This is Going to Hurt is a hilarious and sobering memoir that reveals both the funny and the serious sides of being a junior doctor.  The book is written through a series of diary entries that offer a peek into the six years Adam Kay worked his way up to senior registrar (attending physician) on a labor and delivery ward with the English National Health Service.

In a recent interview, he talks about how his secret diary was the emotional armor that allowed him to navigate bad days. (It’s easy to imagine what that means on a maternity ward.)

I loved that he balances heartbreak with plenty of snide British humor. There are stories of intense sleep deprivation—falling asleep at a red traffic light;  unrelenting pressure—the bride who did rounds in full wedding hair and make-up since no one could take her morning shift; foreign objects wedged into places they shouldn’t go; laugh-out-loud conversations with clueless parents-to-be; and anecdotes about projectile bodily fluids.

Many nights I fell asleep laughing, but the book ends with a powerful message about why Adam quit doctoring and the lack of training for the psychological impact of the job. When I turned the last page, I was full of admiration for the dedication of the doctors of the English National Health Service, including my own brother-in-law.

Despite everything, Adam is clearly a fan of the NHS, and it’s interesting to read how his own perception of private healthcare changes when he becomes a locum (a sort of substitute doctor) to earn extra money. As he compares private medicine with the NHS, he writes: “You get seen a bit quicker, the receptionist’s got all her teeth and there’s a decent wine list for your inpatient stay—but ultimately you get the same treatment.”

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