Letter to a Young Female Physician: Thoughts on Life and Work

by Suzanne Koven

Overview

"A warm and wry epistle, the endless and near-perfect email you wish your mother, your mentor and your therapist would sit down and type out together." —Laura Kolbe, Wall Street Journal

In 2017, Dr. Suzanne Koven published an essay describing the challenges faced by female physicians, including her own personal struggle with "imposter syndrome"—a long-held secret belief that she was not smart enough or good enough to be a “real” doctor. Accessed by thousands of readers around the world, Koven’s “Letter to a Young Female Physician” has evolved into a deeply felt reflection on her career in medicine.

Koven tells candid and illuminating stories about her pregnancy during a grueling residency in the AIDS era; the illnesses of her child and aging parents during which her roles as a doctor, mother, and daughter converged, and sometimes collided; the sexism, pay inequity, and harassment that women in medicine encounter; and the twilight of her career during the COVID-19 pandemic. As she traces the arc of her life, Koven finds inspiration in literature and faces the near-universal challenges of burnout, body image, and balancing work with marriage and parenthood.

Shining with warmth, clarity, and wisdom, Letter to a Young Female Physician reveals a woman forging her authentic identity in a modern landscape that is as overwhelming and confusing as it is exhilarating in its possibilities. Koven offers an indelible account, by turns humorous and profound, from a doctor, mother, wife, daughter, teacher, and writer who sheds light on our desire to find meaning, and on a way to be our own imperfect selves in the world.

Product Details

ISBN-13:	9781324021902
Publisher:	Norton, W. W. & Company, Inc.
Publication date:	05/03/2022
Pages:	320
Sales rank:	341,210
Product dimensions:	8.10(w) x 5.40(h) x 0.90(d)

About the Author

Suzanne Koven is a primary care physician and the inaugural writer-in-residence at Massachusetts General Hospital. Her writing has appeared in the New England Journal of Medicine, Boston Globe, and other publications. A faculty member at Harvard Medical School, she lives near Boston.

Table of Contents

Author's Note ix

Introduction: Letter to a Young Female Physician 1

1 Risk Factors 7

2 Prerequisites 17

3 Admissions 22

4 Clinical Skills 28

5 Mnemonics 33

6 We Have a Body 37

7 Things Shameful to Be Spoken About 59

8 Lineage 65

9 The Last Three Pounds 84

10 Mom at Bedside, Appears Calm 112

11 Curbsiding 117

12 An Inherited Condition 138

13 The Disease of the Little Paper 164

14 The Noncompliant Patient, Reconsidered 171

15 The Hateful Patient, Revisited 176

16 The Doctor's New Dilemma 180

17 Off the Charts 185

18 Head and Shoulder 196

19 Sequelae 201

20 Science and Kindness 212

21 Bury Me in Something Warm 226

22 Extension 238

23 Mixed Emotions 262

24 They Call Us and We Go 272

Epilogue: Women in STEM 278

Acknowledgments 285

Notes on Sources 289

Editorial Reviews

"In Letter to a Young Female Physician, Suzanne Koven charts both the real and the spurious demands that the medical system makes on those who become doctors and care for us all. Her memoir is by turns reassuring and disturbing, comical and tragic, hopeful and dire. Medicine has advanced, but the particular difficulties facing young physicians have grown no less steep, and the impediments women continue to face even as they take a majority place in medical schools are considerable. Koven writes with style and wit and grace—but, more significantly, with insight and compassion."

Andrew Solomon

"Suzanne Koven has written a remarkable memoir about her life as a doctor that is at once heartwarming, poignant, and breathtaking in its precision; this is a book about the essence of medicine, and will be invaluable to any doctor. But in its compassionate reflections on caring for the human body, it is also a book about life, and what makes a good one. I couldn’t stop reading."

Meghan O’Rourke

"[These] phenomenal essays...are full of acuity and generosity... [Koven's] writing is full of humor, candor, by turns (and often simultaneously) beautiful and heartbreaking shards of narrative, about her own life and the lives of her patients and colleagues. She’s also got a killer sense of humor and a fantastic eye for detail."

LitHub - Leslie Jamison

"Suzanne Koven’s Letter to a Young Female Physician is so wise, beautifully written, tender, and full of heart that it should be required reading for every person—young, female, physician, or otherwise. This is a transporting memoir, and an instructive one."

