Book review: This is Going to Hurt: Secret Diaries of a Junior Doctor

It has been a long time since my last blog entry, and confinement didn’t help. But let’s try to use this time to read more, and what more to the point than a book on the NHS, the UK National Health Service in these times where it’s pushed to the limit?


The book follows each assignment of Adam Kay during his first years as a doctor in the UK. It consists of small notes made during a day, and it tries to explain all the medical terms the first time you encounter them (which also means that by the middle of the book, I forgot about them and would have needed to find the definition again several time).

They are usually funny, at least at the beginning, but you always see the dark side of the situation lurking behind each note: lack of people, lack of empathy by people around, efficiency above all…

There is one thing that is missing in the book, it’s a common thread, at least one bigger than just “Oh, that’s his training years”. At least “Bridget Jones’ Diary” had an underlying story on top of the notes, there was a purpose. The notes here sometimes feel like Adam Kay is moving on sight rather than with a purpose. We also have people coming in and out, but we don’t really feel attached to them. For instance his girlfriend at the time.  She’s here at the beginning, a little bit in the middle, and at the end, we just know that he he’s moving out.

I can’t really spoil the end (although if you know the author and research him, you will get spoiled), what I can say is that the more you read, the more you dread the end and the more the reality of a dying health system gets obvious.


Despite the shortcomings, the book shows a state of the NHS that was dire even before the current (Johnson) government and the Covid-19 pandemic crisis. It shows that at the time it was one the verge of collapse, and only surviving because of the people in it.

British people are proud of the NHS, but when you read the book, you have a sense that they let it down on the altar of money.


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