Ex-doctor Adam Kay: Medical school gave me ideas for murder

A hospital is a perfect setting for a murder, agrees former junior doctor Adam Kay, author of This Is Going To Hurt, the bestselling memoir which was turned into a TV adaptation starring Ben Whishaw.

“I can’t be the only person who at medical school was thinking, ‘Oh, if I was a murderer that would be a good way to do it’,” quips the 45-year-old former doctor-turned-comedian and writer.

He’s now written his debut novel, A Particularly Nasty Case, a funny, acerbic and twisty crime caper with rude bits and quite a lot of swearing.

“It opens in a gay sauna so it can’t be ‘cosy crime’. It’s funny crime?” he muses, when asked if he’s joining the genre spearheaded by Richard Osman and the Rev Richard Coles.

“I’m honoured to share a shelf with any crime writer called Richard,” he says wryly, “but I don’t think anyone ever makes any noise by trying to cover old ground. I like the idea that I’ve found my own version. Certainly if it can sit on the bestseller lists with the Richards, I’m very happy.”

The drama begins when a toxic hospital consultant dies suddenly of a suspected heart attack. Fellow doctor, consultant rheumatologist Eitan Rose, isn’t convinced, and when another senior doctor dies in similar circumstances he sets out to prove that there’s more to these deaths than meets the eye.

There’s a side order of romance with a hospital porter called Cole, who helps Rose in his search for the truth.

But there’s more to this first novel than just a uproarious murder mystery. Kay has long been banging the drum for better provision of mental health care for doctors, so unsurprisingly his protagonist suffers from bipolar disorder, and is returning to work following the death of a patient in his care which led to a breakdown.

Kay too has suffered both professional and personal trauma. When he left the medical profession in 2010, where he was a junior doctor in obstetrics and gynaecology, he suffered nightmares and PTSD, and didn’t seek counselling until seven years later, after This Is Going To Hurt was published.

“I was a product of the system that said, ‘You’re a b***** doctor and you b***** get on with it’. It was a very big deal for me.

He continues: “I’m no poster boy for looking after one’s own mental health but the biggest thing I’ve done was getting help and talking about it.”

Since This Is Going To Hurt was published in 2017, Kay has penned a second autobiography, Undoctored, and extended his writing to children’s books, both fact and fiction, all of which have been bestsellers, as well as the award-winning TV adaptation of TIGTH and sell-out one-man tours.

Doing his comedy shows and talking about his life as a junior doctor helped his mental health, he adds, plus the counselling which he still has.

“The other thing I’ve done is I now have a work-life balance,” he says, somewhat ironically as he has two two-and-a-half-year-old toddlers, Ruby and Ziggy, with husband, producer James Farrell, a burgeoning book career and various tour commitments.

“Having two toddlers has upended the equilibrium but the difference now is that if I’m working too much, it’s my fault. I now can say, ‘I’m really sorry Mr Production Company or Mrs Publisher or whoever, that I can’t…”

The children are starting nursery in September, which he says will make a big difference to his writing, working from home in the north Oxfordshire countryside.

Fatherhood has changed him a lot, he reflects.

“It recalibrates your life. I’d been my own centre of gravity for 42 years and then suddenly these dudes come along and my only thoughts are about them.”

Kay takes them on tour with him and says he and James use it as an opportunity to have weekends away as a family in different cities.

He stresses that he’s keen to be their dad, not their doctor.

“When James says, ‘What do you think this rash is?’ my answer is, ‘I don’t know, let’s speak to a doctor’, because they are too important to rely on my half-remembered semi-facts about dermatology.”

Keen to spread the mental health message in the book, he has drawn on some of his own research.

“Eitan isn’t me but he represents lots of real stories that I know. There’s a certain percentage of me in his voice, his sarcasm, his humour, but I don’t have bipolar. I have no experience of serious mental illness impacting me at work.

“However, I’ve done a lot of work in the space of mental illness among healthcare staff and there are numerous people I’ve spoken to who have experienced the deep stigma of being a doctor with mental illness. That’s something I really wanted to dig into.

“I firmly believe that the NHS is our greatest institution but at the same time one of our worst employers.”

He has met numerous health ministers over the years to raise the issues.

“Every time there’s a discussion about the (NHS) workforce – why aren’t there enough people, why is everyone going? – no one digs into the fact that, paradoxical as it is, in an environment where everyone is caring, there isn’t a lot of care for the staff who work there.

“Things are getting better but the NHS is still a decade behind the rest of society in the way it thinks it is appropriate to look after its staff.

“I know someone who wasn’t given compassionate leave to visit their fiancé as a patient on intensive care because the rules of HR said you have to be married or a first-degree relative to get compassionate leave. That is not compassion by any stretch of the imagination.”

Books aside, he will continue to put pressure on the NHS in any way he can to improve the lot of NHS workers.

“My particular drum is one about mental health for NHS staff and that is something that successive health secretaries of different coloured rosettes have taken seriously, for which I’m genuinely grateful.

“Is the Labour government making a difference? I was hugely excited about what the change of regime could mean for the NHS. I’ve been underwhelmed by the lack of palpable difference in terms of what that’s actually translated to. This latest 10-year plan doesn’t look much different to previous 10-year plans.”

He’s currently working on the second book featuring Eitan Rose and hopes there will always be a message behind the funny stories and acerbic quips of his writing and performing.

“Hopefully I can make people laugh but I want people to go home on the bus or the tube or whatever afterwards and just have a chat about a topic.”

Will he ever return to medicine?

“I think I’ve done my last shift wearing scrubs, but when I’ve got more time, when I’m kicking my feet and the kids are at school, I want to go back in some capacity, which I think would be around policy or education or around mental health and looking after staff.

“I hope I haven’t had my last NHS role but I think I’ve picked up my last scalpel.”

A Particularly Nasty Case by Adam Kay is published by Orion on August 28, priced £20