This Is Going to Hurt by Adam Kay – Book Review

A hilarious, candid, witty, moving and frequently stomach-churning collection of diaries that offers an insight into the chaotic life of the junior doctor working for the NHS.

It’s a good sign when a book has you chuckling right at the dedication page – Adam Kay dedicates This Is Going to Hurt to… himself, without whom this book would not have been possible. It’s a perfect way to set up the wry, irreverent tone of the book, which made me laugh harder than any book in the recent memory.

‘Oh Christ,’ I gasp, ‘Michael Jackson’s dead!’ One of the nurses sighs and stands up. ‘Which cubicle?’

We’d probably like to think that everyone who decides to pursue a medical career does so because of some mystical calling, but as Kay puts it, for him medicine was less an active career decision and more like a default setting: his father was a doctor, and he went to the right kind of school. After the university, Kay spent six years working for the UK National Health Service, steadily ascending from a lowly house officer to a senior registrar, specialising in obstetrics and gynaecology.

The diary entries are just that: short dated entries, taking note of the interesting, bizarre, humorous and tragic happenings of Kay’s days and nights in the hospital, with helpful footnotes explaining the more obscure medical terminology. It’s a perfect book for reading in short bursts.

The patient stories range from laugh-out-loud to heart-breaking; a couple of cases were so desperately sad they made me want to put down the book and stare into space for a while. A great many make you marvel at the sheer human imbecility and the variety of objects that seemingly normal people shove up their orifices. Some graphic entries should never be read on a full stomach by a sensitive person with a vivid imagination. In general I can’t remember the last time I read a book so thoroughly drenched in bodily fluids (Kay observes that a smart doctor never keeps their phone in their scrubs, because its chances of survival are slim).

The exhausting life of a junior doctor makes it easy to ask yourself why anyone would voluntarily sign up for this stressful gig that looks so unenviable from the outside. You’re underpaid, working insane hours, rushing from emergency to emergency; your social life is in tatters and so are your relationships with friends and significant others, with holidays, birthdays and catch-ups swallowed by the demands of the job. Though the book is not politically motivated, it is by its nature a scathing critique of the system that treats its staff with such negligence.

Despite this bleak picture of the working conditions, knowing that you play such an important role in people’s lives is genuinely uplifting:

The hours are terrible, the pay is terrible, the conditions are terrible; you’re underappreciated, unsupported, disrespected and frequently physically endangered. But there’s no better job in the world.

It’s not surprising that Kay found a second life in comedy writing: he’s brutally funny and has a way with a sardonic turn of phrase, he’s got impeccable comic timing and doesn’t mince words. Despite the dry and sarcastic tone, and the distant doctor persona that Kay consciously settled on when dealing with patients, his writing does reveal a heart and care for the people who depend on him. We find out at the very beginning that he eventually left NHS and his medical career for good, but it’s still sad to reach the poignant last act and the traumatic incident that finally tipped Kay over the edge. It was even sadder to read that, thanks to the hospital’s code of silence, he wasn’t able to get the counselling he clearly needed.

The last couple of years have been pretty hellish for the medical staff everywhere, and a lot of light has been shed on the daily struggles of the overwhelmed health system, here in Australia and elsewhere. On top of being ferociously funny, this book definitely adds an extra layer of appreciation for the hospital staff, and disdain for the politicians who’ve whittled down the system to the bone.

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