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[00:00:07] Angela: Hello and welcome back to Communicable, the podcast brought to you by CMI communications estimates, open Access Journal, covering infectious diseases and clinical microbiology. My name is Angela Huttner. I'm an infectious disease doctor at the Geneva University Hospital in Switzerland, and editor in chief of CMI cones.

[00:00:25] Angela: Today we're doing a somewhat different show. This one will be released on March 8th, which is International Women's Day. In honor of that, and because of the times we're living in, we've decided to have an honest discussion about where we are in ID and clinical microbiology with respect to both women and men.

[00:00:45] Angela: Yes men.

[00:00:46] Angela: We know that women remain underrepresented in science medicine and in ID microbiology.

But we also need to look at where men are in our field. The fact that the past few decades have brought major changes both at work and at home for many men. And this is not a zero sum game wherein one group starts to gain some rights, another group becomes less favored. Rather, it's about how culture and science consistently show we are better together.

[00:01:15] Angela: And that. Only with community advocacy and empowerment of all do we truly shine. So I've invited my fellow editors, men and women to answer some maybe tough questions and maybe with the answers we can figure out how to keep moving forward in such a way that in our workplaces and elsewhere, no one feels left behind.

[00:01:35] Angela: So I'm really glad to introduce two of our great women editors and four of our great men editors. Erin McCreary, as you will know, is ID Pharmacist and Director of Infectious Disease Improvement and Clinical Research Innovation at UPMC in Pittsburgh, Pennsylvania, USA. She's also currently president of the US' Society for Infectious Diseases Pharmacists, and it's five in the morning for Erin, just like it is for me.

[00:02:01] Angela: I'm hosting from New York City this time. Hey Erin.

[00:02:05] Erin: Hey. I was gonna say Angela's stateside for this. So glad to be here with this phenomenal group of people. Thanks for having me.

[00:02:11] Angela: Thank you so much for being up in the morning with me, and for the first time, we are introducing Dr. Annie Joseph of Nottingham University Hospital's, NHS Trust in the United Kingdom.

[00:02:24] Angela: Annie came on board recently as editor at CMI Comms, and we are thrilled to have her join in this particular communicable episode as her very first one. Annie has a strong interest in infection in women's health. Annie, welcome.

[00:02:39] Annie: Thank you Angela. And hi everybody. A pleasure to be here and to be joining the Communicable team.

[00:02:45] Angela: So Annie's having a, a hopefully normal day. It is 11 o'clock, I think, where you are, Annie.

[00:02:51] Annie: That's right. Yeah. Sunshine's coming through. It's good.

[00:02:55] Angela: So on the men's side we have Mark Bonten, who, as you will know, is professor of molecular epidemiology of infectious diseases at the University Medical Center at re, the Netherlands, and CEO of e Crate.

[00:03:09] Angela: And Mark, you should know, is happily married to Helen, who is a full-time physician and clinical scientist and part of a woman dominated household.

[00:03:18] Marc: Yes. And also happy to be here in this show today looking forward.

[00:03:24] Angela: Thanks, mark. Next up is Josh Davis, professor of Infectious Diseases in Newcastle, Australia.

[00:03:31] Angela: Investigator on many ID clinical trials and father of four feminist daughters in his own telling. Josh, thank you for being here.

[00:03:39] Josh: Thanks for having me back on communicable and just to, , give the time zones from my point of view, it's nine 30 at night, 27 degrees, and I'm wearing a midnight oil t-shirt in in case people can't see.

[00:03:53] Erin: I'll say I just got back from Australia and I forgot that you guys speak in Celsius, and I was so confused the entire week, but it was summer and it was beautiful and it was fantastic. And I was like, it's 17 degrees Fahrenheit and snowing at home. But that didn't translate quite well to

[00:04:09] Angela: Yeah. Yeah.

[00:04:10] Angela: That's Thanks Josh. We love it. Next up is Thomas is also infectious disease doctor and clinical associate professor at the University Hospital in Thomas, thanks for coming back.

[00:04:24] Thomas: Yeah, hi Angela and everyone, it's good to be back

[00:04:27] Angela: , and finally, NAV and Clinical ID Pharmacist at Rutgers University in New Jersey, USA and also member of a woman dominated household in his own telling nav.

[00:04:41] Angela: Thanks for being here.

[00:04:42] Nav: Yeah, thank you. It's, it's great to be here amongst everyone. Yeah. My, my two daughters and my wife definitely run the show, so I'm just happy to be here and support. However, I can.

[00:04:51] Angela: Alright, thank you very, very much. So, in the first half of this conversation, I'll be directing the questions mainly to the women.

[00:04:58] Angela: and later in the second half, which will be aired, separately. In a second episode, we'll be talking to the men. So, to start. What I first wanna ask you may seem a bit sensational, but it really isn't. Think of it along the lines of what you do when you're tackling an ID problem. The first thing you do is define the burden of disease, right?

