Connecticut Children's Women in Surgery: Episode 1

Welcome. You're tuning in to Candid Conversations with Women in Surgery from Connecticut Children's, a premier regional pediatric healthcare system. Topics can range from emerging research to career advice, to the unique challenges female surgeons face when breaking into a male-dominated field. Hello, I'm Lisa Morella and I'm the host of the Women in Surgery podcast. I'm the director of organization effectiveness and learning at Connecticut Children's. I'm a dedicated resource to our physicians to support them in their personal and professional effectiveness. And I welcome you to season one, episode one of the Women in Surgery podcast. Today's topic is the imposter syndrome. And here for our conversation are 6 amazing women in surgery. My name is Janine Collins. I'm a pediatric ophthalmologist. I have been in practice for about 7 years, having joined the Connecticut Children's Family in 2019. I have some professional interests that include pediatric glaucoma, pediatric cataracts, pediatric uveitis, and retinal disorders. Uh, I also have a super awesome 5 year old rescue pup named Wally. And I love cooking and baking and running through the reservoir trails, especially in the fall. Hi, I'm Alison Crapo. I am an orthopedic surgeon and assistant professor. Um, I'm dual fellowship trained in pediatric orthopedics and orthopedic sports medicine. So I'm in a unique position to take special care of our young athletes, uh, and I also take care of common pediatric orthopedic problems and trauma. I joined Connecticut Children's in 2019, after seven years in practice in Virginia. My husband, Andrew and I both are native New Englanders, and we were excited to move back home, and we also welcomed our first child. Um, I grew up as a dancer and gymnast, but went on to play Division One lacrosse in college, so I sort of span the, uh, range of activities, but now sort of limit myself to running and uh spin cycling. My name's Kara Di Benedictus. I'm a pediatric ophthalmologist and assistant professor. Uh, I practiced for 7 years in Philadelphia before relocating up to Connecticut Children's in 2019. I specialize and concentrate my practice on pediatric cataracts, for business, and most medical pediatric eye conditions that also include congenital anomalies and management of oculargenetic disorders. I have two kids. I have a 5-year-old little girl and a 3-year-old little boy and my husband who works in IT. Um, the things I like to do are running, biking, hiking, and rooting for my college basketball team and my baseball team, which is the Orioles, uh, but I married a Yankees fan. Hey, I'm Nancy Grover. Um, I'm a pediatric otolaryngologist, and I guess to put it real simple, ear, nose, throat surgeon. Um, I joined Connecticut Children's in 2019, so it's not been very long. Um, before this, I've worked as a practicing ENT surgeon in 3 continents. Yes, I started in India, trained in England, worked there, and then moved here. So I worked with a diverse set of patient populations and cultures. Um, my special interest in ENT is sleep surgery, um, mostly for kids with complex issues surrounding sleep apnea, and if there's any advanced surgical options to offer them. Uh, about my personal life, I have 12 year old twins. I have a very feisty girl and a philosopher's son. Uh, my husband works in risk management for a corporate bank. As for my hobby, it's pretty simple. I love hiking and catching up on my sleep over the weekends. That's me. I'm Kristen Pierce. I'm a pediatric orthopedic surgeon and an associate professor at the University of Connecticut. I joined Connecticut Children's in 2001, so I think I might be the senior most member here. Um, my particular interests are, uh, motion and gait analysis, neuromuscular disorders, and limb deformity, as well as trauma and routine orthopedic care. Um, personally, I have two sons. They are now 20 and 16. And, uh, I have a terrific husband, Brian, who is in the IT tech field. Uh, my personal hobbies, um, probably soccer and spinning, um, and yes, I do play even after 50. My name is Rana Sinha. I'm a congenital heart surgeon at Connecticut Children's. Since February 2020, or also known as almost the beginning of this pandemic, and I'm also an assistant professor of surgery at the University of Connecticut School of Medicine. I operate on the entire spectrum of congenital heart disease patients from neonates to adults. I have a 9-year-old daughter and an 8-year-old son, and I really enjoy Bollywood music and dancing. Thank you all, and you can see why I said we have 6 amazing women in surgery. So we are going to jump in with our topic today about the imposter syndrome. And one of the things we all read going into this. This was in May 2008 article from Harvard Business Review by Gil Corkendale um on the impostor syndrome. And in that article, the impostor syndrome was defined as a collection of feelings of inadequacy. That persist despite evident success. So, what do you think about that? What about that definition resonates for you? One thing that kind of strikes me about the definition, um, at least from the Harvard Business Review's, uh, discussion, I, I think that it, it can be a, a bunch of different things, but I do believe it is, you know, a collection of feelings of inadequacy. And at that point, I would say, yes, that makes sense. And