Skip to main content
search
Tag

Journal of Neurosurgery Archives - Neurosurgery Blog

Progress Incremental: Understanding Sexual Harassment in Neurosurgery

By Career, Guest Post, Women in NeurosurgeryNo Comments

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 Toward an Understanding of Sexual Harassment in Neurosurgery published in the Journal of Neurosurgery. 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 Women in Neurosurgery Section (WINS) 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 @Neurosurgery and using the hashtag #WomenInNeurosurgery and #CelebratingWINSat30.

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

November 12, 2020
Love0

The Global Impact of the COVID-19 Pandemic on Neurosurgical Practice (Part III)

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The American Association of Neurological Surgeons (AANS) and the Journal of Neurosurgery (JNS) Publishing Group are pleased to announce the publication of four editorials on the impact of the COVID-19 pandemic on neurosurgical practice. This batch of editorials concludes our rapid-response collection on this topic. Altogether the collection boasts 19 papers, an introduction and 18 editorials, published in the Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics or Journal of Neurosurgery: Spine. All of the articles are posted online, and they will also be accessible by PubMed Central as part of the Public Health Emergency COVID-19 Initiative.

The following articles cover neurosurgeons’ experiences and lessons learned thus far during the COVID-19 pandemic:

Xiaoguang Tong, MD, and Yuanfan Yang, MD, discuss precautions taken at Huanhu Hospital in Tianjin, China, for performing emergency cerebrovascular procedures during the pandemic. All patients entering the emergency department are assumed to have COVID-19 until proven otherwise. The hospital rearranged equipment and facilities to isolate patients throughout their treatment. Full personal protective equipment (PPE) — including N95 masks, face shields, goggles and full gown — were worn by all health care workers. Extra layers of face protection were worn during emergency intubation. Whenever possible, minimally invasive procedures were performed. Additional steps to protect health care workers and patients are also covered in this editorial. The authors state the precautions resulted in no infections among the health care workers and patients.

Sepideh Amin-Hanjani, MD, FAANS, and coauthors representing multiple academic institutions throughout the U.S. and Canada weigh in on the overall impact of COVID-19 on neurosurgical practice. The authors discuss the conservation of skilled staff, the heightened risk of some neurosurgical approaches, postponement of elective cases, the necessity of wearing appropriate PPE and the need to convert some specialty facilities into treatment sites for COVID-19 patients. The authors also share resources for neurosurgeons during the pandemic offered by the AANS, Congress of Neurological Surgeons, Centers for Medicare & Medicaid Services, the American College of Surgeons and additional societies.

Adair Prall, MD, FAANS, FACS, John D. Davis, IV, MD, FAANS, and N. Ross Jenkins, MD, FAANS, share their insights on changes in community practice during the COVID-19 pandemic. As independent private practitioners, these authors describe how disorienting it has been to suddenly have “many decisions made for them and [be] required to limit, change, or stop altogether their workflow.” The authors mention new ways of treating patients using phone or video conversations. They also discuss how hospital or ambulatory surgery center administrators may view urgent and elective surgeries differently from surgeons, and how neurosurgeons must advocate for patients whose conditions may not appear urgent but indeed are so. Lastly, the authors speak to the issue of small business ownership during the pandemic, dealing with a reduced caseload and income while trying to retain skilled employees.

A neurosurgical resident at Massachusetts General Hospital, Victoria Clark, MD, PhD, describes the experience of being locked out of the lab during the pandemic. Being unable to continue lab benchwork, she evaluates other avenues of research that can be followed by the resident at this time — such as working on bioinformatics-based projects or chart-based/clinical analyses or focusing on scientific writing. Laboratory research is extremely important overall, and an integral part of residency training, and Dr. Clark offers several suggestions on how labs can be reopened and neurosurgical research can continue using safe, socially distant methods.

Join us in reading these free articles.

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 #COVID19.

