Some of my: Inventions | Magazine interviews | Sheds | Favorite ER memories

Information for people contemplating
a career in emergency medicine and
other medical specialties

By Kevin Pezzi, MD


Women in Medicine Part 1
Can women "have it all?" That is, can they be good mothers, wives, daughters, friends, neighbors, and still be good doctors?
Are women as competent as men?
Are women achieving their potential?
What can women do to achieve more?

Female physician

UPDATE: Some of what I wrote below years ago* rubs me the wrong way, in tone if not in fact. But hey, people evolve, and some of it is right on the mark. (*in the midst of severe sleep deprivation that plagued me for years)

Q: Hi. I'm a mother of two and a premed student. Instead of studying Organic Chemistry as originally planned tonight, I stumbled upon your site and spent a good length of time reading it (that amount of time will remain undisclosed due to my chagrin).

I was particularly interested in your very thorough and lengthy rhetoric about why women don't maximize their potential. I found your list of personal accomplishments somewhat amusing. It's very apparent to me that you spend a lot of time alone and you do not have the demands of a wife or family. Your question was, "Well, what is the single woman's excuse?" Although I do see your point, I feel like you are missing the big picture. I don't have any statistics readily available, but I believe most women do have families.

I would like to give you an idea of my typical day: I get up at 5:00 AM to hop on the treadmill, study scriptures, meditate, and get to class by eight. I get home at 10:30 AM and my husband promptly hands me the baby, explaining he can no longer deal with him. I help my five-year-old daughter with reading or writing (right now we're working on vowels). Between feedings and diaper changes, I put in an hour of housework and a couple of continuously interrupted hours of studying. At 3:00 PM I commute a half hour to a college extension site to resume my work as a writing tutor. When I get home about 8:30, I put the baby to bed and read to my daughter, then I get one more hour of study time before I turn in at 10:00.

A shed designed &
built by Dr. Pezzi
More pictures of it

Now please explain to me just where in there I am supposed to be inventing perfect lawnmowers and beautiful sheds? I do dream of making robots. My real dream (and I am not being facetious here) is to program a robot to do housework. I think women are still in their evolution. I think the day will come when women will be repairing engines and discovering more than uranium. Twenty five years ago, men did not do housework and just look at them now. When I turn 65, (I am now 26) I'm willing to wager that these generalizations will no longer apply. I guess we'll see. As soon as my retirement begins, so does that robot.

As a side note, I loved your writing. I would like to ask you what you have done to lengthen your vocabulary. Very rarely do I run across someone with a more advanced mastery of the English language, but you were throwing some whopper words out there for me! :) I would also like to ask you if you have ever considered having a radio program? You are interested in talking about almost anything, and you most certainly have the abilities.

Thanks for the wonderful site.


Answer by , MD: Melanny sent the above question to me after reading what I wrote about the Can women "have it all?" topic on my site. To facilitate a comprehensive discussion of this subject, I will copy those postings, and then comment further. This is a long topic distributed over the next several pages. On the following page is a question from another person, and my response to it, that summarizes my position on this matter.

I will preface this discussion by emphasizing that my goal isn't to disparage the potential of women to innovate but to point out that they have various biological strikes against them, many of which can be mitigated if intelligently addressed but persist indefinitely when political correctness deems certain topics off-limits.

Thus when the PC police shield women from that reality, they limit the potential of women to improve. This helps explain why the past few decades of scientific and technological liberation for women haven't resulted in them matching male innovation even though the majority of college graduates are now women — and have been for years.

So as someone who aspires to help women improve (something I've done for decades, helping many), I could ignore this topic and be politically correct by zipping my lip, or I could help women by exploring it. This is exactly what I've done in an upcoming book, now over 3000 pages and growing daily, devoted to improving health, happiness, and brainpower by addressing the ultimate roots of why we often — not occasionally — fail to achieve our full potential in everything from how we feel to how we look and perform.

Notably, those answers are very rarely found in prescription drugs or surgery, thus mainstream medicine is not the primary catalyst to better lives. That book includes a section devoted to identifying (and correcting whenever possible) roadblocks that prevent women from achieving more. I haven't totaled its length, but I wouldn't be surprised if it were 200 pages or more — all filled with countless scientific studies to corroborate my asseverations. If I never published those practical tips, I could be more politically correct, or I could be more scientifically correct by discussing them.

Next page on this topic >

June 24, 2020: What America Asks of Working Parents Is Impossible: More and more, the goals of being a dedicated employee and being a dedicated parent seem to be in conflict.

