Two psychiatrists conduct an adversarial review of Adam Kay's 'This Is Going To Hurt,' debating whether his NHS memoir represents institutional failure causing PTSD or a self-inflicted martyr complex, while examining the book's comedy, structure, and impact on healthcare discourse. Longer summary

This book review examines Adam Kay's 'This Is Going To Hurt,' a medical memoir documenting his career as an NHS obstetrician from 2004-2010, written as an adversarial collaboration between two psychiatrists: one who sees it as a textbook case of moral injury and PTSD, and another who views Kay as suffering from a martyr complex. The review explores the book's comedic brilliance, analyzes accusations of misogyny, and ultimately argues that the book documents the systematic institutional failure that broke a competent doctor rather than representing a heroic escape from dysfunction. Shorter summary

A review of 'Great and Desperate Cures' by Elliot Valenstein, which examines the history of lobotomy and psychosurgery, explaining how tens of thousands of patients underwent dangerous brain operations from the 1930s-1950s despite poor evidence of effectiveness. Longer summary

The post reviews 'Great and Desperate Cures' (1986) by psychologist Elliot Valenstein, exploring how lobotomy became widespread despite its horrific consequences. The review details the procedure itself (inserting an ice-pick-like instrument through the eye socket into the brain), then examines six factors Valenstein identifies for its acceptance: desperate patients and families, physician ambition (especially Egas Moniz and Walter Freeman), uncritical acceptance by researchers and media, territorial disputes between medical specialties, and cold economics. The post includes extensive details about key figures, particularly Freeman's aggressive promotion of transorbital lobotomy and his traveling surgery roadshows. It discusses patient outcomes, the lack of theoretical justification, media hype, and the procedure's eventual replacement by psychoactive drugs. The review concludes by reflecting on modern parallels and the tragic story of Howard Dully, lobotomized at age twelve, arguing that while Freeman likely had good intentions, the safeguards that might have prevented such harm were inadequate then and remain concerning today. Shorter summary