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In Stitches
'Despite the headlines, actually the NHS has just had its best year ever.' Patricia Hewitt, Secretary of State for Health, eulogising to the BBC, 22nd April 2006. 'Despite what the politicians say, things seem to have gone a bit tits-up recently.' Dr Nick Edwards, A&E doctor, ranting to his mates down the pub, 22nd April 2006.
Dr Nick Edwards is an Accident and Emergency (A&E) doctor working in the UK and a passionate believer in the NHS. However the reforms, political correctness and the Anglo-Saxon culture of binge drinking and fighting and the resulting A&E visits are a strain on his sanity. So to keep up his morale, he began writing down his feelings - a form of literary cathartic therapy - the results of which make up this book.
From dealing with cardiac arrests and car accidents, to people with 'Arrest Avoidance Syndrome' and others who haven't quite read the big red sign above their heads as they walk into A&E, In Stitches paints a vivid picture of what it's really like working at the sharp end of the NHS today. It's funny, it's heartbreaking and it's infuriating. It's also more informative than any government press release.
So join Dr Nick Edwards as he describes the frustrations and joys of working in the NHS. The traumas and tragedies, the patients and colleagues and most of all the successes and humour that make up life at the frontline of medical care.
Note to reader: ever-conscious of meaningless targets, the author would like it to be known that 98% of the stories contained in this book were written in under 4 hours.
Dr Nick Edwards is an Accident and Emergency doctor working in the UK. He kept a blog under the name of Angry Doctor for a while until his criticisms of the management of the NHS drew unwanted attention and for the sake of his career he removed it from the web.
Dr Nick Edwards is an Accident and Emergency (A&E) doctor working in the UK and a passionate believer in the NHS. However the reforms, political correctness and the Anglo-Saxon culture of binge drinking and fighting and the resulting A&E visits are a strain on his sanity. So to keep up his morale, he began writing down his feelings - a form of literary cathartic therapy - the results of which make up this book.
From dealing with cardiac arrests and car accidents, to people with 'Arrest Avoidance Syndrome' and others who haven't quite read the big red sign above their heads as they walk into A&E, In Stitches paints a vivid picture of what it's really like working at the sharp end of the NHS today. It's funny, it's heartbreaking and it's infuriating. It's also more informative than any government press release.
So join Dr Nick Edwards as he describes the frustrations and joys of working in the NHS. The traumas and tragedies, the patients and colleagues and most of all the successes and humour that make up life at the frontline of medical care.
Note to reader: ever-conscious of meaningless targets, the author would like it to be known that 98% of the stories contained in this book were written in under 4 hours.
Dr Nick Edwards is an Accident and Emergency doctor working in the UK. He kept a blog under the name of Angry Doctor for a while until his criticisms of the management of the NHS drew unwanted attention and for the sake of his career he removed it from the web.
294 pages, Paperback
First published January 1, 2007
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November 17, 2022
The only thing I took away from the book that really amused me was "irate personality disorder",
The way it started out, one quite interesting chapter and two moaning about the management of the NHS or going on about himself in an eye-glazing way, I thought I could manage this. Read one, skim too. But it wasn't to be. The troughs were too deep to bother looking to see if there were any peaks, and so I gave it up.
Really it was nearly-ever-chapter moaning about the NHS management and cost-saving schemes, how he could run it better. The few high spots about his practice in A&E rarely illuminated the patients as people but still they were at least stories.
Talking of stories, he recounted an episode where he was showing brilliance on the football field only to have a friend spoil his game by dislocating a shoulder which of course he had to attend to. In italics he says his wife says this is supposed to be a non-fiction book and apart from the story being about football and his friend dislocating his shoulder, he'd written pure fantasy.
That wasn't the last straw but close. And in the end it was
DNF.
I got very stressed and angry about this. After a while the junior doctor working with me asked me why I was so irate. I explained that, apart from an irate personality disorder and the fact that ranting is my form of therapy, I was genuinely upset.That was the high point for me. The low is so typical as in the very next sentence,
Apart from my lovely family and useless football team, the things I care most about are my patients' care and the state of the NHS. It upsets me that crappy management decisions done in the name of efficiency bugger up both.
The way it started out, one quite interesting chapter and two moaning about the management of the NHS or going on about himself in an eye-glazing way, I thought I could manage this. Read one, skim too. But it wasn't to be. The troughs were too deep to bother looking to see if there were any peaks, and so I gave it up.
Really it was nearly-ever-chapter moaning about the NHS management and cost-saving schemes, how he could run it better. The few high spots about his practice in A&E rarely illuminated the patients as people but still they were at least stories.
