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

by Adam Kay

As you might imagine, learning every single aspect of the human body’s anatomy and physiology plus each possible way it can malfunction is a fairly gargantuan undertaking. But the buzz of knowing I was going to become a doctor one day—such a big deal, you get to literally change your name, like a superhero or an international criminal—propelled me toward my goal through those long years.

I notice that every patient on the ward has a pulse of 60 recorded in the observation chart so I surreptitiously inspect the health-care assistant’s measurement technique. He feels the patient’s pulse, looks at his watch, and meticulously counts the number of seconds per minute.

A strange realization that it’s the first time I’ve actually saved a life in five months as a doctor. Everyone on the outside imagines we roam the wards performing routine acts of heroism; I even assumed that myself when I started. The truth is, although dozens, maybe hundreds, of lives are saved every day on hospital wards, almost every time it happens, it’s in a much more low-key, team-based way. It’s not a doctor performing a single action so much as him implementing a sensible plan that gets carried out by any number of colleagues who at every stage check to see if the patient is getting better and modify the plan if he’s not. But sometimes it is down to one person, and today, for the first time, it was me.

pretty sure it’s the first time I’ve had anything approaching a compliment since I got my medical license. I don’t really know what to say but stutter my thanks. In my confusion, I accidentally sign off with “Love you, bye.” It’s partly exhaustion, partly my brain misfiring because H is normally the only person who says nice things to me, and partly because, in that moment, I genuinely loved her for saying that.

I really don’t know what to say. I want to lie and tell her everything’s going to be fine, but we both know that it won’t. I hug her. I’ve never hugged a patient before—in fact, I think I’ve hugged a grand total of five people, and one of my parents isn’t even on that list—but I don’t know what else to do.

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.

I’ve spent two hours in this room, the longest I’ve ever spent with a patient who wasn’t under anesthesia. On the way home I phone my mum to tell her I love her.

He must realize we have the same chat every time, but it clearly doesn’t matter—he just wants to know there’s someone out there who cares. And actually, that’s a very large part of what being a doctor is.

To make matters worse, I have to call a consultant in to confirm fetal death for the notes, even though both parents know I’ve been looking at the four unmoving chambers of their baby’s heart on the screen. She’s being rational, practical, collected—suddenly in work mode, her emotional shields up as high as mine. He’s in bits. “You shouldn’t have to bury your child.”

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

“It’s funny—you don’t think of doctors getting ill.” It’s true, and I think it’s part of something bigger: patients don’t actually think of doctors as being human. It’s why they’re so quick to complain if we make a mistake or if we get cross. It’s why they’ll bite our heads off when we finally call them into our over-running clinic room at seven p.m., not thinking that we also have homes we’d rather be at. But it’s the flip side of not wanting your doctor to be fallible, capable of getting your diagnosis wrong.