This is Going to Hurt: Secret Diaries of a Junior Doctor

by Adam Kay

Welcome to the life of a junior doctor: 97-hour weeks, life and death decisions, a constant tsunami of bodily fluids, and the hospital parking meter earns more than you.

Scribbled in secret after endless days, sleepless nights and missed weekends, 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, this diary is everything you wanted to know – and more than a few things you didn't – about life on and off the hospital ward.

As seen on ITV's Zoe Ball Book Club

This edition includes extra diary entries and a new afterword by the author.

Genres: Nonfiction, Memoir, Medicine, Biography, Medical, Audiobook, Humor

285 pages, ebook

First published September 7, 2017

About the author

Adam Kay is an award-winning comedian and writer. He previously worked for many years as a junior doctor. His first book "This is Going to Hurt: Secret Diaries of a Junior Doctor" was a Sunday Times number one bestseller for over a year and has sold over two million copies. It has been translated into 37 languages and is winner of four National Book Awards, including Book of the Year, and will be a major new comedy drama for the BBC.

His second book "Twas the Nightshift Before Christmas" was an instant Sunday Times number one bestseller and sold over 500,000 copies in its first few weeks.

"Dear NHS", edited by Adam Kay, was an instant Sunday Times number one with all profits donated to charity. His first children's book "Kay's Anatomy" will be released in October 2020.

Reviews

[Emily May · Rating 5 out of 5]

“So I told them the truth: 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.”

I devoured this book in a single sitting. It is rare to find a book that can make you laugh and cry in equal measure-- especially, I think, a nonfiction book --but this one managed it just fine.

It's very British, with references to British TV shows I'm pretty sure the rest of the world has never heard of, so bear that in mind if you are a non-Brit thinking of reading this. But it is essentially a publication of the diaries Adam Kay kept while he was a junior doctor working for the NHS. It is a funny, moving portrait of a service that underpays, undervalues, and overworks its doctors, and yet, despite all of this, it is a love letter to universal healthcare.

Kay shares his experiences training as an obstetrician-gynecologist, from the gory stories that made me cringe, to the devastating loss of patients, to the destruction of his personal relationships due to the long hours and last-minute demands. It sounds like a nightmare, but he keeps a good humour throughout. Some parts of it are genuinely very funny. Some parts are genuinely revolting.

It exposes a lot that is wrong with the NHS, but never loses sight of how truly important it is. It wasn't until I came to live in California that I really understood how fortunate we were. I had lived in a bubble where healthcare was taken for granted as a human right and no one was ever told they couldn't be made better because they were too poor. The realization that some countries allowed people to die preventable deaths shook me to my core. It still does.

It bothers Adam Kay, too. He finishes his hilarious and touching tales with a direct plea to the government and to us to take the NHS and its doctors seriously. To respect it and them. To not take the work done for granted. Such a powerful and important read wrapped up in a highly-entertaining package.

Facebook | Instagram

[Ruby Granger · Rating 5 out of 5]

SUCH an important book. Anyone who does not work in the NHS should be obliged to read this.

[Petra X · Rating 5 out of 5]

I finished the book. It was a mostly irreverent look at the early years of being a junior doctor, then an obstetrician, until something catastrophic happens to a patient and the author turned from medicine to writing comedy. It was an excellent read, one good anecdote after another and rather than a review I'd like to summarise two. One concerns herbal medicine and the other the very serious topic of spousal abuse and how the hospital dealt with it in pregnant women.

1. Herbal A woman had come to the hospital with a bleeding from her vagina problem. When the doctor told her it was the result of the Chinese herb she had been dosing herself with she said, "I thought it was just herbal how can it be that bad for you?" The doctor said that apricot stones had cyanide in, the death cap mushroom is often fatal, Nature does not equal safe and that there was a plant in his garden where if you simply sat under it for ten minutes you'd be dead.

Later the author asked the doctor what plant that was. He replied, "Water lily." Ah so...

2. Abuse. The hospital had a system to help women admit to abuse, which was difficult as their partners often accompanied them to ante-natal visits. In the toilets they had a sign saying 'if you want to discuss any concerns about violence at home, put a red sticker on the front of your notes,' and there were sheets of red dot stickers in every cubicle.

So the doctor saw a woman with a few red stickers on the front of her notes. It was very difficult to get the husband to leave the room. He tried, the midwife tried, the consultant tried and eventually they got her alone. The woman just clammed up, scared and confused and would admit to nothing. Eventually they established that the red dots were artistic decoration by her two year old child when they went to the toilet together.

I think Ockham's Razor applies here!

5 stars for being a great read and exposing the very emotional side of being a doctor and not just the practice of medicine.
____________________

More anecdotes from when I was reading the book.

This is so funny. This 20 year old student goes to the doctor to request an abortion following condom failure. Turns out that she and her boyfriend didn't have much money so they turned the just-used condom inside out for round two!
_______

I knew I was going to read this book when I read,
"A NOTE REGARDING FOOTNOTES
Read the fucking footnotes."

Laughed out loud.

And then one of the first sentences, "I grew up in a Jewish family (although they were mostly in it for the food)... it's really got to be a good book with such louche writing.

[Jack Edwards · Rating 5 out of 5]

One of the most beautiful, heart-wrenching, hilarious books I will ever have the pleasure of reading. Adam Kay's style of writing is immaculate - so dry yet dripping with witticisms and hysterical anecdotes. I genuinely had to ration my reading of this because I couldn't put it down. I highly recommend this book, and wish it could be dished out as prescribed reading (if you'll pardon the pun).

