Finalist #9 in the Book Review Contest [This is one of the finalists in the 2026 book review contest, written by an ACX reader who will remain anonymous until after voting is done. I'll be posting about one of these a week for several months. When you've read them all, I'll ask you to vote for a favorite, so remember which ones you liked] (An adversarial book review) I. "Tuesday, 5 July 2005. Trying to work out a seventy-year-old lady's alcohol consumption to record in the notes. I've established that wine is her poison. Me: 'And how much wine do you drink per day, would you say?' Patient: 'About three bottles on a good day.' Me: 'OK . . . And on a bad day?' Patient: 'On a bad day I only manage one." A: The first faces I ever saw in this world were three sweaty, anxious obstetricians, and one of them was holding the rest of me. My father had been the senior surgeon on the Caesarean section. The patient on the table was my mother, who is also a gynaecologist. He was assisted by my paternal grandfather, who is also a gynaecologist. My maternal grandmother, who is also a gynaecologist, was outside in the corridor doing crowd control, partly because of her people skills and mostly because the operating theatre had run out of space for elbows. I was extracted from the uterus, given the customary slap on the rump, performed the customary screaming, and resolved on the spot, somewhere below the level of conscious memory, to give the speciality a hard pass. The first impression had been bad. I am, today, a psychiatry resident in the UK's National Health Service (NHS). I came to this through a sequence of choices that involved, at various points, an Indian medical internship, the discovery that I am fond of sleep and a predictable evening meal, and a gynaecology rotation that confirmed every prejudice the Caesarean had instilled. My family is very slightly disappointed. They are quite possibly correct. I tell you this not to establish my credentials as such, but because Adam Kay's This Is Going To Hurt is a book about obstetrics and gynaecology, alongside an unusually clearly documented decline in mental health, and reviewing it without naming where I'm reading it from would be a small dishonesty. The speciality is in my blood, more or less literally. The system Kay is describing is the one I currently work inside. The condition he is describing in himself, although he doesn't quite name it, is one I have seen up close in colleagues and, on at least one bad stretch, in myself. I will let my older, wiser, and possibly more handsome colleague take over: https://www.astralcodexten.com/p/your-book-review-this-is-going-to
