Redefining traditional gender roles and the importance of a growth mindset [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“Maybe it’s a testament to a hardy relationship that there was no resulting argument. Without thinking, I blurted out, ‘You are so sexist!’ I could immediately tell by my husband’s face, his upper eyelids and eyebrows lifted a bit, his mouth freeze-framed in a small ‘o’ — my exclamation surprised and insulted him. Maybe it was a completely unfair assessment; after all, he was standing at the sink, his hands covered in soap, washing the dinner dishes.

Can you be sexist and clean up after a meal?

Can you be sexist and love your spouse?

Can you be sexist and a female MD?”

Christine J. Ko is a dermatopathologist.

She shares her story and discusses her KevinMD article, “Confession from a female doctor: I am sexist.”

Did you enjoy today’s episode?

Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!

Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Christine Ko. She is a dermatopathologist, and she wrote the KevinMD article “Confession from a female doctor: I am sexist.” Christine, welcome to the show.

Christine J. Ko: Thank you.

Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and journey to where you are today?

Christine J. Ko: Sure. I always wanted to be a doctor. I know it’s sort of a stereotype thing. I’m Korean American, and so it can be a stereotype for Asians to be doctors, but it was really something that I wanted to do from fourth grade, when I read about Elizabeth Blackwell, the first female doctor in the U.S. And I sort of always thought I’d actually be in internal medicine, like you. I sort of found dermatology late in medical school and enjoyed it, and then I always thought I would be in private practice doing dermatology. Then I really got interested in dermatopathology and looking at skin biopsies under the microscope, and I still thought I would mainly go into private practice and do dermatology and look at the biopsies that I do. And then somehow I ended up here in academic dermatology and dermatopathology.

Kevin Pho: So I think you’re the first dermatopathologist that I’ve had on the show. So tell me about your training path, as well as some of the typical cases that you see on a given day.

Christine J. Ko: So dermatopathology is something I love. It’s really looking at skin specimens under the microscope. And the training, it’s kind of cool, because you can be trained in dermatology and go into dermatopathology, which is a one- or two-year fellowship, or you can train in pathology and go into dermatopathology. So dermatopathologists usually have either done a dermatology residency or a pathology residency. So it’s cool to see different perspectives, because I think the two residencies are fairly different.

So what I typically see under the microscope: I see a fair amount of skin cancer in this country, because of, you know, lighter skin and sun exposure, things like that, although skin cancer can really affect any skin type. And I also see a lot of inflammatory things. So, you know, I think a lot of people are familiar with eczema, so I’ll see that, or there are other rarer skin diseases, like cutaneous T-cell lymphoma, or things with even longer names, like pityriasis rubra pilaris. So, you know, lots and lots of different diseases to have fun with, I guess, in terms of visual recognition.

I also see patients as a dermatologist, and so the contrast is really fun for me: to see patients who are live in front of you, well, sometimes through COVID we’ve seen them in telehealth, but, you know, they come and they have their own experiences and emotions, and to contrast that with when I’m standing at my microscope and I look at slides of these real-life people with emotions and stuff. But the slides don’t have emotions. There’s no deadline. There’s no, like, “OK, look at the slide at two o’clock and be done by 2:30.” So it’s sort of a fun contrast for me to think about visual recognition in terms of a discrete object, and then how the interaction goes when a patient’s right in front of you.

Kevin Pho: So walk me through, say, a typical week. I guess what proportion of your week is seeing patients, and what proportion is looking at slides and pathology samples?

Christine J. Ko: Right. So every derm-trained dermatopathologist is different, and I know plenty who do, say, 50-50. They do half and half. For me, right now I mostly do dermatopathology, and I see patients on a Tuesday. So COVID has really disrupted a lot of people’s schedules. I used to do dermatopathology generally three days a week, and I would have, you know, a so-called academic day where I wouldn’t get new cases, and I would have patients on Tuesday.

With COVID it’s been different sometimes. I have eight other colleagues in dermatopathology, and so we share the load of what comes in daily. And although a lot of clinics were closed in the Northeast early on during COVID, our dermatopathology lab always stayed open. So initially, since many clinics were closed, and that’s where most of the biopsies come from, we had low volume, and two people could generally handle it. But everything was slower. You know, the mail system was slower. Our staffing was as small as possible, to keep people socially distanced and just out of the office if necessary. So everything took a little longer. And I think, as people have seen across the country, things are coming back toward normal somewhat. But yeah, I think in some ways there hasn’t really been a typical week anymore for me, given COVID, but I still do see patients on Tuesdays.

