The announcement of my pregnancy came in a series of fits and starts over time. It began on an early Spring morning when I woke up and felt a gnawing pang in my stomach. I grabbed at it, rubbing it and hoping that it would go away, knowing what was at stake. I was in my final week of my pediatric residency. Even though the tradition had been that most of the seniors be scheduled to have assignments that did not demand them to be monitored strictly so that they could travel and take time off to begin the next transition in their careers, I was not as lucky.

 

I had been labeled largely problematic for my attitude, something that had accumulated from not smiling through the continuously biased observations made by my fellow residents and attendings throughout my residency. I was told that I was too harsh for rolling my eyes when my residency director at the time announced that he liked only “Jewish and foreign graduates” since they do so much better on exams. I labored through the attendings who would mock me, belittle my baseline intelligence, and feel my eyes glaze over with fellow residents talking about how their night would go better when they were on service simply because they were all of “Asian Persuasion” as they called themselves. Again, people took issue not with the things that were said, they just consistently commented that I needed to take their comments better; to go along to get along and be a “good sport”.

 

It was in my final weeks, before the utter full weight of the trauma that I had sustained would hit me that I felt this small feeling in my stomach. Of course, I had known for a little while that I was expecting. I was generally in tune with my body and knew that it was changing in ways that I had never felt before. Almost like the harbinger of some new strain of virus that I couldn’t quite put my finger on.  

I remember rolling over early in the morning and texting my chief resident that I would not be able to come in that day because I was sick.

 

Now you have to understand that I was a rule follower and always had been. I had rarely, if ever called out sick, even if I felt under the weather. I tearfully remember that this duty weighed on me as I sat with my family picking out my grandmother’s casket shortly after her passing. My heart raced with dismay in finding out that no other resident could cover me for medical practice clinic and that I would have to return back to my program within two days of the message or face severe consequences. I still remember the full glee in the eyes of the other residents when I returned back emotionally broken, like it had been a funny joke, a way to exert their power over me and put me in my place after I had lost someone so dear to me.

 

I remember turning back over and hearing the buzz from my phone. I read the text in disbelief. The chief resident replied something to the effect of- I know you’re lying. Get in here now. I would love to say that I couldn’t believe it, but I could. Certain residents in my program were given free reign to say whatever they wanted, especially if they happened to look a certain way. It became an unwritten rule, a hierarchy that was agreed upon by all involved and I had been threatened numerous times that if I wanted to report it, my career would also go down with the proverbial ship.

 

So, I texted her again that I was ill and would not be coming in. Period.  The chief resident responded with more derogatory comments about me having been a problem to the program (again, rarely missed a day, showed up on time, was respectful to my attendings) and threatened to let the residency director know about my insubordination.  I still relented as I was sick and let it go from there.  After nursing my head over the toilet for an hour or so, my residency director wrote to inform me that he had spoken with the chief resident, and that I should go ahead to find coverage for my absence as well as notify my current attending and the subordinate resident as though I had the energy to do so.  He stated that this would apply for any resident who was planning on missing the last week and that should I not have further proof of my illness he would inform every medical-professional agency to which I was associated. He even went as far to state that, he would write a letter to my future employer. These may have been simple words, but, it horrified me on every level.  I was in the throws of physical illness and felt as though I had been drowning, struggling to get to the surface to finally breathe.

 

I felt as though he had confidently banked on listening to the chief resident, characterizing me as having a conspicuously inconsistent character, no integrity. Based on his actions, I believed that he was certain that I had just made the whole thing up and that I had thought myself equal to the other senior residents who in their last week were resting and traveling, how dare I usurp the hierarchy and the power. I kept on and repeated what I had said all along. Because it was true.

 

He told me that I needed a doctor’s note to justify my absence.  I picked up the phone and promptly called my obstetrician. He was a nice man who I found was caring and supportive. He too had been through the trials and tribulations of his own residency program and knew what it was to battle the torrents of bias. I drove to his office in a daze of confusion, anger, and frustration, gripping the wheel and breathing deeply.

 

I had made a promise to the life growing inside of me that I would concoct a steel womb to protect it. This meant that I refused to have my baby feel the effects of my heightened blood pressure, my racing heart, I tried to filter out the environmental toxins that lined my blood and all but ensured greater health deficits for this child. I had never been so aware and so afraid of my body. But, I continued to envision a womb that only permeated light and happiness.

