Monday, September 1, 2008

Mothering a med student

Pathmom has been off the air for many weeks, primarily due to the addition of a full time med student last month. I have a healthy amount of respect for med students (we were all students once), and this one was particularly bright and appeared to have the requisite "good eye" that any successful pathologist must have. So in the title of this blog, I don't want to sound pandering or condescending in any way, but there was an incident that I found particularly memorable, and worthy of sharing.

This young woman had a 4 month old baby girl at home. She came back from maternity leave and went straight into her general surgery rotations. Her medical school was in the habit of "farming out" students to community groups across the metro area (and even the country) for their clinical rotations. The two surgeons she rotated with were geographically close, but had a reputation for inappropriate behavior.

"K", as I will refer to her, had an initial interest in surgery, but she was fully cured of that in the process of her rotation. Apart from being bad-tempered and complaining vocally about having to have med students at all, these surgeons were apparently openly misogynistic. They reduced one female med student to tears by verbal abuse, got cited for making "inappropriate remarks" to another, and told "K" directly that the only way they would ever hire a woman was if she had a hysterectomy.

The last incident really burned me, but I was more appalled by the way "K" told me about it, almost like she was waiting for me to chuckle or at least smile.

"Are you serious? They said that to you?"

"Well, these guys are pretty old school."

"Old school, nothing! That's an extremely offensive remark!"

I had that bewildered sense of reacting very strongly to something that appeared to have no effect on someone that I would consider more or less a peer, based on age and being the mother of a small child. I explained that you can't change individuals, but that she should not take that comment as something either acceptable or amusing. I also thoroughly derided her medical school for allowing students to be with these physicians (apparently, options are rather on the slim side). Despite having quite strong opinions about many and varied things, I actually do not "soap box" very often. This, however, did ignite a spark. The term "flipped out" sums it up nicely.

I couldn't help but wonder if it was her upbringing or just a lack of social aptitude that made her fail to realize the abhorrent nature of that comment (and, yes, I am intentionally leaving out the option that I was just plain over-reacting).

I also couldn't help waxing philosophical about the whole incident. Obviously, this blog is built around the notion that mothers in medicine are worthy and capable members of the medical field. We are also, frankly, necessary to the system. If every "mother in medicine" were to disappear from the profession, and if only those women who were indeed sans uterus were allowed to practice, what then? Not so great for aging baby boomers, that's for darn sure.

This student was convinced that surgery was not an option for her - and maybe it wasn't her path for other reasons - but these horrid surgeons certainly made it clear that she wasn't a candidate based on who she was. "Of course you can be a surgeon!" I explained to her that my sister-in-law is a practicing general surgeon, and has had two girls and plans to have more. I also pointed out that 3 of the 6 general surgeons at my hospital were women, all of whom had small kids. That being the case, I had already melded her mind towards the utterly cool and completely irresistible field of pathology, so I believe it's unlikely she will do anything else (path props).

Frankly, mothers in medicine typifies a scenario that all professional women of this era face: creating the reality of how working moms fit into the American workforce in the 21st century. We're living at a time when there is no "norm" for working mothers, and the expectations and experiences are supremely varied. Some moms get months of maternity leave with full pay; others get paltry weeks (or even days) and pro-rated salaries. Some moms have to take leaves of absence; others invoke FMLA. But we are an increasingly powerful and valuable voice in the professional community, and I believe the situation for working moms reflects that more with every passing year (a generation ago, my mother in law and her female residency colleagues had to sign contracts with their programs explicitly stating they would not get pregnant - they did anyway). We are more involved in making our own reality today than ever before, and I believe that what we want to be and how we want to practice are out there waiting for us, be we single, married, pregnant, or toting around that mysterious black bag with the plastic suction devices on it. And if there are still the remnant neanderthals who feel that the possession of fully function female parts excludes someone from consideration, they are, of course, free to limit themselves thusly while the rest of the world spins ahead with diverse, talented, and dedicated mothers in tow.


  1. Brava, Pathmom! I think your post should be on the front page of every blog, magazine, and newspaper in the country. And I think those surgeons should be quoted publicly by name in every blog, magazine, and newspaper in the country.

  2. And yes, I realize it's redundant to say "publicly" and "by name" and "in every blog, magazine, etc.!" Let's just say I totally agree with your well-articulated, NON-overreaction!

  3. I agree!! Bravo, pathmom. In primary care, mothers have generally been the doctors I have looked up to, not only for their intelligence and competence, but also for the sympathy and realism of how to deal w/ illness and issues in the real world. Being a mother in medicine only enhances the care and advice you give your patients. The thing we truly are lacking in the end is, unfortunately, sleep.

  4. The surgeons should be sued for sexual harrassment.

  5. That medical school needs to find some more suitable surgeon mentors! Often in the hierarchy of med student & attending - the student just hunkers down and tries to get through the experience not knowing any better. The surgeon's peers need to address the problem.

  6. Of course the funniest thing is that the surgeons don't realize that a hysterectomy can"t keep a woman from having kids.

    There is adoption and surrogacy to thwart them!

  7. Sigh. I was hoping all those guys had died or retired. Such things were not uncommon when I was a student 30+ years ago--in fact at our school every lecture slide show ended with a picture of at least one naked woman, it was just a fact and we dealth with it (like your mother in law and the contracts). It's pretty dadgum depressing to realize this stuff is still going on all this time later. Is there a student advocate at this medical school?

  8. Don't blame your med student for her response. I'm still close enough to having been a student that I remember how many attendings (even the non-sexist ones) think they have the right to abuse and insult their med students. After a year of this, you have to laugh at it, or else you'll cry.

  9. Don't get me wrong, Fizzy. I am not saying the medical student should have done something different, but there is the absolute need to recognize this behavior as being inappropriate and unacceptable (I don't believe this was the case for "K"). Indeed, no progress can be made for working women if we don't have that internal compass that tells us when someone (particularly a mentor) is talking nonsense or behaving incorrectly. As long as someone can retain the ability to realize that those kinds of opinions are archaic and ridiculous, and that abuse or harassment are never OK, they are free to react however they need to.

  10. Pathmom, thank you for addressing this subject. I'm a second year medical student, and my husband and I have been married for three years. I want to start having children during residency, but everywhere I turn it seems there are male physicians talking about how women are ruining the profession by expecting to always be accomodated, and that women who have a baby during residency are selfish because they increase their fellow residents' work loads. What's your take?

  11. Crystal, I think the decision to have a baby during residency is yours to make. As much as others may complain, their perspective is different than yours, and may change once they (or their wives) are in your position. Society in general needs to accept that childbearing is an inescapable event that everyone has to support, whether they like it or not. It's called propagation of the species.

    Furthermore, the perception of your work ethic in residency will be made with or without you taking maternity leave. If you are known as a diligent, conscientious, and hard working resident, no reasonable person will judge you solely on your taking maternity leave. On the other hand, the whiny slackers of the group are recognized immediately, whether they are male or female.


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