Why Barbie resonated with me as a mid-career woman physician: a reflection for National Women Physicians Day - Kevin MD

(Spoiler alert: contains spoilers for the movie Barbie.)

In Barbie, a singular scene resonated powerfully with Women in Medicine across the land.

You know the one. Shortly after Ken and Barbie leave Barbie Land and arrive in the Real World, Ken ventures off, discovers The Patriarchy, waltzes into a hospital emergency room, and demands the first woman he sees to perform an appendectomy.

What are his qualifications? He doesn't need any. He's a man.

When the woman, dressed in hospital scrubs, promptly dismisses his absurd claim, he doubles down and insists on speaking to a doctor.

"You are talking to a doctor," she says, in a voice that tells the audience she's said this many (many) times before.

He stares at her blankly until he spots a man in a white coat in another room.

"There he is!" Ken turns his back on the woman to chase down the man—who was probably a radiology tech.

Poor Ken. The Patriarchy can be so confusing.

But there's so much more to the movie. Last month, I wrote a Women in Medicine adaptation of America Ferrera's character's viral monologue in the film. While the responses I received were overwhelmingly positive, I received angry messages, too, along the lines of "How dare you."

The answer to that question is, in essence, the heart of the Barbie movie.

To further explain, I want to highlight another scene I found even more impactful for women physicians, even though it occurs outside of a hospital. In the boardroom scene (where Will Ferrell plays the Mattel CEO), the men try to flatter Barbie into returning to "her box." In the movie, this is a life-size version of the box that houses the toy Barbie.

At first, Barbie cooperates, stepping into the box.

As the scene progressed and the men started to secure the cartoonishly giant plastic ties at the back of the box, I had a visceral response. I became nauseated, followed by chills, and the backs of my eyes burned.

To my immense relief, Barbie steps out of the box just in time.

Later, when I reflected on my intense reaction, I realized "the box" is so omnipresent that we, as women, aren't even consciously aware of it most of the time. But my body knew—and reacted.

The scene showcases Gerwig's brilliant simplicity throughout the movie. She shows us how the Patriarchy keeps women in boxed-in roles by, well, a literal giant-sized box. As the adage goes, it's funny because it's true.

After I watched the movie with my (non-doctor) husband (my second viewing; his first), I tried to explain how this scene affected me.

"You have to understand," I said, "We're fighting against being put in the boxes every day, and at the same time, we're trying to do our jobs and save lives. It's exhausting."

Because in the Mojo Dojo Casa House of Medicine, women may be gaining equality in numbers but not leadership roles.

The situation can be summed up in a line delivered by Ferrell's character: "There was a female CEO in the 90s and then another one … at some point. So that's two right there!"

What does "the box" look like for Women in Medicine? It's every time a patient calls us "honey" or "sweetheart" or some other gender-charged diminutive to try to reduce us to less than what we are. (I'm a 50-year-old woman, and I've been called both, plus "kiddo" twice, by my patients this week already.) Or when the team ignores the recommendations of the female physician only to jump at the same recommendations from a male doctor. It's being treated as "too young" to take seriously, followed by "too old" to be relevant. Surprise—there never was going to be a "just right." It's being told to speak up more if we want recognition, but in the same breath, criticized for being "too aggressive." It's when female trainees are described as "friendly" and "nurturing" in a letter of recommendation, while Resident Ken is called "intelligent" and "skilled."

Of course, this isn't limited to medicine—or law or business or Hollywood or any profession. Nor to women who work outside the home. The boxes are waiting for us everywhere.

Last week, there was a flurry of talk about the Oscar nomination "snubs": Greta Gerwig passed over for a best director nomination and Margot Robbie for best actress. While in a plotline that could have been lifted from the movie, Ryan Gosling received a nomination for best supporting actor. (Read his statement on this.)

But what no one is saying is that in the most meta of ways, by denying them the nominations, the Patriarchy is sending a message: Ladies, get back in your boxes.

How. Dare. You.

By forcing the audience to confront the big and small ways the Patriarchy controls women's lives and roles in our society, Gerwig and Robbie and America Ferrera (who received a well-deserved nomination for Best Supporting Actress) did what makes the Patriarchy most afraid. They refused to stay in their boxes.

In other words, to quote from the movie, "By giving voice to the cognitive dissonance required to be a woman under the Patriarchy, [they] robbed it of its power."

National Women Physicians Day was started in 2016 by the Physician Moms Group. It's celebrated on February 3rd each year in honor of Elizabeth Blackwell, MD, the first woman to attain a medical degree in the U.S., in 1849. She was famously only allowed to matriculate to medical school as a joke among the men. Despite this, she persevered. She refused to be put in the box they created for her, and her success changed the face of medicine.

To learn more about Elizabeth Blackwell and other under-recognized Women in Medicine who broke barriers—and by so doing not only paved the way for the rest of us but made landmark improvements in patient care and public health—I highly recommend the following two books:

Women in White Coats: How the First Women Doctors Changed the World of Medicine by Olivia Campbell and Twice as Hard: The Stories of Black Women Who Fought to Become Physicians, from the Civil War to the 21st Century by Jasmine Brown.

To Greta Gerwig and Margot Robbie, Women in Medicine have your back. We're long used to doing the invisible work that goes unacknowledged to achieve world-class outcomes for our patients while, often, a man receives credit. Thank you for making us feel seen.

Jennifer Lycette is a novelist, award-winning essayist, rural hematology-oncology physician, wife, and mom. Mid-career, Dr. Lycette discovered the power of narrative medicine on her path back from physician burnout and has been writing ever since. Her essays can be found in The Intima, NEJM, JAMA, and other journals. She can be reached on Instagram, LinkedIn, Facebook, and Mastodon.

Her books explore the overarching theme of humanism in medicine. Her first novel, The Algorithm Will See You Now (Black Rose Writing Press), a near-future medical thriller, is available now. Her second novel, The Committee Will Kill You Now, a prequel in the form of a near-historical medical suspense, is available in paperback and on Kindle.

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