ advances, Di Lorenzo said she continued to communicate with him politely and respectfully because she was afraid of “alienating or angering [him],” per the UWC report. At the time, Simons was supporting Di Lorenzo’s efforts to get a grant. As a prominent figure in the field of medical research, Simons had the power to interfere with Di Lorenzo’s ability to secure professional positions. The UWC report detailed that in his opening statement at a UWC hearing, Simons said he could have “killed” Di Lorenzo’s candidacy with a single word “and she would never know.”

Michael Simons.

And even after Di Lorenzo left Yale in 2011, according to the UWC report, Simons publicly made “embarrassing remarks regarding [Giordano’s] performance and abilities.” Finding no help within the School of Medicine, the couple filed formal UWC complaints in 2013. In the UWC investigation, Giordano claimed that Simons froze him out professionally. Witnesses interviewed by the impartial fact finder during the UWC investigation confirmed that Simons had publicly derided Giordano “beyond the scope of any legitimate supervisory action,” the UWC report stated. Still, the report stopped short of saying that Simons’ actions — including removing Giordano from a grant — had been retaliatory.

The UWC panel found Simons guilty of “creating a hostile work environment” for Di Lorenzo and unprofessionally exercising authority over Giordano. For “significantly [misusing] the leadership role entrusted to him as a section chief,” the panel recommended that Simons be permanently removed from his position at the helm of the department. The panel also suggested that the University abstain from granting Simons another comparable or higher leadership position for a period of five years and that any further violation of Yale’s sexual misconduct policy should result in suspension or termination.

Although University Provost Benjamin Polak claimed to “accept the panel’s conclusion that [Simons’] actions in pursuing Professor Di Lorenzo constituted sexual harassment,” he rejected the UWC’s recommendation and instead gave Simons an 18-month suspension. Amid faculty backlash, and with a New York Times investigation into the case, Yale announced that Simons had decided not to return to his previous position as cardiology chief. Still, Simons quietly retained his Robert B. Berliner professorship, the one endowed to him years prior as a mark of excellence in his career.

“A PLACE WHERE ALL CAN LEARN, WORK AND THRIVE”

Five years after Simons resigned from his position as cardiology chief, the University’s decision to award him another endowed professorship has left many Yale medical faculty doubting whether the school has made any progress in preventing sexual misconduct.

In response to the backlash, Yale spokeswoman Karen Peart issued a statement on Sept. 6 defending the University’s decision to award Simons the von Zedtwitz chair. She argued that the University simply transferred Simons’ professorship without intending to confer a new honor —  the same defense Alpern would offer later in the month. Before Simons received the von Zedtwitz professorship, he held a professorship named in honor of Robert Berliner ’36, a former dean of the medical school. But a member of the Berliner family contacted representatives of the School of Medicine this spring to say she was “quite upset and appalled” that Simons still held her father’s professorship.

However, as criticism accumulated, Alpern issued Simons an ultimatum on Sept. 20: He either had to resign from his position as von Zedtwitz chair, or the appointment would be taken from him. In response, Simons filed a lawsuit against Yale. According to the court documents, Alpern offered that if Simons gave up the endowed chair of his own accord, the University would pay him an annual amount equivalent to the supplementary payout from the chair — approximately $140,000. Simons refused to resign, and, on Sept. 21, Alpern announced that he had stripped Simons of the von Zedtwitz chair “out of concern for the community’s well-being.” On the same day, Salovey affirmed in a statement to the News that sexual harassment and misconduct have no place at the University.

“Sexual misconduct, including harassment, deeply harms those who experience it and is at odds with the trust, respect, and collaboration that are critical to our mission of research, scholarship, education, preservation and practice,” Salovey wrote. “We must continue to build on the University’s years of focused effort to prevent and address sexual misconduct on our campus. Together, we can continue to strengthen our community to ensure that Yale is a place where all can learn, work and thrive.”

