Tools of Bureaucratic Repression
The biggest controversy roiling the University of Virginia today swirls around accusations leveled by 128+ letter signatories against leaders of the UVA Health System and School of Medicine for using the tools of bureaucratic repression to create a culture of fear and intimidation. The accusers have yet to release any specifics to the public. But outsiders can get a glimmering of what they might be talking about by reading a petition to the US Supreme Court filed in September by Kieran Bhattacharya, a medical student who ran afoul of UVA’s administrative apparatus in 2018 after daring to question the academic premises behind microaggression theory.
It is important to note that the incidents described in the petition occurred before Craig Kent became CEO of the Health System and Melina Kibbe joined as dean of the Medical School. The two key figures in the current controversy played no role in the Bhattacharya case. However, evidence surfaced by the Bhattacharya proceedings reveals the nature of the medical bureaucracy that Kent and Kibbe inherited. What they did with the system they were bequeathed is beyond the matters I discuss here.
Multiple tools of control play prominently in the Bhattacharya court pleadings. One is the anonymous system for filing complaints. Another is a system for filing “professionalism concern cards.” Another is the existence of a tribunal exercising the powers of investigator, judge, and jury to administer complaints. Another is the ability of university officials to order mental health evaluations and commit people against their will to psychiatric hospitals. And finally, there is the ability to expel people from the university by means of No Trespass Orders (NTOs).
As summarized in the petition, on October 24, 2018, Bhattacharya was a student in good standing at the Medical School. By November 14, he had been reprimanded for publicly questioning “microaggression” theory; by November 29 he had been suspended. On January 3, 2019, the University issued a no trespass order (NTO) barring him from the Grounds for four years, effectively ending his time as a student.
The precipitating event was Bhattacharya’s assertive questioning during an extracurricular session on microaggressions put on by the UVA Chapter of the American Medical Women’s Association. In the Q&A session following the speaker’s remarks, Bhattacharya engaged in an exchange lasting about five minutes. The US federal district court summed up the substance of his questions this way:
Bhattacharya challenged one professor’s definitions of “microaggression” and “marginalized group” as “contradictory” and “extremely non-specific.” … He also asked several questions about the “evidence” underlying the professor’s claims, critiquing it — and the professor’s research over “years” — as “anecdotal.”
The comments and questions “did not materially disrupt the discussion or substantially invade the professor’s, or anyone else’s rights,” the district court acknowledged.
Some might consider the exchange to be the kind of intellectual engagement that one looks for at a nationally ranked research university. But many observers felt affronted. Instead of debating Bhattacharya, they sought to shut him down. Shortly after the event concluded, UVA Med School received complaints about Bhattacharya’s remarks: one through the online “Listening Post,” three from co-presidents of the American Medical Women’s Association, and one from a faculty member.
Complaints about Bhattacharya’s questions noted that he “called the legitimacy of one panelist’s research into question” and “questioned the validity of the information that [the speaker] had presented, all over the microphone for the entire audience to hear.”
Bhattacharya’s petition goes on to emphasize that it was the substance of his remarks that triggered the investigation that followed. As he fought back, according to the petition, the charges against him morphed: it was not just the content of his remarks that offended, UVA’s lawyers argued, but the tone. Later, the med student’s inquisitors injected the issue of his mental health, eventually suggesting that he posed a danger to others.
The petition to the Supreme Court argues that Bhattacharya was disciplined for his opinions and that the lower courts blocked him from having his case heard by a jury. The petition asks for a jury trial in which the “contemporaneous statements” his accusers made about his political views could be presented.
Med school administrators were keenly attuned to the political views of students expressing views that departed from the prevailing orthodoxy. On September 22, 2018, according to the petition, Senior Associate Dean for Education Randolph Canterbury tweeted that a UVA Med School student who made statements like those attributed to Mitch McConnell about Bret Kavanaugh’s nomination to the Supreme Court would suffer adverse consequences. “If our students behaved so unprofessionally, they would be called to task,” he said.
Immediately after the microaggressions incident, Canterbury noted that Bhattacharya had expressed “unprofessional” views about the 2016 election results at two UVA Med School town halls.
The petition presents other evidence that in the hot-house academic environment in which “words are violence,” the substance of Bhattacharya’s views was entangled with the issue of his tone. The questions themselves were viewed as hostile, belligerent and “disrespectful” of faculty members.