[Dr. Appu Sasidharan (Dasfill) · Rating 4 out of 5]

Summary
This is a memoir of Adam Kay’s life on NHS front line. This book has the potential to make you smile due to Kay’s hilarious writing and also make you cry due to some of the unfortunate events mentioned.

Some interesting topics discussed in this book
Adam Kay was able to discuss almost all the crucial things in Medicine in the short memoir directly or indirectly. If we read between the lines, we can clearly see the Butterfly effect prevalent in Medicine.


It discusses many important topics like Medical economics, Mental health problems and Addictions

My favourite line from this book

“A great doctor must have a huge heart and a distended aorta through which pumps a vast lake of compassion and human kindness.”

Rating
4/5. This was one of the top five Medical Memoirs I was fortunate enough to read.

—————————————————————————
You can also follow me on
Instagram ID - Dasfill | YouTube Channel ID - Dasfill | YouTube Health Channel ID - Dasfill - Health | YouTube Malayalam Channel ID - Dasfill - Malayalam | Twitter ID - Dasfill1 | Snapchat ID - Dasfill | Facebook ID - Dasfill | TikTok ID - Dasfill1

[Pakinam Mahmoud · Rating 3 out of 5]

هذا الكتاب سيؤلمك ..الكتاب الذي بيع منه أكثر من مليون نسخة للطبيب السابق والكاتب البريطاني آدم كاي...

الكتاب عبارة عن يوميات الكاتب أثناء عمله كطبيب نساء و ولادة لمدة ٦ سنوات في إنجلترا و بيحكي فيه مشاهد يومية عن حياته كطبيب و المواقف العديدة التي مر بها مع المرضي إلي أن وقع حادث أثناء القيام بعمله أدي إلي تركه العمل كطبيب واتجه للكتابة..

الكتاب مكتوب بإسلوب ساخر..كوميديا سوداء بتلقي الضوء علي معاناة الأطباء سواء في حياتهم الشخصية أو العملية مع وجود ساعات عمل مرهقة ،رواتب قليلة، عدم الحصول علي التقدير المناسب و إزاي الطبيب يجب أن يكون مستعداً دائماً للعمل تحت أقصي الظروف و إتخاذ قرارت صعبة تحت الضغط كما إنه يتعامل مع الموت بشكل يومي....

الصراحة الكتابة مكتوب حلو جداً والإسلوب سلس..بس بالنسبة لي حسيت إنه مفيهوش جديد أوي عشان قريت كتاب شبهه جداً وهو كتاب سيزيرين للطبيب المصري خالد ذهني و كان تقريباً نفس المحتوي بس بيحكي مواقفه في مستشفيات مصر والمرضي المصريين اللي لو آدم كاي شاف جزء بسيط منها كان ترك عمله كطبيب بعد سنة بالكتير:)

كتاب لذيذ وقراءته كانت ممتعة علي الرغم من الوجع وراء الكلمات..
لا ينصح به لو إنت في كلية الطب أو ناوي تبقي دكتور..حتعرف حاجات ممكن تخليك تغير رأيك..
خليها مفاجأة أحسن:)

[Sean Barrs · Rating 1 out of 5]

I once met Adam Kay, and he left a distinct negative impression on me.

He was performing at the theatre where I used to work. And I feel like I can write this now, I no longer work there so these words are not a reflection on the business but merely the words of a disgruntled former employee. So, Adam came on a busy Saturday night where we had sold all the seats. His name was popular, and people wanted to hear what he had to say. He and his manager approached me to tell me about their show, the visiting companies would inform the front of house manger about the show’s running times and give details about the content of the performance. This was all standard stuff.

Adam’s manager then told me that Adam had promised eight seats to some of his friends last minute. And whilst Adam skulked in the background, letting his manger do all the talking, she told me that if I didn’t find these eight seats for his friends they would pull the plug on us and not perform. And obviously this would have been disastrous for the theatre and its patrons. Me and my team had to magic up these eight seats in an already full auditorium. Not an easy task. And we could not turn any of our customers away who had already paid for their tickets.

So, my review is getting a little bit personal, but it is still about the book and his work if you let me continue. Fifteen minutes into the show, one of the ushers walked out. She was absolutely horrified at the content of the performance. The case Adam was delivery to the audience, sent her back to a horrific childhood memory involving a close friend. Adam delivered the story with humour and mirth, making light of someone’s medical disaster. And from here I decided I must read his book to see what all the fuss is about and to make up my own mind, separate to the negative impression he had already made on me personally.

After reading it, almost two years later, I can say only one positive thing: Adam can write well. He delivers the stories well, but here I question the ethics behind doing so. In all honesty, should we really be laughing at other people’s medical disasters? And should we really be selling them to make a cheap buck?

I don’t think so.

[Abby Sowden · Rating 1 out of 5]

This was a DNF for me, as a nurse working in the emergency room, I can relate to a lot of the references in this book, especially the dark humour - that’s how we healthcare professionals get through the stress of work. However, I could not stand Kay’s obnoxious views on the struggles doctors deal with day to day, yes being a doctor is relentless, stressful and brings little reward, however he seemed to me to be completely disrespectful of other healthcare professionals and actually quite insulting of midwives in particular. Yes doctors have a difficult time, but so does everyone who works for the NHS, from receptionists, to radiographers, to porters - doctors absolutely do not have the hardest time as he would like you to believe, and it’s not all about them!