But for the School of Medicine to be “a place where all can learn, work and thrive,” six faculty members claimed that the University has much more to do, especially when it comes to reckoning with past cases of sexual misconduct.

“IF YOU ARE POWERFUL ENOUGH”

In November 2006, former secretary at the School of Medicine Mary Beth Garceau sued Yale, alleging another case of sexual misconduct. According to court documents obtained by the News, Garceau accused Joseph Schlessinger, the chair of the Pharmacology Department, of sexually harassing her in 11 separate occasions throughout her three-year employment at Yale. Garceau also claimed that the University did nothing to stop him.

The complaint Garceau filed in the Connecticut district court argued that Schlessinger repeatedly made lewd observations and suggestions to her. For example, Schlessinger bragged that he had slept with 46 different women, joked about penis size, showed her photos of naked men ejaculating and commented that Garceau’s breasts were “not very big,” as per the complaint. Garceau also alleged that Yale refused to address her concerns when she brought the situation to the attention of University officials. Instead, she claimed, Yale “protect[ed] Dr. Schlessinger as he was deemed more valuable to the University.”

Garceau’s lawsuit against the University was settled in June 2007, although the details of the settlement are not available to the public. Schlessinger did not respond to request for comment. Alpern said he cannot comment on “personnel issues.”

Schlessinger continues to serve as chair of the Pharmacology Department and holds a prestigious endowed professorship named for William Prusoff.

“You don’t settle unless there is real guilt and no chance of winning,” said a School of Medicine professor who requested anonymity for the fear of retribution. “[Schlessinger] continues to be chair, even now with the #MeToo movement. … If you have sexual misconduct allegations, you shouldn’t continue to be rewarded, and he is frequently brought up as an example of … rewarding bad behavior if you are powerful enough.”

A CULTURE OF “OPEN SECRETS”

At the time of Garceau’s lawsuit, Yale lacked a dedicated administrative body to adjudicate formal complaints of sexual misconduct. But even after the establishment of the UWC in 2011, according to faculty members at the School of Medicine, the University has still failed to properly handle allegations of sexual misconduct.

In February 2015, less than a year after The New York Times published a series of reports on Simons’ case, two federal lawsuits were filed against Rex Mahnensmith MED ’77, former nephrology professor and medical director of the DaVita New Haven Dialysis Clinic, where Yale physicians treat their patients.

Court documents from these lawsuits detail a history of sexual misconduct that stretches back more than a decade and involved seven present and former employees of the dialysis center, including nurses, a social worker and a dietitian. According to court documents, in 2002, Mahnensmith pressed his erect penis against the back of a female social worker — one of the plaintiffs of the case — while she was sitting on a stool at the center’s hemodialysis unit. When she reported the episode, she said her supervisor — who is not identified in the court documents — told her that this was simply the “culture of the clinic” and that she should avoid Mahnensmith.

The complaint also documented at least 10 incidents of sexual assault from 2013. In November, Mahnensmith allegedly approached a nurse who was eating lunch and “began thrusting his pelvis into the back of her chair in a sexual way rocking it to and fro.” The complaint also claimed that in July 2013, Mahnensmith went into a patient’s room where another nurse was sitting on a stool and pressed his erect penis against her back while “firmly holding and rubbing her shoulders.”

DaVita, a company based in Denver, runs the dialysis center where these incidents happened. According to the court documents, DaVita stressed to its staff its “intent to keep Dr. Mahnensmith happy to protect its contracts with Yale” because “the Yale contracts afforded DaVita both financial gain and status.” DaVita could not be reached for comment.

According to a faculty member at the Yale School of Medicine — who spoke to News on the condition of anonymity for fear of retribution — there was a “common knowledge that [Mahnensmith] was acting very inappropriately to the detriment of people who worked with him or who were trained by him.” It is unclear whether these allegations were reported to the UWC.

And according to six School of Medicine faculty, the University’s mishandlings of the sexual misconduct allegations against Simons, Schlessinger and Mahnensmith are not atypical.

