Health Junior Doctors

What happened next…

It’s 4am, Friday 8th February. I’m wide awake so I’ve just picked up my laptop to blog. It’s been just over 8 months since I resigned. I didn’t want to name the hospital I was over-worked at so I’d referred to it as Hospital X, but since it’s come out in the media I’ll use it by name: Bankstown.

[This is a follow up article to my story here.]

After I had put in my resignation, I knew I still had to see out the minimum 4 weeks. After I got home I flopped onto my bed. THANK GOODNESS. I lay there for a while looking at the ceiling. I felt an instant sense of relief, and my very first thought was, I can’t wait to get back into running and go to the gym again. I can go to bed tonight with my phone turned off… oh the bliss of that… On Saturday, I couldn’t, and didn’t, get out of bed at all. My body could not move and I had this massive headache, similar to what people experience after a hangover. This headache would continue for weeks afterwards.

On Sunday morning, I knew that I couldn’t see out the final four weeks. I was tired down to my bones. I was still so exhausted from my 24-day stint but I knew that I couldn’t possibly go back to Bankstown anymore.. so I went there with a suitcase. I unpacked my locker, took my books from the office bookshelf but left a few textbooks behind as a gift for the other junior registrars, and completed my final timesheet.

Awkwardly, the other registrar walked in whilst I was doing this. “Is it true that you’ve resigned?” he asked. I replied, “yes”. He asked what I was doing there, and I told him I was doing my time sheet, conscious of the fact that my suitcase was standing there between us. “But what about the training program?” he asked. “You’re going to look really bad to the bosses,” he continued. “I don’t care anymore,” I said, as I stared blankly at the computer screen in front of me. We had this whole conversation without looking at each other.

After he had left the office, I quickly gathered all of my things and left Bankstown Hospital for the very last time. Bye, Bankstown. I thought about Mr B as I left the building. I’m so sorry Mr B… It won’t be me doing your dressings on Monday… but I know that your finger has improved to the point where you don’t need me anymore. You will be fine by whomever will look after you from now on…

I felt so bad that it wouldn’t be me greeting him on Monday morning. I messaged my intern to keep me updated on Mr B. Please just let me know that his finger is continuing to get better. That’s all I wanted to know. I let the team know on Monday morning that I couldn’t come in because I was still so exhausted. I went to my GP and collapsed onto her desk. I was in tears and told her that I put in my resignation with the minimum 4 weeks’ notice… but I don’t think I can do the 4 weeks.

I got a message from my Head of Department (HoD) that day; “Hi Yumi, I was surprised you didn’t come in to work today as you said you would. Please contact me after 4.30pm”. After my GP appointment I had gone back to my bed and didn’t get up for the rest of the day. I was still extremely tired. That was the last week I’d heard from my HoD.

I didn’t hear from any of my consultants after news of my resignation had been spread. Even now, I have not heard from any of them. The only communication I got was from the accredited registrar, who asked me to email me the last presentation I did for the unit audit because I had done the whole thing, as usual.

Photo credit: James Brickwood

The first I’ve heard from anyone from Bankstown’s Plastic Surgery unit or Administration was an email from the acting Director of Medical Services (DMS) on Monday – the day after I posted my blog on Facebook. Oh, what funny timing! The email read, “Would you be able to come over to see me and talk about the challenging time you had at Bankstown? … I would really like you to talk to me about how we can improve the training experience for our surgical registrars”

First of all, I’m not going to travel an hour to go to Bankstown, and especially not to go to the hospital that tormented me. Secondly, this email is 10 months too late. Where were you when I needed you? Where were you when I had already presented my solutions to my department? I’d already suggested several ways in which we can make things safer for registrars – what more could you possibly want from me?

Apparently there was no DMS when I started my term. How is that even possible? That is such an important role for a hospital to have. The author of the email had apparently started her role as acting DMS in mid-March but, “As you never came to meet up with me, and I did ask Axxxxx to ask you to, you probably don’t know the action Medical Admin were taking in the background.”

Firstly, Axxxxx did not ask me to, and I’m sorry but I didn’t even know you existed. If all of these “actions” were taking place, why did I never hear about them? They were more like proposed plans rather than actual actions because I never saw any changes whilst I was there. Apparently two registrars started doing my job in August. Oh, that’s fantastic!

Apparently the acting DMS thought that I had gone “home to Japan” otherwise she would have contacted me sooner. Does anyone else think that this is borderline racist? I am Japanese by blood, but I am as Australian as anyone else in this country. Why would anyone presume that I’d go home to Japan? Sydney is my home, and has been for most of my life. I did not even reply to this audacious email. Everything about it read DAMAGE CONTROL.

Wind back to June. I thought that maybe after resting for a week, I’d be back to my usual energy. Wrong. There were days where I couldn’t get out of bed – I have those days even now. What is this? Adrenal fatigue? And how long until I recover? I still ask myself that last question…

After just one week, I started to feel guilty that I was at home doing nothing. Why am I not working? Why am I lazy? I started applying for vacant jobs. I reached out to the Head of Burns at the Children’s Hospital, where I’d previous loved working at. He was absolutely wonderful. He listened to my story with empathy and helped me secure a job in Paediatric Surgery, however they needed someone straight away and I was still too fatigued to work. He later offered me the position of Burns Fellow (which would have started this week) but unfortunately I had to decline it as my health continued to deteriorate.

Me trying to crawl back into normal health. This pose is Lizard Pretzel.

I turned to yoga. It’s what has helped me through the toughest times last year. I’ve been a yogini for as long as I’ve been a doctor (8 years), and I decided that I would use this time off to finish my qualification so that I could teach yoga as an option. I finished my 200-hour yoga teacher training, and re-connecting with yoga was the best thing I could have done for myself. Until then I hadn’t been able to make it to any yoga studio for nearly a year because of work.

I officially received my certificate to become a RYT-200 yoga teacher. This felt like my biggest achievement for 2018. I was made to feel like a failure at Bankstown, and I certainly felt like that when I resigned. I know it’s just a piece of paper, but holding my certificate meant everything. It felt like at least I managed to accomplish something.

Yoga philosophy has its roots in Hinduism. I am not of any particular religion, but I loved learning philosophy. The concepts that helped me the most are aparigraha and isvara pranidhana. Aparigraha means non-attachment. This helped me detach from my identity as an aspiring Plastic surgeon. I spent so much of my life dedicating myself to this dream, that I lost my own identity. Without surgery, what am I? I’ve had to learn that it’s okay to change roles. I am me, and I don’t need to be anything more.

In his book, The Power of Now, Eckhart Tolle says, “The compulsion to do, and the tendency to derive your sense of self-worth and identity from external factors such as achievements is an inevitable illusion as long as you are identified with the mind”. Reading this was so powerful and helped me to manifest aparigraha.

Isvara pranidhana means to surrender to the universe. I’ve always believed that things happen for a reason. Maybe I was supposed to go through this suffering. Again, Tolle’s words inspired me. He says that you “create an illness in order to force you to stop, so that the necessary regeneration can take place”. By removing myself from my “illness” (my attachment to becoming a surgeon), I forced myself to stop. I feel that right now, I am regenerating. I do not know how my regeneration will shape me, but it is already turning into something more beautiful.

I have found the ability to stop. Enjoy nature in all its glory. Listen to the waves. Feel the sea breeze on my face. Swim freely like a mermaid and appreciate the sea creatures around me. Let the salty air drift through my hair. Feel the warm mid-day sun on my skin (covered in SPF50+ of course).

It was now September. I had taken more than a year off Instagram, but I reactivated my account… but that’s when I started to get trolled by my stalker. Read about that here. It certainly didn’t help things but it didn’t stop me from living my life in a positive way. In mid-September I completed my training to become a mentor for Camp Magic, which is a grief camp that helps children who have lost one or both parents, a sibling, or other significant loved one.

The training for this camp was intense but awe-inspiring. It is run by Feel the Magic, which is an incredible organisation. I had been approached by the training co-ordinator to teach yoga to the kids. I was thrilled to be able to do that. The upcoming camp was in October. I missed it because I ended up in hospital.

I thought I was getting better, but I was just in denial that I was sick.. and eventually I faced the reality of it when I wasn’t looking after myself and found myself sitting in an apartment full of mess. I lost my energy again. I wasn’t getting out of bed until the afternoon each day – a huge contrast to the “old me” who jumps out of bed at 5am ready to go for a run. I wasn’t sleeping properly (and still don’t).

What still affects me every night is that I wake up every 2 hours. My brain still thinks it’s on call. The hypervigilance makes me wide awake. I’m not even stressed about anything. I’m not the type to ruminate over things. I just wake up, with an empty space in my head, with nothing in particular on my mind. No, Miko, you’re not on call, there are no emergencies to be on standby for. Just go back to sleep. But I can’t.

I strictly follow all of the sleep hygiene rules. I try everything I can non-pharmacologically. I also have a specialist who oversees my sleep issues medically… but I can’t sleep. On top of that, I still suffer from traumatic symptoms. I’ve had to change my phone number – partly because of my stalker, partly because it reminded me of being on call. I hate seeing “No Caller ID” come up on my phone because that’s how the hospital switchboard contacts you when you’re on call; from a private number.

In early October I finally surrendered to my condition. I was admitted to a private hospital for treatment of my insomnia and post-traumatic symptoms. I was told I’d probably be there for three weeks. I ended up in hospital for six.

During that time I was supposed to have competed in the Noosa Triathlon. I had everything booked and it was something I’d been looking forward to all year… except I was in a hospital bed and I couldn’t even walk properly let alone swim, bike, run. I also missed Camp Magic. The only person from Bankstown who had been checking up on me was a lovely general surgery registrar who had given me a lot of support whilst I was suffering at Bankstown. She came to visit me in hospital, as did consultant surgeons and anaesthetists I worked with from previous years. It was nice to know that they still valued me as a colleague and cared about me.

Over Christmas I went to Japan to visit my family, and that’s what made the biggest difference to my recovery. I felt anxious about going back. They’ve never seen me like this. I’m the happy, cheerful one who cracks dad jokes and bad jokes. Instead I was cynical and exhausted… but my family was tremendously supportive. They were all just really worried about me. I feel teary writing this, but my mum has been through so much, and even attended two funerals whilst I was there, but she didn’t show any signs of stress. I’m sure she had carer distress, and I didn’t want to add to that role.

I love you, mum. You are such a strong woman and thank you for looking after me. I was nourished by her amazing home cooking every day. There were some days I just wanted to stay in my futon and she let me be… but on other days when I had a bit more energy she would encourage me to go outside because she always knows what’s good for me. She went for a walk with me and my gorgeous grandma. The three of us went to our local park. I held my grandma’s hand. She said, “I can tell by how you hold my hand that you have kindness in your heart”.

