Chapter 09: Faculty Development: Offering Support in a Stressful Environment

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Chapter 09: Faculty Development: Offering Support in a Stressful Environment

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Ms. Yadiny discusses the stressful work culture at MD Anderson and the challenges that leaders face. She tells a story about a department chair who shed tears during a coaching session and a meeting with his department. She notes that the culture makes faculty members feel unsupported, and they come to Faculty Development for support. She also discusses cross-cultural issues that contribute to the stress, touching on issues that international faculty face and also on issues that arise because of U.S. regional, north/south, differences. She notes that the staff wields informal power, and gives examples of faculty women who have problems with staff members, who call them rude and demanding and often raise enough issues that the female faculty member "ends up in front of a Chair or HR." Ms. Yadiny notes that Faculty Development and the institution in general has not done enough to orient faculty to the southern dimensions of MD Anderson culture. She comments on the fact that 70% of employees are female, but MD Anderson "is a male institution." She comments on her own experience of gender issues and the slow progress made on addressing them since she began her professional life.

Identifier

YadinyJA_02_20160301_C9

Publication Date

3-1-2016

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - MD Anderson Culture; MD Anderson Culture; Working Environment; Gender, Race, Ethnicity, Religion; Critical Perspectives on MD Anderson; On Texas and Texans; Cultural/Social Influences; Women and Minorities at Work; Experiences re: Gender, Race, Ethnicity; Leadership

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey Ann Rosolowski, PhD:

Okay, so we’re recording now, and so just quickly, it’s March 1, 2016, the time is about ten minutes after nine, and this is beginning of my second session with

Janis Apted Yadiny:

.

Tacey Ann Rosolowski, PhD:

We were in the midst of a conversation, you were talking about this man who had come for leadership issues, with team initiatives.

Janis Apted Yadiny:

He was a chair, a chair who had been here maybe not that long, a few years but not terribly long. Fred Schmitt and I were working with him, and he asked us to both do some process work with him, coaching, and do a team alignment, with his team. This is really, to me it’s very important work. It can be personally very deep, because you build a relationship of trust with the leader, and the leader has to feel like they can open up and tell you things. This man certainly opened up and just bared his soul, and by the time we finished the team alignment, he cried in the team alignment, in front of his team, because he felt he had let them down. They were shocked, of course. And then in his office afterwards, when we were debriefing, he sobbed. The man was in his fifties, and I can tel you, Tacey, I’ve met so many very successful people, successful somewhere else, who come to MD Anderson and they have their first taste of failure, of what it feels like failure, and the failure terrifies them, it disorients them so much.

Tacey Ann Rosolowski, PhD:

Well, it’s an identity blow, I’m sure.

Janis Apted Yadiny:

It totally shatters their identity, they feel like they’re on thin ice. They’ve never been on thin ice. They’ve been A students, they’ve been the best medical student, the most brilliant researcher, whatever, and something happens here, within a very short period of time, where they’re doubting themselves. Who am I? Am I not good enough for this place, am I not the person I thought I was? Why am I not understanding the signals? What are these signals anyway? The signals seem to be you’re really not good enough, lucky you, that you’re here. I don’t know how we manage to do that to so many people, and I would say that if I were to sit down with the leadership, they would be shocked if I told them that, because I don’t feel like it’s deliberate, that they mean to give out those signals, but somehow it’s become part of the culture, so the culture can seem very cruel and mean and non-supportive, and you have to find your own way. One of the things that I think is really important for new leaders is that they understand that there are people here who get it. You’re going to walk into a culture where you’re going to feel, at times, terribly unsupported, and come to us and talk to us about it. I can put them in touch with, or one of our consultants can put them in touch with other leaders who felt the same way and who are now very successful at MD Anderson.

Tacey Ann Rosolowski, PhD:

Let me ask you a quick question, to just go back to that scenario, when that department chair was in the situation with his team. What was the team’s reaction to his emotional baring?

