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I had messages from doctors all around the world saying until I read that in your book, I thought that I was the first doctor who'd ever cried in the locker room. But the truth of it is that every single doctor pretty much ends up crying in a locker room.
Hi, I'm kateline Brook. Welcome to No Filter. You know, we don't always think of doctors as people, and it's not just because so many of them have a God complex. It's that we don't often think that they have emotions or hard days and the weight of life altering moments pressing down on them. And it's probably because when we see doctors it's because we're in a time of need ourselves.
But doctors absorbed situations that would stop most of us in our tracks, yet they are expected to keep going shift after shift to cope with the intensity of his work. My guest today, Adam Kay, started keeping a diary during his years as a junior doctor in the NHS in the UK, which has a similar healthcare setup to our
public system here. In it, Adam Kay documented everything the absurd, like the elaborate excuses people give for why certain objects end up in their bot bots, their heartwarming, like the thousands of babies he delivered, and the devastating, the moments when outcomes were not what they should have been. But after years of exhaustion, relentless double shifts, and a system that offered little or no support, Adam reached his breaking point.
He left medicine completely burned. The diary where he once scribbled his unfiltered thoughts became This Is Going to Hurt, a book that not only became an unexpected best seller but also inspired a TV series starring Ben Wishaw. His writing is brutally honest, darkly funny, deeply human, capturing the sleepless desperation of someone trying to do right by his patients while barely holding his personal life together or barely able to keep his eyes open. There's no anesthetic to
soften the raw truths he lays bare. In my conversation with Adam, we talk about why telling the truth about the public health system matters, how he turned his career as a doctor into one as a best selling writer and stand up comedian and what he's learnt along the way. Hello doctor, thank you doctor.
No another could I only use doctor from fans to get an upgrade on a plane, and that never works, so I can just add on.
And also that would come with its attendant dangers because if you've got an upgrade on the basis that they know you're a doctor, oh yeah, when they say send out that is there a doctor on board?
I was having that discussion with my family not long ago. What do you do?
So my route is I just get absolutely hammered the second I sit on the plane, so that if anyone says is they're a doctor, and I am the only person who's done that degree, I can say I'm.
Technically a doctor.
I've not worked for fourteen years and I'm nine bloody Mary's deep.
So it's a real role of to die. So I leave it up to them at that stage.
My dad said he was on a an advertise in airlines here, so he was on he was on British Airways and they were like, is there a doctor.
He's retired doctor. No one else was like oh no.
So they said, okay, there's someone that they had like a tiny rash or something and who's like, oh, if he got like some antihistamines and pyrotal or something.
They were like, yeah, let's have a look in the box.
So here's and so he gave them these said okay, Pope, your ash goes away, sat back down. They got being back in touch with him and gave him like two business class flights.
To anywhere in the world as a thank you.
And then one of my brothers said that he was on a flight on a on a less I won't name them because they don't come out on the best leline, a budget airline, and there was some absolute, you know, catastrophe, and he was doing CPR on a on a patient. He was alternating with another adopt who they're doing CPR and a patient for like two hours until they could found and then at the at the end, they didn't even give him a like a free pack of pretzels or something, Thanks very much, see you later.
You know, that is where you are reminded that medicine is a calling.
It's a calling. You're not doing it. You're not doing it for the pretzels.
No, you're not doing it for the pretzels, not even for the chocolate covered ones or the peanut butter filled ones. But the reason that you have joined us today it is because your body of work is so unusual. This is going to hurt, not this conversation, but this book that you have written about you being a doctor and not just being a doctor but part of a familial legacy and work at the NHS, which is I gather some kind of it's a battle ground, yes, where all of Britain comes together.
Yes, that's a that's a good description.
Can you just talk us through how you decided to become a doctor. Now you said your dad was a doctor, your brother's a doctor.
Oh like everywhere I look those doctors and that's probably the answer. So in the UK, your medicine's almost exclusively an undergraduate degree.
