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You’re the Surgeon?

Dr. Qaali Hussein: “Despite my academic standing and extracurricular activities, my pursuit of surgery has always been received as an improbable endeavor. A hijab wearing Muslim girl was nobody’s idea of what a surgeon should be. And when I did make it into surgery despite the promises of inevitable failure, my motherhood became the new reason for the calls to quit surgery.”
CSM Lab

Published

6 years ago

on

Qaali Hussein, MD

[su_boxbox title=”About” box_color=”#262733″] Dr. Qaali Hussein is a Board Certified Trauma/Acute Care, and surgical intensivist who practices in Florida. This story was originally published on April 16, 2018 on Medium. The revised version is re-published here with permission from Dr. Qaali Hussein. [/su_boxbox]

[dropcap]D[/dropcap]espite my academic standing and extracurricular activities, my pursuit of surgery has always been received as an improbable endeavor. A hijab wearing Muslim girl was nobody’s idea of what a surgeon should be. And when I did make it into surgery despite the promises of inevitable failure, my motherhood became the new reason for the calls to quit surgery. 

But wait. Where did it all start?

Well, my fascination with how the human body works was what attracted me to science. Learning about illnesses and that we are capable of fixing some of these made me eventually fall in love with surgery. 

Fast forward many years of training, I now find myself meeting most of my patients in what is mostly one of their worst days.

They’re critically ill from either an injury or a general surgical emergency. As trauma and critical care surgeons, it is common for us to treat the underlying problem first, with either emergency consent or that of the family, and then meet our patients afterwards. 

Dr. Qaali Hussein

When patients recover and I finally introduce myself, they are usually puzzled and confused. They ask, just to confirm, “Who’s the surgeon, again?” I initially attributed this confusion to my gender as there is always less reluctance to call my male medical students, residents, and physician assistants doctors while I am more readily identified as the nurse. When the clarification is made as to who the physician is, the confusion persists. At this point, there’s usually a double take and the question turns into “You’re the surgeon?” with a sense of disbelief.

I’ve grappled with how to respond to this question for quite some time. I usually laugh and say, “I may look 17 but I’ve got a lot of gray hair under this scarf,” referring to my hijab. There’s really not that many gray hairs but it usually comforts my patients and we move on to discussing their care.

I, on the other hand, am not comforted by these frequent encounters. I don’t take offense to the question or the reaction of disbelief in the fact that a hijab-wearing Muslim woman can be a surgeon. I’m saddened that in 2018 the question, You’re a surgeon?, is still being asked. With women accounting for approximately 50% of medical school graduates, and with more women pursuing surgery, it should not be a surprise that women from diverse backgrounds can be surgeons as well. What is not at all surprising is that pursuing surgery continues to be difficult for women, especially when childbearing is considered.

I have been called a terrorist by a patient, been given multiple lectures on what the “true religion” is, and have had patients refuse my care because of my last name and my faith but I have also had great rapport with many more patients because of my hijab.

With residency occurring in the most productive years of a woman’s life, the already difficult surgery residency becomes exponentially more challenging if you add in pregnancy. There is a negative stigma about pregnant female surgical trainees. This attitude is so pervasive that many women surgeons postpone childbearing and possibly put themselves and their children at risk for complications related to advanced maternal age. In addition, some women are even encouraged to quit surgery and pursue more “family friendly” specialties when they become pregnant. I almost did not pursue surgery because of these aspects of surgical culture.

Explore Next:  Becoming a parent in academia – when science fails you

I was lucky to have met Dr. John Bawduniak, a surgery resident at the time, who advised me during the application process that residency is a finite amount of time and that I should pursue my true passion. Thanks to his sage advice, I changed from applying to a “family friendly” field to applying for my true passion, general surgery. Although I enjoyed the experience of learning to operate and care for surgical patients, I did not enjoy being told to quit surgery simply because I became a mother. I have always desired to have a large family and I did not want to give up that very personal dream because of my love for surgery. I wanted both! 

So, although unusual, I had five pregnancies and six kids during residency and fellowship. The response to my being pregnant as a fellow was no different than the response I was given as a pregnant intern. There’s a lot to be said when it is easier to overcome language and cultural barriers than it is to deal with the difficulties of being a pregnant surgery resident. I have certainly had other challenges as a hijab-wearing Muslim surgeon. I have been called a terrorist by a patient, been given multiple lectures on what the “true religion” is, and have had patients refuse my care because of my last name and my faith but I have also had great rapport with many more patients because of my hijab.

