International Women’s Day: Physicians on Women’s Advocacy at Barrow
Since the early 1900s, International Women’s Day has marked both a celebration of women’s achievements and a continued fight for gender equality.
Some studies suggest there is still progress to be made in overcoming gender bias in medicine, but women have made strides in closing the gender gap. In 2017, the number of women enrolling in medical school exceeded the number of men for the first time. In 1966, women represented only about 9 percent of new enrollees.
For International Women’s Day, neurosurgeon Dr. Laura Snyder and neurologist Dr. Glynnis Zieman discussed some of the ways Barrow Neurological Institute advocates for women—both physicians and patients.
Advocating for Female Physicians: Mentoring and Promotion to Leadership
Dr. Snyder became interested in surgery during her first year of medical school. She liked the idea of being able to perform surgery and see a direct improvement the next day. That summer, she took a research job with neurosurgeons who specialized in spinal disorders and epilepsy and started to envision a career in neurosurgery.
“I was attracted to neurosurgery because I felt that the brain is what makes a person who they are and forms their personality,” she said. “So when there was some sort of derangement in that, it could be devastating to a person and their family, and I wanted to help.”
Her mentors in medical school warned her about the lifestyle of a neurosurgeon, saying she would spend most of her time in the hospital. Neurosurgery also requires seven years of residency training—more than most medical specialties.
“But that’s why I wanted to go into medicine,” she said. “Then and now, I want to be available for patients. I want to take care of patients.”
They also told her the lifestyle wasn’t compatible with pregnancy and that neurosurgery was a “boys’ club.”
When Dr. Snyder graduated medical school in 2008, women accounted for only 5.9 percent of practicing neurosurgeons.
“I think my perception was that I’d always be a little bit different from the general group, but I was willing to accept that because I really wanted to take care of neurosurgical patients and perform those types of surgeries,” Dr. Snyder said. “I accepted that I’d usually be the only female in the room.”
Most of the time, she is. But fears of not being included or supported because of her gender diminished when she started training at Barrow.
“I felt very welcomed here as a resident,” she said. “There were plenty of mentors who were willing to help me achieve my goals.”
Attending Neurosurgeon Dr. Ruth Bristol and the three other Barrow female neurosurgery residents at the time served as role models for Dr. Snyder. She also noted having several strong mentors, including former Barrow President and CEO Dr. Robert Spetzler and residency program directors Dr. Volker Sonntag and Dr. Peter Nakaji. She also acknowledged Drs. Kumar Kakarla, Luis Tumialán, and Nicholas Theodore for their mentorship in spine surgery, which she chose as her subspecialty.
Dr. Spetzler stated that women are vital to the success of neurosurgery, with the number of women entering medical school increasing and the number of neurosurgeons relative to the population decreasing.
He also expressed that childbearing is not incompatible with a successful career in neurosurgery, as Dr. Snyder had heard in medical school. She is expecting a child in April and said her colleagues have been very supportive.
Dr. Snyder, who serves as director of the Neurotrauma Program, also noted that women are represented in multiple leadership roles at Barrow. Women serve as directors of the Neuro-rehabilitation and Neuropathology departments, as well as the Muhammad Ali Parkinson Center, the Cleft and Craniofacial Center, the Migraine Program, and the Neurology Residency Program. Women also oversee brain tumor, neurodegeneration, and neuroimaging laboratories at Barrow.
Advocating for Female Patients: Domestic Violence Victims
Dr. Snyder said Barrow maintains a culture where multiple backgrounds are accepted and recognizes that different background experiences are necessary for innovating and providing better patient care. For example, a more diverse staff provides patients with different options for their care.
“We see many patients, largely women, who have been victims of domestic violence,” she said. “It is often difficult for them to tell their stories to people they do not know. Many of these women do feel more comfortable telling their stories to another woman. By gaining their trust, I’m able to understand their injuries better, which improves their care.”
Although both men and women are victims of domestic violence, the majority of the patients who have come to Barrow through the domestic violence program are women. According to a Barrow study, the Concussion and Brain Injury Center saw 115 patients with traumatic brain injury as a result of domestic violence from April 2012 through November 2015. Women accounted for about 95 percent of those patients.
Barrow’s domestic violence program is believed to be the first of its kind in the nation. Social worker Ashley Bridwell approached Dr. Javier Cárdenas, director of the Concussion and Brain Injury Center, with the idea of providing medical care and social assistance to domestic violence victims with traumatic brain injuries—an underserved population.
Barrow formed partnerships with local homeless and domestic violence shelters and trained shelter workers on how to perform preliminary brain screenings. Those who present with brain injuries receive evaluation and treatment at the Concussion and Brain Injury Center. Services may include brain imaging; cognitive testing; medication; psychiatric care; and physical, speech, and occupational therapy. Grant funding covers any out-of-pocket costs for victims.
“We can see a professional athlete one visit and then walk across the hall and see one of our shelter patients, and they get just as good of care, if not better,” Dr. Zieman said. “We do our best to spend extra time with them because many of these patients have never had anyone evaluate them for their injuries, let alone their brain injuries.”
The program has grown with more shelters and the addition of Dr. Zieman to the faculty. She hopes to perform more research in this patient population and help facilitate the creation of similar programs throughout the country.
“The domestic violence program is professionally the thing I’m most proud of,” she said. “We see a wide variety of patients from all walks of life and are able to help them recover from their injuries. I believe we can make the biggest difference, however, for the domestic violence and homeless patients that we see through this partnership. These are patients who otherwise would not have these resources, and Barrow is able to provide them. It’s life-changing for many.”