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

Kay, Adam

Primary Category: Literature / Nonfiction

Genre: Memoir

Annotated by:
Miksanek, Tony
  • Date of entry: Aug-28-2018
  • Last revised: Aug-28-2018


After a combined twelve years of medical training and working on hospital wards, this British physician leaves the medical profession. Using his diary written during a stint in the National Health Service (NHS) from 2004-2010, he recalls his experiences as a young doctor.

He describes the making of a doctor and a physician's life as "a difficult job in terms of hours, energy, and emotion" (p196) and recounts the overwhelming exhaustion and toll on his personal life. He chooses OB/GYN as his specialty partly because "I liked that in obstetrics you end up with twice the number of patients you started with, which is an unusually good batting average compared to other specialties" (p32). As for his bedside manner, "I went for a 'straight to the point' vibe - no nonsense, no small talk, let's deal with the matter in hand, a bit of sarcasm thrown into the mix" (p163).

Days are filled with doing prenatal visits, vaginal deliveries, caesarean sections, gynecologic surgeries, and lots of women's health issues. Night shifts are often hellacious as they "made Dante look like Disney" (p5). He must handle emergencies, break bad news, deal with intra-uterine deaths, and once gets sued for medical negligence. The anecdotes are sometimes tender and heart-tugging, other times wacky and gross. Consider this diary entry dated 12 March 2007: "a lump of placenta flew into my mouth during a manual removal and I had to go to occupational health about it" (p92).

The final diary entry chronicles a catastrophe. An undiagnosed placenta previa results in the delivery of a dead baby. The mother is hemorrhaging, requires an emergency hysterectomy, and is headed to the ICU. The author sits alone crying for one hour. For the next six months, he never laughs. He quits medicine and lands a job as a comedy writer and editor for television. Seriously.


Residency training is a roller coaster ride, and the experience is captured here with exceptional clarity, honesty, and a sprinkling of humor. From the highs - "there's no feeling like knowing you've saved a life" (p199) - to the depths - "everyone remembers the sad stuff, the bad stuff, so vividly" (p262), it's essentially a story about survival (the patient's and the doctor-in-training's) and the many moments of unavoidable pain for both (hence the clever title of the book). There are plenty of medical memoirs and new doctor narratives out there, but This is Going to Hurt ranks among the better ones.

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



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