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The UI Carver College of Medicine quarterly alumni magazine

Summer 2007

• Foreword
• News Briefs
• Faculty Profile
• Alumni Profile
• Ewww! Grossology!
• Critical Condition
• Teaching Tomorrow's MDs
• Moving Forward
• Women in Medicine
• Alumni News
• In memoriam
• The dis-ease of disease
• Calendar

Determined to Succeed

Margaret Emmons ('49 MD, '52 R) started medical school in 1945 during World War II when traditional roles for women were changing. She never felt there was a career she couldn't pursue, and through the suggestion of a professor decided to attend medical school.

'It started when I was a senior at Cornell College in Mt. Vernon, Iowa, I was talking with my biology professor and he asked me what I planned to do. I told him I didn't know. He said, 'go to medical school.' And, that's what I did,' said Emmons, 83.

Emmons entered medical school at The University of Iowa without a second thought. There were nine women in her graduating class of 85.

'When I started school, I had the support of my family and friends, but I didn't know anyone,' said Emmons. 'There were others in the same situation, one was a woman working toward her PhD in anatomy and the other was a medical student from Clinton, Iowa, who had attended Iowa State for his undergraduate degree. We formed a group of three to be anatomy lab partners and became lifelong friends.'

Like Emmons, Nicole Ehn, currently a third-year medical student at the UI Carver College of Medicine, always felt that a career in medicine was within her reach. When Ehn, 25, entered medical school the percentage of women in her class was very different. Of 142 students, 61 (43 percent) were women.

'Among our classmates, I believe the women feel equal and that they are treated fairly by faculty and staff members. I run into people or patients now and then who assume that I am going to be a nurse,' said Ehn. 'I respect nurses immensely, but I think these assumptions are because nursing has historically been a career where women have been the majority,' said Ehn. 'Within the College, the number of women medical students is steadily increasing.'

Emmons shared one theory about why there has been an increase in the number of women in medical school. 'Today, there are more outside organizations and lawmakers making decisions for those who practice medicine. I believe women, in general, are more amenable, to a point, to tolerating changes from the outside,' said Emmons. Although there is policy created by outside organizations, both women also feel that females tend to be excellent physicians because of their ability to communicate effectively with their patients and to listen well.

Emmons has watched medicine change over the years and that serves as the basis for her theory. In 1947, she married fellow student Richard Emmons ('40 DDS, '46 BA, '49 MD, '53 R), during her third year of medical school and over time has had plenty of exposure to the thoughts, opinions and experiences of male physicians. 'We were very supportive of each other. He chose internal medicine and I selected anesthesia because I thought I'd have more control over my schedule. I figured that would be important when we had a family,' said Emmons.

After they graduated and completed their internships at St. Louis City Hospital, the couple returned to Iowa City for residency for three years, spent a few months in Rockford, Ill., and then started shopping for a place to establish their practices.

'I told my husband, I don't care where we go, but I don't want to move to Clinton, Iowa,' said Emmons. They set up practice in Clinton and lived there for 50 years. 'As far as controlling my schedule by choosing anesthesiology, I was on call alone for 20 years. It worked out okay, but you can't get too many preconceived ideas in this field.'

Today, shopping for a place to establish your practice is still a big task. Although Ehn has another year of school, and thinks she will specialize in pediatrics or obstetrics, she'd like to remain in Iowa. 'If I choose obstetrics, I'll probably end up in a larger practice at first because insurance costs are very high. It makes it a little restrictive,' said Ehn.

Her husband, Matt Ehn, is not a physician, so this may make finding a place to settle easier. They gave birth to their first child in July, so for them, being close to grandparents also is a consideration.

Being a physician and a parent can be a challenge. Emmons who has four grown children, three daughters and a son, found that working out a schedule when they were young required creativity since her husband was a physician too. 'My husband would get called in the middle of the night for a patient with appendicitis. Then he and the surgeon would call me in for the anesthesia. We'd have to call his mother to come over and watch the kids,' said Emmons. 'Having family nearby was very important.'

To meet the demands of parenting, some women physicians reduce their hours, but many women continue a full-time practice. Ehn, who had six weeks of maternity leave, will continue as a full-time student, and is receiving a great deal of support from her husband who will take care of getting the baby to childcare during the day.

Overall, demands on a physician can be great as Emmons relays in a story surrounding the birth of her third child.

'While I was still a patient in the hospital after the birth, I got up and went down the hall and anesthetized another patient for her delivery,' said Emmons. 'I really didn't take maternity leave. We had relatives that helped out and I hired someone for housework and to help with childcare. In the early days, I'd have 1-2 cases in the morning and was home in the afternoon.'

Her advice for Ehn is to enjoy her children as much as she can, and that 'she'll have her hands full.'

