What it means when ‘The Doctor Is Out’

Back in the 1980s, when Mark Schuster was completing an adult neurology rotation at a Harvard teaching hospital, a woman was brought to the emergency room with urinary incontinence and other symptoms, as well as signs of a herniated disc, including a confirmatory myelogram.

She required surgery, making her what the neurology team called a great teaching case. It was one that came with a lesson that, for Schuster, went well beyond how to address medical condition.

The radiologist handling the case unexpectedly reversed his reading and the patient’s neurosurgeon canceled the surgery. When the neurology team asked why, the radiologist admitted that the neurosurgeon had pressured him to change his reading. When the team met with the neurosurgeon, he said that he believed the patient was a lesbian because of what he considered a suspicious novel on her bedside table.

“So, she’s a lesbian, what does it matter?” Schuster exclaimed, in what he recalled was a sort of out-of-body experience. He was startled by his own abrupt and indignant response.

The neurosurgeon made it clear that he would not operate on a lesbian. And he didn’t. Eventually, the neurology team arranged for an orthopedic surgeon to perform the operation.

Now the William Berenberg Professor of Pediatrics at Harvard Medical School (HMS), Schuster was this year’s guest speaker at the School’s second Diversity Dialogue lecture: “The Doctor is Out: A Conversation With Dr. Mark Schuster on Being a Gay Physician at Harvard.”

Attended by more than 200 faculty, staff, and students from the Longwood Medical Area, the hour-long discussion in the Carl W. Walter Amphitheater on Sept. 29 allowed attendees to talk with Schuster about what it means to be an LGBT physician today.

Schuster, who is also chief of the Division of General Pediatrics and vice chair for health policy in the Department of Medicine at Boston Children’s Hospital, used the anecdote to illustrate one of the many instances in his career where he observed LGBT bias in the medical field.

In 2010, Schuster communicated some of his experiences as a gay physician in a speech at Boston Children’s Hospital’s GLBT and Friends Celebration. That wasn’t the end. After the talk was published in the journal Academic Pediatrics in 2012, the speech was reproduced by WBUR and covered by The New York Times. The speech went viral. Today, Schuster’s talk is being used as a teaching tool in medical schools across the country.

“I was just telling my story,” said Schuster. “It was just a speech at Children’s. It wasn’t meant to lead me to speak here today.”

Time for questions

At this year’s Diversity Dialogue, audience questions ranged from how to find an LGBT mentor in the medical field to how to combat conscious and unconscious bias in the classroom or in the clinic.

“It’s important to speak up when you can,” Schuster said.

Schuster recognized that power dynamics between students and their teachers or clinical supervisors often make it hard to speak up against bias. He emphasized, however, that today there are far more resources available to students and faculty to confront these issues.

“There are people to go to. Now, folks can come to the LGBT office,” at HMS and Harvard School of Dental Medicine LGBT Office, a division of the Office for Diversity Inclusion and Community Partnership (DICP), he said.

“It is no small thing that is happening here today,” added Jessica Halem, event moderator and program manager at the LGBT office, of the significance of an open-forum discussion on LGBT affairs in medicine.

“This is hugely auspicious,” she said.

One student asked Schuster what advances may be on the horizon for other minority groups in medicine.

“I hope there will be changes, not just for LGBT people, but for people of color and for women,” Schuster said. “Change is slow, but there are new generations coming.”

One of the final audience questions prompted Schuster to reflect on how the viral response to his 2010 speech made such an impact, and how his continued commitment to LGBT rights in the medical field has affected his life and career.

“I feel appreciative. It was an accidental gift. When I retire, this will probably be the most impactful thing I’ve done,” he said.

Schuster was a principal member of the team that drafted the RAND report for the Clinton administration that showed that openly gay men and lesbians could be successfully integrated into the military. He is an elected member of the Institute of Medicine and recently served on its Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. Now, Schuster works to advocate for the LGBT community at HMS and its affiliates, including giving talks such as the one delivered for the Diversity Dialogue series.

The Diversity Dialogues are a series of presentations on topics exploring diversity and inclusion. They represent a collaborative effort by faculty and staff across the Harvard Longwood Campus. To recommend topics for future Diversity Dialogues, please email sphhr@hsph.harvard.edu.

For more information on resources available for LGBT individuals on the Harvard Longwood Campus, click here.​