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Umbereen S. Nehal, MD, MPH

9 Apr, 19 tweets, 20 min read

When folks online think women at midcareer are “too much” or “overcompensate”

you are 100% right

=working 3-10x as hard to get 1/2 as far
on display

Tired of experiencing us online?
Try living this way ALL THE TIME
#womeninleadership
#womeninSTEM
#womeninmedicine
#Medtwitter

If you don’t recognize it, ask yourself whether your goals and/or identity align with power, privilege, structural inequity

..and in how many domains?

How complex or intersectional is your identity?

Centering on self is the best way to misinterpret the world around you.

If you start by asking yourself questions

you will start to learn to ask others questions, not assume

One version is called “the beginner’s mind” or a child-like curiosity about the world that promotes learning & understanding

Opposite of expert

theemotionmachine.com/beginners-mind/

This is especially hard for #WomenInLeadership #womeninSTEM #womeninmedicine

we have (almost) zero margin for error and yes, do, face greater criticism

That said, I have seen women who practice #servantleadership w/ ethics despite challenging patriarchy sciencedirect.com/science/articl…

So then #WomenInLeadership #womeninSTEM #WomenInMedicine
“lean in” MORE
overcompensate MORE
becoming more “aggressive” & “uptight” & “controlling”

while men get coached on embracing risk & failure, allowed to fail up, leverage network after failure.

finance.yahoo.com/news/failing-m…

@KPMG

When in fact, what we need to be is more risk tolerant per this @KPMG paper on #WomenInLeadership as well as #womeninSTEM & #WomenInMedicine

Playing not to lose is how we lose. Yet make a mistake.. and lose.

Per this, WOC are more risk tolerant

info.kpmg.us/news-perspecti…

In fact we need to be like this

Yet when was the last time a woman like this was taken seriously as a #WomenInLeadership #WomenInSTEM #WomenInMedicine?

When do we start to lose this?

Age 8

gender confidence gap - perfectionism - comes LONG before pay gap or glass ceiling but is a step towards that end for #WomenInLeadership #WomenInSTEM #WomenInMedicine

Perfect is impossible
So #impostersyndrome l

katu.com/news/local/gir…

Perfectionism & #impostersyndrome =self blame
anxiety
feeling about to fall

Kills your courage
#Ethics require courage
Change requires courage

How do we break this internalized societal harm cycle?

#WomenInLeadership #WomenInSTEM #WomenInMedicine

ted.com/talks/reshma_s…

Because ladies & femmes, it is no better past the #glassceiling

You find the #glasscliff

#WomenInLeadership #WomenInSTEM #WomenInMedicine

hbr.org/amp/2011/01/ho…

How often do we feel like this? #WomenInLeadership #womeninSTEM #womeninmedicine

Climb forward, slide back
But... children are not bothered by it. They remain curious, undeterred
Relentlessly curious
Unashamed

Whereas we beat ourselves up
Others point, gawk, gossip, shame

Our mentors taught us the wrong kind of #resilience, often: grit, perseverance, power through, prove your toughness, stay quiet, be “one of the guys”, don’t “whine”, be discrete, preserve optics, etc.

#WomenInLeadership #WomenInSTEM #WomenInMedicine

bizjournals.com/bizwomen/news/…

This quote is true: your #courage will make the world want to break you. They developed “moral flexibility” to avoid breaking
Your courage shames them.

If even men do this, what can a woman realistically do in that same world? #WomenInLeadership #womeninSTEM #WomenInMedicine

So the more courageous you are, the more you will be shamed

to conform to group level of (non)-standards. Shame is a group control tactic towards outlier individuals

This is what they omit in #WomenInLeadership #womeninSTEM #womeninmedicine coaching

scientificamerican.com/article/the-sc…

Shame is only effective if:
-ego
-strong sense of self
-pride yourself on expertise
-driven by your CV of accomplishments
-need validation of “I am a good person”

Beginner’s mind is from #mindfulness
self compassion
sees everything yet to learn
feels, then let’s go emotions

Some of best advice I got in #coaching (free, I negotiated for in kind) from a #business exec was that my CV was intimidating

I realized, less med student gunner “lean in”
Lean back, tent hands, show “#executive presence”
#WomenInLeadership
#WomeninSTEM
#WomenInMedicine

Amy Cuddy teaches this as “power posing.” Some say: cultivate your inner white dude/bro & name him. Mine is “Brad”

I *do* find value in that, to an extent. Except “posing” can reinforce #impostersyndrome

#WomenInLeadership
#WomeninSTEM
#WomenInMedicine

ted.com/talks/amy_cudd…

But you WERE that pre-pubescent girl <8 years old. You have that confident mighty girl within YOU. (Back then adult men proudly or dotingly saw you as a daughter, not a threat - apart from the slimy ones)

#WomenInLeadership
#WomeninSTEM
#WomenInMedicine

wired.com/2012/05/a-migh…

https://twitter.com/usnehal/status/1278087408412696579

Why did this get >7K likes, >800 retweets? It says “proud” for failing. Yes, of course the world needs your CV of accomplishments. But YOU need your CV of failure to immunize you vs shame. It reminds you you’re trying.

#womeninleadership
#womeninSTEM
#womeninmedicine
#Medtwitter

https://twitter.com/usnehal/status/1278087408412696579

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More from @usnehal

Umbereen S. Nehal, MD, MPH

@usnehal

11 Apr

Also, btw, any woman who has been in c-suite in NYC has literally worked with/around people with mob connections.

