There was a riddle making the rounds a few years ago about an automobile accident in which the father was killed and his son badly hurt. As the boy was being prepared for surgery at a local hospital, the neurosurgeon walked in, looked at the child and exclaimed: "Oh God, that's my son." Who was the surgeon? Even committed feminists did not immediately leap to the answer. The surgeon was the boy's mother.
Indeed, there is little basis in reality for such an answer. Fewer than one half of one percent of all surgeons in this country are women. Surgeons have been the ultimate Walter Mitty fantasy of masculine control -- cool, commanding and quintessentially male. They have "the right stuff." Elizabeth Morgan in The Making of a Woman Surgeon has written an interesting and dispassionate anecdotal account of what happened to a bright young woman who pushed into the glare of the operating room in the early 1970s and became a surgeon.
As an undergraduate at Harvard in the '60s, Morgan was not a conscious feminist, but she did select Yale Medical School over Harvard because the physician who interviewed her at Harvard made it clear that if God had intended women to be doctors, He would have given them testes and not ovaries. At Yale she found this same dogma in a more polite version. There were the usual nuisance factors for women -- high jinks in the anatomy lab and a few aging professors who camouflaged poor lectures by showing slides of Playboy nudes together with a running patter of equally aged jokes.
These were in the minority, however. Most of her teachers were serious, highly skilled men with a respect for their profession and for the young students, male and female, who were their future colleagues.
Elizabeth Morgan and two of her women classmates opted for careers in surgery at a time when they had never even seen a woman surgeon in the operating room. In 1971, only 8 percent of all American doctors were women, and a great majority of this minuscule group were pediatricians, psychiatrists or general practitioners. A surgical speciality was simply no place for a nice-girl.
Those women who chose to knock at the door of the fraternity house of surgery had to be strongly individualistic and prepared to take the flack that goes with pushing into inhospitable places. But it was impossible for them to escape totally the internalized mythology of our culture. Morgan remarks at one point that at medical school she found surgeons to be more attractive than the men in other specialties. They were "more dominant, more decisive, and more masculine." She was to encounter those putative traits many times in their less attractive forms during her five years in general surgical residency "training and two years of subspeciality training in plastic surgery. In the personalities of some of her preceptors during those tortured rites of passage into the surgical brotherhood, she found that decisiveness was often just plain pigheadedness, that masculinity was confused with adolescent groping and that dominance was merely arrogance.
Morgan spends little time or emotional energy, however, detailing the strictly female problems of becoming a surgeon. This is no doctrinaire tract that strains to show all male surgeons as chauvinist brutes making life a misery for the fragile flowers of femininity in their midst. The really outstanding surgeons Morgan worked with tried to teach her the skills of the trade as well as the more subtle aspects of excellence in a physician.
Nevertheless, there are special burdens in being a woman in a man's domain. As a woman neurosurgeon said to Morgan one day in the operating room: "Always do your best. Especially as a woman. You have to try even harder. You can't be satisfied with being as good as the men. You have to be better. Otherwise they won't respect you." It's hard to be responsible for the performance of an entire sex and to know that if you fail, all women will be tarred with the pitch of your failure.
It is also impossible to read this book without being impressed and appalled by the physical and emotional demands made on hospital residents -- weeks, months and years of inadequate sleep, critical decisionmaking while in a state of total fatigue, endless time spent in semiskilled hospital scut work because of understaffing, and the ever-present responsibility for life itself. Elizabeth Morgan seems to have come out of this cauldron with her basic humane values intact, but it wasn't easy.
Yet despite the institutionalized torture that makes the prolonged surgical training probably the worst of the residencies, the seductive drama of the operating room comes though on every page of Morgan's saga. Where else in this world of amorphous, unsolvable problems can a man or a woman wrestle alone on a brightly lit stage with the most dreaded problem of all, and win so many quick and dramatic victories? In this book the delicate, skillful fingers of women, when they hold a scalpel in their grasp, are shown to be formidable weapons against death and disease. If women do perceive the patient in the operating room differently from men, their values and ideas add to, rather than detract from, what the great male surgeons have given us. Elizabeth Morgan's book reflects insights into patient care that are in part the result of her socialization as a woman, and these insights amplify her surgical expertise. Male and female surgeons may indeed be different. Vive la difference!