Book Review: This Is Going To Hurt
I’ve been given this book multiple times. By my friend Becca as a speedy read on the train home from visiting her in Canterbury (I still have your copy by the way Becca), by my parents who gave me their copy along with a strong recommendation to read it once they had and there’s an inexplicable third copy of the book now on my bookshelf which came from who knows where. Anyway, what I’m saying is, I’ve felt a lot of pressure to read this and it’s taken me a really long time.
The main reason for this, I think, is that I do not like hospital-centric stuff. I love learning about medicine, particularly books about neuroscience, but anything too close to the reality of sickness is a problem for me. I can’t watch hospital dramas (House was a brief exception but ultimately even that became a bit too much) or soaps, I usually avoid any of the TV docs that venture into medical centres and I’m also a disaster when visiting actual hospitals. I’m not proud of any of this but I’m not one of life’s great copers with the business of illness or death. Sometimes during the pandemic I’ve wished I trained as a nurse or doctor and could head in to help. Then I’ve wondered if there’s something more basic I could be doing in that environment. Really though I think I’d be more trouble than I’m worth.
This Is Going To Hurt was punted around as a hilarious book, which at times it is, but it is heavily set in the world of the hospital and for the first couple of chapters I had to fight the urge to put it down. I think honestly the reason that I read it at this particular point in time is obvious. It’s about the NHS, it’s about junior doctors, it’s about all the people who we’re utterly dependent on right now more than ever. And I felt like, if nothing else, I should truly appreciate what their jobs entail and start to educate myself so that next time we discuss funding the NHS I have a proper, nuanced opinion. So I’ve finally read the book cover to cover.
The book follows Adam Kay, now a TV writer, then a junior doctor, from the end of his training through his whole career as a doctor specialising in obstetrics. Written as a diary, with footnotes to assist with understanding some of the medical terminology, the entries are scattered over a period of six years (2004-2010) and run through the variety of positions that he held, beginning with House Officer and ending with Senior Registrar. He is at times buoyant about the NHS and all it offers and, at other times, scathing about the inner workings and the treatment of its staff. It’s this brutal honestly that renders his opinions as so convincing, at so many points he throws himself under the bus in order to showcase an important point about the system.
I think that in the debates about NHS pay and the stories in the media about doctor and nurse burnout, with suicide rates shooting up, it can be difficult to get clear information about how things actually work. For me, this was a hugely important aspect of Kay’s book. While I enjoyed some of his more outlandish stories I really felt that I got an idea of what day to day life is like for junior doctors, what the job entails and how relationships and life outside of the job are affected. Kay is a good writer and keeps a great balance between talking about the mundane aspects of the job and highlighting funny or shocking stories. Some of his humour is a little dark for me which would sometimes make me feel like withdrawing. However dark humour is a noted aspect of working in the medical industry, a way of coping and Kay’s empathy shines through just as brightly.
A lot of the book did scare me, though not necessarily in the way I expected. On one hand I came out of the book feeling very proud of the NHS and the professionalism and passion for the job that Kay and his colleagues express. You very much get the idea that doctors and nurses are in the good for the right reason and that they care deeply about their patients. Still though, there are some terrifying issues. The lack of communication between departments, the broken computer systems, little errors and the speed at which surgeons are expected to learn new procedures in certain hospitals. Nothing though concerned me as much as their lack of sleep. As someone who barely functions on a full eight hours I was terrified by the fact that these doctors work on so little sleep, having to make snap decisions and perform intricate operations through a haze of fatigue and hunger.
If there is a book that will help with encouraging the British public to support and campaign for the NHS I think this is it. It’s an interesting and entertaining read but also very, very clear about the problems in the system. Particularly intriguing is the idea that doctors and nurses are so patient about earning such a minimal wage because it’s a mark of doing the job as a calling rather than a pay packet. Personally I want doctors and nurses to be in the profession for this reason, the correct reason, to love and respect and care for their patients. This can’t however be at the expense of being able to do the job and live properly. Our care workers need to be healthy before any of the rest of us can be. Kay notes at the end of the book that many of his colleagues are leaving the profession, people who truly couldn’t imagine doing anything else with their lives, and he says that the NHS is losing so many talented health workers. We have to stop this desperately.
(Illustration by Sofi Rose)