As of this writing, I am almost 50 years old.  Born in 1967, to a woman ahead of her time and a man who realized that strong women make life better, I grew up in a household where there were never any limits placed on my potential.  At age 4 or 5, I sat in my mom’s lap as we read a book about what kind of jobs exist in the world.  She posed the question, as parents do, “What do you want to be when you grow up?”  I said, “Well, I suppose I’ll be a teacher or a nurse.  I’m a girl, what else could I be?”

She threw that book across the room, and then in the trash.  Our lives changed.  She became vigilant about the messages I was getting from media.  Ms. Magazine was delivered to our house.  My mom took a leadership role in our home state to ratify the Equal Rights Amendment in North Dakota. She became more dedicated to advancing in her career, ultimately getting her PhD at Stanford.  She and my dad divorced.  All of this completed before I was 11.  Ultimately, she had a long career as a university president and still works as an education and governing board consultant.

My point is that I have had outstanding feminist role-modeling, and consider myself a life-long feminist, even when being a feminist wasn’t cool and I was embarrassed to say it out loud.  (And, yes, I am embarrassed to admit that.)  I recognize the problems with the feminist movement and I do my best to increase my awareness, understanding, and advocacy around the details of those problems.  If I am honest, though, probably my biggest personal take-home message from witnessing the feminist fight was “nobody can tell me what to do.”

As a conflict-avoidant person, this take-home can be challenging to enact. It has, however, made me more creative in finding ways to get people to see my side of an argument before the argument happens. I ask for what I want because if you don’t ask you never know.  (I got into my medical school by asking the dean to reconsider whether I fit their definition of an in-state resident.) This outlook has led me to take on things that I am interested in when I have no idea if I will succeed.  It led me to play on the US Women’s Rugby Team while in medical school and residency.  With all of this said, I still tend to be a little worried about what others think of me, all in the name of avoiding conflict.  Ugh.

As I have taken on more leadership roles, currently as a residency program director, I reassess my skills and weaknesses, hoping that they align with what is required for the task, and trying to build my toolbox with each new experience.  I enjoy gaining new skills and have learned so much from the wise people I have met along the way.  During our recent residency recruiting season, our residents and I made an active effort to recognize our own implicit biases.  I believe we have grown.

Recently, I had an experience that took me back to the girl sitting on her mom’s lap and made me wonder if I have really learned anything at all.  Or, rather, whether we spend our lives continually relearning the lessons that we thought we had already learned.

I work with a great professional organization and was honored recently to take a leadership role at a national conference.  This group is filled with people who I do not think, for one minute, perceive me negatively based on my gender.  Overall, I think emergency medicine breeds people who really appreciate others for their intrinsic qualities and not based on stereotypes or preconceived notions.

So, I was really surprised to find, as I reviewed slides submitted in advance of a conference, that a presenter referred to female graduates of medical school as “girls”.

Language is so interesting.  I will not spend time dissecting the nuances of the word “girl” and the contexts in which that use might be funny, ironic, endearing, offensive, or appropriate.

My first reaction in reading the word on the slide was to physically flinch, and then look for contextual clues that would soften that blow.  I read through the slides and did not feel any reassurance.  I was disheartened that the author seemed to be a male, younger than me.  I flashed back to my implicit bias training and gave the author benefit of the doubt.  And, though I was fully empowered in this instance to do something about the slide, or to educate the author, I blew it off.   I disregarded my reaction.  I did not even really think twice about it.  I allowed the slides to go forward for presentation at a national conference.

A couple of weeks later, another Woman in Charge (WIC #2) called.  She had reviewed the slides herself and wondered about my reaction.  She had a very similar reaction to the slides.  We talked about it and I realized several things.

First, the word “girl” in this context threatened to be offensive to many in the audience.

Second, I dismissed my own entirely valid reaction to this use of the word “girl” as being too sensitive.

Third, I abdicated my responsibility to others as a leader of a national conference to raise this issue myself.

Fourth, I missed an opportunity to engage someone who is an educator and has the opportunity to affect the narrative with his own trainees.

Fifth, I was willing to let the implicit stereotype presented in the slides roll out, potentially reinforcing this stereotype nationally.

Fortunately, we (and a WIC #3, who had also reviewed the slides, had the same reaction, and remained silent, as I had) had one of the most valuable discussions around this issue that I have ever had.  The lessons are many, but in this instance, what is most important is that we took action.

We reached out to the author, discussed the word, the context, implicit bias, and the opportunity to change the narrative around women in society.  He was receptive to having his awareness raised, learned something about himself and who he hopes to be, and happily changed his slides and took the lesson home.  End of discussion.  It was that easy.

So what do I say to my 4-year-old self?  What did I learn?  What can I teach her?

Conflict avoidance does not serve well.  I know this.  I KNOW this.

I did not have the courage to raise an issue that bothered me without prompting and a multi-person validation of my perspective. That is embarrassing, disappointing, and I am writing about it so I can publicly hold myself accountable for being better in the future.

I have an implicit bias against my own group.  Me—the residency program director in a very egalitarian program who strives to understand privilege and combat inequity, daughter of a feminist fighter who dedicated her parenting to making sure I know my worth has nothing to do with my gender.  Intellectually, of course I know that gender has no bearing in job performance, but the steep of the cultural tea is strong enough to leach out my own ability to recognize and respond when it is happening, even when I am doing it to myself.

It is likely that I censor and undermine myself without ever realizing it.  I am hard-working and kind and smart enough to grow up to be a doctor—and even in the face of those facts I devalue my own opinion to the point that I keep silent.  I need to hold myself accountable for expressing my own reactions, opinions, and desires.  They have value because they are mine, not in spite of being mine.  My one-person point of view can educate.  I do not need the validation of several other people to allow me to feel comfortable expressing my opinion.

Community is a treasure—our colleagues can hold us to a higher bar, inspire us to do exceed it, and give us the support needed to do something uncomfortable.  I learned that it should not be necessary to rely on this prompting—that it is painful to let oneself down.  But, also, that failing and trying again are sometimes the only way forward and it is good to have a team to support that process.

I learned that being a Woman in Charge carries the responsibility that I make myself speak up, especially when it is uncomfortable.  I imagine I have the company of others who have kept silent because they are accustomed to disregarding their own opinion.  We all deserve to be heard—let that be an operating principle.   People may disagree with your opinion, but don’t be discouraged.  At least give them the chance to hear you.  Don’t silence yourself.  Your inner 4-year-old is watching.