Dr. Gail Morgan:
I proceeded to walk to the front door. And at that point, he rushed to the front door and placed himself between me and the exit. Needless to say, my adrenaline went sky high, and I started thinking to myself, “What do I do here? I have to exit. I’ve made my point clear, and he’s made his counter threat.” So I felt then the sense of impending physical threat.

Rachel Gerson:
Dr. Gail Morgan is a national leader in radiology. She has been a mentor, not only to me, but to many women in the field. I’m Rachel Gerson. This is the Tunnel of Truth podcast. We jokingly refer to the CT scanners as the tunnel of truth in radiology because they tell you all the answers.

Dr. Gail Morgan:
My life has certainly been peppered with various experiences from childhood even. I grew up in South Carolina at a time of the vestiges of the Jim Crow era, although I am not that old. It took the state of South Carolina 13 years past the Brown versus the Board of Education decision by the Supreme Court to actually enact by law that decision. And so at the level of junior high school, I was actually the first student to integrate the schools. My background is African, English, Native American, and in South Carolina, what that meant was you were relegated to the status of African American and lived as such. The term for that is called hypodescent.

Dr. Gail Morgan:
In medical school, I didn’t have to face ethnic or racial discrimination. Our class was very diverse. We had Italians and people from Eastern Europe and the Middle East and Africa. It was a very diverse class. But I did face an incident of sexual harassment. That particular incident in medical school was with a visiting professor from a prestigious university somewhere. And I had a friend, a classmate, who had been giving him rides from the medical school because he did not have his car with him. His family had it back in New England. And she’d been giving him rides to his house after class on a daily basis.

Dr. Gail Morgan:
And one day, she was sick, and another study partner of ours said, “Oh, Gail, you have to drive past his house. On your way home, can you drop him off?” And since I trusted both of my study mates and hadn’t heard anything adverse, I said, “Well, sure. I’ll do her a favor since she’s sick today.” And on the way there, we had a conversation that was started by him about informing me of an advanced program, academic track, in the medical school and mentorship. And so on the way, he started talking about that, and then he basically invited me to come in, a cup of coffee or whatever, to continue for him to tell me about the program. And that element of trust, again, I think was misplaced on my part because of my friend’s relationship with him.

Dr. Gail Morgan:
And I went in and sat down in the living room, and we started talking some more about it. And after a short while, it became apparent that his direction was changing from that conversation, and he basically let me know that I would have to deliver sexual favors to him in return for this mentorship, at which point I had the realization of the fact that I was in the wrong place. So I stood up at that point, and I said, “I’m sorry.” I don’t even remember his name, maybe because it was kind of emotionally traumatic, but I said, “Professor, I’m afraid you have the wrong… You have the wrong girl.”

Dr. Gail Morgan:
And I got up, and he said to me, “Well, if you don’t comply with that, I will flunk you in your class,” which was histology. I knew that histology was one of four parts of the anatomy class. I proceeded to walk to the front door, and at that point, he rushed to the front door and placed himself between me and the exit. Needless to say, my adrenaline went sky high. I started thinking to myself, “What do I do here? I have to exit. I made my point clear, and he’s made his counter threat.” So I felt then the sense of impending physical threat. I had been a student of karate in college, but my instructor had always said, “Whatever you do, do not tell anyone or show anyone your skills, self-defense skills. And furthermore, the first thing you do is you try to talk your way out of any situation.”

Dr. Gail Morgan:
So I don’t even remember what I said, truthfully. I just started talking, and whatever I said must have impressed him enough that he decided to move out of my way, and I made it to the door and out. And I was very thankful for that, and I was very thankful for the lessons that I had remembered. People would say, “Well, why didn’t you tell someone at the medical school?” Well, I thought about it… By the way, he did flunk me. He went ahead and flunked me in that class, and I passed it anyway because I made sure I made honors in the other three portions, and I went on.

Dr. Gail Morgan:
But I never told anybody, especially school administrators or whatever, because I was… I felt like, from a standpoint of the power hierarchy, just like many women who face harassment, I was in the lower position. I was unaware of what the perpetrator planned, who then placed me in a vulnerable place where I would be in the position of explaining why I was there, as opposed to the perpetrator explaining what their intentions were. So I just felt like I just need to keep going and graduate and continue with my career. And I think that that was also the experience probably of many women, especially back in that time. There was no Me Too movement. So there was a lot less acceptance of women going through it, believing women who went through these experiences.

