Even Shame Has Its Limits

Christina Georgeades, MD

“You mean every day should be shame day.”

I was walking behind two of my co-residents the last month of my intern year when I heard the hurtful comment. It was Pride month, and in the professional world, I was a closeted gay resident. One of them had seen a Pride poster on the wall of the hospital hallway, and it had been heartwarming to hear her genuinely say, “Every day should be Pride Day.” 

But then my other co-resident responded to her with their derisive remark, the words quickly overriding her uplifting one. My heart sunk upon hearing it. Shame is something that those in the LGBTQIA+ community are uniquely familiar with, and it’s something most of us spend our lives overcoming to some degree. The words, therefore, cut deeply, especially considering I still battled with my own feelings of shame at that time.

It hurt, and it was one of the first times where I feared for what the future would hold throughout the rest of my general surgery residency. There were other moments that contributed to my growing hesitance; words spoken in my presence without knowledge of my queerness – making fun of a transgender individual, scoffing at the prospect of going to the annual Pride festival, sarcastic comments about same-sex partners, and more. Would I be able to be “out” in the way that I wanted?

“Death by a thousand paper cuts” aptly described it, and I was certainly feeling the effects.

Everything started to shift, thankfully, in my third year of residency.

The catalyst was a conversation with a co-resident friend over coffee. I felt comfortable sharing my fears and we discussed ways in which I could embrace being myself while avoiding potential professional repercussions. However, when the idea came up that I should perhaps consider remaining closeted throughout residency, my aversion to that notion was swift and strong, and I knew that would never be an option.

Fortunately, my shame had its limits. 

The next impetus occurred when the Department of Surgery at my residency program started an initiative called “Cultural Complications” in 2020 that has since been routinely incorporated into Grand Rounds time. The initiative involves conversations surrounding diversity, equity, and inclusion topics, and although the sessions are data-driven, they are ultimately meant to be interactive, non-judgmental, and personal. At the end of my third year, a serendipitous email arrived in my inbox – an opportunity for a resident to help with presenting one of the Cultural Complications sessions. The topic? Being LGBTQIA+ in surgery. 

By that time, I had worked through a lot of my own internalized feelings of shame. However, after watching nearly a year’s worth of Cultural Complications sessions be handled with care and empathy by the department, and also having unwavering encouragement from some of my co-residents, it was ultimately that overarching support that motivated me to click “Reply” and volunteer for the session.

That Cultural Complications presentation was the first time I publicly talked about being LGBTQIA+ in a professional forum.

I felt empowered. 

Now, nearly two years later, I still feel empowered.

To that point, proactive and deliberate departmental and individual faculty support for LGBTQIA+ residents and medical students is critical; I cannot emphasize that enough. Even the strongest individual can be overwhelmed by the power differential that inherently exists by being a trainee or medical student.

Providing support and fostering empowerment can occur in a multitude of ways. Speak up when distasteful comments are being made. Focus on creating an inclusive culture not only among residents, but also in the department itself. Create forums for education and open, non-judgmental conversation, such as Cultural Complications. Talk to us like you would any other human being: ask us about our weekends or partners the same way you would a non-LGBTQIA+ individual. Each of these actions, among others, can help us feel less alone. Importantly, they can help us not only be the best versions of ourselves as individuals, but also the best physicians we can be for our patients.

I struggle with shame far less these days, including in the professional sphere. My supportive co-residents, faculty, and program have played a critical role in that. It’s nice to feel like I can simply be myself in all aspects of my life, and to also know that one is never truly alone.

Now when I look back on that conversation I overheard my intern year, I focus on the only remark that matters: every day should be Pride Day. 

Happy Pride, everyone.

 

Christina Georgeades, MD, is a PGY-4 general surgery resident at the Medical College of Wisconsin in Milwaukee, WI. She is originally from Tampa, FL and graduated from the USF Morsani College of Medicine SELECT program. She is a proud member of the Association of Out Surgeons and Allies. New coffee, food, and city adventures make her happy, and she also enjoys socializing with friends, reading, and running.