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RJOS President Christen M. Russo, MD, Celebrates 40 Years of Promoting Women in Orthopaedics

Please note: The following article is the speech Christen M. Russo, MD, FAAOS, FAOA, president of the Ruth Jackson Orthopaedic Society (RJOS), delivered at the RJOS Annual Meeting and 40th Anniversary Event on March 7 , 2023 in Las Vegas, Nevada.

Good evening Ruth Jackson members,

I am here today to reflect on the past 40 years, opine on the present and impress upon you the next 40 years to come.

40 years ago, at the academy meeting in 1983, a group of women got together for a luncheon – there were about 20-30 of them, and some of them are here now. Yolanda Roth & Claudia Thomas – could you please stand?

40 years ago, many of the women in this room were not born. I was just born – and so, like RJOS, I am 40.

I am 40, RJOS is 40 and I am wearing a crown. A little more on that as I go on.

First, our History

RJOS was founded in 1983 as a support and networking group for the growing number of women orthopaedic surgeons. The women at the first meeting felt that there were many common problems confronting them, which could best be solved by pooling resources. These range from sharing technical solutions for practice problems to how to survive motherhood and orthopaedic practice or residency at the same time.

Ruth Jackson, the first board certified female orthopedic surgeon. She was told she could not join the Academy and could not take her boards. She was told NO. So what did Dr. Jackson do?
She did what I any of us would have done. She ignored the no. In fact, she deliberately did the opposite of what she was told. She smashed the patriarchy!
She took and passed her boards. She joined the Academy.
Dr. Ruth Jackson was the first – and look around – she certainly was not the last. I do not have to ask how many of have been told no and did it anyway – I know the answer. All of you.

Dr. Jackson said that she never meant to be famous. She just did her work and “paid attention to the little things.”

And now we are celebrating 40 years of an organization named for Ruth – and I feel more than honored to be up here – I feel empowered. I am a girl from a tiny Brooklyn neighborhood famous for another Ruth – Ruth Bader Ginsberg. I trekked 90 minutes to my math & science high school in Manhattan where it was normal, commonplace and expected for girls to excel in STEM. I was the first in my family to go to college and still am the only one to go to medical school. I trained at SUNY Downstate and Kings County Hospital. I had a stairwell I would retreat to – to cry – as a resident.  Never in my wildest dreams did I think I would be standing here in front of you all now – and let me tell you –  I got here by hearing “no” a hell of a lot. And, just like Ruth, I did not take no for an answer – again and again. Tonight, I hope to empower each of you, the way Ruth Jackson has empowered me.

The last 40 years of RJOS have been generously dedicated to recruitment – getting women here – and we have done that.

The needle is moving:
1983 – 42 RJOS members
2023 – 1400+ members

That’s over a 3,000% growth in membership. And we should have more members – there are estimated to be 2000+ practicing female orthopedic surgeons in the US.

Most RJOS members are students and residents – and many of them do not continue their memberships as active members. Young women here tonight – please remember sitting in these seats as trainees – because we need your support as active members to keep our future thriving.
This year 20% of ERAS orthopedic applicants were women. And RJOS member Selina Poon has taught us that stat means 20% of residents next year will be women. Thank you, Selina, for all of your work in this area.

So, 40 years later – we are here. We will not stop our recruiting efforts, but our focus is now expanded. We brought you here – and here, well there are a lot of present issues we need to talk about.

So, back to this crown. When I look out at all of you – I see your crowns – you are queens or kings or non-binary royalty. You fought your way here – or fought for someone else’s way here. I see the crowns of warriors.
No one in this room is innocent to battle – to strategery, to victory, to defeat, to scars. I can see it in your crown – the jewels and the tarnish. You are strong, your crown is beautiful and you wear it well.  But just because you carry it well doesn’t mean it’s not heavy. Sometimes it is too heavy, and so now I encourage you to take your crown and put it down.

