Humanizing the Profession: Patient perceptions of #ILookLikeASurgeon

by Terri Coutee @6state

Trends on Twitter and much of Social Media go at break neck speeds. Here today and gone tomorrow. There has been something trending on Twitter the past few days that inspired me to write this post. The trend followed the hash tag #ILookLikeASurgeon started by a resident in surgery, Heather Logghe, MD.  And yes, it exploded on Social Media!  Dr. Kathy Hughes, a surgeon and one of my favorite bloggers, even started a Facebook page to honor this community.  The movement was further inspired an article written about diversity and equality from a London surgeon, Dr. Ed Fitzgerald. I was mesmerized and actually found two surgeons I follow on Twitter who posted these two pictures.

I know Dr. Chrysopoulo personally and many of you who read my blog probably feel like you do, too, as I’m forever singing his praises. I had an excellent experience having him as my DIEP flap breast reconstruction surgeon. Dr. Karen Horton and I have chatted through Face book and Twitter and I have listened to a webinar she presented for Living Beyond Breast Cancer. She, too, is a well-respected microsurgeon who performs breast reconstruction surgery for cancer patients. She, like Dr. Chrysopoulo is one of the featured surgeons on my closed Face Book group offering extra time and consideration to questions posed by patients regarding topics on breast reconstruction. I looked for the other guest surgeons on my Face Book group to see if they had posted on #Ilooklikeasurgeon but have not found them yet. But, I do see their interest on Face book about their own family, fun, exercise, grilling, cooking, and what they do outside the operating room or theater as it is sometimes called.

Humanizing the Profession

Quite simply stated, this Twitter trend has humanized a profession that at times, is held to a standard that is difficult for even the humblest of individuals to live up to. What this trend shows are surgeons from a variety of practices from across the globe; women, men, single, married, with children, with their colleagues and yes, building human pyramids in the pool with their children or on the way home from a day in surgery. These surgeons go home at night like the rest of us and eat dinner, toss and turn in bed wondering about the complexities of life, brush their teeth, laugh, cry, wipe a child’s tear, hug a friend in need, run, weight lift, play the violin…. YES! They are human like the rest of us.  YES! They are diverse. They have a life outside of their scrubs.

I have a suspicion, unfounded and non-evidence based though it might be, and I will own it. My suspicion is this; the surgeons who have posted on this Twitter trend have high ratings with their patients. These are the surgeons who respect you as a team member in your health decisions, sometimes tagged as #SDM (shared decision making) on Twitter. These are surgeons who go the extra distance not only as team members with their colleagues but spend the extra time it takes to research evidence based medicine (#EBM) to hone their practice and skill achieving the best in patient outcomes.

So humanize your surgeon. Respect begets respect. Let down your fear of their vast amount of knowledge, years of training, and skill. Know that these women and men chose this profession because they recognized a passion, a skill in wanting to help you. There is a person behind every mask!

Terri Coutee is a breast cancer survivor and patient advocate for all choice of breast reconstruction. This post is cross-posted at Terri's blog: DiepC Journey: Reconstructing a purposeful life

What does #ILookLikeASurgeon really say about surgeons around the world? A Call to Action

Ed Fitzgerald

@DrEdFitzgerald

Sitting in London on Friday afternoon, I was intrigued to see the first #ILookLikeASurgeon tweet from Heather Logghe, a call-to-arms which rapidly opened up a floodgate of international support.

Diversity and equality in surgery has long been a thorny issue on both sides of the Atlantic and beyond. In England, I previously wrote a paper reporting that over half of male and two-thirds of female newly graduated doctors did not think surgery welcomed women, so I was interested to see what the response would be to this Twitter campaign. I don’t think anyone could have imagined the strength of support in the 48 hours that followed.

To put this in an English context, recent figures indicate that only 11% of the consultant (attending) surgical workforce is female, ranging from 21.5% of pediatric surgeons to 4% of cardiothoracic surgeons. As recently as 2000, women made up just 5.9% of the surgical workforce, so while the situation has improved, surgery has a problem. Dig a little deeper into these figures and generational differences start to shed greater light on the current debate, with 30% of surgical trainees now female. Their voice was clear and loud enough to be heard this weekend: society is moving on, and surgery risks being left behind.