[00:05:20] Angela: This is critical for understanding where we really are at this moment. I believe honestly, we are often too silent when we don't expose others aggressions or transgressions or microaggressions. We are actually protecting them. So women, if you feel comfortable, please give your answer.

Question 1: An experience that didn't feel right in the workplace
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[00:05:39] Angela: What's something that someone said or did to you in our ID or CM Workplace that made you feel small that didn't feel right?

[00:05:48] Angela: And I'm gonna start. it's a pretty recent one. Just a very small interaction, you know, it's hard for me to forget about it. I was associate professor, I had just been appointed, , director of our hospital's clinical trials unit, part of our clinical research center.

[00:06:02] Angela: And not long after that, a full professor who was a man, sort of obliquely related to the, to this center, told me he'd been surprised by my appointment. And then he said, next, , in French, he said, one might say, though, of course I would never say such a thing, but one might say that you must have slept with the boss to get all that.

[00:06:23] Angela: And I was so shocked. I just couldn't quite give, , an eloquent response. Really couldn't give an adequate response. . so that's. Something that happened. and it's just funny because when I tell that story to women, it's sort of like, huh.

[00:06:40] Angela: Yeah, I know. And then when I tell it to the men, they're quite shocked. And again, as I said before, I think being silent is perhaps not productive. so I'm just putting that out there. Erin. Annie? Yeah. What have you got?

[00:06:56] Erin: Yeah, I would say first, Angela, I'm so sorry that happened to you. I think the problem is one, that it was said, and two, that I'm not shocked, as you said. I think it's very believable, but I think that's what we struggle with, right? Is like, is being believed that such a thing would happen. So first just wanna validate that I a hundred percent believe that story, and that absolutely tracks with certain things we encounter.

[00:07:19] Erin: I guess I. I'll say one that's not as, provocative and as shocking I suppose, but still just structurally shows how much of a struggle I think this can be sometimes,

[00:07:28] Erin: , and I think it is a subconscious, I don't think people go out of their way to say terrible things. I think it's just, you just don't even realize that, or maybe even think you're joking, which that's probably something structurally we need to address.

[00:07:39] Erin: It's like these things just aren't funny. and so when I was in, in pharmacy school, I. I went to a school where we had a dress code of business casual for class, which some people were shocked about that but I loved it. I felt , I'm in professional school, I'm getting a doctorate, and I loved dressing up for class.

[00:07:56] Erin: I thought that was actually something that attracted me to the school I attended.

[00:08:00] Angela: our international listeners, can you tell us what a business casual dress code is?

[00:08:04] Erin: Oh gosh, yes. An important thing to define for women and men alike.

[00:08:07] Erin: Okay. So it's essentially not, you know, fancy formal suit and tie or cocktail dress for women, but a nice. A dress you would wear to a professional conference or, or to a nice work environment and for men like slacks and a button up shirt and plus minus a tie, I guess. Is that, that defined? So good to know.

[00:08:25] Erin: But all that to say, , the building that we had our lectures in was also a patient clinic. So it was like the pharmacy school was this really cool integrated learning environment where we had class and we had these breakout workout groups and then we also saw patients in that same building.

[00:08:40] Erin: And so that was why the dress code, so it was either you're in your scrubs if you're, you know, directly, uh, seeing patients in clinic or we dressed nicely. So patients were like, oh, this is a place I like to come. And, you know, very professional environment. I loved that. I thought I felt like a professional and it was great.

[00:08:55] Erin: But I went to school in, in the Southern United States, I would say women tend to dress up pretty significantly.

[00:09:00] Erin: It's something they take a lot of pride in. And so I would wear like high heels and dresses to class every day. 'cause that was the literal dress code of my class structure. So I Was president of my pharmacy school class. I was like elected the class speaker.

[00:09:16] Erin: And at my graduation. So after four years of living in the structure as defined by. The male leaders of this pharmacy school that said we had to dress up. As I was walking off the stage after giving my elected class speech at my graduation, someone very high ranking in the pharmacy school. Said to me as I was going down the stairs, so in front of like my family, my friends, the whole entire graduation, I.

[00:09:41] Erin: Goes great speech. And as you know, we're so proud of you, and as you move on into your residency, I just want you to know that you should really consider these heels that you wear because if you keep wearing them, men will never respect you in the workplace on stage in front of everyone. Oh my. And I just looked at him and I said, I said, you [00:10:00] require us to dress like this.

[00:10:01] Erin: Like, and so it was really stunning for me because it was basically like, even when I live within the constructs of, of what I've been told to do and try to conform to what. You know, seemingly women are supposed to look like or do or act like within the literal rules of that institution, you're still judged.