So you're going into medical school as an eighteen year.
Old, which means means they want various exams for you to sit first, and you choose them when you're sixteen and sixteens are very bad age to decide to do anything. Everyone's an idiot at sixteen, and so you're making a decision at an age where you can't really make a disc There's a thing in medicine, you know, informed consent, So you need an operation, whatever it is. You sign a consent form which says, here's why would you want
to do it. These are the benefits. Here are the risks, bleeding infection, having an anesthetic, damaging other structure of blah blah blah, And then you weigh it all up and you go, yeah, fine, I still do it. Sign my name off we go. When you're applying to medicine, no one at any point mentions the other side of the coin, particularly to a teenager. So you're going in pretty pretty blind. And so you know the fact that I had adoctors in my family. It's a very bad reason to be adopted.
I mean, it's probably much worse. And then like enjoying er or something, and so went in not knowing what I was expecting. I think most of the rest of the world. Medicine's a postgraduate degree. So you're going in like age twenty one or something, right, and then you're
still an idiot when you're twenty one. Obviously no offense to your twenty one year old listeners, but at least you've probably had to leave your parents' house and earn a bit of money and maybe had a relationship and all these things that slightly broad enight your horizon on the world. But I went in with very narrow horizons, no idea what the job was going to be, and it probably unexpected that the story didn't have a happy ending.
Well, it kind of had a happy ending for you, because it's you've actually I gather through your book and your subsequent work changed certain aspects of how doctors are regarding how they treated, particularly the innhase in the front lines like some sort of cannon fodder. Found it staggering just the status of how many hours you were working as a trainee doctor, and in fact it every even supposedly rising through the ranks, how many hours were you working, and.
I think it topped out about like ninety four ninety five hours a week, which it's seen as I think things are slightly better now, but it was seen as a rite of passage that you know, I had to do it, so you have to do it, which is a terrible you know, it's a terrible reason to do anything, and it's not safe basically, And I remember there was one moment where I was working on a label ward, which is where I spent the vast petority of my career and they had, for some reason taken away like
the the on call room where you could sleep like it never got particular guy, but you'd like be able to grab the odds twenty minutes, and they took.
It away, and we were like, why have you taken this away?
They were like, well, you're being paid to be at work, so you should be at work, not napping.
Wanted to say to these.
People, if it was you or your partner or wife, whatever it is, having the cesarean section, would you rather that doctor had been able to grab twenty minutes sleep beforehand or just being forced to work for, you know, twelve hours straight for the fifth day in the row. But you know, the NHS, I think is the most amazing system and concept. It's based on the fact that healthcare is delivered based on a clinical need, never based
on your bank balance. But at the same time, they're not a good employer, so they don't treat their staff very well historically.
And I don't know, I find it.
I find it the slight paradox that this organization that are all about looking after people and helping people forget that a bit when it comes to their own.
When you decided to become a doctor. Then what did your family say?
My family were in charge of this decision, right, So I was I think everyone wants the best for their children. Yes, I've got two young children, myself very young, and so I'm now of suddenly realizing that it sort of totally recalibates your life. Then it's all about what's best for your kids. What was seen as best for me was
a safe, sensible profession. So my parents are you know, they're from an immigrants population, Polish immigrant population, and it's about making you know the best for you know, of your life, improving yourself and making a difference. And doctor, lawyer, architect accounted like this sort of fairly small list of professions. I'm the eldest of four siblings, and the degrees we did were medicine, medicine, law, medicine, And that was my parents trying to make sure that we had sensible traits.
My partner is also the eldest of four, and his dad worked in the advertising trade, sort of creative world, which my parents just had no idea of. I mean there's none of them mates, you know, did anything like that. And so the best for their children were slightly different. So there now, producer, producer, musician, producer.
Ah.
I don't begrudge them pushing me or strong arming me into that world, but ultimately, I think left to my own devices, I probably wouldn't have found al over the.
