Neurosurgery can be a demanding field, requiring a physical and mental commitment that must be sustained over decades. Even for those in peak condition, the challenges of clinical practice can be daunting, and it is easy to take for granted the abilities used for routine tasks. Over the course of her career, Dr. Karin Muraszko has made the journey from aspiring medical student, to resident, attending, and now Chairman of the Department of Neurosurgery at the University of Michigan, all while facing additional challenges associated with physical disability. Along the way, she has blazed many trails, including being the first woman to serve as director of the American Board of Neurological Surgery, President of the Society of Neurological Surgeons, and chairperson of a neurosurgery department in the United States. Though she has encountered many of the familiar obstacles we all face during our training and transition to independent practice, the added difficulties associated with spina bifida have given her a unique perspective on the field of neurosurgery. Below are paraphrased excerpts from a discussion with Dr. Muraszko:
What inspired you to pursue a career in neurosurgery?
For me, neurosurgery was always about the brain, and though I initially was interested in a career in psychiatry, I knew that I loved anatomy. At the time, not many women had applied to neurosurgery. I remember meeting with a mentor of mine and being told ‘the kinds of things you would need to do’ to be a competitive applicant, most of which were meant to prove that I had resilience. A year later I had checked off all the boxes, and returned back to ask, ‘ok, now why not?’
As much as I love neurosurgery, I recognize that it isn’t for everyone. There are many kinds of problems you see in neurosurgery, with a great deal of complexity and often sadness. There has to be an innate excitement within you to do this. People who love it never grow tired of it.
What have been some of the challenges you faced in your career?
The largest difficulty was actually being short, since this required me to constantly balance on step-stools in the operating room to adjust to the height of my colleagues. During residency, two of the faculty at Columbia helped build me a motorized standee that made a tremendous impact in my career, allowing me to stand at the table with adequate support and without fear of falling. I’ve used it for most of my career as a neurosurgeon, and it has worked beautifully. It is amazing how such a simple design can have a large effect.
How are we doing as a field in adapting to physicians with disabilities?
I have noticed that older neurosurgeons start to appreciate the life of someone with disabilities. Though, I don’t think we have made it a warm environment yet. Those who enter our field with disabilities must adapt to the demands around them. There are relatively few places around the country that have excelled at providing support.
I think we have made more progress with respect to women, but there is still a long way to go. Disabilities will likely be one of the last bastions where people seek to change and grow, but it may be coming as surgeons get older. If really smart and talented people have disabilities, we would be foolish not to have them as a part of our brethren.
What advice would you give to aspiring neurosurgeons who have disabilities?
You have to ask yourself if your passionate about it. Do you have the talents to do it intellectually? Have you thought about the support structures that you will need in place to operate safely, without burdening others? At the end of the day you must be able to offer a cogent argument as to why the neurosurgery community should invest in you, what special abilities you can bring to the table. In the end, all neurosurgeons must be able to safely take care of their patients, and if a surgeon requires some accommodation to accomplish this, it should be considered.