We sat down on a park bench and I gave her a big squeeze. There are no better hugs in this world than my grandma’s. My love for flowers blossomed from when I was a little girl. She has an incredible knowledge of botany, which she always shares with me. She pointed to a bush with white flowers; “Look, Yumiko-chan, the camellias are blooming”. White camellias represent the pure love between mother and child. How apt for that very moment.

Aim for the stars, baby. If you lost your dream, make a new one.

I got home and I had a chat with my dad. He had always supported my dreams of becoming a surgeon and I knew he was proud of me, but when I resigned I felt like I was disappointing him. “Fluffy,” he started (the nickname my family gives me). “Why don’t you go into academia? You used to teach anatomy and you’d come home so excited. You loved teaching at the university.” Wow. I did not expect that from my dad at all, but that moment made me realise that family really does know me best.

He was right. I hadn’t thought of it as a long term option, but I did love teaching anatomy. I wrote to the university Professor I used to work with, and I got a response straight away. I met with him yesterday, in fact. I’m still recovering, but maybe a path in medical education could be for me. I think education and yoga would give me a well-balanced life that still has meaning and purpose. Watch this space.

I wrote my original blog post whilst I was in Japan. It was still painful to write it, but I didn’t want to wait longer. When you go through a traumatic experience, your brain starts to block some of it out, and you lose some of your memory of it. Thus I wanted to write it down before I forgot the details. At the time, my blog post was only read by family and friends.

When I got back to Sydney, I missed my family terribly but I talk to them every day. We even FaceTimed each other during the Australian Open so that we could cheer on Naomi Osaka and Kei Nishikori together and share commentary. What would we be without our families? It’s been hard to experience everything alone in Sydney, but I’m thankful for my friends, and for FaceTime.

I agonised over whether to put my blog post into the public space. I knew exactly when I would do it – Sunday 3rd of February, the day before the new year starts for the junior doctors. I wanted any doctors out there to know that they are not alone if they feel like they are suffering. I had concerns that there might be backlash, hateful responses from my consultants at Bankstown, or that it would be career suicide. My sense of integrity won in the end. I don’t care what the response is going to be. I’m just going to put it out there because it’s my truth to share, with anyone who will read it. And so I did. On Sunday, I posted my blog article on Facebook.

As I did in June, I’ve had people telling me what I should do with my life. I say this with respect, but please don’t. I am still in recovery, and I’m not in a headspace where I even want to think about hospital work. My mind and body are not ready to make that big decision yet. I need to look after myself first. I won’t return to work half-baked. I want to be a fully-baked cookie before I throw myself into something again, because I’m not a half-arsed kind of person. If I do anything, I do it properly and I do it well.

Everyone wants to give me their 2 cents. I appreciate that it’s all with good intentions, but I don’t need to be “saved”. I am an independent 31 year old woman <cue Destiny’s Child>, and I’ve been making decisions by myself for a long time. No one knows me, my strengths, weaknesses, my likes or dislikes, except for me and my nearest and dearest. I’ve even had someone suggest I consider acupuncture. Really? Just because I’m Asian, it doesn’t mean I have any interest in traditional Chinese Medicine (I don’t).

I wanted to be a surgeon, and there’s still a place in my heart for it, of course. Whatever I go back to, it will be surgical (if clinical), or anatomy (if academic). Those are my thoughts right now but I can’t make that decision yet. I need to heal first. In the meantime, I am enjoying some time off clinical work. I’m reading books to nourish my mind, eating a plant-based diet to nourish my body, and doing yoga to nourish my soul. I’m finding myself again. I’m not a plastic surgery registrar right now. I am just Miko, and I hope that that’s okay.

Take care and thank YOU to everyone who has gotten behind my story and sent me their love.

Miko xx

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143 Comments

  1. Philip O'Sullivan says:

    Thanks for sharing your (updated) story. There are lessons here for everyone. The entire system is under strain. Doctors like you bear the brunt on the front line, but I am sure (most of) the people on the administration side are doing there very best too.
    As a society we have been making a lot of very poor choices for decades now that are having adverse affects on our collective health. Almost impossible for the health system to treat everybody fairly. Countless innocent patients have, undoubtedly, suffered even more than you. We should all try to work together to fix the problems…….and eliminate the causes.
    Good luck in your future endeavours. I look forward to reading your updates. Cheers, P.

    1. Miko says:

      Thanks Philip

    2. No i’m sorry to disagree with you Phillip. Having worked recently in a large health district in NSW, I can tell you that good administration is really lacking. I have worked in 5 LHDs all across NSW. Shifts not being covered despite knowing for weeks before. Medical overtime staff stretched to the limits. Doctors being sent home ‘early’ after a day shift, so they can cover that night shift at short notice. Enough is enough – we as doctors do not complain. We stay quiet and don’t let the truth come to light. Enough is enough

      The problems Philip, from Miko’s post at the core include: poorly functioning admin, uncaring consultant staff, and a system where no one communicates with one another. The result: burnt out medical staff

      1. Miko says:

        Thank you for your comment. Yes I agree with you – my experience of administration at most hospitals has been poor. I would love to believe that everyone is trying their best, but that is simply not true, to be frank. Doctor burnout is a serious issue that is multi-factorial, and it will take time for a cultural shift but I do hope that the media attention on this issue at the moment will generate changes that lead to a healthier and more enthusiastic medical workforce in the future, which means patients will also receive greater care. Burnt out doctors cannot perform at their highest capacity. I appreciate you commenting on this.

    3. Debbie says:

      I’m a paediatrician working in Alice Springs. I just wanted to thank you for sharing your story and inspiring further change in medicine in Australia. If I can ever be of assistance to you in anything – a listening ear, a soundboard for ideas, a place to stay, a help for finding work or just a drink if you’re travelling through here, please let me know. I would feel honoured to help. Domo Arigato, Debbie

      1. Miko says:

        Dear Debbie, Thank you for your comment. I appreciate your kind offers, and lovely words. I do hope that I see change in the coming weeks to months. Sending my best wishes to Alice Springs! Thanks again, Miko

  2. Francesca says:

    Hi, I’ve been following your blog since a colleague posted your post (The ugly side of becoming a surgeon) on a doctors Facebook site. I was so upset for you when I read the post. What happened to you was horrible and should not have happened. I guess you still have a way to go but I am so glad that you are taking the time for self-care and sharing your story. Many doctors will not because they want to ‘get ahead’ but it will not change what is a pernicious culture of bullying and harassment. Thank you for writing. I look forward to reading more of your posts and learning.

    1. Miko says:

      Thank you so much Francesca. It was a hard lesson to learn, but putting your health first and self-care are both things I’m trying my best to do. Nothing is worth it if your body is suffering so much for it. My best wishes to you. Miko

  3. Aisha Tahira says:

    So good to read that you are recovering and thank you for writing so honestly and beautifully. I’m a surgical trainee in the U.K. and I can relate to some of your experiences. Reading this has reminded me of how important wellbeing is and has really helped me. Sending you good vibes from the Northern Hemisphere!

    1. Miko says:

      Thanks Aisha. I did fifth form in London so I am very fond of the Northern Hemisphere – sending those good vibes right back at ya! Thanks for reading, and I hope you have sometime for some wellness activities this weekend. Miko

  4. Caroline Bolt says:

    Miko, thank you for putting yourself out there and sharing your important story. I am an emergency doctor and took 6 months out of my training to do some voluntary work for the exact same reason. Reading your blogs have brought back some painful memories for me, but know you are doing exactly the right thing by taking this time for yourself, speaking as someone who has been through this journey already. I am so impressed by your insight and approach to treating yourself as a whole. I wish you all the best and feel confident you will come out of this a better human, no matter what path you decide to take. And your story is already making a difference, for that you should be very proud.

    1. Miko says:

      Thank you Caroline. I still have my days of struggle, but I am glad that I learned sooner rather than later that I don’t need to suffer so much. Since resigning I have done so much research on wellness and enjoy a lot of self-care activities these days. Thanks for reading, and for your kind words. Miko

  5. Anon says:

    Thankyou for writing this, and the original blog Miko.
    You’ve got guts girl. Go strong.
    From a fellow Doc who has suffered and is still finding herself.

    1. Miko says:

      Thank you lovely. It’s a hidden agenda that we all need to talk about, and it seems it is prevalent all over the world. I hope you are okay and will find a sense of peace soon. Best wishes, Miko

  6. Chris says:

    The training system is so broken and this kind of advise should not be allowed. Hopefully positive changes will come soon so that no one will have to be put in this kind of situation anymore. Glad you’re getting better, and all the best with your future endeavours.

    1. Miko says:

      Thank you Chris. I do hope that some change will come of this. I’m certainly doing my best on my part by spreading the message through various media channels, which will be slowly coming out over the next few weeks. Best wishes for your future also! Miko

  7. Benn says:

    Hi Miko,

    Thank you for sharing your story. I spent my first few years after med school at Bankstown and it was a place that i couldn’t wait to get away from.

    I ended up completing anaesthetic training, and now live in San Francisco. I was pleasantly surprised at the gender positive culture that the surgical department has fostered here. More often than not there is not a single man on the ‘other side of the drapes’.

    If you are ever in this neck of the woods, drop me a line and i’ll show you around.

    Good luck and keep sharing – it makes more of a difference than you can ever know

    Cheers

    Benn

    1. Miko says:

      Hi Benn, thanks for your comment. Sorry to hear that your Bankstown experience was also a negative one. I hope San Fran is treating you well! I’m glad to hear that the workplace environment there seems to be much better. Best wishes to you, Miko

  8. Thank you for sharing part two of your story. I am sorry this happened to you and I am glad you are taking time rather than rushing into anything. You will have a legion of doctors supporting you with whatever you decide to do in the future, be it yoga or something else.
    Also teaching is awesome (from another lover of medical education!)

    1. Miko says:

      Dear Em, thanks for your kind words. Yes, teaching *is* awesome! It is also incredibly rewarding to be able to nurture the future generation of doctors, and hopefully teach them to be good eggs. Miko

  9. Leo says:

    Thank you for sharing your stories to the world. Hope you continue to get better soon, and get to spend time with things and people you love! Looking after yourself is the most important thing now, and for someone this capable the whole career thing will work itself out later. No matter what future ends up to be like, I’m sure you’ll be able to bring positive influences in other people’s lives 🙂
    P.S. Your posts inspired me to take up yoga as a mean to handle the stress of med school too, would love to try some classes one day!