Work that kills: The danger of nonstandard working schedules

Shift work, DNA methylation and epigenetic age

New doctors' DNA ages six times faster than normal in first year: Long work hours of intern year associated with accelerated shortening of telomere regions of chromosomes

Why Working at Night Boosts the Risk of Early Death

Long work hours associated with increased risk of stroke

For babies, too: Pregnant women who work nights may have a greater risk of miscarriage: Women who work two or more night shifts in one week may have a greater risk of miscarriage the following week

Rotating shifts shorten lives
Excerpt: “A study of 3,912-day workers and 4,623 shift workers … showed the former lived 3.94 years longer than their counterparts on shift duties …”

Here's why working nights could be killing you

Are night shifts killing me?

Shift work and its effects on the cardiovascular system

Shift workers at risk for heart disease, stroke and type 2 diabetes

Nurses have an increased risk of sleep disorders and sleep deprivation: Chronic insomnia identified in nearly one-third of hospital nursing staff

Sleep deprivation may affect our genes
Excerpt: “In the … study on 49 healthy full-time doctors …, on-call doctors who were required to work overnight on-site had lower DNA repair gene expression and more DNA breaks than participants who did not work overnight. … Damaged DNA increased after only one night of sleep deprivation.”

How Night Shifts Perpetuate Health Inequality

Five Years of Night Shift Work Elevate a Person's Risk of Death

Irregular schedules raise risk of injury for miners working long hours

Long term shift work ages the brain up to 6 and a half years - but how old is your mind? A new study has discovered that working random shift patterns can lead to a loss of brain function

Working the Night Shift May Affect Your Lifespan

Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts

Night shift work at specific age ranges and chronic disease risk factors

Rotating night shift work can be hazardous to your health

Women's long work hours linked to alarming increases in cancer, heart disease

Night shift work linked to an increased risk of obesity

Maximising alertness and productivity on the nightshift

Shift work unwinds body clocks, leading to more severe strokes: Research finds living against our body clocks is detrimental to our health

A gene linked to job-related exhaustion in shift workers increases the risk of Alzheimer's

Eating at night, sleeping by day swiftly alters key blood proteins: Proteins involved in metabolism, immunity disrupted after just one simulated night shift

The effect of night shifts: Gene expression fails to adapt to new sleep patterns: Genes related to the immune system and metabolic processes did not adapt to new sleeping and eating patterns

Kids' sleep may suffer from moms' tight work schedules

Superwoman: A Hard Act to Follow

PepsiCo CEO Indra Nooyi: No, Women Can't Have It All

Article by Anne-Marie Slaughter in the July/August 2012The Atlantic: Why Women Still Can't Have It All (subtitled: “It's time to stop fooling ourselves, says a woman who left a position of power: the women who have managed to be both mothers and top professionals are superhuman, rich, or self-employed. If we truly believe in equal opportunity for all women, here's what has to change.”

A retired female surgeon wrote, “As for women in surgery? You can't have it all and be good at any of it. If you want to be a good mom, then stay at home or pick a 9-to-5 career.” (source: in a comment to that article)

Katya Andresen: Moving Above and Beyond 'Doing It All'

Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study

Burnout: Sleepless firefighters at risk of exhaustion and mental health conditions

[Female] Physician Dies After Patient Attack in Dallas Hospital

Worked to death? Study says lack of control over high-stress jobs can lead to early grave

Book: Opting Out?: Why Women Really Quit Careers and Head Home

If Norwegian Women Can't Have It All, Can Anyone? Subtitle: Even in a country with forward-thinking child-care policies, women still can't get ahead.

Former CFO Erin Callan Regrets Not Having Children, Reignites Work-Life Balance Debate  In a New York Times article (Is There Life After Work?), she reflects “on the decisions I made in balancing (or failing to balance) my job with the rest of my life. … I didn't start out with the goal of devoting all of myself to my job. It crept in over time. … I don't think I could have "had it all" … I can't make up for lost time.”

“Forget work/life balance. You can sleep when you die. At least that's how Snapchat's Emily White and Coca Cola's Wendy Clark said they approach time management …” (source)

Challenges around childbearing owe to dissatisfaction among surgical residents: Refined mentorship programs, further education and understanding are cited as necessary to improve work-life balance
Comment: Or find a way to stretch each day into 36 hours. Realistically, early motherhood is often exhausting. Add in a career working two to three times as many hours per week as average folks, and something is bound to get the short end of the stick: children or current and future patients. As impressed as I am about the ability of women to do a lot, I see no way for them or anyone to escape this reality.

