Surgical Strike

Photo: Barbara Ries

A large crowd has gathered for a book signing at the Stanford Bookstore, despite a downpour drenching the campus. At the author’s lectern, a slender woman with intense blue-green eyes surveys the crowd. She’s no stranger here. Born and raised on campus, she earned three degrees at Stanford, joined the medical faculty in 1975 and won tenure in 1982. Her sneakers have logged hundreds of miles in the foothills, and she’s hurled javelins at Angell Field since the 1960s. Yet over the whir of the espresso machine from the café upstairs, Frances K. Conley, professor of neurosurgery, confides with a grin that when she finished writing her book, her agent cracked: “Well, I don’t think you’ll be invited to sign books at the Stanford Bookstore.”

But here she is, and from the chuckles it’s clear that the audience on this May afternoon appreciates the irony. Conley’s book, Walking Out on the Boys, is a frank and highly critical look at sexism and the sexually charged atmosphere of academic medicine -- with the focus on Stanford Medical School in particular. It is also a personal account of Conley’s brief resignation from the med school in 1991, an event that captured headlines and became a topic in the national conversation on sexual misconduct in the workplace.

Conley describes a world that makes the steamy daytime soap General Hospital look tame: tenured professors volunteering to become spur-of-the-moment “sperm donors” to their students; residents aping their mentors’ sexist slurs and sexist slurs and swagger; faculty members taking professional revenge on students and assistants who rebuff their sexual advances. Conley writes of sophomoric grabbing and groping and routine extramarital affairs -- signs of a “medical culture that condoned stereotypic thinking, outdated behavior and an arrogant superiorist ideology.”

To be sure, Conley, 57, now chief of staff at the Stanford-affiliated Veterans Affairs Palo Alto Health Care System (better known as the VA), has navigated these waters well. For years, she says, she simply ignored the put-downs and the sexist environment -- and learned to give as good as she got. She’s never claimed that she was a victim of true sexual harassment herself, and she mostly kept quiet about the pervasive sexism she did perceive. But Conley’s silence ended in 1991, when her longtime rival in neurosurgery was about to be promoted to department chair. Conley raised strong objections, saying he had been the object of several sexual harassment complaints and that he was a poor leader who would foster a hostile environment for all women. Conley quit and spoke openly about the problems she saw.

She admits that her resignation was mostly pragmatic. It was unlikely, she reasoned, that her career would thrive under a new boss with whom she had clashed. But after she spoke out, she watched with surprise as other women came forward with similar or even more serious complaints about a number of male physicians. “Standing alone, I had looked like an embittered, opportunistic fool,” she writes. “When others put more vulnerable careers on the line to stand with me, suddenly I gained credibility.”

After three months of bureaucratic intrigue and maneuvering, the details of which are recounted in the book, Conley rescinded her resignation and declared she would stay on and fight to change the work environment. The medical school conducted an internal inquiry, which in early 1992 derailed her colleague’s promotion. There’s no question Conley’s actions pushed the medical school to address gender issues more aggressively. (See box.) Conley became a hero for women’s rights in the medical workplace, and has even won some admiring, if somewhat grudging, words from at least one med school administrator. “In the broad context, what she has done has been very positive,” says Richard Popp, senior associate dean for faculty affairs. The book, says Popp, “gave me a great deal of understanding of what she’d been through. . . . It made her a much more sympathetic character to me and others who weren’t clear [in 1991] about her actions.”

By the May book-signing, Walking Out was zooming up the Bay Area best-seller list. It hit No. 1 in nonfiction at the Stanford Bookstore. It was praised in the San Francisco Chronicle and the New York Times. But the reviews were less favorable at the medical school, where Conley’s decision to accuse some colleagues by name of unsavory behavior -- and in other cases to use pseudonyms she admits are transparent -- has infuriated many of her colleagues. Larry Shuer, a fellow neurosurgeon and chief of staff at the medical center, believes Conley is seeking publicity at the expense of embarrassing the families of doctors whose conduct she attacks in the book. Conley’s account, says Shuer, “is her perspective on this issue, and I don’t think it’s 100 percent accurate.”

Conley’s 1991 resignation created headlines -- and headaches -- for the University. But the book, published earlier this year, is even more controversial because in it she says that little has changed. That contention, along with a reprise in book-tour interviews of the original charges, has triggered a new round of bad publicity. A jacket blurb by Deborah Tannen, guru of male-female communication, dubs the book a tale of “the complex injustices that can accrue when institutional power is abused.” In May, Conley told an interviewer on ABC-TV’s Good Morning America that Stanford administrators view her as a troublemaker and that their response to her book has been a “deafening” silence.

In an interview, Provost Condoleezza Rice notes that the University never formally responds to any faculty member’s publications. She offers that she personally found the book “extremely interesting and well written.” Adds Rice: “I think it’s fine that Fran wrote this book. . . . She’s encountered a lot, she’s dealt with a lot and she’s prospered. It’s something of a triumph.”

The irony of Conley signing books surrounded by Stanford T-shirts is topped only by her emergence as a leader at an institution she has so criticized. When the book came out, Conley was finishing a stint as chair of the Faculty Senate -- a position she won by vote of the University faculty. More significantly, in April, Conley was promoted to the Palo Alto VA post that oversees the staff of three hospitals and carries with it an automatic position as an associate dean at the medical school. Conley, who has long maintained her primary clinical practice at the VA, was chief of neurosurgery there until 1997 and had served as acting chief of staff for nine months. Medical School Dean Eugene Bauer backed Conley’s promotion, which was ultimately approved in Washington.

