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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.
You might say gay men arranging to have sex with each other in a toilet shows how disgusting gay men are, but I'm pretty sure it shows how much women class up the sexual experience. There would be a 10000x increase in straight couples having sex on oily cardboard in alleyways if women were down with it.
I never planned for so many of my sexual encounters to be on high thread count Egyptian cotton sheets in nice clean rooms but I'm glad women are there to carry the load on this one.
EDIT: I just remembered a story. A friend of mine was visiting my city. He was staying in a nice hotel. The next day his girlfriend was scheduled to arrive and they would go back to his hotel room. So, that morning he made his bed and scattered rose petals on it to dial up the romance. He then met up with his girlfriend, had dinner and drinks and took her back to the hotel room. The bed was not how he left it! Apparently, housekeeping had come in, seen the clumsily arranged rose petals, seen the shitty way he made the bed, and undid the whole thing, made the bed so that it was crisp and perfect and then more tastefully scattered the rose petals.
I like to imagine that the female hotel housekeeper couldn't even bear the thought of his girlfriend being fucked on messy sheets.
Agreed. Male homosexuality just shows you what male sexuality looks like when it's unconstrained.
I actually disagree and I wonder if this line is just propaganda that millennials have been fed our whole lives.
It seems to be that a large percentage (30%, 60%, 90%?) of gay men truly enjoy being deviant. The gayness is part of their expression of being counter to normal behavior. Many seem to lament the mainstreaming of gayness having taken a lot of the fun out of it. Deviant, abnormal sex is explicitly part of the appeal.
I'm sure there are some, but celebration of deviancy is often a reaction to being stigmatized. If you're an American homosexual older than ~30, you grew up in an environment where casual homophobia was virtually guaranteed even in fairly liberal environments. Much of the point of Pride was(/is) to be in-your-face in reaction to people telling you to stay in the closet (or die) because you were a moral abomination.
See also: Taliban fighters complain about having to work in an office instead of waging jihad. There's always going to be some people for whom the struggle was a source of meaning and excitement. The normalization of homosexuality means less interest in flamboyantly transgressive behavior as a show of defiance and more PTA meetings.
Bro.
I feel their pain.
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