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1-Page Summary of This Is Going To Hurt
Overview
People may think of doctors as having a leisurely life filled with golf and fancy cars, but they work hard for the NHS (National Health Service) hospitals in the UK.
Doctors work long hours and make life-or-death decisions every day. They also have to deal with difficult patients and unusual medical cases that may sound crazy.
Before we begin, I must warn you that the next two points describe a graphic injury and a particularly gory scene. The first point tells us about degloving, which is when skin comes off your body. The second point describes how an unusual marriage proposal happened with help from Kinder Surprise Eggs (a candy egg with a toy inside). In the third point, we learn how someone’s attempt to beat a drug test made for an awkward hospital visit.
Big Idea #1: After medical school, new doctors are forced to quickly learn on the job.
Like all other British students, Adam Kay had to choose a subject that he would be studying for the rest of his academic career. At 16 years old, he didn’t think about this decision too much since it always felt like he was going to become a doctor just like his dad.
So, Adam went to London and studied at Imperial College for six years. Afterward, he started his career as a junior doctor in the NHS (National Health Service). At that time, the standard medical career path was like this: house officer → senior house officer → registrar → senior registrar → consultant.
Adam started his career as a house officer in 2004. He realized that all of the memorization he did wasn’t going to prepare him for the long hours and hard work required. During day shifts, house officers were like glorified personal assistants who made phone calls, scheduled appointments and referred patients. However, night shifts were another story altogether; they required an entirely different skill set than day shifts.
At night, while the head of surgery and registrar were dealing with incoming patients in A&E (Accident & Emergency), junior doctors had to take care of patients in every other ward. They got a beeper that went off when there was an emergency for them to tend to – and there always was.
A medical student was thrown into the deep end of a swimming pool and had to learn to swim immediately, because lives depended on it. For example, Adam was called in for an emergency surgery with only some basic knowledge about how to operate. He did what he knew instinctively by hooking up IVs, administering diuretics (drugs that make you pee), giving him oxygen, installing catheters (a tube through which urine flows) and running tests.
A man was in a terrible accident, but amazingly he survived.
Big Idea #2: As a house officer, Adam was almost immediately exposed to a wide range of absurd medical cases.
Not long after saving a life, Adam was faced with his first degloving case. This involved an 18-year-old man who’d been drinking alcohol with friends and decided to climb up on top of a bus shelter and dance on it. He then slid down the pole at the bottom of the shelter because he didn’t realize that lamp posts are rough. As he slid down, his hands were badly injured due to their texture, as well as his penis which had its skin removed by friction from sliding against the pole. The patient’s genitals looked like spaghetti with tomato sauce stuck to it when Adam inspected them, so they couldn’t be regloved since they were destroyed by friction between him and the lamp post.
The doctors in the hospital admitted a lot of patients because they had ingested household objects. Adam saw four people during his first year alone who needed to have an object removed from their rectum.
