Women In Surgery: "In 20 Years, There Will Be No More Chauvinistic Chief Physicians"

Why do men almost always operate in Germany? The tone in the OR is rough, the strain enormously, says anatoin Heike Kielstein. She also wanted to become a surgeon.



There is only one surgeon in Germany for four surgeons, according to the statistics of the German Medical Association of 2018. Heike Kielstein also wanted to become a surgeon, instead she went to research and teaching. Today, she heads the Institute of Anatomy and Cell Biology at the University of Halle-Wittenberg, among others - and is committed to making more women a career in medicine.

ZEIT ONLINE: Ms Kielstein, how is it that so few female doctors work in surgery? There is not a single chief physician in the 78 cardiac surgery departments of German hospitals.

Heike Kielstein: Surgery is a subject in which physical effort is needed. It is sometimes very artisanal, it takes a tremendous amount of strength, especially in trauma surgery and in the Herzthoraxchirugie: Depending on the operation you have to stand a long time - up to 8 or 10 hours. In addition to the great concentration required for the actual operation - correct positioning, finding one's way with very individual anatomical conditions - one often has to expend a great deal of force, for example, to move the abdominal wall up and away. There are several kilos of pulling power together - for many minutes, without wobbling or loosening the hand. Added to this is the climate in the operating room. Quick instructions must be given and decisions made quickly. Everyone is under stress. Especially in cardiac surgery, the life of the patient often depends on a good course of surgery. There's no time to be friendly. Sometimes it just screams and it's stressful. You have to swallow that. The third point is the fact that so few women work in cardiac or trauma surgery. This is a deterrent for other women because they know there are hardly any female colleagues to support them. It is a doom-loop.

ZEIT ONLINE: But you wanted to go to surgery. But then they have become Anatomin. Why?

Heike Kielstein, born in 1970, is head of the Institute of Anatomy and Cell Biology of the Medical Faculty of the Martin Luther University Halle-Wittenberg and of the Further Education Center for Clinical Anatomy. She is a specialist in anatomy and conducts research on obesity and natural killer cells. Kielstein was the winner of the category Natural Sciences / Medicine at the nationwide competition Professors of the Year 2017 of the Unicum Foundation.

Kielstein: I wanted to become a surgeon at a university hospital and do research and teaching there.Therefore, in Visceral Surgery (surgery of the abdomen and the abdominal wall, the endocrine glands and the soft tissues, the editors) I did my PJ, the practical year, in university hospitals in France and in Germany. The workload was enormous, because at university clinics usually the operations take a long time. We've been in the OR for ten hours, after that we were broken. Although I enjoy working and are also very performance-oriented and determined, I have seen that not even research and teaching can be done. But I could not imagine a life without them. Even though surgery is the discipline that interests me most.

ZEIT ONLINE: So it was not the rough tone that disturbed her?

Kielstein: The mood in the OP was not the problem for me. I was very happy with the operations. It was the working conditions in general. We are talking about 12- to 14-hour days. Although I can hardly imagine how the working conditions at the Unichirurgie can be organized differently. That's why I decided to become Anatomin. Because then I could concentrate only on research and teaching.

ZEIT ONLINE: In the article The big difference from the ZEIT is reported that a chief physician in cardiac surgery in the interview with female doctors asks: "Do you want children? What makes your husband? How flexible is he?" In an interview with a medical assistant, he even said: "We prefer men." What do you think about such statements?

Kielstein: Such chief physicians can only be sorry for one, because they do not seem to know how valuable a gender-mixed team is. Both the satisfaction of the patients and the job satisfaction of the doctors is definitely better when men or women are not among themselves. Women deal differently with patients and also with everyday stress, they have a different perspective. They are not always the more compassionate, but they have a better understanding of certain situations. For example, if two lectures are booked in a lecture hall at the same time, the men often get upset and say, "I booked first."Then a woman comes in and says, "I've just come from next door, the auditorium is also vacant, we're going over." Women can take pressure and offer pragmatic solutions.

ZEIT ONLINE: Do not you appreciate the men?

Kielstein: Yes, they also realize that the way people talk about us women is much more pleasant. I note this in particular in the committees in which I work. And the men have also understood that we bring in other ideas, that they gain something through us. In 20 years, there will be no more chauvinist chief physicians, if only because the many graduates rightly pay attention to which bosses are decried, and then they do not compete.

ZEIT ONLINE: Do you think that then also the notorious question of the desire for children will have done?

Kielstein: The fact that women do have their babies is of course still a problem in clinical medicine.Because there are far too few jobs and mostly no buffers to organize work in a family-friendly way.Often there are no pregnancy representations and all non-pregnant women then have to take on additional work. That excites me insane. There are very clear words to the policy: if hospitals are equipped with so few places, one must not be surprised that chief physicians are reluctant to hire women and say: I have nothing against women, but I have just too little People.

ZEIT ONLINE: How would a balanced ratio of researchers to science affect?

Kielstein: I believe that women sometimes look for other topics. This is particularly noticeable in the field of gender-sensitive medicine. Gender-sensitive medicine means that you do not treat illnesses and therapies as a whole. Rather, one looks at what makes a disease with a female body and what with a male. In cardiology, there are many examples of patients having different symptoms from male patients. This is a research that appeals to women more. 10, 15 years ago, they have been ridiculed for their work. Now many subjects should be taught gender-sensitive. That has become a big topic.

ZEIT ONLINE: In medical studies, there are more female than male students. The women finish their studies with better grades than the male colleagues (as the ZEIT reports). Nevertheless, fewer women make a career. Why is that?

Kielstein: When I was studying, this happened to many of my fellow students in such a way that already in the practical year, at the age of about 24, they looked for electives with which they could settle down well, thus opening their own practice. For example, subjects such as children's medicine.Rarely, however, did they choose the subjects of pathology, forensic medicine, surgery, or very scientific subjects such as human genetics.

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