Women in Neurosurgery: A View from India



Women in Neurosurgery: A View from India

Abhidha Shah
Department of Neurosurgery, Seth G.S. Medical College & K.E.M Hospital, Mumbai, India

From Shaktisangama Tantra (An ancient Indian text):
Woman is the creator of the universe, the universe is her form;
woman is the foundation of the world, she is the true form of the body.
In woman is the form of all things, of all that lives and moves in the world.
There is no jewel rarer than woman, no condition superior to that of a woman

Women in ancient Rig Vedic times held the same or even a more exalted position than their male counterparts. They held high positions in government, education, and practice of religion and were completely involved in all domestic and social affairs. There are many evidences in history where womanpower destroyed kingdoms and mighty rulers. The feminine form held a high level of autonomy and respect and played a decisive role in spirituality and moral development. History is rife with examples of women who have risen to great heights in warfare, spirituality, government, writing, education and science. Somewhere along history women went through a series of misfortunes and tribulations, however the wheel has now turned and women have again started enjoying their exalted status in the society at large.

Neurosurgery is one of the most challenging medical residencies in our profession and the trial and excitement continue throughout the life of a neurosurgeon. It has been a male dominated profession for a long time and the number of women neurosurgeons in the early 1900s could be counted on the fingertips. It is only natural that females are attracted to the discipline of neurosurgery, which calls for great dedication, pure passion, astute judgment, compassion and fine skills which are qualities that a woman inherently possesses.

Women Pioneers:

When the going gets tough the tough get going

No article on women in neurosurgery would be complete before paying homage to the forerunners who entered the profession against all odds. Dr. Diana Beck from the UK, Dr. Sofia Ionescu from Romania, Dr. Ayisima Altinok from Turkey, Dr, Ruth Kerr Jakoby from the United States, Dr. T.S. Kanaka from India and Dr. Yoko Kato from Japan laid the stepping stones that have paved the way for a generation of neurosurgeons. If it were not for the efforts of these exceptionally strong individuals the wing of “Women in Neurosurgery” would not have advanced to its present day status. They have laid an example with their exemplary surgical skills, their leadership and their mentorship. They have built societies that encouraged their fellow compatriots to follow this rewarding profession of neurosurgery.

Current Status in India:

A recent survey conducted on the status of women neurosurgeons in India showed that curently 34.5% of Indian women neurosurgeons are in their residency, and 65.5% are younger than 40 years of age.1 The majority (92.7%) joined neurosurgery with passion and only 30.9% had a medical professional who kindled the interest in neurosurgery. 72.7% were discouraged before joining into neurosurgical residency. 74.4% reported good to excellent support from the parent department. Only 40% had another female colleague in the department and they received good to excellent support from the female colleagues. Though 74.5% received good support from male colleagues, the excellent support remained low. 40% reported facing discrimination by gender. 74.5% are married. 96.4% reported good to excellent support from family members. 80% face difficulty in balancing career and personal life. 70.9% have satisfaction in professional life and 69% lead a satisfactory personal life. They concluded that in India there is a positive trend for female physicians taking up neurosurgery. The majority of the present residency programs in our country are supportive of women. However active measures should be taken to encourage female physicians to take up neurosurgery, reduce the existing gender discrimination, and improve the supportive system – especially during pregnancy and child rearing.

My Ongoing Journey:

“I am a brain, Watson. The rest of me is a mere appendix.”

― Arthur Conan Doyle

This quote from one of my favorite authors describes the starting point for my adventure in Neurosurgery. Ever since the age of 15, I have been fascinated by the fact that a human brain is the essence of our existence.

Having pursued this field actively since I was 15 has led me to conclude, based on first hand experience, that the social pressures forcing women out of neurosurgery – indeed the sciences as a whole – are alive and well in India and in the world. Had I sacrificed even slightly less time or energy to my pursuit of my passion – the elegant architecture and complex function of the brain – I would not have made it. But, as importantly, if I had not had the encouragement of strong mentors, and the opportunities to participate actively in the community of neurosurgeons, I very likely would have fallen in the face of these societal pressures.

Just as I have been developed and supported, it is my role now to carry on the responsibility of encouraging aspiring female neurosurgeons to join this fulfilling branch of neurosurgery. I am happy to say that in my 12 years of neurosurgical practice I have mentored three female neurosurgical residents in my department: two have gone on to become full fledged neurosurgeons and one is just finishing her residency.

Surgical Skill Training:

You have to learn the rules of the game and play better than anyone else.

As a medical resident – be it male or female – entering the field of neurosurgery, my first and foremost recommendation would be – to be geared up and become a warrior. It calls for great resolve, diligence and passion. But at the same time it can be made into a beautiful journey to enjoy and cherish. As a female resident joining the subject, do not expect to be treated differently, work hard, be sincere to yourself and to your patients, the rest will naturally follow. Take every opportunity to train on cadavers that far excel any so-called plastic or clay model on which to operate. A surgery on the cadaver is in-situ surgery, with the most delicate anatomical structures and relationships maintained and is the most fertile learning ground. This particular fact may account for the rapid strides that neurosurgery has made in recent years.

Looking to the Future:

I firmly believe that, much like the neural network of the brain, the advancement of neurosurgery is profoundly influenced by the development of pathways and connections within our community, both with the experienced and with those who are relatively new.

We have to create a neurosurgical world that does not recognize gender, and only cares about science, hard work, perseverance, and serving humanity.

We have to encourage more female medical students to pursue the field of neurosurgery, and create platforms to discuss and resolve issues facing female neurosurgeons. An important component to this would be a mentorship program, whereby practicing female neurosurgeons can guide and train young female neurosurgical trainees from all over the world.

I would like to conclude with this ancient Sanskrit mantra, which is a symbol of sacred feminine energy. This powerful meditation mantra calls upon the Great Goddess Shakti of strength. “Shakti” is the concept or personification of divine feminine creative power, the primordial sacred cosmic energy and represents the dynamic and powerful forces that are thought to move through the entire creation.

“Adi Shakti, Namo Namo
Sarab Shakti, Namo Namo
Pritham Bhagvati, Namo Namo
Kundalini Mata Shakti, Mata Shakti, Namo Namo.”

”First force of all creation, to You I bow
Divine force, everywhere, to You I bow
Creative force, primal force, to You I bow
Rising up, Divine Mother, to You I bow.”

The burden of recruiting, encouraging and training young female medical students now rests heavily on the shoulders of current women neurosurgeons, but like Somerset Maugham put it in Of Human Bondage, Nature gives broad shoulders to those who she wants to bear heavy weight. May Women in Neurosurgery prosper in the next 50 years to unprecedented heights!

Reference:

  1. Palanisamy D, Battacharjee S. What it is to be a Woman Neurosurgeon in India: A Survey. Asian J Neurosurg. 2019;14(3):808-814
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