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?

Tbf, "brats and twats" was how AK's medical school referred to the dept, it's not his own term.

Ah sorry I stand corrected

Yeah he does say ‘brats and twats’ is just how it’s referred to. I do wonder whether that saying will fizzle out a bit now that the majority of newly qualified obgyns are majority female (I’m sure I read something like 85% and climbing so it’s a possibility male obgyn drs will be a rarity in the future). It definitely sounds like a saying coined by blokes and (mainly) used by blokes! And I am guessing it does originate from the time when obstetrics was very much a male speciality?

I'm thinking that why this book might not be landing uniformly well is that obs and gynae has had a history of being quite patriarchal and in many cases dismissive to women. It feels like punching down.

I really agree with JoannaCuppa.

Although he chose to publish this book ultimately this is his personal diary. If women had come forward since publication to complain about his professional attitude towards them then that would be concerning. I’be not heard of anyone doing so suggesting that whatever his private thoughts he behaved appropriately towards his patients at all times, with the possible exception of the tattooed lady.

I often think things about my patients that I would be criticised for raising with them/risk a complaint eg a family eating a a McDonald’s during a clinic appointment. If I wrote a diary would I have commented on this, yes of course I would.

Thoughts cannot and should not be policed imo unless there is evidence of action causing real harm to others.

I suspect that if Adam Kay had gone into Urology there would have been a whole host of anecdotes about penis’s where he behaved professionally but secretly thought “what the hell possessed you to stick that in your urethra?” And had a good laugh with his colleagues before moving on to eg a young man with testicular cancer or an old man with prostate cancer. This is life. We are all human and we find humour where we can whilst dealing with the shit. Medics are significantly higher risk than the general population for suicide, if we can’t laugh at the ridiculous (which a nine page laminated birth plan is) then this will only rise.

I am guessing it does originate from the time when obstetrics was very much a male speciality?

Yes, I think it does ... unfortunately there are probably quite a few bad remnants in the system from when it was a patriarchal area?

If they have to retain those standards behind closed doors to their peers, in their own diaries and even their own thoughts, then that is posters failing to display humanity or empathy towards HCPs.

It's a published work that he is profiting from. The OP saying that she didn't like his book isn't policing his private thoughts.

I have no idea why sexism suddenly becomes ok in the eyes of some posters if it's "just being honest" and "well that's how the NHS really is".

It's a bit of a leap to infer that some dated anecdotes are going to prevent suicide in medics though. No one is suggesting that people's private conversations/diaries are policed. But it's ok to ask are we ok with some of the tired tropes in the book?

I am a Dr and get the stresses and have numerous tales (like we all do) about patients. I just think a male Dr in a specialty with a history like that of obs and gynae probably needs a little more sensitivity.

Paul Kalanithi did a beautiful book which talked about medicine and humanity.

I'm a nurse and loves the book can't think could you give some examples op?

@jobbymcginty the OP gave a specific example. People have pointed out that he doesn’t say what she claims he did at all. But apparently that doesn’t matter

It's a published work that he is profiting from. The OP saying that she didn't like his book isn't policing his private thoughts

Well, the book is a diary of the private thoughts of a medic going about his job, the inherent stresses of that role, and hanging onto his sanity by his fingertips.

Posters objecting to his "off duty" descriptions of what he experienced and how he felt about it, ARE saying that they disapprove of his thoughts. Quite why they read a book about precisely those things, is mystifying to me.

If anyone doesn't ever want a HCP to think human thoughts, despite them treating the patient with the utmost of respect and care, then I strongly encourage you to never seek medical advice.

We ALL do it. We have to. It is what keeps us vaguely sane when wading through short staffed shifts, ridiculous edicts from management, and being spoken to like dirt by patients who are all to aware of their rights, but less bothered about their responsibility to be courteous to their fellow humans.

It is depressing to read the unattainable standards that some would set for us. It's all about YOU - which is as it should be when you are in front of us. The problem is, posters here are still making this book about THEM, the patient, when it isnt about you. It's about a medic working in the NHS, HIS thoughts and feelings.

It stops being about you, when our dealings with you are over and we have to process our own work experiences. HCPs are people too. Have a little humanity and compassion people - after all, that's what you expect AK to not only show, but to think too.

Totally agree Joanna

I work in MH we could not get through meetings without at times laughing at what might be at a situation going on or problem we can foresee or how the patient is behaving - that is not laughing at their condition

We can all be ridiculous at times, we can all demand attention that we don’t really need or think we know better

I am sure my GP has rolled her eyes or thought what I was saying was foolish but she sat there and was empathetic and did her job what more do I need an insight to her personal thoughts so they can be corrected

I can’t ask her to also be a robot too I want to deal with humans I want empathy and professionalism

It definitely sounds like a saying coined by blokes and (mainly) used by blokes! And I am guessing it does originate from the time when obstetrics was very much a male speciality?

