Introduction of Lars G Petersson

I have recently been reading a book titled "Medical Rape," by Lars G Petersson.  You can download it as a FREE ebook here:

Warning: If you suffer PTSD, specific phobias, anxiety disorders, panic attacks, etc., this book has "triggers." I had to put this book down a couple times and then return.

MEDICAL RAPE presents a shocking  story that might look like fictitious sadomasochistic porno. However, it isn’t: it is a true account of state-authorised sexual abuse. Therefore, in the name of millions of defenceless young victims, the author calls for an unconditional apology for what they were exposed to by their own country. He also demands an immediate stop to further ill-treatment.

About Lars (source):

Lars G Petersson (b. 1951) is a Swedish-born Londoner and activist with special interest in peace, mental health, environment, social justice and animal/human rights. He is the author of a large number of articles and seven books (three titles in three languages): FANEFLUGT (Danish Resistance Museum Publishing (2004), DESERTERS (2005), ABUSE UK (Chipmunkapublishing, 2010), MUSTERUNG (2010), MEDICAL RAPE (2010), HITLERS FAHNENFLÜCHTIGE (2012) and HITLER’ DESERTERS When Law Merged with Terror (Fonthill Media), 2013. 

Trained as a nurse – specialising in mental health, social issues and addiction – Lars G Petersson has persistently used his insider knowledge to disclose matters otherwise hidden from public scrutiny. In a number of cases this has led to serious public debate and major improvements for vulnerable people. In one case criticism of serious maltreatment of (non criminal) Iran/Iraq war deserters in a Copenhagen prison (Amnesty International Report 1991) led to significant improvements in the treatment of refugees in Denmark. In another, Petersson’s disclosures from a psychiatric unit under the Danish Ministry of Defence led to major reforms in military ‘training methods’ of recruits. 

For a number of years Lars G Petersson was coordinator for the Danish section of Amnesty International’s work against the death penalty. He is now secretary in a local London branch of the Palestine Solidarity Campaign. 

An insider’s understanding of the military he achieved as a conscripted soldier (trained as a lowest possible grade fighter plane mechanic) in the Swedish air forces at the time of the cold war. Finally, he has gathered extensive knowledge of German politics and society ever since the early seventies when he worked as a massage therapist in the state of Hesse.

Lars is married to Irish Josephine, his staunchest ally, friend and collaborator and together they have two most beloved dogs, Boo and Bentley.  

Lars will be writing a post for my blog in the future. He also has worked with Amnesty International, a group I greatly admire.

--Banterings

Sexual Abuse by Physicians: More common than we think...

Around 25 percent of the physicians in the United States face malpractice charges every year, including sexual misconduct. Psychiatrists, who make up only six percent of all doctors, account for 33 percent of all the sexual abuse claims.

 Prevalence:
The vast majority of physicians in the United States do not commit or condone sexual violence; however, perpetrators exist in every profession and the true prevalence of sexual assault committed by physicians against their patients is difficult to discern due to:

•  Self-reporting by physicians themselves, or from reports by fellow physicians. Due to the obvious professional/career ramifications of self-reporting, the actual prevalence of sexual assault by physicians may be higher than indicated by the available data ; and
• Victims of sexual assault by their physicians are thought to be even less likely to report the assault than victims of assault by other individuals, due to multiple factors. A low reporting rate further indicates that the prevalence of sexual assault by physicians may be higher than what is known.

A 1998 study in the Journal of the American Medical Association1 found:

• The number of physicians disciplined per year for sex-related offenses increased from 42 in 1989 to 147 in 1996; and the proportion of all disciplinary orders that were sex related increased from 2.1% in 1989 to 4.4% in 1996.
• Discipline for sex-related offenses was significantly more severe than for non-sex-related offenses, with 71.9% of sex-related actions involving revocation, surrender or suspension of medical license.
• Of 761 physicians disciplined, 75% of the incidents involved patients, including sexual intercourse, rape, sexual molestation, and sexual favors in exchange for drugs 
• As of March 1997, 39.9% of physicians disciplined for sex-related offenses between 1989 and 1994 were still licensed to practice. 
• Physicians disciplined for sex-related offenses were more likely to practice in the specialties of psychiatry, child psychiatry, obstetrics and gynecology, and family and general practice.
• 
  

The Dynamics of Sexual Abuse by Physicians:

