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Where Does It Hurt?: What the Junior Doctor Did Next
The Junior Doctor is back! He's into his 2nd year of medicine, but this time Max is out of the wards and onto the streets, working for the Phoenix Outreach Project. Fuelled by tea and more enthusiasm than experience, he attempts to locate and treat a wide and colourful range of patients that somehow his first year on the wards didn't prepare him for ...from Molly the 80-year-old drugs mule, God in a Tesco car park, to middle-class mums addicted to appearances and pain killers in equal measure. His friends don't approve of the turn his career is taking, his mother is worried and the public spit at him, but Max is determined to make a difference. Warned that miracles are rare and that not everyone's life can be turned around, those who can be saved will surprise him. Funny, touching, uplifting and wise, Max goes from innocence to experience via dustbin-shopping-trips without ever losing his humanity.
272 pages, Paperback
First published January 1, 2009
104 people are currently reading
1643 people want to read
About the author
Max Pemberton
105 books10 followersLibrarian Note: There is more than one author in the Goodreads database with this name.
Max^Pemberton
Max Pemberton is a British medical doctor, journalist and author. He works full-time as a psychiatrist in the National Health Service (NHS). He is a weekly columnist for the Daily Mail, writing comment on news events concerning culture, social and ethical issues, the politics of health care and the NHS Before his move to the Daily Mail, he was a columnist for the Daily Telegraph. He also writes a monthly column for Reader’s Digest and is a regular contributor to The Spectator. He is the editor of Spectator Health, a quarterly supplement from The Spectator.
Max^Pemberton
Max Pemberton is a British medical doctor, journalist and author. He works full-time as a psychiatrist in the National Health Service (NHS). He is a weekly columnist for the Daily Mail, writing comment on news events concerning culture, social and ethical issues, the politics of health care and the NHS Before his move to the Daily Mail, he was a columnist for the Daily Telegraph. He also writes a monthly column for Reader’s Digest and is a regular contributor to The Spectator. He is the editor of Spectator Health, a quarterly supplement from The Spectator.
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Displaying 1 - 30 of 54 reviews
May 20, 2015
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This review contains spoilers
Written by Dr Max Pemberton, this is an account of a year spent working as a doctor doing outreach work in the city. He was based in a medical centre, but also did a lot of work on the streets, looking after drug addicts, homeless people and people with mental health problems.
Dr. P is a kind, self-deprecating man, with a great sense of humour. His concern for his patients is impressive, although he is often ambivalent about them too, well at least the drug addicts. The choices they make are provocative - their lifestyles, the anti-social ways in which they finance their (incredibly expensive) habits and the frequent lying and self-delusion. For those with mental health problems he just feels compassion.
This book gives us privileged insights into the characters and lives of his patients. They become very real people to us, and over the course of the book we get a rounded picture of the problems and difficulties they face in their day to day lives. Some of these characters include Mr. Allsop who thinks he’s God, Fergal and Antony the heroin addicts who against all odds were coming clean, Rachael, the pregnant heroin and crack addict, and Janice, the middle-aged housewife addicted to painkillers. There are others too. Dr. P describes them and their situations with a mixture of insight, frustration and compassion. Also humour. There are episodes in this book which had me guffawing with laughter.
And here are extracts from the book I want to remember…… Not very nice ‘review’ fare, but the book taught me new things, and I want to note them down.
* ”In essence, two medications are available to prescribe for people addicted to heroin. The first is methadone, a bright green or blue liquid in the same class of drugs as heroin and morphine – the opiates. You take it every day as a substitute for heroin and its stops the physical cravings. Because it’s prescribed the dose is accurate, and can be increased if you need more to stop the cravings, or brought down over several months if you want to get off it altogether without the unpleasant withdrawl symptoms. The downside is that to start with you have to come every day to the clinic to have it, and for safety reasons can only have a weekly or fortnightly prescription once you’ve proved, through urine tests, that you’re not using heroin on top. Methadone doesn’t give you a buzz like heroin does; it just stops the withdrawl symptoms. Given that most people use drugs for the buzz, this rather spoils the fun.
The second option is buprenorphine, or Subutex. This little tablet is placed under the tongue and dissolves slowly. It, too, is an opiate and substitute for heroin, but the dose can be decreased over weeks, rather than the months it takes with methadone, so users are detoxed far quicker. This is great if you’re ready to be drug-free, not so good if you aren’t. It works by blocking the receptors on the cells in the body which the heroin latches on to, this providing the addition benefit of preventing any heroin you do take from working. It doesn’t work if you’re using more than a bag of heroin a day prior to starting on it. It’s also incredibly expensive and reserved for people who are adamant that they want to be drug free.”