    1. Miko says:

      Hi Leo, thank you. Please do try and make it to a yoga class – it really did change my life. There are so many different styles of yoga, so I’m sure that there will be a style that suits you. I have written a blog post on how to get started with yoga, if you are interested: https://mindbodymiko.com/how-do-i-start-yoga/

  10. Catherine says:

    Hi Miko. I’m a junior doctor in NZ. Just wanted to say that you are so inspiring. Thanks for sharing your story. Medicine can be full of unrelenting pressure and bullies. I am only in the beginning of my journey and am already seeing (and feeling) a lot of this. You are so brave. Best wishes for your healing and a lot of us here across the ditch and thinking of you and wishing you well!! Xxx

    1. Miko says:

      Thank you Catherine, I appreciate your lovely words. I do hope to see a cultural shift by the time you are a doctor, and I wish you all the best with your studies. Much love, Miko

  11. Dave says:

    Hi Miko,

    Wanted to say I was quite outraged by your earlier story, which triggered a recollection of my own experience of institutionalised bullying. Many years ago when I was a resident, I had an unfortunate run in with a psychopath consultant complete with trumped up misconduct charges and having to front up to a panel full of HR yes men. An excellent union rep and clinical documentation saved me from being sacked on the spot, but I knew my name was mud, and would have to move interstate if I wanted to continue my career as I couldn’t see any other path forward, and had no capacity or power to fight the injustices. Once I’d made the decision to leave, I remember one of the ward nurses confiding that I hadn’t been the first and had seen a lot of potential registrars leave the state after rotating through stating “If he thinks you are any good, he sees you as a threat.”

    Sometime later I found out from a junior colleague that said perpetrator was someone who had made his life very difficult too, receiving outrageous threats that he would be reported to AHPRA and lose his registration. He fought back, lodged his own complaint and after further investigation it was revealed that numerous cases of bullying had occurred due to this one individual. Despite this, the perpetrator only received what sounded like a slap on the wrist and still held their high position in the college. However, when I had gone to my fellowship award night I had expected him to be in attendance and would have happily given him a piece of my mind, yet he was conspicuous in his absence. At that point I figured that word had got around and he was now too embarrassed to show his face.

    When I look back now, I can say the move was a blessing in disguise. Things have worked out for me, and I hope they work out for you too whatever decision you choose to make.

    1. Miko says:

      Dear Dave,
      Thanks for sharing your story, and I am so happy to hear of your success. Funnily enough, I have had a lot of phone calls from Plastic surgeons interstate. I am still not in a position to make any future decisions, but it is nice to know that I have support if I want to go interstate for training. At the moment I am enjoying taking some time off to focus on my health and wellbeing so that whatever I end up doing, I will be happy and passionate. Best wishes to you and thank you again for your comment. Miko

  12. Kate says:

    Hi Miko. You are an incredibly courageous woman for speaking out. I have been there with burnout and serious health repercussions. Good luck to you. You are an inspiration. X

    1. Miko says:

      Thank you Kate. I’m sorry to hear you’ve experienced burnout too. It really does affect the entire body’s system doesn’t it? I hope you are better now. Miko xx

  13. Cindy says:

    Thank you for sharing your story, and all the best in your recovery xxx

    1. Miko says:

      Thank you so much Cindy, I appreciate your support xx

  14. Zac says:

    As a freshly minted doctor, I have followed your story with great interest. I am hopeful that with various campaigns like Operate with Respect and with colleges removing accreditation for the conduct of senior staff that stories like yours will become less common.
    I hope you find something that brings you fulfilment and joy. No matter what you do, your courage in sharing your story will improve the lot of many junior doctors to come, and as one of them; thank you.

    1. Miko says:

      Thanks Zac. I do hope that things will be better for you once you reach your registrar years. I do believe there are already changes taking place at the ground level, with individual units introducing new protocols for on-call work, from what I have heard back. Best wishes to you, Miko.

  15. Another Jnr Dr says:

    Thank you for sharing your story. Medicine has taken so much from me, and many times I have wanted to quit, but somehow am still here. Fortunately much of the bullying and sexual harassment has lessened since internship/residency, but still now, at PGY6, the difficulties of being a junior doctor, and a female one at that, are continually present and tiring. Glad to hear you are on the path to recovery! Your story is inspiring, reminding me that medicine isn’t the only way forward…

    1. Miko says:

      Thank you lovely. It’s such a tough pathway, but I guess we are all different and need to weigh up the positives with the drawbacks. I hope you are okay and that you’re currently working on a supportive unit. All the best, Miko

  16. Holly says:

    Miko, thankyou so much for sharing your story. As a consultant physician and medical educator, your experiences both during surgical training – and recovery subsequent to very wisely prioritising yourself and your physical and mental health – are inspiring. My first teaching session with our 3rd year students was today and, in addition to teaching them high quality clinical skills and reasoning, I’ll be damned if they don’t also learn to be passionate members of a healthcare team where everyone is supported in all parts of their life. A change is coming. You have the support of all medical women (and mums) in this country in your current and future endeavours. I hope you thoroughly enjoy 2019 and whatever you decide the future holds for you.

    1. Miko says:

      Dear Holly, thank you so much for your comment. I too am passionate about medical education and I am glad to hear that you are nurturing the third years. I appreciate your support. It means a lot to hear back from the medical community. Best wishes, Miko

  17. Greets from Europe says:

    Hi Miko, I’m a female neurosurgery consultant. As I read your story I empathised immediately and deeply with your feelings. I did worked a lot. I still do. I try to make it easier for the residents, but it just means I have to cover more. I have to stay longer just to do things they don’t because it takes time – but I’m a consultant and a trainer. If they fail, I fail. I raise a kid with a “full time contract”, I.e. 42 h/weekly, my schedule counts 70 every week + at least 10 overwork. I’m far beyond the point I would sleep everywhere in the clinic. If there is anytime for sleep on ward, I just can’t anymore. I just don’t fall asleep. And then I’m even more tired of course. I ask myself everyday where my old self is. I went so hard for being what I am, and now I don’t want it anymore. Everytime I drive home alone from the shift I just want to crash my car somewhere and no matter what.
    I enjoyed the part where you get back home. I read your words and I see you and your family and the park all so bright and vivid. It seems you’ve found your new place in this world and not a similar little hell, just keep going. I wish I could ever feel this way. Keep going.

    1. Miko says:

      Hello, thank you for your sharing your story with me. I am so sorry that you feel that way. I know that you must have sacrificed so much to reach your level of success. Surgery is so hard, especially for women, and I hope that this will change in the future because I have seen so many talented and dedicated female surgeons. Thank you for reading my blog post. I hope you are okay, and that your residents show you respect and appreciation for the extra work you are doing to support them. Take care and lots of love to you, Miko

  18. Thank you Dr Miko for blogging about this.
    I read articles about your experience on the way to work this morning and have not been able to stop thinking about it since.

    It unfortunately is not uncommon for the news to circulate around the medical communities about people quitting, leaving, doing something else, etc due to factors similar to what you describe. Theres even been a recent trend for such stories to make it onto the news, which seems like the only way some light gets pointed towards these darker sides of medicine. I have to say the way you have put it has felt more profound than any other case I have read about. I truly feel sorry that you had to go through this and wish you well in your process of recovery!

    It feels even more real coming at the start of the clinical year, and no less ironic that I first heard about your story from a JMO at Bankstown. I hope that staff responsible for rostering of juniors and trainee’s take a good look at the situation. You’ve definitely sparked conversation amongst many doctors in training. I was particularly irked that in none of the news articles I’ve read that anyone has even bothered to apologise to you! Yeah great, they said its now filled in by 2 registrars, but where’s the ‘sorry we had you working 2 peoples jobs’ statement? Probably too much to expect…

    Another topic that you highlighted was the vulnerable nature of being an unaccredited reg. I feel a lot of the complaints you could have potentially made were going to be at the expense of your future career, ie. chances of you getting onto the program. It just strikes me as a very terrible system that we have set up here, I’m not sure how other countries do it. They can essentially treat you terribly and get away with it. Goodness knows how many unaccredited trainees are in a similar situation to yourself but have just remained silent about it. And the comments that your bosses have made are atrocious, some people really don’t care about the work you do for them. Miko you deserve better.

    Again I really appreciate your blog posts and its given me a lot to think about.
    Best wishes for the future 🙂

    1. Miko says:

      Hello,
      Thank you so much for reading my story and for your response. I have not directly received any apologies, although I hear through a journalist that Bankstown issued an official apology last week sometime. Unaccredited registrars are so voiceless and vulnerable. It really is easy to take advantage of unaccredited registrars, which leads to so much abuse and exploitation. I truly hope that this will change in the future, as it really does start to devalue your sense of self. You start to feel less like a human and more like a machine.
      Thanks again for your comment. Miko

  19. Sam says:

    I am a lay person who just happened across your blog when I read about your trials at the hospital. This week we had a young doctor treat my wife and as a follow up, while we were home enjoying the satisfaction of a nice dinner and were settling in to watch a bit of TV, our doctor called to go over test results with us. It was 7:00 and she sounded so very tired and I immediately thought of you. I am thinking about sending your blog to her. Thank you for writing all of this.

    1. Miko says:

      Hi Sam, thank you for your comment and apologies for my delay. I am glad to hear that your wife had a nice doctor treating her. Most of us really do care so much for our patients, and always try to communicate well, keep you in the loop, and be there for your treatment and recovery. I wish your wife a speedy recovery. Best wishes, Miko

  20. Trevor says:

    I’m not a doctor and I don’t do yoga. I can’t say I can relate to any of your issues but I have been following your blog for some time. I admire your strength and integrity and just needed to comment that. If you ever decide to leave Sydney, Melbourne would love to have someone like you – whether it’d be in academia, a hospital or yoga studio! Hope to see updates of you making a full recovery! 🙂

    1. Miko says:

      Thank you so much Trevor. Yes, I am slowly making my way to my old self… at the moment I am doing a lot of yoga, which is nursing me back to good health both physically and spiritually. I appreciate you reading my blog, and I do apologise in advance that the next few posts will probably be dedicated to junior doctor health, but I think burnout and self care is a universal issue with things that could benefit anybody. Best wishes and many thanks for your support, Miko

  21. Lizzie says:

    Dear Miko,
    Thank you for sharing your story with us all.
    I don’t really know what to write to you next as it’s all coming out as trite.
    To take the steps you did – speaking up, saying no, resigning and then recovering – required great wisdom, strength and courage.
    But the next step and choice – to share your story openly and publicly – required even more guts. You’ve contributed significantly, memorably and positively to such important issues: junior doctor working conditions and institutional abuse.
    Thank you for helping us to have a hard conversation about rights and responsibilities and needs and feelings too.
    I wish you a happy 2019. And hope that your recovery continues to go well.
    With love and good wishes,
    Lizzie

    1. Miko says:

      Dear Lizzie, thank you for your lovely comment. It was a hard decision to walk away from everything I had worked so hard for, but ultimately it helped me realise what my core values are – health and family. I am slowly working towards becoming my healthy, happy self again, and I am grateful that I now have more time to spend time with my family, even if they do live far away. I do hope that we will see some significant changes that we desperately need in our system. Best wishes, Miko

  22. しゅあいぶ says:

    Hi Miko,
    So sad to see all this stuff happen in a first world country. It reminded of my time at work. Me myself being bullied by some old women duo and then getting injured with bi-lat cts, and then being bullied by management; so I don’t get on work cover (as it’d increase their annual insurance etc and this was at another Hospital X); not that I wanted to. It’s the same hospital that’d save every penny during a year, not hire casuals etc and splurge on EOFY on computers and upper management bonuses; just so they can keep getting Govt. funding at the similar amounts.

