Book Review

Book Review: This Is Going To Hurt, by Adam Kay (2017)

5 stars!

There are certain books that receive so much praise across all possible print and online channels, yet there;’s never enough time for you to actually sit down and see what all the fuss is about. This Is Going to Hurt was that book for me until recently. When browsing my library’s digital collection, I saw this (though with 3 people ahead of me in the virtual queue) and knew that now was the time to read the book that so many people have recommended to me. After 4 weeks of waiting, the book was uploaded to my account and I basically only stopped reading to meet with my friends in Oxford (where we talked about how amazing the book was) and to go food shopping. I was enthralled from start to finish. I’ll explain why later in this review, but first, allow me to summarise what this book is about.

The premise:

Adam Kay worked as a junior doctor in the NHS between 2004 and 2010. He kept diaries of his experiences, from his first year fresh out of medical school through his gradual progression towards a senior role, and (spoiler alert) his eventual resignation. These entries detail his overwhelming shifts, his encounters with ‘interesting’ patients, and the pressures that being a doctor puts on you, and your relationships. Combined with the reflective introduction that each portion of entries is given, this book becomes a testament to the resilience, fragility, and incomparable value of those who work in our hospitals.

My review:

I’ve mentioned it already but I could barely put this book down. It has such an open tone that I was drawn in immediately.

This book is a mass of contradictions, but in the best way (not least because it reflects the conflicted emotions that this former doctor, and I’m sure many others, felt about their work). The tone of the diary entries, and the accompanying reflections and footnotes, is one of sarcasm and exasperation, in a ‘I can’t believe this has happened’ way. There were moments that made me horrified and laugh out loud simultaneously (which added to my horror, partly because I’d laughed at something that should not be funny, and partly because I was laughing on a packed train on the way to work). In a similar manner, you can sense Kay’s confusion: his roles in the obs and gynae units allowed him to be there at crucial moments in people’s lives, but also see what ridiculous situations others can end up in hospital for. The emotional reward of delivering babies safely into the world is countered by the lack of adequate pay, the inability to make or keep plans with loved ones, and the emotional turmoil of working in a hospital.

I think a key take-away from this book, and it’s one that surprised me given that I have relatives and close friends currently working as doctors and nurses in the NHS, is how much I take for granted the people who help us we’re ill or injured. It’s so easy to forget that they have homes, families, worries, and that they’ve probably not had a break or proper sleep for days. That they’re making decisions about people’s health, but aren’t given adequate time to manage their own (physical or mental).

“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 in this profession, you have to convince yourself these horrors are just part of your job […] your sanity relies on it.”

Yes, it’s a profession that people choose, that they have to go through rigorous training for, but that doesn’t negate the fact that there is seemingly very little support to help them deal with the extreme stresses of the work. And as Kay makes clear throughout, it’s a decision that has to be made at 15/16 years old, when people are completing GCSE’s and choosing A-Levels, a time when they can’t begin to comprehend the reality of it. This Is Going To Hurt read almost like a reality-check, aimed at various audiences and various issues in the health care system.

The structure of the book worked really well, segmented into each of Kay’s roles. Each section began with a reflection from Kay, including further anecdotes not included in the diaries. This helped to pace the book somewhat, providing relief from the intensity of the diary experiences. The footnotes that accompanied the book were also a great addition. They were informative and just as hilarious as the diaries. They were great for explaining the medical terminology and for providing extra reflection on certain moments. As I read a digital copy, the flicking back and forth worked fine, but I’m not sure if readers of the print editions experienced it differently.

“63 – A lot of individuals (I’m not calling them patients; there’s nothing wrong with them) come to hospital under the misapprehension they’re in any way ill – known as the worried well. If this is because of something they’ve read online, they’re called cyberchondriacs.”

I’ve mentioned that the entire book hilarious, but towards the end of the diary content, there is a notable shift in tone towards complete exasperation and exhaustion, culminating in one hugely significant moment that altered everything for Kay. I won’t say what it is, but I will say that I had to stop reading the book for a moment. It’s upsetting, for the moment itself but also for what you can tell it means for Kay to acknowledge and share it.

This Is Going To Hurt is an incredible read from from page 1 to the final footnote. Its an energetic mixture of rawness, poignancy, and caustic humour. It’s a book that delivers a clear message in numerous and overlapping ways: remember that doctors are human beings who deserve to be valued and supported more than they currently are.

Thanks for reading my review today! Have you read this book?

*This Is Going To Hurt, by Adam Kay, was first published in the UK by Picador (PanMacmillan) in 2017.

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