As with all forms of such violence, sexual assault or abuse perpetrated by physicians against their patients is a malicious abuse of power intended to harm, control, and/or manipulate the victim. The physician-patient relationship is unique in ways that encourage an abuse of power by physicians who have malicious intent:

• Physicians possess knowledge and expertise that the patient does not have, but needs. 
• Patients are forced to trust physicians to diagnose and treat them appropriately and ethically. 
• Patients are often at their most vulnerable when interacting with physicians, because of physical pain, injury, illness, disease, mental/emotional distress, or other very personal or intimate problems. 
• Many patients must undress, be put under anesthesia, or otherwise placed in a position of powerlessness or incapacitation when being examined or treated by a physician.

Some of the ways offending physicians may commit and conceal sexual assault of their patients: 

• Assault patients while they are unconscious/incapacitated, and thus unaware of the assault.
• Tell patients that the behavior is a normal part of the examination or treatment.
• Manipulate patients into thinking that their questions or concerns about the abusive behavior are without merit, are confused, or are just a misunderstanding. 
• Convince the patient that no other physician can effectively treat them. 
• Threaten to discontinue treatment if the patient refuses to be subject to abusive exams or procedures. 
• Alter treatment (particularly medications) to keep the patient in need and/or compliant. 
• Threaten to discontinue treatment if the patient reports the abuse.
• Silence the patient by giving him/her money, gifts, or access to prescription drugs/opioids.  
• Convince parents or loved ones of patients that they are trustworthy; or silence loved ones with money, gifts, or access to drugs. 
• Elicit public support from patients they have not abused, and others who believe them incapable of sexual violence.

Sexual Abuse Harms Victims Forever.

Sexual assault has psychological, emotional, and/or physical effects that can last from a few weeks to forever. Victims suffer from depression, suicidal ideation and behavior and post-traumatic stress disorder.

Also, and because of their humiliation, they will probably avoid healthcare in the future. Nurse practitioners and doctors need to be sensitive to all patient’s need for modesty and bear in mind a possible background of sexual abuse.

Gowns or underwear shouldn’t be taken off without patient’s consent. Students don’t have the right to perform non-consensual exams on unconscious patients. Pelvic exams and pap smears are not necessary for birth control prescriptions. Doctors don’t need to ask their female patients to take their shirt off to listen to their hearts.

The Solution

Protecting the safety of the patient should be the first and foremost concern of healthcare. This includes protecting patients from sexual abuse by providers.

The only solution to prevent sexual abuse by healthcare providers is for patients to be able to refuse any intimate exam or procedure without without penalty. 

Any attempts to withhold prescriptions or treatments, dismissal of the patient from the practice, guilting, shaming, or other intimidation, at the refusal of an intimate exam/procedure or the request to undress should be seen as coercion and a pattern of sexual abuse.

This will also protect providers from false allegations.

There are very few (if any) situations where the results of an intimate cannot be obtained by other means:

• Pelvic exams are not required for birth control. 
• An enlarged or high riding prostate can be detected by ultrasound.
• A good physician exam can conduct a physical exam on a patient wearing a bathing suit. 
• A physician pediatrician who insists on viewing a patient's genitals without compromise should be suspect.
• A physician who withholds treatment or prescriptions, or dismisses patients should be reported to the police so patterns of abuse can be established. 

Chaperones are not the solution. Many abuses have been conducted in the presence of other medical personnel. Above all else, the patient's wishes should be respected.

If a patient refuses a chaperone in a situation where one is required (either by law or by policy) should omit that portion of the exam or procedure without penalty to the patient. 

--Banterings

KevinMD: Defending the physician, even when they are wrong

Recently I read a post on KevinMD titled: The blonde minority: Sexism is alive in medicine. on August 18, 2014, by Elizabeth Horn, a resident physician.

I look at the world very differently, I see patterns and connections that others don't see. Think Sherlock Holmes or House M.D. (Here is a little known fact: David Shore, the creator of House, based the character of House M.D. on Sherlock Holmes.)

As i read this article, I saw the proof of the theory (sexism is alive in medicine) presented supporting the opposite conclusion. What put me over the edge was Dr. Horn admonishing someone who was acting in a very respectful manner, in dealing with a confusing situation that healthcare created and refuses to address: the position of a person wearing scrubs.