Billionaire investor says babies are like divorce: they both 'kill' focus

Facebook COO Sheryl Sandberg Isn't Kidding About People Hating Successful Women
Excerpt: Sheryl Sandberg “published a new book called Lean In. The book offers career advice for women in a world that is still dominated by men.”
Comment: A seemingly mundane experience (a stray dog in my yard) unfolded in a way that taught me how true that is, as I discussed in Sexism isn't dead yet.

Randi Zuckerberg thinks burnout is a “lifestyle” problem. It’s not.: In her new book “Pick Three,” the media guru frames work-life pressures as a prioritizing challenge, and prioritizing as a form of empowerment.

Full-time professional to full-time mother: A choice laden with cost

Researchers with children: A disadvantage in academia

Women driven by status, wealth rather than wanting babies, study suggests

Working Moms Spend Less Time Daily On Kids' Diet, Exercise based on Maternal employment and childhood obesity: A search for mechanisms in time use data

Just 20 Minutes Of Weekly Housework Boosts Mental Health (no wonder I'm so happy! :-)

Dads who do chores bolster daughters' aspirations

Living with children may mean less sleep for women, but not for men

Men's Involvement at Home: Sports 1, Housework, 0

Household chores: Women still do more: Study confirms that women tend to do more housework than their male partners, irrespective of their age, income or own workloads

Exactly How Much Housework Does A Husband Create?

Married Men Really Do Do Less Housework Than Live-In Boyfriends

A Man's Occupation Linked to Time Spent On Housework, Study Finds

In Dual-Career Couples, Mothers Still Do the Most Child Care

Dads are often having fun while moms work around the house

When the baby comes, working couples no longer share housework equally

Dads, not just moms, battle balancing work, family, exercise

A Woman's Work Is Never Done?

Housework gender differences may affect health in elderly men and women

Women have less time for hobbies because they spend more time on chores than men

Why the institution of fatherhood is taking so long to change

Comment regarding the several above articles suggesting women do more housework: This isn't always true, of course. Of all but one of the women I've dated, I recall only one who once baked something for me: cinnamon rolls using store-bought dough sheets after I made her cinnamon rolls from scratch that were the tastiest ones I've ever had, easily surpassing Cinnabon's rolls. That resulted from me following a recipe, guesstimating how to modify it to amplify taste, but some of my other culinary successes stemmed from what initially seemed major mistakes: one resulting in the yummiest bread crust I've found, and the other blueberry muffins to die for—both outclassing their counterparts from all bakeries I've sampled.

I could fill a book listing other things I've done for women, from installing crown molding to fixing their mowers to free plastic surgery—yes, really, and they were pleased while one was thrilled with the results! And shoveling snow, painting, laundry, general cleaning, and on and on. But except for that single outlier, women I've known resisted housework and cooking as if they were allergic to it, such as when I was rushing to prepare breakfast and asked one to put bread in the toaster: she flat-out refused, excusing it by saying her cooking skills were so exiguous she would burn water if she boiled it.

I am not fond of housework or cooking (one reason I later invented a robotic chef), but someone must do it. I understand that women are perhaps revolting from how most of that burden once was shouldered by their homemaker predecessors, but the pendulum may have swung too far in the opposite direction—in my experience. Your mileage may vary.

Forget Marcus Welby: Today's docs want a real life

Working Odd Shifts Can Hurt Parent-Child Relationships (Ya think?)

Does Becoming a Doctor Pay Off for Women? * Excerpt: “Women who go to medical school just for the financial rewards of being a doctor could be making a mistake … The research found that after factoring in the high upfront costs of becoming a doctor, most women primary-care doctors would have made more money over their careers becoming physician assistants instead.” (*based on Are Women Overinvesting in Education? Evidence from the Medical Profession)

Average 25% Pay Gap Between Men and Women Doctors Largely 'Inexplicable' based on Is there equal pay in healthcare? Not if you are a doctor

Genetic cause for shift work fatigue discovered
Excerpt: “Some people adapt easily to shift work, but not everyone can handle constant disruptions to their daily rhythm. Researchers have now found that a melatonin receptor gene influences tolerance to shift work.”

Don't shoot the messenger department: An article asks, “Are There Too Many Women Doctors? As an MD shortage looms, female physicians and their flexible hours are taking some of the blame.

