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

In This Is Going to Hurt, Kay’s partner, who is referred to as “H,” is a key figure who provides insight into The Personal Toll of Healthcare Work. Significantly, although Kay lives with H, they are mentioned only occasionally in his diary entries, as the demands of Kay’s job as a junior doctor mean he rarely sees them. H’s presence in the text underlines the strain that a career in medicine can place on romantic relationships.

Kay’s description of H as a “medical widow, post-shift counsellor and now nomad” captures the negative ways in which his job impacts his partner (62). Effectively widowed by Kay’s long shifts at the hospital, H is also the sounding board for his professional stresses. Furthermore, the frequent relocations junior doctors must undergo prevent the couple from buying a home or settling in one place. Nevertheless, H is portrayed as being supportive and understanding of their partner’s all-consuming profession. Kay emphasizes that the relationship lasts longer than that of most doctors due to H’s extraordinary patience. H represents the sacrifices made not just by medical professionals but also by those closest to them.

Kay’s memoir indicates his breakup with H in a brief entry describing how he collects his possessions and moves to a bachelor flat. The author does not provide details of why their relationship ends, as the reasons are evident to readers. Preceding diary entries recounting numerous missed date nights due to work commitments convey the lack of quality time Kay spends with H and the inevitable growing divide between them. The end of their relationship underscores the personal cost of Kay’s time in the NHS.

Ron is Kay’s best friend and represents the author’s social relationships in the memoir. As a non-medic, he also serves as a foil to Kay, highlighting the life path Kay could have taken had he not decided to become a doctor. The all-consuming nature of Kay’s job means that his personal life remains in a state of limbo while Ron buys a home, gets married, and has children. The memoir also charts the dramatic contrast in their careers, which is highlighted when the friends take their professional exams at the same time. As an accountant, Ron works for an employer who pays for his professional exams, gives him study leave, and rewards him with a promotion and salary raise when he is successful. Meanwhile, Kay’s MRCOG exams represent a further source of professional stress while offering none of the perks that Ron enjoys. Furthermore, Ron’s transferable professional skills allow him to change his career path in search of more lucrative opportunities. By contrast, as an NHS doctor, Kay “only [has] one possible employer in the country” (175).

Ron presents an ethical dilemma in the memoir when he asks for Kay’s second opinion on the concerning symptoms his father is experiencing. Despite realizing that the symptoms suggest cancer, Kay reassures Ron, stating that they should take their GP’s advice and there is likely nothing to worry about. The author expresses frustration with himself for compromising his professional integrity, as he would never lie to his patients in this way. However, he is unable to maintain the same professionalism with his friends. Painfully aware that his “job makes [him] such a useless friend in so many ways” (155), he feels compelled to provide the “false hope” Ron is looking for. The incident highlights Kay’s human fallibilities as a doctor.

Kay’s diary entries demonstrate the paucity of his social life as work commitments force him to cancel plans with Ron on numerous occasions. He also misses important milestones in his best friend’s life, such as his stag weekend, his wedding, and his father’s funeral. These notable absences prompt Ron to believe that Kay is using work as an excuse to avoid him and that they have grown apart. His difficulty in believing that Kay’s job can be so all-consuming demonstrates The Gap Between Public Perceptions of Healthcare Work and the Reality.

Simon is the younger brother of one of Kay’s friends. Their friendship, which consists largely of texts and long telephone calls, begins when Kay is the first person to spot a social media post indicating that Simon intends to end his own life. After talking Simon into a better frame of mind, Kay becomes his regular, informal counselor.

The responsibility Kay feels for Simon’s welfare illustrates how his profession is a vocation and extends beyond the workplace. Once alerted to Simon’s susceptibility to depression, Kay feels duty-bound to continue trying to help him. Kay emphasizes that he is “no better trained to counsel him than [he] would be to talk him through replacing a gearbox or laying a parquet floor” (50), but Kay’s status as a doctor causes Simon to put his faith in him. The memoir’s diary entries convey how Kay’s concern for Simon’s mental health adds to the already intense pressures of his working day. Unable to answer his phone during shifts, he fears the consequences of missing a call from Simon. This point is humorously underlined when Kay panics after seeing numerous missed calls from Simon, only to discover that Simon has pocket-dialed him.

Kay continues to be a sounding board for Simon throughout his years as a junior doctor and sometimes feels that his input is not helping. However, he ultimately recognizes that depression is a chronic condition, and their conversations help Simon to manage rather than cure his symptoms. The memoir’s final reference to Simon ends on a note of optimism as Simon invites Kay to his wedding.