I’m all for a good discussion OP but you have shown yourself to be the Queen of Conjecture on this thread.

Posters objecting to his "off duty" descriptions of what he experienced and how he felt about it, ARE saying that they disapprove of his thoughts.

No, we're saying we dislike his book. Where he has taken his thoughts and chosen to publish them, for profit, for the whole word to read and comment on them.

There's a country mile between having thoughts about patients and sharing them with your nearest and dearest (while maintaining confidentiality) and publishing a book to profit from them.
Surely it's ok to not like a book? He hasn't written a seminal deep thought provoking piece on medicine and life (I don't think he intended to either). Although on reflection maybe his book has provoked some discussion on the depiction of women's health in medical literature.
It reminds me a bit of House of God, which was much touted when I was a medical student. Interestingly I saw on a Twitter discussion on books to recommend to medical students that it was deemed too dated and probably offensive in a way.

I think it is thought provoking. It makes it pretty clear that the NHS is in shit shape, that we expect insane things of junior doctors and we’re losing highly trained professionals we can ill afford to do without.

100% Alsohuman. What I got from it was how burned out this chap became. It was a sad read for me in that respect. A lot of my colleagues are like that and it's neither good for them or their patients.

Some drs get so burned out they stop being able to care as their tanks are empty. I actually respect his decision to stop practising.

I hated this book, in fact I didn't finish it. I thought it was too try-hard and it just wasn't that funny. It was also very very similar to Trust Me, I'm a Junior Doctor by Max Pemberton which was published in 2008.

I work in medical education so work with doctors everyday, if that's relevant at all.

I remember Phil Hammond - who is very patient-centred and not at all a typical macho doctor - talking about something terrible that happened with a body after a failed attempt at resuscitation (am not going to give details as too awful but it wasn't due to anyone doing anything wrong). All the HCPs present laughed - not because they didn't see how terrible it was, but precisely because they did and were at a loss how to cope. It's very hard to explain to anyone who hasn't been in those situations.

*It definitely sounds like a saying coined by blokes and (mainly) used by blokes! And I am guessing it does originate from the time when obstetrics was very much a male speciality?

I’m all for a good discussion OP but you have shown yourself to be the Queen of Conjecture on this thread.*

It was just a question? Just wondered whether the term does go back to when obgyn was completely male-dominated and therefore coined/used by men in reference to treating female bodies.

I stated ‘I’m guessing that’ and put a question mark, therefore wasn’t stating it as a fact at all. Am open to the possibility it’s a new term coined by females

“I hated this book, in fact I didn't finish it.”
If you didn’t finish it you will have rather missed the point.

I finished it, but got more and more annoyed as I went on. I was on holiday and didn't have much other reading matter and had bought it because it had rave reviews. I have read other books with doctors, nurses or midwives writing about their experiences and they haven't annoyed me as much as this one did.

I have met and spoken with Adam Kay about this book, I am also a health professional. I can assure you he is compassionate, sensitive and I believe horrified to think that anyone would see him that way. I believe he was honest about the challenges of the NHS, the humour is dark but he is not rude about people’s situations.

“Brats and twats” and “Cunts and runts” both sound like typical juvenile medical student humour to me.

AK qualified in 1998.
Among a broad sample (n=2507) of those who qualified in 1993, there was a 2:1 ratio of females to males in obstetrics/gynae.

So I'm finding it very weird that anyone says AK was working a very male dominated envt that has since become very female dominated. If "twats+brats" terms persisted in early 2000s, then lots of females went along with it.

“Brats and twats” and “Cunts and runts” both sound like typical juvenile medical student humour to me.

Exactly. My urology friends refer to themselves as 'knob-doctors' and my close friend who is anaesthetist refers to herself as a drug dealer

I've worked in urology and gleeful stories about the things men put up their urethras are a daily occurrence.

And A&E stories about things people 'fell on' whilst naked are swapped like trading cards. It gets you through a tough job! I've definitely complained about patients ridiculous expectations (no I can't take your tooth out in A&E because you don't want to pay a dentist!).

It's the culture of medicine. AK worked in Obs and gynae, so his stories are going to be about women, but I didn't get the feel of 'oh look how much stupider women are then men, they are so inferior', more like: 'some people are so weird and mental and entitled' which is a common theme to all public facing jobs, I'm sure.

Men can call out poor behaviour in women without it being misogyny.