This is Going to Hurt summary

Not long after being able to say he’d saved his first life, Adam encountered his first “degloving” case.

This involved an 18-year-old man who’d been out having a few drinks with his friends. Sometime after last-call, he decided to climb a bus stop shelter and use it as a dance floor. Then, in order to get himself back down, he thought it would be a good idea to use a lamp post like a firehouse pole. 

While moving from house officer to SHO signified a promotion in the NHS hierarchy, it didn’t mean Adam was getting a less strenuous schedule or getting paid any more than a basic, junior professional’s salary. That wouldn’t happen for another few years – if and when he became a consultant.

Throughout his time as a junior doctor, Adam was in a relationship with a person he refers to as H, who had the patience and understanding of a saint. Many junior doctors can’t sustain a long-term relationship because they’re constantly working upwards of 90 hours a week, and when they’re not working they’re dead tired. In addition, most attempts at scheduling dinner dates, vacations or even weddings tend to be pipe dreams that end up being cancelled at the last minute due to work demands.

In 2007, experienced enough with the endless days and nights of the labor ward, Adam became a registrar. The biggest change, however, was that on some occasions he’d be the most senior staff member in the ward and essentially running the show. He tried to offset the reality of continuing to be overworked and underpaid by the fact that he was halfway to being a consultant.

Meanwhile, he was continuing to be amazed by some of the patients he’d meet.

On his first day as a junior doctor, one of the things he was given was an email address: atom.kay@nhs.net. In a way, this administrative mistake – the misspelling of a very common first name – was reassuring. It meant Adam wouldn’t be the most incapable person working for the NHS that day.

But as Adam’s time as a junior doctor continued, the incompetencies within the NHS only continued to pile up. 

From stillbirths to fatal complications during pregnancies, Adam witnessed his fair share of death in the labor ward. There were times he had to deliver bad news to families or perform tests on dead babies to determine the cause of death. These are the most difficult parts of the job, but every doctor knows they’re unavoidable, no matter how great the hospital.

An added, specific difficulty to consider in the life of an NHS doctor, is the impact of being forced to work non-stop for over twelve hours, without meals and rest, with the expectation of not making mistakes. Despite what some people may believe, doctors are as human as anyone else, and this set of conditions is a blueprint for disaster.