By Dennis Rodkin
Obstetrics & Gynecology, Northwestern Memorial Hospital
Lauren Streicher was a college student when she first got involved with women's health issues. While juggling her schoolwork and a waitress job, she also found time to help out at a contraception and abortion clinic. Compelled by what she learned there, Streicher decided to focus on improving women's health care, and in the two decades since, that has been the purpose behind all her work. And Streicher works a lot.
In addition to treating patients at Northwestern Memorial Hospital and her duties as an assistant professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine, Streicher writes a column for the Chicago Sun-Times; hosts a show on a new radio channel for doctors; and appears frequently on television. Three years ago she also found time to publish The Essential Guide to Hysterectomy, which is everything its title implies. And whether she is one-on-one with a patient or addressing a large media audience, Streicher has a single goal: to let women know that, when it comes to their health, "there are more options than they may be aware of."
That is particularly true for hysterectomies, where Streicher has been a leader in the use of laparoscopic—or minimally invasive—surgery to remove the uterus. When it is an appropriate option, she says, the use of laparoscopy dramatically reduces the impact of surgery on a woman's body—and on her schedule. After the operation, a patient is more likely to go home from the hospital within four hours and to return to work in a week.
Despite those favorable outcomes, only 10 to 15 percent of hysterectomies nationally are performed using laparoscopic surgery (compared with 80 to 90 percent in Streicher's practice). "That's why I make it such a mission to talk about alternatives to hysterectomy and [about] minimally invasive hysterectomy," Streicher says. "It's astonishing to me the things that are not being offered to some women, things we take for granted because we're at a big-city teaching hospital. I like to know I can save some patients from a big operation—and a big recovery."
Three years ago, Streicher ended the obstetrics aspect of her practice to focus on women in their 40s and older. Obstetrics, she believes, will soon move from a physician's specialty to a hospital-based medical activity, with babies delivered by a rotating staff. Gynecology, though, will become more challenging as women live longer and expect to stay healthy as they age. She notes that in the 1940s, hysterectomy patients would stay in the hospital for a month before recovering at home for another six months. Women today rely on a more positive outcome from the procedure.
"They're not going to the rocking chair with their knitting now," Streicher says. "Women expect to be active, to feel good and look good. In their 70s, 80s, and 90s, they will continue to have vital, productive lives—and it's our challenge to make sure they are able to do that."
Photograph: Katrina Wittkamp