Such deep-seated cultural issues are little surprise here when the wider role of women in medicine faces outmoded opinions from within, guaranteed to provoke a visceral response from any reasonable reader.

So what have we learnt from the overwhelming success of this weekend’s hashtag trend? On a personal, professional and societal level, I’d suggest we’ve learnt a great deal.

Heather’s original blog began with the tagline ‘Be the role model you always wanted but never had’. On a personal level, the community rising through Twitter this weekend demonstrated the breadth of outstanding role models that already exist among us, but that many never knew. When social media can unite this globally, we are all stronger. It was humbling to see the pride in these pictures, and I hope that those tweeting in support realize that they themselves become the role models that will inspire others with their achievements to-date.

Yet on a professional level, this was always about far more than simply shattering stereotypes and finding role models. The frustration of many women in surgery found a long-overdue vent this weekend. From pre-filled operation reports always wrongly titled ‘Mr’, to repeatedly being told ‘you don’t look like a surgeon’ or ‘you'll never get it’, this celebration of diversity carried a cathartic edge. The rapidly accelerating momentum was testament to this. Everyone encounters stereotypes, but would this have gained the same traction if equality of opportunity and acceptance of diversity wasn’t at the heart of this?

At a societal level, what did onlookers see? #ILookLikeASurgeon received over 15 million impressions on Twitter and over 6,000 tweets, numbers which are surely set to rise. They saw surgeons in scrubs, but many more will have seen female surgeons as family members and mothers. As a society, we were reminded that whatever challenges it takes a man to reach the pinnacle of his profession, at best a woman in the same place will have balanced family, childcare and more. At worst, she will have felt it necessary to sacrifice these for career advancement. Is this really societal progress? Do we accommodate this, or even openly recognize this in surgery yet? Again, if the answer was yes, would this have hashtag have gained such traction?

At the start of this weekend we were all challenged to tweet #ILookLikeASurgeon and own it. Across the globe, thousands did. From Mexico to Saudi Arabia, Australia to Colombia, Pakistan to Spain, international support and selfies flowed in.

At the end of the weekend it’s now vital we ask other groups to ‘own it’. We can’t change the world with a hashtag, but this is where it starts. Smashing stereotypes, promoting diversity, and challenging cultures needs support from those that have the power to influence entire professions. How will the American College of Surgeons now step-up to address these issues? What leadership will the Royal College of Surgeons of England, with its first ever female president in 214-years, now provide?

For the sake of all those who stood up this weekend and said #ILookLikeASurgeon, it’s time to listen. Around the world, they told us that opportunity and equality is not yet achieved. For the sake of our patients, our profession, and our wider society, it’s time to give these issues the attention they deserve and tackle them head-on. How will you help?


And Heather says, keep tweeting! This movement is for all of us. We all need to own it and #CelebrateDiversity. Take the lead from Dr. Brendon Stiles and post your pic in solidarity of diverse surgeons around the world!

#ILookLikeASurgeon Tweet it. Own it.

Be the role model you always wanted but never had.

A couple weeks ago saw this inspiring Steel Heels article "Healing with Steel" on Dr. Nikki Stamp, a cardiothoracic surgeon in Australia, and the #ThisIsWhatWeLookLike campaign.

Dr. Nikki Stamp

Fast forward to a text message from my friend and co-resident, Dr. Sara Scarlet.

I logged onto Twitter and saw the #ILookLikeAnEngineer campaign. One tweet and an emphatic response from Dr. Alison McCoubrey in the UK opened a floodgate of support from the #SurgTweeting community.

The photos are stunning:

@heatherlynnyeo @drkarenhorton @LoJackMD 

@laurenbnosanov @Dr_Stepheny @traumapty @alison_doc

I like the hashtag in the first person. As women surgeons, whether we are in our first year of training or an emeritus professor, it's most important that we ourselves believe we "look" like surgeons. Because we do.

