★★★★☆ More tragic than funny

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

Adam Kay

** spoiler alert **

I was told that This is Going to Hurt was a very funny book that would make me laugh out loud. It is that. However, when I reached the end I felt I had just finished reading a tragedy.

In the United Kingdom, the government runs hospitals and directly employs doctors. This is different from the healthcare systems in the USA and Canada, with which I am most familiar. Here doctors and hospitals are small and big businesses -- the government's role is mostly to administer insurance programs that pay the healthcare businesses. (The USA does have one direct government-run healthcare systems that I know of -- the Veteran's Administration.)

At the beginning of This is Going to Hurt Adam Kay is finishing medical school, and decides to become an obstetrician-gynecologist (OB/GYN), a field known among English medical students as "brats and twats". He is also newly married. He becomes an NHS doctor. Most of the stories in the book are of his experiences as a young doctor. At the beginning he doesn't know what he's doing -- this is an experience common to beginning doctors everywhere. As the book progresses he becomes more experienced and more confident.

The humor tends toward the raunchy. As a retired medical school professor, I can attest that this is not unrepresentative of the jokes medical students and doctors make.

The picture of the NHS that merges from This is Going to Hurt is somewhat conflicted. The NHS is portrayed as a machine that eats devoted young students, works them to exhaustion, and crushes them. Politicians and administrators are intent on squeezing the last penny out of the NHS, and that means in practice squeezing the last drops of blood and sweat (not to mention leisure time) out of the people who work there. At the same time, Kay wants you to believe that the NHS is a national treasure that is being systematically degraded by politicians.

At the end of This is Going to Hurt Adam Kay leaves the NHS, having lost his vocation. His marriage has also failed, for the simple reason that he had nothing left over to give to it after satisfying the demands the NHS placed on him. His biography now describes him as a "comedian and writer". He has made his experiences as a doctor into the basis of a stand-up routine. In addition, a television series was made based on his experiences.

While I agree with the person who recommended This is Going to Hurt to me as a very funny book, it is not light-hearted entertainment.

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