Defiant Bitch, MD

Hey y’all.

We’ve all heard about, and experienced, some degree of manspreading on buses and subways. I’ve seen it at sporting events. Maybe even in the chairs in a pharmacy waiting area.

But now, ladies and gentlemen, there is a new frontier for manspreading: the weekly department-wide conference at an academic hospital!

Here’s what happens: Every week, we have a multidisciplinary conference, where we present cases and argue about the best way to manage them. It’s a good time, for the most part. We have attendings from two departments, fellows, nurses and techs, in addition to a number of other members of the team.

With so many people in attendance, the room fills pretty quickly. There are rows of seats in the back, and often, people need to sneak in and out to answer pages.

So, every week, *without fail*, there is a man in attendance who pulls up a rolling chair, places it so that it obscures any pathway to the back row, sits in the chair, then spreads his legs apart to a comical angle, ~100 degrees (I want to take a protractor to this one day). If any of us would like to take a seat in the back row, we have to ask him to please let us through.

He never seems to take a hint that people, repeatedly, need to ask him to temporarily stop obstructing access to seats.

Here’s what gets me: once I realized this was a pattern, the first thought to cross my mind was “Hmm, who is that? Is that an attending that I’ve just never met before?”*

Essentially, in my mind, I found myself wondering, “Does he rank high enough in this system to justify obstructing a row a seats?”

How crazy is that?! NO ONE is justified in sitting that way. It’s probably a fire hazard. But, in my mind, as a reflex, when encountering someone asserting their dominance over space, I first check and see if they perhaps have the RIGHT to spill into the public space without apology.

We, as women, have been conditioned to believe that everyone deserves space more than we do. This is why we don’t even tend to notice the manspreading until it ACTUALLY DISRUPTS A DEPARTMENTAL CONFERENCE.

Ladies- let’s keep on calling out manspreading any time we see it. On the train, or, perhaps, in the middle of an academic meeting.

Defiant Bitch, MD
*Of note, this man is not an attending. He’s a tech who does not work directly in the departmental subsection related to this conference. I am still trying to figure out why he is even there every week. Other than to annoy me.

They call it “everyday sexism” because, it’s, well…every day.

Just the other day at work, one of the techs seemed displeased with me. As it turns out, while I was on call over the weekend (I take call from home to read studies), he was upset that I sounded annoyed with him on the phone.

I was annoyed because instead of texting me the information I need (*every* other tech does this), he calls me every time, forcing me to put the baby down or otherwise stop what I’m doing. Never mind that he has an iPhone with texting capability, has sent text messages in the past, and I have asked him specifically to please text me instead of calling. This is only a small annoyance…but if you’re going to call me at home, you’re going to be liable to hearing my annoyed self speak.

Anyhow, during the day, he came over to give me the information about a new study. As he was handing over the paper, he stopped and said “Who’s the fellow here? Is it you? Because, you don’t look like a fellow. You look like a GIRL.”

I hadn’t even finished my coffee yet. One of the female techs looked embarrassed. Unsurprisingly, Mansplaining Program Director said nothing.

I looked up and responded “Girls can be fellows too…”

He seems taken aback, as if I can’t take a joke: “Oh, ok then!”

Later on in the day, he came over and brought me another study, and he had not filled out all of his documentation beforehand. He asked me, “Can you look it up?” Once again, I was annoyed, and grunted “Yeah, I guess I can.”

He then stops, and asks “Is something wrong? You seem FRAZZLED.”

I steadied my face, focusing on relaxing each individual muscle in my forehead. I told him, “I am a bit behind in reading my studies this morning. But this is truly not a problem at all.” I imagined Eliza Doolittle’s voice training in My Fair Lady, and attempted to steady my voice in a similar way.

Him: “Well, you seem frazzled. TAKE A PILL.”

What sort of pill? I’m guessing it was implied that it would be some sort of “pill” that might help with the presumably humiliating, uniquely female event of menstruation. Something like Midol. I can only guess this would have been his ultimate insult.

