The Jennifer Lawrence Effect

Jennifer Lawrence recently wrote about her experience after learning that her male costars were paid much higher salaries than she was paid in recent films after the Sony hacking episode a while back. She described being angry at herself for feeling it was more important at the time to be likeable than to have equitable, appropriate payment for her incredible work. I know what she means.

As an academician, I have spent my life struggling with this kind of reverse fraud. I call it a reverse fraud because there is active deception, but the deception is not to make people think you are better than you are. The deception is designed to make people think you are less than you are so that they feel more at ease in your presence, less threatened, more likeable. I argue, and really this should be obvious to anyone, but when people are asked to squeeze themselves down into a facade for the personal comfort of others, we all lose terribly as a society. This should be obvious, but perhaps it isn’t.

Training to be a scientist requires that you learn how to critically read scientific literature – the works of those who have gone before you – and formulate your own thoughts about their validity. Then you test the ideas you have generated from studying what has gone before. I have worked with scientists who understand this, and when I share my thoughts about a scientific or medical subject, they enjoy discussing the possibilities, leading to new ideas and discoveries. This is how academia should be.

In my training, mostly male physicians didn’t take well to my expressing my thoughts and opinions. Had I been another male, I am certain I would not have been perceived with any threat. I believe my thoughts and ideas would, at the very least, be entertained, heard. I am not so naive to think that there aren’t men out there threatened by other men, but when you look at academics as a whole, even this is accepted. If men find other scientists’ opinions or thoughts threatening, it generates discussion, sometimes loudly.

An entire book was written about one such encounter among male philosophers, called “Wittgenstein’s Poker”. According to the book, a discussion was taking place between prominent philosophers at the Cambridge University Moral Sciences Club in 1946. Ludwig Wittgenstein, who was chairing the meeting, passionately explained his arguments to the paper that was being presented, highlighting his points using a fireplace poker. Various different viewpoints were taken by those in the room or others who heard the story later, but rather than being silenced and told he cannot accept criticism, the actions of Wittgenstein were ultimately seen as passionate discourse. He wasn’t ignored or silenced because of his passion, even though others may have disagreed with him vehemently.

Men who agree find like minded men who agree with them, or some male scientists are alone in their opinions. Sometimes they are right, sometimes they aren’t. But they can speak their mind without the added fear of being alientated just for having thoughts and opinions.

When I have had the audacity to describe data and explain my interpretation of the facts as presented, I have been told that the results are simply artifact. I have been maligned personally. When I explain that other scientists have seen the same thing, rather than consider that my data is a real effect, or perhaps explaining why they think it is artifact, I have been told that I cannot accept criticism. When I spoke up to defend myself, I was told I was difficult. No one would support me openly, for to do so would have tainted them, as well. I received silent support which helped, but did not heal.

When the statement “she cannot accept criticism” appears on your reviews, how do you think this impacts ones career? Imagine how it would feel to stand up for your ideas based on data that is collected, clear as day, only to be shut down and ignored. One has to make a decision at that point: stand up for what you believe and be seen as ugly and unlikeable, or falsify what you are to make everyone around you happier. I think even the Buddha would have been in a quandry over this. To be myself meant to make those around me suffer.

This is only one of many similar stories in my own life, and I am sure there are many such stories from women across the globe.

Is there a way out of this? Very often the way out of suffering is through it. We have to be who we are. We have opinions, thoughts, feelings – some are likeable and some are not. If we all refused to be less than what we are and support each other through the process, and stand by each other, progress could take form. Perhaps other men who see the threat and fear in their colleagues could speak to the men who feel threatened and show how our opinions could be important. Or, perhaps I was wrong and my data was artifact. It would have been better to redirect me with kindness than to publicly shame me. This would have been a better use of everyone’s resources.

Science is about getting closer to the truth. This process only deepens and improves when the thoughts and opinions of all are considered. History is littered with stories of how both men and women have not been believed. But women are most often not only disbelieved, but often personally maligned, put down by being told they “cannot accept criticism”, or worse. Rather than quiet Wittgenstein, when he wasn’t being heard and threw down the poker he used to emphasize his points, he was heard all the more. If anyone said “he cannot accept criticism”, it was drowned out by those who were drawn to his points by his passion. He clearly didn’t care about being liked.