[Liong · Rating 3 out of 5]

Sad and hilarious.

If you want to become a doctor, please read this book before you decide.

A doctor should be much more empathic, sympathetic and friendly.

[jessica · Rating 4 out of 5]

this is an overall entertaining read and one that has a massive societal importance. it often goes unrecognised just how difficult it is for a doctor during their residency.

‘so i told them the truth: the hours are terrible, the pay is terrible, the conditions are terrible; youre underappreciated, unsupported, disrespected and frequently physically endangered. but theres no better job in the world.’

as someone who worked in a hospital for years, i saw just how hard doctors (and all medical staff) work. but its such a rewarding field of work and i wish this book showed more of that - the positives.

i also understand that everyone handles grief in different ways, and AK obviously uses humour, but i would have liked a little more seriousness in tone when talking about certain things. i think it would have made the reflections feel more genuine.

also, side note - AK specialised in OBGYN, which i did not know before i picked this up. so the majority of the commentary is about childbirth and vaginas, which often leads to crude humour. which got old, very quickly, for me.

but again, i think AK does a great job at spotlighting the demanding nature of the medical profession, which i appreciate.

↠ 3.5 stars

[Sara · Rating 5 out of 5]

‘Promise me this, next time the government takes its pickaxe to the NHS, don’t just accept what the politicians try to feed you.’

2020 - Listened to this on Audio book, its narrated by Adam Kay and it's every bit as heartwrenching as it was the first time around.

-

This book had me laughing hysterically one minute and desperately trying not to cry the next.
It was heart warming, hilarious and devastating all at once.
Easy 5*s

[Emma · Rating 4 out of 5]

A genuinely funny collection of stories from a former doctor; some so horrifying, surprising, or amusing that I had those hard-to-breathe-while-laughing moments, immediately making Audible clips and sending them to all my friends. It's not for the squeamish, be prepared for lots of blood, births, bad language, and assorted 'implements' stuck in places they really shouldn't be. Rarely have I been so impressed (if that’s the right word) by the willingness of individuals to achieve a memorable sex life by inserting objects into orifices and then having to go to A&E to have them removed.

There are, of course, also very sad stories, including the one that led the author to decide he had to leave. It would have been wrong to focus solely on the laughs, denying the inevitable traumas, near misses, and deaths, some of which may have been prevented by having a properly run, well staffed, less overworked team of doctors. If nothing else, you leave the book with the understanding that the NHS is barely getting by. This is the very reason Kay wrote the book, as rebuttal of the politicians' portrayal of junior doctors as money grabbing and lazy, but only in the final section does he address this directly. Instead, he shows you a doctor and other staff worked to the very edge of their ability to cope. It's eye opening and I left it feeling even more grateful for this amazing resource we have. One we need to protect.

In mixing comedy and reality, Kay has found an effective way to show us some truths while making us laugh so hard we have to hold back tears. It's the best kind of learning.

[Maede · Rating 4 out of 5]

شرایط کاری
• شیفت های کاریتون ۴٨ ساعته و بیشتره• شیفت‌های کاریتون ۴٨ ساعت یا بیشتره
• درآمدتون اصلا با مسئولیت‌هاتون جور در نمیاد
• مدت دوره‌ی کارآموزی شما حداقل ده ساله
• آموزش‌هایی که برای این کار می‌بینید به درد هیچ کار دیگه‌ای نمی‌خوره
• بعد از تمام شدن ساعت کاری ترجیحاً نباید محل کار رو ترک کنید
• اگر ترک کردید، احتمالا فکرتون در محل کار می مونه
• باید با روابط و زندگی شخصیتون خداحافظی کنید
• به طور مداوم باید به انسان‌های احمق مسائل رو با صبر و حوصله توضیح بدید
• باید موجودات (بچه آدم‌های خونی) و اشیای مختلف (سر عروسک، در شامپو، براش توالت و چراغ کریسمس) رو از بدن افراد بیرون بکشید
• دائما با خون، ادرار، جفت و سایر مایعات و جامداتی که از بدن خارج میشم سر و کار دارید
• گاهی باید بین جان آدم‌ها انتخاب کنید
• در کسری از ثانیه باید درست‌ترین تصمیمات رو بگیرید
• در صورت کوچکترین اشتباه ممکنه کسی رو بکشید یا ازتون شکایت بشه و کارتون رو از دست بدید

مزایا
حس مفید بودن، حس اینکه زنده بودنتون برای آدم‌های دیگه تفاوتی ایجاد کرده

این آگهی برای شغلی بود که «آدام کی» بدون اینکه حتی به طور کامل خونده باشه، پذیرفته بود و سال‌ها خودش رو براش آماده کرده بود. شغلی که در آخر از پا درش آورد و باعث شد همه چیز رو پشت سر بگذاره و رهاش کنه. حالا سال‌ها بعد، در این کتاب تکه هایی از دفترچه خاطرات این پزشک سابق رو می خونیم که در عین خنده‌دار بودن به شدت دردناکه. آدام که حالا یک کمدین و نویسندست از روزهای خوب و بدش، مواجه‌ش با بیماران و پرونده‌های عجیب، بی‌خوابی‌ها و ترس‌هاش میگه