[00:10:19] Erin: And it was kind of just a, a moment. And so then I wore heels to work for the next 10 years. I stopped this year 'cause I'm 35 and my feet hurt finally. But people would say in my residency, they're like, dang, how do you walk around the hospital in these high heels? And I was like, I am motivated by rage.

[00:10:35] Erin: , so I, I did and at conferences and I mean people can probably speak to this and people who know me are probably like, oh yeah, dang. Erin did walk around in stilettos for a very long time. , but it was because of that, it was because he said that to me and I said, I will earn people's respect in my stilettos.

[00:10:49] Angela: And here

[00:10:49] Erin: we are.

[00:10:50] Annie: Wow.

[00:10:51] Angela: Annie, what do you think about that?

[00:10:53] Annie: Wow. You know, when you were just finishing up then, Erin, I just thought you're so right. Like, you, we can't win. We can't win. You were doing exactly as you were asked to do. And as a woman, you still can't win. Someone will find some way to undermine you or tear you down.

[00:11:09] Annie: and on Angela's story, so similar to previous experiences I've had. You are a successful woman unless you've been accused of sleeping with the boss, are you? I don't know. It's almost like a rite of passage and that story.

[00:11:23] Angela: Yeah, yeah. Seems that way. Seems that way. Yeah. Erin, I have to be honest, I think you are right.

[00:11:29] Angela: You were being judged, but I think there was something else going on. as Annie said, I think you were being undermined. I think you were, you know, you were shining really brightly. You were empowered in that moment. And might have made somebody feel less, you know, brilliant in that moment.

[00:11:45] Angela: And I think, you know, no matter what the gender of the person next to you, I think that can destabilize maybe a little bit and maybe, sort of hit a, a knee jerk reaction in some people to just take you down a notch. I think there is something quite universal about not wanting, you know,, fearing this, this whole theme of , the zero sum game. You know, this whole idea that I will get less if somebody gets more.

[00:12:11] Angela: I, I don't know. I, yeah,

[00:12:12] Erin: no, I agree. And I, I honestly, I think, I think women to women struggle with that. Men to women, men to men. I think that we live in a society where comparison is the thief of joy, and I think that it's really hard to see others succeeding and for some reason, a lot of people think that means they also can't, we're really like, we are just so much greater together.

[00:12:30] Erin: And other people's successes does not mean that you cannot have your own in in any which way. , so yeah, I think that is a struggle. I think that that lens is interesting. 'cause it was this like literal, like cumulative moment of my life and it is forever tainted by those words.

[00:12:45] Erin: I don't even remember what I said in my speech or like what my parents said to me, you know? that was, yeah, that's what, that's what I remember about , the day I got my doctorate. So that's, yeah. . but I think, you know, to Annie's point, I think we all have stories like that , and it's tough, but it's really, you know, you just keep going.

[00:13:01] Erin: So. Yeah.

[00:13:01] Annie: Keep going. Getting hales. Yeah. You keep going heels for 10 years.

[00:13:06] Erin: , no lie, yesterday morning I saw an orthopedic surgeon. 'cause I think I have a meniscus tear. I'm like physically harmed from this experience, but, uh, alas, I'm just old. Sorry. Oh

[00:13:19] Angela: my God.

[00:13:19] Angela: Okay. Annie, how about you?

[00:13:22] Annie: Yeah, so there was a few, well, quite a few I guess I could choose. And I think mine really is to me just sort of like the definition of a microaggression.

[00:13:30] Annie: It's something so small, but just stayed with me for years. so it happened during the first wave of Covid, and I was the, the clinical lead for our microbiology lab in our hospital, big hospital. And, as I'm sure lots of people will remember, the major tasks that we were facing were sort of massively upscaling, covid testing.

[00:13:51] Annie: So, you know, ramping up PCR testing, dealing with shortages, trying to get as much testing capacity as possible to diagnose patients. And, Facilitate patient movement through the hospital safely. so a few months into this, we, you know, we'd done a really good job. Our service was running really well.

[00:14:07] Annie: We were testing hundreds, of covid tests a day. and we got a request from the medical director's office, to see if we could have him come visit the virology lab and see what we do, sort of, kind of maybe a goodwill visit to the behind the scenes staff. As the lab staff often don't really get that sort of focus from people higher up in the hospital.

[00:14:27] Annie: So we were like, great, this is a really good opportunity to showcase everything that we've been doing. so myself and one of the senior virology scientists, met with him and, we gave him a long tour about the lab and we, you know, explained all of the different molecular pathways and how we were doing everything.

[00:14:44] Annie: And we were, you know, we were really proud of what we'd achieved at this point. and then at the end of the tour he said, oh, I just dunno how you managed to get all these covid tests done. , all whilst looking so glamorous. And I just remember feeling so disappointed that that was the response to all of our hard work and, you know, blood, sweat and tears that we'd put into the laboratory that we looked glamorous.

