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

by Adam Kay

All junior doctors at the hospital have been asked to sign a document opting out of the European Working Time Directive13 because our contracts are non-compliant with it.

My first encounter was a handsome young Italian man who attended hospital with the majority of a toilet brush inside of him (bristles first), and went home with a colostomy bag. His big Italian mother was grateful in ways that Brits never are, lavishing thanks and praise on every member of staff she met for saving her son’s life. She put her arm round the equally handsome young man who attended hospital with her son. ‘And thank God his friend Philip was staying in the spare room at the time to call the ambulance!’

In gynae clinic, I go online to look up some management guidelines for a patient. The trust’s IT department has blocked the Royal College of Obstetrics and Gynaecology website and classified it as ‘pornography’.

It’s five minutes until my shift ends and I need to get away on time to go out for dinner. Naturally, I’m asked to review a patient – she’s got a second-degree tear,74 and the midwife looking after her tells me she hasn’t been signed off to repair those yet.75 Me: ‘I haven’t been signed off to do them either.’ 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.) Me: (pleading, in a tone of voice I’ve never managed before, like I’ve unlocked a secret level of my vocal cords) ‘But it’s my birthday.’ (Depressing but true.) Midwife: ‘It’s labour ward – it’s always someone’s birthday.’

A widely held belief among non-medics is that there’s some degree of choice involved in coming home at 10 p.m. rather than 8 p.m. But really the only choice is whether you fuck over yourself or your patients. The former is annoying, the latter means that people die – so it’s not really a choice at all. The system runs on skeleton staff and, on all but the quietest shifts, relies on the charity of doctors staying beyond their contracted hours to get things done. It would be against everything you stand for to knowingly compromise patient safety, so you don’t – which means you stay late after almost every shift.

It’s really sad that this is so true in the current NHS. We are exploited because we took an oath to never leave a patient in harms way, hence unable to leave when no one else is there to save the sinking ship. I’ve been told before by someone that I should try to not be an workaholic when I became a doctor, a remark which I lashed out at. To imply that we do it because we’re some sort of sick masochist is the worst insult to this awful condition we have to work in.

Baby delivered, and just as I was sewing up the uterus, the student fainted, face-planting right into the open abdomen. ‘We should probably give the patient some antibiotics,’ the anaesthetist suggested.

The funniest thing about this book is that it’s true things happening on wards all the time. First rule in theatre guys, fall backwards!!!