The NEJM letter to the young female physician, and some thoughts of my own

I decided to start a pinterest group board for pinning articles and images about empowerment of female physicians, the facts of mom doc life, and inspiration for women in medicine.  I created the thing and then went on to search for applicable pins, and would you believe it (she says sarcastically, because YES you would believe it), there is nothing?!  If you search for women in medicine, you get a shit ton of stuff for and about the awesomeness of nurses (nurses are apparently legitimately good at PR, and we need to take lessons).  If you search for female physicians, or girl docs, or woman doctors, what you get is a 1001 pins on the amazing new female Dr Who, which is amazing for all you nerds out there, but not quite what I meant.  There were a few pins about medical schools tips, and even a girl who constantly pins about what clothes she wears under her short student white coat, which is, you know, sure, her choice and if it tickles her pickle, why not. And I invited her.

But where are all the amazing articles and Inspirational pins dedicated to the life and times of the female doctor?  Is it because we are too busy doing all the other shit we need to get done to be writing, AND promoting, AND pinning?  Or is there just no stuff being written by, about, or for female doctors?   I turned to google, and actually found a few on Kevin MD, Medscape, and NEJM.  But they didn’t have pinnable images.  What a bummer.  I thought I’d make some.

letter (2).png

http://www.nejm.org/doi/full/10.1056/NEJMp1702010

This letter to the young female physician by Dr Suzanne Koven was one of the first things I came across, and I found it very relevant.  I wish someone had written me a letter when I was young and dumb and entering internship.  It may have served as a warning of some sort. I mean, I was clueless about what lay ahead. I may have had an inkling about the ambivalence I would feel about work-life balance, though I called it “lifestyle” back in the day, and it was less about children and more about sleeping in and staying out.  But I had no idea about the sexism I would encounter eventually, or the double standards that exist and would become the bane of my existence.

She touches upon impostor syndrome, which is an integral part of my daily routine, seeing as how I shake in my clogs every time the phone rings because I just KNOW I’m in trouble b/c someone finally figured out that I have no idea what the heck I’m doing.  She discusses ways in which we seek validation and prove our worth, and talks about all the secondary  measures with which we gauge our success and our value, like knowledge of minutia and speed with which you can perform a menial procedure.  These are nothing but secondary measures, and yet they seem to weigh so much…

She urges the young female doctor to realize that she is a “a flawed and unique human being, with excellent training and an admirable sense of purpose.”  And that “[her] training and sense of purpose will serve [her] well.”   Can’t really disagree with that.

Some advice I would add to all of this, for any woman entering into medicine, is…

1. Do not put your own life on too far of a back burner.

A little bit on the back burner maybe, in training, to make it easier for yourself, but only to make it easier for YOURSELF, and not because someone else tells you to.  And don’t put it too far back so you forget all about it.  Remember, after all this is over, you still have to be you somehow.

2.  Don’t sacrifice your biological clock if you don’t want to.

The fact is, it’s different for us girls.  I’d like to fight for equality, but unless we turn into seahorses, things are not equal as far as what men and women do on this earth, if even physiologically.  Thanks to the amazing women who have paved the way, we now can expect to have a family and a career in some shape or form, without being rejected outright.  How to do or when to do it,  is a different matter.  And in medicine we are always looking to “what’s next?”  After pre med it’s med school, and after that it’s internship, then residency, and after that maybe fellowship, then you’re looking for tenure or waiting till you’re a partner…  It’s good to plan ahead, but you know what comes with endless planning?  Infertility.  And IVF.  If you want children, don’t delay them for the sake of this whole medicine business.  There comes a point when no further f*cks can be given.

3. Don’t sacrifice your career if you don’t want to.

On the other hand, don’t give up what you want professionally either.  People will sometimes tell it to your face, and sometimes whisper behind your back: “How hard is she gonna work REALLY now that she’s married…pregnant…has kids… has a vagina…”  The answer is as hard as you f*ucking want and can, and no one needs to be making assumptions without asking what you want, and giving you a chance.  What I’m saying is basically, don’t let anyone pigeon hole you into some idea they have of what your life should be, either professionally or at home.

4.  Try to internalize that you have nothing to prove.

On the third hand, my previous two points are not meant to be admonishments that if you can’t do it all, you fail.  I advise you to realize that the elusive “having it all” everyone talks about depends very much on what “it all” means to you.   And it should only matter what it means to you.  I struggle with this constantly, as I have a competitive streak I didn’t even know I had.  I didn’t start out as a type A personality but I have had to become one in the process of becoming a doctor, and this adds to my impostor syndrome, and makes me feel like I have something to prove.  It’s torturous.  Just don’t.  Your only reference point for comparison is you, and no one else.  So, if you feel you mustn’t outsource house help b/c you have something to prove as a mother or woman – stop it.  And, if you feel you must do research and publish and do extra fellowship, or even simpler, if you feel you must work till you’re in labor or through recommended bedrest because you have to prove that as a woman doctor you can – stop it.  NO ONE will give you hero points.  You shouldn’t have anything to prove.

5.  Live and let live

Chances are it will take a long time for you to figure things out and that’s fine. Once you do, remember that what’s right for you isn’t necessarily for everyone.  Nora Ephron said in some of her writing that the constant subtext in feminist rhetoric is that yes, sure, it’s all about choices, but that obviously the only right choice is mine.  Let go of that.  It’s hard, but work on it.  SO what if your friend left her medical career to be a stay at home mom after all that.  It feels like waste to you?  So, you won’t do it!  She did, and great.  So what that another friend has 8 nannies so she can do 8 jobs and be an administrative leader.  Stop judging.  Everyone is doing exactly the same thing you are: their best in the way that works for them.  Let people do their thing as you do yours.

Good luck, young female doctor and I promise to try to make it easier for you like others made it for me.

3 thoughts on “The NEJM letter to the young female physician, and some thoughts of my own

  1. Excellent points all, and absolutely true. I have lived through all of them. If we don’t find a way to make this whole being a doctor thing something we can live with, we will continue to loose 450 docs a year to suicide and more will retire early or change careers. The first step does need to be supporting each other in our choices and not judging. Good luck from a doc who will be retiring early.

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