Latest / The Hidden Load: For the educators and leaders in medicine who hold everyone up. / The Trailblazer Tax: Women in Medicine and the Burden of Legacy
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. September marks Women in Medicine Month, a dedicated time recognized across healthcare to honor the contributions, leadership, and ongoing advocacy of female physicians. This year September seventeenth, in particular, gives us a focal point in the middle of this month as the inaugural Women in Medicine Day to pause and reflect on how far we have come as women in this profession and also how much work still remains. Often when we talk about the history of women in medicine, our minds often go to pioneers like Dr. Elizabeth Blackwell. Who in 1849 became the very first woman to receive a medical degree in the United States. When you look back at her story, Elizabeth Blackwell's acceptance was actually intended as a joke by the all-male student body who voted to admit her. But she showed up, she endured intense isolation, she even graduated the top of her class. And she permanently cracked open a door that had been slammed shut for centuries. When I think about Women in Medicine Month and pioneers like Dr. Blackwell, I don't just think about historical figures from the 1800s. I also think about my mom and the world that she grew up in. Growing up, My mother made it abundantly clear to me that she wanted me to have the opportunity to become a physician. Now, let me be very clear. My mother held deep, profound respect for many professions, including teachers and nurses. She was a teacher and then a principal for her entire career. Those are laudable, essential, noble careers that keep our society functioning. But when my mom was coming of age, she felt like those were essentially the default professional avenues presented to women. Yes, of course there were female physicians in my mother's generation, and I am extremely thankful to them, but they were few and far between. They were the absolute rare trailblazers who were fighting the immense societal friction. Because those pioneers were the exception rather than the rule, society still handed most women of high ambition a very narrow menu nurse, teacher, secretary, or homemaker. So when my mom looked at me, she saw a chance to pass the baton forward. She wanted me to benefit from pioneers like Dr. Blackwell and the courageous woman of her own era who cracked the door open. She wanted me to have ultimate professional autonomy, to be in the room where decisions were made, and to never have my potential capped by someone else's ceiling. That gift for my mother, built on the shoulders of those early female physicians, was a profound blessing. But here is the piece of the story that is really important to name. Benefiting from past trailblazers does not mean that the trailblazing is over. The relay race did not end when women entered medical school in larger numbers. Yes, I am thrilled that at least 50% of matriculants to medical school now identify as women. Many of us walked into clinics, residency programs, and academic departments Where we still found ourselves as the first or one of the few, maybe the first female division chief, the first female program director, the first woman in a boardroom, or the first in our families to navigate this complex system. Those of us who are women physicians are benefiting from the path cleared before us. But if we're honest, we are still trailblazing today. And carrying that baton comes with a heavy, unquantified hidden load that I call the trailblazer tax. When you know how hard earlier women fought just to get into the room. And when you are actively trying to forge new paths and leadership yourself, an internal mechanism takes over. Sometimes you might tell yourself, I cannot complain. Or I cannot show weakness. I cannot say that I'm tired or overwhelmed. Look at what it took to get here. And look at the women coming behind me who need me to hold this door open and help pull them up. Some of us turn that sense of legacy into a high-stakes performance contract. We carry an invisible guilt when we experience burnout. When we are drowning in inbox messages at 10 p.m., or when we are navigating subtle institutional bias and leadership meetings. We often feel that we have to hush our own distress because sometimes admitting that struggle feels like failing the legacy that we inherited. And then we compound that guilt with the systemic lag. As I mentioned, women now make up over half of medical student matriculants. But the structural architecture of healthcare was built for an era when physicians had full-time support at home. As women pioneer new tiers of medical leadership, they are often expected to run an executive department while still carrying the majority of the cognitive, domestic, and emotional coordination at home. I want you to let that sink in. You can be profoundly grateful for the pioneers who cleared the path before you. You can take pride in the new ground that you are actively breaking today, and you can admit