“I spent a lot of my time apologising to patients that it was running so late, and they’d be upset because it meant that there was a problem with a babysitter or their car’s running off the meter or whatever.
“Not once in a year of doing that clinic did anyone say, ‘Oh, you probably don’t want to be here either’, which I didn’t.
“But you don’t like to think of your doctor as someone who’s human, who’s got this other life, because humans make mistakes. And so it’s much easier to think of your doctor as this non-human person who’s just there when you need them in the hospital.”
Medical training teaches you to communicate effectively with patients navigating some of the hardest days of their lives, Kay told Real Life — but it doesn’t equip you to deal with the life-and-death experiences and traumas you experience on a regular basis.
“In the UK, one doctor takes their life every three weeks and one nurse takes their life every single week, and I know the increase in suicide rates amongst healthcare professionals is a worldwide phenomenon,” he said.
“Of the six years I spent at medical school, a full afternoon a week was spent on communication skills. Not once in any of those lessons over all those years did anyone say, ‘Oh by the way, you are gonna have some bad days yourself, and here are some ways of coping with them’.
“And so in the absence of being taught a way to cope, everyone just improvises with their own methods — some healthier coping mechanisms, some less healthy. I think writing down these diaries that became my book were my form of coping.”
Kay told Cowan junior doctors often experience a “baptism of fire” because they’re forced to work an “enormous number of hours”. He says while it means doctors upskill quickly, it’s not the right way to do it.
He said attitudes from upper management mean doctors are often not thought of as “humans with very human requirements”.
“I spent most of my career working on labour wards and … sometimes things go quiet for 20 minutes and there was a room that we could disappear off to and have a kip (nap), until the bleep next goes off,” he told Real Life.
“And management in their infinite wisdom decided that if you’re at work, you must not be asleep — and they got rid of this facility for doctors to be able to get a bit of rest.
“I felt like saying to one of these nameless, faceless managers, ‘If this was you or your wife requiring a cesarean section, would you rather that the doctor performing it has been allowed to have 20 minutes’ sleep at some point during the shift, or been forced to stay awake?’”
Kay said eventually, working at the hospital became too tough on his mental health and he walked away from the medical profession for good.
“I was the most senior doctor on the shift one weekend. All you want from every case is a healthy mum and a healthy baby, and this was one of these horrible instances when we ended up with neither of those two things.
“There’s this culture in medicine, ‘you’re a bloody doctor, you bloody get on with it’. And so there was no mention of a debrief afterwards, I wasn’t offered a second off work, I wasn’t offered a minute of counselling, and I wasn’t coping.
“I essentially realised I couldn’t face that kind of thing ever happening to me ever again. It was just too damaging to me. Maybe I’m just made of the wrong stuff, I don’t have thick enough armour.
“I decided to step away for three months to try and work out if there was a branch of medicine I could go back into that was maybe slightly lower-octane. Fourteen years later, I’m still on my three months off.”
Since then, however, Kay’s career has taken off — albeit in quite a different direction.
His book This is Going to Hurt about his time as a junior doctor has sold millions of copies worldwide and been turned into a BBC drama-comedy miniseries starring Ben Whishaw.
The success of his writing has also spawned a critically acclaimed comedy career that has now taken him all over the world — including, next month, to New Zealand.
Kay will perform shows in Auckland, Wellington, Christchurch, Dunedin, and Hamilton between May 12-18.
Real Life is a weekly interview show where John Cowan speaks with prominent guests about their life, upbringing, and the way they see the world. Tune in Sundays from 7.30pm on Newstalk ZB or listen to the latest full interview here.
