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Dr. Robin Stern: Welcome to The Gaslight Effect podcast. I'm Robin Stern, co-founder and associate director of the Yale Center for Emotional Intelligence, and author of the bestselling book, The Gaslight Effect. I'm an educator and a psychoanalyst, but first and foremost, I'm a wife, a mother, a sister, aunt, and healer. And just like many of you, I was a victim of gaslighting. Please join me for each episode as I interview fascinating guests and explore the concept of gaslighting. You'll learn what it truly means to be gaslighted, how it feels, how to recognize it, and how to understand it, and ultimately how to get out of it.
Dr. Robin Stern: Before we begin, I want you to know that talking about gaslighting can bring up challenging and painful emotions. Give yourself permission to feel them. Some of you may wanna go more deeply with your emotions. While some of you may hold them more lightly, no matter what you're feeling, know that your emotions are a guide to your inner life. Your emotions are sacred and uniquely you respect and embrace them for they have information to give you. If you want to listen to other episodes of The Gaslight Effect Podcast, you can find them at robinstern.com or wherever you listen to podcasts. Thank you for being here with me. Welcome everyone to this episode of the Gaslight Effect podcast. I'm thrilled today to introduce you to and to have with me, Dr. Arghavan Salles, a physician and author, a speaker, and a, an advocate for women's rights. So, Arvan, will you please tell us about yourself and a little bit about your background, and then why you said yes to being on the Gaslight Effect Podcast.
Dr. Arghavan Salles: Yeah, happy to, happy to do that. So, um, I am a, as you said, a physician. I trained in general surgery and did a fellowship in minimally invasive and bariatric surgery. I'm not currently practicing for quite a number of reasons, um, and I do research. So you mentioned, you know, advocating for women. I, I definitely do that. Um, you know, mainly on social media and through my involvement with the American Medical Women's Association. Um, and I do a lot of research around challenges for women, especially in the workplace, and especially for women physicians and surgeons. Um, and I currently have a grant from the NIH to test an intervention to try to decrease sexual harassment in biomedical research. So that is part of, even though that's research, I think of that as an arm of advocacy as well. I think they overlap quite significantly.
Dr. Robin Stern: And, and I completely agree with you and thank you as a woman. Thank you for doing that for women.
Dr. Arghavan Salles: Yes. Uh, it's the least I can do. Um, and then to answer your other question about why I said yes, uh, I sounded interesting,
Dr. Robin Stern: So I'm, I'm interested to know what you were talking about, about medical gaslighting. 'cause certainly it's a, um, I've experienced it and, um, we just did a recording about it. Um, I've been asked to testify about it. And so I would love to know what you were seeing and experiencing in, in your world, and I know that our, our listeners wanna know,
Dr. Arghavan Salles: Wanna, yeah, sure. So basically, um, I kind of stumbled into it. I mean, I've definitely experienced it myself as I think most women have. Um, but I, I recently was talking about it because we had a manuscript that came out, um, I think it was in July, uh, with, I was just a middle author on this, uh, big manuscript that was looking at long-term outcomes after surgery and looking at the sex of the surgeon and the outcomes for patients. And bottom line was patients did better, um, in terms of complications, death and readmission if their surgeon was a woman as opposed to a man. And I had shared about this study on my TikTok, and, you know, it got a lot of traction. And so I got thousands of comments. Um, I don't actually know how many now, but at the time it was at I at least 10,000 or something, or five th I don't know, there's two ends up being two videos.
Dr. Arghavan Salles: But at least 15,000 comments across these two videos that are almost all, not all, but almost all examples of people's lived experiences as patients going to physicians saying that they had whatever problem, and then the ways that they were misdiagnosed and mistreated and the consequences that had for them. So, for example, there was a woman who talked about, um, and these were almost all women. There were a couple of examples of men experiencing this as well, but the vast majority were women. And so there was one woman who said that, you know, she had gone to see her doctor because she had the worst headache she'd ever had. And her doctor told her it was probably related to her menstrual cycle. She was not, she noted menstruating at the time. And it turned out she had a ruptured aneurysm.
Dr. Robin Stern: Oh my
Dr. Arghavan Salles: Goodness. So there were, I mean, literally there are thousands of stories like this. And so on that first video, when I started seeing so many of these, I felt like I needed to share these stories. So then I created another video that was kind of summarizing the patterns I was seeing in the comments. So not in a scientific way, but just kind of as a rational person trying to make sense of the large volume of data essentially that was coming at me. And it seemed to me that the categories of events that people were sharing fell into a few categories. So one was like the example I just shared, which is basically saying whatever the person was experiencing had to be due to their uterus. That's a whole entire category of ways that people misdiagnose women, uh, at least according to what I see in these comments.