    Sadly people with debilitating pain suffer more, unless you have your hands chopped off, I wouldn’t even consider asking for workers comp. But then came the point of pushing myself for a few months, to the point I could not even open taps without getting some shock/pain and not even able to hold a pencil to write. Then the day came, when I myself was looking up at the ceiling and wondering what am I doing to myself; and what a sad state of humanity we have at the workplace. I mean it’s just everywhere, profits before people. Sadly for me, I had no one in this country, if I had my parents, I would have quit at the bullying stage itself. I value peace of mind now, above anything.

    Hope you find or have found something better.

    1. Miko says:

      I’m so sorry to hear of your experience, and I hope that your hands are feeling better. As all of my family members are in Japan, I too suffered alone, and I kept it from them for a long time because I did not want them to worry about me. Telling them was the most liberating thing I did, because just like any family, they were just concerned about my wellbeing and did everything possible to support me and continue to be very loving and accepting of me in my current state. I do feel better things are around the corner for me, and I hope they are for you too. Best wishes, Miko

  23. Dear Miko
    Like many I have seen your post via Facebook groups. I’m a consultant in Anaesthetics. I’ve been lucky to have worked in nice hospitals with mostly understanding people when I was training.
    Where I work now is still mostly good for our Surgical Trainees but I do my part to help them where I can. Things like answering their pager for them when they are scrubbed during a long case but also on call and so I will take messages or liaise with whoever is ringing etc etc.
    The look in their eyes at how grateful they are for me helping them makes me sad. But if I can help make their lives a little easier then I see that as one small thing I can do. I can’t change the world but I can change my little corner of it.
    Thankyou for sharing your story. I hope with all my heart you heal soon and find your own little corner of the world where you can be at peace.

    1. Miko says:

      Thank you so much for your beautiful words. My best friends at the various hospitals I’ve worked at over the years have been the anaesthetists. They are the ones I have conversations with whilst I operate – they were my social life in theatres. All the anaesthetists I’ve had the pleasure of working with have always had a lot of sympathy for me and have often been the highlight of my day, whether it’s their fun playlists or their kindness and teamwork. I’m so glad that your surgical colleagues have someone like you – you definitely do make their life so much better. Thank you again for your comment, Miko

  24. Wow! your story bought a tear to my eye. I hope wherever life takes you next you are happy and healthy. As a medical school aspirant I hope things change in the future. Thanks for sharing your story. Love H.

    1. Miko says:

      Hello, thanks for your message. Yes I am optimistic that things will improve (sooner rather than later!). All the best to you and your studies. It is a rewarding career, and the working conditions will hopefully be kinder when you are out in the workforce! Miko

  25. Hi Miko,

    I am an Advanced Trainee in a Medical Specialty. Thanks for sharing your story. Its very inspiring and I am sure it resonates with a lot of junior doctors because we all go through a version of this story in our own lives that may be quite small or big but we all find it difficult to bring it out into the public domain. Its courageous of you to share it with us all and challenge the institutions and the closed off medical fraternity to change its culture. I truly wish you the best in whatever choice you make in the future because I am sure it will be the right decision for you.

    1. Miko says:

      Thank you so much for your comment. I’m sure being an APT has a lot of stresses and pressures too. As I wrote the blog after deciding I wouldn’t go back, I felt like I had nothing to lose so I don’t feel like I’ve been particularly courageous. Partly it was for selfish reasons, seeking catharsis. However, I hope some positive outcomes will come out of my suffering because I do now want future colleagues to go through this kind of treatment. Miko

  26. Ryan says:

    Hey Miko

    Thanks for your courage in sharing your experiences which will hopefully improve things for some, and educate others taking that path. I agree everything happens for a reason and hope in a few years you will look back and see your breakdown led to your breakthrough moment/true calling.

    Stay strong and keep up the good blogging and yogi-ing. You have many talents beyond cutting.

    1. Miko says:

      Hi Ryan! It’s been a long time since I worked with you briefly at the Alfred! I hope you have been well. I already feel as though I am regenerating and see myself being happier in the future by taking this different path. Re-starting with a blank canvas can be scary and intimidating, but at the same time exciting. Thanks for your support! Miko

  27. Kim says:

    Thank you Miko, for your resilience, strength and honesty. I’m currently recovering from burnout and it’s taken a lot for me to just tell people I know. The failure at first seemed very overwhelming, until you realise it’s not you that’s broken, it’s the system. I also practice yoga for wellbeing and have found some very helpful resources, namely ‘Healing without Freud or Prozac’ by Dr David Servab-Schreiber, and thehappymd.com. In sharing your experience I am sure you will help create positive change for many doctors and patients. I wish you the very best on your recovery and exciting new ventures, and thank you again for sharing. You are an inspiration!

    1. Miko says:

      Dear Kim, thank you for your comment. I’m sorry to hear that you’ve also suffered burnout. The recovery is a lot longer than expected, isn’t it? I still can’t believe how long it’s been and yet I don’t have the stamina to get through a full day without needing a Nanna nap. I know that I made the right decision for my body and hope that soon I will be back to my normal energy. I wish you the best in your recovery also, and thanks again for reaching out. Love, Miko.

  28. Miko thankyou for sharing your story. I’ve taken a longer road for the same reasons, I did all my early training in Western Sydney and the stories are all the same. At one point the entire workforce unit quit. At another point they ‘forgot’ to send out contracts for 30 junior doctors. To be told it has something to do with resilience is just silly. More and more though, I’m seeing people stop and take time out. Part of me cheers for them, the other part feels angry. No one should be having to take extended periods of leave to recover from their job! And yet here we are, suffering the effects of criminal workloads and piled upon vicarious trauma from everything we see across those insane hours. The bar is SO low for patients in a hospital, that ‘keep em alive until morning’ mentality, that bare minimum we are supposed to provide, where we are derided if we want to offer something more than that…I’m so tired of it. Thankyou again for speaking up.

    1. Miko says:

      Thank you for your comment. I completely agree with you. Yes, of course it’s important to have resilience, but most of us are already very resilient. Years of working in the public system will harden most people up. We see the worst (as well as the best) of humanity, we see tragedy, we deal with difficult situations… and yet when we show any signs of stress, we are suddenly looked upon as someone who requires more resilience. No. We are strong. It’s the system that needs to treat us like humans. Thank you again for your thoughts. Miko

  29. RACP “Accredited “ Maedical Registrar says:

    Dear Miko, I am so impressed the way you express your emotions as you go through a very traumatic time of your life – I think you must consider to be a “ writer
    “the broken system FORCED you to loose your DREAM job that you were in love with and put all your life into it as the system REQUIRED you to do “ this is HOW it is, make it happen , when I was a registrar I was the only one” I am sure every registrar who speaks up for unsafe working hours who heard all these words of arrogant , narssisistic , money hunger fat cat “ RESPECTED” consultants , mainly Anglo Saxon WHITE Males who were always favoured and did the least job to get highest stake. you have started a movement #MikoToo.
    I am sickened to hear that this happened to you because you we’re “unaccredited “ and surgical registrar . You were just BRAVE enough to speak up. I am a Physician trainee and had to resign at the end of my six years training just before submission to Fellowship . Anyone who keeps SILENT will let this brutality to continue at the cost of Patient care. I have chosen a different way to increase awareness – LEGAL Action and aI am hoping the details of mobbing and harrasment by RACP senior members will be soon public. We need to go to the BASE of the iceberg which is the medical colleges and hospital CEOs and Executive directors. My sincere thanks for opening your heart and mind publicly so honestly but you made a dicference MIKO 👏👏👏👏#MikoTOO #TimeisUp# Enoughis Enough

    1. Miko says:

      Thank you so much for your empathic comment. I’m sorry to hear that you had to resign so close to finishing. I know that there are many more doctors suffering in silence for fear of repercussions. I really hope that we see some institutional changes, as you describe. All the best to you, and I hope that you will find a sense of justice with your process, as well as peace in what you choose to do next. Miko

  30. Winnie says:

    Dear Miko, thank you for sharing your story. Our roles as care-givers often mean that we don’t get to look after ourselves in the same way + the system doesn’t look after us the way they expect us to look after others. Gotta constantly top up our cups, that’s for sure. All the best for your future goals, whatever they may be.

    1. Miko says:

      Thanks Winnie. Yes, it’s so ironic isn’t it? We look after others yet we are not looked after. There’s only so much “self care” we can do. When there is blatant abuse, we feel helpless.. and when a career pathway is at stake, we are voiceless as well as helpless. It’s a sickening experience for many.

  31. Dear Miko
    You are blessed with courage, self-awareness, thoughtfulness, connection, community and a shining spirit (and so much more). Your story speaks volumes of the changes that must occur for everyone involved in healthcare to thrive, including patients and the sacrifice you’ve made that’s now inspiring many around the world to take action. Your viral blog made its way into our training sessions to help trainee moderators of our App SafeSpaceHealth learn about what goes on behind the scenes in healthcare & how we would respond to disclosures of this type of abuse by health professionals in our App (safespace.health/moderators). What stands out to me the most from everything I’ve read from you and the response from others is the concept of surrender. Surrendering your job, identity, dreams and the forms they took because you had no other choice that would sustain you, to open up to other possibilities. It seems like you’ve passed a massive test and you’re still recovering and healing from it while also preparing for the next phase/initiation into another way of being in the world and serving others. I’ll be following your story with interest.
    Many blessings for endless support, healing & courage to surrender.

