Can Victims of a Scandal Find Closure?

In this blog entry, Nancy Berns, author of Closure addresses the Penn State scandal.

Hoping that victims will find “closure” in the Penn State sex abuse scandal is wrong. Using the concept of closure helps those responsible for the harm; it doesn’t help victims. What does “closure for victims” really mean when used in these political and criminal cases?

Jerry Sandusky, former assistant football coach at Penn State University, is facing multiple sexual assault charges for molesting many young boys. The grand jury report lays out damaging evidence and outrageous details regarding these criminal acts. And those who knew about these crimes failed to take proper action. They did not view the children worthy enough to risk reputations and jobs.

In 2002, a graduate assistant witnessed Sandusky raping a child, approximately 10 years old, in the shower of an athletic facility. The witness was Mike McQueary, former Penn State quarterback and current receivers coach. After seeing the sexual assault still in progress, McQueary called his father who told him to leave the building immediately. So he did nothing to stop the assault and help the child. After waiting a day, McQueary and his father told Paterno about Sandusky. Paterno (after waiting another day) told university officials. A week and a half later, these officials talked to McQueary and then banned Sandusky from campus. Basically this action says, “We’re not going to stop your sexual assault of children, but please do not do it on campus.” None of these people called the police. None of them tried to find out who the boy was and what help he needed.

Not long after witnessing the sexual assault, McQueary was promoted. He eventually became an assistant coach.  Did this job come with the pressure to remain silent?

People are starting to resign and more will surely follow. Reports indicate that Joe Paterno will announce his retirement today. But the problems of sexual assault and bystander silence are much larger than Penn State.  It is not clear whether our society will seize this moment to understand and change the cultural attitudes that allow this abuse to happen. Unfortunately, the calls for “closure” will only inhibit any ongoing conversation.  And that is a travesty for victims.

Victims of sexual assault do not get closure. Effects from abuse stay with people the rest of their lives.  This does not mean that victims cannot go on to have successful and beautiful lives.  Many do.  But they still carry the pain from the abuse. Other victims don’t recover but are lost to severe depression, drugs, or suicide.

We want to believe victims can find closure. Don’t misunderstand what I mean. Victims can heal and learn to live with the experience.  But when we fool ourselves into thinking they have “closure,” then the devastating, long-term effects of abuse do not stay in the conversation.

The undergraduate student body president at Penn State, TJ Bard, released a statement calling for closure: “I believe that the well-being of the victims and closure for all involved should be the top priority.” He has no idea what those victims experienced, and how they continue to manage the abuse. In calling for closure (for ALL involved), Bard is saying that having this story “go away” would be good, especially for Penn State’s reputation.

McQueary’s father wants the case to be resolved, so his son can move on. What will help the young boys who were molested?  What will prevent future abuse? What will make bystanders do more to stop the abuse?

Rather than seeking closure, we need to talk about what we value in our society. Using the misguided idea of “closure for victims” shifts attention away from the perpetrators and the gut-wrenching cultural truths about sexual abuse that we need to face. There should not be closure to this case.  Seeking closure to the case is what the university coaches and officials have been doing for years.

The Death Spiral of a Health Care System

 In this blog entry, Judith Swazey author of Merger Games, recounts the unfolding of a medical merger that provides truth can be stranger than fiction.

             Merger Games conveys the often unexpectedly dramatic nature of the events that my colleagues and I chronicled from 1994-2003 in a study of a medical merger. That research, and the “reads like a novel/should be made into a movie” book that it generated involved the historic acquisition and union of two medical schools in Philadelphia, The Medical College of Pennsylvania (MCP) and Hahneman University by the nonprofit Allegheny Health Care System. We detailed the fate of the merger process when, after a series of voracious acquisitions under the dominion of its CEO, Sherif Abdelhak, Allegheny financially imploded, becoming the country’s largest nonprofit health care organization to declare bankruptcy. The bankruptcy, in 1998, led to the fire-sale purchase of Allegheny’s Philadelphia-area holdings by the Tenet Health Care Corporation, with management and then full control of the medical and other health science university schools by Drexel University. Allegheny’s death spiral also triggered a cascade of state and federal investigations, lawsuits, and civil and criminal indictments.

            The MCP/Hahnemann/Allegheny story has its own particular elements, especially in its cast of players and their organizations and the effort to fuse two medical schools. The lengthy merger process, still underway when the bankruptcy took place, was a tumultuous, tension-ridden, often acrimonious affair. It involved turf wars between the faculties, staff, students, and graduates of the previously separate medical schools, between the medical school and other schools in the  Allegheny University of the Health Sciences, and between the schools and the corporation; educational problems and stresses for the medical students, who called themselves the “merger guinea pigs;” and clashes between the historically ingrained organizational cultures of MCP and Hahnemann, and, most prominently, between the powerful cultures of the academy and the corporation. Riveting as this story is, it is not unique.

             Mergers are rampant, in non-profit and for-profit sectors of health care and in small and large businesses and corporations. Moreover, the merger landscape is littered with failures. Some 60 percent of business mergers reportedly fail; finances are the most frequent reason, followed by an irreconcilable clash of organizational cultures, whose importance is seldom recognized and dealt with before and during an attempted union Mergers, in short, share many common characteristics and patterns that are documented and illuminated in Merger Games. There are lessons to be learned for those considering or undertaking a merger about what a complicated, lengthy, conflict-ridden undertaking this usually is, and why mergers, akin to marriages, may succeed with a great deal of hard work, may have a broken engagement, or end in a divorce.

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