“Mom, doctors are men and nurses are women,” one of my four-year-olds said to me cuddling up in my lap as the pediatric nurse walked in. He wasn’t trying to be inflammatory. At this age, he had been learning social norms, and his voice betrayed the pride he felt at finally figuring out this “rule.”
“That’s not true!” I said, as the nurse and I avoided eye contact. It is true that his pediatrician is a man, and that the nurses in the practice are all women, but his own mother is a doctor. His own mother is a doctor who works nights in the hospital, who was once questioned, upon returning after a 24-hour-call by this same angel: “Mom, where do you live?” And yet. And yet.
“I’m a doctor,” I said, “and many of the nurses in the hospital where I work are men.” For weeks, I thought about taking this son to the hospital to meet some of the nurses in the intensive care unit, many of whom are men.
“Mom, doctors are women and nurses are men,” he said to me a few weeks later. “I should tell daddy to become a nurse,” he said.
“No,” I explained, “men and women can be doctors and nurses.” Really. But it depends on what kind of doctors.
Although more women are entering medicine, and most medical school classes, but not Utah’s, are majority female, medicine is not a monolithic field. Go to the labor and delivery floor of any hospital, and you’ll struggle to find a male nurse or a young male obstetrician. But walk down to the orthopedic surgery floor, and finding a female orthopedist will prove equally difficult. Don’t get me wrong, it isn’t that there aren’t female orthopedic surgeons, or general surgeons, or trauma surgeons. It is that there are so very few of them. And it isn’t the long hours, either. As any obstetrician and orthopedist will testify, there are far fewer sleepless nights for the latter. Babies get delivered in the middle of the night. Knees get replaced on weekdays during business hours.
It isn’t a hostile work environment that prevents women from entering these fields. Or perhaps those exist, but I am young enough to have trained in an era of medicine that I have not seen surgeons throw scalpels or verbally abuse others. My medical school paired me with a female orthopedic surgeon, a hand surgeon, as a mentor when I said I was interested in orthopedics. The chief of orthopedic surgery was supportive.
People did try to talk me out of orthopedics, but not for the reasons you might think. I was interested in writing, and theater, and tennis, and pretty much everything under the sun, and they thought it wouldn’t be a good fit for me. My supervising resident thought I’d end up single and childless if I did orthopedics, a fear which wasn’t alleviated by going into Internal Medicine. And each person who tried to articulate that orthopedics might not be the best fit for me, convinced me even more that I should do orthopedics. The idea of being one of very few women in the field was appealing to me. It was my attending on the medicine service who, at the end of the rotation, told me that he thought I had enjoyed it and should re-consider. And I did.
I changed my mind. Not because I thought I couldn’t do it, or found the boy’s club too intimidating, but because I liked medicine better. When I was picking a subspecialty, Pulmonary & Critical Care Medicine, part of the way I made my decision was to look at the people in each specialty. The Pulmonary & Critical Care doctors seemed like a nice, fun, collegial group. They were interested in figuring out, like detectives, why someone was sick. But in an emergency, they knew what to do to keep the patient alive. These were my type of people, I could relate to them. Is part of the reason I decided against orthopedics as a specialty because it just didn’t seem that the orthopods were quite my type of people? And what type of people are those, anyway? Men?
I have seen patients, after introducing myself as their doctor, only to be asked, at the end of the visit, when they would see the doctor. An anesthesiologist related how she has found herself in situations where the surgeon addresses questions to the male medical student standing beside her. “I want to tell him – ask me – he’s the medical student. He doesn’t know anything,” she said. I overheard another discussing her job prospects after training. “Most practices don’t care about my anesthesiology skills. They just want to know about my reproductive plans,” she said.
It isn’t that people are trying to intimidate us. It reminds me of how, even after more than two decades of living in Minnesota, my parents have their dinner interrupted to be asked where they are from and are then “welcomed” to the state. These citizens think they are being kind. But the message they send with the kindness is that my parents don’t belong. The surgeon addressing the hapless, but male, medical student instead of the female attending in charge is equally communicating that she doesn’t belong there. Or that she isn’t in charge.
We are not intimidated, and yet we internalize these rules. I was at a retreat recently where we had small group sessions, and each group had a “scribe” assigned to take notes. You won’t be surprised if I tell you that our scribe was, as most were, a young woman. Nor would it surprise you to learn that the task of scribing prevented her from adding anything meaningful to the discussion. I make a point of never bringing paper and a pen to meetings, lest I be called on to take notes. It is probably similar to how proud I was to broadcast my lack of cooking ability. I boasted that my idea of cooking was to boil water to make tea, as opposed to microwaving the cup of water, lest anyone confuse me with a good housewife. “If you want to succeed in life, and in finance, there are two things you should be actively bad at: taking notes and making coffee,” a financier advised my sister along the same lines.
Medicine has come a long way from the all-boys club. Many, many women who have come before me have struggled with overt sexism and discrimination in earlier generations that are unknown to women of my generation. Women physicians are increasingly common in all specialties. But, in medicine, as in other fields, seeing the world through the eyes of my four-year-old has shown me that we have a long way to go.
The other day I was crossing the street with my two-year-old son, when the bus stopped at the crosswalk. “Girl driver!” he exclaimed. Yes, indeed, a girl driver.