AWS BLOG

When Disaster Strikes

By Dr. Minerva Romero Arenas

#HoustonStrong #HurricaneIrma #FuerzaMéxico #PRstrong #VegasStrong

Our world has been in the midst of what seems like an endless series of tragedies. This blog started out as an idea to write about how I was inspired and proud of the goodwill shown by my fellow Houstonians (and other Texans and neighbors) in the aftermath of hurricane Harvey. Much like this love letter. Much like my colleague’s reminder to look for the helpers when disaster strikes. However, it quickly became a seemingly insurmountable task. Just as I was trying to pen a few lines, another disaster was brewing in the Atlantic. Then the earthquakes hit México. Another set of hurricanes. Yet another mass shooting.

Staying safe. Trying to help. Then trying to keep up with everyone’s safety and figuring out how to help in the aftermath. Donate. Volunteer. Meteorological maps seemed like something that could only have come out of a Hollywood blockbuster. I can’t imagine that I would find it essential to follow @NWSNHC, @SismologicoMX, or @weatherchannel? And if I never have to sleep with an eye open for flash flood warnings or tornado warnings… it may be too soon.

To be quite honest, there were a lot of days the past 6 weeks that seem like a blur.

Thankfully, I had my work to help keep my mind (and hands) occupied! I am thankful for the teamwork shown at our hospital, where 1 in 3 employees were affected. Colleagues swam to work, camped out for days unable to assess the safety of their own families or homes, and everyone who boldly came back to offer relief as soon as it was reasonable to do so. It was amazing to see the “good neighbor” spirit that was showcased from Houston to the world – an example to be seen again in tragedy after tragedy.

On a personal note, I have found a way to turn these events into a positive by taking time to reflect on everything. I have made more time than before to actually consider important questions like, am I okay? Am I putting my best effort to live a meaningful life? How can I be part of the solution? Have I done everything I can to help others?

I am thankful for the human spirit and solidarity that continues to shine through disaster after disaster. I am thankful more of our ACS leadership continues to engage in meaningful discussion about firearm injuries. Most of all I am thankful for my colleagues, friends, and *my family* – their compassion, determination, and strength is truly inspiring and figuratively and literally helped me “weather the storm.”

A message from the AWS Blog Team: This is the first in a series of blogs from surgeons who wish to share their experience during these trying times. If you wish to share your story, you may email blog@womensurgeons.org.

Minerva A. Romero Arenas is an Endocrine & General Surgeon joining the faculty at the University of Texas Rio Grande Valley. She completed a fellowship in Oncologic Surgical Endocrinology at the UT MD Anderson Cancer Center in Houston, TX. She completed her General Surgery Residency at Sinai Hospital of Baltimore. She received her MD and her MPH from The University of Arizona College of Medicine and the Zuckerman College of Public Health in 2009. She studied Cell Biology and French at Arizona State University as an undergraduate.
Her interests include surgical oncology & endocrinology, global health, health disparities, quality improvement, and genomics. A native of Mexico City, Mexico, Dr. Romero Arenas is passionate about recruiting the next generation of surgeons and is involved in mentoring through various organizations.
She enjoys fine arts, films, gastronomy, and sports. She enjoys jogging, swimming, and kickboxing. Most importantly, Dr. Romero Arenas treasures spending time with her family and loved ones.


Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author, and are not necessarily the opinion of the Association of Women Surgeons.

 

Sepsis: A Surgeon’s Perspective

By Lillian Erdahl, MD

Around 1.5 million people suffer from sepsis and at least 250,000 die due to it each year in the United States. The majority of these individuals-7 out of 10-were recently treated in a healthcare setting and many of them have chronic diseases requiring frequent medical treatment.1 As a surgeon, I have witnessed how rapidly the process of sepsis can overwhelm a patient’s organ systems. Early, aggressive treatment of the infection and supportive care of the patient is not always enough to reverse the cascade of organ failure leading to death.

Watching a person get sicker despite doing everything you know how to do is both humbling and incredibly disheartening. With all the advanced technology and modern precision medicine we have, we are still fighting single-celled organisms that can kill us from within. I imagine all healthcare providers feel the pain of being unable to successfully intervene against a deadly disease. It never gets easier for me to tell a family that their loved one is getting sicker even though I am doing everything I can to treat his or her illness.

