Sally Flint

Book Review of Adam Kay's This is Going to Hurt

Adam Kay's This Is Going to Hurt is both sad, funny and wise.

AdamKay’s  This is Going to Hurt describes his life as a junior doctor during the years leading up to his resignation. Written in a dry satirical tone, Adam doesn’t hold back and shows the NHS in its raw state. The staff are overworked, underpaid and lacking in sleep. Humorous and heartbreaking in equal measures, Adam Kay’s This is Going to Hurt shows that there is nothing glamorous about being a junior doctor. There are however, enough feel good moments to remind him and the reader of the value of being a doctor, until there aren’t ….

As a memoir, it has proven hugely popular, perhaps because it validates from within the institution, what  the public have thought and feared for a long time.

Book Club Questions on Adam Kay's This is Going to Hurt

  • At the opening of the book, the scriptwriter says of Adam Kay’s self portrayal on the TV show: “And it’s brave of you, making your character so dislikeable throughout.” What was your opinion of Adam? How would you sum him up? Is he dislikeable?
  • Adam says “I went to a school that was essentially a sausage factory, designed to churn out medics, lawyers and cabinet members, and as my dad was a doctor, it was written on the walls.” How likely is it for a young person to follow in their parents’ footsteps careerwise?
  • How would you describe Adam Kay’s humour throughout the book?
  • What was your emotional response to the book?
  • Adam Kay describes the nights as akin to sailing a ship alone. “A ship that’s enormous and on fire, that no one has really taught you how to sail.” How does this description make you feel, both in terms of understanding Adam’s role as a junior doctor, but also as someone who is likely to recevie treatment from the NHS?
  • Adam Kay describes how the medics trade “stories about nonsense symptoms that people have presented us with.” These include itchy teeth, sudden improvement in hearing, and arm pain during urination. What is the most ridiculous symptom you can imagine anyone feeling?
  • The book reveals lots of errors that doctors make, such as the inadequate measuring of pulse. Would you sue the NHS for mistakes made?
  • Simon is depressive and relies on Adam as a kind of mentor/samaritan figure. Discuss the relationship between them?
  • When Adam visits his friend Ron’s dying dad, the dad makes lots of jokes. Adam had been dreading the visit but soon feels at ease. How much burden do you think falls on  terminally sick people to make their visitors feel better?
  • In the final chapter, Adam Kay says “Your time in hospital may hurt them (the doctor) a lot more than it does you.” Discuss whether you have ever viewed a doctor’s role from this perspective.
  • Monday 11th April 2005 – Adam describes how good a registrar is at  explaining to a mum about her son’s appendix problem. He describes how her pride and joy is wheeled away, while she cries, and her son remains dry eyed. What might this show about mother/son relationships?
  • What key messages is Adam Kay sharing about the current situation of the NHS? Discuss.
  • Having read This is Going to Hurt, would you try to put off a friend or family member from becoming a doctor?
  • Adam Kay has to speak to someone about the need to do exercise and suggests a gym. She replies I’m a member of one already but I haven’t been in about 3000 pounds. Does this resonate with you in any way?
  • Kay says that ‘while you become an expert at prioritising at work you generally become even worse at prioritising real life.” Discuss.
  • How would you sum up Kay’s narrative style?
  • What is the purpose of the book This is Going to Hurt? Do you believe what Adam Kay has written?
  • The book reveals some of the tension between private and free health care provision. For example, Adam delivers a baby, even though he is told not to as the private doctor who was scheduled to perform the delivery was en route. In effect he saves the baby’s life. How much faith do you have in private health care?
  • Was there any one incident, event or episode in the book that particularly stood out to you. Discuss why it was significant to you?

Book Club Questions on This is Going to Hurt (if you haven't read the book!)

Adam Kay has made a bit of a career for himself in T.V since quitting his role as a doctor.
  • In 2010 after 12 years in the medical profession Adam resigns from his job as a junior doctor. He claims “my parents still haven’t forgiven me.” How much do you think we live our lives to please our families and parents? 
  • “I chose which medical school to go to at the age of eighteen – and even that was because I was impressed with the curly fries in the student union.” Discuss how many life changing decisions are based on illogical and insignificant events. Do you have any personal stories that you would like to share? 
  • Did you know what a haemophiliac was (a person that has both ovarian and testicular tissue.) Discuss your attitudes to transgender issues and consider how open minded you are.
  • Dr Kay was told he ought not to go to his favourite patient’s funeral. This was perhaps, due to a belief that the doctors would be seen as failing because the patient had died. He went anyway. Was he right to do so? 
  • Dr. Kay describes how medics seldom get a ‘well done’. How important is positive affirmation in any profession?
  • Sunday December 25th 2005 – Adam Kaye didn’t go home on Christmas Eve as he fell asleep in his car. He had to work ChristmasDay. If you were his partner how would you react?
  • Not all of you will have watched the TV show. I haven’t. But, generally speaking would you say it is always better to read the book before watching the TV show? Why, or why not?
  • Adam Kay sends a congratulatory text to his sister on successfully getting into medical school. He says that had he heard her news at the end of his shift he’d have said “Run like The f…ing wind.” Have you ever felt desperate to give someone some advice that goes against their hopes and dreams?
  • At a dinner party, the doctor gives away the gender of the baby of his partner’s friend. Have you ever dropped any major clangers, perhaps regarding a secret you should have been keeping? 
  • Adam says “A patient named her baby after me today.” Has anything like that happened to you or to someone you know?
  • “Yes Madam, you will shit during labour … there’s nothing you can do about it… though I’d have suggested the massive curry you ate to induce labour wasn’t going to help.” What is your attitude to childbirth? Is it something you think is embarrassing? Discuss.
  • In February 2001 Adam Kay is overwhelmed to receive a thank you card and a mont blanc pen. He wasn’t used to receiving gifts. When have you felt overwhelmed by a kind gesture?

Personal Response to Adam Kay's This Is Going to Hurt

I have heard that the TV show of This is Going to Hurt, is pitched as a comedy set on a labour ward. This suprised me, as ultimately the book is looking at the good in humanity, but how, at times, we seem to do everything we can, institutionally and personally to wreck that goodness. Overall, despite its wit I found this book to be fundamentally sad. It reminded me a little of Christopher Button’s The Secret Diary of a Student Nurse.

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