Laughs, Tears and Bodily Fluids: The Life of a Junior Doctor

Adam Kay.JPG

Megan Jackson - MA Journalism, University of Roehampton

Doctor turned Comedian, Adam Kay worked in obstetrics and gyanaecology - or brats and twats as he calls it - for six years until a truly traumatic event unfolded before his eyes. He joined us at BookFest to share his highs and lows, and everything else in between.

This is Going to Hurt is Adam’s wonderfully hilarious, gut-wrenching, and brutally honest account of what it’s like to be a junior doctor. During his time of serving on the front line on the NHS Adam kept a diary about his experiences, which he turned into a bestselling book that has opened up the discussion about the reality of being a junior doctor.

Working 97 hours a week and making life or death decisions daily are considered part of the job- sleep and a work-life balance are not part of the deal. Adam would regularly drive home after the night shift with the radio blaring and the window all the way down to make sure his bleary eyes stayed open. On one occasion he was so tired after a shift he didn’t make it out of the hospital car park. He was woken up by multiple missed calls from his registrar. He was late for work.

Most of Adam’s diary entries are humourous, detailing everything from being sworn at by sweet pensioners to the extractions of whacky items from various orifices (which apparently is a more common occurrence than you’d think). He tells the audience: “Special occasions call for patients to put special items in their vagina's and rectums”. It’s clear he doesn’t have a shortage of anecdotes to shock and amuse dinner party guests.

One Christmas a patient wanted to propose to her boyfriend. To take her partner by complete surprise, she hid the engagement ring inside a Kinder Surprise plastic egg and inserted it into her vagina- for safe keeping? To be romantic? We’re not sure either! Adam recalls that no amount of jiggling from the patient or her boyfriend could get “the goose to lay the golden egg” because it had rotated inside her. Once at the hospital Adam removed the foreign object quickly with some forceps, and his patient finally got to pop the question.

Adam isn’t all about laughs, he doesn’t shy away from the difficult aspects of the profession. An inevitable part of the job is having heartbreaking conversations with your patients. One night a patient with ovarian cancer confided in Adam about her worries. She showed nothing less than “undiluted selflessness” Adam recalls. Adam ended up spending over two hours chatting with her about everything she had found too difficult to talk about with anyone else before. He describes this humbling interaction as: “a strange privilege and an honour I didn’t ask for.”

Then came the final diary entry. A day that he will never forget; the day he became a different doctor; the day he found his breaking point. A patient in his care started experiencing complications during labour. The situation was severe. Adam needed to act quickly. He delivered her placenta first, and then the baby who wasn’t breathing. The mother was losing liters of blood. She had to have an emergency hysterectomy and was transferred to intensive care in a critical condition. A situation that Adam had expected would end with a healthy mum and baby became a nightmare. Afterwards, he broke down in tears.

Following the night that made Adam hang up his stethoscope, he says he didn’t receive the professional support he needed. He said: “it was like I told them I had sprained my ankle ‘oh no, are you alright? You’ll still do clinic tomorrow right?’”

This tragic event had a lasting, and profound impact on Adam. He tells the audience: “I’ve read it out more than 300 times and it doesn’t become an easy thing to talk about.” Adam was able to come to terms with what had happened through his diary writing. He believes they were therapy for him. They were a place to remember the lighter side of medicine and a place to vent. Not only was he able to find his “pressure release valve in humour” he was able to write frankly about the traumas he had witnessed and was expected to see as normal baggage of the job. He explained: “I didn’t tell anyone, I couldn't. Until about two years ago I would wake up in a cold sweat being back in that operation. I've [now] exorcised my demons”.

Since becoming a comedian and author, Adam has become a passionate advocate for junior doctors. He believes the culture within medicine of keeping a stiff upper lip and getting on with things is damaging. “You don’t think of your doctor as being human getting sick, getting sad, making mistakes - I think every health-care professional should be shouting out about the reality of their work - the bad days and the good days.”