[00:15:08] Erin: Can't possibly look good and do good science, Annie. It's not an option. They're mutually exclusive. Ironic was, yeah,

[00:15:14] Annie: we, the ironic thing was we were literally wearing lab coats and masks and you could only really see like this tiny bit from like our, our eyes and our forehead. So I was just like, wow, okay.

[00:15:26] Annie: Thanks very much for, for coming and giving your opinion on what's, what's going on. And it just with me for years that what. I know the impression that we'd left.

[00:15:37] Erin: And it's tough 'cause it's like they probably genuinely thought that was a compliment. Right? but it's not.

[00:15:41] Erin: And so that's why I think we need to do better. I think Angela, to the point we're about to get into is, is we need to talk about these things more and call them out and kind of explain and coach like I know you're trying to be kind and that that's not kind because you just never link men's appearance into their achievements hardly ever.

[00:16:02] Erin: Right? Yeah. And that, so it just is, ,

[00:16:04] Angela: it's a reduction. Yeah. Like you say, I don't think men. Do it necessarily. They certainly don't do it consciously to reduce, but I do feel like, oh, I'm being reduced to my physical, you know, sometimes even just to my physical reproductive organs.

[00:16:20] Angela: Thanks very much. You know, but wait, look at all this work I just did. Look at what Annie, at the success she just had, with like helping people like, yeah. Like a response to a pandemic. and no, you are just being reduced to your, you know, long legs or your, you know, whatever your glamorous, you know, it smacks of being put back into your place. Oh, no, no. As a woman, your first, you know, function is to reproduce and to keep the species going. I get that, you know, I do get that. Mm. Like we, we are very needed for that. but there is more, you know, behind the reproductive potential.

[00:16:56] Angela: I feel sometimes like we're just this collection of useful body parts. but there's also this brain, you know, that's there too.

[00:17:02] Erin: so to that point, one day I was with a group of male colleagues. And I will say I work with a lot of amazing male colleagues, but this was a group of people I don't usually work with.

[00:17:11] Erin: And , you know, wasn't as amazing, but, it was a covid meeting, so we'd been sitting for hours and everyone was stressed and tired. And I was like, man, my neck is killing me. And everyone's like, oh, why like we're sitting here and I was like, you know what? Because my brain is so big, it hurts my neck.

[00:17:24] Erin: I'm tired of holding it up, guys. Like,

[00:17:28] Angela: oh my gosh, the cranium

[00:17:29] Erin: lot. To the point of like, you know, reframing the context of physical aspects. It's really heavy aspects.

[00:17:34] Angela: brains

[00:17:35] Erin: are heavy.

[00:17:36] Angela: What do the men think of this? Like, how do you feel about, what Annie heard, and how that stays with her?

[00:17:42] Josh: I mean, I feel

[00:17:43] Josh: like, a good rule of thumb if you're a man about to make a comment, is what I'd be saying this to a man. Like, they would've never said that to you if you were a man who had just successfully done or pulled off this covid testing, they wouldn't have said, oh, you, you did it while looking so good.

[00:18:00] Erin: I might say that to Mark. I don't know. I might be like, yeah, man, maybe

[00:18:05] Marc: Yes, that's what I hear on a daily basis. what I just heard is, I think there's actually, what, what was told to you, Angela? I know of story, sorry? Of someone that was fired for that,

[00:18:17] Angela: for speaking like that?

[00:18:18] Marc: Yeah.

[00:18:19] Angela: Not the, okay.

[00:18:20] Marc: Yeah. saying at drinks about someone who got appointed to a high ranking position. What I understood what was said was she probably slept with the dean. As a joke, at least jokingly said, Hmm, but that you can't, you can't say that.

[00:18:37] Erin: I would co-sign that and I do think we're making structural strides in that. I also recently heard of a pharmacy residency program in the United States where a, program director was fired because after a, major conference where all the residents attend and yeah, people are going out and socializing and, you know, professional barriers come down a, a step a little.

[00:18:55] Erin: But, a joke was made , a sexually oriented joke. And I heard that, that director got fired. so I think. Institutions are, are moving to this.

[00:19:04] Erin: This is unacceptable behavior, which is what we need. Right? You need the system to support that. This is not something that's tolerated. I.

[00:19:10] Angela: I think that's interesting, mark, that this person got fired and I, I want to be clear, I would not want anyone to be fired. You know, I, I really wouldn't, I would want many other things to happen before that, and hopefully that was the case in your institution.

[00:19:24] Angela: Mark. You know, I think everyone should be given the chance to make mistakes. You know, we're all brought up in the same culture, right? We're all brought up. I know that I have my own, you know, I'm probably self imposing, you know, some, stereotypes and whatnot we're all brought up, a culture that it, you know, that hasn't reached, um, are we allowed to say equity?

