A Trailblazer in Neurosurgery: Dr. Justine Pearl's Inspiring Story
With each passing decade, the dreams of young women grow bigger and more ambitious. For Justine Pearl, MD, a dream that started as a small-town doctor soon morphed into something much more specialized: Neurosurgery.
Historically, men have dominated this specialty – a trend that is slowly changing. In 2008, the Women in Neurosurgery Society (WINS) outlined a goal that by 2020, women would make up 20% of practicing neurosurgeons. Today, just over 8% of neurosurgeons in the U.S. are women.* Dr. Pearl is the only female neurosurgeon practicing in Northern Michigan.
Originally from Montreal, Canada, Dr. Pearl relocated to Michigan and joined Munson Healthcare in 2020. We recently sat down with her to learn more about what prompted her to choose neurosciences, what a day in the life looks like for her, and her advice for aspiring female neurosurgeons.
*(Source: Physician Compare National Database, 2021).
What inspired you to pursue a career in neurosurgery?
Dr. Pearl: From a young age, I was enthralled with the physiology of the human body. I remember being 15 years old and learning about the brain in high school biology. We learned that an unhealthy brain was incompatible with a healthy life and from that moment on I knew that I was going to be a brain doctor.
What was your journey to becoming a neurosurgeon like?
Dr. Pearl: In some ways, I remember every single minute of it, and other days it is a complete blur. It is a long, complex, arduous journey that cannot be completed without an infatuation with the brain and spine.
Including undergraduate training, it takes a minimum of 15 years to become a fellowship-trained neurosurgeon. Every neurosurgeon makes personal sacrifices to achieve their dream – and family, pursuing leisure activities, and maintaining personal friendships always rank last to serve this mission.
Did you encounter any doubt while in medical school pursuing neurosurgery as your specialty? How did you work through that?
Dr. Pearl: Never. I knew upfront what I was getting into, and I promised myself that if I found a different specialty in medical school that could satisfy my personal and professional dreams other than neurosurgery, I would go for it. That specialty never came. It was neurosurgery or nothing.
What challenges have you faced as a woman in a predominantly male field?
Dr. Pearl: Like other women who enter a predominantly male field, there are always challenges. Skepticism, cynicism, and rush to judgment are all commonplace. I remember early on in my career, I was on-call and up all night with an unfortunate gentleman with a devastating brain bleed. I also had a tumor craniotomy at 8 am the next morning. We finished the gentleman's surgery around 7:45 am, and I remember sprinting to the locker room to shower and quickly get over to the pre-op area to see my next patient. As I walked in, his wife immediately looked at the clock on the wall, then looked back at me and said, "Typical female. Always late." I smiled, and our team was able to do an outstanding job on her husband's craniotomy. As the years pass, I am excited that we are closer to a time when a “typical female” is simply one who was up all night doing brain surgery to save a life.
How do you define 'having it all,' and what advice would you give to women striving for balance in their professional and personal lives?
Dr. Pearl: My fiancé jokes that my personal life only exists to support my professional life. It is probably a cuter way of saying that I live to work! That’s part of the pledge and the promise of service that we make in the medical field. The reality is that we neurosurgeons worry constantly. It doesn’t turn off when you leave the hospital. I spend my days with patients who very quickly feel like family and whose highs and lows become mine. There is no "clocking out."
I think that women get trapped in this idea that we can "have it all." Really, it is you who decides what your "all" is. Fulfillment is fulfillment. The joy is the same whether I am doing a successful surgery that is going to help someone or whether I am on the water with my family. The only difference is my outfit! Certainly, living in Traverse City has given me more balance than anywhere else due to a short commute and the proximity of an outdoor wonderland.
What has been your most rewarding experience as a neurosurgeon?
Dr. Pearl: My mentor often told me that "life, like brain surgery, is about the little things." While we do the most formidable operations, operating so deep in the brain I can almost feel the patient's soul, the most rewarding moments to me have always been in the little things. A previously hemiplegic patient drinking his coffee with the affected arm the day after a successful surgery. A patient able to stand up straight and walk his daughter down the aisle because of a helpful chronic pain surgery. A wonderful encounter in the clinic where a patient who has long been marginalized finally feels heard and cries tears of joy. Having been in practice now for over a decade, I know my mentor was right.
Describe a typical day in your life as a neurosurgeon.
Dr. Pearl: There is actually no such thing as a typical day in the life of a neurosurgeon.
As someone who is very organized and prioritizes efficiency, this initially got on my nerves (there's a little Neurosurgery humor for you). It's important to understand that as a neurosurgeon, your schedule will never be your own. It belongs to the patients in need. It is also important to remember that many things that happen in a hospital like delays or changes are generally out of my control. If I were to get frustrated with every single scheduling change, it would be a very short career indeed! Instead, I think of my days as "blocks" of time. I know that on a typical day, I will need to do surgery, procedures, see my inpatients, see clinic patients, be on call, and then all the extra stuff like documentation, patient phone calls, staff meetings, academic commitments, etc. Thankfully I have an incredible team, and together, we make it work and make sure the patients are served.
What advice would you give to young women aspiring to enter the medical field?
Dr. Pearl: Do your research. Talk to other female neurosurgeons and ensure you have a strong realistic understanding of what this life looks like. Recognize that you are making a pledge of service and service means sacrifice. Given that there are only so many hours in the day, other things in your life will have to take a backseat. Once you have an understanding of what a career in neurosurgery involves, the most critical thing to do is to figure out some sense of who you are. What are your core values? What are the governing principles of how you are going to lead your life and conduct yourself? What are the deal breakers? What is your vision, and just how hard are you prepared to work to make it a reality?
If you choose this path, you will spend the rest of your life putting others before you. You will also spend your 20s and 30s in training, not necessarily having the time or the mental strength to figure out who you are. Take the time to have a strong sense of who you are now, and what and where you can contribute. There will be people along your path who may try to deter you or maybe even sabotage you. Seek out the opinions of those that you trust and love, but most importantly those that know and love you and want the best for you. Listen to them. But know who you are. And once you think you know who you are, and once you think you know what you are capable of, be very, very, very sure. Then, shine like the sun because nothing can stop you.
How do you see the future of women in neurosurgery evolving?
Dr. Pearl: We have certainly come a long way! I had the absolute honor of mentoring an incredible female medical student who had never considered neurosurgery. After rotating on my service, she became very interested, and we ended up working on various Neurosurgery projects together. After residency interviews were announced, she texted me to share that she had gotten interviews in Neurosurgery everywhere she had applied. She was over the moon. When I told her how proud I was of her, she replied, "I don’t know that I would have even tried if you had not seen a neurosurgeon in me." So I think the most important thing we can do moving forward is to “see the neurosurgeon” and see the potential in our female colleagues and support them on their way to achieving their dreams.