WORCESTER MEDICINE
JEDI or Die: Not an Option but a Mandate Women Rise up!
Figure 1. The Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine traces its roots back to the October 16, 1846 public demonstration of medical ether
Alice A. Tolbert Coombs, MD, MPA, FCCP Portions of this publication has been published in VSA Newsletter October 2020
A
pivotal moment in the history of anesthe-
is highlighted by a patient being anesthetized in the classic picture, “Under the Ether Dome” at Massachusetts General Hospital, on Oct. 16, 1846 (figure 1). While we are impressed with the historical significance of what happened under the Ether Dome, there exists another narrative. In a 19th century, male-dominated world, women understood the power of influence and basked in the appreciation of informal authority. While formal authority is expected in organizational structures, informal authority stems from relationships that are cultivated and which result in acquired influence. Informal authority or power is your brand and signature that ultimately impacts your organization and society. Female physicians are showcased in Figure 2, administering anesthesia in the operating amphitheater of the Woman’s Medical College of Pennsylvania in 1903. While women may be exhibiting formal authority, successful leadership development does evolve from informal authority. There are examples of positive and negative informal authority. As female physicians, we must understand the value of resourcefulness, empowerment, legitimacy and affinity as they relate to leadership development. Black women in medicine introduced the issue of intersectionality. Columbia University and the University of California at Los Angeles law professor, Kimberlé Crenshaw first coined this term more than 30 years ago in which she described: “the way people’s social identities can overlap, creating various forms of inequality and experiences of discrimination” (1). Intersectionality highlights the fact that not all inequalities are equal. The percentage of female Black physicians has steadily increased over the past 20 years and currently represents 59.1% of all Black physicians while the absolute number of Black female physicians has only increased minimally (2). Minority women in medicine may aspire to advance in leadership positions both in private practice and academic environments. Establishing some informal authority may offer a stepping stone into formal leadership positions. It takes doing the extraordinary and disruptive innovation to break through the glass ceiling. sia
Figure 2. Woman’s Medical College of Pennsylvania operating amphitheater, 1903. Legacy Center Archives, Drexel University College of Medicine
Dr. Elizabeth Blackwell was the first woman to receive a medical degree, doing so in 1849, and her role in mentoring and advocacy of the underserved was a constant theme in her life. She was a sponsor and mentor to her sister and other women. Dr. Blackwell demonstrated informal authority, but she had challenges that forced her to make career decisions based on an acquired physical disability (monocular blindness), infrastructure support, gender and her finances. At one point, she struggled to find work. She found strength in other women, who encouraged her. One of Dr. Blackwell’s closest friends insisted that if she were cared for by a female physician, she would have received better care. Dr. Blackwell’s empowerment allowed her to be decisive. Once she lost her vision, she could no longer be a surgeon, but she considered her next best alternative was to become a generalist. Her legitimizing body was her patients and other women. She recognized the reciprocal appreciation in this sector. Although she was forced to make decisions in the midst of uncertainty, she was empowered because a key element in her decision-making was her “connectiveness.”As female physicians, we must determine, “who is my legitimizing body?”In other words, who are not only my supporters but who shares a similar vision and therefore is a reciprocal relationship (3). Dr. Rebecca Crumpler was the first Black female to graduate from a U.S. medical school , New England Female Medical College in 1864. Sometime after graduation she traveled to Richmond, Virginia, where she cared for freed enslaved persons. The Medical of Virginia had so many marks of discrimination against Black people during this period. There are stories of procedures performed on Black individuals for teaching purposes (Medical Apartheid, Harriet Washington). There
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