Kevin Pho: All right, let’s transition into the KevinMD article that you wrote. It’s titled “Confession from a female doctor: I am sexist.” Now, for those who didn’t get a chance to read that article, can you just walk my audience through it and share the story of why you decided to write it?

Christine J. Ko: Well, writing, I think, is therapeutic for me. It helps me deal with stressors. That article was sort of, in some ways, about something that surprised me, I suppose, because my husband was actually washing the dishes after dinner. So he was doing a household chore. And so I would say, if we think of sexism as having a traditional sense of gender roles, traditional meaning whatever it is, that women do one thing and men do another, if you think of washing dishes as sort of a woman’s job, then he was not being sexist at all. He’s standing there washing dishes.

But he made this comment. During COVID, my son, who’s 11, has been at different times pretty unhappy with the dinner that I make. And so he had been unhappy that night, and so as my husband was washing the dishes, he was commenting, “Oh gosh, I hope he can find a girlfriend who can prepare meals that he enjoys, instead of always complaining.” And that wasn’t a slam against my cooking. He was just sort of saying, “Gosh, is he going to be able to find someone who’s going to cook for him and satisfy his taste buds?” And I just sort of laughed, but in the moment I said something I guess kind of offensive. I was like, “Wow, you’re so sexist for saying that.”

And what I meant was really, couldn’t he learn how to cook for himself, to make himself happy as he grows older? And maybe he’s lucky and he finds a partner who is happy to cook for him, but really, is it his hypothetical girlfriend’s job? And, you know, we didn’t get in a fight, which I also was happy about, because I immediately said, “Oh, I’m sorry,” because he looked shocked when I said that. Because I don’t actually, you know, it was just something I blurted out. I don’t actually really think he’s sexist.

But I will say I realized, in reflecting on that afterward, that both he and I grew up in Korean American households where our mothers did do everything related to the house, and that was the model that we grew up with. And I realized from that one experience, I always knew I was influenced by it, but I realized how much I personally am influenced by that. And I internally really think that the household stuff is my job, and even when he’s doing dishes, I think, “Oh, he’s helping with my stuff,” not “He’s just working in a partnership.” And that’s my problem, not his.

And so it was sort of a realization: I blurted out that he was sexist, and really I’m probably more of a culprit at boxing myself into traditional gender roles at home than he is. And so even though it was sort of this cognitive implicit bias that came up directed at him, I realized it really should have been something that I said to myself.

Kevin Pho: So tell me, what are some of the things that you and your husband are doing to kind of press back or push back against these traditional gender roles and the feelings associated with them?

Christine J. Ko: It’s a work in progress. I would say that I’m no expert, and I wouldn’t want to be hypocritical about it, because really, I think I realized, in thinking about the article and writing it, that I really do take on a lot of that feeling that I think has been in the popular media, that many women, not just Korean American women, many women have: that we need to be great wives and great mothers, and if we work outside the home, also be great at that. And there’s this sort of, I guess, perfectionistic tendency that is really, for myself, I would say, not to speak for anyone else, created in my own head, based on my experiences growing up and things like that. Not to solely blame my childhood or my own parents or anything, but that’s something I think about.

And so I’m trying with my husband to ask and say, “Can you do this?” ahead of time, but also, I think, just to try to get him to step up without me having to ask, in the way that he’s very accomplished. He works outside the home as well and doesn’t need me to tell him at work to do X, Y, or Z. And so in that sense, too, at home we’ll just look around, like, “What needs to be done?” And so that’s something that we’re trying to work on together. But I think one of the biggest barriers, in addition to how we both grew up, is just that we’re busy. I definitely get caught up more than him in whatever thing I’m doing, whether it’s for work or with the kids, and I think it’s just easy to fall into habits when we’re busy.

Kevin Pho: There are some studies that say that traditional gender roles have put an inordinate amount of work on female physicians, and that has slowed down some of their career aspirations. Now, from your standpoint, what are your thoughts on that?

Christine J. Ko: I will go on the record as saying that I think being a mom and working outside the home is really hard. Saying that, though, I’m not saying that to mean that people shouldn’t do it, and that I don’t have, you know, that mom guilt that it seems like 100 percent of moms do have, and maybe 100 percent of dads also do have. You know, maybe it’s just 100 percent of whoever parents has it, because there are no standardized answers for how to parent. I think there are lots of books on it, but there’s no one-size-fits-all model.

For me, though, I think when I say that I’m going on the record saying it’s hard, it just helps me personally to know that it’s a really hard thing that I’m doing, and to accept that I will fail, and then I can learn from it and hopefully do better next time. And so I think that’s something that I didn’t learn as a child, in school, really.

