"My bowel had broken down." The day burnout became too much for Yumiko Kadota.

It was late March and I was miserable, truly exhausted. I was driving to work one morning when I felt something warm and wet in my pants. Wait. Could it be? I kept going for another minute, wondering what the hell to do. Do I keep driving or have I actually lost faecal continence? I pulled over and gingerly lifted up my skirt. 

Shit. Literal shit. It was horrifying. But I had no time to feel sorry for myself. I needed to get to work. It felt like I was in a bad dream. It was, of course, a day I was wearing beautiful satin and lace undies.

I got out of the car, hid behind the passenger door and took off my undies. They were completely soiled. My car was still strewn with beach towels from the last time I’d managed to make it to the beach, which must have been a few months previously. I took the one covered in the least amount of sand, and used hand sanitiser to clean myself up.

Jesus. I couldn’t believe what had just happened. It must have been all the stress, sleep deprivation and highly processed foods I was consuming. My bowel had broken down.

I went to work commando that day, feeling shaken. What was this job doing to my body? I’d always been fit and healthy, so for me to lose such a basic bodily function was terrifying.

How to spot and combat burnout. Post continues below. 

I wrote about the shit-show on Facebook. I knew I was over-sharing but I didn’t care. I was really suffering and suddenly I couldn’t do it alone. I was craving social interaction and some compassion. My post garnered a lot of comments: ‘This is <bullshit / outrageous / terrible / ridiculous / insane / unfair / unsafe / shite>’. ‘You should call in sick.’ ‘Your roster is illegal.’ ‘You need to leave your job.’

Reading the comments helped a little bit. At least they validated my experience, and that the horrors of this job were not just my perception. But in other ways the comments left me feeling even more helpless. There was no way I could quit now. Not after everything I’d already invested, and everything I’d sacrificed.

One friend put me in touch with a surgeon who was on a committee with RACS. I gave her a ring and told her what had been happening. ‘What you’re going through is totally unacceptable,’ she said. ‘But unfortunately, we can’t help you because you’re not on the Program. I only have the capacity to do something for accredited registrars.’ Ah, yes. Another reminder of my failure. I felt like such a cast-off. No one cared about unaccredited registrars. We weren’t good enough to be trained into specialists, and we didn’t have any sort of representation.

My Facebook post must have got back to Dr Sansevieria because she rang me a few days later. I’d forgotten how small the medical community was.

‘Oh, it’s been absolutely awful,’ I said, not holding back. ‘This roster is too much.’

‘I’ll talk to Dr Nepenthes to discuss it,’ she said. ‘We’ve got to look after you. You’re damn good, you’re damn good.’

‘Thank you,’ I said, relieved.

‘I don’t want you to burn out,’ she said.

Burnout. I didn’t like that word. It had negative connotations, as though it was the person burning out who had the problem. I didn’t want to be that person. I didn’t want to be seen as ‘acopic’ – a word we use in Medicine to talk about people who aren’t coping. But was I burning out? I was definitely exhausted, there was no doubt about that. I also felt distant and disconnected from the job I used to love. I thought about how I’d wanted to hurt my hand. Never in the past had I imagined ways to escape work. I’d lost the confidence I once had, too. 

I always knew I was good at my job, but I wasn’t getting much encouragement this term. In a profession rife with nepotism, I’d made it to this stage without having any family members or friends in the medical profession. For this I was proud, but was it also going to be my undoing? If I’d had some inside knowledge on how toxic surgery really was, I’m not sure that I would’ve walked down this ostensibly manicured garden path. 

All I’d ever wanted was to perform operations that would save people’s lives, or improve their quality of living. Why couldn’t I simply do my job and be treated decently while I was doing it? Why these hoops to jump through, arses to kiss, and barriers that were impossible to break down? For the first time in my life, I doubted my survival. My education and commitment had brought me this far, but I wasn’t sure that I could carry myself further.

The next evening Dr Nepenthes was performing surgery on a very complex hand fracture. The patient had injured himself at work so Dr Nepenthes would be paid a handsome amount through the Workers Compensation scheme. The cynical part of me wondered whether he would’ve bothered to come to the hospital if it hadn’t been covered by workers comp. The surgery piqued my interest. The bone was shattered into a number of pieces and would need a combination of a plate and a few different screws to hold all the fragments together. I wanted to see how Dr Nepenthes would tackle this case, just in case I was ever on my own for a fracture this difficult to fix.

‘Oh no, no, you go home,’ he said. ‘We wouldn’t want you to get too tired, now, would we?’ The sarcasm was piercing.

‘I’m not tired. I’d like to stay,’ I said. ‘I want to learn from this case.’

I had raised my voice about the rostering and the consequences were already clear. My career was being ground to a fine crumble. I thought of Hajime battling the chemo. He’d always been my biggest career cheerleader. If he knew how much I was suffering now, he would be heartbroken.

When I got home that night I checked my mailbox. I had a late notice for my electricity and phone bills. It bothered me because I’d always been so organised and paid every bill on time. It was unlike me to be forgetful about anything.

The next day, I was working with an anaesthetist who wasn’t keen on operating on a patient with a contagious bug called MRSA – the golden staph. The patient was on the medical ward, and had a large skin cancer on her chest that needed removal. 

How to know if you're suffering from burnout. Post continues below.  ‘The surgery won’t take long,’ I promised the anaesthetist. ‘We can do it under a local anaesthetic with a bit of sedation.’

‘But it’s going to take such a long time to clean the theatre afterwards,’ she said.

‘This poor lady has already been cancelled a few times,’ I said, finding myself slowly getting angry at the prospect of having to cancel her again.

I was sick of apologising to patients all the time; of waiting all day to get an operation done, only for the operating theatre to run out of time. The disheartening thing was that when patients did get deferred, I couldn’t even guarantee their procedure would happen the next day, or the next.

I could feel hot tears rolling down my cheeks. I hated the fact that I was crying at work but I couldn’t hold in my frustration.

‘I’m just so fed up of cancelling all these patients,’ I said to the scrub nurse next to me. She looked at me with sadness.

‘The anaesthetist has no reason to cancel this lady,’ I continued. ‘She just can’t be bothered with all the contact precautions like gowning up because the patient has MRSA. It’s unfair.’

The anaesthetist looked over and saw me crying. ‘Oh, so you’re going to cry every time things don’t go your way?’ she huffed.

This article is an extract from Yumiko Kadota's book, Emotional Female, published by Penguin. 

Emotional Female is available on Booktopia or at any good bookstores. 

Emotional Female, available at all good bookstores.