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It was there and then it wasn’t: a controversial issue of a Northwestern University bioethics journal about sex and disability featuring one scholar’s account of receiving oral sex from a nurse as part of his rehabilitative process. Did Northwestern demand the removal of the journal essay from the university’s website and threaten to review all forthcoming issues prior to publication? That’s what faculty members claim happened last year. Northwestern, meanwhile, acknowledges that the archive issue of the journal was taken down, but isn’t saying why, or why it was later restored.

The controversy began more than a year ago, upon publication the winter 2014 issue of Atrium, a faculty-produced bioethics journal published by Northwestern’s Feinberg School of Medicine. The issue, called “Bad Girls,” featured several scholars’ takes on disability and sexuality. One of the essays, by William J. Peace, then the Jeannette K. Watson Distinguished Visiting Professor in the Humanities at Syracuse University, offered a frank and somewhat graphic description of getting fellatio from a nurse after he became paralyzed at the age of 18, in 1978.

“Head Nurses,” as the essay is called, says that the young, pretty “bad girl” nurses in Peace’s ward were known by male patients to be part of two distinct groups. The “dick police” were those who helped disabled men use catheters -- a somewhat “humiliating” experience -- and otherwise had “no redeeming value,” Peace wrote. The “head nurses” helped the men reclaim their sexual identities.

Peace described his first visit from a “head nurse” -- whom he claims to have remained friends with all his life -- like this:

“It was late at night and I had pissed all over myself and the bed. I hit the call button, upset. I thought I had had a handle on bladder management at that point. The nurse that came to help was one with whom I was very close. She changed my sheets and came back as I was washing myself. I was playing with myself without much luck. She explained I had to be a bit more vigorous and try non-traditional approaches. Then she rubbed my leg and pulled the skin on my inner groin, and sure enough I grew hard. I started to cry in relief. She wiped away my tears and then went down on me. She brought me to orgasm, and I was taken aback when I realized no ejaculate had emerged. She explained to me that this is common for paralyzed men and that it involves a retrograde ejaculation. She assured me it would not affect my fertility or my sex life in a major way. My son is living proof she was correct.”

Alice D. Dreger, professor in medical education and medical humanities and bioethics at Northwestern, guest edited the “Bad Girls” issue. She says that soon after publication, medical school administrators asked Atrium’s editorial team to remove parts of the essay from the web, because the content was considered inflammatory and too damaging to the new Northwestern Medicine “brand.” Northwestern Memorial HealthCare recently acquired the Feinberg faculty practice and merged with Cadence Health to operate under the Northwestern Medicine brand, she said in an interview, and medical school officials were particularly sensitive about the hospital’s image.

Peace said his initial reaction to the censorship demand was “confusion.”

“I suspected a small number of people might strenuously object,” he said via email. “I was prepared to engage potential criticisms -- this is after all a critical part of academic life.” But never in Peace’s “wildest imagination” did he think his work would be “censored and deemed pornographic by some,” he said. “What I unknowingly did was prompt a knee-jerk reaction that highlights that disability and sex remain taboo. I was merely writing about a part of medical history circa 1978.”

On his blog, Bad Cripple, Peace wrote that he “refused to set aside my sexuality and candidly acknowledged my sexual desire and pleasure. In so doing, I not only asserted my humanity, but undermined the myth that people with disabilities, especially paralyzed men, are asexual or unable to satisfy their sexual needs.”

The essay was “a forthright step in a decades-long effort to reject the negative assumptions about disability and sexuality,” he said.

Objecting to the administration’s request, the editorial team not only removed the essay and issue but the entire Atrium archive, Dreger said. More than a year went by before administrators relented to claims that the request to remove the essay violated faculty members’ academic freedom. But Dreger said medical school officials still proposed an editorial review committee for future Atrium content.