با صدای خودش کتاب رو گوش دادم و با قسمت‌هایی از این خاطرات بلند بلند خندیدم، بخش‌هاییش حالت تهوع گرفته بودم و چشمام گرد‌ شده‌بود و بخش‌هایی هم بود که لحن طنزآمیزش از بین میرفت و صداش بوی مرگ و درد می‌گرفت. اما هدف نویسنده از چاپ این خاطرات فراتر از برانگیختن این احساساته. به عنوان یک پزشک سابق در سیستم درمانی انگلستان (ان اچ اس)، سعی داره زیبایی ها، زشتی‌ها، کاستی‌ها و اهمیت این سیستم رو در قالب این نوشته‌های واقعی نشون بده و به نظرم واقعاً در این کار موفقه. سیستمی که خدمات درمانی رایگان برای مردم انگلیس فراهم می‌کنه و مثل هر چیز مهم دیگری دائما طعمه‌ی حرص سیاستمداران میشه

دیدگاه های منفی کتاب از لحن متکبرانه نویسنده و دیدگاه تحقیرآمیزش نسبت به سایر کادر پزشکی مثل ماماها و پرستارها میگن. با این وجود من فکر می کنم که آدام کی چنین نگاهی به گروه خاصی نداشت و مشکلش با افراد بی‌لیاقت و احمق بود، حتی پزشک‌های بالادستی خودش. این رو هم باید در نظر داشت که این ذات کمدی سیاهه که به کمدین جایگاهی بالاتر میده که از اونجا همه رو چپ‌چپ نگاه می‌کنه و درموردشون نظر میده

این کتاب در ذهن من به اسم‌های "چرا دکتر نشویم" و "قصه‌های واقعی از وحشیانه ترین اتفاق طبیعی - زایمان" ثبت میشه و داستان‌های دیوانه‌وارش احتمالا تا سال‌ها خوراک کابوس‌هام میشه!

۹۹/۱۲/۲۹

کانال تلگرامم که این کتاب‌ و صوتیش رو آپلود کردم و ریویوها رو هم می‌گذارم
Maede's Books

[Paromjit · Rating 4 out of 5]

I listened to the audio of this, with the author Adam Kay narrating the diary entries of his time as a junior doctor in the NHS, simultaneously a hilarious and heartbreaking, eye opening, experience. He worked a god awful number of hours that left him with barely anything he could refer to as a personal life, having to constantly drop out of engagements due to his pressing work commitments, whilst hardly ever receiving any recognition for the work he did. He even finds himself having to organise his cover when he is off sick. There are numerous horror stories, the stress of making life and death decisions, and he is rightly left bitter about the way the government treats NHS junior doctors, not to mention the chronic NHS underfunding and staff shortages. Kay goes on to relate what for him is the final straw, a caesarian that results in a dead baby, and the mother having to receive a hysterectomy, for which he blames himself, even though it was not his fault, and which eventually culminates in him leaving the profession.

This is a must read if you really want to know what life as a NHS doctor is like, I should warn you there are parts that are really not for the faint hearted, although there is joy to be found when patients and babies are saved. There is going to be a TV series based on the memoirs coming soon, with the actor Ben Wishaw taking on the author's role, I am really looking forward to seeing it. I recommend this memoir to those thinking of a career in medicine.

[Mohamed Shady · Rating 5 out of 5]

سيرة لآخر ٥ سنين في حياتي

[Dem · Rating 1 out of 5]

A series of supposedly funny anecdotes that felt more like a podcast than a novel.
Adam Kay was a junior doctor from 2004 until 2010, before a devastating experience on a ward caused him to reconsider his future. He kept a diary throughout his training, and This Is Going to Hurt intersperses tales from the front line of the NHS with reflections on the current crisis. .
This is one of those books that I keep getting asked about "Did you read This Is Going to Hurt: Secret Diaries of a Junior Doctor and when I answer NO! I am told I have missed out the most amazing book and "you have to read This Is Going to Hurt: Secret Diaries of a Junior Doctor and now I can confirm I have read it and YES...... It did hurt!

I really didnt like the book, it felt contrived and cynical and to be honest full of moaning. I listened to this one on audio and the book was narrated by the author. He spoke quite fast and I I didn’t enjoy the experience.

I read 30% and felt that was pretty much as much as I could take. While I didn't enjoy it, it has rave reviews and this review is just my reaction to the book.

[Nataliya · Rating 5 out of 5]

“So I told them the truth: 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.”

Medical training is a meatgrinder. The bootcamp approach is well-known: tradition apparently dictates that learning is effective when you have been awake for inhuman number of hours, overtired, underpaid, and often following the odd dogma of “fake it till you make it”, or that approach of “see one, do one, teach one” which really means in practice “watch one, botch one”. Once you are through it, it’s interesting to reminisce about all the sleepless nights and incredible stress and feeling like you are acting the part of a doctor before you actually can feel like one, and all the times when you felt that you have reached the limits of endurance, mentally and physically, and still need to do more, even if you’ve used up everything you’ve had, every resource has run dry. Add to it staffing shortages and underfunding, as Adam Kay sees clearly in his training, and the picture of an exhausting (and sometimes very darkly comical) trainwreck is complete.

