Picture of Deborah C. Henry, MD

Deborah C. Henry, MD

Brain Waves

There was an article in February 7 LA Times on women firefighter uniforms. They don’t fit. They’re too big. That makes them heavier than they need to be. Because the garb is so big, it also restricts movement and leaves gaps that expose women to sparks of fire. Women currently make up 2.6% of the 3000 LA County firefighters, nearly double the amount of 2017, so perhaps no one ever gave this a second thought. Until now. Which made me think of the challenges woman surgeons and neurosurgeons have faced.

There were several times I could not find gloves small enough for my hands. The 6 ½ size was usually available in the operating room, but if I were to put in an external ventricular drainage device in the ICU or do a procedure on the floor, I was frequently wearing a size 7. Wearing too big a size increases the chance of puncturing the glove with a needle, hazardous both to the surgeon and exposing the patient to contamination.

Women scrubs in various sizes were often in short supply. And let’s face it, the scrubs are not designed for women. The top’s deep V shape meant that if I could not find a medium size, I wore a large or sometimes extra-large and tried to pin the V closed with a paper clip. Though not a problematic as the tops, the bottoms are designed for the narrower pelvis of a man.

But when I first learned to operate, it was the tools in the OR that were hard to get used to. They are designed for the larger hand. Because of my smaller hands, when gripping  a  Kerrison or Leksell rongeur, I had to close it a third of the way to hold it, therefore decreasing its ability to take a “big” bite. This is a disadvantage as a resident (at least when I was one in the 1980s and early 90s) in the macho field of neurosurgery because there is certain (male?) degree of pride on removing lamina in the least number of bites.

Another drawback for me was my height. Though there are tall women and short men, shortness in the OR can be a drawback. As a resident, I was often on two stools to accommodate the elevated operating table of the male attending. Once, while operating on a posterior fossa lesion in the sitting position with the attending, I teetered on four stools. Throughout the case, part of my brain was constantly working at the art of keeping balance.

This height differential reminds me of learning the difference between equity and equality. When equity was in its infancy as a buzz word several years ago, I was shown a picture of three boys peering over a fence to view a baseball game. One was tall enough to just look over the fence, but the other two boys were too short. In the next frame, all three are now standing on crates of equal size. The boy who could just peer over the fence, now did not struggle at all. The middle size boy could barely peak over the fence and the shortest boy still could not see. They were all treated equally. The third frame gave each boy a crate to stand on that allowed him to see the game with ease. Equity was reached.

We can reach equity with firefighter suits and OR scrubs. Firefighter and surgical equipment will require some thinking. After all, the laws of physics apply when using a lever system. And well, I will always be vertically challenged when it comes to some things.

“Interaction Institute for Social Change | Artist: Angus Maguire.”