April 24, 2020
Love0

The Global Impact of the COVID-19 Pandemic on Neurosurgical Practice (Part II)

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The American Association of Neurological Surgeons (AANS) and the Journal of Neurosurgery Publishing Group are pleased to announce the publication of eleven new editorials on the impact of the COVID-19 pandemic on neurosurgical practice. The series kicked off last week with three editorials and an introduction on the subject, which were published in the Journal of Neurosurgery and the Journal of Neurosurgery: Pediatrics.

Last week we heard from neurosurgeons in the United States, Canada, Italy and China on the impact of the pandemic on neurosurgical practice. This week’s installment adds editorials from the U.S., Republic of Korea and Singapore.

The editorials cover a wide variety of important areas demonstrating the impact of COVID-19 on the practice and training of neurosurgeons. Although other fields of medicine more readily come to mind when considering the battle against the virus known as SARS-CoV-2, neurosurgical practice has also had to adapt swiftly in response to the COVID-19 pandemic.

The following articles cover neurosurgeons’ experiences and lessons learned thus far during the COVID-19 pandemic:

Join us in reading these free articles.

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 #COVID19.

April 17, 2020
Love0

The Global Impact of COVID-19 on Neurosurgical Practice

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The COVID-19 pandemic has significantly impacted medical practice across the globe. The effects are most notable in the fields of infectious disease, virology, emergency and critical care medicine, and epidemiology. Other medical specialties, including neurosurgery, however, are also impacted.

To highlight the effect of the pandemic on the neurosurgery practice, the Journal of Neurosurgery Publishing Group (JNSPG), the scholarly journal division of the American Association of Neurological Surgeons, is releasing a series of editorials on the impact of the COVID-19 pandemic on the practice of neurosurgery.

Douglas S. Kondziolka, MD, FAANS; William T. Couldwell, MD, PhD, FAANS; and James T. Rutka, MD, PhD, FAANS, introduce the series and highlight the impact the pandemic has had on neurosurgical practice. Three editorials are available, and additional papers on this topic will appear each Friday, so be sure to check back weekly.

Yirui Sun, MD, PhD, and Ying Mao, MD, PhD, provide an update on the pandemic in China. They speak of colleagues lost and the efforts of neurosurgeons to treat emergency cases regardless of the viral status of their patients. The authors also discuss how COVID-19 has given them “pause to reinforce [their] skillsets and redesign [their] mindsets to perform roles not only as neurosurgeons but also as executive officers.”

Marco Cenzato, MD, and colleagues speak from the Lombardy region of Italy. They describe a reorganization of neurosurgical facilities to expand the number of ICUs available to COVID-19 patients. Fifteen neurosurgical departments were temporarily consolidated into three locations, with neurosurgeons and patients shifted as well. As a result, “opening the hospital doors to neurosurgeons coming from other institutions has offered an unprecedented opportunity of collaboration and integration of teams.”

Leaders of the American Society of Pediatric Neurosurgeons address current management of COVID-19 in the pediatric neurosurgery community and provide recommendations on the preparation and response to the pandemic. Crucial areas addressed in their recommendations include children’s hospitals as a whole, operating rooms, pediatric neurosurgery clinical teams, and patients. Serious illness remains relatively rare among children with COVID-19. Nevertheless, the authors warn against complacency and stress the need for urgency in preparation and response to the pandemic.

Neurosurgeries must be prioritized, delaying less urgent cases so that increased hospital facilities and equipment can be made available for patients with COVID-19.

The COVID-19 pandemic has wreaked havoc in the lives of people across the world. The numbers of cases and deaths from the disease continue to climb at a rapid pace. Many deaths have occurred among health care workers. On both a personal and professional level, the JNSPG editors acknowledge, with sadness, the passing of fellow neurosurgeon James T. Goodrich, MD, Chief of Pediatric Neurosurgery, Montefiore Medical Center, New York City, from complications related to COVID-19 on March 30, 2020.

April 10, 2020
Love0