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?

I totally agree with the OP. I felt exactly the same way.

I agree with you OP. I thought the attitude throughout towards patients (particularly women) and consent was a little troubling.

I'm not really sure why "oh he is just telling it the way it really was" is a particularly compelling defence.

Whilst I empathise with what seems like an impossible job stretching the resources of all those working in the NHS way beyond normal reasonable bounds, and felt hats off, this isn't a job I could do, I found him to be sneery - his humour always seemed to be at someone else's expense and basically him saying whomever it was was stupid (which was usually the patient or nurses or midwives - ie someone he felt was less smart than him).

To expand - I was interested in reading more about him as I enjoyed the book so much. Probably natural assumption made me think H was female while I was reading the book, then I read he had a husband.

I saw some sources that said H had been a female and I wondered if he’d not been supported by his family or something, that made him cover up his sexuality. That was what I was curious about. But those claims about H may be rubbish.

Sorry I hope I haven’t given offence; I support all relationships.

I can’t find anything that suggests H was a woman, nor can I see why it matters either way?

It doesn't matter one jot whether H is male or female. The book is not specific, probably deliberately.

There is no hint of misogyny and the humour is exactly the same sort of dark and dry humour that I have encountered before from doctors, teachers etc. I couldn't take offence at it, and I didn't have perfect experiences of childbirth.

I don't get why people are telling the OP she is wrong rather than just acknowledge that people have different opinions and perceptions, no need to minimise their feelings. I bled all over a doctor after giving birth, and reading the but which says 'wiped the blood off of my cock and wondered how I would tell my friends I got HIV this way and whether they would believe me' made me feel like crap. I know doctor's deal with things how they can to get through, but it made me think of the doctor who helped me, and how humiliated I now feel about it, like I am disgusting, and I was worried when I had my smear in case the nurse would be equally disgusted if something happened. I know it would be gross to be covered in someone elses blood, but I guess when in hospital you assume that it's a safe place and you don't need to feel embarrassed about stuff like that. It just seems something people don't need to hear even though it's not wrong it is said or thought behind closed doors if that makes sense.

@Chivers53 yes I totally get what you mean- a lot of the humour was played off the back of what could easily be somebody else’s trauma which is why I struggled to find humour in some of the situations. A lot of the women are in really vulnerable and frightening positions.

Do you not think it's traumatic to be so soaked in someone else's blood that you have to clean it off your genitals? This is the definition of gallows humour. No one is taking advantage of women's trauma

Worried: of course it would be, but anyone (man or woman) can feel vulnerable in hospital. It's obvious just like many other professionals healthcare professionals use humour to cope with situations, but it doesn't mean that being exposed to these as a patient isn't humiliating and make some people feel embarrassed to seek help. I know it's just a book which is meant to provide an insight and be humorous, but I guess seeing that side of doctors can change your perception. It's only a book though, and I shouldn't have read it.

And the patient isn’t the one sharing the story of them in a vulnerable and frightening situation with others to make them laugh at it

Frustrated by people saying its just gallows humour and a coincidence it's all about women. Like if he worked mostly with patients of colour and just happened to use a racial slur, would that be a coincidence and just dark humour?

He makes fun of women wanting bodily autonomy, he makes fun of women having sexual desire etc, these are specifically misogynist tropes. Well, imo anyway.

worried no one is against gallows humour. One of my favourite novels is Hilary Mantel's Every Day is Mother's Day, one of whose main plotlines is a young woman with learning difficulties being raped by an older man, getting pregnant, giving birth in secret, accidentally killing the baby as she doesn't know how to care for it, and getting committed to a secure facility. It is a very very funny book.

But it punches up, not down. That's the issue.

I have told the story of my difficult birth for laughs, like the bit where the medical team rushed into the room and skidded in the huge pool of my and my baby's blood that was on the floor, or my stupidly asking the paeds to "try not to let him die" - like they were going to say, nah might let this one go!

But that is me telling a story against myself. I would never publish a memoir with all the idiotic things students have said to me, the mental breakdowns I have dealt with, the silly entitled things parents say. Of course amongst colleagues we take a "robust" view but not in public. Add to that he's a member of a privileged class sneering at people whose lives he often made more difficult and yeah, I think it's pretty shit.

Other medical memoirs such as First Do No Harm don't do this.

Twats and brats. Same as FUBAR. Same as many well-known acronyms. You cannot impose your own sensitivities on those who face these situations day in, day out. Black humour is a tool to survive. Surely you want them to treat you based on their extensive education and medical knowledge, not judge them on the basis of their humour which allows them to blow off steam?

Yes. You cannot survive as a doctor without a level of detachment. You would not be an effective doctor without a level of detachment. I have never done obstetrics, but I have often had to go straight from an unsuccessful attempt to resuscitate one child to trying to save another child. I would not be doing the second child any favours if I allowed myself to be affected by watching the first one die. I had to put it out of my mind and focus on the task in hand.

