‘I’m a bitch, I’m a lover
I’m a child, I’m a mother
I’m a sinner, I’m a saint
I do not feel ashamed’
Meredith Brooks, Bitch

I have had this post half-written in my drafts for over a year now. I originally started it after a particularly fraught night-shift when I had ended up in an argument with a colleague, which was such an unusual occurrence that I immediately wrote over 500 words on professional conflict, particularly how difficult I find that as a woman, but I was writing in anger and when tired and it just didn’t quite work so it has laid dormant…until now.

This subject has come back to my attention because of last night’s disastrous US Open Women’s Final between Naomi Osaka and Serena Williams, something about which I have incredibly conflicted feelings. I have made no secret about how much I love and respect Serena – I think she’s incredible – and I do think that Osaka was the deserved winner yesterday. She played better both in the final and for the rest of the tournament, and I am devastated that her first Grand Slam victory when aged only 20 has been so tainted.

But Serena’s actions and the response to see them have stirred so many mixed feelings in me that I don’t really want to dwell on the details of what happened except say that this goes way beyond code violations and rules, and to provide an extended quote from Jonathan Liew in today’s Independent that gets closest to the heart of how I’m feeling: ‘The following things can all be true at once. Serena Williams is an American hero. Serena Williams has one heck of a temper. Serena Williams broke the rules. Serena Williams grew out of one of the most deprived neighbourhoods in the United States to become one of the most decorated sporting personalities of all time, overcoming egregious prejudice at every stage of her career and cheating death at least twice, and you don’t really do that unless you have a healthy disregard for the rules.’

But what I can’t stop thinking about is how this has become almost a cautionary tale about female emotion and female anger, and how it is seen and interpreted. Serena said in her press conference that she felt Carlos Ramos, the chair umpire, had reacted in a sexist manner, claiming that a man wouldn’t have been punished in the same way. Whether she is right in this particular statement is still under review as there are too many examples in tennis where similar emotion in both genders has been punished or accepted to get a clear answer, but there is no doubt that female anger and assertiveness is treated differently to men. Look at John McEnroe’s fame (?infamy) for a tennis-related example!

To sum it up in a few words, men aren’t bossy or feisty; they’re assertive or authoritative. In an example outside of sports, the Guilty Feminist discussed this in a podcast on Male Privilege where the guest presenter was Kate O’Donnell – a trans woman who, among other things, described how instantly she lost her male privilege following her transition. Before, she was good at her job; after her transition, she was bossy.

Which brings me back to the original argument that prompted my original almost-post.

There is perhaps more professional conflict within medicine than you’d expect. Old derogatory stereotypes live on and we often fall back on age old conflicts that are both a joke and a deadly serious source of contention, depending on the context. And the oldest of them all – medics versus surgeons. I am, of course, talking in gross generalisations but medics don’t like surgeons. Our attitudes to helping patients are too different – surgeons like to cut, they want a definitive solution; medics expect more nuance and have a greyer idea of what counts as success – and this difference creates immense conflict. If the surgeons can’t cut or definitively fix the problem, they rapidly lose interest and often don’t want to take responsibility for that grey area. But as a medic, I can’t say no. Someone has to look after the patient, and that is usually the medic.

This all sounds very petty but I promise that it’s how it really is. JD and Turk’s medic/surgeon friendship in Scrubs is the exception, not the norm. Think instead of Grey’s Anatomy where medics don’t even exist or Green Wing, which is about Mac the beautiful cool surgeon and Caroline the kooky but brilliant surgeon…the medic? That was Martin, the snivelling mummy’s boy who was constantly failing his exams and being generally mocked. Great.

The irony is that most doctors are arrogant, regardless of their speciality. We have to have faith in our knowledge and, more importantly, an understanding of what we don’t know. I know I’m good at my job and I can rely on my abilities. I’m just arrogant in a perhaps more passive aggressive way.

