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

By Kevin Pezzi, MD


Women in Medicine Part 5
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?

by , MD

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Review of
Walking Out On The Boys
by Frances K. Conley, MD

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Men groping women. Men coming on to women, and making incredible jackasses of themselves in the process. Men getting drunk and acting like barbarians. Men with one thing in mind. Men whose compulsion to talk about sex is so strong that they do it at highly inappropriate times in public. Men who think that pressuring women is their God-given right. If you think that what I just described is a high school football team on an overdose of steroids, you're wrong. These sexual antics weren't perpetrated by adolescents with testosterone bubbling out their ears, they were committed by male doctors at Stanford University. Not being stupid, these demigods put two and two together and realized that they could use their power to pressure women. One of these men made a fatal mistake, though: he pressured Dr. Frances Conley, a topnotch neurosurgeon and renowned researcher at Stanford. Bad move, fella. I suppose that guy never learned that if you're going to pick a fight, you don't provoke someone who can whack you back so hard you just might rethink whether it's wise to be a bully.

As publicity spread about Dr. Conley's fight, more and more women came forward to reveal their stories. This was certainly an eye-opening book. Before reading it, I'd never given much thought about the sexual harassment of women in medicine and allied healthcare fields. Perhaps we're more civilized here in Michigan, because I've never seen or heard of any such hanky-panky. Well, let me revise that last statement: I have witnessed a lot of sexual inducement, but what I saw was women chasing men—not the other way around. But everyone knows that those California folks are trendsetters.

Dr. Conley never envisioned herself as a trendsetter, though. For years, she passively participated in the abuse until a concatenation of events convinced her that it was time to draw a line in the sand. To make a long story short, the men didn't believe she'd put up much of a fight, but she did, and they lost. Big time.

Judging from her picture on the book's cover, Dr. Conley's repeated description of herself as being "cute" is no exaggeration. Although I inferred that she was almost 60 when the picture was taken, she was still very attractive at that age—leading me to wonder how stunning she must have been years before. So is that what precipitated the abuse directed at her? I think it did, at least in part. While her main nemesis seemed to be a sexist sociopath and thus may have been compelled to act the way he did even in the absence of genuine attraction, it seems clear to me that he had the hots for Dr. Conley and some of his retaliation wasn't as much instinctive as it was a calculated response to avenge his unrequited love.

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Perhaps the most chilling message in this book is that some men in positions of power are willing to use that power to stifle the careers of women. So what is an attractive woman to assume? That if she goes into medicine her pulchritude will serve as a magnet for sexual harassment? Perhaps this abuse is, unbeknownst to me, more pervasive than I think. I suppose because most of my friends are women, I can't understand men who view women as being somehow inferior. However, you shouldn't necessarily construe from that statement that I think women physicians are as competent, on average, as male physicians. There's no doubt that some are, and there's no doubt that Dr. Conley is a superior physician, not just competent. However, Dr. Conley is the epitome of a dedicated doctor: realizing that there are 24 hours in a day, she chose not to have children and she seems far more married to her career than to her spouse. That's the way it used to be for male docs. Sure, they may have had children, but they weren't the ones raising them. Now women are told they can "have it all." A woman can get married, raise a family, watch her kids play soccer, be active in church and other social functions, pursue her individuality through avocational interests AND she can be not just a doctor, but just as good as docs who live, eat, and breathe medicine. Dream on!

Unless a woman was a genius who never slept, it just isn't possible for her to be SuperMom, SuperDoc, and SuperWife. Still, egged on by the politically correct rhetoric in America, some women pressure themselves to be SuperWoman not realizing that something has to give. According to one of my friends who is a woman and a doctor, what gives is often their dedication to and mastery of medicine. Her beef with female physicians is that too many of them are lackadaisical 9-to-5 docs who spend more time baking cookies, shopping, and reading Family Circle magazine than they do reading medical journals. Especially in emergency medicine and the primary care specialties (such as Internal Medicine and Family Practice, both of which draw many women) in which a doctor's knowledge base is so diverse, there just aren't enough hours in a day for a woman to be a superb doctor and everything else that society is telling her she should be. It's no wonder why some women feel so pressured.

Don't interpret this as a criticism of women. It's not. On a level playing field, women can be just as competent as men. The problem starts when women begin diluting their professional time—that's when they begin knocking their heads against the "darn, there are only 24 hours in a day" problem. Even if a woman were married to a man who is willing to share housework, the responsibilities of motherhood are not so easily met. If you're a surgeon who gets home at night after your kids are in bed, who is going to hug them when they need a hug? Your nanny? Or if you skedaddle out of the hospital early to greet your kids when they get home from school, who is going to take care of your patients in the hospital? Or do you think that patients develop problems only from 9 AM to 3 PM? Again, something has to give if you try to have it all. You can decide where you want to cut corners, but you can't avoid the reality that cutting corners will be necessary. I know that, Dr. Conley knows that, and my friend the female doctor knows that, too.

So do male doctors in positions of power have valid reasons for discriminating against women? As painful as that question is, it is a question that begs to be answered. Considering what I just said, you might surmise that the discrimination and harassment of women is a boorish way of informing women that they can't have it all. The problem is that the women, such as Dr. Conley and some other equally dedicated women mentioned in her book, who were the targets of this abuse are not the women who try to have it all and thus are the ones giving their patients the short end of the stick. When a person like Dr. Conley is targeted, it's clear that this is a real problem. In solving this problem, however, I think we should not let the pendulum swing too far and fail to acknowledge that while it is an execration to discriminate against women who are as qualified and dedicated as men, we should not penalize patients by sweeping under the carpet the fact that doctors who think they can do it all are too optimistic.

Before I read this book, its title lead me to believe that it might be a journal of whining similar to Dr. DasGupta's book (reviewed on my site). However, Dr. Conley is a gifted writer who presented a clear, compelling, and substantive story. On a few occasions my eyes glazed over as she droned on and on belaboring a point for the umpteenth time, but for the most part I didn't want to put the book down. My only major criticism of the book is that it is too focused on abuse of women by men. Since the core of this book hinges on some of the depredations that ensue when power is abused, I think she could have achieved a more balanced perspective by pointing out that powerful people often use their power against men, too—not just women. I've seen male docs fight one another with such a vehemence that it made the stories in Dr. Conley's book seem as pleasant as afternoon tea and cookies with a neighbor. Consequently, while I don't intend to trivialize the unfortunate reality of the abuse Dr. Conley documents, it's important to keep in mind that this abuse is but one aspect of a much larger problem. In defense of Dr. Conley, broadening the scope of this book to include other aspects of hospital politics would have diluted the message she wished to inculcate, and it would have made for a very unwieldy book. With that in mind, I suppose I'm on shaky ground by wishing that her book had a wider focus. Her book, her demeanor, her dedication, her resolve, and her competence are commendable. Dr. Conley is a great doctor and I am happy to have met her, however indirectly, by reading this book.

NOTE: If any readers—female or male—think they know how to overcome this "24 hours in a day" problem, I will gladly post your meritorious responses in this web site to help the many young women who dream of becoming doctors and good wives, mothers, friends, and neighbors. The only realistic solution I can think of is for such a woman to work part-time in a narrow specialty in which she won't be shortchanging her patients by the fact that patients aren't the top priority in her life. In other words, think dermatology or dentistry, not surgery, Internal Medicine, pediatrics, emergency medicine, or cardiology.

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