On perceptions of female physicians: from planes to preschools.

I recently read on kevinmd.com the accounts of women physicians who attempted to help passengers in air flight emergencies and were incredulously pushed aside and not allowed to provide emergency care.

Yes, you read that correctly.  Physicians blocked from providing emergency medical care because the flight attendants didn’t believe they were physicians — we can only assume based on their appearance…

Astoria-Megler Bridge, stretching over the mouth of the Columbia River

Astoria-Megler Bridge, stretching over the mouth of the Columbia River

I’ve been since reflecting on some of my own past experiences to do with perceptions.

I was 31 and a first-year oncology fellow.  My husband and I were on vacation with our then toddler-age daughter.  The overhead speaker put forth words that I had hoped to never hear on a flight — “If there is a physician on board will you please identify yourself to the crew.”

I pressed the overhead call light.

A flight attendant rushed up the aisle, saw my call light on, and … shot me a dirty look and kept walking.

Yes, I thought, I am selfishly ringing my call light for personal requests right after you announced the need for medical help.  Because any woman with a young child couldn’t possibly be a doctor.  But since I was worried that someone on the flight might truly need medical attention, I got out of my seat and chased her up the aisle. When I identified myself as a physician, I did not receive the abhorrent treatment as did the physicians on these posts, but there was definite doubt in her eyes, and a pause as she looked me up and down in the way only women can do to make each other feel small, before she took me to the person in need.

Thankfully it was not a life-threatening emergency.  After assessing the patient, I was put in touch by air phone with an emergency medicine physician on the ground.  I was glad to have the back-up in deciding not to ground the flight.  There was a nurse on-board who offered to sit with the woman for the duration of the flight.  I returned to my seat (where, I must say, my daughter was behaving absolutely perfectly and charming the other passengers).

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I was never thanked or acknowledged for my service.  I joked to my husband that I wasn’t even offered the oft heard-of free glass of wine.

Lewis and Clark Tree, Long Beach, WA, imposing against the summer sky

Lewis and Clark Tree, Long Beach, WA, imposing against the summer sky

Flash-forward 11 years:

A little over a year ago, I had the opportunity to participate in my first press conference, to do with the plans for our new cancer center.  It was incorporated into the beginning of a fund-raising gala which was a formal event, so I was dressed for the occasion — evening dress, heels, and hair and makeup done.  The medical panel for the press conference consisted of an academic dean, a hospital president, a hospital vice-president, a hospital CEO, and myself, the medical director of the cancer center.  They were all men besides myself.  I was seated at the end of the table.  I was nervous, but felt I did a decent job at answering the questions that came my way.

The next day, I was excited to see the article in the paper.  It was a favorable, well-written article, in which I was even quoted.  But the photograph was a shock to me, as it was only of the men, and I was cropped out of it.  I do not know if the photographer only included the 4 men when he took the photo, or if the photo could have originally included me and then someone on the editorial team at the newspaper cropped it so I was no longer in view.

How strategic of them, I thought, to have seated me at the end of the table, so I could easily be left out of the picture, as the only woman.

I was perplexed and insulted.  Was it because I was a woman?  Was it because I was dressed for a formal evening gala and not in “doctor clothes”?

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I recently read something that explained this experience in a way far better than I have ever been able to, and so I would like to quote it here.  It is a passage from a wonderful short book by the writer Chimamanda Ngozi Adichie, in which she turned a letter to a friend on advice on raising a daughter into an insightful book, called “Dear Ijeawele, or A Feminist Manifesto in Fifteen Suggestions.”

…men’s grooming is never suspect in the way women’s grooming is — a well-dressed man does not worry that, because he is dressed well, certain assumptions might be made about his intelligence, his ability, or his seriousness.  A woman, on the other hand, is always aware of how a bright lipstick or a carefully-put-together outfit might very well make others assume her to be frivolous.

How does this contrast with how we are perceived in the non-professional side of our lives?

crowd of sea lions on Astoria docks

crowd of sea lions on Astoria docks

Many of us women physicians have had our children in our 30s or even early 40s, thus we are older than many of our non-physician mom peers.

Although I have been told I “look young to be a physician” more times than I can count, I was served an age reality check by a 4-year-old — a boy at my youngest son’s preschool — when he asked me sweetly if I was my son’s grandmother (I was 41).

It feels like we just can’t win at this perception game.  We don’t want to look too young or we won’t be perceived as the professionals we are, but careful — if we focus too long on our careers before starting a family, we will be closer in age to our kids’ friends’ grandparents than their parents!

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Now, at age 43 (as of posting this), the comments from my patients of “you look very young to be a physician,” are less and less frequent, so that my current response is a wide smile and gracious, “Thank you, I don’t hear that as much as I used to.”

I don’t bemoan wrinkles and the finding of gray hairs.  At least, I think, I will “look like” a physician — whatever that means.  But for my young kids, I want to look like “the other moms” – which is harder and harder to do the older I get.  43 is not the new 28 (at least not without Botox and a celebrity trainer — of which I have neither).

rainbow shining on Astoria-Megler Bridge

rainbow shining on Astoria-Megler Bridge

I am much inspired by the new generation of women physicians I see entering practice.  They seem to be above this perception game.

Recently, at a return clinic visit, one of my patients, an older woman, raved on and on about her surgeon, a woman, not only about her surgical skill and bedside manner, but her appearance — the patient went into detailed description of the surgeon’s fashionable dress and heels.

“And so young!” she described her,  not with criticism, but admiration.

I have hope that this new generation of young women physicians will continue to change the general public perception of what a physician “should” look like.

Maybe someday a male physician with gray hair will be demanded to produce his credentials in an air flight emergency.

For looking too old.

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