The Ruth Jackson Orthopaedic Society (RJOS) Dr. Jessi Block Courage Award is awarded annually to an RJOS member who demonstrates strength and integrity in the face of everyday obstacles. The definition of courage is “the ability to do something that frightens one” and “strength in the face of pain or grief.” Courage is a conscious choice and a willingness to confront a difficult situation. As health care professionals, we become aware of, or are witness to, or are the victim of unethical practices. At some point, what is witnessed may be too hard to ignore, and someone steps up and calls out what is wrong. That takes courage and sometimes comes at a great cost.
(For context, women remain significantly underrepresented in orthopaedic surgery despite gradual progress in recent decades. While women now make up about 51 percent of U.S. medical students, they represent only about seven to eight percent of practicing orthopaedic surgeons, making orthopaedics the least gender-diverse specialty in medicine. The training pipeline is improving, with women comprising approximately 20 to 22 percent of orthopaedic residents, up from around 15 percent just a few years ago, but this still lags behind other surgical fields. Representation also decreases at more senior levels: Women account for roughly 20 percent of orthopaedic faculty and a smaller proportion of leadership roles such as program directors and department chairs. Although mentorship initiatives, exposure programs, and increased visibility of women in orthopaedics are helping expand the pipeline, substantial disparities remain, and continued efforts are needed to promote equity and representation in the field.)
This year, I nominated my resident, Dr. Cristina DelPrete, for having the courage to show up to orthopedic residency pregnant. Dr. DelPrete began her intern year three months pregnant and completed her first six months of the year on the orthopedic service. During her orthopedic rotations, she took all of her required intern call, saw consults expertly, worked clinic, and did not miss a conference, lecture, or workshop. In the last few weeks of pregnancy, she appropriately escalated concerns of long days in the operating room on the arthroplasty service, and I met with the chief residents to safely tailor her schedule. Her (or her daughter’s) timing was impeccable; she gave birth to a healthy girl as her last month of orthopedics was closing in.
Dr. DelPrete took her ACGME/ABOS allotted leave of six weeks and returned to work. She continues to shine in a way that often awes me speechless. She is so attentive and efficient at work, perhaps in a way that only a new mom can be, and also is so present at home with her family. Dr. DelPrete has not shied away from the reality that the struggle is real, and yet somehow she incorporates her new residency family into her new biological family (her daughter says good morning and good night to pictures of Dr. DelPrete and her co-residents, picking her favorite of the day).
The outcome of Dr. DelPrete’s courage is happening live, now, and will continue to unfold in our future. Her courage is for every one of us from this generation and older who feared sharing our pregnancy news. For those who shared and were met with anger, disappointment, negativity, or inappropriate comments. For those who shared and were retaliated against, those who lost their job, those who were passed up for positions, and those who were no longer accepted by the boys’ club. Her courage is for every one of us who struggle with infertility because we waited to have babies. For every one of us who miscarried. For every one of us on bed rest. For every one in pre-term labor. Days and nights and weeks and months in the NICU. Written boards. Oral boards. Short maternity leaves, no maternity leaves. Surrogates. Adoption. Twins. We host panels and tell women to be aware of their reproductive rights, to have babies younger, to freeze their eggs, to listen to their bodies. Thankfully, stories that were once whispered are now shared, but we provide these words of advice based on our own poor experiences. They are usually not happy tales.
Our words were heard, and I am so thrilled that now we have action: We have real stories, we have women who are doing it, women who have the courage to do it, and that should be celebrated. I am not sure Dr. DelPrete’s courage story yet has an outcome, only the promise of an outcome, that the next generation of women in orthopedics will share stories of having children that are not nightmares, and instead, will share fairy tales with proud enthusiasm rather than hiding them in shame.
To Ruth Jackson, it took immense bravery to show up to orthopedic residency as a woman. With the help of her and this society, we changed that narrative over the past 70 years. Now, it takes immense bravery to show up to orthopedic residency as a pregnant woman. I do not know what the future holds, and I can only hope I am here to find out. Dr. DelPrete is the courage we need in our field to shatter the next ceiling.
Christen Russo is a pediatric orthopedic surgeon.
