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Saturday, June 20, 2015

Katie Watson on the Atrium Controversy and Censorship

I promised Katie Watson, editor and founder of Atrium, that I would publish anything she had to write about Atrium. I further promised that I would post what she sent on Bad Cripple without change. Below is word for word what Watson sent me. 


Dear Bill,

I’m surprised and disappointed you chose to make public a personal correspondence in which, out of respect for you and our years of positive professional interactions, I shared the confidential details of a difficult situation. But following your lead I will respond in a similarly public way – both to the topics you raise, and to more general questions about the current status of Atrium.

As you note, in my role as Editor and founder of Atrium, I refused to comply with an administrative desire to single out your essay. I did not agree that publishing it was a mistake and therefore refused to apologize, and I steadfastly defended your work and that of your guest editor. Instead of allowing your essay to be treated differently, I chose to temporarily take the entire Atrium back catalogue off-line until things could be sorted out. Your article was not the only topic on the table last summer— in a time of institutional change, complex interpersonal dynamics, and new fiscal austerity, Atrium’s future and several other large issues of great concern to our Program’s faculty and mission were also in question.

So I was sorry to learn from your blog for the first time that my email "horrified" you. I asked your thoughts about a potential temporary work-around because addressing all these difficult topics in turn was indeed a long process, and authors from earlier issues, as well as your guest editor, were understandably eager to have their work back up. But I knew it was also important to you that your essay was accessible through the Atrium website (not just Dreger’s), so I was looking for a way to honor all these feelings of urgency.

What you wrote on your blog (5/20/15) about “the denial of sexuality and disability” is powerful and incredibly important. That’s one reason I was glad my Program paid for you to fly to Chicago last February to speak about this topic in a forum open to the entire medical school after the negative administrative response to your essay. I thought the way you reclaimed a lost history and honestly shared the experiences and emotions you had as a teenager was a gift to all Atrium readers (myself included) who aren't part of that world. I never heard the term "pornographic" applied to your piece, but "the fight for sexual citizenship" is a wonderfully useful paradigm. Those from what might be termed "majority sexualities" can indulge in the luxury of silence, but self-preservation forces the discounted to speak up about sex in ways that are sometimes less than genteel, and for that I applaud you.

That said, I never heard anyone at Northwestern speak the objection you name. That doesn’t mean it might not have been a factor for some – discrimination by the educated is rarely open, and sex does seem to be a common denominator in recent academic controversies.

The concern I did hear was about the depiction of sex between clinicians and inpatients, so perhaps it’s helpful to name the theme of provider-patient sex as another way your story “unsettles conventional norms.” It is no justification for censorship, but some react to this topic with what I interpret as a kind of "incest horror." A taboo against provider-patient sex in the hospital provides clear role boundaries for those engaged in intimate care in closed shared spaces, and can protect both from exploitation. In your blog post you say, "obviously, sexual relations between patients and health care providers is inappropriate," but that sentiment is not clearly present in your essay. (I don't see this as an error; no essayist needs to dilute his or her point of view in an effort to inhabit every other perspective out there.) This may explain why I spent over an hour on the phone with a nurse who has made significant professional contributions to disability rights, and yet was shocked Atrium would publish a piece she viewed as both insulting and threatening to women in her profession. Several other women who aren't nurses told me they were afraid nurses might (and in their view, should) read it as degrading. In contrast, an acquaintance who is the former Dean of a Nursing School sent me an unsolicited email saying she thought the "Bad Girls" issue of Atrium was spectacular. When I asked her thoughts about your piece specifically, she replied, "[N]urses can be very touchy after all they've been subject to by way of stereotype. It gets in the way sometimes of 'hearing' larger points." Again, none of this should prompt suppression. Mixed reactions are the norm in academic work, and I was happy to have all these exchanges because they represent the diverse Atrium readership I've come to know and love.

