Friday, September 17, 2010

Friendship and Female Physicians II

Over a year ago I wrote a post about the challenges of making friends as a female physician. I cross-posted it on Mothers in Medicine, and the comment boards on both blogs were pretty interesting.

One of my best friends in med school was an O.B. nurse. Though she has moved almost all the way across the country and I haven't seen her since I was in school, we're still in touch and expect to be seeing each other at last in a couple of months.

By some coincidence one of my best friends now is also an O.B. nurse. I'll call her Ziva (yes, I watch a lot of NCIS). Ziva is from Israel. She is smart and funny, a lover of books and movies and good music and good food, talented and competent, and above all a great and generous person I would entrust with my children's lives. Ziva and I can talk about just about anything - silly "girl stuff," deep intellectual stuff, spiritual questions, moral/ethical dilemmas, work stress, kids, comic moments from day-to-day life, worries about tough problems, faults and failings, embarrassing secrets, cultural differences, things that inspire us or bring us joy.

For some reason, her colleagues are very uncomfortable with our friendship and underhandedly persecute her for it with snide comments and not-so-veiled criticisms. One time I arrived to provide a spinal for a C-section. Ziva was already in the room counting instruments, and one of the other nurses said, "Oh, are you happy now - your friend's here." Another time she happened to mention that she and I had recently discussed the mechanics of intubation, and in front of all the other nurses one of her other colleagues made some critical remark about her being friends with me. When Ziva called her on it, saying "What's wrong with that? T. is SO nice! She's totally adorable," the other nurse said, "I have no desire to be friends with T. I have my OWN friends." Ziva found this nurse's comments and the tone in which she said them disrespectful and hurtful. Many of the other nurses can barely conceal the clouds of disapproval and resentment that darken their looks when Ziva and I greet each other cheerfully at the nurses' station.

"They feel threatened," my husband said.

"But if I were a single, tall, good-looking MALE doctor it would be FINE for a nurse to be close to me, right? Isn't that totally self-demeaning of these women? Sure, it's ok to befriend a man in a position of authority, but it's somehow wrong if it's a woman?" I was totally frustrated and irritated that the culture in this workplace wouldn't tolerate a genuine close friendship between a female doctor and a nurse.

Ziva and I do not flaunt our relationship in professional situations. I feel I am just as business-like with Ziva while delivering patient care as I am with any other team member, and conversely, just as nice with the other team members as I am with her and with the patients and with any colleague. But there's a lot going on here. Gender issues. Cultural issues. Xenophobia, or, even worse, maybe some anti-Semitism. And perhaps status issues. Maybe they think nurses and doctors can't or shouldn't be friends (unless, of course, it's a dating situation between a male doctor and a female nurse). Or maybe they feel Ziva's smarter and more highly trained and better educated than they are and they just can't stand it.

I am feeling exasperated and a little angry. This type of collective attitude is completely stupid and unnecessary. I don't know that there's much I can do about it. I'm certainly not going to change this blessed friendship for the sake of a few small-minded harpies who aren't comfortable enough in their own skin to show some tolerance, respect, and support.


Jo said...

Oh, I am so sorry that petty and narrow minded people are putting you both through this :-(

I could understand if you were at school (I went through something similar with a friendship with one of the teachers), but you are all adults - why can't they grow up?

Good for you both for rising above it, and I hope that, as the friendship continues, the snide comments and the nastiness disappear.

Michael Leddy said...

Some people resent other people's happiness, don't they?

When I started reading this post, it didn't occur to me to notice hierarchy, rank, doctor v. nurse. I suppose I should feel happy about my naïveté.

T. said...

Jo - I'm not feeling optimistic about any increases in maturity on that unit, but I'm hoping I'm wrong.

Michael - I was just telling my family about meeting and talking to a wonderful woman at the hospital whom I'd love to get to know better. She works as a transport orderly and is from El Salvador, and I felt I could have talked to her for HOURS. We had a great time laughing and chatting together. It doesn't occur to me to think of "hierarchy" either when I'm in a non-professional mode of discourse / situation.

Hierarchical roles have their place for purposes of patient safety, but outside of the professional setting there's no reason we can't make friends with people regardless of job, race, gender, background, etc. For me it amounts to this: can you enjoy talking to and spending time with someone, and can he or she enjoy talking to and spending time with you? I'd talk to my new friend from the transport service over many of my physician colleagues any day.

Nurses can't have it both ways. They can't keep insisting they're "separate but equal" to physicians (a whole blog post topic in itself), then cry foul when a physician and nurse find common ground as equal partners in friendship.

rlbates said...

T, so very sorry. True friends are rare and a joy. Wish I had something wise to add. Wish I could give you a hug.

Anonymous said...

Your post speaks volumes about the mentality of nurses as a herd.

Some of them are so infatuated with their supposed professional value (most of them are really just a bit more than average college grads with nursing experience), and so focused on their longstading common "enemy", the MD, that anybody who "crosses the line" is seen as a traitor to the "cause". It's like a black person befriending a white person in the middle of the civil rights movement.

