“It’s because you’re a woman, you know.”

I looked to my left. She gave me a sideways glance, barely breaking her stare with the computer screen. She was beautiful, but you could tell she styled herself to downplay that beauty. She had a slightly harsh face, but one that didn’t start out that way and developed over time. Eventually, she grew to accept that hardness as comfortable and normal. She wore make up, but never enough to distract from muted walls of the hospital surrounding her. It was as if she tried to make herself blend into her surroundings.

She was a trauma surgeon, and she just witnessed my interaction with the board runner for the day.

“You think you can operate with that small brain up there?” he coyly said to me. I was trying to book an urgent case and this guy thought it would be sport to give me a hard time.

I smiled sweetly through gritted teeth. “Oh, that’s right, it’s an extra effort for me with this teensy tiny little brain I have, but somehow, we women muddle through operating.”

I forced the booking slip into his hand. He looked me up and down. “Well, on account of you being so special, I’ll make sure you get an operating room, sweetheart.”

“Aw, why thanks, I won’t forget the favor.” I hated myself for being so complacent.

The woman at the computer witnessed the entire exchange. She came from a different era of training, one that by all accounts more grueling than my own. But the subtle, or sometimes not so subtle, tones of misogyny and sexism still run rampant. Once, I saw her perform a thoracotomy on a trauma patient, place a central line, and roll him to the operating room in under five minutes. There was nothing complacent about her.

I was mortified she was privy to this encounter. I lowered my eyes and dashed out of the room.

Within the walls of the hospital, the masculinity of medicine is palpable. Look no further than the walls of pictures of former program graduates to feel it. I sometimes counted the women’s faces in the lineup of black and white portraits as I walked past, hoping I missed one or two the last time I looked. But the number was the same every time; just six women graduated in 35 years.

It is no secret that surgery is a male-dominated specialty, but the additional pressure on women choosing this field to not be “weaker than” male counterparts is difficult to explain. I often felt frustrated by the language used towards female surgery trainees, especially surrounding family planning or when a woman even remotely looked she may cry. I swore I would work my hardest not to be seen any different than my male training counterparts. I worried that I would be deemed too “soft” to be a surgeon by my teachers. The environment is one where you put your head down, do the work, and above all, do not let your feelings get in the way.

Living in surgical culture, this all boils down to an overwhelming feeling of needing to be masculine enough for the men, feminine enough for the women, and an expert at both to survive.

I escaped my mortifying encounter with the anesthesiologist to the women’s locker room. I walked to the sink and splashed cold water on my face, trying to snap out of that moment. I caught my reflection in the mirror and it made me pause. My brow was furrowed; I didn’t remember that deep line of concern being there. It was permeant now though, a deep, settled line that would always remind me of what I had seen. I didn’t recognize this version of myself. The woman in the mirror was hardened and more masculine than I ever remembered.

I was happy to leave the hospital that night and desperately wanted to do something to feel like my old self again. I was exhausted, but had plans to go for a drink with friends. I ran home, showered, put on the prettiest dress I could find, and stepped out into the crisp winter air.

My friends were sitting at the bar when I got there. As I walked up, a man sitting next to them turned around, caught a glance of me in my pretty dress, and flashed a smile. I flashed one back and he turned all the way around to engage in conversation. He seemed witty and relatively cute. I could see in his eyes he was interested and entertained by my sarcastic tones. Then, the conversation turned in the usual fashion to basic life topics, such as our occupations.

“So, what do you do?” he asked.

“Oh, I work in the medical field.” The conversation went the same way every time, and I hated this part.

“Cool! Are you a nurse?”

“No, actually I’m a doctor.” My tone was that of an apology, as if I had to apologize for my professional ambition and diminish it to still be seen as attractive to a man.

“Really? What kind?”

“I’m a surgeon.”

“Really? No way!” he said incredulously. I knew what to expect from here.

“Yes, really.” I forced a smirk.

“Ha ha, hey guys! She says she’s a surgeon,” he said over his shoulder to his buddies. They all laughed out loud.

He turned back towards me and as we made eye contact, he noted my stern demeanor. His face sunk as he realized…I was actually serious.

“Oh…” I watched as that flicker of interest and intrigue in his eyes disappear.

“Yes. Oh.” I said flatly, turning away from him and back to my friends.

I was curious what image he had floating in his mind that lined up to the word “surgeon” that I, sitting there in my dress, was so contradictory to. I talked and laughed with my friends the rest of the night and tried to not give it a second thought.

The next day I was back at the grind at 5:30 AM. Coffee, rounds, more coffee, and a lineup of cases in the operating room. The service was busy, and after the events of the day before, I welcomed the distraction of bouncing from one task to the next. I almost forgot the combination of mortification of the anesthesiologist and would-be suitor by mid-morning. That is, until I walked around a corner and ran face first into the badass female trauma surgeon. She looked the perfect combination of put together and stern, as usual.

“I was hoping I might run into you,” she said.

“Oh?” I tried to pretend I didn’t know what she was referring to but my embarrassment of the previous day flooded back over me.

She smiled a knowing smile. “Yes, of course.”

I stood there with one of my six female predecessors from the wall. I was waiting for her to berate me or tell me how stupid I was partaking in the anesthesiologist’s sexist banter.

Instead, she looked me straight in the eyes and simply said, “Don’t forget.”

“Don’t forget what?” I replied.

“Don’t forget. You are more of a man than any of them will ever be.” And with that, she whisked away down the hall with a strong stride and her white coat flapping behind her.

The moment she said it, I knew exactly what she meant, and that she was right. I thought of my female predecessors and their incredible uphill battle to be seen and heard in the surgical world. I thought of my female training compatriots. I could think of more than one who had gone into labor on rounds, working up to the very point of child birth, just so they would be taken as seriously “as a man.” I thought about the never-ending dedication of all of the women, both professors and trainees, that surrounded me.

I decided at that moment that I would no longer apologize. I would no longer apologize for having ambition. I would no longer apologize for being strong. And I would no longer apologize for being a woman.

It has not always been easy, but I carried these lessons with me every day since. I always strive to remember the sacrifice of the women who came before me, paving the way in the surgical field, and those around me now who continue that fight every day. I am constantly encouraged by the young female surgeons of the world who continue to have a passion for this profession. And I am thrilled to say, our numbers are growing by the day.

We, the female surgeons of the world, are here. And we are not going anywhere.