So essentially, here are the takeaway messages I could surmise:
1. It is extremely unladylike to be anything but bubbly and borderline giggling when taking a phone call for work. This was strike one on my part.
2. A male tech can always get the upper hand by reminding the female physician that she is nothing more than a “girl,” and hence, probably not even a doctor.
3. If we don’t take on a tech’s work with a Miss America-style smile, then we are FRAZZLED. We are hysterical and on edge.

If we are not smiling, then we must be UNSTABLE.

Well then. Watch me SCOWL, bitches!!

Defiant Bitch, MD

I can’t bring myself to watch my residency graduation video.

Prior to my final year of residency, I was voted to become a Chief Resident for our residency program. It felt like an honor and it’s a line on my CV, but otherwise, it was approximately 16 months of unpaid secretarial labor.

Even before the year started, there was the > 100 hours of creating a complex schedule involving residents from four different institutions rotating at five different sites. In addition to managing schedule changes and listening to squabbles among the residents, there also was quite a bit of emotional “dirty work.” For example, there were multiple occasions when an attending asked me to give negative feedback to one their residents, since it would be easier to have me deliver the bad news than for them to sit down and have an awkward conversation. There were other times that I was tasked with using my own social capital in order to harass my fellow residents into making scheduling switches that they did not want. While some of these schedule switches were necessary due to unavoidable circumstances, this resulted in me having to beg and plead for people to do favors for me, even though, without fail, these changes never actually helped my own schedule at all.

Overall, it was exhausting. I started avoiding social events, for fear of hearing any more complaints.

Throughout the year, though, I had a nagging feeling that a bit more of this emotional work fell upon my shoulders because I was a woman. It wasn’t anything I could ever prove. But there were times that another resident would approach me to help plan their own social event. When I asked why I was being requested to organize someone else’s event, the response was invariably some form of “Well, you’re just so GOOD at this.” Essentially, I was so good at making lists and badgering people to show up to required events, that I should help the greater good with my “talents.”

This felt akin to telling me “Wow, you’re so good at cleaning bathrooms; since you’re so good at it, you should come over and clean mine, too.” There seemed to be a lack of understanding that everyone should be cleaning up after themselves; asking me to do it for other people only served to imply that I more useful as a secretary than as a physician. Part of me truly wondered if because I was a mom at home, I was simply expected to be everyone’s mother at work, too.

But there was one final event that removed any doubt from my mind that my gender played a role in my treatment as Chief Resident: this was the speech that our very much beloved program director gave for me at our residency graduation.

As I stood in front of the large room of my co-residents and faculty of our entire department, my program director started one of his classic, passionate speeches. It soon became clear, though, that he was not going to speak about my publication record, clinical skills, or rapport with patients.

His speech centered around an extended comparison between myself and his secretary, in which she and I were both touted as “frighteningly organized.” He described how she and I could communicate “without using nouns or verbs.” This was supposed to be my shining moment in front of the entire department, but instead, I was mortified. My work as a secretary had made more of an impact than my work as a resident.

I recognize that any Chief Resident in a program with a complex schedule, male or female, will have to deal with heaps of scheduling labor. But, something tells me that a male Chief Resident would not be lauded only for organizational skills and cheerily compared to the program director’s secretary.

One important lesson did come out of this experience: should I ever be asked to take on a labor-intensive, organizational role again, I will speak up and demand to be appropriately compensated. Sure, I can type fast and create a schedule out of thin air for 80 people, involving 730 overnight calls and 358 back up calls. But Defiant Bitch, MD, won’t ever be doing that again for free!

Defiant Bitch, MD

Stethoscope. Reflex hammer. Short white coat.

There was a long list of materials that we needed to obtain in preparation for medical school. In the early years, we were taught about cultural differences that can lead to miscommunication, the importance of eye contact, and learning to listen more and speak less. We were taught humility. Years of residency training taught us to perform within a strict, militaristic-type hierarchy, and to hold our opinions to ourselves and keep on marching through the dead of the night.

Throughout my 12+ years of medical training, this preparation has served me well during difficult patient encounters and unraveling a diagnosis from a complex history.

But none of this prepared me for dealing with my mansplaining program director.

