Instant Genius - Adam Kay: Is Christmas really the most wonderful time of the year on labour ward?

Episode Date: December 19, 2019

If you’re stuffing your face with mince pies this Christmas Day, spare a thought for the hundreds of thousands of people working in the NHS providing vital medical support over the festive period. One person who has seen his fair share of Christmas shifts is comedian and writer Adam Kay, who in a previous life worked as a junior doctor. His new book, Twas the Nightshift before Christmas (£9.99, Harper Collins), is at times, a graphically intimate diary of what happens on a labour ward over the holidays. Our editorial assistant Amy Barrett spoke to Adam over the phone about whether Christmas is more dangerous than other seasons, some of the issues facing healthcare at this time of the year, and life after medicine. Subscribe to the Science Focus Podcast on these services: Acast, iTunes, Stitcher, RSS, Overcast Let us know what you think of the episode with a review or a comment wherever you listen to your podcasts. Listen to more episodes of the Science Focus Podcast: Dean Burnett: What’s going on in the teenage brain? Sarah Harper: What does a world with an ageing population look like? Andrew Hunter Murray and Dan Schreiber: Is there really no such thing as a fish? Matt Parker: What happens when maths goes horribly, horribly wrong? Robin Ince: Inside the mind of a comedian Dara Ó Briain: Finding the fun in science Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

You said this place was steps from the water. We just haven't found the steps yet. How much did we save? Enough. Enough to get lost! Or you could book a stay with Hilton. Welcome to your oceanfront room. Just steps from the water.

The Hilton sale is on now. Book on Hilton.com or the Hilton app and save up to 20% to get the stay you expected. When you want savings, not surprises. It matters where you stay. Hilton, for the stay. You're great at protecting your data, but lots of places could still expose you to identity theft. I thought it was safe.

If that happens, LifeLock gives you a U.S.-based restoration agent who will stick by your side from start to finish. Phone calls, filing documentation, preparing insurance claims, your agent handles it all. In fact, we're so confident restoration is guaranteed. Pour your money back. Isn't it nice to have someone like that on your side? Save up to 40% your first year at LifeLock.com slash Spotify. Terms apply. When you need to build up your team to handle the growing chaos at work, use Indeed

sponsored jobs. It gives your job posts the boost it needs to be seen and helps reach people with the right skills, certifications, and more. Spend less time searching and more time actually interviewing candidates who check all your boxes. Listeners of this show will get a $75 sponsored job credit at Indeed.com slash podcast. That's Indeed.com slash podcast. Terms and conditions apply. Need a hiring hero? This is a job for Indeed sponsored jobs. This podcast is sponsored by name, audio and focal. Streaming has made music more accessible than ever, but true listening is about more than ease.

It's about quality. British audio experts name audio, alongside French acoustic specialist focal, combine handcrafted tradition with cutting-edge innovation and high-end materials, delivering digital precision with analogue warmth. So you can experience exceptional sound at home. Music just as the artist intended. Visit name audio.com to learn more.

Working over Christmas, you know, and there's a lot more food on the wards and, you know, in the radio blasting out, slayed. But at the same time, when things do go wrong, and unfortunately it's a hospital, so they do, the tragedy is sort of magnified against this backdrop of geology. You're listening to the Science Focus podcast

from the BBC Science Focus, magazine team. With the UK's best-selling science and technology monthly, available in print and in several digital formats throughout the world, find out more at sciencefocus.com, we'll look out for us in your app store. Happy Christmas, everyone. I'm Alexander McNamara, online editor at BBC Science Focus. If, like me, you'll be stuffing your face with mince pies this Christmas day, spare a thought for the hundreds of thousands of people working in the NHS providing vital medical support over the festive period. One person who has seen as fair share of Christmas shifts is comedian and writer Adam K, who in a previous life worked as a junior doctor. His new book, Twas the Night Shift Before Christmas,

is at times a graphically intimate diary of what happens on a labour ward over the holidays. Our editorial assistant Amy Barrett spoke to Adam over the phone about whether Christmas is more dangerous than other seasons, some of the issues facing healthcare at this time of year, and life after medicine. So is it that Christmas is a more dangerous? time than any other time of year? That's a good question. A lot of things are different at Christmas. There are no more babies born at Christmas

than other times of the year, you know, because babies don't really, they don't have a calendar they don't particularly care whether it's the 20th of December or the 20th of March. But there are no fewer babies born. So, you know, you end up, you have to staff a labour ward exactly the same, hence why I ended up working quite so many. Other parts of the hospital get a lot

easier. So we all know about the winter health crisis. There's lots more bugs going around, and there's more ice on the ground, so everyone can clatter to the floor and break their bones. but one thing that is different is that people's spirits are a lot higher. It isn't, I didn't hate working at Christmas. I just thought it had a rather, you know, spent it at home, but it is quite fun being there over Christmas and, yeah, luckily a few funny things happened along the way. And what is it actually like working sort of at Christmas on Christmas Day?