[00:19:45] Marc: Yes. it was not in my institution.

[00:19:47] Marc: And the other thing is I cannot judge about the presence of maybe eight layers of political fights that were behind the ultimate firing of a person.

[00:19:57] Marc: No, of

[00:19:58] Angela: of course. And that's the thing. I [00:20:00] would imagine most hr, uh.

[00:20:01] Angela: Systems have a program. I would hope the ones that do react, the ones that do wanna, actually fix the problem, the first thing is of course, training and, exposure, I think to the consequences of the things you say and do and all of that, you know? hopefully this little discussion we're having right now is making some people think that's the first step, you know, just put yourself in someone else's shoes.

[00:20:24] Angela: I mean, to me it's, it's kind of haunting to hear that Erin's entire, moment. Was taken away from her, and that was years ago. And okay, we might all sound like, you know, champagne problems, , as they say, but these are real, these things do take from us and that thus takes away from our colleagues, our patients, our ability to do our best work.

[00:20:46] Angela: , so I wouldn't want anyone to be fired. I would just want, us all to hopefully like have some, you know goodwill, insight to listen and to reform.

[00:20:57] Thomas: Yeah. So I have a question.

[00:21:00] Thomas: I've heard some compliments that I would think are undermining the, the women in my research group or whatever, and I, I always have the thought that maybe I should step in and sort of defend them, but I think maybe that would undermine them even more.

[00:21:17] Thomas: but for me it's not obvious how I should react to that as a man in the room. So what do you think is the appropriate reaction from others around us?

[00:21:28] Erin: I would say, I think feedback is based on behavior. So again, I think people are inherently good. to Angela's point, like, I don't think there should be like.

[00:21:35] Erin: Extreme consequences at, especially for a first transgression. But I think it goes an amazingly long way to immediately call out that behavior and, comment on the behavior. So I mean, it's tough to get feedback in front of people, but you can, I mean, you can kind of interrupt and say, directly, like, I think we should just be focusing on how amazing Annie was at, launching testing.

[00:21:56] Erin: It doesn't matter how she looked when she did it, right. Or as soon as the conversation goes away and people break from the circle, you could follow that person who said it and say, Hey, I really appreciate what you were trying to do there. And I, think you were trying to compliment her, but when you comment on a woman's looks, it kind of takes away from the science in the moment or it takes away from the achievement.

[00:22:15] Erin: , I don't think you'd say that to me if I had done that.

[00:22:18] Annie: And

[00:22:18] Annie: I think what Thomas's question really reflects is that there are good men watching situations that make them feel uncomfortable, but they're not quite sure whether they're gonna make it worse. when I've been in a situation where, you know, I've been on the receiving end of some sort of microaggression or, you know, even something blatant, if one of my male colleagues that I, you know, had a good relationship with Trusted, stood there and said nothing that would wound me more I think that would hurt me more to know that they didn't feel that they should support me in that moment.

[00:22:53] Annie: And it's sort of training yourself to be a bystander and having those phrases, I think just ready, ready and and practicing saying it out loud. so that instead of kind of feeling like, oh, I dunno what to say and it might cause a confrontation. even something just really, Sort of factual in a, oh, sorry, I didn't hear what you said. Can you just repeat that for me and sort of make that person say it out loud again in front of everybody?

[00:23:21] Annie: In front of a man who's just said, I'm sorry, I didn't hear what you just said. Can you repeat that for me? Just really gives that moment of reflection, everybody knows that wasn't okay and you are not prepared to let that go either. I would really appreciate that in a moment.

[00:23:36] Angela: Here, here. I fully agree. I think that's the wisest approach, Anything else from the men on this point before we move on?

[00:23:44] Nav: My only thing I would just say is, , my immediate thing that I thought of if I was, , standing there, whether I would say it or not, always different in the moment, but my you know, smart ass response would be to say like, oh, I don't look pretty as I'm doing my work.

[00:23:59] Nav: 'cause then it just sounds ridiculous to ask for that as a man. and so maybe that's a very New Jersey thing to just call someone out with like utter sarcasm. And, but that, that's, that's part of it 'cause it's so ridiculous. And, um, you know, it's, it's sort of awful hearing that. But I do think that, men in the workforce need to be primed to that because sometimes you're in a leadership position, you have, learners there, your students, your residents, and you have to be sort of prepared to help supervise that they're in a comfortable position, let alone with, with colleagues, but there's structurally something that you are responsible for. and so you have to learn these things,

Question 2: Microaggressions
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[00:24:36] Angela: So here we are. we're, talking about, , the micro or macroaggressions that have occurred in our lives. , again, I think it's important that we share these realities. It's not just to complain. I think a lot of us tend not to talk about these slights, whether they're major or minor aggressions.

[00:24:52] Angela: n, Annie, why do you think we don't talk about these things?

