Despite the bias against women in medicine, my period of training coincided with a time when women were just beginning to make great strides integrating themselves into the medical field.
However, to make it through the tougher disciplines of surgery or medicine, a woman had to have been born and raised without a thin skin. This is an attribute that happens to be an admirable quality in either gender; and works very well to help anyone succeed in life. That is unless it was the whip and the belt as opposed to loving discipline creating that tough hide.
Whips and belts create bitches, bastards, and psychos. Tough love creates successfully inspired over-achievers.
I had the opportunity to run into a few excellent female residents who can best be described as being good old fashioned “tough cookies.”
One female resident who supervised my fourth-year rotation in cardiology had those necessary brass balls and the guts that Italians call “stendine.” She was extremely talented, with a penchant to dish back as much as she got it from the old guard misogynist Attending Physicians who constantly aspired to punish women physicians.
It reminded me of the egocentric male patriarch who takes it out on his wife and daughters because he is incapable himself of dealing with the emotional vacuum of having to live without a son as his heir.
- My glass is half empty. God only gives me only beautiful daughters.
These old farts wasted way too much time attempting to wear down these brilliant medical tomboys until they finally understood clearly; by realizing that women could actually do the job. The women were then accepted; although with more reluctant vitriol than what would have been applied to reinstating a prodigal son. This capitulation was always made however, with the sour after-taste equivalent of turning aside to spit out a piece of bitter fruit.
- Well, she did fine managing that cardiac arrest. But I still think a woman’s place is in the home.
This Resident was not only very self-assuredly competent but also made it her mission to do her best to put some teeth into my ongoing medical Bar Mitzvah. She assigned me sit in the CCU every third night to watch heart rhythm monitors until I was eventually seeing the little green bleeps on the inside of my eyelids when I was finally allowed to go to sleep.
- The only way you will learn arrhythmias is to watch every bloody beat until you see anything that looks abnormal, then correlate it as best you can with a reference book to see how close you can come to the truth. After that you can come and ask me if you are correct.
This was the extent of her advice:
- Get out your EKG book. Figure them out for yourself. Print anything out that you are not sure of and we’ll go over them later. And try to make any clinical decisions you need without waking me up. The nurses will help you out.
- So just what kinds of things should I call you for, then?
- Cardiac arrests. Call me if they die. Absence of spontaneous breathing, no pulse and no blood pressure associated with ventricular tachycardia or ventricular fibrillation is not something you will have to tediously ponder.
When I eventually entered my Internship at St. Luke’s Hospital in New York City there were two female senior residents who were also tough as nails and did not take any gaff or nonsense from anyone.
One in particular was a fairly rugged, unforgiving mentor. An underling had to demonstrate smarts to first get and then to stay on her good side; while flirtatious subterfuge was no substitute for not knowing the answer to any of her questions. She was not even gay, either, as was the failsafe explanation the rumor mills defaulted to when dealing with women who were all business while on the surface, yet seeming to have very little in the way of a social life.
No. She was not gay; not un-loved; not under socialized nor a grown-up wall flower, either, but only hard core dedicated to her work as she kept her personal or social life completely private.
One incident demonstrated her fearless ability to get down and dirty in the trenches. On this evening, a cardiac arrest victim was brought into the ED in a full resuscitative code scenario. He was probably DOA but all stops were being pulled out to save his life. Regardless of prognosis, everyone gets the maximum benefit of the doubt, and every such scenario has something to offer as a teaching or learning experience.
It is the usually the job of the Resident to supervise and guide the therapy, while letting the nurses and subalterns handle the drudgework.
Doing closed chest CPR compressions happens to be a real drudge and something to be avoided unless circumstances force the doctor to have to do it himself. The chore usually defaults then to the nurses or the respiratory technicians, as the doctor is obviously preoccupied with the other more erudite aspects of running the code.
Most people in these situations do CPR from the side of the bed, which offers little mechanical advantage as the work vector is more laterally oriented than vertical; which makes it incredibly exhausting labor.
As this scene unfolded the female Resident could see that the nurse who was doing the chest compressions was getting exhausted, and so took in upon herself to pitch in as her relief while at the same time barking out all the orders required to keep the code in process.
- Get outta my way. I’ll do that for a while.
Whereupon she jumped up on the gurney, straddled the patient and started pumping his chest with the added efficiency this position afforded as a mechanical advantage.
I had never seen anyone before or since in a hospital setting, do it this way.
She happened to be wearing a tight white, short mini-skirt and with her legs spread out over each side of the man’s torso, a good part of her crotch was nonchalantly but innocently exposed. Good thing she happened to be wearing underwear or the scenario would have really been quite surreal.
It was good for another reason too.
It happened that simultaneously, the Cardiology Fellow had passed a temporary pacemaker empirically into the subclavian vein without X-ray guidance. Then when he turned it on the patient’s right arm started to flail up and down at the paced rate of 70 flails per minute. And each time it flailed, the man’s fist would pound up and down inside the female Resident’s crotch.
As it turned out, the pacemaker wire had taken a wrong turn by snaking up into the carotid vein which juxtaposed it to the brain center that controls right arm function. The result was that each time it paced, it caused the man’s right forearm and hand to involuntarily contract.
Being completely nonplussed by the situation and immediately recognizing the problem, the Resident, in not so much as missing a beat shouted:
- Get that goddamned thing out of the brain and put it into the heart.
After which she turned to me and said:
- I’ve had sex a lot of different or sometimes very strange ways in my life. But this is the first time I ever got it being fisted by a dead guy.
I was sufficiently impressed by her composed demeanor, telling her later this was one sexual foreplay scenario that even the Kama Sutra would be hard pressed to match.
- Yeah. Maybe. But from now on if nothing else, I think I’m going to stick to wearing pants.
Too bad, because she did have beautiful legs; which was the one thing for sure that made it a pleasure to go along with her on those mini-skirted medical rounds and guaranteed that we would always be alert and paying attention to whatever she said.
Completely surrounded by the Indians
Hennepin County Medical Center