The beginning of the end/the end of the beginning

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The same thing happens to me every year.

I’m heading to work in the same sleepy way I start pretty much every day. (I wish I could say I WAKE UP EVERY DAY READY TO TAKE ON THE WORLD! but that would be a dirty lie. Plus, annoying.)

So there I am, riding the train with all the other groggy commuters as we all zone out, staring at the free paper the guy pushes in our hands on our way in, or at our various depersonalizing digital devices, or at nothing at all, eyes unfocused until the conductor calls out our stop.

Eventually, my stop is called. I get up, moving forward slowly with the zombie-walking masses onto the platform and up the escalator.

As I emerge on to the main level of the station – which just so happens to double as a footpath through campus – I remember that it’s not a routine, mundane day at all.

It’s graduation day.

And every year, the sight of those no-longer college students, those-not-so-young-anymore young adults, dressed in their grown-up best with black polyester gown flapping open in the late spring breeze, gets me.

Now sure, I may also have been known to tear up at a really well constructed Coca-Cola commercial, BUT STILL. It’s a pretty amazing sight.

I mean, think about everything this moment – wearing the respectable yet still-uncomfortable heels Mom insisted you’d need for job interviews and carrying the mortarboard hat you stayed up until 2am decorating with scrapbook material from Target – represents.

It doesn’t only represent the end of your childhood. It represents the beginning of the rest of your life – the part where you start down the path you’ve chosen over the past 4-6 years, and continue down that path until…maybe…forever? AND EVER? Let’s hope you made the right choice (nervous laughter). BUT NO PRESSURE. Enjoy your day!

Oh right. That’s where that glint of terror in their eyes comes from. It’s hiding behind the breathless anticipation of all the pomp and circumstance, sure, but it’s there.

There’s an exuberant finality to this Hallmark-approved milestone that makes graduation both really, really exciting and really, really scary, all at once.

When I was a kid, I always thought of adulthood as this time where you’d become A Thing – a doctor, a lawyer, the president, a rock star – and then you did that Thing for the rest of your life.

But speaking as a Certified Grown-Up (GU-C) myself, I think we need to rethink our thinking on this. Mentally committing yourself to one profession for the rest of your life at the age of 22 feels a little like preparing for years to climb Mt. Everest, finally making it to the top, and then pitching a tent (presumably a very small one) and staying there FOREVER.

Yes, graduation day is exciting. But it’s really just the beginning of the rest of your life – just like every day is the beginning of the rest of your life. (Except this one comes with a really good party and thirty years of loan repayment.)

I guess what I’m saying is that if you’re not sure you’ve found your Thing by the time you’re standing there with that heavily decorated cardboard square on your head, don’t let it get you down. Even those of us who thought we’d found our Thing by the time we graduated from college, or grad school, or insert-milestone-here, later realized that the person we’d become wanted to do another Thing altogether.

Because that’s life. Life is evolution. The person we are at 22 might not be the person we are at 30, or 40, or 55. Each of those people has learned some new stuff about themselves and the world, and the super fun thing about all of this is that each of those people gets to decide to change course and start doing a completely different Thing if they feel like it. It might not be easy, or cheap, but it’s your choice to make.

So with that, here’s to all my soon-to-be-former patients: enjoy the party, tell Sallie Mae I said hello when she comes calling, don’t forget to get that repeat Pap in 6 months – and in the meantime, just do the Thing you think you’re meant to be doing, right now. The rest will sort itself out in the end.

Dear too-many colleges: here’s why you’re next in line for a Title IX suit

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Another week, another famous institution of higher learning in the news for mismanaging cases of sexual assault on campus.

This time, it was Harvard. The most common response, from what I can tell, seems to be summarized thusly: “Oh myyyyy – even at Hahvahd?” (eyebrows raised in surprise, mouth forming a delicate “o” of prim concern).

The morning the story broke in the local news, I happened to be having lunch with these two guys who work in administration at a nearby college. Guy #1 says to me, “So, have you heard about Harvard? And the sexual assault case?” Why yes, yes I have. Guy #1 continues, in a voice of genuine concern: “So, what can we do to keep people from drinking so much?”

Guy #2 murmurs in agreement, eyebrows knitted with empathy.

LADIES AND GENTLEMEN. EXHIBIT A. This, right here, is the crux of why colleges keep finding themselves in trouble when it comes to dealing with sexual assault.

I know, I KNOW. It’s not like Guys #1 and #2 are alone in their thinking here. Just read the comments section of any article on the college-sexual-assault topic for a primer on the latest and greatest in victim-blaming. The idea that intoxication negates one’s ability to provide consent seems to be a logical stretch for quite of few of the world’s armchair analysts.

But here’s the thing. I don’t really care if some random dude with a laptop disagrees with whether rape is rape when alcohol is involved. I mean, I don’t like it, but one guy with an opinion just doesn’t matter all that much. The extent of his power ends once his opinion’s been expressed.

However. If you’ve made a career for yourself in college administration or college health, and you continue to think that the epidemic of sexual assault on college campuses is really about excessive drinking and morning-after regret, don’t act shocked when your school is next to hit the news with a Title IX suit and a bunch of unflattering media attention of your own.

Yes, you could be the next Harvard. Or Dartmouth. Or Mizzou. Because sexual assault is happening on college campuses EVERYWHERE. It has, without question, happened on your campus. And if this common-yet-ultimately-wrong-minded perspective frames how you choose to respond to a sexual assault survivor’s case once it’s been brought to your attention, there’s a good chance that survivor will feel justifiably wronged. And, if they’re feeling brave enough, they just might decide to take this dissatisfaction with you and your colleagues public. Very, very public.