When Mom Is CEO at Home, Workplace Ambitions Take a Back Seat

One of many studies documenting the risk of shift work (which is almost inevitable in emergency medicine): Female Shift Workers May Be at Higher Risk of Heart Disease

Increased risk of coronary heart disease seen among women who work rotating night shifts

Untimely immune cell clocks may contribute to obesity and diabetes in shift workers

Time of day influences our susceptibility to infection, study finds
Excerpt: “We are more susceptible to infection at certain times of the day as our body clock affects the ability of viruses to replicate and spread between cells, suggests new research. The findings may help explain why shift workers, whose body clocks are routinely disrupted, are more prone to health problems, including infections and chronic disease.”

Long Term Night Shifts Linked to Doubling of Breast Cancer Risk

Shift Work Linked to Increased Risk of Heart Attack and Stroke based on Shift work and vascular events: systematic review and meta-analysis

Higher Job Strain Associated With Increased Cardiovascular Risk for Women based on Job Strain, Job Insecurity, and Incident Cardiovascular Disease in the Women’s Health Study: Results from a 10-Year Prospective Study

Work-Related Stress Linked to Increased Blood Fat Levels, Cardiovascular Health Risks based on The relationship between job stress and dyslipidemia

Rotating Night Shift Work Linked to Increased Risk of Type 2 Diabetes in Women, Study Finds

Night Work May Put Women's Health at Risk (Higher risk of heart disease, diabetes … and cancer, too? Yikes!)

Women Working Shifts Are at Greater Risk of Miscarriage, Menstrual Disruption and Subfertility

Molecular Link Between Circadian Clock Disturbances and Inflammatory Diseases Discovered based on Circadian clock protein cryptochrome regulates the expression of proinflammatory cytokines

Rotating Shift Workers Have Lower Levels Of Serotonin

Night Work May Impair Glucose Tolerance

Shift work linked to heightened risk of type 2 diabetes

How Long Hours at Work Hurt Your Health

Physicians Lead MomDocFamily Support Group

Study finds Working Moms Feel Better Than Stay-At-Home Moms

Working Moms Multitask More and Have Worse Time Doing So Than Dads

'All Work' Won't Help 'No Play:' Professor Scrutinizes Link Between Job and Life Satisfaction

Medicine -- A Woman's World?

Motherhood 'Detrimental' to Women's Scientific Careers, Study Concludes

Thirty-Five-Hour Work-Week Recommended for Parents

Most Women Would Choose Surgical Profession Again based on Women Surgeons in the New Millennium

Surgeon-Physician Marriages Can Place Stress On Careers, Emotional Health

NOTE: In mentioning these and other drawbacks pertaining to emergency medicine, my goal is not to deter students from choosing that profession, but to educate them so they can make informed choices.

Women Speak Less When They're Outnumbered based on Gender Inequality in Deliberative Participation

Women's Scientific Achievements Often Overlooked and Undervalued based on The Matilda Effect in science: Awards and prizes in the US, 1990s and 2000s

Gender Gap: Selection Bias Snubs Scholarly Achievements of Female Scientists, Study Suggests based on Scholars' awards go mainly to men

Why Are There Too Few Women Consultants in Surgery?

Why Do So Many Women Leave Biology?

Is Shyness Holding You Back at Work?

Women With Elite Education Opting out of Full-Time Careers: Women With MBA's Are Most Likely to Work Less

Stress-diabetes link detailed in new study: Connection established between anxiety control, inflammation, Type 2 diabetes

Many Top U.S. Scientists Wish They Had More Children, Study Finds; 25 Percent of Scientists Consider Leaving the Profession for Family Life

Fathers' long commute to work is linked to children's social, emotional problems

Weight Discrimination Could Contribute To The Glass Ceiling Effect For Women, Study Finds
Excerpt: “Weight discrimination appears to add to the glass ceiling effect for women, finds a new study co-authored by a Michigan State University scholar.”
Comment: Years ago, I noted that the shape of a woman's body affected the shape of her wallet; specifically, thinner body, thicker wallet. I loathe discrimination, so I am not fond of this correlation, but that's just the way the world is, and the last time I checked, few people want to change themselves, only others.

Women Sell Themselves Short On Team Projects, Study Suggests based on It Had to Be You (Not Me)!: Women’s Attributional Rationalization of Their Contribution to Successful Joint Work Outcomes

Operating room reproductive hazards for female surgeons
Excerpt: “Researchers in this review article discuss occupational reproductive hazards for female surgeons in the operating room, including radiation exposure, surgical smoke, working conditions and physical demands, sharps injuries, anesthetic gases and the use of toxic agents. ”
Based on: Occupational Reproductive Hazards for Female Surgeons in the Operating Room: A Review

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