Abhiroop Das
Created by Adam Kay, BBC One’s ‘This is Going to Hurt’ chronicles the life of Adam Kay, a junior doctor at St. Clare’s Hospital, who is being pushed to his physical and psychological limits at every turn. While the labor ward serves as the primary setting for this medical drama series, much of the journey unfolds inward, as Adam finds himself caught between his personal and professional realms. Each episode of this medical drama brings a unique challenge into the fold, be it the complex medical cases that Adam has to work with or the unpredictable twists on his domestic and romantic front. He is not alone in this struggle, as the show also shines a light on the lived experiences of his peer, Shruti Acharya. In bringing forth these two perspectives, the narrative presents an unflinchingly honest take on how strenuous working conditions and hospital power hierarchy can take their toll on its doctors.
This is Going to Hurt is a Loose Adaptation of Adam Kay’s Eponymous Memoir
‘This is Going to Hurt’ is a creative retelling of the real-life Adam Kay’s experiences as a doctor, as captured in his 2017 memoir of the same name. Kay worked on the obstetrics and gynaecology ward in multiple NHS hospitals for about six years, during which he maintained diary entries detailing the highs and lows of his day. The memoir is a collection of these entries, which provide a stark and authentic glimpse into the medical realm. Adam co-wrote the series adaptation with Maya Sondhi and has confirmed that a number of its narrative elements are fictional additions to the original source material. In a conversation with the BBC, Adam explained this decision, stating, “The nature of the book – hundreds of diary entries in a single person’s voice – meant that a totally direct adaptation would have been something of a one-man sketch show. The TV series expands the world, predominantly in terms of the other characters we meet.”
Adam Richard Kay was born on June 12, 1980, to Stewart and Naomi Kay. Given that his father was a doctor, Adam grew up considering medicine as his career path as well, which led him to study medicine at Imperial College London. Before graduating in 2004 with an MBBS degree, Adam made his mark in the performance arts department, starting with medical school shows in 1998. During this time, he also founded the parody music band, named Amateur Transplants, along with Suman Biswas. At its peak, the band wrote for BBC Radio 4, with one of their songs, “London Underground,” becoming a national chartbuster in 2005. As such, even before penning his memoir, Adam showed a deep interest in the creative arts and never shied away from refining his craft.
Adam Kay’s Diary Entries Lay the Foundation for the Television Narrative
Shortly after getting his degree in medicine and surgery, Adam became a doctor at Ealing Hospital, where he worked on the obstetrics and gynaecology ward. His diary entries, as recorded in the memoir, August 3, 2004, mark the start of his journey as a doctor. From there, Adam would often capture his thoughts about the work and his day-to-day experiences, and many of these entries went on to inspire the key events in the television series. He also wrote extensively about the gruelling workload, coupled with the mistreatment and neglect he often had to endure, and that forms the thematic backbone of the book as well as its adaptation. Notably, within the memoir, Adam appears to focus mostly on his own perspective, especially by referring to his co-workers not by name, but typically by their designation. Similarly, he refers to his partner as “H” in the book, in contrast to the show, where the analogous character is named Harry.
Adam explained his reasoning for the same to Newsweek, stating, “I’m the only fully-drawn character in the book. (…) It was a deliberate thing in the book because I’d go to prison if I identify a patient, or I’d get excommunicated from my family, or I’d be struck off from the GMC [the General Medical Council] if I identify colleagues.” He adopted a different approach for the show by using the memoir as a base and adding fictional characters and plot threads to enrich the narrative. While several of these elements might partially reference real life, Adam still had the creative flexibility required to believably recreate a hospital environment in all of its complexity.
A Traumatic Event Changed Adam’s Life
Adam continued working as a doctor from 2004 to 2010, but a turning point came on December 5, 2010. In his memoir, Adam described examining a patient with her first baby on the way, before confirming that she needed a caesarean section. However, the surgery was complicated due to an undiagnosed placenta praevia, which resulted in a medical emergency. Despite Adam’s best efforts, the baby was delivered stillborn. The patient was then rushed to the Intensive Care Unit due to heavy haemorrhaging, and Adam was told to expect the worst, as senior doctors took over. This is the final diary entry recorded in ‘This is Going to Hurt’, and soon after, Adam reportedly began displaying symptoms of post-traumatic stress disorder. A few months after the tragic event, Adam quit the profession.
As mentioned in the memoir, Adam was informed in 2016 that he would no longer be able to work as a doctor. This development prompted him to go through his diary entries in a new light. Around the same time, he felt the need to bring the doctors’ perspective to the public eye, especially in light of their worsening working conditions. As such, both the memoir and its television adaptation are informed by the real-life struggles that doctors in the UK face, with the writing team of ‘This is Going to Hurt’ using dramatized settings and characters to give voice to these urgent concerns.
Adam Kay is a Successful Writer, Music Artist, and Comedian
Prior to the publication of his memoir, Adam Kay had already found professional success as a writer, having co-created BBC Three’s ‘Crims,’ which was released in 2015. In addition, he also wrote for shows such as ‘Very British Problems’ and ‘Partners in Crime,’ cementing his position in the television industry. Adam is also a talented musician and musical performer, having bagged Best Musical Variety Act at the 2014 London Cabaret Awards. Following its release in 2017, the book ‘This is Going to Hurt’ was met with immense critical and popular acclaim, selling more than 2.5 million copies. It held its position as the Sunday Times number one bestseller for over a year and bagged numerous awards at the UK’s National Book Awards of 2018, including Book of the Year. Adam was similarly awarded with New Writer of the Year, and this kick-started his career as a print storyteller, which has continued to make strides since.
In 2018, Adam married television executive James Farrell, and five years later, they welcomed two children into their lives through surrogacy. Alongside being a writer and musician, Adam has also stepped into the world of comedy, which frequently takes him on tour all across the UK. His breakthrough work, a one-man show titled ‘This is Going to Hurt’, has been a consistent hit at the Edinburgh Festival Fringe, with shows being sold out for six years straight. Additionally, Adam also performs at events such as the Cheltenham Literature Festival and the Latitude Festival. In 2019, his second book, ‘Twas the Nightshift before Christmas,’ was released to widespread success, and he has since followed it up with many notable titles, such as ‘Dear NHS: 100 Stories to Say Thank You,’ which engages with a similar set of themes as his debut book. Adam continues to raise his voice against the injustices faced by doctors worldwide and has used his skills as a storyteller to amplify his message.
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