From a young age, it was very clear to me that I wanted to become a doctor. I never had a plan B. I was born in Nazareth, Israel, to a Palestinian family, and I owe a lot of what makes me who I am today to them. I come from a long line of hard-working visionaries and successful self-made businesspeople. They started as farmers, and with sheer determination and ability to see challenges as opportunities, they were able to improve their circumstances, serve their community, and grow their business into one of the oldest and largest privately held companies in the country. Hard work, integrity, honesty, and service are the values I was raised on.
Growing up as a woman in a conservative community and as a minority, it was clear that I had a lot of challenges and glass ceilings to break through in life. At a very young age, I learned the meaning of perseverance and the need to work three times as hard if I wanted to achieve my goals and aspirations in life. I was fortunate to have grown in a family that inspired me to fight for my dreams, make them come true, and know what it means to work hard and never give up. They have always been and still are my biggest supporters. I graduated high school with that sense of clarity and ambition and got into medical school with honors, followed by general surgery residency and then a vascular surgery fellowship.
Over the years, the role of my senior surgeons in educating me and mentoring me was imperative. I learned from them the value of leading and teaching at any level. It became clear to me that being an academic surgeon is my path. After finishing a vascular surgery fellowship in Israel and achieving board certification in general and vascular surgery, I was accepted to CV Surgery at McGovern medical school at UTHealth for the advanced aortic fellowship, a world-renowned program in this field. The "working harder than expected" mentality stuck with me through life. I learned how to perform complex aortic surgery, lead multidisciplinary meetings and teams to discuss and plan care for patients with complex aortic pathologies, and ask questions that would lead to more research to improve our knowledge and, eventually, our patient care. So, when I completed the aortic fellowship and joined the CV Surgery department as faculty, I began taking on responsibilities as an academic surgeon; I continued leading research and writing papers focusing on aortic disease. I believe strongly in the power of education. It is the way to change the world; it changes people's minds and leads society towards change, improvement, and growth. Academia in medicine saves lives; it allows us to keep searching for new treatments, techniques, and solutions and continuously advance our profession. Three years after joining the department, I became the Program Director for Advanced aortic surgery and structural heart fellowship. This role gives me the opportunity to help shape future aortic surgeons. while implementing the values of diversity, equity and inclusion when choosing the next aortic fellow.
As one of my mentors, Dr. Safi, had said to me once, “you don’t always choose what your niche would be, sometimes it chooses you, and you get there by chance.” For me, it was a female patient that I treated in 2017 who presented with a complicated type B aortic dissection one-week post-partum. This experience made me take a deeper dive into cardiovascular and aortic diseases in young women, specifically pregnancy-related. I was shocked by how little I knew about the existing disparities and gaps in knowledge. In October 2018, I started the Women’s Vascular and Cardiac Health Interdisciplinary Initiative “WVACHII,” which later was formalized into the “WVACHI” Center. “WVACHI” Center includes a group of physicians from different specialties; Cardiothoracic and Vascular Surgeons, Adult Congenital Cardiologists (adult congenital, heart failure, cardiac imaging), Maternal-Fetal Medicine specialists, Pulmonary Critical Care physicians, Medical Geneticists, Vascular Neurologists, and Clinical Epidemiologists. Through collaborative research and clinical work, our goal is to eliminate knowledge gaps and clinical disparities and reduce the morbidity and mortality of CVD in women. Understanding the causes of those disparities might lead us to develop sex-based management guidelines for aortic disease, improve the existing technologies to become more suitable for female anatomy, or focus on social determinants of health as the primary influencer on outcomes of patients with aortic disease.
During my fellowship and in the years to follow as an attending, I participated in many national and international meetings presenting our work on aortic disease and often found myself to be the only woman presenting in the complex aortic sessions. At first, I wasn’t sure of the reason, and as a newcomer to the United States, I naively assumed that there weren’t many women who did aortic work, surely it is not because of issues such as women’s rights and equality! However, as I got to meet more fellow vascular surgeons in the US, I started hearing all the stories of the micro and macroaggression that many other female surgeons encounter. I realized that despite the tremendous progress that has been made in the last 50 years in medicine and surgery, there still remains much to do for us to become a more diverse and inclusive community.
When I reflect on my short journey, I realize that the intersectionality of growing up as a woman in a conservative community and a minority and having to challenge much of the status quo to reach my goals and dreams has definitely prepared me for my life as a surgeon. However, that alone is not enough; I have been fortunate to have many supporters, allies, mentors and sponsors. Some were women, but many were men starting with my family, and continuing throughout my life and career. Through them, I learned that being a true ally means listening, believing, and advocating for a change despite the discomfort. I also learned that sponsors could help improve our visibility and provide new opportunities for advancement beyond the mentorship and guidance. We all need to be part of the solution.
In this, to all the women in vascular surgery who paved the way for me and many others, because of you, we dared to dream, thank you.