Dr. Arghavan Salles: Um, and another category is blaming things. This will surprise no one blaming things on people's weight. So a patient, I had multiple of these where it was someone saying, they went in saying they had shortness of breath or difficulty breathing, and they were told it was that they needed to lose weight, when in reality they had either a pneumonia or heart failure or a pulmonary embolism. So that was the second category. Um, the third category, if you think about, there's roughly four. The third category is basically drug seeking. Um, that whatever the patient was describing, the physician would interpret as them seeking pain medications, when in reality that was not their intention. The patient's intention, they were there because they truly were having pain and had a, a physical diagnosis. Like one had ischemic bowel, for example. Uh, that was written off as drug seeking.
Dr. Arghavan Salles: Um, and the fourth category, so we talked about obesity, we talked about menstruation, we talked about drug seeking in the last category, which I think also will not surprise anybody is suggesting that there's a mental health diagnosis that explains whatever the person is experiencing. So this would happen with abdominal pain, again, as described by these folks in these comments. It could happen with abdominal pain, it could happen with shortness of breath, common that that was reported commonly, that they had shortness of breath and they were told they were anxious. Um, and in reality they had like a, again, a pulmonary embolism, which as you know, can make a person anxious. Um, you know, not being able to get enough oxygen can make you anxious
Dr. Robin Stern: And this is from responding to you to what you put out there. How amazing did people also show? I'll, I I don't wanna step on your words, so go ahead and then I'll ask.
Dr. Arghavan Salles: Uh, no, I, I was gonna say is that, so then I had made the original video, which was about our study and got thousands of comments that I summarized in a second video, and I got thousands more comments there. So that's across those two. Again, I don't know what the latest count is. 'cause this was back in July, August-ish. Um, but at least I think 15,000 comments across those two videos.
Dr. Robin Stern: That's really phenomenal. Think about all the people you're helping.
Dr. Arghavan Salles: I mean, we're trying, definitely trying. Um, what what has, what that has all sparked for me is a, a greater understanding of how often physicians who I think are by and large, well intentioned, are causing harm. And I think that as a profession, we don't have a lot of insight into that. Partially because these patients, when we, you know, dismiss somebody or mistreat them or misdiagnose them even out of our best efforts and our best intentions, they, they may not come back to us, right? They may go, like, if we're seeing them in a clinic, they may go to an emergency room somewhere else and get diagnosed with their pulmonary embol and for example. So that feedback doesn't always get back to physicians. That circle of communication is not necessarily closed. So I think a lot of times people are just not aware of what has happened to patients.
Dr. Arghavan Salles: Um, and that without that feedback, it's very hard to make any changes. Um, and we know, of course, there's so many pressures on physicians, I'm not trying to excuse anything, but we know, like physicians have very little time with patients the way that insurance, the hospitals, I mean, there's so many things that are pulling us away from what we, I think most of us would like to do, which is to spend more time with patients. But anyway, uh, I've just been really interested in trying to understand the prevalence of this problem. Um, because obviously what I have, these comments are, uh, completely biased sample, right? It's people who are following someone who talks about issues that affect women, and then they're commenting specifically about this issue as women patients. Um, so it's obviously bias sample. Um, and people who had no bad experiences aren't gonna be commenting, like, everything was fine for me.
Dr. Arghavan Salles: Um, 'cause that's not how social media works. So it's not, it doesn't give me a sense. It give me, it gives me a sense that there are definitely plenty of people who have bad experiences, but is it even 1% of the time? Is it more than that? It, I don't know. And I don't think anybody knows because when you look into, and also it's hard to know like what the right search term is. But if you try to look into something like medical gaslighting, medical misogyny, delay, diagnosis, et cetera, um, there's not a ton out there that like looks at across healthcare to try to identify patterns. 'cause to me, that's what would be really useful is if we could tell physicians, Hey, you know, here are some common traps that physicians fall into when caring for patients. Especially when you're stressed, especially when you're seeing a lot of patients. Maybe keep these in mind, and if you find yourself falling into this pattern, maybe think again and make sure you're not missing something else. Yeah.
Dr. Robin Stern: I love what you're saying and, and I love the fact that you're providing these buckets, you know, so that physicians can think, okay, am I about to tell her this is her menstrual cycle? Am I about to tell her this? Maybe I need to look further. Mm-Hmm.