    Om Namo Narayani

    Nathalie
    Chief Healing Officer & Wellness Facilitation Trainer @SafeSpaceHealth

    1. Miko says:

      Dear Nathalie, thank you for your beautiful words. Sometimes we become horses with blinkers on, because we can only see that one path that we have put all of our blood, sweat, and tears into. The reality is, that a medical education can give us many opportunities… however, once we are set on that one dream we work so hard to make it happen that we don’t realise that there are other options. I am looking forward to exploring what those options might be for me, and at the same time finding myself again and live a happy life where I don’t feel taken advantage of. Thank you again, Miko

  32. Victoria says:

    Hi Miko, thanks for sharing your story. I am an ex surgical registrar and resigned and after eighteen months off am retraining in general practice. I worried it wouldn’t be procedural enough but I am loving it and really enjoy the continuity of care, like you liked with Mr B! I also find it a much more level hierarchy and much easier to have a balanced life (I work part time). I totally relate to learning to love you seperate from your career, that was a really hard adjustment for me but has been really good for me long term and I actually think will make me a more empathic doctor as I am less tied up in my role. I have now got so much beauty in my life that I didn’t have before! In some ways although burnout and the situations that occurred to me were very painful, I am so glad it got to snapping point as otherwise I would never have stepped back so far, and found my unattached self . Kia kaha xx

    1. Miko says:

      Dear Victoria,
      Thank you for reading my story and responding. I am so happy to hear that you’ve found a career you enjoy in GP. Yes, I love being able to provide continuity of care, and I think the patients like seeing a familiar and friendly face to look after them. During this time off, I have also discovered the joys in life that I previously could not find the time for… so in the long term I know that my suffering was needed in order for me to realise that there are greater things waiting around the corner. Best wishes to you, Miko xx

  33. Caroline says:

    Hey I am a nurse and your original story has been reposted a bunch by us at work with shout-outs to our fellow Emergency colleagues and others. I loved reading this and has reminded me heaps of my needed recommitment to self over my job. Nursing has excellent supports but the demand of clinical work and caring for others is high. I could not relate to working that many hours and surviving but I can understand the pressures and demands slightly and could not believe what I was reading. I wish you continued courage in your recovery!

    1. Miko says:

      Hi Caroline, Thanks so much for your comment. It’s so hard to put ourselves first, isn’t it? I’ve learned how important it is… even if it took such an extreme circumstance to help me come to that deep realisation. Thank you for your well wishes, all the best to you too. Miko

  34. Rachel says:

    Hi Miko,

    Thanks so much for continuing to share your story. I found you after somebody on my Facebook feed shared your original story of this happening. Even though I am not connected with the health and medical industry at all (I am a graphic designer and musician), your story is so relatable. It is so touching to read your stories because they come from an authentic place.

    All the best for what will happen next. Thanks for sharing your journey.

    Rachel

    1. Miko says:

      Dear Rachel, Thank you for reading my story and responding to it. I’m glad that my voice came across with the post. I tend to write as I think, and don’t really edit anything unless I find a spelling mistake afterwards. Thanks for your well wishes, and all my best wishes to you also. Miko

  35. Clare says:

    Thank you so much for your blog Miko, I’ve had similar experiences myself although not as bad but I still find myself regularly wondering if there’s a better life out there. I can’t believe that text message your HOD sent to you… horrible

    1. Miko says:

      Hi Clare, thank you for reading, and for your response. I’m sorry to hear you’ve experienced something similar. Yes, the treatment I received was cold and passive aggressive during my term there.. I am glad that I got out of there. All the best to you and thanks again for commenting. Miko

  36. Anon says:

    Thank you Miko for your bravery. I have had to leave surgery recently. My child died and the department I worked at would not let me drop down to part time work. No one in our field thinks this is shocking but it truly is. No one in my department stood up for me—they are still short staffed but all they could see was that my doing less would mean that they would have to do more, and they more or less tried to bully me into doing more than I could cope with in difficult circumstances. You were right when you said that this job is not worth dying for. They think we are flat packed out the back. The awful thing is it is a bit true: they CAN usually get someone else. In my case I decided that I’d been abused by medicine enough and I am two years into a totally different career path now. I loved what you wrote about learning to leave your attachment to surgery in your yoga practice. You sound like an amazing person, and I am hopeful for you.

    1. Miko says:

      Oh, I am so sorry to hear you lost a child… that must be one of the hardest experiences for a person to go through, and I can’t even imagine what that must feel like. I’m so sorry. I’m appalled to hear that no one would support you through such a painful time. I’m sure you are still going through a grieving process, and I send you my thoughts and a lot of love. I’m glad to hear that you have found a new career path, which I hope is treating you much better than your department did. Thanks for sharing such a personal story with me, and I hope that you are okay. Much love, Miko

  37. Dear Miko,

    thank you for sharing your harrowing stint in such detail and thoughtfulness from start to finish. In our high-demand, high-velocity profession, it is not often we get to articulate our thoughts and sentiments with such clarity. Thank you also for reminding all junior doctors (and aspiring registrars) that we have to take care of ourselves before we can begin to heal others, before the light of unconditional love that once burned bright within us dies out. I hope you take much time as you need to recover and find your place, ‘cos by the sound of it, despite the storm, your heart still remains warm and golden. Best wishes from Singapore!

    David, Internal Medicine Resident
    Singapore

    1. Miko says:

      Thank you so much David. I appreciate your kind words. It took me a while to find the strength to write the blog posts related to my breakdown.. sometimes I still talk about it and it makes me teary. It’s been a hard experience, but a necessary one in order for me to realise what’s most important. I hope the experience in Singapore is better. Best wishes, Miko

  38. Doctor Strange says:

    I left hospital specialty training years ago for similar reasons: unsupportive seniors who believed in the cultural hazing and overworking of juniors, an oblivious medical administration with budgetary and understaffing concerns of their own, and despite my love for the case-mix and patients, I was burned out and too unsafe to practice on the patients I was meant to be caring for. Since then I’ve had with no regrets on deciding to become a General Practitioner instead: I completed my training with caring and supportive supervisors, flexible work and study timetable, an empathising study group at the time, my wife and kids are happier, I love my case-mix and patients who I have been seeing for the last decade, and I still dabble in a bit of minor surgery in my practice and surgical assisting at the hospitals. Unfortunately our ambitions and careers are inevitably shaped with whom and where we are working; and, whilst there are probably a handful of supportive and caring bosses and hospitals to work in out there, a significant proportion of them are still culturally stuck with the mistreatment of junior doctors; there seems to be a systemic forgetfulness that if you fail to look after your employees, they fail to look after your patients. At the end of the day, you have to do what is right for you (and your family); and the heartless bosses who see you as less of a person because of this, are probably not worth working for. Burnout affects the best of us, and the scary thing is that you don’t always see it coming. Rest-up Miko, and find comfort in those who care about you; and, when you’re ready, I’m sure there are many people out there will give you a chance 😉

    1. Miko says:

      Thank you so much for your thoughtful comment. I am so glad to hear that you have found a fulfilling career in General Practice. You are absolutely right – I have met some of my favourite humans through Plastic & Reconstructive surgery, but I know that there are still plenty around who will make my life difficult. That is my reservation in going back; that there is no guarantee that things will get any better for me if I am re-accepted into Plastic surgery. It is a heartbreaking decision to walk away from something that has been a dream for a long time, but ultimately I just want to lead a happy and meaningful life… and I am working on it! Thanks again, Miko

      1. Doctor Strange says:

        “Why do we fall? So we can pick ourselves up again.”

        Keep your chin-up, Miko. Your dream is not over yet. When you’re ready, give it another chance.

        Remember you are not alone, and we are here to help stand by you.

        Like you, I am a classically trained piano geek. I believe if you could persevere through the gruelling hours of learning how to perfectly play that piece of music for that licentiate exam receital, then specialty training should be a walk in the park. So long as you find the right teacher and place to practice.

        I look forward to the day I can refer patients to you!

        1. Miko says:

          Thank you. I’m not sure if/when I would return to surgery.. There are so many parallels between being a pianist and a surgeon – emphasis on technique, hours of practice and dedication, and passion. There are times when I feel like my hunger for surgery is still there, and other times when I teach a yoga class and feel so fulfilled. It’s a hard one to decide! I like my non-surgical life now, but perhaps I will miss it after I recover completely, I do not know yet. Miko

  39. stillathospital says:

    Hi Miko,

    I first stumbled on your original post on Facebook and now following onto this blog. Firstly, I want to congratulate you on writing this. It takes a tremendous amount of courage to make public knowledge about any injustice that is deeply engrained due to fear of consequences. As an ex- male surgical registrar, I cannot even fathom what you as a female more advanced trainee have gone through, let alone other things that happened that have even made it onto your blog post.

    The problem is not you. The system is broken. The system has not changed because of dogma, fear and fear of the unknown consequences of attempting to make change.

    I am not in a position to tell you how to recover. But reading the above, I can relate to something simple in my backgarden that I hope can guide you.

    Once I bought some ginger. It was slowly drying out in the the pantry. One day, I decided to plant it. I took it out of the dark and dry and buried it in a light layer of soil in a sunny spot. I had little hope of it surviving. But I watered it. A little amount each day, except when it rained. All I knew was it just needed water and sunlight. Weeks passed, turning into months. I thought it had died, but I did not care. I didn’t change the routine. Only a few days ago, I saw a shoot one day and curious, I dug cautiously around it. The ginger had grown.

    1. Miko says:

      Hello, what a beautiful story! I love ginger too, which made the story even more lovely. You’re right.. we go through a lot worse than what my tame blog post has described. There have been far worse incidents over my working life, but for now I felt that what I wrote was enough to convey the situation I was in. Perhaps I will have an opportunity later on to chronicle more of what I’ve experienced as a female in surgery. I hope that you have found a better life, and I wish you more happy garden stories! Thanks for sharing that one – love it! Miko

  40. Ness says:

    Hi Miko, Thank you thank you thank you for sharing your story. It took so much courage. Medicine is broken – those who survive the brutal conditions are revered, those who do not tolerate the mismanagement are often ostracised. It’s horrible how the medical culture labels the individual as faulty (not resilient enough, not efficient enough, not dedicated enough, “an emotional female”) rather than face the truth that the system is faulty and causing harm (to doctors and patients). Unfortunately hospitals/colleges have a monopoly, too many people are willing to endure the conditions and not enough are demanding radical change. I’ve stepped away from medicine as well and have also come to a place of mindfully detaching my self worth from achievements, it was hard, it is still hard but your story resonates so much with me and with so many and gives us all strength and inspiration. Thank you again.