Overall, I don’t worry about my hijab being an issue for me as a surgeon. Do we need more diversity in surgery? Certainly, and there are many opportunities for us to improve on inclusion. What worries me is the treatment of women in surgery residencies and in practice where motherhood is considered a disqualifying event, hence discouraging more women from pursuing surgery and surgical subspecialties. The reality is, most of our patients don’t really care what we look like, where we come from, or whether we took maternity leave or not. What they need is a competent surgeon to take care of them in their most vulnerable state.

These experiences have not only taught me the importance of persistence but that social inequities still persist in women’s career pursuits. Artificial road blocks are pointed out as reasons to quit instead of alternative routes to success being offered. I’m reminded of the oddity of my being a surgeon on almost daily basis. In today’s political climate of rampant discrimination against immigrants and Muslims as well as the spotlight on widespread misogyny, I believe it’s imperative that we change the narrative and speak up to defy these stereotypes we’re labeled with and demand change.

Cover Image by Engin Akyurt from Pixabay | CC0 Creative Commons

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CivicSciTimes - Stories in Science

Unexpected Stories and Spindle Mistakes: Discovering that Wild-type Cells are Full of Surprises

CSM Lab

Published

3 months ago

on

July 5, 2024

By

Natalie Nannas

Natalie Nannas is an Associate Professor of Biology at Hamilton College in Clinton, NY. She teaches courses in genetics, molecular biology, and bioethics. Dr. Nannas graduated from Grinnell College with bachelor’s degrees in biological chemistry and French. She received her Master’s and PhD from Harvard University in molecular biology and genetics. Dr. Nannas conducted her postdoctoral research at the University of Georgia where she won a National Science Foundation Plant Genome Postdoctoral Fellowship. At Hamilton College, Dr. Nannas enjoys teaching and sharing her passion for microscopy with her undergraduate research students. When not glued to a microscope, she loves spending time with her husband and two daughters. The narrative below by Natalie Nannas captures the human stories behind the science from a 2022 paper titled “Frequent spindle errors require structural rearrangement to complete meiosis in Zea mays” which was published by her group in 2022 in the International Journal of Molecular Sciences.

Science never works out the way we plan. As scientists, we ask questions, hypothesize and outline our goals … then reality of science occurs. The reality of science is often full of failed controls, endless troubleshooting, and sometimes strange findings that lead us in new and unpredictable directions. Our publications give the impression that we planned these scientific journeys from the beginning and do not tell the human side of the process with all of its twists and turns, dead-ends and U-turns. I want to tell you the real story behind my first publication as a faculty member with my own lab. It did not go as planned due to the COVID-19 pandemic. My lab was shut down in the middle of our investigation, and my students and I were unable to generate new data. In the beginning, it seemed like we were stranded with only control data and no story to tell, but the time away from the lab allowed us to spend more time looking carefully at wild-type cells. What seemed like a dead-end suddenly became its own story when we found something unexpected hiding within microscopy movies. Our wild-type cells were making mistakes, attempting fixes and changing directions, just like we do as scientists.

My scientific journey began with flickering green lights and a microscope (you can read more about it here). As an undergraduate, I was mesmerized by the beauty of watching living cells shuffle fluorescently labeled proteins throughout their cytoplasm. I followed this passion for microscopy into my doctoral dissertation research at Harvard University where I investigated how yeast cells build the machinery needed to pull their chromosomes apart. This machinery is a dynamic collection of long protein tubes called microtubules and other organizing proteins that help move and shuffle microtubules. I loved watching the delicate dance of chromosomes interacting with microtubules of the spindle, and I wanted to continue studying this process in my postdoctoral studies.

During postdoctoral studies at the University of Georgia, I won a fellowship from the National Science Foundation to develop a new technique in microscopy. No one had ever watched plants building their spindles in meiosis, the specialized cell division that produces egg and sperm. Other scientists had performed beautiful microscopy studies observing how mitotic spindles function inside of plant cells, but due to the technical challenges, no one had ever observed live plant cells building spindles in meiosis. I was thrilled to take on this challenge by using version of maize that had fluorescently labeled tubulin, the protein that makes up microtubules of the spindle. With this line of maize, spindles would glow fluorescent green, allowing me to image if only I could extract the meiotic cells.