I commented on how her story did not support the title and how she disrespected patients and their families. My comment was deleted. That pissed me off. So now I am going to hit back harder.

Here is my original comment that was deleted on Kevin MD:

There is a glaringly simple answer to the problem that you present and it is not sexism. (I hope you don't diagnose patients like you diagnose social issues).  

First I will address the "marry a plastic surgeon" thing. Plastic surgery is MOSTLY elective. They are usually not covered by insurances so they don't have to jump through hoops to get paid. They are happier with their profession, patients, etc.  

I don't know what your speciality is (you conveniently left that out) , but unless you are going into something where the pay scale is comparable with that of a plastic surgeon, then that person spoke the truth. I will acknowledge that it may have been inappropriate, but still the truth.  

Just as a physician says "we are professional and have seen it all" when a patient expresses apprehension about exposure of their body, thus making it about the physician's feelings and totally ignoring the patient's feelings: you are doing the same with this issue.
Perhaps the real issue is how you present yourself:  

"A natural blonde... my diminutive frame...my blonde mane...rather than a skirt suit... heels to a respectable 1.5” or less. I avoid using the word “like” too often...become disproportionately focused on the thoughts and opinions of male physicians and residents... Not that I mind a youthful complexion...a young, reasonably attractive blonde doctor... trust-fund boyfriend I had... the tortoise shell glasses, changed into my skinny jeans, a favorite sweater, suede heeled boots, put down my hair and applied a little mascara and blush." (Your words.) 

LIKE, oh my God, it's Elle-izabeth Woods of "Medically Blonde."   

Don't take not being called "doctor personally." In the 1970's you saw 3 people in hospitals: doctors, nurses, and orderlies. Each wore a specific uniform and were easily identifiable.  

As you stated, today there are "physician... ...nurse, physical or occupational therapist, student or housekeeper" and everybody wears scrubs. Let's not forget visiting surgical company reps (demonstrating equipment in the OR), janitors (sometimes), phlebotomists, lab techs, quality control specialists, EMT, and a host of others subject to the facility's infection control plan.  

Is it NOT just as disrespectful to you for someone to call a CNA doctor???? 

Calling you "miss" was sign of respect, respect that you are obviously LACKING for the person who called you that! Obviously they did not know your title, and used a respectful address for any unknown woman. 

Obviously with that paternalistic, arrogant, everything-about-you attitude, you are fitting quite well in the medical profession quite well.

While my comment may have been slightly inflammatory, the way she disrespected patients  and their families was more inflammatory. Everybody wears scrubs, there is no color coding to tell what position a person holds. People have been complaining of this for years. Calling her "miss" was polite and respectful!

Here is how she describes herself:

A natural blonde... my diminutive frame...my blonde mane...rather than a skirt suit... heels to a respectable 1.5” or less. I avoid using the word “like” too often...become disproportionately focused on the thoughts and opinions of male physicians and residents... Not that I mind a youthful complexion...a young, reasonably attractive blonde doctor... trust-fund boyfriend I had... the tortoise shell glasses, changed into my skinny jeans, a favorite sweater, suede heeled boots, put down my hair and applied a little mascara and blush.

If she is using sarcasm here, then I apologize for not catching that. I don't think that is the case though. I think that she presents herself (perhaps unconsciously) in such a manner then call it sexist when people don't take her seriously. I am not saying that this is right, and there may be some sexism involved.

There is nothing here about paying for college and med school, the burden of student loans, the years at a resident's salary trying to survive. If indeed she did have a trust-fund boyfriend then the only way you meet someone like that is if you are in those circles. Mentioning "residency at an ivy-league institution" is another giveaway, usually implying influence of the family she comes from. I suspect that she comes from a very wealthy family.

LIKE, OMG, it's Elle-izabeth Woods of "Medically Blonde." 

The frightening thing is how she deals with this issue and (more importantly) it would affect her interactions with patients  and their families:

 I have learned to speak up, to maintain eye contact and to assert myself if needed when rounds become disproportionately focused on the thoughts and opinions of male physicians and residents.

This is PATERNALISM! What if a patient doesn't agree with her decision of treatment?