it can come on as Rayna was saying, at any point in any field of your life, whether it's, you know, your medical profession or your, you know, home life or whatever, there, there can be things where I, I kind of disagree a little with how they explain it. Um, how it, you know, that, that, that impostors suffer from chronic self-doubt, and that override feelings of success. And I find it more of a sporadic, like, you know, you can be feeling great about things, then all of a sudden you find yourself in situations, and you'll have moments and And I think it's definitely very different for different people. And you know, as with everything, it's different levels of severity, but it, it creeps up on people. And I think if people are honest, they all have a little of it somewhere, but not all, but, um, and I don't think it has to be this overriding thing. I think in some people, it really can, it can be, it, it can be limiting and, and really affect. Performance and um behaviors, whereas I think in others, it creeps up and you have to let yourself be aware of it and how you're going to deal with it. It's a really interesting point that it doesn't have to be pervasive all the time. It can rear its ugly head here and there. I wonder if others feel that way. If it's something that creeps up on you, and if so, how do you notice it? What do you notice when it's creeping up on you? So I totally, totally agree with what Kristen said, and I was about to say that, and thanks for saying it. I totally agree with that. I feel this. Doesn't have to be chronic and situations in which I think it has happened to me and it probably keeps up is sometimes when you're in new situations, um, things you have not faced before or new roles, new responsibilities, um, and I don't know whether we would call it impostor, we'd call it, of course, you know, we all have experience in different spheres of lives and personally and professionally. And I guess lots of people in a new, you know, when thrown into a new situation or you're having, you know, taken new roles, probably go through it because although we have experience, we may not have done the exact thing that is expected of us. Um, and I think the more important thing, as we probably, as the podcast goes on, we discuss is how do people overcome it. So I think in my situation, I have faced distinct, um, episodes in my life, which have all been either, you know, a new role or a responsibility. Or a new challenge in my life when I've distinctly faced it, um, and over time, my reaction to that has changed. So that facing it the first time feels like a trigger for that for some people, like it's the first time I'm doing this or seeing this or trying this, and therefore it could flare up at that point. Correct. For me, recently, um, you know, like several of us, uh, I was in practice for a long time and then changed jobs. And so I think coming to a new Practice and sort of feeling like everybody's watching what I'm doing, what decisions I'm making, who I'm indicating for surgery. Um, I think I, I started to feel it a little bit, and I actually sort of felt that, that almost people pleaser part of me that comes out when I feel like I have to sort of do what everyone expects me to do, or, you know, do what everyone else is doing to make everyone happy, um. I sort of felt that come out like, well, what do other people here do? Maybe I should do the same thing, even if that wasn't what I was doing before. And I think it took me a minute to sort of check myself and say, wait a minute, I know what I'm doing. I've been doing this for a long time. You know, just because I have a different opinion and maybe you're, you know, around people with stronger opinions doesn't mean that your opinion's wrong. And so I think, you know, especially because of my personality, I think that that's something that I see myself doing sometimes, and then I have to stop and say, wait. This, this is not what I need to be doing. I completely agree, Alison. Like, I felt like I had suffered, um, a bout of imposter syndrome, if we're going to classify it as like an illness, um, that kind of waxes and wanes. Um, when I was first in practice, and I didn't even realize what it was. I just had this feeling of self-doubt. Like, was I really qualified to do this job? Am I good enough? Am I doing well enough? Am I taking good enough care of my patients? And is somebody going to walk around and tell me if I'm doing a good enough job? And when am I going to get that kind of feedback? And As I grew the self-confidence to overcome it and feel comfortable in my role and comfortable in the care I was providing to children, it kind of went away. And then I moved, and I changed jobs, and it's the same job in a new location, but somehow it just feels very different, and it really knocks you off your feet for a little while, and you are almost like relearning and rebuilding your confidence, um, to, to overcome those feelings of self-doubt and Um, and guilt at, you know, whatever inadequacies you think you may have brought with you. Impostor syndrome kind of resonates with me starting, uh, in my fellowship when I'm matched to a great position and, and a good hospital, and part of me wondered if it was a mistake. Um, I matched to a place that, um, I kind of held on a pedestal and I held in high regard. And so I was constantly worried that I