September is Sepsis Awareness Month which is a good time to talk about what we can do to prevent sepsis and sepsis-related mortality.

  1. Infection Prevention: A number of interventions in both healthcare and domestic settings can help with infection prevention. Basic hand-washing with soap and water prevents the spread of infectious agents from one individual to another. In the hospital, a number of interventions have been shown to reduce infections including central line catheter insertion protocols. Surgeons are often making decisions about when to insert and remove central venous or urinary catheters. We must recognize and commit to preventive measures each time we interact with a patient.
  2. Early Recognition of Sepsis: Recognizing sepsis early is the first step to early treatment. Early signs and symptoms include fever, chills, tachycardia, confusion, and shortness of breath. Patients who are immunocompromised may not manifest typical signs and symptoms, so a high index of suspicion is an important part of identifying sepsis in these high-risk patients.
  3. Early Goal-Directed Therapy of Sepsis: Early recognition must be followed by early goal-directed therapy in order to impact the mortality related to sepsis, especially in cases of severe sepsis and septic shock. There have been many studies of how exactly to manage sepsis and septic shock, but it is clear that early antibiotics, source control, and supportive therapies directed at maintaining perfusion and oxygenation improve mortality.2
  4. Education of Health Care Providers and the Public: The aim of Sepsis Awareness Month is to drive ongoing discussion and education on many levels. The CDC has a campaign which includes education on how to prevent, recognize, and treat sepsis. You can visit their website for resources that might be helpful during the month.3

References
1. Sepsis. Centers for Disease Control and Prevention https://www.cdc.gov/sepsis/index.html
2. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-1377
3. Getting Ahead of Sepsis. https://www.cdc.gov/sepsis/get-ahead-of-sepsis/index.html


Lillian Erdahl practices Breast and General Surgery at the University of Iowa Hospitals and Clinics where she is an Assistant Professor of Surgery as well as the Iowa City VA Medical Center. Her career pursuits include medical student and surgical education as well as improving breast cancer prevention and diagnosis. She enjoys cross-country skiing, yoga, cooking, gardening, and traveling with her husband and two children.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

 

Golden August

By Camila R. Guetter

Created in 1992 by the World Alliance for Breastfeeding Action (WABA), the World Breastfeeding Week completed its 25th edition this year. During the first week of August, campaigns and partnerships take place in order to support and raise awareness on the importance of breastfeeding. It is an international effort that currently involves 150 countries.

This year, to celebrate World Breastfeeding Week’s 25th anniversary, the Brazilian government announced the expansion of this campaign from a single week to a whole month dedicated to the cause, the Golden August. Initiatives include public talks and events, community meetings, advertising on the media, and illuminating monuments and buildings with golden lights. All in an effort to spread even more knowledge and awareness about breastfeeding in Brazil.

The name “Golden August” relates to the fact that breastfeeding is the gold standard for newborn feeding. Compared to Pink October initiatives for Breast Cancer, it intends to make society aware that breastfeeding is a primary preventive measure for many diseases, for both mom and child.

As I  go through my OB/GYN rotation in medical school, I now understand the extent and importance of the benefits of breastfeeding. For mothers, breastfeeding contributes to postpartum weight loss [2,3]. It has also demonstrated risk reduction on ovarian cancer [4], endometrial cancer [5,6], and aggressive inflammatory and invasive forms of breast cancer [7,8].

When it comes to the newborn, breastfeeding plays an important role in the development of the dental arches [9,10], speech, and breathing. It is also a protective factor for allergies [11], infections [12,13,14], gastrointestinal illnesses [13] such as gluten intolerance, obesity [15], and reduces neonatal mortality [16]. Last but not least, it contributes to the effective bond between mother and child. Another recent blog by Nickey Jafari highlights more the benefits of breastfeeding.

Given all the well-known benefits of breastfeeding to both mother and newborn, the WHO recommends exclusive breastfeeding for at least the first six months after the birth of the newborn. Nevertheless, this practice still encounters many barriers worldwide, mainly due to lack of information. Globally, only 38% of newborns receive breast milk until six months of age. The goal set by WHO is to increase this number to 50% by 2025.

