Women with knives

Wives, mothers, dedicated surgeons. Claire Keeton talks to four women who have chosen surgical gowns over ball gowns

Female surgeons abound in popular TV shows like Grey's Anatomy but in reality they are scarce. In South Africa, some of the fiercest women surgeons work the theatre every day. These women are A-type leaders with a passion for surgery and a determination to save lives.

Paediatric cardiac and cardiothoracic surgeon Suzanne Vosloo; pioneering transplant surgeon Elmi Muller; breast surgeon and activist Carol-Ann Benn and South Africa's first surgeon of colour, Veronica Wilson, are among this elite minority.

As children they were dissecting snakes or following a father on hospital rounds. Their husbands - two of them specialist medics themselves - support them, and their children have grown up familiar with the urgent demands of surgery.

Muller had her first child the day after she wrote her final surgical exam and did her oral exam when he was a month old. Benn's youngest child went with her to work at two weeks old. She says: "The first two grew up in Chris Hani Baragwanath Hospital and the youngest one here at Milpark."

Wilson's toddler threw a textbook across the room to get her attention while she was swotting between working 48-hour shifts. "I was studying on the floor and he flung the book into the furthest corner and said: 'Ma.'"

Vosloo and her anaesthetist husband, Dr Anton Leopold Ferreira, have twin daughters who are nine. On some days she works in theatre with Ferreira. "I don't notice if he is there or if it is one of his partners. We are all professionals," she says.

These women are all at the top of the discipline. A Human Sciences Research Council study found that 37% of women went into specialist fields with most choosing disciplines like paediatrics and obstetrics ahead of surgery and medicine.

DR CAROL-ANN BENN

Benn, 43, lives in Joburg. She works six days a week and one night, never does the shopping and has a house full of dependants. Three children, 10 cats, four husky Malamutes, a pig, ducks and rabbits at the last count. She founded and runs the Breast Care Clinics at Chris Hani Baragwanath, Helen Joseph, Johannesburg and Milpark hospitals, operates, teaches at night and consults on Saturdays.

"You don't have to be a ballbreaker, though some people would say I am," she laughs. "I'm aware that you have to work twice as hard and be twice as good, but I don't stand on ceremony."

By the age of 30, Benn was a qualified surgeon. "I loved surgery from the word go, but don't ask me to decorate the house or dress up."

In the early '90s, when Benn had just qualified, she worked with trauma victims of political violence and went into the townships. But she found her true calling when she was asked to supervise a breast clinic at Chris Hani Baragwanath.

"When I walked in and saw these stricken faces, it touched my soul. They were not reconstructing women who had had mastectomies, and doctors were telling them it was their breast or their life."

Benn says nine out of 10 women are alive 10 years after a diagnosis and treatment for breast cancer. "My work is not just about operating. It's also about health awareness and taking away the stigma."

She confronted prejudice when she started working as a surgeon. "When I pitched for my first duty, the senior registrar, a little guy in clogs, said to me: 'Women are not meant to do surgery. If you want, I'll take you out to dinner.'"

Now Benn is training the next generation of surgeons. One of her students, Leanne Prodehi, 31, says: "She tries to buck the system to support us so that we also have time to study."

To keep her life on track, Benn and her emergency specialist husband, Dr Charl van Loggerenberg, employ seven people. "I never cook during the week and don't know homework details. My mother-in-law called me to ask for the children's shoe sizes and I got it wrong."

But on Sunday mornings the family relaxes together at home. "We are a good team, my three children and Charl. He is fabulous and we have been together forever - like dinosaurs. We go out on a date once a week."

DR SUZANNE VOSLOO

Vosloo, 53, seldom takes days off because working on weekends is simpler for her than organising a replacement. The first paediatric cardiac surgeon in SA, she has done about 7000 heart operations since she qualified in 1988. But when she started out, the slim blonde with painted fingernails had to prove herself. "When I was younger, I was a surprise to patients. Now I'm more accepted," she says.

Her enthusiasm for medicine started early. "My father was an orthopaedic surgeon and from a young age I would go with him on weekends when he did his rounds. When I did medicine, I loved surgery the most. I became interested in cardiac surgery and progressed to paediatric cardiac surgery.

