Latest / The Hidden Load: For the educators and leaders in medicine who hold everyone up. / Beyond Grin and Bear It: The Art of Standing Up for Yourself
Transcript
- Santina Wheat: Welcome to the hidden load for the educators and leaders in medicine who hold everyone up. We will tackle the hard topics and help you conquer your chaos and get to calm all by starting to acknowledge and remove that hidden load. This podcast is a space for us to name the things that are common, but not normal. Each week, we'll look at the invisible weight you're carrying and explore practical coaching-based tools to help you find more calm, better boundaries, and a sense of purpose that doesn't require you to run on empty. I'm so glad that you've carved time out for yourself today. Let's get into the episode. Welcome back to The Hidden Load. I am your host, Dr. Santina or Tina Wheat. I want to start today's conversation with a question that might make you squirm just a little bit. Have you ever actually learned how to stand up for yourself? Not standing up for a patient, not standing up for a trainee or a team member, and not advocating for a clinical. protocol or change to a system. I mean standing up for yourself, your boundaries, your workload, and your personal needs inside a high friction relationship or institution. If you are anything like me, or like most high-achieving professionals, one of the most persistent, exhausting challenges in life is knowing when you should step forward and stick up for yourself versus when you should just grin and bear it. This exact tension hit me right in the face recently through a moment with my oldest child. She had a concern that she wanted to address at her dance studio. Regarding one of her lessons. And normally she expects me to fix it her. And I'm trying to teach her not to do that. So I scheduled a meeting for her with the studio and I showed up right alongside her to offer complete unconditional support. But the night before we walked through the door, I drew a line. I told her, I'll be there with you and I will be your backup. But you have to speak up for yourself. And you have to share this yourself. Watching her navigate that nervous energy, finding her words, and realizing that her voice mattered was such a proud parenting moment. But also, as I sat there watching her, it held up a quiet mirror to my own adult life. It is so easy for us as parents, mentors, and educators. To coach the young people in our lives to find their voice. We tell them: be brave, speak your truth, don't let people push you around. Yet, in our own professional lives, we spend years executing complex, exhausting risk calculations every single time we consider raising our own voices. We ask ourselves, Is this really worth the drama? If I bring this up, am I just going to be labeled a dwiner or am I gonna be labeled as difficult? Will this actually do any good? Or am I just wasting my breath and burning what little social capital I might have? So what do we do? We default to what we've been trained to do since childhood. We grin and we bear it. We absorb the extra task. We tolerate the unmanaged schedule. We stay quiet during the committee meeting. When a boundary is crossed, we convince ourselves that taking the high road means swallowing the friction. Let's be honest, though, about why it is that we grin and bear it. It's not because we lack courage. It is because as high achievers, most of us are masters of adaptation. When you spend decades succeeding in medicine or academic leadership by pushing through hard obstacles, your default setting is to view friction as something to be endured, not something to be challenged. You rationalize it. You tell yourself, I'm resilient. They expect a resilient employee. Or I can handle this. It is easier for me just to fix it quietly than to have that difficult conversation. If you're honest with yourself, how many times have you told yourself a version of one of those phrases? And then there is the intense fear of the institutional label. Particularly for women or minoritized faculty and mid career leaders, the fear of being branded as not a team player, a complainer, or a whiner is a very real and unfortunately rational fear. In a culture that glorifies martyrdom, the problem is The person who raises their hand to say, this system is broken and this workload is unsustainable is frequently treated as the problem rather than the broken system that they are pointing out. So what do we do? Well, we keep grinning. We keep bearing it. But here is the truth we need to name today. Grinning and bearing it is never free. When you swallow friction to keep the peace outside, you start a fire inside. The cost of grinning and bearing it is paid in quiet resentment, emotional fatigue, and Physical exhaustion, and unfortunately eventually, complete psychological detachment from the work that you used to love. When you refuse to stand up for yourself, you don't actually avoid a difficult conversation. You simply turn that difficult conversation inward, where it eats away at your professional longevity. So how do we break this reflex of grin and barret? How do we know when an issue warrants swallowing the annoyance versus when the issue requires us to stand firmly in our own defense? Well, I think we need an objective, cold diagnostic rubric. You cannot rely on emotional fatigue alone, because by the time you are angry enough to snap, you will deliver the message with frustration rather than with strategic authority. And unfortunately, by the time we get there, our arguments often do no good. And so I'm going to share a refined three-part framework that dictates the exact moment you must stop grinning and bearing it and start speaking up. Criterion number one, when you're considering leaving or letting go. And this actually might be too late, but it's still an important one. If a situation, a role, an administrative mandate, or a relationship has become so misaligned that you are actively considering walking away, if you are mentally packing your bags, updating your C V or preparing to resign, you have zero left to lose. Why grin and bear a situation straight out the door? Speaking up in that moment is not burning a bridge. It is a quality control exit audit. If you are ready to walk away anyway, giving leadership the unvarnished truth isn't an act of defiance. It is handing them a free diagnostic report that could save the department and protect the person who eventually fills your seat. If the conversation goes poorly, you are leaving anyway. But if you articulate the boundary with absolute clarity, you give the system another chance to retain a high value leader. And maybe, just maybe, if the system is able to meet your needs, you're able to continue doing the position that you used to love and find that you can love it again. Criteria number two. when it impacts more than just you. The moment you realize that your silence is enabling a toxic pattern or an unsustainable workload that is also hurting your colleagues, your residents, your clinic staff, your teammates, or your family, the entire equation changes. Standing up for yourself in that moment is no longer whining or complaining. It is community