Being a Woman Surgeon: Sixty Women Share Their Stories
Preeti R. John, MD, MPH, FACS
Gordian Knot Books,
Paperback, 337 pages, $29.00.
Admittedly, I was not excited to review this book. I have read previous ''women in medicine'' literature and felt it left me wanting, much of the writing trite and not quite ''hitting the mark.'' However, Being a Woman Surgeon
edited by Dr Preeti R. John, despite its eye-roll-inducing title by many who see me with it (in and of itself a reflection of why such a book is not only timely but also imperative), is refreshingly different. From the first pages, I was drawn into chapter after chapter as the contributors described their lives in surgery that were marked, for better or for worse, by the target-shaped indicator of their female sex: an X chromosome. It was impossible not to relate to the myriad sentiments, stories, and even specific sentences throughout the book as so many remain constant truths in surgery. Atul Gawande, Pauline Chen, and Abraham Verghese whose positive comments pour over the glossy back cover of the book, seem to agree. For me, a female surgical resident, many of the tales stemming from surgical training in a ''different era'' seem impossible yet inspiring—much like surgery itself.
In this 337-page compilation of personal essays, poems, and interviews, 60 female surgeons of varying age, race, and surgical discipline recount what it means to be a ''female surgeon'' or, in some cases, lessons learned about being a surgeon irrespective of sex. The essays are succinct, extremely well edited, and some phenomenally well written. Each essay pleasantly ends with an ''inspiring quotation.'' Although 69 essays, interviews, and poems on similar topics start to feel repetitive, each contributor has an important story to tell, and they each deserve the stage they are given. Perhaps read the book in pieces, as it was composed, and the similarities will instead feel as novel as they did to each writer.
The contributions range from light-hearted to heartbreaking, but there is a human tendency to reflect on real events through the warm glow of rose-colored lenses. In the midst of blatant sexual harassment (physical and verbal) and frank sexist discrimination, many contributors proclaim they ''wouldn't have changed a thing!'' Such remarks make the retrospective lens seem not just colored but rather warped. Still, these experiences, good and bad, are what shape whom we become, and for many who pick up this book, they will be searching for hope of what is possible not necessarily reminders of what is iniquitous.
Importantly, Being a Woman Surgeon
is not all ''sunshine and roses.'' One contributor's (Claire Cronin's) dry sense of humor depicts a time of inherent biases not just in surgery, but also in the world. I was relieved when she wrote, ''The most impartial stakeholders are the patients. The sicker the patient the more gender blind they are,'' as it reminded me that regardless of the obstacles, insecurities, or convoluted motivations we face, the patients are why we come to work. Another contributor, Carol Sawmiller, spends her precious few pages discussing a patient's negative view of her and how that has positively influenced her treatment of others. A third contributor, Kerry Bennett, details life when she was no longer a surgeon because of the critical illness of her son. She describes it as ''the best thing that ever happened'' to her, reminding us that there is also important work to be done in life, not just in the hospital. These honest moments among many others temper whatcould have been a trend towards glorification of both reality and challenges. This is the beauty of this book—many of the statements in these pages need no embellishment or flare to leave the reader astounded by what is possible, despite all conceivable impediments. However in giving each woman a platform to voice what it means to her to be a surgeon, we are reminded as another contributor, Sarah Cross, so poignantly states, ''medicine is a human endeavor besieged with the limitations of humanity.'' As a result, their stories are both relatable and intangible because of the dual nature of surgery's most human and super-human qualities.
What is plainly stated and rarely exaggerated is a common theme of mentorship, with many contributors recalling chief residents or senior surgeons (both male and female) who influenced them, encouraging them to pursue their interests in surgery. For anyone who lacks such a champion in any career path, perhaps this book can fill that purpose. In its varied pages, this book holds the voices of reality, hardship, failure, and eventual triumph and success. I imagine any minority could relate to the contributors and to the sensation of being a ''token'' or ''the only one'' who ''does not have to work hard to have her presence noted but does have to work hard to have her achievements noted.'' (a quotation from the strikingly insightful Foreword written by anthropologist Joan Kassel—an unbiased student of women in surgery who confirms what could be seen as folklore to instead be undeniable fact and was perhaps my favorite part of the book).
This book could also be useful for any non-medical family member or any residency program director or colleague who wants to understand what ''life as a woman surgeon is like.'' I am sure many think they know, but whether they are excluded from the closed doors of the operating room or from the protected thoughts of their female colleagues, this book gives them entry to a truth that is often unspoken for fear of sounding weak or ''too feminine.'' With a glossary of medical terms included, the book becomes accessible to anyone with an interest. Unequivocally, this is not a book for women surgeons only—it is a book for anyone looking for wisdom and inspiration.
