Saturday, August 15, 2015

#ILookLikeASurgeon: An Ally's Perspective

By: Nancy Ho, PhD, RN, NP-C
@NancyHoPhD

Although I am not a surgeon myself, I work closely with surgical residents on a surgical team. Thus, I have an idea of what the life of a surgeon looks like. This post is for those who want to be both surgeons and mothers. It’s also a post for those who want to support these amazing women. I don’t actually live the life and cannot truly understand. This is just the perspective of an ally. I wake up as early as they do, 4:30 am in order to be at the hospital by 5:30am to review charts and start rounding by 6am, but I only work half as much as they do. I can only imagine how hard it is.

I see the tough life decisions that come up and the sacrifices that people make to pursue their dreams of one day becoming a surgeon, and not just any surgeon, a female surgeon in a historically predominantly male profession. I watch women decline being a bridesmaid in a dear friend’s wedding, since she doesn’t know if she’ll have that weekend off. Attending the bridal shower and bachelorette party is not even an option, because that would just be too much time off. I see the internal struggles as family members, especially mothers, grandmothers, and aunties, nag female residents about getting married. She barely has enough time to eat, sleep, and shower. Getting out on the dating scene, with the hopes of finding a man who is not scared off by the fact that she is a well-accomplished woman, is a daunting task to incorporate into an already overbooked schedule.

I also see these women struggle as they try to fulfill their duties as a resident (80 hours a week, while rotating on nights, working 12 or 19 days in a row), while also being 8-9 months pregnant; that’s if they don’t go into pre-term labor. Meanwhile, their fellow colleagues frown upon the fact that she is pregnant during residency. Others intentionally take time off of residency completely, or disappear into the lab for several years, in order to add children to their family. People do this because as they get further in their training, they are also getting older and that dreaded biological clock just keeps on ticking.

But then what about parenting? Female residents generally do not get 3 months off for maternity leave. They get 4-6 weeks off, IF they are lucky. That leaves other people doing the childcare. This could be spouses, parents, in laws, and sometimes even family members living several states away. For those who can afford it, daycare and/or nannies are other possibilities. The price for this, however, is they go days to weeks without seeing their baby. They struggle with their identity as a mother since their baby doesn’t seem to recognize them or their four-year old cries for the nanny after they bruised their shin. This is just a small snap shot of what I see as I walk along side them through their training, while also building friendships along the way.

I’m pretty sure no one told them that these are the sacrifices that are necessary to survive in this field. We encourage our young women to aim high, but we never talk about the hardship and sacrifice that is to come. By the time one realizes it, it’s often too late to jump off the train. One oral and maxillofacial surgery resident said it best. Keep in mind that these surgeons not only go through medical school, but they also go through dental school. She said there are only a handful of jobs that will ever allow her to pay off her student loans. In a sense, she is now stuck on the surgeon train unless she is willing to commit financial suicide. It’s a tough predicament to be in. (Our society believes that student loan debt is good debt and thus, it’s okay to have a lot of it. I’d like to challenge that idea, but that’s another topic in and of itself.)

In terms of the big picture, I see two main solutions:

1)   Change the surgery culture.
2)   Be wise in who you choose to partner up with (AKA marry).

Changing the culture in surgery is going to take time. Since I’m not a surgeon, I don’t have a say in how to change surgery culture specifically, but I can speak to how we can change work culture in general. We should start by granting men paternity leave that is equal to maternity leave. This is not a new idea and a handful of companies in the United States are already doing this. If men and women both take similar amounts of time off from work, it levels out the playing field. We fear that women of child-bearing age will disappear once she has children. If men of child-bearing age (which is actually a much longer span of time) took the same amount of time off of work, it becomes less of an issue. Also, when men take paternity leave and participate in childcare early on, it sets the stage for the other 17+years of parenting. Men and women would be true partners in the parenting process. With men being just as involved as women, children may end up asking for their fathers just as much as their mothers. Additionally, either party will be just as effective in consoling a crying child. Granting men paternity leave, that is equal to maternity leave, is one huge step in the right direction.

Currently, what I see happening most is the second solution, mainly because it is going to take time for the culture to change. My word choice of “partner” in life is purposeful. These marriages really are partnerships. They do what works and do not ascribe to traditional gender roles. They take turns making career sacrifices and it’s never assumed that the woman stays at home to care for the children. Their marriages are strong and their spouses are either doing the majority of the childcare/housework or willing to outsource these things. Some will live simply on the surgery resident’s salary (I don’t know how, but I see them do it) and the spouse will stay at home to raise the kid(s). Others have a spouse who also works and they hire help. Even in these non-traditional marriages, every now and then, I still see a double standard pop up. Most people know that residents’ schedules are demanding and they will spend more time at work than they are at home. However, when the female resident is home, we sometimes expect her to contribute more at home than a male resident in the same situation. We need to watch out for this double standard, and we need to be aware of when it is self-imposed.


In the end, what they have going is not typical but necessary. The process often times feels lonely because few are talking about it. I see them come through, one at a time, and I hear their stories. At the same time, I wonder if they know each other’s stories. I’m glad there is a community of women surgeons out there supporting each other. It’s time to talk about these things. The time is now. For all those women out there doing it and living it, know that I am an ally and I support you. You are some of the most intelligent, strong, and inspirational women that I know. Hats off to you! #ILookLikeASurgeon

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