 

As I sat on my OB’s table, I told him of my morning, of the gnawing hunger interrupted by the tidal waves of nausea and the discomfort that weighed on my soul. He listened to me and gave me reassurance about the program, told me that it was almost over, and to hang tight and strong. He wrote a prescription with the diagnosis and sent me home.

 

I uploaded the prescription as requested to my residency director, including my correspondence to the Pediatric Department Head as well.  I was sheepish as I knew that the diagnosis clearly beheld the underlying cause and would spread throughout the program. Though medical information was supposed to be private, I knew that I was not privy to this privilege— not by law, it was just what happened in my program- everyone talked. And so, I sent it out clearly stating “Hyperemesis Gravidarum”.  After I pressed “send” I felt the chatter quell on the other end of the Ethernet wire and a soft hum begin to grow louder in my ears. My face burned with frustration and impending humiliation. All I could do was curl up on my side and take deep breaths hoping that my baby did not feel the weight of my world.

 

 

                   *                                    *                                      *

 

 

It was a few months later when I had started stretching out my tummy bands that I had decided to let my new department know about my pregnancy.  I had kept my head down and tried to settle in, hoping that the horrific blur of my residency could be somewhat forgotten.  I had looked up to my Pediatric Department head at my new position simply because I had remembered her as a student.  She seemed to be smart, confident, and caring.  From what I had seen, she was a great leader and I was yet to wipe the stars from my eyes when seeing her.

 

I sat down at her desk in her office and let her know of my pregnancy.  I awaited her response and was put at ease with the cheer that rolled off her tongue- she appeared to be ecstatic.  I was unmoved, however.  I wanted to let her know that my pregnancy would not be a issue, that I had a plan and that my partner was involved.  She still appeared smiley and reassured me that all was well.  She asked if she could share the happy news with the rest of the department and I responded affirmatively.  Part of me began to relax that day as I could begin to imagine a place where I could be where I felt comfortable and seen.

 

The next few days were a blur as I continued seeing patients and watching my belly grow slightly more day by day.  I smiled for the first time regarding my pregnancy as some of the staff came up to me with congratulations and I began to feel excited for my baby to enter the world.  I had been so nervous about what my pregnancy would mean for me as a physician and new mother, with questions constantly swirling about my head wondering how all of this would work.  Now, I was starting to become somewhat relieved.  I was grateful.

 

The Friday that it happened was like any other.  It was close to lunch and I was finishing up seeing my last patient for the morning.  I received a knock on the exam room door and thought nothing of it.  I was speaking with my patient and his family, giving my assessment and paused mid-sentence while opening the door.  Karrie, our office manager, stood in the doorway. 

 

“Yes?”  I inquired.  I was confused why she was there since this had never happened before.

 

“I just heard that you were expecting.” She sneered. She was blocking the doorway.  I made an attempt to come out of the exam room to finish the conversation and had started to shut the door when she asked, “Was it planned?”

 

I looked incredulous at the question and looked past her to see two other staff members’ faces that were both shocked and red.  Their mouths formed tiny o’s and they stood stock still.  I looked at Karrie, stepped back into my examination room and quietly shut the door finishing my visit.

 

As the day went on, I grappled about what I should do.  Should I confront Karrie for her disgusting and egregious behavior?  I knew that I was the only African American in the office and I had undergone some of my training in the department, the Department head had been somewhat of a mentor.  I couldn’t help but consider that my future career and happiness in this office and larger institution was at stake.

 

Before I had a chance to do anything, the Department chair called me into her office.  I sat down and she stated that she had been made aware of the events that had transpired earlier in the day.  She stated that the behavior was unacceptable and that as Chair, she was obligated to report it. “Unless…” Unless?  She described how I was new to the department and that the fall out from reporting this incident could be catastrophic to Karrie’s career.  That there also might be greater fallout with my colleagues and the medical staff.

 

She assured me that she was “thinking of all involved” and wanted to know what she wanted me to do.  I had already been in a past toxic environments and wanted the best for my future.  I sat there contemplating the choice that my department head had just squarely placed on my shoulders and came up with the obvious choice.  Don’t make waves, I told myself.  Maybe it would get better.  “Please don’t say anything. I’ll be fine.”

