About The Author
Adam Kay is an award-winning comedian and writer for TV and film including Mitchell & Webb and Very British Problems. He lives in west London. He previously worked as a junior doctor, and has used his diary notes from that time to detail his funny and sad experiences in his first book This Is Going To Hurt, to provide an eye-opening and at times jaw-dropping account of the highs and lows of life as a hospital doctor, from the ludicrously long hours to the often unfathomable workings of the NHS. Below, exclusively for Foyles, Frances Gertler talked to Adam about what finally drove him to leave the NHS, how his medical background has made him immune to heckling and what he misses about being a doctor.
Author photo © Martinovic and Noble Photo Agency
The Author At Foyles
If the medical profession had been different do you think you would have stayed in it, or was the path to writing inevitable?
I left my job after I had a really bad day at work. (Sorry to ruin the ending, but you all watched Titanic knowing how that was going to play out.) We all have bad days at work, of course, but nothing compares to a bad at work in medicine, and nowhere more so than in my field of obstetrics. I was told afterwards that doctors on the labour ward should expect to have some kind of major tragedy every five years or so, but I couldn’t face it ever happening to me again, so I hung up my stethoscope. The truth is, there’s nothing that could have been changed about the medicine itself, it was more that I’d gone into the wrong specialty – if I’d had chosen something lower octane, like dermatology (or dermaholiday as it was known) I think I’d probably have been able to stick it out.
Have your parents come to terms with no longer being able to say, ‘my son the doctor’? How hard was it to convey why you were walking away from all those years of training?
Being the parent of a doctor means a huge investment of emotion, energy and money whilst your kid’s at medical school, then their routine absence from family weddings and Christmases once they’ve qualified. They found it extremely difficult when I told them I’d left – I'm pretty sure I’ve been taken out of the will. In fairness to them, I didn’t tell them the reason I left – in fact they only found out the details when they read my book a few weeks ago – it was something I just couldn’t talk about, even to those closest to me. They understand now. Plus, ‘my son the bestselling author’ has taken the sting out slightly.
In common with many others, you endured terrible hours, lack of support, training and feedback and being paid a lower hourly rate than the hospital parking meter. Do you miss the things that made you put up with all this in the first place?
As a doctor, I’d routinely find myself driving home three hours late, splattered in blood, with the radio blaring and windows down just to keep myself awake, in the full knowledge that dinner was now in the cat. But you always have a smile on your face, somehow, because of the feeling you did something good at work that day. The same hardwired desire to help that made you tick the box on your UCAS form all those years previously. I definitely miss that.
Now that you’re away from it, do you wonder how you managed to do it for so long?
When I read back through my diaries for the first time in years, it all felt so abstract and obscure – like I was reading about someone else’s life. What now seems extreme and unreasonable, back then was just normal. 90-plus hour weeks, immersing yourself in the job to the exclusion of friends and relationships, missing flights when shifts over-run, missing weddings when rotas change. There were points reading back through it where I wouldn’t have flinched if an entry had read 'swam to Iceland for antenatal clinic' or 'had to eat a helicopter today'.
In putting the book together you spoke to dozens of former colleagues. What were the biggest changes in the six years since you’d been away and do you think the rate of change and decline is quicker than ever before?
When I left medicine in 2010, I was amongst the first in my cohort to do it – a total glitch in the matrix. People assumed I’d gone mad: you don’t just LEAVE medicine. Now I can barely go on Facebook without seeing former colleagues who’ve moved to Australia or Canada, or found jobs in the city or pharmaceutical companies. And talking to friends still in the profession, they all speak of the scars on every single rota: doctors have left in droves, demoralised by constant attacks from above. All this in turn puts further strain on an NHS which had very little slack in the first place. I heard hospitals being described as 'at breaking point' a heartbreaking number of times.
You said, ‘One day you’ll blink and the NHS will have completely evaporated.’ Is there any hope at all?
I think if the NHS received a significant injection of funds now, and if that funding was sustained then there is absolutely hope. If the current process of slow starvation continues – accompanied by the lie from our overlords of 'everything’s fine – there’s more money than ever' – then I don’t see a way out.
Your book includes an open letter to the secretary of state for health. Did you send this and did you get any response?
Not only did I send Mr Hunt a copy, but at various events where I’ve been signing books, people have bought a second copy to send to him themselves. I dare say he’ll eventually reply, if only to stop the books cluttering up his desk. Whether it will change his mind on policy is a separate matter – let’s not forget this a man who a few weeks ago got into a fight about statistics with Stephen Hawking…
How did you make the move from doctor to scriptwriter and comedian. It’s not necessarily an obvious one….
You think? Ask Jonathan Miller, Graham Chapman, Graeme Garden, Harry Hill, Paul Sinha, Phil Hammond, Mike Wozniak, Lee Nelson… There’s a long tradition of Christmas revues at medical schools – students getting up on stage and performing lowest-common-denominator sketches and songs – and it was something I did a fair bit of. When I left medicine and was desperately reaching around for a rip-cord, it was the closest to a Plan B I could come up with.
In your new life as a performer have you drawn on any of the skills required to work with the public?
You learn how to deal with terrible hours, for one – as a doctor I was more than once so tired after a nightmarish nightshift that I found myself being honked awake by other cars when I’d dozed off at traffic lights. This was replaced with coming off stage in Durham at midnight and driving back to London, wide-eyed and hallucinating mirages of my own duvet. Then there are the tough crowds: no amount of audience heckling could throw me off my stride after half a decade of relatives threatening to break my legs because there’s no hospital bed available yet. But ultimately it’s difficult to compare any other job with being a medic – the highs can never be as high, and sadly the lows can never be as low.