In an anonymous essay published in the Annals of Internal Medicine last week, a physician gives us a sickening — and potentially triggering — look behind the operating room curtain.

The short but powerful piece describes a discussion in a medical humanities class, in which the author and a med student each recount witnessing horrifying behavior by male doctors treating unconscious female patients — and admit to their own complicity in laughing along with it. It begins:

One day in January, I was facilitating a fourth-year elective course with eight medical students. It was a medical humanities class, and the topic that afternoon was the virtue of forgiveness. A student named David led the discussion, and I listened as they exchanged ideas. When their energy waned, I asked, “Do any of you have someone to forgive from your clinical experiences? Did anything ever happen that you need to forgive or perhaps still can’t forgive?” I waited for an answer, but no one said a word. When a classroom becomes that quiet in response to a question, I sometimes have the strength to sit with the silence. So, I looked out the window and waited. I leaned back in my chair and waited. Finally, David said, “Something unforgiveable happened to me.” “What happened?” I asked him. “I was scrubbed into a vaginal hysterectomy. The patient was under general anesthesia. My attending was prepping the patient’s vagina. He picked up a clamp holding sterile cotton balls and dipped them into Betadine. While he was cleansing and scrubbing her labia and inner thighs, he looked at me and said, ‘I bet she’s enjoying this.’ My attending winked at me and laughed.” Someone gasped. I stared at David. He shifted in his seat and crossed his arms on his chest. A splotchy red rash appeared on his neck. Staring down at the table, he murmured, “Man, I was just standing there trying to learn. The guy was a dirtball. It still pisses me off.” David glanced at me. I asked, “When your attending said that and laughed, did you laugh, too?” My question touched a nerve; perhaps my tone was accusatory. David snapped back, “Yeah, I laughed, but what was I supposed to do? Have you ever been in a situation like that?”

In an accompanying editorial, the journal’s editors explain their reasons for publishing a piece that “could damage the profession’s reputation.” Noting that “the first incident reeked of misogyny and disrespect—the second reeked of all that plus heavy overtones of sexual assault and racism,” they write that they “hope that the essay will gnaw on the consciences of readers who may recall an instance of their own repugnant behavior” and push doctors not to remain silent in the face of such misconduct. “If the essay gives just one physician the courage to act like the anesthesiologist in this story, then it will be well worth publishing.”

Rather incredibly, in my opinion, some apparently defensive OB-GYNs have objected to the essay’s publication, arguing that these incidents are extreme outliners (well, I should hope so), claiming that “no harm was done” (seriously, fuck you), and worrying that exposing such incidents might deter women from seeking medical care. Sadly, women often have no choice but to seek medical care — I’m guessing that patient wasn’t getting a hysterectomy for funsies — and it’s incumbent upon the profession to win our trust. I know that I, for one, will continue to opt for women doctors whenever I can.