For the most part, being pregnant while in school has worked out well for Ehn. 'We've been working on a four-week elective credit for medical students in their third or fourth year who are experiencing family transitions,' said Ehn. 'This would be available to male and female students and could be used for maternity leave, family illness, etc. It would reduce the amount of vacation time a student would have to apply to a leave.'

After her six-week leave, she'll be completing a radiology rotation for two weeks, a family medicine rotation for two weeks, and then resume a full schedule. While finding a balance between family and career has always been a primary concern for women physicians. Emmons has seen other changes that affect the way medicine is practiced.

'I like to say I practiced medicine in the golden age,' said Emmons. 'Same day surgery has changed things quite a bit, everything is rush, rush, rush. We used to be able to sit down with our patients the night before for a pre-op visit. It doesn't happen anymore. The government's policies have changed medicine too. One time my surgical team had to wait two hours for Medicaid approval before we could treat a child's broken arm.'

One difference Ehn has noted is that medical students are getting earlier contact with professional patients'individuals who are paid to receive exams by students.

'I feel this is a good way, and comfortable way, for students to learn because the patients know what is going on,' said Ehn. 'I can't imagine what it would be like to be a physician seeing a patient for the first time without having had this experience or practice.'

When Emmons was in school, the medical students learned from the residents who would demonstrate an exam and then they would repeat the process. She saw patients throughout her education and felt very well prepared for practice.

'I loved interaction with the patients and enjoyed my career immensely,' said Emmons.

As these two women and many others have shown, determination and the drive to succeed can carry someone a long way. Ehn asked Emmons if she ever felt like there was something she couldn't do because she was woman. Emmons replied, 'No, it was never a problem. Things just went along. You know what they say though? Women have to be a little bit better. '

Exhibit illustrates fortitude of women physicians

'Changing the Face of Medicine: Celebrating America's Women Physicians,' an exhibit made possible by the National Library of Medicine, documents the history of women in medicine as it recounts the milestones of more than 40 women who have been pioneers in the field. Telling the story through photos and text, this captivating display brings to life how women have established themselves in the medical profession in the U.S., and will be on display at the UI Hardin Library for the Health Sciences from Oct. 10-Nov. 30, 2007.

Over time women have assumed a natural role as healers, whether by nursing the sick in their homes or assisting with childbirth. However, as medicine became a profession in Europe and America, women were excluded.

Women have overcome discrimination, racial tensions, community criticism, and financial hardships to become practicing physicians. More than 150 years ago, Elizabeth Blackwell became the first woman in America to receive her medical degree. She and her sister, Emily, founded the Women's Medical College of the New York Infirmary in 1869. However, as recently as 1994, Lori Arviso Alvord became the first Navajo woman to be board certified in surgery.

Some of the first challenges for women began in the late 1800s as they began to tackle discrimination. Dr. Mary Putnam Jacobi won the prestigious Harvard University Boylston Prize for arguing against Harvard Professor Edward H. Clarke's theory that women risked illness and even sterility if they were educated with men and held to the same academic standards. She provided scientific proof through sphymograph tracings, an instrument used to study and record measurements of the pulse, to show that a woman's health is stable despite physical and mental exertion.

Racism and financial hardship also were a challenge to many women. Dr. May Edward Chinn fought for suffrage as she marched for women's rights, and was the first African-American woman to graduate with a medical degree in 1926 from University and Bellevue Hospital Medical College. She practiced in Harlem, New York and had a strong interest in researching cellular methods for detecting cancer. Working with Dr. George Papanicolaou, she helped to develop the 'Pap' smear test to detect cervical cancer. In 1945, after years of little welcome in the profession, she was invited to join the staff of Strang Cancer Clinic of Memorial Hospital in New York City. Finally, she had received the respect she deserved.

As these and other women worked hard to establish their roles in the medical field and breakdown the barriers before them, they inspired the women following behind. Dr. Antonio C. Novello, was the first woman, and Hispanic, to hold the office of U.S. surgeon general. She was appointed to the post in 1990 by President George H.W. Bush after almost 20 years of public service at the National Institutes of Health. Early in her career she focused on children's health and AIDS, and targeted cigarette advertising aimed at children. In addition, she spent a great deal of time visiting American Indian reservations to bring attention to the health needs of the population.

These compelling stories are just a few that are a part of the 'Changing the Face of Medicine' exhibit. The success of women in the medical profession continues as they contribute by developing new treatments for disease and providing outstanding patient care. The number of women in medical classes around the country has increased, making the place they have established for themselves more solid.

The exhibition Web site, includes biographies of more than 330 women physicians, as well as photographs and short films. There is a special section featuring local legends from across the country. Jennifer Niebyl, MD, professor and head of the Department of Obstetrics and Gynecology, and a leader in high-risk obstetrics, and Carol E.H. Scott-Conner, MD, PhD, professor of surgery and an accomplished surgeon, teacher and author, are two UI Carver College of Medicine faculty members listed on the site. Visit the National Library of Medicine locallegends to learn about women in your state who have made a special contribution to the field.