When the objection to your essay arose, I understood myself to be defending not just you and all past Atrium authors, but also future authors – all the challenging, illuminating voices just as wonderful as yours that I knew I wouldn’t be able to publish in the future if our Program’s larger issues weren’t resolved positively. So my view that the journal’s future and past were linked, and that this topic was also linked with my Program’s overall strength, accounts for part of the delay. It would be fair for you to say that the future of the journal that published your voice or program behind it is not your concern; that people with disabilities are tired of being asked to wait. But in my role as Editor, I thought it was my responsibility to take the time necessary to pursue all these goals together. For example, when the objection to your essay arose I was in the initial phase of assembling the next issue, which is reviewing proposals. (Atrium first invites proposals responding to theme, not full articles.) But before I could move forward with that step, the medical school required me to allow a Vetting Committee to review my editorial choices and veto them if they were perceived to conflict with other institutional interests. (It was not an academic Editorial Board, as has been incorrectly reported elsewhere.) A week after a disheartening meeting with this group, I learned Atrium’s print budget had been eliminated, and I cancelled that issue-in-progress.

The good news is that, over the course of nine years, Northwestern's medical school gave Atrium’s readers the gift of spending more than $200,000 (and a portion of my time/salary) so the Medical Humanities & Bioethics Program could produce, create, and distribute free of charge (in print to thousands and to more through our website) a publication which many tell me is a forum unique in our field and invaluable resource—and despite this financing of a non-peer reviewed publication, the school never tried to control any content until this essay. The bad news is that, in a time of change, my school stumbled. The question is whether we can right ourselves and move forward.

Months ago my Program Director gave me permission and authority to “take Atrium private”—that is, to personally sell it to another institution or journal publisher—if in my sole discretion that’s what I thought was best for the publication. He did this in recognition of our changed environment, our University’s broad protection of faculty member’s intellectual property, and out of respect for my role as creator and sustainer of the publication. (Atrium has no “editorial team,” as has been incorrectly reported elsewhere. I’m thankful for the wise, generous input I’ve always received when I’ve asked my colleagues for help, but formally speaking Atrium has been run by this one-person editorial staff since 2005, with the exception of two times that colleagues asked if they could guest edit an issue and I happily agreed (#10 Belling & Czerwiec; #12 Dreger). The wonky “every 9 months” publication schedule was because that’s as often as I could fit the work in on top of a full load of my own teaching and scholarship.)

But I have not yet acted on my option to take Atrium elsewhere because I think it’d be best for my Program to continue to be represented by, as you put it Bill, this “eclectic, high-quality academic journal known for pushing the edge.” I hope the medical school and University will come to agree, and we can return to Atrium’s prior practice of full academic freedom and zero editorial interference. That’s why I was willing to be what may have seemed from the outside as “unreasonably patient” with this process—because education, collaboration, and cooling off take time, and because the Atrium question is part of a larger fabric of institutional change that isn’t yet finished. I work with good people in both the medical school and the hospital, and I remain hopeful. But if I become convinced Atrium can no longer move forward with integrity here, I will drop the publication’s MH&B and NU affiliations and move it elsewhere, or I’ll throw a party for the terrific run it enjoyed and end it.

The years I spent as a public interest lawyer before becoming a professor have led me to see analogies between institutions like universities, academic hospitals, and the ACLU. The pursuit of multiple important goals sometimes causes internal conflicts of principle (eg some attorneys want to fight abortion clinic harassment and others want to defend picketers' First Amendment rights), and sometimes leads to tension with allies (eg a gay rights group is unhappy the ACLU has chosen police brutality as its lead issue in a given year), but over time it usually results in positive progress on all fronts. And sometimes good institutions make mistakes. Apologists excuse them. Gadflies punish them. Loyalists pursue restorative action to remedy them.

I'm truly sorry this has been an unpleasant experience for you, Bill. I wish you all the best in your future work, and I thank you again for your important contribution to Atrium.

Katie Watson, JD
Editor, Atrium
Assistant Professor, Medical Humanities & Bioethics Program

Northwestern University, Feinberg School of Medicine

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