This is Going to Hurt

This is Going to Hurt: Secret Diaries of a Junior Doctor – Adam Kay

Not the kind of book I would probably normally read but definitely worthwhile. Originally a one-man stand up at the Edinburgh Festival, this book has become a best-seller and just won three awards at the National Book Awards.

A political book, which includes a letter addressed to Jeremy Hunt at the end, it was written in response to the pay dispute between junior doctors and the government.

“The NHS isn’t made up of hospitals, pharmacies and GP surgeries – it’s made up of the people who work there. Be the politician in a generation who changes the stuck record and treats them with an ounce of respect.”

It is an incredibly funny book, full of one liners and anecdotes. But it’s a dark humour, at the expense of the ridiculous patients he comes across during his time in obstetrics and gynaecology. And the humour is constantly used as an antidote to the harsh reality of life as a doctor – overworked, underpaid, saving lives through the poor conditions and despite all that, taken for granted. “It’s an established fact that death rates go up on Black Wednesday. Knowing this really takes the pressure off, so I’m not trying very hard.” Definitely gripping and shocking on numerous levels, it is eye-opening into the life of junior doctors and the toll the job takes on their lives. It is also a tribute to the people who make up the NHS, to which almost everyone owes something.

It is hard to read This is Going to Hurt without questioning the truth, accuracy and exaggeration for effect – it is a book after all. The author and editor have decided what to put in and what to leave out. It does not tell the full story of his life. Some diary entries seem too ridiculous to be true. Nonetheless, this is not fiction, it is based on reality (even if not all the details are accurate) and it provides a valuable insight.

The ending is shocking and abrupt. After a heart-breaking case where he is in charge of an operation where a baby is delivered dead and the mother is left in intensive care, we come to the ‘Aftermath’: “That was the last diary entry I wrote, and the reason there aren’t any more laughs in this book”.

The book is incredibly personal, and it seems, almost a catharsis for its writer as we learn that “some of my closest friends will read this book and hear that story for the first time” – he has been unable to speak about it and not offered any formal counselling or time off.

Life has radically changed: “A bad day at work now is if my laptop crashes or a terrible sitcom gets terrible ratings”. This is Going to Hurt certainly gave me some perspective on what a bad day at work really is and how being a doctor is not just a job, it is a way of life. His friends consult him on all medical and related issues. He even sews up their fingers, talks them out of suicide. It leads him to miss holidays and weddings and eventually to the breakdown of his relationship.

The popularity of the book certainly shows that it has a big impact on its readers. It is not just a good read but an important one.