March 4, 2017
KATHMANDU, NEPAL — Neurosurgery, introduced to Nepal in the 1980s, remains a male-dominated field. According to the Nepalese Society of Neurosurgeons, there are 63 neurosurgeons in Nepal. Only five are women.
GPJ spoke with Dr. Maya Bhattachan, 42, Nepal’s first woman to work as a master neurosurgeon (M.Ch.), about her work and life. She currently works at Nepal Medical College Teaching Hospital, where she also is an assistant professor.
Why did you want to become a neurosurgeon?
I was really interested in thoracic surgery, but in 1992, my grandmother had a stroke. Dr. Upendra Devkota [founder of the first neurological trauma unit in Nepal, at Bir Hospital] and his team saved her.
At the time, there were no women neurosurgeons. I worked in the general surgery department and was sent to the neurosurgery unit, as they were short-staffed. The environment was friendly.
In neurosurgery, you have to do everything promptly and on time. You cannot do the surgery the next day. If the patient comes to you at 2 a.m., regardless, you have to operate then. Time is very crucial in neurosurgery. Senior surgeons used to come to operate even at 2 at night or 3 at night. I saw how hard they worked and, seeing their dedication I got inspired to follow them.
The patients I thought would not make it were able to go back home on their own two feet. More patients survive in other surgeries, but in neurosurgery the mortality rate is very high. In neurosurgery, if you can save a person’s life, the feeling is wonderful.
What challenges do you face in your work each day?
In neurosurgery, you need physical strength and stamina. You have to stand for long hours during surgery. You can’t take a break in the middle of the surgery. Once you start the surgery, you have to complete it, and it can go on for 15 hours. After surgery, if something is wrong, then you have to go back in. You have to be physically strong to continue.
You can hand over your case to a colleague, because you have to do what is best for the patient. But it is your patient, and your responsibility, so you have to be present for that surgery also. Your heart won’t allow you to leave.
You have to sacrifice your sleep. There is no regard for time — day or night. Every surgeon goes through this.
What was challenging for you as a woman to achieve your goal?
In this field, you have to be aggressive. You have to be demanding to get cases. You cannot be passive. You have to ask for and demand cases. Men are forward. They say they will take the case. But women don’t say that. Women don’t ask. We have to be more confident and make our presence felt.
You also have to be physically strong. You cannot ask for special treatment. It is not fair on others. Everyone works hard.
Do patients look for male doctors?
They look for male doctors. Patients call me sister [a term for nurse]. Even educated people call me sister. Sometimes my male junior interns are called “doctor saab.” The perception is that doctors are male.
I introduce myself. I tell them about the disease. It is easier for them to call me sister, “didi” [slang for a big sister in Nepali] or aunty. The perception of people is that a doctor is a male.
Shilu Manandhar, GPJ Nepal
What does it mean for a woman to have a successful career in Nepal?
I had no restrictions at home. My family supported me. I spent many years studying. Studying medicine takes a long time. M.B.B.S. [bachelor of medicine, bachelor of surgery] takes five to six years. Then you do a year of internship. I did my M.B.B.S. in Russia. After that, I did my M.S. [master of surgery] general surgery in Russia for three years.
Then you work to gain experience. You do post-graduate [work] for three years, followed by a fellowship of six months to a year. And then an M.Ch. [master of chirurgical surgery] specialization. I worked at Bir Hospital for eight years. I then did my fellowship in Japan.
My family supported me financially. I am in this position because of my family’s support. You cannot be in this field without your family’s support.
Even in a male-dominated field, I have made my place. My family is proud of me.
Why, in your opinion, are there few women neurosurgeons in Nepal?
You have to dedicate a lot of time to the hospital and your department. It is not a nine-to-five job. You have to be available to work at night. Women have to go back home, because not all families understand. So many women don’t join the surgical field. The training is also difficult.
Residency surgical programs are hard and require time investment. There should be no excuse because you are a woman. It is not just about studying; you also need to train and practice. You need to develop your skills. You invest time to develop skills. You have to assist in a surgery, and you have to work with others. It takes a lot of time to become good.
Surgeons have no timetable. Emergencies can come up at any time. It is your patient’s life at hand. You have to sacrifice family time. You have night duty. Most families won’t support this. So it is difficult for women to join the surgical field.
Without the support of your family, it is difficult to get in and be established in this field.
How do you balance your career and your family?
I have a daughter [whom she is adopting, and who is 2]. I give her time in the morning. When I get back from work, she is asleep. On Saturdays, we usually go for outings to the zoo or the mall. We also go hiking, but I have to carry her.
I hope she grows up to be healthy and strong. I want her to pursue whatever she desires. She can be whatever she wants to be. She will be able to choose any field she wants.
How do you inspire girls and women who want to join this field?
I tell the women interns who are hardworking to be even more competent. Those who are really hardworking, I try and encourage them to join surgery. Women need to be more confident. They are passive. Some are shy, so I try to make them more confident. You have to try and make them bolder.
It is a male-dominated field. Women have to prove themselves, so they have to work harder. People are skeptical, especially the patients.
We need more competent women surgeons — not just more women neurosurgeons. You have to be competent. Being a woman is not an excuse. You cannot make an excuse. We don’t want any special preferences. We don’t want special privileges. We should not ask for special privileges because we are women. We should be able to compete with men.
What are your future plans and goals?
In emergencies, I saw many cases related to child protection and physically abused children. I want to do something for them.
I want to raise awareness to prevent child abuse and do something for physically handicapped children.
EDITOR’S NOTE: This interview was edited for brevity and clarity.