Your Health

Ceiling breakers: Female surgeons at ECH own their profession against the odds

When Dr. Sari Levine began working at El Camino Hospital in 1991, something stood out to her about the operating room changing areas: The men’s side was labeled “Doctors,” while the women’s side was dubbed “Nurses.”

“I was raised by parents to be independent and outspoken,” said Levine, a urological surgeon. “Within about two weeks, I met the CEO of the hospital and said, ‘You know, it’s sort of interesting that we’re already in 1991 and I’m supposed to change in the nurses lounge. Why doesn’t it just say ‘Men’ and ‘Women’?”’

Sari Levine
Courtesy of El Camino Hospital
Dr. Sari Levine, speaking at a luncheon in 2016, is a urological surgeon and served as chief of staff at El Camino Hospital in 2004. When she arrived at the hospital in 1991, she led the charge to change operating room dressing room signs from “Doctors” and “Nurses” to “Men” and “Women.”

Three weeks later, she said, the signage on the doors changed.

In the era of the Me Too movement, which has brought to light decades of covered-up sexual harassment and assault, some female surgeons at El Camino Hospital have been echoing related sentiments after years of working in a field where men reign.

In Levine’s case, her surgical specialty, urology, is dominated by men – both fellow physicians and patients. She spends most of her time examining bladders, kidney stones and prostates. The prostate, in particular, is what Levine said makes her line of work an “old man’s club.”

“They talk a lot about sex and about erections and big prostates,” she said of her fellow urologists. “It has the potential to be one of those sort of crass barrooms.”

But Levine is no stranger to paving – and braving – the way for women in a field of men. In 2004, she served as the third female chief of staff for the hospital. She noted that the role helped her understand the reality of “equal but different.”

“When I was chief, it was a really tumultuous time, but I felt that there were times when people felt very comfortable questioning a decision because of circumstances they may not have understood,” Levine said of how men challenged her as a woman in a leadership role.

Subtle discrimination

Levine’s story isn’t a one-off. Dr. Shyamali Singhal, a surgical oncologist and general surgeon at El Camino Hospital, underscored Levine’s comments about the subtle ways women are treated differently by their male counterparts while on the job.

Megan V. Winslow/Town Crier
Dr. Shyamali Singhal, a surgical oncologist and director of El Camino Hospital’s Cancer Center, said she has experienced “subtle” bias over the years, noting that a male patient recently repeatedly mistook her for a nurse and not his surgeon.

Singhal’s area of expertise isn’t for the faint of heart. She said approximately 30 surgical oncologists are trained each year, making it a highly competitive specialty.

In 2005, Singhal was hired to help create and lead the hospital’s Cancer Center and has served as its director ever since. But despite her skills and her position of authority, she finds herself without the title “doctor” before her name more often than not.

“When I get up to speak to my colleagues, there would be other male doctors there, and they would (introduce them as) ‘Dr. Smith’ or ‘Dr. Jones,’” she said. “But they would always refer to me by my first name, which is very different, and in part it’s a level of comfort that other people have with women that they don’t always perceive you as (a) doctor.”

The problem doesn’t stop with her male co-workers, according to Singhal – she must overcome her patients’ assumptions as well.

Singhal said she recently spoke with a male patient with appendicitis, informing him that they were going to take him to the operating room soon. An hour later, she received a call from a nurse saying that the patient complained that a doctor never spoke with him. She went back to visit the patient a second time. When the nurse called her yet again with news the patient claimed that no doctor had consulted with him, she realized that he thought she was a nurse, not his surgeon.

“I think (discrimination is) a lot subtler than you think it is,” Singhal said of the situation and dozens of similar ones she’s experienced. “No one is going to come up to me (as an Indian woman) and say, ‘I’m not going to a brown doctor.’ It’s less overt than that. They’ll say, ‘Oh. Are you really the doctor?”’

