Content Warning: This section of the guide includes discussion of pregnancy loss and death.

On a literal level, the memoir’s title refers to the physical pain patients might expect to experience during medical procedures. The phrase “This is going to hurt” is associated with doctors warning patients about imminent pain and is a recognizable expression, conveying that Kay’s book is a medical memoir. However, the title is also symbolic of the book’s exploration of The Personal Toll of Healthcare Work and the systemic failures of the UK’s National Health Service (NHS).

Throughout his memoir, Kay emphasizes that the nature of his job hurts him as much as his patients. In addition to developing high blood pressure, he experiences the physical discomforts of sleep deprivation and exhaustion. Kay’s account of falling asleep at traffic lights highlights the potentially deadly consequences of his constant fatigue. Furthermore, Kay’s diary entries describe several occasions when he was at risk of contracting HIV from accidental contact with patients’ blood or used needles. In addition to the physical impact of the job, the memoir reveals the psychological strain of working in the NHS, from delivering devastating news to patients to witnessing tragedies such as the baby’s death that finally prompts him to leave the profession.