BY DR. KAREN ADLER, MMS WOMEN’S PHYSICIAN SECTION CHAIR
Dr. Karen Adler
It started with a piñata.
I was six years old at my first drop-off birthday party. Before leaving me, my mother carefully reviewed her expectations: Use good manners, thank the hosts, wait my turn, and put others before myself.
Everything went smoothly until we gathered around a colorful papier-mâché donkey hanging from a tree in the sunlit backyard. After several blindfolded children struck it with a bat, the donkey burst open and candy spilled onto the grass. The other children
ran, pushed, and scrambled for it. I politely stepped aside to give them room and waited for my turn.
Eventually, the birthday girl’s mother noticed me standing there. When I explained that the other children seemed to be taking a long time with their turns, she gave me a gentle shove forward.
“No, honey. You just jump in and grab what you want.”
By then, only a few lollipops and Tootsie Rolls remained. I was disappointed and confused. I had followed all my mother’s rules, yet apparently missed another rule everyone else understood.
For much of my life, leadership seemed like a version of that piñata scramble: confidently pushing forward and claiming what you wanted. I pictured leaders as bold, decisive people, comfortable competing for influence and occupying the center of the room.
Because I did not recognize myself in that image, I assumed leadership belonged to others.
I preferred listening to different perspectives, sharing my own, and working collaboratively to create something better than any of us could have imagined alone.
It took me years to understand that these qualities could also be forms of leadership.
My perspective began to shift through my clinical and teaching roles. I discovered that I was often moved to act decisively when advocating for someone whose needs might otherwise go unmet: a patient whose experience was misunderstood, a trainee who needed
support, or a colleague whose voice was being ignored or suppressed.
During my intern year, I cared for a patient hospitalized for multiple falls and weakness. The admitting resident attributed her symptoms to her eating disorder and recommended same-day discharge after rehydration with IV fluids. However, her head CT
from the emergency department referenced progression of white matter disease compared with prior imaging. Concerned that her psychiatric diagnosis might have led previous clinicians to overlook a neurological disorder, I reviewed her records and discovered
a prior brain MRI with white matter abnormalities consistent with multiple sclerosis.
When I spoke with her outpatient physician, he told me he had attributed the MRI findings to “nutritional deficiencies.” The inpatient team subsequently helped obtain a more complete diagnostic workup and connect her with outpatient neurology.
Later, during my first year out of residency, I attended a weekly multidisciplinary team meeting. Our director, a world-renowned senior psychiatrist, was critcizing a female psychologist for the “terrible treatment plan” he blamed for her patient’s recent
decompensation. Everyone else in the room was staring at their toes.
I tactfully reminded him that he had been the architect of that plan.
The tension broke, and the clinicians were able to focus on determining the next steps for patient care.
Speaking up, I realized, was itself a form of leadership.
My experience within the Massachusetts Medical Society’s Women’s Physician Section (WPS) brought that understanding into sharper focus. Because the section exists to improve the experience of women physicians, mentorship and sponsorship are embedded in
how the Governing Council operates. Senior members share institutional knowledge and encourage newer members to try unfamiliar roles. Leadership is cultivated, nurtured, and shared.
This June marked the beginning of my final year on the WPS, and I am honored to serve as chair. I look forward to working with Vice Chair Dr. Diane Shannon and our dedicated colleagues to better understand and meet the needs of our members.
It is largely because of the mentorship and encouragement I have received from my WPS colleagues that I find myself leading these efforts. Despite being hardworking and accomplished, I spent most of my life believing I was not “leadership material.”
My journey has not required adopting a more authoritative persona. It has required expanding my definition of leadership to recognize qualities I already possessed: listening closely, developing ideas collaboratively, following through, making complexity
understandable, and speaking when someone’s needs might otherwise be overlooked.
As Chair, I hope to help create for others what WPS created for me. Many potential leaders are already doing the work of leadership without calling it that. They may not need to become better at pushing to the front or grabbing what they want. They may
need a community that notices their contributions, shares the knowledge they need, gives them visible credit, and invites them to lead.
Perhaps leadership is not always about grabbing the most candy when the piñata breaks.
Sometimes it is about noticing who has been left standing at the edge of the circle and making sure there is room for them to step forward.