Nina Stachenfeld, co-chair of SWIM and senior research scientist in the Department of Obstetrics, Gynecology, and Reproductive Sciences claimed that there is a culture of “open secrets” at the school, where stories of sexual misconduct circulate among female faculty and students, but very few incidents are reported.

“So much of this is woven into the fabric of this place that names just pass by,” said Lynn Fiellin MED ’96, associate professor of medicine. “You don’t know what happened and how the situation went, but you know that it happened. You could talk to five different people at the school, especially women, and they will each have a couple handfuls of stories like this.”

“WHEN PEOPLE WITH A LOT OF POWER ARE ACCUSED BY THOSE WITH LESS”

According to a survey published in the Journal of Personnel Psychology in 2003, universities have the second highest rate of sexual misconduct across workplaces. Fifty-eight percent of female faculty and staff in academia experience harassment, second only to 69 percent in the United States Military.

In its recent report examining Title IX cases brought against Yale faculty members since 2011, the Women Faculty Forum attributed the high frequency of sexual misconduct in universities to the organizational hierarchy that “creates particular power asymmetries [and] leave[s] certain populations vulnerable.”

According to Claire Bowern, chair of the Women Faculty Forum and professor of linguistics, “nearly two-thirds of faculty sexual misconduct cases are directed against people faculty members have power over.” She added that power hierarchies in academia breed “an unhealthy environment where [students and junior faculty members] frequently become victims of sexual harassment or assault and still have a hard time coming forward.”

In an interview with the News, epidemiology professor Nancy Ruddle GRD ’68, who is also a member of the SWIM executive board, said faculty positions at the School of Medicine are particularly hierarchical. While costs for running other professional schools come from “hard money” — or the University’s budget — the School of Medicine funds a big portion of their faculty salaries, utilities fees and research expenses with “soft money,” or grants.

Ruddle explained that professors at the School of Medicine, especially those in departments without clinical revenue, are expected to earn grants that will fund a portion of their salary. In addition, grants are used to finance the “indirect costs” of their research, including rent, utilities and other administrative expenses of the school. In fact, Alpern said 10 percent of the school’s total revenue in the most recent fiscal year came from indirect costs from grants.

“Indirect costs are very important to the School of Medicine because that’s what keeps the place running,” Stachenfeld, co-chair of SWIM, said. “It pays for everything. It keeps the lights on, and it pays for clerical support. … That’s why the University has to hold on to the people who bring big grants.”

She added that the School of Medicine’s reliance on grants makes it difficult for the administration to hold perpetrators of sexual misconduct accountable, especially those who receive large grants.

According to the National Institutes of Health website, Simons is the principal investigator for six different projects. This year, his projects are receiving a total of $4,453,090 from the NIH, which funds the majority of the school’s grant revenue. Of this, $1,757,058 go to the school’s indirect costs.

Psychiatry professor Christopher Pittenger ’94 GRD ’94, who serves as the vice chair of the the School of Medicine Faculty Advisory Council, said indirect costs are “part and parcel of the power differentials” at the school.

“In any organization, people in positions of power … have some built-in advantage,” Pittenger said. “Having lots of grants — which correlates with doing important work in the field and bringing status and money to the University — gives you that power. … Some people have more power and some have less power, and the situation gets messy and complicated when people with a lot of power are accused by those with less power.”

“IF WE KEEP DOING THE THINGS THE WAY WE ALWAYS HAVE”

Amid controversy over Yale’s decision to grant a new honorary chair to Simons, Alpern’s third term as the dean of the Yale School of Medicine is nearing its end. In the past months, Salovey has solicited medical faculty’s “views concerning the state of the school under [Alpern’s] leadership.” Although the survey is part of a standard reappointment procedure, the timing of the review could be damaging to Alpern, whose administration has faced intense scrutiny over the past few months for its handling of Simons’ professorship.

