Reflections on a trailblazing career in surgery
Karen Deveney, MD
Professor of Surgery; Vice Chair, Education, Department of Surgery, Program Director of the Department of Surgery Residency Program
Ask Karen Deveney, MD, what personal qualities she believes have most contributed to her success as a physician, surgeon, teacher and director of arguably one of the best surgical residency programs in the country, and she has a ready answer: “Competitiveness, assertiveness and tenacity, otherwise known,” she laughs, “as stubbornness.”
When she is told, “You can’t do that; nobody has ever done that before,” it’s like waving a red flag in front of a bull. This statuesque woman – who ran 21 marathons at a blazing seven-minute-a-mile pace when she was younger and still, in her 60s, runs to stay in shape – has been proving naysayers wrong her entire career. Her strategies for success, if she had any, have been quite basic: “Do everything to the best of your ability and don’t slack off. ‘Okay’ is not good enough and I really don’t have a lot of respect for people for whom ‘satisfactory’ is a good grade.”
After a brief detour as an inner city school teacher, she has spent nearly four decades perfecting her skills in the operating room and helping young medical students and residents learn how to become good doctors.
"They wouldn’t let me have a rest because they wanted me to cry ‘uncle,’ so they could say, ‘Well, what’s the matter, aren’t you strong enough to do this?'"
Aspiring to be a doctor, however, never occurred to Dr. Deveney, née Suhr, when she was growing up in the 1940’s and 50’s in then tiny Gresham, Oregon. “I didn’t know women could even be doctors,” she says. Teachers were the only educated women she knew so it was only natural for this whip-smart young farm girl to gravitate toward a career in the classroom, perhaps as a high school English teacher, she thought.
With that in mind, she went off to Stanford University, was invited into the English honors program, spent a year abroad studying German language and culture at Stanford’s campus in Stuttgart, did her senior thesis on Vladimir Nabokov, and met Clifford Deveney, a classmate, ultimately a soul mate, and in their senior year at Stanford, her husband.
When Cliff enrolled in medical school at the University of California, San Francisco, Karen dutifully went over to Berkeley for the education courses she needed to get her certification and took a job teaching English at a San Francisco junior high school. “I realized right away that that was not what I was cut out to do,” she says. “It was a pretty rough situation.”
It was then, at something of a low point in her life, that Cliff suggested, “Why don’t you just do what you’ve always wanted to do.” She had inklings along the way that a medical career held some appeal. “If you could be a doctor, why would you want to do anything else?” she had told Cliff when he was struggling to make up his mind whether to go to medical school or get a PhD in math. That advice should have rung a bell for her as well, she remembers.
Storming the gates of UCSF
She occasionally found herself when she was younger gritting her teeth when hospital patients assumed she was a nurse rather than a doctor.
Once, having decided to go for it, she applied her trademark grit and determination. She worked as a billing clerk and switchboard operator at a little Catholic hospital to pay for pre-med courses and in 1968, three years behind Cliff, stormed the gates of UCSF medical school, one of 10 women in a class of 142, and knew that she had found her calling.
She sailed through medical school and was only the second woman ever to complete the surgical residency at UCSF, which was not a bed of roses, given the 120-hours-plus work weeks and the hazing to which she was subjected. “There were a lot of people who felt that women just weren’t by nature designed to be surgeons. They didn’t have enough stamina, they weren’t tough enough, they didn’t have the emotional stability, they were too delicate.”
Karen was forced to do things the male residents didn’t have to do, she recalls, like holding up a patient’s arm interminably during a particular procedure while the surgeon and his first assistant made an incision into the arm pit and removed a rib to take pressure off certain, arteries, veins and nerves. The male residents assigned that duty would be allowed to take a breather periodically. “But they wouldn’t let me have a rest because they wanted me to cry ‘uncle,’ so they could say, ‘Well, what’s the matter, aren’t you strong enough to do this?’ I would never give them the satisfaction.”
In a specialty as male dominated as surgery was then, Dr. Deveney was determined to be viewed as a surgeon first, not a woman surgeon. “I didn’t want to be singled out…I think that has had some bearing on the attitudes that I carried through the rest of my career, not wanting to ask for special favors or entitlements. I want to get positions I get on merit, not because I’m a woman.”
She occasionally found herself when she was younger gritting her teeth when hospital patients assumed she was a nurse rather than a doctor. She tells the story of a call that interrupted a dinner party she and Cliff were giving after both had become practicing surgeons. She answered the phone and the caller asked for “Dr. Deveney” and, without thinking, she responded, “Just a moment, I’ll get him.” As she went back to the dining room, she thought, “Wait a minute, what am I saying?” and returned to the phone to ask which Dr. Deveney. “You still have conventional ways of thinking that are environmentally and historically dictated and those things take awhile to be obliterated.”
