Are you ‘lucky’ enough to have a friend who is a doctor? Or better yet, a doctor who works in emergency? They always have the best dinner party stories…

Adam Kay’s memoir, This is Going to Hurt, tells of his time as a junior doctor in a busy London hospital. Kay is no longer a doctor, he’s a writer and stand-up comedian, so I guess he can’t be struck off the medical register for contravening patient confidentiality… nonetheless, stories about the degloving of a penis; ‘Eiffel’ syndrome, otherwise known as ‘I fell on a remote control and it got stuck in my nether regions’; and a patient Facetiming a friend during a pap smear are startling and uncomfortably funny.

“…and mild vaginal burns from a patient stuffing a string of lights inside and turning them on (bringing new meaning to the phrase ‘I put the Christmas lights up myself’).”

Kay chooses obstetrics and gynaecology as his specialty, or as it is known among the students, ‘brats and twats’.

I liked that in obstetrics you ended up with twice the number of patients you started with, which is an unusually good batting average compared to other specialties. I’m looking at you geriatrics.

The book was Kay’s response to the unprecedented 2016 NHS doctors strikes – he does an excellent job of highlighting the extreme pressure doctors are under, with juniors regularly working more than 90 hours a week. Kay notes that the ‘…parking meters outside the hospital are on a better hourly rate.’ He makes light of the stupidly long hours and lack of support –

I spend the entire night shift feeling like water is gushing into the hull of my boat and the only thing on hand to bail it out with is a Sylvanian Family rabbit’s contact lens.

But the unwritten and terrifying message is clear – that doctors (and nurses) who are extremely overworked and stressed are having to make ‘life and death’ decisions.

Overlooking Kay’s pithy one-liners, you do have to wonder what draws someone to medicine. As he states –

Every doctor makes their career choice aged sixteen, two years before they’re legally allowed to text a photo of their own genitals. When you sit down and pick your A levels, you’re set off on a trajectory that continues until you either retire or die.

Ultimately, there’s a limit to how many people will choose, and continue to work, in medicine for the love of it – even the most committed suffer from burnout in testing conditions (I think the same applies to all health carers, teachers, and first responders).

This book had me laughing out loud, however, it ends on a sobering note, when an operation with an unforeseen complication goes tragically wrong. Kay struggled to come to terms with what had happened and troublingly, was shown little understanding and no real support by the medical authorities. The incident prompted his decision to leave medicine. These sorts of stories are frustrating – we want people with the qualities Kay has (caring, committed, good bedside manner, empathetic) and yet if the ‘system’ does nothing to keep them, you have to wonder about long-term outcome for health services.

4/5 Funny and thought-provoking is a odd mix…