In episode one of This Is Going to Hurt, Junior Doctor Adam describes working for the NHS as, “like sailing a ship alone, except a ship that’s massive and on fire and no one’s had the time to teach you to sail”. This dry sense of humour in the face of crisis is a thread that runs throughout this new mini-series that aired on the BBC in February 2022.
The series is a highly awaited adaptation of the best-selling memoir of the same name by Adam Kay. Based on his own personal experience as a doctor in a Obstetrics and Gynaecological ward of an NHS hospital, the series follows Ben Whishaw’s Doctor Adam as he races between A&E and labour wards. The show draws attention to the perpetually frenetic state NHS workers are put through and the stress, trauma and lows of the job. The series pivots on a mistake made early in the first episode which dictates the trajectory of Adam’s arc for the rest of the series, emphasising the jeopardy of the labour ward and the strain on Adam’s own personal life. Whilst Whishaw’s excellent performance is fast making him a national treasure, newcomer Ambika Mod puts in a star performance as Adam’s wide eyed trainee colleague Shruti.
While This Is Going to Hurt addresses many social issues plaguing the British healthcare system, it does so in a manner that never feels didactic and adheres more to social realism. Underfunding in the NHS, the mental health epidemic amongst medical practitioners, the extreme requirements of a job that requires an immense degree of self-sacrifice are all touched upon and inform the story and the viewer of the conditions in hospitals.
Based in 2006, one can only imagine that the issues raised in the series have only been exacerbated by the ongoing pandemic. In one episode, the stress on the ward revolves around an impending ministerial visit. Competing bureaucratic forces clash over maintaining the appearance of a functioning system or letting slip the systemic dysfunctional of a system operating on “a budget of about £12.50”.
The internal issues between staff are also depicted: class differences between doctors, assumed heterosexuality in the workplace and the impossibility of creating work/life boundaries when the physical and emotional demands of the job are unwaveringly tough. Programmes, such as these, which hold a lens to uncomfortable subjects are instrumental in raising national consciousness about social issues. Clapping for our carers seems a disproportionate thank you in light of the series, yet no one truly knows the solution to tackling the larger institutional problems at stake.
However, despite its unflinching depiction of serious topics, This Is Going to Hurt has widely been praised as the best comedy of the year. Maintaining the tone between drama and comedy is a difficult operation (if you’ll excuse the pun) yet Kay’s writing treats the brutal juxtaposition of the labour ward with a tender hand, capturing the balance of humour and horror that is essential in Kay’s book.
This Is Going to Hurt is careful not to glorify or overly praise its central character. The fictional Adam is difficult to contend with as a man under immense duress from work, his actions are often brash and unconsidered, poisoning both his professional and personal relationships. Strangely, this humanises the character and emphasises how immense pressure can cause a professional to crumble. The series does not shy away from the abject realities of life on a labour ward. The jeopardy at any given moment when a patient is admitted to urgent care, the pressure to provide a standardised exterior of professionalism to all patients, no matter how aggravating, and the human bonds formed through work, all whilst working a twelve-hour shift with no rest. Humour becomes a necessary tool to contend with the aspects of life that are difficult to face.
Patients with strange objects in obscure orifices, grumpy, uncooperative patients, lost swabs, the miracle of childbirth: all in a day’s work. Health is the most personal and intimate subject, when it goes awry, the results can be devastating. A simple misdiagnosis can be catastrophic.
Being steeped in paperwork and blood and the incessant beeping of a pager calling you back from the edge of consciousness. This Is Going to Hurt communicates the exhaustion and sacrifice of our NHS staff by placing you in their position. The microcosm of the labour ward is representative of institutional issues whilst the ‘in your face’ immediacy of the script does not understate the larger truth that there is simply never enough time. A shocking incident at the end of episode six left me completely breathless, causing an incredibly visceral reaction. The role of clinical staff is often a thankless position, the expectation to carry on despite it all because there is no alternative with a lack of a framework of support.
The series is an incredibly affecting humanist drama. It mediates tragedy and comedy with equal regard for all arenas of human experience: love, disgust, abandonment, hope all mingled in a contained dramedy that speaks to the dedicated workers behind one of the UK’s most neglected institutions. Life is vast and absorbing, it can be wonderful, miraculous, and fulfilling at various intervals, but it’s never painless. This is Going to Hurt is never an easy watch but it’s undeniably a poignant one.
Warning: contains content that may be disturbing