Wednesday, April 28, 2021

Veterinary bibliotherapy: "Emotional Female" by Yumiko Kadota


Hero also loved Emotional Female, but for slightly different reasons. Image (c) Anne Quain 2021.

In February 2019, the Sydney Morning Herald ran an article by Kate Aubusson entitled “Exhausted Surgeon Dismissed as an Emotional Female”.

I recall reading the heartbreaking story of plastic and reconstructive surgery unaccredited registrar Yumiko Kadota – the punishing hours she worked, the extreme demands she faced in her workplace, including sleep deprivation, and her account of the dismissal of her own illness by medical colleagues.

What struck me was how ironic it was that any kind of healthcare system was designed in such a way that it could have a detrimental impact on the health of its workers. We see healthcare professions as healthy, right? They know the stuff about health and wellbeing that we don't. But knowing and doing are different things.

Dr Kadota’s story resonated in the light of the current discussion about the wellbeing of veterinary professionals. We devote energy to promoting and restoring the welfare of our patients – right down to reflecting on their fear, anxiety and distress in veterinary settings, and doing everything in our power to minimise these. Synthetic pheromones. Places for shy patients to hide. Allowing buddies to be hospitalised together. Offering treats when we give injections.

We talk about the five freedoms of animal welfare – freedom from hunger, thirst, discomfort, pain, and freedom to express normal behaviours. We know all about welfare and the things that compromise it. 

But we seem challenged when it comes to protecting our own freedoms, promoting our own welfare. In some cases, I think it is safe to say that we wouldn’t work dogs or cats like we work ourselves.

And when I say ourselves, I am not suggesting that the blame lies with individuals. Sickness in healthcare settings is a complex interaction between individuals, management and environments – the systems in which we operate.

I contacted Dr Kadota and she gave a brilliant talk at the Mental Wellbeing for Veterinary Teams Symposium in 2019 about the need to put your health first. 

                                Dr Alicia Kennedy, of Cherished Pets, with Dr Kadota.

Earlier this year, Yumiko – describing herself as a “recovering doctor” – released a frank book about her experiences.

Appropriately, the book is entitled “Emotional Female”.

It is a thought-provoking, highly readable autobiography documenting a gruelling career trajectory. Despite clear differences between veterinary and human healthcare, I think many veterinary professionals will be able to relate.

Yumiko talks about beginning her career with konjo – Japanese for approaching everything with guts, “drawing inspiration from the samurai spirit”. She describes the challenges of her medical degree and training, early encounters with trauma and suffering, reflecting on what it means to be “a good doctor”, and the constant drive to be better.

As she climbs the training ladder, she admits that “I did sometimes wonder if I’d ever be satisfied. When there’s always more, you feel like you’re never good enough.”

At the same time, her social life becomes “bargaining with friends and loved ones all the time – a continuous cycle of cancelling and making up for cancelling.”

She shines a spotlight on sexism, misogyny and the treatment of women who “speak out”.

Her work becomes all-consuming, but it isn’t sustainable. Yumiko, a doctor, eventually becomes a patient, aware that the roles can be seen as mutually exclusive.

“We accept when patients have mental illnesses, but if it’s a colleague there can be a lot of stigma attached. It’s seen as a sign of weakness or a personality flaw. I was realising I had the same prejudices and needed to fight them.”

Emotional Female is a brilliant, sometimes difficult, always compelling read. It will make you think about what it means to be a good health care professional, how health care systems impact the health of healthcare professionals themselves, and what it really means to be a good doctor.