Play Fair
Sports can provide valuable lessons for
medicine or be a vehicle
for exclusion. This physician cautions: Don’t let the wrong kind of
sports talk create a toxic environment for females on the medical team.
for exclusion. This physician cautions: Don’t let the wrong kind of
sports talk create a toxic environment for females on the medical team.
It is true that sport is a paradigm for
life. It teaches lessons that apply in other arenas, including
medicine. From sports you learn to be a team player, a good
loser, and a gracious winner. You learn from your mistakes when
you lose, and when you’ve lost, winning is sweeter. You
learn it’s important to acknowledge your teammates,
although sometimes team loyalty may be sacrificed for personal
goals. Finally, if you give it your all, you can win the
“Big Game,” but sometimes you lose no matter what.
I’m a sports
fan, and as I type, the movie stand-up from “Bull
Durham” of Costner and Sarandon is staring at me with
another of those lessons—”Love is a lot like
baseball. It’s not whether you win or lose. It’s
how you play the game.”
On the other hand, I
vividly remember the atmosphere on my surgery rotation with my
best friend, Paula, along with four male students and three
male residents. During rounds and in the O.R. conversation
often centered on the Royals and George Brett. Paula and I
realized we had better start paying attention to the team so we
could engage in the conversation, enjoy our group’s
camaraderie, and be ‘varsity’ players on our
surgical team...even if that meant diverting attention from
surgical topics while we were just trying to make our way in
med school.
The minute we joined
in the conversations, however, the guys switched the subject!
It was discouragingly clear they didn’t want us to be
part of the team.
I saw much more of
this behavior as I proceeded through training, which included
general surgery and sub-specialty rotations as prerequisite to
plastic surgery residency.
There was the female
student who answered every surgical question correctly during a
late-night emergency operation, so the resident switched to
some increasingly difficult baseball questions, which she aced.
The resident asked, “OK, who holds the record for
most-consecutive-games-played?” Without blinking once,
she got it right: “Gehrig” (pre-Ripken).
Finally, the resident smugly asked, “OK, honey, how
many?” Again, without skipping a beat, she nailed it:
“2130—honey.” The resident shut up and
concentrated on his patient from then on! The nurses and other
women in the room loved it. We later learned the student, older
and more secure than her classmates, had for years been a star
in the summer leagues.
One plastics chief,
rest his shriveled soul, rhapsodized about Arizona State
football to a male student while we were all scrubbing up. I
was standing right between them at the sinks, so I tried to
join in by asking what they thought of the state basketball
prospects. Said chief turned to me, arched his eyebrows,
dropped his scrub sponge, and summarily proclaimed, “I
HATE basketball” as he blew into the O.R. (Sorry, Lute
Olson, I tried.) I laugh about it now—maybe he was sore
from losing money in the office pool—but it was said in a
purposely mean, spiteful, and—even if he were the
chief—inexcusable way, meant only and overtly to exclude.
Orthopaedics was the
absolute worst, the success of Dot Richardson notwithstanding.
I remember a woman who naively thought she had an equal chance
to snag an ortho residency as the men who were applying, and
officially she did. So she spent time, energy, and money on her
application and interview. She didn’t know that the spot
had been promised years earlier, sub rosa, to a male student
who just happened to have been an All-American.
In the past, one
stumbling block to women entering surgical subspecialties was
the usual general surgery prerequisite. Women weren’t
encouraged to enter general surgery, or were actively
DIScouraged, even if they were “just” preparing for
a subspecialty. I believe things are better now. For example,
more women are in plastic surgery.
I know disrespectful
attitudes toward women have existed in law and finance, too,
and many other fields. My point is, please be sensitive to how
sports talk and sports analogies have been, and still are, used
(sometimes subconsciously) in attempts to exclude or alienate
women. In one way, it’s simply about good manners, but
professors call such actions “micro-inequities”
that contribute to sexual harassment. This label is a valuable
way to highlight ‘little’ things that over time can
add up to create discouraging atmospheres or even frankly
hostile environments for women.
So to you men in medicine,
please be aware of your game. To you women, don’t be
naive rookies. Recognize these micro-inequities for what they
are, or can become, and deal with them in the way you think
most appropriate for your situation. Are you good at repartee?
Humor can make your point (and not threaten egos), but
it’s easy to be sarcastic and thus be labeled
‘bitchy’ (although a man would be called
‘assertive’). An open, simple statement that you
are feeling excluded may be disarmingly best. Just be aware
there can be an additive (and eventually toxic) effect to
micro-inequities, so don’t let them slide, or
they’ll throw your game off. Choose your battles
carefully to make your point most effectively, and conserve
your energy for your own version of the ‘playoffs.’
g
Nancy Coates, MD is a plastic surgeon
living in the Kansas City area. She is ‘rabid’
about dogs.
A Duke graduate and a Kansan, she is not to be disturbed during NCAA basketball tournaments.
A Duke graduate and a Kansan, she is not to be disturbed during NCAA basketball tournaments.
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