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Vitali Isaev
Vitali Isaev

This Is Going To Hurt BETTER

This Is Going to Hurt is transfixing in part because it is prepared to portray, both in drama and in dark comedy, the toll this all takes on doctors personally but also on the care that they're able to give. It is an honest look at the limits of individualism in a system that is designed to be collective. There is no "Get me an amp of epi, STAT!"-style heroism that can compensate for lack of resources or lack of sleep. Tired people make more mistakes. Rushed people make more mistakes. People who spend years in abusive work environments pass down the same to those who follow them. Whishaw can play characters who are gentle and overwhelmed, but this is not that: Adam is unsettled partly because he can tell something in him is corroding; Shruti is unsettled partly because she has no desire to end up like Adam.

This Is Going to Hurt

It's funny; this isn't a COVID-era show, but it feels like a COVID-era show, in much the way paranoid thrillers can feel like a post-Watergate movement, even though many were too early for that to be literally true. This is a series that is not about COVID, but it is about the limits of the human beings we ask to step close to pain and death every day, day after day, with no relief in sight. It suggests a system that is always on the edge of disaster, where doctors and nurses are so busy trying not to drown that the personal satisfaction a lot of us may think saving lives would bring is something they are simply too overwhelmed to experience.

This is Going to Hurt: Secret Diaries of a Junior Doctor is a nonfiction book by the British comedy writer Adam Kay, published in 2017 by Picador. It is a collection of diary entries written by Kay during his medical training from 2004 to 2010. Kay's book discusses political issues in the health care system of the National Health Service in the United Kingdom and societal conflicts between the general population and neglected doctors. Kay accomplishes this by incorporating humour into his personal anecdotes that depict his life as he progresses through his medical training, and his eventual resignation from this career.[1]

This is Going to Hurt is mostly composed of diary entries Adam Kay wrote during his medical training under the National Health Service. It was recommended to Kay to write this diary as a "reflective practice" in which he could log any interesting clinical experiences he experienced throughout his training. Five years after his resignation, Kay was officially removed from the medical register which prompted him to dispose of all the medical files he had been storing, leading him to review his reflective journal. Around this time in 2015, junior doctors entered contract disputes with the NHS leading the Secretary of State for Health and Social Care, Jeremy Hunt, to accuse junior doctors of being greedy. This event motivated Kay to respond to this accusation by releasing This is Going to Hurt, which illustrates his own experiences as a junior doctor.[2]

Kay began his medical training as a House Officer in 2004 with the United Kingdom's National Health Service after attending Dulwich College and Imperial College School of Medicine. In his comedic recollection of his time as a house officer, Kay describes four foreign objects he removed from patients' rectums, saving his first life, and long nights spent in the A&E. Kay became a Senior House Officer by August 2005, a year after officially becoming a doctor. It is at this point in his career that he decided to specialise in obstetrics and gynaecology, or "brats and twats" as Kay referred to it.[3]

In August 2007, Kay was promoted to Registrar, the third highest ranking position after Consultant and Senior Registrar. His diary entries in his time as these positions describe multiple successful births, failed births, infertility problems, and sexually transmitted diseases/infections, along with a gruelling workload that included sleepless nights, unpaid overtime, minimal gratitude from co-workers, sleeping in the car park, and inability to have someone cover a shift leading to minimal holiday and sick time. Throughout these experiences, Kay recalls times in which he gets close to quitting due to the vast amount of stress the job inflicted on his life, harming his health and social relationships. What kept him going was positive outcomes from helping patients in multiple ways ranging from helping couples become pregnant to delivering a multitude of babies a night. This feeling of being a "low-grade superhero" is what Kay claims helped him push through all the other inconveniences related to the job.[4]

On 5 December 2010, Kay began to perform a caesarean on a patient who had undiagnosed placenta praevia. Kay first delivered the placenta and then the baby, which was dead and unable to be resuscitated. The detached placenta caused heavy haemorrhaging; Kay and the senior consultants called into theatre failed to stop the bleeding and, after 2 hours and 12 litres of blood loss, a hysterectomy was performed. The mother was transferred to the intensive care unit and Kay was told to expect the worst. After this event Kay became depressed. Whilst he had followed best practice, and the missed placenta praevia should have been found in previous scans, Kay obsessed that he might have prevented the death of the baby and endangerment of the mother's life by somehow diagnosing the placenta praevia prepartum. Several months after this event, Kay resigned his position.[5]

