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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 6
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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Now let's return to Melanny's comments. She said, "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."

I don't have a wife, but I do have a family: two brothers, four nephews, and countless other relatives. My father was murdered years ago (tragically, but there is an intriguing story about that event which I told in Fascinating Health Secrets). My Mom recently died of metastatic bladder cancer, but I saw her frequently before that. I slept on the floor next to her bed while she was dying so I could hear if she was moaning in pain, and thus take corrective action. I spent months caring for my Aunt before she died. I've spent innumerable hours clearing the snow off my neighbors' driveways, sidewalks, and porches. Sometimes this was necessary (as in the case of a disabled neighbor, and sometimes this was just a way for me to make my neighbors' days just a bit easier so they could arrive home from work and find a clean driveway instead of one covered by a foot of snow. At my last house I was good friends with a family that included five children, and we'd do all sorts of things together: go boating and swimming, ride my Sea-doo, take bike rides, play baseball, bake cookies, eat pizza, go snowmobiling, watch movies, I'd help them with their computer or with homework, and so on. I truly enjoyed that, but it was very time-consuming. In fact, I bet that I spent more time with those kids than many fathers would have. I've "adopted" other neighbor's children in the past, too, so I don't think that it is accurate to imply that my accomplishments came at the expense of my personal life. I've also been on numerous dates. In general, I invent and "do things" when I don't have anything better to do. If one of my neighbor's kids called me up and asked to go jet-skiing or biking, I can't recall ever saying no. I make time for inventing and building things by not succumbing to time-drains such as watching sports, instant messaging, participating in chat rooms, going to the bar, etc. Hence, I am efficient, but not a hermit.

Melanny also said, "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." As do most men. I agree that our cultural expectations of mothers places a burden upon them that often precludes further accomplishments while they are raising their kids, but that still leaves many years afterwards, and sometimes before, to accomplish things that generally never materializes. Why? Is it the inertia of being stuck in neutral?

You certainly are not, Melanny. Even I would not start down the path to becoming a doctor if I were a mother and married. Can you be a great mother, wife, daughter, friend, neighbor, and doctor? I cannot fathom how that is possible. Medical school takes an inordinate amount of time, as does internship and residency. Relationships take time, too. Lots of it. I don't buy that psychobabble about how 15 minutes per day of "quality time" is sufficient. It's not. I would never have had enough time for all my friends and family even without medical school and the 110 hours per week that I spent engrossed in that. Could you get by with an investment of less time? Yes, but cutting back in this way is the first step toward mediocrity. I discussed this topic with a female friend who is an experienced nurse. I was somewhat surprised by what she said, so I asked her to write it down and e-mail it to me. She wrote:

"Most female doctors I have known were mediocre at best. As a woman who is constantly striving to better myself by furthering my education, I think that it is unfortunate that more women are not as accomplished as men. It is rare for a female physician to be as highly regarded as her male counterparts. Nurses know when doctors are superb or just so-so. Sadly, the topnotch doctors are usually men. I know of two exceptions, but how many physicians have I interacted with over the years? Hundreds. There are more male than female physicians (although this is slowly changing as medical schools now accept more women than men), but the ratio of female to male doctors is nowhere near low enough to explain why there are so few first-rate women physicians. Being somewhat of a feminist, I hate the fact that this is true, but it is. I have a simple message for any woman who thinks that she can have it all and be a wonderful wife, mother, and doctor: you can't! Don't delude yourself and think that you are immune to the limitations of time. There are 24 hours per day, and never more. Something must give in the end. Either family life or work/career. It's your choice."

Melanny, I do not expect you to build a shed shaped like a lighthouse or to make a robotic lawnmower. You already have more than a full-time job. But what of the millions of women without kids? Why isn't there more tangible evidence of their accomplishments? Why are they seemingly content to let our world be one that is chiefly a result of what men have created?

One reason is that women, especially the attractive ones, are more likely to receive positive feedback even when the only notable thing they've done is look pretty. We all want compliments and "positive strokes," but men must generally work harder than women to receive these rewards—so they do. To see a real-life demonstration of this, watch The Bachelorette on ABC-TV. I like to watch this series while exercising because it's an interesting way to mentally unwind while still providing some provocative sociological insights. One of these lessons is that a woman can be effusively and incessantly lauded as being "great" and "wonderful" if she is attractive, but nothing more. If you heard the praise given to the current bachelorette, Jennifer Schefft, you might think that she was a truly remarkable person. She strikes me as being ordinary, except for her cute face and mouth-watering body. I would love to hear the men glorifying her explain what is so wonderful about her, other than her appearance.