“A widely held belief among non-medics is that there’s some degree of choice involved in coming home at 10 p.m. rather than 8 p.m. But really the only choice is whether you fuck over yourself or your patients. The former is annoying, the latter means that people die – so it’s not really a choice at all. The system runs on skeleton staff and, on all but the quietest shifts, relies on the charity of doctors staying beyond their contracted hours to get things done. It would be against everything you stand for to knowingly compromise patient safety, so you don’t – which means you stay late after almost every shift.”

Adam Kay, a former NHS junior doctor turned comedian and writer, went through six years of OBGYN training (from house officer to senior registrar in the British parlance) before he quit after a bad outcome which affected him deeply (and medical establishment culture combined with chronic staffing shortage did little to help him get through the trauma), and during those years he kept a journal, which served as the basis for this book.

“Among the funny and the mundane, the countless objects in orifices and the petty bureaucracies, I was reminded of the brutal hours and the colossal impact being a junior doctor had on my life. Reading back, it felt extreme and unreasonable in terms of what was expected of me, but at the time I’d just accepted it as part of the job.”
————

“I’ve not sat down for twelve hours, let alone rested my eyes, my dinner’s sitting uneaten in my locker and I’ve just called a midwife ‘Mum’ by accident.”

Yes, this book is incredibly funny, although often in flippant and gallows humor-like ways. Because some of those stories are really ridiculous and yet very true. A condom failure from reusing it by turning it inside out after the first use, countless objects people insist on sticking up their orifices, stupidity on prominent display and endless ridiculous situations that make you a bit ashamed of humanity. It’s the intersection of tense high-pressure drama and flippant comedy that perfectly sums up a lot of healthcare.

“Bleeped awake at 3 a.m. from my first half-hour’s shuteye in three shifts to prescribe a sleeping pill for a patient, whose sleep is evidently much more important than mine. My powers are greater than I realized – I arrive on the ward to find the patient is asleep.”
—————

“Crash call to a labour ward room. The husband was dicking around on a birthing ball and fell off, cracking his skull on the ground.”
—————

“Yes, madam, you will shit during labour. Yes, it’s completely normal. It’s a pressure thing. No, there’s nothing I can do to stop it. Although if you’d asked me yesterday I’d have suggested that the massive curry you ate to ‘induce labour’ probably wasn’t going to help matters.”
—————

“I’m as big a fan of recycling as the next man, but if you turn a used condom inside out and put it back on for round two, it’s probably not going to be that effective.”
—————

“In gynae clinic, I go online to look up some management guidelines for a patient. The trust’s IT department has blocked the Royal College of Obstetrics and Gynaecology website and classified it as ‘pornography’.”

And this book is also sad and angry, slowly building up to it throughout until at the end the laughs are over and somber reality is brought in. Because going through six years of understaffed and resource-overstretched meatgrinder and burnout has cost Adam Kay quite a lot — incredible stress, relationships, normal life — all because apparently the huge stress is justified within the system by “it’s always been done this way” excuse. Overworked, underpaid, undervalued and despite all that still putting your whole self into work where life and death are at stake — and yet at some point it can all become too much, and mistreatment and stress take their toll. Luckily, he seems happy in his afterword to this book, but yet he seems to miss the job that somehow, despite all of the craziness, was so meaningful to him. And if at the end of this book you don’t feel even a little bit shaken up, then something is broken here.

“Among all the predictably ‘hilarious’ remarks the patients made to me, one said something surprisingly astute. ‘It’s funny – you don’t think of doctors getting ill.’ It’s true, and I think it’s part of something bigger: patients don’t actually think of doctors as being human. It’s why they’re so quick to complain if we make a mistake or if we get cross. It’s why they’ll bite our heads off when we finally call them into our over-running clinic room at 7 p.m., not thinking that we also have homes we’d rather be at. But it’s the flip side of not wanting your doctor to be fallible, capable of getting your diagnosis wrong. They don’t want to think of medicine as a subject that anyone on the planet can learn, a career choice their mouth-breathing cousin could have made.”

I loved it, both in print and on audio, and I want to go back in time and give Kay a hug, or whatever he could have used back then — so likely find someone to cover his shifts once in a while.

5 stars.

——————
Also posted on my blog.

[Diane S ☔ · Rating 4 out of 5]

I so needed this book. Of course in the states we don't have National Health, but many of the snippets of humor are universal. Irreverent humor, spread around. If you are easily offended this book is probably not one you want to read. The many things people can put in their bodies, unreal. Some of the stories are cringe worthy, some unbelievable, but things these young doctors encounter.

The ending though was serious and includes a letter to the National Health service, explaining the many changes that need to be enacted to keep doctors from making mistakes. Too long hours, burnout, trying to do too much with too little. So, the tone does change, but up to them it is narrates by the author himself in a modular tone. I enjoyed this and agree with the changes he would like to see. These changes would benefit all doctors, no matter where they practice.

[Barney · Rating 2 out of 5]

I was expecting I'd enjoy this book but I ended up really disliking it. It starts off well with a few funny anecdotes but after a while I realised a lot of them are at the expense of the patient themselves. Yes I am the fun police, and I know humour is a way of coping, but there's something about the thought of a group of doctors chuckling about the time a dementia patient sexually assaulted another patient - and then a group of readers reading that and also chuckling - which doesn't sit well with me.