defense. High achievers will rarely fight for themselves, but they will fight fiercely for others. Use that momentum. Recognize that when you say no to an unmanaged expectation, you create a protective umbrella for every junior person standing behind you who is potentially too terrified to speak. And then on to criteria number three. When there is a greater than 0% chance of improvement with data over drama. We often assume that people or institutional leaders are intentionally being malicious or unreasonable. But in reality, most institutional friction is born out of simple organizational blind spots. Leadership often has no idea how heavy a specific requirement feels on the ground. Because they are not necessarily living it every single day. If there is even a 1% chance that the other person simply does not realize the impact of what is happening, staying silent is unfair to both of you. Speaking up gives a good faith system the opportunity to self-correct. It allows you to approach them with curiosity about wondering if they knew that this was going on. But here is the operational key to criterion number three. The odds of a situation getting better depend entirely on how it is you deliver that message. If you walk into a chair or a director's office leading with raw emotion, the chance of an outcome that is positive likely drops straight down to zero. But if you walk in with data over drama, bringing a clear Operational alternative rather than just the raw problem, your odds jump to 50% or higher. When you offer a viable solution alongside the boundary, you move from complaining about a problem to actively solving an organizational risk. Now, if you are not willing to run this rubric and stand up for yourself for your own sake, I want you to look at this through the lens of medical education, team leadership, and mentorship. In medicine and healthcare, our learners and our junior colleagues are watching our silence far more closely than they are actually listening to our advice. Think about the profound disconnect we create in academic medicine today. In lectures, in coaching sessions, and in wellness modules, we tell our residents, fellows, and junior faculty: set good boundaries, speak up if you're overwhelmed, practice self-care, and advocate for yourself. I have certainly said all of those things myself. And then Those exact same trainees watch us walk into a clinic or committee room, get handed an unmanageable, unresourced administrative load, and quietly swallow it. They watch us smile, say yes, and complain bitterly in private while publicly complying. When we do that, we completely invalidate our own advice. We teach them that the self-advocacy is just a nice bud. That we use on orientation day, but that the real hidden rule of survival in medicine is to grin, bear it, and burn out in silence. When you refuse to stand up for yourself, you set a dangerously low cultural ceiling for your entire team. Your junior colleagues will conclude that If my attending, who has decades of experience, title, and institutional authority does not feel safe speaking up about this broken system, how could I ever dare to raise my hand? On the flip side, when you step forward using the data over drama model, when you demonstrate how to respectfully, firmly, and constructively challenge an unsustainable expectation, you execute a profound effect. Leadership. You show your trainees what professional maturity actually looks like. You give them a real-world blueprint for setting boundaries without being destructive. You show them that you can love this profession, be deeply committed to patient care and academic excellence, and still refuse to sacrifice your humanity on the altar of institutional dysfunction. Just as I stood next to my daughter at her dance studio so she could learn to use her voice, we must stand alongside our trainees and our teammates by modeling how we use ours. Now, once you decide to stand up for yourself using that three part rubric, for your own sanity and for the sake of your team, how do you actually execute the conversation without looking like a whiner? Well, I want you to reframe the entire interaction. You are not walking into the room to complain about how hard things are. You are walking into the room to align operational realities. You use low-emotion, high data communication. You might say, I am bringing this to you because I am deeply committed to the long-term success of this department, our training program, and my role within it. Right now, the current structure of this clinical assignment creates an operational bottleneck that directly impacts trainee education and increases error risk. Here is the data and Here are two ways we can restructure this so it remains sustainable for the entire team. Look at what that example does. You aren't whining. You are stepping forward as an executive partner who values the mission enough to demand that the structure actually supports it. Remember this standing up for yourself does not mean standing alone. Find your allies, get your data, hold your boundary, and let your yes mean yes, and your no mean no. So here is your Monday morning challenge for this week. I want you to look at your professional and personal life right now. Identify one area where you have been quietly grinning and bearing it for months. Run it through our three-part rubric. Are you considering walking away from it, whatever that means? Is it hurting others or setting a toxic precedent for your trainees or even for yourself? Is there a greater than 0% chance it could get better if leadership actually knew the truth? If it hits even one of those criteria, make a commitment this week to schedule the meeting. Bring your data, offer your solution, and speak up. Show the junior colleagues and trainees coming behind you that we don't have to swallow the friction to be worthy of the room. And if you need support with it, reach out to me, schedule a coaching session, and I can help you walk through it. Thank you for joining me on this episode of the Hidden Load. If this conversation about standing up for yourself and modeling self-advocacy spoke to you today, I hope you'll share it with a colleague, a mentor, or a trainee who might be grinning and bearing it a little bit too much right now. Let's lighten the load together. I'm Dr. Santina Wheat, and I will see you next week. Thank you for listening to The Hidden Load. If today's conversation spoke to you, I would love for you to share it with a colleague who might need to hear it too. It's one of the simplest ways we can start shifting the culture of medicine together. And remember, your time spent reflecting here matters. You can earn free CME or CE credits for listening to today's episode through the Pinnacle app. You'll find that link in the show notes. If you are looking for one-on-one coaching support or want to dive deeper into the resources we discussed today, let's connect. You can find information on how to reach me in the show notes. don't forget to hit subscribe so that you never miss an episode ⁓ and leave me a rating so that others can find me too. and take care of yourself because you deserve to be held up too. And I'll see you next time.