Janis Apted Yadiny:

Shock. Like so many people who are not used to having this, they’re used to patients crying in front of them, but a chair, their chair? They were stunned, they were silent, they weren’t—they were shocked, I would say. There wasn’t even one comment of sympathy for him. Now, he got caught between a rock and a hard place, and I think that I have seen this as problematic at MD Anderson from time to time, where new people are brought in and then put in very complex political situations, which they don’t really know about until they get here, and they have to try to figure out how to maneuver, and they don’t know who are their friends and who are their enemies. They don’t know who to talk to about it. They try to resolve it in a mature way and they find out that part of the problem is in one silo and part of the problem is in another, and they don’t know how to bridge that. I don’t know that they could successfully bridge it, you know, it’s such a surprise to them.

Tacey Ann Rosolowski, PhD:

There’s also—I don’t know, this must come up in your conversations, but there’s a difference between this institution being influenced by southern culture, and I think for people who come from the north or from the West Coast, and probably from certain cultures overseas, that’s just the way of interacting. Kind of muting of certain kinds of messages is an issue and it takes a while for people to get used to it.

Janis Apted Yadiny:

Yes, exactly, and that’s a hard thing to parse, you know it’s a hard issue to really understand fully, and I think about it a lot. There have been faculty I’ve coached here, who have told me, I’ve had more of a culture clash, coming from New York City, down to this institution, then I ever thought was possible, because I’m a northerner, and it took me a year or two to figure out, I mean a southern state, but also a southern institution. Now, the interesting thing is, a lot of the faculty, 42 percent or something, as Asian, or minority say, from other places, and a lot of the other faculty, they’re not southern. It’s the staff, because you have now, we’re up to about 21,000 people or 22,000 people; many of the staff here are southern, and about 70 percent of the staff are women. So, I would love to do—I would like to understand what that is really all about, if we did a cultural study. The staff have enormous power, yet they feel powerless. The staff interact with the faculty and they have their own ways of punishing them or controlling them.

Tacey Ann Rosolowski, PhD:

Can you give me some examples?

Janis Apted Yadiny:

Yeah. We have recently, in the past year, dealt with four faculty women, all from other culture, all of whom have run up against staff, nurses, PAs, CADs, or whatever, who say they are brusque, rude and bullying. When you talk to the faculty, they say they are not doing their jobs, they’re not doing a good job, I have high standards. You hear this from the men too. I have high standards, I really care for my patients, blah-blah-blah. The staff say, whether they’re doing a good job or not, who knows, because we’re not dealing with the staff. Staff say they are rude, they are demanding, they have this superior attitude, you know, and behind that you can just hear a ‘Bless your heart,’ right? You can be rude and demanding but watch, watch me. And so what happens is the faculty member ends up in front of the chair or with an EEO complaint in HR. In some way, they’re stunned that this has happened. Part of it is our fault in the institution, in that we don’t do a welcome to the United States and to Texas orientation for faculty, they should all get it, in which these cultural issues are raised and in which we can say this is a southern culture, here’s how a southern culture operates, here’s what you might come up against. They expect to be treated politely and respectfully, and when you have to deliver a message that is critical, you need to frame it. We suggest you frame it in this way, so it can be heard.

Tacey Ann Rosolowski, PhD:

I was going to ask, is there also a gender overlay on that too?

Janis Apted Yadiny:

The women staff will put up with a lot more from men faculty than they will from women, definitely. Definitely. In fact, the female surgeons, some of the female surgeons, women surgeons, have told me that they can get into trouble very easily in the OR. A man will go in and take charge and say hey, do this, do this, do this, you know, very commanding and very much in charge. When the women do that, the nurses and so on can react badly. I don’t know what that looks like but that’s how they feel it. Some of the women surgeons just plow on through and are dominant and commanding, and manage to handle the teams well enough, but some of the women surgeons have complained to me that they feel disrespected in the OR and they’re not sure quite how to handle it.

Tacey Ann Rosolowski, PhD:

Are they feeling as though that compromises their ability to work effectively?

Janis Apted Yadiny:

It compromises their sense that they’re really doing the job that they want to do, because they’re in an environment in which, you know, people are looking at them and not quite trusting them.

Tacey Ann Rosolowski, PhD:

Right, right.

Janis Apted Yadiny:

As surgeons. There are a lot of issues here that we really should examine more fully, I think, within the institution. I think it would be worthwhile, you know, hiring in cultural anthropologists. People like you, doing oral histories, are really important. People who can come in and observe the dynamics over a period of time, with male and female faculty, in different contexts, and really draw a map of what is going on in this institution.