 

 

                 *                                       *                                           *

 

It had been a particularly cold end of Fall.  My belly had grown even more, and I was beginning to notice that the rest of me had been growing in other ways as well.  My feet began to swell to unmatched proportions and looked like loaves of bread.  It was no matter as I was still moving at my old pace and striving to keep up with my earlier, more svelte self. 

 

No matter what, I had grappled with the earlier decision of not reporting Karrie’s conduct, and it had continued to haunt me.  The Department Chair not reporting the incident only gave Karrie free reign to do whatever she wanted.  I felt as though Karrie would speak to me harshly in front of my colleagues, “scramble my schedule” routinely, and do whatever she could to undermine me.

 

I had continued to smile through it as to maintain balance in the department.  I wanted a workplace where I could just focus on being me, liked for my work, hopefully starting to fit in… but this was becoming even harder for me.

 

During lunch hours, me and my colleagues had to answer patient calls.  This was where we could address non-urgent matters, look through and sign paperwork, and finish up charting for the morning.  All of this was fine and good, accept I couldn’t do that.  My workstation was comprised of a desk and an old, 80’s computer chair that was loose in the back.  I had no phone at my desk to answer calls and was told to get up or lean back at a 70-degree angle to pick up the phone at the desk behind me. 

 

One of my colleagues told me that I had to start “pulling my weight” with the phone calls and balked at me not having a phone.  “Just make due, everyone else is” she barked.   All of my other colleagues had a phone at their desk, including the nurse practitioner.  When I asked Karrie for a new chair (or at least a chair without a loose back, she stated that she would “look into it”.  I waited for weeks with my growing belly as this chair never arrived.  But, I noticed that she ordered new ergonomic chairs for the medical assistants at the front station that arrived shortly before my impending delivery.

 

It was disheartening. During this time, I spoke with family who all but assured me that my former mentor likely had my “best interest at heart”.  That she was likely “looking out for me.”  But it definitely didn’t feel like it.  Karrie knew the ins and outs of paperwork that was needed and just wouldn’t inform me of deadlines, so the department head would bring me in her office and yell at me when those deadlines were missed.

 

I lived two hours away during this time and took a beeper home with me for call.  For some reason (likely the distance) my beeper would only receive some of the night calls.  But I didn’t know what calls that I didn’t receive.  There was one particular morning where Karrie and the department head confronted me at the front desk in front of staff and medical students.  The department head made it known in front of the whole team that they had received a complaint from a patient the night before who had called the beeper and had not received a call back. 

 

I looked on in shock as the department head shouted at me, accused me of avoiding calls. Karrie stood by her side with a faint smirk.  I had to go to the back office and bring the department head my beeper, had her scroll through this in front of the whole team.  As she scrolled through the numbers, the department head was incredulous that the numbers on my beeper were the ones that I had answered, the unanswered patient call was not on my beeper.

 

 I fully began to see that this workplace was not going to be for me.  My feet grew plumper by the day, my face fuller, and patients began to comment at how I was beginning to look like a loaf of bread.  I found relief in leaving the office and heading home daily where I would talk to my baby on the rides home to calm myself down and hopefully, the baby as well.  I knew that this workplace was toxic, and I questioned my future there.

 

It was around this time that the department head had decided to throw me a baby shower for the department.  I was flabbergasted as I have always been keen on energy and goodwill.  I didn’t want a baby shower at this workplace.  However, I also didn’t want to ruffle any feathers and had been advised by my family to keep my head down and keep going with a stiff upper lip. 

 

The day of the baby shower was like any other.  I waddled my way into the lunchroom and sat and laughed as gifts were laid out for my baby boy.  I tried to appear jovial, even though I had routinely come to undermine my lack of sense of safety.  I leaned over and took pictures with the staff, most of them happy and positive, but still not knowing what laid before me.

 

As the shower dispersed, I opened a gift from one of my colleagues. He was older and a clear fan of the previous Republican POTUS.  He constantly made jokes about misogyny, politics, and routinely commented on how the current POTUS at the time was a fascist and a Nazi… I held up the clothes from the gift bag and could not escape the putrid smell coming from the bag.  I looked for stains and only had my fears confirmed.  He had gifted my baby mildewed clothes.

 

I sat there in shock and sadness.  I had not wanted the baby shower, had just tried to keep my head down, but had become so used to humiliation at every turn.  I thought about the thank you card that I was going to write while the tears streamed down my face.