Butterflies emerging with stellar and functional raiment after metamorphoses is a phenomenal representation of change. Numerous other insects develop wings over time, but not in the way of the butterfly. Born to the world as caterpillars, they gather resources and then sequester themselves before their reincarnation.
Though most beings are not as dramatic as butterflies in their transition, a major aspect of living is change. (If everything stays the same then we are probably missing something.) We have all started something new; we understand the whirlwind of information, emotions, skills, and experiences that beginnings entail. To begin something requires stretching because we leave our comfort zones to explore the Earth.
Stretching is a gentle descriptor for what it was like to leave the Sunshine State to start my career in medicine. Fresh out of college and immersed in what felt like foreign lands I was alone navigating society, education, and life. Stores, people, food, technology required, and transportation were all different. Imagine going through such a drastic transition and encountering unwarranted negative social interactions at every turn.
There was one interaction in particular that is worth recounting. To set the scene note that in medical training it is typical to receive feedback from supervisors regarding patient interactions, whether staged or organic.
One day I walked into an observed interview and introduced myself.
“Hello. How are you doing today?” I cheerfully greeted the gentleman.
“I am doing good.” Was his quiet response.
“Good?” I reflected. “That is awesome.” Done with my generic greeting, I proceeded with the interview.
When out of the room, my peers were ready with strengths they noted and areas for improvement. One supervisor opened with feedback that was most memorable for being shocking rather than instrumental to the bedside manner I would later use to engage patients.
Before the group, he explained that when coming into the room: I was far too happy. As evidence, he put forth my use of the word “awesome” and he shared other aspects of my tone and demeanor that gave him this impression.
By that point, I had been alive for some time and never during those few decades did anyone inform me that to be happy impaired professional performance. (Had I known that physicians were required to be unhappy I would have been more skeptical in choosing the role.)
As my supervisor, “too happy” was all the feedback he gave. There was no concrete evidence for improvement nor acknowledgment of strengths. At that time, I was new to the field (and fairly new to adulthood) so though surprised I believed that there may be some credence to what he was sharing so I mulled over my performance.
Immediate circumstances surrounding his feedback later allowed me to recognize what he was doing; there was a second supervisor in the room.
“I noticed nothing wrong with the way Josiane greeted the patient, and she even adjusted her tone to match his emotional level later as she got more details about the scenario.” She gently countered. It would take me years and many more interactions like these to realize the beauty of her statement.
To have an experienced clinician in a group setting immediately debunk the arbitrary opinions of another supervisor was major allyship. I as a trainee lacked the credibility and even the understanding to see that his feedback, aside from being shocking was RIDICULOUS. Too happy? Carefully selecting his vocabulary, the male supervisor took up space to explain that I should have known, with no background information and before the interview, that this was a somber patient discussion and happiness was inappropriate. He was politely trying to articulate that it would be more professional if I was less me.
The presence of the second supervisor makes a case for diversity and an example of effective allyship. As a woman, who had more experience with feedback to draw from than me, she at some level understood the power of words (or prejudice) disguised as feedback, particularly for early trainees. She quickly redirected the conversation and made it a teaching point as the interview was orchestrated to be. Thus, I did not expend time ruminating on the first supervisor’s careless inferences.
Now I would be remiss if I did not posit why he would have felt empowered to contribute what could only be described as gaslighting to the mix. As a diversity trainer/scholar, I will do it through the lens of assuming positive intent. Medicine, historically, was a white male dominated field. The first supervisor fell into that demographic. In his experience, it is likely that he never encountered the mannerisms that he now faced in my interview. He therefore could not conceive of them as being doctorly. His experiences, though valid, do not negate the potential harm he could have caused by arbitrary explanations whose underlying intent was to prove that I don’t belong in medicine.
Harm of this kind requires courageous people to remedy it. People with power who are willing to speak up. People willing to advocate for institutional change and training. People who are willing to, in and out of a group setting, take the time to debrief what is happening and bring clarity to what would have been most appropriate.
Life has many challenges and changes; it helps to have caring people contributing to an environment that helps the less informed decipher what is true and what is meant only for harm. Before medical training, I lived a full life and emerged onto the doctoral scene happy. I am grateful that I had an ally trying to make space in medicine for people like me.
To not know the impact of our words is not an acceptable excuse. Reflection on interactions that feel off/strange, gathering information (through books and variable sources), talking to people with expertise in that realm could all help to both be an ally and avoid being a person that causes unnecessary harm. The resources are available if we want to strive for better and more beauty. Life means change. Butterflies will tell you that to become something new takes a lot of resources. But there is beauty to be had in the sequestration of self with resources.
Overview:
Change in life is inevitable, should be associated with growth, and the right allies may make it more beautiful
Allies or upstanders may have more knowledge, power, or credibility than a victim
Institutions should invest in appropriate training of supervisors to ensure that their feedback is unbiased and effective
Multiple and various resources should be used to gather information to improve as an individual and serve as an ally
Often scenarios that do not feel right, aren’t right
Butterfly image from: https://www.junglexperiences.com/blog/blue-butterfly/
Dr. Josiane Joseph is a Scientist, Educator, Physician, Entrepreneur, Author, and Success Advocate. She integrates skills from current and prior roles to improve wellness in individuals and communities through workshops and personalized sessions. As a life-long student, mentor to numerous individuals, contributor to several committees, healthcare provider, and well-connected community member, she is equipped to collaborate with motivated individuals to plan for greater successes in life.
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venmo: @doubledocj