Dr. Pei Tsau, a cardiothoracic surgeon at El Camino Hospital, is of Chinese descent and has had to deal with similar comments about her gender and ethnicity.

Pei Tsau
Courtesy of El Camino Hospital
Dr. Pei Tsau, a cardiothoracic surgeon at El Camino Hospital, said working in a male- dominated field means there will always be people look- ing for you to fail. She focuses on the job at hand, noting that “to be just as good as the guys, you have to be better.”

“If people don’t like that I’m a female cardiothoracic surgeon, or they don’t like that I’m of Chinese descent, there will be plenty of other cardiothoracic surgeons they can go see,” she said of patients’ biases. “The main thing is the patient has to be comfortable with the surgeon and me as a female cardiothoracic surgeon of Chinese descent – that’s who I am.”

Unlike Levine and Singhal, Tsau said it never really felt as though she’s a woman in a man’s field. She said she focuses on being the best cardiothoracic surgeon she can be, and her gender doesn’t need to factor into that.

Despite her confident demeanor, however, Tsau said she recognizes that working in a male-dominated field means there will always be people looking for you to fail.

“There are always excuses or reasons as far as why you shouldn’t be there,” she said. “To be just as good as the guys, you have to be better. I see female residents who work harder than the guys because you can never buddy up with your attending (physician), because most of them are male.”

Balancing hospital and home

With schedules that often include 12-plus-hour days, it’s no surprise that Levine, Singhal and Tsau lead busy work lives at the hospital. On top of that, they find time to be wives and mothers at home.

Singhal was the first fellow in her group to become pregnant – which not everyone in her surgical environment was comfortable with. No adjustments were made for standing for 12 hours straight, taking time off for doctors appointments or being nine months pregnant and barely able to reach the operating table. Fellows were expected to work, and when she was ready to return to work after giving birth, nothing changed.

“When I was a fellow, there was no place to pump (milk),” Singhal said of her breastfeeding woes. “I was told as a fellow that if you want to breastfeed, you have to take more maternity leave. … It seems archaic.”

But Singhal was stuck and couldn’t do anything about it. She had one year left of fellowship, and raising concerns could have jeopardized her future.

“You can’t make waves,” she said. “You need recommendations from these people. … You have all these dependencies, and so if you don’t toe the line, then you run the risk of screwing up the rest of your career because you didn’t follow what they wanted.”

Singhal and her husband now have two children, whom she praised for being “surprisingly supportive” of her career. And even with her hectic schedule, she still manages to attend most of her kids’ activities, as long as she has a week’s notice to block out the event on her calendar.

“One of the things that women professionals have (to deal with) is when you go home, it’s often a whole second job,” Singhal said of balancing her career with an equally demanding home life. “Your colleagues who are men don’t often have all that responsibility in addition to their day job, which is why you have to work it out with your partner.”

Levine, also a mother of two, counts on her husband to help manage what could be quite the juggling act. When her son was 4 years old, she was chief of staff at El Camino Hospital – no easy feat when it comes to time management.

“My favorite story is my son saying, ‘Mommy, when will you be un-chief? Whoever’s chief has too many meetings,’” she said.

Thanks to Levine’s husband, who has assumed most of the cooking, cleaning and administrative tasks when it comes to their children, she’s been able to master the balancing act and thrive at work.

Evolutionary change

In a day and age when women are stepping forward to shout “Me too,” Levine said she hasn’t had any instances where she felt horribly disrespected.

“I have lots of anecdotes and reminders that it was a challenging and lonely road, but not one that was too hard to travel,” she said. “I don’t think there are women in working worlds that don’t have examples of ‘Me too.’ But I wasn’t suppressed. … It was subtler.”

But even that is changing, and will continue to change, according to Tsau. As younger generations pursue careers in medicine, the deep-seated roots of the field’s current atmosphere will begin to evolve.

“If more of us are willing to take the hardship that goes with it, then the younger people who are coming up are more used to it, and therefore the hardship won’t be there anymore,” she said.

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