Wired to be self reliant
Dr. Deveney is incensed at the stories she’s heard about first and second year female medical students being advised by some faculty members not to be surgeons if they want to have children, or, in one case, “because you’re too nice.”
Dr. Deveney’s stubborn independence has sometimes proven a handicap, she concedes. “I didn’t want anybody to help me with anything. That’s how I’m wired and I can’t help it.” Contrary to current fashion, the idea of a mentor “to get somewhere where you want to go” has for her always been a foreign concept. “I really never was clued in on how you played the game…and that’s kind of my generation, I think.”
She never embraced any particular role models, although she counts her mother as the one person, who had the most outsized influence on her. Her mother played tennis and golf and could drive the ball as far as the men could, she recalls. After her father – the biggest volume rose bush grower in Oregon at the time – died in a tractor accident when Karen was in medical school her mother carried on by herself. “I think the toughness and the stubbornness in me emanated from her.”
Ironically, Dr. Deveney, who has been a pioneer in her field and is known nationwide for her expertise in graduate medical education, has never been ambitious either for rank or monetary rewards. “The last thing I would ever want to do is be a department chair. “You take everything you’re good at and have no time to do it to take on stuff that’s hard…especially the headaches.” Nurturing young people and helping them achieve their goals has been “the pinnacle of what I have wanted to do,” she says. Teaching – at least of bright motivated medical students and residents – turned out to be her calling after all.
Dr. Deveney has been recognized with a multitude of outstanding teacher awards in every place she has taught from UCSF to the University of Pennsylvania Medical School to OHSU, where she and Cliff (Clifford Deveney, MD, Professor of Surgery) have been faculty members since 1987.
“I feel that you would have difficulty finding anyone who is more selflessly dedicated to resident education and resident welfare than she,” said Dr. Frank Lewis, Executive Director of the American Board of Surgery in 2005 when Karen was awarded the prestigious Parker J. Palmer Courage to Teach Award by the Accreditation Council for Graduate Medical Education.
As for money? “I don’t measure myself by that,” Karen says, “so I didn’t ever care about it. I never negotiated a salary. I was grateful to have a job. That’s kind of the way I was raised. You don’t talk about those things.”
Having children was never on her list of priorities either. “Number one was my relationship with my husband and that small immediate family which I had, and then it was really my career and being as good at it as I could.” But she empathizes with the young women coming into the profession today who do want children. She is incensed at the stories she’s heard about first and second year female medical students being advised by some faculty members not to be surgeons if they want to have children, or, in one case, “because you’re too nice.”
“The sky’s the limit”
"Don’t be quite as independent as I was. People who build little networks can progress faster in academic medicine. If you have to figure it out for yourself, it takes longer."
For women in surgery, Karen says, a sea change has occurred in the decades since she was a resident.
Women surgeons were a rarity when she started. A decade later there were more but they were tokens. The resident selection committee at UCSF that Karen sat on as the only woman marveled at their good fortune, she recalled, when a superlatively talented African American woman turned up in the applicant mix. “Great,” they guffawed, “we can get both of our tokens in one person.” It was a moment of chagrin for her, but she didn’t have the guts, she said, to voice her disapproval.
Another 10 years on and a retrograde faculty member on an OHSU selection committee could only mutter to a colleague in the privacy of the men’s bathroom, “Whatever happened,” he asked angrily, “to the good old red blooded American boys we used to have applying in surgery?” Today, even the private muttering is gone, Karen says, replaced by pride in the diversity the program has achieved. Karen is proud that nearly half of OHSU’s surgery residents today are women.
“Women now just need to follow their hearts and do what they want to do and not feel artificially constrained and think, ‘Oh, I can’t do this because I’m a woman.’ Because you want to have a family is no reason to do anything that you don’t otherwise want to do. Right now all opportunities are open and the sky’s the limit.”
Lessons learned, lessons shared: Advice from Dr. Deveney
What advice would Dr. Deveney give to young women starting out today?
- Work as hard as you can, play as hard as you can.
- Don’t let anyone scare you into believing that procedural specialties like surgery aren’t for you if you’re interested in having a family. As team-based medicine becomes ever more the norm, a balanced lifestyle will be less and less difficult to achieve. You can be a surgeon and still do all the things you want to do.
- Don’t be quite as independent as I was. People who build little networks can progress faster in academic medicine. If you have to figure it out for yourself, it takes longer.
- Learn and perfect your craft so that you are capable of dealing with all the things that might be thrown your way. After your residency and you are starting in as a practitioner, you’re still not fully mature in your skills and judgment and that really is an evolving process. You really have to concentrate your attention on building your skills, whether at operating, taking care of patients, or, if in academic medicine, giving lectures and teaching.
- Ultimately, after striving and striving to improve in your career, you’re going to reach a place where you’re in a comfort zone that gives you the liberty to try out new things and be innovative and feel safe in doing that.
Article written by Harry Lenhart