*“There is a belief among addicts that residential rehab is the answer to all their problems. Patients often request it. In the private sector they will happily take your money and provide you with a nice, peaceful room offering a view of rolling countryside, but in the state sector a residential placement is hard to come by. Unusually for the NHS, this isn’t because of funding but because it isn’t that effective……Removing the person from temptation doesn’t address the underlying reason as to why they were using drugs…..”
*”Heroin is physically highly addictive; crack is not. But both drugs are addictive because of the psychological benefits they provide for the user: the sudden rush, the euphoria, the overwhelming, all-enveloping sense of anaesthesia from one’s life. It might sound heretical for me to say it, but if that’s what you’re looking for, then I’m afraid the drugs do work.”
*”The world of hard-core drug addiction is dark, seedy and hidden. …the general public have only a hazy awareness of what that world is really like; how these people long to be free of their addiction, hate themselves for what they do every day, and their bleak despair.”
*”Pharmacologically, morphine and heroin are the same drug, the only real difference being that morphine is given to you by a doctor and heroin by a drug-dealer.”
*”In many ways, crack is the poor man’s cocaine. They are chemically very similar, crack being a solid, smokable form of cocaine; the same drug for two very different social echelons. The effect of crack is more intense than that of cocaine, but very short-lived.”
*”As both (crack and cocaine) are stimulants …users often find themselves trying to take something to ‘mellow’ them and help them get to sleep: the stimulant properties last long after the buzz from the ‘high’. After crack or coke, a mug of Horlicks won’t help. Heroin, on the other hand, is a sedative and works wonders. But, unlike Horlicks, it brings with it physical dependency.”
*”For several years she had been taking an increasing number of over-the-counter painkillers. She was now consuming around six packets a day….She didn’t like to talk about her addiction and referred to it as her ‘silliness’….. However, when I sat down and worked out exactly how much codeine was in each tablet and the number she took each day, I was horrified to discover that she was taking the equivalent of a bag of heroin each day…..’I can’t be an addict’, she had said earnestly, only last week. ‘I pay my taxes and listen to Radio 2, for goodness’ sake’.”
*”Managing them (heroin addicts who are pregnant) was particularly difficult because by the time they presented at the clinic, it was not just they who were addicted to drugs but their unborn child. While an adult woman’s body is relatively resilient to the effects of heroin, the developing foetus’s is not. Using heroin during pregnancy increases the risk of premature birth, stillbirth and restricted growth.”
* “‘This is Anna’ said Flora…….I looked closely at her. She was limp and grey. She wasn’t responding. …..The nurse shook her head. ‘No, it’s OK, don’t worry. She’s just been given her morphine. Opiate babies aren’t very responsive.
The idea of given someone so small such noxious medication made me feel ill. ‘She started withdrawing a few days after she was born and then began having fits so we had to start her on it’, she continued. I remembered reading about it at medical school: it’s called Neo-natal Abstinence Syndrome and is common in babies born to mothers addicted to heroin or taking methadone….It came about because opiates cross the placenta, so the developing baby becomes addicted. When it is born, the opiates are not longer supplied by the mother’s body, so the baby goes into withdrawal.’”
Please don’t be swayed by the rather grim extracts above – the book is warm, funny and caring – as well as dealing with the more serious sides of addiction. It is also incredibly readable. I found it hard to put down. It opened my eyes to issues faced people on the edge of society, and I was left with admiration for the way the National Health Service here in the UK tries to help them with their problems – for their sakes and our sakes.
PS The title of the book seems completely irrelevant and unrelated to the book's content and direction. More suitable for an Enid Blyton story than the issues it actually deals with, in my humble opinion.
This review contains spoilers
Written by Dr Max Pemberton, this is an account of a year spent working as a doctor doing outreach work in the city. He was based in a medical centre, but also did a lot of work on the streets, looking after drug addicts, homeless people and people with mental health problems.
Dr. P is a kind, self-deprecating man, with a great sense of humour. His concern for his patients is impressive, although he is often ambivalent about them too, well at least the drug addicts. The choices they make are provocative - their lifestyles, the anti-social ways in which they finance their (incredibly expensive) habits and the frequent lying and self-delusion. For those with mental health problems he just feels compassion.
