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PRSonally Speaking
Tuesday, November 19, 2013
Being a female in plastic surgery
by Anu Bajaj, MD

Part I
It’s been a while since I have written a blog – life has run away from me.  I keep on thinking that things will calm down, but instead, time just goes by faster.  However, I have wanted to write this blog for a while – but like other blogs that come from deep within my heart, it has been particularly difficult to write and to focus my thoughts.
Part of my hectic schedule included going to San Diego for the American Society of Plastic Surgeons annual meeting in October. 
At the annual meeting, the Women Plastic Surgeons Steering Committee, of which I am chair, hosts a networking lunch – this year, we had a minor catastrophe one month before the luncheon.  On a Friday evening a month prior to the meeting I received a call from my staff liaison at ASPS saying that the keynote speaker for our luncheon had to cancel for personal issues.  After stressing for 24 hours, I put myself to the grindstone.  I resisted my urge to panic and reached out to everyone I knew through phone calls and emails.  Fortunately, one of my contacts suggested Natalie Strand.  Ultimately, by the end of the weekend, we had a speaker for our luncheon. 
Unless you are an Amazing Race fan, you probably are not familiar with Natalie Strand.  Natalie Strand is an anesthesiologist who practices in LA.  She and her friend, Kat Chang (also an anesthesiologist), were the first female-female team to win the Amazing Race in 2010.  During our luncheon, Natalie spoke about winning the Amazing Race, being a female physician, and about teamwork, specifically about how women are unique and can and should work together. 
My dad said, “She is like all female surgeons.  She has a chip on her shoulder.”  My question to him was “what do you mean.  I am a female surgeon.” 

Part 2
I had said at the beginning of this blog that I have wanted to write this blog for a while.  About a month prior to Natalie’s talk, I had read Sheryl Sandburg’s book, Lean In.  The book has been somewhat controversial – people either like it or they don’t.  And part of the controversy surrounding Sandberg’s book has had to do with how women may contribute to the inequalities we face – by “leaning out.”  I have to be honest and say that that the book resonated with me on so many levels because I have been one of those women.  As a child and young adult, I had believed it when I was told that “surgery is not a profession for women,” or that I will “not be able to have a family as a surgeon.”  And then when I “leaned in” and chose to become a surgeon, I lost my husband and fought against my family along the way.
I remembered the sense of frustration that I felt when I was told to “cut like a man” during residency.  I also remembered feeling as if I was ignored -- my chairman would call on me to answer a question, and I would speak.  And then he would move to one of the guys who would give the same answer but would be praised for their correct answer instead.  I had believed that this was secondary to my inability to communicate effectively and couldn’t understand how to make my answer more clear.  I would try short, succinct and to the point; I would try elaborate and detailed.  But nothing worked.  After reading Sandberg’s book, I realized how people were more likely to remember the responses of men, and I understood.
Sandberg also describes how women in the workplace experience an inverse correlation between “success and likeability.”  As I read about this relationship, I remember a comment my father had made two years ago.  My nephew had fallen and suffered an open skull fracture and required a craniotomy.  His pediatric neurosurgeon was a female.  My dad said, “She is like all female surgeons.  She has a chip on her shoulder.”  My question to him was “what do you mean.  I am a female surgeon.”  The comment troubled me because I struggle everyday with trying to be friendly and nice but also wanting to be taken seriously.  Does this mean that I have a “chip on my shoulder?”  It reminded me of the nurse who used to refer to me as “that obnoxious resident” when I was a surgery intern; the same nurse who used to dote over and make cookies for my male colleagues.  If you ask any successful woman, I’m sure that she will recount stories about how the same behavior in a successful man is criticized in a successful female.  One comment that I received from a scrub tech recently was “you’re not fun.”  I really wanted to say, “I’m here to operate.”  But instead I was stunned – I thought working in the operating room meant that we were there to take care of the patient.

