Sexual Harassment Under the Lens in Series by JACC: Case Reports

Cardiology, much like the world at large, has seen an awakening of awareness when it comes to sexual harassment in recent years. Now, a three-part series in JACC: Case Reports is addressing how this misbehavior holds women—and sometimes men—back in the profession, as well as what can be done to turn the tide.

“Sexual harassment rears its ugly head every few years, sort of like racial injustice does, and we all get fired up about it and get upset,” Gina Lundberg, MD (Emory University, Atlanta, GA), told TCTMD. This energy translates into action that tends to wane, but soon enough another “egregious thing” restarts the cycle anew, she said.

Early this spring, the $45 million lawsuit against Oregon Health & Science University and a former anesthesia resident served as the latest wake-up call, said Lundberg. “It’s wrong, and we have to fight it on every level.”

Lundberg, who serves as a social media consultant to JACC: Case Reports and is chair-elect of the American College of Cardiology’s Women In Cardiology (WIC) section, said that under the leadership of Editor-in-Chief Julia Grapsa, MD, PhD (Guys and St Thomas NHS Hospitals Trust, London, England), she and her co-authors sought to reinvigorate broad attention toward sexual harassment.

“The reason we’re still talking about it is because . . . it’s still happening. We’ve got to keep talking about it,” said Lundberg.

In an email to TCTMD, Grapsa credited her friend Zeta Douka, a Greek actress who came forward about harassment, for sparking her interest in pursuing the series. “She reminded [me of] my story, which took place 6 years ago and actually changed the whole route of my career,” said Grapsa. Then, amid discussions with her colleagues about work environments, “we felt that a strong voice against harassment was missing,” she noted. “That’s the main reason we decided to write this series. I was slightly reluctant at first, because I didn’t want to expose my personal story.” What changed her mind, said Grapsa, is the realization that she will protect other women and give them a chance to raise their own voices.

The Voices of Cardiology section where the series appears, Lundberg stressed, is the only place for opinion pieces within the Journal of the American College of Cardiology family of publications. Timing was key, as their work was underway around the same time that the ACC joined forces with the American Heart Association to develop their standards for professionalism and ethics in cardiology, which were released at this month’s virtual ACC meeting.

As we advance in the profession, we know that we can help, we can act against it. Julia Grapsa

Grapsa introduces the series by sharing her own experience of being sexually harassed—and resisting the pressure—during a 2015 job search, while the other two pieces explore the harm caused by victim blaming and offer avenues for advocacy.

Cardiologists in leadership roles must step forward, she urges. “I have been bullied and witnessed bullying in my work environments. As a resident, I could not do much but just sit and watch,” Grapsa writes. “But as we advance in the profession, we know that we can help, we can act against it.”

In their paper, Christina Mansour, MD (Loma Linda University, CA), and colleagues outline the data on sexual harassment in medicine as a whole and within cardiology in particular. They delve into the psychology behind why people blame victims, with attention to how it deters reporting and damages mental and physical health.

“Solutions to the problem of sexual harassment can start with women in cardiology identifying our own implicit biases in such cases. We can challenge the victim-blaming culture by believing the survivors, letting them know it is not their fault, reporting incidents when they occur, and not making excuses for an abuser’s actions,” they say.

Changes must also come at an institutional level, Mansour et al advise. “Diffuse power structures, a culture of transparency and accountability, strict implementation of sexual harassment policies and disciplinary consequences, and development of support systems for victims can help change the organizational climate and decrease the incidence of sexual harassment for either gender,” they write. “Being the only woman at the table makes it challenging to address inappropriate behaviors.”

The reason we’re still talking about it is because . . . it’s still happening. Gina Lundberg

Kamala P. Tamirisa, MD (Texas Cardiac Arrhythmia Institute, Dallas), and colleagues, in their paper, discuss current US antiharassment laws, regulations in academic medicine, and support offered by professional societies in cardiology. “As dedicated educators, clinicians, and researchers, we need to continue to reform to eradicate sexual harassment and discrimination and rebuild a more just and equitable cardiology culture,” they write.

For Lundberg, the articles should send a message to men who believe sexual harassment doesn’t happen at their workplace. “But you think that because you’re not looking for it, because you’re calmed into this ‘we’re doing a good job here’ peace of mind, if you don’t look for it, you’re not going to see it . . . and you’re not going to address it,” said Lundberg, adding, “You can’t ask the victim to fix the problem.”

WIC will continue to “keep this on our dashboard and monitor it and see if we’re making changes,” she concluded. They also are collaborating with the group Women as One.