Ever wondered what life is like behind the scenes in the NHS? How do doctors navigate through the grueling hours, low pay, and intense pressures of saving lives? Can a profession driven by a calling and not monetary gain truly be rewarding? Dive into the world of a senior house officer and discover the stark realities, heartwarming victories, dark humor, and immense challenges that come with the medical profession.

This is Going to Hurt: Secret Diaries of a Junior Doctor

Many doctors make life-altering decisions at 16, based on a parent's career or a TV show, but seldom on a true understanding of the job. Adam Kay, the author, observed that medical schools, more focused on extracurricular achievements than genuine compassion, churn out doctors who are often unprepared for the grueling realities of the job.

In 1998, Adam embarked on his journey to become a doctor, driven by the thrill of potentially changing lives. However, nothing could have prepared him for the reality of being a house officer. His days were filled with monotonous tasks and endless forms, while night shifts were chaotic and overwhelming, with life-or-death decisions resting on his shoulders.

Despite the challenges, there were moments of exhilaration. The night Adam saved a man's life, pulling him back from the brink, made up for months of routine work. Yet, the job also brought unexpected encounters, like the patient who inadvertently helped him find confidence with his constant praise, or the woman who offered a bribe for a longer sick leave.

Every shift was a learning experience for Adam, from dealing with quirky patients to handling emergencies. His first death was a harsh reminder of mortality, while other days were marked by bizarre incidents, like removing foreign objects from places they shouldn't be. There were moments of humor too, like the time his friend's email address became a running joke, or when he found himself subconsciously reacting to a restaurant's pager, mistaking it for his hospital bleep.

Balancing the demands of the job with a personal life was another challenge for Adam. Missing a friend’s stag due to last-minute rota changes left him juggling work and relationships, a common theme for many medics. Amidst the chaos, small victories, like a compliment from a nurse, were cherished, providing a glimmer of encouragement in an otherwise relentless profession.

Adam realized that being a doctor was not just about medical knowledge but also about empathy, quick thinking, and resilience. Whether it was managing a crisis with limited resources or breaking bad news with sensitivity, every day brought new challenges, shaping him into a better doctor and person.

Is Choosing a Career in Medicine a Lifelong Commitment or a Risky Gamble?

By August 2005, Adam had become a senior house officer. Despite the title, he was still quite junior, having only been a doctor for a year. The 'senior' part was likely to give patients confidence in the young doctor about to operate on them, and it gave Adam a small morale boost to face the grueling new rota.

During this time, Adam witnessed some rather absurd situations. One house officer he knew slept with a patient, and another prescribed penicillin instead of paracetamol to a patient with a penicillin allergy. Both passed their house officer year without issue, making Adam wonder what one must do to actually fail.

Choosing a specialty was a significant decision. If one opted for general practice, they stayed in the hospital for a few years before moving into the community. For hospital medicine, choices ranged from surgery to various branches of general medicine. Adam chose obstetrics and gynecology, attracted by its blend of medicine and surgery. He liked the idea that in obstetrics, you often ended up with twice the number of patients you started with, which was a good batting average compared to other specialties.

Adam's first week on the labor ward was intense. He had to press the emergency buzzer when a patient started hemorrhaging, and the senior registrar managed to remove a piece of retained placenta, saving her. It was moments like these that echoed the emotional highs and lows of this career.

Adam's first ventouse delivery was a milestone, making him feel like a real obstetrician. However, not all moments were triumphant. There were days like when he had to explain to a patient why her baby would be delivered at an angle due to his wonky incision during a caesarean.

Christmas morning 2005 was spent on the labor ward, having fallen asleep in his car after the previous night's shift. He scrambled to start his shift only ten minutes late. Adam and his partner had to push their Christmas celebration to his next day off.

As Adam progressed, he encountered more of the hospital's harsh realities. From handling a cord prolapse to respecting a Jehovah’s Witness patient's refusal of blood transfusions, each case was a reminder of the gravity and responsibility of the job.

The emotional peaks of the job were numerous, like assisting in the caesarean section of a pre-eclampsia patient whose baby, after twelve weeks in the neonatal unit, finally went home healthy. These moments made the grueling hours and difficult decisions worthwhile.