Johanna N. Riesel
Department of Surgery
Massachusetts General Hospital
Department of Plastic and Oral Surgery
Boston Children's Hospital
The Program in Global Surgery and
Harvard Medical School
Copyright 2015 Wolters Kluwer Health, Inc. All rights reserved.
Annals of Surgery Volume XX, Number X, Month 2015 www.annalsofsurgery.com
This issue highlights Global Health Advisory Board member Dr. Luis Barreto – one of the most influential figures in vaccinology, epidemiology and public health, both nationally and globally. Over the past 30 years, his work has helped to eradicate polio, dramatically reduce Haemophilus Influenzae type b (Hib) and whooping cough infections, and shape immunization policy in Canada and around the world.
Global Health Advisory Board member Dr. Luis Barreto is one of the most influential figures in vaccinology, epidemiology and public health, both nationally and globally.
Few people can say they have had a hand in helping to rid the world of potentially deadly bacterial and viral illnesses. Dr. Barreto is one of those people. Over the past 30 years, his work has helped to eradicate polio, dramatically reduce Haemophilus Influenzae type b (Hib) and whooping cough infections, and shape immunization policy in Canada and around the world.
In 1967, Barreto gained an undergraduate degree in medicine (M.B.B.S.) from St. John's Medical College in Bangalore, where he went on to run clinics in the neighbouring slums. Next, he helped establish primary health care centres and training programs in Southern India. Working in tea and coffee plantations, he educated Medical Officers, employers, and workers about occupational health and safety risks.
Barreto recalls his Community Medicine (M.D.) training that followed at the Mahatma Gandhi Institute of Medical Sciences, a school that operates on Gandhian principles. "It was simple living," says Barreto. "Don't drink or smoke. Engage in manual labour. Wear locally produced, hand-woven cotton clothing to support local jobs. And every Friday the whole community came together, united in prayer." Regardless of one's political or religious outlook, this way of life "brought the students, staff and doctors closer to the population they served, while narrowing the gap between rich and poor."
Catalysts for Thinking Globally
"These early experiences," Barreto explains,"exposed me to great disparities in health care delivery and the very basic reasons for such high rates of mortality and morbidity." Involved in mass immunization campaigns for polio, typhoid and cholera outbreaks, he also witnessed first-hand the ravages of smallpox, typhoid fever, cholera, tuberculosis, leprosy, polio, and lathyrism. "And I had the incredible opportunity to be part of response teams offering primary care and immunization following the 1977 tsunami in Southern India which killed over 100,000 people in a matter of hours," he recalls.
While he credits this time in India with providing "the catalysts needed to think more globally about health care, immunization, and medical education," Barreto is quick to point out that "you don't have to go to India to experience global health. Such catalysts are all around us." But to be part of a global health agenda, he says, "one has to engage with key opinion leaders, political leaders, NGOs, advocacy groups and industry, both locally and globally."
Having completed a Masters in Community Medicine and Epidemiology at the University of Toronto, and his four-year training towards a Fellowship in Community Medicine in 1985, Barreto set off with his young family for the Canadian Arctic. The government was looking for a Territorial Epidemiologist with public health training – and Barreto was the person for the job. "Native culture was being affected by oil refining in the Western Arctic, resulting in an inflow of money to the communities," he explains. "This led to high rates of alcoholism, smoking, suicide, and significant disruption to native ways of life which depended heavily on the land."
Eliminating Hib Infections
Among the diseases that needed attention were TB, lung cancer, and, in particular, Haemophilus Influenzae type b (Hib) infections, which the Federal Medical Officer of Health wanted to investigate via an epidemiological study and clinical trial. With the first generation of Hib vaccine showing promising results in Finland, Barreto co-led clinical trials amongst the Inuit people in the Northwest Territories. Working with Connaught Laboratories, he combined this vaccine with DPT (Diptheria, Pertussis, and Tetanus) and DPT-IPV (DPT with Inactivated Polio Vaccine) to introduce the first pentavalent vaccine across Canada in 1992. In the Canadian Arctic, Hib infection rates were among the highest in the world, in line with Iceland, as well as Navaho aboriginals and Alaskan natives in the US, and Australian Aboriginals.
Following the introduction of the Hib vaccine, the disease was virtually eliminated in children who received immunizations. At this time, Barreto also worked closely with the Icelandic Public Health department to introduce the Hib vaccine. "It was gratifying to eliminate this disease and its carriage within 8 months of immunizing every child under 5," Barreto says. He also worked with GAVI (the global Vaccine Alliance), WHO, UNICEF, Gates Foundation, and vaccine industry colleagues to support the inclusion of Hib and DPT-Hib within Africa's GAVI Vaccine program, which provides children in the world's poorest countries with equal access to new and underused vaccines.