[00:24:56] Annie: for me, I don't think it's a fear of sort of negative career consequences necessarily, or fear of sort of retaliation. It's more that sort of hanging threat of being labeled as a difficult woman or being labeled as, oh, she gets hysterical.

[00:25:10] Annie: You know, that awful sort of implicitly feminized insult, which is saved just for women who want to speak out and make a fuss about something that's not right. And you know, sometimes you just think, gosh, I'm actually trying to do a job here as well. I'm quite busy. I'm juggling lots of things and this is just one more thing that I now have to deal with.

[00:25:29] Annie: and you think, well, I can just keep my head down and easy life. I'm not gonna mention that today. I'm just gonna pretend I didn't hear that and move on. But then I guess that sets the standard we're prepared to walk past. So I guess we do have to just take those moments and it's been really great to hear these other experiences and, how, it gives me ideas on how, you know, in the moment you can tackle it.

[00:25:51] Erin: Yeah, I, think there's a lot of reasons that people don't talk about this stuff. I was trying to, sorry, how to eloquently state this. . So Annie, I completely agree with what you said. I think there's this struggle with. At least I personally. So I'm a pretty direct and transparent person and I'm, I'm not afraid to like move quickly and act. And I've been called aggressive more times than I can count. And, you know, maybe some days I am being a little aggressive. I'm not to say that I never am, but I, I often pause and go, man, if I was a man, I would just be commended for my leadership style.

[00:26:22] Erin: And I really do. I think of that Taylor Swift song, , I promise I didn't force this in here, which is very natural. So she has a song and it's very simple. It's like, if I was a man then I'd be the man. And I think about that a lot. Not to say that I'm the coolest ever, but there are .

[00:26:35] Erin: Certain words that I feel when we pin them to women, they have a negative connotation. And when we pin them to men, they have a positive connotation. And honestly, I'm not even sure how we got there or why that is, but it's very true. And so to that degree, sometimes I'll send something out and I'll get an email reply back and I read it and I just think, dang, if I had sent this email, I would never hear the end of it.

[00:26:59] Erin: and Email's tough. Tone is tough, right? We read into things, but I feel like we just constantly have to overcome the past. Right. It's like you just always have to be better. You're not allowed to have an off day because an off day sets you back like six months of stride you've tried to make in terms of respect and community and things like that. And I think that's tough, and I think that's why people don't speak up. I also think there is a pretty significant fear of retaliation.

[00:27:22] Erin: So I have heard stories of colleagues who have reported things, and so they either report it and nothing happens, which is just pretty demoralizing. You're like, why did I even bother then? Or they report it and then there is, and because there's not a very good structural support for how to give feedback to that person and how to go through some, you know, exercises to ensure that situation doesn't happen again.

[00:27:45] Erin: Then that person is just. Annoyed. Right? And they can kind of subtly take that out on you in your day to day if you don't have colleagues who have switched jobs because of it, which is, a very extreme part of it, but happens.

[00:27:57] Erin: And so that's, that's why people don't wanna say anything 'cause they value their careers and they're like, I can just deal with this. which isn't right. So I think to what we talked about earlier, we need to find constructive ways in real time to point out these behaviors and, and try to, move past them.

[00:28:13] Angela: We have to be so careful with the way we assert ourselves. We've gotta be assertive, we've gotta call out the aggressions, but we must be very careful how we do it because we can so quickly be labeled. You know, for, for us three, I think we're at a point in our careers where we've got some job security, right?

[00:28:32] Angela: But for these younger ones, they really have got to watch out how they do this, how they navigate this world because , there is retaliation. It's just a long form, you know?

Q: how can we support women?
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[00:28:43] Angela: So we've talked so far about all the problems, and, we've painted a picture. We have defined the burden, I hope, uh, somewhat at least.

[00:28:52] Angela: Now let's talk about how, we can move on. How can we build International Women's Day? How can we support women? What can we do?

[00:29:02] Erin: Well, I'm gonna start by sharing the progress we've made with one of my favorite stories, which is the first time I saw Angela speak. So I'm gonna embarrass Angela, but I'm gonna tell this story because I think it's so powerful for how representation matters no matter who you are.

[00:29:15] Erin: Right? And this applies to young men too. I mean, seeing people like you doing accomplishments is, is huge. So at ECCMID 2018, it was my first ECM mid, I was only about eight months out of training. I was very new. And I went to the conference and I went to the late breaker session. And it, it's kind of an infamous late breaker session 'cause so many amazing trials were spoken about in that session.

[00:29:36] Erin: Uh, it was the Marino trial, it was the dance trial. It was seven verse 14 days of gram-negative therapy, and then it was Phosphomycin versus Nitro Fortine. For uncomplicated UTI and, I mean, it was truly just such an amazing session. Like when you think about now, how pivotal those trials all still are, but it was men, men, men, men.

