By MEGAN FROST BABB, MD (10)
The other day while I walked to work, I deliberately slowed my pace to allow time for my left hand to lightly graze the brick wall I was passing. I watched as my fingers ebbed and flowed through every groove and imperfection. There was a familiarity to this. Perhaps it was the texture, perhaps the grit. Either way, memories emanated as I was no stranger to brick walls. Over the years as I pursued a career in medicine, my hands had gotten quite used to dismantling them.
The journey to becoming a physician is a long one. When I started upon it, littered everywhere were remnants of items belonging to predecessors who had once traveled the same path. At one point along the way, I found a piece of literature recommending whiskey for a teething child. This provided me some context to its age. Interestingly, despite the medical and technological advancements throughout healthcare in the last few centuries, for female physicians, significant inequities still exist. And as a result, for those of us on this road, brick walls are a common obstacle to meet.
The first wall I encountered came at the beginning of my third year of medical school while on a surgical rotation. Its brick-supplier was one man: an attending surgeon. Its building contractor was the system that employed him. The project itself was funded by the profits he generated for them. My brick was #864. I remember the day mine got added to the wall.
It started with, “Your hair smells incredible.” Followed by, “My hands may touch you. They are hard to control.” It even went as far as, “You were in my dream last night. Did I mention it was wet?” He made my skin crawl. I spent more time focused on trying to be where he wasn’t that I had no space left to focus on why I was there in the first place, and that was to learn. The awkward stares from OR staff looking upon me with pity made me want to vomit. And the number of male physician on-lookers who seemed to watch this behavior for sport did nothing but enable his behavior (when one brought his daughter to work with him, it was all I could do but hope she never had to experience from a man what I was experiencing from him). The lack of shock of such behavior from everyone aware in the system confirmed its normalcy.
The bricks that these walls are built, each have a unique story to tell. They all represent the individual experiences of female physicians plight with gender bias. The misogyny is the mortar that holds each brick together. The wall itself represents the cumulative effects of sexism in healthcare. And the support lending to each wall comes from those controlling these systems who allow the pervasiveness of such behaviors to continue.
The wall I stare at today, more than one-thousand bricks tall and wide. Inspired originally by the #MeToo movement and most recently by representative Alexandria Ocasio-Cortez’s most poignant address on sexism in politics (that provided the confidence I needed to publish this), the following vignettes have been collected from fellow female physicians who, like me, have a story to share.
Brick #4: I was asked by a male patient if I needed to practice my prostate exam technique because he was happy to allow me to do so on him. When I asked the administrative team to move him to the service of any one of my many male colleagues I was told, “These are the sort of things that build character. I think we need to thicken your skin. The patient will remain on your service.”
Brick #29: I recently gave a presentation at grand rounds in my hospital. When I walked to the podium, I overheard a male physician say to a group of others, “Isn’t the lecture today supposed to be given by an orthopedic surgeon?” I am the orthopedic surgeon he speaks of.
Brick #56: I am a trauma surgeon. When I was in fellowship, a male attending told me he wasn’t a fan of women being trauma surgeons because he didn’t think we could stomach the type of injuries that they typically treated.
Brick #82: My research team was being introduced at a major medical conference in front of an audience of over 10,000 physicians. I was the only female in our group of eight. Each male was introduced as Dr. So-and-so. I was introduced as Susan. Just to be clear, like the other seven, I am also a physician.
Brick #122: Today a physician asked me why I didn’t go to nursing school. “Because I wanted to go to medical school. Why didn’t you go to nursing school?” I asked. He looked puzzled.
Brick #215: At our medical group’s Christmas party a male colleague approached me and said, “Who knew that under your usual frumpy outfits there existed a body like that!”
Brick #297: I am currently in residency and one of my male attendings said to me, “I don’t know how any female physician finds a husband. Don’t most men find your level of education unattractive?”
Brick #365: I once disagreed with the treatment plan of one of my hospitalist colleagues and made different recommendations to the management of the patient’s kidney disease. He later saw me in the physician’s lounge at lunch and said, “I appreciate your input but I am going to ask Dr. X (another nephrologist but male) to consult on the case because I don’t agree with your recommendations. You don’t care do you?”
Brick #398: Our hospital board of directors recently sent out an email welcoming their new diversity officer. He is a white male. We now have sixteen board members. Sixteen of them are white males.
Brick #441: I am a cardiology fellow and every month my male colleagues ask if I am still taking my birth control. They are worried about me getting pregnant and going on maternity leave.
Brick #507: As a medical student I was on a surgical rotation with a male urologist. While assisting him with a TURP he asked me, “Would you like to see what a well-endowed penis looks like?”
Brick #558: One of my kids got sick and so I had to cancel my patients for the day. My male boss responded to my text message with, “Don’t you have a nanny for that?”
Brick #606: I was a medical student when my breast was grabbed by a male attending. When I went to report it, the individual taking down the information asked if I had done anything to make this physician think I wanted him to do that.
Brick #670: I am a surgeon. It happened to be a Friday afternoon when I was doing a routine surgical procedure that was taking longer than expected. The male anesthesiologist on the case yelled out in front of everyone in the OR, “If you weren’t a female perfectionist, we would have been done hours ago!”
Brick #781: A colleague of mine was offended when I told him he tended to be sexist. He told me that was impossible. “I have three daughters!” As if being a father to daughters excludes men from this behavior.
Brick #836: I asked my medical school classmate why he wanted to pursue a career in obstetrics and gynecology. His response, “Because who doesn’t like to watch women moan?” I found out where he was applying and emailed each program with the following: If you have any doubt about this candidate, there is a reason for it. Listen to your gut.
Brick #887: I emailed an orthopedic residency program I had just interviewed with to thank them and to express my enjoyment in meeting them. The Program Director replied-all to the group asking, “Can someone find out if she is married, with or without kids?” I was crushed. For those that don’t know, this is unethical and highly frowned upon.
Brick #914: To improve physician retention in my medical group I suggested we consider offering the female physicians twelve weeks of fully paid maternity leave following the delivery or adoption of a baby. A male colleague was quick to shut down the idea stating, “Nah, that’s a terrible idea. Women will just take advantage of it.”
Brick #991: The following is an excerpt from a note written by a female colleague who died by suicide (this is shared with family permission under the premises that she remain anonymous), “You sexually harassed me for months. Your desire was that I believe in myself to be nothing. You win. The system weakened me. You broke me. I did physically what you did verbally. Words can kill too.”
It is incredible how much information can be gathered by the fingertips. I require myself to feel every brick so that each experience they represent can be heard. With each behavior tolerated, left unattended by those with the authority to correct them, the mortar strengthens and in turn the wall itself. As women, we are taught that it must be us who improves uncomfortable situations. And since it is clear these walls strengthen with time and that only we can improve the uncomfortableness of it all, I leave you with just one suggestion: Get yourself a sledgehammer because getting uncomfortable just got a whole lot easier. It is about time these walls start coming down… indefinitely.
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