This is Going to Hurt: Why Our Gory Details Divide the Dinner Table

Exploring the non-medics’ love-hate relationship with hospital stories

There’s a sketch in the BBC documentary “This is Going to Hurt” where Adam Kay and his partner attend dinner at the high-end home of his old-time friend Greg and Greg’s partner Emma. The last thing anyone needs straight from a gruelling shift is to be confronted with shallow conversation like whether Barbados is a good option at Christmas, but Adam is forced to do exactly that. In an attempt to change the conversation, however, Adam is asked to recall a patient he encountered who ended up having a degloving injury of his penis as he slid down a lamppost…

What sticks out in this scene is the reaction of his friend Greg, who asked further about the unfortunate state of the penis, to the dismay of Emma. “Gregory, enough”, put an end to that conversation.

The Dichotomy of Medic Tales

This dichotomy of how engaged and interested non-medics are in hearing medical tales is an interesting one. Some love nothing more than to hear the intricacies about what goes on behind the hospital’s walls. They ask questions, they are enticed by the gory details and add humour to unfortunate scenarios. The Gregs of the world enjoy consuming these medical stories as a form of low-stakes entertainment that they can turn off whenever they like and get on with their lives, detached from the burdensome realities of being a doctor.

Admit it, sometimes there’s a part of us that enjoys the role of being the storyteller. Some may call it a nice way of unloading trauma, but it’s a pretty easy way to get a crowd listening. Say whatever you want about medicine, but it creates an environment that is rife with story-worthy moments.

Then there’s the “Emma” reaction. The individual who wants little to do with the unpolished realities of medicine. These aspects of medicine aren’t for everyone, and that is perfectly fine. Indeed, many doctors picked their specialities based on the idea that the gruesome or perhaps, emotionally challenging aspects of medicine weren’t for them. But to wince at the mere prospect of the topic being raised is perhaps peculiar.

Some members of the public may want doctors to carry the weight of human suffering and emotional challenges all day, and then “sanitise” themselves before they enter a living room dinner party. But perhaps, there is something of value for the average member of the public in sometimes hearing these stories, which allow for a more well-rounded understanding of reality, and perhaps a more interesting dinner party.

Doctor, You Don’t Know… and it’s Okay

If you have a genuine thirst for knowledge, few professions offer more than medicine. It is worth contemplating just how far our clinical understanding has evolved. Dr Ranjana Srivastava recalls the HIV wards of her training, once filled with the "graphically ill", which have now almost ceased to exist in the developed world. Oncologists were once armed with very few successful therapies, and greater specialisation has allowed for outcomes that were once deemed impossible.

Yet, despite these leaps, much remains unknown. How does it feel to acknowledge that there is so much about our own specialities that we cannot yet answer?

What do some of these gaps look like? They can take the form of prognosis-related questions: “Doctor, will my ability to walk return to normal after the surgery?” Sometimes these questions are based on the unstudied: “What are the long-term effects of this new drug decades from now?” Or how about questions pertaining to the highly specific: “If I smoke in the house, but only when my child is away, will they still develop asthma?”

It’s not easy in a profession that is supposed to cultivate confidence in its patients, but not knowing should be expected. The philosopher Alain de Botton suggests that acknowledging one’s ignorance is the root of sophisticated thinking. You can possess all the data in the world, but medicine remains riddled with uncertainty, and patients will always continue to defy our predictions.

The Infantilised Patient: Why “Simple Language” Isn’t Always Better

Why terms like “Naughty cells” risk making patients feel like children

How doctors decide to explain medical issues to their patients is not an exact science. We all take different approaches in our pursuit to convey information accurately and succinctly to our patients.

There is a particular type of doctor, however, whose weapon of rhetorical choice is to explain medical issues in a manner designed for your average ten-year-old. We have long had it ingrained in us not to use medical jargon, and of course, this is a noble pursuit. But on a daily basis, we interact with patients of all educational attainments and also interests in medicine and a desire to know what is going on in their health.