that carrying the weight of being a trailblazer is absolutely exhausting. Honor and exhaustion can exist in the exact same heart. So how do we honor the women who came before us without destroying ourselves in the process? Well, we have to realize that the battleground has shifted. Dr. Elizabeth Blackwell's battle, it was about access, getting through that front door of a medical school. My mother's battle was about opportunity, breaking out of predefined society roles. Our battle today, the battle of this generation of women in medicine, I think it's about sustainability, or even better, about learning how to thrive. Honoring my mom's dream does not require me to burn out on the altar of medicine. She certainly did not want me to become a doctor so that I could be chronically exhausted, perpetually isolated, and emotionally drained. She wanted me to become a doctor so that I could live an empowered, fulfilled, impactful life, and be able to share that with my loved ones. And so I want to share three concrete coaching reframe. And so I want to share three concrete coaching reframes to help you drop the trailblazer tax starting today. The first reframe is martyrdom is not gratitude. The first reframe is martyrdom is not gratitude. I want you to stop using your mother's or your mentors' sacrifices as a whip to drive yourself to exhaustion. No, I'm just recording. Sorry. That's okay. How are you doing? Terrible. Terrible? My head hurts and I feel dizzy. Okay. And my head hurts way worse. We didn't even do that much though. Okay. So how about you eat and then get to bed? Okay. And Dad said I can't take out your profan yet. Yeah, so how about you eat and then we get you to bed, okay? And put some ice on your head. You feel dizzy too? Okay. Really dizzy. Okay, well how about you lay down for a few minutes and then eat and then let's Okay, yeah. How much homework do you have? It's just one sheet where I color stuff in. Okay. And then you need to assign some yes, and you assign your lab paper, right? Yeah. For science. Okay. Here are three concrete coaching reframes to help you drop the Trailblazer tax starting today. Reframe number one: martyrdom is not gratitude. I want you to stop using your mother's or mentor's sacrifices as a whip to drive yourself to exhaustion. True gratitude is not staying at work until midnight to prove that you deserve your badge. True gratitude is using the authority you earned to set boundaries, protect your well being, and enjoy the life that their sacrifice made possible. On to reframe number two Normalize the I need support stance. We must dismantle the toxic myth of the women physician superwoman. The superwoman who manages a full clinical panel, sits on four institutional committees, cooks organic meals, and never asks for help. Reaching across the street to a neighbor, hiring domestic support, or delegating administrative tasks at work are certainly not failures of your capability. They're an act of operational intelligence. And in fact, My whole episode last week was all about asking for help, so go take a listen if you need a reminder. And reframe number three, shift from individual endurance to system redesign. For decades, women in medicine were told, just work harder, learn to speak up more, and more recently, take a mindfulness class. That is individual endurance framing. As leaders and educators, we must shift the conversation to system design. We need to advocate for parental leave policies where they don't exist, lactation support for those who want it, protected administrative time, and realistic clinical caps and job descriptions that actually make sense. We honor our forebearers not by surviving a broken system, but by redesigning it for the women who walk behind us. We could all be better for it. So this National Women in Medicine Day, as we honor Dr. Elizabeth Blackwell and all of the incredible women physicians who cleared the path for us and continue to do so, I want you to look at your own journey with immense grace. And so I offer you this challenge for this week. I want you to take five minutes before your shift or before your meeting to write down one expectation you are carrying simply out of trailblazer guilt. Maybe it's a project you took on just to prove you could. Or maybe it's a boundary that you haven't drawn because you felt you weren't allowed to complain. I want you to identify it. I want you to look at it. And then I want you to say out loud, I can be grateful for my opportunity without sacrificing my humanity to keep it. Ultimately, I want you to give yourself permission to step back from that over-functioning loop. You earned your seat at the table. Now give yourself permission to enjoy the meal. Thank you for joining me for this special episode of The Hidden Load. If this conversation about legacy, mothers, and Women in Medicine Day spoke to you today, Please share it with a female colleague, a mentor, or a trainee who might be holding up a little bit too much weight right now. Let's lighten our loads 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.