Reflections on being awarded tenure as a woman with kids and a disability / chronic illness

Written by Holly Witteman 

We have kindly been given permission to reproduce this from Holly's blog, where you can read the full article.

There is no universal experience. In my individual experience, a good partner can make the ‘with kids’ part much easier but the ‘and a disability / chronic illness’ part remains tough. Support helps, but no one else can ever do the daily, relentless work of keeping myself alive in a world and career that isn’t always well-structured for staying healthy. The things that have worked well for me have been: (1) being flexible geographically, even at a cost to my family, (2) being extra disciplined about working hard whenever I can to balance out the times when I can’t, (3) using a calendar, not a To Do list, for planning my work, (4) writing constantly, and (5) having full drafts of grants ready 6-8 weeks ahead of deadline for rounds of pre-submission review. It also gives me hope for the future of science and research to (6) use my position to work to improve the system so that research and researchers don’t continue to be held back by barriers that have nothing to do with the quality of one’s work. This effort may or may not help me, but I am determined that it will help others. I am glad not to be alone in these efforts, and I invite anyone who isn’t already involved in such efforts to join in. Especially if you are an academic in Canada, please read this book.

In November, my application for tenure and promotion was approved. June 1, my rank went from Assistant Professor (professeure adjointe at my French-speaking institution) to Associate Professor (professeure agrégée), a bigger deal than I ever understood before I became a professor. This means that the university at which I am a professor has more of a commitment to me, and I to it. I will still be reviewed annually and need to continue to work hard, especially if I want to continue doing work that is funded by competitive grants, but this provides a higher level of job security than I had before. It means, essentially, that I cannot be fired without cause.

It has been a long road to get here, and the road doesn’t end here. My colleague Dr. Brian Zikmund-Fisher once told me, “Getting tenure is like winning a pie-eating contest in which the prize is more pie.” I have already found this to be true. But it’s a good time to take stock.

I originally started writing this for myself. I write for myself a lot. It is how I sort through my thoughts. In this case, those thoughts were about how I got here, what has gone well for me that I should keep doing, what has gone less well for me that I should stop doing, and what else I can do to help improve the system. I read something recently that really resonated with me and so I decided to share this post in case any of what I’ve written might be helpful to others, especially any others like me. (Those others will have to be people who can make it through many, many paragraphs. Scroll down towards the bottom if you just want my list of things that have helped me.)

I have two kids and have spent nearly all my life living with type 1 diabetes, a time-consuming autoimmune chronic illness classed as a disability. My kids are 10 and 5 years old. My diabetes is 34 years old. It took me quite a few of those 34 years to identify as disabled, a period of time I now recognize as being marked by my own internalized ableism that took some time to address, a growing awareness of how much I still have to learn about other forms of disability, and fear. When I say internalized ableism, put plainly, I mean that didn’t want to identify as disabled because I saw it as a negative attribute rather than just an attribute. It took me a while to deal with that. My fear comes from being afraid of having my ability to do my work impeded by ableism. I’m having a very successful career so far. I’m thrilled to be able to do research that I hope will help many people. I love doing the work I do. I love solving problems, answering research questions, and being able to support trainees in their paths toward their career goals. I don’t want that to stop for any reason, but I especially don’t want it to stop because people who have power over my career may be prejudiced.

My fears are well-founded. Academia is a competitive, reputation-based business, reputation is determined by people, people shape and are shaped by fundamentally unequal social structures, and many people also have individual biases. Individual biases may be conscious or unconscious, against groups of others or against groups of which we are members. There are many randomized controlled trials and well-analyzed observational studies in which the data support what people from underrepresented groups have long said: when you are a member of one of these groups, you have to be extra good to get an even chance. (For those who are curious, here is an excellent annotated bibliography on gender bias and other biases in academia. I also linked to a number of studies in this editorial and you may also wish to use search engines and academic databases just like you would for any other academic topic.) 

The effects of four such biases in academic research in Canada are most easily apparent in statistics for the Canada Research Chairs program, a prestigious salary award program that was required to set targets for equity after a court settlement. Canada Research Chairs pay whole salaries or portions of salaries of professors and thus, are used as recruiting tools and/or budget line adjustment tools by universities. It’s up to each university to nominate people for the chairs they have been allocated. They may nominate professors already appointed or they may recruit new professors.  

