Dr Neela Janakiramanan's debut novel shares the unseen toll of medical careers

‘I wrote the first three chapters in one night’: Dr Neela Janakiramanan’s debut novel shares the unseen toll of medical careers

Neela Janakiramanan

As a reconstructive plastic surgeon, Dr Neela Janakiramanan knows the unique personal toll that pursuing a career in medicine– especially as a young woman– can take. And it’s why, in her debut novel The Registrar released today, she’s able to so adeptly paint an honest and evocative portrait of hospital life with powerful words.

The book shares the harrowing story of a female surgeon-in-the-making, trying to survive a medical system at its breaking point. Unlike the abundance of medical shows we see on TV that glorify the profession, Dr Janakiramanan offers insight into the culture of overwork, bullying and misogyny found in hospitals. It’s an emotional telling of personal experience woven into compelling fiction.

A regular Women’s Agenda contributor, Janakiramanan generously co-hosted the latest episode of the Women’s Agenda podcast last week. During the conversation, she opened up about the inspiration for her new novel, and the changes that need to occur in medicine to level the playing field for women. And, as she says, part of that takes place when women’s stories are shared and listened too.

“It has particularly annoyed me that from what small amount of writing there is, it’s all from a male perspective. There’s no one really telling women’s stories,” she explains simply.

Much of the medical workforce is made up of women, but they don’t always get the same levels of attention or respect as men. Janakiramanan says that the care economy– feminised parts of the workforce such as aged care and general practice– have often been neglected, while professions such as intensive care physicians– which tend to be made up of older, white men– are awarded with more prestige at a social level.

“It’s easy to forget the broad base that actually keeps most of [the medical system] going,” she says. 

Janakiramanan’s drive to share women’s stories in medicine stemmed in part from personal heartbreak.

When she was a first year surgeon, she discovered through a casual conversation that a female colleague and friend of hers had committed suicide six months after they’d worked together.

“I spent a lot of time reflecting on the time we’d spent together,” she says.

“I moved through those phases of analysis and guilt of wondering whether I could have done something different. The thing was, [she] wasn’t the first person I’d known who had died during the course of their work– some by suicide, some by medical conditions that were exacerbated by the nature of the work they were doing. It was a moment when I realised the cost we all pay to get to the finish point which is the end of training. There’s a lot of stories and it made it a very easy book to write in some cases.”

Even though the book’s narrative follows her main character through surgical training– the specialty Janakiramanan knows best – she says a lot of the issues affecting junior doctors in a healthcare setting are actually quite universal and they are stories that need to be told.

Not only does Janakiramanan use her creative writing to give a voice to the shared experiences of medical professionals, she also finds that being creative helps her to better treat patients.

“Medicine is fundamentally creative,” she says. “We treat medicine as a science – and there are scientific aspects to it– but it is an art. It’s about people. It’s about communication. It’s about connection. It’s about understanding individuals as a whole person because if you don’t, then the care that you provide is not going to be very good.”

While some might not immediately associate the professions of medicine and creative writing as similar, Dr. Janakiramanan finds there is actually quite a lot of overlap between the two undertakings.

“Sometimes creative solutions are required,” she says. “I think that’s why there are so many doctors who are also writers. There is a synergy there.”

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