would be found out or a fake or they would think, hmm, why are you here? So I had gotten to where I was with hard work and then it was this cycle where I would work hard because I was scared they were going to find out that, you know, maybe they had made a mistake. And so it was It helped me in a way uh to be driven, but it also became this constant cycle where I was worried that if there was some imperfection that was revealed that it would be my downfall. Who's the they, when, when we think about the imposter syndrome, who's the they that's going to figure this out? So, uh, uh, it could be anyone. It could be a patient if they're not happy with something or if they go to another doctor and the other doctor found something that I missed or one of my colleagues or my mentor or um any of my, you know, Colleagues who might say, Why did you do this? You didn't do it the right way. Um, or, you know, the nurses in the OR, why are you operating this way, so and so doesn't do it that way. So it really could be anyone, um, who might think that you're doing something not the right way. Being a working mom, a surgeon, having twins wasn't easy. Um. And I, the only time I, I think I used to feel bad was that. I was like, Kristen said, I was not ever there for the concerts, performances. I missed it for years, um, but I coped fine with that. I think the, where I started getting the imposter syndrome was I wasn't probably doing enough for, you know, the school PTOs and my kids would come up to me and say, hey, you know, so and so's mom. She's so popular. Everybody knows their mom. No one knows your mom. Um, so that's when I, and I just never had a chance to get involved with a lot of activities in school. So that made me really guilty, um, and that's what I used to think, you know, what can I do to involve myself so my kids don't think that way for me. So I felt a little bit inadequate that I wasn't really being a part of, you know, the team of moms looking after the school as if I wasn't doing enough. I mean my concept was my kids go to school, they get their education, that's what they're supposed for, you know, that's what they're there for. But again, that's where I used to get that I'm not involved with anything out of school or class, so I used to feel very inadequate about that. But again, you know. I actually distinctly remember at one point having heard a female CEO of a very big company. She is now retired. I think we probably all know what I'm talking about, the PepsiCo CEO, and she had an interview and she's like, She had the exact same feeling when her kids made her feel so guilty about not doing things, and finally she actually spoke to a few parents, and it turns out a lot of parents were in the same boat, and then she never had that guilt again. So I think that's how I sort of. A little bit got over it. It's OK for me not to do it because he has this big lady who thought she, she was guilty of not doing it, and then when she chatted up with, no one, there were many parents in her boat who were not able to attend that particular event that she thought was a big sin that she couldn't go to. So it sounds like you're saying that it's widespread, that many people are experiencing it. What about others? Are there other places in our lives that as women that we experience this outside of our profession and even outside of motherhood? Are there other places you feel it? Um, I'll just talk about my experiences in training and having children while I was training because it was something that was unique, um, for me personally, not having seen anybody else in my family or close relations where someone's trying to actively pursue a career and have children. Usually, I had thought, as others may think that things are sequential in life. You have your childhood, you Finish college, some form of postgraduate education, start your career, then family life, uh, plus or minus, and somehow for me, my personal choices just led me down the path where I ended up doing both. And because of that, I failed a lot of imposter syndrome outside of work, because I ended up having two healthy children. Um, although they've both been in the ICU and I still feel guilty that I didn't realize I was in labor and I kept working with my first, um, child, and she ended up being, uh, in distress and I had an emergency C-section and I feel a lot of guilt about that to this day that I prioritized work over health, but I literally didn't have the usual or classic symptoms of labor. And so I didn't and I continued to work because our training programs don't allow this kind of flexibility that other people might have when it comes to maternity leave, when it comes to childcare. And so I was again trying to do the best I could, but she was born on time, but only 2 kg. Ended up having um some aspiration and ended up in the ICU and both um my husband and I are physicians and I felt like the worst parent ever that I didn't know I was in labor, plus I'm a woman, like how did I miss it? And that imposter syndrome, that feeling inadequate as a mother has carried over. Now she's 9, she's healthy, no problems, but I feel like that I failed as a basic role in life before I'm a physician, before I'm a surgeon, I'm a mom, I'm a woman, you know, and that lays with me heavily, and I have to keep reminding myself, I just did the best that I could. And not let her guilt