Thursday, April 8, 2010


Here is the scene that unfolded at work last week.

A fellow resident and I are working together to provide anesthesia for patients undergoing very short procedures. Working together, we can get patients into the procedure room and then back out to the recovery room, and then turn over the room, making it ready for the next patient, faster than if just one of us were doing this on our own. We also have our attending anesthesiologist with us, since as residents, there are parts of delivering anesthesia that have to be done under supervision (okay, you can all breathe a sigh of relief).

The day has been going very smoothly. We've come up with a rhythm of move the patient in, move the patient out, go go go, that works very well.

We're laughing and joking with the surgeon and the surgical resident.

Somewhere near the end of the of the day, the attending surgeon, a 50-something male, turns to me.

"Katherine, I have a question. I heard that CRNAs (certified registered nurse anesthetists) don't like doing [type of procedure]. Have you encountered any of this attitude?"

I shrug. I tell him that I haven't worked with any CRNAs, so I can't speak to their feelings about doing this type of case.

And that is when he looks at me, after now two days of working today, and says, "What? You're not a CRNA?"

You could feel the awkward silence fill the room like a shock wave.

Maybe it was only seconds later. It felt like minutes later that my attending turned to him and said, "Absolutely not. Katherine is one of our anesthesiology residents."

The surgeon apologized briefly, muttering something about now seeing the "MD" on my name tag.

Afterwards, the nurse and the surgical resident both approached me and apologized for the surgeon's remark. As the nurse, um, so aptly put it, "The only reason he assumed that was because you have a va-jay-jay."

But it's hard to be offended. Now. I've been encountering this assumption since the day I enrolled in medical school.

When people found out that I was in medical school, whether it was overly nosy passengers on the train as I commuted, or neighbors, or even distant family members, the most common response was "Oh, that so nice that you're going to be a nurse."

On clinical rotations, both during medical school, and during residency, walking into patient's room, I've heard on more than one occasion, "Oh, my nurse is here."

With some patients, it doesn't matter that I introduce myself as "Doctor," or that my white coat says "Dr." or that my name tag says "MD."

Admitting a patient into the intensive care unit just last night, it happened again. The nurse was hooking up monitors and IV tubing as I did a quick neurological examination. Once the patient was settled and able to talk, I introduced myself.

The patient looked from my blond, 5'5 self to the 6 foot tall bearded nurse standing next to me. "But aren't you my doctor," the patient said to the nurse, who laughed and corrected him.

As a female, I've come to accept that I will always be mistaken for a nurse.

Okay, before you go and assume that I'm all hating against nurses, let me clarify.

I'm NOT.

I love the nurses I get to work with. Especially the amazing ICU nurses. Most of them are more experienced in what they do than I will ever be. While physicians write orders and notes and philosiphize about the sublteties of pharmocokinetics and pathophysiology, nurses are taking care of patients. They are handing the patients pills, turning them in bed, bringing them blankets, wiping their mouths after they vomit.

Nurses are amazing and critically essential to patient care.

But here's the thing.

I'm not a nurse.

I used to get upset when people assumed that, because I was a female in healthcare, that automatically made me a nurse. I don't get mad or even embarrased anymore. It's been a frequent occurance, and eventually, I've gotten use to it.

But some of the internal reactions are still there, popping up automatically. Whether it is a patient, a relative, or an attending surgeon who assumes that I am, I occasionally feel that it devalues the years of hard work that I've had to go through to get where I am. I feel that it reprsents ongoing gender equalities in my field. That even if I'm just as qualified as my fellow residents, that being mistaken for a nurse by patients (and colleagues) could hurt my chance of promotion and partnership.

I've worked hard to get to where I am. I've sacrificed a lot. Some days, I'm not sure it's been worth it.

And while it is discouraging to still encounter the assumptions and attitudes, I've come too far to be thrown off track by an awkward moment.


  1. That would drive me crazy! You seemed to handle it with grace.

  2. I feel the same way...I am not a teacher. I think teachers are amazing and probably could never be a teacher, but I have worked so hard for my degree and am proud of what I do.

  3. I think you handled it better than I would.

  4. I have been a teacher .... went back to school for my master's degree ... started my doctorate.... and becamse a Principal.

    People said (quite often) ..." Really? You are the principal? I though it'd be a man"...OR "I thought you'd be older"

    Power to you.... and what a great attitude!

  5. You've come a long way, baby . . . just keep doing your part to chip away at the inherent sexism of society.

  6. I'm glad you are strong and steady. Yes, you have earned the right to be recognized for what you are: A doctor! I'm proud of your chin up, forward looking composure. When patents used to tell one physician he was too young to be their doctor, I kept hoping someone would counter, "Oh how sweet. I bet you'll be saying that when I'm sevety-five!" Isn't there a tongue-in-cheek rejoinder like,"Oh, I'm the best nurse you'll ever have, because I will treat you with a nurse's great bedside manner, but I'll be able to answer all the questions that you want to ask the doctor!" I wish I'd been there to say to the surgeon, "Well, Dr, is there anything else you want to ask me, while I'm still a nurse? Because in a second, I'll want to know what it was you wanted to ask the resident."
    I agree that the stereo types are limiting. Margaret Thatcher over came those by learning to speak in the low voice tones of a man. I hope you can do that by your commanding presence.

  7. Dear Sister,

    I am glad you stick things out. You always have! If feel that you are one that gets to go through more abnormalities than most ever will, and instead of letting it get to you too deep, you simply reflect, evaluate, and understand. Your judgments are becoming ever more gentle, if at all, and always seem to arrive to the roots of a good lesson and experience.

  8. I can imagine how frustrating it would be, after all your years of study and work, to be mistaken for a nurse. And I totally get what you're saying. Nurses are amazing people. But they're not doctors and doctors aren't nurses.

    My current doctor is a woman and I've never had better care. Your patients are lucky to have you.