What's the atmosphere like? it's often it's a very difficult question because it's often very jolly working over working over Christmas you know and there's you know there's a lot more food

on the ward and you know in the radio blasting out slayed and and it can feel like a sort of home from home atmosphere but at the same time when things do go wrong

and unfortunately it's a hospital so they do the tragedy is sort of magnified against this backdrop of geology. So it's quite a difficult question to answer. It can be extremely fun working at Christmas. It can be so busy that you don't even notice it's Christmas. And things can happen that are so sad

and made all the more tragic for the time of year. I guess breaking bad news is never easy, but it must be so much harder during the holidays. It is, you know, like the song, said, you know, simply having a wonderful Christmas time. That's what you're meant to be doing. And not everyone does, hence there are hundreds of thousands of staff working in hospitals over Christmas just in place you need them and you hopefully don't, but sometimes you, sometimes you do. And, yes, it can be a very bad place to work. And for other reasons,

there's this thing that I don't know how well known it is, the concept of granny dumping, which is what families do over Christmas, sort of imagine some sort of medical complaint in their elderly parents and leave them in A&E so they can get gone with having a week or so family time at home without their older, Absolutely. It's heartbreaking. But it happens and it's sort of lots of people left on the wood. And, you know, it's a miserable place to be a lot of the time if you're a, if you're a patient.

Absolutely. Obviously. And how many Christmases did you end up working and how did you end up doing so many of them? So on seven Christmases, I was qualified as a doctor, I worked for six of them. And it was a combination of factors, really. So, first of all, I didn't and don't have kids. And quite reasonably, the people who've got kids, oh know, rise to the top of the tree in terms of whether they should be excused, you know, during Christmas Day itself on the, on the on the rotor and by the way um

you know if you don't do christmas day you will end up doing that night or boxing day or new year's east there's a lot of shifts to cover but christmas there itself i ended up working a lot of because because not having kids um i'm technically Jewish I'm not very Jewish uh but uh apparently I'm quite Jewish enough to not uh to apparently not mind if I'm working uh working at Christmas Day um And also there's this annoying fact that you work, move as a junior doctor, by that to mean a doctor who represents, hospitals who's below the grant of consultant. So basically, the vast majority of doctors are apparently known as junior doctors,

whether they can be in their 40s with multiple postgraduate qualifications and degrees. And they are the experts you see in clinic, but they're still technically a junior doctor. So every year as a junior doctor, you move hospital. And so every single Christmas I worked was in a different hospital. And I couldn't really ever say, oh, no, but I worked last year. He said, I'd be like, and it wasn't here. It's like saying you don't want to buy the first round of drinks because you bought the last round in a different pub with a different group of friends.

It doesn't really come into it. So it's this sort of perfect storm of factors that Mentai ended up. up working quite a few Christmases. And did you mind? Just, medicine has, has a big effect on your life, and your ability to have a work-life balance.

And it ends up just being your normal. So actually, working Christmases is a lot less disruptive to your life than the fact that you're often losing work late. because if there's an emergency, there's no slack in the system, no one's going to take over from you if it's five o'clock. So, you know, you stay an extra couple of hours, because, of course you do, because, you know, who else is going to do it. And you're always texting people to cancel long arrangements.

And so your social circle contracts because you quickly become the flaky friends, the person who's always bailing last minute. And then you're moving out once a year because you're, I'm just talking about moving hospitals. These are not hospitals that are three roads down from each other. You get randomly scattered within large areas of the country. So things like that.

So it's difficult to maintain relationships. And so missing Christmases just is one piece of a slightly depressing jigsaw by which medicine takes a bit of a toll on your life, but it's the job you signed up for and it's, you know, you're accepted. And, you know, your first book ended in tragedy, which led to you leaving medicine. Would you ever be tempted to go back? I think about this a lot.

So I basically chose a specialty in the protectics and gynaecology that the bad days at work were too tough for me to do with. The height of the highs, because the highs are so high, you know, living babies, you know, you end up twice a number of patients you start with, which is a great batting average in any medical specialty, but set off by the depth of the lows when, you know, all you have wanted to a healthy mum and healthy baby, and that's not always the case. And I chose the wrong specialty, I think.

