Friday, September 13, 2013

Men In Surgery

As a woman in surgery, gender issues come up frequently.  It’s something that really weighs on my mind, and I want to take this opportunity to set the record straight.  Gender equality matters, and we all need to do our part to the even the playing field in surgical specialties.

The fields of sewing and knot tying have historically dominated by women.  For thousands of years, everything that was sewn by a human, was sewn by a women.  In the modern era,  woman  are taught from a very young age to handle needles and thread, and go through rigorous afternoon craft sessions where our work is critiqued and judged until it reaches a level of precision suitable for a surgeon, or at least enough to hold our handmade pillow case together.   When we wanted to cement our social standing with our best friend, we were forced to undertake a tedious and tiresome knot tying ritual known as “making friendship bracelets”.    The intricacy and precision of the bracelet was believed to be reflective of the commitment to the friendship, forcing BFF’s to engage in a never ending competition to out-tie and out-braid their brightly colored mess of threads into a work of art.  
Our hands would ache, our eyes would water, and all we could think was  “one more knot,  just one more knot….”  Looking back at my Girl Scout experience, it really could be renamed “Surgical Technique 101”.  Except there would be less cookies.

Despite our natural and obvious dominance of the skills required for surgery, women must actively work to welcome men into the field of surgery.    This revolutionary and controversial viewpoint is not embraced yet by the mainstream surgical audience, so allow me to make my case.  I truly believe that there is a role for Men in Surgery, and that, over time, we will come to find them a truly valuable part of the surgical community.

Despite their obvious deficit in sewing and knot tying based on childhood experiences, men can in fact develop these skills if given proper time and training.  A patient teacher and an abundance of motivation must be present in order for these men to make up on lost time, but it is possible.  There’s a growing body of evidence that video gaming at a young age improves laparoscopic skills.  So we should remind them that their wasted youth, devoid of knot-tying, may still have some usefulness.

Another obstacle that men must overcome is their natural urges and biologic shortcomings which often distract them from surgery.  Their frequent requests to time off to attend major sporting events, improve their golf game, or simply to fart and scratch their balls at home, must be met with tolerance and understanding.  The biologic differences between women and men cannot be changed, but we must work to adjust our expectations and work schedules to account for these inconvenient and unexpected interruptions to the work flow. 

The operating room can be a hostile place for men in surgery, and as women we must actively work to reform this.  Both circulating and scrub nurses are almost uniformly female, and careers in anesthesia (including CRNA’s) is rapidly trending toward a female predominance.  Many scholars have postulated that men are simply no longer a relevant part of the operating room culture.  The sisterhood that has developed often alienates men. They are kept out of the social circle by their lack of understanding of our reality TV show and Glee references.  Metaphors related to the contestants on the Bachelor often go over their head  and they  find themselves lacking a common language as their female peers.  As women in surgery, we must actively reach out to these men.  Take time away from the operating room to review common metaphors which they may overhear.  Answer their questions about Grey’s Anatomy in a honest and respectful way.  It’s not their fault that they cannot participate in the female-dominated operating room culture- they were simply raised differently.

Change must come from the leadership in our field.  There is no room for gender bias in the hiring process. Science has proven repeatedly that women tend to be more detail oriented, more patient, and better at resolving complex emotional and relationship issues- all of which are highly valued in chosing which surgeon to hire for an open position.  But I urge my colleagues to consider some of the lesser known traits of men which may in fact be just as valuable.  For example, I bet you didn’t know that men can lift very heavy things.  Additionally, men tend to have larger hands.  While this makes them struggle in many of the fine and delicate aspects of surgery, it could be seen as a positive when considering stool disimpaction.  Lastly, remember that men have feelings too.  They just might surprise you with their compassion and grace.  Oh yeah! And they are tall.  Think of all those dead light bulbs they could change.


Allowing men to become surgeons enhances the diversity of our work force, which I’ve been told is a good thing.  If we hope to remain a vital and relevant field amongst medical specialties, we must embrace all gender equally- even the ones with external genitaila. Gross.