Opportunist or victim? Hero or pariah? Depends on whom you ask. One thing is certain: Conley is accustomed to taking on tough challenges -- and succeeding.

As a medical student in the 1960s, Conley was one of 12 women in a class of 72. She faced all the usual rigors -- exhaustion, stress, political infighting -- but her decision to pursue the virtually all-male world of neurosurgery seemed to her husband, Phil, like masochism. Conley recalls Phil responding, “Why do you have to pick the goddamnedest most difficult thing you can think of?”

She emerged from the program a tough, competitive and highly respected doctor, the first female neurosurgeon to receive tenure at a medical school in the United States. “I’ve known her since she was a medical student,” says Stanford’s famed heart surgeon, Norman Shumway. “She’s hard-working, bright and funny, an excellent technical surgeon with great judgment.”

Conley says she never considered herself a feminist and admits that for many years she had little time or inclination to reflect on sexism or support other women following in her path. She freely admits she joined in the macho, ribald antics so common among her surgical peers. “Had I voiced any objection, I would have derailed my career in surgery almost as rapidly as I would have by becoming pregnant. What else was there to do but join in -- and have a good time?” Conley writes of her cronies’ drunken outings and locker-room teasing. She is known, colleagues say, for oft-made threats to male residents that they risk losing a testicle to her scalpel if they don’t shape up.

Conley has always made time for her interests outside the operating room. For many years, she ran a research lab probing the complex immune activities of the brain -- and published extensively in that field. She’s invented surgical instruments, and helped found a biotech company when she took a year off in 1985-86 to get a degree in business.

And there are other feats for which she didn’t have to be a brain surgeon. She was the first woman to cross the finish line of the 1971 Bay to Breakers’ Race (and was described as a “Palo Alto housewife” in a local paper’s write-up). She started tossing the javelin competitively after she turned 40, traveling to meets with her husband, a Harvard MBA and onetime Olympic javelin thrower. She even snagged several national championships for her age group. Despite her criticism of inappropriate sexual overtures in the workplace, Conley is no prude and was photographed for a 1982 Time magazine cover story in skimpy shorts, clutching a javelin for an article celebrating the “new ideal in feminine beauty.”

In many articles, Conley comes across as curt and brash. But in an interview in her office at the VA, she shows a softer side. Flashing a ready smile, she bears a resemblance to actress Janet Leigh. She recalls her upbringing on campus where her father, Konrad Krauskopf, now emeritus, was a professor of geological and environmental sciences, and she credits early needlework training from her mother for some of her surgical prowess. She also reveals that her days as a surgeon are winding down. Not only is she swamped with administrative duties, but carpal tunnel syndrome and arthritis in her wrists make it increasingly painful to operate.

Some at the med school are more concerned with the discomfort Conley has caused by writing the book. She says she regrets any pain she may have brought to the families of husbands or fathers charged with sexual misconduct. But she says the blame belongs with the offenders for their behavior and with Stanford for tolerating it. And she remains disappointed that, in her view, the leaders of both the medical school and the University have not fully acknowledged the validity of her complaints.

Javelins, of course, are easier to toss than to catch. Faced with several sexual harassment lawsuits, the University is constrained from discussing the topic. Conley admits in her book that she has urged some women to pursue litigation, and her reference to Stanford’s “hostile environment” is specifically cited in at least one pending lawsuit from a former assistant professor at the medical school. “Her book has given heart to a lot of people who otherwise would feel lonely, isolated and unwilling to challenge,” says Woodside attorney and former U.S. Rep. Paul “Pete” McCloskey, ’50, JD ’53, who has represented plaintiffs in grievances against the University.

The publicity and lawsuits have changed the environment at the med school -- and, some say, not entirely for the better. “She makes a lot of good points, but she’s also created a climate where any time a woman doesn’t get what she wants she can charge sexism,” confides one Stanford nurse. Conley simply acknowledges that women have different reactions to her book. “Some women think I’ve totally gone off the deep end. . . . [Then] there is a group that becomes clingy . . . and there is a group that becomes more empowered to do more on their own,” she says.

In recent years, Conley has made time to meet with students who want to talk about sexism, and she has been active in public discussions. She argues that a pattern of sexist behavior should at least be a factor in determining promotions. “The way we select leaders in academic medicine is wrong,” Conley writes. “It favors those who have built their careers by intimidation and fear.” But medical school administrators say progress has been made. Suggests Popp: “Maybe because she’s so close to it, she doesn’t see change.”

A whistle-blower whose career has prospered. A faculty member who claims to respect Stanford’s administration but publicly vilifies it for supporting a culture of sexism and injustice. A crusader against sexism who loves a good dirty joke. Conley is not your classic victim. Then again, who else but a tenured, tough, accomplished woman -- someone who’d been one of the boys, then seen the light -- could have championed this cause? “I’ve done a lot of soul-searching about other ways I could have made this an issue,” says Conley. “I truly do not know any other way.”

Joan Hamilton, a frequent contributor to Stanford, is editor of Signals, an online biotech magazine.