Talking of stories, he recounted an episode where he was showing brilliance on the football field only to have a friend spoil his game by dislocating a shoulder which of course he had to attend to. In italics he says his wife says this is supposed to be a non-fiction book and apart from the story being about football and his friend dislocating his shoulder, he'd written pure fantasy.
That wasn't the last straw but close. And in the end it was
DNF.
December 28, 2019
It's quite obvious that this book began as a blog for Dr Edwards to vent his daily frustrations, and perhaps it would've benefited from some tidying up when it transitioned to book format. That's not to say that it's bad - only that you'll enjoy it about as much as you enjoy binge-reading old blog archives. I daresay if these entries were read at the rate of 3 per week they'd seem more balanced, but to read them all at once is to be repeatedly struck by the same old jokes, complaints, and stylistic tics.
Setting that aside, the repeated complaints are very interesting if you care at all about medicine and the NHS. Dr. Edwards's main complaint is that bureaucrats are useless bastards who are paid vast sums to impose ill-considered rules which make it harder for doctors to do their jobs and, in the long run, cost the tax payer more money.
Some examples:
Ambulances are now outsourced to ambulance companies that bid for contracts with hospitals. In a stroke of money-saving genius the bureaucrats decided not to pay for any non-essential ambulance services after 11pm. How does this play out? A old man is suffering from dementia in a nursing home. He develops a cough, and the care home call an ambulance (you think they'd have their own doctor who might examine him, but alas, they also are subject to cost cutting).
The ambulance brings him to A&E, where Dr. Edwards determines that he just has a cough. Ideally, he would go straight back to his home, but it is now past 11pm. The ambulance crew are doing nothing and would like to take him home, but their superiors won't allow it. After all, if they start doing those kinds of unpaid favours for the hospital then it will seriously effect their bargaining position in the next contract negotiation.
So the ambulance crew twiddle their thumbs and the old man gets a bed in the hospital which could've been saved for a more needy patient. His dementia means he becomes agitated and gets a dose of sedatives, which would've been unnecessary if he had gone home. And if he catches something nasty from his stay in the hospital then he'll be back again.
Does anyone benefit from this silly arrangement?
Does anyone benefit from dividing up the accountancy between GPs and hospitals in such a way that Dr Edwards, in A&E, cannot order necessary tests if they are not emergency tests? Instead, he must send patients back to their GP with a letter for the GP to order the tests so that the GP can pay for it, causing a delay of 10 days or more in medical treatment.
Is there any point in a hospital having a bed manager, whose only purpose to ensure that targets are being met? In practise, this means nagging nurses to allocate patients to beds that the cleaners haven't yet had time to properly prepare, endangering everyone with the risk of infection (but achieving those patient flow statistic targets!)
If there is one bit of bureaucracy that makes him angriest it must be the 4-hour rule: every patient seen in A&E must dealt with and gone within 4 hours. Intended as a noble attempt to prevent patients languishing in the waiting room, it actually prevents doctors doing their job well because some patients obviously need to stay under observation longer than 4 hours. It results in patients being pointlessly shunted from ward to ward around the hospital, in a mad game of musical beds, racing ahead of the arbitrary 4-hour deadline. Or failing that: doctors and nurses simply do what's best for their patients and lie in their records. It cannot be good to encourage habitual workplace dishonesty.
Overall, Dr Edwards description of the NHS is a description of penny-pinching and bad incentives. And despite all that he loves the NHS, and he loves his work as a doctor. He has a faith - which I must admit appears astonishingly naive - that all that's needed is for the government to pull its socks up, increase NHS funding, and make sensible rules instead of silly ones. If only it were so easy...
I was somewhat alarmed by the similarity between this book and the novel Cancer Ward. The British system is, of course, not half as bad as the Soviet one, but there are parallels. In both cases doctors are chasing statistics more than best practice. The Soviets discharge patients approaching death so that they don't die on the Ward and mess up the death rates, while the Brits move people around to meet the 4-hour rule. In both cases departmental squabbles can effect whether a patient gets proper care. In both cases there's a cyncial acknowledgement that being a politician or a bureaucrat will get you the fastest and best treatement. In both cases, some people are working flat out while others are jobsworthy shirkers, and there's little procedure for dealing with it. (I suppose that's a problem with work everywhere though - not just in socialised healthcare!)
Bureaucrats aren't the only ones acting badly, if rationally. One patient who lived next door to the hospital frequently faked heart-attack symptoms in order to get a free ride home in the ambulance. The smart ambulance crew solved that problem by taking him to the hospital across town instead.
After bureaucrats, Edwards most likes to complain about patients. For the more part the British patient falls into one of three categories:
1. drunks and drug-takers who have overdosed and endangered themselves
2. drunks who have got in a fight and broken their hand
3. people who have inserted fruit into a bodily orifice and can't get it out.
I am not proud of my country-men.
