This is a book review of "This is Going to Hurt" by Adam Kay.


Have you ever wondered what the life of a junior doctor is like? Have you ever given a second of thought for the doctor that you see in your visits to the hospital? Have you ever thought about how much they care for you, or how hard they work?


Adam Kay served as a junior doctor for the NHS and went on to become a Senior Registrar in the Obstetrics and Gynaecology Department. In his funny yet informative book, he describes his life and the thrilling path that he took as a junior doctor over six years.


Adam Kay depicts the pendulum-like job that is medicine. He describes with heartfelt emotion, how the highs of his job include saving lives, helping others, and how doctors, after a long and tiring thirteen-hour shift, still walk home with a spring in their step. This is because the knowledge he has contributed something beneficial to the world, even having the chance bring people back from the brink of death, as well as resolving people’s lifelong pain and helping others get their lives back after an illness is an incredible feeling, and makes that extra hour in the hospital worthwhile. Adam Kay passionately describes how “you may be late home, but you’re an hour late because you stopped a mother bleeding to death.” [1] The skill of doctors to do such unbelievable things on a daily basis is breath-taking. But how many of us actually spare a moment to appreciate this? Doctors and the NHS play a pivotal role in our lives. We need them and we always will.


Doctors are always there at crucial times in people’s lives. Adam Kay describes how he has now almost forgotten the impact he has had on others. A former patient remembers him and he reflects, “it was one of the most important moments of her life, and for me, she may well have been delivery number six that day.” [2] For me, this just highlights the humility and humble nature of doctors; they forget how important they are in individual’s lives, and the major impact they have. The doctor’s daily work can have astounding outcomes, but for them, the impact they have is all part of what they do, day in, day out.


However, Adam Kay points out it is not all long hours, stress and overwork. There is plenty of laughter and fun in the life of a doctor, interacting with the many patients he encounters on a daily basis. At the start of the book, he recalls the story of a patient with Dementia and Urinary Tract Infection, who pretends to be a German professor, “and chips in with “Yes!”, “Zat is correct!” and the occasional “Genius!” whenever a doctor says something”. [3] Disease and illness take many forms and laughter can be a great natural medicine!


Kay also hammers home how undervalued doctors are. This book was written a couple of years ago to amplify the voice of the junior doctors who were on strike due to a forceful increase in work with pay cuts. Kay describes how, as a senior house officer, he took home “less money week than a train driver” [4] whilst also engaging in “over a hundred hours of unrelenting slog” [5] per week. This epitomises the relentless workload of doctors, and the personal sacrifices they make to care for patients. Kay argues that the salaries doctors and NHS staff are paid should reflect this heavy, stressful and draining workload. However, Kay also suggests the best payment doctors receive is the gratitude from their patients and the satisfaction of knowing they have improved the quality of their patient’s lives, and in some cases, even prevented deaths.


Adam Kay also reveals the immense stress that doctors endure, which is exacerbated we forget that doctors are human beings too! He describes how the professionals in healthcare are sometimes thought of as machines and we just expect them to keep going, stay calm and care for us, all the while working under extreme pressure. Kay reveals the shocking fact that “85 per cent of doctors have experienced mental health issues, and 13 per cent admitted to suicidal feelings.” [6] Adam Kay shows how doctors can be impacted with the life and death decisions they have to make. Reflecting on this after leaving the profession, Kay says, “A bad day at work now is if my laptop crashes or a terrible sitcom gets terrible rankings.” [7] It reveals with incredible clarity the intense working life of doctors in comparison to other professions. Kay tries to relate the real struggle of being a doctor, but also how rewarding it can be when he sees that his patient has recovered and is doing well after treatment.


Adam Kay’s book opens our eyes to the hidden world of junior doctors and exposes the highs and lows of life as a medic. We will all need doctors, nurses and NHS staff at some point in our lives, and this has been highlighted during the coronavirus crisis. Even though we are no longer clapping for the NHS every week, let’s not forget to appreciate and be thankful for the hard work, dedication and selflessness of those risking their lives for us. Fighting on the front-line. Fighting for us.



[1] Under Adam Kay’s Chapter 8- “Registrar- Post Four”

[2] Under Adam Kay’s diary entry for “Saturday, 7 March 2009” in Chapter 7- “Registrar – Post


[3] Under Adam Kay’s diary entry for “Wednesday, 18 August 2004”

[4] Under Adam Kay’s Chapter 4- “Senior House officer- Post Three”

[5] Under Adam Kay’s Chapter 4- “Senior House officer- Post Three”

[6] Under Adam Kay’s diary entry for “Tuesday, 31 July 2007” in Chapter 4- “Senior House officer-Post Three”

[7] Under Adam Kay’s Chapter 10- “Aftermath”