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Under the table, his hand landed uncomfortably high on my thigh. Our conversation had drifted from our mutual interests in molecular biology research of brain tumors to books and music. Until that moment, I had felt really positive about our connection. It was 1984, and my infatuation with neurosurgery had led me to try and break into an overwhelming male subspecialty. I knew it would take something special to convince a program to make the leap and accept a woman. Throughout the lavish dinner event for the visiting resident applicants, I had foolishly thought, perhaps this was such an opportunity. When the hand landed, the conversation abruptly changed, and the senior faculty leaned very close and, with an unmistakable leer, said, “I would really love to help you become the first woman in our residency program. Shall we make those plans later tonight?”

Somehow, I managed to secure a residency training position in neurosurgery despite the odds and for the last four decades have navigated my training, clinical growth, academic advancement and rise in national leadership positions. Fortunately, I never again encountered such a blatant attempt for someone in a powerful position to coerce me into a sexual encounter. Still, there certainly were many times when I experienced other forms of sexual harassment. As is typical, for years, I said nothing — even to close friends or family — because somehow I felt “responsible” or else feared the consequences. All this time, I blindly assumed this was only happening to me and because I lived in a male-dominated surgical specialty.

Slowly over time, I became aware that I was not alone, and my experiences were similar to others. Unfortunately, others experienced far worse. (See Table 1). Those of us in the first wave of women in neurosurgery — training in the 1970s to early 1990s — naively hoped that our increasing numbers, sheer presence and leadership positions would lead to change. We had hoped that such behavior belonged only to the past. Sadly, we realized that was not the case.  When those efforts seemed ineffective, many of us quietly tried to rally neurosurgical leadership around efforts to try and improve the situation. Yet we were often met with disbelief there was a real problem.

When the #MeToo movement hit the media, however, many in neurosurgery recognized our potential vulnerability. And in 2018, the One Neurosurgery Summit established the Neurosurgery Professionalism Taskforce (NSPT). Under the leadership of James T. Rutka, MD, PhD, FAANS, and Karin M. Muraszko, MD, FAANS, the goal of the NSPT was to provide a comprehensive report on policies and recommendations regarding sexual harassment in neurosurgery. While the NSPT undertook many activities, one major initiative was the creation and administration of a survey to assess the depth and breadth of sexual harassment across neurosurgery.

I am proud to have co-authored the manuscript published in the . I genuinely believe it is a huge step forward for our specialty and part of slow but meaningful incremental progress. (See Table 2). The information gleaned from the survey, and the recommended strategies are important and can also serve all of medicine — especially those traditionally male-dominated specialties.

As the saying goes, “we have come a long way, baby,” as we celebrate 100 years of women’s right to vote in the U.S., the 30th anniversary of the and now the publication of this landmark article. I hope this means no future neurosurgical residents — of any gender, race or sexual preference — will face the serious challenges of harassment that I and too many others have over many years. I remain ever hopeful.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #WomenInNeurosurgery and #CelebratingWINSat30.

Deborah L. Benzil, MD, FAANS, FACS
Cleveland Clinic, Vice-Chair, Neurosurgery
Cleveland, Ohio

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