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Toxicity, gaslighting, and passive aggression in fellowship

Anonymous
Physician
May 9, 2022
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“Yeah, I mean, whatever, it’s a master’s! Have your own damn party.”

My jaw dropped in disgusted shock. The wall was thin, very thin. Come to think of it, it wasn’t even a wall. It was a partition: the separation of space between different office spaces. My mentor uttered these words: Assigned to support, encourage, and guide me through training; the person supposedly invested in my personal and professional growth. This was his response to the irritation my program director was expressing to my invitation to my commencement ceremony. The very same mentor who, the previous week, had responded to the invitation with praise, emailing me, “Congratulations on your accomplishment. Very proud of you!”

Just as neither he nor she had any idea that I was sitting one foot from the other side of that partition, neither of them had any idea of the sweat and tears it took to obtain this degree while in fellowship. Where was this resentment coming from?  Why the angry, infantile outburst in a public space where the overlap of ethics and professionalism, or lack thereof, could feasibly pronounce this behavior as professional misconduct?

I am female. I have never let this be a reason to act or behave in certain ways. Nor did I honestly, maybe in my own naïveté, imagine that others would act or behave differently towards me because of my sex. While in training, I decided to complete my family and chose to have my last child. My performance was where it was expected, my evaluations placed me “on target” for my level of training, and I was even highly proficient in some areas. My return from maternity was prologued by an email from the program director that utilized guilt to have me return to patient responsibilities one month prior than anticipated. She stated that as she had supported me and as I had burdened the rest of the program, now it was my turn to “give back.” She added that if I was not ready to do so, she was willing to “discuss options such as extending leave to decrease [my] stress.” I replied with a warm email, expressing my appreciation for the program’s support of my maternity.

The first evaluation upon my return was horrid. I was no longer meeting expectations; there were “concerns regarding [my] clinical decision-making progress,” and I seemed “uncomfortable leading discussions.” The evaluation after this one was exponentially more appalling, where I now lacked the “ability to process stressful/complex situations” and lacked assessments and plans. How one loses skills and decision-making abilities with time is a mystery. And why the program would allow such a deplorably incompetent trainee to take care of patients is frankly more concerning. Despite these egregious deficiencies, it took six weeks for someone to meet with me. Within this time, I met with my mentor for career advice. The meeting started with friendly banter discussing travel, wine, and art. Suddenly, he abruptly silenced me with his piercing blue stare: “It sounds like you have all of your ducks lined up. So I wouldn’t go making waves.” He repeated things that had been shared in confidence with my program director how much time I was expected to make up. His mouth distorted as he barked, “You will graduate whenever we say you will graduate.” He gave me “friendly” advice to lay low and be quiet, and I should be thankful for the suggestion.

Shortly after these events, I shared my sense of discomfort and injustice with one of my friends. He confided that he had heard numerous conversations in public settings between male attendings, who scoffed, “She thinks she’s better than everyone else because she did [another residency],” or that “just because she [did something else before training] she thinks she knows everything.” It went on and on. My heart broke. Their own personal failures and professional regrets manifested themselves as a deep and hostile rancor that could easily be displaced upon a female target. Their incapacity to voice these comments in my presence or to my face makes them cowards; bullies that project their devalued selves passively can deny their words or retreat, feigning ignorance. These, by the way, were men I had trained with. My peers. One of them was a dear friend I had confided in and trusted for over a decade.

And now I had to listen to this mentor nearing retirement, who no longer participated in clinical care or had once worked with me at the bedside, loudly proclaim demeaning remarks that traversed our partition. “She thinks she is above everyone else, beyond being reprimanded. She can’t continue to keep her head in the sand.” Reprimanded for what? Having a baby? For choosing to not risk infertility?

The worst part of this “educational” environment is not the anxiety I feel every time I step into my office, not the fear of asking a question about patient management as I predict retribution in the way of a patronizing comment or implementation of additional call “for my learning.” It is the incontestable fact that none of this can be proven. All of this can be chalked up to “my perception” that “I misunderstood” or “misheard.” Or, worse, that such things were never said nor ever happened. The dishonesty, the lack of integrity, and the abuse of those that are not in a position to stand up for themselves must stop. To my esteemed mentor, who feels empowered by subjugating others to presumptuous judgment, who basks in the pleasure of other’s submission; to my program director, who has taught me how to skillfully lead with lies and deceit, how to rise while tearing others down, and how to be impressively charming behind veils of threat and coercion: Próst! My head is out of the sand. And I will have my own damn party.

The author is an anonymous physician.

Image credit: Shutterstock.com

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Toxicity, gaslighting, and passive aggression in fellowship
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