Don’t misunderstand me. I’m not denying that there’s a problem with binge drinking on college campuses that we need to address. But it needs to be addressed as an issue that’s separate and distinct from that of sexual assault. After all, just because it might be easier to mug someone who’s walking home late at night after they’ve had few drinks with friends, it’s not like the mugging itself isn’t still a crime.

I mean, someone who’s been attacked and robbed isn’t told by the authorities that their mugger didn’t REALLY commit a crime, because, y’know, you WERE pretty wasted, after all, and maybe sorta kinda asking for it by walking down the street in the middle of the night. I mean, who’s to say you didn’t HAND that aggressive stranger your money when he asked nicely? Who knows? He said, she said. You know what? Let’s just chalk this one up to youthful indiscretion and a lesson learned.

Hell no. Safety bulletins are sent out, city and campus police start patrolling overtime, and no one rests until the assailant’s been caught.

Intoxication may make a predator’s job easier. But it doesn’t make them NOT a predator.

In a perfect world, everyone would GET THIS, and this tortured public debate over what-is-or-isn’t-rape would cease to exist. I’m not naive enough to think that sexual assault wouldn’t still happen – because some people are terrible human beings – but society would deal with it the way it does any other violent crime. Meaning a) those who choose to commit a crime are consistently removed from the community for the safety of others, and b) the threat of criminal charges and incarceration might make some of the would-be assailants of the world think twice before committing assault. Both of which would result in less sexual assault. And I’m pretty sure we can all agree that less sexual assault = GOOD.

Those of us who work on college campuses need to be held to a different standard than Random Laptop Guy. You can’t hold regressive and harmful views on a topic as important – and yes, public – as sexual assault, with those views shaping your institutional response to individual reports of rape, and NOT expect that it might come back to bite you someday.

Unless, of course, you’d been hoping to end up on the front page of the Globe someday. In which case, vaya con Dios, my friends.

More than an absence of No

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The chief complaint varies: “STI testing”, “pregnancy test”, “GYN problem”. It’s not until I enter the exam room and see my patient, eyes downcast and voice in a near-whisper, that the real reason for the visit becomes clear.

Apparently, it continues to be open season on questioning the legitimacy of the sexual assault epidemic. This time, it was the Wall Street Journal that decided the world needed yet another article blaming women for their own rape. So brave, WSJ! It’s about time someone stood up for those poor accused assailants.

I mean, it’s not like assault survivors have had their trauma minimized and dismissed for years – er, decades – wait, no, EONS now or anything. “She was drunk, so she was asking for it” is today’s “she was wearing a short skirt, so she was asking for it”, which is really just another version of “she’s female, so she’s always, somehow, asking for it”.

In case you missed it, the numbers around rape in college are pretty insane: approximately 1 out of every 4 to 5 college women will experience sexual assault at some point while they’re in school. Numbers like this are hard to ignore; a incidence rate of 20-25% must meet epidemic criteria by pretty much anyone’s standards. But rather than saying “holy crap, we need to do something about this”, some people prefer to respond to these numbers by questioning their legitimacy, citing evidence that assaults involving college students often involve alcohol — ergo and therefore = not-rape.

If you’re one of these people, a question: have you, or anyone you know, ever actually been to college? You know, that place where day-that-ends-in-Y is cause for celebratory drinking? Where the next generation’s ingenuity is expressed through the laborious construction of elaborate snow-carved beer pong tables? Where it’s often harder to find an event WITHOUT alcohol involved than with?

In other words, yeah, binge drinking in college is a legit problem. I’ve seen more injured wrists and broken collarbones than I’d care to admit due to the ubiquitousness of college alcohol use. But part of being a young adult living on your own for the first time sometimes means figuring things out the hard way – like how to consume alcohol responsibly, without the puking and blackouts. Today’s monster hangover paves the way for tomorrow’s dignified glass of Malbec (or three) with dinner. We’ve all been there. I know I have.

Which is why I see myself in the eyes of my patients. The ones who come to the clinic after a night where yeah, maybe they had too much to drink, but that didn’t mean they planned, or deserved, to wake up too-early the next morning, dawn not quite ready to breach the horizon, in an unfamiliar room, clothes and hours unaccounted for. In pain.

There is no amount of alcohol, no level of intoxication, that justifies assault.

If you think that the real epidemic is one of morning-after-regret-turned-false-accusations, spend some time with me at work. Look in my patients’ eyes as they struggle to tell their stories. And know that you, and others like you, are part of the reason that most of them will never file a formal report, no matter how many ways I talk to them about their rights, and resources, and recourse. All they can handle, in that moment, is a modicum of damage control: please, just tell me what I can do, what I need to do, to be okay.

Today, all I can offer is damage control – antibiotics, EC, labs, lots of counseling. But tomorrow, I’m hoping for more. I’m hoping I’ll stop waking up to rape apologia in the mainstream news. I’m hoping that the socially accepted definition of consent will shift from an absence of “no” to an enthusiastic “YES!”

Because eventually, I’m hoping that the gradual elimination of rape culture (eternal optimist that I am) will mean that I get to spend more time focusing on the more mundane aspects of a career in college health: strep tests, ankle sprains and contraception.