Tacey Ann Rosolowski, PhD:

You know, I’ve never really heard any—I mean there’s no official statement from MD Anderson that this is a southern institution, I mean that’s not brought out as an official part of the identity of the institution. What it’s really focused on is more, we’ve grown beyond the time when this was really a Texas institution, and now it’s international. I’ve heard faculty members say, yes this is a southern institution and if you don’t figure that out pretty quickly when you get here you’re in trouble, and you probably will end up leaving if you can’t make the adjustment, because it’s so strong. So I wonder what’s that about. Do you have any suspicions, or maybe it’s nothing. Why doesn’t the institution kind of acknowledged this and has put it into the mix of understand itself?

Janis Apted Yadiny:

That’s an excellent question and I don’t know that I know, because those of us who go around saying it’s a southern institution have come across that through our work. We say it to each other, but I’ve never heard it said by leaders. The leaders tend to come from elsewhere, north, west, somewhere else, so I’m not sure that they even would agree, you know, if we put it out. If I were to sit down with people on the 20th floor and say this is very southern culture and here’s how it operates, they may not agree with that.

Tacey Ann Rosolowski, PhD:

Well, it was kind of interesting, I interviewed one person on that floor who said—I don’t think it was—I think it was just the throwaway line, off record, you know, I’m from the north, I do things this way, you know, and it was like okay, hitting home.

Janis Apted Yadiny:

So there is some, yeah, there’s a difference, yeah.

Tacey Ann Rosolowski, PhD:

And I said, “Yeah, I do it that way too, I’m from New York too.”

Janis Apted Yadiny:

You know, when you think about it, is it a criticism, is it demeaning? Is it… what is it, I mean, if you go saying it’s a southern institution.

Tacey Ann Rosolowski, PhD:

Yeah, yeah, what is that about.

Janis Apted Yadiny:

Yeah, what is that about, what does it mean, really.

Tacey Ann Rosolowski, PhD:

Yeah, and I think if that were going to be made part of the way MD Anderson represents itself, it would have to be thought out, you know how is that done. I mean certainly, if what happened is what you were talking about. So for example, there might be some orientation sessions or some workshops. How do you deal with the specific challenges, interaction challenges that may come up because there is this north/south, or southern overlay. It would have to be done kind of carefully.

Janis Apted Yadiny:

Right. There are aspects of it that are very nice, and which brought me back to the South. People are friendly, people are warm, people are curious about you, they’re accepting to your face anyway. I don’t know what’s going on behind your back. I found it very disconcerting to move from Houston, up to Michigan. You walk in the stores—you know when I go back home to Toronto, I find the same thing; no smiles, no greetings, hey, how are you today or have a good day or whatever. None of that is going on and I find it cold.

Tacey Ann Rosolowski, PhD:

It is, and people don’t make eye contact, I mean there’s all kinds of things.

Janis Apted Yadiny:

No. They’re not interested in you, really. Down here, I love the warmth and the curiosity and the acceptance, but behind that is a way of dealing with people that’s in its own way, pretty ruthless, if you don’t get—you know, if they feel like they’re not on their side, or in some way, you’re making their lives difficult, watch out.

Tacey Ann Rosolowski, PhD:

We kind of started on this direction because you had mentioned that the staff has a lot of power. I’m wondering if there are other dimensions to that.

Janis Apted Yadiny:

It’s informal power and it’s power that they don’t acknowledge or see. The fact of the matter is, that when I say 70 percent, could be a little higher now, of the institution is women, do you feel like it’s a women’s institution? No, you don’t feel it at all. You walk around here and you feel like men are in charge. I’ve been here since 1999 and that has not changed. Even though the women staff are dominant in terms of numbers, you don’t feel it in the culture.

Tacey Ann Rosolowski, PhD:

Yeah, well certainly the higher up you go.

Janis Apted Yadiny:

The fewer there are.

Tacey Ann Rosolowski, PhD:

Absolutely, yeah. I mean the whole issue with gender was one of the many I wanted to talk about today. I don’t know if now is the time to do that or if you’d like to kind of integrate it into other discussions.