Setting that aside, the repeated complaints are very interesting if you care at all about medicine and the NHS. Dr. Edwards's main complaint is that bureaucrats are useless bastards who are paid vast sums to impose ill-considered rules which make it harder for doctors to do their jobs and, in the long run, cost the tax payer more money.
Some examples:
Ambulances are now outsourced to ambulance companies that bid for contracts with hospitals. In a stroke of money-saving genius the bureaucrats decided not to pay for any non-essential ambulance services after 11pm. How does this play out? A old man is suffering from dementia in a nursing home. He develops a cough, and the care home call an ambulance (you think they'd have their own doctor who might examine him, but alas, they also are subject to cost cutting).
The ambulance brings him to A&E, where Dr. Edwards determines that he just has a cough. Ideally, he would go straight back to his home, but it is now past 11pm. The ambulance crew are doing nothing and would like to take him home, but their superiors won't allow it. After all, if they start doing those kinds of unpaid favours for the hospital then it will seriously effect their bargaining position in the next contract negotiation.
So the ambulance crew twiddle their thumbs and the old man gets a bed in the hospital which could've been saved for a more needy patient. His dementia means he becomes agitated and gets a dose of sedatives, which would've been unnecessary if he had gone home. And if he catches something nasty from his stay in the hospital then he'll be back again.
Does anyone benefit from this silly arrangement?
Does anyone benefit from dividing up the accountancy between GPs and hospitals in such a way that Dr Edwards, in A&E, cannot order necessary tests if they are not emergency tests? Instead, he must send patients back to their GP with a letter for the GP to order the tests so that the GP can pay for it, causing a delay of 10 days or more in medical treatment.
Is there any point in a hospital having a bed manager, whose only purpose to ensure that targets are being met? In practise, this means nagging nurses to allocate patients to beds that the cleaners haven't yet had time to properly prepare, endangering everyone with the risk of infection (but achieving those patient flow statistic targets!)
If there is one bit of bureaucracy that makes him angriest it must be the 4-hour rule: every patient seen in A&E must dealt with and gone within 4 hours. Intended as a noble attempt to prevent patients languishing in the waiting room, it actually prevents doctors doing their job well because some patients obviously need to stay under observation longer than 4 hours. It results in patients being pointlessly shunted from ward to ward around the hospital, in a mad game of musical beds, racing ahead of the arbitrary 4-hour deadline. Or failing that: doctors and nurses simply do what's best for their patients and lie in their records. It cannot be good to encourage habitual workplace dishonesty.
Overall, Dr Edwards description of the NHS is a description of penny-pinching and bad incentives. And despite all that he loves the NHS, and he loves his work as a doctor. He has a faith - which I must admit appears astonishingly naive - that all that's needed is for the government to pull its socks up, increase NHS funding, and make sensible rules instead of silly ones. If only it were so easy...
I was somewhat alarmed by the similarity between this book and the novel Cancer Ward. The British system is, of course, not half as bad as the Soviet one, but there are parallels. In both cases doctors are chasing statistics more than best practice. The Soviets discharge patients approaching death so that they don't die on the Ward and mess up the death rates, while the Brits move people around to meet the 4-hour rule. In both cases departmental squabbles can effect whether a patient gets proper care. In both cases there's a cyncial acknowledgement that being a politician or a bureaucrat will get you the fastest and best treatement. In both cases, some people are working flat out while others are jobsworthy shirkers, and there's little procedure for dealing with it. (I suppose that's a problem with work everywhere though - not just in socialised healthcare!)
Bureaucrats aren't the only ones acting badly, if rationally. One patient who lived next door to the hospital frequently faked heart-attack symptoms in order to get a free ride home in the ambulance. The smart ambulance crew solved that problem by taking him to the hospital across town instead.
After bureaucrats, Edwards most likes to complain about patients. For the more part the British patient falls into one of three categories:
1. drunks and drug-takers who have overdosed and endangered themselves
2. drunks who have got in a fight and broken their hand
3. people who have inserted fruit into a bodily orifice and can't get it out.
I am not proud of my country-men.
August 5, 2017
An amusing dip in and dip out book about a doctor's time on an A&E ward. I found I could only read chunks of it at the time, but overall it was a good read, and the author obviously knows his stuff and is clued up on various up and coming policies.
January 16, 2016
I am an NHS doctor and recognise a great deal of the anecdotes in this books; it certainly is a reasonable representation of the frustrations, highs and lows of working in the NHS. However, while at times this book is amusing, my overall feeling upon reading it was a sense of annoyance. Two factors make this an irritating read: the disjointed nature of the prose and the constant whinging contained within.
The disjointed prose is perhaps a necessity; it is a series of short vignettes and so will be disjointed. The problem is that the vignettes appear to have been arranged in a somewhat random order, with no real overarching message or story. It's ok if you dip in and out of the book but it makes it an unsatisfying read if you want to read it in one go - you end up moving randomly from topic to topic.
