Secret Diaries of a Junior Doctor
"This Is Going to Hurt" by Adam Kay is a humorous and heartbreaking memoir of a junior doctor's journey through the UK's National Health Service (NHS). It highlights the joys and trials of the medical profession and showcases the importance of supporting healthcare workers.
Like all other British 16-year-olds, Adam Kay had to make a decision about which subject was going to be his primary area of study for the rest of his academic career. At this age, he didn’t give this decision a great deal of scrutiny since it always felt like he was destined to follow in the footsteps of his dad, who was a doctor.
So, in 1998, Adam was off to South Kensington, where he attended Imperial College in London for six long years. Afterward, he began his career as a junior doctor, which is basically the name the NHS gives to every doctor who isn’t a consultant – the highest rank a doctor could attain at the time. Back then, the standard trajectory of an NHS doctor’s career path was as follows: house officer, senior house officer (SHO), registrar, senior registrar, and then, finally, consultant.
Adam started his career as a house officer on August 3, 2004. It didn’t take long for him to discover that all of the memorization he undertook in school would’ve made him a great contestant on Masterminds, but did little to prepare him to work for over 90 hours a week as a house officer.
During a day shift, a house officer was not unlike a glorified personal assistant: they made lots of phone calls, booked MRI and ECG appointments, and arranged for patient referrals. But during the night shift, it was an entirely different ballgame.
At night, while the SHO and registrar were dealing with incoming patients in the Accident and Emergency (A&E) department, house officers were meant to take care of the patients in every other ward of the hospital. They were given a pager, known as a bleep, that went off whenever there was an emergency to tend to – and there was always an emergency to tend to.
It was very much like being thrown into the deep end of the pool and realizing that you better learn to swim immediately because the lives of patients can literally depend upon it. For example, just a few months into his first year as house officer, Adam was bleeped to help with a man in his sixties who was moments away from death. Operating on autopilot, Adam began performing what procedures he knew by hooking up an IV, administering diuretics, getting him some oxygen, installing a catheter, running tests and so forth.
Amazingly, the man responded almost immediately and was pulled back from death’s door.
This is Going to Hurt (2017) is a revealing look at the daily reality of working as a doctor in the UK today, as experienced by one man who rose through the ranks of the country’s National Healthcare System (NHS). At times painfully funny, and in others disturbingly grim, author Adam Kay’s personal recollections and diary entries offer a warts-and-all look at the life of a doctor in the NHS.
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