me into doing extra stuff for her. I just did the best that I could. I, again, I love that. Have others of you had this? I, I, I, I did the best I could, or I'm doing the best I could, can. Is that a feeling that others of you have shared or experienced? All the time. Well, especially now during corona, I feel like all you can do is the best you can do and um sometimes, honestly, it's, it's, it's a challenging time to be a person, a challenging time to be a human being and to get up out of bed and, and go to work and take care of your family. Um, so sometimes the best you can do is, is all that you can do. Um, and I think showing yourself, uh, kindness and, and grace, um, is how you can go get over some of your imposter syndrome type feelings, allowing yourself to fail and knowing that it's OK to fail, and maybe you're fail. Failure isn't even really a failure. It's just an experience that you can learn from. One of the things that we've read about is that imposter syndrome is experienced across genders, across professions, across different lived experiences. But what might be unique about the imposter syndrome for women in medicine? I mean, I think first it's just that most of us are minorities as far as, you know, being a woman in our field. I know in orthopedics we are 6%, you know, Rena's basically a unicorn. I don't know what the numbers are in ENT 2 with 2 little, one for each child. But I think just, just being, you know, different in your field as it is, or, you know, all the things that we go through during our training and, um, you know, just to get to where we are, I think impacts us significantly, um. As far as, you know, how we feel about who we are and what we do. What else might make women in medicine particularly, I don't know, vulnerable or ripe for the imposter syndrome? One reason that women might be slightly more um Likely to have imposter syndrome or experience it are there's a lot of expectations that are placed on to women in society today, um, to kind of handle everything. Um, Many women are expected to uh not only perform their work outside of the home, but they also take on a large portion of the occurrences in the home, uh, in addition to the mental load, um. I also think that it can depend on your family life and, and how you were raised, but there is a pervasive feeling among women that they need to care more about others than themselves, and they are more likely to feel like they let people down, uh, if they're not living up to these expectations. And so I think that can likely play a role. OK. So I, I like that you talked about that we have to handle everything, uh, the home, inside the home, outside the home, and then I heard you say even the mental load. And I think by that I'm assuming you mean like sort of the emotional, taking care of the emotional needs of the people in our lives as well. Well, emotional, the scheduling, um, you know, preparing, um, you know, getting the clothes ready for the next day, making sure that everything is prepared. Uh, making sure schedules are aligned, making sure that communication is happening. Um, you can't just kind of show up and do your thing. You have to really plan and, and plan ahead. I think what I feel is it's, it's not, it's also about how other people perceive women, how they see what their expectations are from a physician or a surgeon who's a woman. Um, versus somebody who's, who's, who's, who's a male, so it's not necessarily how it's of course it could have to do with, you know, how we are brought up and our cultures and what's expected of women, but I think it's also like if a beauty lies in the eyes of the beholder, what do other people think of women if you're working with a team of You know, your anesthesiologists and nurses and patients and your team, it's also how they perceive a woman. So you're not only fighting, um, you're not only what you're not only trying to prove yourself. Because, you know, one, you're a woman and there's other expectations from you, so you're working hard for that. You also are at some point saying, you know, I have to try and see what their perception of me is, what is it they may or may not like about me, and I need to overcome that. It's all sort of like an, an extra, um, you know, thing to for me to achieve. So I may or may not have. That inadequacy about myself because I'm confident, but then I want to see, like I said, I've been in 3 different cultures in 3 different continents. What are people's perceptions of me as a woman, as an ENT surgeon, you know, as a person of, you know, whatever culture I am from, you know, how do I overcome those values. So I think that's the other problem which I foresee with women having more imposter syndrome. So it's not just your own expectations of you, but it's what might be all of the others other people's expectations of you based on their perceptions of what, who and what you should be. Mhm. Exactly. What are some of the other things I, I, I think it might be therapeutic for us to just put out there. What are some of the other things? You have heard over your lifetime that have triggered this sense of uh uh uh uh uh uh the sense of inadequacy or the sense of, uh, I'm just not, I'm just not the real deal. I have an extremely superficial example, that's something that has stuck with me, um, twice in my training program, uh, people commented on, like, one