This Is Going to Hurt: Secret Diaries of a Young Doctor

by Adam Kay

It would be unfair to label every single orthopedic surgeon as a bone-crunching Neanderthal simply on the basis of the 99 percent of them it applies to, but my heart does seem to sink with every nighttime bleep to their ward.

I prescribe IV fluids for the patient, though it would be more efficient to prescribe common sense for some of my colleagues.

I told a patient that his MRI wouldn’t be until next week and he threatened to break both my legs. My first thought was Well, it’ll be a couple of weeks off work. I was this close to offering to find him a baseball bat.

The other thing I realize is that none of her many, many concerns are about herself; it’s all about the kids, her husband, her sister, her friends. Maybe that’s the definition of a good person.

In any other profession, if someone’s job drove her to attempt suicide, you’d expect some kind of inquiry into what happened and a concerted effort to make sure it never happened again. Yet nobody said anything—we all just heard from friends, like we were in the school playground. I doubt we’d have got so much as an e-mail if she’d died. I’m pretty unshockable, but I’ll never cease to be amazed by hospitals’ willful ineptitude when it comes to caring for their own staff.

I dress him again, look up to a God I don’t believe in, and say, “Look after him.”

You don’t cure depression, the same way you don’t cure asthma; you manage it. I’m the inhaler he’s decided to go with and I should be pleased he’s gone this long without an attack.

Next question. “Why do we always say that people lost their battle with cancer and never that cancer won its battle against them?” He keeps making jokes—to be fair, he’s done it the entire time I’ve known him. I find it uncomfortable for the first few minutes of my visit, but I’m soon genuinely enjoying a morning I’d been dreading. It’s a kind and clever move—it doesn’t just make it easier for his friends and family when they visit, it also means we’ll remember him as he always was, diminished physically, maybe, but not in personality.

During my career as a doctor, for every “Would you mind having a look at this [lump/rash/penis]?” I heard off-duty, there was always one “I don’t know how you do it.” This generally came from people who wouldn’t qualify for jury service, let alone for medical school, but it’s still a valid point.

But it’s the flip side of not wanting your doctor to be fallible, capable of getting your diagnosis wrong. They don’t want to think of medicine as a subject that anyone on the planet can learn, a career choice their mouth-breathing cousins could have made.

All we’re doing is allowing people to make a choice they would have otherwise had were it not for a medical condition. Or not, because their surname begins with the letter G. I’m exaggerating, of course—that would be ridiculous. They’d only be denied it for sensible reasons, such as living one road outside of an arbitrary catchment area.