I recently had occasion to listen to the podcast series “Believed.” There I heard individual women’s stories, including the pain that some felt when their own parents doubted the veracity of their accusations. One story stands out, that of Kyle Stephens, a woman who, as a child, knew Larry Nassar as a friend of the family rather than as a physician. Larry molested Kyle in his home while purporting to be taking care of her. She became the first of Larry’s victims to speak during victim impact statements at sentencing. The difference between her story and those of the women who visited Larry for medical care provides a window into why Nassar was able to victimize so many with impunity. In this column, I will examine what we might find in peering through that window.
What Made Kyle Stephens Different?
The #MeToo movement has focused largely on rape victims’ reluctance to come forward. When women or girls report a rape by someone they know, someone they trusted, police and others frequently manifest suspicion and disbelief. We want to think that we can tell who the bad guys are and sniff out predators. Perhaps because of this wish, we do more than presume the innocence of the accused when a victim alleges acquaintance rape. The victim who tells us that people are not always what they seem brings unwelcome tidings. We may respond by concluding that the bearer of bad news is the true villain, a false accuser.
Understanding the dynamic that I describe above might help us forgive the father who insisted that Kyle Stephens apologize to Larry Nassar for falsely accusing him of what he in fact did to her. If “blame the victim” dynamics represent a psychological defense against helplessness, then we might feel compassion instead of—or in addition to—anger when we contemplate the many people who brought nothing but skepticism to the true allegations that confronted them. The “Believe Women” movement has represented an effort to temper that skepticism in our encounters with alleged victims. If we can listen with an open heart, then hidden victims might feel emboldened to come forward.
Kyle Stephens’s story is in some ways a typical #MeToo narrative. An acquaintance or friend of the family sexually assaulted his victim and, for a long time, got away with the crime. What made Stephens’s story a little different from the usual acquaintance rape story is that she was a child of six when the abuse began, and it went on for six years. Larry therefore acted as a pedophile, preying on a child. And unlike an adult, a child victim can do little—without adult cooperation—to avoid her assailant.
The More Typical Victims
The other Nassar victims to whose assaults Larry pleaded guilty came to know their assailant as their doctor. They were gymnasts whose workout routines sometimes resulted in pain requiring medical attention. Larry treated their conditions. While doing so, Larry touched and penetrated his victims’ vaginas. In a number of cases, he sexually assaulted them in this manner while the girl’s parent was in the examination room.
Some victims may have been unsure about whether Larry was engaged in criminal assault. They knew that they did not want him to do it, but they may have questioned their own judgment that it was wrong. Some parents had the same confused reaction when their daughters told them what had happened. How could we doubt the good intentions of a doctor who showed such dedication to his work and who put in long hours to make sure that his gymnasts could heal? Girls who did manage to come forward, with the support of their parents, encountered police who initially felt similarly skeptical.
Visiting the doctor and being sexually assaulted there is very different from acquaintance rape (though the doctor may technically be an acquaintance). We expect and demand that doctors act in a kind of parental capacity toward patients. Imagine that you go to a doctor for treatment, and the doctor decides to have sex with you while you are in his care, while he is examining you. You can consent all you like, but we still regard the doctor as behaving in a reprehensible fashion that may result in professional sanctions.
By contrast to a date rape scenario, then, few will accuse a doctor’s victim of having “asked for it” or otherwise seduced the doctor into sexual interactions during an examination. Skeptics are far more likely to recharacterize what happened in the doctor’s office as medical or otherwise in keeping with his professional role. “He put his fingers in your vagina?” they might ask; he must have had a good reason. They extract the sexual motive and chalk it up to a thorough examination.
Why did some parents and police officers who heard from Larry Nassar’s victims conclude that he had done nothing wrong? What made them trust him so much that they rejected the accounts of true victims whom they knew and in some cases loved?
It may actually be more predictable than we might imagine for people to extend a massive benefit of the doubt to a doctor. In 1963, Yale psychologist Stanley Milgram performed an experiment in which a scientist asked each subject to “teach” lessons to a “subject” (actually a confederate of the scientist) by inflicting progressively more severe shocks on the subject. As the “teacher”—the actual subject of the experiment—turned up the voltage in response to the scientist’s instructions, he showed signs of emotional discomfort but kept going, often beyond the point at which the formerly screaming confederate became eerily silent. Compliance dropped under various conditions, some of which corresponded to the scientist looking less like a doctor or scientist.
