25/4/19 "THIS IS GOING TO HURT" by ADAM KAY

Adam Richard Kay (born 12 June 1980) is a British comedy writer, author, comedian and former doctor He grew up in a Jewish household and with his father being a doctor; he describes becoming a doctor as being a default decision.

“This is Going to Hurt” is Kay’s first book and was published in September 2017 becoming an instant Sunday Times number one bestseller, a position it has held for over a year, selling over one million copies. It was the book of the year in the UK’s 2018 National Book Award and has been translated into 28 languages, achieving number one status internationally. It was the UK’s second-best selling book of 2018. 

There were 6 members present (plus 1 e-mail input).  The book appealed to its proposer, a retired General Medical and Hospital Practitioner, because of its medical content, its humour and the trials and tribulations of life as a junior doctor. Although, in the book, hospital doctors are depicted as poorly paid, undervalued and grossly neglected professionals who are unfailingly willing to give up their own time for free to do battle with the health of the nation, the group agreed that the book had largely been written to entertain, being well written and full of great humour, quick wit and metaphors, reading like a Fringe Show!

The medical memoir is not a new idea and three years ago our group read Henry Marsh’s “Do No Harm”. This focussed more on the ethical and the surgical, and as a consequence conformed to a scrupulous style of writing. Kay’s approach is a much more personal and, not infrequently, flippant recounting of his experiences, but he insists that the book is “reasonably accurate”. Nonetheless we felt that there are many situations that tested plausibility and also that he had probably “borrowed” a few tales! At the end of the book he stated that the NHS was underfunded, inefficient and not understood by “the powers that be” with Health Secretary, Jeremy Hunt being highlighted as the villain! But it was felt that he had failed to provide a strongly argued case in the book.

An early issue raised was whether it was ethical to use his patients’ experiences as a source of comedy and whether their permission had been sought. Might they be distressed? His lawyers had been involved in his final draft! Some felt that he also might have brought the profession into disrepute undermining the public’s confidence and raising anxiety for some patients. The group didn’t substantiate these comments as the author had changed the patients’ names and details of the incidents modified to respect privacy. This is common practice. e.g. in Colin Douglas’ excellent series of books on an Edinburgh doctor and A J Cronin’s books such as the “Citadel”, the latter which we read in the group, contained anonymised medical stories. The general public obviously enjoy reading about the misfortunes of others!

His leaving the profession with a strong sense of guilt, although he had done his best, led to a discussion on the problem that must be resolved of losing too many trained staff from the profession for many reasons including the “greener grass” overseas but it was pointed out that we probably had a net gain with our incoming professionals.

In between laughing out loud our e-mail commentator had amused himself by noting the sources of Kay's  humour: 1/. Sexual 2/. Human idiosyncrasies in 21st century Britain 3/. Unreasonableness of the NHS 4/. Remarkable physical ailments 5/. Unexpected twists. 

It was all pulled together by self-deprecating wit, deadpan delivery, sharp sarcasm, and economy of language.

He also agreed with many of us that the use of black humour is a defence mechanism against awful situations as also often emerges in war memoirs.  He did find the downbeat ending a bit of a surprise, a crashing of the gears, but it added poignancy to the diaries.

The group agreed that overall it was a remarkably funny book, well written, easily read and that it encouraged debate on our national treasure, the N.H.S.