Back in medical school, I helped to organize a leadership retreat for women physicians-in-training. I had spent a tremendous amount of effort cold-emailing women doctors who embodied leadership—through vision, courage, influence, interesting career trajectories—and to my amazement a good number had graciously agreed to join us.
On the opening day of the conference there we were: 20 or so female medical students, eager to inherit wisdom, sitting in a conference room just outside of DC where the buzz of (mostly male) politicians vibrated through the apparatus of our democracy, when the first speaker of the day arrived and started in on her talk. Gathering us around conspiratorially, she explained how she persevered to attend medical school over forty years ago, back when it was genuinely remarkable for a woman to do so. As a result of all her hard-won success she had some advice for us. Advice that we were unlikely to hear from the establishment but that would help propel us as leaders in medicine to the upper echelons, where few women seemed to dwell—to wherever it was that we wanted to go in our careers.
Advice like: Get your makeup tattooed on your face. It saves so much time!
I remember thinking that this advice, drawn out over the next ten horrifyingly animated minutes that covered topics including whether “blush” could realistically be achieved by tattoo technology, was almost Shakespearean in its refraction of issues related to the theater of gender and to the palpable undercurrents in all our lives related to resource allocation, power, and performed identity.
On the one hand, this advice represented a kind of repudiation of gender norms: if this is what society tells me I have to look like, well fine, I’ll do it, but you can’t make me really give a fuck.
Yet obviously, on the other hand it was a tacit, maybe even celebratory, acceptance of expectations around normative female beauty. Otherwise, why not just go without makeup? (Saves just as much time, and money too.)
Back then, as now, the double bind of gender struck me. Like most women (and many men too), I experience daily the ways that I modulate my tone, my language, my dress, my stance, even my internal sense of identity to fit into the varied professional landscapes that a woman with any interest in power and influence might navigate. These are issues taken up of late in Lean In type circles and long subject to feminist thinking historically.
But what’s interesting to me now is that six years into being a physician and reflecting back on that advice I received maybe ten years ago, I’m struck by a far more prosaic fact, which is: tattooing your make up on is about time. Specifically, about saving it.
Time is not a quandary unique to women; we all labor, some would say quite equally, under its constraints. Yet it is fair to say that my own experience of time—and the demands upon it—reflect problems that many women in medicine face uniquely. And these are problems born of and shaped by the sexism that is more broadly a product of patriarchy, and more specifically a product of the systems of Western medicine and medical training which traditionally have excluded women from their ranks.
The story of time, for me, has a lot to do with the fact that the period in my life requiring an extraordinary dedication to my training was also the period when I was desirous (and biologically capable) of generating a family.
I am not alone in this predicament; it turns out that your twenties and thirties are a really great time for women to have kids. I was blessed (a word I use in absolute seriousness, but also a hint of mom-sarcasm) to get pregnant in my intern year of residency, a child I then delivered in my second year. In my third year of residency I had another child. In my fourth year, I rested. By which I mean I worked full-time to finish residency and labored before and after those working hours to take care of my family. Altogether from maternity leave and a 3-month period of being at half-time status, my graduation was delayed by 6 months.
Hence time became my Shiva, the creator and the destroyer of my life. And the resting place of my soul came to be my google calendar, where it still resides.
For me, management of time came in many forms. It came in the form of my best friend in residency bringing me breakfast every morning for two months when I returned to work after my ten (generous!) weeks of maternity leave when my first child was born. These were the months that I would frantically, several times a day, run across the hospital and up two flights of stairs to the call rooms to pump, just hoping my let down would wait until the right moment when everything was precariously strapped on, while I typed notes on the computer to keep up with my work on the inpatient units. (This period didn’t last long because, not unsurprisingly, it’s hard to keep up milk supply under these conditions.)
It came in the form of a thousand big and little choices, like where I shopped for food (the more expensive store that was on the way home), how I bought clothes (on Amazon or at Costco), what I read for fun (haha, nothing), whether I fell asleep or watched TV (fell asleep), or how often I took a shower (for posterity, I am withholding this information). Decisions about proximity of work, housing, and daycare were crucial: time commuting between the three cut into any morning preparations for the day or into evening family dinners, and represented countless potential lost snuggles.
Time is money, the saying goes. And while it is sometimes said that you can’t buy time, this is both existentially true and pragmatically false. We were in the privileged position to buy time in myriad ways, by shopping at the more expensive store, by eventually hiring a (more than) full-time nanny, by using meal delivery services or ordering our food out, by living close to the university where I trained, by having someone clean our apartment once a week. These were luxuries afforded by my husband’s salary, since my resident income was essentially taken up by childcare expenditures.
I often hesitate to tell this story, for several reasons. One is that privileged people exclaiming their challenges can be irritating; I’d rather use my voice to highlight issues of more pressing need and voices that are under-emphasized. But also, it’s because I don’t really want this issue of time and parenting and money to be a woman’s issue.
This was a point made persuasively by the president of the Association for Academic Surgery, Dr. Caprice Greenburg, in her recent lecture on the widespread biases and discrimination against women that remain in surgery. Conversations about the advancement of women in medicine—and in spheres of power and influence more generally—need to go beyond issues of childcare and maternity leave because these are actually needs that apply to men and women who jointly occupy roles as parents.
I agree with this, and I yearn for this post-gender, pro-parent world. But I also know that my own story of struggling to balance “life” and “work” (the most overemphasized calculus about which working women are interrogated ad nauseum), a story essentially about the management of my time and attention (or emotional energy), is a common one.
My solution to this problem, or at least my attempts at a solution, involved throwing money at it (see above) but also co-opting any hospital-wide survey as an opportunity to fill the free-text box at the end with some version of an all-caps rant explaining how WE NEED MORE INSTITUTION-SUPPORTED CHILDCARE SOLUTIONS THAT ARE CLOSE TO THE HOSPITAL, AFFORDABLE, AND FLEXIBLE!!! The poor people who were collecting answers to their survey about the parking structures on campus I’m sure had a good laugh.
But I wonder sometimes if the solution is actually to have my makeup tattooed onto my face. I haven’t tried it yet, so it could be the thing that’s holding me back. I’ve definitely considered the proposition favorably in recent months after my three-year-old got into my cosmetic bag and turned my bathroom pink.
While a part of me begrudges the advice to make permanent the double standard of gender performance on my own face, another part of me feels the deepest of empathy toward all the women who invoke their big and little hacks to maximize their greatest resource: the time we’ve been given to be on this earth, and how we distribute that time among our many loves, passions, and values. I salute you. I, for one, plan to use the time I save in not showering every day toward getting one more snuggle in with my kids in the morning, and then going to work and changing the culture of medicine for the better.
This piece is part of a collection of narratives and perspectives on women in medicine, curated by Jessica Gold, MD MS.