This takes a tremendous toil on you as a human being - and is one reason I no longer work in hospital medicine. You need coping mechanisms to survive personally and to be able to carry on providing care. People who criticise HCPs for detachment and gallows humour aren't putting themselves in the position of the HCP - or of the second child's parents in my example.

I bled all over a doctor after giving birth, and reading the but which says 'wiped the blood off of my cock and wondered how I would tell my friends I got HIV this way and whether they would believe me' made me feel like crap. I know doctor's deal with things how they can to get through, but it made me think of the doctor who helped me, and how humiliated I now feel about it, like I am disgusting, and I was worried when I had my smear in case the nurse would be equally disgusted if something happened. I know it would be gross to be covered in someone elses blood, but I guess when in hospital you assume that it's a safe place and you don't need to feel embarrassed about stuff like that

You don't need to be embarrassed and I am sure Adam Kay never made any patient embarrassed about bleeding on him. But doctors are human, and we experience the same emotions that you would if we find someone else's blood on an intimate bit of our bodies. And we are allowed to talk about it - as long as it is never in a context that identifies, let alone humiliates, the patient concerned.

It seems to me that some posters want the impossible - a doctor who is completely empathic but also immune to normal emotions. Part of the reason that doctors burn out is the impossibility of meeting this standard, particularly given the total absence of psychological support.

I think it was more the fact that situations involving vulnerable and frightened women are played out in a book for laughs. My forceps delivery was probably not particularly pleasant to be involved with but for me, being the only person in the room undressed and lying down around clothed, standing people, frightened and vulnerable and humiliated and subsequently dealing with trauma and depression/anxiety from the experience... I just cannot bare the thought of that situation being turned into a funny anecdote or a ‘hilarious’ tale to tell at dinner parties by one of the HCPs who were present with me at such an intimate moment. So in turn I just can’t find humour out of others in that situation.

Again it may just be a warped way of viewing it through a lens of post-birth trauma. I’m certainly enjoying reading all these different views, it’s very interesting.

I loved it and didn't find it at all misogynistic

I find it concerning that the critics of this book have totally ignored the part where he was expected to go back to work without talking about the horrific case that traumatised him.

There is a culture of not talking about difficult situations in medicine.

Books like this get doctors to open up. A funny anecdote opens the door for a sad one.

Read Also Human to learn about this.

The public expect the impossible: a doctor with perfect diagnostic ability, who never makes mistakes, always says the right thing and is extremely empathic, never talks about work to decompress and never burn out or becomes cynical, oh and works in a 24/7 health service.

Hi.

I'm a critic. I'm also a doctor and know from first hand experience what he is taking about in relation to tough cases. I can simultaneously think "god that poor guy was completely burned by the system, as so many doctors are" as well as wince a little about how he talks about womens bodies. It's not an either or you know!

It seems to me that some posters want the impossible - a doctor who is completely empathic but also immune to normal emotions.

This. I have spent a lot of time being treated by doctors and get very annoyed by the 'halo effect' where they are regarded as some higher order of being altogether, saints walking among us who shouldn't ever be criticised. Here we have the other end of the scale where some human being is expected to be beyond reproach in their working practices and their attitudes to others, 24/7.

I've had all manner of awful things happen as a patient. If I worried about any of them becoming 'anecdotes' for medical professionals, I'd never set foot in a hospital again, to my own detriment. We can't have it both ways, as has been said above, and expect doctors to be human themselves but somehow impervious to all human weaknesses.

Because of this thread I reread it this afternoon. Now I’m actually wondering if I read the same book. The one I read was about the insanity of the system of medical training, the miraculousness that things go wrong so seldom and the utter dedication of overworked, underpaid, exhausted junior doctors.

That nine page laminated birth plan was complete insanity - and most people would think that. It’s possible to combine humour and compassion and I think Kay does that in spades.

As I’ve said before I totally agree that the example he gives of the woman with the birth plan (whether she actually existed or not) was very OTT, but to use it to dismiss ALL birth plans, including ones that really help sexual abuse survivors or women with previous birth trauma or just women who want a bit of bodily autonomy is unfair. It peddles the myth of the ‘hippy’ mother ignorant of intervention and the facts of childbirth who wants whale music and candles as the epitome of birth plans which is untrue.

I read it in one sitting and loved it. It made immensely grateful for the NHS.

He didn’t dismiss all birth plans. Just the lunatic whale music one - which its owner threw on the fire - and the idiot who wanted candles next to the oxygen cylinders.

worried I think you're way off the mark tbh. The best dr I have ever met is my son's paeds consultant who said very openly in a consultation that he himself had experienced MH issues. My wonderful kidney surgeon talked about how when he had back surgery, he was surprised by how rough he felt and advised me to take longer off work. The surgeon who saved my 2yo's sister's life cried after the operation in which removed her massive cancer.

These people are human, humane, have feelings and show them. I value those drs and appreciate how tough their vulnerabilities, and their moments of weakness.

That is different to publishing a book getting laughs out of a woman desperate because she was in serious pain and basically got told it's all in your head, dear.

Anyhow, doubt we'll agree in this.