We all just put down different things: promotion, infertility, unfair call schedules, missed opportunities, unfinished grants, family health issues, children we don’t see enough, financial hardship, unsuccessful matches, matching, applications, research stalemates, miscarriages, divorce, being told you are too much – too bossy, too quiet, too energetic, too feminine, too masculine. Every person in this room has something heavy to put down. I know you are strong enough to hold it. But put it down – because the women in this room, our male allies, our non-binary colleagues, 40 years of RJOS – we are all here to help you carry it from now on. I want this to be a safe space. This room now, is not a safe space for everyone.

If you don’t know me, and you were not sure if this was going to get uncomfortable, rest assured: it is about to. Because being uncomfortable is the only way to change. The Ruth from Brooklyn, RBG said, “Real change, enduring change, happens one step at a time.” 

So put your heavy crown down and take the first step with me – I promise it will be good for you.

Women have so many incredible gifts – and one of the best is connecting and networking.

One of the worst is pettiness and grudges. Truth: I went into orthopedics to get away from women – because some of the worse “gifts” women have:– I was done with; in fact, all of my life I ran away from women to avoid this. And now, I find myself in the medical specialty with the lowest percentage of women and I am ready to put my ladypod crown on – and I am faced with this uncomfortable truth about women. Many of you have grudges/beef/problems – with one another. I do not know the history of these conflicts – but I do know they exist – and there are even more that I am not privy to. I am asking you, pleading with you: Squash it. Stop it. We can not get stronger this way. We can not compete with the men if we are fighting and competing with each other. If you are keeping another woman down you are keeping all of us down. If you are holding someone back, you are holding all of us back. Be kind, her crown is heavy, too – just like yours. To those who feel they have been the one scorned, you need to forgive, too. Real queens straighten each other’s crown without telling them it was crooked in the first place. Be that queen.

Tonight, as we celebrate the last 40 years we attempted to gather all the past presidents of RJOS – our ladypod royal family – which is a wonderful thing – but did you realize all of them are white women? We did – but it was too late. Like the parade of grey white men we often walk past on our hospital walls, we fell victim to the sins of our mothers. In this mission to highlight our triumphs we are also keeping our sisters of color down. To ignore the intersectionality that exists for many women in RJOS is wrong – we learned that last year, right? When Victoria Alexander took the stage with an amazing panel of intersectional diversity: race, sexual orientation, ethnicity and gender. And we do want to celebrate our past – we are in no way devaluing what these 39 presidents have done for women in orthopedics – and we also want you to know we are consciously looking toward our future In four years, there will be a non white President of RJOS, and just like Ruth Jackson – she may be the first and I know she will not be the last.  

There is someone sitting at your table who has had an abortion, or a miscarriage, or has reproductive challenges. I am sorry you had to go through that. The truth is, we have welcomed women into this profession – encouraged & recruited them – told them they could do this – and now we are dropping studies about infertility and how hard it actually can be to get and stay pregnant as an orthopedic surgeon. We are also recently faced with restrictions that have been placed on our reproductive rights. Now more than ever, we need to start talking earlier about the reality of family planning and the difficulties that may arise. We need to initiate the conversations about egg retrieval and reproductive endocrinology before it is too late. And then we need to get to our male allies on board: program directors, partners, chairmen – we need to educate them – about women residents and colleagues needing to obtain medical care related to these issues. We need to make them uncomfortable so that this can be more comfortable for women in orthopedics for the next forty years. We need more male members of RJOS so that this is on their radar – so they get the emails, see the social media posts and ask us questions. What if every person in this room got one male ally to join RJOS? I challenge you to that.

We need to share our successes – celebrate the pregnancies and the babies. Support our new mothers – birthing parents, co-parents, adoptive parents – we need to have the hard conversations about maternity leave and compensation. Many of us are, or will be, the first woman in a practice. Many of you are, or will be, the primary breadwinners for your families. I do not want you to have to choose between caring for your newborn and your RVUs. These waters are not murky, they are merely unchartered – and together we can navigate through them.

