Who is the surgeon?

Here’s a riddle for you:

A father and son are on a road trip. They get into a car accident, and, tragically, the father dies on impact. An ambulance arrives and brings the son to the hospital for emergency surgery. The surgeon walks into the operating room, looks at the boy on the table, and tells the nurse, “I can’t operate on this boy. He’s my son!”

Who is the surgeon?

 

When this riddle first appeared in the mid-twentieth century, the accepted, but challenging conclusion was that “The surgeon is the boy’s mother.”

A female surgeon in the mid-twentieth was a revolutionary concept. According to the National Library of Medicine, until 1970, no more than 6% of students in any medical school class in the United States or Canada were female, and until 1975 the American College of Surgeons never admitted more than 5 female surgeons per year into its ranks.

Now, for the first time in the history of the American College of Surgeons, women hold the three highest leadership positions: Dr. Barbara Lee Bass, MD, FACS, as President; Dr. Leigh A. Neumayer, MD, FACS, as Chair of the Board of Regents; and Dr. Diana L. Farmer, MD, FACS, FRCS, as Chair of the Board of Governors.

With the swift growth of women in the surgical field, it would stand to reason that the aforementioned riddle has become easier to answer. However, psychologists Deborah Belle, professor emerita at Boston University, and Ashley Tartarilla, a lead clinical research specialist at Boston Children’s Hospital, found that this is not the case.

In January 2021, Belle and Tartarilla published their study, “I Can’t Operate, that Boy Is my Son!”: Gender Schemas and a Classic Riddle, in which they concluded that only 30% of people between the ages of 17-26 can determine that the surgeon in the riddle is the boy’s mother. In seeking an answer to this riddle, Belle and Tartarilla were hoping participants could redefine their gender schemata and see past their implicit gender biases.

Gender schemata are mental frameworks each person creates to define different genders; these schemata inform implicit gender biases. The most traditional female gender schema is that to be a woman a person must have long hair and wear dresses; stay home and wash the dishes; and be the child’s primary caregiver. Because of this categorization, for many years, an implicit bias against women said that they could not hold high-power, stressful jobs that would take them away from their family life, such as surgeons.

In their study, Belle and Tartarilla hypothesized (1) participants who self-identify as female are more likely than men to answer the riddle (none of the participants identified as being transwomen); (2) people with previous exposure to female physicians and/or grew up with employed mothers are more likely to answer the riddle; (3) people who hold more sexist beliefs are less likely to answer the riddle; (4) people who are self-declared feminists and/or describe their political views as liberal are more likely to answer the riddle; and (5) people with exposure to same-sex parents and/or LGBTQ+ identifying individuals would be more likely to answer the riddle.

After gathering data from 472 undergraduate students—170 of whom had already heard the riddle—Belle and Tartarilla disproved all but their first hypothesis. Participants living as women were three times more likely to determine the surgeon is a woman.

Participants who had exposure to female physicians and employed mothers were no more likely to determine the surgeon was a mother than those without previous exposure. Participants with more sexist attitudes—as determined by the Modern Sexism Scale—were no less likely to determine the surgeon was a mother than those with less sexist attitudes. Participants who were self-identified feminists or held liberal political beliefs were no more likely to determine the surgeon is a woman. And participants who had exposure to same-sex parents or members of the LGBTQ+ community were not more likely to answer the riddle.

Despite its negative results, this research is revolutionary in the psychological study of gender schemata because Belle and Tartarilla did not mark an answer as wrong if it was not “The surgeon is the boy’s mother”. In previous studies, researchers marked any answer that was not “The surgeon is the boy’s mother” as incorrect, regardless of if the answer was logical. Belle and Tartarilla accepted answers such as “The surgeon is the boy’s second father (father in a same-sex marriage), adoptive father, or step-father.”

Only answers with “considerable originality”, though fun to read, were marked incorrect. “It could be a dream and not reality”. “While the son was in the operating room he died, and when he saw the surgeon, it was his dad’s ghost”. “Maybe the surgeon is a sperm donor and he is the biological father of the patient”. “The ‘father’ killed could be a priest, because priests are referred to as fathers and members of the church are ‘sons’.”

This revolutionary inclusion of multiple answers to the riddle reflects the swift social change brought about by the LGBTQ+ rights movement and growing number of “blended” families in the United States.

While Bella and Tartarilla were excited about the scientific proof of growing cultural acceptance of the LGBTQ+ community, they were still baffled at how few people concluded the surgeon in the riddle could be a woman.

Women make up 76% of employees in the health care field. According to the 2019 census, one third of all surgeons and physicians are female (about 229,000 of around 763,000 total). They work predominantly in pediatric, family, neonatal-perinatal, obstetric, and geriatric medicine. In 2019, 48% of students who graduated from medical school in the United States were female, up from the 6% in 1970.

More people are exposed to women in diagnostic positions than ever before (as opposed to in nursing positions; women make up 90% of all registered nurses in the United States).

On top of the surging number of real-life female physicians and health care workers, television venerates female physicians and surgeons such as Dr. Meredith Grey, Dr. Cristina Yang, and Dr. Miranda Bailey from Grey’s Anatomy (2005-present), Dr. Lisa Cuddy, Dr. Allison Cameron, and Dr. Remy “Thirteen” Hadley from House, M.D. (2004-2012), Dr. Elliot Reed from Scrubs (2001-2010), and Dr. Abby Lockhart from E.R. (1994-2009). These fierce, fictional characters are examples of women thriving as surgeons and physicians.

Women as surgeons can no longer be a foreign concept.

With COVID-19 still raging across the country and around the world, we must challenge ourselves to redefine what makes a woman and see past our implicit biases that prevent us from recognizing the surgeon in the riddle as a woman. We need to remember and celebrate all the female physicians, doctors, surgeons, nurses, EMTs, and other medical professionals risking their lives to end this pandemic.

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