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Boston Globe
May 21, 2002

Hazing becomes a public health problem

By Jenna Russell, Globe Staff, 5/21/2002

When a woman shows up in a hospital emergency room these days with
suspicious burns, cuts or bruises, she's likely to be asked if her
husband or boyfriend hurt her.

But when a college student shows up with the same injuries, it's
almost unheard-of for doctors to ask similar questions about hazing.
And a Boston-based emergency doctor said that medical blind spot
could hinder efforts to raise awareness about the dangers of hazing
and prevent the practice.

Michelle Finkel, an emergency room physician at Massachusetts General
Hospital, combed medical journals, newspapers, magazines and Web
sites to collect descriptions of dozens of hazing incidents from the
18th century onward. And, in a paper recently published in the
American Journal of Emergency Medicine, she makes a case few others
seem to be making: That patients harmed by hazing should be
identified and treated differently by doctors, both for their own
good and to prevent future injuries.

''These are horrible, traumatic outcomes, and no one's talking about
it,'' Finkel said. ''It's such a public health issue in that it's
preventable.''

No one knows exactly how often hazing happens, but in a 1999 survey
by researchers at Alfred University in New York, 80 percent of
college athletes reported being subjected to some kind of hazing when
joining a college sports team. Two in five described ''questionable
or unacceptable'' experiences that included branding, sexual acts,
being tied up or confined in a small space, beatings or abandonment.
Someone has died from hazing every year since 1970, said Hank Nuwer,
who maintains an antihazing Web site.

But, when injured students report to the emergency room, Finkel
argued, doctors rarely look past the symptoms and address the real
cause.

''Most physicians don't ask the obvious question, `How did this
happen? '' said H. Range Hutson, an emergency-room doctor at Brigham
and Women's Hospital who invited Finkel to speak to his class on
violence prevention at Harvard Medical School.

College health staffers say the students' own silence is part of the
problem. William Kettyle, medical director at the Massachusetts
Institute of Technology, said fear of retribution makes students
reluctant to come clean about hazing. Treating students on campus, he
said he encounters patients whose injuries don't match their
explanations - but attempts to identify hazing meet with only
marginal success.

One student described a skateboard injury, but Kettyle and his staff
thought he had been hit with a paddle - a common hazing practice.
''It took a while for everyone to agree'' that it was probably
hazing, he said. The patient never acknowledged it.

Kettyle said he reports such episodes to the dean's office, though if
students describe hazing in confidence, he withholds names and
details. Doctors should be more aware, he agreed, though he cautioned
that if ER visits bring harsh penalties to teammates or fraternity
brothers, it could keep hazing victims from seeking care.

Though sometimes dismissed as a harmless college ritual, hazing can
exact high costs. The University of Vermont canceled its men's hockey
season three years ago after a team member filed a suit against the
school, later settled, alleging that his civil rights were violated
during hazing rituals that reportedly included drinking more than 30
beers and doing push-ups in the nude.

More tragic consequences were seen at the Massachusetts Institute of
Technology in 1997, where the Phi Gamma Delta fraternity was charged
with involuntary manslaughter after 18-year-old Scott Krueger lapsed
into unconsciousness and died following a night of heavy drinking.
The fraternity was shut down by MIT.

As with domestic violence, Finkel said she aims to change the way
medicine sees the problem. Those with hazing injuries should be
treated as victims of violent crime who are dealing with complicated
emotions, including shame and fear, rather than willing participants
in their traumatic injuries, she said. Hazed patients should be
identified and made to feel safe, their injuries documented and legal
options laid before them.

''Look at what happened with domestic violence,'' she said, noting
safeguards in place at her hospital to ensure that abuse by a partner
is caught. ''Like domestic violence, we need to make hazing something
we don't tolerate in our society.''

Her ideas have been well-received by colleagues, she said, but in a
clear illustration of how far she has to go, none had thought much
about the issue. Searches of existing medical literature came up
''almost blank'' on the topic of hazing, she said.

Lacking the time to embark on a comprehensive hazing study, Finkel
undertook the smaller and more manageable task of compiling reports
of hazing violence, describing what its consequences might look like
and developing recommendations for the treatment of its victims.

The injuries she describes are as varied as they are disturbing,
ranging from cigarette burns to skull fractures. A student in
Missouri died in 1994 after being beaten and kicked by fraternity
brothers. In 1991, a first-year law student was beaten to death.
Sorority members burned initiates with cigarettes in 1997. Fraternity
pledges and athletes nationwide have drowned, suffocated, and fallen
off roofs, sustaining spinal-cord injuries, organ damage, brain
damage, seizures and comas.

Though she never doubted her effort was important, Finkel said her
paper was initially rejected by two medical journals for which
editors asked for more hard numbers.

Nuwer said awareness of the problem has climbed in recent years, and
new antihazing laws have been passed, but incidents are more
skillfully covered up than they were in the past.

''The ones who should be studying it the most are doctors, because
they're the ones who are going to be lied to when pledges come in,''
he said. ''They're hard, hard questions to ask. Š You're asking
someone to admit to a crime.''

At another Boston emergency room, one physician's initial skepticism
turned quickly to curiosity. Mark Pearlmutter, chief of emergency
medicine at St. Elizabeth's Medical Center of Boston, said he doesn't
think hazing injuries appear frequently in the ER there - a handful
of times in 15 years, despite serving a large college population -
but he allowed that he may be missing something.

''I'd love to be further educated,'' he said. ''It could be similar
to domestic violence, where you have to take your blinders off.''