This is Going to Hurt - starts 8th Feb

[ouch321]

I loved the book of this by Adam Kay. I know others weren't so keen.
BBC has dramatised this and starts in early Feb. Just a heads up for others who liked the book.

Me too @SmellyOldOwls

Finished it last night. It does become exceedingly less 'based on the book'

It's a shame if people don't watch it just because of their dislike of Adam Kay

I quite liked the book, but I didn't particularly enjoy the TV series - I found a lot of it utterly depressing and the character of Adam was way more of an arsehole than I remembered. The last one was better. As I recall though (I read the book two or three years ago), there was quite a lot of difference between the book and the series.

I wonder if those who work in the NHS now can comment on if the culture has changed? It was portrayed as absolutely toxic, with the anybody senior mocking and shaming the more junior person they were meant to be training, total lack of compassion and support for their colleagues. Leading to people being unable to ask questions or admit when they feel out of their depth. Complete overwork and burnout. Accompanied by ingrained sexist and classist attitudes and a lack of respect for the patients. A horrible workplace and a horrible place for any patient to have to arrive in. Even Shruti began to behave in that way, having come in as a empathetic person.

I note Adam's difficult, frosty relationship with his mother and the comment about shaking his hand when she saw him off at boarding school for the term. I wonder if the culture might have been led by a lot of the older medical staff, emotionally undeveloped men with boarding school syndrome. Hopefully this is changing now as such people retire.

I feel sympathetic towards Adam - it seems like he had a very difficult upbringing and mainly became a doctor because of pressure from his parents rather than feeling a personal desire to serve and care for others. His misogyny and classism were a part of the culture he was raised and working in. However, the way he treated his patients was unacceptable, and I am glad he is no longer a doctor.

The NHS has improved mildly. Very mildly. Shruti's story is very familiar to many, and many have walked that dark path. Consultants are around more, some are more supportive, some are not.

In some ways, things are worse than then, in terms of burnout.

I've been a patient for the last 7 years - serious stuff. Can't really comment on the culture behind the scenes but even before covid the Hospital series on BBC 2 was documenting the problem with a lack of ICU beds and nurses and its knock-on effect on waiting lists. When Blair left office, the NHS had the highest patient satisfaction score ever. Then we had austerity and cuts and the disastrous Lansbury reorganisation which made it easier for private firms to step in and cherrypick services which would make a profit for shareholders.

Post-covid, from all accounts, morale is at rock-bottom and burn-out is practically universal. Staff leaving, emigrating or taking early retirement.

I had excellent surgical care on two occasions, just before covid. Nursing a bit patchy. Tbh, scary even, at nights. I think they were seriously under staffed and there was a bad atmosphere.

@Blossomtoes
I was in the national flagship hospital for midwifery at Woolwich. Now closed. I think my dd and ddil are fed up with hearing about the jugs of foaming hot milk that arrived twice a day for hot chocolate. The nurses even encouraged us to go out for dinner with our partners on the last evening, while they acted as babysitters.

Oops wrong thread!

Just finished the series. I rarely get emotional about tv programmes but episode 6 really floored me and likewise some of episode 7. I thought it was a great series.

Though some thing have improved I understand from those I know who work in the NHS that unsafe staffing levels are a regular issue, particularly since Covid. Dramas like this and the amazing Help can only help to shine a light on how the NHS and care sector are so badly funded and how more and more is expected of nurses, doctors, midwives and carers without giving them the respect and recompense they deserve.

@felulageller

It's depressing all the woman here who don't recognise misogyny when they see it.

If the sides were flipped men would be crying out misandry!

Or do you mean 'all the women who don't agree with you'? 🤔

I'm an HCP and I didn't have a strong sense of misogyny, book or film.

@Wavypurple

Haven’t watched this yet but read the book a while ago.

It further supported my argument against male obs/gynae staff.

How silly.

I'm an HCP; I do an intimate procedure on patients 8 times in one day per week. 99.99% of my patients completely appreciate what I do.

But last week, a woman (who, oddly, left us a great review!) said 'Do you girls have to undergo this procedure as part of your training???' (I'm 59...)- to which I couldn't help myself other than to say, with a laugh, 'No, but would you want your brain surgeon to undergo brain surgery as part of their training?'.

She had the grace to laugh.

@Bex000

Unfortunately this is a highly accurate representation of what it was like to be a trainee doctor at the time.

I was a year ahead and worked at many of the same hospitals as Adam Kay albeit in a different but similar specialty. The humour is not misogynistic just a deeply warped coping mechanism that many of us developed to deal with the everyday horrors and stress of the profession. Many of us left the NHS or died!

Yes.

It was brutal. And still is, in many ways.

