This Side of Doctoring: Reflections from Women in Medicine

by Eliza Lo Chin

Overview

Throughout history women have practiced the art of medicine and healing. Yet they have always faced difficulties in the medical profession—not only have they struggled to gain acceptance from their male colleagues, they have also struggled to find a balance between being a doctor and being a wife and mother.
Here, in This Side of Doctoring Eliza Lo Chin offers a penetrating analysis of what it's like to be a woman in the highly competitive field of medicine. Written over the last century and a half, this collection of personal stories, poems, essays, and quotations reveals the intimate lives of over a hundred female physicians. There are touching testimonies from early 19th-century medical pioneers like Elizabeth Blackwell, the first woman to graduate from medical school and Harriet Hunt, who had her own practice that catered to women and children yet was never formally trained, to modern-day medical students and doctors.
Poignant and compelling, these narratives offer insights into the struggles and triumphs of women in medicine. Much like an American quilt, this book is a unique and richly textured patchwork of each woman's extraordinary life and career. This assemblage of so many different voices exemplifies the varied paths that women have created within the medical profession. Together they stand as an enduring tribute to the dedication of all women physicians to both their patients and their families.
"These accounts of doctoring and family concerns are universal enough to transcend gender in relationships with patients and colleagues, balancing work and family, and finding meaning in one's profession.... For those looking for a compendium of experiences that document the lives of a diverse cross-section of women in US medicine, This Side of Doctoring is a fine addition to the literature."—The Journal of the American Medical Association

Product Details

ISBN-13:	9780195158472
Publisher:	Oxford University Press
Publication date:	05/15/2003
Edition description:	New Edition
Pages:	432
Product dimensions:	8.00(w) x 5.20(h) x 1.20(d)

About the Author

Eliza Lo Chin is a general internist and former Assistant Clinical Professor of Medicine at Columbia University College of Physicians and Surgeons.