Dean Christine Peterson said at one point that she hoped to meet with Bhattacharya “to explore his thoughts about the topic of microaggressions” but expressed concern whether he would “be able to get beyond the concrete semantics he seemed to be concerned about.”
Assistant Professor of Urology Nora Kern, who filed a Professionalism Concern Card (PCC) against Bhattacharya, perceived his questions as combative and aggressive because they created fears that he might pose a threat to patients’ “emotional safety.”
In response to the complaints from Kern and others, Canterbury brought the med student before the Academic Standards and Achievement Committee (ASAC) for “unprofessional behavior.”
In the drama that ensued, Bhattacharya resisted the accusations against him. The sense I get from the pleadings is that he reacted emotionally and hostilely at times to his travails, which gave his interlocutors more cause to insist that he was mentally unstable and professionally unsuited to be a doctor. (Read a detailed chronology of the administrative proceedings in The Bureaucratic Banality of Academic Oppression.)
The petition argues that the initial concerns with Bhattacharya centered on his political views, and the focus shifted to his mental health after his girlfriend, with whom he was undergoing an acrimonious breakup, provided administrators with information about his mental illness. “Credible or not,” states the petition, “her claims were not the subject of any attempt to verify them, and they were not disclosed to Bhattacharya so he could address them.”
Canterbury ordered Bhattacharya to undergo two psychiatric evaluations in November 2018: one at the UVA Medical Center and another at the Poplar Springs Hospital in Petersburg. Neither found a basis for his involuntary hospitalization, and he was released. In a sign of the escalating mutual hostility, wording in the petition implies that Bhattacharya threatened the dean with litigation.
After a series of posts of contested authorship on “Alt Right”-associated websites, Canterbury referred Bhattacharya for review by the University’s Threat Assessment Team. According to the petition, Director Ed Markowski stated that Bhattacharya “did not make any specific threats of violence … although some individuals in chat rooms encouraged Kieran to engage in this behavior.”
Finally, with the cooperation of the ex-girlfriend, Med School officials were able to obtain an NTO, forbidding Bhattacharya from stepping foot on UVA property on the grounds that he represented a threat to others.
Based on Bhattacharya’s and the University’s pleadings, here’s how I read the evolution of the dispute. While offended by Bhattacharya’s transgressions against Med School orthodoxy and determined to sanction him, University officials did not set out to crush him. That desire came later, after he contested the Professionalism Concern Card and what he likely perceived as an effort to railroad him. Bhattacharya responded defensively, intemperately, and at times inappropriately, feeding the antagonism of those who perceived him negatively from the beginning due to his political views. Multiple mandatory psychiatric incarcerations — none of which found grounds for detaining him — no doubt fueled a justifiable sense of persecution. Med school is a stressful environment under the best of conditions. If Bhattacharya was breaking up with his girlfriend at the same time as he was undergoing administrative persecution, he might well have given vent to anger and frustration. By the end of this sorry episode, it appears that the conflict had become personal and university officials were determined to crush him.
In our assessment of the bureaucracy’s response to Bhattacharya, a key point arises that is not explored in the legal pleadings. Canterbury and his fellow accusers said the student had been diagnosed with bipolar disorder, going so far as to order him against his will to undergo psychiatric evaluation. What is remarkable about the administrators’ interactions with Bhattacharya was their utter lack of sympathy for his disability. Rather than making allowances or accommodations, they adopted an adversarial stance from the beginning and weaponized his disability against him. Indeed, one could advance the argument that their persecution of Bhattacharya aggravated his condition. Hostility toward his political views blotted out concern for his disability, making a mockery of their commitment to diversity, equity, and “inclusion.”
That’s my interpretation for whatever it’s worth. Others will spin their own narratives. What seems indisputable is that an administrative machinery exists that gives med school officials extraordinary powers to achieve any ends they wish.
Professionalism Concern Cards
School of Medicine Policies and Guidelines say that faculty can submit a “professionalism concern card” for students for excess absences, for failure to attend mandatory activities, or for “any breach of professionalism.” States the UVA website:
Praise/Concern Cards and written narratives are assessment tools used to describe behaviors in areas of altruism; honesty and integrity; caring, compassion and communication; respect for others; respect for differences; responsibility and accountability; excellence and scholarship; leadership and knowledge and other skills related to professionalism. These professional attitudes and behaviors are monitored and recorded throughout undergraduate medical education.