Janis Apted Yadiny:

Sure. I think it’s very important and I downplay it. I have downplayed it in my entire life. Why? I don’t know. Partially because I tend to act like a guy in meetings and stuff. I’ve never had a problem speaking up, putting my thoughts out there. In fact, I feel much more comfortable the higher up they are, because you can be direct and you can just put it out there. As long as you do it appropriately, you know, you understand, you do it respectfully, but you have some knowledge or some insight into something that they don’t have, because they’re up there dealing with other issues. So, I’ve not felt personally sometimes, the whole issue that being a woman has put me in a lesser place, but realistically it has.

Tacey Ann Rosolowski, PhD:

How so?

Janis Apted Yadiny:

Let me see. Well, because I think that on the planet, if you’re a woman, it does put you in a second class position, and it takes a while to get a sense of that. Now, when I was with the World Health Organization, one of the things that really interested me was the issues of women and children, and that still interests me today, the issues of women and children, because at the World Health Organization, for instance at the annual meetings, when they bring in all the membership, let me tell you, there was always so much talk about the need. We’re talking about 1975, ’76, ’77, in that time span. Oh, we need to address women’s health and the education of children and children’s health, and until we do that, there’s no way we can develop our countries. At that time, some countries in Africa, 85 percent of the population, 85 percent, had one or more tropical diseases. Now, how do you develop a country with people who are sick, who don’t have the energy, just don’t have the health and strength to do what they need to do? Certainly, the women and children. The men were bad off too, but the women and children were not cared for. Okay, so there was a lot of blah-blah-blah about that. Forty years later, it’s still the same, right, really not much has been done. Now you look at the situation with the refugees coming out of Syria and the molesting of these women on the way to Germany, oh my gosh. Now they’ve had to set up Germany trauma centers, to treat PTSD, because the women who make it, and their daughters, have been so traumatized by being with these men, sometimes strange men, not family men, all around them, and being molested or treated very badly, violently and so on. That is a fact in the world, of the way women are treated. I certainly see it when I go to my husband’s country, in Morocco. I see, you know, when I talk to professional women there, one of the things they have a problem with is there are no sexual harassment laws in corporations, and they’re treated like they’re owned by the men, in some situations. Now they’re starting to get, you know, you can meet some fabulous professional women there who are amazing, but underneath it, the issues of women and children are horrific, and I don’t know why it’s been, maybe because… I don’t know why. I have not really—and yet, I’ve been in situations where certainly, I’ve been told, you know you’re a woman, so don’t expect to be—working on Tunisia was no picnic, in the 1970s, so I really got a full dose there, of how badly you can be treated. But on the other hand, I stood up for myself and said, you may want to treat me like this and you may think I’m a European woman, watch me. But here, what I have done is not a gender issue, what I’ve done to myself is not a gender issue, I don’t think, it’s a personal issue. I’ve, perhaps—I say it’s a personal issue. I don’t think it has to do with gender. Realistically, I should have gone and done a PhD, to do this kind of work and to go even further. I got into a PhD and I never finished it, because it got pregnant and I couldn’t afford to do $6,000 a year in tuition, this was the ‘80s, and have a kid in daycare.

Tacey Ann Rosolowski, PhD:

Right.

Janis Apted Yadiny:

So I had to make a choice, so my choice was my daughter obviously, and then I never went back to finish it, and I do have some regrets around that. I wish I had, but I don’t know. Then you know, it is what it is, I’ve done fine without it, but there’s just a linger wish statement there.

Tacey Ann Rosolowski, PhD:

Sure. Well, you know, and you operate in an environment when those letters after somebody’s name matter. They do matter and no matter how Zen and serene and enlightened you are, I think you have to get really Zen and serene and enlightened in order to get to the point where you are simply not affected by that in your environment, and that it doesn’t have any effect, that other people need to have those letters there in order to give you, you know.

Janis Apted Yadiny:

Right. Right, right.

Tacey Ann Rosolowski, PhD:

That’s pretty hard, so yeah, I get that. I mean, you know, I’ve got those letters after my name and it does make a difference, you know, it does.

Janis Apted Yadiny:

Well, there we are.

Tacey Ann Rosolowski, PhD:

Yeah, I know, so yeah, those funny regrets.

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Chapter 09: Faculty Development: Offering Support in a Stressful Environment

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