Part 3
In her book, Sandberg does say that when women deviate from their expected roles, they are more likely to be perceived negatively.  She suggests that women should approach conflicts and negotiations communally in an effort to combat this inverse correlation for “success and likeability.”  I can understand how I can be perceived as an intense woman who is focused on my job; however, it is my job. 
One approach is that when we are at work – in the clinic or in the OR – our first priority is and always should be the patient.  Instead of approaching every conflict as an individual, we have to be part of community and not hurt one another because of a perceived threat.  The concept of being a part of a team is also why I loved Natalie’s talk -- because it emphasized the concept that we have to help each other to get ahead.  As an example, the same year that she and her teammate won the Amazing Race, there were a three other all female teams.  Her team and the team that they formed an alliance with came in first and second.  The other female-female teams weren’t interested in forming alliances and ultimately lost.  Natalie suggested that the while she and her teammate wanted to win, the ultimate goal was for a female-female team to win.
As a group of women, we are more likely to succeed if we each give one another a step up.  While we all receive validation by remembering our role in buying into the stereotypes we are placed in, we also have to assume responsibility for overcoming them.  While at the meeting in San Diego, I felt that I received my ultimate validation.  One of my former attendings has a daughter who is in medical school and would like to become a plastic surgeon.  His comment to me was, “I would like her to come and spend some time with you because I think that you would be a good role model.”
About the Blog

Plastic and Reconstructive Surgery

PRSonally Speaking is the official blog of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Visit our blog for exclusive previews of and discussions on hot topics in plastic surgery as well as insider-tips on open access content. PRSonally Speaking is now powered by frequent contributions from the American Society of Plastic Surgeons’ Young Plastic Surgeons Forum (YPS); these practicing plastic surgeons provide the personal side of the plastic surgery story, from daily challenges to unique insights. PRSonally Speaking is home to lively, civil debate on hot topics and great discussions pertaining to our field. So, bookmark us, subscribe to the RSS feed and join in the on-going conversation with Plastic and Reconstructive Surgery. This is your Journal; have fun, be respectful, get engaged and interact with the PRS community.

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Anureet K. Bajaj, MD is a practicing plastic surgeon in Oklahoma City. She completed residency and fellowship in 2004, had a brief stint in academia at the University of Cincinnati, and then chose to join her father (Paramjit Bajaj MD, also a practicing plastic surgeon) in private practice in OKC, where she focuses on breast reconstruction and general cosmetic surgeries.

Devra B. Becker, MD, FACS, is an Assistant Professor of Plastic Surgery in the Department of Plastic Surgery at University Hospitals/Case Western Reserve University School of Medicine in Cleveland, Ohio. She completed Plastic Surgery residency at Washington University School of Medicine in St. Louis, and completed fellowships with Daniel Marchac and with Bahman Guyuron. She currently has a primarily reconstructive practice.

Henry C. Hsia, MD, FACS is at Robert Wood Johnson Medical School of Rutgers University in New Brunswick, New Jersey and also holds an appointment at Princeton University.  When he’s not working hard trying to be a good father and husband, he runs a practice focused on reconstructive surgery and wound care as well as a research lab focused on wound biology and regenerative medicine.

Stephanie K. Rowen, MD is a senior physician at The Permanente Medical Group in San Jose, California.  She joined TPMG upon finishing residency and a hand surgery fellowship in 2005.  She has a primarily reconstructive practice, about 50% hand surgery.  Outside of work she enjoys participating in triathlons and spending time with her family.

Jon Ver Halen, MD is currently Chief of plastic surgery, Baptist Cancer Center; Research member, Vanderbilt- Ingram Cancer Center; Adjunct clinical faculty, St. Jude Children's Research Hospital. He also acts as Program Director for the plastic surgery microvascular surgery fellowship. His practice focuses on oncologic reconstruction.

Tech Talk Bloggers

Adrian Murphy is a plastic surgery trainee in London, England. He studied medicine in Dublin, Ireland and has trained in Ireland, Boston, MA and the United Kingdom. He is a self-confessed geek and gadget aficionado.

Ash Patel, MD is Assistant Professor of Plastic Surgery and Associate Program Director at Albany Medical College, in Albany NY. His practice is primarily reconstructive.