If a student receives “three or more written observations of concern … or a single egregious breach of professionalism,” notice will be sent to ASAC, according to the Guidelines.
Bhattacharya was referred to the ASAC on the basis of a single incident, justifiable only if his remarks constituted an “egregious” offense. Egregious behaviors, state the Guidelines, include but are not limited to “assault on or threat to a patient, patient’s family member, student, GME trainee or faculty member, conduct that may constitute a felony.”
By challenging the microaggressions professor on academic grounds, it could be argued by the logic of academic orthodoxy, Bhattacharya showed insufficient “caring, compassion, respect for others, and respect for differences.” But the microaggressions episode triggered his first concern card. Three are required for the ASAC committee to get involved, unless the incident was deemed “grievous.” By no stretch of the imagination could it be argued that his initial offense construed an assault, threat, or felony. But the administration was able to elevate its case to the ASAC committee regardless.
Academic Standards and Achievement Committee
The ASAC committee holds academic life and death power over a student. In theory, ASAC Guidelines give students an opportunity to defend themselves. They are assigned a faculty advisor, but they are not allowed legal representation. “Since these are not formal legal proceedings, but internal meetings of an official school committee, no counsel representing a student shall be allowed,” the Guidelines explain.
The Guidelines enjoin ASAC to follow basic principles, including: “fairness to students; following due process; promptness of action and notification; maintaining confidentiality when possible; and, balancing the best interests of each student with its obligations to the [School of Medicine] and University community.”
Bhattacharya complained about being notified of hearings at the last minute and of the administration’s failure to give him enough time to prepare a defense. If UVA administrators made an effort to “balance the best interests” of Bhattacharya with those of the institution, it is hard to see in the pleadings.
Mandatory Psychiatric Evaluations
The UVA Medical School can use mandatory psychiatric evaluations to ensure student wellbeing and ability to meet the rigorous demands of medical training. ASAC can order the evaluation. If a student refuses to undergo a mandatory evaluation, the committee can implement a review to assess whether the student can meet the school’s professional standards without it. Depending on the outcome, a student can be suspended or dismissed.
As antagonisms deepened, Bhattacharya engaged in behavior that administrators described as “manic and likely psychotic.”
Bhattacharya was involuntary committed to two psychiatric hospitals for psychiatric evaluation and cleared. Despite admonitions from University attorneys that Bhattacharya could not be compelled to go to Counseling and Psychiatric Services (CAPS) for yet another psychiatric evaluation, the petition argues, Canterbury scheduled an “emergency” ASAC meeting and invoked non-existent “emergency powers” to compel him to submit to a CAPS evaluation.
No Trespass Orders
The University Police Department can issue no trespass orders banning individuals from the University Grounds if they are deemed to post a threat to themselves or other members of the university. According to University guidelines, students have the right to file a written administrative appeal within five days. The associate vice president for safety and security has twenty-one days to review the appeal. The Guidelines contain no provision for a formal hearing.
The petition contends that UVA “cut off Bhattacharya’s right to appeal his suspension — turning it into a permanent expulsion and preventing Bhattacharya from pursuing his medical education and career.”
This is how the administration of justice works for students at UVA’s medical school. Faculty and staff are subject to different systems such as annual reviews and peer reviews, although there are common elements such as Professionalism Concern Cards and NTOs. Particularly chilling are these words in the Guidelines: “These professional attitudes and behaviors are monitored and recorded throughout undergraduate medical education.“
This phrase echoes charges by the 128 medical practitioners of information being kept in their personnel files that could be used to retaliate against them.
In assessing the practitioners’ allegations, it would be worthwhile to examine what mechanisms exist to enforce conformity of University employees. Perhaps such details will be revealed in the internal investigation undertaken by the Williams & Connolly law firm hired by the Ryan administration to probe the letter writers’ allegations — but only if the administration releases the findings to the public, which it has said it will not do.
Whatever one thinks of the way Bhattacharya was treated, his case brings to light the mechanisms by which medical school administrators can punish or retaliate against those who cross them.
James A. Bacon is the founder of Bacon’s Rebellion and a contributing editor with The Jefferson Council.
