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Book Review – This is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay

This is the first time I’ve ever reviewed a book I have listened to, rather than read.  There’s been a huge boom in the popularity of audiobooks in recent years and I’m a partial convert; with fiction I don’t want anything to come between me and the words and seeing them is a big part of that. But memoirs now regularly feature amongst my favourite books, and hearing authors tell their own story in audio really adds something.

If you haven’t already, you’re probably going to be hearing a lot about today’s featured title This is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay.  It’s a Sunday Times Bestseller and last night it won both the non-fiction and  People’s Choice categories at the Books are my Bag Reader Awards.

I first heard Adam Kay read at a large event hosted by his publishers, Picador, earlier this year.  It was a very funny performance, not surprisingly, considering he now works as a comedian and TV writer.  He is no longer a doctor, and that’s not surprising either once you’ve read the book.

For many, it’s a shocking eye-opener into the inhuman working conditions endured by junior doctors  (anyone under the rank of Consultant, so not just the newbies) in a National Health Service (NHS) stretched to the absolute limits.  Adam reached the rank of Senior Registrar, only one below Consultant, and was motivated to write this book in response to the suggestion by Secretary of State for Health Jeremy Hunt that junior doctors were ‘greedy’ when they went on strike over pay and conditions.

We’re used to hearing certain professions described as money-grabbing, but hospital doctors?  Really?

Really not. (It gets a bit personal for me here.)

My husband JC, our 15 year-old son and I listened to the audiobook on a long drive to west Wales at half term; we were all rapt but two of us really weren’t that surprised by anything we heard. JC, who’s about 15 years older than Adam, is also an ex junior hospital doctor, who left the NHS much sooner, although for very similar reasons.  And I know what it’s like to be the long-suffering other half, like Adam’s then partner in the book. We attended the last date of Adam’s book tour at Big Green Bookshop together last week.

There are tons of hilarious anecdotes as he rises through the ranks, starting in A&E (emergency room) then specialising in Obstetrics & Gynaecology – known in the business as ‘Brats and Twats’, which gives a fair indication of the tone.  Honestly, the things people do… there are some truly tasteless and repulsive (but GREAT) tales and I will never see Christmas lights or broccoli quite the same again.  The jargon is explained in footnotes – even in the audiobook, imagine that! – for the benefit of non-medics. I don’t want to underplay how entertaining and fun this book is, as proven by our son’s reaction (although he probably found out way more than the average teenage boy wants to know about ‘women’s issues’.)

But it’s not all laughs, far from it.  Some parts of this testimony are very moving, and as you can imagine in this speciality, the sad stories are very sad.  It may be the story of a junior doctor, but it touches on things that matter to us all, like family, relationships, mental health, work/life balance –  and the significant but apparently overlookable fact that doctors are human beings who have a right to all that. Nobody would enter the medical profession without good intentions and although emotional distance is an essential requirement, everybody has limits.  As this story illustrates, doctors are not a species apart; they are traumatised and marked when mistakes are made or awful unavoidable things happen, but instead of being offered support, they’re expected to turn up and carry on.

Much as I enjoyed it, I also found the memoir painful and enraging, especially as I’ve witnessed at close hand the damage this job can do.  Most of us would consider everything about its demands intolerable: the horrendous hours (many unpaid, but you can’t just walk away from patients), the sleep deprivation, the chronic understaffing, wrecked relationships and endless changes of location.  The feeling that you can’t do the job properly no matter how hard you try.  It’s not what anyone envisages when they decide to become a doctor, and the system is losing people who went in with a vocation and were lucky to escape with their health and sanity.  (Suicide and addiction rates are unusually high amongst doctors). Listening to Adam relive the tragic events which caused him to leave the medical profession – especially when we heard him live – was utterly wrenching.

This is an important book which should be required reading for any sixth-former contemplating a medical career (except that this would further aggravate the staffing crisis, as Brexit already is); but nobody who has ever used the NHS could be indifferent to it.  Adam Kay is right – people do need to know what it’s like on the inside – at the event he urged us all to support the NHS workers we know and provide an outlet if they need to say, ‘actually, I’m not OK’.

Jeremy Hunt, the Health Secretary, has been bombarded with copies of this book but apparently hasn’t read it.  Adam’s account of the time they met post-publication beggared belief.  Some of you will recall the embarrassing incident in which a radio broadcaster mispronounced the minister’s name. The first time was an accident but it’s since caught on.  If it weren’t such an insult to female genitalia, I’d say it was spot on.


There was a very enthusiastic response to last week’s post How do you know if a novel’s worth writing?  Thanks very much to everyone who shared and commented here and on Twitter.

Next week I’ll be writing about Stories for Homes Volume Two, the fantastic anthology in aid of Shelter which is newly out in a beautiful paperback edition.  If you’re anywhere near the Folkestone Book Festival this weekend, you can hear me read my story A Place to Paint Yellow and readings by fellow contributors at the Brewery Tap Project Space, 53 Tontine Street, Folkestone, CT20 1JR, Saturday 25 November at 6.30.  Details of other events here.

About Isabel Costello

Writer (novels: Paris Mon Amour 2017; Scent 2021).Host of the Literary Sofa blog. Co-founder of Resilience for Writers with Voula Tsoflias. Perfume lover and Francophile.


4 thoughts on “Book Review – This is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay

  1. Fascinating. I agree with you that audio books are ideal for long drives – they keep you alert and seem to use a different part of the brain.
    It’s very pleasing to see a memoir so lauded, and you make a very good point about us expecting doctors to be ‘outside’ of human experience, and to need help themselves sometimes.
    Thanks for this refreshing read.

    Posted by Whisks | November 22, 2017, 10:40
  2. Love that! I heard about this book in London, and I read the Italian translation. It is absolutely stunning

    Posted by thebookshot | March 13, 2019, 18:08


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