page_title: This Is Going to Hurt
section_title: Outline
hierarchical_section_title: This Is Going to Hurt / Outline
caption_attribution_description: English: Adam Kay, 20171207
context_page_description: This is Going to Hurt: Secret Diaries of a Junior Doctor is a nonfiction book by the British comedy writer Adam Kay, published in 2017 by Picador. It is a collection of diary entries written by Kay during his medical training from 2004 to 2010. Kay's book discusses political issues in the health care system of the National Health Service in the United Kingdom and societal conflicts between the general population and neglected doctors. Kay accomplishes this by incorporating humour into his personal anecdotes that depict his life as he progresses through his medical training, and his eventual resignation from this career.
context_section_description: Kay began his medical training as a House Officer in 2004 with the United Kingdom's National Health Service after attending Dulwich College and Imperial College School of Medicine. In his comedic recollection of his time as a house officer, Kay describes four foreign objects he removed from patients' rectums, saving his first life, and long nights spent in the A&E. Kay became a Senior House Officer by August 2005, a year after officially becoming a doctor. It is at this point in his career that he decided to specialise in obstetrics and gynaecology, or "brats and twats" as Kay referred to it as.
  In August 2007, Kay was promoted to Registrar, the third highest ranking position after Consultant and Senior Registrar. His diary entries in his time as these positions describe multiple successful births, failed births, infertility problems, and sexually transmitted diseases/infections, along with a gruelling workload that included sleepless nights, unpaid overtime, minimal gratitude from co-workers, sleeping in the car park, and inability to have someone cover a shift leading to minimal holiday and sick time. Throughout these experiences, Kay recalls times in which he gets close to quitting due to the vast amount of stress the job inflicted on his life, harming his health and social relationships. What kept him going was the positive feeling that he would get after a shift in which he helps patients in multiple ways ranging from helping infertile couples become pregnant to delivering a multitude of babies a night. This feeling of being a "low-grade superhero" is what Kay claims helped him push through all the other inconveniences related to the job.
  On August 2010, Kay received his promotion to Senior Registrar. In the diary, Kay takes note of the increased responsibility that came with the promotion and how it added a new form of pressure since he now was supposed to be the person that got contacted in severe emergencies where the Senior House Officer and Registrar were unable to solve the problem.
  On 5 December, 2010, Kay unknowingly begins to perform a caesarean on a patient that had undiagnosed placenta praevia. Kay has to first deliver the placenta and then deliver the baby, which is dead and unable to be resuscitated. The detached placenta caused heavy haemorrhaging; Kay and the senior consultants called into theatre failed to stop the bleeding and, after 2 hours and 12 litres of blood loss, a hysterectomy was performed. The mother was transferred to the intensive care unit and Kay was told to expect the worst. After this event Kay became depressed. Whilst he had followed best practice, and the missed placenta praevia should have been found in previous scans, Kay obsessed that he might have prevented the death of the baby and endangerment of the mother's life by somehow diagnosing the placenta praevia prepartum. Several months after this event, Kay officially resigned from the job.
caption: Adam Kay
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