This book gives us privileged insights into the characters and lives of his patients. They become very real people to us, and over the course of the book we get a rounded picture of the problems and difficulties they face in their day to day lives. Some of these characters include Mr. Allsop who thinks he’s God, Fergal and Antony the heroin addicts who against all odds were coming clean, Rachael, the pregnant heroin and crack addict, and Janice, the middle-aged housewife addicted to painkillers. There are others too. Dr. P describes them and their situations with a mixture of insight, frustration and compassion. Also humour. There are episodes in this book which had me guffawing with laughter.
And here are extracts from the book I want to remember…… Not very nice ‘review’ fare, but the book taught me new things, and I want to note them down.
* ”In essence, two medications are available to prescribe for people addicted to heroin. The first is methadone, a bright green or blue liquid in the same class of drugs as heroin and morphine – the opiates. You take it every day as a substitute for heroin and its stops the physical cravings. Because it’s prescribed the dose is accurate, and can be increased if you need more to stop the cravings, or brought down over several months if you want to get off it altogether without the unpleasant withdrawl symptoms. The downside is that to start with you have to come every day to the clinic to have it, and for safety reasons can only have a weekly or fortnightly prescription once you’ve proved, through urine tests, that you’re not using heroin on top. Methadone doesn’t give you a buzz like heroin does; it just stops the withdrawl symptoms. Given that most people use drugs for the buzz, this rather spoils the fun.
The second option is buprenorphine, or Subutex. This little tablet is placed under the tongue and dissolves slowly. It, too, is an opiate and substitute for heroin, but the dose can be decreased over weeks, rather than the months it takes with methadone, so users are detoxed far quicker. This is great if you’re ready to be drug-free, not so good if you aren’t. It works by blocking the receptors on the cells in the body which the heroin latches on to, this providing the addition benefit of preventing any heroin you do take from working. It doesn’t work if you’re using more than a bag of heroin a day prior to starting on it. It’s also incredibly expensive and reserved for people who are adamant that they want to be drug free.”
*“There is a belief among addicts that residential rehab is the answer to all their problems. Patients often request it. In the private sector they will happily take your money and provide you with a nice, peaceful room offering a view of rolling countryside, but in the state sector a residential placement is hard to come by. Unusually for the NHS, this isn’t because of funding but because it isn’t that effective……Removing the person from temptation doesn’t address the underlying reason as to why they were using drugs…..”
*”Heroin is physically highly addictive; crack is not. But both drugs are addictive because of the psychological benefits they provide for the user: the sudden rush, the euphoria, the overwhelming, all-enveloping sense of anaesthesia from one’s life. It might sound heretical for me to say it, but if that’s what you’re looking for, then I’m afraid the drugs do work.”
*”The world of hard-core drug addiction is dark, seedy and hidden. …the general public have only a hazy awareness of what that world is really like; how these people long to be free of their addiction, hate themselves for what they do every day, and their bleak despair.”
*”Pharmacologically, morphine and heroin are the same drug, the only real difference being that morphine is given to you by a doctor and heroin by a drug-dealer.”
*”In many ways, crack is the poor man’s cocaine. They are chemically very similar, crack being a solid, smokable form of cocaine; the same drug for two very different social echelons. The effect of crack is more intense than that of cocaine, but very short-lived.”
*”As both (crack and cocaine) are stimulants …users often find themselves trying to take something to ‘mellow’ them and help them get to sleep: the stimulant properties last long after the buzz from the ‘high’. After crack or coke, a mug of Horlicks won’t help. Heroin, on the other hand, is a sedative and works wonders. But, unlike Horlicks, it brings with it physical dependency.”
*”For several years she had been taking an increasing number of over-the-counter painkillers. She was now consuming around six packets a day….She didn’t like to talk about her addiction and referred to it as her ‘silliness’….. However, when I sat down and worked out exactly how much codeine was in each tablet and the number she took each day, I was horrified to discover that she was taking the equivalent of a bag of heroin each day…..’I can’t be an addict’, she had said earnestly, only last week. ‘I pay my taxes and listen to Radio 2, for goodness’ sake’.”
