This Is Going to Hurt: Secret Diaries of a Medical Resident

Reading This Will Hurt

Horrifying doesn't begin to describe many of the author's experiences and actions in this book! As a comedy writer for tv, he is very good at telling a story in a funny way. However most of the stories also include gory descriptions, profanity (including taking the Lord's name in vain), or a lack of concern for the feelings of patients and even so called friends.

After reading this book, I wonder how much is manufactured or changed for entertainment value. He seems prone to exaggerate. Remember, Adam Kay now writes comedy for television. I doubt he kept a faithful diary because of the general lack of time for ordinary life and complete exhaustion he mentions.

*Anyone who knows the rarely used (by moms in the natural birth community) term placentophagia is also sure to know what a placenta looks like and that placentas are generally dried and encapsulated NOT eaten raw like a lioness no matter how humorous it may seem.

Adam describes the whole experience as "perversely exhilarating" which feels like this was a bit of a narcissistic power trip. Interestingly he shows us the foibles of other medical staff in questionable integrity but his honesty is nearly always above reproach. There is the episode where he hypothetically talks about a humiliating passive aggressive surgical act he could have done in regards to a patient but claims to have not followed through with as it could lead to potential litigation. This "funny" situation places him as a potential 'social justice hero'. Frankly, an intolerant passive-aggressive doctor is frightening!

One of the job non-benefits that surprised Adam Kay was frequent over time that strained personal relationships. He complains about total fatigue and uncompensated work hours throughout the book because of understaffed hospitals. He says they don't even have time to eat or take breaks most of the time. Very dangerous to have over tired medical personnel!

Perhaps you might say we need to hire more doctors. Forbes has suggestions (link) for fixing medical schools and through this improving the medical system. The most notable suggestion is to stop incentivizing medical schools and students to focus more on specialty practice over general medicine. Yet it isn't clear how to accomplish this. The true bottleneck to medical schools receiving more students is not addressed either.

Adam Kay's assertion that he respects patients' choices rings hollow as he describes scare tactics he employs to bully patients into his way of doing things often using forceps or cesarean deliveries despite the inherent risks.

Mocking patients for being overweight, using natural remedies, or religious beliefs were other demeaning stories. Yet the author seems unsatisfied not knowing the end result for his patients. One of his more human aspects. His further feelings of awkwardness in dealing with grieving patients and wish to do more is a familiar feeling for most of us. He talks about the necessity of developing a "hardened emotional exoskeleton" to deal with all the hard stuff that happens with patients.

He concludes with a plea to not allow government, i.e. British government, "to take a pickax to the (nationalized) health-care system." I suggest taking a different approach. More government controls, more legislation will never fix what was broken through that process in the first place.

As more doctors and hospitals embrace meditation, yoga, healing touch, and now we may begin to see health coaches (link) involved in patient care there may begin to be more tolerance toward patient choice in the medical system in general. Let us hope!

Tyler Cowen's new book Big Business: A Love Letter to an American Anti-Hero looks like it has some interesting advice on the topic of healthcare reform. I am intrigued by what I've read about the book and hope we can integrate more free market principles in the healthcare system.

It is interesting to note that amidst the push for Medicare For All, there has been a significant reform to Medicare in recent history that brought some measure of relief to people in the system. Medicare Part D's success in reducing costs and improving health outcomes seems to be in large part because of the increased choices (link) and free market principles it afforded.

When I first read the title, This Is Going to Hurt, I did not realize it referred to how it would feel to read (and review) this book. I urge you to consider reading Big Business: A Love Letter to an American Anti-Hero instead!

I received a free advanced reader copy of this book. All opinions are completely my own.

See the full review on BookofRuthAnn.com for quotes and article links!