One poignant encounter was with a patient diagnosed with terminal ovarian cancer. Her selflessness and concern for her family during their conversation left a profound impact on Adam. These interactions underscored the human aspect of medicine and the importance of empathy.

In the end, being a senior house officer was about more than just medical procedures; it was about navigating the highs and lows of patient care, making critical decisions, and finding moments of humanity amidst the chaos.

Doctor Diaries: From Rookie Mistakes to Life-Saving Moments

During his early years as a Senior House Officer (SHO), Adam watched a documentary about Shaolin grandmasters and envied their stability, despite their rigorous training. 

In contrast, NHS deaneries shuffled doctors between hospitals every six or twelve months, covering vast regions like Kent, Surrey, Sussex, or even all of Scotland, making it impossible to settle down. This constant relocation was tough. Adam and his partner H ended up renting inconveniently located places, adding to the list of ways his job affected her: medical widow, post-shift counsellor, and now nomad.

Despite the instability, Adam enjoyed his first year in obstetrics and gynecology, transitioning from a terrified beginner to someone more confident, thanks to supportive seniors. However, his second posting landed him in an old-fashioned, unsupportive hospital where the "see one, do one, teach one" approach was prevalent. It was challenging, and he had to quickly learn and adapt to maintain an air of confidence.

On Black Wednesday, when all junior doctors change hospitals, Adam started at St. Agatha’s. The day is known for higher death rates, but it took some pressure off, oddly enough. During his time there, he encountered various memorable experiences, like a mother worried her baby had a brain tumor, which turned out to be a normal skull part. Another instance was running a clinic with no prior experience, learning on the job.

Adam's poker face was tested many times, like dealing with a patient who had a magnet implant for an "extra sense" or a man who checked his wife's dilation at home. He also became a mental health helpline for a friend, Simon, who struggled with suicidal thoughts. Balancing this with his demanding job was overwhelming, but it reminded him that being a doctor often means just being there for someone.

There were lighter moments too, like a patient storming out of a clinic and a posh child’s amusing definition of the economy. But there were also frustrations, like arranging his own sickness cover when food poisoning struck or navigating bureaucratic hurdles like parking fines.

Through it all, Adam learned to maintain a sense of humor and resilience. Whether it was dealing with unexpected objects in patients' orifices or attending a beloved patient's funeral against his boss’s advice, each experience added to the rich tapestry of his medical journey.

Can Junior Doctors Survive the Chaos of NHS Deaneries and Black Wednesday?

As a senior house officer (SHO) in the NHS, Adam couldn't help but reflect on the stark realities of the job. Despite the immense responsibilities, the pay was shockingly low, often less than a train driver’s wage, and the grueling hours meant doctors were essentially on an unfavorable hourly rate compared to parking meters.

Doctors don’t typically complain about money; it’s not a profession driven by financial gain. Instead, it's about a calling, with centralized pay scales leaving little room for monetary negotiation. The lack of conventional rewards was evident – no bonuses, no promotions, just a relentless pace with little acknowledgment. The only semblance of a bonus came from ‘ash cash,’ a grim £40 for signing cremation forms ensuring patients had no pacemakers, which could otherwise cause explosive incidents during cremation.

Recognition from superiors was rare, which made patient gratitude all the more meaningful. Adam cherished every thank you card from patients, keeping them through every house move as they provided a sense of validation his bosses rarely offered. Unlike the butlers at Buckingham Palace, who likely receive more acknowledgment, doctors often go unnoticed for their life-saving efforts.

A rare moment of recognition came when a consultant offered Adam a chance to act up as a registrar, acknowledging his work, though it seemed more a matter of luck and timing than genuine appreciation. This opportunity meant a lot personally, as Adam and his partner were trying to buy a flat, striving for stability amidst the chaos of a medical career.

Daily anecdotes and experiences further highlighted the absurdities and challenges. A patient once asked if one morning-after pill was enough after sleeping with three men. Another time, Adam dealt with a patient in gynecology who couldn’t fathom her pregnancy weeks, offering a bizarre numerical guess instead. And let’s not forget the hilarious yet concerning IT mishap where the Royal College of Obstetrics and Gynaecology’s website was blocked for being classified as ‘pornography.’