Dr. Gail Morgan:
I was in the reading room, which is where we would read x-rays and review them with our faculty members. And back in the old days, we had films. We had actual x-rays. We didn’t have digital images, and they would hang up… We’d hang them up on these big screens, and then your faculty member would come by after a couple hours or so and see what you read, what your impressions were, et cetera. So I was sitting there one day, and one of the faculty passed by, and he looked at me, and he said, “Dr. Morgan, what are you doing here?” And I immediately had these fleeting thoughts of the imposter syndrome. “Oh my gosh, is he saying that maybe I shouldn’t be here because… What about my competence and my skills? Is he saying it’s not the right field?” And at least in a fleeting few seconds had that experience.

Dr. Gail Morgan:
And then what he said next really made it apparent that that was not what he was implying at all, even though I had had that experience for a few seconds. He said to me, “You could marry a radiologist rather than trying to become one.” I said absolutely nothing in reply. I was kind of taken aback, and I didn’t want to say what I was thinking. I think I just kept on reading. I really can’t remember anything after that about it. But I think that’s probably not an uncommon experience. And people say, “Well, what do you remember about this?” I think you just sort of blank some things out of your mind. You’re just so wrapped up in the emotions you’re having at the time that you can’t remember details.

Dr. Gail Morgan:
I actually started out in pediatrics. I wanted to become a pediatrician, because my family… My father’s a family practitioner. My brother actually is an internist, my older brother. So I thought I would become a pediatrician and go back and serve in our community. And I did my internship and residency. As part of that pediatric training, I had to work in intensive care units and a huge one, in fact, in a county hospital that served many indigent people and a diverse array of people. I remember one night I was in the ICU taking care of about 25 or 30 very sick babies, and I was on duty with a senior resident. We always had a fellow. And I was working with a nurse. It was Martin Luther King weekend, and we actually had a baby on a table, and we were placing an arterial line into the umbilicus, into the navel area, to give this very sick baby some antibiotics and other things that the baby could not get on its own.

Dr. Gail Morgan:
I remember the discussion basically starting about the holiday weekend, and while we were working on this baby, this nurse basically said how much she didn’t believe in the weekend and how much she hated the fact that Martin Luther King’s birthday was celebrated in the country. She went on and on. I can’t even remember everything she said. And I was looking across at my senior resident, seeing how he would react. He was just kind of wide-eyed and stunned. And finally I said to her, “Well, I don’t understand why you would have those feelings against someone who believed and worked towards peace and equality for all people.” And she said to me, “Well, why do you care?” And I said, “Well, I care because I’m proud. I’m a proud African American, and I really think that the whole point of equality and justice for all people is very important, and that should be celebrated.”

Dr. Gail Morgan:
I said it just like I’m saying it to you, and I went back to work on this baby. And I guess it occurred to her I could have been Hispanic or God knows what, right? Mistaken for a lot of things. And so at that point, she glared at me, and she said, “Well, I tell you what. If we have a problem in this unit and I have to make decisions, I’ll let the Black babies die first.” So at that point, I turned to her, and I remember she was on my right side. And I said, “Well, that’s unfortunate that you feel that way because we are here to do everything we can to save these babies, many who are sick, no matter who they are.”

Dr. Gail Morgan:
She spent the rest of the night going around to all of my charts, writing notes about how she disagreed with my decisions, and then she started withholding vital signs and information about the babies related to their care. At that point, she crossed my line, because I was used to people saying things like hers. It was not a big deal. I just turned to my script, just kind of went, “Okay, page 323, paragraph two. What do I say to her?” But when she endangered the care of the babies, that was my crossing point. So I did mention it to my fellow the next day, who was a very tiny, probably 5’2″ petite Jewish woman from New York. She was absolutely incensed. She went ballistic, and I guess she reported it to the hospital, and they did suspend the nurse for six months. And then she was back in that unit, working with those babies again. So that was my… the one that stands out for me in pediatrics.

Rachel Gerson:
I’m speechless really about some of these stories. I think it underlines for me the importance of capturing some of these, because I think people have no idea just how pervasive these actions and small conversations here and there are and the impact that they have. And I’m always amazed at your calmness and evenness, I’m sure, at the moment and even in recounting them. It’s really amazing. So I appreciate your sharing with me.