@anjlm7

 

T shirts can be purchased here.

Owning it, @MamtaSwa 

Addendum: Here is the story of Isis Anchalee, the women behind the movement, in her own words. Thank you for your courage Isis. You changed the world.

Isis Anchalee

In other news, Dr. Scarlet, who was busy operating and being a surgeon all night, finally had time to post her own selfie:

@ColumbiaSurgery responded with this powerful collage:

Dr. Stamp posted a powerful response in support of the #ThisIsWhatILookLike and #ILookLikeASurgeon campaigns:

"I want to share that you absolutely do not have to be a certain race, gender, personality, sports fan or other group to be a surgeon. In fact, diversifying our specialty to involve women, for example, is a fantastic thing. Every different person has something unique to bring to the table and we should encourage that enrichment. And finally, I want to show the world that I don’t have to be a stereotype to be a surgeon. Because I am a surgeon and this is what I look like."


Amazing blogs keep coming!

New blog by Dr. Alison McCourbrey, the first female general surgeon at her hospital in Northern Ireland.

She writes, "It’s been amazing to see so many inspirational women pulling together & supporting this campaign & each other. I am so happy to be a part of this, promoting positive role models and changing perceptions of women in male-dominated professions. I hope that this might encourage more women to join a career path that i love and feel privileged to do. Defy the stereotype & be part of the solution!

#ILookLikeaSurgeon because I am a surgeon."



To see all the inspiring pics, 
check out the Storify 
compiled by future surgeon Jasmine Miller.

Surgeons have taken the Twitterverse by storm!

Photo Credit

Excited to be back! After a new baby and the start of surgical residency in 2013, I took a two-year Twitter hiatus. Now that I have returned to research and reentered the Twitterverse, I am thrilled to see so many old faces as well as countless new ones!

The ease with which I am reentering the Twitterverse is one of the many reasons I love Twitter. There is no chastising for being away--just well-wishes, retweets, and of course amazing conversations and links shared.

The most gratifying development has been the exponential increase in the number of surgeons actively tweeting. I remember the days (i.e. 2013) when it was notable to find a new surgeon to add to my “Surgery” Twitter list, which at that time contained just over 100 accounts. Now I add 10+ new surgery-related tweeters EVERYDAY and the list contains well over 1000 accounts!

There are new features and nuances of Twitter that I am getting the hang of—new retweeting, quotes, favorites, and more. As always, there is a learning curve and it’s fun learning! There are new surgeon blogs-- Life in the Wild West by @AmaliaCochranMD, Hot Heel, Cool Kicks, & a Scalpel by @surgeoninheels and @surgeoninkicks, Behind the Mask by @DrKathyHughes, and Jones Surgery by @JonesSurgery.  There is also an active International General Surgery Journal Club #IGSJC and the new Eastern Association for the Surgery of Trauma journal club #EASTjc. Today the Thoracic Surgery Social Media Network #TSSMN announced their collaborative effort to bring thoracic surgery scholarship to the Twitterverse.

Looking over Twitter for Surgeons 101, I am pleasantly surprised to see it is as relevant today as it was in 2012.  However, with so many expert surgeon Tweeters in the Twitterverse, it's clear the surgery world is ready for a "Twitter for Surgeons 201" to advance the conversation of how Twitter can be maximized to learn, disseminate information, educate patients, and to build our professional networks and global presence.

Tweet on my friends!

Modern Medicine: Technology Will Advance, But Human Connection Remains

In a recent NY Times article, “Redefining Medicine with Apps and iPads,” Katie Hafner describes a “generational divide” in medicine. On one side sits the younger generation, at ease navigating EMRs and diagnosing disease with the assistance if digital apps. On the other side of this presumed generational divide, she describes the older generation, worried “that the human connections that lie at the core of medical practice are at risk of being lost.” This juxtaposition begs the question; does the use of digital medicine preclude human connection?

As a recent medical school graduate who has enthusiastically embraced technology, I have no fears that my use of digital technologies handicaps me from sharing the human connection essential for a healing and therapeutic patient-physician relationship.

