This is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay

Author:Adam Kay
Language: eng
Format: mobi
Tags: Biography
Publisher: Picador
Published: 2017-09-07T07:00:00+00:00

Friday, 6 February 2009

Patient HJ needs an emergency caesarean section for failure to progress in labour. This has not come as a surprise. When I met her on admission, she presented me with her nine-page birth plan, in full colour and laminated. The whale song that would be playing on her laptop (I don’t recall the exact age and breed of the whale, but I’m pretty sure it was documented to that level of detail), the aromatherapy oils that would be used, an introduction to the hypnotherapy techniques she would be employing, a request for the midwife to say ‘surges’ rather than ‘contractions’. The whole thing was doomed from the start – having a birth plan always strikes me as akin to having a ‘what I want the weather to be’ plan or a ‘winning the lottery’ plan. Two centuries of obstetricians have found no way of predicting the course of a labour, but a certain denomination of floaty-dressed mother seems to think she can manage it easily.

Needless to say, HJ’s birth plan has gone right up the fuck. Hypnotherapy has given way to gas and air has given way to an epidural. The midwife tells me the patient snapped at her husband to ‘turn that bullshit off’ when he was fiddling with the volume on the whale grunts. She’s been stuck at 5 cm dilatation for the best part of six hours despite Syntocinon.109 We’ve ‘given it a couple more hours’ twice now, so I explain baby isn’t going to come out vaginally and I’m not prepared to wait until it inevitably becomes distressed and there’s a huge emergency. We’re going to need to perform a caesarean section. As expected, this doesn’t go down particularly well. ‘Come on!’ she says. ‘There must be a third way!’

I’m loath to court a PALS110 complaint from a patient who wants their birth to be blogpost-perfect and has somehow been let down by nature. I’ve had a complaint in the past from a patient who I refused to allow to have candles burning while she laboured. ‘I don’t think it’s such an unreasonable request,’ she wrote. About having naked flames right next to oxygen tanks.

This patient’s got ‘strongly worded email’ written all over her, so I cover myself by asking the consultant to pop by and have a quick chat with her. Luckily, Mr Cadogan is on duty – he’s fatherly, charming and soothing, and he smells expensive, which has posh women flocking to the private ward he’d much rather be on. He soon has HJ consented for theatre. He even offers to do the section himself, to quiet mutterings of derision and amazement from the other staff. No one here can remember the last time he delivered a baby for free. Perhaps golf’s been rained off?

He suggests to the patient that he performs something called a ‘natural caesarean’ – it’s the first time I’ve heard of such a thing. The theatre lights are dimmed, classical music plays and baby is allowed to slowly emerge from the tummy while both parents watch.

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