    1. Miko says:

      Hi Ness, thank you for your thoughtful comment. It’s always a shame when someone has to walk away from medicine because we have dedicated so much time and effort into becoming great doctors… but in the end we must have self worth and the desire to have a life that aligns with our values… that was something that was obviously missing for me towards the end. I hope you are in a happy place now. Warmest wishes to you, Miko

  41. Anna says:

    Miko,

    Thank you so much for sharing your story 🙂 It’s such a scary thing to do in medicine, where speaking out can have all kinds of ruinous consequences for your career. The word ‘brave’ is thrown around excessively these days in response to people sharing personal stories but in this case it’s apt – this was really really brave of you <3

    I'm a female junior doctor (only PGY-1!) and I was really confronted (as I should be!) by your story, and I found it really heart warming in this follow-up post to see that you've found some happiness after everything you were put through. I especially love your message that we are not our occupations – that's not where our self worth should lie. It's such a tenuous, fleeting and superficial thing to put our self-esteem into – but it's hard not to when that is the message we are constantly bombarded with! You're so right – it's enough to just be ourselves. After all, medicine is just a job at the end of the day. A good job, sure. A worthwhile calling – absolutely. But still -it's just a job. We can't go home to it at the end of the day and it won't be there for us when we're sad, or hold our hands when we're sick in a hospital bed.

    I hate how our system treats junior doctors, especially our surgical trainees – I really hope that those in power start to listen to stories like this and work to change things. If not – I hope I have the moral fortitude to change things once I am in that position.

    I also think you're a talented writer! All the best <3

    1. Miko says:

      Thank you so much for your sweet words, Anna. Please don’t feel discouraged by my story, and know that I absolutely loved my job until my poor experience last year. It doesn’t always have to be like this, although sadly from the responses I’ve received, it seems to be a common and prevalent problem. We become our jobs because we dedicate so much of our life and soul into it… but ultimately medicine is what we do, not who we are.. and sometimes it’s hard to separate those things because medicine becomes so much of our identity with time. I hope your internship is going well so far, and please take care! Miko

  42. Francesca says:

    Thankyou so much for posting this, I was worried about you. I am a physician trainee and one of the things I carried the most guilt after my exams was that I couldn’t see that my colleagues were really unwell. I was just trying to swim and I was unable to see beyond that. Our hours were nothing compared to yours. We had a few deaths in our cohort, and it took time to come to terms with the fact that we as juniors aren’t really in the best place to look after each other. I hope you know how brave, resilient and strong you are, and I am so glad that you are ok/working on being ok.

    1. Miko says:

      Dear Francesca, thanks for your message. I have several friends who have gone through physician training, so I was aware of the suicides around that time. It is so incredibly sad. You’re right – we are all under so much stress that it’s hard to look after others when we can barely get by ourselves. Don’t feel guilty – it’s not your responsibility to look after everybody. These things always have so many factors to it that we don’t always know about. I hope you are okay. I am doing much better, thank you. Warmest wishes, Miko

  43. Valentina says:

    Hi Miko,
    Reading about your time with your family made me tear up. Mom really always knows best and I always found myself confiding in my mom when I’m feeling so overwhelmed and broken. Reading about your grandmother and mom really warmed my heart and I made a phone call to them right after. Most of my family is on another continent , thankfully the most important person in my life, my mother, is here with me in Rhode Island, USA . Sometimes I wonder what I will do when I must move away to explore careers and countries beyond anything I have experienced yet. How have you coped with being so far from you family especially when you experienced doctor burnout? You blog is inspiring thank you for your good vibes.

    1. Miko says:

      Dear Valentina, thank you for your comment. Family is just so important – I really underestimated their power in my healing process. It’s hard for me living alone in Australia but thankfully I have a good support system in Sydney. I feel like I am surrounded by people who care about me, and can call them at any time. Of course it’s not the same as having family around, but I talk to them every day at least by message, or if I can, with FaceTime. I am glad to hear that your mother is close by. All the best to you, Miko

  44. Angie says:

    You are amazing and brave Miko.

    1. Miko says:

      Thank you Angie!! Much love to you

  45. Adrian Mondry says:

    Dear Miko, I’m wishing you a good recovery back to a fully enjoyable active life. Your blogs are read by many medical professionals , I’ve gotten the link from one of my favourite younger colleagues. Burnout is, of course, not a new thing- but talking about it is. An older version of the Oxford Handbook of Medicine has this essay on teamwork and a struggling colleague who at the very end- when it is too late- cries out: ”why did you never say something?”. So with you being in the opposite corner, I believe that not just your former hospital, but your whole specialty training establishment should THANK YOU for speaking out, many times, to tell them what went wrong. What they did wrong. Reading the above update, I have no doubt that you will find your way. In my own experience, I’ve often seen that the best doctors were the ones most affected by inhumane training or working conditions, but I have also seen some remarkable careers come out of the struggle. It doesn’t have to be medicine- please make sure you analyse why you chose that path in the first place. If the choice is one you made for yourself- not to please others- and the reasons you had are still valid, you will ease back in when the time is right. But if this is not so- let it go. Life is beautiful, and it is yours to live. All the best!

    1. Miko says:

      Dear Adrian, thank you for your lovely words. Ultimately, I want to pursue a career that gives me a sense of purpose. I can still help people and have a rewarding career by becoming a medical educator, for example. I know that I have been lucky to have a job that I loved (until that last fateful term), which not everyone has the privilege of having. However, going through such immense suffering and being forced to stop has made me realise that there is so much more to life than a perfect post-operative x-ray. I see it as a blessing in disguise that I now have more time to dedicate to my spiritual practice of yoga, as well as more time to spend with friends and family. Thank you for reading my story, and for your thoughtful comment. Miko

      1. Adrian Mondry says:

        Dear Miko, it is a blessing overall, to be sure. I am glad that you see it as such already. Changing tack along the way makes for a more interesting life and, ultimately, helps to gain the experiences and maturity that a “good doctor” really needs. Sometimes you will look back and wish you had lived closer to the line, then chuckle and enjoy the full 3D technicolour reality of what you have become (I hope). That chuckle, and a solid social network (partner, birth family, friends…) will then pull you through. All the best!

        1. Miko says:

          Dear Adrian, thank you for your comment and lovely phrases. I do think of it as a blessing in disguise, and 2019 has already turned into something completely unexpected – in mostly a good way. My best wishes to you too, Miko

  46. happy to be a GP says:

    I was nearly broken by a paediatric training program (not even as extreme as your experience) but got out before I got to true burnout point. After a period of re- evaluation and considering leaving medicine completely, I went into general practice and medical education, and there I found my niche. I have always considered 8 sessions a week full time work (and mostly I do less). Sure, I will never be wealthy but at least I am happy. Yoga is not my thing, but the Tennis club is where I go to de-stress and bushwalking is where I find peace. I do my best to support other doctors one-to-one, and admire your bravery in speaking out for change. All the best for your future path.

    1. Miko says:

      Thank you so much. I’m sure the other doctors whom you support are grateful for your care. I’m sorry to hear that the paediatric experience was a tough one. I am also hoping to be involved in education, which I think is very rewarding. I understand that yoga is not everyone’s cup of tea (although I’d love to help people discover yoga, because I actually believe everyone can do yoga, and would enjoy it with the right teacher!) but I do believe that any form of physical activity, especially combined with nature, is so good for the soul. Thanks for your well wishes, Miko

  47. Thanks for outlining how broken our NSW Health system is. In my career I have seen countless excellent surgical and medical trainees being mistreated by their bosses. There seems to be 2 recurrent themes. Senior doctors cutting down talented doctors as they are perceived as a threat. In the US it seems anyone with talent is sought after as they will enhance the facility/private practice. The second theme is to abuse the talented trainees so that public patients can be sorted. This of course frees up private time (work or leisure) and lessens inconvenient call backs for the bosses. Medical Administrations facilitate this by saving money on Consultant hours and trying to underpay genuine work hours claimed by trainees. The AMA and Colleges are keen to take your money to subsidise their own agenda and not our issues at the coalface. I became despondent as a Consultant in a public hospital and after many years of abuse, quietly operate in private practice looking after those patients mistreated by the health system. Take time finding your new happiness.

    1. Miko says:

      Dear Vim, thank you so much for your comment. With time, it’s so easy for us to become jaded and disillusioned by the “system”, as you have observed. At the moment I can’t see myself possibly going back to the public health system… I feel like I gave my everything. I don’t regret anything, and treasure some of the beautiful interactions I’ve had with patients and their families.. but now I put myself first, and hope that from now on I will value myself enough to live a happier and healthier life. Best wishes, Miko

  48. Dear Miko,
    Thank you for sharing your traumatic experience. I am a big Dragonball fan. I just want to say that a Saiyan’s power increases dramatically every time they get beaten down.
    Gambatte !

    1. Miko says:

      Hi Winston, thank you. Despite being Japanese I don’t know anything about Dragonball, but I appreciate the thought. Best wishes, Miko

  49. Zelda says:

    Hi Miko,
    reading about your love of yoga and anatomy and maybe education – may I suggest talking to the team at Imperial College in London? They are running 12 week mindfulness courses for their undergraduate med students as an elective, utilizing Yoga and how it relates to anatomy. I listened to a talk they gave at a conference last year, and it was fascinating. I really admire you for speaking out, it takes courage.

    1. Miko says:

      Hi Zelda, Oh that’s fantastic! What a great elective. That’s definitely something I would be interested in. I will keep that in mind. I might ask the Facebook page what they think about doing a similar course in Australia. Thanks so much for that information. Miko

  50. Andrew says:

    Dear Miko,

    Thank you for your courage in sharing your experience.

    As an ex plastics hopeful, i feel your pain as an unaccredited surgical registrar. In one instance, i went from co-author on a plastics textbook, to editor, to single line in the acknowledgements. I didn’t speak up because i didn’t want to be black listed.

    Another time i worked 39 hours straight in gen surg/trauma. Another time i didn’t see sunlight for 3 months (evening rounds, weekend shifts and preparing audits). You have shone a light on the previously invisible unaccredited doctor.

    The aftermath is something not talked about. We cannot help but be self critical. The fact we can just “disappear” once we don’t get re-employed or resign is a real problem. There’s no junior doctor welfare officer for us.

    As someone who has moved on from my “calling”, stepping out into the unknown can be just as terrifying, if not worse. As a doctor pausing a career or considering another, it can become an existential crisis. It is something experienced by a number of us but not openly discussed. Again, thank you for being so open in your thoughts. Your words will help many in similar situations for years to come.

    I pursued a doctorate and worked as an anatomy tutor before getting onto another program. It took me 8 months to feel human again. Initially i felt very guilty for having so much free time. Again, thank you for keeping us up to date with your experiences. For doctors transitioning in some way, it can take many months to years.

    I’m not going to suggest a path, because for every one of us it is unique. You seem already more balanced and in tune with yourself than a number of other doctors.

    It will present itself in time and you will be GREAT at it.