[00:29:56] Erin: And then the last person to get up and talk was Angela Huttner. And [00:30:00] she got up and spoke for her 10 minutes about the phosphorus, nice nitro trial. And I was sitting there with three. Male colleagues, and you got up and, presented that trial, Angela, and it was, you were so eloquent and poised and smart and it was your trial and you were the lead author on a JAMA publication. And it, moved me so much and I remember being so impressed with you and I was like, obsessed with you for a long time because I was like, she's so inspiring.

[00:30:26] Erin: I love her. I talked about you for year, literal years. And then it just really motivated me and I was like, I'm gonna speak at ECCMID one day. then. Last year we joined a group project and I remember seeing the list of all the people on the call and you were on the team and I died. I was like, oh my gosh, I get to finally meet her.

[00:30:47] Erin: And then we were broken into work groups and as the fate would have it, you and I were on the same work group. And then since then, we've become really good friends and now we're doing the CMI thing together. And this year I got asked to speak at ECCMID. And I just think that is, you know, that's the progress we're making.

[00:31:04] Erin: And I think it just takes one person to show people that you can do it and to motivate you and to work with you and to sponsor you. And that can come from a woman or a man or. A dog, you know, it doesn't matter. It can come from anyone, anything. that being said, the first professional talk I ever gave was at ID week.

[00:31:21] Erin: And I got that opportunity because a mentor who is a man couldn't give the talk and he nominated me in his place. And that was the first chance I ever had to speak on a international stage. And then, thankfully, I guess I did well. And so I've been able to give other talks.

[00:31:36] Erin: 'cause it just takes that one opportunity. And so I think we're, we're making great strides in that, at least in the academic space. I see all female panels at conferences, which I know is a conscious structural decision. I see. Women in leadership positions.

[00:31:50] Erin: I, I have a, a unique perspective working in the United States in pharmacy. 'cause this is a female dominated field. but to that point, I think it's a female dominated field because I think there was a lot of women interested in going into medicine who thought they couldn't do 10, 12, 15 years of, medical training.

[00:32:07] Erin: And so they said, okay, pharmacy's a nice compromise where I can be in the medical profession but do 4, 6, 8 years. admittedly I was one of them. I, when I was 17 years old and having to make decisions about university and things like this, I said, you know, I really wanna have a family one day. I don't know that I can be 40 and graduating as a physician resident.

[00:32:26] Erin: So pharmacy sounds like a really good. Path instead. And then jokes on me. I ended up being in training for 11 years and I still don't have kids. So, you know, it, it's how that turns out. Right. But, I think we're seeing those that progress. I think other things it's, we're normalizing having your kids in the background on meetings.

[00:32:44] Erin: If you have to multitask and manage your family and manage your career, there's lactation rooms at conferences. I see consistently now shared paternal leave amongst my friends and colleagues.

[00:33:02] Erin: So my, my dear friend just had a baby, she's a pharmacist at the University of Maryland and she did her 12 weeks and now her husband's home for 12 weeks and she went back to work. And honestly, she loves her baby, but she's thrilled to be back at work. And she's like, I'm better when I'm at work. And I think we're normalizing that, that it's not, you don't have to feel guilty if.

[00:33:20] Erin: You enjoy being at work and you're a mom. And so I think that's where we're seeing a lot of, a lot of changes in positive strides. And then, sorry, I'm talking forever, Annie, but the only other thing I'll say is I, I have direct reports now, so I've moved into a role now where I work more with HR and kind of understand structurally how things happen, at least in the, in the states.

[00:33:41] Erin: so, I'm proud of my institution, like HR does not offer different salaries, compensation packages, opportunities based on your gender. I've hired men and I've hired women. I will say, that is not a thing systematically, but what is very much a thing, and where I still think we see pay gaps and disparities is when I hire men, they always negotiate. They never take the face value. So as the hiring manager, like the steps are very clearly defined and they're equitable. but you make an offer and then you can either just accept it outright and then that's the contract I give you.

The men I hire always negotiate. The women I hire almost never negotiate. And so I can have the same job code, the same level of training, the same whatever, and offer them the same hourly rate and the man's gonna negotiate.

[00:34:28] Erin: And so when you start at $3 more an hour. In 10 years, your pay disparity is great. That is something we need to, at least now, it's on us to be stronger and ask for what we're worth. Because men don't have a problem doing that.

[00:34:41] Erin: But we do. And then, and so that's just something I think, you know, so my duty then is to coach people on that. So I spend a lot of time coaching students, residents, fellows, trainees on how to negotiate because I think we think that, if we ask for more, we're gonna be seen as greedy or they're gonna take away the job offer. That's not a thing. They can't do that. .

[00:35:00] Angela: Thank you so much, Erin. Annie.