Discrimination and criticism over breastfeeding in public is still a major issue in Brazil. In this regard, the Golden August has partnered with public and private companies to empower their employees who are new mothers. Some companies now offer special rooms for breastfeeding, showing recognition of its importance. They offer private and adequate environments for mother-infant interactions and bonding as well as for pumping breast milk, if needed, during work hours. These conditions may lead to less work absenteeism as they improve the ability for women to return to their work routine more easily. They also maintain breastfeeding as a unique and special experience, as it should be.

Happy Golden August to all parents out there!


Camila Guetter is a fifth year medical student at Universidade Federal do Paraná, Brazil. In her third year, Camila received a scholarship to study at UCLA. Subsequently she became a research student at Beth Israel Deaconess Medical Center (Boston, MA) on pancreatic cancer, HPB surgery outcomes, and patient education materials. Camila is passionate about pursuing a career in academic surgery and is currently a Teaching Assistant for Principles and Practice of Clinical Research, a Harvard T.H. Chan School of Public Health course. She currently serves as International Representative for the 2017/2018 AWS Medical Student Committee. Outside of medicine, Camila enjoys playing tennis, playing the piano, and traveling.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

 

 

AWS Day of Service 9/9/17

By Simin G. Roward

Being a medical student is challenging: between studying, rotations and research, it seems there isn’t enough time for everything. Often, it’s easy to lose track of why we chose this profession in the first place. Community service and engagement are put on hold amidst other pressing responsibilities. The goal of the AWS National Day of Service is to designate a day on which medical students from all over the country would come together with residents and attendings and make service to others a priority.

The members of AWS are compassionate, humanistic leaders, who chose the field of surgery because of the ability to make lasting improvements in people’s health and to provide a vital service to communities. These positive characteristics were exemplified in last year’s AWS National Day of Service event, where students nationwide provided much needed services and donations to their community. These service events differed from state to state- some schools put on educational sessions with high school and middle school girls to talk about medical school or to provide mentorship to students from disadvantaged backgrounds. Other schools organized clothing drives to provide supplies for shelters helping domestic abuse survivors or immigrant .

Each service event was specific to the needs of the community: in Washington, students raised funds for a local non-profit organization after it had been broken into and vandalized. In Arizona funds were raised to provide pre-employment TB testing to refugee women. In Texas, cookies were baked with the residents of the Ronald McDonald house, and students in North Carolina helped girl scouts earn badges by teaching them First Aid. Students in DC spent the day packing meals at a local food shelter and Boston students volunteered at a clinic for the homeless.

The participating schools should be proud of the events they organized and the important contributions they have made to their communities. The spirit of volunteering and community service are well aligned with the mission of the Association of Women Surgeons. As the AWS day of service will become an annual event, each year will build on the strengths of the previous year. This year’s AWS National Day of Service is September 9th, 2017, please contact us for additional resources or questions about participating!

Pictures:

 

 

 

 

 

 

 

 

USUHS put together bags of food donations at Food for ALL

 

 

 

 

 

 

 

University of Texas Medical Branch  hosted a Valentines cookie baking event at Ronald McDonald house

 

 

 

 

 

 

 

Paul L Foster School of Medicine (Texas Tech-El Paso)-organized a clothing drive for Anunciation house, a migrant shelter

 

 

 

 

 

 

 

 

 

University of Arizona- Fundraising for pre-employment TB testing for Syrian refugees

 

 

 

 

 

 

 

Boston Chapter-Hosted a game night with patients from their clinic


Simin G. Roward is a recent graduate of University of Arizona college of medicine.  She is currently a general surgery intern at University of Texas at San Antonio and she is planning to pursue a career in pediatric surgery.  She served as the community service chair for the Association of Women Surgeons during the 2016 school year and began the AWS day of service event. Her interests include global health, running marathons, traveling and participating in community service.   