World that you find yourself entering in you that you recount, and how brilliant was this Even though you came from this very traad medical family. Obviously, the creative in you was very strong, because you journaled even at your most exhausted. You kept a record of what had happened every day, and you write down funny stories and some of them
heartbreaking stories. Do you think even then that there was something in you that knew that you weren't you just weren't that standard cut out of a doctor.
I think I thought I was just someone who had a lot of hobbies, whereas what I actually had was something creative trying to burst out and take over.
And it's interesting that you know why I was writing this stuff down.
I think in retrospect it was probably my form of therapy, looking for the light amongst the dark, because going back through my diaries at the start, there were mostly the funny, silly, disgusting stories, and it actually took a few years before they became more reflective or I started talking about more of the tough stuff that had happened in my in
my life. Medical school, for whatever reason, when I was there, an afternoon a week for six years was spent teaching us communication skills, which is good and right, because that's the cornerstone of what you do. It's about speaking to patients. But not once in all of that time was there a single minute spent telling us, Oh, and by the way, at some point, you're going to have some really bad days, and this is how you're going to have to cope.
Here are some strategies for that. And in the absence of being taught any way of coping, you land in the deep end and have to improvise with your own And I guess what I did then is exactly the same as what I do now, which is writing this stuff down and drinking white wine.
And both of those work.
Neither of them are the gold standard, but you know, it's a way of dealing with stuff.
Well, that's the self medicating thing that also, and possibly for the reason that you that you've just referred to, is a trap that ensnares a lot of doctors is the self medicating.
Oh absolutely, And I think doctors have terrible what's called health seeking behavior. Like I've had so many occasions in my in my life where I've just not seen a doctor when I when I should, I've just been I've made myself ill, both physically and mentally because of I think it's suddenly you get taught at medical school. You're a bloody doctor. Your bloody get on with it, and that extends to your own health. You sort of think it's embarrassing being the doctor who speaks to another doctor.
It'd be like a car mechanic taking the car to different mechanics and say, I don't know what's wrong with it. And so you've got a bit of that in you.
You just plow one and that's never the right thing to do.
The ideology I find very interesting because you're dealing with people who have come to you because they're in need, and you're on the one hand the person that has to present as the person who can help. But then on the other side of that, when that door closes, no matter how traumatic that experience and that exchange may have been, which in some cases does result in death, there's no one on the other side of that, looking after you in your hour of need.
Yes, I mean you put it like that very eloquently, and it makes no sense at all. I don't think there's any way of framing it where it makes sense. The onner where I can rationalize it is that we don't like to think of our doctors as being human because humans make mistakes, and so you sort of, as the doctors, start to believe that that myth that you're somehow other and you don't make mistakes. But humans do make mistakes, and they get sick and they get sad.
And here's an example, and this.
Is patients not thinking of their doctors as humans, which is the same phenomenon as the bosses. So I did this prenatal clinic once a week, and it always ran late, so there was just this mismatch of number of doctor, number of patients.
Should have ended at five, it ended at seven or eight, which is you know, this was rough.
And so I did this for a year, and every single week when it came to six or seven o'clock, patients will be true. My year off quite rightly saying I have been waiting this long. I've seen their childcares all the cars on the meter, and I've apologized not once in a year of doing that, clinicted a single patient saying, you probably don't want to be here either, and I didn't. No one wants to be at work
three hours late. But you don't think of your doctor as a person who's also got a life back home.
They're just part of this organization. And the other illustration I think of that is I wrote in this book, I think fairly openly and honestly about struggles I'd had, which is something that doctors traditionally don't talk a whole load about, And as soon as it came out, I had messages from doctors all around the world saying, until I read that in your book, I thought that I was the first doctor who'd ever cried in the toilet,
who ever cried in the locker room. But the truth of it is that every single doctor pretty much ends up crying in a locker room.
But the fact that nobody talks about it.
Means that, on top of whatever bad day just had that's led you to that position, you now.
Also feel, I don't know that you're unique in struggling.