So are we in danger of creating a culture that infantilises patients and makes them leave the conversation and tell their next-door neighbour about their “patronising” encounter with the doctor? We know that the best doctors mould their information-giving style based on the information and cues they receive through the consultation. The best doctors may even ask their patients, “What would you like to know today?” 

The Anti-Jargon Movement

In recent years, there has been a move to “humanise” medicine, and it is believed that the way to do this is to use so-called “simple language”. The mere mention of complex words like neoplasm immediately spells medical heresy and a failed OSCE station. This makes perfect sense, but this culture can easily begin to expand and encapsulate more and more words.

Reading through our old OSCE feedback provided some examples. One of the On-Call team was marked down for using the word “radiate”. Really? Is this really a term that would get the general population in a state of confusion? Have we reached a point where we’re terrified a patient will hear “radiating pain” and believe they are turning into the second coming of King Kong?

In fact, this issue seems to be more prevalent than you think. If you spend any time on online forums (which we wouldn’t recommend) or reading newspaper opinion columns, you will find countless well-educated, articulate and professional people on the receiving end of language that is fit for an astute primary school child. One cringeworthy example included a doctor explaining what chemotherapy might do to the “naughty cells” in the body.

One of the hardest skills a doctor needs to cultivate is how to convey information to patients. Is it always possible to do this without offence or coming across as patronising? No. But maybe we need to remember that a uniform way of talking to patients (especially through the mandatory use of "simple language") doesn’t actually exist.

“Should it really take Consultant doctors 14 years of work as a consultant to reach the top of the pay scale?”

“CT1 who is coming to the end of the first year of an orthopaedics-themed rotation. Obviously, I have long known about orthobullets as an avid lover of the bones since medical school, but I am genuinely surprised at how much I have relied on it and learned from it since beginning my ortho rotations. Unbelievable resource.”

“I’ll be honest, I do love HouseMD, but when re-watching, I find it so hard to look past about three people running an entire hospital doing their own labs, operating lists and diagnostic work.”

“I felt like my clinical knowledge was lacking, and just biting the bullet and signing myself up for the MRCP Part 1 exam forced me to revise and cover the gaps in my knowledge. To be honest, it wasn't until I sat the exam that feelings of incompetence went away.”

“Allow me to nerd out for a moment and keep your steroid jokes to yourselves for a minute. What I love about neuro is how much can be diagnosed from a good clinical exam alone.”

What’s on your mind? Email us!

Some things to review when you’re off the ward…

Too many patients are still turning up to clinic appointments clutching their post-it notes of facts about their condition and health to tell their Consultant. A 2025 study from Healthwatch England revealed 23% of patients reported inaccuracies in their NHS medical records. This account in The Guardian talks about alternatives to this current unfortunate predicament for patients.

University Hospitals Sussex has introduced body cameras and knife amnesty bins after a BBC report found that staff had experienced nearly 2000 incidents of verbal and physical abuse in the past year. It’s the sort of article that makes one wince, with anonymous reports recalling patients who had “threatened to slit my throat”. The number of physical attacks on NHS staff is at a three-year high. Here is the full report from the BBC.

Weekly Poll

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To compensate for a prolonged journey to consultancy, should longer training pathways be compensated with higher starting salaries?

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Patients Hate the Unknown More Than the Wait

At some point in our lives, we have all found ourselves in an NHS waiting room surrounded by the collective sighs of patients whose names are yet to be called. As doctors nervously prepare to call in the patient who has faced a long wait, they generally believe that longer waits automatically correlate with a poor patient experience.

But research advises us to consider a more nuanced equation: That value and certainty often trump speed. Here’s the truth: patients sit down expecting to face a wait. Their ‘willingness’ to wait beyond that arbitrary idea of an expected timeframe is directly proportional to the perceived value of that consultation. For your most anxious and concerned patients, the reassurance of the doctor is completely worth the protracted wait.

Human beings are tolerant of delays, provided they aren’t infinite. We don’t mind the wait, but we do mind the unknown. Uber makes us feel in control as we see the little car moving towards us on the map. In the NHS, that “map” is often blank. The most effective clinics try to remove uncertainty by informing patients if there is going to be a longer wait, sometimes even estimating how long the wait is going to be.