Book Reviews

Book review: Slice Girls by Joan Arakkal

I really, really wanted to love this memoir. Slice Girls is written by Dr Joan Arakkal, who writes about her experiences in the male-dominated field of Orthopaedic Surgery, where only 4% of surgeons are female. She grew up in India but has worked in the UK and now resides in Perth, Australia.

I still remember the day I found this book. I had walked into Better Read Than Dead in Newtown, a book store that my friend Karen had recommended. As I always do, I started from the front of the store and worked my way systematically towards the back. As someone who has worked in retail in the past, I always have a keen eye for visual merchandising. I like to look at how the books are arranged, and study which covers grab my eye first. I start with the central table of books to see what the current bestsellers are, and then trace the shelves that line the sides of the shop. I stop at every book that has a white tab and read the recommendation written by one of the booksellers. I take a mental note of which books I want to add to my reading list.

I ask one of the store staff to show me where I would find the memoirs. I generally read fiction, but I’ve taken an interest in memoirs after reading the marvellous memoir by Magda Szubanski earlier this year. I scale the shelf up and down, side to side, and my eye falls on a book in the top left corner. It is green and pink, a colour combination I appreciate, but importantly, it is an image of a surgeon with wordplay in the title referring to the Spice Girls. Sylvia the lovely bookseller climbs a step ladder and grabs a copy for me, and I immediately decided that that was the book I wanted to purchase that day.

I’ll start with the cover. My hawk eyes don’t miss a thing. Whilst I enjoyed the colours, I noticed a few things that got me questioning. Why is the person on the cover not wearing theatre attire? The gown that is being worn is a light, unsterile gown that is worn for contact precautions. The scalpel has a plastic blue handle – one that we use for minor, non-sterile procedures on the ward and in the Emergency Department. The glove that holds the disposable scalpel is loose-fitting and slips underneath the gown, rather than over it. Hold on. This is a memoir about surgery. Where are the surgical scrubs and metal scalpel? Is this a deliberate or ironic choice?

I put aside my dissatisfaction with the cover image and read the notable endorsement on the cover by Dr Barry Marshall, Nobel Prize winner for his groundbreaking work on Helicobacter pylori; ‘Uplifting and very readable’. Great. Exactly what I want out of this memoir – an inspirational story of a woman who rises against the odds. I turn the cover and start reading. Arakkal quotes the Pavamana Mantra, one of my favourites in the Upanishads. I sing along to it in my head and feel the peace of the melody.

I keep reading the book and start to find it uncomfortable. Come on, I’m supposed to like this book. Sisterhood. Women in Surgery. Otters. #ILookLikeASurgeon. I want to support this writer, I want to like her. That’s the thing about writing a memoir – it’s deeply personal and you put yourself out there for people to judge. The early chapters of Arakkal in India glaringly reveal how privileged and relatively easy life was for her, being one of the ‘forward’ groups in society that were advantaged by ‘positive discrimination’. I kept reading about Arakkal’s achievements which are written with feigned modesty. It is only later in the book that Arakkal acknowledges her privilege.

I am by no means a professional book critic. I’m just someone who has a love and appreciation for languages and literature. From that point of view, I found the style of the book a little confusing. In parts it reads like narrative non-fiction, and in others it is an Op-Ed by someone with a bone to pick (#sorrynotsorry for the pun). There are some truly wonderful passages that describe a beautiful sari at an Indian wedding, the splendid flora we have in Australia, and this:

The smell of sardines fried in coconut oil, the hot unpolished rice, the early morning aroma of puttu – layered rice flour and grated coconut pushed out of its long cylindrical steamer – the tropical vegetables and heady fruits – all played havoc with my taste buds

There is no doubt that Arakkal is an intelligent woman. Her writing is so intellectual, however, that sometimes I’m begging to know how she’s feeling about certain scenarios that allow us to get to know her better. For example, meeting and getting married to her husband is over and done with in one and a half short paragraphs. She also describes her experience with metastatic breast cancer in an unemotional, matter-of-fact way. Indeed, the book travels at a fast pace, and the writing often choppy and jumpy. Towards the end when she writes fervently about her issues with the Orthopaedic community in Australia, she comes across as bitter, cynical, and defeated. There were more than a few times that I noticed repetition (almost word for word) of her arguments, which felt like I was listening to a debate.

Despite the obvious chip on her shoulder, Arakkal does highlight some very important issues for the medical profession in Australia to consider. I had great sympathy for her when she shared anecdotes of racism and sexism, which are still sadly commonplace. Arakkal has had to tolerate so much bullying and discrimination since coming to Australia, which I can relate to. She also observes bigoted attitudes towards Indigenous patients.

Arakkal has a strong feminist voice, which genuinely encourages women to lift each other up. I think that this surgical sisterhood is so important, and one that has also kept me buoyant during difficult times.

Slice Girls also explores the hostility one faces when coming to Australia as an International Medical Graduate. Even though she passed her fellowship exams in the UK, she was required to sit the AMC exams, which tests medical knowledge that most of us have left behind in medical school, or once we decided upon a specialty to pursue. She also found herself having to work as a service registrar, which I can only imagine is a rough gig for someone who had worked in more senior positions overseas.

There were times when I gasped at the politically incorrectness of the book, including the assertion that someone ‘eccentric’ would be suitable for Psychiatry. I wish that people would not paint entire specialties with one stroke. She is also scathing of Orthopaedic surgeons, which I do not think supports her cause:

The principle ‘Primum non nocere’ – ‘First do no harm’ – is often overlooked. After all, Hippocrates didn’t have a new Porsche to pay off.

Lastly, I really hoped for a happy ending, but I did not find the ‘uplifting’ effect that Dr Marshall described. Arakkal has still not been accepted into Orthopaedics, and is working in occupational health. I so wanted to read about how she had overcome obstacles to practise her beloved sub-specialty of hand surgery – an area of surgery I can totally relate to having a passion for – but alas, that was not to be. This is why I took a couple of days to write this review. I had such mixed feelings during and after reading this book. I really hope that Arakkal has found some solace in writing this memoir.

I am onto my next book, which is also a memoir – The Erratics by Vicki Laveau-Harvie, which won the 2018 Finch Memoir Prize and 2019 Stella Prize (an award for women writers in Australia). Please look out for my review later this week.

Happy reading,

Miko xx

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