Last month, I got my hands on a pre-release copy of This Is Going to Hurt, the medical memoirs of Adam Kay which were published this week.
It had landed on my doormat when I arrived home on a Monday morning after my first set of nights as the medical registrar, which was also the first weekend after August changeover and therefore my second shift working in a hospital so unfamiliar that on leaving induction two days earlier I had driven nearly as far as the ferry terminal to Troon before I realised that this probably wasn’t the road back to Glasgow. I left the book on the kitchen table, changed my shoes, and went in search of breakfast.
The next day, my day off for catching up on life admin and grocery shopping and for getting my body clock turned the right way up, I sat down and read the whole thing in one sitting.
Adam Kay is a writer and script editor of comedy. In a previous life, he was an obs and gyn registrar and is known to medical students all over the country as one half of Amateur Transplants. This Is Going To Hurt is taken from the diaries kept in his years of junior doctoring.
Now, the memoirs of doctors are ten a penny these days. We are required by our training boards and the GMC to reflect on our practice, and I suppose some of us think we may as well publish it. It would be disingenuous of me to say otherwise; you are after all reading my blog. I’ve read some of the ones that made it into book form, the oldest of which was published in 1992. (I have never read House of God.) I’ve liked some more than I’ve liked others. (This is unsurprising. I like some of my colleagues more than I like others.) This is the first one I’ve read that has made me want to invite it over to Sunday lunch with my four best loved doctors, and that is among the highest compliments of which I am capable.
My affinity with it exists on a number of levels.
It knows the value of a good footnote.
It’s written by someone who plainly loved his job and was good at it. (I realise that you might then ask why he left. That isn’t my story to tell.)
It’s funny and friendly. It reads as easily as a colleague telling me stories about their week, which I suppose is what it is. It contains at least a dozen anecodotes that sent me into a tailspin of, “oh, remember that time…”, which is the hallmark of good medic chat. Fair warning, one of those anecdotes contains a vagina, a railway spike, and Newtonian inevitabilities.
And it would be disingenuous of me to not admit that at least part of my affinity with this book comes from having read it just exactly when I did. Adam writes about what it’s like to be on nights, “sailing the ship alone: a ship that’s enormous, and on fire, and that no one has really taught you how to sail.” He writes about how as House Officers we all think that our registrars are geniuses, “like God maybe, or Google”, and the horrifying moment when, “before you know it, the registrar is you.” He writes about how as the senior on call he couldn’t sit down, but would “prowl anxiously around labour ward, flitting from room to room asking ‘is everything ok?’” It is a strange and immersive experience to read a book like this immediately after a weekend like the one I’d had. I kept thinking, “YES THIS ALL OF IT ALL WEEKEND,” and then looking up to say it out loud, only remembering after I already had that no one was actually in the room. The job I do is nothing like being an obstetrics registrar, apart for in all the ways that it’s exactly the same.
The existence of the book owes itself at least partly to the Secretary of State for Health. In his epilogue, Adam writes about the Conservative government waging war on doctors and his own realisation that everyone who works or has ever worked in healthcare needs to shout about the reality of the work that we do. His acknowledgements include no thanks whatsoever to Jeremy Hunt.
It isn’t a book about politics, except in the sense that we live these days in a time and a place when to tell the truth about being a doctor is a political act. For those of us who believe in what Nye Bevan believed, there is no option to be apolitical about healthcare. And there is no such thing as “just politics”, for, please, if the next generation learns anything from ours let it be the inconvenient truth that “just politics” was always a lie.
This Is Going To Hurt is written by Adam Kay and published by PanMacmillan. It is available now.