What you really want is to sit around in your pajamas and read the paper

I am a woman in a male dominated field. Once I started studying the heart, I was hooked. I enjoyed thinking about the heart, reading about it, and learning about it. There were probably other fields of medicine that I could have been happy practicing, but cardiology (for me, at least) was exciting, intriguing, and challenging. Given my background in research (I had been in basic science labs for many years), it seemed like a natural fit for me to spend my life in academic cardiology.

When I felt confident that cardiology would be my life career and I began sharing that with people, I was surprised by the responses I got from others. I had done very well in my training as a medical resident. When I compared my work with those of my colleagues, it seemed to me that I was at the very least comparable; based on comments from others, there was no reason to think I couldn’t or shouldn’t consider cardiology as a career.

So you can see that I was completely unprepared for the skeptical looks I got from people when I started to announce my life interest. While I was on the wards rounding on my patients in preparation for rounds with my attending, one of the cardiologists who practiced at the same hospital sat next to me and told me about how his wife, who was a practicing lawyer, now enjoys staying at home in her pajamas and reading the paper, now that she is married to him. Another suggested that what I really needed was a vacation. I am not sure to this day what he meant by this. Perhaps he thought that I was only imagining I could be a cardiologist, that if I took some time off I would get over the idea. I was told by others that I didn’t “look like” a cardiologist – no, I looked more like a pediatrician or a geriatrician. A male resident asked me what kinds of things I cook for dinner. When I told him my husband does the cooking, he paused and started getting red in the face. The resident, my senior, suggested he talk to my husband and tell him who does the cooking in a family.

All of these comments were made in 1995 – only 20 years ago. There were many, many more at the time and since then. These remarks did what they were intended to do – sow doubt. Despite my accomplishments, I began to think I was making a bad choice. Despite the fact that I was in love with the heart, I doubted my ability to practice cardiology.

Fast forward to 2015. Since that time, I have successfully completed a fellowship in cardiology, successfully performed several research post-doctoral fellowships, and published papers both in basic science and clinical science. I earned the esteem of scientists and clinicians and have been invited to speak internationally and domestically. Am I perfect? Of course not. I don’t see myself as the “triple threat” you hear so much about (academicians who are excellent practitioners, writers, and scientists), but I am certainly able and accomplished.

Would the world look different without my work? I would like to think so, but much more important, the women for whom I am now a mentor and a role model would not have had me to look at and decide, “Yes, I can do that”. And of course they can.

Perhaps the most important point I want to make here, and I will say this many times because it is so critical, is that I never had to take what those people said personally. Of course I did, but all that did was cause me to doubt myself. When I listened to my heart, I knew better. I spent many hours feeling hurt by their unskilled comments, but there was no reason I had to take their comments to heart. To be here now is more than revenge. I did what was inside of me, no more, no less. By taking what they said personally, I wasn’t able to live in the present. I gave precious moments to pain and doubt, when all I had to do was smile politely, and keep on going.

Waking Up

I am an academic physician. Being an academic physician is fairly unusual in itself, ┬ábut add to that “woman” and “cardiologist”, and you understand why I’ve felt somewhat alone and separate most of my adult life. I feel this way not only at work where I am one of 16% women cardiologists in the US, but also often in my private life where I have not felt understood by many people, some of whom are related to me.

In the past few years I have embarked on a path of awakening. What does that mean, you may ask? It means taking the time to understand who I really am, and what that means to everyone else. It means learning how to respond and not react in my day to day life. This sounds very easy, but it has been extremely difficult, requires lots of time and honesty, and has involved many tears. But it has lead to real groundedness that feels palpable and solid, and has gotten more powerful as I progress in my awakening. I feel more connected to my own life and those of my patients, family, and friends, and even people I’ve not yet met.

I want to share my experience with you, to perhaps be another voice to strengthen your own waking up process, or inspire you to your own practice. I’d love to hear your stories, and I hope mine help you feel less alone. It is my hope that even if you aren’t a woman academic cardiologist, you will still find support and comfort here. Namaste, and welcome.