“The ideal surgeon should have the eye of an eagle,
the heart of a lion and
the hands of a woman.”
15th century English proverb
Women now make up 51% of western medical school trainees, yet we are greatly under-represented in specialties, particularly surgery.
Many male doctors feel that women should not be surgeons and that if they are, they somehow have a right to treat them as less than the men.
Stories of abuse, discrimination and harassment have come to light in recent years and women surgeons have come forward (anonymously) and said things such as this:
“They tolerate female general surgeons in small numbers, as long as they are single, childless and pretend to be men.”
“I was told when I was an intern that there are only two types of women surgeons: women who shouldn’t be surgeons and surgeons who shouldn’t be women.” (1)
What is it about the culture of medicine and surgery that allows these attitudes to prevail?
It is all too easy to say that women work fewer hours, that we take time off to have families etc., but that is certainly not true for all of us. And even if it were, does that mean we are not equally capable of being surgeons while we are at work?
Surgery can be a demanding profession. There are differences between the specialties, but in general, it requires focus, commitment, dedication, attention to detail, an ability to think quickly and respond to what is actually happening, not what you would like to happen, and sometimes stamina and endurance.
The human body is a strong but delicate creation and the more gentle we are with the tissues, the more quickly we recover and heal. A delicate touch is an asset in a surgeon. Rarely is the brute strength of which not all women are capable required.
And surgery is not just about technical operating skills – there is an art to the craft. The craft is exacting and precise, and learning the technical skills and how to use them is a huge part of the training, but there is an art to this craft, which is the true mastery of surgery, of knowing if and when to operate, not just what to do, which means connecting with and having a deep care for people.
All of these qualities and abilities are found in women, just as well as in men.
The ‘old boys club’ nature of surgery, with its ridiculous work hours and punishing conditions, is no longer necessary, if it ever was. Plenty of doctors would like to be surgeons; there is no shortage and no need to limit the numbers so that each surgeon is overworked and overburdened. If those in positions of power were willing to release their stranglehold on training positions, open them up and increase the numbers of trainees, it would be possible to job share, work fewer hours per week, take time off for sick leave and child care, have holidays, and generally have a life, as well as being a surgeon.
Other professions have reasonable training and working conditions that understand that people cannot learn effectively and work safely when they are fatigued…what makes us so special?
The argument that we need to work long hours because the patients we operate on require continuity of care seems sound at one level, but really, makes little sense. Even when we work for days and weeks at a time, we hand over to someone else eventually, so why can we not develop systems where we hand over every day? The important thing is that we communicate clearly what is going on with each other, so that all the information we have is made available to the person taking over the care of our patients. And if more theatre time is needed, we could develop shifts of work like other fields, rather than working long shifts ourselves on a regular basis.
If we were actually paid for all the overtime we did, hospital bureaucracies would realise it would be cheaper to employ more people at normal rates of pay, countering the cost reasons that are given for why they don’t. And a tired surgeon becomes less efficient, takes longer and makes more mistakes…none of which are cost-effective, in the long run.
If it were possible to be a surgeon and also have a life, many more women would choose to be surgeons… deciding not to do surgery is often a lifestyle decision, rather than the fact that we are not drawn to it as a career.
I am a surgeon and I also have a life. Having been trained in the ‘old school’ way and subsequently having made a decision to live in a balanced healthy way myself, that is more loving and caring of me and therefore of everyone else, I can certainly vouch for the greater quality I bring to my surgery, and to my everyday patient care now, as well as to my family and friends.
Perhaps if we were willing to put things in perspective, restore balance (and simple common sense) to our training programmes and working hours, and allow surgeons to have families and lives that included medicine but were not exclusively medicine, we would all benefit from this.
Men too would love to spend time with their families and friends, explore other interests, take time off when their kids were born, see them grow up, and live as surgeons who are also human beings.
Men too are delicate, tender, sensitive beings who love people and life, but surgical training tends to us ask to leave all this behind us in the pursuit of our profession.
Women bring a deep care to the profession, a sense of balance and perspective, and a delicate feminine touch. We feminise and humanise what has become a very male, driven and hardened profession. The more women surgeons we have, the more likely we are to become a profession of people who live balanced and healthy lives and practise the noble art of surgery, for the great benefit of our patients, our families and friends, and ourselves.