Doctors and lawyers are not noted for their mutual admiration. This week, however, we two doctors are cheering for the lawyers who are protecting the civil rights of a young doctor-in-training. We're referring to the lawyers defending Sandeep Rao, a second-year medical student at Texas Tech University in Lubbock.
Rao, 23, is also enrolled in the MBA program and somehow finds time to write a column for The University Daily, the official school newspaper. As part of his medical-school training, he observed an autopsy, and his piece for Jan. 24, "Autopsy Proves Eye-Opening," recounted his personal reactions to that experience. The column, which had its thoughtful, its tasteless and its lurid aspects, did not mention the deceased by name.
For his efforts, Rao was expelled from medical school. According to Andrew Golub, one of Rao's attorneys, the initial complaint was filed by the doctor doing the autopsy, who was named in the column. The complaint cited a violation of the confidentiality agreement signed by all medical students before they can witness autopsies. But the med school alleged that Rao also violated its unwritten code of conduct regarding medical professionalism, raising the issue of whether tacit and unwritten codes can be legally enforced as "discipline" and carry such draconian measures.
In true American fashion, Rao is going to court.
According to a May 3 release from the American Freedom Center, Rao has sued Texas Tech in state court, challenging his expulsion on the grounds that he was exercising his First Amendment rights. He seeks reinstatement so he can take his final exams later this month. The news release says that in disciplinary hearings school officials interrogated Rao about his other columns, which dealt with topics such as the performance of Lubbock's mayor and the war in Afghanistan. To us that sounds like a proceeding in which Rao paid an exorbitant price for his opinions on matters other than the medical.
Jane Orient, M.D., executive director of Association of American Physicians and Surgeons, writes: "It is absolutely outrageous that someone has the dictatorial power to ruin a medical student's career because he exercised his right to free speech. The student violated no one's rights; profaned no one's religion; advocated no violence or incivility or lawlessness. He spoke truthfully, from the heart. I suspect that the authoritarian official who made this decision is sensitive about trends in American medicine that need to be exposed and corrected, not hidden."
Here's our take, as citizens and as physician-journalists.
First, the autopsy account strikes us as a personal narrative that might be of interest to other students, especially prospective medical students. We find no flagrant violation of medical confidentiality. In fact, recalling the pranks of our own medical school days, we ... well, what can we say?
Second, if Rao did break any unwritten – or written – rules of professionalism, he should have been reprimanded, in private, by medical-school officials. In being expelled, he has suffered far more than is appropriate, given the circumstances, even if he did violate "unwritten school policies on medical professionalism." Professional sensitivity – not some unwritten code, but basic humanity – might argue that some parts of his article might better have been left unsaid or said better some other way. Nonetheless, Rao has the First Amendment right to say what he did and a right to due process – and those rights must be legally protected.
Third, and most importantly, if Rao's First Amendment and procedural civil rights were violated as alleged, he must be reinstated immediately.