*”Managing them (heroin addicts who are pregnant) was particularly difficult because by the time they presented at the clinic, it was not just they who were addicted to drugs but their unborn child. While an adult woman’s body is relatively resilient to the effects of heroin, the developing foetus’s is not. Using heroin during pregnancy increases the risk of premature birth, stillbirth and restricted growth.”
* “‘This is Anna’ said Flora…….I looked closely at her. She was limp and grey. She wasn’t responding. …..The nurse shook her head. ‘No, it’s OK, don’t worry. She’s just been given her morphine. Opiate babies aren’t very responsive.
The idea of given someone so small such noxious medication made me feel ill. ‘She started withdrawing a few days after she was born and then began having fits so we had to start her on it’, she continued. I remembered reading about it at medical school: it’s called Neo-natal Abstinence Syndrome and is common in babies born to mothers addicted to heroin or taking methadone….It came about because opiates cross the placenta, so the developing baby becomes addicted. When it is born, the opiates are not longer supplied by the mother’s body, so the baby goes into withdrawal.’”
Please don’t be swayed by the rather grim extracts above – the book is warm, funny and caring – as well as dealing with the more serious sides of addiction. It is also incredibly readable. I found it hard to put down. It opened my eyes to issues faced people on the edge of society, and I was left with admiration for the way the National Health Service here in the UK tries to help them with their problems – for their sakes and our sakes.
PS The title of the book seems completely irrelevant and unrelated to the book's content and direction. More suitable for an Enid Blyton story than the issues it actually deals with, in my humble opinion.
December 11, 2022
This was an interesting insight into what it's like working in a drug dependency unit.
I wasn't really aware of things like the phoenix project before, so this book was very interesting and I learnt a lot.
This book was very funny, but still was respectful to the individuals he was discussing.
All the anecdotes were informative and fun to read.
I don't think I enjoyed this book as much as his first one, because it was more varied than this one. However, it was still an informative and fun read which I would recommend to anyone who likes to read medical memoirs.
I wasn't really aware of things like the phoenix project before, so this book was very interesting and I learnt a lot.
This book was very funny, but still was respectful to the individuals he was discussing.
All the anecdotes were informative and fun to read.
I don't think I enjoyed this book as much as his first one, because it was more varied than this one. However, it was still an informative and fun read which I would recommend to anyone who likes to read medical memoirs.
November 18, 2024
This book was a really good insight into working in psychiatry and with patients who have a drug addiction, and had the same addictive combination of humor and medicine. However, the dramatization of events through the narrative, whilst important for storytelling, sometimes gave a caricatured view of characters and felt almost as if Max was capitalizing off patients for the sake of a good story…
November 27, 2022
Max Pemberton is starting his second year as a junior doctor out on the streets rather than in the wards.
Spoilers ahead.
There's no better way to procrastinate on a pile of cardiology lectures than reading a medical memoir. Often, the doctor-author will throw in medical jargon and explain it in a kid-friendly way so that stuff like "oesophageal varices" finally makes sense and you're getting some pretty decent teaching. However, more than that, it's doctors like Max Pemberton who keep me motivated at medical school. I devoured his first book, Trust Me, I'm a (Junior) Doctor in one sitting (yes, it was THAT good). Neither the university nor the public libraries had the rest of the series and it didn't occur to me to request copies until earlier this year, and lo and behold! I now have both the second and third books to read! <3 (Well, third book remaining now as I've clearly finished the second one.)
This book details Dr. Pemberton's time working for the Phoenix Outreach Project where he's required to treat patients from various backgrounds. Most are drug users and one of the primary goals of the project is to prescribe methadone to wear patients off their substance abuse. A lot of these patients also happened to be homeless so Dr. Pemberton often had to track them down (or bribe them with McDonald's) to get them to talk or even accept treatment. Then there were some patients who had delusions or were schizophrenic, one even paid a man to kill her by injecting a lethal dose of heroin. Absolutely wild stuff.
I had to sit in the drug clinic while on my GP block and it was so difficult to suspend judgement. I remember talking to the doctor I was shadowing that morning and explaining how horrible I felt for being so judgemental. It's not the people's fault that they turned to substance abuse. Yes, there is a way to "treat" substance abuse but the underlying problem still remains unresolved. There are a host of mental health factors and circumstantial aspects that the NHS doesn't have the means to cope with. Plus, it's so frustrating when you believe so much in patients to stay clean and then they relapse and have to start over. I found it fascinating to read about Dr. Pemberton's evolution throughout the memoir. He started off quite timid and unsure of himself. He could hardly believe the patients' stories or the things he would have to do to gain their trust (like digging through a dumpster to obtain a Prada shirt). However, the more exposure he gained, the more open-minded and compassionate he was about these people's stories.