None of those professionalism lectures taught me what to say when my senior attending and fellowship program director tells me that my marriage doesn’t involve enough “team work” with respect for child care. None of the books gave me guidelines on what to do when this boss grills me on whether my husband gets my “permission” when leaving town for work (I mean did I get *his* permission for my gazillion overnight calls during residency?!). None of my standardized patient encounters gave me the tools to keep my mouth from hanging open as this man began a pedantic lecture to myself and another female colleague (who also has children) about what constitutes a “mother’s worst nightmare,” and how our opinions on the matter were simply incorrect.

If anything, learning to hold my tongue since I was 22 years old has made me feel like Defiant Bitch, MD, when I try to stand up for myself.

Today’s encounter was prompted by me showing up late to a 7am lecture due to needing to drop my baby off to daycare. My husband is out of town for work, and, as anyone with young children in daycare knows, getting anywhere by 7am with childcare duties is a near impossible task. Furthermore, my clinical activities for the day would not start until after 9am (I know I’m lucky- I love this rotation at the VA hospital!), so it didn’t make sense to arrange for additional coverage for the morning (and I’m not even sure what this would even entail– hiring a one time nanny from care.com?).

So I showed up late. Mansplaining Program Director actually didn’t say anything about my tardiness, but he did wonder aloud about why there was ZERO faculty attendance at this particular lecture. (Of note, this is a non-surgical specialty, where mornings generally don’t have any reason to start before 8am.)

I explained to him that 7am is a difficult time for anyone with young children. I told him about my own daycare drop off situation, as an example. His response was a rather derisive, “Well can’t your husband help?” I blurted out “He’s in Mexico! For work! He works too!”

I thought it was over at that point. How wrong I was.

Next came the questions about my marriage: “Did you husband ask your permission to go on this trip?”

Excuse me?

Me: “Actually, he doesn’t have a choice. He’s the project manager, he had to go, or else risk losing his job.”

Him: “Well did he ask you?”

Me: “Are you kidding me? I need him to keep this job!!”

This response, though, didn’t even begin to express my outrage. I delivered our son during my final year of residency. While there was significant elective time during this year, there were also many weeks when I would disappear on the inpatient service, generally not coming home until well after baby went to bed. My husband, without a question, or a single complaint, became the primary caretaker for our infant son. In addition, he did all of those invisible chores which often fall to women in a household: meal planning, grocery shopping, paying bills, cleaning bottles, stocking up on diapers and endless loads of laundry.

Honestly, that probably doesn’t even cover it– I wouldn’t know. I wasn’t there. Even when I came home, I was often staffing patients by phone through the night (while breastfeeding), or triaging patients at outside hospitals as the covering physician for our answering service.

My mansplaining boss still wasn’t done; he then began a lecture about how in a marriage, there should be an effort for both parents to trade off child care responsibilities. That it should sometimes be one parent or the other, but an equal contribution.

The skin on my face felt hot with indignation. My heart pounded. How could anyone possibly say this to me, particularly about my marriage, when my husband has silently, unflinchingly, more than the majority of the time, taken on the lion share of childcare responsibilities?

I gathered my courage, looked him in the eye, and spoke:

“Why am I getting a lecture on teamwork?”

I was surprised at myself for talking back at all. In medical training, particularly during the third year of medical school and the years of residency, it is ingrained into your psyche that you, as a lowly peon, do not have opinions that matter. Your job is to take care of patients and not make your attending look bad. You are certainly not supposed to talk back. Sass is not encouraged.

So now, following 4 years of medical school, 3 years of a PhD (it was an MD/PhD program), 5 years of residency, and now most of the way through my first year of fellowship, I am finally learning how to speak.

I am 35 years old, a former musician, a mother, a board-certified physician in my specialty and a scientific researcher, and following all of these years of indoctrination into the culture of medicine, I am just now realizing that I have a voice.

Hear me ROAR.

Defiant Bitch, MD

UPDATE: After this particular argument, Mansplaining Program Director agreed to “revisit” our lecture timing with the faculty, in an effort to boost faculty attendance. There has been been a hilarious ensuing email chain, in which, one by one, every faculty member has unanimously voted against the 7am time in favor of a noon lecture.

Defiant Bitch, MD: 1. Mansplaining Program Director: 0.