The Terror of Knowing

Title: This Is Going to Hurt (2017)
Author: Adam Kay
Read: 5th – 12th November 2017
Genre: memoir; non-fiction
Rating: 5 out of 5 stars

“Welcome to 97-hour weeks. Welcome to life and death decisions. Welcome to a constant tsunami of bodily fluids. Welcome to earning less than the hospital parking meter. Wave goodbye to your friends and relationships . . .

Welcome to the life of a junior doctor.

Scribbled in secret after endless days, sleepless nights and missed weekends, comedian and former junior doctor Adam Kay’s This Is Going to Hurt provides a no-holds-barred account of his time on the NHS front line. Hilarious, horrifying and heartbreaking by turns, these diaries are everything you wanted to know – and more than a few things you didn’t – about life on and off the hospital ward. And yes, it may leave a scar.” (Synopsis from publisher)

Book awards aren’t everything, but there is a reason that this book smoothly scooped the Books Are My Bag Non-Fiction Book of the Year, Books Are My Bag Readers’ Choice Award, Blackwell’s Debut Book of the Year, and iBooks’ Book of the Year awards – it’s immensely readable. At times tragic, at times side-splittingly hilarious, Adam Kay’s diaries from his time training and working as a doctor (one and the same) are glib and matter-of-fact and you definitely don’t need to be a doctor to find them compelling and addictive, but I’m sure if you are, this book would resonate on every single sleep-deprived level.

“Whatever we lack in free time, we more than make up for in stories about patients. Today in the mess over lunch we’re trading stories about nonsense “symptoms” that people have presented with. Between us in the last few weeks we’ve seen patients with itchy teeth, sudden improvement in hearing and arm pain during urination.”

From the outset, you, as a reader, know that this book is coming from a place of retrospect – Adam Kay is no longer a doctor (junior or otherwise) so you know there’s a story there, and he’s turned his hand instead to being a comedian and writer, so you may very well expect storytelling ability and a few jokes too. This book is chock full of funny moments, I laughed almost constantly through this book, except during the few very sobering moments when Adam recollects a patient who was hurt and, ultimately, couldn’t be saved. For every amusing ‘I just fell on it, honest Doctor’ anecdote, there’s another ‘I’m so sorry, we did everything we could’ recollection to balance it out – but the highs emphasise the lows, and vice versa. I had a lump in my throat at times – I didn’t expect that from a book that is, essentially, one bloke’s diaries about being an OB/GYN.

“3am attendance at labour ward triage. Patient RO is 25 years old and 30 weeks into her first pregnancy. She complains of a large number of painless spots on her tongue. Diagnosis: taste buds.”

Fair warning for anyone in possession of a uterus and with even the vaguest inclination of someday wanting to push a baby out of it, maybe don’t read this book if you’re at all squeamish. I have one word for you (and I apologise profusely) – tearing. Adam doesn’t sugar-coat anything, least of all his time in gynaecology.

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

If you’re from the UK, I think you cannot fail to take a peek into the life of a junior doctor and feel truly blessed that we have a National Health Service at all, that people put their entire selves on the line and become doctors. I became incensed in a way that I’ve rarely felt before, as I witnessed through Adam’s diaries the immense pressure “junior doctors” (although there’s nothing very much “junior” about them) come under every single day, for a rate of pay that doesn’t really match their skills, responsibilities, and commitment to their chosen career. Because you have to be focused and driven to get into med school in the first instance and, even more so, you have to be committed (or crazy) to work your way up the ladder to consultant level. It’s something that Adam talks about honestly and openly and, as someone who has never even considered a career in medicine, it was eye-opening. I’ve watched many a drama and sitcom set in a hospital and featuring doctors, but I don’t think I’d ever fully realised not just how many of them are struggling on through gruelling hours, but how this is actually required to make it anywhere in the medical profession.

“I glance at the notes before reviewing an elderly gynae patient on the ward round.
Good news: physio have finally been to see her.
Bad news: the entry reads, ‘Patient too drowsy to assess.’
I pop in. The patient is dead.”

In the UK, the NHS is struggling, straining under the weight of an ageing population, under investment, and various privatisation efforts, and we work our doctors to breaking point, so we shouldn’t be surprised when they jump ship and become comedians instead – you have to develop a sense of humour, or you wouldn’t last through your F1 year. Adam Kay’s memoir provides a humorous and heart-breaking look into the stresses and strains of working in the medical profession and I think readers of any background experience (or non-experience) of medical work will find something relatable and compelling about This Is Going To Hurt.

“Day one. H has made me a packed lunch. I have a new stethoscope, a new shirt and a new email address: atom.kay@nhs.net. It’s good to know that no matter what happens today, nobody could accuse me of being the most incompetent person in the hospital. And even if I am, I can blame it on Atom.”

You can find the book on: Amazon | Book Depository | Goodreads

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