As are men.

    Photo: Journal of the Norwegian Medical Association
    Photo: Journal of the Norwegian Medical Association

    In 1899, the gymnastics teacher Johan Nicolaisen (1847–1929) composed 'Gymnastikkmarsj' (1), a song about the importance of physical activity for children in Norwegian society. The song was popularly known in Norway with the title 'Mot i brystet', as a reference to showing courage. We used to sing the song at primary school and at the end of the first verse a gender divide occurred, with half the class singing 'such girls, that's what Old Norway wants'. The teacher never passed comment. The second verse starts by praising the boy's daring, and continues with 'The girl follows suit, terrible things that such young people dare. One fine day you'll see her catching up with the boy'. The terms catching up with and surpassing are used interchangeably. In terms of the current situation in education, surpassing is the most applicable, and medical study admissions in Norway are no different.

    An old rule of etiquette from my childhood was 'Ladies first, but not on the stairs'. Women in a dress or skirt were to be spared inquisitive glances from below when climbing stairs. Today's androgynous style of attire has removed much of the punch from this expression. However, there are other stairs and ladders that represent barriers, not least the career ladder. To date, women have never been seen to take precedence – quite the contrary. Men still experience significant demographic advantages, such as age, competence and status.

    A statement I gave as an expert witness in 2009 concerned claims of scientific misconduct, where a female research fellow had lodged a complaint about a merited male professor. I wrote the following: 'There may be reason to point out an evident asymmetry in the relationship of power, that is, one against the many, and possibly the established employee against the not yet (fully) established one' (2). Even without bringing the sex of the parties into it, the case is unfortunately as common as it is sad.

    The literature historian Sara Danius was the ninth woman to be elected to the Swedish Academy since its inception in 1786. She was removed from her post as the institution's standing secretary when the ruckus surrounding sexual harassment, camaraderie, leaks and financial irregularities came to a head in spring 2018 (3). Prominent Norwegian women like Åshild Mathisen, former editor of the Norwegian newspaper Vårt Land, and Berit Svendsen, former Vice President of the Telenor Group, have recently suffered the same fate (4, 5). The common denominator was that they wanted to continue in their post but were either dismissed or chose to leave. The lines will always be blurred between professional disagreement, personal conflicts, harassment, bullying, ostracism, being pushed out and fading into oblivion. One problem with non-sexual harassment is that it occurs in a less visible manner and is consequently more difficult to establish, document and prove (6). These cases testify to a persistent pattern of strong men progressing and women being phased out by stealth.

    The examples can easily be linked to current practices in today's world of medicine and academia. The majority of Norwegian doctors are women, accounting for two thirds of the under 40s in the profession. Women are set to make a clear mark on Norwegian medicine in the years ahead. All parties lose and resources are wasted when female doctors are overlooked or feel that they have to change their area of specialisation, keep their ideas to themselves or leave the profession altogether. The case described above took place almost ten years ago. The worst part is that the asymmetry in the exercising of power still seems to be in men's favour.

    During the study, our professor of forensic medicine Jon Lundevall (1919–91) commented on a contemporary situation in his usual laconic fashion: 'One doesn't sleep with one's patients. It's just not done!' Apparently not everyone 'got the memo'. The argument can clearly be extended to colleagues and research fellows: It's just not done!

    In many environments, urban myths circulate about someone who 'slept his way' through half the department, and another who used the night watchman's bedroom for 'extracurricular activities', or the one who 'did it standing up' in the stairwell during the Christmas party, or the professor at a conference who 'just wanted to help the research fellow carry her luggage to her room'. The confidence interval behind such stories varies considerably, from 'no smoke without fire' to 'adding two and two and getting five'. However, it's more than a tad unwise when a senior consultant invites two younger female colleagues to a porn show abroad and a wandering hand strays onto one of the prospective research fellows.

    'In the end', said the civil rights activist Martin Luther King Jr. (1929–68), 'we will remember not the words of our enemies, but the silence of our friends'. Courage and action must take the place of weakness when dealing with both sexual and non-sexual harassment. Prerequisite no. 1: The person who dares to report the behaviour must have a legitimate hope of being taken seriously. Prerequisite no. 2: There must be a reasonable gender balance among those responsible for dealing with the report, and there must be an uncompromising attitude to harassment that is diffused throughout the entire organisation. As Sara Danius said, 'All of the apples in the basket need to be taken care of, not just the rotten ones.' (7).


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