Kristi Kirschner, now an adjunct professor of disability and human development at the University of Illinois at Chicago, said she resigned her faculty position Northwestern in December 2014 due in part to the incident. Formerly a clinical professor in medical humanities and bioethics at Feinberg, she also wrote an article in the “Bad Girls” issue of Atrium.

Kirschner said she’d read Peace’s essay prior to publication and found it “provocative” but worthy of publication. She said it touched on themes similar to those of the 2012 film “The Sessions” about sexual surrogacy, and so hoped it would help further the discussion about “how the medical profession, and rehabilitation in particular, deals with sexuality and disability.” Moreover, she said, Atrium had become “emblematic” of the medical humanities and bioethics program’s non-traditional and multidisciplinary approach, in that it was “absolutely unique, edgy, scholarly, artistic and reflective of the issues of the time.”

Of the censorship, she said via email, “These events had a chilling effect, antithetical to the idea of the university. Universities thrive when there is academic freedom and vigorous debate. Hospitals and clinical care thrive when systems operate as well-oiled machines. One is about disruption and creativity, the other about conforming. The branding movement will undoubtedly favor the latter, in service of fund-raising and reputational scores.”

​Dreger said the university only caved on its censorship demand after she threatened to publicize the incident. The essay is back up on the web. But the Foundation for Individual Rights in Education (FIRE) still became involved in the case, sending a letter to Northwestern President Morton Schapiro asking him to reaffirm his commitment to academic freedom and abandon all plans to censor future issues of Atrium.

“Northwestern must recognize that when academic freedom becomes subservient to branding concerns and public relations, it ceases to exist at all,” FIRE said in its letter. “Atrium’s treatment raises the concern that it is being held to an indefensible, content-based double standard. We note that numerous other [medical school] academic programs and institutes publish a variety of newsletters, blogs and journals -- all seemingly without administrative interference.”

FIRE hasn’t yet heard back from Northwestern.

Katie Watson, assistant professor of medical humanities and bioethics and permanent editor of the Atrium, did not immediately respond to a request for comment.

Alan Cubbage, a Northwestern spokesman, said in an emailed statement that the university is “strongly committed to the principles of free expression and academic freedom. The journal, Atrium, is published by Northwestern University Feinberg School of Medicine. The article at issue was printed as edited by its faculty editor, mailed to subscribers and posted on the web. The website archive of the issue was later taken down and at that time, the faculty editor of the journal took down other issues of Atrium. All of the issues are now back online.”

He added, “The magazine now has an editorial board of faculty members and others, as is customary for academic journals. Subsequent to the publication of the article, Dr. Peace, the author of the article, was invited to Feinberg School of Medicine to speak.”

Cubbage did not respond to requests for clarification about why the issues had initially been removed from the web.

The case has remained relatively quiet thus far, save a recent op-ed in the Huffington Post by Geoffrey Stone, the Edward H. Levi Distinguished Service Professor of Law at the University of Chicago. He called Northwestern’s action one of “blatant censorship.”

“Presumably, the university's concern was that the inclusion of such an ‘offensive’ article in Atrium might put off some of the university's donors and the hospital's patrons, either because of its acknowledgment of oral sex or because it might be construed as demeaning to women,” Stone wrote. “Neither concern is a justification for censorship. The journal, the issue and the essay were all squarely within the bounds of academic freedom, and Northwestern University should have stood proudly in support of that principle.”

Dreger, who has written about academic freedom issues in the sciences, said she thought the Atrium affair was part of a larger “collapse of academic freedom” across academe. And the repercussions are grave, she said, since there are fewer and fewer places left in society where “truth telling” happens.

Kirschner doesn’t see the problem as unique to Northwestern, either, she said. “There is an inherent tension within academic medical centers between the missions of the hospital and the university, but recently the commercial interests of the hospital are dominant. The tipping point at Northwestern was the 2013 purchase of the university faculty practice by Northwestern Memorial Healthcare. Northwestern’s medical school is no longer the institution I was proud to be a part of for a quarter century.”

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