This Is Going to Hurt: While the Docs At The Pitt Go To Therapy... They Get Tough Love at the NHS

November 2025

 

HBO had The Pitt...

Netflix has This Is Going To Hurt...

 

And there are common themes in these two medical dramas...

Set in two countries separated by an ocean...

 

But more on that later...

 

Now The Pitt was mainly concerned with American politics and how it impacts health-care policy...

Which are the current obsessions of American showrunners...

So the stories center on abortion access, mass casualty gun violence, sex trafficking, homelessness, and medical misinformation....

Because the producers don’t just want to have a successful series...

They want to think they were influencing politics by mobilizing public opinion...

 

In contrast, This Is Going To Hurt has a very British feel...

 

Which, of course, means the Brits mostly just deal...

So you don’t get the sense that their filmmakers think they can change anything the government does...

By making a tv show....

 

Because working in a single-payer system will do that to you...

 

Now the main character in This Is Going To Hurt...

Is Adam... one of those very British misanthropes...

Possessed of keen intelligence and a scathing wit...

With just a wee bit of that class prejudice that is still so English...

 

And which surfaces every now and then...

 

Such as when he corrects the grammar of Ms. Houghton...

 

The hard-drinking, chain-smoking, food-loving senior physician at his hospital...

Who is not only his superior, but an excellent surgeon...

 

But she didn’t go to the right schools...

And so talks like where she came from...

 

Which means when she references the Duke of Bedford...

Unlike Adam, who might actually know him...

She is talking about the pub where her dad played darts...

 

And when Adam’s lovely Irish boyfriend from a fun, but definitely down-market, family....

Gives him a ring made out of a penny...

Adam is clearly put off...

 

But it is when he dismisses the complaints of a working-class patient...

Because she is clearly a ditz...

The results become disastrous...

An upend his life...

 

And that happens because Adam, despite his off-putting demeanor...

 

And he is truly awful to everyone...

 

Actually cares about his patients... a lot

 

As do most...

 

But not all...

 

Of the doctors at his NHS hospital...

 

Because there are the ones who don’t show up for work...

Forcing those like Adam to work double shifts...

 

And if this series is accurate...

Which it likely is because it was written by a doc in this system...

 

Then doctors not showing up for their shifts is a recurring problem...

 

And there are the specialists who complain when they are called...

And report a poor intern to her superiors for calling them for help...

 

Seriously?

 

Or even worse...just simply refuse to see a patient...

 

So this might have something to do with those years-long waiting lists at the NHS....

 

And that recent government report that talked about how senior staff at the NHS...

Were too slow providing care in a crisis...

 

And the NHS does look like a terrible place to work...

It’s run down, understaffed, and under resourced....

 

Although I find it hard to believe they were really going to let a woman with an ectopic pregnancy

Sit overnight...

Because supposedly at the NHS....

You can’t get a scan on the weekends....

 

But if you really don’t have enough money to keep the lights on...

 

Why are you wasting it on water bath birthing rooms?

 

Especially since there have been so many scandals about the NHS hospitals...

That have involved neglected patients, some of whom were actually starved...

Dirty rooms.. and unexpectedly high mortality...

Especially in OB...

 

But in This Is Going To Hurt...

The OB docs are heroes...

Who are saving lives every day with their awesome obstetrical proficiency...

 

And I will give this series credit for educating its audience about the risk to lives associated with shoulder dystocia or an ectopic pregnancy...

 

And how fast a woman can bleed to death after giving birth...

Which is something truly frightening if you have ever seen it...

 

So this series is not the version of obstetrics...

That is all about handing warm cooing just born babies to their grateful mothers...

 

Because there is little that is glamorous about what Adam does ...

In fact, a lot of what he encounters is full of blood... lots of blood... and other body fluids...

Most of which gets sprayed on his scrubs...

 

While he spends most of his day like a miner with head lamp...

Between women’s legs...

Sometimes encountering some pretty gross things...

 

Because some people just get weird...

And docs get to see a lot of that...

 

So This Is Going To Hurt is very real...

 

Now that doesn’t mean there aren’t stereotypes at play in this series...

 

The white patients are racists...

Or know-it-all demanding mothers obsessed with eating the placenta...

 

There are horrible husbands who should be banished from the birthing room...

Especially when they get drunk and pee on the wall...

 

But, of course, they are always white working class....

 

Cranky racist old ladies...also white....

 

Nasty back-biting colleagues... who do come in all colors...

And a white trainee who assumes a South Asian female physician is a nurse...

 

Of course....

 

And there are also the woke consultants hired by administrators far removed from patient care......

Who waste the overworked staff’s time teaching them to use the “correct” labels...

 

And then there is the private hospital...

Where Adam moonlights...

Which is everything the NHS isn’t... and more...

With birthing rooms that are more like a five-star hotel

Serving asparagus risotto along with your epidural...

 

Except they seem not to have some important meds for when the shit gets real...

 

Which I doubt...

 

Although it is true they are mostly birthing centers with well-dressed staff...

And when things really do go south...

You will end up at the NHS...

 

And as Adam tells his posh friend...

You will want to be there if something bad happens...

 

Because despite their problems...

The big public hospitals... on both sides of the pond...

Are where you want to be in a crisis...

Because their staff is used to dealing with the worst cases...

 

And believe me ...that matters...a lot

 

But this series is more than a window into what is bad and good about the NHS...

Which as bad as the health-care system is currently in the US...

Where the Affordable Care Act made sure health insurance was unaffordable....

And the Private Equity sharks are making things even worse...

 

Which means we are all learning the hard way....

That having health insurance is not the same thing as having access to health

care...

 

But if you can actually get into the hospital in the US... most of the time the care is good...

And they won’t starve you if they think you are too old and disabled...

Which is what happened at the NHS...

 

So our screwed up system is better than the Brit’s...

 

But the young docs in both systems are currently suffering from a similar problem...

And this is where This Is Going To Hurt and The Pitt...

Tap into a common theme...

 

Which is that this current generation seems unable to handle the stress of being a doctor...

 

And specifically in This Is Going To Hurt....

The emotional toll that comes with OB...

 

So both Adam and Shurti, the woman physician he is mentoring ...

Struggle with this...

 

But Shurti’s case is complicated...

Because she seems particularly ill-suited for OB...

Even though she is technically proficient...

Because her bedside manner is absolutely awful....

 

So this is not the specialty for her...

Because OB involves a lot of hand-holding and reassuring...

Which she just does not have the personality for...

 

So I kept wishing someone would tell her to go into neurosurgery...

Where the patients are often comatose...

 

But Adam loves his job...

And is good at it...

But suffers greatly when things go bad...

 

But one of the facts of life of practicing medicine...

Is that mistakes will be made...by everyone ...

 

And so in this series ...

 

The older doctors tell their junior colleagues...

You will feel bad about your mistakes...

But you can’t function in this profession if you can’t get back up, dust yourself off, and get on with it...

 

In other words...

 

Keep Calm and Carry On...

 

So the crusty Ms. Houghton tells a junior doctor that there is a box load of dead babies that were her fault...

And that is what comes with this job...

No matter how hard you try... or how good you are...

 

And if you can’t handle that... then you should get out of this profession...

 

And that is where This Is Going To Hurt differs from The Pitt...

 

Because while the experienced British docs are handing out tough love....

 

The Americans are sending everyone to therapy....

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