We have come along way and...

In beginning The local MD I left the gender box blank deciding to avoid the issues of being a woman in medicine. The advantages to being female in medicine are many. For instance in an illness most of us want to be cared for by our mother. The advantages in my specialty of obstetrics and gynecology are also obvious, not only do most woman want their mother when having a baby, they want someone who has had a similar experience and has lived to tell about it.

I never spent time dwelling on discrimination issues when it came to gender. Recently when interviewed by a medical publication, I was ask, "What has been the most difficult aspect of being a woman and practicing medicine?" I didn't even have to think about it. "Finding nice looking comfortable shoes." was my instant reply.

On July 1 it will be thirty years since I matriculated at Well Known College of Medicine . I was not one of the ground breakers since women had been in almost every medical school class for well over fifty years. Yet the women numbered only twenty seven in a class of 168. All but one of us graduated four years later. I have no idea how many are still practicing.

I never found it difficult being female in medical school. If anything because women stood out a bit more than most of the men we seemed to have more opportunities. The surgeons I worked with wrote me wonderful recommendations but only after finding out that I was entering what was considered an acceptable specialty for women. For my friend who wanted to pursue cardiothorasic surgery the attitude was different.

Having done reasonably well in medical school, I chose a residency where there was a great deal of competition for positions. The program that I ranked number one on my match list had a special history. Only five women had finished the program in more than forty years. Two of the last four females this program accepted left after the first year. When I interviewed with the program director he asked me two questions: "Is your husband willing to move to this city and when do you plan on starting your family?" Rather than file a lawsuit, I quietly answered that my husband was ecstatic at the prospects of moving and we really wanted to wait until after my residency to have children. The truth was that my husband would have to give up his job to move. Finding new employment would be difficult in the economic down turn the area was experiencing and we could not even afford to thing about having kids.

I was awarded a residency spot and spent the next four years as the only woman in a program with eleven men. In the end I was one of the guys. It is funny now that I look back on those years and realize that I did learn to think like the men. I also became very good friends with many of the nurses and the few female attending physicians, most of whom were anesthesiologists and pediatricians, who were on the hospital staff.

When I finished my residency, I joined a group of physicians, all men of course, at Big Name Medical Center. Practicing medicine with them went smoothly until my first child was born. Strange as it now sounds, that was really the first concession I made to my gender. I never guessed motherhood would become such an important part of who I am. I only planned to take three weeks off after N was born. I did return to work after three weeks bringing N to the office with me as I arranged my schedule to breast feed while hiring an additional person to care for him as I saw patients.

When my second child, B, was born, I realized the envy that my situation produced among my partners. One of the younger partners, who had children and a stay home wife, told several of my patients that I was trying to "have my cake and eat it too" as if working and motherhood should be incompatible. I was taking six weeks of unpaid leave to "have it all". I did not have it all but I was getting the best portion. Proof of that fact was a conversation my partner had with his young son one morning. Asked why he had to go to work all the time, my partner replied, "That is what Daddies do. Mommies stay home." "No!" His son replied, "When I grow up I will stay home with my kids and my wife can go to work!"

My time off was not only for recovery from childbirth. My mother was diagnosed with lung cancer one week before B was born. As an only child I became her primary caregiver too. She had surgery and then began radiation therapy. My only solace during this time was the chance to be a mother myself nursing my newborn and playing with my two year old.

Yes, I took six weeks off to have my baby and help my mother, but the partner who complained the loudest fractured his leg snow skiing. He was in a wheel chair and then on crutches for twelve weeks. During this time I took all of his call. The other partner had a rotator cuff injury (also skiing) and could not lift his right hand for several weeks. I preformed all of his surgeries and many of his deliveries for six weeks without compensation.

I am not sure to this day why I did these things but doing them felt much like caring for my children and my mother. These were tasks that needed to be done. I was the junior partner in the group so I did them. One gynecologist outside our group asked me, "How difficult is it to be 'the boy' when you are a girl?" If ask that now, I would reply, "I am not 'the boy.' I am simply doing what needs to be done." I was the caretaker of my immediate family and of the family made up of those with whom I practiced medicine.

While much has changed in medicine, there is still a huge gap in salaries between men and women. I believe this is due to differences in practice patterns. I limit the number of surgeries that I will do on any given day. I am no good after a certain number of hours in the operating room. It has been shown in several studies that women spend more time with each patient than our male colleagues. I believe that I and my female colleagues ask and answer many more questions when seeing patients. We are not as procedure oriented and try to fix more with medication or life style changes.

I could go on but I think the point is that men and women do things differently. There is not a right way and a wrong way, a good way and a bad way. There are just different ways. As I watch patients and friends who are in other professions I see that we all struggle with this gender diversity. I also see that because the population is made up of men and women, women and men are needed in all professions.

After all I am raising sons. I want them to enjoy meaningful work, to have an adequate income and to be able to send time with their families. I feel that women have come a long way and I hope that men feel they have come a long way also.