"I don't know why medicine felt like coming home but, for some reason, it fits. I keep thinking about how the tohu, once awarded, can never be taken back. There are few things in life that emphatic. Better not f*** it up" - Dr Emma Espiner in her memoir There's a Cure for This.
Award-winning writer Dr Emma Espiner (Ngāti Tukorehe, Ngāti Porou) talks to Kim Hill about her unconventional upbringing, ditching her recruitment job for med school and how New Zealand can improve healthcare for Māori.
Dr Emma Espiner on the cover of her memoir There's A Cure For This Photo: Penguin Books New Zealand
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Emma Espiner's RNZ podcast Getting Better - A Year in the Life of a Maori Medical Student won Best Narrative Podcast at the 2021 Voyager Media Awards.
She will be appearing at the Auckland Writers Festival on 19 May.
Emma was 30 and pregnant with her daughter when she gave up a prestigious job in executive recruitment to become a doctor.
With the encouragement of her husband, journalist Guyon Espiner, applied for and was accepted into medical school.
"I thought I've only got one life and I would never forgive myself for not being brave… but it was terrifying."
Emma applied to Auckland University's School of Medicine via the Māori and Pacific admission scheme - a social intervention that attracts more racist ideas about preferential treatment than others targeted at under-represented groups, she notes.
She is dedicated to improving the experience of Māori people in New Zealand's health care system, and although it will take time, hopes to see Māori doctors soon be proportional to New Zealand's population.
Our current medical school cohorts include enough Māori students to reflect Aotearoa's population, yet in 2023 only 4 percent of working doctors are Māori.
Because of how long medical training takes, it will take a very long time to that "shift the dial", she says.
Emma, who is currently a surgical registrar at Middlemore Hospital, hopes to become a general surgeon - the job she has always wanted to do - seven to ten years from now.
Read / Listen - Emma Espiner on witnessing a health system that fails Māori
Big picture, the community-led Māori research institute Te Atawhai o Te Ao - which is currently exploring the impact of Covid-19 response on Māori - has great potential to spearhead change, she says, but we also need to find ways to bring mana to people in communities.
Dr Kyle Eggleton Photo: Bird of Paradise Productions
On a GP placement at Whangārei's medical centre Ki A Ora Ngātiwai, Emma was impressed by their kaupapa Māori approach.
Related: Northland's Dr Kyle Eggleton on working as a doctor for a Māori health provider
In New Zealand, not only is the shortage of doctors a "massive" issue, the workload that people are willing to accept is changing.
"Not only do we have a population that's ageing, the expectations of the specialist workforce in 10 to 15 years, particularly in surgery, around how many hours they work will be quite different to what's being done at the moment.
"Not only do we need to train more specialists across all fields, we also have to account for the fact that the ones we do train may not want to work themselves to death in the same way that the current ones do."
In a chapter of There's a Cure for This called 'Don't plant a fruit tree over your uterus', Emma writes about her recent decision to undergo a risk-reducing hysterectomy.
She took the plunge after her "close-knit, slightly mad family" discovered they had a hereditary syndrome which meant a predisposition to bowel and endometrial cancer.
Specialists told Emma there was no rush but she should consider the procedure before reaching her mid-40s. Her response was that's not far away, so why wait?
"Mum found out first and she had a hysterectomy and I thought I might as well do that, as well … My way of making decisions is quite rapid.
"We all buried our uteri with Nana who had died and is interred in the Catholic cemetery just outside of Tākaka."