The Western (and especially American) nurses are highly-spoiled individuals, who are proud of the (stupid) fact that the MD is not the absolute decision maker in patient care anymore (which is as intelligent as having the general negotiate orders with the private). But this is the politically correct BS that comes with having non-MD senior hospital management, nurse unions and supposedly a nurse shortage.

You and your friend are just in the middle of this battle, between the real doctors and the nurse doctors.

At least your friend is not a CRNA. Some of YOUR colleagues might not take THAT lightly.

Ziva said...

:) A small price to pay for our friendship.

Anonymous said...

I am an anesthesia resident. One of my best friends is a CRNA student. You can imagine the strife we go through! By the way, could you comment on the future of anesthesiologists jobs with the upcoming independence of CRNAs? I'm interested to hear your opinion.

Michael Leddy said...

T., just in case my comment wasn't clear -- I meant that it was the other people in your post, not you, who saw the friendship in terms of a difference in rank. In other words, I didn't realize when I began reading that there was a difference there that would mean anything to anyone. But I should know better -- there are after all tenure-track people who don't talk to adjunct faculty.

Anonymous said...

Thanks for the post. It has reminded me once again of the dynamics going on in my clinic. I am a fairly new to my clinic (2yrs) whereas all the other docs have been there at least 10 yrs. The majority of docs are females and older than me. The PCTs and nurses are all female and are closer to my age group. Not only that, my husband being Mexican, I feel like I can relate quite easily to the culture of the majority of the nurses/PCTs, so I chat with them a lot.
I've had one female doc in particular remind me on several occasions that 'they' are different from us, that 'they' are really from a very low socioeconomic background, are poorly educated and immature. I have been known to bake brownies and cookies on several occasions for the nurses/PCTs (they help me so much) and I've noticed her comments coincidentally (?) followed those incidents.
I don't know what to do in this situation either, but to ignore her.

Anonymous said...

I don't mean to sound rude, but I know many people that believe doctors are all snobby individuals who act as though they know everything and are too good for anyone else... maybe you give off some kind of negative vibe like this to those girls? I have no idea, I suppose you should probably just play nice for now...
Have you tried having a conversation with any of them? Because if you haven't, I think I could see why they aren't impressed, they may think you think you're too good for them..
One thing you said that kind of bothers me, "But there's a lot going on here. Gender issues. Cultural issues. Xenophobia, or, even worse, maybe some anti-Semitism. And perhaps status issues. Maybe they think nurses and doctors can't or shouldn't be friends (unless, of course, it's a dating situation between a male doctor and a female nurse). Or maybe they feel Ziva's smarter and more highly trained and better educated than they are and they just can't stand it." How can you possibly know what these people are thinking? I mean, if you're thinking those kinds of things about them first of all, you shouldn't be so surprised if they think bad things about you.. maybe you come across as rude to them, maybe your friend talks about you all the time and they're sick of it, maybe they're jealous she's talking to non-nurses, maybe they really don't care and you're both making too big a deal about it. If it bothers you THAT much, maybe you should talk to one of them to find out what's wrong? Or just let it go.

T. said...

I don't claim to know what anyone is thinking, hence my repeated use of the word "maybe." And, I don't have to "play" nice with them, I AM nice to them, so much so that the head of nursing for that department came to my boss a week or two ago and requested that I be sent to that unit more often because I am one of the physicians they consider super-nice. I don't know what makes you think I would ever be rude to anyone, but it's not feedback that I tend to get from people who spend time around me.

Anonymous said...

Me: "How much longer do you think you might be?"

Surgeon #2 (muttering): "Why are these people always chomping at the bit?"

Me: "Why do you assume that I'm asking because I'm 'chomping at the bit?' "

Surgeon #2: "Well, that other guy asked the same thing a while ago."

Me: "Has it not occurred to you, after all your years of experience, that questions about the duration of surgery have nothing to do with being in a hurry to finish surgery but rather have everything to do with planning and executing a safe anesthetic for your patient, and making sure the TIMING of the drugs we give coordinates with what you're doing? Some of us actually try to put some THOUGHT into our moment-to-moment management of patients. When we ask you how long you have, it's almost always for the sake of pharmacologic timing, so we can be sure to provide the drugs you NEED for the procedure to go on, not because we give a flying fig how long you're going to take."


Surgeon #1: "About twenty more minutes."

Me: "THANK you."

I now understand why they don't like you, if you speak to people in this tone. I wasn't meaning to be rude with my post, I was suggesting other things, like maybe they really don't care and you're looking too far into it, but all you seemed to get out of my post was that I said you may be rude to them. After reading your unnecessarily mean response and looking over that post, I think I'm seeing the picture....

T. said...

It's a shame you feel that taking an anecdote completely out of context - one, by the way, that people who know the people involved found quite humorous, in context - counts as evidence of my habitual tone or way of being. If this is how you choose to judge someone you don't know at all, and situations you don't know at all, and if these remarks are your definition of "mean," then there's really not much I can do or say - we are clearly not on the same page.