IT WAS JUST ANOTHER DAY inside the beige-toned dentistry offices on SE Stark Street, until the buxom blonde showed up.

Spotted in January 2009, she was sitting on a table thrusting a D-size chest outward, and her arrival quickly erupted in scandal. But for some black strips over her most intimate body parts, she sat naked on the computer screen, hands on the table, head rolled back.

She was only an image, more burlesque than hard-core, but set against the cheerful yellow walls and pastel accents in the offices of Drs. Douglas Boyd, William Underwood, and Terry Isom, the scene was just plain wrong. Enid Webb, a no-nonsense dental hygienist and one of the 20-person, all-female support staff, stumbled onto the electronic interloper during a 9:30 a.m. break between patients as she went searching for a cup of tea down the long hall past the examining rooms. Straight ahead, just before the turnoff to the break room, she saw Isom alone in the dentists’ shared office keeping company with the blonde.

“The door is open,” said Webb, “and I glance in like I’ve done 100 times before, and there he is at his desk with the door open staring at this pornographic pose of a woman on the computer screen.” Shocked, she urged dental assistant Shannon Riverman to have a look. Within minutes, the two were huddled with a colleague in the break room, embarrassed, with Webb fearing a repeat of an even uglier moment she knew had happened nine months earlier, when another worker wandered through an office door and interrupted Isom viewing porn and masturbating.

According to an interview in a later investigation by the Oregon Board of Dentistry, during that incident Isom slammed the laptop shut, stood up and silently faced the female employee, then zipped up his pants. A day or so later, according to the transcript, Isom brought up the incident and apologized when alone with the woman in an office emptied after closing time.

Boyd assured the woman that he had had a serious conversation with Isom, warning him of the severe consequences he would face if such behavior should surface again. Isom, he said, was humble and apologetic. But the episode had left a deep mark on the small circle who knew of it.

The dentists were not partners, just independent practitioners who shared staff, referrals, and space in two offices. But Boyd and Underwood, who had a 29-year history together compared to only 12 years with Isom, feared a sexual harassment lawsuit. After the second pornography incident, the two doctors allowed no strike three. They gave Isom two weeks to collect his things, changed the locks, threw away Isom’s business cards, and took his name off the doors of the offices they had shared for more than a decade.

Isom had a quick response: a $4.2 million lawsuit. An innocent click on an icon titled “gifts” on a computer shared by Isom and Boyd resulted in “pictures of naked women appear[ing] on the screen,” he claimed in the suit. Isom’s lawyer argued his client’s ouster severely hampered his 12-year-old business, and accused Boyd and Underwood of rescheduling his patients for themselves.

At first, the staff thought the claim so preposterous they couldn’t wait to see how it would play out in court. In December 2009, however, arbitrators ordered Boyd and Underwood to pay Isom $619,726 toward lost earnings, plus his share of office equipment and software. By then, Isom had already revived his practice nearby to become a competitor.

One month later, Webb received notice from the Oregon Board of Dentistry about a new state law requiring employees to report any misconduct toward patients by medical professionals, or face discipline. So she filed a complaint against Isom. But the board, which sets standards for dentists and hygienists, ruled that the dentist had done nothing worthy of discipline.

The ethical and legal line between personal rights and public wrongs has always been blurry when it comes to pornography. Boyd, Underwood, and their female staff entered a hall of mirrors as they tried to rid their office of a business colleague whose porn-cruising was potentially creating a hostile workplace and a harmful environment for patients. The staff members could have sued under federal sexual harassment law, but they feared such a high-profile action would harm the other two dentists. Thus, Isom’s actions, the arbitrators’ ruling, and the subsequent inaction by the state dental board left them exhausted, disheartened, and seemingly without redress.

The staff was stunned by the arbitrators’ and dental board’s rulings. “We couldn’t believe when [they] came back and said Dr. Isom had a right to be in the office,” Shelly Casson, the dentists’ office manager, recalled. “It’s surprising that such important details like this would be kept hushed, even by the dental board,” said Riverman. “This is serious.”

Isom declined numerous requests to be interviewed for this story. In an e-mail, he wrote: “In response to your inquiry, these matters are now closed, and I have nothing to add.” Later, through an attorney, he provided written statements denying any intentional pornography use at work and blaming his ouster on his former partners, saying their business was in decline and they were trying to steal his clients. Isom said he has no difficulty keeping pornography out of work and his life.

Portland Monthly sought other records regarding the case from the Oregon Board of Dentistry to shed light on the decision to not discipline the dentist. The effort ultimately became a prolonged and divisive battle, one the board and Isom aggressively fought. However, the Office of the Attorney General ruled in the magazine’s favor.