Committed to Good Science
Global concerns over the safety of using the whole cell whooping cough (DPT) vaccine grew in the 1970s and 80s, with Japan and Sweden stopping immunization. As whooping cough epidemics increased, public health and vaccine industry leaders started to look at options to restore faith in pertussis vaccinations. After large studies in Canada and the US, comparative studies at the National Institutes of Health, and two efficacy trials in Sweden, Barreto and Connaught Laboratories (now Sanofi Pasteur) introduced the combination vaccine containing acellular pertussis. DTaP-IPV-Hib, was licensed in Canada in 2007 for use in babies at 2, 4, 6 and 18 months, and a booster at 4-6 years old. The vaccine is now included in the routine immunization schedule across Canada, the US, Europe and many parts of Asia, and Latin and South America. However, believing more can be done, Barreto continues to help initiate development and licensure of acellular pertussis vaccines for adolescents and during pregnancy to protect neonates and young infants.
Today, Barreto works with the National Research Council to support discovery research by small and medium-sized organizations and larger biopharmaceuticals. "We need to make sure we stick to good science," he says, stressing the importance of vaccine research, development and innovation. "With rapid progress in science and biotechnology, it's important that newer vaccines that are safe and efficacious are available to those who need them most." It is this commitment to good science – and a dedication to creating innovative solutions to global health challenges – that has earned Barreto accolades and awards from BIOTECanada and Research Canada, as well as a Paul Martin Senior Award from the March of Dimes, a Meritorious Award from the Biosciences Education Canada and, most recently, the Community Service Award from Life Sciences Ontario.
Many pandemics have crossed North American borders: SARS, H1NI and Ebola. Re-emerging infections like measles have also raised their ugly head. "With rapid travel, political chaos and wars disrupting peoples' lives, we need to be vigilant, and able to respond rapidly and globally," Barreto explains. "So many of these outbreaks occur at the animal/human interface so we need to coordinate our efforts with those working in agriculture and in the animal world." To address these issues, VIDO-InterVAC, a world leader in developing vaccines and technologies against animal and human infectious diseases, has opened in Saskatchewan. "I have been very fortunate to be a Board member, and Chair when we opened this unique state of the art level 2/3 facility in 2012," says Barreto.
Addressing vaccine safety concerns, which are as prevalent today as they were in the 1970s and 80s, Barreto says, "We can't merely ignore the efforts of the anti-vaccine movement. As with any difference of opinion, we need to listen, and continue to address some of their concerns with objective measures and good science. We all need to work harder in this space, with the ultimate goal of increasing control of infectious diseases and events such as the recent measles outbreaks in the Netherlands, the US and Canada, or polio in Nigeria. We need to keep immunization rates high to avoid these outbreaks."
Making a Difference
Barreto continues to spend his time volunteering as director on boards of government, academia, industry and philanthropic organizations and is also a member of scientific review panels in Canada and internationally. "I am very fortunate to have been able to make a little difference," Barreto says, humbly reflecting on his 30 years of influence. "And today I am honoured to be involved in the MSc in Global Health. It's an amazing program, supported by dedicated staff from McMaster-Maastricht Manipal universities, and it's shaping the next generation of global health leaders. It's excitingto be a part of this great initiative."
Batch 1975 has ten missions doctors who graduated in 1981 all doing inspiring work in their respective areas .Since the AA is talking about a Dr. Sr. Mary Glowery award I felt that I could tell the story of our very own classmate who belongs to the same order as Sr Mary Glowery. We also have Dr. Sr. Mary Thomas who also belongs to the same batch and same order whose story will be highlighted on another occasion.
After graduating from MBBS and DGO from SJMC Sr. Dr. Rosily worked in many rural areas of India till 1989. In 1990 they were invited by Sunyani Bishop Rev. James Owusu Of Ghana Africa to extend the services in the land of Gold to work among the people of Africa , a remote and backward area namely in Yeji, Atebubu and Kwasibuokram (KBK) through apostolates of education, healthcare and social enterprise.. A group of five JMJ Sisters were selected for this mission Dr. Sr. Rosily Kannampuzha, Sr. Jovita Plakkal and Sr. Luciana Kalapura all three from India and Srs. Johanna Roring and Sr. Angelinio Poluan from Indonesia. They left for Yeji-Ghana on 25th July 1990.
They started a small clinic in Yeji with six sisters and a few local staff for serving the local community with proper healthcare, and then started JSS School at Atebubu in 1997 to help the backward community with better education facilities.
