“People are just now getting used to doctors being women,” says Dr. Sandra Ettema, a head and neck surgeon at Springfield’s Southern Illinois University School of Medicine. “Doctors are still considered to be men. Especially surgeons — people think ‘men’ right away.”
They often are mistaken for nurses.
Surgical patients make appointments with them to receive detailed explanations about opening the body and making life-changing repairs. Still, some are amazed to realize these women will be the ones holding the scalpel, directing the operating-room team and performing the surgery.
It’s a situation Dr. Sandra Ettema frequently encounters, and it makes her smile to think how far women have progressed in medicine, but how far they still have to go.
“People are just now getting used to doctors being women,” said Ettema, 39, a head and neck surgeon at Springfield’s Southern Illinois University School of Medicine.
“Doctors are still considered to be men. Especially surgeons — people think ‘men’ right away.”
By the numbers
Nearly half of the country’s medical students are female, and women account for 28 percent of all practicing physicians. But except for obstetrics and gynecology, where 44 percent of doctors are women, medical specialties involving surgery overwhelmingly remain male-dominated.
Nationwide, women represent only 4 percent of heart surgeons, 6 percent of neurosurgeons, 12 percent of plastic surgeons and colon surgeons and 5 percent of orthopedic surgeons.
Studies say these low numbers may be related to the often-unpredictable lifestyle associated with surgery, long training periods and harassment or gender biases reportedly faced during training.
While more young, female doctors are entering surgery residencies, short-term numbers aren’t likely to change, as surgery-training programs and fellowships last longer after medical school.
Not including obstetricians or gynecologists, Springfield is home to 20 female surgeons. At SIU, where 12 are employed, 24 percent of surgery faculty members are women. Based on figures from the Association of American Medical Colleges, that’s almost twice the national average.
Balancing family and work
As with professional women in other fields, Springfield’s female surgeons juggle work and personal responsibilities, making sacrifices along the way.
The willingness of SIU surgery chairman Dr. Gary Dunnington to make “family time” a priority for surgeons was a selling point for Dr. Jan Rakinic. The colorectal surgeon and divorced mother of two left the faculty of Jefferson Medical College in Philadelphia to join SIU in 2001.
At many medical schools, where male surgeons traditionally set the tone, “family time is not considered a priority,” she said.
“You can’t legitimately say, ‘I need to leave at 3 o’clock because my son has a basketball game,’ ” Rakinic said. “Surgery is such a macho undertaking. Getting through the macho is so hard.”
Female surgeons say they enjoy working with their hands, the adrenaline rush of troubleshooting on their feet and seeing, almost immediately, the results of their sweat — for good or bad. Several female surgeons said women take more time and communicate more easily with patients.
“We’re not afraid of showing care and compassion,” said ophthalmologist Dr. Sandra Yeh, 46, owner of Prairie Eye Center. “We have that natural nurturing ability.”
These doctors aren’t immune to the guilt of many working women, though high incomes make it easier to afford nannies, baby sitters, housekeepers, spacious homes and take-out meals.
Median earnings for surgeons generally range from $300,000 to $400,000 a year, depending on the specialty, compared to about $170,000 for family physicians and pediatricians, according to the Medical Group Management Association and other sources.
Dr. Gayle Woodson and her husband, surgeon Dr. K. Thomas Robbins, raised three children and a stepson from Robbins’ previous marriage. The youngest child just finished her freshman year in college.
“We had continuous live-in help for 16 years,” said Woodson, 58, an otolaryngologist and chairwoman of SIU’s division of head and neck surgery. “The one fundamental thing is: If there’s something you don’t like doing, you hire somebody else to do it so you have time to do the things that you want to do, like helping your kids with their homework.”
But female surgeons are much less likely than their male counterparts to be able to depend on a stay-at-home spouse for child-rearing and other family responsibilities.
Dr. Nicole Sommer, 37, an SIU plastic surgeon and married mother of three children younger than 7, joked she sometimes considers male colleagues’ situations and thinks, “I need a wife, too.”
Still, Sommer’s husband, Eric, a 35-year-old mechanical engineer, has made sacrifices to allow her to build a practice in Springfield. He recently operated a furniture-making business from their home and currently is working to finish the interior of their family’s new house.
On most days, two of their three children — ages 1 and 4 — spend time at Memorial Medical Center’s day-care center, with Eric and both sets of grandparents available as a backup.