Table of Contents

	Foreword	xxi
	Acknowledgments	xxvi
	Introduction	xxix
1.	Historical Perspective	1
2.	Early Pioneers	11
	Glances and Glimpses	11
	Letters from Elizabeth Blackwell	12
	In the Words of Mary Putnam Jacobi	13
	The Fortress	14
	Some of My Life Experiences	14
	From More Than Gold in California	16
	From Mine Eyes Have Seen	17
	Petticoat Surgeon	17
	From A Child Went Forth	18
	Fighting for Life	20
	From Bowery to Bellevue	21
	A Woven Fabric	23
	Woman at the Gate	25
	A Woman Doctor Looks at Love and Life	26
	The Antique Roadshow of a 90-Year-Old	27
	Sound Investments	29
	The First Women at H.M.S.	29
	I Will Not Pass Away	33
	The Beginnings of Women's Health Advocacy	34
	From Chivalry and Off-Color Jokes to Acceptance and Respect	32
	Medicine and Motherhood	36
	Medical Internship	40
3.	The Formative Years	45
	A Youthful Encounter	45
	From Kitchen Table Wisdom	48
	Anatomy Lesson	51
	Cold Hands	54
	Here Is What I Learned	56
	Jane	56
	Circumstance	62
	From the Deccan Plateau	63
	Song of the Dying Ova	64
	How I'll Become a Good Physician	67
	A Gift	68
	Thirtysomething Meets ER	70
	Freckles	72
	Summers With My Aunt	74
	The Discovery Clinic	76
4.	Life in the Trenches: Internship and Residency	79
	Unknown Alpha	79
	Birthday	83
	How I Survived Residency	85
	Necessary Journeys	86
	Post-Call	89
	We're Not in Kansas Anymore: Men as Medical Mentors	90
	Whine List	94
	The Only Night I Cried	96
	A Long Road	97
	A Time for Change: Innovative Pathways for Residency Training	100
	Lamentation of the Female Academician	102
	But I Do Care	106
5.	On Doctoring	109
	In Between Before and After	109
	Heartsick	112
	My Patient, the Doctor, and Me	115
	Heart Doctor	118
	Common Ground	119
	Dawn	126
	Life Force	127
	A Doctor Alone With Her Decision	128
	Through the Eyes of a Physician	130
	Why You Came to Me	132
	Generations	134
	Finding Beauty in Annie	142
	A Visit to the Doctor	144
	Job Description	147
6.	Mothering and Doctoring	151
	Mutual Benefits	151
	Doctor's Daughter	152
	Conversation Hearts	157
	Monday Morning	158
	"mommydoc"	159
	A Mother's Prayer	164
	On Being a Medical Mom	170
	Tsunami Baby	171
	A Patient's Wife	174
	The Transition Game	175
	Interview for Clinician-Educator Position	176
	Spiderlings	177
	Teeter-Totter	180
	Breast-Feeding: Straddling the Fence Between Work and Home	181
	A Reminiscence	183
	The Second Road	184
	Patients as Patron Saints	185
	Mother's Day	188
	"To Love and to Work"	189
	Balance	189
	Numbing Down	192
	Maternity and Medicine	196
	Parenting Without Pregnancy	196
	Body Snatcher	198
	Redefining Motherhood	200
	Taking Children Seriously	202
7.	Making Choices	205
	Finding the Balance Point Between Overdrive and the Mommy Track	205
	Between Lawn Cuts	207
	Not Having Children	210
	Missed Opportunities	214
	Taking Stock	214
	Life Choices	215
	Composing a Life in Medicine	215
	On Packing for the Information Superhighway	217
	Thoughts on Time Management	219
8.	Barriers	221
	Glass Ceiling	222
	Why Don't You Quit?	223
	Woman in Orthopedic Surgery Stories	223
	Life in the Boys' Club	226
	Professionalism	229
	The Feminization of American Medicine	230
	An Interview Tale	230
	Not Easy to Please	231
	On Reaching Visible	232
	Triple Jeopardy	232
	A Minority Perspective	234
	My Path Through Medical School	236
	The Life of Women in Medicine	237
	Leave	238
	Emotional Conflicts of the Career Woman	239
	Kath's Graduation	242
	An American Experience	242
	A Warm Gesture	243
	A Lesbian Voice: What Does It Mean to Be a "Dyke Doctor"?	246
9.	Connections	251
	The Doctor in the Family	251
	Tobacco, Tulips, and Terminal Care	255
	The Friendship of Women	260
	A Doctor in the Family	262
	The Two-Casserole Test	264
	The Cafeteria	267
	Memories of Our Mother	268
10.	Balancing	271
	August 1994: Letter to My Student	272
	Balancing, Juggling, and Other Feats	273
	Juggling the Personal and Professional Life	274
	Workday Mornings--Three Weeks	274
	Where Is the Self?	275
	The Multitude of Little Things	275
	Is It Worth It?	276
	Can It Be Done?	276
	A Few Thoughts on Part-time Faculty: The Push for the Summit and the Long Climb Down	281
	Centered in the Deep Connections	283
	An Independent Scientist	286
	How to Do It All at Once	290
	Late Lunch	292
	Balancing Family and Career: Advice From the Trenches	294
	One Page at a Time	297
	To Rachel	299
	Pregnancy and the Professional Woman	299
	The Changing Role of Physicians as Working Mothers	300
	Reflections on Balance	303
	Notes From a Personal Journey	304
11.	Our Families' Perspectives	307
	Jelly	307
	From Balm in Gilead: Journey of a Healer	308
	Our Medical Marriage	309
	From Her Infinite Variety	310
	What's a Mother For?	312
	Life With Mother, the M.D.	314
	What We Have Fashioned Together	315
	I Remember as a Child	316
	Renuka Gera	317
12.	Reflections	319
	The Feminization of Medicine	319
	Double Helix	320
	Identity Crisis	321
	A Personal Journey	321
	My Experience as a Woman in Medicine	323
	Scopes, Hopes and Learning the Ropes	326
	Defining Ourselves	329
	Looking Good	329
	What It's Been Like	330
	Reminiscences of My Medical Career	330
	Enjoying the Moment	333
	Navigating the Maze of Academic Medicine	335
	From Teacher to Psychiatrist With Family	336
	Generation to Generation: Mother-Daughter Physicians	337
	Afterword	343
	Glossary	345
	Resources for Women in Medicine	355
	About the Editor	357
	About the Contributors	359

