Editor’s Note: A method of resident-devised direct feedback about macroaggressions used prior to social media.

Today, groups such as SpeakUpOrtho, WomenofOrthopaedics, inspire.ortho, and others are shedding light on the macro and microaggressions experienced by women and other minority groups who practice orthopaedic surgery. This account from four decades ago, describes another more primitive method of providing direct feedback to those engaged in these offenses.

Back then, to learn modern fracture fixation, it was necessary to leave the country for instruction. The week-long courses, held in a picturesque European setting, were open to orthopaedists and residents from around the world. During my week, four other female residents attended from the United States. None of us knew each other previously but I fondly remember each one of them after this unifying experience. One of the women became a lifelong friend and confidant.

During the lecture and lab sessions, we heard from an international panel of speakers. The humor shared during their lectures may have reflected their own individual cultures. The most memorable speaker was a man from a well-known island nation who included a number of photos of semi-clothed and nude women among his slides. The five American female residents represented less than 2% of the course participants. Our presence did not seem to faze him or encourage him to temper his slides or remarks. His multiple lectures were scattered throughout the week, so we experienced quite a large dose of his tiresome and offensive humor. What he probably never knew was that his sessions helped forge a camaraderie among us early in our training years.

The course culminated in a lovely banquet in the large auditorium where our classes were held. The cocktail hour and dinner were followed by live music and dancing. We five decided that “Dr X” had earned some feedback for subjecting us to his humor and attitudes over the course of the week. Each of us asked him to dance. During our dance sessions, we shared our personal responses to his slides and commentary. When one appeared to be finished, the next of us cut in and delivered their own comments. I dare say it was a stunningly long dance for the good doctor. Whether it made any difference to him going forward is uncertain, but it did each of us some good. We used humor to express our feelings but made strong points just the same. If he is still alive, I hope he remembers that evening.  I suspect we all do.