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

by Adam Kay

Officially, I hadn’t been negligent and nobody suggested otherwise. Medical negligence will always be judged by asking the question “Would your peers have done anything differently in that situation?” All my peers would have done exactly the same things and had exactly the same outcome. But this wasn’t good enough for me. I knew that if I’d been better—super-diligent, super-observant, super-something—I might have gone into that room an hour earlier. I might have noticed some subtle changes on the CTG. I might have saved the baby’s life, saved the mother from permanent compromise. That “might have” was inescapable.

Yes, I went back to work the next day. I was in the same skin, but I was a different doctor—I couldn’t risk anything bad ever happening again.

No matter how vigilant I was, another tragedy would have happened eventually. It has to—you can’t prevent the unpreventable. One brilliant consultant tells her trainees that by the time they retire, there’ll be a bus full of dead kids and kids with cerebral palsy, and that bus is going to have their name on its side. A huge number of “adverse outcomes,” as they say in hospital-ese, will occur on their watch. She tells them if they can’t deal with that, they’re in the wrong profession. Maybe if someone had said that to me a bit earlier, I’d have thought twice. Ideally, back when I was choosing my A levels and getting myself into this mess.

I realized that every health-care professional—every single doctor, nurse, midwife, pharmacist, physical therapist, and paramedic—needs to shout about the reality of their work so the next time the health secretary lies that doctors are in it for the money, the public will know just how ridiculous that is. Why would any sane person do that job for anything other than the right reasons? Because I wouldn’t wish it on anyone. I have so much respect for those who work on the front line because, when it came down to it, I certainly couldn’t.

Senior consultants’ voices shake when they talk about their disasters—six-foot-tall former rugby champions on the verge of tears. A friend told me about a perimortem cesarean he performed: A mum dropped dead in front of him and he cut the baby out on the floor. It survived. “You saved the wrong one! You saved the wrong one!” was all the dad could cry.

But promise me this. Next time a government tries to denigrate doctors or take a pickax to the health-care system, don’t just accept what the politicians feed you. Think about the toll the job takes on every medical professional, at home and at work. Remember that all of them do an absolutely impossible job to the very best of their abilities. Your time in the hospital may well hurt them a lot more than it hurts you.

I’ve had the mechanism of MRIs explained to me any number of times and I’m still none the wiser, but no X-rays are involved; images are obtained using a combination of protons, magic, and an enormous fucking magnet. And I mean enormous, the size and weight of a one-bedroom flat. The MRI checklist asks if the patient’s got a metal heart valve (it would tear out of her now-dead chest at eighty miles an hour and splat onto the machine) or worked in a metal factory (tiny bits of metal would have found their way into her eyes, making both eyeballs explode when she opened the door to the MRI suite).

The savvy obstetrician doesn’t carry his mobile phone in his scrubs. All it takes is one iPhone drowning in a tsunami of blood for you to learn your lesson, and I can assure you that no amount of drying it in rice will revive it.