Metro

How a crude photo from a Boston surgeon roiled the medical world

The bronze statue of Shakespeare’s Juliet near the balcony of her house in central Verona, as pictured in 2008.
Maurizio Lapira/AFP/Getty Images
The bronze statue of Shakespeare’s Juliet near the balcony of her house in central Verona, as pictured in 2008.

During a speech to hundreds of doctors at a medical conference, a prominent Boston surgeon showed a slide that had nothing to do with medicine: Displayed on huge screens was a photo of a famous Italian statue of Shakespeare’s Juliet — with the surgeon and a colleague touching her breasts.

As chuckles and whispers rippled through the room at the November gathering, many female surgeons were incredulous — and then angry.

Dr. Jon Einarsson, then president of the large gynecological surgery organization holding the meeting outside Washington, D.C., at first seemed to defend this and another part of his presentation that drew objections. He pointed out that “all tourists’’ in Verona traditionally touch the statue’s breasts for good luck.

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But when colleagues responded with a petition in protest, Einarsson, chief of minimally invasive gynecology at Brigham and Women’s Hospital, apologized. In an e-mail to the Globe, he said he made an error in judgment.

Brigham and Women’s Hospital
Dr. Jon Einarsson.

His speech, however, has had long-lasting repercussions, helping to prompt a reexamination of what many female gynecological surgeons say is a pervasive culture of sexism and sexual misconduct in a corner of medicine that is supposed to be all about caring for women.

Two weeks after Einarsson’s address, more than 100 surgeons sent the petition to the board of the AAGL, a leading organization of 7,000 gynecological surgeons who practice minimally invasive surgery. Female members, they wrote, have been sexually harassed and assaulted, and experienced workplace intimidation by colleagues. They “have felt objectified by male colleagues, uncertain for their safety at AAGL functions, and undermined in their efforts to advance their careers,’’ signers wrote.

“This is not the experience of few; this is the experience of many,’’ said the petition, which noted that the “president’s address’’ brought to light their concerns but did not identify Einarsson by name. Einarsson’s term has since expired.

The women — and men — who signed the petition requested a host of changes, including a written apology for Einarsson’s slides and comments, a sexual harassment policy that includes third-party reporting options for members worried about retaliation, a process for investigating allegations, and expectations for speaker content and member behavior at AAGL events, as well as more women in leadership positions.

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Dr. Lauren Schiff, a surgeon in North Carolina who was one of the petition’s initiators, said women are afraid to speak up for fear of retribution that will hurt their careers, but that incidents have been shared through an informal network of women who belong to AAGL. Schiff and other women said they did not want to violate colleagues’ privacy by discussing specific situations.

When allegations have been reported, Schiff said, it’s hard to know whether AAGL leaders have taken them seriously because the process is not transparent. Women who complained about Einarsson’s presentation to him and other leaders during the recent meeting felt their concerns were initially dismissed.

The AAGL board later sent out a memo apologizing to members and saying it is “taking immediate action,’’ including organizing a task force to recommend stricter policies as well as consequences for violating them.

The open confrontation of sexual harassment that has roiled many industries nationwide has been slow to emerge in medicine. But male doctors still dominate leadership positions. Surgery, in particular, has a strong hierarchy, thought to make patients’ operations safer by being clear about who’s in charge. Now however, the reticence about speaking out is starting to diminish.

In December, Dr. Reshma Jagsi, a radiation oncologist at the University of Michigan, wrote a personal piece in the New England Journal of Medicine: Sexual Harassment in Medicine — #MeToo.

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The next day, a well-known San Francisco obstetrician/gynecologist, Dr. Jen Gunter, posted her personal account on her blog: Gunter said that Dr. Khalid Khan, editor of the British Journal of Obstetrics & Gynaecology, repeatedly touched her breasts and rubbed her back in a bar crowded with doctors attending a conference of the International Pelvic Pain Society in 2014 in Chicago, where she and Khan were speakers.

Elizabeth D. Herman for STAT News
Dr. Jen Gunter in July 2017.

At first, she wrote, she couldn’t believe what was happening and tried to gently move his hands away. Eventually she screamed at him to stop, she said.

“If Dr. Khan hadn’t been editor of the journal, I wouldn’t have given him as much leeway in the beginning,’’ Gunter said in an interview. “When people are in positions of power, we give them the benefit of the doubt and then you doubt yourself.’’

Khan has stepped aside as editor amid investigations by the journal and his employer, Queen Mary University of London.

Contacted by the Globe, Khan denied groping Gunter. “I am keen to clear my name,’’ he said in an e-mail. “I will be cooperating with any investigations.’’

In a survey of US medical faculty published in 2016, Jagsi found that about 30 percent of women said they had been sexually harassed by colleagues or superiors compared to 4 percent of men — similar rates to the general population.

“We know that at the very least the problem in medicine is as bad as it is in any other field,’’ she said.

The number of women in medicine has climbed steadily since the 1970s, but men still hold many more positions of power. Women make up about 46 percent of all residents, or doctors in training, and more than 80 percent of obstetrics/gynecology residents, according to the Association of American Medical Colleges. But men head five times as many medical school departments as women.

At the AAGL conference, Dr. Georgine Lamvu confronted Einarsson about his presentation on a social media feed set up for attendees to comment on seminars and post photos of get-togethers. Einarsson had also shown a slide of Leif Erikson, the Icelandic explorer, in a skirt and indicated that the skirt wasn’t manly, women said.

“Topping it off by a picture of him fondling a statue’s breasts,’’ Lamvu wrote. “Highly unprofessional and disrespectful to all the women surgeons in that room.’’

MAURIZIO LAPIRA/AFP/Getty Images
A tourist took a picture of the Juliet statue.

Einarsson wrote back that he was “sorry that you or anybody in the audience feels that way.’’ He said the Erikson comment was a joke about one of his ancestors, and the “second was a picture of me doing what all tourists in Verona do.’’

Lamvu tweeted back, “The current times and your prominent stature should make you particularly sensitive to comments you make in public.’’

Einarsson declined to speak with the Globe, but in an e-mailed statement, he said, “Upon learning of the reaction to certain images used and comments made during my address, I realized my error in judgement and apologized. I made an imprudent decision, and I am truly remorseful.

“In light of the feedback, and as president of the AAGL at the time, I encouraged the Board to seize the opportunity to examine the culture within our professional association, and am gratified that a process is underway to do so,” he added.

The Brigham said in a statement that it expects “that all employees uphold our institutional values, which include professionalism and empathy.’’

Board member Dr. Jubilee Brown, a gynecological cancer surgeon in North Carolina, is leading the new AAGL task force. She said she has not personally experienced sexism or harassment and feels the board takes reports of misconduct seriously. She disagrees that there are few female leaders in the organization, and said those paths have been open to her.

But “we need to make sure that moving forward people have a way to feel safe with any concerns they might have,’’ she said. “We are all in a new age now.”

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Liz Kowalczyk can be reached at kowalczyk@globe.com.