Rachel Gerson:
The experience of people training while you were there, people coming behind you. Were you aware of other instances that some of the trainees or your fellow faculty members might have experienced, or you or the group as a whole was able to create a culture that prevented those? Were those discussions that were had in your group?

Dr. Gail Morgan:
I don’t think the awareness or level of consciousness about issues of diversity and inclusion were really acknowledged. Maybe they were not thought to be relevant, and times have changed. I think early on also, before we became more aware of issues around maternity leave and women radiologists having working conditions that support them as young mothers or nursing mothers, that there were issues with female residents or residents wanting to take time or needing to take time or enough time away from training and getting pushback. I think that things have definitely improved, but largely because there are probably more females in radiology also who are pushing for these improvements for women.

Dr. Gail Morgan:
The other thing I was very happy about in our practice was that the first two people that went part-time in our practice were both males. Women that want part-time hours, shorter working hours, or less working days or whatever in a practice meet with, I think, undue lack of understanding and prejudice about us being females and not pulling our weight as equal partners. And you really want to say to some of these men, “You’re married, and you have children too, right? You want your wives to be able to take care of your children, right? That’s important. So it’s important for us in practice to accommodate that because that’s an important role played in society. And maybe males as fathers need to be given time as well and more work-life balance so that they can be better fathers.”

Dr. Gail Morgan:
Back in our day of time of training, that was just kind of impossible. I know I put off childbearing probably until it was too late. I did adopt a child, but I put off childbearing too late because there was never a convenient time for me to do it, where I wouldn’t be punished in some way, have a price to pay. So I’m happy that young women physicians now don’t have to face that sort of environment.

Dr. Gail Morgan:
I also went through an experience where my chief actually tried to elevate a junior male partner behind me to a position of training that should have been my opportunity and that I had really earned. That would’ve been really, I think, crushing as I was also going through a divorce at that time, which he knew. And I think he thought, “Well, she’s vulnerable. What is she going to do about this? She’s the only woman here. I’ll just pull this trick.” But he didn’t know that my other practice was already trying to hire me back in Seattle with a promotion and a salary increase. And so at that point in time, I decided I’m not going to put up with this as my future. And I went back to Virginia Mason to work for them. So that was an interesting experience for me, being the only woman and really not feeling, as a female, supported, not really having anyone to talk to except for those women who were being treated worse.

Dr. Gail Morgan:
My experience in Seattle was different, because when I went back to the practice three years later, there were more women who had been hired in the interval. And we, I think, were unusual in some respects, that we had so many women in the practice. We had women in leadership roles in the practice. And we were not only comrades; we are friends. And even though I’m retired now, I still keep in contact. We do Zoom sessions, friends sessions. And so those became lifelong relationships.

Rachel Gerson:
Do you have any advice, words of wisdom to people who might be coming up in radiology, and I would say in particular… You shared a few experiences, and you said you just kept them to yourself, right, for a number of reasons. And even today, I think, radiology feels like a small space, particularly in the Northwest, that everyone knows each other. Particularly with regards to if you do encounter an incidence of discrimination or sexual harassment or even just a general culture, not a specific moment necessarily, what are the avenues to report that? How does one fight back against that?

Dr. Gail Morgan:
Well, I think the environment and the culture is somewhat more supportive. I would feel more comfortable now going to a residency program director. I think it’s important for female residents to seek out mentors. And I actually had a resident who was graduating, who went to do a fellowship somewhere in the Midwest. She asked me for advice, and I said, “Don’t wait until a mentor finds you, and don’t assume that one mentor will do. There may be certain traits in one person that you admire and want to emulate. There may be other characteristics in another mentor that you want to learn from. Don’t think it’s all wrapped up in one person, number one. And number two, you seek out your mentors.” We don’t realize the impact. We are thinking we’re just giving suggestions or advice or maybe a listening ear.

Dr. Gail Morgan:
I had another experience where I had a resident, who was not a radiology resident, from another specialty program at my institution, but she met me through another one of her mentors. And she had a negative experience with a faculty member that brought her to tears, and she found me. She cried, and she wanted someone to listen to her and to be supportive and tell her that she was going to be okay, that she would get past whatever incident this was. So it’s not even just always in the area that you work in. You will find that you are mentoring when you’re not even aware of it.

