To have hated ‘This is going to hurt’ by Adam Kay?

[SweetMelodies]

Just that really. So many recommendations to read it from others, it seems to have so much praise and is a number 1 seller.

I like to think I have a good sense of humour and sometimes a pretty dark one at that but I just found the book absolutely dripping in misogyny. Sure it IS well-written and he is obviously a very talented writer and some bits were indeed funny... but a lot of it really turned my stomach, the language, the way he speaks about women, his really narrow-minded attitude towards birth that isn’t evidence-based at all, just based the very limited picture of birth he has. He clearly puts the women in a category of ‘other’ and ‘less than’.

I did feel terrible for him having experienced the dreadful situation at the end and it did highlight how overworked drs can be... but at the same time I think the language and attitudes displayed in it really summarised the paternal and disrespectful attitudes in the maternity system that lead to so many women traumatised by childbirth.

Despite this I appear to be completely alone in this way of thinking, did anyone else not get a great feel from this (or parts of this) book?

Honestly, I don't see the misogyny - you don't like the way he speaks of patients, fair enough. His patients all happen to be female due to his speciality but that doesn't make him misogynistic.
If he was an A&E doctor, for example, then his anecdotes would refer to all types of patients.

In one anecdote he talks about the importance of medical professionals being vigilant to domestic abuse in pregnant women.
In another he helps a woman who wants an elective caesarean state her case for it and thereby give a green light for it to be booked in.
His views on ivf, whiskey for the elderly patient etc all show his compassion.
You see his compassion for his patients throughout.

Chronic pain is a hugely difficult condition to treat and not one that can be dealt with in a 10min appointment. Again, if he had been a GP, for example, the chronic pain analogy may have referred to a male patient.

Re: birth plans - the are not a form a of consent so at any point your can decline any type of medical intervention. The midwives, doctors will explain the reasons and risks but it is still up to you to decide what you want. Until the baby is out it is your body.

The decision process is taken over by the medical team only if you become so unwell that you lose capacity to consent - the birth plan still does not constitute consent at this point, although it's probably too far gone for forceps etc at this point. I don't know about the rules for blood transfusions in Jehovah's Witnesses but I suspect this well laid out in medical law.

I am pretty alert to misogyny and genuinely didn’t get that at all from this book. I found it very funny and sad and have recommended it to others

I don’t see where you’re coming from op. And sorry but it’s pretty rich to dismiss him as generally not evidence based given his extensive training and practice (likely a little more than the OP). In any event he wasn’t setting out to write a treatise on scientific evidence base but instead to present the reality at the coal face of how it actually was.

I’ve just read a book by Caroline Elton, a psychologist who works with doctors to help them deal with difficulties in their professional lives. One of her case studies is a gay gyn/obs, it’s very interesting the way they unpick why this man decided to work in that area, in the same way that Adam Kay did. I’ve met him a few times and enjoyed his company but the last time was just as this book was launched so I don’t know how success has affected him.

I've been very interested in this thread although I haven't read the book.

As a doctor, my experience is that gallows humour is common and most patients would be very upset if they knew how they were spoken about and their lives dissected when they aren't there.

Many posters have commented that he has a cynical tone and that is generally a sign of burn out - and at the end of the book it's clear he is burnt out and gives up medicine for good.

Finally in terms of misogyny - I wonder how the book would have come across if he had been practising in an all male patient specialty instead of all female. If all his stories were from urology talking about men stressing about their balls and erections, or old men with incontinence would the book have felt anti-men? Or is he just commenting on the medical culture he was a part of at the time?

I just read it and thought it was hilarious. Like sunnybeachtime I thought it was more of a case that he didn’t suffer fools. As he mainly treats and works with women, it probably appeared slightly misogynistic, but there were many places in the book where he admired and respected women.

The shoulder dystocia delivery for example ‘...the mother is a dream so far, remaining calm and going along with everything asked of her.’ And of course, his trauma at the mother/baby death at the end of the book is not something that should so significantly affect someone with a hatred of females.

I think he just feels derision for people who think they know it all, medically speaking, and don’t listen to what they’re being told. I would roll my eyes just as much as he at a laminated birth plan, or anyone using homeopathy.

I did find it a bit curious that he was with ‘H’ in the book, who is apparently a woman, but is now married to a bloke. Perhaps he’s just bi though and there’s nothing more to it.

Also I didn’t get this sentence at all if someone can explain:

“I offer: ‘It might help you to join a gym?’ ‘I’m a member of one already,’ comes the reply. ‘But I haven’t been in about £3,000.’”

Finally in terms of misogyny - I wonder how the book would have come across if he had been practising in an all male patient specialty instead of all female.

Or maybe more to the point, a female doctor practising in a male speciality. My impression is that men would not find it as funny.