That's really that's very othering and it makes a bad day even worse. But ultimately, what you know, the book, the show, Everything I Do is you know, it sells itself on being funny, and I guess it is, yes, But ultimately, underneath it, it's hopefully just a reminder that this is just a bunch of flawed human beings muddling along and doing their best and sometimes you know, not managing to get through their day.
Right, but mostly managing to get through the day and managing to get other people through, managing to do the work of the doctor, which is healing. And that's quite remarkable.
It is.
And yeah, I reflect on that sometimes that but it ultimately comes down to the fact that so I'd leave a labor ward three hours later or whatever.
I'd be still half covered in blood.
Because I had time to wash it off, and the dinner's in the dog and I have to wind the window down and have the radio blow and just so I can stay awake on the drive home.
But you still have a smile on your face because you know, working on a labor ward, you know, you know, having that unique role helping families, you know, bringing babies into the world. You know, potentially you know, resolving some difficult situation for a mum or a baby. I mean, that is amazing, and that's the reason if you didn't have those highs, there's no reason to come back to work the next day, given the number of blows there are.
And also, I think humor is a great connector. And I do know. I've got girlfriends who own nurses, and I have to say they have a very dark sense of humor. Something about exposure to body bodily fluids makes people's sense of humors kind of going to the normal culder sex.
Oh, totally, And the humor is one of the things that's fairly universal. And ultimately I suspect it comes down to this coping mechanism idea. In the absence of someone you know giving you the sensible ABCD, this is what you need to do. You need to have a debef you need to take some time that needs to speak to a counsel and all that. People are just like, well, let's just have a joke about it, because that's a
lot better than nothing. And so that's what I was focusing on when I was writing writing my writing these stories down in Madari's.
Humor is just such a great decompressor.
Absolutely, and it's it's absolutely, it's absolutely vital. And yeah, and I'm very glad that I leant into it because you know, as well as giving me this this new career I now have, I suspect it was one of the the main reasons I was able to keep plowing on.
There is so much more to my conversation with Adam Kay. After this short break, we go into why he left the medical industry and how his family of medical professionals responded. Hint, they weren't happy. You know what. I'm very glad about that people put things up their bottoms.
Yeah, they absolutely do.
That's got to be one of the top three questions. Surely, it's an.
Interesting one, this one, because I've been I've written up all of my exciting objects in orifice stories and there's there's no shortage of those in my show whatever. Yeah, Sometimes when i'm you know, i'm speaking to interviewed or whatever, someone will say, oh, this one where someone could have a toilet blush, kinder.
Egg or whatever it is.
And when I'm speaking to doctors, like if i'm you know, if I do a show and I'm signing books afterwards or whatever, someone will come up to me and what they said, that's nothing. Here's my top five things I've removed from inside a face. I think it's a very competitive part of medicine.
And what do they what do they trump your toilet brush with? I mean, that's hard to try.
I don't think I don't think anyone has beaten the kinderreg story, to be honest, an Australian phenomenon.
Little toy in the little toy.
Yeah, so's so slippery, I imagine.
Yeah, it's a little plastic egg thing. So this is a story from February to twenty ninth, two thousand and four. So this sort of leap you where in the UK surpi. There's this very old fashioned tradition that is sort of I'm sure not observed in what we used to be a thing where that was the day of the year, it was considered traditional for the woman to propose to the man rather than vice versa. So this is this,
you know, sort of slightly Victorian whatever idea. Anyway, this particular patient of mine decided that she was going to take this opportunity to to propose and put an engagement ring inside the plastic bit from inside the kinderreggs and inserted the egg vaginally, and the plan would be that her boyfriend would locate it, remove it, and then she would get down on one knee.
All right, right, there'd be an element of surprise, obviously.
Imagine there'd be a huge element of surprise. So she does this.