    1. Miko says:

      Dear Andrew, Thank you for sharing your story. I am so happy to hear that you have found success in another training program. You’re absolutely right, it’s so shattering to leave what you thought was your future path… and it truly is an existential / identity crisis. Detaching my sense of self from my job was difficult, as we become our jobs due to the sheer number of hours and mental power we commit to becoming surgeons. However, once I was able to do that, I was able to see myself as more of a human spirit rather than just my job title. I’ve been shocked by how long it’s taken for me to recover .. it’s a long process that is not linear. I have my ups and downs.. but overall I am on the rise again and hope that I will soon be able to find my new routine. All the best to you, and thanks for your comment. Miko

  51. Dear Miko, thank you so much for sharing your story. Thank you for being so brave. I hail from Singapore and we have very different careers (I don’t work in the medical field) but I can completely relate to your story of overworking for an organisation at the expense of your own health. I thought I had found the right job, something that I had potential in, with many opportunities for growth, and recognition from senior management. Until it started to become overwhelming and consumed my mind and soul. I was given more and more work to do until I realised that I was spending up to 80 hours a week at work for at least a year. My weekends were burnt working at home, and it got to a point where if I didn’t bring home my laptop for the weekend, I would feel guilty about not working because I knew that my workload would be piling up on Monday. Like you, I felt like going on leave was a crime. I stopped living a healthy life and had countless sleepless nights. The nights where I could sleep, I dreamt about work. And like you, I developed health problems and even anxiety attacks. That was when I realised I had some sort of work depression. A fainting spell episode finally woke me up and I resigned. It was a real pity because I knew it would have been the place for me to develop a great career in, but at what expense? I knew that if I had stayed, I would have definitely ended up in the hospital, and probably still be worried about getting that report out while on the hospital bed.

    I’ve since joined a different company with a much healthier work-life balance and while it’s less challenging now with probably lesser opportunities, I’ve become a much happier person. So I would like to applaud you and give you a virtual high five for your bravery because NOTHING ELSE is more important than your own health and personal well-being. And you deserve every happiness in the world. I’m sorry this comment ended up a little long but I just wanted you to know that you have my full support, and I wish you all the best for your future endeavours! Stay strong, find that peace, and keep smiling! Cheers 🙂

    1. Miko says:

      Dear SH, thank you for sharing with me your story. I’m sorry to hear that you had gone through such a difficult time at your old job. It sounds very much like work-related depression, as you describe. I’m glad you are much happier now. Even though our generation is obsessed with climbing the career ladder, it’s not worth it if you are unable to enjoy good health and quality time with yourself and your loved ones. Thanks again, Miko

  52. Grahame says:

    Well done young lady ,
    you have opened up a can of worms in the medical scene in this country which is long over due ,
    keep up the great work especially for all those new to your profession ,
    Kind regards ,
    Grahame

    1. Miko says:

      Dear Grahame, thank you for your comment. I’m glad I was able to come out with my story, as there are so many people stuck in the same predicament. I only hope that this will lead to change. Best wishes, Miko

  53. partner says:

    Thank you for sharing your story. I am sure it was hard to write.
    My partner is also a trainee doctor in NSW. The hospital complex grinds up and spits out junior doctors like they are chaff. Nobody should be treated like that.

    1. Miko says:

      Thank you for your comment. I know it’s so hard on the partners because you see your loved one suffer and there’s not a lot you can do except to be there for him/her with your support… but that is already more than what other have, so your partner is lucky to have you. Many trainees (especially surgical) are single and it makes it that little bit tougher to deal with the hardships!

    2. Miko says:

      Thank you for your comment. I know it’s so hard on the partners because you see your loved one suffer and there’s not a lot you can do except to be there for him/her with your support… but that is already more than what others have, so your partner is lucky to have you. Many trainees (especially surgical) are single and it makes it that little bit tougher to deal with the hardships!

  54. Dr Sam says:

    Hi Yumiko. I read your story and wanted to reach out and thank you for going public with it. It is such an important issue that needs to be addressed and hopefully fixed. You taught me while I was a 1st year UNSW med student and you were inspiring! I’m not surprised to hear you pursued a career in surgery. I was so sorry to read what happened to you. I have a little bit of insight in this, as I worked as an unaccredited dermatology reg for only a few weeks before quitting, that is how bad it was. Even such a short time in that environment broke me. I’m now in GP land and much happier, but it still saddens me I had to give up my dream, and I am sad to hear you had to as well. Good luck for your future and thank you again for sharing!

    1. Miko says:

      Hi Sam, thanks for your comment. It’s so lovely to hear from people I’ve taught in the past. I’m glad to hear you’ve found a much happier life doing GP. Most of my friends are GPs, and they love it! I’m sure the experience you gained as a derm reg will be helpful as a GP as you’d be seeing a lot of skin lesions! Thanks for getting in touch, and all my best wishes to you. Miko

  55. Helen says:

    Hi Miko, I came across your blog via a colleague’s twits. I am deeply moved by your story and courage. I’m an emergency physician in one of the major centres in NSW and like you, am an Asian female who loves yoga.
    I was wondering if you would put aside all assumptions/ bias about emergency medicine and visit our department, meet the trainees and consultants and see the work we do, not just for the patients but for each other.
    EM is a dynamic, intellectually challenging and hands-on speciality I think you would love. Best of all you can do as much or as little hours as you like. We have plenty of trainees working part-time for all sort of reasons. Please email me if you would like to have a chat or schedule a visit. Whatever you do, I wish you a speedy recovery and all the best in whatever you choose to pursue in the next stage of your life!

    1. Miko says:

      Hi Helen, thank you for your comment. I have done 9 months in ED in the past. And whilst I enjoyed all three of those terms, ED is not for me. I do appreciate you reaching out to me, though. At the moment I don’t want to think about any sort of clinical work, as I am still not fully recovered from my experience last year and would like to take a break from thinking about anything hospital related at this stage. Thank you for your well wishes. Miko

  56. Dear Miko
    Thank you for sharing your story. I am also a female Australian doctor. My career path as a female medico has not been linear either.. I worked as JMO & did many years doing service psych registrar before taking up GP training part-time.
    Your story resonated with me and brought tears down my face. It reminds me of the earlier years of gruelling hospital internship & residency, which left me questioning my vocation & career path. There were times when I felt suicidal, but am glad I have a supportive GP who stood by me & gave me a lifeline.
    Yes, bullying & harassment is a real problem. And no job is worth our sanity, wellbeing, or lives.

    I am grateful that you shared your story courageously. To walk away from a dream that does not serve our best interest takes a lot of self-awareness, maturity & wisdom.
    I pray for your recovery & future, trusting that you’ll emerge stronger, kinder, healthier & wiser through this journey.
    Keep the faith.
    Much Love, Blessings & best wishes.

    1. Miko says:

      Thank you for sharing your story with me, and I’m sorry to hear that you went through a tough time. I trust that things are happier for you now. I am so glad to hear you had a supportive GP. I am also very lucky to have a wonderful GP who has known me for a while now. I think all doctors should have a GP. My very best wishes to you also, Miko

  57. Elisabeth says:

    Miko your story is so moving; thankyou for your bravery in sharing this so publicly knowing that you would likely be giving up a dearly-held dream. You really are a wonder woman.
    I know we don’t know each other, but I hope you don’t mind me sharing a story. My experience was nowhere near as awful as yours but your story really hit close to home.
    When I was a med reg 2 yrs ago I had a horrible ‘perfect storm’ 8 months – I developed a bad disc prolapse that progressed over a month to cauda equina and I put off surgery for a few days to sit the written exam (only to fail by one mark), then go through my rehab and be put onto 3 months of horrible night shift, followed by covering for ATs in specialities I had no experience in. I’ve never had panic attacks before but but the end of it they physically stopped me from being able to go back to work. That was my moment of “I can’t do this anymore”. Your post gave me flashbacks to that awful time where I felt that my body and soul had left me. I couldn’t move. I was heartbroken and physically broken too. My GP and family were my saviours, but I never told anyone at work why I needed to take so much leave. I still feel ashamed about it. Ashamed about failing the exam, about failing my patients and failing my colleagues who had to cover for me while I was away. But mostly ashamed that I couldn’t just keep going.
    Fast-forward 18months and happily, I’m a well cared-for AT at a different hospital now and my world couldn’t look more different. I have a kind roster and lovely colleagues; I’m able to do yoga and gym workouts to protect my back (and look after my soul) and have time to study, volunteer and cook.
    I finally feel like myself again.
    I sincerely hope you have a similar recovery. I hope your health and spirit return, and you find yourself able to care for others in whatever capacity you choose.
    You sound like a wonderful human and I wish you only the best.

    1. Miko says:

      Dear Elisabeth, wow what a story! You’ve been through so much… I’m sorry to hear about how sick you became. You should not feel ashamed at all about any of that. I think we are all conditioned to feel that way. We are made to feel guilty about so many things. It’s so ironic that we treat people with illnesses and injuries but when a colleague becomes sick, we do not have the same empathy or sympathy for that person. It is often met with cynicism. I’m so happy to hear that you are now in a more nurturing workplace and I wish you the very best. Love, Miko

  58. SAS says:

    Hi Miko, medical student from California here. I am inspired by how competent, lively, and brave you are. It’s a shame that instead of rewarding competence, your former institution took advantage of it. There’s just no winning, it seems. But I applaud you for prioritizing your health and integrity over your aspirations. I was very pleased to read that your family helped you through this. (They always do know what’s best for you!) Anyway, thank you for sharing with us even though it may not have been the easiest. I hope this garners more publicity and change. Warmly, SAS

    1. Miko says:

      Hi SAS, thank you for your comment. I appreciate your kind words, and wish you all the best with your studies! I hope that the conversations that have started from this blog will lead to change. Miko

  59. Kaye says:

    Dear Miko, thank you for sharing your story. I can relate to 100% of your experiences. I also worked at this hospital X many years ago as a junior doctor. I was in a specialty training programme. I did similar hours. I faced similar bullying/abuse/manipulation. Unlike you, who bravely took it up to the HoD and the medical administration, I just allowed things to continue in fear of career jeopardy. As horrible as the placement was, it taught you one great lesson in life: You must look after yourself above all (career, aspiration, achievement etc). If you drop dead in the process of surgical training, only your family will suffer. The surgical team can find a replacement within seconds. Your life matters nothing to the hospital, the department or any of the consultants. Why would you sacrifice your health for them then? You are a beautiful young woman, full of good qualities and passion for life. There are so many more things in life. Within medicine, there are so many other career options. I hope you are making good recovery, physical and emotional. Whatever you choose to do in the future, I am sure you will do well. You need to find a career which allows you space for family/sports/social time and other important aspects of life. Good luck Miko. Hope to hear good news from you soon.

