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This is Going to Hurt by Adam Kay




Prescribing a morning-after pill in A&E. The patient says, "I slept with three guys last night. Will one pill be enough?"

I can’t have been the only person to assume that when you are waiting 5 hours in A&E, it is undoubtedly due to one of the doctors polishing his solid gold bust and deciding which shade of suede he is going to order his Ferrari in. Whilst this is of course, an exaggeration, as we are all aware of the enormous pressures that the NHS is under, but there is that niggling sentiment lying dormant. Adam Kay opens the door to the surgical ward, specifically the gynaecology ward where he delivered thousands of babies and worked for inhumanly long stretches – I’m not sure I’ve ever been awake for 24 hours, let alone worked that many in a row. Tales of working the morning of your wedding because you can’t get the time off, and weekly working hours clocking in the region of three numbers, inevitable relationship breakdown and hardship beyond what I had assumed. Kay ties it together with repeatable patient anecdotes, illuminating medical procedure commentary, to make it one of my funniest reads in years.

Every doctor makes their career choice aged sixteen, two years before they're legally allowed to text a photo of their own genitals

My main criticism of This is Going to Hurt is my inability to accept a “sad ending” in spite of being told at the inception of the demise. This was my problem with 500 Days of Summer and is perhaps this is why I have so much optimism towards Trump – I just don’t accept things. Kay warns in the preamble that he is no longer in the medical profession, just as how the aforementioned film was presented as absolutely not a happy ending. The issue is, we see Kay in the traditional page driving arc – moved from a nervous junior up to an extremely capable registrar. We are really driven to trust Kay as a doctor, you hear the lifesaving manoeuvres and the moments of brilliance, how he is everything that you would ever want a doctor to be – someone that really, truly cares, and will sacrifice everything else for his career and patients…but in an act of caring too much, he has to turn his back on his job.

There may well be a light at the end of the tunnel, but the tunnel is eighty-five miles long, crammed full of impacted faeces, and I have to eat my way out of it.

Crucially, Kay delves deeper than the anecdotes and lists of items found inside places they shouldn’t be with an analysis of the NHS and why it is so important, and where it might be going wrong. Whilst we all have awareness that junior doctors are worked to exhaustion, I was unaware of the institutional practice of diary card exercises. These “exercises” supposedly measure the true hours worked by doctors and thereby serve to improve, but in reality they just expose pressure put upon them to lie, or extra staff hired to compensate. This illustrates just one issue and elevates this book from coffee table fodder to something you would actually lend a friend – and this one is being packaged off to my nurse friend on a gynaecological ward immediately. Arguably, Kay could have gone further in discussing the position of women doctors, and at times the lack of reference to them, and also perhaps the plight of nurses. Similarly, I was surprised when on a quick google of Kay to find he was gay, and whilst you must respect this private choice, I couldn’t help but question the analysis this information could have instigated.

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