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

BLOG for FINDING FRIENDS

By Beth Shaughnessy

This lifestyle we have chosen seems to come in 4-5 year runs, Each new phase of training means we may have to pick up and move somewhere else, again. At least until we get that first real job. And with that comes a little loneliness. What if we have never lived there before? What do I do to find a friend?

Before I left for my fellowship in Los Angeles, I had lived in Illinois nearly my entire life – and was lucky enough to complete medical school and residency training close to home. I knew NO ONE in California except for my husband. As I started fellowship, he appointed me his social secretary! What to do? The social culture was a bit different in L.A. as compared to Chicago, as compared to Cincinnati where I now live. In California, people tend to live farther away, commuting long distances. Gone were the days of spontaneous get-togethers with co-workers. Locating friends nearby was not so easy. People kept to themselves more. Obviously, this was one of those times I would have to take matters into my own hands and be proactive. So, how did I find like-minded individuals? The easiest way for me was to find some common ground. These are some of the ways I was able to make new friends as an busy professional in a new city:

  • Take a class: My yoga friends have been around 12 years now. We support each other, we network, celebrate weddings, suggest restaurants, etc. No one else in this group is in medicine, and it is refreshing to get a different perspective. Find something that you are interested in, such as yoga, spinning, cooking, photography, painting/art, bee-keeping.
  • Volunteer: I helped to organize the Susan G. Komen Affiliate in L.A., then contributed to the new one in Cincinnati. Met lots of people through this organization.There are many ways to donate your time, such as putting on a running race or bicycle race, or help with the handicapped, or be a big sister through the “Y”.
  • Join a club for running, hiking, bicycling, book club, or an organization like Sierra Club, a club for a cause.
  • Neighborhood meet-ups.
  • Network with existing friends to find names of people they know in this new city. You are more likely to meet a potential new friend in someone who knows a friend of yours.
  • Become active in an alumni organization or chapter. In Los Angeles, I met up with women who had been members of my same sorority in college. They came from a wide variety of ages and backgrounds, from many parts of the country.
  • Get a dog and walk that dog. They don’t call it a people magnet for nothing.
  • Go to a fund-raiser that is meaningful to you, and introduce yourself to a lot of people, and/or volunteer to do something for that charity.

In reading articles on new websites, meetup is supposed to have notices of multiple meetings that you could possible go to. Bumble is supposed to be a new way to find your next BFF. I haven’t tried it, mostly because they are new.

Finding new friends as we get older becomes more challenging as we age. This is well-documented, but not impossible. Think about it; making a friend takes time and emotional investment. It takes a certain level of commitment, albeit as small or as large as you are willing to commit. And it usually starts with finding common ground. As the demands on our time grow, and we might get a career, get married and might start a family, the extra time shrinks. So does theirs. Friendships through classes or activities help to serve you in participating in an activity, but also having a friend with whom you have something in common. You can keep the commitment at the level of the activity only, or you can expand beyond it, depending on your time constraints.

But take heart; remember you have made friends before, and you will make friends again. They don’t come prepackaged. Try to remain loose, flexible, and open to conversations and meeting new people. One lasting friendship I made casually through a discussion in a grocery store, commenting on the person’s sweatshirt design, and the individual became like family in time.


Beth Shaughnessy was born and raised in the Chicago area, leaving to go downstate for college at the University of Illinois at Urbana-Champaign, but returning for medical school at the University of Illinois at Chicago. After residency at the University of Illinois’ program, she felt she became too inbred, so she left for Los Angeles to complete a fellowship in surgical oncology at the City of Hope National Cancer Center. She is currently a professor of surgery at the University of Cincinnati, in Cincinnati where she lives with her husband and son. She enjoys cooking, yoga, the arts, choral singing, and gardening.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Fireworks on the Fourth

By Cheyenne “Cassie” Sonntag, MD MS

Say it with me: the Fourth of July.

Just saying those words fills your mind with fond memories of watermelon, BBQ, and warm summer nights spent with family and friends lighting sparklers and setting off toy caps. It’s a familiar story, relatable to most who read this – but one unfamiliar to me. Sadly, I spent a large portion of my childhood living in locations with strict fireworks restrictions due to dry desert climates. As such, my firsthand experience with fireworks and firework safety has been limited to setting up a proper picnic space in the park to avoid being trampled in the dark while still maximizing one’s view of a public show.

