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This Is Going to Hurt

The book and its structure

Adam Kay’s This Is Going to Hurt: Secret Diaries of a Junior Doctor is a British nonfiction memoir first published by Picador on 7 September 2017. It draws on diary entries Kay wrote while working in the National Health Service from 2004 to 2010, during his training as a doctor and his work in obstetrics and gynaecology. The book is best understood as a memoir assembled from selected dated episodes, rather than as a novel with an invented plot. Its brisk, comic voice combines medical observation, workplace writing and personal testimony.

The narrative follows Kay from the demanding early stages of hospital life into the responsibilities of a junior doctor. Readers accompany him through wards, maternity work and emergency situations, encountering long shifts, difficult procedures, peculiar incidents, bureaucratic frustrations and the practical demands of caring for patients. Each diary extract tends to begin with the particulars of a day or case; together, the entries build a broader account of the profession. The episodes can be hilarious, awkward or grotesque, but the accumulation also makes visible the fatigue and emotional strain beneath the comic surface. As the years pass, Kay’s attachment to medicine sits alongside increasing exhaustion and the question of whether a life in the profession is sustainable. The book ultimately offers a portrait of a doctor’s working life, not a tidy fictional tale of triumph.

Themes and writing background

Kay’s humour is rooted in lived experience and is often directed at himself as much as at the hospital around him. His sharp observations make the absurdities of clinical routines and administrative systems entertaining, while the diary form keeps those absurdities connected to real responsibilities and consequences. The book is frank about the pressures facing junior doctors: long hours, demanding workloads, limited support and the difficulty of maintaining a personal life while remaining available to patients. It also considers the emotional cost of medicine, including the distress of bad outcomes, the burden of responsibility and the compassion required to keep caring.

The result is neither a simple celebration of doctors nor a cynical dismissal of the profession. Kay presents medical staff as fallible people who can be tired, funny, frightened and deeply committed at once. His self-deprecation makes the account personal, while its attention to working conditions gives it a wider social dimension. The NHS is not merely a backdrop; its systems and pressures shape the experience of both staff and patients. Kay kept the source diaries during his years in medicine and later selected and shaped their entries for publication, giving the memoir its distinctive combination of immediate detail and retrospective perspective.

Reception and legacy

The book became a widely read account of junior-doctor life and helped bring public attention to the demands placed on NHS staff. Its impact rests in part on its ability to make serious subjects approachable without reducing them to slogans: comedy draws readers in, and the human cost of the stories remains after the joke. The memoir also reached a much wider audience through a television adaptation of the same name, broadcast in 2022, with Ben Whishaw playing Adam. The book’s continuing reputation comes from this balance of irreverence and sympathy. It is remembered as both an unusually funny medical memoir and a candid account of the pressures, responsibilities and emotional vulnerabilities that accompany caring for patients.

About the Author

Adam Kay

Early life and education

Adam Richard Kay is a British writer, comedy performer and former physician. He was born in Brighton, England, in 1980 and attended Dulwich College before studying medicine at Imperial College London, where he earned his medical degree. Some biographical accounts describe him as coming from a Jewish family. His medical education and clinical work gave him the direct experience that would later distinguish his writing from fictional accounts of hospital life.

Medicine and the move into writing

Kay worked as a junior doctor in the United Kingdom’s National Health Service, training and practising in obstetrics and gynaecology. The central period represented in his diaries ran from 2004 to 2010. Hospital work exposed him to long and irregular shifts, demanding clinical responsibilities, administrative frustrations and the emotional consequences of caring for patients. During those years he kept diaries, recording both absurd daily incidents and the strain of the job. He later selected and reshaped this material for publication. After several years in medicine, he left clinical work and moved into comedy writing and performance; accounts differ slightly over the precise year of his departure, so his transition is best described as following a six-to-seven-year medical career.

His move into comedy did not erase the seriousness of his medical experience. Instead, he developed a voice that uses sharp jokes and self-deprecation to make the pressures of hospital work readable while retaining sympathy for patients and staff. The contrast between comic timing and genuine emotional vulnerability is central to his public identity as a writer.

Books and reputation

Kay’s best-known book is This Is Going to Hurt: Secret Diaries of a Junior Doctor, published in 2017. Its selected diary entries made him widely known as an author and offered readers a candid account of junior-doctor life in the NHS. He followed it with Twas the Nightshift Before Christmas (2019), which draws on his experiences of working through the Christmas period, and Undoctored: The Story of a Medic Who Ran Out of Patients (2022), a further account of his life and career. His books for younger readers include Kay’s Anatomy (2020), about the human body, and Kay’s Marvellous Medicine (2021), which explores medical history. In 2020 he also edited or contributed to Dear NHS, a collection of reflections addressed to Britain’s health service.

The television adaptation of This Is Going to Hurt was broadcast in 2022. Kay was involved in adapting the book, and Ben Whishaw played Adam, the doctor whose story is based on Kay’s experience. The series introduced the memoir’s mixture of comedy and hospital drama to an additional audience. Kay’s lasting reputation rests on his ability to make medical realities both entertaining and humane: he writes about overwork and institutional pressure without losing sight of the people caught up in them. His work has also helped bring discussion of junior doctors’ conditions into public conversation. As of 2026, Kay is living; there is no supported date of death.

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