Dani Shapiro

"[Koven] is rueful and delightful and keeps on building a careening and fascinating life... [Letter to a Young Female Physician] is a warm and wry epistle, the endless and near-perfect email you wish your mother, your mentor and your therapist would sit down and type out together."

Wall Street Journal - Laura Kolbe

"Funny, touching, and self-deprecating... [A] thought-provoking and inspiring memoir."

Booklist

03/15/2021

Physician Koven expands her New England Journal of Medicine essay, which chronicled her struggle with imposter syndrome, into a vulnerable if often frustrating memoir of a life and career spent continually questioning her place and abilities. Her doubts formed from childhood; her mother started law school “after years as a housewife” when Koven was a teenager, and quizzed her daughter on legal dilemmas but also passed down her obsession with dieting. Her father was an orthopedic surgeon, but he “didn’t encourage... nor discourage” Koven’s medical ambitions. Perceived missteps and failures weighed heavily on Koven’s recollections of med school and her entry into the field when she joined Harvard Medical. (“I don’t understand the pancreas!” she wails to her husband.) She worried that she might “kill someone” or just “look foolish,” and blamed herself for not diagnosing her own mother’s heart attack. She calls out sexism—when appointed chief resident at John Hopkins, she gets called the “token woman”—but also recounts moments of connection, such as hugging a belligerent dying patient who had been labeled a “pain” on the ward, but as Koven writes, the woman was “her pain.” The insidious nature of insecurity in women’s professional identities is on full display here, and will land as painfully familiar for many readers. (May)

Publishers Weekly

04/09/2021

Following in the path of Richard Selzer's Letters to a Young Doctor and Perri Klass's Treatment Kind and Fair: Letters to a Young Doctor, Koven, a primary care physician (and daughter of another physician) who teaches at Harvard Medical School and is a writer-in-residence at the Massachusetts General Hospital, directs her book's thoughtful and honest essays to women entering medicine and flags some of the challenges they may face in a demanding field. Drawing inspiration from Selzer, as well as from her father's medical career, Koven recounts what drew her to medicine and the obstacles she faced along the way, including enduring misogyny at the hands of fellow students. Her debut covers imposter syndrome (doctors' doubting their own intelligence or ability), discrimination, harassment, pay inequity, and work-life balance (working while pregnant, or while caring for elderly parents). Young doctors-to-be face many challenges; some are gender-specific, but Koven's most important advice (which patients and their loved ones might also appreciate) is gender-neutral: "My dear young colleague, you are not a fraud." The author also touches on her own privilege and discusses the medical racism that her Black colleagues regularly endure. VERDICT A candid account that will spark the interest of aspiring physicians.—Marcia G. Welsh, former with Dartmouth Coll. Lib., Hanover, NH

Library Journal

2021-01-23
Graceful reflections on being a female doctor by a longtime primary care physician.

Koven, a Harvard Medical School faculty member and writer-in-residence at Massachusetts General Hospital, builds on the tradition of Richard Selzer’s Letters to a Young Doctor in a collection of personal essays, some published in the New England Journal of Medicine. As a medical student, the author learned that a senior doctor saw her presence on a urology rotation as “pointless” because “no self-respecting man would go to a lady urologist,” and sexism persists in her profession: Female physicians earn $20,000 per year less than their male peers, hold fewer leadership positions, and face sexual harassment ranging from “bro” humor in operating rooms to abuse severe enough to cause some women to switch careers. Yet this book is no rant against a field Koven clearly enjoys. Writing without rancor and with self-deprecating humor, the author debunks myths (it’s untrue that nurses dislike female doctors—“nurses were, in fact, especiallysupportive of us new women MDs”) and suggests how she has avoided such perils as burnout (she began working part time when her children were young and didn’t expand her practice as they grew). She also ably describes how her work affected her care for her parents and her childbearing years (she spent part of her first pregnancy at home with preeclampsia, “my dangerously high blood pressure no doubt caused by my long work hours”) and why she volunteered to help in a Covid-19 clinic. Less effectively, she argues that a female doctor faces an obstacle “more insidious” than sexism: the fear that she’s a fraud, or “imposter syndrome,” a pop-psych term that may strike some readers as glib or anti-feminist in its implication that self-doubt could be worse than sexual abuse or being denied raises or promotions. Nonetheless, Koven’s down-to-earth message is likely to win over skeptics, as she learned “that I can only be who I am. And that this is OK.”

A fine graduation present for a newly minted female M.D.

Kirkus Reviews