This alone might not be a problem if it weren't for the whinging found throughout the book. I am well aware of the problems the NHS faces and I do believe it is important to inform the public of these issues. However the way the some of the issues are tackled in this book just left me exasperated - problems were constantly treated as someone else's fault (government, managers, public), to be lamented and whined about. The times that solutions were offered up were often over simplified and will actually add to the publics misunderstandings of the NHS by being oversimplified rants along the lines of "obviously all you need to do is...".
For example, early in the book the Author complains about a lack of access to patient's records in A&E overnight - this is a very real problem and is one very slowly being resolved because it is so complex (making records electronic, secure and accessible is a complex and expensive process). Yet instead of acknowledging the reality, the author complains about the problem and then makes an unrealistic comparison to Tesco's clubcard system - the idea is that somehow if a supermarket can keep track of our shopping habits, why can't the NHS keep track of our health? The problem is that this is a gross oversimplification - both in that Tesco's system is actually highly complex and expensive and that the NHS's data is quite different and the potential outcomes of a failure of the system far more serious than if Tesco mistakenly thinks you buy carrots. This sort of "solution" (if tesco can do it, why can't the NHS) is exactly the sort of misrepresentation and over simplification that politicians and the media constantly put forward, and it is frustrating to see it done by a member of the profession.
Overall it's an OK book but not as good as it could have been and ultimately, for me at least, a frustrating read.
The disjointed prose is perhaps a necessity; it is a series of short vignettes and so will be disjointed. The problem is that the vignettes appear to have been arranged in a somewhat random order, with no real overarching message or story. It's ok if you dip in and out of the book but it makes it an unsatisfying read if you want to read it in one go - you end up moving randomly from topic to topic.
This alone might not be a problem if it weren't for the whinging found throughout the book. I am well aware of the problems the NHS faces and I do believe it is important to inform the public of these issues. However the way the some of the issues are tackled in this book just left me exasperated - problems were constantly treated as someone else's fault (government, managers, public), to be lamented and whined about. The times that solutions were offered up were often over simplified and will actually add to the publics misunderstandings of the NHS by being oversimplified rants along the lines of "obviously all you need to do is...".
For example, early in the book the Author complains about a lack of access to patient's records in A&E overnight - this is a very real problem and is one very slowly being resolved because it is so complex (making records electronic, secure and accessible is a complex and expensive process). Yet instead of acknowledging the reality, the author complains about the problem and then makes an unrealistic comparison to Tesco's clubcard system - the idea is that somehow if a supermarket can keep track of our shopping habits, why can't the NHS keep track of our health? The problem is that this is a gross oversimplification - both in that Tesco's system is actually highly complex and expensive and that the NHS's data is quite different and the potential outcomes of a failure of the system far more serious than if Tesco mistakenly thinks you buy carrots. This sort of "solution" (if tesco can do it, why can't the NHS) is exactly the sort of misrepresentation and over simplification that politicians and the media constantly put forward, and it is frustrating to see it done by a member of the profession.
Overall it's an OK book but not as good as it could have been and ultimately, for me at least, a frustrating read.
February 5, 2020
This is a genre that I usually love. I did find it interesting gaining insight into the hidden goings on of an A&E department, but whilst a lot of the complaints Dr Edwards has about the NHS are legitimate problems and I share his annoyance and frustration, I find a whole book dedicated to his grievances too much (this book is MUCH more centred around the 'lows' than the 'highs'). Reading Dr Edwards' repetitive whining is not made easier by his ridiculous holier-than-thou attitude about it all and continued offering of over-simplified solutions to massive and complex problems as if everything could be sorted out, if only the government would consult HIM - clearly an unsung genius (and owner of many a high horse).
My engagement with Dr Edwards' stories was continuously interrupted by bad grammar and poorly constructed sentences; spaces are missed out between words, there are so many missing commas, mismatched word tenses or pluralisations... I often had cause to pause and wonder if there had been an editor involved at any point in the publishing process of this book.
Page 174 had me reading the line, "Until recently the only thing I wanted to change about Europe was to bring in a treaty banning female underarm hair." I think this was the point at which I decided (finally) that I no longer cared what this man had to say, no matter what interest I may have in the inner workings of the NHS.
My engagement with Dr Edwards' stories was continuously interrupted by bad grammar and poorly constructed sentences; spaces are missed out between words, there are so many missing commas, mismatched word tenses or pluralisations... I often had cause to pause and wonder if there had been an editor involved at any point in the publishing process of this book.
