Quick Reads This Is Going to Hurt Read online

  Quick Reads

  This is Going to Hurt

  Adam Kay

  Specially rewritten for ease of reading by Francesca Main

  This is an edited extract from This is Going to Hurt: Secret Diaries of a Junior Doctor, rewritten for ease of reading. Everything you will read is true but names, dates and some details have been changed to protect the people in the book.

  In 2010, I left my job as a junior doctor. My parents will probably never forgive me.

  Last year, I was sent a letter that said I would never be able to work as a doctor again. It wasn’t a big shock, as I had not set foot in a hospital for so long. But I still found it sad that this part of my life had come to an end.

  It was good news for my spare room at least. I cleared out box after box of papers, and the only things that I saved were my old diaries. As I read through the stories – some funny, some sad, some painful – I remembered the long hours and the huge effect the job had had on my life. I could not believe I had worked so hard, though at the time I just got on with it.

  Around the time I was reading my old diaries, junior doctors were being attacked in the news. It was hard for them to tell the public their side of the story, probably because they were too busy working all the time. I thought people should know the truth about what it really means to be a doctor. I wanted to do my bit to stick up for them.

  So I decided to share my story. Here are some of the notes I kept during my time in the NHS – the good, the bad and the ugly. They show what it’s really like on the wards, the ways the job changed my life, and how one day it all got too much.

  Tuesday, 3 August 2004

  Day one. My partner, H, has made me a packed lunch. I have a bag full of brand-new doctor’s equipment, a new shirt and a new email address. The person who set it up has spelled my name wrong. It is [email protected]. It’s good to know that, no matter what happens today, no one can say I’m the most useless person in the hospital. I can blame everything on Atom, whoever he is.

  Monday, 30 August 2004

  We may not get much free time, but we make up for it in stories about patients. Today over lunch we are telling each other the strange things we have had people complain about. They include itchy teeth and a patient who felt pain in their arm every time they went for a wee. Each story gets a polite laugh.

  Then it is Sam’s turn. He tells us he saw someone this morning who thought they could only sweat from one half of their face.

  He sits back and waits for the laugh, but there’s nothing. Until we all say at the same time that it sounds like the sign of a serious lung problem. Sam runs off to make a phone call and get the patient back on the ward. I finish his Twix.

  Friday, 10 September 2004

  I find it strange that every patient on the ward has a pulse of sixty on their chart, so I go and watch the nurse at work while he’s not looking. He feels the patient’s pulse, looks at his watch and carefully counts the number of seconds per minute.

  Sunday, 17 October 2004

  I didn’t panic when my patient started spraying blood out of his mouth and onto my shirt. But I didn’t know what else to do either. Shove a load of kitchen roll down there?

  When my boss arrived, he acted quickly and put a tube down the poor patient’s throat. Blood was going everywhere: all over me, my boss, the walls, the ceiling. It was like a nightmare episode of Changing Rooms. The sound was the worst part. You could hear the blood choke the man with each breath.

  The man did stop bleeding, but for the saddest reason. My boss confirmed the patient’s death, wrote in the notes and asked the nurse to tell the family. I changed out of my wet clothes.

  So there we go, the first death I’ve ever seen and every bit as awful as it could have been. My boss took me outside for a cigarette – we both needed one after that. And I don’t even smoke.

  Tuesday, 9 November 2004

  I am called down to the ward at 3 a.m., just as I’ve closed my eyes for the first time in three shifts. It’s to give a sleeping pill to a patient whose need for sleep is apparently more important than mine. I must have magic powers, because I stagger down there only to find the patient has already fallen asleep.

  Friday, 12 November 2004

  My boss, Henry, has worked out why a patient’s blood tests aren’t normal. They have been affected by some herbal tablets the patient has been taking to make her feel calmer. Henry explains the side effects and she is shocked. ‘I thought they were just made from plants. How dangerous can they be?’

  Everyone else in the room goes silent, as Henry sighs. It’s clearly not the first time he’s heard this from a patient.

  ‘Apricot stones contain poison,’ he says. ‘The death cap mushroom has a fifty per cent death rate. Plants are not always safe. There is one in my garden where if you simply sat under it for ten minutes you would be dead.’ The patient throws away the tablets. Job done.

  Later on, I ask him the name of that plant.

  ‘Water lily,’ he replies.

  Monday, 6 December 2004

  I have been asked to fill in a form about the extra hours I’ve worked this week (not that I will be paid for any of them). I realize I have seen H for less than two hours and worked for a grand total of ninety-seven.

  Monday, 31 January 2005

  I saved a life tonight. I was called to see an old man who was very close to death. If the vending machine I went to had been working and I’d bought my Mars bar as planned, I might have been too late.

  There wasn’t time to think about what to do. I just had to act fast. I did what I was trained to do and very soon the man was looking much better. Sorry, Death, better luck next time. By the time Henry arrived, I felt like Superman.