In medical school, I witnessed much fanfare surrounding the teaching and “importance” of the physical exam. Still I found myself somewhat suspicious of what I was being taught—would it really warrant a workup if a healthy patient displayed “diminished reflexes”? Would I really be able to elicit an abdominal fluid wave in an obese patient, and even if I did, wouldn’t the patient have more urgent symptoms and treatment dictated by more accurate diagnostic testing?

A few times I ventured to express my skepticism, and across the board, my instructors responded as if questioning any aspect of the traditional physical exam was an act of blasphemy. They all assured me it was “very important” and often had an obscure anecdote to illustrate this importance to me.

I tried so hard to believe them. Yet, once I hit the wards in third year, the clinicians’ actions spoke louder than words. Early on I took time to report the minor changes in the patients’ daily physical exams. With great care, I documented new murmurs and the onset of crackles. But quickly I realized that no one cared. If the patient did not have corresponding symptoms, these details were brushed off as a waste of time.

Still I tried to maintain my enthusiasm for the physical exam by doing mini presentations based on material from JAMA’s “Rational Clinical Examination” articles. During these presentations I sensed the attendings reminiscing and the residents appreciating the refreshers. Still, the information I presented seemed little more than a nostalgic intellectual exercise. When it came to patient care, I couldn’t help but notice how rarely we changed our treatment plans based on the clinical exam.

As I look forward to residency, I worry about the limited time I will have to spend with each patient. Knowing the time constraints, I do not want to waste time percussing my patient’s heart when an X-ray or echocardiogram is more efficient and accurate. Does this mean that I do not value human connection? Of course not. Fortunately, I do not need the excuse of an obsolete physical exam maneuver to touch my patient. In forgoing the unnecessary exam, I will have time to take the patient’s hand in my own and ask her what scares the most or how we can make him more comfortable.

Please be assured I am not suggesting the physical exam is obsolete. The physical exam was and always will be an indispensable tool to diagnose and treat patients. Indeed it is imperative we continue to teach and maintain these essential skills. Acknowledging the technological advances in medicine and teaching a strategically streamlined exam would allow educators more time to emphasize the human connection and teach students skills to better connect and relate to their patients.

In his article, A Touch of Sense, Dr. Abraham Verghese extols the importance of the physical exam as a means to convey the message, “I will always, always be there, I will see you through this, I will never abandon you, I will be with you through the end.” Call me crazy, but I hope to take the time saved by my digital technologies and gently place my hand on the patient’s shoulder, look them squarely in the eye, and share the same message in my own words. Technology will never replace this privilege of human connection.

Twitter 101 for Surgeons: How to set up a professional Twitter account

This article was first written in 2012. Surprisingly most of the advice still applies. I edited it slightly in Nov. 2017.

Since starting my own personal Twitter account nearly a year ago, I have mentored numerous peers and faculty on how to get started. I’ve noticed that most surgeons have similar questions and concerns. Below I have detailed the most common questions along with my answers.

Twitter? Isn’t that just a bunch of people talking about what they ate for breakfast? Think again. Twitter is about who you follow. Sure, you can choose to follow celebrities and people who tweet pictures of the donuts they eat for breakfast, but the beauty of Twitter is that you don’t have to. Think of Twitter as millions of people talking at once, and by choosing who you follow, you choose who you want to “listen” to. As an aspiring surgeon, I choose to follow surgical societies, surgical journals, and leading surgeons--literally from all over the world. Through Twitter, I learn about upcoming events, the latest research, and the opinions of surgeons I look up to. I also follow influential non-surgeon physicians and patients who are effecting positive change in medicine. None of the “tweeps” I follow mention what they eat for breakfast. (Well, most of the time anyway.)

But I’m not even on Facebook! Don’t be fooled by the misguided logic that if you didn’t take to Facebook, you’re not going to like Twitter. Twitter actually has a very different flavor and utility. Rather than a purely social network (like Facebook), think of Twitter as more of a “subject” network, where users share information and access it based on common interest. You can take advantage of this endless wealth of information, whether or not you are “friends” with those you are following.