One of Dr. Pemberton's colleagues Professor Pierce said this about their work:
I haven't worked in an outreach program yet but even talking to patients on the wards and learning their stories makes me feel so privileged. I hadn't been able to name that feeling before but it truly is a privilege and incredibly rewarding when they are comfortable enough to open up and cry in front of you or chat about their family and cats and dogs and how "children from your generation are always on gadgets!"
It's unfortunate that social determinants are seriously lacking in the medical school curriculum. They're usually tacked onto a tutorial that is optional to attend with a monotonous lecturer (usually) who regurgitates the same useless information about respecting cultures and being sensitive while asking questions. We need more hands-on work to really understand what that even entails!
I enjoy Dr. Pemberton's books because he doesn't shy away from the realities of medicine. There are countless details of his overworked life, the stress of not earning enough, barely having time to socialise with anyone and studying for exams until you drop dead. However, his passion for medicine shines through and is, dare I say it, contagious. I loved how relatable he was in his interactions with patients--the first pang of anxiety before getting a grip on himself--and his sense of humour totally vibes on the same wavelength as mine.
Spoilers ahead.
There's no better way to procrastinate on a pile of cardiology lectures than reading a medical memoir. Often, the doctor-author will throw in medical jargon and explain it in a kid-friendly way so that stuff like "oesophageal varices" finally makes sense and you're getting some pretty decent teaching. However, more than that, it's doctors like Max Pemberton who keep me motivated at medical school. I devoured his first book, Trust Me, I'm a (Junior) Doctor in one sitting (yes, it was THAT good). Neither the university nor the public libraries had the rest of the series and it didn't occur to me to request copies until earlier this year, and lo and behold! I now have both the second and third books to read! <3 (Well, third book remaining now as I've clearly finished the second one.)
This book details Dr. Pemberton's time working for the Phoenix Outreach Project where he's required to treat patients from various backgrounds. Most are drug users and one of the primary goals of the project is to prescribe methadone to wear patients off their substance abuse. A lot of these patients also happened to be homeless so Dr. Pemberton often had to track them down (or bribe them with McDonald's) to get them to talk or even accept treatment. Then there were some patients who had delusions or were schizophrenic, one even paid a man to kill her by injecting a lethal dose of heroin. Absolutely wild stuff.
I had to sit in the drug clinic while on my GP block and it was so difficult to suspend judgement. I remember talking to the doctor I was shadowing that morning and explaining how horrible I felt for being so judgemental. It's not the people's fault that they turned to substance abuse. Yes, there is a way to "treat" substance abuse but the underlying problem still remains unresolved. There are a host of mental health factors and circumstantial aspects that the NHS doesn't have the means to cope with. Plus, it's so frustrating when you believe so much in patients to stay clean and then they relapse and have to start over. I found it fascinating to read about Dr. Pemberton's evolution throughout the memoir. He started off quite timid and unsure of himself. He could hardly believe the patients' stories or the things he would have to do to gain their trust (like digging through a dumpster to obtain a Prada shirt). However, the more exposure he gained, the more open-minded and compassionate he was about these people's stories.
One of Dr. Pemberton's colleagues Professor Pierce said this about their work:
What the patients in our line of work teach us is that, despite our differences, we are all the same. We have the same desires, motivations and concerns. They teach us what it is to be human and it's always a privilege to be taught.
I haven't worked in an outreach program yet but even talking to patients on the wards and learning their stories makes me feel so privileged. I hadn't been able to name that feeling before but it truly is a privilege and incredibly rewarding when they are comfortable enough to open up and cry in front of you or chat about their family and cats and dogs and how "children from your generation are always on gadgets!"
It's unfortunate that social determinants are seriously lacking in the medical school curriculum. They're usually tacked onto a tutorial that is optional to attend with a monotonous lecturer (usually) who regurgitates the same useless information about respecting cultures and being sensitive while asking questions. We need more hands-on work to really understand what that even entails!
I enjoy Dr. Pemberton's books because he doesn't shy away from the realities of medicine. There are countless details of his overworked life, the stress of not earning enough, barely having time to socialise with anyone and studying for exams until you drop dead. However, his passion for medicine shines through and is, dare I say it, contagious. I loved how relatable he was in his interactions with patients--the first pang of anxiety before getting a grip on himself--and his sense of humour totally vibes on the same wavelength as mine.