The job’s intensity often crept into Adam's personal life, like sacrificing social outings for the sake of saving up for a deposit or handling emergencies off-duty, such as aiding a severely bleeding teenager in Glasgow. The balance between professional duties and personal life was a constant struggle, often leading to awkward situations, like mistakenly identifying a pregnant friend’s baby’s gender at a dinner party, causing significant tension.

Despite these challenges, the camaraderie among colleagues and the shared dark humor in the doctors' mess provided some relief. Yet, the lack of support for mental health among doctors was alarming. A colleague’s suicide attempt underscored the dire need for better pastoral care in the profession, highlighting the systemic issues within hospitals.

In the end, while the NHS provided a stipend rather than a competitive salary, the real reward for Adam was the gratitude from patients and the invaluable experiences that, despite the hardships, reaffirmed why he chose this path.

Inside the NHS: A Doctor's Tale of Struggles, Sacrifices, and Unseen Heroes

When Adam was a house officer, his registrar seemed infallible, like a deity or Google. But as he progressed to Senior House Officer, the registrar became his savior in tricky situations. Then, one day, he was the registrar, leading clinics, teaching students, and making life-or-death decisions. It was exhilarating yet terrifying, like juggling a dozen logic puzzles while navigating the chaos of a labor ward.

One day, a patient, GL, declared she wanted to eat her placenta, calling it "placentophagia" to sound official. Despite the midwife and Adam pretending not to hear, she later began eating blood clots, mistaking them for her placenta, and inevitably vomited.

Working for the NHS instilled immense pride in Adam. Despite the grueling hours and bureaucratic challenges, being part of something so vital made it worthwhile. However, the temptation of private practice faded for him after witnessing its limitations and risks compared to the NHS's comprehensive safety net.

In one memorable shift, a woman in labor had a concerning heart rate for her baby. Her consultant was minutes away, but Adam couldn't wait. Acting on instinct, he delivered the baby just in time, reinforcing the unpredictable nature and critical responsibility of the job.

Adam's days were filled with paradoxes and unexpected moments. From calming a patient's fears with humor to dealing with tragic stillbirths, the emotional rollercoaster was relentless. Yet, amidst the chaos, small gestures of gratitude, like a handmade thank-you card, reminded him why he endured the hardships.

Non-medical friends marveled at Adam's diagnostic skills, but sometimes, it backfired, like identifying a stripper's infection at a stag do. Even personal sacrifices, like missing holidays and working endless hours, were part of the job's demanding nature.

Despite the challenges, there was a unique camaraderie among medical staff. Whether it was sharing dark humor or supporting each other through tough shifts, they navigated the intricacies of healthcare together. And while Adam often felt like a temporary visitor in a permanent workplace, small tokens of appreciation, like a gifted pen, showed that their efforts never went unnoticed.

Is Life as an NHS Doctor Like Being Google in a Chaos-Filled Labor Ward?

Deciding what kind of doctor to be is crucial. Beyond choosing a specialty like urology or neurology, it's about one's bedside manner. Is one smiley and positive or straight to the point? Adam chose the latter, saving time and avoiding unnecessary chit-chat. However, a complaint about his clinical performance floored him, making him reconsider his approach.

One patient sued Adam for a routine bladder injury during a caesarean, despite being informed of the risk. The legal process was exhausting and stressful, but the hospital settled out of court, as they usually do. This experience left him questioning his career but ultimately, Adam decided to protect himself from future complaints by improving his bedside manner.

In another instance, a patient with a detailed and unrealistic birth plan ended up needing an emergency caesarean. The consultant suggested a "natural caesarean," which appeased her. This reminded Adam that patients often have unrealistic expectations, and managing them is part of the job.

One memorable emergency involved a midwife accidentally tearing down the ceiling while pulling the emergency cord. Another was delivering a baby named Sayton, which prompted discussions about terrible baby names.

Working long hours, dealing with complaints, and facing medical emergencies can be draining. But moments like helping couples conceive in infertility clinics or safely delivering babies make it worthwhile. Despite the challenges, Adam concluded there's no better job in the world.

