A Valentine’s Day editorial in the official newspaper of the American College of Surgeons has set off a firestorm of controversy that has divided the largest professional organization of surgeons in the country and raised questions about the current leadership and its attitudes toward women and gay and lesbian members.
The editorial, written by Dr. Lazar J. Greenfield, an emeritus professor of surgery at the University of Michigan School of Medicine and president-elect of the American College of Surgeons, extols the mood-enhancing effects of semen on women. It begins with a reference to the mating behaviors of fruit flies, then goes on to discuss studies on the menstrual cycles of heterosexual and lesbian women who live together. Citing the research of evolutionary psychologists at the State University of New York, it describes how female college students who had been exposed to semen were less depressed than their peers who had not, concluding: “So there’s a deeper bond between men and women than St. Valentine would have suspected, and now we know there’s a better gift for that day than chocolates.”
This month, in response to complaints, the editorial was retracted and pulled from the group’s Web site, and Dr. Greenfield was asked to step down from his position as editor in chief of the surgeon’s newspaper. But criticisms continue to mount.
“I was aghast,” said Dr. Colleen Brophy, a professor of surgery at Vanderbilt University School of Medicine in Nashville, and a member of the organization for over 20 years. Dr. Brophy, who served as chairwoman of its surgical research committee, publicly resigned from the College on Thursday. “I’ve gone back and reviewed the science, and it’s erroneous,” she said. “But I’m resigning from the college not so much because of the editorial but because of the leadership’s response to it.”
The organization has more than 75,000 members (I am one). Roughly 10 percent are women. There are five women on the organization’s 22-member governing board; this month, they issued a letter requesting that Dr. Greenfield step down as president-elect. The entire board is set to vote on the issue on Sunday.
Dr. Greenfield has not issued a formal statement and could not be reached for comment, but in an e-mail to his colleagues in response to the criticism, he wrote that his editorial “was considered by the Women in Surgery Committee and the Association of Women Surgeons as demeaning to women. Despite my apologies, they brought the issue to the Board of Regents.”
Dr. L. D. Britt, the current president of the organization and chairman of surgery at Eastern Virginia Medical School in Norfolk, also did not respond to requests for comment. But at a surgical meeting this month, he invoked the experience of “oppressed” South Africans who chose “reconciliation,” adding, “If someone is truly apologetic, we have to consider that.”
While women now make up almost half of all entering medical school classes in the United States, fewer than a third choose to go into surgery, in part because of a perceived male bias, negative attitudes of surgeons and a lack of female mentors. Once in practice, studies have shown, well over half of all women surgeons report feeling demeaned, and nearly a third say they have been the objects of inappropriate sexist remarks or advances.
Dr. Greenfield has had what many believe is an exemplary career not only as a surgeon but also as a longtime mentor and advocate of women in surgery. He is the editor of one of the major textbooks of surgery and the inventor of the Greenfield Filter, a device that has been used in hundreds of thousands of patients to prevent life-threatening blood clots from entering the lung. And Dr. Greenfield has been a mentor to countless surgeons, many of them women, while serving as chairman of surgery first at Virginia Commonwealth University and then at the University of Michigan.
“He has always been above reproach,” said Dr. Mary T. Hawn, an associate professor of surgery at the University of Alabama School of Medicine in Birmingham, who worked as a medical student, surgeon-in-training and faculty member under Dr. Greenfield. “Our understanding was that he went out of his way to recruit women on the trainee and faculty level.”
Dr. Diane M. Simeone, a professor of surgery at the University of Michigan who was a co-author of a recent article on barriers faced by women in academic surgery, agrees. “There still is a lot of gender bias in surgery, and I have seen it myself on multiple fronts,” she said. “That was never evident from Dr. Greenfield. I think it’s important to know that this is one event and to weigh it against a long career where he has always been completely above board and a role model for supporting women in surgery.”
It is less clear what attitudes Dr. Greenfield or other leaders of the organization have toward the college’s gay and lesbian members. “I think race and religion have made a lot more progress in the college than women, and particularly gay women or men,” Dr. Brophy said. “This is probably the first time I’ve ever seen the word ‘lesbian’ used in a piece or associated with the college. Ever.”
For some, the controversy is less a matter of Dr. Greenfield’s fate as president-elect and more a reflection of what some see as a deep disconnect between the old guard and its respect of hierarchy and professional omerta, and a newer generation of surgeons and leaders who embrace a culture of transparency in the age of the Internet.
Many surgeons chose not to comment on the matter, for fear of professional repercussions, but one said, “It’s frankly been heartbreaking for all of us.”
“There are all these men and women out there who are afraid to say something,” said Dr. Barbara Lee Bass, chairwoman of surgery at the Methodist Hospital in Houston, who recently served on the college’s governing board. “It reveals that there is still this intimidation and fearfulness, and that’s what troubles me most.”
“I’m not sure some of the old guard see this as the watershed moment it is,” she continued. Referring to the college’s role as a standard bearer for surgeons and an advocacy organization for patient care and patient safety, she added: “It’s not so much about Dr. Greenfield anymore. It’s about the spine of our organization and the principles by which the organization governs itself.”
