This book taught me the importance of understanding cultural influence on healthcare. Fadiman’s novel describes the heartbreaking story of a Hmong immigrant family acclimatizing to Western culture in the USA and dealing with their daughter’s emerging epileptic medical condition. Hmong cultural perceptions of epilepsy interpret this as a spiritual issue, not a medical disease. As such, traditional Hmong beliefs were at odds with modern medical intervention. For instance, the Lee family chose to have their daughter treated by a spiritual shaman as opposed to receiving the usual clinical care that would have allowed their daughter to manage and live with her epilepsy.

   The author did great in presenting both sides of the story. From the Hmong perspective, it might be easy to think that the Doctors aren’t trying to help at all. Fadiman did a great job displaying the intentions and motivation behind the actions that Lia’s Doctors took. She was thorough in interviewing both the Lee family and the Hmong community, as well as Lia’s care providers and the MCMC (Merced Community Medical Clinic) medical community. Fadiman does a fantastic job of allowing the reader to understand that both sides can be right and wrong at the same time.  I can see how some physicians would take exception to this book. There is no training in Medical school for how to deal with patients from a different culture that do not believe in modern medicine. It is not in the job description and a Doctor would have to go above and beyond to provide proper care.

   My main takeaway from this book is the importance of understanding cultural differences in healthcare. Cultural differences can be a source of frustration for both patients and healthcare professionals and may result in poor health outcomes. While every individual is unique, each culture holds certain beliefs, values, and customs that distinguish it from other cultures. To provide culturally appropriate care, it’s necessary to know something about the patient’s ethnic and religious background. This information can have a direct effect on the patient’s treatment plan. Neil, Lia’s doctor, wondered if he should lower the quality of care he provides Lia so that it would improve her health outcomes. A non-Hmong patient might continuously alter and update the drug regimen to best treat epilepsy. Changing Lia’s medication scared her parents and they would be more hesitant to give Lia her medication. This dilemma is not something I would encounter in a textbook or lecture and I believe this is just one example of how this book has taught me an invaluable lesson.

Reading the War Doctor by David Nott offered me a profound insight into the values of volunteerism and empathy. Nott's relentless dedication to providing medical care in some of the world's most dangerous conflict zones such as Syria, Libya, and Haiti, embodies the essence of volunteerism. His selfless commitment to serving those in need, often risking his own life to do so, showcases the transformative power of humanitarianism.

 Throughout the book, Nott's unwavering empathy towards his patients, regardless of their backgrounds or affiliations, is evident when he even heals the wife of the previous ISIS leader. He approaches each individual with compassion and a genuine desire to alleviate their suffering, illustrating the importance of empathy in delivering effective medical care, especially during war and chaos. Nott's experiences serve as a poignant reminder of the human capacity for kindness, even in the face of adversity. His story inspired me to reflect on my potential to make a difference through acts of volunteerism and to cultivate empathy towards others, fostering a more compassionate and interconnected world.

 Moreover, the book sheds light on the profound moral and ethical dilemmas faced by medical professionals working in conflict zones. Nott grapples with the agonizing choices forced upon him, navigating the complexities of providing care in environments where resources are scarce and neutrality is often compromised. There were times when they ran out of blood, or doctors with different backgrounds argued about how to operate on a patient. I feel that Nott managed to overcome these drawbacks excellently. The book also delves into the personal toll that Nott's work takes on him, both physically and emotionally. His struggles with PTSD and the constant threat of violence serve as a stark reminder of the sacrifices made by those who choose to confront the horrors of war head-on.

Ultimately, this book is a testament to the power of compassion and the human spirit in the face of unimaginable adversity. It was a compelling and profoundly moving read that challenged me to confront the harsh realities of war while inspiring hope for a more peaceful and just world.

Additional lesson:

 Sometimes you’re so caught up in saving others, that you forget about those closest to you. Nott was overseas volunteering to save other people whilst his mom was sick in the UK. It was too late by the time he came back and she passed on.

This book gave me a poignant and brutally honest account of life as a junior doctor in the National Health Service (NHS) in the UK. Through a series of diary entries, Kay took me on a rollercoaster journey filled with humor, heartbreak, and a deep sense of duty. It gave me a real picture of what it’s like to work in the medical field and concludes with a heartbreaking story that was the last straw and ultimately led to him leaving the profession. 

One of the most striking aspects of the book is Kay's ability to balance humor with the gravity of the situations he describes. His comedic timing provides much-needed levity in a narrative that is often heavy with the weight of human suffering and institutional challenges. Some of which are “a great doctor must have a huge heart and a distended aorta through which pumps a vast lake of compassion and human kindness.”, or  “I finished explaining the risks of a cesarean section to a couple. ‘Any questions at all?’ I ask the room. ‘Yes,’ chimes in their six-year-old. ‘Do you think Jesus was black?’”.

This book also sheds light on the NHS in the UK. It is clear from the book that the NHS is a government run universal healthcare system which experiences staff shortages and low pay which ultimately affects the quality of care people receive because of overworked and exhausted caregivers and the limited access to what they need. Which is why Kay wrote this book; to be a voice to change that.  Kay lays bare the chronic underfunding, bureaucratic red tape, and relentless demands placed on medical professionals. His firsthand experiences paint a picture of a system in crisis, where doctors are stretched to their limits, often at the expense of their own well-being. The emotional and physical toll on healthcare workers is evident in Kay's reflections, and his candidness about his own struggles adds a layer of authenticity and vulnerability to the narrative. One particular story he shares is of a c-section he was in the middle of sewing back up when an emergency alarm went off. He goes off and delivers two other babies and by the time he comes back to finish the c-section 90 minutes have elapsed.

Kay's narrative is not just a critique but also a heartfelt tribute to the resilience and dedication of those who work in the NHS. He highlights the extraordinary efforts of his colleagues and the profound impact they have on patients' lives. The book also delves into the personal sacrifices made by doctors. Kay's reflections on his own life, relationships, and mental health provide a sobering reminder of the cost of caring for others. 

In conclusion, "This Is Going to Hurt" is a powerful, eye-opening read that offered me a raw and unfiltered look at the realities of working in the NHS. Kay's skillful blend of humor and honesty creates a compelling narrative that is both informative and deeply moving. The book serves as a stark reminder of the challenges faced by healthcare professionals and the urgent need for systemic change.