The Trauma Surgeon, the Mother, and the Myth That You Can’t Have Both
Today is National Working Parents Day. I am a working parent and have been for my children's entire lives. But my job has largely been contained to daytime, weekday hours.
So I can't think of a better day to talk about a group of working parents who don't get nearly enough attention: women trauma surgeons who are also raising families.
Women have made enormous gains in medicine, but surgery continues to lag behind many other specialties. Women now make up roughly half of U.S. medical residents and fellows overall, but they remain underrepresented among practicing physicians and particularly in the surgical specialties. Data show that women represent 37% of the US physician workforce in 2021 but only 29% of physicians in surgical specialties. (Source)
And the numbers become smaller when we narrow the lens to trauma and surgical critical care. Women represented 28% of surgeons certified in surgical critical care as of 2018. In the major trauma organizations, female membership ranged from 13% in the AAST to 29% in the EAST. (Source and Source)
The pipeline is changing, but the experience of women in trauma surgery has historically been very different from that of their male colleagues. A study of trauma surgeons found that 48% of female respondents reported having no children, compared with 13% of male respondents. (Source) That statistic doesn't tell us why those differences exist, and it certainly doesn't suggest that every woman surgeon wants children. But it does raise an important question about whether the structure and culture of trauma surgery have historically made it harder for women to combine the career with the family life they want. And statistics can't tell us what it actually feels like to do that.
So I recently talked with Dr. Alison Gildehaus, a trauma critical-care surgeon in St. Louis, about exactly that.
"I Never Bought the 'You Can't Do That' Mentality"
When Dr. Gildehaus was coming through surgical training, she didn't have many examples of women who demonstrated that being a surgeon and being a mother were compatible. The women surgeons she saw as mentors generally didn't have children, were divorced, or had older children.
But Dr. Gildehaus didn't accept the conclusion that because she hadn't seen it, it couldn't be done. She didn't find a way to make herself fit into trauma surgery. She found a version of trauma surgery that fit the kind of surgeon -- and the kind of parent and person -- she wanted to be. And that distinction matters.
Trauma Surgery Doesn't Have to Mean a Life With No Boundaries
Dr. Gildehaus described starting her career with a call model that wasn't sustainable, so she collaborated with others to create something different: a model in which surgeons could come in, work intensely, and then actually go home.
That doesn't mean trauma surgery became easy. It means the work became more structured. For Dr. Gildehaus, it was particularly important because she didn't want trauma surgery to invade her home. Her husband is also a surgeon, and his home-call responsibilities meant that call could follow him through the front door. Alison wanted a different boundary: when she was at work, she was completely at work. When she was home, she wanted to be home.
That boundary didn't happen accidentally. It had to be designed into the practice. And perhaps that is one of the most important lessons for trauma programs.
Work-life balance isn't something we should expect individual surgeons to manufacture through sheer willpower. Sometimes it has to be built into the system.
You Need a Village. And Accepting Help Isn't Failure.
Dr. Gildehaus is very open about another reality of being a working parent in trauma surgery: you need help. She and her husband had a nanny. They relied heavily on family. When she worked nights, she learned that she couldn't immediately assume parenting responsibilities post-call. Sometimes she needed to sleep or simply recover before she could be fully present for her children.
That can be a hard lesson for high-achieving professionals who are accustomed to being the person everyone else can depend on. But needing help isn't a character flaw. It is a logistical reality of demanding careers -- and especially demanding careers that operate 24/7.
The Culture Matters More Than the Policy
One of the most striking parts of our conversation wasn't about schedules or childcare. It was about culture. Dr. Gildehaus described becoming the Trauma Medical Director of a trauma group that was changing. When she joined the group, she was the only woman with a surgeon husband and she was pregnant. The other surgeons were men with stay-at-home wives, while the one other female surgeon had grown children. Four years later, more than half the surgeons are women.
She believes something important happened along the way: women saw other women doing it. And when they saw that it was possible, more women were willing to imagine themselves there. That may be one of the most powerful recruitment tools a trauma program has. Seeing another woman successfully build the life you want can be transformative.
But that only happens if the culture actually supports it.
Trauma Surgeons Are Allowed to Be Human, Too
There is another part of Dr. Gildehaus' story that stuck with me.
Trauma is an intensely human specialty. Trauma surgeons see people and families at some of the worst moments of their lives. That humanity doesn't disappear when a trauma surgeon walks out of the hospital. Trauma surgeons give a lot - intellectually, physically, emotionally, and spiritually - to their practice and patients.
But trauma gives something in return, as well. Perspective. Some things matter enormously. Some things really don't. And when you see life-and-death situations regularly, it becomes easier to recognize the difference.
Her children may not remember every activity she made (or didn't make) but they are likely to remember something bigger: that their mother built a meaningful career, loved her family, accepted help when she needed it, and figured out how to make both parts of her life work.
What Do Our Children See?
Dr. Gildehaus' daughters and son have not been in the operating room with her. They haven't watched her resuscitate a patient. They haven't experienced trauma surgery firsthand. But what they have seen is their mother doing work that mattered.
In 2022, the American College of Surgeons published a piece in its Bulletin that highlighted mother-daughter surgeons. A comment from one of those surgeon-daughters highlights this point: “When people think about women in surgery and about having a surgeon as a parent, a lot of them think their children would never see them, but I didn’t experience that,” Dr. Courtney Ford, OB/GYN resident at MedStar Georgetown University Hospital, said of her mom, Dr. Debra Ford, a colon and rectal surgeon at Howard University Hospital. “I saw that it was possible for someone in medicine also to be a great parent.”
Children can benefit from seeing their parents pursue meaningful work, care for others, set boundaries, make difficult tradeoffs, ask for help, adapt, recover and try again. They can learn that careers don't have to look exactly like anyone else's—and neither does family life.
Maybe our children can grow up understanding that caregiving and professional ambition belong to everyone.
If We Want More Women in Trauma, We Have to Make Room for Their Whole Lives
If we want women to enter trauma surgery, stay in trauma surgery, become trauma medical directors, lead trauma programs, and eventually mentor the next generation, we have to create environments where having a family -- or choosing not to have one -- isn't treated as a professional liability.
That means:
Reasonable call structures
Meaningful parental leave
Coverage that doesn't punish the person who takes leave
Pumping and lactation support without embarrassment
Allowing people to trade shifts and creating transparent systems for doing so
Recognizing that childcare is not a personal failing or a lack of commitment to medicine
Accepting that sometimes the surgeon will have to leave for a school event -- and sometimes they will miss it because a patient needs them
Acknowledging that people have important responsibilities outside of work -- whether those involve children, partners, aging parents, community, or simply their own lives and well-being
The goal isn't to make trauma surgery easy. Trauma surgery will never be easy.
The goal is to make it sustainable.
Because the future of trauma surgery needs talented surgeons. And talented surgeons come with families, partners, children, aging parents, communities, interests, and lives outside the hospital.
And while this post is centered on women who are raising children, the larger lesson is bigger than parenthood: a sustainable trauma practice has to leave room for surgeons to be whole people.
The Bottom Line
On National Working Parents' Day, I'm grateful for the women who paved the way in careers before they were fully accepted as a peer. For the women who taught me that I can be a good mom and a professional woman -- that I didn't have to choose one identity at the expense of the other.
And I'm grateful to Dr. Gildehaus and to the women trauma surgeons who are helping redefine what a sustainable career in trauma surgery can look like, whether or not they have children. They are role models for their colleagues and for the next generation of women physicians.
