This Is Going To Hurt by doctor-turned-author, writer and comedian Adam Kay, was a cultural phenomenon on its release in 2017, having been translated into 37 languages it left millions in stitches (thankfully not literally).
The book consists of a series of diary entries from Kay’s time as junior doctor from 2004 to 2010 covering both the highs and lows of the profession – although there were significantly more of the latter.
It’s rare that a book can make you laugh, cringe and sob in equal measure which is clearly why it rocketed up the bestseller lists. Its success has since led to a live tour, a TV adaptation and two further books - a novella entitled Twas The Nightshift Before Christmas and a follow-up, Undoctored: The Story of a Medic Who Ran out of Patients, which has led to a further live tour.
Kay brought his Undoctored tour to Belfast this week. Although described as a comedy on the Ulster Hall website, Kay explains that it isn’t really a comedy show but there wasn’t a category for “some bloke reading his book”.
Similar to his 2019 tour, the show consists of Kay reading a selection of entries from the book interwoven by the occasional witty musical pastiche.
In addition to his hilarious accounts, including a misjudged evening after overindulging in Pinot Grigio with messy consequences and a cautionary tale about attempting to pass bladder stones without any medical advice or intervention, there is a stark political subtext: Kay highlights how doctors spend their careers taking care of others, but no-one takes care of them.
In his previous show Kay explained that his ultimate decision to leave medicine was preceded by a traumatic experience in obstetrics which involved the loss of a mother and baby in his care. This event is briefly mentioned during his new show but Kay focuses more on the aftermath of his decision.
Kay recalls that a few months after the incident he asked his superiors if he could work part-time on the obs and gynae ward, such was the impact of the incident on his mental health, to which they responded: “Why? Are you pregnant?”. Kay says this emphasised the lack of empathy and support in place for junior doctors dealing with stress and trauma.
This is something which was explored further in the 2022 TV adaptation of This Is Going To Hurt. It followed the story of junior doctor Shruti Acharya, who ends up taking her own life due to the unrelenting pressure of the job.
In the show hospital staff plant a tree in memory of Shruti. The external shots were filmed at Ealing Hospital and after the drama aired many visited the grounds looking for the tree even though it was only a prop used during filming.
That encouraged Kay and the team behind the series to plant a real memorial tree at the hospital to commemorate all doctors and healthcare workers who have lost their lives to suicide. It is his hope that there will eventually be a memorial tree at every NHS hospital.
There is real poignancy surrounding this issue as these awful statistics are never publicly discussed. In Kay’s estimations at least one NHS doctor per month and one NHS healthcare worker per week dies by suicide.
Despite the emotive undercurrent, Kay kept the show relatively light, relaying his infamous ‘degloving’ anecdote and sharing his experiences about becoming a father with his Richard Curtis-esque dash to get to the birth of his premature child in the United States.
Overall, the show is funny, clever, heartfelt, at times heart-wrenching but mostly thought provoking. Kay manages to strike at the heart of an issue which is both divisive and topical, particularly as junior doctors in England prepare to strike for five days this month and junior doctors in NI could stage a 24-hour walk-out on March 6.