The COVID pandemic has revealed chasms between health care delivery system tectonic plates, revealing disparities of care and treatment of people of color and underrepresented groups. I write this from my own feminine perspective in hopes of cultural change. We have to start with us, the doctors and other health care workers. We have to see the inequities.
I have one regret about my career as an obstetrician/gynecologist. I regret my obsessive worrying. Worrying was with me all the time. Looking back, it would not have been — if I would have had the support I needed and deserved. I think of how that much worry impacted my health, work, kids, and my intimate relationships. I worried so much there was no time to have a soul or enjoy being human. There was a doing and not a being. I was on alert for something to go wrong, the next shoe to drop, the next disaster.
And, it was worry for the security of my career future that had me mute many times. Worry turned into fear, and fear was an indication of weakness, bringing shame, and shame is a life killer. I was in fear when I was not perfect. I was an imposter — a woman trying to be like the male doctors. I had to be pleasing enough, nice enough, and sweet enough to male colleagues, attendings, nurses, and other female residents. I could not trust the other women because they were in the same boat as me — trying to be like the men — only better. There was scarcity indoctrinated into all of us women, especially as we applied and interviewed for competitive residency positions. This was our lot. I decided to interview at a total of three programs, spending precious resources on travel and accommodations in the process. It was an “investment” in my future.
In the first interview, before even getting a tour or a chance to visit with the residents, the residency director met me. There was a round, smooth, blonde table, like many institutional tables in cafeterias. This seemed to be a breakroom of some sort. Dr. “Patriarch” closed the door and faced me, nodding his head like he was talking to himself or trying to remember something, definitely not a nod or acknowledgment of my presence.
Suddenly, the room was cold, especially as he pulled back the metal and plastic chair from the table. It made that scraping noise that was like fingernails on a chalkboard to me. I tried to close my ears as it echoed in my head. It sent shivers down my spine. I thought I was supposed to sit down, so I carefully pulled the chair out, as quiet as I could to prevent that god-awful sound, sat down, and tried to be comfortable in my dang pantyhose I was not used to wearing.
As he stood there, he opened the manila folder that was my file. He glanced at it, closed it, and slid it aggressively across the table into my chest. Dr. Patriarch said, “You wasted your time. You have two kids.” And then he abruptly left the room without saying another word! I was left sitting in a room, by myself, wondering what the F just happened! What was I supposed to do now? There was nothing to do but move up my flight and take a taxi to the airport.
The second interview, weeks later, seemed to go pretty well, at first. I knew that Dr. Patriarch #2 was a superstar in the world of gynecology and was excited to meet the man behind the procedure and textbooks and to be considered for this residency program. We chit chatted. I answered questions. I asked questions. Then, with absolute smooth hubris, he suddenly said, “I see you have two children. I’m the expert in tubal ligations,” he boomed with chest puffed out.
“Could I interest you in one?” My jaw went slack, just for a moment, with the incredulous and inappropriate offer. I felt slimy, almost violated. He was talking about my personal reproductive sex organs. Eww. At least he had been nice about it. This time, though I was not totally prepared for what had come out of his mouth, I was more prepared than the first interview. Clearing my throat, “Ahem. No, you may not — pause — You could talk to my husband about a vasectomy, though.” I turned on my heels and walked away. Click, click, click of my high heels. I left first this time.
I was to have an interview with the department chair of my alma mater. I dreaded the interview.
Why wouldn’t I worry and wait for something awful to happen after my other interviews? Dr. Patriarch #3 was effusive. He smiled at me like I was his sweet girl about to get a pat on the head. “I really like your red hair, Robyn. It reminds me of my granddaughter.” And that was it; I was in. So why wouldn’t I worry chronically with that interview experience behind me? This is a true story. You can’t make this stuff up!
Unfortunately, the impact on me was that I was demoralized. And that had an impact on all those around me.
The discriminatory and even aggressive behavior of Dr. Patriarch #1, #2, and #3, of the medical education and training system caused damage to me and mine. I felt like an imposter most of my career and had to be perfect. The woulda, coulda, shouldas consumed me, stole my power and had me resigned to this kind of treatment. I am not whining or a victim. I am mad, and I won’t stand for it — that it is still happening to beautiful, bright, smart, competent, and worthy young women in medicine! I believe that we need feminists, and feminist theory applied to medicine and our profession. The culture has to change. Now, I am off to tell all of the Dr. Patriarchs out there that they now need me to educate them. I’m ready.
Robyn Alley-Hay is an obstetrician-gynecologist and can be reached at her self-titled site, Dr. Robyn Alley-Hay.
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