Page 174 had me reading the line, "Until recently the only thing I wanted to change about Europe was to bring in a treaty banning female underarm hair." I think this was the point at which I decided (finally) that I no longer cared what this man had to say, no matter what interest I may have in the inner workings of the NHS.
November 15, 2019
Read via KU (Kindle Unlimited!)
2019 has certainly been the year of reading medical memoirs and I have no idea why other than KU keeps recommending a bunch of them to me... In Stitches is not a recent release, yet it really opened up my eyes to the NHS and past struggles (a few of them still currently happening!) and what working in an A+E department is really like. I smiled, I was shocked and annoyed. There are lots of brutal but honest opinions throughout along with a bunch of patients, some of who were very rude. A good read for memoir and medical fans!
2019 has certainly been the year of reading medical memoirs and I have no idea why other than KU keeps recommending a bunch of them to me... In Stitches is not a recent release, yet it really opened up my eyes to the NHS and past struggles (a few of them still currently happening!) and what working in an A+E department is really like. I smiled, I was shocked and annoyed. There are lots of brutal but honest opinions throughout along with a bunch of patients, some of who were very rude. A good read for memoir and medical fans!
September 2, 2012
In Stitches was a collection of short anecdotes from the author's time as an Accident and Emergency (A&E) doctor in the UK.
I have mixed feelings about this book. At some points, it was funny, life-affirming and interesting; at others, it made me question why the hell I want to work for the National Health Service (NHS).
The fact is, Dr Nick Edwards complains way too much about the state of the NHS. Normally, I wouldn't mind that much - most of his complaints were valid, interesting and eye-opening. But the fact is, he repeated the same complaints over and over again. By the third or fourth time he mentioned the 'four hour rule', I wanted to shake him and tell him that I'd got it already. I didn't need it reiterated through another few anecdotes. (It didn't really help that the book was written in 2006, and some of the things he complained about have been sorted out - a point that is, thankfully, shown in the later-added epilogue at the end of the book.)
Once you get past the repetitive complaining, there are some genuinely interesting human stories here, and a real look at what it is like to work in A&E. Some of the stories were even humorous, though often I did feel that Edwards was trying a little too hard to be witty and sarcastic. One of my favourite anecdotes was about the old lady who came in with an orange up her vagina. Yes, really. Of course, not all of the anedotes were funny. A couple were tragic and one (about a stillborn baby) even made me cry.
This book really shows the highs and the lows of working in A&E - the banter, the troublesome patients, the success stories, the death and loss. It also shows the huge pressure that the government puts on doctors and other NHS staff to meet targets, meaning that patient care is compromised. It also shows the ways that NHS staff have found to get around these targets and restrictions.
One thing I didn't like was the gender stereotypes occasionally thrown in as an attempt at humour, and these were the moments where the humour fell flat and it felt Edwards was trying too hard. On a couple of occasions, he tried to make jokes about women and shoes, and this irritated me rather than made me smile. I'm a woman, and I hate shoes.
Overall, however, it's a book that's easy to read in small doses and, if you can get past the moaning (bearing in mind he started writing as a way to vent stress after work), it is an interesting insider's look at the NHS.
I have mixed feelings about this book. At some points, it was funny, life-affirming and interesting; at others, it made me question why the hell I want to work for the National Health Service (NHS).
The fact is, Dr Nick Edwards complains way too much about the state of the NHS. Normally, I wouldn't mind that much - most of his complaints were valid, interesting and eye-opening. But the fact is, he repeated the same complaints over and over again. By the third or fourth time he mentioned the 'four hour rule', I wanted to shake him and tell him that I'd got it already. I didn't need it reiterated through another few anecdotes. (It didn't really help that the book was written in 2006, and some of the things he complained about have been sorted out - a point that is, thankfully, shown in the later-added epilogue at the end of the book.)
Once you get past the repetitive complaining, there are some genuinely interesting human stories here, and a real look at what it is like to work in A&E. Some of the stories were even humorous, though often I did feel that Edwards was trying a little too hard to be witty and sarcastic. One of my favourite anecdotes was about the old lady who came in with an orange up her vagina. Yes, really. Of course, not all of the anedotes were funny. A couple were tragic and one (about a stillborn baby) even made me cry.
This book really shows the highs and the lows of working in A&E - the banter, the troublesome patients, the success stories, the death and loss. It also shows the huge pressure that the government puts on doctors and other NHS staff to meet targets, meaning that patient care is compromised. It also shows the ways that NHS staff have found to get around these targets and restrictions.
One thing I didn't like was the gender stereotypes occasionally thrown in as an attempt at humour, and these were the moments where the humour fell flat and it felt Edwards was trying too hard. On a couple of occasions, he tried to make jokes about women and shoes, and this irritated me rather than made me smile. I'm a woman, and I hate shoes.