Dr. Robin Stern: And, um, I went to, to my doctor and I said, you know, I'm really exhausted. And he said, well, of course you're exhausted. You just had a baby. Um, go home and have a drink. Um, and I said, okay, fine. And so I went home and I had a drink, a glass of wine, and I just gave myself extra permission to, to rest. And the next day I called him up, I said, I don't feel any better. In fact, I feel worse. And he said, um, because physicians were allowed to say these kinds of things, then, honey, it's okay. Don't worry about it. You just had a baby and, um, you are just stressed and you're just tired and have another drink tonight and call me tomorrow if you don't feel better. Well, it turned out I didn't feel better the next day. And it turned out actually that I had what he called a cousin of hepatitis that was caused by a medicine that he had given me. Wow. Six weeks before that. Um, that had a rare side effect of that. And so, of course, the drinking on top of, um, the whatever I had that was affected, my liver only made me so sick. Just,
Dr. Robin Stern: But it was his complete astonishment with, oh my God, you're actually sick. Yeah. That was a, like a flag for me. And I at that time was in private practice. I was looking at gaslighting as a dynamic. I didn't pay very much attention to what was going on in my personal life outside of personal relationships. Right. But there it was, there it was him wanting me to believe yeah. That it was something that I was or wasn't doing or was, or wasn't feeling. And there have been a number of instances like that in the lives of friends of mine, particularly somebody, um, thinking about a friend right now who is, has had a really tough time and of it in general. And so she's chronically anxious or depressed or tearful or reacting to her life circumstance when she has a medical problem, they barely look at it before. They give her the rundown of, well, you sure it's not this, are you sure it's not that? But at least then in that case, they're asking her
Dr. Arghavan Salles: Mm.
Dr. Robin Stern: My case, they didn't even ask me.
Dr. Arghavan Salles: Yeah. And, and that's, I important that you brought that up. I didn't talk about pregnancy earlier, but I definitely did get a bunch of comments from pe pregnant people or people who had been pregnant who talked about that. I think the most common thing, if I'm recalling correctly, was after sort of like what you're describing after having, uh, given birth. So in the postpartum period, basically there were multiple people who said they had postpartum depression, but their doctor told them it was normal. Like what they were experiencing was normal because they had just had a baby. And so then their, their diagnosis was delayed, so their treatment was delayed because of that.
Dr. Robin Stern: Yeah. And I, I would love to hear, um, whether you have heard from people about what happened to, uh, their sense of reality down the road, whether, I'll give you another example. I'm interrupting myself, but for this example, um, I consulted on a case where a woman had a surgery, uh, that she was having a tough time recovering from. She said, I'm in pain. Doctor said, of course you are. You had surgery. She kept going back, I think my pain is too much, just too much pain. He said, well, have, you know, did anybody ever tell you that you might have low pain tolerance? And so, um, that's what the issue is. Wow. And so she kept going, I'm really hurting. This is really terrible. End of the story, months, maybe a year or two later, she went, I don't think it was two years, but definitely a year later, she went to another doctor who f did another surgery and found that, uh, in the first surgery, some tiny part of a needle was left. So of course she was in excruciating pain meantime. And, and I wanna hear what you have to say about this, um, what happened to her sense of her judgment? Mm-Hmm,
Dr. Arghavan Salles: Right? And I think that we do that commonly in medicine when there's something that we don't understand, we're not sure what it is. And I think, I think we're taught that like if it's not these scary things that we do know, then it must not be anything too worrisome, right? Like, we're taught about the things that are gonna kill people that are going to cause significant harm, and we're taught to make sure we don't miss those, right? That's kind of how most of us, I think, are trained. And so because of that, when people come to us with a series of symptoms that we can't understand, I think what most of us do is we think, is it a heart attack? Is it a, you know, whatever the thing is that, that we're most worried about. And once we rule that out, we're kind of like me.
Dr. Arghavan Salles: It doesn't seem to be anything I know, right? Mm-Hmm.
Dr. Arghavan Salles: And it wasn't until over a year later that somebody did a CT scan and they had left a wound retractor inside her a wound retractor. There's different sizes, but it's at least like the size of a, like an appetizer plate or something like that. I mean, it's hard for me to say I'm showing what your audience won't see, but, you know, they're not small
Dr. Arghavan Salles: So one ring sits on the outside and one ring sits on the inside. So it, it technically should not ever be inside. It should never be fully inside the patient's body. So it sounds like something obviously happened there that led to it being falling inside. And at that particular hospital, their practice was not to count those wound retractors. As some people may know, we count all the instruments and devices that we use in surgery so that we count them at the beginning and we count them at the end to make sure everything's accounted for. And this particular device at that particular hospital was not part of the count because it never was supposed to be inside. So anyway, so it's bad enough that happened. I mean, that happens, right? Like we all know if you've been in medicine long enough, bad things happen. Um, and that's always going to be the case. But that she was having pain for so long and it took over a year to identify, this is really disturbing to me because she probably felt the same way that this other person you were describing felt that she was somehow messed up, that she was having so much pain when in fact she had a large foreign object inside her abdomen. And it took 18 months in the end, it was 18 months later that she had surgery and they removed it.