Milgram carried out his experiment to determine the circumstances under which ordinary, decent people with a functioning conscience become capable of committing atrocities. He conducted the experiment less than twenty years after World War II, when some (including Hannah Arendt) believed that the Germans who had participated in the Holocaust were, like everyone else, vulnerable to a malevolent authority figure. Daniel Goldhagen later proposed that the Germans who perpetrated the Holocaust did so out of an intense hatred for Jews and not because they were “just following orders.” If Goldhagen is right, then Hannah Arendt may have been naively accepting the excuses that Nazis offered for their atrocities rather than shedding light on what drove them. Milgram too might have erred in believing that he had studied behavior resembling that of the Nazis.
Yet Milgram did shed light on a real phenomenon, even if it was not the Nazi phenomenon. Stated broadly, many and perhaps most of us are prone to defer to scientists and doctors. We defer even when matters fall outside of their expertise, including the realm of morality or patient autonomy. We all have stories, and I will share one of mine.
During part of the last year of her life, my mother suffered from a very marked dementia and lived in a nursing home, unable to remember anyone she had met after 1960 (including me). On a number of occasions, the home sent her to the hospital because her heart was malfunctioning. At the hospital, she would sometimes suffer a life-threatening emergency such as a cardiac arrest. When doctors mobilized a team to “bring her back,” a sympathetic visitor pointed out that my mother was DNR (do not resuscitate); she had—when she was still competent—indicated her wish to be allowed to die in such a situation. The doctor replied, “not on my watch” and did the “life-saving” treatment that he wanted to do. He never paid for denying my mother her autonomy, for effectively committing an assault and battery against her by forcibly treating her against her will.
This story and the millions of similar ones that patients and their loved ones could tell all revolve around the same phenomenon: we tend to defer to the choices that doctors make, even when their choices are (a) medically incompetent; (b) a violation of our rights to bodily integrity and autonomy; and (c) immoral. Even when something in us knows that the doctor is wrong, we allow them to do what they are doing, and we feel unable to step in and say “stop!” We may not know enough to catch (a) the medically incompetent, but patients and their loved ones have greater access to medical knowledge than they ever did. And when it comes to (b) the violation of our rights and (c) immorality, we seem at times almost constitutionally incapable of objecting. And once deterred from objecting, we may become motivated to rewrite what we have seen and heard (and done) so that it sounds like something different from what it is.
It is in those spaces of rewritten reality that Larry Nassar found safe harbor. Parents and police officers stood by and allowed him to thrust his fingers into teenage girls who had come to his office seeking medical care. The girls knew that he was violating their bodies and that they wanted him to stop, but they could not say “what the f— are you doing to me?!” They felt as incapable of asserting themselves as their families and law enforcement later were about accepting the truth of what they were hearing.
Some of their parents wanted to assume that Larry was simply treating the girls medically. The police, when they heard Larry explain his treatment techniques through a PowerPoint, wished to believe that Larry was being honest with them and had just been practicing medicine. A doctor with a prestigious post at Michigan State University was able to reassure people whose job it is to be suspicious that he did only the most ordinary and normal doctor things to the girls in his care.
If we asked Stanley Milgram what makes us defer, he might say that it is in our nature to obey a true authority. Humans have an impulse to find a trustworthy leader and then defer to his decisions. Doctors have occupied the status of such a leader for many of us, distinguished by the white coat or scrubs as being on top of the hierarchy. With little explanation of costs or benefits, we swallow the pills and the capsules that they prescribe, and we submit to needles, scalpels, anesthesia, and large and potentially carcinogenic doses of radiation on their say-so. Many doctors decide rather than ask us what we want or what we hope to get out of our visits. Doctors have drunk the Kool-aid (with apologies to the victims of Jonestown) and believe themselves to know better, even when they do not. Some exercise this power benevolently, but the power is there either way, just waiting to be abused.
Larry Nassar understood human nature. He understood that people—patients, parents, police—would defer to him. They would bend over backwards to construe his behavior as innocent, as treatment rather than sexual abuse. As in the Milgram experiments, such deference results in victims, many of whom despaired of ever seeing justice. We might therefore want to enhance #BelieveWomen with a corollary: #QuestionDoctors. Larry Nassar was more than a serial sexual predator. He was very much a medical doctor, suited up in his uniform of invulnerability.