This is Going to Hurt by Adam Kay Summary

This Is Going to Hurt is a candid memoir chronicling Adam Kay’s experiences as a junior doctor in the UK’s National Health Service (NHS). Through darkly humorous diary entries, Kay exposes systemic issues like grueling hours, emotional burnout, and institutional neglect, while humanizing healthcare workers. The book critiques NHS underfunding and highlights the personal toll of medical errors, culminating in Kay’s traumatic resignation after a devastating obstetric case.

This book is ideal for healthcare professionals, medical students, or anyone interested in NHS realities. Its blend of dark humor and raw honesty also appeals to readers of autobiographical memoirs. Fans of Kay’s comedy writing or those seeking insight into frontline medical struggles will find it especially compelling.

Key themes include the dehumanizing demands placed on doctors, systemic NHS failures, and the emotional fallout of medical errors. Kay emphasizes junior doctors’ sacrifices—chronicling sleep deprivation, underpayment, and lack of mental health support—while critiquing societal expectations of infallibility from healthcare workers.

Kay resigned after a traumatic incident where he misdiagnosed a patient with placenta praevia, leading to a near-fatal hemorrhage. Despite begging for time off to recover emotionally, he was denied therapy or leave, exacerbating his burnout. This pivotal moment underscored the NHS’s lack of support for staff mental health.

Kay balances grim realities with sharp, satirical humor—like describing nights on call as “sailing a ship alone, a ship that’s enormous and on fire.” His comedic tone amplifies absurdities, such as patients reporting “itchy teeth” or “arm pain during urination,” offering levity while critiquing healthcare inefficiencies.

The book condemns NHS underfunding, junior doctors’ poverty wages (Kay notes earning less than fast-food workers), and unsafe workloads. It also highlights institutional indifference to staff well-being, exemplified by Kay being denied therapy after his traumatic error.

Kay compares night shifts to “sailing a ship alone… that’s enormous and on fire,” symbolizing junior doctors’ isolation and crisis management duties. This metaphor underscores the NHS’s reliance on overburdened staff to navigate systemic flaws without adequate training or resources.

Kay reveals doctors’ vulnerabilities—fatigue-induced errors, missed family events, and emotional breakdowns—to challenge perceptions of infallibility. His resignation story and reflections on patient tragedies emphasize that doctors, like patients, need compassion and support.

Yes, it’s a memoir drawn from Kay’s personal diaries during his medical career. The events, including graphic childbirth accounts and his resignation, reflect real experiences. Names and details are anonymized to protect patient privacy.

The book spent over a year as a Sunday Times bestseller, won multiple literary awards, and was translated into 37 languages. Its BBC/AMC adaptation earned Kay a BAFTA for Best Comedy Writer in 2023.

Kay’s own breakdown post-resignation—and the NHS’s failure to offer therapy—spotlights systemic neglect of medical staff mental health. The book advocates for better support systems to prevent burnout and trauma among frontline workers.

Kay’s prose is candid, darkly funny, and journalistic. Diary entries blend medical jargon with colloquial humor, creating an accessible yet brutally honest narrative. His tone shifts from sarcastic to poignant, particularly when recounting patient tragedies.