January 20, 2025
4.75 stars - beautifully written and enjoyed much more than the first in the series. The patients that the author helped had heartbreaking stories and the author showed the reality of drugs and lack of support that there can be. He acknowledges its not just one issue but many that these patients need help with such as mental health, addiction and homelessness. Some patients made you cross and some you were routing for. The woman that helped Patrick showed that there are still good people out there willing to help strangers. Only thing to improve would to be to hear about some of the patients indepth
February 12, 2022
Fascinating insight
Some really interesting insights into homelessness and drug addiction, written in a refreshingly honest and humourous way. I really enjoyed reading.
Some really interesting insights into homelessness and drug addiction, written in a refreshingly honest and humourous way. I really enjoyed reading.
December 11, 2020
Loved this sequel, just as good as the first book and again a good insight into what Max went through.
May 14, 2024
⭐️⭐️⭐️⭐️ REALLY REALLY GOOD, BUT NOT THE BEST THING I'VE EVER READ -- Generally I hand out this rating to books that I thoroughly enjoy/find extremely interesting/have a lot of fun reading. I save 5 star ratings for only the best of the best, so a 4 star rating is usually indicative of a high quality book. A book could be knocked down to 4 stars because there were some parts that I wasn't entirely fond of, some parts that could be improved upon, or maybe I just didn't like the ending. Still, I would likely recommend this book to most people, with the proviso that I enjoyed it but it wasn't the best ever.
----------
My ranking criteria (✅= Yes, ❌= No, ➖= Kind of/a little bit):
*Bonus points if I can't put the book down, it makes me feel strong emotion, or genuinely surprises me in some way.
*Penalty points for editing errors (spelling, grammar, punctuation, etc.), for children who act too mature or too young for their age (this is a bugbear of mine), or if there is something in the book that just really pisses me off for any reason.
1. I was sucked into the story from the beginning ✅
2. The story had a proper beginning, middle, and end ✅
3. The writing evoked a feeling of suspense ✅
4. I was engaged the whole way through/didn't get bored ✅
5. The characters were interesting ✅
6. There was some form of character development ✅
7. The book wasn't predictable in terms of relying on tired tropes, clichés, themes, stereotypes, etc. ➖
8. I cared about the outcome of the story ✅
9. I didn't work out the ending/the ending surprised me ➖
10. The ending was satisfying ➖
🌟 Bonus points: None.
☠️ Penalty points: None.
🏅 OVERALL RANKING: 8.5/10 (4.25/5 stars)
----------
Thoughts, Conclusion, and Recommendation:
*I am about a year behind on my reviews due to starting a new job, and Goodreads giving me a "the servers are over capacity" error every time I tried to use it for MONTHS. As a result of this (and also my memory not being perfect), this review is likely going to be lighter on details and shorter than my reviews normally are.
Where Does It Hurt is the follow up to Trust Me I'm a (Junior) Doctor by Max Pemberton. While the first book follows Max as he traverses the trials and tribulations of being a brand new doctor, Where Does It Hurt takes Max to an all new arena - a drug treatment centre. I think that I liked this one a little more, primarily because it was all so new to me. Max's experiences at the treatment centre are so visceral and confronting, but he tempers this with his trademark sense of humour and heart. Definitely worth a read. 4.25 stars (rounded down to 4 for the purposes of Goodreads).
----------
My ranking criteria (✅= Yes, ❌= No, ➖= Kind of/a little bit):
*Bonus points if I can't put the book down, it makes me feel strong emotion, or genuinely surprises me in some way.
*Penalty points for editing errors (spelling, grammar, punctuation, etc.), for children who act too mature or too young for their age (this is a bugbear of mine), or if there is something in the book that just really pisses me off for any reason.
1. I was sucked into the story from the beginning ✅
2. The story had a proper beginning, middle, and end ✅
3. The writing evoked a feeling of suspense ✅
4. I was engaged the whole way through/didn't get bored ✅
5. The characters were interesting ✅
6. There was some form of character development ✅
7. The book wasn't predictable in terms of relying on tired tropes, clichés, themes, stereotypes, etc. ➖
8. I cared about the outcome of the story ✅
9. I didn't work out the ending/the ending surprised me ➖
10. The ending was satisfying ➖
🌟 Bonus points: None.
