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  • Strength Without Armor:Reflections from a Woman and a Surgeon
  • Karyn Butler

Pass the baton. …

As women we stood together, passing information as if in a relay.

"Make sure you wear a t-shirt under your scrubs so Dr. X. doesn't look down your shirt."

"Do not get pregnant."

"Forget about your relationships if you want to make the cut."

Pass the baton. …

"Stay away from him."

"He tries it with all the women."

"Don't meet with him alone."

I was different, I thought. I was careful, I never wore pastels, never let my long hair down, never wore 'dangly' earrings, never wore skirts or heels … never. My femininity was well-concealed under the armor of the pursuit of success. I thought that was enough to protect me.

My first contacts with him were as I expected. I was prepared for cases with him; I answered his questions correctly about anatomy and disease, I stayed as late as needed to ensure his patients were ok after surgery. I 'fell on my sword' when my junior resident removed a drain prematurely—I told him I would do better.

He showed interest in my career, said I was a very good surgeon, that I excelled in the OR and that he believed I could accomplish whatever I set my mind to. He said he would help me, and that whatever I needed him to do, he would do.

He asked me to meet with him over dinner to discuss my career aspirations.

I said yes—I couldn't, or didn't, see it. The invitation seemed so genuine.

I was lucky: I had someone who did see, who was incensed at the thought of the invitation.

Someone who said, "Why do you think he's asking you to dinner?"

Shame on me for not recognizing it myself. Then I thought, 'How stupid am I.'

I thought he cared about my career, about the grounds I could level by excelling as a female [End Page 192] surgeon. I was wrong. That uncertainty, that shame stayed with me throughout my career.

How could I ever be sure that I would be seen as just a surgeon?

Pass the baton. …

As a woman, the decision to become a surgeon changed every single aspect of my life. In the very beginning, during interviews for residency as a fourth-year medical student, I was asked questions that male applicants were not asked: "How do you know you're strong enough to become a surgeon?" "What will you do if you have children during residency?" These are questions that are illegal today. They were questions that paradoxically fueled my ambition to become a surgeon but also, somewhat unbeknownst to me, set a backdrop of ensuring that I never 'showed up to work' without my 'armor.' That armor took many forms including minimizing my femininity, consciously focusing on my body language, my verbal presentations, and my hand gestures all in an attempt to be seen as a surgeon and not a 'woman surgeon.' This distinction is crucial to understand as, with the passage of time, I have finally become proud of being a woman and a surgeon.

My memory is long regarding the inequities that I confronted during my training and my career. These experiences did not diminish my enthusiasm to succeed. In fact, they invigorated my passion to excel in academia and aligned with my personality of 'going against the grain.' The choice to become a surgeon, however, came with a price tag of failed relationships and anxiety, balanced only by the personal satisfaction acquired from academic success and the joy of raising two wonderfully independent children.

Over two decades ago, it would have been impossible to predict that the face of surgery would become more diverse and more feminine. Over two decades ago, the benefits of gender diversity in surgery were not recognized. Over the course of my career I experienced gradual acceptance that, as a woman and a surgeon, I bring a different perspective to the care of my patients and their families, a different view for my students and residents, and a different face for the community that I serve. My journey has...


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pp. 192-194
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