SALLY LANGLEY

From single mum to surgeons’ leader

Sally Langley’s violin teacher shattered her dream of becoming a professional violinist when she was 16. She did not play well enough for that, he told her, and would become a doctor like her father instead.

Decades later, Langley still loves playing the violin. She has even played at orchestra level a few times.

She also this year became the first New Zealand woman to be president of the Royal Australasian College of Surgeons (RACS) in the college’s 49-year history.

Her father might have been a doctor and her mum a nurse, but the path to a successful medical career was not without challenges for the Christchurch plastic surgeon.

At 17, Langley gave birth to her son Sam. This did not put off the Christchurch Girls’ High School student starting medical training, at a time when the profession was dominated by men and sexism was rampant.

Surgery is still male-dominated today. Only about 15 per cent of RACS members are women. Specialities such as paediatrics and plastic surgery have increasing numbers of women, but others, like orthopaedics and neurosurgery, struggle to reach equality.

A 2018 qualitative study of 14 senior female doctors in their 30s in New Zealand found they felt discriminated against for having children, for how often and how hard they worked, and, at times, simply for being women.

Respondents said they were often mistaken for nurses because patients still ‘‘expect to see a man’’.

Research published in the Journal of the American Medical Association (JAMA) in 2017 found that of 5782 physician mothers, 35.8 per cent had experienced maternal discrimination.

Female physicians also reported experiencing high levels of burnout, and gender bias from patients and colleagues – men and women.

Langley says the college is trying to increase the number of women surgeons, as well as promoting diversity, but there is still ‘‘a long way to go’’.

So imagine what it was like in 1975, when Langley set off for medical school in Dunedin with a toddler in tow, and as a single mum until she met her husband in the early 1990s.

‘‘I don’t know what other people thought. I let it slide off me. I didn’t register it.’’

After Sam was born, Langley finished high school through correspondence school. She credits her chemistry teacher Margaret Austin, who later became a Labour MP and a minister, for encouraging her, taking her to university science lectures and giving her advice.

Langley did her first year of university in Christchurch while living with her family, who helped look after baby Sam. He stayed with her parents for her first year in Dunedin and joined her the second year.

‘‘It was fine. I took him to a creche every day. He was well-behaved. It’s easier to stay home and study with a small child,’’ she says.

By the time she reached the high-pressure registrar years, Sam was already 10.

Langley did two of her registrar years at Auckland’s Middlemore Hospital, working an average of 80 hours a week, away from her family and with no money to pay for a babysitter the first year.

How on earth did she make it through the long hours, early starts, undefined finishing times, and on-call requirements?

‘‘I wouldn’t say I did it the hard way. I just did it.’’

Langley and her son lived in a one-bedroom flat for health staff across the railway line from the hospital (they would not let her have a twobedroom flat because she was not married, she says).

Sam looked after himself after school until his mum came home around 5pm, and they would go to a playground, the swimming pool or for a bike ride. If she had to work late, ‘‘lovely neighbours’’ kept an eye out for Sam.

She would pop over across the railway line through the evening to check on him.

‘‘It was always difficult getting off to school and getting home on time, but he was always a good little boy,’’ she says. ‘‘It is probably more straightforward if you have a partner who looks after the children at home.’’

Langley says she never demanded any flexibility to look after Sam after school, when he was sick or during school holidays. She felt like the slightest demand would be noticed more because she is a woman and a mother.

‘‘You didn’t want to be seen as taking excessive leave and have it held against you. I didn’t know to ask.’’

Times have changed, and people are more aware of their entitlements now, which is a good thing, she says.

‘‘People like me who are seniors should be making sure we allow our colleagues to take leave to look after their children or elderly parents.’’

Sam turned out fine, although ‘‘still quite aware that I was at work a lot’’.

Langley laughs as she recalls the time she invited a friend for dinner and was called in to work just before her friend arrived. Sam was 14 and just cooked dinner for her friend – tomato soup out of a can. ‘‘I did try my best to make up for it. We did go to a lot of playgrounds, activities, bike rides. I spent all my free time with him and do any study required after he would go to bed.’’

For about 10 years in her 30s and early 40s, Langley was the country’s only female plastic surgeon. Now, she is about to turn 65 and there are about 18 women plastic surgeons out of a total of about 80.

Langley’s appearance, tone of voice and opinions are neat, measured and humble. She is well aware of the challenges women face in her profession, but shrugs them off on a personal level.

‘‘I know some surgeons I have worked with were quite old-fashioned, but they have come around. Once you work with them, and they get to know you, it’s OK.’’

Langley is unruffled, which is probably exactly what you want in a surgeon.

Her work has covered the whole spectrum of plastic surgery, including craniofacial, cleft lip and palate, head and neck, paediatric, reconstructive including microsurgery, hand surgery, as well as skin cancer and breast surgery.

She does very little cosmetic surgery and loves the dramatic improvement in people’s lives she can make through her work.

She has reconstructed people’s hands, faces and breasts after they experienced severe burns, had their fingers chopped off in an accident, or had cancer.

‘‘One man had his ear bitten off. We put it back on with major surgery. We joined up the major blood vessels and reattached the ear. The man got a perfect ear after that,’’ she says with a humble chuckle.

Plastic surgeons need to adapt their skills to every part of the body, and multiple conditions, unlike other specialities such as cardiology or urology, which are localised to a part of the body. ‘‘We apply our wound care, reconstructive tissue layer and microsurgery skills to whatever problem comes to us.’’

For the last 20 years, Langley has held leadership roles in clinical practice and is clearly highly regarded by her predominantly male peers. With quiet determination, she is committed to improving outcomes for women, indigenous people and increasing diversity in medicine.

‘‘Some of our surgeons have not been wellbehaved with respect to the role of women in surgery. We are addressing that through diversity and inclusion programmes.’’

Sexual harassment is the ‘‘worst end of the range’’ and is taken seriously when reported, she says.

‘‘I always feel very concerned and upset to hear of incidences of sexual harassment or preferencing of men for academic roles. We have to make sure there is no bias on sexual, ethnicity, religious or other grounds.’’

‘‘I don’t know what other people thought. I let it slide off me.’’ On being a sole parent at medical school