Saturday, May 08, 2021

In Her Words: ‘Maybe something’s wrong’

A candid conversation about burnout.
Sophi Gullbrant

By Ruchika Tulshyan

"When my gut broke down, that's when I thought maybe something's wrong."

— Yumiko Kadota, a physician in Sydney, Australia, and the author of "Emotional Female"

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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.

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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 physician 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.

Write to us at inherwords@nytimes.com.

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What else is happening

Here are three articles from The Times you may have missed.

  • "When moms like me worry about our children, we have to ask ourselves, 'What should I fear most?'" Black mothers across the country discuss how gun violence has shaped their lives. [Read the story]
  • "A fighter for the people and the planet." When Vanessa Nakate, 24, was cropped out of a Davos photo featuring her and four white activists, it drew attention that she now uses to expand her work in Uganda and beyond. [Read the story]
  • "Being part of two marginalized groups results in marginalization that's more than the sum of those two parts." In Covid vaccine data, L.G.B.T.Q. people fear invisibility: Few states collect sexual orientation or gender identity data, so no one knows how many people in some communities are getting vaccinated. [Read the story]

Making Home Safe

Damon Winter/The New York Times

Intimate partner violence accounts for a majority of domestic abuse in the U.S. — about one in three women has experienced physical violence, sexual violence or stalking victimization by an intimate partner in her lifetime. How can survivors escape abuse?

Join us for a candid conversation between Tanya Selvaratnam, an artist and Emmy-nominated producer who in 2018 accused her former boyfriend, Attorney General Eric Schneiderman of New York, of physically and psychologically abusing her, and Alisha Haridasani Gupta, gender reporter at The New York Times, about Ms. Selvaratnam's journey and the resources for spotting intimate partner violence and getting help. The live conversation is hosted by Sakhi for South Asian Women, a nonprofit focused on helping survivors.

Monday, May 10, at 6 p.m. Eastern.

In Her Words is edited by Francesca Donner. Our art director is Catherine Gilmore-Barnes, and our photo editor is Judith Levitt.

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Friday, May 07, 2021

On Politics: What Elise Stefanik’s rise means for the G.O.P.

We spoke with our reporter Catie Edmondson about the lawmaker in line to replace Liz Cheney.
Representative Elise StefanikCourtesy of the Committee on Arrangements for the 2020 RNC, via Associated Press

Note: Lisa Lerer is off this Saturday.

Donald Trump is out of the White House — and mostly gone from the public eye — but his grip on the G.O.P. base has probably never been stronger.

In the House, Representative Liz Cheney's tenure as the No. 3 Republican appears to be coming to an end, thanks to her willingness to stand up to Trump's fabrications. With Cheney on her way out, a new era in G.O.P. politics is being ushered in: As early as next week, every member of the House leadership could be fully committed to a pro-Trump platform.

Which means we'll continue to hear a lot of false claims about the electoral system being broken — and less emphasis on traditional Republican policy goals.

Representative Elise Stefanik, who's in line to take Cheney's place, is a perfect symbol of the shift. Just over six years ago, at 30 years old, Stefanik was the youngest woman ever elected to Congress at the time. She did it by flipping an upstate New York district that had sent a Democrat to the House for the past two decades, and since then she has legislated mostly like a moderate.

The staunchly conservative think tank FreedomWorks gave her voting record a score of 37 percent, which it called "dismal" in a tweet on Wednesday. She has actually voted with Trump far less often than Cheney has.

But Stefanik has increasingly played along to his tune, at least rhetorically, and lately she's become a major defender of his unfounded claims that the 2020 election was stolen. Thus far, the balance she's struck appears to be working: She has won re-election by double-digit margins three times in a row in a relatively nonideological district, where loyalty to Trump is becoming the coin of the realm.

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The House Republican Conference is expected to hold a vote next week on replacing Cheney with Stefanik. Our Washington reporters Catie Edmondson and Luke Broadwater published an article yesterday on Stefanik's recent drift into Trump loyalism. I spoke to Catie to get her perspective on what this means for the future of G.O.P. politics, in the House and beyond.

Hi, Catie. Trump's first impeachment trial was the moment when Stefanik was seen as fully casting her lot with Trump. How did that unfold, and why do you think she decided to go all-in?

