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My inner monologue. Based on the overt and subliminal messages I am receiving every day at home, at work, in the media, on social media, in my dreams, in my nightmares, in the society that I am both a product of and a part of, all at the same time. A monologue that will not stop. A monologue that follows us, threatens us and defines us. A monologue that has the power to destroy us as women and as physicians. A monologue simply labeled, “but not like that.”
Be confident, but humble.
Be bold, empowered, fierce, but not like that.
Be exacting in your expectations, but kind.
Be forceful and intentional, but be nice.
Be here now at work, but don’t be selfish with your time.
Be, be, be…but not like that.
Be you, except not like that.
Be willing to push the boundaries, but professionally.
Be a perfect mother, but not right now.
Be a perfect employee, but your children miss you.
Be, be, be…but not like that.
So you dig in and you do the work that you are supposed to in order to be “better.” You do self-care, meditation, yoga, working out, therapy, even maybe taking medication to ease some of the pain of trying to do it, but not like that. And you think you are making progress. You are getting there. You feel your light shining. You feel your ship sailing. You are making it…and it is beautiful and wonderful and everything you imagined, and then someone says, but not like that.
And you come crashing down and immediately blame yourself, as does everyone else, because you shouldn’t need the approval or respect of others to be you. Look at you, so desperate for external validation. So in need of it, you are willing to go to extreme lengths to prove your worth to those you work with…how desperate are you? You should just know you are amazing and worthy and be confident in the person you are…but not like that. What are you, arrogant, entitled and self-righteous? What gives you the right to be you?
I’m sorry but is it any wonder so many women say “not like that” and leave medicine? We are born and raised in an environment that breeds “not like that” into those who identify as female. We are praised and validated in our dogged pursuit of greatness as students and trainees, and lamented for the same behavior as attendings. We are left with a constant thought within us, in front of us, beside us and behind us reminding us “not like that.”
And the worst part is that so many of us then turn and tell other females “not like that.” We perpetuate the fear and gender discrimination that ruins our ability to fly as both females and physicians. Myself included. I am not above calling myself out for my rabid dedication to some strict “not like that” mentoring. But what is even worse than this is when women mentors advise their mentees to watch their p’s and q’s and advise a break, or a transition, all the while they are utilizing the very “not like that” qualities that are needed to reach positions of power. Whether true or not, the appearance is demoralizing and disempowering for those junior women. Are we or are we not supposed to buy into the “not like that” behavior and expectations?
It’s up to us to decide the way forward. Continue the cycle of abuse or break it and show women physicians that we are absolutely, masterfully, and wonderfully suited to be in this profession. Emotions and passions and hormones and all of it included. Together, along with those men who are willing, we can create an environment where even thin skinned and fragile females (like myself) can flourish because these same attributes attune us to our team and patients’ needs. Our trauma history gives us the ability to read patterns easily and understand the emotions of others.
Our femaleness uniquely aligns us with the art and practice of medicine, anesthesiology and critical care. And there is no need for us to leave or break because there is no one there to say “not like that” at every turn . Instead with every passing moment we are saying, “just like that.”
About the Author
Nicole M. King, MD is a critical care anesthesiologist at the University of Cincinnati. She is currently getting her Executive Masters in Clinical Quality, Patient Safety and Leadership at Georgetown University. She has spent the past year battling COVID, fighting for innovation and advocacy in medicine, and trying to find her why while being a wife and mother. She is tired but committed to medicine and the future.