Wednesday, December 9, 2015

#ILookLikeASurgeon: The Journey to the First Tweet

Tweeting this:

on August 5 and writing an accompanying blog post, I never imagined #ILookLikeASurgeon would become a movement. I am truly humbled and inspired daily by the powerful, global response the message has generated.

In meeting advocates of the movement at the American College of Surgeons Clinical Congress, I realized that many are also curious about my own story--who I am and what inspires me to start and sustain the movement. While some articles have simplified my background and described me as a “general surgery resident,” it’s actually a bit more complicated than that. Perhaps not surprisingly, my life trajectory has been anything but stereotypical.

Growing up, doctors seemed superhuman; a profession far beyond the reach of anyone in our small, agricultural community. I was raised on a dairy farm in rural Wisconsin, and both my maternal and paternal grandparents and great grandparents were dairy farmers. When I was 6 years old I was asked to draw myself “20 years from now.” I drew myself looking out the kitchen window, doing the dishes. Fast forward to 8th grade “tech ed” class (i.e. woodworking) where we were encouraged to choose a career from the Department of Labor Occupational Handbook. I chose surgery because it combined my love of science and my passion for helping others. Given there were no physicians in our community, there was really no one to tell me I couldn’t do it. Yet in many ways, the paucity of role models from a similar background has led me to question many times whether I “belong.”

When it came time to go to college, I received an academic scholarship to the University of Wisconsin, Madison and thus didn’t feel the need to apply anywhere else. As a first year student, there were more people in my dorm building (1100) than in my entire home town. While geographically a 4-hour drive, it felt worlds away. That first semester my mind expanded to greater dimensions than the previous 18 years combined. College proved to be a time of both professional and personal growth. I majored in psychology and earned a certificate in women’s studies. The women’s studies courses enlightened me to the strong gender socialization I had internalized growing up in rural America. Also, having grown up in an all-white community, I was eager to attend every “diversity” event I could. While Wisconsin may not be the most diverse state in the nation, the community of Madison is passionate about celebrating diversity and promoting equality. Such opportunities included attending courses at the Institute for the Healing of Racism founded by renowned bassist, Richard Davis.

Part of my journey of uncovering and unlearning my own internalized gender stereotypes included healing from personal experiences with sexual violence. I found empowerment in social activism. I started a peer education program, “Silent Crimes, Outspoken Voices,” which used stories of actual survivors of sexual violence to educate peers. We also started a men’s group focused on pro-feminist, gay-affirmative, and anti-racist issues as well as ending male violence against women. Skills and wisdom gained from these experiences have informed my leadership in the #ILookLikeASurgeon movement.

In medical school at University of California, San Francisco, I found tremendous inspiration in my surgical mentors who modeled a strong history of improving public and global health through learning from and giving back to local and global communities. As a student I was encouraged to continue my passion for advocacy, hosting conferences on both domestic violence and bias in medicine. After graduating from medical school, I took a year before residency to have our first child, Sierra. During that time I worked with a few health tech startups in Silicon Valley. It was a formative learning experience to witness the challenges at the intersection of medicine and entrepreneurship. It was also inspiring and rewarding to work with the many e-patients advocating for their own health and for positive change in medicine. These experiences brought to life the power of social media to connect patients and physicians and inspire innovation.

When the Monday before Match Day arrived, I clicked open the anticipated email and learned I did not match. I consulted with my mentors and quickly made the long list to whom my application was subsequently sent. That Wednesday I secured a spot as a preliminary general surgery resident at the University of North Carolina Chapel Hill (UNC) and was subsequently invited back for a second preliminary year. I loved my experience at UNC, and continued to be inspired by strong female and male role models. Given the limited time residents enjoy outside of the hospital, I chose to focus on expanding my clinical knowledge and caring for our growing toddler at home, rather than aggressively seeking a categorical position. It was not a surprise last July when UNC did not magically have an opening to offer me as a third year resident and thus my initial plan was to work on research projects, network and apply for a categorical position to complete my general surgery training.

As is often the case, “life is what happens while you’re busy making other plans.”

In early August my husband, Chris, was offered a position opening a battery research lab for Tesla Motors. Chris had set up Tesla’s first battery research lab and left this dream job to be the lead parent while I was in residency. We quickly realized that me taking two years out to do research or industry work would allow Chris the opportunity to return to the workforce for this once-in-a-lifetime project, while at the same time give us the opportunity to have a second child. Given that I developed a cystocele at week 26 of my first pregnancy, it is important that I not be clinical (i.e. on my feet) during pregnancy. It does not serve me or my (present and future) patients to put my health, the pregnancy, or ultimately my career at risk.

It was the culmination of these life experiences that inspired the #ILookLikeASurgeon movement.

Given the magnitude of the movement and the doors it has opened, many have asked me if I plan to return to surgery. The answer is a resounding YES! I love surgery and my goal is to secure a categorical position and complete my training. To me, the privilege of cutting open the human body and healing it from the inside out is the single greatest honor that can be bestowed upon someone. Similarly, it has been an honor and a privilege to lead the efforts of #ILookLikeASurgeon.

Not in my wildest dreams did I think I could impact the world of surgery in this way, especially at such an early stage of my career. Yet, when I look back on my life so far, I have lived my belief that we can inspire and help others on their journey, even as we are in the midst of creating our own.

#ILookLikeASurgeon has uncovered a global community of surgeons who are shedding the outdated surgical stereotype. They forge their own unique paths, maintaining their individuality, and prioritize being both the best people AND surgeons they can be, rather than forcing themselves into an ill-fitting stereotype. Personally and professionally, I—along with countless others—have learned that I am not alone. Surgeons come from all walks of life. The pictures and tweets shared publically, as well as the direct messages shared privately, have been a gift and a responsibility.

So what is next for #ILookLikeASurgeon? My vision for #ILookLikeASurgeon is for it to serve as a supportive community promoting positive change, ideally strengthening the networks of existing surgical organizations in the process. This will be accomplished through the continued conversations on Twitter and Facebook as well as blogs and more formal publications. The message remains the same since the very first tweet, that we can ALL look like surgeons. Just like our patients, we are all unique and we all have our own storyoften much different than appearances might suggest.