The open letter to Salovey, signed by more than 1,000 Yale community members, referred to Alpern’s reappointment process. The letter criticized that the school “[had] become synonymous with harassment” during his tenure and called for “new, innovative leadership” that will create an “academic institution that is safe and equitable for everyone.”

“Dean Alpern is responsible for fostering the culture in which these cases arose, and for the culture that allows such men to remain in power,” the letter stated. “It is time for a change to return Yale to an institution of which we can be proud.”

Responding to criticism, Alpern defended that he has helped the medical school make “substantial progress in advancing all of [its] core missions — education, clinical care, research and climate.” Noting that he addressed transparency in faculty compensation, improved parental leave policies and opened a second childcare center, Alpern said he helped foster a welcoming environment for female faculty and students.

In an email to the News, he stated that he is working “to identify and implement ways to enhance our programs to prevent and address sexual misconduct.”

The percentage of female faculty at the School of Medicine has gradually increased during Alpern’s deanship. According to Ruddle, who is a member of the SWIM executive board, the percentage of female tenured faculty increased from 17 percent in 2002 to 27 percent last spring, and the number of female endowed professors rose from 12 percent in 1973 to 24 percent this year.

Still, gender imbalances persist at the school. According to a 2017 report that the Women Faculty Forum published last December, there are 107 male professors and 22 female professors with endowed chairs. Only six out of 31 section chiefs are female and four out of 28 department chairs at the school are held by women.

In an interview with the News in September, Provost Polak said Yale has made great progress improving gender equality and that its diversity initiatives have “exceeded expectations.” Polak attributed the difficulties female students and faculty still face to “the pipeline,” or the historical underrepresentation of women in academia.

However, Elizabeth Jonas ’82, internal medicine professor and a co-chair of SWIM, argued that “numbers simply don’t add up” when assuming that the current gender imbalance is exclusively the result of a historical underrepresentation of women.

According to 2015 research conducted by the Association of American Medical Colleges, women have made up at least 40 percent of medical school students since 1992. Per the Women Faculty Forum report, 46 percent of Yale school of medicine students in the 2001–02 school year were female.

Pittenger, who serves as the vice chair of the Faculty Advisory Council, said that were the persistent gender imbalance “just a pipeline issue … it would’ve fixed itself by now.”

“Superimposed on the pipeline issue is the effort we put in for gender equity,” Pittenger said. “If we keep doing the things the way we always have, then we are going to keep getting the same results.”

“I DONT THINK HIS HEART IS IN IT”

Since January 2015, SWIM has worked on 18 different projects to promote gender equity at the School of Medicine. In their conversations with Alpern, SWIM board members proposed increasing the number of Title IX officers, appointing more women to leadership positions and avoiding promotion of a faculty member with a history of harassment. At the committee’s request, Alpern created the positions chief diversity officer and deputy dean for faculty affairs.

Still, six executive board members of SWIM said Alpern has effectively neglected many of their proposals.

According to a recent report by the National Academies of Sciences, Engineering, and Medicine, the two major characteristics of work environments with high rates of sexual harassment are male-dominated gender ratios in leadership and an organizational climate that conveys tolerance of sexual harassment.

For years, executive board members of SWIM have been advocating for the school to hold perpetrators of sexual misconduct accountable. Faculty members found guilty of sexual misconduct should not only be prevented from receiving promotions, but their current positions — including endowed chairs — should also be reconsidered, Stachenfeld said. In February, the committee recommended to Alpern that the faculty handbook should specify that individuals found guilty of sexual misconduct risk losing their endowed chairs. SWIM and the Women Faculty Forum have requested University Title IX Coordinator Stephanie Spangler and University President Salovey to consider adding the clause to the handbook.

SWIM also proposed that the University should increase female representation among section chiefs and departmental chairs. SWIM is hoping that the School of Medicine will increase the ratio of women and underrepresented minorities interviewed for leadership positions to 40 percent by January 2020, both Stachenfeld and Jonas said.