When she was first sworn into the House, then the youngest woman elected to Congress, Stefanik had a pretty establishment set of credentials, having worked for Paul Ryan on his vice-presidential campaign and in President George W. Bush's administration, and she was widely seen as a moderate. To understand her transformation, you need only to look at the way her district has changed throughout the years: Her voters swung hard to the right in 2016 after voting twice for President Barack Obama. She has publicly spoken about how stunning it was to her to see so many Trump yard signs popping up in her district in 2016.

But that transformation has won her a number of hard-right allies, like Representative Jim Jordan of Ohio, maybe the most well-known Trump ally in the House. Some other deeply conservative members have been more skeptical about that metamorphosis, though.

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In the last election cycle, Stefanik ran a political action committee that helped elect over a dozen female G.O.P. candidates. At a time when the party is having an increasingly hard time with female voters, how important has this résumé item been to her ascent?

Stefanik very early on in her time in the House vocalized that helping Republican women get through primary elections was crucial to addressing the party's gender diversity problem, especially as Trump's caustic style threatened to alienate female voters and further narrow Republicans' appeal. Initially, her outspokenness on the issue rubbed some of her (male) colleagues the wrong way, but Stefanik is now widely seen as one of the key engineers of a strategy that saw female candidates in 2020 almost single-handedly secure the party's impressive gains against Democrats.

Stefanik and her PAC supported many of those women, several of whom are now considered rising stars in the party, and as a result she benefits from a deep well of support.

As you point out in your and Luke's recent article, in an interview yesterday with Steve Bannon, Stefanik hammered on the theme of voting integrity, mimicking Trump's falsehoods about a stolen election. Despite all the debunkings, could this remain as the major theme in many Republican primaries in 2022?

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Those comments really highlighted one of the ironies driving Cheney's ouster. House Republicans agitating to purge her from their leadership ranks have insisted that the problem isn't her criticism of Trump's false election claims — it's that she insists on re-litigating them.

But the fact that Stefanik championed those same claims on her media blitz yesterday demonstrates that the Republican Party isn't going to be able to escape them just by removing the one leader willing to rebuke them, particularly when Trump continues to trumpet them almost daily.

The White House sticks to its economic strategy as a jobs report disappoints.

By Jim Tankersley

A disappointing jobs report released today by the Labor Department is posing the greatest test yet of President Biden's strategy to revive the pandemic economic recovery, with business groups and Republicans pushing the president to end an expanded benefit for the unemployed that they say is causing a labor shortage and risking runaway inflation.

But administration officials say there is no evidence in the report — which found the economy added 266,000 jobs in April, well below the one million jobs many economists expected — that hiring has been slowed by the additional $300 per week that unemployed Americans are currently eligible to receive under the $1.9 trillion economic aid bill that Biden signed into law in March.

Speaking at the White House, Biden urged "perspective" on the report, dismissing negative reactions to the news, including Republican arguments that generous jobless benefits were encouraging workers to sit on the sidelines. The president said it would take time for his aid bill to fully reinvigorate the economy and hailed the more than 1.5 million jobs created on his watch thus far.

"Our efforts are starting to work," he said. "But the climb is steep, and we've got a long way to go."

"We're still digging out of an economic collapse that cost us 22 million jobs," he said.

Biden rejected what he called "loose talk that Americans just don't want to work."

"The data shows that more workers are looking for jobs, and many can't find them," he said.

Administration officials stress that the monthly employment numbers are volatile and subject to revision and that the average gain over the last three months remains well above the pace of job creation that Biden inherited when he took office in January. They say that any clogs in the labor market are likely to be temporary and that the recovery will smooth out once more working-age Americans are fully vaccinated.

"This is progress," Heather Boushey, a member of the White House Council of Economic Advisers, said in an interview. "We are adding an average of over 500,000 jobs a month" over the last three months, she said. "That's evidence that our approach is working, that the president's approach is working. It also emphasizes the steep climb coming out of this crisis."

This piece comes from our live briefing, where you can find more updates on the news in Washington today.

NEW YORK TIMES PODCASTS

The Ezra Klein Show: Elizabeth Warren on what we get wrong about inequality

On today's episode, Ezra spoke with Senator Elizabeth Warren about the rising costs of child care, the stagnation in women's labor force participation, whether billionaires are a policy failure, the social philosophy behind Warren's tax proposals, how markets can be channeled toward progressive ends, and much more.

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