Overall, however, it's a book that's easy to read in small doses and, if you can get past the moaning (bearing in mind he started writing as a way to vent stress after work), it is an interesting insider's look at the NHS.
April 5, 2020
As much as I enjoy a good biography/true life book I don't think everyone needs to write one... and this is one that I honestly didn't enjoy.
I did honestly considering DNF'ing this at times because it was quite slow and boring. It felt very repetitive to me and it was clear that Dr Edwards had an axe to grind; which I completely understand, because working for the NHS must be completely shit at times but there was so much focus on the negative that it was bordering on painful to read. Some of the paragraphs are so long that I just had to skim read them because it was too much.
Don't get me wrong, there were definitely some interesting bits and I found some of the bits that focused on his patients really emotive and enjoyable, but there wasn't enough of this to offset the negative. I think if you read this as a series of blog posts over a few weeks it would bearable, but reading them all in one go just makes him seem like such a whiny person.
Also, he didn't seem that likeable to me. There are quite a lot of "italic" comments which are things that he writes in the book that didn't actually happen, which seem to solely centre around his inner desire to flirt with a bunch of nurses, wish that a nurse would pull him into a cupboard, and just general sexist and inappropriate comments about women, all whilst having a wife. It felt uncomfortable to read at times.
This isn't a book I could recommend and I honestly don't think it finds the balance between informative and humour at all in the book and just ends up being very whiny.
I did honestly considering DNF'ing this at times because it was quite slow and boring. It felt very repetitive to me and it was clear that Dr Edwards had an axe to grind; which I completely understand, because working for the NHS must be completely shit at times but there was so much focus on the negative that it was bordering on painful to read. Some of the paragraphs are so long that I just had to skim read them because it was too much.
Don't get me wrong, there were definitely some interesting bits and I found some of the bits that focused on his patients really emotive and enjoyable, but there wasn't enough of this to offset the negative. I think if you read this as a series of blog posts over a few weeks it would bearable, but reading them all in one go just makes him seem like such a whiny person.
Also, he didn't seem that likeable to me. There are quite a lot of "italic" comments which are things that he writes in the book that didn't actually happen, which seem to solely centre around his inner desire to flirt with a bunch of nurses, wish that a nurse would pull him into a cupboard, and just general sexist and inappropriate comments about women, all whilst having a wife. It felt uncomfortable to read at times.
This isn't a book I could recommend and I honestly don't think it finds the balance between informative and humour at all in the book and just ends up being very whiny.
March 9, 2022
An honest diary account of a doctor working in the nhs. This book is a few years old now so some of the current nhs rules would not apply to this book. At times it was sad, mainly in terms of volume of patients who are unknowingly under the constraints of the management of hospitals who have rules that just do not make sense and are not for the benefit of the patient. It was also quite inspirational when you realise what they have to face every day. There was though also quite a few funny things in the book. As it was in the form of a diary you could just pick the book up for a short time and not have to wait until the end of the chapter you were reading.
August 30, 2018
A decent stab at describing what it's like to work in Accident and Emergency. Touches on some of the main problems the NHS was facing ten years ago (and probably still is today). Some amusing anecdotes, but not as funny as the other one I read recently ("This is going to hurt", which was much more Carry On Doctor). The writing is a bit amateurish though, and it gets quite repetitive. And I really don't think this book was the place for the author to publicly complain about his wife refusing to have sex with him.
November 5, 2017
I always wanted to be a doctor growing up and so I thought this book would be an interesting read. It is a little dated but it’s amazing and a little sad how practically all of the issues detailed in the book are still issues. God bless the NHS but it seems like the politicians and the doughnuts who go there needlessly are working very hard to destroy it. I hope they don’t succeed.
August 22, 2018
Tries too hard to be funny. Fails.
If you're looking for a good book on the subject, Adam Kay's "This is Going to Hurt" is terrific.
If you're looking for a good book on the subject, Adam Kay's "This is Going to Hurt" is terrific.
February 25, 2023
I've had this book for years. I really enjoyed reading it the first time around (I can't even remember when that was).
A February 2023 re-read shows that nothing has changed since 2007 when this book was published! In fact, the NHS has slid further into the shitter! Things were bad enough pre-Covid; now they've deteriorated further.
Edwards is just one of many who've highlighted the issues with the failing, broken, bureaucratic, top- heavy NHS. His writing is nothing special and his stories can be replicated many times over. An average read. Off this goes in the name of bookshelf culling.
A February 2023 re-read shows that nothing has changed since 2007 when this book was published! In fact, the NHS has slid further into the shitter! Things were bad enough pre-Covid; now they've deteriorated further.
Edwards is just one of many who've highlighted the issues with the failing, broken, bureaucratic, top- heavy NHS. His writing is nothing special and his stories can be replicated many times over. An average read. Off this goes in the name of bookshelf culling.
