Barbara K. Kinder, M.D. ’71, HS ’77, says that when she trained in surgery at Yale in the mid-1970s, the attending surgeons—all of them men—never questioned her aptitude. Chief surgeons William F. Collins Jr., M.D. ’47 and later C. Elton Cahow, M.D., “were both men who thought women could do anything. It was a matter-of-fact thing for them, not any kind of a crusade. Their attitude was, ‘Why couldn’t they do it?’ ”
Nonetheless, the culture of surgery has changed, shifting from a military model to one that accommodates give-and-take. “The changes that have taken place mirror social changes,” says Kinder, an endocrine surgeon and senior faculty member. Women have brought “a very different management style, a consensus-building style. I think men have become more this way, too. ... The throwing of instruments doesn’t happen any more.”
Kinder and fellow resident Mary Alice Helikson, M.D., HS ’77, who is now a pediatric surgeon in Oregon, were the first two women to complete general surgery training at Yale. Kinder says she tolerated five years without playing tennis, spending time with friends or reading anything except medical journals because, “I rotated into surgery and fell in love with it. It was an epiphany.”
As for the long hours, “I think by and large everyone functioned pretty well doing the 128-hour workweek. On the other hand, I don’t think it made for a rich life outside of medicine,” Kinder says, and she laughs.
Today, women and men alike want to take part in family life. “I think that’s probably healthy,” says Kinder, whose daughter, Caitlin, was born in 1985 when Kinder was 40. Once she became a mother, Kinder says, career became less important. “Could I be doing some more things in surgery nationally? Yes, I probably could, but that’s been my choice. From the day she was born, my daughter has been my first priority.”
Kinder has reservations about the reduction in residents’ hours. “The 80-hour workweek necessarily diffuses the sense of responsibility that a surgeon-in-training has for his or her patient,” she says. As an attending surgeon, Kinder feels responsible for her patients even when she leaves the hospital. “If it’s a weekend or a night, I expect to hear about my patient,” says Kinder. If younger surgeons “don’t learn it by living it, I’m not sure they’ll have the same sense of that contract with the patient. Maybe we overdid it.”
Kinder says surgeons of her generation are disenchanted and are retiring, on average, at age 58. (She is 59.) “I’m incredibly frustrated with medicine. We need national health care. Interspersed between the physician and patient are layers and layers of bureaucracy and nonsense.”
As a member of the School of Medicine admissions committee she looks for applicants “who have concerns about social justice questions. I think we ought to recruit these people. Hopefully they’ll be part of solving this health care crisis.”