The board’s records indicate the most telling documents relating to Isom’s porn-viewing were sealed by a judge as a part of the arbitration, including depositions and findings by forensic experts after Isom’s computer was seized with a subpoena. But the board’s records included the final arbiters’ ruling, which states, “Dr. Isom repeatedly used Internet access to view and download sexually oriented material in the workplace in violation of the anti-harassment policy he and Drs. Boyd and Underwood established for their joint endodontic offices.” While Isom contended he did not download or otherwise place the material on the computer, the ruling states that “forensic analysis showed that the material was downloaded under Dr. Isom’s login.” He “did not promptly close the screen image or delete the file,” the arbitrators found, but viewed the material “in full view of the two employees for an estimated 15 to 20 seconds.”

Interviews with the employees revealed the details of the masturbation episode: Isom’s turn toward the staff member before zipping his fly and the apology made to her alone after office hours. Nevertheless, investigator Paul Kleinstub advised the dental board that “…Dr. Isom’s viewing of material apparently protected (by) the 1st Amendment and…accidentally viewed by an employee does not appear to be a violation of (state rules), distasteful as those incidents may be.”

In the short history of online porn in the workplace, office standards have not kept pace with the medium’s proliferation. A March Nielsen survey found that 21 million Americans accessed porn on work computers during that month, or 30 percent of working adults. Because porn consumption has exploded so quickly, it is little understood, according to Wendy Maltz, a licensed clinical social worker and nationally recognized sex and relationship therapist. While some experts believe porn can be powerfully addictive, eliciting similar kinds of symptoms and behaviors as many drugs, it doesn’t fit neatly into the arenas that attract funding for research and treatments. And unlike gaming and cigarettes, porn is not taxed, so it doesn’t support public education on its own ills.

In Portland, prevailing cultural attitudes may even further complicate the issue. Sex therapists and sex workers alike routinely call our fair city “Pornland” for its notoriously prolific sex industry. A live-and-let-live morality combines with Oregon’s liberal interpretation of free speech to create a comparatively permissive environment for adult entertainment. Oregon voters have twice rejected attempts to regulate the locations of such businesses. No one has proven that Portland is home to more sex shops and strip clubs than any other American city, but the claim has become a kind of sotto voce civic boast.

Beyond the issues of personal kicks versus sexual harassment raised by porn in the workplace, Isom’s case provokes the question of whether a doctor’s office porn-cruising habits could impact patients and whether the state’s medical regulatory boards are obliged to inform the public when that cruising is well-documented and the subject of a complaint.

Experts on sexual pathology such as Dr. Mary Anne Layden, director of the Sexual Trauma and Psychopathology Program at the Center for Cognitive Therapy at the University of Pennsylvania, believe professional boards and other employment officials should take immediate action with people who are unable to control sexual habits at work. In a draft released in February, she notes, the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders now lists such behaviors as symptoms of “hyper-sexual disorder,” a problem Layden argues should be treated with similar urgency as incidents of alcohol or drug abuse.

“Lawyers and judges are so ignorant of the problems that they have normalized the behavior and don’t see how troubling it is,” she says. “Regrettably in the US, we don’t seem to be taking the problem of pornography as seriously as we should.”

Boyd and Underwood declined to be interviewed. But by the staff’s accounts, Isom’s behavior initially came as a surprise to his colleagues and employees, though it also capped a longer series of changes. Shannon Riverman, an assistant to all three dentists for 12 years, remembers how Isom was once a bubbly person with an infectious sense of humor. Passing tools hand-to-hand over patients, she recalled, she had a rapport with the dentist that was once so good the biggest glitch was keeping the patients from laughing. It was Isom, she said, who rushed to grab takeout when busy days whittled lunch to 10 minutes. He tagged along with the office staff to matinees. A religious man, he was known as the friendly evangelizer for pushing, to a point just shy of irritation, his moral and ethical convictions.

“I really thought Dr. Boyd and Dr. Underwood would retire first and I would work another 10 years with Dr. Isom,” Riverman said.

During the two years before the porn episodes precipitated his departure, Isom’s behavior shifted, according to his staff. He became moody and grumpy. His cheeriness shifted to bossiness. He ate alone. There were no more matinees. When Isom started staying late at work and spending hours on the office computer, claiming to be watching television or playing solitaire, Casson, the office manager, said she suspected depression.

“We didn’t, at the time, understand what it really meant,” said Webb. “If you don’t know what he’s doing, you don’t know how weird it is.”

Gazing through a sliding door toward her garden, tightly gripping her cup of tea, Webb describes damages the lawsuit’s arbiters failed to account for: the thick tension that filled the office after Isom was caught masturbating and the creepiness that made even his long trips to the bathroom seem suspicious. No one knew what to say to him. Yet another woman, a former employee, then came forward to say she, too, had happened on Isom viewing a full-frontal nude image at work.

Beyond the awkwardness and worries about future encounters with Isom, Casson worried about clients: “We didn’t want to schedule patients with somebody who goes into his office and masturbates during the middle of the day.”

The arbitrators released their ruling on the day of the office Christmas party in 2009. The outcome had some people in tears at the Old Spaghetti Factory. During the party, the staff gave each of the doctors a card with personal messages of thanks for protecting them from Isom.