The idea of having these targets is to help ensure that known biases in academia don’t prevent qualified candidates from being nominated. These targets are achievable, not aspirational. They reflect realistic, even low, proportions within the available pool of candidates in academia. All of the targets are well under than the associated proportions in the general population. In Canada, including Indigenous nations, women represent 50% of the population, visible minorities (a Canadian term for people of colour) represent 22%, Indigenous peoples represent 4.6%, and disabled people represent about 14% of the population aged 15 years or older. For context, in the US, 19% of the population have a disability. In Australia the figure is 18%. In France, the statistic is 18%, with 80% of those being invisible. In the UK, 16% of working aged adults are disabled. Countries don’t all have the exact same definitions of disability but it’s clear that in all countries, there are a lot of people who face different kinds of barriers.

The fact that the Canada Research Chairs program isn’t achieving easy targets suggests strongly that the nominations processes as a whole are unfortunately biased, most likely in subtle ways that may be hard to identify in any single decision. This means we, as a group, are likely failing to hire and/or nominate excellent candidates. Data below are from the Canada Research Chairs’ Program Statistics, using their nomenclature. They only report single categories, no combinations. In other words, as Dr. Malinda Smith notes, there is no intersectional presentation. In statistical terms, this is like looking at main effects but not interactions, even though you know that interactions are likely to matter.

Canadian universities have had trouble with all four targets but they failed most spectacularly in nominating disabled people, so much so that the target was lowered. Among the people I know in academia in Canada who advocate for leveling the playing field for everyone, they often bring up issues of sexism, sometimes racism, sometimes colonialism, but rarely ableism. (There are also other dimensions that get less attention in academia; e.g., gender identity, sexual orientation, socio-economic background, and others.)

About the Author

Holly Witteman, PhD, is an Associate Professor in the Department of Family & Emergency Medicine, Université Laval (Laval University), Quebec City, Canada. Quebec City is unceded traditional territory of the Abenaki and Wabenaki Confederacy and the Wolastoqiyik (Maliseet) people. Dr. Witteman directs the research unit within the Faculty of Medicine’s Office of Education and Professional Development. She is also a scientist at the Research Centre of the CHU de Québec-Université Laval, at the new Institute of Primary Care Research affiliated with Laval University, and an Affiliate Investigator at the Ottawa Hospital Research Institute, Ottawa, Canada, unceded traditional Algonquin territory. With an interdisciplinary background in human factors engineering, human-computer interaction, and decision sciences, her research is about the design and evaluation of digital and other media in health decision making. She specializes in human-computer interaction in health education, risk communication and decision making, including design methods to support broad, inclusive user-centredness and patient-centeredness. Her work as Principal Investigator has been funded by the Fonds de recherche du Québec – Santé (FRQS), the Patient-Centered Outcomes Research Institute (PCORI, United States), the Canada Foundation for Innovation (CFI), and the Canadian Institutes of Health Research (CIHR).

Taking medical Leave: What I would tell myself now

Written by Stephanie

Let me start by saying I have no professional qualifications whatsoever to give anyone advice as to making a decision about taking medical leave. So I won’t. What I will do is tell you what I would have told myself when I was faced with this very decision in my own career, not so long ago.

First, here’s the brief backstory of how I found myself at the point of medical leave.

I was in the second year of my PhD. Anyone from the outside looking in would have said things were going very well. I had completed and passed my qualifying exam (called various things in different country contexts, but essentially the big exam in which you defend your research proposal). This meant I had the green light to go ahead and actually start doing the research I planned for so long and was excited about. I had publications in the works and a slew of upcoming conferences. I was working as a teaching assistant for a course on a subject matter I loved.

But one morning a disastrous thought floated through my head and it was downhill from there. I didn’t know what was happening at the time, but later was diagnosed with obsessive-compulsive disorder, or OCD. You can read more about my experience here: https://thesecretillness.com/2015/09/01/stephanie-33-ontario-canada/. All this to say, I reached a point where I was pretty much debilitated, but I was actually able to keep up with work (for a while), and even still do it well. I think that’s one of our best guises in academia—we can keep up appearances and sustain unhealthy practices dressed up as success—but that’s another story. I probably could have kept plugging away like this, miserably, for some time. But I realized that if I were to actually get better, I needed to dedicate my attention and energy to treatment. Treatment alone needed to be my priority. This could not happen in the (off)balance of my PhD life. Of course, knowing what you need to do and actually doing it are two different things and I wrestled with the decision to a medical leave of absence from my PhD program. In the end I took a 4-month leave and it was the best decision of my life.

Looking back now, here are a few things I would have told myself at that difficult moment in time that might have eased my angst about taking the leap into medical leave.

If you can’t be happy and healthy enough to enjoy your professional success, it’s just not worth it.

