Writing, Behind the Mask

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kathyhughesmdKathryn A. (Kathy) Hughes, MD is a general surgeon and blogger who has spent the majority of her career in private practice in community hospitals. She blogs at Behind The Mask, where she shares experiences from her surgical career and life. She is a Fellow of the American College of Surgeons, and a member of the Association of Women Surgeons, The American Society of Breast Surgeons, and the American Medical Association. She is a member of the Massachusetts Medical Society, as Vice-President of the North Essex District and member of the House of Delegates and the Committee on Women in Medicine. Dr. Hughes has been active throughout her career on numerous hospital committees, and has held hospital leadership positions including Chief of Surgery positions and Vice-President of Medical Staff; these positions have fostered and developed her interest and expertise in medical ethics and quality/peer review including measures and processes, in addition to her clinical interests and practice. She has given numerous talks and lectures, to both colleagues and for community events, and has appeared on radio and local television.

I talked with Dr. Hughes about what led her to go into surgery, why she started writing, and what it’s like to put writing on the web.

V: Why did you go into medicine, and specifically surgery?

Dr. Hughes: I was really interested in science and biology as a kid, and that led me towards medical school. It evolved into a calling rather than just an intellectual pursuit. It was a profession where I felt a very strong sense that I would be able to take advantage of a broader range of skills while still using science. The aspect of service was the final piece that sparked it for me. I never envisioned early on that I would be a surgeon. When I was pursuing medicine, it was still a minority of women in engineering, science, math and medicine. I think my medical school class was about thirty percent women, which, back then, was a pretty large percentage compared to many other medical schools. It was hard to tell if women were mainly gravitating towards internal medicine, pediatrics, gynecology, pathology, or if there was a gentle nudge and push towards those fields. So surgery wasn’t on the radar—but every surgical stereotype was on the radar. I remember a conversation I had with my dad when he was driving me home for the weekend in the spring of our second year of medical school. My classmates and I were agonizing over what order we wanted to do our clinical rotations for the third year. I was telling my dad, “I’m really fine with doing surgery first, it’s going to be really hard, so I’ll get it out of the way. I’ll just be getting used to what clinical rotations are like. It won’t matter if I don’t get honors in it, because I know I’m not going to be a surgeon, because all surgeons are jerks, or a bunch of sexist pigs, and they’re all men. I don’t need to fight that battle the entire rest of my career. I know I’ll never be a surgeon, so I’ll get it out of the way.“

I know those phrases because I’ve been eating those words ever since. I found during my rotations that the surgeons were really enthusiastic about what they were doing, they weren’t just cowboys who cut first and asked questions later. I encountered some very thoughtful and open-minded and supportive people. Later on down the road, I certainly met people who fit the surgeon stereotype, but they are very few and very far between.

V: When and why did you decide to start blogging?

Dr. Hughes: I never thought of myself as a writer, but a little over a year ago, I found out about this group within the Massachusetts Medical Society called the “outside interests group.” Once I joined the group, I saw they had an announcement for a creative writing workshop. What was really great was that it was run by somebody I admire, Susan Pories, who’s a breast surgeon at Mount Auburn hospital and past president of the Association of Women Surgeons. So she was a role model of a surgeon-writer running a workshop, and she’s a wonderful teacher. As we were going through some of the little exercises, I realized other people seemed to like what I was saying. I was telling a friend about it, and she’s also a life coach, and she challenged me to continue writing by writing one piece a week for six weeks. I started it, and actually was writing a couple a week, and so here we are. It’s kept going. It was something I started doing mostly for myself, but it’s a different feeling when I know I’m putting it out there where other people can see it and it’s been a wonderful experience.

V: Out of all your blog entries so far, is there one that you’re the most proud of or that’s received the most feedback?

Dr. Hughes: There were a couple of them that are particularly personal for me, and I don’t know that they’re the ones that got the most traffic. I wrote one about things I had learned when my dog was dying of cancer, and also wrote one about what it was like to be present when my uncle died. But I think the one that got the most eyeballs, and still does, is the one I’ve written about the surgical stereotype. There have been a lot of surgeons commenting on that one.

V: Has blogging impacted your career or the way you feel at work in any way?

Dr. Hughes: Absolutely. It gives me an opportunity to take a step back and think about things and express them. It’s a different way of processing things that are going on and things that I’ve been thinking about, and it’s kind of therapeutic. I have something that I can point to and say, “This is something I made. This is something I created.” I hadn’t anticipated how great that could be to create something and have it spark conversation and collaboration. It’s drawn me into social media, and I’ve felt much more of a sense of community.

V: What are some strategies you think are effective for doctors to prevent burnout and cope with the stresses of medicine?

Dr. Hughes: I think coaching is something that’s under-utilized. Business and other professions utilize coaching, and a lot of professional enrichment. But despite all of the continuing education in medicine, it’s all focused on clinical and intellectual knowledge rather than professional and personal development. I think even just a small commitment every day to write is a good strategy. Writing and expressing oneself is important and can be therapeutic, but any sort of creative endeavor is helpful, whether it’s the written word, music, visual arts, or even gourmet cooking. Being creative feeds a different part of us that we can often let go by the wayside. The act of being creative was so often for me the first thing I would let go when my schedule was overflowing and overwhelming. I think in order to combat burnout, we have to realize that that is a really important piece of the puzzle to keep space for.