I was determined that this year would be different. My relocation to the lush lands of Central Pennsylvania for surgical residency and a favorable call schedule (about time!) has finally afforded me an opportunity to experience that all-American Fourth of July fireworks fantasy.

Excited for my first Fireworks Fourth, I visited the Pennsylvania State Police website to find out exactly what shenanigans I could pull off within legal limits. To my disappointment, I discovered that state law (specifically Title 35, Chapter 13A) prevents the use of consumer or display fireworks without a municipality permit and purchase at a Department of Agriculture licensed outlet. However, my Summer of Sparklers was saved as further reading revealed that “ground and hand-held sparkling devices”, “novelties” and “toy caps” as defined by the American Pyrotechnics Association Standard 87-1 are actually designated “non-fireworks” and can legally be sold at convenience stores and tent stands.

Wanting to make sure I celebrate appropriately, I spoke with some of my co-residents about their experiences with fireworks to elicit product recommendations. While all expressed very clear favorites- from sparklers to bottle rockets- every person also related a “this one time” or a “just-missed” story as well. From a sparkler resulting in a singed pigtail and new haircut to a bottle rocket misfire that flew directly into a pile of unlit fireworks and sent a whole party ducking for cover, it was clear that even these designated “non-fireworks” could be extraordinarily dangerous. I certainly regret asking the opinion of a friend who incidentally spent the last Fourth of July on “hand call.”

The Consumer Protection and Safety Commission (CPSC) website and their Annual Fireworks Report estimated that in 2015, 11,900 fireworks injuries were treated by US emergency departments. Sixty-seven percent of these injuries occurred between June 19 and July 19, 2015, with children under 15 years of age representing a fourth of those injured. To my dismay, the report estimated that my beloved sparklers accounted for 1,900 emergency department treated injuries that year.3

It became clear to me that that the absolute safest way to enjoy fireworks this Fourth of July would be to once again set-up my picnic blanket and enjoy the public show. However, for those of you for whom the temptation to light a sparkler may prove just too strong, the following are a few resources with fireworks safety advice for all ages that are worth reading:

National Council on Fireworks Safety
National Safety Council

I wish everyone an amazing summer, and a safe and injury-free Fourth of July.


Cheyenne “Cassie” Sonntag, M.D., M.S. is a general surgery resident at the Penn State Milton S. Hershey Medical Center in Hershey, PA. Born in Colorado, she spent the formative years of her youth in Arizona before earning her B.S. in cell and developmental biology from UC Santa Barbara. Dr. Sonntag attended medical school at the Keck School of Medicine of the University of Southern California, where she also earned a Master of Science in Global Medicine. She is currently starting her second of two academic development/lab years a Penn State Hershey as a research fellow focusing on surgical simulation and surgical education. Cassie will be spending her Fourth of July once again observing the local public fireworks display, from a safe distance, on her picnic blanket.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Life in an Instant

By Sasha Adams, MD

I am a multi-tasker. I thrive in chaos. Managing multiple projects, people, jumbled schedules – that’s when I’m on my game. And that’s a good thing, because I’m a surgeon, a wife, and a mother of 2 wonderful kids. I have an amazing husband who is an incredible stay-at-home Dad, but there is always more to do. So I multi-task: 2am waiting for my OR case to start, I jump on my phone and order diapers, confident that they will be delivered before we run out in 2 days. I check my emails (both work and home!) and rapidly respond while walking down the hall from the OR to my office. During morning checkout, I hear reference to a book I should probably read, and surreptitiously jump on my phone and order it for my Kindle app within a minute. Heading back to the office, I look at the calendar and notice the kids birthday party next weekend! Quickly I go online and order the gift so it’s delivered in time! All this while being on the go! Like I said, I thrive in chaos-#Ilooklikeasurgeon!! We live in a world where technology has made this possible: if you think of it – you can get it done, check it off your list, and move on to the next task. It’s all about instant gratification.