Dr. Robin Stern: And did it have an impact, do you know, or, or did the, um, you, it was an article you read or interviews?
Dr. Arghavan Salles: Yeah, it was an article I read that was, um, out of New Zealand, and they didn't say, I don't think they even talked to the person. They were more reporting it as a news story. So I don't know. I mean, I'm sure it had to have impacted her, you know, mentally, emotionally,
Dr. Robin Stern: And I, you know, if you think about that as like the ghost of gaslighting following you, I mean, it is pretty scary that, you know, so the event is over and this is not, it's not your lover. So you're not breaking up, usually not your lover. You're not breaking up with the person. And, and, um, it may not be that heartbreak, although for some people they're very attached to their doctors, especially if they've gone through a very difficult time with their doctor. And, um, so you go on to another doctor and then you get the correct diagnosis. And what about the fact that you've been second guessing yourself for a, like, what is the long-term or short, long-term effect of that, you know, how hard is it then to trust yourself? I know in romantic relationships where the breakups can be very painful or in friendships or, um, even with family, it there is that ghost that follows you that you have been in fact wondering, is it me for all that time? And so what happens then when you're in the next relationship? Or what happens in the medical world when you next have a pain? Do you go to the doctor on time or do you think, well, maybe it's, maybe it's me.
Dr. Arghavan Salles: Yeah, no, I'm sure there's definitely negative downstream consequences. One of the things that I found very sad is a lot of people saying that they just don't go see doctors anymore because they don't believe we're trying to help them. They don't believe that we care. Um, I mean, we saw a lot of that with the pandemic, right? All these doctors are just in it for the money. Whatever
Dr. Robin Stern: That is really sad. Is there any kind of public, um, know messaging about that, about don't hesitate your doctors are here to help you. Any acknowledgement in, in medical education, physician education about, you may be aware that this has been going on for a while and do your best to reassure your patient. I mean, I don't know, I don't know what the answer is in medical culture, but it seems like if that is the reputation that doctors are getting because of the, I believe widespread medical gaslighting, especially against women and minorities, um, uh, I think there must be something pro-education that people or pro proactively that people can do. What are your thoughts about that?
Dr. Arghavan Salles: Yeah, there was an article, um, and I'm gonna forget this person's name right now, but there was a psychologist who's very interested in this idea of medical gaslighting and had written an article for CNN that came out, I don't know, maybe a month or two months ago. Um, and her main kind of thesis was that we need to do an educational intervention in our medical schools and in our medical training to teach physicians and physicians in training about medical gas lighting and, and how to, you know, be aware of it, to not do it, the harm that it causes, et cetera. Um, which definitely, definitely needs to happen. Um, I, I'm not aware of, it doesn't mean it's not happening, but I'm not aware of places that are addressing this. Um, but it does seem like something that we really need to urgently do. I think to your point about public messaging, like public health is really kind of in shambles in this country at least. So I, I, I don't think people trust the CDC, you know, like if the CDC were gonna put out a message about let's say, you know, trust your physician, go see a doctor, don't wait, whatever. I, I don't know that most people would listen to that, or at least not the people who are already skeptical, right? I don't think they're likely to be convinced by a kind of a messaging campaign from the CDC or other health authorities, unfortunately.
Dr. Robin Stern: Yeah, I think that's pretty fair, especially after three years of mixed message and dual messages from, um, during covid. You mentioned, and I I believe on your website, um, did some writing about your being on the front lines during Covid. And I, I wonder even though, um, this is about gaslighting, whether, and maybe that's, that is as well, but I'd really love to hear, I think it's really an important service, um, that you and gift that you gave people. So if you'd be willing to talk about that. I, I also was on the front lines, not as a doctor, but, uh, working with doctors and nurses who were on the front lines. And, um, it was just the most unimaginable time where, just as an example of the Yale New Haven Hospital where they're doing great work and, um, very committed to, in the children's hospital where I was working with nurses, uh, pediatric nurses were suddenly like overnight, um, asked to go to minister the dying on covid floors when they had never even worked with adults, uh, in their daily, their daily practice. And then not only were they working with adults and with a disease that nobody knew was unpredictable and outta control, and who knew when it was stopping, um, raising everybody's anxiety, but also then they were, uh, in end of life care. So that was my experience, and it was, um, certainly life changing for a lot of the nurses and doctors, uh, in a way where people are still reeling from it and recovering and healing from it. So, love to hear from you what you did and why it's been important for you.