Yeh’s husband, Mason City dentist Gregory Kane, takes Fridays off to take part in activities with their sons, Alexander, 14, and Jonathan, 8.
At age 5, Woodson told adults she was interested in being a doctor like her father, a small-town family physician in Texas.
“People would say, ‘Oh, you mean a nurse,’ because this was in the ’50s,” said Woodson.
So Woodson didn’t plan to become a doctor when she entered Rice University in Houston.
That changed after she interviewed a female pediatrician for a sociology assignment. She enrolled at Baylor College of Medicine and gravitated toward surgery.
Woodson began her surgical training at Johns Hopkins University in Baltimore during the 1970s. “In those days, sexual harassment was common,” she said.
She recalled a night sleeping at the hospital as a resident while on call. Her boss, a male chief resident, climbed in bed with her. Woodson said she laughed — and neutralized his advances with a strategic kick — but didn’t consider complaining to supervisors.
“I was embarrassed, and I did not know I had any grounds for complaint,” Woodson said. “It was not politically correct at that time. The men have to be very careful now about what they say and what they do.”
Yeh said she encountered chauvinism and a hostile work environment after moving to Springfield in the early 1990s and joining the practice of a male doctor planning to soon retire.
“The first day I started, he actually came up to me and said, ‘I like my tea with two lumps of sugar and a dollop of cream at 3 o’clock.’ He was not joking,” Yeh said. “And then he said, ‘I only hired you because you’re a woman and you’re so easy to control.’ ”
Yeh said she also dealt with a backstabbing, all-female office staff.
“Sometimes your worst opponents are not men. They’re women who are used to serving men,” said Yeh, a native of China whose physician parents moved her family to the Chicago area in the 1960s.
When she took over the practice, Yeh said, she made the office environment warm and inviting. She began operating in many rural hospitals, and the main Prairie Eye Center in Springfield now has five branches. Yeh’s 70 employees include four other physicians, all men.
Relationship ups and downs
In college, Dr. Ruth Mayforth considered becoming a pianist or a scientist. She said choosing surgery was like choosing both science and music.
“A lot of it feels the same to me,” said Mayforth, 45, a pediatric surgeon at SIU. “You have to have the procedure memorized, and even if something goes not according to plan, you have to keep playing.”
Mayforth never married or had children.
“That’s probably been largely influenced by my decision to go into surgery,” she said.
Female physicians are less likely to be married than male physicians, and female surgeons are even less likely than other female doctors be married or have children, according to a 1998 report in the American Journal of Surgery.
Ettema broke off an engagement during medical school when her fiance made it clear he wanted her at home for dinner by 6 p.m. each night. She said they’d dated for years and discussed a doctor’s lifestyle, but the man (a construction worker) made his demands “once the ring was on the finger” and while an exhausting, multi-year surgical residency was ahead of her.
“We never would have made it through residency,” Ettema said.
She is engaged once more, this time to a mechanical engineer from Champaign, and they’d like to adopt a child or two after marriage this summer.
Rakinic, 50, has two children, ages 8 and 12, and has been divorced twice.
“Being a female surgeon doesn’t mix well with having a lot of relationships,” said Rakinic, 50. “We’re used to being in control and running the team. You take that home.”
Rakinic first was married to a neurosurgeon-in-training and, later, an Internet startup consultant who became bothered that she worked a more high-powered job, and earned more money, than him. Now, the Detroit native uses two part-time nannies to help with her children.
Rakinic tries to always do homework with them and made it to most of 12-year-old daughter Alina’s volleyball games with the Franklin Middle School team this past school year.
Sommer’s first and third pregnancies were unplanned, which might seem surprising for a physician. But she’s glad because she might have only one child otherwise.
“There’s never really a good time,” said Sommer, whose mentor was her father, Dr. Elvin Zook, founder of SIU’s plastic surgery program.
Having one baby was manageable, just barely, for Dr. Anjali Singh, an SIU pediatric orthopedic surgeon.
“Having two is going to be hard,” Singh said, weeks before delivering her second child, a boy.
Singh, 37, who grew up in Sherman and whose father was an obstetrician/gynecologist, is married to another orthopedic surgeon, SIU’s Dr. Thomas Hansen.
Working and raising children “can be done,” she said. “It’s just hard. I think it’s hard no matter what your job is.”
