Science, like all human activity, has its individual cultural milieu. The culture of science evolved in a period when it was being practiced exclusively by men, and that has greatly influenced the outcome. It is a men's game and it continues to be played by men's rules.

Although we would like to believe that scientists are driven by a desire to understand some aspect of the natural world, in fact they are also driven by a desire for personal recognition. Sociologists of science like Robert Merton have identified this need for personal recognition as a motivating force in science. This can lead to behavior which is, at the very least, unattractive: aggressive attacks on competitors, secrecy, sometimes even prevarication.

Linda Wilson, president of Radcliffe and a chemist, recently raised a firestorm by suggesting that the fierce rivalries and ruthless competition among scientists was incompatible with the inclusion of women and minorities in science. She predicted that there will be little change in women's participation until scientific decorum changes. The predictable reaction from men was to extol aggression as the fuel that drives the enterprise and to argue that any attempt to civilize scientific discourse will be its undoing.

Feminists have generally had two responses to this issue. On one side, it has been acknowledged that aggression is a necessary quality for a scientist and that we should be encouraging it in our female students. The opposite view is that women should and will stay out of science so long as it is practiced in such a distasteful way. I find the latter position unappealing at best: ceding the playing field to males will lead to no change. My response is, as much as possible, to encourage my female students to be verbal, confident and curious.

The second cultural aspect that dramatically affects the prospects for women's participation in science careers is the jealous demands on our time. A friend of mine once described science as a black hole, prepared to suck up whatever proportion of your life that you allow it. This complete devotion to science was fostered in the culture of the 50's in which women stayed home and raised families while their husbands conquered the secrets of the universe.

When women began to enter science careers in the 1940's and 1950's, they were expected to renounce any intention of having a family. This is the ultimate unlevel playing field, one that persists to this day. Women have paid a terrible price for the success they have realized in the last 20 years. Study after study of all fields, not just science, document that women have forgone marriage and children for their success.

The problem of reconciling a scientific career with some semblance of a normal life is exacerbated by the tenure system. A woman is usually 30 years of age before assuming an assistant professorship at a university, which puts her tenure decision at age 35 to 36. Thus her critical scientific years, in which she is establishing her reputation, and her peak reproductive years coincide. This is a dirty trick. Many in my own generation chose to forgo child-bearing until the security of tenure had been granted, only to find that their biological clock had stopped ticking.

Institutions are beginning to grapple with this problem, with different solutions. Some have initiated programs allowing women to have one or more years before the tenure decision to compensate for the time lost in child-bearing. Others have adopted policies to allow both fathers and mothers to take this option.

I favor an even more radical solution: abolish tenure entirely, in favor of rolling appointments that are reviewed regularly. Tenure is no friend to women. It does not protect them from institutional discrimination. Rather it rigidifies their career path when they need maximum flexibility.

Ultimately we must solve this conflict between work and family if we hope to increase the participation of women in science. The alternative is to accept that women will never reach parity or continue to pay an unequal price for their success.

It is not sufficient to improve child care, though that is certainly a worthy short-term goal. And I would not advocate a society in which our children are raised by efficient and subsidized surrogate parents. Rather I would like to create a workplace in which our roles in our families and in society are equally valued. I have sat through too many late-night sessions listening to my male colleagues brag about their busy schedules and long absences from home.

On the other hand, I don't believe that science must be practiced to the exclusion of all other human activity. The system I object to confuses quantity with quality. It is not the number of hours you work that determines your contributions to science: it is the quality of your insights and your creativity. The distinction between quantity and quality needs to be continually pointed out, and I suspect that it is going to take women to do it. Most important, we must begin by declaring it loud and clear to our students, who still fear that the two are the same.

What are the prospects for changing the cultural milieu to make it more hospitable for women? There is only one solution and that is the recruitment of more women into science. Numbers really matter. Where women reach a critical mass in a field, the cultural barriers naturally begin to slip away.

I would suggest that the greatest change will come in institutions that focus in the short term on the senior faculty level. University faculties are extraordinarily hierarchical, and the graduate students and assistant professors at the bottom of the totem pole are very vulnerable. They are excluded from the most serious decisions on hiring and promotions, and often find it difficult to have their voices heard when they are included in decisions.

When women at the lowest level are vocal, they are too often dismissed as strident. Senior women, on the other hand, participate in all aspects of decision-making, and their presence in senior-level deliberations acts as a brake on the more egregious forms of discrimination. They provide the example to young students and faculty that women can have successful science careers. By acting as mentors, they can interpret not just the science, but the scientific culture.

Focusing on the hiring and retention of senior women is clearly not a national solution: there just aren't enough senior women in most fields of science. But it is a solution for institutions eager to change rapidly, and to take a leadership role.

The reason we care so must about this subject is that science is an extraordinary profession. I know of few other professions where the excitement that brought you to the field in the first place is sustained over so many years. It would be a tragedy to exclude women from all this fun.

(excerpted from a speech given by Shirley Tilghman at Washington University at the Olin conference on Women and the Culture of Science)

On June 16 the Congressional Caucus for Women's Issues convened a national summit on women's health, which I attended. I also attended a strategy breakfast before the forum. Several Congresswomen, including Pat Schroeder and Olympia Snowe, co-chairs of the Caucus, discussed the need for grassroots mobilization to ensure equitable treatment of women's health in national health care reform legislation. As one congresswoman said, "We must do what we were taught in kindergarten, hold hands and stick together in traffic."

The Caucus issued the following statement of principle on health care reform:

"Historically, women's health has been treated as an afterthought. Thus, as we form a new health care system, the Congresswomen will be paying special attention to ensure that women and men are treated equally. Improving access to comprehensive quality health care for all is vital for the health of our nation, but fairness and equity for American women must be central to our consideration of health care reform. Using the standard of equal access to health care, women's health care, including reproductive health care, cannot be separated or isolated from other health services. The standard benefits package developed for any new health care system must include comprehensive reproductive health services. Comprehensive reproductive health services include family planning services, pregnancy-related care, and post-reproductive care."

This is a critical issue in health equity for women. Universal health care is not universal if it does not provide for the full range of women's reproductive services. Many insurance companies already pay for such services so failure to include them in the universal health care package would result in the loss of health care coverage for women. The proposal to allow women to purchase insurance riders to obtain such coverage prompted Pat Schroeder to comment "Women shouldn't have to buy private insurance for their private parts."

We in St. Louis can play an important role in ensuring that health care reform does not compromise on women's health and includes reproductive health services. Rep. Gephardt is the leader in the House of Representatives on health care reform. I urge all those concerned about women's health to write or call Rep. Gephardt to let your views be known on this important issue.