It is troubling issue is that she aims this at ALL men. Has no man ever taken her seriously? This is stereotyping and REVERSE SEXISM. Then she makes the following comment where the man that she chose to marry is the only "good man" in the whole post, And the gender of the "trusted adviser" is conveniently undisclosed due to lack of pronouns:

During my internship, I went on a date with a good man and a couple of years later, he proposed. As I made plans for my career after residency, I met with a trusted adviser who after discussion of the several options I was considering, fellowship, research, physician positions, assured me not to worry too much. I was, after all, marrying a plastic surgeon.

I also comment on lack of disclosure of what her choice of speciality will be. All physicians are hurting financially, but general practitioners are hurting the most. The physicians that are thriving are the ones free of the bonds of medicare, medicaid, and insurance. Concierge physicians and plastic surgeons are two of these, and they are prospering. Dr. Horn fails mentioning her choice of speciality.

On July 28, 2014 KevinMD titled "Doctors today: Young, broke and human" by Aunna Pourang M.D. Indeed financial security is a major concern, even when both spouses are physicians. One being a plastic surgeon, alleviates much of the financial burden of that household.

Either I am missing sarcasm in this article, it is poorly written, or she is learning to be paternalistic. Looking at how the healthcare system operates, I go with the latter.

As a man I am offended by this post. As a patient, this post invokes fear in me of how Dr. Horn as a physician would respect my choices and my dignity.

I welcome a response from Dr. Elizabeth Horn or KevinMD.

--A. Banterings

A Physician that can Truly Empathize with the Patient

What if our providers had to do this? How different would they treat patients? You think it silly, but how would you really feel?

Needless Undressing in Healthcare

Question: Why do physicians make patients undress?
Answer: Because they can!!!

A Bantering on Changing the World

"Give me a lever long enough and a place to stand and I will move the world"- Archimedes, 230 BC

Patient Dignity 15: The "Eye of the Beholder"

I was in a talking with someone today who made me thought of this analogy. Previously there was a discussion about our bad encounters with healthcare providers who were paternalistic, lacked empathy,  just didn't care about our dignity, or suffering stress from the healthcare system. It was suggested that we might be "the exception and not the norm."

Just because a physician is paternalistic, it does not mean he doesn't care about the patient. Think of paternalism as a pair of glasses that only let the physician see the physical body of the patient. The physician does not see the soul, spirit, or mind of the patient. He ignores the patient's wishes, especially for modesty.

He is running on the autopilot that was instilled in him over the many years of his training. This autopilot is good because he can react immediately to any situation. The downside is not seeing the patient's soul or wishes. He is the source of knowledge, of healing, and the treatment has to be his way.

Remember the Twilight Zone episode "The Private World Of Darkness" (originally titled and more commonly referred to as "Eye of the Beholder")? It originally aired on November 11, 1960 on CBS.

Fact: Many TZ fans mistakenly believe that the tile of this episode is "The Eye Of The Beholder," which would have been quite appropriate as the relative nature of beauty was discussed. Apparently, that was the original plan as creator Rod Serling referred to this episode with that title in a preview announcing it as the next week's episode, but somewhere along the line it was changed...

Janet Tyler has undergone her eleventh treatment (the maximum number legally allowed) in an attempt to look like everybody else. Tyler is first shown with her head completely bandaged so that her face cannot be seen. She is described as being "not normal" and her face a "pitiful twisted lump of flesh" by the nurses and doctor, whose own faces are always in shadows.

The twist in the tale is unveiled when the bandages are removed, and the reaction of the doctor and nurses is horror and disappointment. The procedure has failed, and her face has undergone "no change—no change at all". The camera pulls back to reveal a gorgeous blonde surrounded by grotesque doctors, nurses and hospital staffers.


Distraught by the failure of the procedure, Tyler runs through the hospital. Flat-screen television screens throughout the hospital project an image of the State's despotic leader giving a speech calling for greater conformity.


As she runs through the hospital until she encounters another "disfigured" human with the same "condition" as her. He arrives to take the crying, despondent Tyler into exile to a village of her "own kind", where her "ugliness" will not trouble the State. Before the two leave, the man comforts Tyler, saying that "beauty is in the eye of the beholder."

This made me think that the patient's dignity is mistreated by the healthcare system, and providers can't see it because of how the healthcare system enforces conformity...

Don't believe me? Read: "Death by a thousand cuts: how the machinery of academia enforces conformity." Academia is also involved in the teaching of the healing arts.

--Banterings