At work, however, I see a different kind of instant, and it is not gratifying. I’m a trauma surgeon so I see how in an instant, lives and families are changed forever. A moment of distraction while driving leads to an MVC, and they come to me, facing injury, or even mortality, the loss of loved ones, the shattered dreams of the future. I see the shock and pain in the eyes of the families that come wide-eyed to the ER, anxious and afraid to hear if their loved one is okay. As I tell them what has happened, I watch their well-planned, organized, happy world crumble around them. My heart breaks for them, and sometimes I cry with them. Some of their stories haunt me for years. In the Trauma Bay, there is no judgement, just resuscitation of the injured patient. But the stories unfold over the coming days. Yes – some are obviously intoxicated, but others seemingly innocent. Headed to /from work or dinner, some on the phone. “I never saw the other guy”, or “I just looked down for a second”. In 2014, over 400,000 people were injured from distracted driving, and over 3,000 were killed. 78% of them were on the phone, and although the “novice” drivers (15-19yo) get a lot of attention in the media, they are only 20% of the problem. The other 80% of us “experienced” drivers think we can just look down for a few seconds and we’ll be fine. But 4 seconds at 60 mph is the distance of a football field!

So as I drive to work this morning, my mind starts running – what do I have planned today – meetings, cases, appointments, catching up on the ever-behind notes, wondering how many emails are waiting for me. I should check on the patient from yesterday. The To-Do list grows as I quickly become preoccupied with my day before I even arrive. The multi-tasker in me is awake and on the move! Suddenly my phone notifies me of an incoming email. What could it be this early in the morning? Can’t be good. As I reach for my phone, one of those faces come to mind – a life changed in an instant of distraction. I see the faces of the family looking at their loved one in my Trauma Bay, damaged, hurt, with an uncertain future. The multi-tasker in me takes a breath and pauses. I put down the phone. Now is the time to focus on driving. I turn on the radio and sing along, enjoying the sunrise over the Texas landscape and my 20 minutes of off-the-grid peace while I watch carefully for the other drivers who don’t have the benefit (or curse) of knowing what can happen when they aren’t focused on the road around them.

The chaos can wait.


Dr. Adams is a Trauma Critical Care surgeon at the McGovern Medical School in Houston, TX. In addition to her clinical duties at the Level 1 Trauma Center, she runs the Surgical Clerkship for rotating 3rd year medical students, and is an inaugural Society leader and advisor for the McGovern Society, mentoring 8-10 students per year throughout their med school career. Dr. Adams’ research is focused on improving the care of geriatric trauma patients, through earlier identification of those at increased risk, changes to inpatient care practices, and early rehabilitation efforts to improve long term outcomes.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Knocking on the Door of Disparity

By Danielle Henry, MD

Before the end of National Minority Health Month, I am compelled to take the opportunity to talk about how a disease I’m passionate about affects black women – breast cancer. National Minority Health Month gives us another chance, outside of October, to focus on breast cancer’s impact on the black community.

After being introduced to the Sisters Network by one of my patients, I gained a greater understanding of breast cancer’s impact on the black community. During one of the events I attended, “Stop the Silence”, there were women who traveled from near and far who were currently battling breast cancer, survivors of breast cancer, loved ones of those who previously passed away from breast cancer and simply supporters coming together to raise awareness. Many admitted that cancer was a taboo topic growing up, and went on to share personal stories of struggles, triumphs, and loss due to breast cancer. As a part of the event, we also walked door to door asking to speak with the women of the household to share breast cancer facts and invite them back to the event site for free mammograms. This part of the event stood out the most, as it took an active role of going into the community instead of passively waiting for them to present to the clinic.

Below is a list of statistics shared during the walk, in addition to a few others, which resonated with me on the topic of breast cancer:

  1. Among black women, breast cancer is the most commonly diagnosed cancer and the second most common cause of cancer deaths.
  2. Although the incidence of breast cancer is lower in black women, they have a 42% higher mortality than white women.
  3. Only 52% of breast cancers are diagnosed at a local stage in minority women.
  4. Twenty-two percent of breast cancers among black women are triple negative (loss of receptors for estrogen, progesterone, her-2-neu), which behave more aggressively, have a poorer prognosis and lack targeted therapy.

