Our generations

When my oldest daughter, Lydia, was four years old, she announced that she wanted to be a nurse when she grew up.

“Why not a doctor?” I asked.

“Women can’t be doctors,” Lydia replied.

This was an idea she had picked up in nursery school, although I, her mother, had practiced medicine her entire life. We had a talk, and I mounted a re-education campaign. At age 10, Lydia was determined to become a physician; today she is one, with a promising career in academic medicine ahead of her.

Since her graduation from medical school in 1991 and her residency at Yale, we’ve had the opportunity to compare notes about the experiences of women in medicine. Despite significant differences in our professional lives — it is clearly much easier for women today — there are remarkable similarities and many obstacles yet to overcome.

I grew up in the 1950s when 95 percent of women got their M.R.S. along with their B.A. or B.S. and most stayed home to raise a family. When I entered medical school in 1960, women were openly discouraged from applying and limited by quota. A pamphlet handed to many female applicants bore the title “Why Would a Nice Girl Like You Want to Become a Doctor?” I was warned that no one would marry me, and that if I did manage to have a family, my children would be emotionally damaged by my career.

I was determined to prove that I could indeed do it all. Fortunately Adam, my husband-to-be, was ahead of his time in wanting to be one half of a dual-career couple. We married while he was a graduate student at Yale, just after my first year of medical school in St. Louis. There was no question in those days that I would be the one to transfer, and, despite my breaking the quota on women, Yale ultimately accepted me as a second-year student. We started our family soon afterward. Jonathan was born in my last year of medical school, Lydia and Catherine followed during my specialty training, and David after I entered practice. We were young and energetic, and we managed.

Others have written about gender discrimination in academic medicine. For my generation, it was a matter of overcoming attitudes that seem ludicrous today, but were taken for granted at the time. “You’re taking a man’s place,” we were told, either directly or in dozens of more subtle ways. But it has been a wonderful life and I wouldn’t give up any of it, except perhaps for the difficulties in finding and keeping good child care.

Lydia had a very different experience. As a Yale undergraduate, she knew many young women who were planning careers in medicine. About 40 percent of her class at Albany Medical College were female. During her pediatric residency back at Yale, she was strongly mentored by faculty who nurtured her ambitions for a first-rank academic career. At Boston Children’s Hospital, where she trained in adolescent medicine and is now on the Harvard faculty, her division chief is a woman, as are the majority of her colleagues.

Yet, while Lydia tells me I am her role model, I tell her she only followed the career half of the model. She is not yet married and has no children. She has choices: to marry or not, to live with someone or not, to have children or not, to delay having children into her 30s or beyond. It’s a different world — and in most respects far better for a woman who wants to make her own choices. But in some ways it is harder to have so many choices.

One day during a long walk together, Lydia and I talked about what could be learned from mothers and daughters in medicine and whether this might be a useful group to study. Many male physicians have followed in their fathers’ footsteps, and a good bit is known about that parent-child pattern. Much less is known about the mother-daughter pairing. We’ve located more than 100 such pairs in medicine around the nation and are embarking on a long-term study to learn more about the lives of these women physicians of different generations.

We’re very curious: What has changed over the years for women in medicine? What has stayed the same? What facilitates or inhibits a child following her mother into the field? We also wonder about the future. Though women now make up nearly one-quarter of all physicians in this country, they account for a much smaller percentage of leaders in medicine. Is it different for women whose mothers are physicians? Can these women stand on their mothers’ shoulders? Do they have knowledge that can be useful to other women in medicine?

We hope to locate as many mother-daughter pairs as possible, and we welcome your interest (not to mention the names of additional pairs). For Lydia and me, it’s a welcome chance to learn a little more about ourselves and our colleagues, and maybe what we discover will help make life better for all women in medicine.

Diane K. Shrier, M.D. ’64, is a clinical professor of psychiatry and pediatrics at George Washington University Medical Center and a psychiatrist in private practice. She can be reached via e-mail at diane.shrier.med.64@aya.yale.edu or by fax at 202-965-2942. Her daughter Lydia A. Shrier, M.D., M.P.H., HS ’91-94, contributed significantly to this article.