Three years ago, in July of 2015, Dr. David Law invited me to be a keynote speaker at the Australian Society of Anaesthetists National Scientific Congress (ASA NSC) – their big annual meeting. It was scheduled for October of 2017, more than 2 years in the future (you conference planners know how this goes). It was a noteworthy international invitation, and I was really thrilled to have the opportunity to travel to Australia. My husband and I planned an adventure vacation to coincide with the conference. Then, one email away from booking our plane tickets, my husband was diagnosed with cancer. Suddenly and clearly, we weren’t going to Australia anymore.

Despite the gravity of the situation, I stressed a bit about backing out of the keynote (and several other sessions) at essentially the last minute, given the very long time ASA had been planning the event. I reached out to the two people I knew could represent the content exceptionally well – Avery Tung on decision making bias in medicine, and Ed Mariano on social media in healthcare. I recommended them to the planning committee as possible replacements for my presentations. It turned out that they had someone local for the social media sessions, but they did ask Avery to cover the keynote. It was short notice for a big trip, especially for an academic physician, but he got the green light somehow and said yes. It was a huge relief to me. The show would go on, and was guaranteed to be great.

During the conference, I followed the hashtag on social media. When the tweets starting coming about ‘manels’ and how there were no women represented on the big stage, I felt very mixed emotions, including defensiveness on behalf of the ASA. I was supposed to be there! The committee invited me, I had agreed, and I had bailed at the last minute. They trusted my recommendation, and I had recommended a man. Not because he’s a man. Because he’s a master presenter, and expert in a niche area, and we’d co-authored publications on the topic. I thought he would do the best job.

At the same time, there must have been a relative underrepresentation of women speakers overall, or my absence wouldn’t have shifted the perception of demographics so much. And of course, there’s the undercurrent of concern that women will wonder if they are being offered opportunity for the sole purpose of checking off the equality box, rather than because they are outstanding physicians and the right person for the job. And the concern that others will perceive a female physician’s success in that same light – that she was somehow given an advantage or ‘easy pass’ simply because she is a woman. These are all valid concerns, and I have strong feelings about them as well.

The ASA took some public heat for having an imbalance of diversity among speakers, particularly for the plenary sessions. Awareness was raised, and that’s a good thing. But the other good thing was less visible.

My male colleague supported me by jumping through whatever hoops he had to, at work and at home, to make a trip halfway around the world and give a huge presentation without much notice. I know the conference should have been the least of my worries, but I’m guessing some of you can relate to how I was stressing about it. The tension between whether work or family comes first – and the need to be supported rather than punished for putting a family need first – is a common theme among today’s conversations about professional advancement of women. #HeForShe calls on men to recognize, sponsor, advocate for, and support women. Typically, at least within my professional community, this is interpreted to mean a man recommending a woman for a visible leadership or advancement opportunity. This was definitely not that. The visible role was transferred from a woman to a man, and the host organization felt the blame. But knowing Avery would be at the microphone made it much easier for me to put my attention where it was truly needed. It allowed me to back out of a major commitment with peace of mind. This #HeForShe support was incredibly important to me, but probably invisible to everyone else.

So by all means, let’s keep working on ensuring balanced representation. Let’s study it, talk about it, let’s achieve real progress and enduring change. And while we’re doing that, let’s keep in mind that things aren’t always as they appear.

heforshe in medicine

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