Dr. Arghavan Salles: Yeah, I mean, I think that's an accurate reflection that I don't think we definitely as a society have not, and I think we as physicians, uh, and other healthcare workers have not really processed what happened, um, in the early days. Like even 20 20, 20 21, there's not been time for that, right? It's just gotta keep moving. There's always something else that we need to be taking care of. Um, for me, I was, uh, so in spring of 2020, I was working a nonclinical job. And when the kind of the wave or the surge hit New York, um, I felt very much like I wanted to try to help. And I, even before that, I just was looking at, we have a healthcare problem, like a, a real pandemic, and I have skills and training, but I'm not using them right now. 'cause again, I was in a nonclinical job.
Dr. Arghavan Salles: And so I felt, um, a lot of guilt and just wanted to be of service somewhere. And so I was lucky to be able to connect with a sys, uh, physician society that was helping people get to New York to volunteer. And so I was able to go for a couple of weeks to New York in April of 2020 and help out in a makeshift ICU. You know, I was in a unit that was a pre-op unit previously. So, um, it was functioning as an intensive care unit, but there's no doors on, there's no rooms, there's just beds with curtains around them. 'cause that's how a lot of pre-op units are. Um, and where
Dr. Robin Stern: Connected to a hospital or was it just like in Central Park somewhere?
Dr. Arghavan Salles: It was, no, I was in a hospital. Um, I was in one of the kind of public hospitals in New York. And, um, it was definitely, as you mentioned, an experience that changed me forever. I mean, I've never experienced anything like that in the sheer volume of death and the, um, really lack of tools that we had at the time to try to help people. You know, it's easy to forget where we were then, but we didn't know what ventilator strategy would be effective. We, if you remember, it was like convalescent plasma or rem dessi severe or, you know, all sorts of things that people were just trying because we didn't know what would work. And we were losing a really high proportion of patients. So in that particular makeshift unit, you know, we were losing multiple patients per shift. Um, and that's not a thing I had experienced in my time in the ICU as a resident, for example.
Dr. Arghavan Salles: Um, so it was just a large volume of loss. And then if, you know, everyone remembers that people couldn't come to the hospital, so it was a lot of FaceTime or WhatsApp or whatever other video calls with, um, patient's, family members to keep them updated. And especially at, at their last moments, um, holding up that screen to show someone their loved one who, you know, was on a ventilator and had all these tubes and lines. And anyway, so that was a, certainly a unique and traumatizing, um, experience for all of us, whether you're in healthcare or not. But for me, being there in New York was something that definitely changed a lot in, in me, in the way that I perceived the world. And, um, and also how I perceive the pandemic and the virus and even where we are now, right? I'm, I will be forever marked by that experience in a way that people who weren't there and who didn't see all those people dying, I think, um, will never see it the same way.
Dr. Arghavan Salles: Um, and then, so that was a couple weeks in New York, and then I was asked to help out in a hospital in Arizona after that. So I had the opportunity to spend like three or four months in, in intervals, um, across the next like year or so in Arizona, helping out. And, um, that's just, I knew someone there knew me. They'd seen that I had gone to New York and they needed help. So I was happy to be able to go. Um, and it was, you know, not the exact same situation, but also not so different. I mean, we had, especially by the last time I went there, we did have more information. Um, but still a lot of people, because I was in the intensive care unit, right? These are the sickest people, still a lot of people were dying. Um, and, you know, we were just trying to keep them alive as long as we could and hope that their body could kind of fight whatever was happening and we could just support them through that time. Sometimes it worked and sometimes it didn't.
