This is Going to Hurt
by Adam Kay
(London: Picador, 2018)
A great doctor must have a huge heart and a distended aorta through which pumps a vast lake of compassion and human kindness.
Pages 2-3.
I’d spent a quarter of my life at medical school and it hadn’t remotely prepared me for the Jekyll and Hyde existence of a house officer.
Page 4.
The nights shifts, on the other hand, made Dante look like Disney.
Page 5.
Even when you can recognize every sign and symptom of a heart attack, it’s very different to actually managing one for the first time.
Page 5.
Whatever we lack in free time, we more than make up for in stories about patients.
Page 8.
Although dozens, maybe hundreds, of lives are saved every day on hospital wards almost every time this happens it’s in a much more low-key, team-based way. Not by a doctor performing a single action, so much as implementing a sensible plan which gets carried out by any number of colleagues, who at every stage check the patient is getting better and modify the plan if they’re not.
Page 15.
Work has pretty much given me PTSD.
Page 18.
For me, the true miracle of childbirth is that smart, rational people with jobs and the ability to vote look at those half-melted fleshy blobs, their head misshapen from being squeezed through a pelvis, covered in five types of horrendous gunk, looking like they’ve spent a good two hours rolling around on top of a deep-pan pizza, and honestly believe they look beautiful.
Page 49.
Nothing about the job plays along with the conventional reward structure for employees.
Page 87.
I keep talking, talking, talking - telling him the ambulance is really close, I’m a doctor, everything’s going to be fine. It doesn’t matter how many times you say it or whether any of it is true - well, at least the ‘doctor’ part is true - you have to believe it, because they need to believe it.
Page 99.
Issues of morality, probity and legality sadly restrict revenge opportunities to near enough zero.
Page 104.
You’re given huge responsibilities, minimal supervision and absolutely no pastoral support. You work yourself to exhaustion, pushing yourself beyond what could be reasonably expected of you, and enc 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.
Pages 106-107.
I’m pretty unshockable, but I’ll never cease to be amazed by hospitals’ wilful ineptitude when it comes to caring for their own staff.
Page 107.
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.
Page 110.
subconscious ends up making a decision on your behalf. Either you fail to tune out the bad stuff from work and become permanently distracted and haunted at home or you develop a hardened emotional exoskeleton which, apparently isn’t considered an ideal quality in a partner.
Page 111.
Once I became a registrar, I noticed the interesting paradox that while you become an expert in prioritizing at work, you generally become even worse at prioritizing in real life.
Page 111.
You can make anything sound official by translating it into the ancient Greek.
Page 112.
You can make anything sound official by translating it into the ancient Greek.
Page 112.
It feels like a woeful gap in our training that no one’s ever told us about talking to grieving couples.
Page 128.
Science may trump the supernatural, but once someone tells you an operative technique is bad luck, it’s probably better to be safe than sorry.
Page 131.
People who know that while money might not buy your happiness, it certainly buys you nicer stuff.
Page 138.
From the most insignificant of actions can come the most serious of consequences.
Page 144.
You don’t cure depression, the same way you don’t cure asthma; you manage it.
Page 171.
Patients frequently attend clinic with reams of paper they’ve googled, printed off and highlighted, and it’s pretty tedious spending an extra ten minutes per patient explain why a blogger in Copenhagen who uses a pink hearts Wordpress theme mighty not be a reliable source.
Page 191.
By the time I was six years deep into medicine, the shine had definitely rubbed off the surface.
Page 196.
There were two tings keeping me there. Firstly, I’d worked long and hard to get as far as I had. Secondly - and I realize it might sound a bit worthy - it’s a privilege to be allowed to play such an important role in people’s lives.
Pages 196-197.
The hours are terrible, the pay is terrible, the conditions are terrible; you’re underappreciated, unsupported, disrespected and frequently physically endangered. But there’s no getter job in the world.
Page 198.
There’s no feeling like knowing you’ve saved a life. Not even that, half the time; just knowing you’ve made a difference is enough.
Page 199.
The computer denies knowledge of almost every patient - we’d be better off with tarot cards. Page 209.
Non-medics can never appreciate quite how tough it is to be a doctor and the impact it has on real life.
Page 229.
Medicine is the host who manages to keep you at their party hours after you first think about leaving.
Page 231.
Patients don’t actually think of doctors as being human. It’s why they’re so quick to complain if we make a mistake or if we get cross. Page 234.
There’s no such thing as a non-traumatic vaginal delivery.
Page 241.
The GMC will always judge medical negligence by asking the question, ‘Would your peers have done anything differently in that situation?’ Page 258.
There’s a mutual code of silence that keeps help from those who need it most.
Page 259.