Preview: This is Going to Hurt
This week sees the release Adam Kay’s medical memoir, This is Going to Hurt, in which the former Mongrels and Crims writer and musical satirist revisits his seven years as a practicing Doctor. TVO took a sneak peek at the results, to find out if you should buy a copy yourselves.
As journalist, author and full-time punk rocker John Robb once sang: “We live in media-evil times.” Every day we’re bombarded with things we’re supposed to want and things we’re supposed to need, to the point that almost every conversation we have in earshot of our phones or our smart-TVs is then recycled into an advert to make us buy more stuff. Some would have you believe this is all a ploy by our governments to distract us from the growing problems in our society which they’re failing to fix. Sometimes, you have to wonder if they’re correct.
And gawd knows, we here at The Velvet Onion are guilty of contributing to that cycle with almost eight years of every successive “best thing ever” that you simply have to experience. Indeed, here we are again, with another review and a list of reasons why you need to buy something.
Except… this one is different. Anyone who knows anyone who works in medicine will appreciate that they work their arses off to provide care for hundreds, possibly thousands of people every year. Those of you in the UK in particular will know that our National Health Service is under constant threat from cuts to services and budgets that force Doctors to work excessive amounts of overtime that puts patients at risk.
It just so happens that Adam Kay – one of the wittiest musical satirists we’ve ever seen – also happens to be not just one of the loveliest people on the planet, but a former Doctor, working in obstetrics and gynecology, from House Officer up to Registrar. He resigned in 2010 following a truly horrendous series of events nobody should ever have to live through, and ended up writing for Mongrels and Up The Women, as well as creating the criminally underrated sitcom Crims, alongside a career as a script editor and musical comic on the live circuit.

© Karl Webster
This is Going to Hurt takes the actual diaries written by Adam whilst on the job (the medical one, not his appearances on The Now Show), and lays the reality of life in a 21st century hospital bare. Previously performed as a sell-out Edinburgh Fringe show, Fingering A Minor on the Piano in both 2016 and 2017, Kay’s diaries have reduced audiences to tears of laughter in one moment, and left them with a gut punch of harsh reality in the next.
The obligatory disclaimer here: the diaries have had the gentlest of tweaks and refinements to protect patient confidentiality and to placate worried lawyers. There may be some jokes added here and there, too, but the harsh reality is that Kay’s natural responses are intrinsically funny, even if at some points they may seem surprisingly cold, or the descriptions may be overtly graphic – with one passage on a degloving incident almost certain to put off a few readers. The gallows humour throughout is arguably the only logical way to process some of what Kay experienced, and while sometimes you may find yourself wondering if it’s genuinely okay to laugh at something, it’ll immediately be followed by an entry which will do one of two things: warm your cockles or break your heart in an instant.
Through it all, Adam’s incredible warmth as both a comedic writer-performer, and as a truly remarkable person shine through, and the result is a tome which, though stark in places, never truly feels dismissive or cruel towards the variety of unusual patients Kay meets, nor does it exclude audiences unfamiliar with this incredible life so many wonderful people undertake.
And the book doesn’t shy away from the difficulties of working in this profession outside of work, either. Sacrifices are made on a regular basis, relationships crumble under the weight of the intense pressure, but through it all, Kay’s smile stays on… until one pivotal moment which provided Kay with the realisation that this life really isn’t for everyone, and in particular, it was no longer for him.

© Adam Kay
It’s fair to say that, in comparison, life has been kind to Adam since he resigned, but he’s still acutely aware that the pressures he faced haven’t gone away for countless other medical professionals still out there. This is Going to Hurt concludes with an open letter to the Health Secretary, suggesting he stops getting tours of swanky new facilities with men in suits, and actually tries to do a shift with junior Doctors to truly experience the strains they are under. And if you’ve made it this far into Kay’s text, and don’t conceed he’s got a point, it might be worth making an appointment with your local GP to check you have a pulse. Or a heart.
That’s the rub: for all our passionate pleas for you to watch this tv show, buy this blu-ray, go and see this comic on tour, we’re acutely aware that it’s all a giant distraction from the problems and struggles people face on a daily basis.
This book isn’t. It’s funny, and it’s heartwarming, but it’s also a wake-up call to anyone who isn’t living this life that a lot of what practicing medical professionals go through truly beggars belief.

© Charlie Clift for The Sunday Times
There’s a lot of snobbery in the arts world about comedy’s place as an artform, but it’s arguable that through humour society truly understands itself. In much the same way that, for example, comedic play Every Brilliant Thing manages to handle depression, anxiety and suicide better than most ‘serious’ dramatical portrayals, This Is Going To Hurt cuts to the core of the struggles faced by medical professionals around the world better than a book written by a comedian will ever be considered able to do.
If push came to shove, and you could only ever purchase one thing from the entire back catalogue of products The Velvet Onion has plugged over the years, this is the one which matters the most, and the one this particular writer would be most keen on you choosing.
We all know that the NHS is under threat, and that all around the world medical professionals are being pushed to their limits, whilst having their life’s work reduced to cheap political weapons. This is Going to Hurt is an essential reminder of just how much society owes these individuals, and how vital it is we support their fight, at a time when we really need it the most. Buy it.
Tell us what you think!