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

As Kay’s career progresses, the memoir continues to highlight The Personal Toll of Healthcare Work. The author conveys how regular relocations create a lack of stability in his life in addition to the steep learning curve of adapting to a new work environment. He also details how these changes impact his relationship with H, preventing them from achieving their goals as a couple. While their friends are getting mortgages and establishing roots, he and H are in limbo, perpetually reduced to renting short-term in a “mutually inconvenient” location between their workplaces. Kay describes their inability to buy a home as “another item on the list of ways [his] job was inflicting collateral damage on H” (62). Gifts emerge as a motif in the memoir, reflecting how Kay’s work slowly erodes his close relationships. Unreasonably long shifts prevent him not only from spending quality time with H but also from collecting their birthday present. Meanwhile, the gift of flowers recorded on Kay’s bank statement serves as a reminder of the theater performance he was unable to attend with H.

In his attempt to highlight The Gap Between Public Perceptions of Healthcare and the Reality, Kay emphasizes that the profession is in no way comparable to any other. This point is illustrated when Kay is forced to arrange cover for his own sick leave. It is also highlighted by the comparison with his best friend Ron’s circumstances. While taking professional exams places more pressure on Kay and yields no tangible rewards, Ron receives perks when preparing for and passing his accountancy exams. A further unique pressure experienced by doctors is that their responsibility extends beyond the workplace. Kay’s ethical compulsion to offer his medical expertise outside of working hours is illustrated by the responsibility he feels for Simon’s mental welfare. Although untrained in psychiatry, he recognizes that his status as a doctor prompts Simon to rely on him and place his faith in him. This point is similarly illustrated in the author’s account of assisting a severely injured young man on a night out with Ron. Despite being drunk, Kay takes on responsibility for the youth as the only person at the scene with medical expertise. Reflecting on this instinctive sense of duty, Kay states, “I’m pretty sure heating engineers don’t feel the same way about every kaput boiler they encounter. The difference is the whole ‘life and death’ thing, which is what separates this job from all others, and makes it so unfathomable to people on the outside” (74). By demonstrating that the rewards of the job in no way reflect its demands, Kay challenges the notion that those who enter the profession are solely motivated by money.

In these chapters, the memoir’s humorous tone occasionally shifts to anger as Kay presents a critique of the systemic failures of the NHS, drawing attention to The Constraints of Patient Care Within Strained Medical Systems. He reveals that the day all junior doctors change hospitals is known as “Black Wednesday” due to its high death statistics, underlining that this poorly thought-out practice threatens patient safety. Kay also highlights how management decisions frequently make doctors’ lives harder. For example, the absence of a staff parking lot at St. Agatha’s causes medical staff to pay the same parking rate as visitors to attend their own workplace. Kay presents the suicide attempt of a House Officer as epitomizing the personal toll of the myriad pressures on junior doctors, stating, “The only surprise is it doesn’t happen more often—you’re given huge responsibility, minimal supervision and absolutely no pastoral support” (106). Furthermore, Kay says that the failure of the hospital’s management to hold an inquiry into the case illustrates a willful neglect of staff welfare.

These chapters also show that doctors must deal with patients who unnecessarily add to their stresses. Kay illustrates the unreasonable demands of the public when he recounts an emergency buzzer interrupting a surgery because a patient wanted him to sign her passport. He also describes the large number of “worried well” who arrive at A&E “under the misapprehension” they are ill (75). Meanwhile, the young woman with a urine sample bottle stuck in her vagina provides an example of the many patients who require medical assistance due to unwise behavior.