What People are Saying About This

Janet Dollin

Janet Dollin MD CCFP, Assistant Professor, Department of Family Medicine, Director, Office of Gender & Equity Issues, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
This book is a must read for its wonderful compilations of stories. Lately, I've been struck by how much my life as a family doctor is full of stories. this book reminds me that I am definitely not alone on this journey of story collecting. It has beautiful stories of being a doctor, mother, wife, daughter, teacher, learner, mentor, mentee and of trying to find balance between all of these complex and demanding roles. I can identify with becoming a "flat out blur, praying for no traffic" as I shift between roles. I can appreciate hearing the stories of others as they navigated internship, residency, and making career choices along their career paths. This Side of Doctoring is recommended reading at any stage of your career."

Foreword

Foreword by Janet Bickel, Associate Vice President, Institutional Planning and Development, Director of Women's Programs, Association of American Medical Colleges, Author of Women in Medicine: Getting in, Growing, and Advancing (2000)

I've never been so glad to be proven wrong. When the idea of this anthology was first proposed, I was skeptical and hoped that Eliza wouldn't be too disappointed when so few women responded to her call. That so many physicians put their emotional and creative and feminine sides on hold during training, and never recover them, also seemed likely to doom this project. But behold the assembled voices of more than 140 women physicians, each authentic and strong. While this compendium cannot span equally well the universe of women physicians and underrepresents some, most women will discover in this book connections to a welcome network of like experiences.

Male readers will find this compendium valuable in quite another way. A brief anecdote illustrates why. I'm among the thousands who are grateful for the mentoring of Dr. Carola Eisenberg. Carola was the first woman in a decanal position at MIT prior to becoming the first woman dean of student affairs at Harvard Medical School. During the 1970s, women residents as well as students discovered in Carola a much needed beacon of sanity and support as, despite dramatic increases in the numbers of women trainees, the "gender climate" remained decidedly chilly. She began opening her home on occasional evenings to the residents so they could share with each other their stresses and coping mechanisms. Her fine husband, Dr. Leon Eisenberg (then chair of Harvard's Department of Social Medicine) told me that he did not understand why these very bright and obviously highly competent women needed extra help. But one evening while making himself a cup of tea in the kitchen, he overheard the voices coming from the living room. He remained transfixed for the next hour or so while lightbulbs flashed on. He had flattered himself to be a champion of equal rights for women but had simply failed to see what went on right in front of his eyes in the mostly male faculty groups he was part of every day. Thus, the ancient power of stories to draw in, to educate.

In Writing a Woman's Life, Carolyn Heilbrun (1988) urges women to write their stories because "power consists to a large extent in deciding what stories will be told." Women professionals looking for their foremothers' stories find comparatively few published ones. And as Heilbrun notes, the women's stories that have been published "are painful, the price [has been] high, the anxiety is intense, because there is no script to follow . . . let alone any alternative stories." Actually, women seeking to combine family, love, and work still lack anything resembling a script; no journey myth works either (Odysseus?). Each woman is still devising her own path on a far from level playing field, dodging unexpected paradoxes-for example, treating other people's children in the hospital while hers are sick at home or professional isolation whereas the experience for men is highly social and socializing.

Most of this book's entries pose questions that converge around three main themes interweaving across the chapters: Who am I in relation to my family? Who am I in relation to my patients? What about my own plans and ambitions? With regard to the latter, as More (2000) noted in her study of women physicians, the effects of "choice" and "necessity" remain more tangled in women's than in men's careers. As McClelland (1967) observes, "A woman's success is less easily visible [than a man's who is following a single course] . . . because it consists of the sum of all these [part-time] activities." But as Williams (2000) shows in Unbending Gender, "women do not prefer marginalization. . . . What is needed is not a mommy track, but work restructured to reflect the legitimate claims of family life."

