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There's a specific type of news story that works like a Rorschach test for whether you believe in the official version of reality that institutions present, or the messy, underground reality of actual human beings. The recent case of Dr. Samuel Stefan, a colorectal surgeon at Queen Alexandra Hospital in Cosham, is a perfect example. The headlines are all about a "doctor struck off after stripping naked in a toilet and propositioning a colleague." It's framed as a story about a predatory surgeon and a bunch of shocked, innocent victims.
But if you actually read the Medical Practitioners Tribunal Service (MPTS) report with any kind of awareness of how the modern world works, you'll spot a massive hole in the story where a very popular yellow-and-orange smartphone app should be.
The tribunal tells us that Dr. Stefan had been "chatting to a colleague online" even though they were "unknown to each other." They arranged to meet in a toilet. The colleague, we're told, thought this was a "mutually convenient place" and "did not plan to have sex" with Dr. Stefan. When the cubicle door opened to reveal a naked surgeon beckoning him over, the colleague was "shocked, numb, and scared."
Let me just pause here to appreciate the absolutely wild level of benefit-of-the-doubt the MPTS is giving this situation. We're apparently living in a world where the Medical Practitioners Tribunal Service believes that two men who've never met, after chatting on some unnamed internet platform, regularly arrange to meet in a hospital toilet cubicle to do... what, exactly? Exchange sourdough starters? Talk about the finer points of laparoscopic mesenteric excision? Compare notes on the hospital's pension scheme?
If you follow the link to the actual MPTS ruling, you'll come across gems such as:
Sounds silly?
Sorry, Mr. A, it sounds retarded. But I'm impressed at the chutzpah. Maybe he wanted to apply mouthwash to your cock too, to be extra safe. You "get to know each other" in public toilets in much the same way that "Netflix and chill" involves ardent attention to the best of the Silver Age of television.
Of course, there was catfishing involved:
Unless the "online platform" was LinkedIn and the "chat" was about a job opening in the proctology department, there's exactly one reason why two men who don't know each other arrange a meeting in a toilet stall. That reason is Grindr. And the main purpose of a Grindr meeting in a toilet stall is definitely not a "mutually convenient" chat.
The tribunal's choice to just accept the colleague's claim of shock at face value suggests one of two things. Either the MPTS members are literally the last three people in the UK who don't know what a hookup app is, or they're putting on some kind of elaborate legal performance where everyone pretends the "victim" was just an innocent bystander who stumbled into the world of public sex by accident.
If you're a man and you arrange to meet another man in a toilet stall after an anonymous internet chat, the "naked" part of the reveal is usually what "meeting" means. The idea that this was some kind of ambush on an unsuspecting guy requires us to believe in a level of innocence that would make a Victorian governess look like a hardened cynic.
And yet, this is the story the tribunal went with. Why?
Maybe it's because the legal system just doesn't have the right words for "misunderstood sexual subcultures." In the official world of the General Medical Council, there are only Doctors and Patients, or Harassers and Victims. There's no category for "Two guys who tried to have a quick hookup during a shift, but one of them got cold feet or thought the other was being way too weird and decided to blow the whistle to save his own ass."
To be totally clear, Dr. Stefan sounds like a nightmare. The report lists other incidents where he tried to kiss colleagues or repeatedly touched the genitals of junior doctors on the wards. Groping people while they're trying to do their rounds isn't a "misunderstanding of subculture." That's just being a sexual harasser. If the tribunal wanted to strike him off for the ward-groping alone, they would've had an open and shut case that didn't require them to pretend a toilet meeting was some kind of platonic coincidence.
But the toilet incident is the one in all the headlines. It's the "deplorable behavior" that the public finds most shocking. And because it's the main charge, the tribunal has to treat the colleague's story as the gospel truth. They have to believe that a grown man walked into a toilet to meet an internet stranger expecting a perfectly normal, non-sexual encounter.
This creates a really weird set of incentives. If you're a junior doctor and you get involved in some risky, slightly unprofessional behavior (like meeting a senior colleague for a hookup in the hospital)*, and it goes badly, your best move is to claim you had no idea what was happening. You have to play the "shocked and numb" innocent to avoid getting caught in the fallout from the other person's misconduct. The tribunal, meanwhile, has to go along with this performance because admitting otherwise would mean acknowledging that NHS hospitals are places where people have complicated, messy, and sometimes illicit sex lives.
The MPTS is obsessed with "public confidence." They mention it specifically: "The Tribunal was of the view that public confidence would be undermined if Dr. Stefan was permitted to practise."
Public confidence is a weird thing. It's rarely based on actual truth, it's based on keeping up a certain appearance. The appearance here is "The Medical Register is a Sacred List of Saints." If the tribunal admitted that Dr. Stefan and his colleague were probably engaging in a common, if risky, gay subcultural practice, it would mess up the appearance. It's way better for "public confidence" to pretend that Dr. Stefan is a lone predator lurking in toilets, jumping out at innocent men who were just looking for a "mutually convenient" place to stand around.
