As a student doctor, there are a few well-loved texts that are a little different from our required reading. Sometimes, it’s these books, TV shows or films that inspired us to consider medicine as a career in the first place. Grey’s Anatomy and Call the Midwife, medical dramas with their fingers firmly on the pulse, are common reference points. Call the Midwife has brought complex health and social issues to life, from vaccination programmes to illegal abortions. Grey’s Anatomy depicts the drama of the operating theatre (not least when a patient is brought in with a bomb inside them). And my copy of Your Life in My Hands by Dr Rachel Clarke is dogeared from being passed around so many times.
But Adam Kay’s grim, darkly funny memoir about life as a junior doctor, This is Going to Hurt, stands out. I read it when I applied to study medicine, then again in my first year, and then again in November 2021 after my first placement. It was recommended by a friend as a way to get a feel for working in the NHS, and I was left shocked but intrigued. It felt like a friend trying to tell you how horrible and hard their job is, all the while doing their best not to put you off. So when the TV adaptation was released, I knew I’d be hooked.
It wasn’t my first time seeing harrowing cases of placental abruptions and cord prolapses play out in a drama – I’ve had my fair share from religiously watching 11 seasons of Call the Midwife. However, seeing it depicted in a time period closer to mine was extremely vivid and, at times, horrifying. It reminded me of the reality of what was to come, and made me wonder if I was ready for it. Being covered in body fluids, faced with staff shortages, working day and night shifts back to back on little sleep – I felt as if I was watching my future, courtesy of the BBC. A future that, to be honest, I was beginning to question.
For me, the storyline of the junior doctor Shruti showed the very best and very worst of working in medicine. We see her start off on the back foot as a nervous junior doctor, eager to impress as she builds a friendship with Dr Kay. She faces racism from patients because of the colour of her skin. Yet while her abilities as a doctor grow, she also begins to burn out. The breaking point is a night shift, where we see her turn into a confident doctor in unimaginable circumstances, yet struggle to cope with the intensity of the situation.
The picture Kay painted was of a chronically underfunded and understaffed NHS in the mid-2000s. Since then, Covid-19 has added a whole new set of pressures and challenges – from staff giving more to the job then they get back, to watching the government let the NHS down while clapping for them at the same time. So if working in the NHS is full of doom and gloom even without a pandemic, as Kay suggests, why do we dedicate five (or six) years at university, followed by years of training until we reach a senior position? Why do we opt for a career where one day, someone’s life will, very literally, be in our hands – and often under difficult circumstances?
It’s difficult to pinpoint what keeps me going, but I know it includes wanting to make my parents proud, and the small moments that make the slog worthwhile. I remember helping out with taking bloods and doing examinations while on my placement at a GP’s surgery earlier this year. I didn’t do anything very groundbreaking as I’m still a second-year student, but the deep sense of satisfaction I felt as I left to get the train home stayed with me for a long time.
In This is Going to Hurt, it was the small moments that showed how much NHS staff can make a difference – like the relationship between Dr Kay and an older patient. She has uterine prolapse, which is normally treated in a clinic – but after sensing her discomfort, Dr Kay decided to treat her at the bedside while chatting with her, giving her the privacy and comfort that she wanted. Sometimes, going an extra mile can make a huge difference. I see the same thing when I’m on placement on the ward. Doctors and nurses go out of their way to make patients feel comfortable, from making them a cup of tea to just listening to their worries.
I also try not to lose sight of the fact that it’s a huge honour to be studying medicine. At the same time, it’s important to be realistic about what’s to come. Otherwise, it really is going to hurt.
Zesha Saleem is a freelance journalist and second-year student doctor
