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SUSTAINABILITY| 11.06.2021

“Practicing medicine gives you a permanent reality check”

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Mar Córdoba, Head of Thoracic Surgery and Lung Transplants at the Puerta de Hierro-Majadahonda University Hospital, is currently one of the few women who lead surgeries in Spain. “Traditionally, there have been few female surgeons, so reaching positions of authority takes time.” She emphasizes, however, that medicine—in addition to being exciting—is eminently feminine and that her work is demanding and requires continual training. She is proud of everything she’s done throughout her career, especially “being able to treat people every day.” She also would have liked to learn how to play the piano or paint, where she could have used the same sensitivity and dexterity she uses to manage her team, perform operations and coordinate the transplant process.

Is there a feminine quality to surgery?

No. Women and men are equal in terms of education, skills and professionalism. I don’t think that we contribute any more or less. When we talk about a gap in STEM, science, physics or mathematics professions, medicine comes out on top. There are more women in college than men. We just surpassed them in number, exceeding 70 percent in schools, and in hospitals, more than half are women. In that sense, women have been contributing to medicine for many years, because it’s a career that is eminently female. So much so, we almost went the opposite way.

The gap is still remarkable in STEM careers, both in the public and private sectors. Why?
It’s because we started later. Everything takes time. Right now there are many men in positions of authority, but the time will come when that’s not the case. At least in medicine. But to achieve this, you need training, a professional career, progression… and with that, it’s true that we women have a greater challenge, because while we become more active and dynamic as we age, women reach childbearing age and have children. And most of the time, that means our career suffers. But we’ve achieved a lot… When I gave birth a few years ago, my husband had just two days of leave. Right now, younger colleagues have the same leave as their partner. That helps a lot.

How has your life been in this sense?

In general, we women have faced more challenges: finding balance in this work is complicated. There’s still a long way to go, but rights have been won. That encourages women and they enter the labor market in increasingly demanding professions, positions or specialties, where “you make life more complicated.” Sometimes, women have to choose more precarious jobs in order to make ends meet and balance work and family life. That’s why there’s a gap in many professions. There may be many women who have to choose specialties that allow them to have a better work-life balance. Women are less likely to go for on-call, late nights or endless hours in the operating room. Or they were. With more rights and parental leave, that’s changing. We won in that sense and we have to earn more, of course. 

 

“Robotics is going to be revolutionary for all surgeries”

How are scientific curiosity and STEM professions promoted in girls?

I would emphasize that there are two ways. Families have always had to encourage curiosity in girls in the same way they would with boys, without stereotypes. Girl don’t have to be nurses, nor do boys have to be doctors. Same for boys as astronauts and girls as teachers. I don’t know if that’s still the case, but that’s what my generation heard. I heard it. That doesn’t encourage curiosity. Then, school should not be gendered: not the classes, not the subjects or anything else. If everyone is treated the same, the same curiosity arises.

 

Did you have a calling since you were young?

I was studious but I didn’t know what I wanted to be. I went to a girls’ school for elementary and secondary school, I don’t know if it’s still around. Everyone has peers. I was encouraged to study, but there were a lot of stereotypes. In my family, I never had an issue studying, but perhaps my parents would have preferred me to choose a less demanding profession. I don’t think this is true anymore, but there was a time when parents didn’t want their daughters to get an education. Why? It was a waste of time. “If you’re going to get married…” Luckily, that’s behind us.

 What are you most proud of in your scientific career?

It takes a lot of personal effort, it’s a lot of time away from your family and from yourself. In general, doctors require constant training and it’s almost more than we’re able to absorb. Medicine is very demanding. I’m truly proud of all I’ve done, of all that’s happened to me in medicine. It’s exciting to me because, compared to other scientific careers, it’s also a liberal arts career. You’re not just a scientist: you’re a doctor. Every day, you work with people firsthand, with the sick, with their relatives. This is a special profession, because it gives you a constant reality check.

Which skills do you prioritize most when treating people who are suffering?

In order to treat the sick well, it’s important to be well trained and retrained to offer the best scientific evidence. Teamwork and group decision-making is critical. You never work alone, but with several surgeons, and of course you have to put the patient at the center of everything you do. You have to have a soft touch with the patient and their families. With COVID-19, we realized that the lung is a very important organ. I hope it will help us to lead healthier lives, to take better care of ourselves and to attract resources to health care. This pandemic, although unexpected, should teach us to take care of ourselves and adopt new habits.

How do you see health care in a decade? 

Prevention and self-care must be encouraged, especially in terms of diet and physical exercise, but always with common sense. I think we’re improving in that area. Our mothers or grandmothers worked a lot, but they didn’t exercise regularly, do pilates, go walking. Exercise is pretty mainstream and good nutrition should be taught in schools. It should be varied with reasonable portions. We have good raw ingredients here! You don’t need to eat all organic or super foods. And we can’t all choose where we live, but I hope that governments and citizens will adopt new living habits that will generate less pollution. And that’s going to be a challenge. Environmental pollution causes many people to die each year.

How important is digitization in a field like yours?

Digitization is essential in medicine. Now it’s much easier: we have patient test results instantly, those from other hospitals in the network… electronic medical records are essential. Before it was awful, with everything on paper. In terms of training and updating, we have so many references: the latest that comes out, all the health system protocols from around the world and from scientific organizations in every country on the computer, and that helps us move incredibly fast. With the pandemic, we discovered the importance of virtual consultations. Often, it’s not necessary for the patient to come in.

Inside the hospital, what has life been like in the last year?

We were all very concerned, especially during the first wave. Until protocols were put in place it was difficult and unclear. At first, COVID patients were prioritized, but also emergencies and oncology patients like ours are priorities for the most part, in addition to transplants, which are generally considered an emergency. So our thoracic surgeons haven’t reduced their working pace any less than before. 

What are the lung’s biggest enemies?

Of course, tobacco, environmental pollution in urban areas and radon—in areas where there are high emissions—increase the risks of lung cancer. Living healthy, eating well, not smoking, exercising and living in a non-contaminated home helps to ensure good lung health.

The way the research is going, is there anything you expect to be a milestone in combating lung disease?

In medicine, things change from day to day. Everything goes in fast motion… In lung cancer, immunotherapy combined with or without chemotherapy as a pre- or post-surgery step will be a major change from chemo alone. There will surely be much more progress. In my surgery, chest surgery, and in all surgeries, robotics is going to be a revolution. There’s going to be a lot of new things in transplants for sure. Right now, the preservation of organs is being widely researched. Soon they will be able to preserve them for longer, which will allow them to bring organs further, and they’ll be able to improve and treat them before they are implanted. We lose many organs, because they aren’t viable. What’s happening and what can happen in medicine is exciting.

What makes Spain a world leader in transplants?

Most importantly, donations and its fabulous national organization for many years. Coordination between hospitals and the generosity of people have resulted in very good numbers. It’s always improving. With lungs, there are world references such as the United States, Austria or Canada. Spain is in a very good position.