Also we can all agree that doctors deserve absolutely every penny they get and are entitled to far more than they're being paid currently. But there's nothing like someone pre-financial crash describing themselves as poor while also having just bought an apartment and a trip to the Mauritius which just aaaargh really gets under my skin.

I couldn't finish the book in the end. I was about half way through and fading fast, only to come across an vignette about the doctor being called in to deliver a new-born 'mid-wank', which ends with him completing the procedure "still erect". It was genuinely the most horrifying sentence I have ever read.

So yeah, 2 stars but mostly because (even though the book isn't really political itself) its popularity in the UK has contributed to conversations about how hard junior doctors work and how valuable their contributions are to the NHS.

[Christine · Rating 5 out of 5]

5 big stars!

Being a retired physician and needing something light after finishing a heart-wrenching novel, this one caught my eye. It promised some laughs and I thought it would also be a chance to see how my brutal residency and fellowship programs in the US compared to an NHS (universal health as opposed to private) program in Great Britain.

Without any exaggeration whatsoever, I have to say this book gave me more laugh-out-loud moments than any other book I’ve ever read!! It was so good (or bad, depending on your perspective, like my wife’s) that I had to stay on the other side of the house while reading this in order not to disturb Jean with the hilarity of it all. A few reviewers took offense to some of the humor, and I admit a bit of it may be construed as irreverent, but it made me happy! It’s hard to find happy in the world today, so I’m not going to apologize for how much I love Adam Kay’s sense of humor.

This memoir is for the most part constructed as a series of anecdotes. At first, I wasn’t sure if that would work for me, but it took virtually no time to ditch that concern. During Adam’s training, he would make notes of all the notable events that happened each day, which made it easy for him to put his memoir together several years later. The book does have its serious moments. The young physicians in training sacrificed so much. They frequently worked over 100 hours/week with no extra pay added to their measly salaries. Time worked over what was expected contractually was considered free labor, and that was the norm rather than the exception. That was bad enough, but under no circumstances were these young doctors granted special time off. One woman had to work the morning of her wedding day. Your mother dies and you want to go to her funeral? Tough, if you are on the work schedule. Many personal relationships are broken during these training years. You have essentially no other life.

There were times that Adam thought about changing career goals, especially when facing difficult life and death decisions while severely sleep deprived. The stress could be immense. But he kept going. He loved his job, though there was obviously too much of it. He discovered there is nothing better than making a difference in someone else’s life, especially if you actually save that someone’s life. I know that feeling—it’s the major thrust that keeps you going. Of note, there is minimal positive reinforcement from the system. Whatever little you get comes from the patients or their families or even just from yourself when you know you did a great job with a patient. But again, that all comes with huge sacrifices in terms of finances, personal relationships, and your own mental health.

I could really relate to all of this, though overall I believe the NHS program was a tougher place to survive than my program at the Mayo Clinic. Adam Kay has my deepest respect.

If you are need of some humor accompanied by an eye-opening look at the sheer dedication of young doctors in training, this is the book for you. I highly recommend it.

[Jen · Rating 1 out of 5]

This book was so close. So close. It was excellently funny and then as it went on, I started thinking “wait, this guy is an asshole, isn’t he? Yep, he’s an asshole.” So. That kind of ruined it as his true colors came out.

[Sara · Rating 4 out of 5]

I loved this. In part funny and heartwarming, yet also utterly heartbreaking and disillusioned. I think this strikes a particular cord with me at the moment as the author was an obs & gynae doctor, and I’ve recently spent time myself as an inpatient on such a ward.

This is the first book in a while where I’ve read passages out to my husband while laughing out loud one minute and then had to hold back tears the next. It’s a full on rollercoaster of emotions that also seems to very accurately describe what it’s like to work as front line staff for the NHS. I should know, I do it everyday too, and we all have our stories to tell that encompass the best and worst of British medical care. It’s one of my favourite things about the job, hearing stories from everyone about ‘that time a patient shoved a remote control up their rectum’ or ‘remember that night shift a woman faked passing out’. I think it’s what binds and bonds you all together. The camaraderie. Told with a liberal dose sarcasm and self deprecating humour, the author manages to walk that tightrope between friend, colleague and reliable narrator to a finely tuned ‘T’.

My admiration for other healthcare professionals is limitless, and will continue to be so. It’s really the awful and gut wrenching stories interspersed throughout (especially the last chapters) that make you realise how much pressure and guilt our doctors are under. And for little pay might I add. Day after day, night after night they fight to provide the best level of care they can without succumbing to sleep deprivation, depression or worse. There’s a lot of emotion here, a lot of anger and sadness that’s so hard to see, yet is oh so common in the increasingly frequent demoralised NHS worker.

It’s a very bittersweet read, that I devoured in one day, and I’m sorry it’s over. It’s one of the best memoirs of this kind I’ve read in a long time and I loved following Adam Kay on his journey through life as a junior doctor.

[Lea · Rating 5 out of 5]

Adam Kay is not the most likable person, he can be cocky, narcissistic and make completely inappropriate jokes about his former patients, but at the end of the book when he shows his emotional side and reveals reasons left medicine and that part was hitting a bullseye for me. I could resonate with every single word he wrote, and I'm sure, most doctors can.

