When I was 8 years old, I remember Dr Victor Chang appearing on my TV screen showing how he was going to make the world’s first artificial heart. I was mesmerised. This man was going to change everything and it was just so incredible.
My Year-3 teacher asked us to write in our daily journal what we wanted to be when we grew up. Some kids chose ballerinas, astronauts, mummies or police officers. I wrote that I wanted to be a heart surgeon and finish the work of Dr Victor Chang.
To my 8-year-old brain, the fact that I was female was not an issue. I could do that, or indeed, any number of jobs and gender just didn’t rate a mention. I had two parents who were raising a young woman who believed that gender equality was just the way things were.
It wasn’t until I was older, when I started to hear things like “you’re pretty smart, for a girl” or that girls can’t be doctors, let alone surgeons, that I even realised that this was an issue. And when I truly declared my desire to become a surgeon, the opposition was pretty common. Now, having completed my specialist training, it has become a mix of surprise, humble pie but a lot of support and pride.
The past week a whirlwind of attention has been thrust upon women like me. Dr Gabrielle McMullin sparked controversy by saying that women in surgery would be better off accepting the sexual advances of surgeons they are training under than to complain, or risk irreparable damage to their career. The ensuing discussion has been everywhere, in the news, on social media and in our hospitals. It has been a hot topic of conversation in theatre. Particularly, if you are a woman in surgery, everyone wants to know your take on ‘blow-job-gate’. Excuse the language.
My phone has rung hot with emails, phone calls and social media feeds. I felt compelled to write a blog post about it, as the dust settled and I contemplated my own thoughts and feelings on bullying and harassment in surgery.
Dr McMullin’s opinions have been divisive, even amongst doctors, but she has started a real conversation and I am thankful for that. The overwhelming opinion is that yes bullying and harassment is a problem. And, no, doctors do not feel safe speaking up about the abuse they have seen or experienced.
We are scared. Very scared. Because even if the processes are followed, there are far too many stories or first-hand experiences of overt or covert retribution. As I’ve talked to friends and colleagues about all of this, it became sadly evident that we have all experienced or seen bullying in the workplace. Having been on the receiving end of it, I can vouch that it is destructive, both personally and professionally.
I have said, all along, that I will not make a formal complaint. Unfortunately, that still holds true. I am sincerely concerned as to the repercussions on myself and my career that I simply cannot. It’s a sad fact and something I will have to make my peace with.
A lot of women have the added bonus of sexually-based or gender-based harassment or discrimination. A lot of people are very interested as to whether they’re going to have children and whether that will make them a sub-optimal surgeon. They are scrutinised for their appearance and outfits.
They’re told to be careful about how they dress – don’t be too sexy or feminine. They are seemingly harmless jokes or comments, but they count. I used to want to be an orthopaedic surgeon but heard repeatedly that I was too little and weak to do that as a job. I once had an overseas doctor visiting say to me “It is ridiculous that you are a heart surgeon, you should do something more appropriate for women like endocrinology”. What an insensitive comment to make. I cannot respond to things like that with anything other than disgust.
There is a commonly quoted philosophy about being a woman in surgery. You start on the back foot by being born with two X chromosomes, therefore, you have to work harder than the men. You have to better, perfect, at everything. You have to be good humoured about the odd blue joke in theatre, carefully picking your battles as to when to be modestly offended and when to laugh it off. And don’t be too ambitious, it’s mistaken for aggression or just being a bitch.
I read a book when I was in medical school called ‘The Woman in the Surgeon’s Body’ written by anthropologist Joan Cassell about several women surgeons in the US. She noted that some of these women are almost as masculine as their male counterparts. The first time I read it, I was so shocked that we had to fit this mould, I stopped reading it. It was later when I re-read it that I realised it was a reflection of the extra hurdles and the need, or desire, to blend in to the male dominated environment.
There is even a handbook written specifically for women surgical trainees in the US on how to survive surgery. It’s actually very good and extremely practical but does there have to be a book to tell women to wear inoffensive perfume and keep feminine hygiene products in their locker? Do the guys get a handbook on how to tie a Windsor knot or make sure their Lynx or Rexona isn’t too pungent?
The Royal Australasian College of Surgeons conducts workforce surveys to profile the surgical workforce. In Australia, women only make-up 10% of surgeons – which is far lower than in some specialties. Although female medical students often outnumber males by a little over half in Australian universities, it will take some time to trickle through to surgery.
The difference is so obvious to me. I see very few women at professional events and I see the surprise in some people’s responses upon realising that I am the cardiac surgeon. Patients often refer to me as a member of the allied health team and seem genuinely shocked when I tell them I will be doing their operation.
Some days, I have to be honest, it’s difficult to not be offended. Other days, I like being a surprise package and feel a little bit proud that I can shock and awe. Mostly I just wish the assumptions would stop for a little while. When I passed my fellowship exam, the college gifts you with a tie for men and a scarf for women. I took the tie.
With all of this in mind, why would anyone choose to be a woman in surgery? Because it is a great vocation. I have had the incredible privilege of being present at the best and worst times in people’s lives. I have met some incredible patients whose stories have touched me and entertained me and educated me. Make no mistake, it is hard work. And if you have the unfortunate experience of bullying or harassment, then it’s even worse.
Despite the terrible message in the media right now, I have had the privilege of working with some fantastic male surgeons, several of whom I count as my mentors, friends and colleagues. I wouldn’t switch them out for all the tea in China. If they happen to be reading this, thank you.
In the last day, the Royal Australiasian College of Surgeons has set up an impressive looking task force to tackle bullying and harassment in the workplace and I offer my sincere congratulations to the College for taking a stand. I truly hope that they do an excellent job and we can make real change occur.
Bullying, discrimination and harassment happens everywhere, I suspect. In the current environment, I chose not to ‘make a fuss’ and maybe, or maybe not, risk my career. But I have also chosen to learn from it. To ensure my behaviour is better than it ever was before. To lead by example and teach, not torture.
I also encourage women – or indeed anyone – to take up surgery. Actually, to take up anything they want. To be different and stand out. Diversifying our workforce will, I hope, lead to better understanding and tolerance. Doctors are people who really do want to help people, trite as that may sound. I believe we have it in us to be better to each other.