Of Locker Rooms and Labor Pains

Being a woman in medicine has its obstacles. I once expected that my gender would diminish in importance with each added year of schooling. That is, I thought that as my gray matter increased in prominence, the casing would become immaterial. As with many other childhood expectations, however, all that remains is a dream.

In grade school, cooties differentiated the sexes. Later, my secondary sex characteristics developed and remarks from the streets initiated me into the realm of womanhood. My intellectual awareness then followed, as college acquainted me with the academic nature of the feminist cause. These three—cooties, catcalls, and Virginia Woolf's “A Room of One's Own”—gave me a vague and distant sense of living in an unjust world. It wasn't until medical school that inequalities broadsided me personally. To heighten the shock, the first blow came from the institution itself and not from an individual person. School hadn't even started when a random dean greeted me:

“Congratulations, you are a class of firsts. You are the first class to use our new science facility, and you are the first class to reflect the general population. This class is comprised of 51% females and 49% males.

Unfortunately, the brand new gross anatomy locker room was designed on the premise that the percentage of female students in medical school would never exceed 30%. So, the women will have to share lockers. Men, you'll have lockers to spare.”

I had just agreed to pay my medical school $33 000 plus interest well into the 21st century, and I couldn't even have my own locker. I didn't think much of this during the balmy days of September. As the days grew colder, however, my locker partner and I discovered that the feathers of three thousand geese would only be compressed into a 1' × 2' × 6' space with the assistance of a battering ram. I'm sure the men next door wondered what that relentless pounding was as they frolicked about in their forest of lockers. Perhaps this pre-lab chaos was useful in that it prevented me from brooding over the task of human dissection. Thus, my soul may have been served. My problem-solving skills may have also been enhanced by the challenge of keeping my partner's street clothes free from bile stains and perineal juices. These elaborate rationalizations soon wore out my brain, and I was left feeling inconvenienced and out-of-place.

What architect drew up the building plans? Which professor gave feedback about the buildings' needs? Which board member approved those blueprints? I don't know any of those people, but I do know that none of them expected me. And they weren't expecting my daughters or my granddaughters either. That is, none of these people hoped or dreamed that medicine would someday become a profession reflecting the general population.

Some women are overcome with self-pity. Others shake their fists at “the establishment.” Though I desperately try to wrench myself from the Victim-Valkyrie [1] spectrum, I feel tempted to some form of retaliation when an attending calls me “doll” but my male counterpart “sir.” Such “role models” ignore my achievements in the medical world and focus on my sex. Am I to follow their example, then, and focus on their manhood?

For example, a cardiologist led one of my physical diagnosis sessions. Outside the patient's room, he reiterated the seven-syllable physical findings we were to listen for, and, if graced by God, find. I entered the room, trying to remember the difference between Kentucky gallops and Tennessee horses, when my preceptor hailed the patient with a hearty “See, I told you I'd only bring you beautiful women.” At first, I was stunned that an attending was capable of simple sentence structure. Then, after an awkward moment, I wondered whether curling my hair would have been a better way in which to prepare for this physical diagnosis session. As a wave of self-consciousness swept over me, I realized that my physique was being diagnosed.

After the cardiac examination, I began to notice other things. The attending physician I was to admire and emulate had disappeared. Instead, he had transformed into a tall and attractive vision of the doctor I hoped to be someday. As my thoughts wandered into frankly unprofessional territory, I berated myself and attempted to concentrate on his description of auscultative procedures of the heart. But hadn't those lips declared me beautiful? Was I not simply following the example of my attending?

Confusion and chaos reminiscent of the gross anatomy locker room filled my mind for the rest of my physical diagnosis session. Try as I might, I couldn't understand what was out of place. My attending's comment? His attractiveness? Me? If I left medical school, women would continue to be in the minority just as the architects, professors, and board members had planned. If I weren't in the locker room, we'd all be less inconvenienced. The attending could continue to view all females as objects of beauty instead of as future colleagues, and I wouldn't be frustrated by such distortions.

The frustration occasionally gives rise to the rage, which at times erupts at the drop of a hat. Once the fury is released, though, all that remains is rubble. What needs to be destroyed is not the species of men, but the ever-present fear that haunts women and reminds women of their sisters and their friends who have served as victims. Some men inspire this fear, and some men deny it. Unfortunately, the righteous rage often sours, and as a consequence, the Valkyrie makes all too many men pay for this fear.

Victim or Valkyrie. Is there another choice? Neither serves as a constructive option for me or for my male counterparts. In a feeble attempt to wax poetic, I searched through my mental thesaurus for words that begin with “V.” Victor? Maybe in a few years. Vicious? That's for the Valkyrie. Valium? For the Victim. Venus? Hmmmm. A vision of the breathtaking Botticelli painting filled my eyes. There she stood, rising from the foam with the North Wind at her back. How exciting to witness the birth of a goddess. How enthralling to witness birth.

“Congratulations, you are the first class to reflect the general population. This class is comprised of 51% females and 49% males.”

If not for me, then 50%. If not for Lisa, Jane, and Ellen, then 46%. Each individual woman has made my class what it is: the first of my medical school's classes to reflect the population. Thus, in the 1995-1996 academic year, it will be commonplace to be a woman in the medical school community. When I grasp the magnitude of my position as a woman of the Class of 1996, I realize that I am on the crest of a wave that has been journeying to shore for years, decades, perhaps since the beginning of time. The despair of Victim and the rage of Valkyrie evaporate, and a sense of awe envelops me. A minuscule bubble of foam—myself—and 90 others unconsciously joined together to result in this birth.

This turn in the history of medicine, however, is not without its labor pains. Being called “doll” and being accused of sexual harassment are not pleasant experiences. Though the female medical students are the agents of change, the new heterogeneity of the medical community affects everyone. Old and young, men and women, patients and doctors, students and teachers must join together and nurture this birth. If not, it will indeed fail to thrive, and make victims of us all.

As I make my way into the medical establishment, I keep in mind all the girls behind me. They sit on the playground and play doctor while I roam about the hospitals and play pioneer. I hope that, by the time they arrive, those girls will never feel as though there isn't a place for them in medicine. And maybe, by then, we'll have a new locker room.

Acknowledgments: The author thanks Douglas R. Reifler, MD, for his advice and encouragement.

• Copyright ©2004 by the American College of Physicians