“Cheeky”

I remember the first time I experienced sexism in the workplace. I thought it was my fault.

You may write me down in history with your bitter, twisted lies.

I have never bothered to talk about it outside of my circle of family and a few close friends. But this week, two things happened: AOC breathed fire on the floor of the House, and an article so sexist you could smell the muck through the computer screen was published in a medical journal like it was actual. medical. literature. Titled “Prevalence of unprofessional social media content among young vascular surgeons” and authored (of course) by male vascular surgery residents, it involved these same residents creating fake online profiles to “investigate” (read: creep on) their female colleagues’ photos. At first, I thought to myself, unprofessional… like, butt drunk? Committing vandalism? A particularly disgusting hotdog eating contest? None of the above. Nope, turns out these greasy-haired self-righteous sleaze balls defined “unprofessional” as wearing a swimsuit… while going swimming.

And so it took me back. I started thinking about my internal medicine rotation in medical school – 10 weeks of grueling hours, a lot of stairs, and scut work galore. I worked my butt off. I know, because my clinically depressed self did not do so with my other rotations (a story for another time, or perhaps a journal article: The effects of the toxic culture of medicine on mental health). But for IM, I pushed. Internal medicine was my future, and I was determined to get an A. I put everything else aside, and as desperate as I felt on the inside, I put on one hell of a show and did the work (to be clear, I do not advocate for this). In the end, with a three-part grading system where one received either a Fail, Pass, or Honors, I wound up with a “Pass.”

I stared at the word, monosyllabic and not a little pathetic, dumbfounded. I had pulled liters of ascites off of a patient’s belly until 10pm with a fellow student, my resident nowhere to be found (against the rules, which no one follows). I had listened to my attending drone on about something completely irrelevant before finally starting rounds on my patients, distributed all over an 11-story hospital, also around 9-10pm. I had written a 15-page case report on thyroid storm that earned an excellent grade (from the same attending). I studied nonstop, and complained not once. Not only did I work, I KNEW what I was doing, which would later be reaffirmed when a different (female) attending told me I had the exam skills of a resident.

If this was Pass, what would I have to do for an Honors? Give up my firstborn? Turns out I was close – for this particular attending, I’d probably have to give up my vagina.

When I went in to speak with (read: confront) him about my grade and what more I could have possibly done to earn an Honors, the man did not have an answer. I mentioned the time I had put in, the grade that HE had given me on the case report, the utter lack of feedback during the rotation that could have helped me improve. In the end, this was the sorry excuse of an explanation I got: “You walked in front of us on rounds. It was…cheeky.”

Cheeky.

It’s not the word itself that bothers me. I can be at times, among many other things, cheeky. But coming from an older male attending in a position of power who was holding – it felt like – my future in his hands… all of my work, time, literal sweat and tears I had put into that rotation were reduced to this one word. Cheeky. The fact that I had walked in front of him on rounds (never mind that he was old and I would have had to take a single step for three of his in order to stay behind him) had effectively disappeared all of it. Like Mundungus Fletcher in a crisis. Poof.

Does my sassiness upset you? Did you want to see me broken?

When I brought this up with the rotation director, a younger, more reasonable man who was a great teacher and doctor, I was met with another gem: “Oh, him. He’s just like that. Don’t worry about it. It won’t affect your grade.” So it was that my supposed advocate, who should have reported the incident as an offensive interaction, placated me with an assurance that I would have my grade, just leave it be. It is what it is. My 20-something self was too inexperienced to know where to go next. So I buried it.

The following year, I struggled to coordinate rotations with my home school and my new husband’s home city of Buffalo, so that I could spend a meager few weeks with him after we were married. I called – as in literally a single phone call – to find out about the status of my away rotation application, and the woman on the other end who I can only imagine was going through a terrible divorce or her dog’s death, told me that I was being rude and needed to sit and wait and accept whatever decision came, and that I was NOT to call back. In tears, I called the associate dean – a woman, and another supposed advocate – for reassurance, guidance, just maybe some advocacy. I was told that this was my problem: “I have said it all along, you are just. too. aggressive.”  She lamented that I had likely screwed it up, and I would have to settle for whatever bone was thrown my way.

Does my haughtiness offend you? Don’t you take it awful hard.

It is human nature to begin to doubt yourself when you are knocked down repeatedly – your thought process, your logic, your sanity. Thankfully, as a good friend and colleague used to say, they couldn’t stop the clock, and before I transformed into an unrecognizable doormat, I graduated. It would take me a few years still to figure out what had happened, but I knew not to let whatever it was happen again. I chose a brand new community residency program, although with my USMLE scores and the name of my medical school (ironic) on my resume, I would have been accepted anywhere. But I knew that if I had to sacrifice my mental health and self-esteem for my education again, I would not be worth anything as a doctor.

Some of this was, unfortunately, medical school. But most of it was being a woman. I would bet my degree that, ceteris paribus, a male student would not have in a million years been called “cheeky.” He would not have been dismissed if he brought up an actual offense with someone in charge. And he would NOT have been called “aggressive,” because only women are aggressive. Men…well, they’re in charge. They set the standards, and let’s face it: If Desi Muslims’ thought processes are still colonized (see last blog post), then there are plenty of women of every color brainwashed enough to uphold these same asinine standards.

Equality is not a perk. It is not a fancy addition to an otherwise acceptable system. It is a basic right without which the ship cannot sail. It’s like having to pay extra for the steering wheel. But for argument’s sake, let’s say that it is something to be earned (it is not).  Well, she can’t earn equality with an MD. She can’t earn it by being elected a Congresswoman. So what price, please, does a woman have to pay to be taken seriously?

I guess it’s the price of being called a “bitch” for demanding a steering wheel. I was called the same (he didn’t know I heard) when talking to a physician’s assistant who had with laughable supervision effectively caused my patient to overdose on opiates and land in the ICU with an MI. It’s probably what the ER colleague who thought he could dismiss my emergent handoff as a level 4 thought, after I called him to demand respect in no uncertain terms for my clinical assessment and, more importantly, the patient’s life. And I’m sure that’s what my internal medicine attending meant by “cheeky.”

I will say it until I’m blue in the face or it becomes law, whichever comes first: Whether a woman wears a bikini or a headscarf is irrelevant to her worth. We do not earn the right to equality or the right to be respected. Rights are unalienable, endowed by our Creator. They are debts owed to we who are simultaneously too much and not enough: Why are you so covered? Don’t show so much skin. You’re drinking is unprofessional. You’re so uptight, have a drink and loosen up a little! You talk too much. You should be more assertive! Dress down. Dress up. Have kids. Have a career. Stay at home. Look sexy. What a slut.

Breaking free from this nonsense looks different for every woman. For me, it was putting on the hijab. It reminds me that I answer only to my Creator, the Giver of my rights, Al-Adl, The Just. I made a conscious decision to reclaim my life and my identity as whatever kind of woman I wanted to be. And when my patient asked me a few months ago whether my husband had forced me to wear the headscarf, I was able to laugh – genuinely – and tell the truth: that he didn’t even know I had put it on until I came home from work that day.

You may trod me in the very dirt. But still, like dust, I’ll rise.

AOC, those female vascular surgeons in the “medical” study…make no mistake. They – we – have more skill in a single pinky finger than the bullies who instigate this garbage. And we will, despite everything, rise.