The Fine Art of Saying ‘No’

I was the first woman ever hired as cardiac electrophysiology faculty at the University of Virginia. Like many academic electrophysiologists, I had a lot of ambitious plans and goals. However, one of the first things that I did was pretty mundane: I planned a holiday party. The concept of a holiday party had long been a sore spot with the electrophysiology staff — many of the other sections in the Division of Cardiology had a party, but EP did not. Several of the staff members asked about it, since it seemed like the staff should be shown appreciation for their hard work, so I agreed to do it. I did the usual things that one does when planning a party. I calculated a budget, found a venue, and arranged for catering and decorations. Eight years later, I was still doing this; however, a few things had changed. First, budgets got tighter, so I was having to do more of the actual work as opposed to hiring caterers. Second, there was a lot less appreciation for the party and a lot more expectation that it would just be done. After eight years, I decided that I simply no longer had the hours to devote to this and that someone else needed to take over. A staff member got wind of this and asked me point blank, “So I hear you don’t want to do our party anymore?” I explained to her that it wasn’t really my job to arrange a holiday party, and after doing it for so long, I thought it was reasonable for one of the other physicians to take over. She looked at me somewhat incredulously before saying, “It’s not like any of the men are going to do it.” And she was correct. None of my male partners were willing to take over the role, and seemed perfectly fine with just ending the tradition.

There is a name for this sort of thing. It’s called Emotional Labor, and women do the bulk of it in almost all walks of life.¹ Author Gemma Hartley describes it this way: “Emotional labor…is emotion management and life management combined. It is the unpaid, invisible work we do to keep those around us comfortable and happy.”² An example in the home is women writing thank you notes for wedding presents. When thank you notes are written and received in a timely manner, they will be perfunctorily read and discarded without another thought. However, if they aren’t received, it will be viewed negatively and the majority of the criticism will be leveled at the wife, not the husband. In many families, women do the bulk of scheduling vacations, packing, remembering family birthdays, buying presents, registering kids for activities, and in short, planning the majority of family life. This tends to be true whether the woman is working outside the home or not. When emotional labor tasks are done well, there is usually little acknowledgement of them, let alone appreciation. They are just expected.

While much has been written about emotional labor in family life, the original descriptions of it were actually in the workplace.³ In physician groups, it is common for the women physicians to plan parties, events for Nurses’ Week, and remember staff member birthdays. The female physicians also tend to assume an outsized role in managerial duties, including creating call schedules, vacation schedules, informal mentoring, and handling grievances. The problem is that while these are important for the functioning of any physician group, they are unpaid, unappreciated, time-consuming, and useless for academic advancement. Unfortunately, there is often a subtle expectation that women physicians will fill these roles, and they can be viewed as difficult if they aren’t willing to do so.⁴

I have come to view duties that are ancillary to my clinical and academic work in three different ways: there are activities that are good for the functioning of the group, those that are good for my personal career advancement, and those that I enjoy. The sweet spot is to find activities that fulfill all three of these, but those are few and far between. Therefore, the key is to evaluate tasks that only fulfill the first critical criteria. Why am I being asked to do it? Are these tasks being shared equally? Am I doing my share? Am I doing more? Having answers to these questions helps to frame the answer, especially when the answer is ‘no’ and when the answer has to be given to someone in a leadership position.                    

After 12 years on faculty, I still don’t have all of the answers to these issues. When I look back on those years of planning that holiday party, I actually don’t think it was the wrong thing to do. In truth, the staff does deserve to be acknowledged for their contributions. As a new faculty member, it was a good way for me to show that I valued them. But it was never really my ‘job’, and I allowed myself and everyone else to start to feel that it was.

In the several years since I declined to plan the holiday party, we have continued to have one. Someone ultimately did step into the void. It was one of my EP fellows, and yes, you guessed it, it was our one female fellow. She planned a venue, arranged the food, and did all the cleanup. She is graduating this year, and it will be interesting to see what will happen next year. I’m actually thinking that I will get more involved again starting next year. But it is not because I am the woman faculty member — it is because I am now the Director of the Electrophysiology Lab, and a good lab director should make sure that their staff is appreciated. 

1. Hartley G. Women Aren’t Nags — We’re Just Fed Up. Harper’s Bazaar. https://www.harpersbazaar.com/culture/features/a12063822/emotional-labor-gender-equality/ Published September 27, 2017. Accessed March 24, 2019.
2. Hartley G. Fed Up: Emotional Labor, Women, and the Way Forward. HarperOne; 2018.
3. Hochschild AR. The Managed Heart: Commercialization of Human Feeling. University of California Press; March 2012.
4. Wong K. There’s a Stress Gap Between Men and Women. Here’s Why It’s Important. The New York Times. https://www.nytimes.com/2018/11/14/smarter-living/stress-gap-women-men.html Published November 14, 2018. Accessed March 24, 2019.