Why did such a murky outcome where neither the primary accuser or the defendant come out smelling of roses collapse into such a binary outcome? We might prefer thinking about it as legibility, in the same sense as Seeing Like A State. The state and its institutions (like the GMC) need the world to make sense in a certain way. A "predatory doctor" makes sense. A "messy situation involving two men, a hookup app, and a complete disaster of professional boundaries on both sides" doesn't make sense. It's too complicated. It raises too many questions about what else is going on in those toilets. It suggests that the hospital isn't just some sterile place of healing, but somewhere humans with hormones and smartphones actually exist.
(And absolutely don't ask about what happens on the beanbags, the ones in the mess)
Watch what happens when you try to tell the truth:
"Dr. Stefan and Mr. A met on Grindr for a bathroom hookup. When Dr. Stefan turned out to be older and a different race than his profile pictures, Mr. A got uncomfortable and left. Later, when Dr. Stefan was under investigation, Mr. A decided to protect himself by claiming he never intended a sexual encounter."
Now what? Now you have to ask: Is catfishing someone on Grindr professional misconduct? Is meeting a colleague for bathroom sex professional misconduct, or only if one person changes their mind? If Mr. A was also planning to have sex at work, does he also get sanctioned? What's the standard? How do we enforce it?
This is all rather inconvenient. Messy.
So the tribunal goes with the version of reality that makes the most sense in their framework, even if it's the version that makes the least sense to anyone who's lived in a city in the last twenty years. They treat the colleague's "shock" as a medical fact rather than a legal move.
We should also think about the "timeline concern" the panel mentioned. Dr. Stefan was already under investigation for the toilet incident when he allegedly went on to grope people on the wards. This is where my sympathy for the "he was just a guy on Grindr" defense completely disappears.
If you're a surgeon and you've just been caught in a toilet cubicle with your pants down, and the GMC is breathing down your neck, the rational response is to become the most celibate, professional, and invisible person in the history of medicine. You should be the guy who won't even look at a colleague's thigh, much less touch it.
The fact that Dr. Stefan apparently kept making unwanted advances while actively under investigation suggests a level of impulsiveness or lack of reality-testing that's genuinely incompatible with being a surgeon. Surgery is all about extreme impulse control. It's the ability to stand still for six hours and make movements measured in millimeters. If you can't stop yourself from grabbing a junior doctor's genitals while the medical board is literally in the middle of deciding whether to end your career, you probably shouldn't be holding a scalpel inside someone's abdomen.
So yeah, the guy had to go. Getting erased from the register was the only possible outcome. Even if there's no evidence that he was a threat to the general public (or an incompetent surgeon), he certainly was a menace to any nearby twinks, and not a great colleague.
(This is dry British understatement, before someone gets their knickers in a twist)
But I still can't get over the toilet thing.
I keep imagining the tribunal members sitting around a mahogany table, reading the transcript. One of them says, "So, he met a man he didn't know in a toilet stall. Why would he do that?" And another one says, "The witness says it was a mutually convenient place. Maybe the library was full?" And they all nod seriously, recording in the official judgment that this was a believable and logical chain of events.
There's a real cost to this kind of institutional blindness. When we force people to lie about the context of their lives to fit into the "victim/predator" binary, we lose the ability to actually regulate professional behavior effectively. If the NHS wants to stop people from having sex in the toilets, they have to admit that people want to have sex in the toilets. They have to deal with the reality of workplace culture, the stress of the job, and the way technology has changed how colleagues interact.
Instead, we get this whole show. We get a "Digital Reporter" (are there any analog ones left?) writing about "deplorable behavior" like we're still living in 1955. We get a tribunal that pretends Grindr doesn't exist. And we get a medical register that's "protected" from a man who was clearly falling apart, but for reasons the tribunal is too "proper" to actually spell out.
Dr. Stefan didn't show up to the hearing. He offered no remorse and no attempt to fix things. He's basically vanished from the profession, likely on a one way flight to Romania. Maybe he figured there was no point in showing up to a trial where the fundamental premise of the "crime", the toilet meeting, was being discussed in language that had nothing to do with the reality of what actually happened.
In the end, the system worked. A surgeon who didn't have the basic judgment to function in a professional environment was removed. The "public confidence" has been "maintained." But as I read the article, I can't shake the feeling that the only person who's truly "shocked, numb, and scared" is anyone who expects our public institutions to have even a basic understanding of how modern humans actually live.
Queen Alexandra Hospital will keep on functioning. The toilets will stay "mutually convenient" for all sorts of activities. The GMC will keep striking people off using the moral language of the mid-20th century. And the rest of us will keep reading these articles, squinting at the space between the lines where the real world, messy, sexual, and mediated by technology, is hiding in plain sight.
