Bibliophile | ‘The Registrar’ explores struggles working in hospital system

The Registrar
by Dr Neela Janakiramanan
Allen & Unwin

Emma Swann is in her first year of a 5 year training program to become a surgeon at the Mount Hospital, and she is carrying the weight of family expectations. Her brother Andy is in his final year of being a general surgery registrar at the same hospital and her father, who has now retired, was an imminent surgeon and a professor there as well.

Emma hadn’t intended following in her family’s well-trodden path but on a holiday to Vietnam, where she also met her now husband Shamsi, she witnessed the miracle of medical science. Fortunately Shamsi is just as dedicated and ambitious, and even more focused on his career in corporate law, so the two of them can spend horrendously long hours at work and support each other.

Although prepared for the hard work, the hours are excessive and she was not prepared for the subtle gender discrimination and not so subtle bullying and sexual harassment. Dr Neela Janakiramanan exposes the dangerous faults in Australia’s health care system (for doctors and patients) and, given some of the things that happen later in the book, has chosen to write it as a novel and not name names.

Now a successful reconstructive plastic surgeon specializing in hand and wrist surgery, Dr Janakiramanan has stated that she has lived experience of all the issues explored in the book – “burnout, mental health deterioration, the impacts of failing an exam, exhaustion and sexual harassment. Since finishing my own (Registrar) training, I’ve spoken about and advocated for those coming behind me, both on an individual and systemic level.”

The narrative unfolds like a thriller as it is obvious that Emma is heading towards some sort of crisis, but the breakdown that occurs is totally unexpected. Lamenting the lack of time she has to care for her patients, she is also crippled by lack of sleep, lack of food and knowing that if she fights her bullying and sexually harassing superiors, she will jeopardise her place at the prestigious teaching hospital.

Dr Janakiramanan has called for an audit of trainee doctor work hours and Dr Yumiko Kadota has highlighted the exploitation of trainees in her book Emotional Female, after she described being dismissed as an “emotional female” when her pleas for support were ignored as she worked up to 70 hours a week and was on-call 10 out of 14 days at Bankstown Hospital’s plastic and reconstructive department.

Using a fictional story based on personal experiences to engage readers about conditions that need to change in the stretched hospital system, Dr Janakiramanan also points the ripple effect to patient care in the subtitle to her book – “She wants to help her patients. First, she must survive.”

Lezly Herbert

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