day I was in the OR with an attending, we're doing a case, and he said something and I laughed, and he sort of like made a backhand comment, like, boy, you'll laugh at anything, won't you? And then I, you know, I sort of, it was almost like a bullying comment, and I just sort of like. pulled back, and then I started thinking, like, every time I Laughed with, you know, do people take me seriously? And then I actually had someone pull me aside and, you know, sit me down and say, listen, you know, you, you have to watch the way that you talk to people on the phone because, you know, the way that you talk or the sound of your voice, they don't take you seriously, you know, you, you, I don't, it's all the things that you can't change, you can't change the way that you laugh, you can't change. It's the sound of your voice. Um, and so these little things that just sort of like eat into you and make you feel like, oh my gosh, am I not going to make it? I'm a 2nd year resident. I'm being told that people aren't going to take me seriously because of the way that my voice sounds, or the way that I laugh. Um, and so that just sort of doesn't leave you. And I'm not sure, you know, I feel like that's one of the things that sort of. Probably unique to some women that people feel free to comment on, you know, the, the way that other people see us, um, whereas maybe they don't do that as much with men. I can think of two really distinct moments where you're like, wow, you just said that, and can you say that? Um, but then it puts you going, Should I be doing what I'm doing? Um, when I was, both of which, when I was applying to residency in orthopedics, which now at least is up to 6% women, I guess that's really good, but 20 years ago, whatever, you know, it hasn't always been that good. But, um, I, I was, one, I was at an interview and somebody once asked, well, how are you gonna handle being a woman in orthopedics? And I went, I guess the same way I've handled being a woman and everything else up until this point in my life. And the surgeon went, well, you're either really lucky or really naive. And I went, I hope I'm a little of both. I'm pretty sure I'm pretty lucky. And I'd like to be, you know, ignorance is bliss to a point, because that comment was just so dooming at that moment. And yet, I was like, well, you know what, I've gotten to this point in life, and I'm going to keep going. But there was that moment of, oh my gosh, what am I doing? Because up until then, I didn't even know there weren't a lot of women in orthopedics. I just knew it's what I want to do. And it was naivete, and I was kind of happy to be at that point, right? And on that, I'm sorry. I'm sorry. I, I please in the same year of my interviews at another place I was interviewing, and it was a place where they had lots and lots of people that interviewed you kind of in order. And by, about my, I don't know, 8th or 9th interview of the day. One of the surgeons and so by now, I'm sure you've heard the history of women in the program. And I went, no, no one's mentioned like women in this program that hasn't come up in topic. He goes, oh yeah, we've had two in the past. One was pretty good, one left a bad taste in everyone's mouth. So this year, we think we're going to take one. And I went, OK, don't write this program, because at the moment I went, this is so bizarre. But literally, if I go to this program and do well, that's great for women forever. And if I do badly, that will be damning to all women forever in this program. That was exactly how I felt at that moment. I went, oh, great. So I could be the 3rd. And it was just, you know, the, these feelings like, are you kidding me? And this is what I'm gonna do for a career and a life, but they're out there. And I think both your example and Alison's example underscore that those are sexist and oftentimes illegal, um, and just unethical comments that people are making. So I think we should just call it what it is. Right now. So, uh, our listeners understand those comments are not OK, not acceptable. I have two very specific examples. Um, I look pretty young. Uh, I'm 42 years old, but I, you know, I look a little older now since I've had my two kids. But, uh, before that, I looked even younger. And on multiple occasions, I have had patients either tell me or uh one of the uh senior um doctors uh where I've worked that they thought I was very nice, but they wanted someone a little older with a little more experience. Um. So that definitely would set the impostor syndrome into motion uh and wondering if you're good enough, right? I can't change, um, you know, how young or old I look, and that definitely would set that chain in motion. Um, the second specific example is when I finished my fellowship and I was a new attending. Uh, I was trained to do pediatric cataracts and I worked with the residents a lot. And so they would send me a lot of their patients. I worked with them and they knew that's what I did. And so they wanted to send me a patient that was referred by an outside eye doctor, an outside ophthalmologist. And when the outside ophthalmologist found out that I was a new attending, they said, uh, and I quote, She's only been out for a year. That's like me sending this to a fellow. I need to send them to someone who has more experience, end quote. And that really kind of, it affected me because I