It's a comfortable fiction. It's a world where doctors are either saints or monsters, where toilets are just places for quiet reflection, and where online chatting between strangers is always leading up to a polite conversation about the weather. It's a world that doesn't exist, likely never has, but it's the only one the MPTS knows how to deal with.
*It's worth noting that Stefan was a SHO/Senior House Officer. That's an antiquated but commonly used term, and it absolutely doesn't mean a doctor very high up the totem pole. That doesn't necessarily mean that he wasn't senior to many people, but they'd have to be interns of one flavor or another.
Updated version on Substack, with a few juicy extras.
I don't know. Maybe I am too credulous but Mr. A's account seems fine to me. Was he naive about why someone might want to meet at the toilets? Sure, but even he admits that! As best I can tell he expressed a consistent preference against having sex in public, or proceeding to sex without getting to know Dr. Stefan better. Even before the incident occurred. I guess I'm not sure about other people but I would consider "the toilets at my work place" to be "public", at least in terms of having sex. As the tribunal mentions it's also not clear to me what Mr. A has to gain by reporting this as sexual harassment if he didn't think it was. Like, what's the downside to him if he never says anything about it to anyone? Mr. A's disturbed demeanor after the fact was also noted by, like, half a dozen colleagues who testified. I guess this was all a Machiavellian show he put on to get the guy who catfished him in trouble?
I am happy to believe Mr. A was willing or intended to proceed to a sexual relationship with Dr. Stefan at some point in the future but I am skeptical he went to this particular meeting with the intention of having sex.
I think the debate we're really having here is:
What level of activity do you consent to when you consent to meeting someone from a dating app?
This is essentially the same as the debate over whether you need to [consent to every action in a romantic escalation] or whether there are basic menu expectations you have, an overton window of things that you consent to when you start. And then of course the argument over what is in that overton window.
Do I have to ask specifically before trying to put my arm around a girl on a movie date, or is that basically expected and her saying "no" after is sufficient? After a date, if I try to kiss her goodnight, is that allowed? Clearly kissing someone who says they don't want to be kissed is bad, but when you get kissed once when you didn't want to be, that's just a hazard of being in certain situations with someone, you have effectively consented to it by going on a date/going to the movies/going to a dance club etc.
But of course, we're talking about gay men so the question is, do you consent to seeing a naked man by going to meet a man in a men's room stall. I think the answer is probably yes, inasmuch as it is bad and offensive to see a naked man you didn't want to see, that's just a risk you took when you met a guy on Grindr.
But they should probably both be fired for this.
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He "admits" to a level of naïveté which I would expect from an adult suffering from Down's syndrome, not from a medical doctor. If he really is as naïve as he claims to be, he has no business working in this capacity and ought to be struck off.
(Paraphrasing) "I met a man via an app which everyone knows is a hookup app for gay men. When he invited me to meet him in a bathroom, I assumed this was because he was concerned about being hygienic and wanted to make sure we both washed our hands (even though he never even suggested that this was the reason for the choice of venue). I had no idea that he wanted to have sex with me in the bathroom – I just use the app in question (which everyone knows is a gay hookup app) for professional networking. Also he wasn't anything like as hot as pics made him out to be but that's neither here nor there..."
I'm sorry, but I refuse to believe a qualified medical doctor can be this naïve. I'm even having a hard time believing that you are this credulous.
It struck me later, but it's worth noting that A is consistently referred to as Mr. A throughout the report.
In the context of a British hospital, that means:
It is very unlikely that he's a senior surgeon. He could be a med student. He might be a particularly dimwitted porter.
Does this make things better or worse? Idk. I would only hope a medical "colleague" would have the common sense not to come up with such farcical excuses, but I've met idiots in the profession. They are overrepresented in both those making and receiving GMC complaints.
That being said, it is still idiotic, regardless of career choice.
Mr. B doing some administrative task while in the same room as a Dr codes as young intern to me (and his included writing, like 'not very slay' codes as very young), but you'd know far better than I how the UK medical norms on that go. Doesn't necessarily mean Dr. Stefan was looking especially young as chickenhawks go, but could be part of it.
Agreed that it's a hilariously bad as an excuse, even assuming Mr. A was genuinely derpy enough to have bought Grindr's 'it's a social meeting app' spiel.
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I guess I might buy this if he's young and this is his first attempt at "okay I am gay, I want to do it with guys, how do I meet guys, okay there's an app for that" and he didn't know the rules of how encounters off Grindr are supposed to go.
Yeah, maybe he's stupid, but being socially awkward and stupid in that way can go along with "smart enough to become a medical doctor".
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It does seem quite plausible he didn't want to engage in sex that day with Dr. Stefan. That's a wise and rational move for many reasons.