Navigating Medicine: From Legal Battles to Heartfelt Deliveries

Imagine being at a party hosted by someone who keeps you there long after you intended to leave. That was Adam's medical career—always a step away from reaching the next level. He found himself a senior registrar, still chasing dreams he signed up for over a decade ago with the flimsiest reasons. 

The path from medical school to consultancy is relentless, packed with stress and responsibility. As a senior registrar, Adam was the highest-ranking person out of hours, forced to resolve problems others couldn't. He felt the weight of responsibility, knowing a mother or baby’s life could hang in the balance if he didn’t act swiftly. 

The pressure took its toll. His blood pressure soared, mirroring the stress of his job. During a clinic, a patient remarked, "You don’t think of doctors getting ill," highlighting the misconception that doctors are infallible. But they are human, capable of making mistakes, feeling stress, and needing care themselves.

One day, a patient named their baby after him—a rare moment of joy amidst the chaos. It was a small victory in a field where the stakes are incredibly high. Adam often dealt with life and death, like the time a shoulder dystocia required every ounce of skill and nerve to save a baby’s life.

As a doctor, you face ethical dilemmas, like deciding between a quick but invasive surgery or a longer, more meticulous one that might salvage your personal life. Adam often found himself in situations where patients’ needs conflicted with religious beliefs or bureaucratic red tape. Each decision carried weight, sometimes leaving him with a haunting 'might have'—what he might have done differently to prevent a tragedy.

He faced a devastating situation when a mother and baby almost died under his watch. Although his actions were officially deemed non-negligent, the 'might have' lingered. Adam realized he couldn’t continue; the burden was too heavy. He left medicine, but not without guilt and longing for the sense of purpose it gave him.

Now, Adam writes comedy—his worst days involve crashed laptops and bad ratings, trivial compared to the stakes of medicine. Yet, he misses the good days, the camaraderie, and the feeling of making a difference. 

His story, like many others, is a testament to the pressures and sacrifices healthcare professionals endure. As the government continues to challenge the NHS, remember the toll it takes on those who work tirelessly to ensure others’ well-being. Their job is impossible, but they do it with dedication and heart, often at great personal cost.

Is the NHS Crisis Pushing Doctors to Swap Stethoscopes for Stand-Up Comedy?

Many doctors begin their careers with idealistic motivations, often influenced by family or media, without truly grasping the demands of the job. Medical schools tend to prioritize extracurricular achievements over the essential qualities of compassion and resilience, which are crucial for the profession.

The reality of being a junior doctor, filled with monotonous tasks and high-pressure situations, can be a stark contrast to the initial excitement of saving lives. Despite the challenges, moments of success and patient gratitude can provide significant emotional rewards, making the grueling work worthwhile.

Balancing personal life with the intense demands of the job is a constant struggle, often leading to missed milestones and strained relationships. The journey through various medical specialties, like obstetrics and gynecology, involves continuous learning and adaptation, with each day bringing new challenges and responsibilities.

The profession is not just about medical knowledge but also about empathy, quick thinking, and resilience. Dealing with emergencies, making critical decisions, and managing patient expectations are all part of the job. The emotional highs and lows, from life-saving moments to dealing with patient loss, shape doctors into better professionals and individuals.

Despite the immense responsibilities and low pay, many doctors are driven by a sense of duty and the fulfillment that comes from helping others. The camaraderie among colleagues and the shared experiences provide some relief amidst the relentless pace of the job. However, the lack of support for mental health and the constant pressure can take a toll, leading some to reconsider their career paths.

In the end, being a doctor is about navigating the complexities of patient care, making sacrifices, and finding moments of humanity and humor amidst the chaos. The experiences, both challenging and rewarding, reaffirm why many chose this path, despite the personal costs involved.

Home

Trending Books

News & Mags

Relax

Curated

Collections

Key Ideas & Notes

Insights

Highlights & Bookmarks

Listening History

This is Going to Hurt: Secret Diaries of a Junior Doctor

Adam Kay

Ever wondered what life is like behind the scenes in the NHS?

How do doctors navigate through the grueling hours, low pay, and intense pressures of saving lives?

Can a profession driven by a calling and not monetary gain truly be rewarding?

Dive into the world of a senior house officer and discover the stark realities, heartwarming victories, dark humor, and immense challenges that come with the medical profession.

Key Ideas

#1