The NHS being a demanding mistress, that is.
Adam Kay is a screenwriter for various UK TV shows, but before he switched careers he was a doctor specialising in gynaecology and obstetrics. During his studies, he was advised to keep a diary. Years after switching careers, he received a letter from the Medical Board of Whatever stating that they’d struck him from the professional register as he hadn’t practised medicine in years. It led him to revisit his diaries, now presented here in book form.
The book tracks his career as a doctor, from a House Officer (inexplicably, a junior doctor is someone who has quite a bit of years of experience already making his first strides in the medical world, to a medical specialist. Kay went to study medicine because it was really the only choice: both of his parents as well as two older siblings are doctors (and so is a younger sister). He sails through university in a fairly uneventful way, but like so many others is dropped into the real world of hospitals without a lot of support and quickly finds himself working 80+ hours per week, doing things for which he hasn’t been trained for wages that roughly equal those offered at McDonald’s. The pay increases slightly as he climbs the ranks, chooses a career in obstetrics and gynaecology, but so does the pressure and the responsibility.
Most of the book is fairly light-hearted: there are funny things that patients say or do. Kay, as a Brit, has a dry sense of humour and generally stays away from the sentimental. What he does do, though, is highlight the plight of him and his colleagues: unpaid overwork, ungrateful or even violent patients, unhelpful colleagues and, most pressingly, the neverending demands that the job puts on them. Decisions of life and death that have to be made after twelve hour night shifts so busy that even grabbing a snack to shove into your mouth is too much to ask for. Weddings are missed, dates are postponed inevitably. Friends complain, then give up on the friendship. Kay and his fellow doctors put up with it because they have heart for their patients, which makes it all the more galling that the book came out when the Conservative UK government imposed stringent budget cuts, with the responsible minister accusing doctors of being greedy. A lot has been written about the Tory effort to destroy the NHS; reading this book makes it all the more galling.
The book ends fairly abruptly when Kay explains in a dry, factual staccato what made him quit his career in spite of all the sacrifices he’d had to make. The chapters preceding that event are a quick and easy read, entertaining and compelling. And honestly, in spite of all Kay’s complaints about gruelling hours, racist patients and Fireman Sam sponges shoved up people’s hoohas, as a love letter to the NHS, it could be worse.