This is Going to Hurt by Adam Kay, UK, 2017

Told as a series of diary excerpts, this is the story of Kay’s six-year period, working for the NHS, as Junior House Officer, Senior House Officer, Registrar and Senior Registrar. He is well on his way to becoming a Consultant, but before this happens he leaves the medical profession. There is probably no one reason for his leaving, and the sad thing is that none of the reasons have anything to do with his chosen career as such but everything to do with the impossible expectations placed upon medical staff by NHS management.

After his first year as JHO, Kay chose obstetrics and gynaecology because: ‘. . . in obstetrics you end up with twice the number of patients you started with, which is an unusually good batting average compared to other specialities’ (32), and he liked the fact that it was a mixture of both medicine and surgery.

I do not doubt that Kay was a very good doctor, and, as he says on page 260: ‘ . . . I miss my colleagues and I miss helping people (…) you never totally stop being a doctor. . . ‘ Had he not had to work 97-hour weeks and had management been able to relate to its medical staff with at least some compassion and understanding, it is more than possible that Kay would still be in his chosen profession.

An extremely funny book which also describes many thought-provoking and even tragic incidents that tend to balance the humour and put it in its right perspective. Because of the diary style This is Going to Hurt can be read in small bursts, or it can be read completely out of order. That Kay chose to wrap the unbelievable and the tragic in humour is not so strange. He writes about leaving the profession: ‘At first I couldn’t talk about it, then it became something I just didn’t talk about. When cornered, I would reach for my red nose and clown horn. . . ‘ (260).

Read it simply for the humour, to gain insight into a handful of medical emergencies, or as a way of understanding that the NHS needs to listen to, and improve, its relationship with all of its medical practitioners.

(Photo of Kay from The Times)