This is [not] Going to Hurt book sales

This is Going to Hurt, published in 2017, is Adam Kay’s memoir detailing his experiences working in a hospital obstetrics and gynaecology ward as a junior doctor. It was an instant bestseller, has been translated into 37 languages and was accompanied by a live tour.

The book has now been adapted into a major BBC television series by the author himself, starring Ben Whishaw as Kay. The seven episode series also marks the opportunity for a new edition of the book (complete with a picture of Ben Whishaw) and the opportunity for an ‘exclusive’ preface by Kay. He has also just announced a second tour, ‘This is Going to Hurt More’, starting in September 2022. 

This is Going to Hurt is split into chapters titled by Kay’s role as he becomes more senior, and each chapter is broken down into very short diary entries. This structure creates a rapid sense of pace, which works well to create the impression of a doctor rushed off his feet. It also makes it easy to read, and easy to keep reading, as you tell yourself ‘just one more entry’.

Kay’s style is slightly crass, heavy handed humour with a decent smattering of swear words. Considering it is entirely set in an obstetrics and gynaecology ward, it felt like a very masculine approach to take. The book is trying very very hard to be funny, but out of every ten jokes, only one of them is genuinely laugh-out-loud, repeat it to your friends, funny.

At times This is Going to Hurt hovered at the border of insensitivity, with complex health issues and life changing moments reduced to their best punch line. But Kay seems aware of this, treading carefully at the border. You can also understand why; dwelling on upsetting health issues would make it harder to get through each day in a hospital, while making jokes about the serious lightens the load. The same book without the humour would make for a very tough read. 

The lengthy and regular footnotes are some of the best bits. They often explain medical jargon and abbreviations, but they also hide some of the best jokes. One of the first pages states: ‘A note regarding footnotes: read the f*cking footnotes’, which maybe eradicates their subtlety. 

Kay is also releasing a new book in September 2022, Undoctored: The Story of a Medic Who Ran Out of Patients, in which he reflects on his life since he left the medical profession. He has also released a christmas ‘gift book’ Twas The Nightshift Before Christmas and a children’s non-fiction book Kay’s Anatomy: A Complete (and Completely Disgusting) Guide to the Human Body. I can’t help but feel like he’s milking it a bit.  

This is Going to Hurt’s greatest success is its eye-opening portrayal of the NHS. The work the NHS does is incredible, but our experiences can often be frustrating, time consuming and unsatisfactory. Kay reveals outdated working practices, lack of funding, immense strain and poor resources. It’s also a damning reflection of the conditions of junior doctors: constant unpaid overtime, 97-hour working weeks, cancelled holidays, exhaustion so great it leads to falling asleep in the car park (the moment the BBC adaptation opens with), failed relationships, strained friendships and an immense amount of pressure. As a reader you can only think ‘this cannot go on, something has to change’.

And yet, Kay’s book story is set in 2004 to 2010: pre-Covid, pre-Brexit and with a Labour prime minister. Re-reading it in our new context invites thought of how much strain and pressure the NHS is now under, and the impact of this on patients and staff alike. 

Kay, on the other hand, has had an immensely successful career since leaving the NHS, and his success doesn’t show any signs of slowing down.