☠️ Penalty points: None.
🏅 OVERALL RANKING: 8.5/10 (4.25/5 stars)
----------
Thoughts, Conclusion, and Recommendation:
*I am about a year behind on my reviews due to starting a new job, and Goodreads giving me a "the servers are over capacity" error every time I tried to use it for MONTHS. As a result of this (and also my memory not being perfect), this review is likely going to be lighter on details and shorter than my reviews normally are.
Where Does It Hurt is the follow up to Trust Me I'm a (Junior) Doctor by Max Pemberton. While the first book follows Max as he traverses the trials and tribulations of being a brand new doctor, Where Does It Hurt takes Max to an all new arena - a drug treatment centre. I think that I liked this one a little more, primarily because it was all so new to me. Max's experiences at the treatment centre are so visceral and confronting, but he tempers this with his trademark sense of humour and heart. Definitely worth a read. 4.25 stars (rounded down to 4 for the purposes of Goodreads).
June 21, 2025
Read this in just one day - excellent on so many levels. Snappy, frank writing style, perverse humour, and complex thought processes around topics such as substance misuse, homelessness, and the variety of medicine.
It’s offered me a lot of insight into the complexities of the mentioned topics and the fact that substance misuse is a symptom of a wider issue rather than being a main presenting complaint.
Learned in the middle of reading this book that the author works today as a psychiatrist and could truly see the driving force and compassion for his line of work in his writing.
As a medic, I found this book truly eye opening and taught me so much about topics that we were taught how to medically treat in school but not so much the social and psychological aspects.
The wide variety of stories ranging from people prostituting themselves to afford substances, heroin addicted babies, unlikely recoveries from drug addiction, middle class substance misusers and using heroin to silence paranoid schizophrenia we’re emotionally stirring and offered so much to learn from to widen my understanding.
It’s offered me a lot of insight into the complexities of the mentioned topics and the fact that substance misuse is a symptom of a wider issue rather than being a main presenting complaint.
Learned in the middle of reading this book that the author works today as a psychiatrist and could truly see the driving force and compassion for his line of work in his writing.
As a medic, I found this book truly eye opening and taught me so much about topics that we were taught how to medically treat in school but not so much the social and psychological aspects.
The wide variety of stories ranging from people prostituting themselves to afford substances, heroin addicted babies, unlikely recoveries from drug addiction, middle class substance misusers and using heroin to silence paranoid schizophrenia we’re emotionally stirring and offered so much to learn from to widen my understanding.
January 23, 2019
As you can probably guess from the title, this is one of those “Medical Professional writes about their job in an amusing fashion” books. I like these kinds of books but they can have difficulty standing out from one another, especially as even the terrific ones (like Adam Kay’s This is Going to Hurt) can’t manage to avoid the Junior-Doctor-Book Bingo Card. Happily, this one pretty much does.
This time round, Pemberton’s is attached to the Phoenix Outreach Project, dealing with the homeless, the drug addicted, and octogenarian former prostitutes.
Pemberton is a decent writer who has a nice line in fish-out-of-water humility going on. There’s a good variety of stories, interesting, funny and sad, if never quite as emotionally wrenching as the end of the Kay book mentioned above.
If you like this sort of thing, which I do, it’s well worth sticking Pemberton on your TBR pile - his first is the usual Junior Doctor in a hospital stuff, while his third is about his stint in Geriatrics. This one was great and I really quite enjoyed it.
4 stars
This time round, Pemberton’s is attached to the Phoenix Outreach Project, dealing with the homeless, the drug addicted, and octogenarian former prostitutes.
Pemberton is a decent writer who has a nice line in fish-out-of-water humility going on. There’s a good variety of stories, interesting, funny and sad, if never quite as emotionally wrenching as the end of the Kay book mentioned above.
If you like this sort of thing, which I do, it’s well worth sticking Pemberton on your TBR pile - his first is the usual Junior Doctor in a hospital stuff, while his third is about his stint in Geriatrics. This one was great and I really quite enjoyed it.
4 stars
June 5, 2022
In this his second book, Max Pemberton tells the reader what he did in his second year of medicine, whilst working for the Phoenix Outreach Project.
Pemberton, in his usual funny, touching, uplifting and wise wittiness, attempts to treat a wide range of patients, for which his first year on the wards never prepared him for, such as 80 year old drugs mule Molly, a gentleman who thinks he is God, to middle class mums.
