Every so often the 80hr work week comes up in conference. It’s like a nonhealing wound that we keep coming back to pick at. Usually the residents keep quiet during these discussions; there’s absolutely
nothing good that could come from us saying anything, either positive or negative, on the subject. We listen to the attendings, and we find out what they really think of us.

Despise may be too strong a word, but there’s a general feeling of contempt. We didn’t ask for the 80hr rule, and we do our best to push the limits, but the attendings seem to feel that we, personally, asked for it, and are whining about it being too little, or not adequately enforced.

The best part is when they get to talking about women in surgery. That’s when I and the other women start shrinking into our chairs and looking at the floor, or perhaps shrugging at each other, either way trying to act as though we’re not present and are not aware of what’s being said.

Usually, I feel remarkably equal with the guys, for being at a program whose attendings are all on the older side. They listen to me on rounds, answer questions, give advice, and seem to treat me and the other women the same as the guys. The male residents also seem equitable, and we share floor work and case load based solely on seniority. Of course you can always find the men, residents and attendings, in a corner talking sports with an enthusiasm even the women who know the rules of the different games can’t equal, or complaining (or boasting) about their wives and girlfriends.

But when we get to the 80hr week, then we hear the truth. “The women are in it for breast surgery. . . all the women want to do is plastic surgery. . . they want a practice where they can go home at set hours, and not get called back about complications. . . we should make it easier for some surgery residents, like the women, to go into purely critical care. . .” Somehow it hurts worse for being so rarely said. I get to thinking that we’re all on the same page, and it’s always a blow to realize that the attendings don’t think so.

And so I’m left with an increasing determination to demonstrate my commitment by coming in early and staying late, by showing up on every occasion with all possible information about my patient. Mention their
name, and I’ll tell you their procedure, the date, the date of their discharge, the day they came back with a complication, what their labs were at that time, and all their course since then. I stay late to watch big cases. I scrub in at the slightest invitation, even if I’ll get to do nothing but watch from a little bit closer. It’s probably a losing battle. They’ve made up their mind about the new generation of lazy residents, and my efforts can’t cancel the effect of half the women even in my program planning to do breast and plastic surgery. To me, that stuff isn’t surgery; that’s scratching the surface. I care about complications and late night cases; if I practice surgery in the long-term, I’ll be there in the middle of the night. (But that’s an if; a big one, and one that I’m not letting on to.)

Besides twisting our ethics into knots, as discussed yesterday, the 80hr rule also builds a wall between residents and attendings, leaving us unable to earn their respect as residents used to do. It also puts female surgery residents at a continuing disadvantage, since it gives the men the excuse to believe that we’re only in this because it’s easier now.

I am not a feminist. I strongly dislike the feminist agenda, which to my mind consists of insisting that men and women are interchangeable, and trying to force society to stop recognizing the differences which do exist between men and women. Nevertheless, since I am here, I believe that I am as capable of learning the knowledge, the technical skill, and the judgment needed to be a good surgeon as any other male resident. If I fail, it’s because of my own flaws, not because I am a woman. The new rules handicap me and the other women in our efforts to prove that.