Adam Kay’s “This is Going to Hurt: Secret Diaries of a Junior Doctor”: A Review

This is Going to Hurt was published as a response to the 2016 row between junior doctors and the health secretary, Jeremy Hunt. Adam Kay writes and edits comedy for television but the book is made up of his diaries kept while he was a doctor.

These were born out of a ‘reflective practice’, a recommended exercise for junior doctors that, for Kay, ‘seemed to involve…writing down anything remotely interesting that had happened that day’.

This description somewhat downplays Kay’s day-to-day as a junior doctor. Events ranging from the unbearably squeamish to the comical to the heartbreaking fill the diaries. Along the way he explains medical terminology and the context if necessary. These footnotes, as well as often containing the funniest lines of the book, also serve to humanise junior doctors. They allow the non-medical reader to fully understand the hilarity or gravity of the situation at hand.

The novel’s first joke comes three lines in:

‘In 2010, after six years of training and a further six years on the wards, I resigned from my job as a junior doctor. My parents still haven’t forgiven me.’ The stark realities of what it means to be a junior doctor stand alongside the hilarious – and Kay notes that reaching ‘for my red nose and clown horn, and bring[ing] out my anecdotes about objects in anuses and patients “saying the funniest things”’ is a necessary self-protective reflex when it comes to discussing the other side of his career in medicine.

At the start of the novel Kay describes a night shift as a House Officer as like ‘sailing the ship [the hospital] alone. A ship that’s enormous, and on fire, and no one has really taught you to sail’. At first Kay finds this ‘exhilarating’. However the pressure on his mental and physical health increases as he progresses through his career. By the end of the book, Kay’s shifts send his blood pressure skyrocketing and he’s left so traumatised by a tragedy that he leaves medicine for good. It’s clear that the poor pay (lower, he notes, than a shift supervisor at McDonald’s) and the hours (at one point he wakes up in his car in the hospital car park on Christmas day, having fallen asleep as soon as he sat down) hardly compensate for the pressure placed on junior doctors.

Why, then, do people still choose to go into medicine?

Despite the downsides, Kay describes being able to help people as the best job in the world. In doing so, he hammers home his point that junior doctors are not, in fact, greedy. Rather, they should be treated with the same level of decency that they treat their patients with.

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