January 10, 2021
A mixed bag - the medical interludes are extremely entertaining and the writing is excellent, but there's just too much political whining about NHS policy, inefficiency, govt targets and wasteful bureucracy.
Fair enough, those things may all be entirely true - but it doesn't make for an interesting read. It's like being hectored by a local politician.
I hugely enjoyed the medical side of things, but not the rest...
6/10
Fair enough, those things may all be entirely true - but it doesn't make for an interesting read. It's like being hectored by a local politician.
I hugely enjoyed the medical side of things, but not the rest...
6/10
October 6, 2021
2.5
If your looking for a book with real life health issues mixed with some humour, this isn't it. 90% of the book was complaining about the politicians and their changes to the NHS.
If your looking for a book with real life health issues mixed with some humour, this isn't it. 90% of the book was complaining about the politicians and their changes to the NHS.
November 18, 2025
Pretty much just a collection of rants. resonated with some ++
July 27, 2014
This was a very interesting read. It follows Dr. Nick Edwards as he works in A&E, and includes a lot of great stories. Some of them were funny enough to have me laughing out loud, and others gave a great insight into the NHS and the lives of medical staff and other people who work within the hospital.
The layout was good because it was episodic, in chapters that lasted one or two pages, and therefore it was easy to pick up and put down again, and the fast pace kept it constantly interesting. Dr. Edwards also had a clear voice and it was easy to see his personality shine through.
However, there were a few places I got frustrated in terms of writing style, especially when Dr. Edwards tried to make jokes (that were sometimes misogynistic). There were also one or two typos, but these didn't really bother me.
I actually didn't mind that there was a lot of ranting - it gave a good insight into what some of the issues are within the NHS (or at least were, back then) and the NHS culture - both good and bad. Overall it was an interesting read.
The layout was good because it was episodic, in chapters that lasted one or two pages, and therefore it was easy to pick up and put down again, and the fast pace kept it constantly interesting. Dr. Edwards also had a clear voice and it was easy to see his personality shine through.
However, there were a few places I got frustrated in terms of writing style, especially when Dr. Edwards tried to make jokes (that were sometimes misogynistic). There were also one or two typos, but these didn't really bother me.
I actually didn't mind that there was a lot of ranting - it gave a good insight into what some of the issues are within the NHS (or at least were, back then) and the NHS culture - both good and bad. Overall it was an interesting read.
February 19, 2012
A slightly interesting read into the real world of an A&E Doctor. However you can only take so much of Nick Edwards moaning and ranting without thinking that if he is that frustrated with the poor management & bureaucracy of the NHS then what is he trying to do personally to change it? For example there are no stories of him arguing with management only Nick Edwards raging on what the Government should be doing & how pathetic for example that money is wasted on new signs for the X-ray department that are now called 'Department of diagnostic imaging,' which confused his patients who end up getting lost.
Nevertheless it is an easy read & some of the tales do give you a brief insight into the world of the A&E dept.
Nevertheless it is an easy read & some of the tales do give you a brief insight into the world of the A&E dept.
October 31, 2012
Another on of those "memoirs" of someone in a specific job where, using short vignettes, they want to try and show the public what their job is really like. This one, written by an A&E doctor, was interesting, insightful and funny. Even when ranting (something he calls his hobby), Dr. Edwards doesn't come across as an angry shouty man, but someone who cares about his patients and the way management and the NHS make his job harder.
But please, someone, get this man a proofreader, stat! Mistakes such as a patient saying he had "overdosed on heroine" should not happen in a book that isn't self-published. Especially when this edition is a reissue of a book from 4 years ago where they've gone to the trouble of adding extra stories at the back.
But please, someone, get this man a proofreader, stat! Mistakes such as a patient saying he had "overdosed on heroine" should not happen in a book that isn't self-published. Especially when this edition is a reissue of a book from 4 years ago where they've gone to the trouble of adding extra stories at the back.
June 20, 2009
I generally like these kinds of books - I find the concept of an A&E doctor's life very interesting. But this guy, who wrote the book as a way to whinge and relieve his day-to-day stress without completely annoying his wife and colleagues, just ended up annoying me. I agree with him - the NHS is a mess today compared to what it was when it started 60 years ago, and it is and was a wonderful service in concept - but there is so much more to writing than complaining. It could have a been a fab book; instead, it was just dead dull and I put it down after 39 pages... Dr Edwards, get an editor!!!
April 20, 2012
I had hoped that this book would provide amusing, funny and good stories about life as an ER doctor. Although the author did address that there were issues with the NHS system, it was also mentioned that the books was meant to be light-hearted. Almost all of the stories were "okay" in content but the main point of the stories was almost always how and why the hospital system was faulty. I was disappointed.