She and her husband previously practiced in Rochester, N.Y., and joined SIU two years ago when two faculty spots opened. The timing was right, she said, because she was having difficulty managing work and child-rearing responsibilities in Rochester. She knew a “stay-at-home” best friend from high school in the Springfield area who could help with the kids in emergencies.
Singh’s 3-year-old daughter is in Memorial’s day-care center, but Singh was worried about care for her newborn son because that center wouldn’t have room. And no other relatives live nearby.
But those concerns apparently didn’t affect Singh during the corrective surgery she performed May 23 on 12-year-old Courtney Hilleary of Potomac.
One person on the operating-room staff at St. John’s Hospital said Singh and other female surgeons are generally “more empathetic toward their patients” and kinder to the staff.
Courtney’s mother, Michelle Watson, 32, said Singh is “a great person” and treats Courtney “like she was her own kid.”
Learning to say ‘no’
Women differ little from their male counterparts in approaching a surgeon’s often-unpredictable life, said Dr. Colleen Johnson, 36, an SIU vascular surgeon who grew up a dentist’s daughter in Cape Girardeau, Mo.
“You have to have some sort of personality disorder to do this job,” Johnson said, half-joking. “Normal people just don’t accept as a fact of life that on a Friday night, you may have plans and you’re not going to do them. You just accept that you’re not going to have a scheduled life.”
Johnson, however, has managed to have a life outside of work. She is engaged to a public-service administrator with a state agency. One of her patients set them up.
Dr. Diane Hillard-Sembell, a standout high school and college basketball player from a small town near Galesburg, went to Northern Illinois University to become a physical therapist but became enthralled by surgery when she witnessed a knee operation.
“I just followed my heart,” said Hillard-Sembell, 47, an orthopedic surgeon at Springfield Clinic and medical director of AthletiCare Sportsmedicine.
She and her husband, real-estate developer Mark Sembell, were married 11 years before their son, Evan, was born. Hillard-Sembell delayed having a child to focus on orthopedic training and building a practice so that she could better control her schedule.
She said Mark’s flexible work hours help to meet Evan’s needs. But Hillard-Sembell has adjusted her office hours to be able to fit in family activities, and she limits the elective surgeries she performs.
“I’ve had to learn sometimes to say no,” she said. “My priorities are faith, family and career. I’ve been blessed to have the jobs of wife, mother and orthopedic surgeon, and I’m determined to be the best I can at all three.”
Is it worth it?
Like many surgeons, Dr. Jacquelyn Quin has had second thoughts about her choice of career.
“The highs are high, but the lows are really lousy,” said Quin, 44, an SIU cardiothoracic surgeon who grew up in San Diego.
Good jobs in heart surgery aren’t available everywhere, so Quin lives in Springfield with her 2-year-old daughter, Lauren, while her boyfriend and Lauren’s father, Jim Macy, lives in Connecticut. Macy works as a veterinarian on the faculty of Yale University.
Neither is willing to give up good jobs to live in the same town, said Quin, who added that they might marry someday regardless of where each is living at the time.
They visit each other once or twice a month, and the couple and Lauren all get together via Web cam every night. Lauren will spend the summer with Macy, and Quin’s mother visits her and her boyfriend frequently to help with the toddler.
“This kid bounces all over the country,” Quin said.
While acknowledging her situation isn’t ideal and can’t continue forever, Quin said her lifestyle doesn’t mean Lauren suffers for lack of attention.
Quin said her Christian faith helps her deal with life-threatening and disabling conditions requiring her care. Over several recent days, she inserted a trachea tube twice to help Bruce Jacobs of Chatham breathe easier after an earlier surgery at Memorial to repair a tear in his aorta.
For her, surgery’s financial rewards don’t offset the stress of caring for patients whose lives depend on her quick decisions. Quin became visibly upset recounting how Jacobs, a 57-year-old retired Air Force weapons loader, regained partial consciousness after initial trachea-tube surgery and told his wife he wished he were dead.
Jacobs’ spirits improved in the following days, and his wife, Pat, said on June 17, “He’s doing great now. He gave me a kiss.”
Quin, said Pat Jacobs, “is the most caring and personable person I’ve every known. There couldn’t be a better doctor.”
Dean Olsen can be reached at email@example.com or (217) 788-1543.