I don’t know if you’re familiar with Carol Dweck and her concept of a growth mindset, but I think that’s what I’ve been really trying, once I learned about it. My sister, who’s a clinical psychologist, is the one who first sent me the book, when my daughter, I have an older daughter who’s 14, was young. She was like, “Oh, you know, this is really important in terms of, you know, raising your kids.” But I realized, when reading it, I had never heard of the concept before.

The concept of a growth mindset just means when there’s a challenge, don’t just think, “Oh, you know, this is hard for me because I’m not good enough,” basically. So, “Parenting is hard because I’m not a great mom.” Parenting is hard because it’s hard, in my opinion. And so that’s the way I think of it. And there are going to be challenges, and then learn from them, you know. And when I fail, just try to learn from it. And that’s the growth mindset.

Whereas I think, not to put blame on anything, one of the things that was habit for me, before reading this book about growth mindset, is my upbringing was more of a fixed mindset. That’s the opposite of a growth mindset, where you’re told you’re smart, for example, and maybe you are smart, but you still have to work hard. You know, good grades don’t just fall out of the sky. Something is still going to be hard for someone who’s smart, and just because they get, you know, God forbid, a B or a C or something, doesn’t mean they’re not smart anymore. It’s just that that one test, or whatever that material was, was challenging, or maybe they didn’t study or something. And so there are ways around it.

And I don’t know exactly how it happened, you know, whether it was cultural or just me or upbringing or whatever, but I know that I definitely grew up with a fixed mindset, and I didn’t necessarily enjoy having challenges put in front of me. And so maybe in some ways that’s also why parenthood just slammed me into the floor, because, I would say, I mean, I found internship hard. You know, residency was not easy either, for its own reasons, but I never experienced anything like being a parent. So God bless all parents.

Kevin Pho: Well, I definitely hear what you’re saying, because I have a 16-year-old and then a 12-year-old daughter as well, so I certainly can empathize with what you’re saying. So let me ask: What are some of the things that you did to transform from that fixed mindset to a growth mindset, other than reading the book?

Christine J. Ko: You know, interestingly, I think one of the things that really helped me was that my son is deaf and has cochlear implants. And so he did not have spoken language, even at age two, when he got them. And so it was about a four-year journey to work with him on speech and language, and we did that as a family with an auditory-verbal therapist who specialized in it. But basically the whole concept of auditory-verbal therapy, I realized, reflecting on it, is about a growth mindset. It’s like, you can’t say this word or syllable or phrasing yet, and you work on it.

And so there were always these measurable goals that we had each week, because we would meet with the therapist either once or twice a week, because we met six times a month, and we would have daily homework. And we had these measurable goals, and so, you know, I would see my son fail at something, or me fail at being patient, and you just realize, “OK, you know, the next time we try, it’s another session. It’s another effort.” And I slowly realized that, you know, he developed age-matched speech and language after about four years of this work. And of course we were seeing progress all along, but it sort of opened my eyes to, “Yeah, this is really hard, but look what this work creates. It pays off.”

But I think I had such a fixed mindset that it really took this prolonged period of: You set this goal, you fail, you try, you reach it. OK, then you set this goal, and you fail, because each time there was failure, and each time it was, “Well, we try again.” And so I think really that’s how I learned. And I saw how I could either complain about it, or, as I recently read in another self-help book, because I guess they say it, I think the Marines maybe: “Embrace the suck.” You know, it’s hard, but if it means enough to you, you can do it. And I realize there are certain things that really do mean a lot to me: being a parent as good as I can be, through the failures, being a great wife and mom and person, and doing the best by my patients that I can.

Kevin Pho: We’re talking to Christine Ko. She’s a dermatopathologist, and she wrote the KevinMD article “Confession from a female doctor: I am sexist.” Christine, what’s your take-home message that you want to leave with the KevinMD audience?

Christine J. Ko: I think maybe a simple way to put it would be: Even though the title of my article is “I am sexist,” you know, kind of going along with what we’ve spoken about, a growth mindset and things like that, I can change that “I am.” And I can change it to “I am, you know, converting over from being sexist,” or “I am trying hard to not think about traditional roles all the time,” or “I am trying hard not to put this perfectionistic standard on how I parent and how I try to achieve some sort of work-life balance.”

Kevin Pho: Christine, thank you so much for sharing your time and insight, and thanks again for being on the show.

Christine J. Ko: Thank you for having me.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes