Gender, Medicine and Some Isms

I am by no means a feminist.

I know that statement alone will tick a few people off.

I believe that men and women were created differently and that we do have some defined roles and limitations.  I also think that despite our differences, for the most part men and women can do the same jobs and fill many duties equally.  Or at least similarly with different styles based on their baseline differences.

Medicine is becoming more and more female dominated.  In my med school class, we were 2/3 female.  In my particular field, the majority is still male, but with an increasing female component.

It has been argued that medical school selections are often actually selecting more for females with a shift in more patient centered and compassionate care.  There is more of a focus on people and service and such and this is somehow selecting more for females.  I am sure that in some ways, unfortunately this is true.  That selection criteria may sometimes select for certain types of volunteer work and certain personalities that are more commonly of female gender.  Maybe not.  I don’t know.

I don’t really care about proportions.  Either way, it is about producing the best physicians for the people out there.  And honestly, selection criteria change over time, but so do people.

I feel like I am fortunate to be in medicine.  Not just because it is tough to get in and is an opportunity that many don’t have.  But also because I am female and up until the past 50-60 years, it was rare to see a female doctor.  And it was tough to become a female doctor because of the whole “old boys’ club” mentality and, honestly, a lot of sexism.

The thing is, sometimes I take for granted my equality in my profession.  I expect to be treated as a professional peer.  As an academic equal.  At least insofar as I am a learner.

That is probably why I have had a few things happen that ticked me off a little.

And I might just be crazy.  Or oversensitive.  Because sometimes things get misinterpreted.  Especially in the context of other events.

This one time, while I was on call, I received a call from a nurse on the floor half freaking out about an unstable patient (who I wouldn’t quite call unstable, but definitely not well).  I went down and discovered the clinical associate on the team caring for the patient was still there.  I was half ticked because why would I be called if one of the patient’s team is still there.  So, I thought maybe I would just get a bit of handover and then go see what was going on.  The clinical associate patted me on the back and suggested (somewhat condescendingly) we could see the patient together because he didn’t understand what all the fuss was about.  Fine.  So, we went in to the room where he was rude to the nurses and ignored the patient and me.  And then went on a big rant about how the management was to be.  Despite voiced concerns.  And then patted me on the head and said I can surely understand he knows how to take care of things and follow his lead.  And ignored my suggestions.

I disagreed internally, this wasn’t the way to handle the situation at all.  But just stared blankly.  And then assessed the patient.  And helped the nurses as best I could.

I felt terrible.  He treated me like a child.  He was rude and condescending to me and the nurses.  And we were the ones left behind to do the caring.

Aside from being flaming mad and having to help clean up that mess, I couldn’t believe that someone in this day in age could be that awful.  Okay, I could.  I have seen it before a number of times with different people.  Sadly, this behavior still exists.  And I had run-ins with this person a few other quick times and thought they just didn’t like me for some reason.  But it seemed they didn’t really like anyone.  Maybe because of gender or not.  But I do remember this person has been respectful to my med student and was suspiciously not so much to me.

I am well adjusted to being presumed to be a nurse or a nursing student because I am a girl (and there is nothing wrong with this presumption).  To having people be surprised that I am a resident. I am not well adjusted to someone patting me on the back and speaking to me like a child.

And maybe I was being oversensitive.  Especially given I had been frustrated with the fact that I had been feeling ignored by a member of my clinical team for reasons that were beyond me, but that are more likely related to my home program (also not a fair assumption).  And I had had a patient who quintessentially did not believe that I was the other resident on the team because the rest were male and older than me and then called me progressive (not that progressive is a bad thing, just that I don’t think at this point in time it is progressive at all).

So, I was definitely initially blaming this whole thing on the fact that I was a girl.  Or that I am young and female.  Because that was the flavor of the encounter… Man being mean to women.  One of which had already felt labeled based on gender that day at least once.

And when I think about it, that makes me feel like a feminist and paranoid.  Both things I usually am not.

There are better explanations that don’t include gender for almost all of this behavior.  Like being an unpleasant person, for instance.

But really, it doesn’t matter why.

I do know that the way the situation was handled was not appropriate.

And I do know that many women in the past have had it much worse.

I am glad this is something I don’t encounter on a daily basis.

But, we should be better than this.  It shouldn’t matter that I am young or a girl.  It shouldn’t matter if you are a nurse or a doctor.

People should be treated fairly.

We have different strengths and weaknesses, but there is never a reason to be disrespectful or condescending.  Especially on the grounds of gender or age.

I opted to suck it up and get over it because the clinical concerns were addressed and the other concerns were more about perception.  Although I am still mad.

Some of this stuff is all in my head.  Compounded by a bad day and a rough week.  And I wish my week didn’t have that flavor.  But sometimes things are just not quite as good as other days.  I know that there will always be people with bad attitudes and that sometimes I will get ignored or talked down to.  And it doesn’t always mean anything.  It just stinks when it all comes at once.

Unfortunately, as much as I want to be the change I want to see, some of it is just implicit in the culture and difficult to change.  I know we need to change it.  But it is so hard.  Plus, the bits that are not in my head are difficult to prove or disprove.  And they are things that I can’t let beat me down.  And reporting those sorts of things is a lot of effort and has very little yield.  So, I wouldn’t want to say something unless I was really sure.  And it is tough to be really sure.

I crush it with kindness.  I respect people who don’t always respect me and I respect those who aren’t always respected.

I have it so good.  I work, for the most part, in a respectful environment.  I am treated as an equal.  Things are good these days.  It isn’t like it once was where women were shunned in medicine.

Maybe that is why on bad days when it feels as if everything is against me I get so angry.  Because I am so fortunate on those good days.

That doesn’t excuse it the bad days.

At least the bad days are relatively limited.

But it does get me thinking about where we came from and how we perceive one another both in different professional roles and in gender roles.  How sometimes we can make ourselves feel like victims and other times not.  And how one person’s bad attitude can impact the days of others.

Sometimes things that appear to be  gender issues are really just people issues.  And often people issues are things we just have to deal with in any field.

I am not a feminist.  But, I do think I should be treated fairly for my equal work.  Thankfully, medicine and society have moved in a direction where that happens more often than not.

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