鶹ýӰ

Reclaiming the Night in the Wake of 'Abhaya's' Murder

— To everyone in medicine: don't underestimate the gentleness of Indian women as weakness

Last Updated October 2, 2024
MedpageToday
An 1898 painting by Raja Ravi Varma titled: Shakuntala looking for Dushyanta.
Lee is a psychiatry resident.

This op-ed is the second in a series on violence against Indian women in healthcare. Part one is available here.

Abhaya, meaning "fearless" in Sanskrit, was the name given to the 31-year-old victim from Kolkata during protests for physician safety last month, following her rape and murder at RG Kar Medical College and Hospital. Abhaya represents us all -- Indian women in medicine who refuse to allow our fates to be governed by violence and our identities to be decided by people who do not know us.

The Western belief that we are submissive bears professional consequences for us in medicine.

"People think we're passive. I was told on clinical rotations to work on my confidence, like many other Brown women," said internal medicine resident Neha Narayan, MD. "Our medical knowledge is even questioned because we're not as loud as our white peers."

General surgeon Mohini Dasari, MD, MS, added, "Only now am I realizing how those cultural components contribute to professional outcomes."

image
From left to right: Lee, Dasari, Narayan.

Collectivism Versus Individualism

Understanding us means understanding two contrasting cultural philosophies: Asian collectivism versus Western individualism. In the U.S., we are taught to prioritize the self, self-advocacy, to stand out. But Asian cultures revere social harmony over individualism. We are taught humility, quiet diligence, and deference to our elders. We believe wisdom comes from listening over speaking with unsubstantiated self-assurance.

Unfortunately, Western medicine often interprets our cultural values as weakness.

While our colleagues may not appreciate our softness, our patients certainly do. Back when she was my medical student, Narayan handled extremely complex cases with outstanding compassion. I covered her census on her day off and her absence was noted. "Where's Neha?" one family inquired. "We love Neha. She's wonderful."

I and in medicine consider selflessness and kindness gifts that create more meaningful and enduring connections with each other and with patients. "It's the strongest asset I have," said internal medicine resident Aditi Misra, MD, PhD. "It's why I went into medicine. Our kindness is our strength as doctors."

Our Value As Doctors -- And As Women

We wish our colleagues and society would value us not only as doctors but also as women. But uninformed judgments about us abound: from fetishization of Indian women, for our "submission to men" as they criticize Western feminism for eschewing traditional gender roles, to condescension masked as progressivism, claiming we expect men to treat us as though we are nothing because our culture mandates it, assuming we couldn't possibly know or want better.

We are indeed raised to be nurturing and more stereotypically feminine. We are taught to prioritize family stability first. If a relationship becomes challenging, our first instinct isn't to leave immediately, but to invest deliberately in strengthening it. But we are not weak; many of us have survived immense hardship, despite this perception.

Demeaning assumptions from medical colleagues were hurled at me as I struggled to leave an abusive relationship, many of which stemmed from these biases about Indian women. "You just care more about what society thinks than your own happiness," sneered one male physician. My former partner's mistress revealed her own biases as she obliquely threatened him with blackmail: "She'll forgive you. Indian women never leave."

My former partner would belittle me, unconsciously using that common assumption about Indian women: "You're so submissive."

These judgments made me question my value as a woman and as a doctor. I felt powerless and incompetent -- as though my cultural identity were a liability in both my personal life and the medical world. I learned that people may see me as functional, reliable, weak, "the good Indian girl," but not a desirable, wanted choice.

Even today, that injury to my identity hurts more than getting hit ever did.

Many of us are not overtly aggressive, hence the "submissive" label. But there are means of resistance other than screaming or instigating violence. I come from a long line of women who have endured domestic abuse, a shared experience of many Indian women. What we will tolerate for ourselves, we will never tolerate for our loved ones -- or our patients. Our mothers and grandmothers instilled dreams of brighter futures in us from childhood, combing coconut oil and whispering their aspirations into our hair.

I once dreamed of a future daughter. I would have ensured she knew how deeply loved and wanted she was, that she deserved the best from life. We learn from the trials and mistakes of prior generations and become stronger over time. We have grown from barely literate to earning multiple graduate degrees, and remain flawed, but ever-loyal and kind. And despite male violence over generations and the demeaning stereotype of our submissiveness, we're still here.

Kindness Is Not A Weakness

"Indian women in medicine are resilient," says Kanksha Buch, a current medical school applicant. "I wish the world would see how strong we are. Kindness isn't our weakness, it's the way we show love. It isn't something my culture forced onto me. It's who I am."

image
Buch (left) and Misra (right).

But our fight can only go so far. Male violence remains under-punished and unchecked, and until we confront it with honesty and without immature defensiveness, women remain disproportionately at risk for sexual violence, even in a hospital.

As I write this piece, an onslaught of violence against women overwhelms the headlines: the mass rape of in France, the murder of in Kenya, the alleged sexual torture of in Poland -- yet many still shout, "Not all men!" and demean women who speak up as hysterical misandrists, effectively silencing us.

This is the worldwide context of violence against women in which we exist, and no place, even the hospitals where we give our best selves for our patients' sake, is safe. In fact, its widespread nature further normalizes it in the hospital setting.

I see too much of this as a function of my work, and no matter what I do, there is always more. Whatever fight wasn't demeaned or slapped out of me before I left my abuser is being drained from me by the cruelty I see in too many spaces. Increasingly, I cannot see the light in the world when basic respect for women's dignity proves so challenging to achieve.

I can't speak for other communities, but Indian women in medicine are screaming to the world: We have had enough, and now, we will force you to hear us.

"I write and advocate because I know if I don't, my story will just die in silence -- and without speaking out, there cannot be change," says Dasari.

We've made gains: the public outcry in India after the doctor's murder in Kolkata alerted the Central Bureau of Investigation, who , former principal of RG Kar Medical College and Hospital, on financial misconduct charges. The West Bengal Health Department has , as more information comes to light. Our collective voice is powerful.

And so, even if I, one physician, decide I can't go on, any guilt I have about it is assuaged by my faith in my community of Indian women in medicine. Don't underestimate our gentleness as weakness. Sexual violence and medical corruption persist, but so do we.

In the words of another Indian lady, Mindy Kaling, ""

It is with immense thanks and gratitude to the following women that I write this article: Aditi Misra, MD, PhD, Mohini Dasari, MD, MS, Kanksha Buch, BA, and Neha Narayan, MD.

is a resident physician in the Department of Psychiatry at the University of Rochester Medical Center in New York.