By: Heather Dimmitt, DO
“Are you stupid?!”, exclaimed my 8th grade science teacher in front of the whole classroom, after I asked her a question about the upcoming science fair. My mind had been wandering during her spoken explanation of what was expected of us. Presumably, she must have just said the answer to the question I asked. I stopped asking her questions after that.
“Space cadet”, “head in the clouds”, “ditzy”. A slew of such insults were constantly thrown my way growing up. I can still feel it when I first meet someone. They assume I’m stupid before I even open my mouth. It must be something to do with how young I look (most say I look like I’m 12! When I am 28!), or how pretty I am, or how I seem to be staring into space. I confess I still don’t really know for sure. Most people seem to have a hard time understanding their own biases, which makes it even harder to explain them to me.
I used to be very blissfully non-committal and un-opinionated about things, and was content to endlessly intellectualize within my own internal world. Then I met life’s bullies. I never really knew what to do with them. I usually didn’t even realize I was being insulted half the time. What could be wrong with thinking to myself? Thinking is a smart thing to do. My thoughts and observations were much more intense and interesting than whatever else was going on. My mother was the first to endlessly come to my rescue. She always knew I was smart and creative, and she vehemently hated other people who misunderstood me.
I remember she seemed to always be yelling about something. She had to be that way as a woman from humble origins, who became a doctor through sheer force of will, when it was largely a male dominated field. I watched my mother scream at educators the way she would scream at me at home. My 7th grade history teacher gave me a final grade of “D” because she wouldn’t let me turn in an assignment I had completed simply because it wasn’t turned in before the start of class. I had remembered when she mentioned it about 5 minutes after class began. I tried to get up to turn it in, but NO! Automatic failure of the assignment! I thought that was silly and forgot about it. I knew I did the assignment.
I only remember it now because later on I was brought to tears by my parents endless yelling at me over it. “How could you get a D in this class?!”. When my mother found out what happened, it was the teacher’s turn to cry. My mother has the determination of an iron fist. She gets what she wants through sheer force of will. I knew I had to adopt this practice if I was going to survive in this world. And I have.
I had always tried to be “good” and just did my assignments like I was supposed to. I was always a great student. The alternative was hours of yelling about how I got a “D” in history class, so I did just enough to get “A” and “B” marks. Just enough to make them happy and get them to leave me alone. I don’t think it was until about high school that I started standing up for myself in the classroom. Despite how “good” I was, I would still receive berating remarks from teachers in class pointing out how stupid I seemed. It was like they were a comedian at a club and I was the punch line. They got a lot of laughs, and presumably felt pretty good about themselves. At some point in sophomore year, I had enough. I was determined to blow them out of the water and shut them up for good. I started speaking bluntly, with authority, like my mother.
I was in the IB program at my school and was taking 7 college level classes at once. For my final IB project, I chose the meanest, jerk, bully, comedian teacher in the school as my advisor. I was going to show him how much I knew about war poetry! I filled up every inch of each 8 x 11 inch piece of paper with my intricate ideas interpreting the poetry printed on it. I practically yelled at him my ideas on the subject in our meetings together while shoving those papers with all my thoughts written down in his face. I loved that war poetry the way a mother aggressively loves a child she’s trying to understand. It worked. That teacher stopped treating me like a joke and I made it my mission to get straight A’s in all of my college level classes. I would show them! I got 3 scholarships and got accepted to an amazing college where I got a phenomenal education that I didn’t have to pay for. I worked full time and graduated with a bachelors degree in biological psychology.
I made it through high school, college, a senior thesis, med school, and part of residency before this aggressive fight to be included backfired on me. Unfortunately in my residency, it wasn’t about what’s right for the patient. It’s about what’s right for the attending’s ego. If you question them, you’re wrong, and stupid! It doesn’t matter what the actual evidence says, even as they tout their ideas as “evidence based medicine”. It doesn’t matter that the patient could be getting better care. It only matters that the attending is right and the resident is wrong.
I tried to be open and comprehensive with my suggestions for care plans, exploring all possible treatments available, and was told that I don’t seem confident enough, which makes me seem stupid. When I started stating my plans outright (“go wrong and strong” they told me), the attending would always pick a contrary view and would try to tear me down so that they would look good in front of others. Then they would get upset when I tried to support my ideas with evidence, forcing them to think outside the box. They literally fired me for being too forthright.
Strong, smart women with opinions tend to piss people in power off. And that’s exactly what happened to me. I couldn’t understand why I kept getting evaluations saying things like “lacks medical knowledge” when my board scores were among the highest in my residency program! It was completely illogical, but it didn’t matter. Attendings and coworkers can say whatever they want in evaluations, and it’s taken as complete fact. There was literally no other method at my residency program for evaluating a resident’s progress in place. My attempts to explain and protest this literal gaslighting were seen as “not taking responsibility” and “unteachable”. I will admit and learn from mistakes in a heartbeat. But I simply cannot admit to something I didn’t do! It didn’t matter that I had high board scores and that my patients were well cared for. Again, I did everything that was asked of me and I did nothing wrong. No matter what I tried, it was useless.
I was desperately searching for an answer to my problems online, and stumbled upon the idea of autism as it presents differently in women. It was like the answers for why I was different were out there this whole time! I finally had an explanation for why life seemed so much harder for me! It was clarity, and a blueprint for how to bridge the gap between myself and the rest of society. I made the mistake of mentioning this to an administrator, and was abruptly fired in the next week or so. I can’t really prove it, but this was flat out discrimination against my neurotype. And because I have this black mark on my record, I’ve been unable to get a residency position anywhere else. I had a plan for my life. Finish residency. Work 9-5 in a clinic somewhere and help people with my gifts and skills for the rest of my life. Simple. Straightforward. Perfect.
Now? Utterly unattainable. I was devastated. All of the focus and hard work I’ve put in my whole life, just to have my dream snatched away by this bigoted residency program. I’ve since come to understand that the program itself was flawed in so many ways that had nothing to do with me. It was relatively new, the program director had changed 2 different times in the short time I was there. Multiple qualified and excellent staff, residents, and faculty had been fired, even before I started there. The most recent program director was only a few years out of residency himself. The program had been struggling financially and had to stop taking new patients, while at the same time being forced to increase all resident salaries to the competitive standard. Firing a resident probably saved them the funds.
This was one of the lowest paying residencies when I first started, but I chose it because I didn’t care about the money. I wanted to work with this community because it is one that has suffered major oppression. I can relate to being dismissed and bullied by society, and I have experience fighting oppression for myself. I thought, if there’s anyone who can understand me, it’s others who have been subjugated their whole life. And they did! The patients, at least. The majority of my patients had been through trauma, and it was like we just understood each other. It was so wonderful to be able to just validate and help others who were struggling, as a person in a position of some power. I advocated for my patients the way my mother did for me. I called insurance companies and demanded those MRIs that my patients needed, dumping endless information on them until they caved. I would go above and beyond for my patients to get the care they needed.
Now I feel like all of my gifts and skills I’ve worked so hard to acquire are being wasted, if I’m not using them to help others. It’s a common autistic tragedy. I bring this up in support groups and EVERYONE nods with understanding before elaborating on their own tragic story of misunderstandings, discrimination, and eventual unemployment. So now I have a new call to arms. I’ve finally found my community, and my voice. My mother’s iron will, ever determined to crush our enemies, continues to flow through me and into the face of discrimination.