Women in Medicine- Under appreciated Challenges…

And she reaches for it…and has to devise some entirely new combination of her resources, so highly developed for other purposes, so as to absorb the new into the old without disturbing the infinitely intricate and elaborate balance of the whole.” Virginia Woolf, A Room of One’s Own, 1929.

What can I say about the particular predicament of being a female physician, or even of a female professional, that has not been stated so often before? Our struggles with personal ideals of family and responsibility, and the ensuing guilt from within combined with the pressure from without—all of these have been discussed by much more incisive and eloquent authors than I. Our conflicts were both anticipated and made possible by the great feminists of the past, whether they explicitly claimed these titles or not.

Elizabeth Blackwell and Virginia Woolf would hardly have been able to imagine a world where women dared to want and struggle for so much. How do you become a part-time mother, wife and homemaker, when performing these roles excellently was the sole goal of very intelligent, caring and capable women for so many generations? And how do you excel in a profession where your availability and total dedication are always assumed (or lack thereof derided)?

When my daughter was nearly two years old, she developed a complex abscess underneath her chin; this enlarging fluid collection had failed to respond to two different oral antibiotics, and during her second emergency room visit, she was admitted to the hospital for urgent drainage by head and neck surgery, in addition to intravenous antibiotics. All in all, she was in the hospital for only a few days, and though seriously concerned, we knew that she would make it through alright. Still, it was a very difficult time for our young family. I was in the middle of my medicine clerkship, an intense and critical rotation for all medical students. I was offered the chance to take off some time, but I did not want to risk the chance that this would delay my completion or affect other upcoming rotations (the rotation schedule is packed and often difficult to adjust, especially for the “basic” or essential clerkships). So, I slept in the hospital room with my daughter at night while she was in a metal crib that resembled a cage with the mattress at table height, and my husband stayed during the day, attempting to work remotely. On the day of my daughter’s procedure, I took her into the operating room (for she had to have general anesthesia due to the location of the abscess and her young age) and left to return to my clerkship after she fell asleep. Later that day, my husband called me while I was with my clinical team in the elevator – everyone could hear my daughter screaming in the background, and he was despondent that he could not comfort her. She had done well, the procedure took very little time, but when she woke up, she was utterly confused and terrified. You cannot explain general anesthesia to a toddler, all she knew was that she fell asleep with her mother, but then awoke in pain and surrounded by strangers.

Later, during the last week of my medicine rotation, my attending (or supervising physician) told me that though I had started out doing very well, I seemed to be not as engaged during the second half. I thought this was probably valid, and mentioned my daughter’s illness as possibly contributing to this change. She said that if I chose to remain in my clerkship and at my job, than I had to give 100%, regardless of what was happening at home. This has never stopped being a shock to me—how could someone who witnessed the wails of my daughter, someone whose profession it is to care, have so little understanding of what is possible within the human heart?

But then I realize, I do not know the sacrifices she has made in order to be a physician. That was probably the message during her training, that was certainly the message in the early days when women scientists or physicians had to renounce all thought of motherhood to have any chance at a career. Sadly, though so much more seems possible today, the delicate balance between family and work often seems more of a holy grail than an achievable state of being.

I have little advice to give on when to start a family, or what kind of individual should be your partner, for so much of life is uncertain. Indeed, having just completed my internal medicine residency, I feel that I have barely enough experience on which to base any advice at all. All I know is that you must have a sense of your worth. Will you be satisfied as a mother and wife, or will you want for something that moves you beyond your home? Will you leave your children in the arms of trusted caregivers and still feel that you are betraying a part of your very being? You must answer the hard questions, I know of no “right path”, no “good time.” When you make your choices, I hope that you will be supported by those who understand that confusion is part of the process, discovery part of the key. You will have the sisterhood who have gone before but you will still feel alone with your musings, for none can be in your place. Be honest, be brave, do not sacrifice so much that you do not recognize yourself.


-Dr. Denise Duan-Porter MD,  Duke University Medical Center

One thought on “Women in Medicine- Under appreciated Challenges…

  1. Profile photo of Andi AstuAndi Astu

    Amazing post! I am a pre-med student and my mom voiced her concern on this issue.. essentially she told me I would have to choose between a career and family life. Of course it is possible to have both, although it is hard. But as you said I need something that moves me beyond my home. That is my ultimate goal in life.

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