Many people think of medical doctors as superhuman. Some people think of them as inhuman. Former physician, Adam Kay, writes in his 2017 book, This is Going to Hurt: Secret Diaries of a Junior Doctor, that anyone can be a doctor. Personally, I disagree with that opinion, but then, I have never aspired to be a doctor of any kind. Maybe if someone held a gun to my head and told me I had to study medicine, I might be able to do it. I am pretty math challenged, though, and I have a weak stomach. Adam Kay reminds us that working in healthcare, especially as an obstetrician-gynecologist, can be messy, exhausting, hilarious, and tragic.
I see from Amazon.com that I bought This is Going to Hurt last summer. I don’t remember why I bought it, but buying it wasn’t a bad decision. It IS a best seller, and I did legitimately enjoy reading Kay’s diary entries about being a young doctor in Britain’s famous National Health Service. Kay is often very funny, which stands to reason, as he now makes a living as a comedy writer for television and film. But before he commenced his career making people laugh, he brought over 1200 babies into the world.
So why isn’t he still doctoring? By now, he’d be long finished with the arduous training physicians go through. He might be enjoying a full night’s rest, a couple of days off, here and there, and deference from his more junior colleagues. I won’t ruin the book by explaining why he left the field. Instead, I’ll just say that medicine wasn’t for him. Before he realized that medicine wasn’t for him, Kay spent years climbing the ranks from medical school to senior registrar, just one level beneath consultant. Over the years, he collected many funny anecdotes, which he cleverly recorded in a diary… the basis of this book.
Kay writes that he decided to become a physician when he was about sixteen years old. He’s Jewish, and his family is chock full of physicians, and he was expected to carry on the tradition. In the United Kingdom, medical school lasts for six years and begins after graduation from high school. So, before he really had much of a chance to dwell on the decision, he was off to medical school. Once a person embarks on such a career odyssey, it cam be hard to admit when the fit isn’t quite perfect.
Starting in 2004, Kay chronicled his adventures and misadventures in the British National Health System, often with hilarious anecdotes about patients, colleagues, and superiors. He offers a look at how the British healthcare system works, wryly commenting on the politics that affect embattled doctors in training, who are chronically exhausted, underpaid, and overworked. Some of Kay’s stories are downright disgusting, but in a hilarious way. For instance…
I shared the above passage with friends on Facebook. One friend called bullshit on it, but frankly, I could see this happening. From what I’ve read and observed, doctors in training work so hard that they don’t always pay attention to hygiene. Kay writes that he gets very little time off and frequently has to cancel plans with friends and family because he has work to do. He explains that the NHS is often understaffed, especially on weekends, nights, and holidays. So the mostly young staffers in training do get exhausted to the point of not caring so much about things that most of us would notice and take care of right away after a shift.
Some of the entries are very short, while others run for a page or three. I liked the short anecdotes, which made the book easy to read and hard to put down. I also liked that Adam Kay adds lots of footnotes, which are convenient to read on a Kindle. Click the links, and a brief explanation of certain medical terms comes up. I learned new things reading this book, not just about medicine, but also some British language differences.
I will warn that the book ends on a serious note. Kay was inspired to publish this book when, back in 2015, the Secretary of State for Health and Social Care, Jeremy Hunt, accused junior doctors of being “greedy”. Kay had left the profession by 2015, so he had nothing to lose by speaking out about the realities of life as a junior doctor in England. He reiterates that the job was often awesome, especially when he saved a life, or when he helped someone feel better. But there’s a high price to pay for that privilege of saving lives and being respected for doing that job on a daily basis.
Some readers might not appreciate Kay’s cynicism. Again, I must point out that some of the humor is pretty gross, and Kay isn’t always respectful. Some people might not appreciate his graphic descriptions or use of vulgar language. Personally, I loved it… but I have a very ribald sense of humor and I enjoy scatology. 😉
Below are a few more samples…
On many levels, I could relate to Adam Kay’s predicament. I was supposed to be a public health social worker myself. I can imagine that if I’d actually done that work, I would have eventually become burned out, cynical, and bitter. I don’t know that healthcare would have been the ideal career for me. But I wanted to be employed. Kay says that he was expected to be a doctor, and his family was pretty upset when he gave up his medicine career. I expect he’s much happier as a comedy writer. He doesn’t have to make life and death decisions anymore. Now, he just worries whether his comedy kills, rather than his doctoring skills. It’s a lot less pressure. Since he’s been so successful, it no doubt pays better, too. I guess that goes to show that people really ought to choose their careers… just like they should choose whom they love.
I liked This is Going to Hurt. I highly recommend it, especially to anyone in the medical field, but also to anyone curious about the British healthcare system. It’s a real eye opener.
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