At the heart of the matter: cardiothoracic surgeon Professor Silvana Marasco

Kelly Southworth, Editor

When Professor Silvana Marasco (1986), as a trainee surgeon, met the person who would eventually become a mentor and her biggest supporter in medicine, he was surprised to hear that she wanted to pursue cardiothoracic surgery as a career. ‘You couldn’t possibly,’ he told her. ‘You’re a girl!’

Silvana is now one of only 13 female cardiothoracic surgeons in Australia out of about 130 – although she doesn’t feel entirely comfortable with the distinction of gender in her job title.

‘I don’t think of myself as a female surgeon, I think of myself as a surgeon,’ she says. ‘If you go in with the mindset that you’re there to do a job, your gender is irrelevant. I’m there to be the best surgeon I can be, and I’ve always aspired to be better than everyone else, regardless of who they are!’

This confident attitude and drive to be the best has carried Silvana through many years of education, including her 15 years of medical training, three years at Carey and her preceding years at a single-sex girls’ school.

When she started at Carey in Year 10 in 1984, co-education was still fairly new. Silvana was one of only 20 girls in her cohort, alongside 65 boys. She describes it as a wonderful and welcoming experience, although she was intrigued by the different styles of learning.

‘At my previous school, I was used to sitting back in class, learning passively,’ she says. ‘I distinctly remember my first science class at Carey, where there were only three girls. The boys kept interrupting the teacher, putting up their hands and asking questions. I was so shocked. It was a very different style of learning to what I was used to. It’s so important to ask questions, so I thought it was wonderful that it was encouraged.’

Although Silvana knew she had a keen interest in the sciences at school, she had no idea what to do after school. In order to keep her busy in the school holidays, Silvana’s mum signed her up for all sorts of short courses and classes, from learning how to change the oil in a car to arts and crafts activities. ‘I used to love making these electronic sets where you soldered all the little resistors onto the board, and then you could make it into something like a little radio,’ Silvana says. Once she realised medicine was the path she would take, her love for fine, detailed work like sewing and soldering led her to cardiothoracic surgery, which involves anything to do with the heart, lungs and chest. Sometimes Silvana finds herself sewing individual veins together with ‘a suture as fine as a hair and a needle as big as an eyelash,’ as she told the Sydney Morning Herald.

Today, Professor Marasco is the Director, Cardiothoracic Surgery at the Alfred Hospital, and after 20 years of open-heart surgery, lung transplants and medical assist device implants, she still loves going to work each day.

‘I am so lucky that I love my work,’ Silvana says. ‘My advice to current Carey students who are thinking about what they want to do beyond Year 12 is to consider what they enjoy, not what the salary is or what the lifestyle of it is – you can make everything else work.’

Silvana says the research aspect of her work helps to keep things interesting, too. Her curiosity and determination to be continuously learning and improving has led her to contribute to 160 peer-reviewed articles and 14 book chapters, and she has received over $6.5 million in research grants. Her research interests have focussed on transplantation outcomes, chest trauma and innovation in surgical techniques.

In particular, Silvana is pioneering rib fixation in Australia, a surgery to assist with the healing of broken ribs after severe physical trauma. Even some members of the Carey community have undergone this specialised surgery by Professor Marasco!

I don’t think of myself as a female surgeon, I think of myself as a surgeon. If you go in with the mindset that you’re there to do a job, your gender is irrelevant.

Silvana is an advocate for having confidence and knowing your worth, especially for women in the male-dominated field of surgery. According to the Royal Australasian College of Surgeons in 2019, 60% of Australian medical students are female, yet women account for just 13% of senior surgeons. In her talk to the Carey community on International Women’s Day this year, Silvana addressed the high drop-out rate of female surgical trainees.

‘We’re investigating the issue at the moment, but we’re not entirely sure yet what’s causing it,’ she says. ‘However, one thing we see is that there’s always a range of abilities in the trainees, and

the male trainees who are a bit below the average can make a go of it, find the self-confidence to stick with it and work to improve their skills. I think the female surgeons in the same situation often don’t have the confidence to see them through this stage. We need to work on that and support them through those difficult early years as a cardiothoracic surgeon.’

Silvana adds, ‘I think, as women, we’re not really taught to appreciate our worth. Knowing how much you’re worth is very important and needs to be instilled at school and as you go through your training.’

Professor Marasco is the perfect example of someone who has understood her worth from an early age, who doesn’t allow the biases of others to get in her way, and who knows that she can achieve anything she is passionate about and puts her mind to.