The Cost of Silence

Karin Kerfoot
6 min readDec 4, 2020

The last several years of my life have been about putting it back together.

The first steps of this journey were simply to figure out what had gone wrong — to identify the events, decisions, and external factors that led to the violence, coercion, and abuse I suffered at the hands of a man who was my patient, and then to the public shaming and destruction of my career that followed. In other posts, I’ve explored some of the systemic failures in medicine, the judicial system, and workplace violence that intersected in my experience, as well as how my own failings led me to be vulnerable to a predator. I made mistakes and, since I have the most control over my own shortcomings, they have been the easiest to address. Still, I’ve spent hundreds of hours in therapy and reflection trying to fix them.

But while I’ve been working on my own weaknesses, I’ve also dreamed of being able to contribute to fixing the larger systemic problems. I’m not the only person who has been failed by the same systems that failed me — far from it. I dreamed that my story could be the catalyst for change so that someone else doesn’t have to suffer through what I did.

At first, I honestly thought that this was possible. The #MeToo movement was driven by stories with a lot of similarities to mine. The world started to change because people paid attention to those stories and, finally, began to demand something better. Since my story has so many of the same elements that drove #MeToo — workplace violence, gender-based abuse, the failure of systems — a part of me that hoped that, by telling it, I might contribute to systemic change as well. In retrospect, I was much too hopeful and naïve.

Still, in the early days there was some reason for hope. Long before I started sharing my experience publicly, I shared it privately. I literally told hundreds of people, usually one or two at a time, about what had happened. These people included family, friends, other medical professionals, lawyers, police officers, and politicians. Nearly all responded with shock and empathy for what had happened, and also with disappointment and anger over how so many different systems had failed.

Several of those people — including university faculty and administrative brass, leaders in national medical organizations and physician health (if you’re a Canadian physician, you would know their names), and advocates in feminist organizations promoting women’s issues and safety — specifically told me that they looked forward to the day that I would share my story publicly. They too seemed to hope that it could drive much-needed change, just as I dreamed of in my own fantasies. Many recognized long-standing issues with misogyny, injustice, and shaming within the profession of medicine — because there really is a lot of it. I interpreted what they said to mean that they were invested in the outcome of such a conversation. Most encouragingly, I also thought they were saying that they would stand behind me when it came time for me to step into the spotlight.

It turns out that I was wrong.

It took considerable courage for me to step into that spotlight, but now that I’m here it seems that I have done it alone. A small number of people, most notably my husband, have visibly supported me and I am incredibly grateful for each of them. A few brave former university colleagues are willing to acknowledge my Twitter posts, but most of the people who once gave me private support and encouragement have completely disappeared. Perhaps all those physicians, leaders, and advocates are quietly watching events play out before deciding whether or not they can take the risk to speak up, or perhaps they have decided that I am not the cause to rally around — that I am too much to blame to be the perfect victim.

I’m actually very sympathetic to either option. Violence against women is uncomfortable to acknowledge and talk about, as is admitting weakness — especially in the medical profession. As I’ve been sharing some very raw and painful experiences through this blog, several people have told me that such pain and vulnerability are very difficult to sit with. Not a lot of people are comfortable with vulnerability — it causes us to think about our own. Advocating for systemic change also means taking risks. Many of the people who I reached out to privately are still in the same toxic system that harmed me. That system has gone to great lengths to attack, discredit, and condemn me, and it could just as easily do the same to them given the smallest excuse. If nothing else, my story is proof that, contrary to the regular assurances otherwise, the system is quick and ready to condemn rather than to support those who are in it. It’s understandable that those people would rather not stick their necks out.

But the cost of that silence is this: the same systemic failures that intersected in my life are continuing unabated to cause damage in the lives of a lot of others. You’re not going to hear many of those stories, because a lot of women who live through what I did don’t have a voice, and shame is a powerful tool to keep those that do from speaking up. Unless my tormentor is back in jail, he is undoubtedly luring and raping another woman as you read this. He’s been doing it for years, and I doubt he’s going to stop now. At the hospital where I worked, multiple staff have burned out and left, some of them leaving medicine for long periods of time and others not returning at all. In my former department, the resident physicians finally got so sick of the working conditions and dearth of competent leadership that they recently threatened to go on strike. And medical regulators are continuing their patriarchal, shame-based practices that directly contribute to physician mental illness and suicide.

Perhaps fittingly, the current chair of my former department was one of the few people who I reached out to all those months ago that didn’t offer me support or encouragement, even privately. She thought it was ridiculous that I would even think about telling my story publicly. Why would you do that?, she asked me.

I’ll tell you why. Because the systemic failures that cost me so much are damaging others, and they will continue to do so with our implied support so long as we stay silent about them. That’s why I’m still speaking up, writing this blog, and telling my story as loudly as I can — even if it seems like no one is listening and I’m standing out here alone. I was silent all those months that I was being hit, extorted, and raped by my abuser, and it didn’t do me any good then. It certainly won’t save me now. All it will do is protect the hospital, university, and medical administrators who would rather I disappear for their own sakes.

More women are suffering at the hands of the same man who abused me, and more physicians are being broken, blamed, and shamed by toxic systems that have gone unchecked for far too long. I sincerely hope that each person who finds themselves caught in some piece of what I experienced will find a way through. I also know it’s entirely likely that not all of them will. They are the cost of silence, and I will not pay that price.



Karin Kerfoot

Psychiatrist turned yogini, writer & educator. Survivor of sexual violence & systemic injustice. I write about gender-based violence & medical regulation.