To focus first on who a woman physician is vis-à-vis her family, tensions around women's multiple roles begin even before medical school. During their medical school interviews, many contributors were asked questions such as, "Why don't you want to be wife and mother?" At the same time, Linda Clever ironically notes, "Being a physician is one of the few socially acceptable reasons to abandon a family." Catherine Chang speaks for many when she says, "I have so much to say, it is difficult to find the words. . . . the struggle to balance my career and family . . . constantly tears at me." Cynthia Kapphahn confesses, "The sheer determination that helped get me through medical school and residency has proven quite useless in my family life. . . . instead, intuition, patience and a form of 'non-effort' are required." Marcia McCrae advises women to give up idea of balance: "Don't be frozen in the middle. . . . learn to prance, slide, skip, skid, and skitter from one end of the see-saw to the other." Laughter is also recommended; Patricia Temple found herself "at the park when the children had runny noses and wet diapers and all I had in my purse was a stethoscope." Linda Clever offers strategies on keeping family glued together and enjoying each other: "negotiate, accommodate, and recreate." Finally finding statement is the emptiness that can occur when women wait too long "to fit the mystical process of reproduction into the unerringly practical cycle of our professional production" (Sayantani DasGupta).

In Barbara Sommer's words, medicine still demonstrates a "pervasive lack of seriousness toward women who want an academic career while providing a loving environment for their family." Thus, most women physicians are still patching together individual solutions and shoehorning their professional and second-shift responsibilities into structures created by men with full-time support at home. The continuing tyranny of dualistic thinking-for example, either you're fully available during your 20s to 40s to work or you'll never reap academic rewards, either you're tenured or nontenured-remains beyond the scope of this book (McElvaine, 2001). But such systems issues beg to be addressed, given that (a) youth is associated with neither scientific achievement nor clinical acumen, (b) women physicians (at least in primary care) tend to be most productive between age 50 and 60, and (c) we cannot afford to waste medical careers, involving substantial public investment (Etzkowitz, Kemelgor, & Uzzi, 2000).

As McMurray and Jordan (2000) have written, "Medicine is particularly appealing to women because it offers the opportunity to have significant intellectual stimulation embedded in a relational context." For physicians, family and professional roles can enrich each other in unexpected ways. Daphne Miller remarks, "The moments of talking with patients about my conflicts and challenges [regarding family responsibilities] have helped me become a wiser doctor and mother, and they have bolstered the confidence of my patients in their ability to care for themselves and others." But witness the contrasts between the days when physicians had opportunity to talk with patients along such personal lines and today. As Lucy Candib declares, "I have chosen to remain in one setting for the past 15 years. . . . A doctor used to be a person who came and stayed . . . in the community." Not only is this community orientation much less common now, but the increasing corporatization of medicine can put physicians at war with patients, as Julia McMurray here notes, "New patients are enraged at the more than three months' wait for a physical. They feel betrayed by the slick advertisements . . . there just doesn't seem to be enough time for them to begin to trust me . . . I am simply heartsick."

Negative influences on the patient-physician relationship are indeed disturbing. But one of the strengths of the book is that contributors wear their hearts on their sleeves. The poetry here comes from the heart too: "Babies . . . slippery as chance" (Alison Moll); "Your love cut through the layers of my . . . shield" (Kathleen Franco); "the hospice within, buried in fertile soil, germinates and flowers tubular fruit" (Stephanie Nagy-Agren); and "Rare/restive respite, only briefly restful/the press of things undone still live and warm" (Mary Clark). Nassim Assefi discusses how writing complements her medical work: "We trace anatomical landscapes with our hands and battle pathology with the latest technology . . . the professional culture . . . fosters disagreement with the emotional realm . . . [But] with fiction, I get under the skin and am able to express processes at work in human life that cannot be explained in a medical textbook." Even women who don't consider themselves writers are advised, "Keep a journal of your stories. They are the vitamins that will help you grow as a person and in a profession . . . a roadmap of where you have been and where you are going" (Beth Alexander).