And this changes how I face professional conflict. I’ve never been much of an arguer but sometimes it is important. Sometimes I have to stand my ground or argue my corner and not just capitulate but it’s tough, particularly as a women. My male colleagues can shout and demand and throw their weight around and they’re just dominant or assertive or, at worse, arrogant. As a women, I only get to be a bitch or perhaps a doormat if I just give in instead. And I know this is true as I’ve worked in hospitals where I have been involved in meetings to ‘improve relationships’ between departments because a female colleague was thought to be too argumentative and uncooperative but no action was taken on a male colleague of the same seniority who had to be restrained from punching another male staff member following a similar argument.

The particular details of my own disagreement aren’t that important, except to say that it ended because I caved. Not because the surgeon won me over with logic or persuaded me that I was wrong, I caved to avoid further conflict and because I didn’t want to be ‘that med reg.’ I didn’t want to be that bitch. This is a pattern for me. I always modulate my argument to rein myself in, I never blow my top or lose my temper, and I am always consciously aware of how I am being seen, seeing the patronising look in my adversary’s face and knowing what they are thinking of me.

And as my career has progressed, I have changed how I deal with these conflicts, even in the 18 months or so since I started this post. I just don’t have the energy to fight anymore because I don’t win. Ever. Or if I do, it costs me so much that it barely feels worth it. I’ve had enough of being made to feel irrational or ignorant. I’ve had enough of my opinion being treated with less weight than that of others. Instead, I sigh, make sure that my disagreement with the opinion of my colleague is documented, and take on responsibility for the patient. My arrogance is such that I know that medics do a better and more thorough job of looking after the patient anyway and ping-ponging them back and forth between disinterested teams helps no one. Yes, it creates more work for my team and, yes, some of my own colleagues are appalled at what I accept, but I have made my peace with that. It is what is best for my patient and most of my consultant colleagues agree with my approach. Medicine is a much more female dominated speciality but even the men can only argue for so long!

Watching Serena last night was uncomfortable viewing. Her distress and anger were so palpable that I could barely watch. Was that because she was acting inappropriately and violating a code among athletes, or was it just because negative female emotion is so rarely seen in such a raw state? I don’t know. Maybe both. And that almost makes me angrier! Am I interpreting her response through patriarchal eyes to feel that she overreacted and brought this on herself? Is my discomfort because ‘women shouldn’t behave like that’ or because she has been terribly wronged? Or am I uncomfortable because I just don’t stand up for myself in the same way? Because I don’t fight back, I don’t stand my ground. I don’t want to be seen exactly as Serena is being seen.

Again, I don’t know the answer. I have found my own way to deal with conflict in my own profession, but today it feels like a cop out. It feels like I’m just maintaining the status quo by hiding powerful but negative emotions to make my day easier.

I’m going to leave Serena with the last word, as I still think she’s wonderful. I don’t know if she was treated unfairly, I don’t know if Ramos should have stuck to the rules in such an unforgiving way, but I do know that I am still immensely grateful to Serena for continuing to fight! For revealing what makes us uncomfortable and forcing me to rethink how I want to be perceived.

5 thoughts on “Bitch…

  1. Disappointing as a trained scientist, though not a professional one as of yet, sadly, but I digress. The argument should be settled on facts. I know medics isn’t always science, but an art to it at times, but logic should still win out.

  2. I was out at dinner last night while Serena was playing. One television at the other end of the restaurant had the game on so I couldn’t hear or see too much. I was surprised at the outcome and then I heard of the game penalty. She’s correct in saying that few men ever get penalized like that and I’ve seen a lot of umpires abused by players. They will usually take it from the men. Maybe issue a point penalty. Seldom more. Taking a game is huge!! I felt bad for both players. I admire Serena. I expect she will continue to play better as she regains her fitness and skills!

  3. I really don’t know what to think about this one. I know who’ll win the toss, though, as to who was ‘right’.

    Your post does not increase my confidence in the medical establishment, but I guess it’s no surprise either.

  4. It is hard for women to express anger, discontent and disappointment without garnering the ‘bitch’ label. (I have looked at another label often given to talented women–diva–as a way of saying they are bitches that can be loved and tolerated.)

    There is a double standard for women complaining about what they perceive as unfair and men doing the same. In fact, for a man to let certain things pass is viewed with derision.

    I’m not sure how much sympathy for their feelings athletes get past the surface, as they are adults playing games. Games that people crave, of course but there is often a note of “you should be grateful” that runs within the adulation.

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