But if you are chatting to a man on Grindr, by far the most "hookup" of all hookup apps, and you agree to meet a man who you met on Grindr (who had already asked if you wanted to fuck in the woods!) in a BATHROOM, I genuinely don't know what to expect.
I can't even begin to attempt to explain this logically. Why would you need to meet up to mutually wash your hands? If anyone needed to wash their hands, couldn't they just do that before? If washing your hands before a coffee date is important to you, just do that? Has anyone ever said "hey I know we're chatting over coffees and not touching, but it's really really important to me that I know your hands are washed"
Similarly, back to the bathroom, why not just meet for a coffee in the place where coffee is (the cafeteria, a nearby cafe)? Why on earth would you detour to a bathroom with a man you just met on Grindr? No one could be this oblivious. I'm not gay and I know for a fact if a gay man invited me to a bathroom, it's because he wants to fuck me. If I was talking to a girl on ChristianMingle.com and she asked me to meet her in a bathroom, my first thought would not be "damn she must love washing her hands".
I expect that Mr A pictured the encounter as "we meet fully-clothed, size each other up, flirt and banter a bit; if the chemistry is off the charts we are already in the perfect place to take things further, if not we can take things slower or end it there".
That sounds very plausible
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My guess is Mr. A's justifications for meeting in the bathroom are post-hoc but I don't think it's in, like, a malicious way. Stefan probably suggested meeting in the bathroom. Maybe Mr. A thought it was weird in a general way but he didn't interrogate him about why he wanted to meet there. Any explanation is Mr. A trying to come up with what he could have been thinking when he actually didn't think much of it. But he doesn't feel, for whatever reason, like he can just tell the investigators that he didn't think anything of it, so he has to concoct come post-hoc explanation and there are, frankly, not many good ones!
I don't understand how you couldn't think anything of "this man I met on the gay sex app wants to meet in a bathroom after previously asking if I wanted to have sex in the woods"
But thankfully, this isn't my job to understand, I just get to be amused by this incredible story.
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Probably he is trying to come up with post-hoc explanations, but Dr Stefan seems to have wanted to get straight down to it, Mr A wanted to take it slower, so "meet me in the loo" was the compromise choice. Private enough that they could, as you say, size each other up; public enough that Dr Stefan can't just jump his bones immediately. At least, that would be the idea, looks like Dr S was ready to get to the jumping right away even so.
Yeah this tracks
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There's a significant addendum that I discovered on a second trawl through the tribunal records. It's in the Substack version, I didn't bring it over here because I'd have to juggle markdown and HTML.
The gist of it is that there are significant discrepancies in A's accounting of events. Just after the incident happened, he claimed he was physically dragged in and assaulted. This was later watered down to being flashed and inappropriately beckoned.
Call me cynical, but I don't see how even the immediate shock of seeing a dude horny and nude would cause someone to jump to accusing them of physical assault.
I'm not sure what A is getting out of this. Perhaps he just was that genuinely spooked, and decided to escalate pre-emptively. He might have thought that rejecting a senior would come to bite him in the ass (metaphorically), or he might not have been thinking straight (pun not intended).
A hospital toilet... Well, it's a bit of a liminal space. Not quite private, not quite public. This one seemed very low traffic, it seemed to be specific to a floor and surgical theater, so probably closer to private for the purposes of a quick fuck.
While I was willing to give A the benefit of the doubt, his rationale for even being there is ludicrous. Does he expect us to believe that handwashing was all that was on his mind?
The least unlikely explanation, to me, seems to be that A felt genuinely aggravated by the catfishing, lost their cool, and disclosed too much before they were able to calm down and collect their thoughts. Or perhaps they didn't like the surgeon in the first place, he seems like a rather unpleasant chap. But it's all speculation, and I haven't heard anything on the grapevine.
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I had the same thought. Even if you do meet someone with the intention of having sex with them, it's a further escalation if they get fully naked before you arrive. The combination of catfishing and rapid unwanted unreciprocated escalation would certainly shock me, although I admit I'm not a gay doctor so maybe I'm not as jaded as Mr A.
It actually feels to me like a comedy beat in some kind of off-beat sketch.
"I've got a hot date?"
"Where?"
"In the bathroom on the 3rd floor."
"Is he hot?"
"Check out his profile pic." (The profile pic shows an attractive white man in his late 20's who vaguely resembles Pete Buttigieg.) "Wish me luck!"
<Smash cut to the bathroom. A stall door slowly swings open to reveal a fully-naked older man of ambiguous ethnicity, grinning creepily while maintaining eye contact. The camera is aimed too high to see his genitals, but his arm can be seen moving suggestively in that area.>
<Pan to Mr. A, who looks into the camera and screams.>
record scratch
You're probably wondering how I got into this situation
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