I don't think we're honest enough as a profession about the fact that that, that, I don't, things do happen. But they do, and I hadn't really thought it through, and I couldn't really deal with it when it actually happened to me. I think I would be making a mistake if I went back onto Labour Ward. That said, I do really miss it. I miss the reason that I went into the job in the first place, which is, you know, it sounds pathetic, but it's true, and it's what motivates every healthcare professional on it to help people. And I've,

for the last couple of years since my first book came out, I'm aware that I've been able to make a bit of a difference on the, on the outside, but I know I could do more. And when the writings calm down a bit, and, you know, I'm no longer slaving for the month as a writer. which happens to all rights, obviously, I do want to go back and I don't know if it's in terms of policy,

and I don't know if it's in terms of teaching medical students or junior doctors, but I do miss it, and I do want to do want to do something, but I've probably done my last Tussaria. I read earlier that the NHS in England is short of almost 10,000 medics. What would you say to those considering studying for a medical performance? profession? So I think the numbers are worse even than that. It's over 10,000 doctors and it's actually over 100,000 members of staff in total across NHS employees. I think it's something like

11% of the workforce is currently a vacancy. So it's a big, big, big problem. There's a crisis in recruitment and there's a crisis in retention. That said, and the answer to that is money, as you can probably guess, what do I say to people thinking about doing medicine? I say that it's the most wonderful job in the world, and it's the most rewarding job in the world, and there's honestly nothing like it. but I also say that it's a job to go into with both of your eyes wide open. I get the occasional email from someone on Instagram message or whatever,

saying my daughter was going to do medicine, my son was going to do medicine, and my grandchild was going to do medicine, they read your book and now they don't want to. And the answer to the reply to that is good, because if you're going to be put off by that book, you will definitely be put off by the actual job. And it's important to know what the job is before you go into it rather than after than Aster. And I think that, you know, my book should be a set text for people who want to do medicine and not just for financial reasons.

Just because you do need to know it getting into or any book like mine. So that's what I say to people who want to do medicine. make sure you know what you're getting yourself into. And then once you're qualified as a doctor, choose carefully the specialty you want to go into. Because I chose this high-octane one, which I think was ultimately not the right decision for me because I hadn't thought it through.

If I'd have chosen, you know, I'm talking about the highs and the lows, if I'd have chosen a flatter sine weight, because there will always be lows, it's never totally flat, there's no branch of medicine, can't have the bad days by the nature of the job. If I'd have chosen a gent for sign wave,

I think I would probably still be in it. So that's something else that's worth saying to them. And the other thing to people going into medicine is to remember that everyone struggles. I get a lot of messages from doctors saying they thought they were the first doctor who'd ever cried in a locker room, who'd ever felt like they couldn't cope.

I talk fairly openly about my struggles I had with the difficult bits. And that's something that's not actually really spoken about. And that's a cultural thing. There's a cultural thing that needs to change. And the only way you can change a cultural thing is from the ground up. And that is from medical students. and medical schools need to get better at teaching psychological preparedness. You know, the best part of 20 years ago now,

when I first went to medical schools as a fresher, they were starting to bring in communication skills as part of medical school teaching, which is very strange because you think that it's always been a cornerstone as medical school teaching, but it happens. And it had to have a first year, I was on the first years where they taught it. And there's a lot of resistance from people saying who don't need to teach communication skills,

you know, the old guard of people. Some medical, and now it's the core mistake of medical teaching. Some medical schools now are starting to teach resilience to calling it, which I don't think it's quite the right word, but psychological preparedness. And it's meeting resistance from similar people saying, nonsense you don't need to teach that but you do need to teach that and hopefully in 20 years time it will seem absolutely absurd that there was any resistance to teaching that but you need to

have coping mechanisms for for when the when the bad stuff happens and in the absence of the NHS as a system providing it to you you just you need to have stuff in in place for yourself and I I didn't And in fact, the reason I wrote down all of these funny stories was my coping mechanism, looking for the shards of light amongst the dark. Are there any similarities between what you do now and working as a junior doctor? That's an interesting question. I think once you've been a junior doctor, the big difference, what you do in the future is that the state,

for basically zero. So I can feel stressed about all these writing deadlines I've got about how am I possibly going to fit in, you know, am I going to make it to this, delivering this lecture after I've flown back from this conference or whatever it says? But ultimately, none of it really matters. Once you've literally been on the life and death, you know, environment of labour ward. So there are still pressures

on me but ultimately if I have a bad day at work now type off the ball deliver a rubbish article to a terrible interview you know people who think less of me

or sell less of your books but ultimately it doesn't matter everything's fine the world keeps on turning and no one's died and you know lots of people say in their jobs you know no one died and it's true and in my job now no one died I wonder what do you think the most common sort of misconception about working as a junior

doctor or in the NHS is amongst the general public that's interesting I think that a lot of people forget that their doctors are human and you don't want to do that you don't want to to think of your doctors being too human because humans make mistakes. And you don't want to be doctors to make mistakes, we just assume that they're not really human. But humans also have lives and they get sick and they get sad. And I think people forget that. I was, I remember doing this anti-natal clinics that ran. really, really late every week.

