Who run the world?

When I first arrived at Monze Mission Hospital our team consisted of 2 resident trainees and 8 interns that had been placed onto the surgical service for their 6 month rotations. I was encouraged to find that half of our interns were female - an unusual occurrence in a country where medical students are still overwhelmingly male with about a 70% preponderance. My first week, I noticed confused looks on each of their faces every time they met me or scrubbed into a case that I was doing. Finally, one day while in the changing room, one of them spoke up.

"Dr. Kazen, sorry if we seem confused, it's just that we have never met a woman that's a general surgeon."

She followed this statement with a confession that she loved surgery she just didn't think that women could be surgeons. I asked why and she told me that someday she wanted to be a wife and a mom. I asked her if she thought it was possible to be both of those things while also pursuing a career in surgery and she said no. She then asked why I didn't do obstetrics or gynecology so that I didn't find myself constantly surrounded by men. I told her honestly that some of my greatest mentors have been men, although, admittedly I wish just once I could find a hospital where our changing rooms were the same size. We proceeded to talk for several minutes about being a woman in surgery and I debunked some of the very common myths that pass through medical schools in Zambia, and the US, alike that women pursuing surgery will be forced to sacrifice every other part of their life in order to do so.

I never lie to female trainees. Being a woman in a male-dominant field is not easy. There are huge challenges to being a female surgeon. For example, infertility rates in female surgeons are around 32% compared to 10.9% in the general population. Surgeon moms are also more likely to face pregnancy complications and pregnancy loss. Motherhood aside, women in surgery have demanding careers. In societies where it is expected that women carry the majority of household duties this can make finding a partner understanding of these demands extremely difficult.

Despite this, women have consistently been found to make very adept surgeons. In fact, a recent meta-analysis comparing outcomes between male and female surgeons found that patients of female surgeons have lower mortality rates. Women are smart, capable, empathetic, and often detail-oriented. Despite this, however, we are under-represented in the field and especially under-represented in leadership.

I have been very fortunate to be surrounded by female surgeons throughout my career. I have seen first-hand examples of outstanding surgeon moms. I have learned what it means to both love your job and love your husband. I have been reminded every step of the way that it is possible to have it all, and do it all, with enough practice. And I know that I am damn good at my job not in spite of, but because, I am a woman.

What a privilege it has been to show these women the truths that I have come to know and live. To be an example to them that a woman can thrive in this field is a dream come true. Two of them have told me that they plan to pursue a career in surgery after their internships are complete. For me, this is more than enough reason to do what I do.

PS for those of you that donated money and/or supplies I have been absolutely floored by your support. With the funds you provided I was able to purchase:

• 5 replacement parts for the endoscopy machine that we desperately needed

• 5 gigli saws (we use for amputations - one of our most frequent cases)

• 3 post-mastectomy bras for breast cancer patients

• A wheelchair for a 90 year old patient that underwent amputation for gangrene and could not afford one on his own

• Numerous cases of gauze and medical tape for our wound care patients

The supplies were also very well received and our team at Monze has been so excited to have stocked cabinets entering into the Holiday season. I plan to use a bit of the remaining money to put a Christmas tree and some small gifts in the Children's ward so that they get to feel a little bit of Christmas cheer. I will share photos once I do. I wish I could have captured the joy on our elderly patient's face when he received his wheelchair! It was a moment I won't soon forget.

Thank you is not enough but I will say it again and again. Please contact me if you donated and provide me with an address I can send a thank you card to. I really do appreciate you all.

Katy