Sure, in academia there are tough moments when we all grin and bear it and our work-life balance may get temporarily out of whack. But that’s not what I’m talking about here. When I was in the deepest, darkest grips of my OCD, I received the incredible news that I had been awarded an extremely competitive multi-year federal doctoral research award. This was something I had worked so hard for. This was an achievement that could not only step up my career trajectory, but it would make my life so much easier for the next few years. My funding was secure. No more applying for grants and the award included money for research expenses, meaning no more conferences out of my own pocket! When I got this news, I should have been jumping for joy. Instead, it was like…thud. In fact, it almost made me feel worse. I felt like I didn’t deserve it. I was so consumed by the doom of my OCD fears I could not even enjoy and savour this moment of success. And we all know that these can be few and far between in academia! That’s when I knew how far gone I was—that I couldn’t take pleasure in an accomplishment that I had worked so hard for and that was so important to me. It was at that point that I knew I could not continue to just push ahead in my PhD. I had to get well again or there was no point in continuing. If I couldn’t take pleasure in such an achievement, what was I doing in this PhD?

Things can and will wait.

Academic timelines are brutal. Often everything has a sense of urgency. We are an overworked bunch, for sure. The truth is 4 months, 1 year, whatever it is, will not make that much of a difference, if any, in the long run and the investment in your health will pay off with much greater returns. Yes, I’m scheduled now to finish my PhD 4 months later than I would have if I had been healthy. But the reality for me is that if I hadn’t taken leave for treatment I may not have finished at all and now that I am back to work, I can tell you that the leave did not have a significant impact on my trajectory. There were no critical opportunities in that time that I missed out on—even if there were, I know there would have been others in the future. All of the publications I had in the works still made their way out the door. My career went on.

Medical leave is not time off.

As academics we are notorious for not giving ourselves a break, and when we do we’re often ridden with guilt that we should be working but it is important to remember that medical leave is not time off. It is not a break. Medical leave has an objective—and that is to improve and attend to your health, whatever your needs may be. For me, it provided me the dedicated time I needed to focus on treatment. I was finally able to see a psychiatrist for assessment and diagnosis. I had the time I needed to read and educate myself about my condition. And the kind of treatment I underwent (ironically!) had plenty of homework. Whether your condition is physical or psychological, it is important to remember that the purpose of medical leave is to get better. And that is not something we should allow ourselves feel guilty about!

Don’t half-ass it.

For a time, I toyed with the idea of not taking a formal leave of absence and just sort of “taking it easy” over the summer. But thankfully a wise mentor said to me, “I know you, and you won’t stop working or feel like you should be working if you don’t take a formal leave” and she was right. I can see now that I would not have properly prioritized my treatment if I didn’t make it formal. Maybe this is also a by-product of our academic formalities and habit self-induced guilt—formalizing my leave gave it the legitimacy I needed to allow myself to prioritize it. As an academic I was so used to giving 110% to everything, but I almost thought about giving myself a half-assed leave!

Don’t let the red tape scare you.

There is paperwork but it is doable and you might have to be your own advocate to navigate some of it or perhaps you have a supervisor or partner who can help. In my case, I did have to do some manoeuvring through the bureaucracy, and this was not without some stress and uncertainty. For example, my university initially told me they would withhold my funding during my leave. But I reviewed the policies of the funding agency granting my scholarship and learned they actually had policy for paid medical leave, which superseded my university’s policy. I then had to present this information back to my university. I also had to request leave both from my university and from the granting agency. In the end, it all got sorted out and my university was actually very supportive, which I give them a lot of credit for. All this to say, don’t let any red tape deter you. It’s just part and parcel of the ridiculousness of some university bureaucracies. And as academics we’re used to that.

It’s nobody’s business if you don’t want it to be.

Yes, you need to communicate with your supervisor and the appropriate administration. But actually, very few people need to know, if at all, that you are taking medical leave. And really no one other than probably one high-level administrator who actually receives the confidential note from your doctor needs to know the reason for your leave. I was very open with some people about my leave, and didn’t even bother telling others. You should not feel pressure to disclose anything you’re not comfortable with.

***

I can tell you in no uncertain terms now that if I didn’t take leave and treat my OCD I may have left academia altogether. This realization helped me to cement a new-found commitment to put my wellness first. Everything else stems from that. I’m pleased to say that having returned to my PhD post-treatment, I’ve been able to more than simply re-connect with the passion for my research that brought me there in the first place—I’ve been able to experience what it’s like to be healthy AND pursue a PhD I’m passionate about. That’s a powerful combination. I have more passion to go around. I take pleasure in discovery. And I even enjoy some of my successes. I now engage with my career on my terms. And those terms prioritize my OCD recovery and living well.

About me

Stephanie is a PhD Candidate at a University in Ontario.