Fear, they say, has an object, whereas anxiety floats more freely, attaching to nothing in particular, or to everything. The two roles that have stirred in me the most fear and anxiety are that of doctor and that of mother. The latter is made worse, no doubt, by being a mother who is a doctor: being constantly confronted with real-life examples of the terrible things that actually can happen. I was unable to watch my twin daughters on playground swings when they were toddlers as it made me sick with fear. I’d get their father to supervise, then crouch somewhere and wait. I heard of an emergency physician who made his kids wear crash helmets in the playground. But that wouldn’t protect their tiny necks, would it? And now, what’s a swing compared with the mangling car crash that is female adolescence in this world? Those headlines, the abuse, glass ceilings, primping, plastics and porn. How to protect them and still let them play? How to arm them, internally?

On a plane a few months ago, the guy-in-a-suit next to me splayed his Australian newspaper wide open such that half the paper (and his fist) curtained the front of my face, while the bottom edge of the paper stroked my thigh. I turned and stared at him. But he just kept on importantly reading his important newspaper, in his space and mine. I cleared my throat. I wriggled. Coined unspoken protests. I could have politely said, “Excuse me?” I could have gently nudged the fist-paper-package over to his side of the plane. I didn’t. I assumed his manoeuvre was purposeful – him staking a claim – and it made me feel small and later enraged, at him and at myself. It was a trivial event, but I thought a lot about my reaction. What the hell was I afraid of? An imaginary patriarchy?

I’ve been punched in the face, called a filthy slut, a cunt, a moll, a dog. I’ve been groped and cat-called and propositioned. I’ve had a guy scream that I should watch him “cum all over the floor” as he aimed his stream of piss at me. All the perpetrators were patients under my care, out of their minds with delirium, dementia or psychosis; drug-addled, tumour-riddled or dying. I took no offence. I was not harmed (the puncher was an 85-year-old, very frail woman). I have only rarely feared for my physical safety at work. In clinical situations, the kinds of abuse that are sound-minded, premeditated and purposeful are usually perpetrated by doctors (a minority of doctors) against their patients or against their staff. Which is unsurprising, given it’s the doctors who are generally in the position of power.

What would you do if you could get away with it, if you could ignore all the rules and suffer no consequences? What pleasures would you indulge, what shortcuts would you take, what part of the social contract would you ignore? What would you ask for if you knew no one would ever say no?

At a literary festival some years ago, Bret Easton Ellis commented that people would do anything to get a part in a movie. He paused, looked us one by one in the eye and said, “Anything.” I wonder what it must be like to be an A-grade celebrity or head of state or boss of some giant corporation. To be surrounded by admirers, flatterers, assistants, dependants. To be always met by applause, agreement and cheer, as if the entire world were your cartoon wife, smoothing her skirt, fixing her smile, quietening the kids and filling your glass at the sound of your car in the driveway.

They say every country, every town, every institution, every workplace, every home has its own unspoken caste system. For a minute, an hour, or days on end we’ll inhabit a small universe with its particular power structures and then bounce out into another. In some we are powerful, in some we are at risk. One minute you’re a CEO and the next you’re half-naked on a stretcher being allocated a medical record number and triaged into a vast emergency room, whimpering. Competent mother to squashed on a bus to end of the queue at Centrelink.

It’s been many years since I’ve been in a situation in which getting the sack from a place of work would render me destitute. So, for now, I’m protected from whatever combination of desire, fear or need would compel me to do “anything”. I recognise that such a position is privileged. I also have power over others – my patients, my juniors, my children. It’s not absolute, and neither is it simple or all one-way. It’s a huge responsibility, given that I care for their wellbeing. And I invite them – patient, registrar, child – to question, to disagree, discuss, decline. Part of my job as the “powerful” one is to empower my charges. Speak up. I’m listening. You won’t wound my ego. Nothing’s off the table. What a thrill it is to help a girl find and use her voice. Teaching those who can to speak up. Allowing them to.

Yesterday, one of my daughters was in a fit of rage over “feminine hygiene products”. She hasn’t started menstruating yet, but she’d just heard (on YouTube) that tampons are taxed as a luxury item. “Tampons!” she said, her eyes bulging, hands on her hips. “Extravagant, indulgent, bloody tampons are a luxury item?” She paused and looked me in the eye, “So. Fucking. Sexist.” And I was like: Right on, daughter.

Karen Hitchcock

Karen Hitchcock is a doctor and writer. She is the author of a collection of short fiction, Little White Slips, and the Quarterly Essay ‘Dear Life: On Caring for the Elderly’.