Dr. Robin Stern: Was that, was that a part of, um, practice that many, I mean, you weren't working clinically, so it was new for you and maybe at first for other people where you were there so much as, uh, in support and in palliative care, um, even if it just lasted a little bit. Mm-Hmm,
Dr. Arghavan Salles: Yeah, that's a great question. I mean, I think that was very, very challenging. Um, especially those early on in, in New York. I mean, that was a time when we, there were physicians online who, um, were sharing that they like moved out of their family home, for example, because they didn't wanna bring the virus home. And people were, um, showering immediately when they got home and then showering again in the morning. And then, you know, like not sure whether they could bring their scrubs that they had left the hospital in, into the, their house, or like, we just didn't know. We didn't know how, what we should do to be safe. And so there were a lot of things we were doing right. Remember wiping down groceries and not knowing Yeah. What could you even eat? Like it was
Dr. Arghavan Salles: Um, and as you mentioned, there were a lot of people who were in these hospitals who were working in roles they had never been in. And I, and I was one of them. So there was, like, when I was in New York, there was an endocrinologist who was working in the ICUA cardiologist, you know, nephrologist, whatever, different people who had exposure to different aspects of ICU Care, right? But weren't based in the ICU. And I trained as a surgeon. So I spent a decent amount of time in the surgical ICU, but I had not done an ICU or critical care fellowship. I was not trained in intensive care. So I was, um, there supporting, basically kind of acting like a physician extender in some ways, um, with the intensive care physicians. 'cause there weren't, there weren't enough of them to handle that volume. Um, and you're right that, that it's a different set of skills.
Dr. Arghavan Salles: Um, and having those conversations with patients, for me, that was really, really tough. I'm a pretty empathetic person. And so I would end a lot of these conversations crying and feeling bad about crying and, and you gotta like, just move on to the next patient and do what you need to do. And there's not space during your shift, certainly to process any of that. And then you go to your hotel room, you know, in my case it was a hotel room 'cause I was in New York or I was in Arizona, so I was going back to a hotel room and you have a couple of hours to eat some food and maybe try to work out, like go for a run or do some yoga or something to try to do some kind of self-care. Um, but also I'm a single person. And, and so it was very isolating the whole experience of seeing so much tragedy when I was at the hospital and then leaving the hospital and being by myself where there was no one to share even aspects of it with. I mean, I could have called somebody, you know, but you can't just kind of do that every day and offload, um, on people who have their own struggles.
Dr. Robin Stern: Yeah. And so every, yes, I was gonna say everyone was struggling. Yeah. And in New York, I, I live in New York, even though I work in Connecticut. And, um, one of my most vivid memories is the sounds, the sounds of sirens constantly. Mm-Hmm.
Dr. Arghavan Salles: Mm-Hmm.
Dr. Robin Stern: On you. And, um, I wonder if you did your yoga practice as a way of
Dr. Arghavan Salles: I did actually. Even like from the very beginning of the pandemic, you know, when we went into, you know, the stay at home phase, you know, mid-March, uh, of 2020, I like most people was like, what am I doing with myself? Like with now I don't have my, my meetings are canceled, my talks are canceled, you know, what am I doing? So I, um, practiced yoga for many, many years and I started doing more of it. I actually posted quite a lot of, um, little bits of like, here's how to do a headstand or like, here's this other whatever. I posted a lot of yoga, uh, at that time. And, um, that was part of it for me. That was part of how I kind of tried to care for myself and detach a little bit from all the tragedy that I was otherwise seeing. Um, and, and I did that in Arizona as well. I did, I did that in the hotel room in New York, you know, did what I could.
Dr. Robin Stern: Well, and giving to others is also a way of, of healing yourself and lifting yourself.
Dr. Arghavan Salles: Well, I also, I totally forgot about this. I started teaching, um, online yoga classes on the weekends. Um, I had done a yoga teacher training many years ago. And so I, for I don't know how long, like six or eight months or something, I taught a yoga class. I think it was like every Saturday morning or something online for whoever wanted to.
Dr. Robin Stern: That sounds wonderful. Thank you for doing that.
Dr. Arghavan Salles: They're all available on my YouTube. If anybody wants old yoga classes to do, they're free
Dr. Robin Stern: And we're gonna get there in a minute. 'cause I wanna know, I want people to know where they can find you, but I, um, I really would love to ask, and you're free not to answer, but is your decision not to practice in any way related to Covid?
Dr. Arghavan Salles: No, not for me. No. And, and it's not really for me. It's also not like a, I'm never gonna practice decision. It's that I, I had a really, really difficult experience in my first job as a, um, full-time academic surgeon, and it was extremely traumatizing for me. So when I left there, I knew I did not want to go anywhere near that type of experience. And I knew that I wanted to protect myself from the toxicity that exists in the surgical culture and had hoped that I would find some sort of part-time, um, job in surgery so that I could do it some, I mean, I invested a lot of time and gave up quite a lot of my life, um, to gain those skills. And I think they're really valuable skills and not everybody has them. So I would love to be able to use them, but not at the cost of me. Like, I'm not willing to give up who I am and my mental health and my emotional health and my physical health to do it. Um, I'm just looking for that right. Opportunity, you know?