''It’s a system that barely has enough slack to allow for sick leave, let alone something as intangible as recovering from an awful day. And, in truth, doctors can’t acknowledge how devastating these moments really are. If you’re going to survive working in this profession, you have to convince yourself these horrors are just part of your job. You can’t pay any attention to the man behind the curtain – your own sanity relies on it.
....‘Would your peers have done anything differently in that situation?’ All my peers would have done exactly the same things and had exactly the same outcome. But this wasn’t good enough for me. I knew that if I’d been better – super-diligent, super-observant, super-something – I might have gone into that room an hour earlier. I might have noticed some subtle changes on the CTG. I might have saved the baby’s life, saved the mother from permanent compromise. That ‘might have’ was inescapable.
I’d mocked consultants for being over-cautious before, rolled my eyes the moment they turned their heads, but now I got it. They’d each had their own ‘might have’ moment, and this is how you dealt with it.
The other recurrent theme, doctor after doctor, is how everyone remembers the sad stuff, the bad stuff, so vividly. Your brain presses record in HD. They can tell you the number of the room it happened in, on a labour ward they last saw a decade ago. The shoes the patient’s husband was wearing, the song playing on the radio.''

During the peak of the pandemic, I too thought about leaving medicine, I too ruminated on people who didn't make it. As one of my colleagues on youtube said - I just wanted to work somewhere where people weren't suffering all the time. Kay shows good, great and terrible sides of the job, and reading him was like talking to someone who had a similar experience and is blunt and honest about it, and consequently, I felt less alone in my own. As Kay said, being a doctor is both the best and the worst job in the work, but I don't blame him for at all for quitting and finding a different venture.

''These days, the only doctoring I do is other people’s words – I write and script-edit comedy for television. A bad day at work now is if my laptop crashes or a terrible sitcom gets terrible ratings – stuff that literally doesn’t matter in the scheme of things. I don’t miss the doctor’s version of a bad day, but I do miss the good days. I miss my colleagues and I miss helping people. I miss that feeling on the drive home that you’ve done something worthwhile. And I feel guilty the country spent so much money training me up for me just to walk away.''

The book is at the same time hilarious and devastating, as life itself. Kay ends on the great note of rising awareness about over over-worked, under-paid medical staff that holds health system that will otherwise collapse. In the end, I could feel the genuine love he has for both his fellow colleagues and his patients, and his former work, and that is all that counts for me.

[Yara Yu · Rating 4 out of 5]

هذا الكتاب سيؤلمك .. وفعل ..

لأول مرة أقف أمام كتاب بعد قراءته وأتسائل هل كان من الصحيح قراءته في هذا الوقت .. أو هل هذا هو الوقت المناسب لقراءته ..
كطبيبة امتياز حاليا فأنا في فترة ما بعد دراسة الطب المرهقة ٦ سنوات كانت صعبة ومليئة بالضغوطات هذه الفترة هي فترة تدريبي وبداية الطريق في ممارسة المهنة وهذا الكتاب خفت من قراءته في هذا الوقت حتي لا أتعرض الإحباط

الكتاب هو يوميات الطبيب آدم كاي كطبيب امتياز ثم طبيب مقيم ثم أخصائي في النساء والولادة
يشرح فيها أسابيع طويلة من العمل المرهق والذي بدون راحة .. حالات صعبة تواجهه وقرارات مصيرية وأرواح قد يفقدها في أي لحظة .. لحظات والمقابل .. لا مقابل آجر ضئيل وقلة احترام وخلل في حياتك الصحية والإجتماعية
الكتاب ملئ بالمواقف الطريفة التي واجهها في فترة عمله ولكن هذا لم يخفي الوجع الذي تحمله صفحاته
حيث تمثل آخر صفحات الكتاب الرعب بالنسبة لأي طبيب وهي فقدان لمعانه وممارسته للمهنة ..

[Lucy · Rating 4 out of 5]

4****

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 absolutely no condoms fit him, I establish he’s pulling them right down over his balls.

Extremely witty and funny!! I fully appreciated the use of Harry Potter aliases.

This gives a realistic picture of what it is like to work for the NHS as a junior doctor and jut trying to make your way up the ranks. It is a sad state the way these doctors and nurses are treated by those who employ them, and of course how they are treated by politicians: no breaks, back-to-back shifts, being under immense pressure, not going home, not getting a proper salary etc. The reality of their job is painful as well as the consequences of their job (examples: no social life, difficulty maintaining relationships, increased mental health issues among hospital staff).

Adam Kay worked in the obs and gyn department so had many a funny story to tell, but also had the sadder stories to tell as well. While he is no longer a doctor due to a case he had that completely changed the person he was, he has also found that those still in the profession were also desperately wanting to get out of it at times due to the treatment they receive. While many stay in the profession to reach the level of consultant and enjoy the helping of others, the continuous cuts to NHS services and the treatment of those who maintain this service is completely unfair. It is another call to rally that the doctors in the NHS are under-funded, under immense pressure, suffer from unfair treatment (see above with regards to salary, rest, etc)... which leads to mishaps when dealing with patients (this can lead to many mistakes and negligence and suing when dealing with patients) and severe mental health problems. Adam Kay also reveals the immense stress he was under and how this causes him to have a really high increase in heart pressure when working.

The British Journal of Psychiatry, 2009, showed that young female doctors in the UK are two and a half times more likely than other women to kill themselves.

[Sonja Arlow · Rating 5 out of 5]

I am going to be in so much trouble when my sister finds out I gave this book to my niece as this is probably not a very appropriate book for a 17-year-old. But she is determined to become a doctor and she needs to know it’s not just about rockstar surgeries and making buckets of money. It is the most insane working hours, thankless work with crap pay.