In a similar series on another network, the encomia given to the gorgeous bachelorette ended the minute she was made to look overweight and unattractive by makeup artists. Unbeknownst to the hapless male contestants on this show, the hot woman they once extolled was still there, just camouflaged. Judging by the revulsion evinced by the men, whatever it was they once found so wonderful was now absent. Instead of being regarded as wonderful, she was now thought to be disgusting. This is obviously an unflattering manifestation of how men prioritize attributes. Appearance is paramount.

Clearly, men are enamored with beauty. If you've got it, men are apt to generalize your attributes and deem you to be wonderful. This quantalization of your overall desirability demonstrates the weight that men give to the importance of appearance. However, it does more than that. Given that beautiful women are almost reflexively considered to be great and wonderful, it demonstrates how men inflate their assessment of your other attributes if you have the one thing—beauty—that makes them eager to put you on a pedestal.


Something to think about

A man born with a great mind
must do something with it
(often toiling for years) to
achieve success, but a woman
born with a great body can
become successful merely by
letting others look at her.

Perhaps the ultimate compliment is when someone falls in love with you. Boys are generally taught that success is a prerequisite to being a good husband and father, and hence lovable. What man does not want to be a good provider? It's drummed into our heads from Day One. Women wish to be loved, too, but for them financial success is not an essential ingredient to being lovable. Through its creation of different standards for what constitutes being lovable, society instills a different behavioral roadmap for men and women. A woman could be a high-school dropout who is unemployed and in debt, but if she is very attractive, she can have her pick of countless successful and attractive men. Even if she were a Plain Jane, she need not be lonely. She has what men want. Brilliance and accomplishments are not part of the equation; anatomy is. Women are born with their anatomy, but men are not born successful*, so they work hard to achieve it. In the process, they're created the world around us. A woman can coast for decades and still have her anatomy, and hence desirability. If a man coasted for decades, he would be a failure. His appeal would dwindle.

* Men who inherit great wealth rarely do anything noteworthy even though their many advantages should give them a head start in outperforming others. Cognizant of this, Bill Gates said he will give each of his children ten million dollars (instead of the ten billion they might receive if his estate were equally divided), but if he truly loved them and wanted each to maximize their potential, he would give them nothing.

The greatest achievement of most rich kids is sliding down the right birth canal. Those words are harsh but true; most rich children become adults who take more from this world than they give to it. With their monumental head start, they should be the ones blazing new trails and making noteworthy contributions, but most become little more than glorified leeches.

Before leaving this topic, I should mention a related story. On the radio, I heard about a female teacher who was annoyed by the frequent proclamation that men have more natural aptitude in science. She performed an experiment in which she took the brightest females and the worst males in her chemistry class, and asked them what level water would assume in tubes of various shapes as they were tilted (a concept that was not taught in her class, but something she thought would be intuitively evident). She was shocked to find that the worst men trumped the brightest women. She said that women had difficulty grasping the fact that water always seeks it own natural level because of gravity. No matter how convoluted the tube, the water level is the same on both ends. (Which is, incidentally, why water levels work and can be more reliably accurate than high-tech laser levels. Having used both, I can attest that it is better to trust gravity than an electronic gizmo.)

Women and men are innately different with individual strengths conferred by biological and cultural dissimilarities. Women are usually regarded as being superior in verbal skills, while men seem to have brains that equip them to excel in science and math. Incidentally, I am not saying that women cannot be very knowledgeable about science and math. However, judging by the relative infrequency with which women create notable breakthroughs that advance our world (with metrics such as inventing something or winning a Nobel Prize), there seems to be some barrier that keeps women from rising to the very top. Some people think that this barrier is culturally imposed by men who actively seek to stymie the progress of women, while others suggest that men are more likely to be geniuses—and hence have the mental ability to be innovative. Innovation requires more mental horsepower than just being "good" at some task, because true innovation requires one to accomplish something that has eluded the many billions of people who have inhabited this planet, both past and present. Outdoing this collective group of over a hundred billion people is difficult. In contrast, it is comparatively easy to be "good" at something, earn a degree in it, and work in that field. Women do that millions of times per year. They can be skilled and very competent, but—judging by their historical accomplishments—they are less likely than men to possess the genius required to create breakthroughs. The February 28, 2005 issue of Forbes magazine discussed this matter and said that there was an abundance of data indicating that the innate capabilities of men and women are indeed different. It noted that there are more gifted men, but also more men who are learning-disabled. Statistically speaking, the Bell curve for male IQ is broader, with higher highs, but lower lows.

Gender stereotyping and innate interests may explain why women are less likely to pursue careers in science and math, but they do not plausibly explain why the women who do enter those fields are less likely to accomplish things that can arise only from giftedness, not just quotidian competence. If a woman becomes a math professor, do her male counterparts conspire to suppress her brilliance? Such a sexist cabal is ludicrously untenable, yet the notion that men are what is holding women back seems to be a common explanation. The Forbes article said that less than 1% of the winners since 1938 of the William Lowell Putnam Mathematical Competition were women. Forbes said this test measures ingenuity instead of knowledge. Thus, the lack of a strong math education should not appreciably hamper the results.

