Like most doctors, Adam Kay’s friends sought his counsel after noticing a funny-looking bump or rash. That changed after he quit the profession and wrote his bestselling 2017 book This Is Going to Hurt. The sharp-witted Brit’s darkly comic memoir of life at the medical frontlines was adapted into a TV series in 2022, and Kay has since penned more than half a dozen books as well as selling out live shows around the world.
“I clearly don’t present myself as a particularly good doctor in my books ... As soon as the book came out the number of people texting me questions suddenly dried up. Because I worked on the labour ward lots of friends who were pregnant or going through fertility work or whatever fell off an absolute cliff. Very insulting.”
The career pipeline from doctor to humorist might seem a narrow one, but comedians from Monty Python’s Graham Chapman to The Goodies’ Graeme Garden to Community’s Ken Jeong all started out in medicine. Kay certainly has the chops as both a writer and a live comic – his books have sold millions of copies – but he insists in that charmingly English manner that he wasn’t a particularly great doc.
He’s not much of a patient, either. “Doctors in general make quite bad patients. There’s this thing you get taught at medical school, that you’re a bloody doctor, and you bloody get on with it,” he says. “That ends up extending to your own health. As a medical student, you find it embarrassing to see a doctor.”
That gulf between a doctor’s job and their own self-care is at the heart of much of what Kay does today. This Is Going to Hurt – the show he’s performing live at this year’s Melbourne International Comedy Festival – chronicles his years in obstetrics and gynaecology. His career ended abruptly after a scarring episode at work left him unable to go on.
Ben Wishaw as Adam in the 2022 adaptation of Kay’s memoir This Is Going to Hurt.Credit: SISTER/BBC/BBC Studios/AMC. Photographer: Ludovic Robert
He’s pretty sure it left him with PTSD. He was waking at 3am thinking he was back in the operating theatre, drenched in a cold sweat, pulse racing at 200bpm. He didn’t talk to a professional about it, of course. “It was the same reason nobody helped me after that bad day at work, there was no debrief, no offer of time off work, no offer of counselling. It’s a profession that’s paradoxically quite bad at looking after mental health.”
Our relationship with doctors is one of the strangest we have. We allow these relative strangers access to our darkest corners – literally, in some cases – while never paying much mind what’s going on in their world. We can treat them like confessor-figures, parent substitutes, divine authorities or emotional punching bags.
Kay’s work humanises these people. We all know the cliché of the sad clown. But what about the sad doctor? “You don’t want to think of your doctor as human. Humans make mistakes. Your doctor has to be absolutely unimpeachable in your head. The person who’s saying ‘right, so the brain surgery is only going to take seven hours’, this person cannot be human.”
Kay’s memoir won over health workers who saw themselves reflected in its pages.Credit:
Kay believes part of the challenge facing the medical profession is how young its members are when they sign up. “Medical school is pretty much exclusively undergraduate. You’re starting when you’re 18, you’re a doctor when you’re 23 or 24. I don’t think that’s very sensible.”
The glamour or the money, parental pressure or ideas about saving lives can all lead to dreams of becoming a doctor. But, Kay says, “you decide that when you’re 16. You’re such an idiot when you’re 16. You’re still an idiot when you’re 21, but at least you’ve probably left home, had to earn some money, had a relationship.”
These are things that might broaden your view of the world and let you know what you’re getting yourself into, he says. They might make you think twice, but that knowledge will also probably increase the odds that you’ll stay the course.
“I left a profession where I didn’t really know what it was when I signed up. Had I known more, I would probably have still done it. Would I have chosen Obs and Gynae with its high highs but desperately low lows? Probably not. I’d probably have found a flatter sine wave where the highs aren’t so high, but the lows aren’t so devastating.”
Despite the bad moments that Kay experienced on the labour ward, he still maintains it’s the best job in the world. “Nothing I have done since has given me anything like the satisfaction and the pride of literally saving a mum or a baby’s life. I know the arts have value, but you’d have to have quite the ego as a writer to claim that what you’re doing there is as important.”
And yet, This Is Going to Hurt struck a nerve with readers who had never really thought of medics as ordinary folks. It also won over health workers who saw themselves reflected in its pages. “I started to get all these messages from junior doctors all around the world saying: ‘Before I read your book I thought I was the first doctor who’d ever cried in a locker room or a toilet’. But the truth is, every doctor ends up crying in a locker room. The fact that no one talks about it, and everyone pretends that they’re a superhero, means that when it does happen to you, you feel so isolated.”
Today Kay keeps a file on his desktop listing helplines and groups that he can pass on to healthcare workers who contact him about their struggles. “I’m totally unqualified for this, but it’s much better that they’re approaching me, who has a small document of support lines, than not speaking to anyone.”
Kay now also has two young children of his own, and it’s his old doctor friends who get those worried texts about rashes and lumps. Delivering a couple of thousand babies left him wholly unprepared for parenthood. “You’re responsible for them for about three or four seconds, and then you hand them over to the midwife who takes them over to the paediatrician or whoever and that’s that.”
If looking after two real youngsters wasn’t enough, Kay has recently been hard at work bringing his first novel into the world. You’ve probably heard the phrase “cosy crime” – Kay says his fiction debut is the opposite of that.
“Itchy crime, maybe,” he says. “It’s funny and dark because that’s the certain tone I write in, but it’s also disgusting and goes to interesting places.”
It’s called A Particularly Nasty Case, Kay says, and will be published later this year. Like much of his work, it’s partly inspired by his days in healthcare. “When you’re a doctor there are a few times where you suddenly work out a really amazing way to kill someone using your medical knowledge. Obviously for various reasons you can’t enact it, but I thought a crime novel was a very good way out of that.”
Adam Kay: This Is Going to Hurt is at Arts Centre Melbourne, April 15 -20; Norwoord Concert Hall, SA, April 23; Enmore Theatre, Sydney, April 29; Regal Theatre, Subiaco, WA, May 3-4; Powerhouse Theatre, Brisbane, May 7-8.