Are Surgeons Who are Women Modern Day Witches?
Author: Sarah Temkin, MD
Keywords: women in medicine, misogyny, gender bias
As Halloween approaches, thoughts turn to witches, which means women – but what about the witchiness of those women who are surgeons? As a woman, a surgeon, and the executive producer of 1001cuts, a film in production designed to explore the barriers to entry and success for women within surgery, I’ve seen how surgical culture has remained stubbornly inhospitable to women. Passage of the Title IX amendment of the Civil Rights Act in 1972 prohibited discrimination based upon gender by institutions that provide higher education and paved the way for women to enter medicine. By 1980, 30% of medical students in the United States were women and since 2003, half of students entering medical schools have been women. Yet women continue to be underrepresented in surgery. Only recently has the number of women choosing to train in surgical specialties begun to increase; the percentage of women practicing certain specialties, like neurosurgery and orthopedic surgery remains single digits.
Surgery is a profession created and traditionally dominated by men, hence without discursive spaces for women. The environment of the operating room was established to accommodate the prototypical male surgeon. The scrubs fit a male body (no waist). The gloves fit male hands (thick fingers). The handles on surgical instruments are typically too large for an average female hand – some women need to use two hands to use instruments designed to be one-handed. The height of the operating room tables assumes a surgeon height of at least 5 feet 8 inches. Not having equipment or an environment that was made for you, however, is just one part of the messaging received by women in surgery that they do not belong.
Women are expected to be warm and communal, not bold or technically proficient. For simply practicing surgery, making decisions, utilizing equipment correctly, or speaking up about patient safety issues, women are punished for violating gender roles (socially ascribed sets of expectations associated with the perception of masculinity and femininity). Women who are surgeons who have been interviewed for the film describe falling prey to the classic and well-described “double bind”. The double bind is the no-win situation women find in the workplace where if they perform well, they’ll be perceived as unlikeable, but if they are likeable their competence will be questioned.
Although women are no longer drowned, hung, or burned as witches, many of the roots of our modern social and cultural responses to women holding power (including the power to heal) can be traced to the story of witch. Rounding up and punishing women for violating gender norms and roles was central to the witch hunts of the 16th and 17th century that swept much of Northern Europe ultimately reached as far as New England. Although both men and women were accused of witchcraft, women were disproportionately charged and executed for this crime. One of the most common accusations of witches was having the power to affect health - often specifically the possession of midwifery or other medical skills. After being accused witches underwent a trial by ducking to determine whether they were guilty. If she drowned, she was innocent, if she floated, she had proven herself a witch and was subsequently hung or burned at the stake.
The “damned if you do, damned if you don’t” outcomes of a witch-hunt resonates with many of the stories of surgeons who are women that have been shared in the making of the film. Hardly a surgeon who is a woman has not been called a “word that rhymes with witch [bitch]” at work. The accusations arise from simple acts required to do the job of a surgeon – being assertive, asking for instruments, or staying calm in the face of chaos. Surgeons have described being either too loud or not loud enough, too bubbly or too serious, talking too much or not enough. Efforts to prove that you’re a regular surgeon doing your job suddenly become proof that you are indeed a woman in possession of supernatural powers capable of using dark magic to exercise your will. Broomstick, caldron, potions, and all are suddenly part of your persona.
Please watch our webextras on the 1001cuts website that describe the themes of out interviews with surgeons who are women. Consider telling your story of being a woman in the operating room. The film is still accepting donations of photos and videos. Tax deductible donations can be made through our fiscal sponsor, Fractured Atlas.
About the author: Sarah Temkin, MD was trained as a gynecologic oncologist. She is the executive producer of the documentary film in progress 1001cuts and an advocate for gender equity (Twitter: @temkins)