[00:35:02] Annie: It's so interesting that Erin has a story about that late breaker session where Angela was presenting. 'cause Angela knows that I knew her in that, and I would like waddle in six months pregnant, trying to find a seat.

[00:35:13] Annie: And because it was so busy in that, oh my gosh, it was the smallest room ever. Yeah. It was a tiny room. Everyone was like sitting on the floor and it was boiling hot and I had this huge pregnant baby bump and I just like went right down to the front and just like stood next to a load of men in suits and they all stood up for me and let me sit down.

[00:35:31] Annie: So Shival, we wasn't dead in that room.

[00:35:33] Erin: Amazing. Yeah.

[00:35:35] Annie: But in terms of progress that we've seen made, I mean, Erin, you've covered so many of the, the great things there. I think, you know, it's not that long ago where there weren't those structural, systems in place like, a blind recruitment panel where your initial assessment of candidates is completely blinded to their name, their race, and their gender as well. and having, equal representation, on recruitment, and interview panels.

[00:36:00] Annie: When, for my very first job interview, for my microbiology training, I went into a room and there was, nine people sat behind the desk for the interview, nine of them. And there was one lady from HR who said, oh, hello, I'm from HR and I won't be asking any questions. I'm just here to keep an eye on the men.

[00:36:18] Annie: And there was just eight men just, just staring at me asking questions, and I was like, wow, okay. This is intimidating for, you know, a woman in her mid twenties to walk into. And I do, I do think that, you know, perhaps that wouldn't happen now, certainly in, in the NHS, which I know is a, it's its own little world, its own little microcosm.

[00:36:37] Annie: , and it does differently to the rest of the world. I think Annie, oh, national Health Service in the uk, so free at the point of access. it's a wonderful institution. but it, you know, it does things in its own particular way and we certainly don't get to negotiate for our salaries either. Unfortunately. It's, exactly the same. no matter, no matter who you are on every level, which is a great leveler, you know, that, that is a great thing structurally.

[00:37:05] Annie: and you mentioned about shared parental leave as well. I mean, I, think it's been fantastic, the changes that have been made with that. and for me personally, being able to come back to work after six months after having both of my, my little boys and transfer the rest of my leave to my partner so he could have six months.

[00:37:22] Annie: looking after them at home was great. I mean, it had a double benefit for me of sharing the work outside and inside of the home, equally between us, but also I think just gave that role modeling to my boys of what parenthood is. Yes, it is Daddy at home doing everything for significant periods of time as well as mommy.

[00:37:41] Annie: so hopefully that will reap the benefits in the longer term as well.

[00:37:44] Angela: Thank you so much. , Erin, I'm so happy you were in that room because at that time, and Annie as well

[00:37:51] Angela: I , it's amazing to think that that's where , we really did first meet, but we didn't know it. I would echo both of you. I would just briefly say, I think it is actually so important to have women up on a stage, even if, it might just look, you know, performative or it's just, you know, vanity or whatever.

[00:38:08] Angela: It's not, I think it's hugely important for the next generation, like Annie says, it just makes it more normal that a woman could be, speaking and leading something. it's much more. important than I think people realize, at least some people. and so, I think the few of us who have made it to some kind of leadership position, we need to be available to the younger ones.

[00:38:31] Angela: We have to,

[00:38:32] Angela: obviously patients come first, but in my list of priorities, it's patients and then it's the next ones. there aren't very many of us, I think to, be there for them. So we just have to do it. It's just, can't say no. I make myself, I try really hard to be available, to young women who might want an academic career.

[00:38:51] Angela: Okay. So, I think, we're gonna take a break, and we're gonna come back and we're going to talk to the men . women are making strides, even though sometimes we don't always feel like it's going fast enough.

[00:39:04] Angela: We are making strides and, , it's not super easy for, , the men in this time of transition. , this is the end of the first part of a two-part series on women and men in infectious diseases and clinical microbiology. Thank you so much to my guests, fellow CMI comms editors Erin McCreary in Pittsburgh, Pennsylvania, nav Narayan in Rutgers, New Jersey.

[00:39:28] Angela: Annie Joseph in Nottingham, England. Mark. Thomas in Sweden and Josh Davis in Newcastle, Australia. And thank you for listening to Communicable the CM I Comms podcast. The first in a two part series was edited by Dr. Katie Hostettler.

[00:39:47] Angela: For the first time, it was not peer reviewed. Theme music was composed and conducted by Joseph McDade. This episode will be citable with a written summary referenced by A DOI in the next eight weeks. You can subscribe to [00:40:00] Communicable on Spotify, apple, wherever you get your podcasts, or you can find it on estimate's website for the CMI COMMS Journal.

[00:40:07] Angela: Thanks for listening and helping CMI, comms and ESCMID move the conversation in ID and clinical microbiology and our workplace further along.

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