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Kaustubha Ghate
School of Medicine
Faculty of Medical and Health Sciences
University of Auckland
“Hilarious.” “Riveting.” “Painfully
funny.” 1 These are not typical
descriptions one would
associate with books of the
medical non-fiction genre.
Then again, this book is not like
other medical memoirs.
In 263 short pages, Adam Kay
provides his perspective on
the medical profession through
his five-year journey as a junior
doctor working in Britain’s
National Health Service from
2005–2010. Through a diary-
entry writing style, he reflects
on his most memorable
moments on the job – both the highlights and the lowlights. In doing
so, Kay achieves the difficult balance of delivering an important and
powerful message in a thoroughly entertaining manner.
Kay has been a professional comedian and writer since 2010. We
need to understand his motivations for writing this book in order to
appreciate its message. For this, we need to rewind to 2016 when
there were a series of strikes as part of industrial action by the Brit-
ish Medical Association – the union for junior doctors in the United
Kingdom. This was the first strike action by British doctors in over
40 years following disagreements in contract negotiations with the
government regarding pay and safe working hours.
Contract negotiations had in fact started from 2013 but had been af-
fected by “media manipulation and attempts to sway public opinion”. 2
From the author’s perspective, “junior doctors… [were] struggling to
get their side of the story across”. 1 Having worked on the front line
himself, Kay felt he “had to do something to redress the balance.” 1
The reader is taken on a vicarious journey of Kay’s progression up the
professional ladder through nine chapters over five years – ending as
a senior obstetrics & gynaecology registrar. We begin alongside him
in his very first post as a house officer. Through a series of selected
stories of his days in the hospital – whether it be the workload, a
troublesome patient, a difficult decision or being perpetually exhaust-
ed; the lifestyle of a junior doctor becomes more and more apparent.
We also gain an insight into the personal toll of the job – one Kay de-
scribes as often being dominated by challenges and difficult situations
but also having significant highlights that make the job seem worth-
while. However, as the author warns right from the onset, there is no
happy ending; his account culminates in an event which proves to be
the end of his medical career.
Overall, these diaries of a junior doctor are a blend of two contrasting
themes; a dichotomy of heartbreak and hilarity. As one reviewer puts
it, “hilarious as they are horrifying”. 1 This is a unique example of writ-
ing when considering the genre and the author’s overarching message.
Never does the reader feel weighed down by the stories and this is
due to the writer’s ability to bring forward the humour in his situation
without belittling the humbling, sometimes painful, reality of the job.
Although the book is largely aimed at those who may be unaware of
the truth of what it means to be a junior doctor, doctors and other
health professionals alike will also revel in Kay’s story-telling craft.
The book concludes with an open letter from Kay to the Secretary
of State for Health: “you and your successor and their successors…
should have to work some shifts alongside junior doctors…to know
what the job really entails. If you knew, you’d be eternally grateful for
everything they do. The way you treat junior doctors demonstrably
doesn’t work”. 1 Unlike the carefully constructed nine chapters where
he has subtly portrayed his thoughts, here Kay is blunt and direct. The
message is crystal clear.
This collection of tales is particularly relevant in New Zealand given
the ongoing contract dispute between the Resident Doctor’s Associ-
ation and District Health Boards regarding safer working hours. From
the opposite side of the world, this is a timely reminder of the invalu-
able work done by junior doctors. Kay’s goal is to represent an honest
and moving perspective from someone who has been in the trenches
themselves. If the numerous positive reviews are anything to go by,
this award-winning Sunday Times bestseller has achieved exactly that.
References
1. Kay A. This is Going to Hurt: Secret Diaries of a Junior Doctor.
London: Picador; 2017.
2. Goddard A. Lessons to Be Learned From the UK Junior Doctors’
Strike. JAMA. 2016;316(14):1445.
Correspondence
Kaustubha Ghate: [email protected]
Kaustubha Ghate
School of Medicine
Faculty of Medical and Health Sciences
University of Auckland
“Hilarious.” “Riveting.” “Painfully
funny.” 1 These are not typical
descriptions one would
associate with books of the
medical non-fiction genre.
Then again, this book is not like
other medical memoirs.
In 263 short pages, Adam Kay
provides his perspective on
the medical profession through
his five-year journey as a junior
doctor working in Britain’s
National Health Service from
2005–2010. Through a diary-
entry writing style, he reflects
on his most memorable
moments on the job – both the highlights and the lowlights. In doing
so, Kay achieves the difficult balance of delivering an important and
powerful message in a thoroughly entertaining manner.
Kay has been a professional comedian and writer since 2010. We
need to understand his motivations for writing this book in order to
appreciate its message. For this, we need to rewind to 2016 when
there were a series of strikes as part of industrial action by the Brit-
ish Medical Association – the union for junior doctors in the United
Kingdom. This was the first strike action by British doctors in over
40 years following disagreements in contract negotiations with the
government regarding pay and safe working hours.
Contract negotiations had in fact started from 2013 but had been af-
fected by “media manipulation and attempts to sway public opinion”. 2
From the author’s perspective, “junior doctors… [were] struggling to
get their side of the story across”. 1 Having worked on the front line
himself, Kay felt he “had to do something to redress the balance.” 1
The reader is taken on a vicarious journey of Kay’s progression up the
professional ladder through nine chapters over five years – ending as
a senior obstetrics & gynaecology registrar. We begin alongside him
in his very first post as a house officer. Through a series of selected
stories of his days in the hospital – whether it be the workload, a
troublesome patient, a difficult decision or being perpetually exhaust-
ed; the lifestyle of a junior doctor becomes more and more apparent.
We also gain an insight into the personal toll of the job – one Kay de-
scribes as often being dominated by challenges and difficult situations
but also having significant highlights that make the job seem worth-
while. However, as the author warns right from the onset, there is no
happy ending; his account culminates in an event which proves to be
the end of his medical career.
Overall, these diaries of a junior doctor are a blend of two contrasting
themes; a dichotomy of heartbreak and hilarity. As one reviewer puts
it, “hilarious as they are horrifying”. 1 This is a unique example of writ-
ing when considering the genre and the author’s overarching message.
Never does the reader feel weighed down by the stories and this is
due to the writer’s ability to bring forward the humour in his situation
without belittling the humbling, sometimes painful, reality of the job.
Although the book is largely aimed at those who may be unaware of
the truth of what it means to be a junior doctor, doctors and other
health professionals alike will also revel in Kay’s story-telling craft.
The book concludes with an open letter from Kay to the Secretary
of State for Health: “you and your successor and their successors…
should have to work some shifts alongside junior doctors…to know
what the job really entails. If you knew, you’d be eternally grateful for
everything they do. The way you treat junior doctors demonstrably
doesn’t work”. 1 Unlike the carefully constructed nine chapters where
he has subtly portrayed his thoughts, here Kay is blunt and direct. The
message is crystal clear.
This collection of tales is particularly relevant in New Zealand given
the ongoing contract dispute between the Resident Doctor’s Associ-
ation and District Health Boards regarding safer working hours. From
the opposite side of the world, this is a timely reminder of the invalu-
able work done by junior doctors. Kay’s goal is to represent an honest
and moving perspective from someone who has been in the trenches
themselves. If the numerous positive reviews are anything to go by,
this award-winning Sunday Times bestseller has achieved exactly that.
References
1. Kay A. This is Going to Hurt: Secret Diaries of a Junior Doctor.
London: Picador; 2017.
2. Goddard A. Lessons to Be Learned From the UK Junior Doctors’
Strike. JAMA. 2016;316(14):1445.
Correspondence
Kaustubha Ghate: [email protected]