@WhoAteAllTheDinosaurs

Watched the first episode last night and frankly found it a bit triggering. In 2006 (if that's when it was set) was a junior doctor. Left alone to run a whole A&E department overnight. Was literally the only doctor in the department as a 2nd year doctor. Registrar was in bed, as was consultant. They rarely bothered to come in even if you called them. Had to manage things I'd never managed before. I remember several nights just moving round the department, from sick patient to sicker patient to even sicker patient, unable to finish with the previous ones as needed to see the sicker patient NOW. No breaks, unable even to wee. Thank fuck I got out. Sadly realistic if you ask me.

People just do not understand this, do they? They're attacking the victims, not the system that allows this.

I am not a doctor (and would actively discourage any DC of mine with good enough grades to 'go there'), but I'm a HCP and have over many years, comforted many a 'near tears' exhausted junior houseman getting overwhelmed by the chaos of their unfolding nightmare of a night.

I'd suggest to many if the 'Well, he wasn't very nice, was he?' - brigade to stop voting Tory and ponder the wisdom of their Brexit vote.

Things are better now. Because you can't get to see a doctor at all, they can't fuck up, can they?... 🤔

@Kendodd

I’m horrified that the NHS let barely qualified doctors deliver babies in an emergency situation.

I'm horrified that we, the electorate allow the government to so underfund the health service that it has such a shortage of doctors. I mean, where to you think all the doctors are? Do you thing there are loads of unemployed doctors sitting around somewhere or all the senior doctors are playing golf all day?

Yes.

@LagganBubble

Shruti's 'bunch of cells' comment reminded me of my D&C after miscarriage 30 years ago to 'remove the products of conception'. That cut me to the core then - such a heartless choice of words!

You see, this will always be controversial, but I MC twice at 8 and 10 weeks, with a straight forward pregnancy between these, and one after. But, to me, those MC were a bunch of unviable cells. Shruti spoke the truth. And it is interesting how the consultant implies to the couple that her junior was out of order, but tells the junior she did okay. Perhaps knowing her junior was on her knees.

You see it all the time on MN 'I'm 2 weeks pregnant/ I lost my baby at 3 weeks' etc. it would be better if we did recognise the fragility of early pregnant in the same way it would be better if the NCT more readily acknowledged what can 'not go according to plan' in child birth.

I find it a disturbingly accurate portrayal of my junior Dr years in the last 90s/ early noughties.

I really identified with poor Shruti. The feeling of being out of your depth and having to manage stuff you have only ever practiced on a dummy at 4am with no support and a roomful of people looking on expectantly. That's how I put in my first central line. Also taking the flack for seniors decisions and actions that you don't agree with and saying nothing. Being spoken to in derogatory terms or even sworn at was par for the course. It was entirely accepted that as a house officer you were the lowest of the low and you took what was coming to you.

The consultants are very realistic types too I thought. My first surgical consultant was just exactly like Mr Lockhart. Immaculate 3 piece suits, always to be found in the theatre smoking common room unless he was actually operating, he was on his 4th wife and had a large collection of classic cars. Simon, our put upon registrar, did most of the work and was as kind to me as time pressures allowed but often I was left to manage the ward on my own in my first ever job out of med school whilst they were all in theatre. I cried in the store room a lot of times. Once Simon called the consultant in when we were on call and he was drunk and incapable of coming and one of the other consultants had to cover for him. Nothing was done about that to my knowledge or if it was it was 'a quiet word'

Shifts always started half an hour before the rota said and finished 1-2hrs late if you were very lucky or later if the notoriously slow consultant was on the post take ward round. Leaving on time was not an expectation. Going off sick was frowned upon to the extent that one of my friends worked through chemotherapy and another through a UC flare so bad she collapsed and was admitted to her own ward. Pressure to do extra shifts or stay on if there was a gap was none too subtle. I missed so many special occasions and bumbled my way through others completely knackered.

I did not feel I fitted in very well coming from a state school working class background. A lot of people I went to medical school with and met on the job were public school rugger bugger types and there was a culture of masochism and a lot of swopping of war stories and disrespect for patients that I found distasteful.

After a few years I contemplated leaving medicine but made a move from acute medicine to psych instead. It's not easier in the way some people may think as it's emotionally very taxing but at least that is acknowledged and reflected upon and I have found the work culture much better and more supportive.

I do believe, or at least I hope, that things have changed a bit for the better in medical culture. Less than full time work for men as well as women is starting to be quite common now whereas it was regarded as a cop out back in the day. Leaving on time is a reasonable expectation for my juniors and I like to think that I am a whole lot kinder and more supportive to them than some consultants were to me.
I still would not want my DC to have a career in medicine though.

I don't exactly think the programme (haven't read the book) is misogynistic I think that is an artefact of the specialty he's in. I think the culture is just brutal overall and dismissive to patients generally and honestly that's how it often was. I think he is honest about how he was a part of that and doesn't portray it in heroic terms.