  Everyone thinks we go around like superheroes, preventing disasters every day, but it’s the first time I’ve actually saved a life in five months as a doctor. Many lives are obviously saved every day on hospital wards, but almost every time it happens it’s down to people working as a team and calmly carrying out a plan.

  However, today it was down to me. Henry seems happy, or at least as happy as he ever gets. ‘Well,’ he says, ‘you’ve bought the man another few weeks on earth.’ I bet nobody ever says that to Superman.

  Monday, 7 February 2005

  Today I saw an injury I will never forget, although I would quite like to. Patient WM is eighteen and was on a night out with friends. At 2 a.m. he was dancing on the roof of a bus shelter and decided to use a lamp post to get back to the ground. He slid down it as though it was a fireman’s pole. Unfortunately, the lamp post wasn’t smooth at all, so it was a bumpy and extremely painful ride to the pavement. He ended up with deep cuts on both hands . . . and all of the skin and muscle torn off his penis. The medical term is a ‘degloving’. It was a bloody mess, to say the least. It made me think of the last piece of pasta stuck to the bowl with a smear of tomato sauce.

  WM was upset, and even more so when he asked if the skin could be stuck back on. My boss had to explain that this would be too difficult, since the skin was spread over an eight-foot lamp post in west London.

  Monday, 21 February 2005

  I sign a patient off work for two weeks, and she offers me £10 to sign her off for a month. I laugh but it’s not a joke. She raises her offer to £15.

  On the way home, I wonder how much she would have needed to offer before I said yes. £50 would probably do it. I could do with the money, after all.

  Monday, 14 March 2005

  I go out for pizza with H and some mates. It is one of those places that is trying to be fashionable, with ugly decor and an annoying ordering system. They give you a plastic thing that makes a noise when your order is ready. Then you go and coll
ect your pizza from a bored waiter who will no doubt still expect a tip, even though you’ve done all the work yourself.

  When it goes off I say, ‘Oh my God’, and jump to my feet. The fucking thing sounds exactly like my hospital alarm.

  Monday, 11 April 2005

  About to take a ten-year-old to surgery. I watch and learn as Colin, a charming older doctor, deals with the worried mum. He explains what’s going on in her son’s tummy and how we plan to fix it. He then tells her how long this will take and when the boy will be able to go home.

  She seems to relax as he talks. Colin has clearly put her mind at rest. When it is time to take the kid upstairs, Colin nods to the mum and says, ‘Quick kiss before he goes?’ She leans over and pecks Colin on the cheek. Her son is wheeled away, his own cheek sadly dry.

  Thursday, 16 June 2005

  I told a patient that he could not have a scan until next week. He was so angry he said he would break both my legs. My first thought was, ‘Well, it would be nice to have a couple of weeks off work.’ I wondered whether to find him a baseball bat.

  Tuesday, 5 July 2005

  I’m trying to work out how much alcohol an old lady drinks so I can record it in her notes.

  Me: ‘And how much wine do you drink per day, would you say?’

  Her: ‘About three bottles on a good day.’

  Me: ‘OK . . . And on a bad day?’

  Her: ‘On a bad day I only manage one.’

  Thursday, 7 July 2005

  There has been a horrific terror attack in London. All doctors are told to report to A&E.

  My job was to send home any patient whose life was not in danger and clear the wards for new arrivals from the bombings. I went round the wards like a steamroller, kicking out anyone who didn’t look like they might die. I got rid of hundreds of the fuckers who were using up all of our beds.

  Wednesday, 13 July 2005

  After the terror attack, the hospital didn’t receive any extra patients. Because I was a little, shall we say, keen and sent all my patients home, I have hardly done any work all week.

  Saturday, 23 July 2005

  This weekend is my best mate Ron’s stag do and I have had to cancel at the last minute. I’m sad for him and even sadder for myself. That’s £400 I’ll never see again, and a T-shirt with Ron’s face printed on it that I’ll never wear.

  I did my best to swap shifts with other doctors, but now one of them has let me down because there is an issue with one of their children. I’m not sure they even have a child. So here I am on the ward, stone-cold sober.

  My friends find it hard to see why I have to cancel so often when they make plans in advance. But, sadly, the bastards who make the hospital rota don’t care about my social life.

  I order a bottle of whisky that I can’t afford and send it to Ron to say sorry. We arrange to meet up in two weeks’ time, after my run of night shifts, and after the extra hours I had to take on to cover the cost of the stag do.

  Friday, 29 July 2005

  I spend the night shift feeling like I am on a boat. Water is gushing in and the only thing on hand to bail it out is a mouse’s contact lens.

  Every patient needs at least fifteen minutes of my time. I am called to see a new one every five minutes so the sums just don’t add up. The senior doctors are tied up in a busy A&E, so I deal with the people who sound the sickest first and try to explain to the nurses who call me about other cases.

  ‘I’m really sorry but I’ve got a load of patients who are much more urgent,’ I say. ‘It will take me about six hours to get to yours.’

