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Navigating a Toxic Work Environment

Written by: Pamela Kunz, MD
Published on: Aug 26, 2021
This article is published in the 2021 edition of the
Women in Medicine Summit Compendium
Click here to find out more and read the other articles

By Pamela Kunz, MD

I was in my mid-career as an academic medical oncologist, when I found myself in a toxic work environment. To be honest, it took me a while to even recognize and acknowledge that there was a problem. I had grown accustomed to the hierarchy and power differential in medicine as well as the male dominated leadership structure and the narcissistic behavior of colleagues, especially leaders.

When I reached mid-career and experienced a level of professional success, I was perceived as a threat by some male colleagues (Lewiss, et al, 2020; Carnes & Bigby, 2007). I started experiencing regular gender discrimination and harassment, mostly in the form of microaggressions. Among the many examples, I was told by a male colleague that my physical appearance helped me to get speaking opportunities, overheard complaints from a colleague when he was asked to provide coverage for “another one of my maternity leaves,” and experienced public put-downs that undermined my leadership. I felt alone, demoralized and stripped of my self-confidence and, worse, was made to feel that I was at fault. The years of accumulated disrespect created such a toxic work environment that I dreaded going to work each day. I felt stuck in a cycle of negativity from which I could not see an exit.

In working with an executive coach, I learned skills that started with the practice of equanimity, defined as mental calmness, composure and evenness of temper, especially in a difficult situation. The virtue and value of equanimity are celebrated by a number of major religions and ancient philosophies. It was even the topic of one of William Osler’s most famous essays, “Aequanimitas.” In my discovery and practice of equanimity, I learned the power of meditation and narrative writing and embraced them as important forms of self-care.

In order for me to really achieve equanimity, I took a pause in the form of a sabbatical (Farrell, 2020). The time away from clinical medicine and my administrative roles allowed me to hit reset and learn what mattered most to me. I systematically examined my work environment and made an inventory of my likes, dislikes, values, needs and asks. The value assessment, based on Brené Brown’s “Dare to Lead,” was especially meaningful. My search for equanimity, the pause, and living in my values were all important pieces in my transition from feeling stuck to feeling empowered.

It was only after this deep self-assessment that I felt ready to pivot towards action and change, which I approached through five deliberate steps:

  1. Research: I immersed myself in researching the data on gender disparities that was contributing to my toxic work environment and examined my own research through the lens of gender equity.
  1. Educate: I sought to educate myself and others through courses, meetings, lectures, books and films.
  1. Advocate: I found ways to immerse myself in advocacy for gender equity through professional societies and my home institution as well as through national and international organizations.
  1. Connect: I felt incredibly alone as I navigated the challenges of a toxic work environment and sought connection through mentors, allies, professional societies and social media.
  1. Heal: I learned the value of aggressive self-care through nutrition, exercise, sleep and time management (Harrington & Merrill). Giving myself permission for self-care is still a work in progress.

This journey allowed me to heal and gave me strength. I eventually decided, on my terms, to leave the toxic work environment. I learned that we all have the power to control our narrative, always have an exit strategy and can move from stuck to empowered. The journey through and out of a toxic work environment has forever changed me. I feel called to create a respectful, inclusive and collaborative workplace (Duma, et al, 2019) and dismantle disparities. It took me 48 years to find my voice. Now that I have found it, I’m never going to lose it.

Pamela KunzPamela L. Kunz, MD

An Associate Professor of Medicine in the Division of Oncology at Yale School of Medicine and Director of the Center for Gastrointestinal Cancers at Yale Cancer Center and Smilow Cancer Hospital. She received her medical degree from the Dartmouth Geisel School of Medicine. Her postgraduate training included a medical residency, chief residency and oncology fellowship at Stanford University School of Medicine. Dr. Kunz is an international leader in the treatment and clinical research of patients with gastrointestinal (GI) malignancies and neuroendocrine tumors (NETs). She holds key leadership positions in the field including Chair of the National Cancer Institute’s Neuroendocrine Tumor Taskforce and officer of the North American Neuroendocrine Tumor Society. In addition, she has emerged as a leading voice for promoting gender equity in the medical workforce and has recently been appointed Vice Chief for Diversity, Equity and Inclusion for the Section of Medical Oncology at Yale. Dr. Kunz is a wife, mother of three sons and proud feminist. She believes in kindness, collaboration and the value of a respectful workplace.

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