This junior doctor's memoir is not for the faint hearted

Before reading Adam Kay’s diary of working as a junior doctor for six years between 2004 and 2010, I was blissfully unfamiliar with the medical term “deglove”—describing a kind of injury in which the skin is peeled off the underlying tissue like a glove. This is Going to Hurt is not for the faint-hearted.

One of the earliest diary entries recounts the horrific demise of a patient “hosing enormous quantities of blood out of his mouth.” It is the first death Kay witnesses and afterwards he gratefully accepts his registrar’s offer of a cigarette, even though he doesn’t smoke.

Kay eventually specialised in obstetrics because, as he writes, “you end up with twice the number of patients you started with… an unusually good batting average compared to other specialities. (I’m looking at you, geriatrics.)”

The final entry is a distressingly vivid description of an incident so awful that Kay simply cannot carry on and so resigns. “I went six months without laughing, every smile was just an impression of one,” he writes.

Yet, extraordinarily, this book is filled with laughter. It is not all about “adverse outcomes,” as the management jargon has it. Kay, who clearly decided that laughter is the best medicine and is now a comedy writer and performer, has a brilliant, scalpel-sharp wit which he uses to dissects the lunacies of the NHS—its patients and, sometimes, its employees. Probably best not to read it if you have any medical procedures scheduled though.

This is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay (Picador, £16.99)