There was no coffee. That’s always a worry for me. Coffee is a good thing, a shared experience and a symbol of friendship and understanding. Perhaps it’s the most important sign of how any unplanned meeting is going to go with a senior colleague. If there is coffee, or tea then it’s probably going to be OK. If there are food, then fantastic, it’s going to be great news.
This was not a coffee day, just an instruction to attend a meeting at short notice with the head of service and the senior nurse. No coffee, no tea and definitely no food.
“Have a seat, there is something we need to talk to you about”.
Instantly my mind turns to all the patients I’ve seen in the last week, trying to remember those that went home, the febrile child who might have returned with meningococcal disease or the middle aged man with chest pain who might have come back in cardiac arrest. My heart skips a beat and my palms start to sweat. It’s obvious in my face that I know that something is deeply wrong and I can see that my inquisitors know that I am worried.
They know that I know and I can see them realize that I believe myself to guilty of some as yet unuttered clinical disaster. It’s not that I know what’s wrong, it’s just a lifetime of experience that tells me that meetings that start like this do not end well.
The chief speaks “I’ve asked XXXXXX to join me today as we need to talk to you about a matter that’s sensitive and difficult for us to discuss”, a pause and a short intake of breath as I await the judgement on whatever clinical disaster has ensued. It’s only a second or two between sentences but I’m already in an imaginary malpractice hearing with my career on the line. It’s stupid, but if you’ve worked in EM long enough you know exactly how this feels.
The next few words nearly knock me off the chair.
“We need to talk to you about your relationship with Dr YYYYYYYY (a senior resident in the department). Although it’s not directly our business we need to tell you that people are talking about your affair and we feel that you need to know that it is out in the open and inevitably others will find out. We need to talk to you so that we can manage this without disrupting the work of the department and to avoid any difficult conversations with you, or any other members of the team”.
A bombshell of competing emotions descends. On the one hand there is no clinical error. On the other, where the **** did that come from?
All concerns about patient care and malpractice evaporate in an instant, but what is this? There is no affair. I’m happily married and to be quite honest far too busy to try and ruin my really quite remarkable existence.
I deny it, but the evidence is presented. It has been noted that I have supported the trainee for several months. We have published papers together and I have helped prepare posters and conference presentations. We have presented workshops together and more recently have travelled to two conferences together. Photos exist of us at conference dinners and on social media. We have been seen to have an easy working relationship in the department and call each other by our first names. These behaviors have aroused suspicions and since the last conference the department has been awash with rumors that an affair is in progress. The implication that this relationship was a reward for my support was deeply implied. The implication that they felt I was using a position of power to gain personal reward was clear.
2+2+2+2=jackpot in the gossip world
The evidence is true as presented. I have supported this very bright and capable trainee. They have worked incredibly hard and have had their rewards in the form of co-writing papers, educational materials, workshops and yes, going to the same conferences, speaking at the same venues, attending the same events and yes, getting into the same social media photos that conference attendees end up in. What’s new? This happens all the time doesn’t it?
So what’s different about this conversation? I’ve co-authored many papers, spoke at lots of conferences and been a strong advocate of supporting trainees in pursuit of an academic career. That’s what we are supposed to do isn’t it?
The problem is the effect on what it can do to the support of colleagues.
Back in the room with my boss and the difficult conversation. I’m not quite sure what to make of it. I obviously deny everything, but the look back is one of ‘well that’s what you would say’. More denial from me and a request for the source of information, which is declined. We spin round in circles for 10 minutes or so until we end with the advice that ‘whether it’s true or not, you clearly need to be more careful’. I’d love to tell you that I retorted with something succinct and witty, but I did not, I was too scared that this would spread and true or not, the implications would be personally and professionally damaging. Indeed they were for some time.
Being accused of something that has the potential to do you reputational harm is not a good experience. When accused of having an unprofessional relationship with one of my junior docs I was upset, angry and bewildered. It had never happened before, despite me sponsoring a whole range of trainees in the past. The difference here was clear, it was because this trainee was female, pretty and confident. Difficult though it is for me to imagine the accusation is almost certainly based on a series of uncomfortable implications. “A senior male might sponsor a junior female for sexual favor”, or perhaps “ a junior trainee might use their sexual charm to entice the senior into giving them preferential treatment”. Of course such accusations could be made about a same sex relationship, it’s just that they usually aren’t.
Sadly, such accusations are based in more than just gossip. There are many stories out there on the unwelcome expectations of male seniors (1,2,3). More recently evidence was presented of routine sexual harassment by senior surgeons in Australia (4), and so we cannot simply dismiss the notion that such accusations are ridiculous. If a culture has adopted a culture where such relationships are normalized and expected it cannot then be unexpected when they surface in the social and connected world of emergency medicine.
Events like this frighten people, and they frightened me. It changed the way I dealt with the doctor, and changed the way I dealt with other female trainees. I was less inclined to offer them the same level of support at the risk of being accused again. It did not feel good, it did not feel fair, and ultimately it felt selfish and weak. I continued to support trainees but without the same vigor and effort as I had in the past. I would never meet a trainee alone, never be caught in a photo without others around, overtly make sure that everyone knows where and what you are doing. Subtle behavior changes, but all the result of a fear of future accusation and ‘a reputation’.
At the recent SMACC conference in Dublin I was really struck by a presentation by Resa Lewiss (5) who spoke on Leadership (not just for men). It’s a great talk and when it comes out I strongly urge you to listen . It has a feminist base logic, but everything in that talk is relevant to all genders. Listening to Resa I was struck by the ideas and differentiations between coaching, mentoring and sponsoring; something that we can all consider in supporting women (and men) in emergency medicine. It struck a chord with me as I think it’s something we can all do whenever we find ourselves in a position of influence or authority.
To be clear a sponsor is a senior leader or other person who uses their influence to help others obtain assignments, promotions, jobs and in health care the opportunities that drive career development and success.
I’m lucky enough to be one of those people. Time, and the SMACC talk have clarified why people with influence need to sponsor trainees irrespective of their gender or any other personal characteristics. Although there may be kickbacks, gossip and jealousy it does not matter. We need to offer support to everyone, taking on that sponsor role can make an enormous difference and it’s a responsibility of those in senior positions to pay their success forward.
So, what’s the point of this story on the FeminEM blog? Well, I’ve wondered that myself. In retrospect the experience was challenging and interesting. It stopped me form being a good sponsor for longer than my trainees deserved and it changed my behaviors in ways that were not helpful to anyone. I absolutely do not want sympathy or empathy for this experience, but I do want potential sponsors to understand that there are risks, albeit transient ones in acting in a very overtly positive way towards bright and capable female trainees.
Perhaps some men would take a different view. Might they be flattered to be accused? I’m sure that’s possible, but it just perpetuates the view that sex and sponsorship make seedy bedfellows and we must counter such gossip when we encounter it.
I’m in a better place now. I know who started the rumors and how far they went (a very long way as it happens), but that’s in the past. I really no longer care what people think of my sponsorship of women or men and I’m proud to have opened doors for many of them. The accusations of inappropriate relationships still crop up from time to time, the subtle off the hand remarks, ‘I can see why you offered to write a paper with her’ sort of comments. Not quite the locker room talk of Mr Donald Trump, but a similar implication that bad behavior is OK. I correct it when I hear it, but I know it still goes on.
No sympathy then, just a plea to trainers to actively sponsor trainees regardless of who they are, or what people might say. It’s also a caution for those tempted to gossip; don’t presume that professional support relationships are anything more than that, you might just stop someone else getting the support they need. It might even be you.