This is Going to Hurt - Book Summary

by Adam Kay

"Painfully funny. The pain and the funniness somehow add up to something entirely good, entirely noble and entirely loveable."
– Stephen Fry

"Uniquely funny and unexpectedly heartbreaking"
– Adam Hills

The book presents Adam Kay who just began his career as a house officer, and worked 90 hours per week.

Days shits were different the night once. During the day he felt more like an assistant having lots of calls, booking MRI and ECG appointments and prepared patience. On the night shift, the SHO and registrar were working on the A&E department and the officers had to take care of the patients already hospitalized. He also had a pager for emergencies that was all the time beeping.

He also had absurd cases, from a man that wanted to use a lamp post like a firehouse pole and he added up with a skinless penis or patience having objects where they shouldn't be.

Adam picked to specialise in obstetrics and gynaecology, to help people bring new life into the world and become a junior doctor. He had to deal with a new level of issues, performing cesareans, pregnant woman stressing about her bumps from her tongue - turn out she discovered her taste buds or a man who has issues putting his condom on - he was trying to go all the way down to his testicles or a woman who wanted to pass a drug test and hide in her vagina e bottle with someone else urine.

After some time, he became a registrar. Here he finds other "cases" like a woman wanting to eat her placenta, patients refusing their medication because they said he is hand in hand with the pharmaceutical industry or a woman with a ring in a kinder surprise that got stuck in her vagina.

"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."

The event that changed his life was when he was the most senior person in the ward. He went to assist a caesarean section for fetal distress. The surgery started and the SHO was cutting into the deep layer of skin, but instead of amniotic fluid, it came out a lot of blood. There was an abruption - it is very serious since the baby's oxygen and nutrients are delivered via the placenta; the baby couldn't be delivered so he took over the operation. The patient had an undiagnosed placenta praevia, and when he managed to deliver the baby, he was dead. The mother was bleeding heavily from the uterus and as he tried a brace suture - large stickers that go around the uterus to stop the bleeding- it was without luck. He called the consultant and puts both hands to try to stop the bleeding - when the consultant arrives tried to do another brace but fails.  In the end, they call another surgent - that wasn't there and took turns squeezing the uterus until he arrived - 20 min. The surgent performs a hysterectomy and the bleeding finally stops.

That was his last diary entry and was one of the reasons he quits the job.

"A friend told me about a perimortem caesarean he performed: a mum dropped dead in front of him and he cut the baby out on the floor. It survived. ‘You saved the wrong one! You saved the wrong one!’ was all the dad could cry. "

Note: Some pieces of information are left out of the book.
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