Interview with author Adam Kay

We talk to author Adam Kay about the inspiration behind his bestselling book chronicling his years as a junior doctor, This Is Going To Hurt (Picador, £16.99)

by Danielle Woodward

Hilarious and heartbreaking, shocking and satirical, scriptwriter and comedian Adam Kay’s memoirs of his career as a junior doctor is a truly eye-opening and unputdownable read. 

With that courageous type of humour that only emerges when you’ve been in situations that really test the human spirit, we follow Kay’s career from the NHS front line as he deals with life-or-death decisions on little sleep, mourns the loss of his social life and eventually hangs up his white coat for good. This must-read will leave you with a greater understanding of what junior doctors go through, and how much we all take them, and the NHS, for granted. 

What made you write this book? It was the idea of getting a message across. You’re obliged to make a record as a junior doctor; you keep a log of how many operations you’ve done that day and any reflective learning, and I also included anything interesting that happened that day that might have been funny, sad or mundane. When I left medicine, my diaries sat in the bottom of a drawer, but when junior doctors came under fire, I thought I’ve got something to say now.

The government was promoting the message that the junior doctors were being greedy, which was a dagger to my heart, because they really weren’t – they were worried about working conditions and patient safety. Everything is confusing about the junior doctor story, even the term ‘junior doctor’, as it means that people can actually be highly qualified and not junior at all.

Was it about trying to change people's minds and educate people? Yes. I started reading out the diary entries at the Edinburgh festival last year and Picador picked it up and suggested making it into a book would be a more efficient way of reaching people. I won't be able to change Jeremy Hunt’s mind – he’s deaf to Stephen Hawking! – but I can reach members of the public and the next time doctors come under attack, the public will think: Yes, that’s nonsense, why would doctors be in it for the money? They're in it to help people, to save lives.

What's been the reaction from your ex-colleagues in the NHS? I tried to make it an accurate reflection of the mix of things that happens when you are a doctor. I’ve been so happy with the reactions from my friends who are now consultants; some of them have told me they've bought half a dozen copies for their juniors, as it should be the set text!

I’d love people to read it before they decide to do medicine; it would prepare them in a way that I wasn’t; no one sat me down and said, ‘it’s the most rewarding job in the world, but…’ I didn’t think it would be a book that lots of doctors would read, in the same way we don’t all go home and watch Holby City, but I've had a lot of positive messages from doctors. Clare Gerada, ex-president of Royal College of GPs wrote me a letter, saying it’s the first memoir that captured what it meant to be a junior doctor, which meant a lot.

There's a sense of seeing it through the doctor's eyes, which you don't get when you're a patient. Yes, I wanted to humanise a profession which we all hope is absolutely correct in every respect, but doctors do get things wrong - they are only human. When you’re yelling at the doctor because you’ve been kept waiting for your appointment, the doctor also should have left two hours ago but no one ever says, ‘this might be annoying for you too’. You don’t think of the doctor as getting ill or sad, and when the doctors were coming under fire, no one really thought of them as people and how much the job takes its toll. There isn’t a support network.

What made you leave medicine? Ultimately, I couldn’t face going back to work. I was dreading something bad happening; I practised ‘defensive medicine’, being extremely cautious, but I wouldn’t have stopped anything happening anyway. There was nothing I could have done regarding the event that made me leave, however cautious I was as a doctor, it would have still happened. I investigated moving specialities, going part-time, but there was no interest in me doing that. I’m told there is better holistic care now for doctors who are struggling.

Writing comedy was the closest I had to a Plan B. Since medical school, I’d done stand-up and performed comedy songs, so I did a few gigs and started writing which eventually took over from performing. It wasn’t that I needed to find a job with joy – there is relatively little joy in comedy! – I just needed a job.

Is there anything about being a doctor that you miss now? You can come home after a 20-hour shift, covered in blood and absolutely exhausted, but you’ve got a spring in your step because of the non-specific feeling that you’ve done good somehow, that you’ve been useful, that you’ve helped, which is actually the reason why you’ve become a doctor in the first place. You choose medicine because you want to help and I am still driven by that; helping out is important. And with my book, the motivation has been to get the word out, as that will hopefully help junior doctors.

What's your next project? I would like to write a second book; I’ve got a lot more to say about what it’s like to be a doctor. I thought when I was writing the book, that the stuff that people would care about would be the comedy, but what everyone has focused on has been the personal stuff, the bits I was nervous about writing, the bits about my actual life.

The book has just been optioned by Sister Pictures which is very exciting. Being a doctor isn’t comedy and isn’t drama – it’s something in between. If I tell this story for the screen, it has to have drama at its heart, otherwise you risk trivialising some very big things, but it has to be funny too. It will be straighter than Green Wing!

What do you do to relax? I play the piano; I can sit for three hours after a stressful day and playing the piano does more for me than going to a spa for the day. It takes me into a different world – that’s my magic trick.

This Is Going To Hurt by Adam Kay (Picador, £16.99), is out now. Follow Adam on Twitter @amateuradam and visit thisisgoingtohurt.co.uk for details of Adam's book tour.