Let it go!

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By: Dr. Shruti Venkitachalam, Head and Neck Surgeon, Chennai, India

It was an early morning surgery. I was the second assistant, retracting for a neck dissection. After almost three hours of retracting, I asked if I could get a five-minute break. The prompt reply was, “Why? Are you pregnant?” I was appalled and embarrassed.

The others in the OR giggled. It made me cringe. He didn’t pause to think before saying that, and I was embarrassed – not him!

Since completing my fellowship training, I have worked with only male superiors in different hospitals. I saw them as ‘surgeons’ and not as ‘male surgeons’ – until certain situations forced me to look at them that way. Years passed and faces changed but the story remains about several ‘hims’ and me.

One morning, ‘he’ gave me several tasks to do. I scrambled to finish them but was late for the clinic. When I reached, there was a nurse and two patient relatives in the room. Panting and sweating, I apologized for the delay and entered behind the curtain where he was examining the patient. He was quick to say, “I think you are hypothyroid”. The patient immediately replied with a “No, I am not, Doctor”. He clarified with a “Not you, Ma’am. I am talking to her, who seems too slow for anything.”

One may think that could be reasonable! I could be slow, hypothyroid, or plain lazy or inefficient. Well, here’s the context to that. This is how my ‘work’ worked! He would see patients in the clinic and give orders. I counselled the patients and family members about the tests, financial aspects, surgery, post-op events, and everything else. I saw patients when they were admitted. He saw them after they were on the OR table and most often intubated. He’d do the main part and leave. I spoke to the patient’s family after surgery, coordinated with other teams of doctors, did post-op dressings, managed drains, discharged patients, and took patient calls on my phone 24/7.

When he passed the “hypothyroid” comment, it never struck him that I was the one interacting with the patients constantly. Or even worse, maybe he didn’t care.

I was working almost 6.5 days a week. And was “on call” (or as he liked to call it ‘available at all times’) 24/7. Often, I’d fall asleep at the steering wheel at a long traffic signal and wake up to honking on my way home at night. I was constantly exhausted, physically and emotionally.

After slogging several months in this thankless role, I told him I’d like to have a few days off. He asked if I was going on vacation. I said, “No, I just need a little break. I am worried I am having burnout”. He said, “You don’t have burnout; you’re just incompetent!”

The second time he called me “hypothyroid”, there was no one else in the clinic room but the two of us. I had a breakdown and started weeping. He immediately sat me down and started “consoling” me. Slowly he meandered to “Are you happy at home? Maybe you are frustrated because you don’t have a child?” I was so shocked that I couldn’t react.

Over the years, I was so gaslit, that my fingers trembled to apply a single surgical knot.

On tough days, I would slip away from his clinic and go into other doctors’ clinics- just to get away from him. They would smile and ask, “Need some breathing space?”. Everyone seemed to know!

No one encouraged me to confront him. No one else confronted him on my behalf. All the witnesses, the nurses, other surgeons, and anaesthetists consoled me but did nothing. To me, they all participated!

I would often vent my frustrations at home. I became a very bitter person. Most friends and family I discussed this with asked me to “let it go” and many even pointed out how I wasn’t ‘smart enough’!

These instances and many more, made me question my role as a doctor, my personal growth as a surgeon, and how much I could tolerate before I was driven nuts.

In my last role, when I couldn’t take it anymore, I simply quit. No one was surprised, except him.

What I experienced, through several perpetrators, wasn’t misogyny. It was just disrespect for another human being! One needn’t be a “feminist” to be hurt (Although there is nothing wrong with being one!). One just needs to be human.

I have re-run my story to myself a million times, telling myself the wrong narrative all along, one of a victim! After several years, I realized, I was not a victim. I was amongst the perpetrators!

I am not ashamed anymore to say that I sought therapy for several months. Nevertheless, now I can talk about this without shedding a tear and without hating ‘him’ (them).

I am still ‘unsettled’ in my career but I am a happier and nicer version of myself. People close to me see that too. Several things that I managed to achieve later were simply out of the grit to prove ‘him’ (them) wrong – I am grateful for that.

It is important to speak up, stand up for oneself, to build a healthy team where communication isn’t restricted merely by hierarchy.

#ilooklikeasurgeon, an online campaign, was started to celebrate women in surgery. It sought to break the stereotype of the arrogant, white, male surgeon as a barrier to surgical professionals. It set out to emphasize that appearance, motivations, and behaviors of surgeons are as varied as humanity.

Diversity, equality, and inclusion are fancy PowerPoint presentations prepared by HR teams. But in reality, each one of us needs to assert it. If these issues are addressed early, good professionals and good careers can be built, enabling sustained good patient care.

Burnout is real! And it starts in the early years of training. If one has the avenue to clear one’s mind off other things and focus just on work, we could build a much stronger and more confident future generation of doctors.

“Women shouldn’t have to carry the burden of proof at personal risk to self and career. But for those who have the bandwidth — your stories are the fuel needed to drive change.”- Erica C. Kaye (Kaye EC. Misogyny in medicine. New England Journal of

Medicine. 2021 Jun 17;384(24):2267-9.)

This is my story. What’s yours?

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I am a head and neck consultant at a tertiary care corporate hospital in a metropolitan city in the South of India. Other than being a passionate surgeon, I am vocal about issues like parity in care for patients; emotional, financial, and social as much as physical rehabilitation of cancer patients; and equal cerebral opportunities for women at work workplaces, to name a few.

I am also a founder and director of a young biopharmaceutical company, having some brilliant women scientists on our team. I feel fortunate to have their support to help me inch towards a dream I have had for a long time- the indigenisation of products/ drugs/ technology leading to sustainable, world-class quality and affordable health care for Indian cancer patients.