Sr Rosily describes this as a enriching cross cultural experience. There were many patients who were HIV positive that other doctors were unwilling to treat .She bravely did caesarians sections on these folks while also being confronted by other emergencies like ruptured spleens and obstructed hernias.Not having much experience with the above she still successfully did surgery with good outcomes on these poor abandoned patients.Sr Rosily could possible be the first Johnite to do Caeserian sections on HIV positive women, a skill now common place in OGYN.As her confidence grew so to her reputation so much so that she was known as the Renowned hernia doc in that region of Africa.
When she came back to India she went on the study HIV fellowship medicine at CMC Vellore .She came across the Director of Red Cross HIV Centre in Maharashtra who informed her that no one was willing to work among these patients in Panchagani.She took permission from the JMJ sisters her order and went to work there till they could find a replacement for her which took roughly about 7 years. Bel air hospital Panchagani. is a red cross society institution which specially focused on HIV/AIDS care managed by catholic priests society.
While they treated all kinds of patients their focus was women and children. In those days there would be about 200 inpatient HIV patients many women who became HIV positive after marriage. Some of these women lost their husbands to the disease and some of them also has HIV infected children.These women were thrown out of their homes and faced unimaginable problems.Orphan children were placed in homes and some of the women besides being treated also got jobs in the local area and hospital as also rehabilitation is/was what they did at this center. Dr. Sr Rosily and others in her team had not only to treat their medical conditions but also make sure they were taken care of by other means.
She was not only a compassionate doctor but also a social worker ,teacher,pioneer and wears many other hats.Today she is working in a rural part of Bangalore called Nagawara which is less challenging compared to areas she has previously worked in, but never the less continues to do good and make a difference in peoples lives around that area. By this brief inspiring short story on Dr Sr Rosily you can see how she has lived the dream of Sr Mary Glowery and her mission work does not stop but continues to inspire all around her.Not only is she a brave doctor who pioneered in many fronts ,she never forgot her compassion and love for fellow human beings.Mother Theresa said "I alone cannot change the world, but I can cast a stone across the waters to create many ripples" Dr. Sr. Rosily has by her work created many ripples in the water that she has throw a stone in.
We the batch of 1975 are honored to have her as our classmate.
Initiative to create awareness on the importance of exercise for a healthy heart
Mr. Robin Uthappa & Reeth Abhram flagged off the Walkathon organised by Vikram Hospital,Bengaluru
Bengaluru, September 27, 2015: Hundreds of healthcare professionals participated in a walkathon organized by Vikram Hospital Bengaluru to commemorate ‘World Heart Day’ today with an objective to spread awareness and sensitise people on the importance of exercise for a healthy heart. The Walkathon was flagged off by chief guests – Mr.Robin Uttappa, Indian Cricketer and Ms. Reeth Abhram, Indian athlete and former South Asian Games champion who walked for the cause with 400 other odd participants.
The Walk started at 6:30am from Vikram Hospital, via Rajbhavan Road, High Court, Cubbon Park entrance and ended at Press Club.
Speaking at the occasion, Mr. Robin Uttappa, Indian Cricketer said “I am glad to be a part of this initiative which gives me an opportunity to interact and share my experience on fitness with everyone. Only a theoretical knowledge about heart health is not sufficient; we must start incorporating these small healthy changes in our day to day activities, to actually see results.”
Heart related diseases are the world’s largest killers, claiming 17.3 million lives every year. This year, the theme for World Heart Day is- Creating Heart-Healthy environments. Dr. Ranganath Nayak, Chief Cardiologist at Vikram Hospital, Bengaluru “At least 80% of premature deaths from cardiovascular disease (CVD) could be avoided if four main risk factors – tobacco use, unhealthy diet, physical inactivity and overuse of alcohol – are controlled.
Further he added that “Exercise plays a major role in preventing and modifying risk factors for heart disease. It reduces the risk of developing diabetes and high blood pressure. If one is already a diabetic, it helps in improving blood sugar control.” In addition to benefitting various organ systems, exercise also helps to reduce stress, tension, depression, anxiety, and promote overall health and wellbeing”.
While Ms. Reeth Abhram, Indian athlete and former South Asian Games champion said that “ At least 30 minutes of moderate – intensity aerobic activity at least 5 days a week (or at least 25 minutes of vigorous activity at least 3 days a week) PLUS moderate – to – high – intensity muscle strengthening activity at least 2 days per week is ideal for a healthy living. Walking happens to be one of the best forms of exercise to reduce the risk of cardiovascular disease.
Mr Sudhir Pai, Executive Director and CEO, Vikram Hospital said that “We at Vikram Hospital believe that such initiatives will help in sensitising people about the role of walking in preventing heart disease. Due to an unhealthy lifestyle, stress and lack of exercise, we see a lot of youngsters succumbing to heart related ailments. This walkathon is an initiative by our cardiology department to reiterate the benefits of walking & exercise .