According to Jonas, taking endowed chairs away from those found guilty of sexual misconduct and increasing female chairs and section chiefs have “not been taken seriously by the administration.” In fact, female representation in leadership positions has remained largely static in the past years, Jonas said.

In an email to the News, Alpern defended that every search committee at the School of Medicine now includes at least 50 percent women. Alpern added that Latimore leads implicit bias training for search committees and is present at all meetings.

“Both Dean Latimore and I believe that our search committees have been strongly committed to diversity and, more specifically, continually strive to expand the diversity of our leadership,” Alpern said.

But according to SWIM executive board member Ruddle — who has been on at least five chair search committees — gender biases still inform the search processes for leadership positions. Ruddle said she has often heard her fellow committee members ask “what the husband is going to do” when considering a female candidate, while the question is rarely asked of their male counterparts. She added that because departmental chairs and clinical chiefs are selected based on many criteria, search committee members can “easily find reasons to blame” to explain why a female candidate was disqualified.

“From unconscious bias to conscious bias, I’ve seen all kinds of things I would not want to have to see again,” Ruddle said. “But at the end, [the committee members] would just say that she didn’t meet the criteria.”

Given this slow progress at the School of Medicine, five executive board members of SWIM — who talked to the News on a condition of anonymity for fear of angering the dean — said they questioned Alpern’s commitment to achieving gender equality.

One SWIM member said she thinks Alpern is satisfied with the current power dynamic at the school and is “a part of the problem” as someone “in charge of the good old boys club.”

Another member of SWIM accused Alpern of saying that the school could choose “to have either diversity or excellence” at a meeting with the committee a few years ago.

“If he’s motivated to make a better environment for women because he thinks that will save his job, fine,” said the same SWIM member. “But when people have that kind of motivation, they make small mistakes that show that their heart isn’t in it. … I don’t think his heart is in it. [Alpern] has had so many opportunities … to create change from the top, but it just hasn’t happened.”

Asked for comment, Alpern said that he was “highly committed to [increasing] the diversity of the faculty especially at the leadership level.”

At the time of his appointment, there were only three female chairs at the School of Medicine. Now, four of the departmental chairs are female.

“THERE’S MORE TO COME”

As community members have pushed the university to support victims, the accused have begun to apply their own pressure on Yale. On Sept. 21, Simons filed a lawsuit alleging that the University has been “pandering to the rage of activists” whose “sensibilities are perhaps too tender to appreciate Dr. Simons’s need not [to] pay” a lifetime consequence for a case that was adjudicated years ago. Earlier that day, Alpern had announced in a schoolwide email that he had stripped Simons from the endowed professorship “out of concern for the community’s well-being.”

In response to Simons’ lawsuit, executive board members of SWIM issued a statement reaffirming their commitment to ending sexual misconduct and promoting a healthy environment for women at the School of Medicine. Regardless of the outcome of the lawsuit, SWIM members stated that the energy surrounding the controversy is going to “galvanize the administration to examine issues affecting gender and race inequality in general.”

Other professors also noted that more faculty members, students and alumni are advocating for a healthier culture at the school.

“Recently, we have seen the Yale community stepping up, standing their ground and making their voices heard,” Fiellin said. “Until now, powerful men have had control over the medical school, but we are seeing what can be accomplished with the collective voice. … There is so much that still need to be addressed. There is a lot of unrest in the community with people demanding that things need to be done the right way. And there’s more to come.”

Correction, Nov. 9: Due to an editing error, a previous version of this article incorrectly stated that Joseph Schlessinger was accused of 1,111 separate instances of sexual harassment. He was, in fact, accused of 11. 

Clarification, Nov. 12: A previous version of the article stated that during his 15-year tenure as dean, Alpern added only one female chair. The number of chairs increased from 3 to 4 in the last 15 years. Still, Alpern has appointed four chairs, but a few of them have

left the position.

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