Women in Stroke – Bojana Zvan

Interview with Professor Bojana Zvan (Slovenia)

What is your career advice to young women about to take their first steps in stroke research?

Young women should always be aware that gender equality in science means that women and men have equal opportunities to follow their dreams and objectives. Therefore, they should courageously take their places on the demanding path of research and present children with the mindset that there are equal opportunities for women and men. They should simply be a role model with their activities as this is the best method of showing others the potential.  With the help of their female mentors, young women can influence society and help to critically assess the criteria of excellence in science, increase female representation in organizations deciding on the assessment and financing of research, and strengthen the accountability of all, women and men, for their decisions.

Did you have mentor? What is the role of female mentorship?

The term mentor was used in Homer’s the Odyssey as Odyssey left the day care and upbringing of his son Telemachus to his friend, a wise and trustworthy man, when Odyssey went to the Trojan War. Presently, the term mentor is used for an experienced counsellor to a young person. A formal mentor monitors a young person in their individual professional or research work. I believe informal mentorship is important. This is when an initiative for cooperation between two people arises where the core of the conversation is professional or personal development or there is the possibility of helping the less experienced individual progress. In my professional career, I have worked as an informal mentor many times. In this, I promote relaxed communications that arise from a volunteer’s decision to help somebody in their development. I experienced such valuable mentorship through an informal friendship mentorship with my colleague from Croatia, Academic pofessor Vida Demarin. She was a key person on my career path. She was always willing to listen, she understood and accepted other people and had the ability to empathize. Her three main motivation characteristics in our cooperation were expectations, equality, and fairness. Presently, we are still best friends, who are still united in our continuous desire to defeat strokes.

What were major challenges in your career?

After I implemented color Doppler neurosonology in Slovenia, I formed a research group together with enthusiastic colleagues in the field of neurosonology, where we mostly implemented research in the area of vascular neurology, and where we are presently focused on migraine research. After my colleague interventional neuro-radiologist, also huge enthusiast, and I realized an endovascular treatment, within the only neurovascular clinic in the country, was so far away, I started the TeleStroke project. The TeleStroke (TeleKap) network still presents successful help for patients with stroke across the entire country, 24 hours a day and 365 days a year (1).

Of course, my goal is also to introduce new European Stroke Organization (ESO) guidelines for intravenous thrombolysis and mechanical revascularization throughout the country.

How did you become interested in stroke research?

From the beginning of my neurology specialization, I was confident in the future of vascular neurology. In this field I recognized the possibility of better treatment for, the then forgotten, patients suffering from strokes, who had lost their personal identity, and whose destiny was a miserable life. In this period, endovascular cardiology was ascending. It was only a matter of time, before each clogged brain artery would have its own catheter. In the University Medical Centre in Ljubljana, we began performing carotid angioplasty in 2002 with the presentation of vascular stents, and soon after, within the treatment of aneurysms in arteriovenous malformations. Mechanical revascularization was used to treat patients with acute ischemic strokes as early as in 2013, and treatment with intravenous thrombolysis was improved from just under 3% to 18% with the introduction of the TeleKap network at the end of 2014.

Do you think leadership in Neurology differs somewhat by gender? If yes, how?

The Division of Neurology of the University Medical Centre in Ljubljana, where I work, is typical evidence of the inequality among men and women regarding leadership functions. Recently, I was the only female leader at the Division of Neurology, and also at that time in the Division of Vascular neurology, which I also founded. Today, there are only male colleagues in the leadership functions at the Division of Neurology of the University Medical Centre in Ljubljana. The professional qualifications of women do not apply when selecting candidates for leadership positions. This is a typical male dynasty in medicine, which has difficulties accepting responsibility for failures, remains silent regarding female successes or represents them in their own way. Even in cases of the established discrimination, nothing happens.

In your opinion, what are the reasons for women’s lack of advancement into leadership positions, despite there being no visible barriers?

The share of women in research activity has been increasing in recent years, but the path to equality is still long. 29.3% of scientists around the world are women, and in the European Union this percentage amounts to 41%, but for Slovenia the most recently available data from the Statistical Office of the Republic of Slovenia revealed that share of women in research activity in 2016 was far lower than the EU average, namely at 34.5% (2).

Lack of women in leadership positions is a result of the dilemmas of a modern woman, who must coordinate the professional demands on one side and family demands on the other side. In addition, a woman faces numerous barriers in her career path, such as deep-rooted invisible stereotypes and those still present traditional beliefs that a woman belongs in the kitchen. A woman must invest a lot of effort and achieve results in order to overcome these stereotypes and succeed in the professional and research fields. It is believed that everything a woman does must be twice as good as what men do. Women must step out of the shadows and appear more in public. The more we develop in some important fields and invest in profession and science, the more we will be recognized as experts, and this increases the probability that people will notice us, listen to us and gives us a recognition.

What is the best piece of advice you have ever received?

When I was named as a Scientist of the Year among 10 candidates in Slovenia in 2009, my motto was the thought expressed by Jean-Baptiste Thiaudiere de Boissy: “The wider the mind, the more it suffers because of its limits.”  With this thought I want to emphasize that, due to the width, we must allow our minds to go beyond their limits and let them fly into infinity. When I became a Scientist of the Year, I experienced massive male envy. At that point, I remembered the Serbian national that says: “Success is never forgiven”.

What inspires you?

I am not only inspired by the medical profession and science, but also by the depth and beauty of painting and musical art. I am also inspired by nature, as each of the smallest blossoms reminds me of how magnificent every life is. From these things that I love, I get inspiration and energy for my work in the field of vascular neurology, and which inspires me to ensure the best quality life regardless of the individual’s state.

What has been the greatest achievement of your career? 

It is difficult to decide what my greatest achievement has been. In the academic field, I successfully completed my doctoral dissertation, and received the title of full professor of neurology at the Medical Faculty in Ljubljana. Perhaps it is also an adequate achievement when I received the title of senior consultant from the Minister of Health of the Republic of Slovenia. However, I believe that an even greater achievement is that I have managed to ensure equal treatment of all patients in the country and access to state of the art treatment by introducing the TeleStroke network that operates based on telemedicine.
Currently, I am dealing with new challenges in the area of telemedicine. With the arrival of biological medicines for preventive migraine treatment, and regarding the situation in Slovenia where we face a lack of neurologists specialized in headache treatment, I am implementing the Telemigraine project.