Does Twitter substitute for real, live, face-to-face interaction? No, however it often leads to it. On multiple occasions I have met surgeons and medical students via Twitter whom I then chose to meet in person. Not only did Twitter provide me with these professional connections I would not have otherwise had, it also gave us a common ground to start from, enabling a solid introduction before even meeting. This allowed us to hit the ground running.

Do I really have to join Twitter to stay “on top” of the field of surgery? Of course not, but you may be missing out on a powerful way to connect with your colleagues and learn from others both inside and outside of medicine. (Update: In 2017, my answer is "Yes, yes you do.")

That sounds nice, but I’m afraid I don’t have the time. I’m not going to tell you that Twitter doesn’t take time. As a surgeon, you know that most endeavors that are worthwhile do have a learning curve and do take time. However you do not have to become a Twitter expert overnight. Tread slowly but confidently. I will lay out some basic steps to get you started.

1.   Open a Twitter account at www.Twitter.com. All you need is an email address.

2.   Set up your profile. For your Twitter handle (that “@thing”), I recommend choosing something as close to your real name as possible. Try @FirstLastMD or @DrFirstLast or any variation thereof.

Do I have to log in everyday? Definitely not. Twitter is not something that you have to “keep up” with. You do not need to read every tweet. I repeat: You do not need to read every tweet. It’s like the news. It’s interesting when you feel like tuning into it, but it’s fine if you don’t as well. I like to log into Twitter with a cup of tea. Others might sneak a peek at their Twitter feed while waiting between cases or in line at the grocery store.

I’m not sure I want to use my real name, isn’t it better to be anonymous? No. The days of maintaining an anonymous internet presence are over. Besides, you will only be posting professional tweets, and it’s important you get proper credit for your effort and contributions. Think of it this way--would you attend a conference and introduce yourself as someone else? Would you tell them a fake name just in case you said something silly and didn’t want anyone to remember you? Of course not. Consider your Twitter account an extension of your professional persona. You want it to represent you in a meaningful, memorable way.

3.   Use a real photo of yourself for your avatar (profile pic).

Can’t I use an image of a scalpel or a picture of my kids or dog? Going back to the conference analogy, picture yourself at a conference with a bag or mask over your head--kind of creepy right? You probably wouldn’t expect people to trust you or take you seriously. The same goes for Twitter. Post a real picture of yourself.

4.   Write your Twitter profile bio, in 160 characters or fewer.

My whole bio in 160 characters? Don’t stress too much about this. The important thing is to put something. You can always edit it later. For ideas, I suggest looking at the bios of other surgeons on Twitter. With the character limit, it will be slightly informal. Add your clinical interests and feel free to include something slightly personal to add character, such as you enjoy cooking or play a mean game of tennis. The goal is professional but personable.

You are now ready to confidently enter the Twitterverse. (Yes, there is a “Twitterese” version of nearly every word in the English language...)

5.   Choose some accounts to follow.

How do I choose who to follow? I recommend following liberally, as it only takes one click to unfollow someone if you do not enjoy their tweets.

For starters, I recommend following your professional surgical organizations such as American College of Surgeons: @AmCollSurgeons; the Association of Women Surgeons: @WomenSurgeons; the Association of Academic Surgery: @AcademicSurgery and others. You can search hashtags within your specialty such as #colorectalsurgery, #plasticsurgery, or #ENTsurgery. Following user within your field will give you a solid start. Also be sure to follow conference hashtags and follow those who live tweet. Finally take advantage of Twitter suggestion on who to follow.

What happens when I follow someone? Do they know I’m following them? When you follow someone, they receive an email notice and have the option to click on your profile and decide whether they want to follow you back. Thus you want to maintain a professional image from the first day you sign up for Twitter.

If I receive an email that someone is following me, is it polite to follow them back? You are never obligated to follow someone back. This is the beauty of Twitter. You choose who you read and learn from. When you receive an email notice that someone is following you, I recommend clicking on their profile link. Often, you can determine whether or not you want to follow them from reading their profile. If you really want to be thorough, you can also look at their Tweets and see if their tweet content is of interest to you.