The book combines these themes to form a powerful argument against Jeremy Hunt's comments concerning the motivation of doctors, justifying the view that doctors are not greedy, and do not pursue a career in medicine entirely motivated by money. Through this book Kay highlighted the many adversities junior doctors must face for the minimal pay they receive, and sought to spread awareness to support doctors in their contract disputes with the NHS.[5]

Shortly after its release in September 2017, Naomi De Pear of Sister Pictures acquired the television rights to This is Going to Hurt. Sister Picture, an independent production company founded in 2015, acquired these rights in a 12-way auction between other interested producers. The television series based on This is Going to Hurt is being written by Adam Kay and developed by Katie Carpenter along with Naomi De Pear, who will also executive produce the series.[8] On 6 July 2018, the BBC announced that the adaptation would be made by Sister Pictures and shown on BBC Two as a seven-part comedy-drama.[9] In February 2022 this adaption was broadcast as a seven-part comedy-drama on BBC1.

Shedding a harsh, and much-needed, light on the stress and mental health issues faced by many medical providers, this is a series that could not be more appropriate for the times. Though This Is Going to Hurt takes place before hospitals were stretched to their breaking point by COVID-19, it's still a sobering look at the unforgiving demands routinely put on the people we trust with our health and our lives. Using biting sarcasm and sometimes even speaking directly to the camera, the show's protagonist, Dr. Adam Kay (Ben Whishaw), quickly wins over the viewer in a manner similar to the title character of Fleabag (played by Phoebe Waller-Bridge). And just like that character, we quickly come to see that Adam's flippant, gritty attitude is the product of some serious trauma. Adding another layer to the story is the new doctor learning under Adam, Shruthi (played by Ambika Mod), who introduces a unique set of struggles faced by a woman of color in a teaching environment with very few resources, or time, for her. Compelling, uplifting, heart-breaking, and at times so brutally honest it's hard not to look away, this is a story that needs to be told.

Kay's writing is full of sharp moments like this, with his protagonist constantly sparring with patients, superiors, and colleagues alike. Midwife Tracy (Michele Austin) is more than a match for him in this regard, as is junior doctor Shruti (Ambika Mod), who grows in confidence as the series progresses. Harry (Rory Fleck-Byrne), meanwhile, is a solid and dependable force as Adam's partner, struggling to break through his shell in order to get him to open up about life in the hospital while navigating issues in their own relationship (Adam's icy parents, who he's yet to come out to, being one of them).

The seven-part TV series that came from this, also titled This Is Going to Hurt, debuts on streaming service AMC+ (and Sundance Now) after running on BBC One earlier this year. It is, in a word, spectacular; different from the book, as it needed to be, but every bit as effective in conveying the central theme while still being hugely funny and hugely watchable.

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For a medical series laced with humor and heartbreak, you can't beat "This Is Going to Hurt," on AMC+ and Sundance Now for seven episodes starting this week. Ben Whishaw headlines this fact-based British sensation with an award-caliber tour de force that uses wit like a scalpel.

Of course, Adam is far from fine. Narrowly escaping dismissal for the lethal mistake of sending home an expectant mother whose distress he doubted, Adam addresses another complaint -- this one anonymous-- by accusing the few friends and colleagues he has left of betraying him.

Kay's decision to quit or carry on isn't resolved this season. But turning his crisis into cathartic comedy is a high-wire act that keeps you riveted from first scene to last. Kay and Whishaw succeed triumphantly in creating one of the best and most bracingly brilliant TV shows of the year. You'll laugh till it hurts.

For a medical series laced with humor and heartbreak, you can't beat \"This Is Going to Hurt,\" on AMC+ and Sundance Now for seven episodes starting this week. Ben Whishaw headlines this fact-based British sensation with an award-caliber tour de force that uses wit like a scalpel. 041b061a72


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