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ER Goddess: Gender Bias Knows No Boundaries : Emergency Medicine News


gender bias, women in EM, gender equality


I went from tourist mode to EP mode when my son collapsed in the Eiffel Tower. We watched the man at the macaron counter arrange a rainbow of sweets while we waited for his sign to say “open”.

My bored teenagers started bickering, and an argument over Cole’s print on Graham’s new white sneakers escalated into Graham punching Cole in the stomach. Cole winced as I yelled at Graham, and seconds later I heard a loud thud and turned to see Cole motionless on the floor.

Two passers-by with British accents, including a GP, knelt with me to help Cole. The couple tried to take a story, throwing out questions and wanting answers. I just wanted to assess my son. He was pale and bleeding from the mouth. I held her legs bent as I inspected her lips and teeth. “How old is he? Does he have an episode history? Who is his mother?” passers-by asked.

“Seventeen. No, I am,” I said, noting that only a bump remained on one of his front teeth. I spotted the tooth fragment lying on the floor like a piece of vanilla macaron, and I instinctively reached out for him. “There’s nothing to do with that part of the tooth,” the GP said as I pocketed it.

“Yes, I know,” I replied. “I’m an emergency doctor.” People usually realize I can handle the situation when I tell them that, but my profession carried no weight with those two. They hovered as I inspected Cole’s face, scalp, neck and stomach. “He must have had vasovagal syncope.”

Understanding Qualifications

Cole started coming and saw all the faces hovering in bewilderment. “What happened?” he moaned. I knew the crowd was going to upset him, so I did my best to convince passers-by to go, explaining that my fiancé was also an EP.

Matt had gone to buy drinks. “He’s here with us,” I said, thinking they’d be happy knowing Cole would be in care of two EPs, but no. Soon, two doctors from Paris approached with a medical kit wanting to make sure Cole was okay. I asked them for ice cream. “Do you want us to call an ambulance?” asked the doctors.

“No, I’m an emergency doctor. I will be with him.

“Oh, are you an emergency doctor? No wonder you’re so calm. Finally, someone seemed to understand my qualifications.

Shortly after, the macaron man presented us with a bag of ice cream. I helped Cole sit down and he let me know he was done being a show. Hearing Cole’s wishes, passers-by left, but not without confirming: “So your fiancé is an ER doctor and will be with the child?” I pointed to Matt, who had just appeared with a beer in one hand and wine in the other, and somehow the presence of a male doctor reassured them more than the presence of the female doctor who was managing the situation. It wasn’t until they saw Matt that they resumed the Eiffel Tower tour.

Implicit bias

I don’t remember if I thanked them. I hope so because they were nice to worry, but I suspect I forgot my manners because I was flabbergasted that my medical degree didn’t seem to matter to them. Their efforts to care for my child as I asserted myself as her mother and a qualified doctor to treat her wounds left me with an all-too-familiar feeling that plagues women in medicine. Being shunned, ignored and subtly trivialized is an experience female doctors know all too well.

Rationally, I know that implicit gender bias is unconscious and unintentional. I understand that I am at a disadvantage because my feminine wiring and behavior is at odds with the assertive and classically masculine behaviors expected of doctors. Still, that doesn’t mean the bias doesn’t irritate me when I experience it.

I tried to give those well-meaning passers-by the benefit of the doubt. There may be a cultural difference; maybe the ER doctor doesn’t mean to them what it means to the United States. Maybe they saw me as a fragile mother rather than a capable doctor because I approached Cole as a compassionate parent rather than a scene-controlling cowboy. Considering that medicine can be a profession of ego, perhaps this general practitioner was simply too proud to rely on a “modest” PE. Whatever their state of mind, no cultural difference prevented them from recognizing Matt’s expertise. They may have been uncomfortable deferring to me, but they had no qualms deferring to my male counterpart with the same qualifications.

I’ve had 20 years to get used to microaggressions towards female doctors, so you wouldn’t think they’d bother me again. But the bias is more obnoxious than ever since I started dating Matt and found a new vantage point from which to compare these microaggressions with the respect male doctors receive. A minor instance of feeling trivialized by some onlookers at the Eiffel Tower may have been irritating, but it outweighed the obvious relief by passers-by when they saw Matt. Even double fisting booze, Matt was still seen as more doctoral than me just by being a man. I never realized how much the experiences of male doctors differed from mine until I was in a relationship with another EP.

Implicit gender bias affects women’s cognition as much as men’s. The disturbing twist to my story is that the GP who seemed uncomfortable leaving a female EP in charge that day was a woman herself. I clearly fell short of the societal notion of “doctorate” imprinted in his subconscious. Ingrained stereotypes of doctors being white and male know no demographic or national borders. It’s time to start shattering these painfully outdated stereotypes and imprinting new notions of what a doctor should be to better align with who practices medicine in 2022, in Paris and elsewhere.

Dr Simonsis a full-time nighttime emergency physician in Richmond, Va., and mother of two. Follow her on Twitter@ERGoddessMD, and read its past columns at