Ok. I have a profile, and I’m following a few people--now what? I recommend laying low for a bit. Spend some time skimming your Twitter feed and reading the links that look interesting. There are many unwritten rules to Twitter and it takes some time to understand how it works and how people interact.

I’m nervous about tweeting. Don’t stress about your first tweet. It’s like making an incision--hesitation suggests lack of confidence and clarity. Jump into the conversation. For your first tweet, you can try something like, "Excited to enter the Twitterverse! Eager to learn and share with fellow surgeons and beyond.” This makes it clear that you are joining Twitter to learn and be part of the conversation. This will make other Twitter users more interested in following you.

What if I don’t have anything to say? Don’t worry about having something novel or witty to say. One of the strengths of Twitter is that it fosters sharing of ideas and information. If you are reading an interesting online article and you see the option to tweet it, go for it! If you found it interesting, it’s likely that your followers will as well. Also, for many people, the majority of their tweets early on consist of “retweets.” If you like something someone else shared, retweet it!

Ok. This gives me a basic start, but I know I’m going to have lots of questions. You’re absolutely right. I recommend that everyone find a designated “twentor.” Yes, that’s a twitter mentor. This will likely be someone younger than you, though not necessarily. Find someone you feel comfortable checking in with from time-to-time with your Twitter questions. Ideally, this person will also follow your tweets and can even give you feedback via direct messages (private tweets).

What about those #hashtag things? See here for an article detailing the use of hashtags in academic surgery.

I hope you explore the rich commentary, conversation, and knowledge shared in your Twitter feed. Don’t be afraid to click on the profiles of those who look interesting. You never know who you will meet!

The Gift of Time

A little over one month ago, I graduated from medical school. Losing the title of “student” for the first time in my life prompted me to reflect on what I’ll miss most about being a medical student.

Without a moment’s hesitation, I know unequivocally the answer is time. From the first day of my clinical rotations, it was clear to me that more than anyone else on the team, as the medical student I had time. And time has the power to heal.

I took advantage of this gift every opportunity I could. The resultant conversations often impacted the patient’s trajectory. For example in talking with an overweight patient who needed a lung transplant, I learned he had recently lost over 80 lbs in six months. Prior to this realization, the team had feared he was unable to lose enough weight to qualify for a lung transplant. In a one on one conversation with a gang member who was demanding his own room upon transfer out of the ICU I learned he had been molested by a man as a child and was fearful his PTSD would worsen sharing a room with another man. We arranged for a private room.

There were also heart touching moments. Watching the eyes of an 80 year old woman with dementia light up as she sang every verse of her favorite Sunday school song with the palliative medicine team. Or watching a previously paralyzed man surprise his wife by standing up to greet her after his successful spine surgery. I can only hope these moments were as healing for the patients as they were educational and inspiring for me.

It saddens me to know that as a resident, I will no longer have the unstructured time I had as a medical student. I find solace in knowing med school memories of patients will forever be close to my heart. In residency I will strive to be efficient with my duties so when a patient remembers “one more question” as I walk to the door, I will have time to truly listen. Time may not heal all wounds, but it’s in these unscripted moments with patients that I find my inspiration.

Addendum: After writing this post, I came across a great blog post by Dr. Robert Centor titled, "Why do we expect productivity from physicians" arguing that we must continue to value time in the physician-patient relationship. I couldn't agree more.

Survivor as Physician

8/17/2017: Sharing this again. Inspired by all the courageous women and men of the #MeToo movement. 

8/2/2015: In light of the recent New York Magazine article in which 35 women share their stories of being assaulted by Bill Cosby and the #TheEmptyChair hashtag that followed, I am retweeting my own story in honor of the female surgeons and physicians who have privately shared their story with me and sit daily in #TheEmptyChair.

Yesterday I had the tremendous honor of receiving the UCSF Chancellor's Award for the Advancement of Women. As difficult as it is, I would like to share with you my acceptance speech. I have thought long and hard about "coming out" as a physician and in the end I have decided that if I can share the message of hope and healing with just one survivor, it will be worth it.

As a rape survivor and domestic violence advocate, I have shared my story with dozens of audiences. The majority of those times, I have relayed the lessons of my experience with minimal emotional investment or consequence. However last night, when I sat down to write this speech, I realized that this time is different. In less than two months I will be a doctor. Since getting my acceptance letter from UCSF, in the back of my mind I have always wondered how I would someday reconcile my new physician self with "Heather the survivor." Being chosen for this award has given me the courage to accept that "Heather the physician" will forever be inseparable from "Heather the survivor."

Preparing for this day, I debated how much I wanted to talk about my own story. Then I remembered how lost I felt picking up the pieces after the assault, how I yearned for the stories of other survivors. I wanted to know that recovery was possible.  I wanted to know how I could possibly heal from an invisible wound so deep the only way I could describe it was so say that “my soul was bleeding.”

15 years later, I can tell you that the healing never would have been possible without the commitment and support I received from the faculty and administration at my alma mater, the University of Wisconsin, Madison. From start to finish, my undergraduate degree took 8 years. Whether it was counseling support, excused late assignments, or weekly meetings with the dean and special test accommodations when my PTSD-induced exaggerated startle made it difficult to take my exams in a crowded room, the University of Wisconsin gave me the time and space I needed to heal and the support I needed graduate.

When it came time to choose which medical schools to apply to, I knew I would need a school that could provide me that same kind of support. Against the better wishes of all but my closest friends, I only applied to only one medical school. I literally decided upon UCSF based upon the impression I felt from their website. I did make a few campus visits to confirm my intuition and I made a special UCSF binder with paraphernalia of evidence as to why I felt at home at UCSF. I’d like to share with you two pieces of outreach materials I collected. One is a Sexual and Relationship Violence Resource Guide and the other is a guide for how managers can support faculty and staff dealing with the challenges of domestic violence. It was essential to be to be at an institution that had mechanisms in place for supporting survivors of me sexual and domestic violence. And I knew I had found that in UCSF.

After getting accepted, I looked up the UCSF’s resources for women and printed off the “Focus on Women” website. I took pride in joining an institution that visibly supported women.  I am even prouder today, knowing I will graduate from an institution with a female chancellor, Dr. Susan Desmond-Hellmann. Another document I printed off was Dr. Barbara Gerbert’s “Slow Steps to Change” report on the History of the Chancellor’s Advisory Committee on the Status of Women. I met Dr. Gerbert early on in my time at UCSF and Dr. Gerbert has been a tireless cheerleader and supporter throughout my medical education. Dr. Gerbert chaired the committee that proposed this award to Chancellor Martin in 1994. We wouldn’t be here today without her vision and hard work to make this award a reality.

If I can leave you with one message, it is that we need to provide increased support for survivors of sexual violence and foster a dialogue of healing. According to the National Intimate Partner and Sexual Violence Survey, conducted by the CDC in 2010 and was based on telephone interviews with more than 16,500 adults, more than one in three women have experienced sexual assault, physical violence or stalking by an intimate partner during their lifetime and the same is true for more than one in four men.

When I first began to deal with the emotional and physical health consequences of sexual violence in my life, I found some comfort in statistics such as these. Yet at the same time, I felt a deep sense of confusion—if intimate partner violence were so prevalent why didn’t my doctors know how to address my emotional pain? Why wasn’t anyone talking about healing? I couldn’t help but wonder if I were the only survivor who wasn’t able to quickly get over it and move on with her life.

As I became a vocal advocate, I learned most women and men suffer in silence. If you are a medical practitioner, I urge you to ask your patients about past and current sexual and domestic violence. Just acknowledging that intimate partner violence has an impact on our health can make a big difference. If you are a survivor yourself, I encourage you to share your story with others when it feels safe. My first month of medical school when I began to question if I had what it takes, a faculty member shared her own story of how being assaulted had impacted her medical education many years later. I held her story close to my heart and knew that I would be okay. Creating conversations of healing will allow survivors to know they are not alone and that healing and recovery are possible.

Thank you for this honor and thank you for your support.