I consciously made the decision this week to disconnect from work and to focus on my own internal reflection, on my “Why” and what drives me – as a physician, a leader, a woman, a wife, a daughter, a sister, a fur-mommy, and a human being.

I reflected on my own story, of why I am so driven – I should really confess, why I am “On Fire!” – to lift up and empower all women. I have shared with many of you my experience of being near-suicidal and my severe burnout from my job as a pediatric hematologist/oncologist last year. I have shared my experience of hitting rock bottom, and of contemplating leaving medicine altogether after a period of tremendous collective and personal hardship at work.

After returning to work last fall, slowly and apprehensively, the turning point for me came when I reconnected by chance with a classmate from Brown Medical School. She shared what has been the most pivotal experience in her life and career since we had last seen each other over 5 years ago. She told me about how she had encountered severe backlash as a young woman physician, how she had been written up and reported to HR by her medical assistant, also a young woman, who reported that she was difficult to work with and a “monster,” and how she had been placed on a performance plan by her organization. She also told me that when she connected with our other female physicians friends, they shared similar experiences.

What blew me away was that I knew all of these women so well, and I knew without a doubt that these complaints could not have been further from the truth. These were incredibly kind human beings, friends, mothers, and physicians. How anyone could ever think of any of these women as “monsters” was bewildering – and yet it was an experience they all had in common.

Or, I should say, it was an experience we all had in common. I too had experienced similar backlash that had left me shaken, unsure whether being a woman physician was worth it. It had come as a shock. As I have shared with many of you, I grew up and went through all my years of education and training somehow oblivious to the “double bind” that so many women in positions of leadership and higher education face: the fact that, as has now been well-researched and widely reported, the window of acceptable behavior for a woman is vanishingly small. Be too assertive and directive, and risk being labeled a “bitch.” Be too passive and timid, and risk being trampled.

I think I had been so unaware of the “double bind” because I likely never seemed like much of a threat to anyone, having been a very shy and soft-spoken, hard-working, compliant, and obedient child, teenager, college student, medical student, intern, resident, and fellow. It was not until I became a new, young female attending physician in my mid-30s, learning how to be assertive in a way that felt true to who I was as a highly educated, accomplished, talented, and well-trained physician, that suddenly I too experienced the “double bind” and backlash. I too received little grace when I was stressed or under extreme pressure. My words, actions, and behaviors were labeled as “mean, condescending, sharp and rude” by female staff – I was “a bitch.” Sadly, I knew that the exact same behavior by a man in the same situation would not have been met with similar criticism or judgment.

The feedback was crushing for me; the fact that anyone could ever perceive me this way brought on overwhelming feelings of shame and self-doubt that are difficult for me to describe. This was the opposite of who I am, the opposite of the kind of human being I aspire and strive to be in the service of others. I struggled with these feelings of overwhelming shame, guilt, and self-doubt to the point that I over-delivered, over-pleased and overworked myself into a deep chasm of suicidal ideation and severe burnout.

In connecting with other women physicians through our incredible community, and in reconnecting with women physicians and classmates from all phases of my life, I have discovered that my experience was not unique. In fact, my experience has been shared to at least some extent by almost all of my friends and colleagues.

I have reflected deeply, for months now, about why this is the case. Why has this been such a struggle for so many of us, regardless of our role or position? Why have we struggled to be taken seriously – not only by older male colleagues, division chiefs, and C-suite executives, but by other women?

What I have come to realize is that this backlash from other women comes from a place of disempowerment, of women not feeling that they have influence or a voice, of women feeling small and not valued. I understood this, because I too knew the feeling of not feeling valued, of not having a voice, and of feeling small and invisible. I found that instead of feeling hurt or anger, I was filled only with love and compassion for these other women. I understood that they may not have had opportunities or the encouragement of others, that they themselves may have felt limited in their own lives, education, and careers. I understood that our antiquated culture of medicine has not yet adapted to the new reality that women now comprise more than 50% of medical students in our country, and that the old, hierarchal power-distanced culture of medicine with the male physician/surgeon as “God” and female staff as subordinate not only no longer serves us as an industry, but is detrimental to our survival as an industry.

I am driven to help all of us as women, in any way I possibly can, because I know that our experience – as all women, regardless of our title or position – while frustrating, degrading and demoralizing at times, is still exponentially better than that of our mothers and grandmothers and great-grandmothers before us. Fifty years ago, women could only dream about becoming physicians, lawyers, executives, or CEOs. And yet we still have so far to go. Even though women make up more than 75% of the workforce in healthcare, we make up less than 15% of division chairs or leaders in the C-suite (Weber, Wall Street Journal Oct 2019). Even though women now make up more than 50% of medical students in our country, 40% of women physicians choose to go part-time or leave medicine altogether within the first 6 years of finishing their training (Paturel, Association of American Medical Colleges Oct 2019). This staggering attrition is the same in nursing, with almost one in five newly-licensed RNs (17%) leaving their first job within the first year, and one in three (33%) leaving within two years (Policy, Politics and Nursing Practice 2014).

When I see all of the bright, talented, incredible young women coming up behind us, I am that much more motivated to make this world better for them, as the generations before us have done for us. We owe it to them, and to ourselves.

My medical school friend who I reconnected with last fall shared a story that resonated with me and is at the core of what drives me today and every day. She told me about her darling little daughter, who loves to dress up in her mother’s White Coat, heels, and stethoscope and proudly proclaim to everyone, “I’m going to be a doctor when I grow up!” And my friend told me that the first time this happened, her gut instinct was to tell her proud, bright, spunky young daughter, “Don’t do it. It’s not worth it.”

My friend’s gut reaction was a sucker punch to my gut. How can we have come so far, and yet still have so far to go? How can our gut reaction to a young girl twirling in a White Coat be “don’t do it, it’s not worth it?” We cannot let our own experience be the experience of our daughters or granddaughters. We have to do better.

It is my dream, like a fire in my belly, that we as women and human beings ALL support, empower, and lift each other up. It is my dream that we create a world together – regardless of our role, position, title or gender – where little girls do not struggle the way we have. That with each generation we make this world a better, more loving, kinder, more thriving one for the next generation, as the women before us have done for us. That together we build a world where we no longer need “Pussy Hats” or #MeToo, or women’s empowerment movements.

What will be our legacy for our daughters and granddaughters together?

With love and gratitude for you all,
Tammie

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