It is said that visionaries don’t see what everyone else sees. That they see what others can’t. It takes courage to see what others cannot, and they hold on to that vision no matter what others say or think. This is usually used to describe entrepreneurs. Yet, activists are just the same.

An activist will see an injustice that others cannot see, and they will hold on to this and fight for it regardless of the stakes involved. They will pursue their vision and goal even when they are faced with personal attacks, intimidation, retribution, physical pain, or hunger because their belief is unshakable.

I recently saw an interview with Dr. Marion Mass, who is an advocate for patient protection, in which they asked how she became an activist. She described how she thought of some things she was observing. She said, “Why are you letting this happen? I just can’t let things go…I mean, it’s like, I’m not built that way… I’m like built for justice, and this didn’t seem just because it wasn’t going to help patients.”

It is the vision of being able to see something so clearly that others are too unconscious about, too tired, too scared, too indifferent to take any action for. Yet, an activist and a leader who is a visionary will continue and will not falter despite the toll it takes. And every activist will state that no matter what the personal retribution is, they will do it again because it matters: humans matter. What activists fight for is not a bigger paycheck or a bigger mansion; it’s about equality, humanity, and people.

The stakes are not small when women speak up. Female physicians will be called “insane, needing psychiatric evaluation, conspiracy theorists.” We will be gaslighted and told: “Gender discrimination cannot truly be there,” “This is just a matter of perspective,” “This is how older generations see things,” “It is not that bad,” and “no others have ever spoken about this before you,” etc.

It is no surprise that in academic medicine, a study from the New England Journal of Medicine in 2018 found that less than 10% of women ever report any injustice they experienced. The stakes are high. Women physicians will be burned at the stake twice, just like Joan of Arc was in 1431.

We will fight for the injustice, only to then have our reputation, our credentials, our promotion, and our job stripped away. At the same time, our sanity will be called into question. It is no coincidence that the word “hysterectomy,” or surgical removal of the uterus, which was coined in 1881, comes from the Greek words hysteria or uterus. So that when women were thought of as having hysteria or neurosis, this was due to a problem caused by the womb or uterus. Thus, to fix the dysfunction of the hysteria, a “hysterectomy” had to be performed.

I wonder if these ideas and definitions, which trace back to the Greeks, continue to influence our thoughts. There is an implicit bias that we may not be aware of how our subconscious thoughts are affecting our conscious thoughts, opinions, or actions we have daily. They manifest in all aspects of life. Whether you come to see me for a surgical consultation, and when you walk into the room, you think to yourself, “She is too young to be a doctor, too pretty to be smart, too feminine to be a good surgeon.” Before a word has been uttered by me, you have already decided a narrative in your head. It is instant, unconscious, but it is there. It is just running in the background, like the music in the elevator that brought you to the office. Or like the air conditioner that keeps you cool, but you are not aware of it until you are conscious of the music or too uncomfortable and hot.

This implicit bias will affect how women are judged when we speak up. There are countless examples of courageous women who have stood up for what they believed and paid an unimaginable price. You can Google Dr. Abby Rosenberg and her KevinMD article, “Questions of a canceled whistle-blower.”

Read about the prolonged legal battles in which Dr. Diana Blum spoke up about policies pressuring physicians in Sutter Health to increase productivity or prescribe medications that were possibly inferior and not indicated to save costs. It then used unlawful practices to wrongfully terminate those who disagreed with them. In turn, Sutter Health sued her for $1.3 million in legal fees.

Another example is how The Regents of the University of California were sued, and the verdict awarded $13 million to Dr. Lauren Pinter-Brown at UCLA for disability discrimination claim, which was then moved to a mistrial. Most recently, Dr. Brytney Cobia, an Alabama hospitalist who stated in a local newspaper article how she was sorry, “but it’s too late” to vaccinate those dying of COVID because they had refused a lifesaving vaccine, as 70% of her state is unvaccinated. Her voice brought about intimidation, personal threat to life, being called a “murderer, and many other expletives as her story went viral.

All these women have an unwavering courage despite the toll it takes on them personally, to their families, their patients, and their neighbors. We can take a moment and be grateful for the courage of these visionaries and leaders, and, whether privately or publicly, support them. Injustice is ubiquitous, but our humanity, empathy, and support for each other can be as well.