Some of the discrepancy between male and female intellectual performance is traceable to hormones and their effects upon the brain. Virtually no women would be willing to try replicating that hormonal milieu to achieve the benefits conferred by it. So does this mean that women cannot hope for a biological boost? No. While doing research for my book The Science of Sex, I found a food that does more than stimulate libido and heighten sexual pleasure: it actually changed the way I thought. I felt more confident, energized, dynamic, productive, and happy. A female friend reported similar effects, saying that she felt "brighter, more uplifted, and more on the ball" in addition to enjoying improved sexual sensitivity that ranged from good to exquisite. I would say that I felt 20 years younger, except that I never felt that good 20 years ago. By the way, these were not secondary effects resulting from the endorphin bliss triggered by intense orgasms, but genuine results from a brain that was working better in many ways. Yes, I did have sex, and yes it did feel much better, but the cognitive changes precipitated by eating that food preceded the intercourse. Thus, coitally induced endorphins were not the explanation for why I felt better. In The Science of Sex and Fascinating Health Secrets, I describe other ways to stimulate brainpower and improve mood.

Why are there more male geniuses?

My article on why geniuses are often so fond of sex elucidates why genius is more often found in men, and hence why the accomplishments linked to genius are more common in men. Researchers discovered a link between giftedness (especially the eminently gifted) and prenatal exposure to higher levels of testosterone. Who is more likely to have higher prenatal levels of testosterone? Boys, of course.

Women and men have different brains, and bodies. Thank God!

To conclude this discussion, I have shown that women are not clones of men. They are better in some ways, but worse in others. When they are better than men at something, such as verbal skills, the roots of that superiority seems to be biological. When women fall behind men, especially at the zenith of intellectual achievement, only part of their shortfall appears to be biological. Part of it may be cultural, and part may result from the fact that women are too inclined to coast through life—at least in my experience. You may think that I am wrong about this. Perhaps I am. If so, then you may wish to prove how wrong I am by accepting this challenge: Recruit the ten smartest women in the world (if this is not fair enough, select the ten smartest single women without children), and compare what they've accomplished outside of work to what I have accomplished. (Keep in mind that what I mentioned on this site is but a small percentage of what I have done.) It is fair to compare avocational accomplishments instead of vocational ones for two reasons. First, as I've previously said, what men and women of any given occupation do at work is necessarily very similar. A female ER doctor does everything a male ER doctor does, and vice versa. We're essentially just robotic cogs in a very regimented healthcare system. Ditto for countless other occupations. Second, if a person is capable of great achievement, that brilliance will be unfettered by releasing the restraints imposed by occupational regimentation. Some auto assembly workers are bona fide geniuses, but do their regimented jobs enable them to manifest their brilliance at work? Obviously not. But what they can do in their off hours is conceivably the same as what the smartest professors at Harvard might do—if they possessed comparable brainpower. If a person is one of the ten smartest women in the world, surely in a group of ten such individuals there must be at least one who accomplishes something of significance in her free time. True brilliance is not extinguished the moment one leaves work.

I think that women need a roadmap for stellar achievement more than men. Postgraduate education can provide that roadmap, but in spite of getting it, women are usually not the ones inventing things, winning the Nobel Prize, or even the Putnam Mathematical Competition. Women seem to demonstrate less initiative and accomplish less not so much when their path is spelled out for them (as it is in school and work), but especially when their capabilities are fully unshackled (as they are in their free time, when a person might invent something useful or just squander their hours with perpetual unproductiveness). Perhaps women need more guidance than men, or perhaps they just need some hormonal/neurochemical boost to kick-start their success.

By discussing this subject, I am not trying to assail women but to goad them into action. Women have achieved so much less than what they could achieve. I want to help everyone achieve, particularly women, because there is a huge chasm between what women could do and what they have done. The failure of women to live up to their potential is usually attributed to the demands of raising kids. This explanation is specious because it fails to elucidate why single childless women are less likely than men to be inventors or Nobel Prize winners. Let's face it: there is a problem here. We may quibble about the etiology of that problem, but only an ostrich could assert that this problem does not exist. However, in fairness to women, it has only been in the recent past that they had the freedom to do what men do. Previously, they were culturally brainwashed into thinking that baking cookies, raising children, and pleasing men were sufficient aspirations. Raising kids and pleasing one's spouse will always be very important, but women could do so much more. We are now seeing some evidence of what women can do. I think this is just the tip of the iceberg. We will certainly see more in the years to come as women "get in gear," so to speak. In my opinion, most women are still coasting. They're not in gear. They're not achieving anything like they could accomplish.

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