I did it for a year, for 50-odd clinics. And every single time there was the mismatch, traditional mismatch of number of staff and number of patients, and I'd be apologising to people at 7.30 who were meant to be seen at 4.30.

And they'd be quite reasonably cross or upset because, you know, the problems of cherelle with care and, you know, the parking is all mucked up or whatever, and I would apologize. And not once in those 50-ish clinics did a patient ever say to me,

you probably don't want to be here either, do you? And I didn't. But you know, you don't really think of, as your doctors and your nurses and your midwives quite like that. But, you know, at Christmas, there will be hundreds of thousands of people working, you know, on Christmas Day in the NHS.

Yes, they're your insurance policy, you know, in case, and we hope it doesn't happen, but lots of people will need to go to hospital on Christmas Day, whether it's to deliver their baby or whether it's something a lot less, you know, joyful because, you know, no part of your body is aware it is. It's Christmas. And, you know, it's a time of, time of, time of, where it's important to reflect and we all do that and we think about the year ahead. But I also think it's worth also remembering the people who are at hospital who we hope we don't

get to see. But we do rely on if we do. And from that perspective, what sort of five things would you advise people avoid doing at Christmas time or maybe be aware of at Christmas to prevent maybe that visit to the doctor? That's a good question. most of the things that I saw were unpreventable by going into labour it's actually much more important

to remember to seek medical attention don't you know don't put things off because because you're worried there won't be the doctors there or even worse you don't want to bother the hospital that's what they're there for So, you know, the same rules apply if you have any worrying symptoms.

Don't wait for it to settle down until after Boxing Day, do, you know, do still go in if you need to. You know, sensible precautions, you know, don't drink too much. Definitely don't drink and drive. Those are things that happen a huge amount. be aware that it's likely to be slippy on the pavements and, you know, things, things like that. The one thing that everyone can do, obviously, stop sticking stuff inside yourself. I know you've got a lot more time on your hand because you've got a week off, and I know there's a lot of alcohol sloshing around everywhere, but that's, I mean, that is an unnecessary use of NHS to.

it does make for good anecdotes of hopefully the occasional funny entry in a book. But that's one thing that's basically an act if you do. Finally, how will you be spending this Christmas? I think I will be spending it on holiday. I've not worked it out yet, but I'm still not, talked a bit about work like Alice. I'm still not great at taking holidays. because I'm now freelance, that means blocking off a bit of time.

Every time we've blocked a bit of time, then something interesting will come in during the time I've blocked off, and I'll keep canceling it and cancelling it. And my partner works in Telly, which is another similarly chaotic lifestyle. And I think we've worked out that over the next six months, the only block of 10 days, or a week even, that we've got without any work in over Christmas. So much as it will involve neglecting both of our families,

I think we might just disappear off to a cottage somewhere and just come at the holiday. That was Adam Kay, who is hopefully enjoying himself somewhere relaxing in the countryside by now. His new book is called Twas the Night Shift Before Christmas, which is available to buy now. Continuing the Christmas theme, next week we talk to Hannah Fry,

this year's host of the annual Royal Society Christmas Lectures about all the ways maths affects your daily life. We also have a very festive Christmas issue of BBC Science Focus magazine where we explore some of the most far-out theories that will be doing the scientific round in 2020. As ever, there is loads more inside and feel free to send us a few festive messages by leaving us a review or rating wherever you listen to your podcasts.

And until next time, have a happy Christmas from all of us. Thank you for listening to the Science Focus podcast from the BBC Science Focus magazine team. With the UK's best-selling science and technology monthly, available in print and in several digital formats throughout the world. Find out more at sciencefocus.com or look out for us in your app store. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal.

Name audio believes you can have digital precision with analog warmth. Alongside French acoustic specialist vocal, Name creates high-end audio systems combining innovation with craftsmanship so you can listen to music, just as the artist intended. Discover more at nameaio.com. Ambition comes in all shapes and sizes.

At First Citizens Bank, we roll with your goals because we're built for what you're building. Fit for your ambition for Citizens Bank. In a place like Los Angeles, people don't stop being who they are. Writers, thinkers, creators, people with stories still unfolding. That spirit lives on at Kingsley Manor, a community shaped by individuality, creativity, and lives well lived. So when the conversation turns to what's next, it isn't about stepping away. It's about continuing the story. Explore your options at kingsley manor.org, a non-profit

month-to-month senior community within the Front Porch family.