This is Going to Hurt: Secret Diaries of a Junior Doctor
by Adam Kay
30 popular highlights from this book
Key Insights & Memorable Quotes
Below are the most popular and impactful highlights and quotes from This is Going to Hurt: Secret Diaries of a Junior Doctor:
“So I told them the truth: 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 better job in the world.”
“Her extremely posh eight year-old asks her a question about the economy (!), and before she answers it, she asks her extremely posh five year-old "Do you know what the economy is, darling?""Yes mummy, it's the part of the plane that's terrible". This is how revolutions start.”
“a great doctor must have a huge heart and a distended aorta through which pumps a vast lake of compassion and human kindness.”
“the depth of the lows is the price you pay for the height of the highs.”
“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.”
“I notice that every patient on the ward has a pulse of 60 recorded in their observation chart so I surreptitiously inspect the healthcare assistant’s measurement technique. He feels the patient’s pulse, looks at his watch and meticulously counts the number of seconds per minute.”
“From the most insignificant of actions can come the most serious of consequences.”
“It’s funny – you don’t think of doctors getting ill.’ It’s true, and I think it’s part of something bigger: 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. It’s why they’ll bite our heads off when we finally call them into our over-running clinic room at 7 p.m., not thinking that we also have homes we’d rather be at. But it’s the flip side of not wanting your doctor to be fallible, capable of getting your diagnosis wrong. They don’t want to think of medicine as a subject that anyone on the planet can learn, a career choice their mouth-breathing cousin could have made.”
“Tuesday, 5 July 2005 Trying to work out a seventy-year-old lady’s alcohol consumption to record in the notes. I’ve established that wine is her poison. Me: ‘And how much wine do you drink per day, would you say?’ Patient: ‘About three bottles on a good day.’ Me: ‘OK . . . And on a bad day?’ Patient: ‘On a bad day I only manage one.”
“Tuesday, 9th Novermber 2004Bleeped awake at 3AM from my first half hour shut-eye in three shifts to prescribe a sleeping pill to a patient whose sleep is evidently much more important than mine. My powers are greater than I realised; I arrive on the ward to find the patient is asleep.”
“Apricot stones contain cyanide,’ he replies drily. ‘The death cap mushroom has a fifty per cent fatality rate. Natural does not equal safe. There’s a plant in my garden where if you simply sat under it for ten minutes then you’d be dead.’ Job done: she bins the tablets. I ask him about that plant over a colonoscopy later. ‘Water lily.”
“I realized that every healthcare professional — every single doctor, nurse, midwife, pharmacist, physical therapist, and paramedic — need to shout out about the reality of their work so the next time the health secretary lies that doctors are in it for the money, the public will know just how ridiculous that is. Why would any sane person do that job for anything other than the right reasons, because I wouldn’t wish it on anyone. I have so much respect for those who work on the front line because, when it came down to it, I certainly couldn’t.”
“I’m as big a fan of recycling as the next man, but if you turn a used condom inside out and put it back on for round two, it’s probably not going to be that effective.”
“Electrolytes are the salts in the blood – mostly sodium, potassium, chloride and calcium. If levels become too high or too low, your body has a way of alerting you, by making your heart stop or putting you in a coma. It’s clever like that.”
“But unfortunately the depth of the lows is the price you pay for the height of the highs.”
“I’ve not sat down for twelve hours, let alone rested my eyes, my dinner’s sitting uneaten in my locker and I’ve just called a midwife ‘Mum’ by accident.”
“This morning I delivered little baby Sayton – pronounced Satan, as in King of the Underworld.”
“They must have something that cannot be memorized and graded: a great doctor must have a huge heart and a distended aorta through which pumps a vast lake of compassion and human kindness.”
“I liked that in obstetrics you end up with twice the number of patients you started with, which is an unusually good batting average compared to other specialties. (I’m looking at you, geriatrics.)”
“Doctors must be psychologically fit for the job — able to make decisions under a terrifying amount of pressure, able to break bad news to us anguished relatives, able to deal with death on a daily basis. They must have something that cannot be memorized and graded; a great doctor must have a huge heart and a distended aorta which pumps a vast lake of compassion and human kindness.”
“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.”
“If I ever have to go to hospital, madam,’ one of the midwives calmly tells her, ‘I want to be seen last. Because that means everyone else there is sicker than me.”
“I tell a woman in antenatal clinic that she has to give up smoking. She shoots me a look that makes me wonder if I’ve accidentally just said, ‘I want to fuck your cat,”
“Called to the Early Pregnancy Unit by one of the SHOs to confirm a miscarriage at eight weeks – he’s new to scanning and wants a second pair of eyes. I remember that feeling only too well and scamper over. He’s managed the couple’s expectations very well, and clearly made them aware it doesn’t look good – they’re sad and silent as I walk in. What he hasn’t done very well is the ultrasound. He may as well have been scanning the back of his hand or a packet of Quavers. Not only is the baby fine, but so is the other baby that he hadn’t spotted.”
“But it’s a Saturday night and the NHS runs a skeleton service. Actually, that’s unfair on skeletons – it’s more like when they dig up remains of Neolithic Man and reconstruct what he might have looked like from a piece of clavicle and a thumb joint.”
“Think about the toll the job takes on every healthcare professional, at home and at work. Remember they do an impossible job, to the very best of their abilities. Your time in hospital may well hurt them a lot more than it hurts you.”
“The other thing I realize is that none of her many, many concerns are about herself; it’s all about the kids, her husband, her sister, her friends. Maybe that’s the definition of a good person.”
“I ask a patient in antenatal clinic how many weeks she is now. There’s a long pause. Cogs turn. A camera slowly pans across a wasteland. Maths isn’t everyone’s strong point, but I’m after the number between six and forty that people must constantly ask her about. Finally: ‘In total?’ Yes, in total. ‘God, I couldn’t even tell you in months . . .’ Has she got amnesia? Is she a clone of another woman currently being held prisoner in an evil sci-fi villain’s lair? I start to ask when her last period was, and she interrupts. ‘Well, I’m thirty-two in June, so that’s got to be more than a thousand weeks . . .”
“For me, the true miracle of childbirth is that smart, rational people with jobs and the ability to vote look at these half-melted fleshy blobs, their heads 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. It’s Darwinism in action, an irrational love for your progeny.”
“Crash call to a labour ward room. The husband was dicking around on a birthing ball and fell off, cracking his skull on the ground.”