Rachel Gerson:
Are there areas of radiology we could address issues of equity with regards to our patients?

Dr. Gail Morgan:
Well, that is interesting that you ask that question, to impress upon us that we are absolutely intimately involved in the challenge of addressing inequities and disparities. It’s not a role that we have seen ourselves in before, so we’ve not put on the garments, but there are areas that only we can really address, because they’re directly under our purview. For example, and this is one of the areas that I’m pursuing now in a task force that I agreed to chair in Georgia, that we will be looking at how to address disparities in breast cancer screening and ultimately care, not only among African American women, but also other underserved populations, rural populations, uninsured and underinsured folks, and really just women in general.

Dr. Gail Morgan:
And I’ll tell you some tragic stories, some personal. I had a friend not too long ago, who is a high-ranking legal counsel in the Northwest for an organization, African American. And she was recently diagnosed with breast cancer, and she said to me, “Well, I followed the guidelines. I did everything they said. I was getting my screening every two years, and then I was a little bit late. So maybe the last one was between two and three years. Do you think that this may have been discovered earlier?” to which I replied, “Well, we’ll never know,” because I didn’t want to really tell her, “Yes, it’s highly likely that last year or maybe even the year before we could have known.”

Dr. Gail Morgan:
And the tragedy is that physicians and other healthcare providers are not educated about the fact that African American women, in particular, are considered a higher risk group than average and should have yearly screening. In fact, we believe, as you know, Rachel, that all women should have yearly screening because women in their 40s, although they have less incidence of breast cancer than women in their 50s, are also women who are taking care of families, who have critical roles to their families at that stage of life and their communities. And so it’s no less important that they get screening on a timely basis.

Dr. Gail Morgan:
So some of the things I’m talking about in some of my lectures and wherever I can is the fact that we have inequities in many areas in radiology, that we have the responsibility to address and to educate other physicians, our primary care and other physicians, not just including breast and mammography. Inequities about breast MRI, for example, and who gets them and the socioeconomic impacts of access to care in those areas. Lung cancer screening is another one, okay, where we inadvertently accept screening guidelines that disproportionately disadvantage underrepresented populations because the guidelines exclude them from eligibility, but they’re not relevant to that particular population. Colorectal cancer: well, what do we do as radiologists? We have imaging that we screen for that as well. Neuro, stroke and other care, NIR. Including issues of pain management for procedures, where we know that there are disparities in how patients’ pain is perceived and what pain management they receive as a result of their backgrounds.

Dr. Gail Morgan:
So there are many areas that involve radiology directly that we have assumed… We’re in reading rooms. We all do this for years, right? We’re in reading rooms, and we’re doing our jobs. We’re cranking out the work. We’re doing our procedures. We’re delivering excellent clinical care, and then we go home. So we’ve assumed that it’s the obstetricians and the gynecologists and the internists and the cardiologists that have to deal with all those disparities and inequities in heart disease and diabetes and hypertension, all the things we know well. So we have not, until very recently, begun to look at these inequities in healthcare that directly involve radiology, radiation therapy also. Our professionals really should be directly involved in advocating for our patients to receive equitable care when it comes to imaging and also, as I said, in therapy.

Dr. Gail Morgan:
Another reason why it’s important to get our colleagues interested in diversity and inclusion efforts are not just because it’s related to faculty advancement and recruitment of underrepresented in medicine and women into radiology and radiation oncology, which is very important. We need to do that because that helps us also to ultimately address healthcare inequities, because we know from the Institute of Medicine report that that improves care. We also have to make sure that our colleagues who are not in those groups also are able to deliver culturally competent and relevant care to their patients. It’s just as critical. So we really have a lot of work to do. We’ve just sort of been… Our heads have been kind of like in the holes in the ground, and we haven’t been aware of it. But this diversity and inclusion stuff is not just mom and apple pie and good feelings. The whole point is to have a meaningful impact on healthcare delivery in this country.

Rachel Gerson:
Tunnel of Truth is partially funded by the Washington State Radiological Society’s Committee on Women and Diversity. We are grateful for their support. If you’d like to share your story on this podcast, visit our website, tunneloftruth.com. These stories can be difficult to tell. We create a comfortable recording environment and can keep your identity private, should you wish to maintain anonymity.