October 22, 2017
'A note to all readers. The Man United comment was meant as a sarcastic joke. All NHS hospitals will see supporters of any football club. Don't worry... well, unless you support Chelsea - then you are on your own.'
February 28, 2009
Dr Edwards likes a good moan. And a rant. This book is basically him venting his spleen at the current state of the NHS with a few amusing anecdotes in between.
April 9, 2020
This book was another recommend to me by my nurse housemate. I absolutely loved it and read it in 2 days. It was so funny and I laughed aloud a lot. I also feel that I now have a much better understanding of how A&E works as well as how policy decisions can impact on the lives of doctors and the care of patients. The only reason I haven't given this book 5 stars is that it is quite out of date. It was originally published in 2007 and there are a lot of references to the government as it was then and the impact that their policies were having. Whilst this was really interesting, it is difficult to know how much of this is still relevant. I only wish I could have read this when it was first published. Despite this though, I would still 100% recommend this fabulous and funny book to anyone that asked me.
January 24, 2023
3.5 stars.
A good, dark, humorous and frustrating insight into the life of A and E. Nick made very valid points on how politics/the government have annihilated the NHS and makes good suggestions on how to improve practices but the points he made were very repetitive, and very very ranty. I enjoyed the medical stories and his sense of humour, I laughed out loud a number of times during the book so would still recommend reading it. Nick is upfront about the way he expresses his anger and frustration through venting and ranting, and a lot of it is completely warranted so you can't really begrudge him that, but boy did he bang on about it every other page.
This book is now 15 years old so bear that in mind too, a lot of the politics talk is referencing Blair's Labour government so it is a bit dated now having been under Tory rule since. But it was an interesting and informative read.
A good, dark, humorous and frustrating insight into the life of A and E. Nick made very valid points on how politics/the government have annihilated the NHS and makes good suggestions on how to improve practices but the points he made were very repetitive, and very very ranty. I enjoyed the medical stories and his sense of humour, I laughed out loud a number of times during the book so would still recommend reading it. Nick is upfront about the way he expresses his anger and frustration through venting and ranting, and a lot of it is completely warranted so you can't really begrudge him that, but boy did he bang on about it every other page.
This book is now 15 years old so bear that in mind too, a lot of the politics talk is referencing Blair's Labour government so it is a bit dated now having been under Tory rule since. But it was an interesting and informative read.
October 2, 2025
A reasonable memoir of time working in the NHS as an A&E doctor.
Some very amusing anecdotes, as you can imagine, which had me laughing, some political chapters around management of the NHS, although the author has his utopia of doctors and nurses actually being consulted in public policy within the NHS. I can’t see how/why a political party would do such a thing. Clearly it would be beneficial and he has some ideas that make perfect sense as ideas, but they would not be headline grabbers or vote winners which is unfortunately not hat politics is all about.
Nevertheless, nothing wrong with idealism. Credit due for a very readable and entertaining book. It’s a little dated now (I think from around 2008 originally) which shows in some descriptions of NHS, terminology etc but still worth a read.
Some very amusing anecdotes, as you can imagine, which had me laughing, some political chapters around management of the NHS, although the author has his utopia of doctors and nurses actually being consulted in public policy within the NHS. I can’t see how/why a political party would do such a thing. Clearly it would be beneficial and he has some ideas that make perfect sense as ideas, but they would not be headline grabbers or vote winners which is unfortunately not hat politics is all about.
Nevertheless, nothing wrong with idealism. Credit due for a very readable and entertaining book. It’s a little dated now (I think from around 2008 originally) which shows in some descriptions of NHS, terminology etc but still worth a read.
April 1, 2023
I love a medical memoir but was slightly put off by the negative reviews of this one. Many comments complained it was 'moany'. I suppose it was but you don't have to be a doctor to be aware of the problems NHS staff face on a daily basis so I feel a non fiction book about working in the NHS would not be painting an accurate picture if it did not feature these problems. I actually enjoyed the parts where DR Edwards explained how things are currently run and how they could be better as I found them very informative. I read the updated copy with the preface explaining that this was written a while ago and there have now been some significant changes which I think was important to know. Overall I really enjoyed this and would recommend to anyone who enjoyed Adam Kay's 'This will hurt'.
October 18, 2025
An AE doctor who clearly has a passion for hating on the government and their ridiculous policies, whilst maintaining a positive attitude towards the NHS. A book of slagging off the government, I vibe with that.
January 19, 2020
Funny, sad and enlightening. Nicely written and well worth reading.
February 11, 2021
Eye opening
This book is a rollercoaster , funny, sad and eye opening in equal measure and I thankyou the author for sharing it.
This book is a rollercoaster , funny, sad and eye opening in equal measure and I thankyou the author for sharing it.
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