I am motivated both by my experience with this grassroots event, as well as the overwhelming data that shows disparity in black women, to address and shed light on this disparity. With National Minority Health Month and this blog offering a prime opportunity to bring awareness, the rest of the months can be spent “Bridging Health Equity Across Communities”. Through the Office of Minority Health, you can find many resources for working with minority populations related to education, prevention and treatment strategies.

Resources:
www.cancer.org
https://minorityhealth.hhs.gov

#NMHM17


Danielle Henry is a chief resident at Orlando Health General Surgery Residency Program and currently serves as the administrative chief resident. She is planning to pursue her passion with a career in breast oncology after residency. She completed her medical degree at Florida State University and undergraduate degree in Applied Physiology and Kinesiology at the University of Florida. She enjoys playing soccer, a good game of scrabble and time at the beach. She also enjoys community service projects and mentoring medical students.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Grey’s Anatomy: 5 Reasons to Aspire to be Like Seattle Grace Hospital

By Sristi Sharma MD, MPH

I confess–there are days when I like to unwind and binge watch Grey’s Anatomy. I revel at the personal drama, root for certain characters (Jackson!), cringe at medical atrocities and then spend (my precious) hours on the internet looking up this mythical hospital, that I can assure you, does not exist in the United States.

All real-life medical doctors, especially surgeons, have several issues with Grey’s Anatomy: the medical science in the program is all wrong, interns in the show have an impossible life, the attendings have a severe I-need-to-do-it-all complex-and don’t even get me started on the hair! However, what Grey’s Anatomy does get right is the alternate reality of gender roles in the field of surgery. Here are 5 things that Seattle Grace Hospital Department of Surgery can teach the real-life surgical community:

  1. The number of female surgery residents: As per AAMC 2016 residents report there are a whopping 163.4% more male surgery residents than female ones. This reflects the general surgery residency application figures which during the ERAS 2016 cycle had around 4870 males vs 2600 females. That is 187.3% more male applicants to these programs. The female heavy residency program at Seattle Grace Hospital does not reflect residency programs in the US. All programs in the country should make a better effort to recruit qualified women surgical residents.
  2. Miranda Bailey as the Chief of Surgery is an outlier. There are 271 general surgery residency programs in the United States. Of these only 16 programs are headed by women. That number was 1 in 2014. So although it looks like we are headed the right way, a lot still needs to be done. The ACS recently hosted a webinar on Principles of Leadership for the Young Surgeon. The fact that it was presented by an advocate for gender equity in general surgery was a great step in the right direction.
  3. In Seattle Grace Hospital the chiefs of cardiothoracic surgery, neurosurgery, orthopedic surgery AND pediatric surgery are all women. Time and again, the show reiterates the high degree of technical skill these women have in their respective fields. So clearly, Seattle Grace Hospital is promoting people based on their qualifications and not on their gender. In the real world however, there exists a glass ceiling that is quite difficult to break, particularly in fields like surgery.There are many reasons why there is a scarcity of women in surgical leadership roles, however inherent systemic biases are some of the most unaddressed reasons that hold women surgeons back. We need to address these biases one at a time and do away with the barriers that prevent women surgeons from achieving their fullest potential.
  4. This year during the International Day of Women and Girls in Science, the UN deplored the bias and stereotyping against women in science and went on to make a bold statement “The world needs science and science needs women”. Melinda Gates has made it a personal mission to increase the number of women in science. Now here is a list of research studies that the women surgeons of Seattle Grace Hospital do: Cristina Yang’s Conduit Trial, Meredith Grey’s Alzheimer’s drug trial, Miranda Bailey’s diabetes research, and Callie Torres’ limb simulation trial, to name a few. Clearly, this hospital has great policies that support research activities among these surgeons. This in turn makes them great academic surgeons, which in turn explains their promotion as department heads. It is a cycle that keeps on going and growing.
  5. Mentoring opportunities: The mentoring relationships portrayed in Grey’s Anatomy is what we all hope to have and give at some points in our careers. The deep bonds (although sometimes over-the-top) that every mentor has with their juniors explains why it seems every surgeon in the show is so successful. The show demonstrates men mentoring the women to rise to the top. A report published recently by Harvard Business School showed that male champions can change the workplace culture so that women actually get what they deserve. The women in turn mentor not just other women but also men (Arizona and Alex anyone?) and the entire system self-propagates. The report shows that companies which adopt gender diversity did better than others,which then kind of explains why Seattle Grace Hospital would be one of the ‘top choices’ for competitive residents.