Dr. Robin Stern: Yeah. Well, thank, thank you for venturing into that space with me. I appreciate it. Um, I, I wonder whether it was also gaslighting or some kind of emotional abuse that you felt at the hand of other doctors rather than your physician who was treating you for a medical illness.
Dr. Arghavan Salles: Yeah, I mean, I, I would say there definitely was a lot of, um, a lot of things that were said to me were not appropriate. A lot of things that were done to me were not a appropriate, um, I think that what happened to me, um, or what I experienced, I should say, it didn't happen to, I wasn't passive. I was there, I was part of the whole thing. Um, but what I experienced, I think happens to a lot of people, especially women and otherwise marginalized people in medicine and especially in surgery. Um, and it's very similar. I, I know this 'cause a lot of people come talk to me about their own struggles in these ways. And it's very similar. It, the, the group that you're in or the department that you're in, or wherever you are, they decide that you are a problem for whatever reason.
Dr. Arghavan Salles: It could be due to bad luck. It could be due to a mismatch of personality. It could be any number of things, but they decide that you're a problem. And then they start scrutinizing everything you do. And then things that could happen to anyone, um, happen to you. And they're used as evidence that you are a problem, even though they happen to other people and they're not evidence of them being a problem. Um, and then when you're under that level of scrutiny, of course you're not usually then at your best because you're anxious and worried about everything. And so then maybe you even make more mistakes. Who knows? Um, and then those are held against you. And the more this happens, the more you start to feel shame and guilt and, and then the more you isolate yourself. Because especially if you think about physicians or surgeons who've generally been very high achievers, um, to go through an experience like this where you're made to feel like you are not worthy of existence, um, is, is it's a very, um, it's a very strange sensation and it's not something that most of us have really dealt with.
Dr. Arghavan Salles: Um, you know, if we've had, a lot of us have had certain levels of privilege, and again, we've done well academically, and so we're not used to being made to feel like the worst person who ever lived. Um, and that is what they try to do. That's, that's the intentional playbook that they are implementing because then if you feel that way, you're not going to talk to anyone. So the, the organization will never look bad. They will never have to worry about anything because you have been made to feel, and you have started to believe that you are worthless. And, um, and that's exactly what they want. And so then you, you go away in whatever way they force you or you leave either way, um, and you're not their problem anymore. And you may not be anyone's problem anymore because they may have sabotaged you to such a degree that you can't get an opportunity somewhere else.
Dr. Arghavan Salles: That definitely happens. I've seen it happen to many, many people. Um, and it's all, if you ask me vial and disgusting, especially when you go back to what we were talking about at the beginning, which is that we know when we look at gender or sex of the physician, that patients do better when cared for by women. And that's not just from this one study that I mentioned. It's from many, many studies, uh, extending back over decades, really, if you wanna look at the differences in how women physicians practice compared to how men physicians practice, you know, on, on the whole obviously that these are kind of large population data sets. But, um, when you know that that's what the data are telling us, and then you also know that the people who are providing the best care are the ones who are being pushed out. It's very disturbing.
Dr. Robin Stern: It is very disturbing. I'm so, first of all, I'm so sorry that you had to go through that. That sounds, I mean, it's straight up abuse and it's awful. Gaslighting and emotional abuse sounds horrible and no one should have to go through that ever. And what's so terrifying about that is, so you left to take care of yourself and so that you could heal and, and go on. They're still there. And are they doing it to the next person and the next person and the next person? So what, what,
Dr. Arghavan Salles: Wait, let me tell you this. Let me tell you this. When I talk to the Ombuds person, because often, uh, people who are in situations like this, you're advised, you know, we should talk to the Ombuds person. And I'm not trying to take anything away from Ombuds people. I think they're very helpful and thoughtful people in general. But when I talk to this ombuds person, one of the first conversations I had with them, they said, well, this is just what they do. And I said, what do you mean? And also, who are they?
Dr. Robin Stern: Sure. Because then that'll be more evidence that you have a problem.
Dr. Arghavan Salles: Yes. But they had seen this happen enough times that they knew what the pattern was with this specific department that they could tell me
Dr. Robin Stern: Exactly.
Dr. Arghavan Salles: Do you know what I mean? Like, that was extremely disturbing to me. And so to your point of after I left, did they do it to someone else? I'm sure they did it to someone else. I'm sure they're still doing it to people. Like that's, they were
Dr. Robin Stern: Doing it to people before you came and you were just supposed to accommodate and just roll with the, like, this is the way we roll here. The men are abusive and just suck it up.