“I’ve been to funerals that were not as hard to deal with as that,” said Casson. “The reason they were crying was not the money. It was the betrayal and the lack of justice being reinforced.”

Casson and Webb strongly believe Boyd and Underwood did the right thing by casting Isom out. Reflecting on the ruling, Webb remains puzzled by the arbitrators’ decision: “I think the arbitrators need to explain why they ignored federal law. Our employers were required to protect us from unwanted sexual contact. Why did [Isom’s rental agreement] supersede our right to work in an environment where we’re not being harassed?”

In an interview, Albert Bannon, one of three arbitrators who decided the case, explained that Isom’s habits were not justifiable cause to be cut off from his livelihood. Isom was a business owner and a co-signer of the office leases, not an employee, Bannon says; thus Boyd and Underwood had no right to simply lock the door. Whether it was separating Isom from the staff, buying him out of his business, or giving him more time to relocate, Bannon contends, “Certainly there were other things they could do to avoid any potential sexual harassment.”

The new state regulation that prompted hygienist Enid Webb to file the misconduct charge with the state dental board was inspired by a 2007 criminal trial of an anesthesiologist who groped his sedated patients. Despite knowledge of his behavior (which netted him a prison term), several licensed dental professionals had failed to report the acts to anyone, including the board of dentistry.

Webb said in her letter that Isom’s sexual behavior made her feel “extremely uncomfortable and offended,” adding, “My feelings have compelled me to notify the dental board of this situation, so that others may not be affected.”

On May 21, in the cramped conference room at its office in Southwest Portland, the dental board’s members sat around U-shaped tables rattling off nothing more than indecipherable case numbers. In some instances, they quickly approved sanctions. In others, they issued cautionary notices. A few cases they simply dismissed. Not once did they actually name a dentist, patient, or hygienist affected by the decisions. Those who filed the cases, much less a wider public faced with choosing a dentist, would have no idea what evidence was weighed or why the board chose to discipline or dismiss.

That’s typical of many of the state health boards, where confidentiality laws require them to protect identities of professionals who may be wrongly accused of misconduct, later releasing names and sanctions only for those disciplined.

In an interview with the magazine, the board’s executive director, Patrick Braatz, said that, overwhelmed by “employee/employer disputes,” the dental board two years ago defined its powers more narrowly. “If you’re having sex with your dental assistant in your dental chair after hours, that’s not our purview,” he said. “If you’re having sex with a patient, that’s our business.”

After the Oregon Board of Dentistry declined Portland Monthly’s request to release its records on the Isom case, the magazine asked state Rep. Mitch Greenlick, D-Portland, chair of the House Health Care Committee in the Oregon Legislature, to review the matter. He quickly locked horns with Braatz over the board’s inaction.

“It was not a very happy conversation,” Greenlick said. “I thought it was irresponsible for them not to investigate it further or at least make public what’s been going on. I didn’t think he was working in a way to protect the public.”

Even when the Office of the Attorney General ruled in favor of the magazine’s appeal, the dentistry board initially responded with an extremely rare move: a legal action for “injunctive/declaratory relief” with the Oregon Court of Appeals—in short, an effort to block the attorney general’s ruling to release the case files. But days later, after hiring and consulting with its own attorney (another unusual move for a state board, which would typically consult with the Office of the Attorney General), the dentistry board reversed course. Its president, Norman Magnuson, said the board’s primary concern was not protecting Isom, but rather its ability to withhold information on investigations that don’t lead to discipline.

“We have a policy,” he said, “and regardless of what you or I might think is in the public interest, you have to do what’s in the best interest of the policy.”

Greenlick says it’s business as usual. He and his committee have spent four years questioning whether the state’s medical boards are properly balancing public interest with confidentiality protections. Their work has led to six bills over two legislative sessions, increasing transparency and bolstering the boards’ charge to protect consumers.

Appalled by the dental board’s fight to keep the files closed, Greenlick said that even more oversight is needed. “Right now, the boards have none,” he said.

The University of Pennsylvania’s Layden argues that the arbiters’ and dental board’s rulings in Isom’s case were a tremendous step backward in experts’ ongoing efforts to raise awareness about the harmful effects of pornography. Before education, research, and courts “put the genie back in the bottle,” she says, similarly relaxed attitudes once allowed smoking to become a national addiction. The protection of the perpetrator rather than the victim, she says, “is the standard response to this kind of problem.”

Three days after Webb received the Oregon Board of Dentistry’s decision to not discipline, another letter from the board arrived informing her that the Oregon Bureau of Labor and Industries “does appear to be the appropriate agency to deal with your concerns.” But after feeling legally compelled as a licensed professional to report Isom’s behavior only to be greeted with inaction—and once again fearing the impact on the other two dentists—Webb and her colleagues felt dispirited.

“When they did that, I thought, ‘That good ol’ boys club; they just protect their own, don’t they?’” she recalls. “And with my faith in the dental board? Why bother?”