Dr. Natalie Nannas

We were so busy collecting data and prepping for our mutant studies that we never really took time to analyze the wild-type cells.

After almost a year spent dissecting maize plants, I finally managed to develop a method to isolate these tiny cells and keep them alive in a growth media long enough to image them. This new method of live imaging was going to serve as the foundation of my new lab at Hamilton College, a primarily undergraduate institution. With my students, I planned to investigate the pathways governed spindle assembly. Most animal mitotic cells have a structure called a centrosome that dictates how spindles are formed; however, female animal meiotic cells lack these structures and must use other pathways to direct spindle assembly. Plants also lack centrosomes, and I wanted to inhibit these known animal pathways in our plant live imaging system.

Explore Next:  My Passion for Microbes

As I set up my lab, my students and I collected live movies of wild-type maize cells building their spindles. I told my students and myself that these movies were not the main event, they were just the control cells so we would have a baseline comparison for our experimental conditions. We were so busy collecting data and prepping for our mutant studies that we never really took the time to analyze the wild-type cells. At the surface level, they built spindles and segregated chromosomes in a generally expected amount of time, so we focused on preparing for our upcoming experiments…. then March 2020 occurred.

The pandemic forced us to slow down and look more carefully at our wild-type data, and I am grateful for the detour.

My students headed home for spring break with a warning that there may be a delay in coming back to campus due to the spread of COVID-19. None of us were prepared for the shutdown that followed. Like many colleges and universities, our campus was closed for the remainder of the spring 2020 semester and the summer of 2020. My students and I began meeting on Zoom, trying to make a new plan for our research. The only data we had to work with were the microscopy of wild-type maize cells, so we decided to spend time digging more deeply into these movies. Originally, we had only measured the total time it took to build a spindle as it would be a baseline for comparison to our mutants. We had not looked carefully at any of the intermediate time points in the assembly process. When my students looked more closely at our movies, they discovered that wild-type cells built an incorrectly shaped spindle over 60% of the time!

We found that maize meiotic cells often built spindles with three poles instead of two, and they had to actively rearrange their spindle structure to correct this mistake. We also found that in these cells, there was a delay in meiosis as cells refused to progress until this correction had been made. This is an exciting discovery as it showed that plants are error-prone in their spindle assembly, much like human female meiotic cells. Our findings also suggested that meiotic cells were monitoring their spindle shape when determining if they should move forward in meiosis. Previous work has shown that cells monitor the attachment of chromosomes to the spindle to make this decision, but our work adds a new dimension, showing that they also monitor spindle shape. As we continued to analyze our videos, we also learned that cells corrected their spindle morphology in a predictable way. They always collapsed the two poles that were closest together, creating a single pole and resulting in a correct bipolar spindle.

The image shows the first page of the paper which can be accessed here.

My students and I had begun our scientific journey planning to breeze over wild-type cells, moving on to what we envisioned would be a more exciting story of spindle mutants. The pandemic forced us to slow down and look more carefully at our wild-type data, and I am grateful for the detour. I rediscovered my love of closely watching flickering green fluorescent lights, the dance of microtubules sliding into place or making missteps and shuffling into new arrangements. Watching life attempt a complicated process, make mistakes, and try again, is a lesson that never grows old. It reminds me that our scientific journeys are just the same, they start in one direction but are fluid and constantly changing, and hopefully, they end with a functional spindle!

Read the Published Paper

Weiss, J.D., McVey, S.L., Stinebaugh, S.E., Sullivan, C.F., Dawe, R.K., and N.J. Nannas. 2022. Frequent spindle errors require structural rearrangement to complete meiosis in Zea mays. International Journal of Molecular Sciences, 23 (8):4293–4312.

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ABOUT: Stories in Science is a special series on the Civic Science Times. The main aim is to document the first-hand accounts of the human stories behind the science being published by scientists around the world. Such stories are an important element behind the civic nature of science.

SUBMISSION: Click here to access the story guidelines and submission portal. Please note that not all stories are accepted for publication. After submission, we will let you know whether we have selected the story for the review process.

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