I’ve just reread the book. There is only one place where he gives any indication at all about the sex/gender of his partner, and that’s where he refers to his partner as a ‘medical widow’. That implies female to me, but not definitively as terms like this are now used for both genders, and everywhere else it’s left ambiguous. I’m therefore not sure how anyone can state that the gender of the partner was obvious. People may have assumed the partner was male (because otherwise why not just say she/her) or assumed the partner was female (because of the widow comment and because it’s more common for a man to have a female partner) but I can’t see how anyone can say that either conclusion is obvious. It’s all just based on people’s assumptions.

@Mooserp

Not often I feel so emotionally moved by a TV drama. Just watched episode 6.

Me neither. I binged it yesterday and today and feel quite emotionally wrung out!

@CovoidOfAllHumanity

I find it a disturbingly accurate portrayal of my junior Dr years in the last 90s/ early noughties.

I really identified with poor Shruti. The feeling of being out of your depth and having to manage stuff you have only ever practiced on a dummy at 4am with no support and a roomful of people looking on expectantly. That's how I put in my first central line. Also taking the flack for seniors decisions and actions that you don't agree with and saying nothing. Being spoken to in derogatory terms or even sworn at was par for the course. It was entirely accepted that as a house officer you were the lowest of the low and you took what was coming to you.

The consultants are very realistic types too I thought. My first surgical consultant was just exactly like Mr Lockhart. Immaculate 3 piece suits, always to be found in the theatre smoking common room unless he was actually operating, he was on his 4th wife and had a large collection of classic cars. Simon, our put upon registrar, did most of the work and was as kind to me as time pressures allowed but often I was left to manage the ward on my own in my first ever job out of med school whilst they were all in theatre. I cried in the store room a lot of times. Once Simon called the consultant in when we were on call and he was drunk and incapable of coming and one of the other consultants had to cover for him. Nothing was done about that to my knowledge or if it was it was 'a quiet word'

Shifts always started half an hour before the rota said and finished 1-2hrs late if you were very lucky or later if the notoriously slow consultant was on the post take ward round. Leaving on time was not an expectation. Going off sick was frowned upon to the extent that one of my friends worked through chemotherapy and another through a UC flare so bad she collapsed and was admitted to her own ward. Pressure to do extra shifts or stay on if there was a gap was none too subtle. I missed so many special occasions and bumbled my way through others completely knackered.

I did not feel I fitted in very well coming from a state school working class background. A lot of people I went to medical school with and met on the job were public school rugger bugger types and there was a culture of masochism and a lot of swopping of war stories and disrespect for patients that I found distasteful.

After a few years I contemplated leaving medicine but made a move from acute medicine to psych instead. It's not easier in the way some people may think as it's emotionally very taxing but at least that is acknowledged and reflected upon and I have found the work culture much better and more supportive.

I do believe, or at least I hope, that things have changed a bit for the better in medical culture. Less than full time work for men as well as women is starting to be quite common now whereas it was regarded as a cop out back in the day. Leaving on time is a reasonable expectation for my juniors and I like to think that I am a whole lot kinder and more supportive to them than some consultants were to me.
I still would not want my DC to have a career in medicine though.

I don't exactly think the programme (haven't read the book) is misogynistic I think that is an artefact of the specialty he's in. I think the culture is just brutal overall and dismissive to patients generally and honestly that's how it often was. I think he is honest about how he was a part of that and doesn't portray it in heroic terms.

Sorry, long quite followed by short response, but yes.

The work culture for junior house officers was brutal. Unrelenting, and brutal. My experience (HCP, not doctor) began in 1984 when I qualified.

I think, watching from the sidelines of my profession, I've only seen it improve in the last 10 years (driven by work-time directives?). I don't think it is quite as hideous as it was. But, Christ, it was brutal.

@Teenagetrouble

Made me thing we should all insist on female obs/gyn staff.

I'll disagree there, I can't name one nice midwife I had apart from a great male one. Big teaching hospital too, was bloody appalling.

I'm surprised people are so shocked at the dark gallows humour, lots of medics in my family, it's a coping strategy.

It’s one thing it being a coping strategy and another being lauded as hilarious on the BBC.

I too had a lovely male midwife who listened far better than the female ones, changed my previous view that I’d always request a female HCP

So basically your objection seems to be that the BBC has mis-sold or mis-advertised it as a comedy about women giving birth, when in fact it isn’t like that at all? No-one who has watched it all the way through would describe it as “hilarious”.

Where was it described as a comedy?

@MrsPelligrinoPetrichor

Where was it described as a comedy?

Think my tv mag said a comedy

Some bits are funny but not funny iyswim

But also show the serious side like in e3 this week and the red dots on her notes to say abused

I think it is good

Ah right,thanks. Should've been. Described as darkly comic. There were bits I properly laughed out loud at and I rarely do that,along with bits I got really teary over.