"Surgery is not so much about cutting as about sewing and that's where women are talented. It's about connecting things together perfectly. You need to have a 3D image in your head and be very alert to sidestep any potential mistakes."

Although Vosloo works full-time in private practice, she has an "informal arrangement" with Red Cross Children's Hospital to help out when they need her. Her family time is constrained by her job and the amount of travelling her work entails. "My kids are my first priority when I have free time and I spend as much time with them as I can."

Vosloo, who lives in Cape Town, recharges her energy with a bit of pampering and enjoys having her hair and nails done. "I manage because I have a good support structure. I have a personal manager, Wendy Els, and my mother is very involved."

DR VERONICA WILSON

In the late '70s, when Wilson started studying medicine, apartheid was intensifying. "Working in a male-dominated world that was discriminatory was difficult," says Wilson, 60, who has been in the public health system for 35 years. "I had to be assertive to the point of being aggressive. One male colleague would literally steal my cases. Once I rolled up my sleeves and actually hit him."

Specialising in surgery was challenging for Wilson because she was a single mother. "I would come back from 48-hour shifts with my eyes falling out of my head and my son would want to play. It was difficult, but we had good domestic help."

In 1988, Wilson qualified as a surgeon. "I was the first woman of colour in South Africa [to qualify] and there were only two of us [women]. We did a lot of operations, especially emergency and trauma surgery. I operated on stabbed hearts, stomachs, gunshot wounds and amputations. It was rewarding, but there were minimal resources."

Wilson says surgery has changed with many specialists going into units like neurosurgery, urology and paediatric surgery. "We now have many more women here."

It's a different world to the one where a male consultant used to pick on her. "He would insult me in front of patients and would not listen to me. Once he blamed me for not following a simple instruction. I told him I was no longer working for him and walked out. While I was crying in the bathroom, he knocked on the door and told me to open it. This made me laugh and I realised what he wanted was for me to stand my ground."

On the home front, Wilson had the challenge of making time for her son, who is now 27 and a chemical engineer. "We once went to buy school shoes and I was feeling for his toes and he said the shoes were too tight. But they weren't. Much later, when he was at university, he reminded me of that occasion and said, 'I gave you a hard time.'

"Becoming a surgeon requires sacrifice and something has to give."

Wilson is now married to her long-term partner, Derek Benton, and gets to relax with him at home. "I like to potter in the garden and sometimes go to the beach. I like to listen to classical music and old-fashioned disco music from the '70s."

DR ELMI MULLER

Muller, 39, who performed ground-breaking surgery last year, says she is "not generally the most sympathetic person" and likes the quick results you get in surgery.

"Short-term results, like the ones you get in surgery, are few and far between with patients being much more chronic and taking ages to get better with small changes in medication.

"I try to resolve problems rather than look for them," she says. "I'm not a detective and my instinct is to tell people there's nothing wrong with them unless they look very ill."

Since 2005, Muller has worked at Groote Schuur Hospital, where they perform between 50 and 70 transplants a year. "I have a fantastic boss who always lets me do the surgery."

Last year, she transplanted kidneys from HIV-positive donors to HIV-positive patients, a pioneering move which has revolutionised the lives of those patients.

"The most difficult thing is to deal with complications without feeling personally responsible. I think the challenge is not to be so involved that you cry or feel depressed when one of your patient's dies, but to be involved enough to care about them.

"A surgical consultant once said to me, 'If you don't want complications and you can't handle complications, don't do surgery.' And it's true. When something goes wrong in surgery, you are very exposed."

Muller says she was the first surgeon in her department to get maternity leave and when her second son came along - her boys are now five and 12 - her boss was " delighted".

She tells a story about her first pregnancy - that she had been in labour for several hours while out shopping for the first time after months of studying. "After a while, I realised the abdominal pain I had was cyclical and might be getting worse. I now hold the record for having a baby closest to exams."

Her husband, Stephanus, a Stellenbosch University music lecturer, supports her all the way. Muller relaxes at home with her family when she's not at work. "I like cooking and baking and pottering around in the garden."