So yes, while interns going berserk with LVADS and a gunman roaming around loose in the hallways may not bode well for a successful setup, Seattle Grace Hospital has some great qualities which surgical communities in the country should aspire to if they want to be considered a success overall.


Sristi Sharma MD, MPH is an aspiring surgeon, a clinical researcher at the Brigham and Women’s Hospital, a previous Paul Farmer Global Surgery Research Associate and a proud alum of Manipal University, India. She is an passionate about advocating for global surgery. She was born in the Himalayas and is a Gorkha to the core.
Twitter: @drsristisharma

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

National Minority Health Month

By Robin Williams, MD, FACS

Despite the vast advancements of modern medicine, significant health disparities remain amongst minority populations. Heart disease, cancer, stroke, diabetes, and unintentional injuries are the top 5 concerns that disproportionately affect minorities. Just to highlight a few disparities:

  • Thirty percent of African Americans are more likely to die from heart disease. Coronary artery disease occurs earlier in life and in higher percentage of Asian Indians than in other ethnic groups.
  • Seventy percent of African Americans and Latinos are more likely to be diagnosed with diabetes compared to non-Hispanic whites. Twenty percent of Asian Americans are more likely to have type 2 diabetes than their non-Hispanic white counterparts.
  • Although the incidence of breast cancer is higher in white women, African American women tend to be diagnosed at an earlier age (58 compared to 63) and have a death rate that is 42% higher. Hispanic women have among the highest rates of cervical and gallbladder cancer.

The above information juxtaposed with the following heightens the need for awareness to be raised regarding minority health.

  • In 2008, approximately 33% or more than 100 million people identified themselves as belonging to a racial or ethnic minority population.
  • The Census Bureau predicts that by 2045, the racial and ethnic minority populations in the United States will grow to become one half of the US population.
  • The potential excess medical care expenditures for African Americans, Asians and Hispanics that were due to health inequalities is 30.6%.

April is National Minority Health Month. Sponsored by the Office of Minority Health (OMH), the theme this year is “Bridging Health Equity Across Communities.” Healthy People 2020 defines health equity as the “attainment of the highest level of health for all people.” This definition incorporates social determinants of health- where we live, work, play- as factors impacting overall health. OMH invites individuals and organizations to engage in their own communities to achieve equity. There will be a Twitter Town Hall on April 12 and a Twitter Chat on April 25. For more information, go to www.minorityhealth.hhhs.gov.

“Without health, and until we reduce the high death rate, it will be impossible for us to have permanent success in business, in property getting, in acquiring education, or to show other evidence of progress”

~Dr. Booker T. Washington

References:
Current Cardiology Reviews 2015 Aug:11(3): 238 – 245

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558355/table/T1/
The National Negro Health Week, 1915 – 1951: A Descriptive Account, Sandra Crouse Quinn, PhD; Stephen B. Thomas, PhD http://health-equity.lib.umd.edu/541/1/National_Negro_Health_Week.pdf
www.cancer.org
www.minorityhealth.hhs.gov


Dr. Williams is board certified in general surgery.  Her clinical interests are diagnosis and treatment of diseases of the breast.  She is currently the Co-Chair for the Association of Women Surgeons Clinical Practice Committee.  She is a member of the Tennessee Medical Association and serves on the Insurance and Constitution and Bylaws Committees.  She is also a delegate for the Nashville Academy of Medicine.  Over the years, Dr. Williams has been an active participant in the Nashville community.  She has served as a board member of the Tennessee Breast Cancer Coalition, the Nashville Affiliate of Susan G. Komen for the Cure, and the MidSouth Division of the American Cancer Society.  From 2000 to 2007, she was president of the Nashville Chapter of the National Black Leadership Initiative on Cancer.  

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.