Unfortunately it sort of manages to wedge itself like sideways, and it gets you know, he can't remove it, and then she has again. She can't remember it. She's not told him what's going on at this point, and then eventually decides she needs to pop to the hospital, the emergency department where she meets me and we you know, hang out in cubable three and there's a fairly easy delivery. We've got a pair of spongeholding forceps remove it and then sorry, how.
Did she tell you? Did she tell you the whole story?
She said there's something up there, no further details. She didn't want to run the surprise for any of us. You've got a poker face, you don't ask too many questions. I've got another thirty eight patients to see. Let's just remove whatever it is. Checks, she's all right, get her home on we go, So remove this this thing and about to chuck it in the bin. She says, oh no, no, no,
atnd of that, he needs to open it. Oh god, So so I passed him a pair of Latex gloves, you know, sand last in the last remnant of romance from this situation. He puts them on, opens it up, engagement ring, he said, yes, presumably out of fear at this stage.
Uh what's what's what's she likely to do? As interest as no?
So, but yeah, there's I mean, there's a lot of a lot of the Christmas was very good for this sort of stuff happening. Maybe it's like a special special occasion thing. But the worst I had was someone who put a string of Christmas lights inside and then switch them on, causing like all these little burns. Oh, bringing new mean to the phrase I put the Christmas lights up myself. And what else we had we've had.
The remote control. I love that you say people would always come to you with stories about it's always you. I think you refer to it as Eiffel Eiffel tower syndrome. I feel I fail.
Yeah, exactly, And the.
Remote control one sounded quite plausible.
Until until because I mean, I mean basically one, don't lie to your dot it's never helpful. They're trying to they're on your team. And also they're not going to I mean i'd say they're not going to remember it. They might be me and just write it down a little.
Bit of books.
I mean, but I always anonymous level anyway, But it's just unhelpful, just makes being slower and patients decide they have to spare our blushes or like we've seen worse.
We have one hundred per cent to well. But there was one story when I could sort of believe it because it wasn't a big remote control and it was wedged between sofa cushions.
This I was like, I mean, that could have happened, and you know, you try and get it out and when you do it push it's further anyway, So they told me there's big preamble.
They sort of removed it, and when I removed it, it did have a condom on it.
So that that maybe maybe went against anyway.
I mean, we could literally talk for ten hours just on this topic. But maybe that's why so many people bought the books. They just like to hear these stories.
It's much like I think how people watch reality TV because you can kind of feel a bit superior in some way to someone.
I mean, I've not invented the medical biography, not by hundreds and hundreds of years, but I think what I leant into more is sort of the other side of life when you're not at work, that you don't sometimes see what happens when the doctor and the nurse and a paramedic gets home and like what their actual life looks like. So I think people have been quite interested in sort of peering behind the blue curtain and learning more about, you know, the staff room and the home.
Life, also the home life that you barely got to enjoy.
That's the thing for all sorts of reasons. Being a doctor is all consuming. So in the UK you have to move hospital every six or twelve months, which is a good idea in theory took at some big hospital or some small ones I'm experts in and that's so that by the time you're a consultant the senior doctor, you're the best possible version of yourself in terms of your training. But they move you around a huge area.
You could be randomly allocated around Scotland, which is you know, it's hard to find an apartment's.
Candy for all of Scotland.
It's like the equivalent to being told, oh, you're just going to be working somewhere randomly New South Wales and good luck finding a place that's handy for all that. And so every six or twelve months you end up moving sixty or seventy miles away, and which is okay if you exist in a vacuum. But if you've got a partner, they might say yes once to moving the uproots in their lives, and they're going to say yes,
you know, six times in a row. And also there's this thing where you become I don't know, so like you're working a labor wordshift on paper. Your contract says that you know you'll finish at five o'clock, but it's never really five o'clock. There's some emergency and I guess technically have a choice at five o'clock if there's someone you know bleeding out, you could, but I mean, it'd never really applied to medical school in the first place
if that was a real decision. So you end up and there's not enough people to mop up and you know, and to you know, to take your place.
There's no slack in the system.