    1. Miko says:

      Dear Kaye, thank you for your lovely words. I’m so sorry to hear you went through a lot of suffering too. I sometimes wonder, how many doctors need to die before something changes? There have been many doctors who die in car accidents, doctors who commit suicide… there are many tragedies in our profession. I am glad that I have left and am finding more time to heal myself. I really appreciate your kind wishes, and I wish you the best also. Miko

  60. Mel says:

    Miko, thank you for sharing your story! Like many others commenting, your writing and your experiences really resonated with me. I applaud you for your courage in publicly speaking up at great personal cost in the hopes of supporting others going through similar challenges and sparking renewed attention for reform to the Australian medical industry. I’ve always thought Australia has world-class medical standards (and it DOES, so you can imagine what most other less developed countries are like!) but we still have so much room for improvement. I’m not from a medical background at all, so definitely no ‘well-intentioned but inadvertently annoying/pressuring’ suggestions on what to do with your life next haha! Despite totally different career backgrounds, much of what you are experiencing resonates strongly with me. I’m a similarly aged Asian go-getter woman, in a period of reflection/redirection after a couple of busy and challenging years, feeling confronted by an onset of cynicism, lamenting the loss of my 21 year old bright-eyed bushy-tailed self. I wish you the best in your journey to recover physically and mentally, to discover new and old passions, and to forge a healthier, fulfilling life. French writer Romain Rolland has a quote which I think a lot about these days: “There is only one heroism in the world: to see the world as it is, and to love it.”

    1. Miko says:

      Dear Mel, Thank you for commenting. It’s nice to hear from a non-medical perspective. I think a lot of type-A people who are ambitious and work in competitive workplaces experience very similar stories because we are under so much pressure. It truly is an existential moment when we think about how we have lived our lives over the last decade. I decided that I don’t want to turn 40 and realise that I lived my 30s in suffering. I’ve done enough studying and working like a slave throughout my 20s, so now it’s time to enjoy my 30s I think! Thank you for sharing that beautiful quote too. All the best to you, Miko

  61. SungHo says:

    Hello.
    My name is SungHo. I am a doctor working and living in Nagano, Japan.
    I came across your youtube video and cried my eyes out.
    I appreciate your courage for coming out and expressing your thoughts on your experience.
    I am a stranger and I live far, but I would like to support you for the way you live your life and the path you choose.
    Just wanted to thank you for being brave and strong!

    1. Miko says:

      Hi SungHo, thanks so much for your comment. I really appreciate your support. I hope that you are enjoying working in Nagano. My very best wishes to you, Miko

  62. Katie says:

    Hey Miko,
    Thank you so much for sharing your story. This has lifted me up to keep trying in life. I have been feeling so depressed since I started a new job as a graduate engineer on February last year and am still feeling depressed at times since I resigned from my position late last year. My story is not as terrible as yours but it took a toll on my mental and physical health.

    Just one month working in this company, I was already told to go on a construction site at Mittagong to replace someone at the very last minute. Before this, I had never been on a construction site before and yet they wanted me to go alone with very little information about the site. As a new graduate fresh out of uni, I wanted to make a good impression and went on with it. But before I even went on site, I knew that this was going to be hellish for me.

    As soon as I entered the site, there so many machineries around that I wasn’t familiar with. I was alone, no one to guide me, it was my first time on a construction site yet they expected me to go in and take some soil samples by myself. It was such an unfamiliar environment for me and I couldnt help but felt anxious. I finally got some guidance later that day after calling my boss and colleagues numerous times. However, when I went back to the office, they said “Well that’s the industry. Toughen up.”

    What didnt help was the fact that I am also an Asian female and I am to work on this site for the next three months for 3 days a week. Meaning I have to drive from Sydney to Mittagong for 3 days a week whilst putting up with all the bullying from the site workers with racist comments like “stop taking over our jobs you bloody asian.” This humiliated me because I have been raised here in Sydney and have worked so hard to get to where I am and yet I get this sort of treatment. Bad things were happening in the office as well but I am too traumatised to write it all down. But i ended up having a couple of mental breakdowns and by then I knew it was time to quit.

    When I finally resigned, I thought that everything would be better, But it wasn’t for me. I was too anxious that it would be hard for me to get my next job and so I straight away applied for new positions. As days gone by, still no new job, I became depressed because I felt like my job is who i am. Now, I have realised that it is not who I am. Thank you so much for sharing your story. Now I promise that I will focus on healing myself mentally and physically and hopefully find my way 🙂

    1. Miko says:

      Dear Katie,
      Thank you for sharing your personal story. I’m terribly sorry to hear about your experience.. I feel anxious just reading about it! It’s an awful thing to feel like you have been thrown into the deep end. When I first started working as a registrar, I felt like such a fraud. I was suddenly expected to be giving advice on a specialty I was only really a beginner in. Without knowing anything about your industry, it does sound like there were very unfair expectations on you as a fresh graduate. I really hope for you that you will find a more nurturing workplace to grow your career, as you are an educated woman who deserves to move forward and grow in your field… but in the meantime, yes, don’t let what happened to you at work affect the way that you feel about yourself. It has nothing to do with your identity as a person. You are the person that you love, and the person that your friends and family love. That’s number one. I hope you are able to come out of your traumatic experience stronger. One of my favourite quotes is: Let your comeback be greater than your setback. Sending you my love, Miko

  63. ANON says:

    Dear Miko.
    You have so many comments and I’m not sure if you’ll ever read this. I am a medical registrar and your original story brought me and my group of friends close to tears. We understand everything that is wrong with our system and yet feel hopeless that anything could change. But thank YOU for being brave in telling this story, It is a story that is told on behalf of all of us.
    But also, thank you for providing some perspective for myself. I am still tossing up between pursuing a relatively gruelling and competitive medical specialty (Specialty A) vs. a more lifestyle-friendly one with a relatively easier path (Specialty B). I love both, but am more drawn to the medicine and science of the former. Yet your comments about being disposable and replaceable could not ring truer. I could pour years and years of blood, sweat and tears to attain something which I think i love at the moment- but is the process all worth it? I feel sad that I may ‘give up’ pursuing a career in Specialty A because I cannot imagine what a toll it would bring on myself and my loved ones in order to achieve it. As someone who clearly loves surgery, how did you rationalise it for yourself that it was OK to give up something you love because ultimately other things matters more?
    Once again, you are amazing, inspiring, and strong. Keep at it.

    1. Miko says:

      Hello,
      Thanks so much for your comment. Most of us in medicine are very driven and ambitious. We love the idea of doing a specialty that is complex, fascinating, challenging, and scientifically interesting. I think that I became too attached to this idea – I loved that operating under the microscope allowed me to use my dexterity to its finest, I was proud of my post-op x-rays when I achieved a perfect reduction, etc. etc. etc…. but eventually I gave up not by choice, but simply because my body broke down. Only then did it force me to stop. I think that if I had really questioned myself, I might have left earlier… but I am very determined. Since resigning, I struggled with moving forward but reading a lot of philosophy texts has helped me the most. I have been able to let go of surgery as being part of my “identity”. Choosing a “lifestyle” specialty makes us feel like a cop-out, but there’s something culturally wrong with that. Why should we be ashamed to choose lifestyle? I have no shame in resigning and allowing myself to live a richer life, full of hobbies that make me happy, time for loved ones, and time to look after my health. It’s a cliche, but it’s true: our own health is the most important thing!
      Best wishes,
      Miko

  64. I can so relate to your story. I’m a mental health counselor in the US, and I went through 9 years of hell at a community mental health agency, with very much of the exploitation and disregard for my health and my very life. My income wasn’t sufficient to pay basic bills without doing on-call shifts which meant I got dragged out of bed at any time of the night to go to some “secure” setting to assess someone who was either suicidal or psychotic. over the years pay either stagnated or actually decreased (with less contributions to retirement and the on-call shift pay scale got rearranged to be much less). Productivity requirements went up all the time, but at the same time so did documentation responsibilities on a newly installed electronic system with numerous bugs. In the last 2 years was when things for me got downright dangerous. My normal working days were 10-12 hours and I was doing 3-4 on-call shifts a night. Meanwhile, my every waking hour was on depressed people, paperwork I couldn’t keep up with or household chores I couldn’t keep up with. Like you, I was starting to not be able to eat properly, or even use the restroom when I needed to and it started to create digestive problems. My stomach hurt all the time and I was constantly tired to the bone like you described. I was going home to an increasing mess that was starting to look like a hoarder. You can’t have your mind marinated 10 hours a day in depressed and suicidal people and not start feeling that way yourself. When my immediate supervisor started to be concerned about my mental state (but middle management is notoriously powerless) she took it to upper management. Despite being licensed mental health professionals, they ignored my own expressed concerns about my health, including mental health, and just suggested that I see the EAP counselor (although I had to “make up” hours I would be out for an appointment and was still held to hte same productivity requirements). I got out and started a private practice which fortunately is now thriving, but I still have symptoms of PTSD that can flare up even 9 years later, and it took me a good 4 years to get to where I wasn’t having any physical or psychological symptoms on a daily basis. It cost me a few thousand dollars out of pocket for therapy, and I went for 5 years with no health insurance, but I’m glad I jumped ship. I truly believe that if I hadn’t got out when I did, that I would have been dead within 6 months.

    1. Miko says:

      Dear Monica,
      Thanks so much for sharing your story with me – looks like we have experienced some similar things. I’m sorry to hear that you still get symptoms sometimes. I’m glad to hear that you have now been able to set up a successful private practice. I wish you continued success and ongoing recovery. I was very interested in psychiatry in medical school, but I knew that spending time around people with depression may also make me feel depressed, so I can only sympathise with you. It must be really hard not to feel affected by what you hear at work, especially if you’re a caring and empathetic person (which it very much seems like you are!)
      Lots of love to you,
      Miko

  65. Kaye says:

    Dear Yumiko, I hope you are making a good recovery, physically and emotionally. Whatever you choose to do in the future, I am sure you will be very good. Hope you find a balance between medicine and life.

    1. Miko says:

      Dear Kaye,
      Thank you so much. I am definitely improving day by day. At the moment I am living a nicely balanced life, although I can get a bit sidetracked by the media and advocacy work that has arisen from my blogging. I need to learn how to say “no” and how to chill out sometimes haha. All the best,
      Miko

  66. Miss A says:

    Thank you for sharing and good luck finding yourself again wherever that takes you, medical or not! x
    From a fellow (female) junior surgeon

    1. Miko says:

      Hi Miss A, thanks so much for your comment. I hope training is treating you well. I am recovering day by day and feel hopeful for the future. I appreciate your support! Much love, Miko

  67. Eesha says:

    I am not a doctor by profession. Heard a similar story of once by an intern. Since then, i have only one question — If Medical Science is not taking care of its own people, whom are they gonna take care?

    1. Miko says:

      Hi Eesha, you’re absolutely right! The people who take care of the public’s health need to be looked after too. I hope that in the future the working conditions for all health workers improves.

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