felt that I was well trained and I had a lot of support and. Yes, I didn't have as much experience as some of the older, more senior doctors, but again, it just set everything into motion with, am I ever gonna be good enough? Am I ever gonna have enough experience to feel confident and for people to look at me the way they're looking at these other more senior doctors that they trust. I wanted to move us forward and talk a little bit about um what are some of the ways that you have Successfully or successfully try to deal with or conquer the imposter syndrome. One thing was delegate. Profession was really important for me. So the day I found out I was having twins, I should have been really happy, but I was so nervous and stressed out. And when I had my ultrasound, and that's the day I decided, OK, I can take care of it. I just need a very good nanny. And my husband was very, very, very helpful throughout. With my kids in my personal life, and that helped a lot. So delegation helped me a lot in my personal life. So I could pay a lot of attention to my profession. So I, I think we can expand that and really talk about that, um, having, uh, people that we can count on, rely on to share some of the burden, work, uh, with us, uh, can help us feel calm. And confident that tip, uh Nancy, thank you. That delegation tip could also work professionally if we have colleagues that we can trust to hand things off to, to ask for help, to seek help, to, uh, ask for their support. Uh, that's a, that's a, a professional version of, you know, having a, a, a nanny or a partner we can count on is having a, a, a work partner. I can count on as well. Alison, I think you were the person who first mentioned, I, I check myself, I say to myself, and I'm just wondering if you could tell us a little bit about how successful some of your self talk has been. Part of it maybe isn't so much just actually talking to myself, but sort of, you know, sitting down and thinking about where I've been and what I've accomplished, and then realizing that I don't. You know, always need to fit into the mold or, or necessarily um gain people's respect by just doing what they think is the right thing. So I think that I, part of it is just realizing that I have experience and it's OK to have opinions and that I bring something else to the table. Alison, you began, I think by talking about, I'm going to call it taking an inventory of all of the accomplishments you have, all of the things you have. Done, you've seen, you've faced, and you've, um, mastered. So I love that inventory of our accomplishments is another great tip. And then you, you, I think you kind of took off on Nancy's suggestion, which is not delegate, but delegate, you know, bring in a colleague, a professional, a colleague for support, um, either as validation for what we do, or to kind of share some of that, um, the whatever that load is that we're carrying. So I love that we've got some great tips. I feel. I feel like it's very helpful to share your feelings and share what you're going through with colleagues that you can trust. And that's really the first time that I actually learned about impostor syndrome. I had no idea what it was. I knew how I felt, and I trusted friends and colleagues to share how I was feeling and what I was going through. And they kind of tapped me on the shoulder, and they were like, Have you read this article? This is you. This is who you are. This is how you feel. And you're not alone. And I think there's a lot of power in 1, having a name for what you're going through and identifying it. And number 2, knowing that there are plenty of other people out there who have been through the same things that you've been through, and they've gotten through the other side, and they might have some awesome motherly advice for you. Um, and so I think talking about it, not being afraid to talk about it, um, and sharing your concerns with others, uh, can be therapeutic for you. You can learn a lot and, and you might be in a position to help someone else. I think one of the things we have to try to do, and it's easier said than done, you know, if you're brought up, you know, self-praise never pays. But if you can find moments of pride and joy to try to relish them, the longer you go on, you realize, you've been doing this long enough. At some point, you realize you're, you know, you're going to keep getting better because you keep growing. But you get to a point in your life or your career going, who am I trying to please anymore? I got to please myself. I got to do what I love. And I hope I'm doing as good as I can. And if you feel that, try to take that moment and say, yeah, you go girl, or go guy, you got to somehow pat yourself on the back because people will definitely step on your back. I love that idea of being your own cheerleader. I think that's a great philosophy to live by. On that note, I want to thank all of you for your insight, your wisdom, your courage, and most importantly, your resolve to. Uh, to allow your gifts. I appreciate all you've contributed this evening. That's our show. Thank you for listening. Stay tuned for episode 2 as we bring women surgeons in to discuss the impact and difference between sponsorship versus mentorship in the workplace. Please make sure to rate, review, or subscribe to the Women's Surgery Podcast on iTunes, Spotify, or Google Play.