It seems that Pemberton's friends don't approve of this turn in his career. Yet Max is determined to make a difference to some people he treats, and those whose lives he is successful with do surprise him.
Pemberton, in his usual funny, touching, uplifting and wise wittiness, attempts to treat a wide range of patients, for which his first year on the wards never prepared him for, such as 80 year old drugs mule Molly, a gentleman who thinks he is God, to middle class mums.
It seems that Pemberton's friends don't approve of this turn in his career. Yet Max is determined to make a difference to some people he treats, and those whose lives he is successful with do surprise him.
February 18, 2022
This was slow burner for me however gave me such an amazing insight into a side of medicine I hadn’t thought about before. You see people who are drug dependent on wards but for a book to give details on how they live off the ward is insane! Would 100% recommend this book to anyone who is unsure what medical field they want to go into. I 100% want to avoid this field at all costs as it’s personally not for me but having read the book I can say that my knowledge and understanding of this field has increased!
August 14, 2022
Didn't expect to enjoy this as much as I did!! Picked it up as my local charity shop had free books with any purchase and this seemed like the one I'd be most interested in. Was a really interesting look at drug and homeless outreach, appreciated the honesty from the author about his own middle-class bias and misconceptions around addiction and mental health. A good read if you're into medical books!
August 15, 2022
This is the second book of which Max has wrote about his life of becoming a junior doctor. This one has him working with people who suffer from drug addiction. It showed people from all walks of life and how drug addiction had impacted them through Max's eyes.
*If you want to read more of my thoughts, read review for third book in series, as it often talks about the book series as a whole.
*If you want to read more of my thoughts, read review for third book in series, as it often talks about the book series as a whole.
November 6, 2018
Not entirely what I was expecting but enjoyable nonetheless. Slightly outdated but thankfully in positive ways! Well written, easy to read. Could be read in isolation but does have references to Max's earlier book
November 13, 2019
Read this book!
A brilliant read! Sensitively written and looks at real life situations from both sides of the coin. Certainly made me think twice about our dedicated and talented NHS workers not to mention those blighted by homelessness and addiction.
A brilliant read! Sensitively written and looks at real life situations from both sides of the coin. Certainly made me think twice about our dedicated and talented NHS workers not to mention those blighted by homelessness and addiction.
February 10, 2022
So enjoyable! Well written, informative, funny, inspiring, hopeful and sad all at the same time. I couldn't quite give it 5 stars because I just couldn't give it the same rating as This Is Going To Hurt.
February 11, 2024
this is not what i was expecting after reading max’s first book but god did i love it! the comparison of life within the wards to life on the streets was done with such compassion. i found out so much about drug use & the catering of medicine towards vulnerable people who don’t have your typical access to help. thank you max, such an important book!!
December 3, 2018
Really insightful and you grow to love the characters in your own way, despite what they've been through you cant help but have a warm feeling for some of them :)
February 24, 2019
A great insight
This book was a great insight into drug use and mental health issues. A great read that makes you see things a bit differently.
This book was a great insight into drug use and mental health issues. A great read that makes you see things a bit differently.
March 20, 2019
An easy to read lunchtime dip in and out. Nice that it focussed on a section of society i know very little about.
August 25, 2019
Max definitely grew on me. I loved his voice in this book and his different experience in Medicine. Pretty good memoir.
November 24, 2019
Excellent read
Another excellent read. Just a small glimpse of the problems people have to deal with and the lack of funding for people in these situations
Another excellent read. Just a small glimpse of the problems people have to deal with and the lack of funding for people in these situations
May 23, 2020
Rounded up to 4 stars. A take on the world of homelessness from a junior doctor trying to do some good.
February 1, 2021
Brilliant book - thoroughly enjoyed it - v v interesting
February 13, 2021
Good read. Well done
April 20, 2021
Not as good or as amusing as the first one (Trust Me I’m a Junior Doctor), but enjoyable nonetheless! At least he seems to be enjoying his job now, ha
May 19, 2021
Well written book but not as good as the first.
June 13, 2021
read this after very much enjoying his first book.
very interesting, amusing and heartfelt. seems like a great guy who wants what’s best for his patients. a thoroughly good read !!
very interesting, amusing and heartfelt. seems like a great guy who wants what’s best for his patients. a thoroughly good read !!
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