Editor’s Note: This account describes the self-injurious side of silence.
As I mentally prepared for my residency, I was aware that I might experience sexual harassment from my instructors. As a PGY I and II, I wasn’t prepared for it coming from a senior orthopaedic resident.
My trauma chief wanted to go out with me. I was unsure how to respond. In my opinion, “it would not look right.” My ambivalence may have led him to feel I was leading him on. In retaliation, he spread stories about me and even told classmates not to treat me kindly. It made my second year of residency very difficult, and I found it hard to focus. I wondered what I had done wrong.
In medical school I was treated like a “golden child” and never had reason to doubt my abilities. We as students were treated well and “coddled” to some extent. I was doubly shocked when I entered a residency program with a profoundly different atmosphere. Harassment was present along with a strong message not to complain. The “keep quiet about transgressions” part was true for both the women and men in the program.
My sense of self was shaken by the harassment and its repercussions. Finally, when I threatened to report it to the program director, my chief let up. Despite the change, there were still effects on how I saw myself and how the program viewed me.
In retrospect, reporting it would have been the best strategy. I later came to know the program director was really an ally. This experience taught me how pernicious silence can be. At the end of the residency program, another female shared that she had a similar experience with one of the seniors and did not speak about it. It appears that within the program there was a “generational shift”. The older male residents were those who felt no qualms about harassment whereas the young men who were our co-equals had a different mindset and would not treat women that way.
I did not have a female mentor in medical school, and I never felt the need for one. The male instructors were great and provided guidance when needed. I had my first female attending during residency and even then, did not tell her about how the harassment I was experiencing was tainting my training. Had I spoken up, I am convinced that she would have taken forceful action on my behalf. Today, I am pleased to say she is a valued colleague.
My residency experiences color how I conduct my own clinical and academic practice. The “Me Too” movement has also influenced my thinking. Here is what I have learned:
• Sometimes female patients need to speak to a female physician, the same can be true for male patients needing male physicians. We must be sensitive to this possibility.
• We can all be allies instead of adversaries.
• If a resident has a change in demeanor or performance, be curious and seek to find out what is happening with them. Be empathetic.
• Try to project an aura of someone female and male residents can talk to about important issues.
• Orthopaedic culture is changing. My current chairman and others will undoubtedly not stand for harassment in any form once they are aware of it. Speak up, tell someone rather than further injure yourself with silence.
• Be aware of power differentials in relationships. If you are seeking to date someone at work, engage in self-interrogation. If they are a subordinate, does the person being pursued give consent or not? Do they even know how? Think carefully about these issues.