Nevermore. It’s time to get uncomfortable

This blog post by medical student Jamie Katuna (who does wonderful creative work!) cites 20 anecdotes of things that women in medicine hear.

It’s prompted lots of additions on Twitter, in which friends and colleagues have added spins to the comments from their own experiences. Some of these additions have been perhaps more egregious than anything cited in the original blog post.

Reading these comments, as well as recently hearing stories from women in training about ongoing flagrant sexual harassment at a variety of institutions, has me in a place that falls somewhere between rage and disgust. Sure, there are some physical things that men can do and women can’t and vice versa, but the modern social professional contract accepts that there should be equity in opportunity and equity in pay, and that gender, race, and other defining characteristics should not be limits. Nor should these defining characteristics provide a basis for degrading commentary or debasing actions from those who are threatened with the changes occurring in the professional power structure.

Yet here we are in 2018 with exactly those things continuing to occur.

Before we go any further, I’ll state that I know that MANY very good people who stand up routinely for those who have less power, who believe in social justice as something we have to actively pursue every single day. You know who you are, and I see you and appreciate your efforts.

Yet here we are in 2018 with people in positions of power who continue to deny opportunities to those who threaten their comfort zones and their world order.  After all, we can’t have too many women in charge, can we?

Here’s something for you that’s not exactly a secret:

Sexism and misogyny are not just a women’s issue.  They’re an everybody issue.

Here’s another not-so-secret idea:

Racism is not just a minority issue.  It’s an everybody issue.Yet here were are in 2018, in which many are uncomfortable with sexism and racism AND have a fear of disapproval if they try to change the narrative.

How do we change this?

For those in positions of power and leadership who “get it”- you have to make sexism and racism unacceptable. Zero tolerance. And you need to “help” those who are sexist and/ or racist and have power by removing their power.  It’s hard, it’s scary, and they’ll be angry.  Without action they won’t change because so far they haven’t had to do so.  Call. Them. Out. Use your power for good.

For those who are not in positions of power and leadership, you can still make a difference once you choose that the outcome (dismantling unjust systems) is of value. What small things can you do?

  • Ask someone to repeat their comment.  It’s easy enough to throw the, “I must have misunderstood you…can you please repeat that?” card in a non-confrontational way. If they repeat something that seems mind-boggling to you (“General surgery is not an appropriate field for women”), another non-confrontational response might be, “Help me understand why you think that because I know of many successful women in general surgery.” Oh, and feel free to report your discussion to someone who has power over them and who understands why this isn’t okay.
  • Step in if you see someone in an uncomfortable or awkward position.  If you don’t want to look at the person causing the issue and say “This seems very uncomfortable” it’s easy enough to shift things by coming up with something you need to discuss privately RIGHT NOW with the person being victimized. If you can, get their whole story and share it with a powerful ally who has influence over the perpetrator.
  • Was there something you wish you had said in a situation? Remember it and use it later!

What other ideas do you have for how we can create a climate that is fully respectful of our differences, both in little ways and in big ways?  Please share here, or @ me on Twitter (@AmaliaCochranMD). What have you seen done well? We must do this together.

And we must do it together NOW.

“It’s not your time”

I’m hopeful, dear readers, that we can have a bit more of a dialogue this week.  I need to learn something, and I particularly need the wisdom of the men in the audience.

One of the undeniable joys of spending last week on the road at the American College of Surgeons Clinical Congress is the time I got to spend with surgeon-friends from many places and at varied career stages. Yes, there was learning and thinking and organizational work, but at the end of the day the connection is (as ever) what means the most to me as I reflect. I came home so thrilled to know more about the work that my friends are doing, and feeling supported in my own.

As one would expect if I’m spending time with varied surgeon friends, it also means that I got to spend time with some phenomenal surgeons/ scholars/ leaders who happen to be women. As one would expect, plenty of stories get shared.  As a qualitative researcher, I’m always looking for themes in stories, and last week was no exception.

What I heard was quite a few amazing, talented, accomplished women with tales of leadership roles deferred or denied, with the standard rationale of, “It’s not your time” or “We need to give Brad* a chance.”

This is where I need the crowdsourcing help, because I only know the female experience of many of my colleagues and myself. I feel like in the last year I’ve heard more and more of this sort of deferral or denial. Is “It’s not your time” code for implicit or explicit bias that keeps women out of leadership roles they have legitimately earned? Or is this a reflection of generational shift, and is something that’s being used to keep men and women who might buck the status quo a bit out of roles that, again, they have legitimately earned?

If this is simply reflective of old institutions dying with a long exhale, we need to address it.  We need the best leaders in the most crucial roles, and we don’t need to wait for that.

If this is truly a “new” form of gender bias, it’s even more imperative that we address it. Nothing will change unless we do, and, again, we don’t need to wait.

Help me learn, readers- is this gender or generation bias at play?


*”Brad” is simply the standard guy, and is usually the standard white guy who doesn’t upset the apple cart. My apologies to any Brads out there because I do, in fact, know that some of you are amazing people and leaders who do think beyond tradition.

What if it’s not our fault?

“If we are to achieve a richer culture, rich in contrasting values, we must recognize the whole gamut of human potentialities, and so weave a less arbitrary social fabric, one in which each diverse human gift will find a fitting place.” – Margaret Mead

In the last week I have found myself in the midst of two interesting Twitter conversations, both with a similar underlying theme regarding the impact of culture and how we seem to underestimate its impact on the individual.

Here’s conversation #1 (remember to start reading at the bottom):

I particularly loved the empathy behind the idea that the term burnout implies that it’s a personal choice. While we’re getting smarter about identifying organizational factors that drive burnout (ahem…my group’s call schedule), there still seems to be this idea that if you’re struggling with burnout, you’re simply not resilient enough. Reality check: I’ve witnessed some people who are remarkably resilient struggle with burnout, and without exception they have been in a work environment in which they had little to no control. Yes, I understand that individual characteristics may predispose people to burnout or may limit the impact of a dysfunctional system upon the individual…but at the end of the day, victim blaming and pretending it’s ALL about resilience?  That’s simply feeding the dragon.  It’s not helpful.

On to Twitter conversation #2:

(The link that you can’t see from here is this recent piece in the Atlantic.)

So, maybe it’s not about biological clocks or because we’re not ambitious enough.  Maybe, just maybe that ambition is situational…and that if we’re in an environment where we see other women hitting their heads repeatedly against the glass ceiling,  or we experience that ourselves, we adjust our expectations accordingly. Or we leave when we realize that we shouldn’t have to adjust those expectations because there isn’t anything wrong with them.

It’s time to stop telling us to try harder, or telling us that we can’t be mothers and academic surgeons, or telling us that we don’t measure up because we don’t know the 100 extra double-secret and unwritten criteria that you’re using to evaluate us. Most importantly, it’s time to create a culture in which we feel valued and supported, not because you tell us that we should, but because we actually are.

What if it’s really not our fault?