AUGUST 1 — Along with the rest of the nation, I woke up to disturbing news of allegations of sexual harassment within the medical fraternity.
The article seemed to have opened the floodgates, with numerous young doctors speaking out and recounting their personal traumatic experiences. What was even more alarming were some of the comments written in response to the article such as “the doctors also enjoyed the attention...” and “housemen will do anything to escape work...”.
Sexual harassment, in any environment, can lead to long standing psychological consequences for the victims. Victims may develop anxiety disorders of varying severity, for fear of further episodes. In extreme cases, Post Traumatic Stress Disorder (PTSD) can occur, especially if the harassment bordered on violence. Depressive symptoms are the most common sequelae and individuals who have had previous emotional disturbances may find their symptoms exacerbated.
A recent study in New South Wales reported 19 per cent of junior doctors faced sexual harassment and 25 per cent were victims of workplace bullying.
The majority of the doctors did not take official action, citing fear of reprisal as a reason. In some instances, doctors who did come forward found the process and outcome ineffective. It should be highlighted that men can also face sexual harassment and face more stigma and ridicule than women and are blamed for showing “weaknesses”.
The following case vignette illustrates daily sexual harassment:
M is a young doctor recently transferred to a busy outpatient clinic. Her supervisor laughingly suggests that she should “sweeten the deal” by buying him dinner when she approaches him to approve her annual leave forms. M’s supervisor also insists that she accompany him for courses in the Klang Valley (under the guise of her needing more knowledge). He insists that they drive there together as a cost-cutting measure and behaves flirtatiously throughout the duration, asking her to accompany him to the cinema to watch a romantic movie.
M’s colleagues resent her being able to attend these courses, and avoid her during work. Nurses in the clinic smirk at her and make snide remarks about her dressing, implying she is “attention-seeking”. M rebuffed his advances and her supervisor has refused to approve any of her annual leave over a 3 month period.
M has been unable to work due to the rampant gossiping. She experienced several frightening panic attacks while commuting to work and has been on frequent MC’s due to a new onset of “migraines”. She experiences insomnia and feels defeated by the situation. M finally contemplates resigning as a means to escape the situation.
The above hypothetical scenario is unfortunately a common occurrence. How do we learn from this situation and manage it effectively from an administrative and medical point of view?
M clearly developed an anxiety disorder in the months after this episode, manifested by the insomnia and panic attacks, even after the harassment ceased. Her headaches may be a form of somatisation, where physical symptoms are reflecting a disturbed emotional state. M’s colleagues also suspected “something fishy” but instead of speaking out, instead chose to gossip about it. This emboldens the perpetrator who feels invincible and the harassment evolves.
A referral to a mental health professional would be of benefit to M. Her anxiety disorder can be managed pharmacologically, with short term Benzodiazepines for alleviation of symptoms. A Selective Serotonin Reuptake Inhibitor (SSRI) can be prescribed if her symptoms persist as first line management. Other treatment options include educating M on deep breathing techniques and Cognitive Behavioural Therapy (CBT).
A supervisor / administration officer of the health department should be informed in confidence. This supervisor has an ethical and legal obligation to investigate the allegations in an impartial manner. Confidentiality is of paramount importance and this matter should only be discussed with key personnel. The supervisor should maintain a respectful approach to both the accuser and accused. M should be assured she is safe from retaliation of any sort and her career will not be jeopardised.
It is deeply disturbing to discover that the medical fraternity, once considered the pillars of society, has been discovered to have a dark side. Alas, even the Gods have feet of clay. I would emphasise however, that the vast majority of doctors are hardworking, humble individuals who work tirelessly for their patients and the education of their subordinates. I urge any doctor who has been the victim of abuse at work to seek psychological help if you are in distress.
* This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