Eugene I took it that she'd paid the membership to the tune of £3k but hadn't been. DH says my step class last Friday cost £75, because I've only been once thus month

@EugenesAxe. I took that to be a joke about someone who has the direct debit for the gym going out each month because they keep telling themselves that they will go back next week again on a regular basis, then never does. Money down the drain. I think there are a lot of gym members in the same boat!

Ive put it on another thread 'books that made me laugh out loud' I abso loved it he is such a great story teller it also has a moral message as well NHS is on its knees

Hmm, yes I thought it must mean that but I still think it is weirdly worded!

I agree with you OP.

The worst part was when he deliberately disfigured a woman through her c-section scar. I found that really chilling - a man with a knife deciding to punish a woman who is completely helpless.

He should be prosecuted for that IMO. I am glad he is no longer a doctor.

I've only listened to the audio version, which I loved.

I thought he came across as quite humble man actually! He clearly has a dark sense of humour but I wouldn't have said he was misogynistic.

“The worst part was when he deliberately disfigured a woman through her c-section scar.”
Blimey- I must have missed that bit.....what happened?

I am an avid reader and always interested in what books are highly rated/ recommended but I have absolutely zero desire to read this.

I liked it and didn't find it misogynistic. But maybe that's because in my two difficult births it was without exception the doctors who attended to me who treated me with compassion, accepted that I was in pain and struggling, and gave me a hug when I was upset that my wonderful natural birth had gone out the window. Whereas the midwives were awful. The ingrained misogyny I experienced in my obstetric care all came from midwives. They were the ones who rolled their eyes, tutted, told me off for not doing things 'right'.

I thought it was okay, the 'disfiguring' comment was something to do with a tattoo wasn't it?

I sound the Prison Doctor far more annoying, patronising and cringey.

And I thought the 'Brats and Twats' comment funny, I too am 'feminist as fuck' and think it's actions that are damaging, not catchy nicknames.

I’m another (feminist, female) medic who didn’t find it misogynistic.

I agree with the many PPs who’ve said that gallows/black humour is very common in medicine. People make jokes that to the uninitiated may be shocking, but 9 times out of 10 it bears absolutely no resemblance to the way they talk to and care for their patients.

Wrt the patient with pelvic pain, one of the things that most surprised me when I started out in medicine was how many patients you see day-to-day who have symptoms that you can’t find any physical cause for. By some estimates in as many as half of new hospital referrals there will be no physical cause found for their symptoms. That’s not to say that their symptoms aren’t real, but there’s nothing we can physically do, no operation or medication that can help. As doctors we are trained to find and treat illnesses, but if there is no physical illness to treat it can be really difficult. The doctor feels helpless, the patient gets frustrated and loses faith in medical professionals (making it harder for any subsequent HCP to gain their trust), and nobody wins. It’s hard and arguably doctors’ training doesn’t adequately prepare you for this part of the role. I don’t think it’s as simple as the woman in the book not being listened to (though this is definitely an issue in women’s healthcare).

And just briefly because I’ve already written an essay here, I do think there are issues around consent in childbirth. Obviously in a true emergency there many not be the time to properly explain everything, but there are times when there is a little more wiggle room and that could and should be used to inform the patient about what is happening, especially as we know that it’s not necessarily the birth itself that is traumatic, but not being listened to.

OP I thought it was a great book. I thought he sounded very caring towards his patients and frustrated with the NHS.
I didn't see any misogyny at all.

Confessions of an A and E Dr is absolutely brilliant!!! Very funny and I really empathised with him!!!

I agree with OP!

I loved it - thought it was funny and humbling. I get the gallows humour may appear a bit off but it's a personal reflective log originally not written for publication.What it does highlight is the tortuous Working conditions and the hours for junior doctors at that time. I can only hope that this is no longer the norm. I saw Adam Kay on tour with this book and he came across as a genuinely nice and caring guy. The part at the end was so movingly read, I Got the sense that he still feels the pain of that event.

The c section story is when a very racist women is having a c section and she has a dolphin tattoo that he could avoid or he can slightly stuff up the incision and stitching and ruin the tattoo. So he ruins it in revenge on her for her awful behaviour.

I did find it a bit curious that he was with ‘H’ in the book, who is apparently a woman, but is now married to a bloke. Perhaps he’s just bi though and there’s nothing more to it.
I re-read the book last night on the back of this thread (because my memory was the same as yours, i.e. him being partnered with a woman), but actually at no point in the book H is explicitly described as female, or gender pronouns used. At one point he mentions that him and H do not have children yet, but again, this says nothing about whether H is male or female.

“I did find it a bit curious that he was with ‘H’ in the book, who is apparently a woman, but is now married to a bloke.“
Why do you think H was a woman? And why does it matter?