Being a female surgeon in a man’s world

 “I have tried never to miss work to look after my children, and I have always been the first to stay longer when necessary”. She maintains that perhaps the pressure has been self-imposed.  At the same time, she defends her role as a partner, as a mother when it comes to looking after her children, and so on. “I also made costumes for carnival a few days ago”, she concludes.  This attitude demonstrates, once again, the effort that women from certain groups have to make to fight for equality in the workplace.  Dr. Irene Bello of the Thoracic Surgery Service has experienced this first hand: “Because of being a woman and being young, I have had to prove that I can do the job as well as or better than a man". 

Being a woman and a surgeon is a difficult pairing, but in recent years a few battles have been won. “Years ago, the situation was worse. We have a spectacular glass ceiling”, says Dr. Irene Bello. Dr. Dulce Momblán, acting head of the Gastrointestinal Surgery Service gives one example of how the situation has improved (even if only slightly): “In our Service, now, there are more women than men, but this was not the case before and it is not the case in other Services in Spain”.
 

Dr.  Elena Sandoval, of the Cardiovascular Surgery Service, meanwhile, was the second woman to do her residency in the Service in the Hospital Clínic’s history. The Spanish Association of Surgeons currently has 5,538 members, 56% of whom are men and 44% women. This glass ceiling metaphor is an attempt to make visible the various obstacles that prevent women from reaching positions of power and decision-making in most fields of work and professions. 

If we look at the MIR specialities focused on the field of surgery and chosen last year, we can see that women choose fewer of these specialities than men: Thoracic Surgery (43.5%), Orthopaedic Surgery and Traumatology (45.7%), Oral and Maxillofacial Surgery (45.7%), Aesthetic and Reconstructive Plastic Surgery (47.1%),  and Cardiovascular Surgery (48%). 

The 4 surgeons agree that the situation has improved in recent years. However, it remains to be seen how many of these women will end up in positions of responsibility or with consolidated staff positions. Spain is the fifth country in the world with the most specialist surgeons, with 109 per 100,000 inhabitants, according to a study published in The Lancet. In Spain, approximately 70% of the surgeons are male and 30% are female. 

One swallow doesn’t make a summer, but it is important to put on the table (and on the political agenda) the fact that International Women’s Day is a day of vindication for the struggle for rights, equity and social justice.  In the hospital sector, and specifically in the various surgical specialities, it is also necessary to continue working to eliminate stereotypes against discrimination between men and women, but¬—above all—to build a paradigm shift with a view to full equality of opportunities. 
 

From “pass me the bedpan, girl” to “will you operate on me?”

All four female surgeons at the Hospital Clínic say they have encountered unpleasant or awkward situations when dealing with patients, ranging from “pass me the bedpan, girl” to experiencing realities, even surreal ones, in the consultation room or while doing the hospital ward round. 
For example, “when I am with a male colleague or a male resident, they always look at him and never at me", points out Dr. Bello. We are “the girls”, says Dr. Momblán. Dr. Musquera has also had this type of unpleasant and awkward experience. She explains how after a weekend on duty and without stopping for a minute, early on Monday morning she returned to the ward and saw a patient complaining to the nursing staff because “no male doctor came round all weekend”.  “I was very angry”, she says. Dr. Musquera also remembers that one day a male patient asked if “she” had to examine him, referring to a woman. “At that moment I was coming in with a female colleague and I said: ’No, no, we’ll both do it’.  And he was stunned.  I could give you lots of examples of this kind of situation”, she says resignedly.  Dr.  Sandoval explains that one patient even snapped at her saying, “you’re not going to operate on me, are you?”.

Being a woman and practising a surgical speciality is not easy, but all four agree that the relationship with their male colleagues is generally good, although in some cases I have come across a situation where “I have noticed a bit of condescension”, says Dr.  Bello. “Maybe there are people who think I don’t deserve to be where I am, but I don’t care what people think”, Dr. Musquera says resignedly. Despite everything, she stresses that it is necessary to continue working to break down this inequality, especially in women’s leadership at hospital level, in scientific societies or professional associations.  “A man does not give orders in the same way as a woman does. A man is more hierarchical”, stresses Dr.  Momblán. “Some men exercise leadership in a more aggressive way”, concludes Dr.  Bello. Meanwhile, Dr. Sandoval explains that when “I am the primary surgeon in an operation, no one questions the fact that I am in charge there”. All of these four female surgeons except Dr.  Momblán have only had male bosses.
According to data from the Government of Catalonia's Department of Equality and Feminism, the Gender Equality Index in Catalonia is 73 points out of 100. Sweden is the European country with the highest level of equality with 83.9 points.  These data are not bad, but we still have a long way to go. 
 

“If they take me out of the operating theatre, they will kill me!”

They all feel comfortable in the operating theatre and even relaxed. However, sometimes you have to assert yourself more than men, and sometimes I have the feeling that I have to justify myself more”, says Dr.  Irene Bello.

Surgical specialities require a great deal of dedication; surgeries are long and that "means that it is hard to manage time and this can affect your personal life”, explains Dr.  Sandoval who performs 150-200 surgical procedures each year. All four say that their profession is very vocational. They love their work and for them the operating theatre is a “safe and comfortable” environment, as Dr. Sandoval defines it.   For example, Dr.  Irene Bello does not perform any rituals before going into the operating theatre. However, when she has surgery first thing in the morning, she does not drink coffee, in order to prevent her pulse from trembling. “I try to go into the operating theatre in a good mood and I always put music on.  If the team sees you cheerful and relaxed, this atmosphere spreads to your colleagues and everything goes better”, she explains. 

Meanwhile, Dr. Mireia Musquera from the Urology Service confesses that, “when I am operating my worries disappear and I always end up happy”. “If they take me out of the operating theatre, they will kill me!” she says.