Dr. Arghavan Salles: Exactly. And I had been told, you know, this is one of these things where you look back and you're like, Ooh, maybe that should have meant more to me than it did. I, I had a resident who had said, you know, they would mention different, um, physicians who had been there before. And I'd be like, who's that? And multiple times the answer was, oh, she got run out. And anyway, at the time I was like, why would that happen? That's so strange. Um,
Dr. Robin Stern: I'm so glad that you didn't get caught up in trying to understand them and you just took care of yourself and eventually got out
Dr. Arghavan Salles: Eventually. Yeah. But you know, when you're in those situations, the damage is, the damage is long lasting.
Dr. Robin Stern: Yeah. And maybe that's why you couldn't just take the word of caution as, as a, um, into an action step because you didn't know what it felt like yet.
Dr. Arghavan Salles: Mm-Hmm.
Dr. Robin Stern: You know, like experience is everything.
Dr. Arghavan Salles: Well, and I had been told, and I'm just sharing this in case these things happen to other people, but I had been told by someone that the chair of the department was the type of person where if he liked you, you were great. And if he didn't like you, he would make you miserable. And at the time I thought, like, why, why wouldn't he
Dr. Robin Stern: Exactly. So how have you been taking care of yourself since? And, um, what are you doing now?
Dr. Arghavan Salles: Yeah, so I am, um, so even though I'm a surgeon, I am in a department of medicine and that has been so lovely. The people I work with are amazing. Um, they're so thoughtful and kind and generous. And we work, I I work with a team of three other physicians, um, kind of running our programming and overviewing our policies and procedures as they relate to diversity, equity, and inclusion for our department. So that's, yeah, actually that's really great. So that's part of my time. And then the rest of my time is on research, like I mentioned the, um, NIH grant and um, some of the medical gaslighting stuff that I'm starting to try to do research on now and other work, I do work in fertility and family building and all sorts of things.
Dr. Robin Stern: Oh, wonderful. You're giving so much to the world. Really appreciate hearing that. And, and I'd love for people to know, know where to find you,
Dr. Arghavan Salles:
Dr. Robin Stern: Wow. Um, well, you've certainly had experience with people taking advantage of you and being mean and, and abusive. And, um, and I thank you for your very generous sharing and for being so vulnerable and open and, um, being it with me in this conversation. And for our listening audience, I know that this hour has been really meaningful and important and many takeaways. Uh, if you wanted to leave one message with our audience, what would that be?
Dr. Arghavan Salles: Um, that's a great question. I, I think one of the most important things that I've learned is, um, when something feels wrong, it probably is wrong. Even if you can't quite figure out the label for it, if, even if you can't quite articulate it, listen to those signals and document them, because sometimes it's the beginning of what's going to become a pattern that you just can't see yet or hasn't developed yet. But it will. And if you don't keep track of it from the beginning, it's hard to recreate that. Um, but if you just kind of start jotting things down that don't feel right, then later on it may become helpful. Um, even just for yourself to see like, oh, this happened before. I forgot about that and this happened and this happened because when, um, and I really believe in this quote, when people show you who they are, you should believe them. Yeah. And if we can do that more, I think it'll all be better off.
Dr. Robin Stern: Well, I couldn't have said any of that better myself. When something feels wrong, it probably is wrong. And thank you so much Arvan, for being with me and for, um, for gracing us with your stories and your presence, and thank you for the work you're doing in the world, and I look forward to it next time when we can talk and, and share stories. And, um, thank you again. Thank you everyone for listening and see you next time on the Gaslight Effect podcast.
Dr. Arghavan Salles: Thank you. Thank you for having me.
Dr. Robin Stern: Thanks for joining me for today's episode. I hope you found it helpful and meaningful. If you want to listen to other episodes of the Gaslight Effect podcast, you can find them@robinstern.com or wherever you listen to podcasts. And please leave a rating and a review. I also invite you to follow me on Facebook, LinkedIn, Instagram, and Twitter. This podcast is produced by Mel Yellen, Ryan Chang, Coco, Mike Lens, and me. The podcast is supported by Gabby COAs and Sala Cari, all of my work and my upcoming book is supported by Susan Petit Marcus Estevez and Imaginarium, also by Sally McCarton and Jackie Daniels. I'm so grateful to have many people supporting me and especially grateful for all of you, my listeners.
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robin.stern@yale.edu
