Women Physicians as an Elephant Herd.

I was a speaker at a recent female physician moms conference (PMG2020 conference) where there were 200 physician moms, mostly younger than me, with their children of all ages and a few brave dads. Most were early to early mid -career. I had to laugh because I was one of the oldest in the room. Then my thought was, wait a minute, where are the later career moms? How many women are quitting medicine mid to late career? According to recent research done at the University of Michigan, 40% of female physicians go to part-time or leave their medical careers completely. Is anyone else alarmed?! This is a crisis in my mind.

During my talk at the conference, as this was one of the first all-female physician professional CME conferences I have attended, I was nervous, triggered by past traumatic training experiences (still 30 years later), hot flashing and sweating so much I had to remove my outer layer (at a certain age, you know how to dress in layers), and my heart was going a million miles an hour, almost a panic attack. What did I have to say on the stage with so many other national women speakers? I felt like I was separate from this group of amazing busy, competent, accomplished, way above my puny career and skills, women … until I looked out to see these beautiful faces of these women, appreciating the bad-assness of being a woman physician that grows, delivers, and parents their children while maintaining careers. I saw in their faces how difficult and complicated their life can be. I paused to connect with my younger colleagues and physician coach peers, and then said (too loudly, very awkwardly, with a shake in my voice, and, most of all, it was booming because the volume of the microphone volume was too high), “I think I am the Matron elephant of the group!” as the microphone temporarily screeched with that ear-piercing sound of feedback. This time with the feedback gone, but still unbearably loud, “I am the matron elephant of our herd of mother, children, and auntie elephants!” I continue, as the volume is now corrected, and in the next breathless breath say, “We’re a herd of mostly female elephants and children and I see myself as a Matron elephant. I have something to say…”

Now, if you know anything about elephants, you know that they are commonly observed, in their natural habitat, as families with children and many aunties. The males leave the family as young bulls and join the hierarchical herds of males, or stay alone (Hmmm, isn’t that interesting!? There is a whole other story to tell there). The Matron is one of the oldest in her herd. She is the one that remembers the various grazing and water sites. She remembers where the predators are most active and seasons they are hungry. She knows where poachers most frequently travel. She is the wise one. She is the heart of the extended family and shares her wisdom and influence over group decisions, behavior, and movements. In the social networks, she is a gentle, and, although she is less gregarious as she ages, she is the beloved leader, encouraging life long bonds in the herd, and cooperation with the raising of the young elephants. She knows this is crucial to survival. The matriarch influences social behavior and provides the memory and record of ancestors’ stories. She is providing the memory of the herd so she can lead from knowledge and wisdom and pass on to the others the knowing needed for the herd to survive. It is crucial to survival of the herd. These matrons, mothers and aunties help each other to raise the calves. They are known to group together (called bunching) around a female in labor and birth. They are there to protect the soon to be mother from predators and unfriendly males. Together, they keep watch, bunching and circling around her, gently nuzzling her and each other in concern. They gently kick up the red, dry dirt, and put the dirt over the calf and placenta and blood- the smells of birth. This instinct is necessary to increase the likelihood of the survival of this one infant and young mother, and the overall survival of the herd.

In that moment on the stage of the conference, with my gigantic projected slides on both sides of me, I connected with my audience of the accomplished women in my herd. I felt their knowing. Whatever fear, self- abasement, embarrassment (I did continue to sweat, for full disclosure), shame at a career fucked up (could not say that out loud in the moment because of the little people in the room), wondering what I had to say, melted away. I knew in that instant that I was an essential part of them – the elder. I took a breath and exhaled to let all of the body sensations and unnecessary annoying thoughts and not relevant go, and I began to speak from the heart — as the heart of that herd — about life and the topic I was there to impart. I experienced my herd of women physician colleagues newly, as connected to something way more powerful and sustainable than my separateness of thought and physicality. They looked up to me with knowing. Each of the many sisters, and aunties nodding because they have stories and bruises and survival stories. They, too, even at their relatively young careers, have stories to tell — stories of feeling separate and trying to survive alone. Stories of loss and danger; as a career that has huge impact on the life, family, and health of these women because they chose this beloved profession… as a woman knows in a way the men will never know fully.

Did you know that elephants’ express personalities and even mourn together? They mourn the death of every member, from the pregnancy losses, stillborn and weaker calves to loss of their beloved oldest Matriarch. Did you know the herd is most at risk when herd loses their matriarch? After my two talks were concluded, I was given over and surrendered to the glow of new-found friends and new-found connections. My heart was full – filled with expanding love for all sentient beings. I belong. I have purpose in the world of clinical training and the practice of medicine. I have the “soft topics” knowledge and skills that I was castigated for in my training—finally the mostly male hierarchy in medical institutions are starting to see that we must take care of our physicians, especially the mothers, the parents, those with disabilities, health problems, and our physical, emotional, and spiritual needs. It is needed in an urgent way –now. Now, to stave off a crisis. America has lost a generation of quality and competent physicians by establishment poo-pooing the “soft topics”.

Life is perfect in its imperfection; medicine is not, but after this conference, I have way more hope for medicine and women in medicine than I have for years. I am filled up at being needed and wanted. I am angry about the abuse, neglect, and misogyny I have experienced that still impacts my life (that is another whole different story to tell). The herd’s survival hangs in the balance.

Dr. Alley-Hay is an Ob/Gyn, mother of four adult children, and a physician certified life coach.
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Robyn Alley-Hay, MD, Physician Coach, retired Ob/Gyn, Dir. Women’s Health, Hands On Global