A Medical Student Resents Having To Make Smart Choices. Here’s Why

The human experience is an exercise in connection. Nothing is seen, heard, or felt in isolation. This is what can make womanhood in a large urban city so challenging. A catcall is not a single comment, heard on a single morning about the tightness of your jeans or the way your hair falls; but instead carries with it every unsolicited thing you’ve ever heard about your body, a shadow of every time someone has touched or cornered you without permission, every time you’ve ever felt unsafe.

This is not something the fourth-year medical student leading my clinical experience team likely thought about when he selected me, along with a male classmate, to practice interviewing and performing a physical exam on a patient that he, rather than one of the female fourth years, was assigned specifically because of the patient’s history of being “inappropriate to women” during intake. What he was thinking about, instead, was my reality. I will see patients like this at many points in my career, and to avoid treating them is to validate their disrespect, to accept womanhood as a limitation.

And so I entered the room to find the patient: elderly, sprawled in bed, his belly spilling out and over the sides of his abdomen, EKG leads protruding from his hospital gown, stuck tightly to the skin over his failing heart. He had presented with syncope, the episode likely due to dehydration after a recent change in his diuretic regimen, prescribed for congestive heart failure. But we are second-year medical students, and so a relatively straightforward admission following an episode of syncope calls, in the interest of practice, for a full neurology exam.

“Does this feel the same on both sides?” I asked, running my finger along each of his shins. He giggled and nodded, using gestures to communicate with me instead of words. My male counterpart had examined this patient just before me, and he received verbal answers to his questions, not the eye movements and gestures I was enduring.

I listened to his heart, watching him undo the entirety of his gown and lay, spread-eagled on the bed, grinning, even as the male fourth year leading the group insisted that a single button would suffice. I asked him to stick out his tongue, an attempt to test for cranial nerve function. He obliged, at first, and then began to move it back and forth, first slowly and then faster and faster, smacking and licking his lips as the grin grew wider and then folded again into laughter. At this point, the senior student stepped in and reminded the patient of appropriate behavior, but the damage was done.


The things I felt in that moment were familiar: a little bit of anger, a little bit of disgust and a little bit of hurt. I felt a little like I want to scream, to demand to be taken seriously, and a little like I want to call my mom and ask her how she’s survived a half a century on the planet Earth, only to hear her to tell me that she could never do what I am doing.

There is a lot to resent about the way that women are treated. I live in a world where I am told I have to make “smart choices” in order to stay safe, and I am tired of it. I am tired of ignoring and absorbing rude comments on the street, I am tired of my dad offering me cab money because he is worried that I am unsafe, not because of the places I am going or the people I am hanging out with, but because of I am a girl and it is nighttime. I am tired because making smart choices makes me implicit in the patriarchal system that denies me the right to basic safety afforded to males in a public space.

I accept that my body comes with a certain set of physical limitations. I will never be taller than 6 feet. It was never in the cards to play professional football. If I want to sing, my options are alto and soprano. And that is OK. I can accept these things as facts of life, and live within and around these parameters.

But the absence of safety, the violation and objectification of my personhood by men around me is not in any way inherent to my biology. There is nothing about my breasts or my hips that causes men to stare at them. There is nothing in the high pitch of my voice that makes it less authoritarian. These are limitations that those around me attempt to impose, something that, I refuse to accept and that treating patients like these, gives me the power to change.

Taking the initiative to treat patients that act inappropriately towards women is one way to put a stop to the myth of smart choices. “Smart choices” are a crutch, important for survival in a hostile environment but, ultimately, a barrier to equality. They are a kind of self-segregation, invented to limit conflict but not to better us. Smart choices are protective, yes, but I don’t want to be protected, because that means accepting that I am in some way a victim.

Treating patients like this gives us a way to reclaim space. By refusing to let the way patients act towards me define who I am as a doctor, I claim the hospital as my own; something that is often hard to do out in the world, because, as much as I resent having to make smart choices, I also understand that there is a physical safety risk involved in trying to reclaim the streets of a bad neighborhood.

The hospital is a place where I am empowered. If a patient is sick and in my exam room, whether or not they respect me or my gender will not change the fact that I may very well stand between them and oblivion. And that reality trumps the illusion of gender inequality every time.

As a woman born to a very liberal family in the 1990s, there is a lot that I didn’t have to fight for, a lot of voice and opportunity I was given by women who came before me. But I also know there is a lot of space left to gain. I don’t have grandiose visions of the future. I don’t think I am going to make the subways safe; I don’t think that I am going to be able to sit in the front seats of cabs in foreign countries or even that there will be an equal number of men and women holding political office in my lifetime.

But I do think that this inch of equality, this space in a hospital, is mine to fight for. And I plan to do it, with a smile and a cheerful tone as if nothing anyone says or does can touch me, because it can’t, not here in the hospital, not in a place that belongs to me.

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The author is an anonymous medical student. This article originally appeared inFemInEM.

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