“Most of our medical students who are here today are supported by scholarships.”

Orthopedic surgery is expensive. Getting to orthopedic surgery is expensive. Trying and failing to get to orthopedic surgery is expensive. Poorly paid research years, post-bacc programs, unpaid summer orthopedic experiences, traveling across the country for in person interviews – the cost is unknown and astronomical. The time spent on these activities also advances maternal age, eating away the healthiest time of women’s lives. All of this favors the continuation of the past – the legacy of orthopedic surgery reigns – upper middle class white male orthopedists – who can afford to jump through these hoops. Perpetuation of this pattern is hurting women and others underrepresented in orthopedic surgery. What can we do? What can you do? We can financially support scholarships for URM students for summer research, acting internships. If you are in private practice, you can host a woman or another underrepresented student during office hours – you can buy lunch or pay for their RJOS membership. Most importantly, we can all talk about this – the unspoken privilege that not everyone has. I know it is uncomfortable now – as it surely was for Ruth Jackson in 1937. But she pushed the boundaries, she refused to take no for an answer, she cared about the little things – and we should do the same.

Your crowns – your heavy crowns – are made up of these little things that Ruth Jackson speaks of – the jewels of your crown.

It is time to pick them up and put them back on – it is time to polish those jewels (with sweat, or sometimes tears) – and acknowledge the jewels of your own crown. Who are they? What are they? Have you said their names or thanked them recently?

I want to take these last few moments to acknowledge the jewels of my crown – the royalty that has supported me here.

  • Diana Lau, my co-resident who likely had her own stairwell in cry in. Whoever is sitting next to her, please help me convince her not to leave our field.
  • Monica Payares, who made a crown with me @ our last RJOS mtg in Vegas, and has been on this crazy ladypod pedipod journey with me from NYC.
  • Anna Cohen Rosenblum, who has been making me laugh since we pumped together in the Venetian lactation room 4 years ago.
  • Lisa Cannada, my fellow tiger mamapod, our reciprocal venting sessions are both diagnostic and therapeutic.
  • Nicole Belkin, my orthopedic partner at Columbia, who has taught me I am worth more and that I should not be afraid to ask for it.
  • Linda Suleiman, who will stand here in 4 years as the first black president of RJOS; thank you for keeping me in check and helping me understand how to be a better ally.
  • Liana Tedesco, current chief resident at Columbia – friend, fellow mom, leader – sometimes I wish I could go back to residency and do it with the grit and grace that you have taught me.
  • Julie Samora, who has the biggest footprints in the orthopedic world and has let me literally step in them for the last 7 years.
  • Alexe Page, who recognized I should be on this presidential line even when I did not.
  • Dawn LaPorte, my sounding board and cheerleader.
  • Bill Levine, my chair, RJOS member, RJOS board member, He for She winner, who realized this girl from Brooklyn was the right fit for his paradigm shift at Columbia 7 years ago.
  • My husband, Michael Nicoletti, also a musculoskeletal physician, who has never denied me the opportunity to wear a crown.

Thank you to my royalty – for making my crown, for polishing my crown, for straightening my crown – I am committed to doing the same for so many of you in the next 40 years of RJOS.

The next 40 years?

I am not sure what it holds – but I am empowered to be part of the future herstory of RJOS. Right now, I look forward to next year – the launch of local RJOS chapters, the rise of male allies, an RJOS leadership retreat, a book club this Spring, and the launch of the first ever RJOS auction – tonight. I am not here for lip service, I am here to earn more jewels, I am here to polish my crown with sweat.

And now, as you and I put our crowns back on and we pick our heavy thing back up, I want to leave you with the words of both Ruths:

“Do the work and remember the little things.” – Dr Ruth Jackson

“So often in life, things that you regard as an impediment turn out to be great, good fortune.” – Justice Ruth Ginsberg

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