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

by Adam Kay

What I’m pretty confident is going on here—and I want a Nobel Prize at the very least if I’m right—is that you’ve been bulking out your supply with your nan’s furosemide.* Aside from the fact that you’re wasting my evenings and my unit’s beds, it feels like fairly terrible business practice to be hospitalizing your customers. Kindly use chalk like everyone else.

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.

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.

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.

the depth of the lows is the price you pay for the height of the highs.

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.

All physicians come to grips with the lack of promotion and financial incentives, but it’s harder to accept the fact that it’s rare to get a “well done.”

Midwife: You don’t need to get signed off to do things—you’re a doctor. [Depressing but true.] Me: Isn’t there another midwife who can do it? Midwife: She’s on her break. Me: I’m on my break. [Untrue.] Midwife: You don’t get breaks. [Depressing but true.]

often—you’re given huge responsibility, minimal supervision, and absolutely no pastoral support.* You work yourself to exhaustion, pushing yourself beyond what could be reasonably expected of you, and end up constantly feeling like you don’t know what you’re doing. Sometimes it just feels that way, and you’re actually doing fine—and sometimes you really don’t know what you’re doing.

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’ve never once had a goodbye card, let alone a present. Until today, when I found a package in my pigeonhole from Dr. Lockhart. A card to say thank you and goodbye, and a brand-new Montblanc pen.

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.

Half an hour of panicked phone calls later, we’re in the OR, JS is a few bags of blood better off, a fallopian tube worse off, and will be absolutely fine. I have no idea what the moral of this story is.

First Valentine’s Day spent with H in four years. I suggest that, Valentine-wise, going out with a doctor is like having your birthday on the twenty-ninth of February.

The engineer mutters he’ll do his best, but no promises—and besides, what happened on labor wards a hundred years ago, before emergency buzzers? Professor Carrow fixes him with a zero-degree Kelvin glare. “One in twenty women died in childbirth.”