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To the Editor I feel motivated to respond to the Incident Report in the Feb. 21, 2003 edition. The introduction manages to embrace the goal of discussing our differences and to call for a shared vocabulary and a safe context to keep us all on the same wavelength. We all have opinions, and many of us have opinions that are resented by others. We all live within our stereotypes, and we order our larger world with them; it is only when one circles close enough to see the freckles that the individual overrides the preconception. The incident of the senior resident mocking the gay attending conjures several thoughts. In the course of listening to patients tell me about themselves, I freely admit, I have been shocked, repulsed, and entertained. I have had to excuse myself and leave the room so I would not break down in laughter (less often, tears); I then reenter trying to remedy the problem for which I was consulted. The protection of a patient's dignity from any breach, including ridicule from his physician, is one of the core aspects of our professionalism. In the incident in the column, the derision was not between doctor and patient so it lies on a less adamantine edge. The incident occurs in the workplace and it describes a rude attempt to diminish a supervisor by a lower-ranking employee. It is unprofessional in any business, but it is also personally ill-mannered and vulgar. It is part of the workplace, and there are rules against it for all employees. The idea that the lack of reprimand is a power problem because the senior resident was the ranking member of the team seems a bit far-fetched. We have seen students and other team members correcting or at least amplifying almost anything said on the medical teams. One would be more convinced of power shutting off the response if the remark had been from a rich donor in the midst of the Medical School's fund-raising season. The silence comes, I am sorry to report, from a less subtle and far more insidious cause. The last bigotry that is tolerated in our society is the hatred and humiliation of the homosexual. If the resident had done a Stepin Fechit routine and the epithet was "nigger" instead of "faggot," he would have been fired. Thomas Walshe, HMS assistant professor of neurology at the Brockton VA and Brigham and Women's Hospital