Practicing Neurosurgery as a Woman in Pakistan
Author: Aneela Darbar, MD
For me, neurosurgery is, at its core, not about the brain but the heart.
It is informing the 40-year-old professional with three kids that he has 9-15 months to live, and watching life begin to drain from his face. It is operating on a two-day old child who weighs less than the small packet of rice I bought the previous evening.
But amid the heartache and tragedy, neurosurgery is many moments when the spirit soars and hope triumphs. When my 16-year-old patient is fighting for her life with a large tumour while her friends are going to the mall, and my male colleagues can’t relate to how shaving off her long hair compounded her emotional pain, it’s talking her through it, heart-to-heart and escorting her out of the operating room to see that her girlfriends had also shaved their heads in solidarity and sisterhood.
Neurosurgery also means practical challenges and daily hindrances, many unique to being a woman in Pakistan. I was the first US-trained female neurosurgeon in Pakistan. Patriarchal prejudice infects many parts of our society, and the idea that a woman might operate on someone’s most prized possession—their brain—seems to exacerbate this bias.
Despite graduating from a top medical college in Karachi, completing a post- doctoral fellowship, residency training at the State University of New York, Syracuse, an Assistant Professorship at St. Louis University Hospital, working with renowned neurosurgeons in Australia and Pakistan, authoring multiple chapters in books and publications, winning several awards, serving as faculty for surgical anatomy courses, giving over 100 talks at local and international conferences, providing free treatment to children in Zanzibar through an NGO, being a member of multiple bodies and congresses, and many years of consultancy and surgery experience, I am still often asked by Pakistani patients and their families:
‘Will I really be operated on by… a woman?’
Our profession is high stakes and high pressure on its own terms; throw in ongoing battles against the boys’ club and everyday sexism, and I am sometimes surprised my surgical instruments don’t also include boxing gloves.
I am grateful, though, for my US training. Being treated equal to male residents, and given the necessary skills to become an expert in my field, gave me the confidence to take on whatever life throws at me.
It wasn’t all a walk in the park: I will never forget one residency day in December 2001 in Syracuse: 5.30 am, pitch dark and -20 degrees; I can’t feel my fingers and ears; but I take a deep, freezing breath, shovel the snow off my drive and get in my car, because I’ve learned over the years that you have to keep moving.
When I think back to those days, and to my childhood days trying to create the wavy swells and crevices of a human brain with play dough, I realize how far I have come. When I started, only 1.3% of neurosurgeons in the US were women. It was a white, male-dominated field, but that is changing, even in my country. A significant part of my current focus is on mentoring and training young female surgeons; to catalyse change, I founded the Women in Neurosurgery chapter in Pakistan.
Every morning at dawn I wake up and go for a long bicycle ride along the Karachi coast with the sun rising across one side of the Arabian Sea. I have had a wonderful journey so far, but for me – and for neurosurgery in Pakistan – there are many miles still to travel.