Dr. Yumiko Kadota, a surgeon in Sydney, and the author of “Emotional Female,” on stress, burnout and toxic work environments.,
“When my gut broke down, that’s when I thought maybe something’s wrong.”
— Yumiko Kadota, the author of “Emotional Female”
[In Her Words is available as a newsletter. Sign up here to get it delivered to your inbox.]
Most young girls don’t grow up worrying about workplace burnout, but by the time they’re adults, and fully entrenched in careers, many will experience it. Over half of women surveyed in a 2021 CNBC and SurveyMonkey poll said their mental health at work was suffering to the point of burnout.
For women of color, the numbers are worse. Black women experience accelerated “biological aging” in response to repeatedly encountering stress. While 9.8 million working mothers in America experience workplace burnout, it’s more pronounced for Black, Latina and Asian mothers, according to the largest study on working parents to date.
Living through a pandemic takes an immense toll on mental health too, of course. The Centers for Disease Control found that 40 percent of U.S. adults were struggling with mental health or substance abuse issues because of the pandemic, although mental health concerns were already on the rise prepandemic. Add work to the mix and it can feel untenable. Nearly three million women have left the U.S. work force because of the pandemic, many of them quitting because of a lack of child care options.
And racial tensions make it worse. The twin pillars of the pandemic and systemic racism have been particularly challenging for Black employees, while anti-Asian hate crimes rose nearly 150 percent in 2020.
It’s a recipe for burnout, which the psychologist Christina Maslach defines as “a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job. The three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment.”
Two friends from childhood, Dr. Yumiko Kadota, a surgeon in Sydney, Australia, and the author of “Emotional Female,” and Ruchika Tulshyan, a Seattle-based journalist and the author of “The Diversity Advantage,” discuss how compounded stress leads to burnout, and how to get through it.
Their conversation — their first since they were classmates in Singapore 20 years ago — has been condensed and lightly edited.
Ruchika: You were 13 when you left Singapore first to move to the U.K. and then eventually Australia, I remember you already wanting to be a doctor, even though I don’t remember us knowing many female doctors.
Yumiko: Yes, and I was very firm about doing surgery. By the time I reached medical school, I saw a clear path ahead in medicine.
Ruchika: Did you ever doubt yourself?
Yumiko: I knew it would be stressful and high pressure but I never doubted myself. I remember you telling me I was fiery when we were like 8 years old. Do you remember that?
Ruchika: Wow, I don’t! But I’ve been called that word too.
Yumiko: I’ve always been very fiery, so there you go! I think a lot of these personality traits develop when you’re young.
Ruchika: What does it mean to be fiery as an Asian woman … as a Japanese woman in Australia?
Yumiko: There’s this trope of the submissive, meek and mild Asian woman. People don’t know how to respond when they meet an Asian woman who stands up for herself and wants to lead. I don’t know whether it’s discomfort or surprise. Women like us experience both the glass ceiling and the bamboo ceiling because there’s just so many stereotypes about us.
Ruchika: It’s been tremendously hard to see the anti-Asian hate and violence in the U.S. How is it in Australia?
Yumiko: I’ve grown up feeling a lot of anti-Asian hate here in Australia. And racist comments from politicians have escalated the anti-Asian hate over the past year. I remember feeling self-conscious on public transport at the start of the pandemic when masks were not yet mandatory. I chose to wear one, but was worried that it made me look like I had the virus.
Ruchika: That’s so hard. I find that different communities of color in the U.S. are very connected in how they experience racism, even if the exact words and ways can differ. Is that so in Australia?
Yumiko: We had our own Black Lives Matter protests here because we have a huge problem with discrimination against Indigenous Australians, including the high number of deaths in police custody. It’s not too dissimilar from the police brutality against Black people in the U.S.
Ruchika: I’m writing a book about women of color at work. Every woman I interviewed spoke about how she felt both invisible and visible at the same time. This becomes even stronger as you progress — you don’t want to ruffle feathers by being too ambitious. What’s your take?
Yumiko: I enjoyed most of my medical internship, but when I became a resident I realized there were other kinds of power dynamics at work. I was told that I was acting too confident. I don’t know whether I got that feedback because I am an Asian woman or because I was in a junior position and someone in a position of power was trying to put me down.
