Since I was a little girl, I have been called a lot of things. Sensitive. Funny. Strong-willed. Outgoing. Take-charge. Friendly. Bossy. Focused. And my favorite — domineering.

I’ve always been a direct person. I’m an extrovert, which means I walk into a room and I am energized by the people around me. I am also a positive person; I assume you are my friend until you prove otherwise. On most days I’m going to tell you exactly what I think, as my thoughts often become words before they make it through my internal filter.

I put on a national conference every year, and one year, my co-director, as I was prepped to take the stage, whispered to me, “Sash, remember we don’t know these people. We are not in your living room.” Haha! He knows me well. I typically talk to my colleagues from a stage like I would talk to them if they were standing next to me in the operating room. This means I generally have a lot of friends; it also means I am going to communicate very directly and openly whether we have shared a meal or only a handshake.

I have always had a strong spirit. I can typically see beyond niceties and formalities to the big picture. I appreciate direct people. I don’t get bogged down in drama and if someone tells me no, it doesn’t offend me. It may not stop me, but I also don’t take things personally. Take my decisiveness and add my outgoing nature and well, you get what some would call … domineering.

However, if you talked to my closest friends, they would tell you I’m a girlie girl. I like spa days and romcoms and love me some Jimmy Choo’s. I care deeply for my friends and love poetry and writing and music. To my kids, I am the parent who gives in the most. While I am not a crier, I’ve been known to hide in a closet in the hospital for a minute while I compose myself after dealing with trauma or death. Things get me in my gut. And I wear my heart on my sleeve. I can still remember every patient death I have ever experienced; I remember each face. And it hurts.

Becoming a physician was difficult, with challenges too many to describe. But in some regards, it was perfect for me. I am good at decision-making, I like structure, and I am quick to act. I love getting to know people, really know them; I don’t care for small talk. If you want to talk about the weather or what you had for dinner last night, I am probably not your girl.

So enter medicine, where there are a hundred different women and men moving in different directions to save lives. Small talk often does not exist in many of these arenas. You would think this is perfect for me. However, I have to be honest: there have been many times where I have been judged by others for how direct I am. Not because I am rude, but because I am a woman.

I have watched my male partners take action, make fast decisions, give orders to save lives, and direct codes, traumas, resuscitations, and impending disasters with immense precision, leadership, and accuracy.

But for years, after stabilizing the event, I would find myself trying to make small talk. “Oh hey, thanks for getting that crash cart so fast. How are you? How is the soccer season going?” Or “Thanks for getting XYZ. Sorry if I seemed to snip those orders, how are the kids?” (Never mind the patient was coding, and I was stating orders to save a life).

For years, I would breathe a sigh of relief the patient was OK. Then, I would look around to stares and realize I needed to go into soft Sasha mode and placate my social environment to make sure everyone knows I was just doing my job (but not stepping on any toes in the process).

Guess what? I stopped placating. I stopped worrying.

I stopped for two reasons.

First of all, I realized that being a leader in a stressful situation, where people may die, was what I signed up for. I didn’t sign up to win a beauty pageant or a mayoral race. It didn’t mean I had to be a jerk, but it did mean I had to lead in a hostile environment. Guess what? Death is hostile. I stopped worrying about my popularity vote. I put all my focus on who I was there for — my patient. I realized that as long as I always put the patient first, and led each situation by treating my coworkers with dignity and respect, I was winning.

Sometimes that means walking into a room and taking charge.

Often that means giving direct orders in a timely fashion and skipping small talk.

Second, I realized something very valuable: I was a good doctor because I was a woman, not despite of it. While I often felt (and sometimes still do) judged more harshly for having both a take-charge spirit and being female, I realized that leading as a woman gave me some unique qualities that made me a great physician and colleague. I don’t hesitate to debrief with the nursing staff or other team members when something tragic happens. And in my work environment, I have a lot in common with other women in the room, most of them who are nurses. This has led to some pretty amazing friendships with my coworkers with the ones who look past the fact I just asked them for epinephrine stat and appreciate me as both a doctor and a fellow woman.

Can it still be awkward when one moment I am asking them about the best place to get a manicure and the next I am asking them to go get me some drugs I need ASAP?

Yes. But guess what?

It is what I signed up to do. And it is an amazing blessing to live in a country where I can be educated and lead as a woman.

I think if you talked to most female leaders or professionals who work in male-dominated fields, they would tell you that they have probably faced similar situations. It can feel lonely and isolating, and you are hesitant to let your guard down. Your job requires direct leadership and decisiveness — two things not considered very “feminine.” It is a tricky balance.

There have been times I know I have been too blunt, too strong, and I have had to own those. There is no such thing as a perfect leader. I am a work in progress. But for the most part, once I owned who I was, and the job I chose, I embraced being called domineering or bossy. Sick, scared and dying people appreciate clear direction and action from their doctors.

So go ahead and call me bossy. Bossy saves lives.

Sasha K. Shillcutt is an anesthesiologist who blogs at Brave Enough.

Image credit: Shutterstock.com