So you keep helping this this patient and then suddenly at seven point thirty and you're texting someone, I'm really really sorry, I'm gonna have to bail on drinks this evening because you know this happened the world and they understand because you're a doctor and you know you're not lying as you know some stuff that happened. Once you've texted the same friend two or three times in a row to counsel, you've become the flaky friend and they
just stop inviting you out. And so you see real time, in your first year or two as a doctor, your social circle just just shrinking to almost nothing. And when you do get home, you're just you're just knackered. You just want to have a nap. And so it does does have this big impact.
Well, it goes back to the point that you were saying that people don't necessarily think of their doctors as being human. But what you're describing is a system that also doesn't see its doctors as being human. And in Australia, I understand why people see parallels with your book because we also have praise be socialized medicine, so anybody can get the treatment that they need, regardless of their ability to pay. But what you need for that to work is the best doctors in the world to be working
in the best conditions. If you are dehumanized, what does that mean? Who am I coming in to see?
Exactly?
And ultimately they leave and I know for a fact like I did, and I know for a fact that Australia treats their doctor is better than the UK because of the exodus of staff from the UK to Australia. In two News even the number one and two places that British doctors go to. Last year in the UK, seventy seven zero doctors quit their jobs every single week. That was three times as many doctors quit their jobs as retired. Wow, it's a crisis in the retention of staff.
And there was a big thing about pay in the UK and doctors end up going on strike and that got resolved with the government and that was sorted out. And doctors do get paid more on Australia than in the UK. I think it's fair to say, but it wasn't just about that. It's about how you're treated, how you're looked after.
You know, I speak quite a lot.
About this, and you know I talk about it on social media and people you know, tell me their own stories of what had happened to them. So like someone telling me that on the day of their own wedding, which understandably they'd given, you know, I don't know how whether it's six not three years noticed that they were
getting married. On this stage, they couldn't get the full day off and they were only given the afternoon and evening off, so they had to do a clinic in the morning wearing their wedding care and makeup.
That is not looking after your style.
Someone who I know, who's I think fiance at the time, became very ill and was admitted to an intensive K unit.
It's fine now, but I was admitted to intensive K you obviously a very stressful time and said to her hospital, sorry, I need to go and be supportive, and they said, I'm sorry, but that you do not get compassionate leave unless it's a first degree relative or a spouse and you're not married, so technically that wasn't given compassion at leave, and so that is not looking after your staff properly.
It's about making sure that if something bad happens on the ward, there is a debrief afterwards that it's all sorts of things. It's about making sure you've got a staff room, just a place, you know, even a knacked old sofa in a sort of a thirty year old kettle to make yourself a cup of coffee with some horrable granules. It's just the very bare basics which places don't have, like they close down the staff room.
I'm so curious about how there was never any sense of mutiny.
I think the mutiny doesn't happen because it's ultimately about patients, and patients suffer. If the doctors say that's it, I'm off, and is still have a huge amount of guilt about leaving the profe. Most people don't leave leave, they go somewhere else, And I don't think there's any need to have guilt about that, because you're helping human beings, you know, wherever they are in the world or all one big family. I have a huge amount of guilt because I'm not helping.
I mean, the arts obviously have the most enormous value, but I'd have to have quite the ego as an author or a comedian to say that what I do on a day to day basis is in any way comparable to saving a mum's life on a labor ward. And it was that feeling that kept me in medicine, probably longer than.
I might have otherwise done.
I had to wait until I had a big, you know, acute thing happened. You know, the thousand cuts I was having on a weekly basis. I was, I was just I was just wearing those. It wasn't still a big thing happened that I actually left. And I think it's that guilt that means that I still, you know, do what I can to support my former colleague who are still working on the front line.
Hey, you know that period between when you left the NHS, which as it happens, I mean at the end of the book, it's just it's such a devastating thing. It's the most devastating thing that I can imagine would happen to the woman involved and also to the doctor who's involved in a labor ward. Yeah, when that happened, and I, like you said, prior to that, it had been the
death of a thousand cuts. Prior to that, you'd had you know, your best friends saying I don't think there's any point in us being friends anymore, because You've missed so many of the significant things in my life, but this and that was very moving. But this at the end is just so hard to read, almost impossible for you to come back from as a doctor. Is that how it proved to be?