This collection is a vibrant and accurate roadmap of the past and present of women physicians. I also read it as Acts 1 and 2 of a drama with tragic, comic, and poetic elements. Act 3 is about to begin.

References

Etzkowitz, H., Kemelgor, C., & Uzzi, B. (2000). Athena unbound: The advancement of women in science and technology. Cambridge, UK: Cambridge University Press.

Heilbrun, C. (1988). Writing a woman's life. New York: Norton.

McClelland, D.C. (1967). Wanted: A new self-image for women. In R. J. Lifton (Ed.), The woman in America (pp. 187-188). Boston: Beacon.

McElvaine, R. (2001). Eve's seed: Biology, the sexes and the course of history. New York: McGraw-Hill.

McMurray, J. E., & Jordan, J. (2000). Work in progress: Relational dilemmas of women physicians. Wellesley College, MA: Stone Center.

More, S. E. (2000). Restoring the balance: Women physicians and the profession of medicine, 1850-1995. Cambridge, MA: Harvard University Press.

Williams, J. (2000). Unbending gender: Why family and work conflict and what to do about it. New York: Oxford University Press.

Editorial Reviews

3 Stars from Doody

Any woman contemplating a career as a physician or already working in the profession will gain a good deal of insight from this collection of personal essays and poems by female physicians over the last century and a half. Organized into categories such as "Internship and Residency," "Mothering and Doctoring," and "Barriers," the anthology presents feminine and feminist perspectives on all aspects of a medical career. Most of the pieces are contemporary and previously unpublished, solicited by Chin, an internist and former Columbia University medical professor. In her essay "We're Not in Kansas Anymore: Men as Medical Mentors," pediatrician and author (Her Own Medicine) Sayantani DasGupta describes how her search for a "female" professional mentor turned up a vital male role model instead. Psychiatrist Bhuvana Chandra's evocative poem recalls how much it meant to her father that she became a doctor. Several pieces deal with reconciling the commitment to patients with the commitment to family life, such as Molly Carnes's down-to-earth "Balancing Family and Career: Advice from the Trenches." Chin also provides a historical overview of the barriers that faced 19th-century women physicians like Elizabeth Blackwell, the first woman to graduate from an American medical school, and Harriet Hunt, whose recollections are among the archival pieces featured in the anthology. This is an engaging and frequently inspiring collection. (Feb.) Copyright 2001 Cahners Business Information.

Publishers Weekly

Reviewer: Patricia Wong, MD (Private Practice)
Description: This book is a communal sharing of the sentiments and thoughts from female physicians on their medical training and experiences, and how their careers have impacted their lives as mothers, spouses, physicians, and human beings. There are letters, poems, and personal vignettes on why we, as female physicians, celebrate and dedicate ourselves to a very demanding, stressful, and rewarding life choice.
Purpose: Through the sharing of this collective knowledge, the book will encourage, strengthen, support, and provide insight into why we have chosen this life, and continue to believe in what we have chosen, even at those times when it seems like things are not going to work out.
Audience: The audience is female medical students, residents, and physicians.
Features: The fear of losing control of one's life, the fear of making the wrong diagnosis, the sorrow over the death of a patient despite doing one's best, the elation one experiences when one has touched someone and made a difference in how that person copes with an illness, the guilt one feels when one has no energy left for family or spouse, and the acceptance of understanding that one cannot be superwoman are all poignantly represented in the writings.
Assessment: I am unaware of similar books written on the subject. Women physicians may find this book inspirational and enlightening personally.

Doody's Review Service

Like a patchwork quilt, this richly-textured compilation represents each woman’s extraordinary life and career while their common experiences clearly emerge, cutting across different specialties, ages, and geographic divides.

Academic Library Book Review