The final week of a clinical rotation is always interesting because a trainee may be at peak proficiency for that specialty and, as is usual in medicine, you can never predict what will come through the door. For example, I recently accompanied a physician into a crammed patient room and searched for a seat. When we realized that the pull-out step of the examination bed was stuck and inaccessible, the patient offered me a seat—on his lap.
The physician was visible shocked at the patients offer, but I’ve been female and Black my entire life. I simply responded “no thanks, I already have a seat” and promptly demonstrated sitting on more suitable furniture.
After exiting the room, the physician quietly mentioned that what was said in there was inappropriate and he wondered if I was doing okay. That was when I was shocked. For me and many women I know, that was fairly typical behavior. In fact, it was so standard (and irrelevant to the chief medical complaint) that I forgot about that part of the interaction. At a loss for words, I tried to articulate that older men often feel welcome sharing similarly suggestive statements in the office but that response (that I gave to escape an awkward conversation) resonated as ridiculous.
Then I was left to reflect on why what was normal for me was shocking to another care provider. Had he never had anyone say something inappropriate to him? Not even during day-to-day activities? Could supervising a woman be the only time some men ever deal with such interactions? Having someone with enough kindness and courage to point out mistreatment forced me to reflect on what I am socialized to accept as a professional woman; particularly in medicine, where I have limited time to achieve a high priority goal.
Providers must choose where their energy is expended. With verbal pestering being a fairly regularly situation for women (and minorities), is it worth our limited resources to address every instance of inappropriate behavior, or should we ignore it to facilitate moving forward with the task? If we choose to address it, what can we say that would maintain the rapport but get our point across succinctly?
The fact that we must navigate this mental rollercoaster while working should NOT be normal. Everyone should see us at work and respect the time we have given to serve. There is something about society that does not allow that level of peace for women at work (and elsewhere). From this patient experience, I recognized that we all have a responsibility to increase awareness and improve our culture. Though I have appreciated every attempt that team leads have made to address unwelcome statements, there is no guarantee that our teams are equipped to address similarly inappropriate conversations.
Serendipitously, soon after my (apparently shocking) patient encounter, fourth year medical students received training on microaggressions. The instructors explained that the effects of these situations could be cumulative and encouraged the group to be upstanders in such scenarios. A framework for navigating tough conversations was offered with a snazzy pneumonic: GRIT. The “G” for: gather your thoughts. In emotionally charged situations this may be key to articulating a concern. “R” for restate, thus allowing all parties to clarify what was said and heard. The “I” for inquire which should focus on the comment and the potential impact it has on individuals. And finally, “T” for talk it out—possibly the most challenging tasks for folks on a team.
In the past, I preferred to talk out these events with people I have strong relationships with, but that preference does not prevent such harmful language from occurring in the future. Furthermore, as a trainee it is difficult to command the attention that these comments deserve. That is why I am always grateful when team leaders make space to move past damaging words through thoughtful conversation.
Though it may cause some cognitive dissonance, take the time to talk it out. Being an upstander for a victim supports the whole team; it builds trust and ensures that everyone on the team is respected. Be that person who strives to improve the work and training environment. For the moment it may be tough, but in the long run it is worthwhile.
Josiane Joseph is a Haitian-American M.D.-Ph.D. student at Mayo Clinic. She is pursuing a career as an academic general surgeon. She was born in Miami, Florida and earned her B.S. at the University of Florida. During her free time she enjoys traveling, movies, writing, and learning about what makes other individuals unique. Josiane values discussions of meaningful issues and looks forward to sharing diverse views with others.
NPR site for first image: https://www.npr.org/2020/06/08/872371063/microaggressions-are-a-big-deal-how-to-talk-them-out-and-when-to-walk-away