  Some of them understand, but some look at me as if I’ve just said, ‘Fuck off, I’m in the middle of watching a box set.’ I run from patient to patient all night. Somehow we all get out alive.

  At 8 a.m. one of the nurses calls me to say I did really well tonight and she thinks I’m a good little doctor. This makes me sound like a character on CBBC, but it’s actually the first time someone has given me any praise since I started the job. Because I am still in shock, I end the call with ‘Love you, bye.’ My mistake is partly because I’m so tired and partly because H is the only person who ever says nice things to me. But in that moment I really did love the nurse for saying that.

  Monday, 8 August 2005

  I have had to decide what type of doctor I want to be for the rest of my career. I have chosen to work in women’s health, dealing with labour and infertility. What could be a better use of my training than to deliver babies, and help couples who don’t seem able to have them? In this area of medicine you tend to end up with twice as many patients as you had at the start, which can only be a good thing. Much better than working with old people, where you eventually end up with none. Of course, working with pregnant women means it is very sad when things go wrong. But the depth of the lows is the price you pay for the height of the highs.

  It’s my first week working on labour ward. Today I was called in by the midwife because patient DH was feeling unwell soon after the birth of her healthy baby. I had a feeling this might have something to do with the huge amounts of blood DH was losing all over me. I tried to stay calm and tell her everything was going to be fine.

  After the worst was over and DH was stable, I went to change into some clean trousers. It’s the third time this week that my boxer shorts have been soaked in someone else’s blood. Each time I have had to chuck them away and continue the shift with no pants on. My salary barely covers the cost of my underwear!

  Saturday, 27 August 2005

  A first-year doctor asks me to come and look at a patient who has not had a wee for nine hours. I tell him I haven’t had a wee in eleven hours because of people like him wasting my time. His face crumples like a crisp packet in a fat kid’s fist, and I feel bad for being mean to him. I was in his position only a few months ago.

  The patient is indeed unable to have a wee. It’s because the tube (called a catheter) she needs to use is trapped under the wheel of her bed and her bladder is now the size of a space hopper. I stop feeling bad.

  Monday, 19 September 2005

  I deliver a baby for the first time and suddenly feel like a real doctor. My boss, Lily, talks me through it gently, but I do it all myself. It feels amazing.

  ‘Well done, you did such a great job,’ says Lily.

  ‘Thank you!’ I reply. Then I realize she was talking to the mum.

  Wednesday, 16 November 2005

  I glance at the notes before visiting an elderly patient on the ward.

  Good news: she has finally been seen by a specialist.

  Bad news: the entry reads, ‘Patient too sleepy to examine properly.’

  I pop in. The patient is dead.

  Tuesday, 22 November 2005

  I’ve already helped other doctors with fifteen c-sections. They have offered to let me do the operation myself, but each time I’ve wimped out. I’m now the only one of the new doctors who’s still a virgin, as my boss Ernie is so keen on putting it.

  Ernie doesn’t give me a choice today. He just tells the patient I am the doctor who is going to deliver her baby. And so I do. I cut through human skin for the first time and deliver a baby through the tummy for the first time. I’d like to say it was amazing, but I had to focus far too hard on every step to take any of it in.

  It takes nearly an hour from start to finish, twice as long as it is meant to. Ernie is very kind. He shows me how to write up the notes and takes me out for coffee after. Now I’m no longer a virgin, he tells me, I will get better at it in time. He sounds like some kind of sex pervert. It will get less bloody and less scary and one day will feel routine, he says. Another doctor chips in: ‘I wouldn’t try to make it last any longer, though.’

  Sunday, 25 December 2005

  Good news/Bad news.

  Good news: it’s Christmas morning.

  Bad news: I have to work on labour ward.

  Worse news: my phone goes off. It’s my boss. I didn’t set my alarm and they want to know where the hell I a
m.

  Even worse news: I’m asleep in my car. It takes me a while to work out where I am and why.

  Good news: it seems I fell asleep after my shift last night and I’m already at work, in the hospital car park. I leap out of the car, grab a quick shower and get there only ten minutes late.

  I have eight missed calls from H and a text saying ‘Merry Christmas’. No kiss.

  This year we are doing Christmas on my next day off: the sixth of January. I tried to be positive about it: ‘Just think how cheap the crackers will be by then!’

  Friday, 27 January 2006

  I have been visiting Baby L on the special care baby unit for three months now. It has become part of my routine before I head home. It’s always nice to see a familiar face, even if it is through a glass wall.

  He arrived fourteen weeks early and when he was born he weighed less than a jar of jam. His mum was seriously ill and I looked after her for many weeks.

  A few decades ago, this baby would have been unlikely to survive, but today his odds are very good. I’ve watched him change from a tiny scrap of a thing, hooked up to tubes and wires, to a proper screaming, vomiting, and occasionally sleeping, baby.

  He’s going home this afternoon. I should be pleased, and I am of course, but I’m still going to miss seeing my little pal.