It is?
So I'm not going to go into huge details, but essentially I was the most senior label doctor on a particular shift at a weekend, and all you want from every case as a barman and as a healthy mom and a healthy baby, and this is one of these terrible situations where we had neither of those two things. And essentially I realized at that point that I didn't have the emotional I don't know buffer to deal with this stuff.
I could deal with a.
Certain level a bad day at work, but there was a point at which it just absolutely knocked me over.
And it was obvious I wasn't coping.
I wasn't speaking to anyone about this, but my friends, you know, people on the boards knew what had happened, because you know, were travels quite quickly, and I wasn't doing very well. I was I was being very overcautious as a doctor because I never wanted this to ever happen.
Ever, again.
So I was thinking, I have to prevent this, but everyone gets this is there in section as soon as our baby's heart rate drops by one beat.
Permante was But being.
Overcautious is just as bad as being under cautious. And I'd lost my confidence in myself and I'd stop being if I have always a good doctor, I'd stop being
a good doctor in terms of my clinical judgment. And people would want me to feel better about what has happened, and they'd remind me that it doesn't matter how good you are, how experienced you are, how many courses you take, how many babies you've delivered, it's just a horrible fact of the job that, through sheer awful luck, if you're in that role, you will have some kind of big disaster to every five or six years. And that's just part of the job. And so it wasn't your fault,
just one of those things. But hearing that made me realize that I couldn't face that kind of thing ever happened as to me. Ever again, I've just you know, I don't have the armor, the exoskeleton that whatever it is, the coping mechanism to deal with it. And so I stepped away what I thought would be six months while I while I regrouped and and you know, got my life back together, and I'm essentially still in those six months off fourteen years later.
So how is that? Because well, you know, we've spoke about the family dynasty, the doctor dynasty or the dynasty for our non American listeners, how was that when you had, to, for instance, tell your family that you were not returning to medicine.
It went very badly, and again out of concern because you know, what on earth am I doing?
Why would you give up this job?
And I suspect that if I were to announce to you and I was going back to medicine, I would hear the cheers my mother all the way. She'd hear from Australia and we'd hear the cheer from England.
She must have thought you were a beautiful doctor.
Actually, she was very proud of my achievements in medicine. Found it slightly harder to recognize what an achievement was in a world that she wasn't part.
Of, like writing TV shows or writing books. But now she sort of now she gets it. I mean, there was a very long period of time where I was a jobbing TV writer, so I'd write on episode four of series six of someone else's sitcom or be a script editor. And I was so fortunate as a writer because the vast majority of writers don't get to write full time.
So I was, of course, even though you know, no one knew who I was, and I was just sort of getting on with her. I was having a lovely time.
Coming up. Adam tells me whose decision it was to casp beIN wi Shaw as himself spoiler, It was him. Do I go anywhere? How did you transition into writing me?
That's an interesting question. So when I left medicine, everyone was like, oh, you'll be fine. You'll be fine, Adam. You've got loads of transferable skills. And then I thought about, like, I don't know what these transferable skills are.
I could do cesarean sections, and who else wants that other than hospitals.
Exactly.
And so the only other thing that I'd done, you know, I said, So I went straight from school to medical school, and they's straight into medicine there, straight into obstetrics, and I hadn't taken a breath. The only thing that I could identify that i'd done was at medical school doing these like comedy shows, and so I was like, I'm going to give comedy ago. I've done it a bit before I enjoyed it. Some other people have pretended to enjoy it, and so if not, now when? And so
I started doing stand up comedy. And it's not a full time job doing comedy because most of the gigs are Thursday, Friday, Saturday nights.
Most of those gigs are a five hour drive away.
