A non-fiction prescription: “This Is Going To Hurt: Secret Diaries of a Junior Doctor” by Adam Kay

Paperback cover, published by Picador (2017)

No matter how hard you think a junior doctor works, they work ten times harder. This is Going to Hurt is a collection of diary entries from Adam Kay’s six years on the front line of the NHS. Often funny, at times stomach-churning, and inevitably heartbreaking. This is life on and (very rarely) off the hospital ward, “verrucas and all.”

Divided into 10 sections, each dedicated to a specific post throughout his career, the bite-sized storytelling makes it the perfect book if you only have sporadic moments for reading.

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

It’s hilarious!

Describing it as an easy-read would feel like a lie considering the grisly details of some stories — the DLR was not the ideal environment to read about a de-gloved penis. However, the text is very accessible, and Kay explains jargon with humorous ease. You’ll never be lost.

You will laugh, likely out loud, when you read this. The quotes I’ve pulled out for this review barely scratch the surface of comedic anecdotes. From ridiculous patient responses to unfortunate accidents, it’s no wonder the book is being adapted by the BBC as an eight-part comedy-drama.

Today crossed the line from everyday patient idiocy to me checking around the room for hidden cameras. After a lengthy discussion with a patient’s husband about how no condoms fit him, I establish he’s pulling them right down over his balls.

For me, though, the funniest moments are when Kay is unafraid to be darkly humorous. His commentary on a father making quips through the birth of his child is still fresh in my mind despite having read the book last year. Why? Well if you read it, you won’t have to ask.

It’s horrifying!

I had to tell her that the patient in the bed next to her dad’s became extremely agitated and confused last night. That he thought her father was in fact his own wife. That unfortunately by the time the nurses heard the commotion and attended it was too late, and this patient was straddling her father and had ejaculated onto his face.

As alluded to earlier, some sections make for hard reading. There’s no shortage of bodily fluids, and several medical procedures are described in graphic detail. I have a pretty strong stomach when it comes to the written word, but even I had to squirm from time-to-time.

This perfectly illustrates Kay’s storytelling prowess. Even when the imagery is so gut-wrenching that you want to look away, rather than put the book down, you turn the page.

Patient GL, whose genetic make-up appears to be 50 per cent goji berry recipes and 50 per cent Mumsnet posts, has announced she wants to eat her placenta.

…I’m delivering the placenta and look up to have the awkward discussion about what GL would like me to do with it. She has a kidney dish in her hands and is shovelling handfuls of blood clots into her mouth.

‘Isn’t this the placenta?’ she asks, blood dribbling out of the corner of her mouth like the disgusting progeny of Dracula and the Cookie Monster. I explain that it’s just some clots I left in a bowl after delivering baby. She turns ashen, then green. Clearly blood isn’t the delicious post-delivery snack she imagines placenta might be.

Some of the horrific situations Kay describes really made me ponder on how fragile our bodies can be. A drunken dare gone wrong or a single ill-thought moment could lead to grotesque damage. And despite advances in medicine, not all damage can be repaired.

It’s heartbreaking!

Considering Kay tells you in the introduction that tragedy is to follow, it’s not a spoiler to say it’s not all happy endings. There’s a reason Kay quit his medical career to become a comedy writer.

The hospital ward has its tragedies, as you would expect. None of us are naïve enough to go into a book about the realities of the NHS and think it’s all going to come out rainbows. Even so, the pivotal moment that changed Kay’s life forever is a hard read. It’s less of a bombshell and more of a train collision you’re watching in slow motion. And when it hits, it hits hard.

But equally saddening is the strife in Kay’s life off the ward. Always being on the clock leaves very little time for a personal life. The toll it takes on his relationships is its own kick in the stomach. H is the recurring character you wish had more time on the page. Kay probably felt the same way once, too.

Doctors are people. Not the most radical statement, I know. But they’re so overworked that one can’t help but wonder if there are those in power who need to hear it. This book was released before the coronavirus pandemic, and it’s only become more apparent just how little the Conservative government values our health workers.

Think of a word that rhymes with “Hunt”

In the back of the book is an honest and scathing open letter to Jeremy Hunt. What Jeremy Hunt did to the NHS is presumably no mystery to you, even if you don’t know the full details. A toned down version (IMO) can be read online, at the bottom of his account of what happened when he met Mr. Hunt face-to-face. I’d strongly recommend you read it.

The NHS isn’t made up of hospitals, pharmacies and GP surgeries – it’s made up of the people who work there.

Conclusion: Essential!

Unless you already work on the front lines of the NHS, this will be an enlightening read. You will laugh, you will feel sick, and you’ll probably cry. What more could you ask from a book?

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