The diary entries follow Adam’s ascend through the ranks, from a junior doctor to becoming a consultant, specialising in gynaecology or “brats and twats” I learned more about giving birth than I ever EVER wanted to. The writing style is not geared towards making you feel a deep connection with Adam however towards the end my heart really went out to him and is the reason I rounded up to a full 4 stars.

The format took a while to get used to as some diary entries were so short they felt like Doctor Doctor jokes, but once I got used to it I could not stop reading.

This was really entertaining, in fact at times I had to literally wipe away tears of laughter. But there were a few stories where I felt the author went over the line, where someone should have told him to leave it out of this collection. These made up only about 10% of the book so it was easy to forgive. I also found the footnotes explaining medical procedures very interesting and not as intrusive as footnotes normally tend to be.

But this was not just all laughs, there were quite a few very touching stories that brought me back to reality, this is not a book full of fictitious jokes, it’s a book full of real people with serious medical problems.

The overall impression I was left with was how utterly grueling the process of becoming a doctor really is, how the NHS is setup to grind the doctors down even further, getting to know the human (warts and all) behind the white coat and how much a thank you from a patient means.

If you have an interest in medical memoirs and want a good laugh, then give this a try.

[Alice · Rating 4 out of 5]

Funny and devastating. Not for the squeamish.

[Reading_ Tamishly · Rating 5 out of 5]

I didn't mean to cry when I read the last two chapters but ...


And no, don't jump to the last two chapters just because I have mentioned it as the reason why I cried. It would not give you the impact of what I felt. It's just that it told me what we feel when it comes to our jobs which are quite misunderstood by everyone else, especially those in authority who should have understood us better.

🚨 "Think about the toll the job takes on every healthcare professional, at home and at work. Remember they do an absolutely impossible job, to the very best of their abilities. Your time in hospital may well hurt them a lot more than it hurts you."


It hurts to see someone suffering this much at the cost of doing something great for the rest of the world. Yes, it's our choice to choose this profession but everyone else trying to find fault in what you do just because you make a small mistake or for the inevitable things that would happen, is just insulting and humiliating.

The healthcare professionals chose their profession to heal, to care and to save others. Yes, there are flawed ones too. Name one profession which doesn't have the flawed ones in it. You can give me various reasons why doctors are this and that except for what they're supposed to do and what they're supposed to be. Again, name one 'respectable' profession which doesn't have a few of the worst of their kind.

Read this book and try to know how much of a "glamorous" life doctors have, how much "loads of money" they earn Vs the crucial life events they let go because they are so "happy" and "proud" everyday of what they do.

[Rebecca · Rating 5 out of 5]

97 hour weeks. Life and death decisions.
A constant tsunami of bodily fluids.
The hospital parking meter earns more than you…

Welcome to the life of a Junior Doctor.

A few years ago this book was everywhere! I grabbed a copy and sadly it sat on my shelf gathering dust. A few days ago I randomly decided to pick it up and start reading. I’m glad I did because I really enjoyed this book.

‘This is Going to Hurt’ is the tell all diary of Adam Kay, a Junior Doctor who shares all of the gory, hilarious and heartbreaking details of his job.

Throughout the book I found myself either laughing out loud, cringing or shedding a tear. Adams diary entries are incredibly raw and a huge eye-opener to how hard medical professionals work and the challenges they face each day. I finished this book with a massive sense of respect for them and I’m much more aware of all the things that can and do go wrong during surgery.

We forget to appreciate how incredibly hard it is to work in the medical field. If anything, the global pandemic currently happening has opened our eyes to this.

Highly recommend 👌🏻

[Hamad · Rating 3 out of 5]

This review and other non-spoilery reviews can be found @The Book Prescription

Actual Rating : 3.5 stars

“A great doctor must have a huge heart and a distended aorta through which pumps a vast lake of compassion and human kindness.”

🌟 Yet another non-fiction I am reviewing at my blog! Who am I???
This book is special since it is an insight to the medical field. I read this as a medical student but I am reviewing it as a doctor now.

🌟 The book had a shaky start and I was not impressed which I actually foresaw. I just didn’t expect that the author’s style is for me from the start but things were going in the right direction and I was intrigued so I continued to give it a chance.

🌟 I didn’t know that the author was a Gynecologist and funny coincidence is that I read this one while preparing for my Gyne exam. I am mentioning this because I want to point out that Adam was apparently an excellent doctor and that the book was scientifically very accurate.

🌟 The humor may have made a difficult topic easier to approach but it was not always funny nor it was always appropriate. I just wish that the book had a more serious tone at some points.

🌟 I like that this showed how doctors and the medical workers in general suffer, it showed how there is a problem with the system. What I am going to say is that we doctors are human!! It may sound stupid but really people do think of doctors as robots who should function on 100% all the time, not have any negative emotions!
When I got really sick earlier this year, the first response I was getting from like 99% of the people around me is “You are a doctor, you should not get sick”. I am pretty sure it is all in good spirits and meant as a kind of a joke but people really want that from us!

🌟 I am ending with a quote that I loved and that sums our mission in life as doctors. I think Adam said it perfectly:

“So I told them the truth: 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.”

🌟 Prescription: For all people in general and for medical workers specially. I already recommended this to my close friends/ colleagues!