Ruchika: Your book details perfectionism in a way that feels really familiar to me as an Asian woman working in the U.S. You wrote about practicing and mastering hand ties [surgical knots] obsessively long before your mostly white peers in medical school did. When I was starting out as a journalist I put this immense pressure on myself to deliver breaking news stories so that I would not be considered “less than” the male journalists. In medical school, did you ever see men struggle?
Yumiko: You know, I don’t think I saw any man struggle. Some of them were lucky to have women at home, supporting them. I was living on my own, I was single and it was a lot harder to do everything by myself.
Ruchika: In your book, you detail your chronic fatigue. When did you know it was time to tell your bosses you were overworked?
Yumiko: My bowel broke down in the car so I literally pooped everywhere. And that’s when I thought, oh this is not normal — a young healthy person should not be losing continence.
Ruchika: Oh my goodness! “Continence” is such a doctor’s way to put it, but it must have been traumatizing.
Yumiko: Yes! The gut never lies, and when my gut broke down, that’s when I thought maybe something’s wrong. Until then I did not stop, I just kept going because I learned how to ignore the signs of stress.
Ruchika: Research shows health care workers are at risk for greater burnout, stress and depression. And you yourself refer to your former workplace as a toxic environment. You were doing ten 24-hour shifts every two weeks and working over 100-hour weeks. You described getting a call — after working a 24-hour shift — at 3 a.m. for a nonurgent matter and being (understandably!) upset about it. Then the guy on the other end called you an “emotional female.” I was foaming at the mouth when I read that, because we all know no man would be called that! There was also the part where a patient thought you were a nurse just as you were getting ready to operate on them! When you brought up how toxic everything was to your managers, they just told you to be stronger. Do you think you would have been treated differently if you were a white man?
Yumiko: Most of the time I forget the fact that I am an Asian woman. I guess I’m just me. But there are reminders, often. I was heckled with kung fu noises when I lived in England during high school. I brushed off the incidents, but over time those little things add up.
After I left medical school, slowly my confidence dropped.
Ruchika: I wrote an article with the writer Jodi-Ann Burey about how impostor syndrome is not inherently a “women’s issue” but a side effect of experiencing sexism and racism. I’ve always thought of myself as confident and strong, but when I experience overwork cultures, sexism or racism, I see myself shrinking to fit in.
Yumiko: I remember catching up with a girlfriend when I was in medical school. She said, “You’ve lost your sparkle.” Those were her exact words. I definitely became quieter and more subservient to my bosses and to the health care system. Until I quit.
Ruchika: I remember watching you on the Australian news after reading your viral blog post that exposed how badly junior doctors were being treated by the medical system and the challenges you faced as a woman in medicine. At that time, it sounded like you were planning to leave surgery forever.
Yumiko: Well, I was burned out. I was diagnosed with depression, and I ended up in hospital that year, and my health just continued to deteriorate. I had terrible insomnia; it took 18 months for me to get my sleep back. Overwork disrupts your brain so horribly.
Ruchika: How did you get through it?
Yumiko: I can’t talk about recovery without talking about therapy. We need to normalize it. I was facing such acute trauma that for a while, any reminder of my medical past put me in a really bad place. So learning to cope with that through therapy was really important. But also, physical exercise and the outdoors helped me a lot.
Ruchika: I’m glad you’re back to doing surgeries now at a more manageable pace, while also having a life outside “the knife.” What else helped with your recovery?
Yumiko: When we experience burnout, we need to take a holistic approach to healing. I studied yoga, and read yoga philosophy which helped me reframe how I thought about my identity. When you’re a workaholic, your job becomes your identity. And now I’m learning to define myself beyond that.
Resources & Ideas
Burnout is a serious workplace issue, according to the World Health Organization. Ellen Keithline Byrne cites Maslach’s research and suggests asking yourself three questions to assess whether you may be experiencing burnout:
Are you regularly physically and emotionally exhausted?
Are you more cynical and detached than usual?
Are you feeling as if you’re not contributing anything meaningful, where you once were?
Work cultures that reward overwork are often the biggest culprits for holding women back from professional progress, not work-life balance, according to the researchers Robin J. Ely and Irene Padavic.
Mayo Clinic has a list of resources about workplace burnout and cautions that ignoring job burnout could lead to a host of consequences like excessive stress, fatigue, sadness, anger or irritability. It suggests discussing concerns with a supervisor, seeking support from colleagues or loved ones and practicing mindfulness.