REVIEW: The Registrar by Neela Janakiramanan

In brief: Emma is starting her first year as a surgical trainee. It’s going to be tough to study and look after patients, but the toughest part will be keeping her head above water…

The good: It’s honest, interesting and doesn’t sugarcoat the pressures of being a doctor in training.

The not-so-good: Can be very sad.

Why I chose it: Sounded really interesting. Thanks to Allen & Unwin for the copy.

Year: 2022

Pages: 357

Publisher: Allen & Unwin

Setting: Australia

Rating: 9 out of 10

The Registrar is a realistic look at what it’s like to work in healthcare these days. It’s fiction, but all of the scenarios could be very true. Long shifts, unpaid overtime, poor patient outcomes, no lunch, computers breaking down, no beds….to some it will be a very familiar story.

Emma is about to start her first year as an orthopaedic trainee (doctor specialising in orthopaedic surgery – think hips, knees, shoulders) at an old, prestigious hospital. It’s where her father was an eminent surgeon and her brother is completing the final year of his general surgery traineeship before he sits The Exam. It’s the first of several years of long working hours, weekends and nights at the hospital or on call and studying. Emma thinks she can do it and she has the support of her husband Shamsi and brother Andy. But this year is going to throw much more at her than she expected. Relationships will break down, mistakes will be made, lives will be lost and others saved. It’s harrowing at times, frustrating at others. (For example, during Emma’s orientation the quote: “The woman from Human Resources is succinct. Do not be asked to be paid overtime, it will not be paid…Any overtime is for your benefit and not that of the hospital.” What an awkward statement of this character, who doesn’t seem to understand that doctors help patients and therefore the hospital.)

Neela Janakiramanan paints an honest picture of life as a surgical trainee and doesn’t leave anything out, big or small. (I had to chuckle at the point when the hospital removed the junk food vending machines and replaced them with healthy food…at 2am when your last meal was lunch, the last thing you want is healthy food. Coke and chocolate please – sugar rush needed to get you through to the morning). There are the annoying colleagues who don’t seem to care, such as skipping out for lunch and leaving a full clinic of patients waiting. There are the colleagues who have Emma’s back at all times, no matter what. Technology is always precarious, and I loved how the theatre wouldn’t use an electronic system for assigning patients to a theatre, but a whiteboard, because it’s ‘tradition’. (Maybe, but is it better? For who?) The recurring character of patient Jacqui is a lovely, if sad story. It brings names and lives to the patients sitting in the bed. Some of her colleagues are callous, but for some, that may be the coping mechanism needed to get through the never-ending queue of patients.

The story itself is fast paced, mixing Emma’s work life with her declining time spent with her husband and family. Her husband is supportive, but worried and later annoyed (understandably) as work consumes Emma. Her father continually berates her and Andy for not being good enough, with disastrous results. It shows the toll it takes on those in the system and around it. It’s incredibly powerful, and I hope eye opening to those not in the system to understand a little of the many pressures going on. I hope The Registrar helps in changing attitudes to not just overtime, but how we care for those who care for others. It’s a relentless, and sometimes thankless slog which is captured perfectly in this well written debut novel.


3 thoughts on “REVIEW: The Registrar by Neela Janakiramanan

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  1. I’ve read another excellent book that gives the low downs and the highs of being an intern/resident in a hospital. Written as a light contemporary novel/fiction. The White Coat Diaries
    by Madi Sinha

  2. The White Coat Diaries
    by Madi Sinha has the same theme, the unrealistic demands and pressures of doctors under training in the hospitals. This one, though, is less sad, and would rank as contemporary fiction or women’s fiction. The descriptions of the situation for surgical residents and interns are very real in this novel.

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