I take a lot of stands & speak on things that people want to keep hidden.

If there were “dirt” on me to find, it would have been found & used against me already.

I’m super annoying that way (in many ways) to folks who align against me.

When you are Muslim, activist, female, not seeking anyone’s patronage or protection, you are always exposed, surveilled, at risk - it is unavoidable.

Protection is in transparency, ethics, standards

These are life’s trade offs, I avoid certain shackles or cages and in doing so, carefully check off certain boxes to stay protected. I have worked in #compliance vs #fraud & #abuse, and I have seen every tiny detail that gets people caught up in the system. Stay out of harm’s way

Read 8 tweets

Umbereen S. Nehal, MD, MPH

@usnehal

11 Apr

https://twitter.com/usnehal/status/1119801503508762624

One of those times a #tweetiatrician
entered anti-vaxx space to speak truth to conspiracy

Claiming victim status & “witch hunt!”, Wakefield rallied support via anti-system/science distrust

-> loyal mob of supporters, now cyberbullies (yet who claim to be bullied) #medtwitter

https://twitter.com/usnehal/status/1119801503508762624

Experience of past medical harm is not itself evidence every doctor is bullying you. As a woman & WOC, in/out of hospitals as a child, there is tons of trauma & medical sexism & racism I have experienced

yet all that is erased/denied by those using one lens vs intersectionality

@NicoleB_MD

#tweetiatrician online for decades fighting fear & fake news #MedTwitter

doctors beaten down, made caricature of evil, gotten death threats @NicoleB_MD @DrToddWo

@AmerAcadPeds needs to step up on supporting clinicians vs #cyberbullying

Of online doc-celebs only @ZDoggMD helped

Read 4 tweets

Umbereen S. Nehal, MD, MPH

@usnehal

10 Apr

https://twitter.com/liz_harrison/status/1380970188737220618

I have a range of writing & #communication styles

Outside the ED of hospitalist medicine, when I “talk like a man” - direct, unvarnished truths and or “taking up too much space”, there is pushback, affront. Others have noted men with same style as me are👍
#WomeninSTEM
#SciComm

https://twitter.com/liz_harrison/status/1380970188737220618

In reality women can’t just email or communicate “like a man” for same results. Society *expects* different communication from women.

I’ve never been an exclamation point person but I use smiley faces

#womeninleadership
#womeninSTEM
#WomenInMedicine

vice.com/en/article/8xy…

These studies + anecdotal experience:

“women don't negotiate for a very simple reason: they sense—correctly—that it will hurt them if they do... when women *do* negotiate... they end up worse off than if they’d kept their mouths shut”

#womeninSTEM

psychologytoday.com/us/blog/family…

Read 25 tweets

Umbereen S. Nehal, MD, MPH

@usnehal

10 Apr

This “fertility” fake news has been going on since December, apparently.

focusonreproduction.eu/article/News-i…

“CDC report found that 62% of nursing home workers are refusing the vaccine”

“...First responders in New Mexico have sued after a county official ordered firefighters, corrections officers and other first responders to receive injections.”

#MedTwitter

abcnews.go.com/US/employers-g…

Lawsuits over staff mandates to vaccinate or mask boggle my mind.

This has been brewing for years.

There is SO much anti-science rampant within #healthcare staff more so in those “anti-establishment” on either extreme of political spectrum

nbcboston.com/news/local/jud…

Read 19 tweets

Umbereen S. Nehal, MD, MPH

@usnehal

9 Apr

Shame & #impostersyndrome = energy waste you canNOT afford (I realized w/ chronic illness & pain). You WILL fall - while rest & recovery are important - sometimes the ball about to drop is too important
Don’t miss your shot

#womeninleadership
#womeninSTEM
#womeninmedicine

BUT do miss a lot of shots. I promise you, it will drain you of less energy to try over and over than to try to be perfect. You will ALWAYS fail to be perfect. You will only sometimes fail to make the shot

#womeninleadership
#womeninSTEM
#womeninmedicine

Of course there will be these people, (whether in reality or your perception of it - but perception becomes reality).

They have only as much power as YOU give them.

Go to your beginner’s mind. Find that inner child’s courage.

#womeninleadership
#womeninSTEM
#womeninmedicine

Read 8 tweets

Umbereen S. Nehal, MD, MPH

@usnehal

9 Apr

https://twitter.com/OrganJM/status/1380253166718029832

I state, highlight, mark up, not insinuate
Why is someone who likely does not menstruate a sudden expert on #womenshealth to identify a WOC seeking #data #quality & #integrity as the threat...to women?
"Respecting" social science = using respectable methods, not online surveys.

https://twitter.com/OrganJM/status/1380253166718029832

What you see in the tweet and the "study" is ego, defensiveness & flagrant Dunning-Kruger effect for #womenshealth, #menstrualhealth, #COVID19, #vaccine #research.

The best way to demonstrate the value of a field is to be consistent on #quality not

sciencedirect.com/science/articl…

Academic language on #online #survey #data:
"systematically assess carelessness in a crowdsourced sample" Denial that quick & dirty is poor #quality is an odd use of time & ineffective. One could better defend one's merit, by delivering #quality per best practices and standards.