And then I get to do like ten minutes on a stage to twenty people, and then I'm driving back and then they're doing nothing for four days and then it starts again. And then I just started started writing, thinking of comedy ideas, starting to meet TV producers, and I'm very grateful to a couple of TV producers who gave me my initial break, you know, helping out at a very junior level writing on some TV shows. And then I clearly didn't destroy those shows because I got
invited back to another one. And then that built over over a couple of years until I was I was in this lucky position of being able to earn across that was only a fortune. But I think I suspect I was earning less than I ever was as a doctor. But I was doing something with zero stakes. A bad day at work meant someone on a stage, you know, through a can of to marches on my head or whatever, or someone a producer said, this is the worst script I've ever read, Please never darken my door.
But no one.
Died unless you killed on stage.
Unless I killed on stage.
And so far I've had a lot of collapses, but no one has died in one. And in fact, if you're particularly infirmly considering a comedy show, mine are a great audience to be in because the number of doctors and nurses and paramedics who come along to these shows, it's probably the safest place in any city. So I was doing this predominantly writing bit of stand up, and I went up to the Edinburgh Fringe, where I performed a number of times for but haven't been for maybe five or six years.
Wow, that's tough.
It's tough, but.
I've done it before and by this stage I'm fairly battle hardened, and I decided I wanted a full month at the Edam Fringe to remind myself back to basics of comedy. And I didn't write the show until very very late, I didn't quite know what it's going to be. And James, my partner, said, why don't you read out from some of your diaries, which he knew that I'd kept and they'd come with us on you know team, you know, moved from apartment to apartments and wherever to whoever in my filing cabinet.
And I thought about it.
I said, okay, I'll give it a go, and so I went on stage and I literally read that from scraps of paper and it was by far the best received thing I'd ever done on stage.
And suddenly stories that I.
Suspected they were interesting because I knew they had liked, you know, funny moments of them and interesting moments and sad moments, but I hadn't quite appreciated that, outside of the medical bubble that I lived in, how much people would would be into this these first And I think it probably applies to Melbourne as well. It's often the only chance you get to see your old mates who do comedy because if you're like you know, if you're a touring comedian, you're sort of or a TV comedian
or whatever that's fairly solitary. You don't hang out with huge numbers of other comedians, but this is the AGM, and you will hang out in one place. And so you go and see your mate shows, they see your shows. There's a friend of mine, brilliant comedian called Mark Watson who I know, who know tours in Australia, brilliant and I went to see his show here my show. His plus one at my show was his editor for the
books you write. He's a brilliant author. And Francesca, his editor, said to me, after, how many more of these diaries have you got, because I'm pretty sure there's a book in there. And she was right there and there was and that was there, and that was a pivotal moment in my in my life, totally changed my life.
And so I.
Still write and perform full time, but now I get to choose the projects that I write, which is the single hugest privilege as a as a writer.
Well, because you brought a world to people that I that appeals to everybody universally really, because either it's people who have got your experience, like you said, the doctors, the nurses, or it's people like us who have walked in to see a doctor who have had our babies delivered. Whatever it may be, there's no one that's untouched by the experience that you brought to people.
Yeah, I think everyone's got everyone's got an inn and hospitals can be quite miserable, scary, difficult places that aren't laced with great memories, and so I think there is something about then the like a side of it. Plus obviously hearing lots of discussing stories, objects and orifices.
Well, yes, of course there's always there's there's always dessert after the mara course. But you know you were saying when you first started writing, and you weren't you were earning even less than you were in medicine. Now a lot of us have got this idea about doctors that they're incredibly well paid and they've got a holiday house and a Lala and they're driving European cars whatever. I
was so shocked to read. I think you worked it out that you were earning like six quid to something an hour as a doctor.
I was never paid badly, but you just had to work a huge number of hours in order to guess that. And I remember doing the sun and working out at one hospital that I was earning less per hour for my shifts than the parking meter I could see outside the window was earning for Beata chuck In to come and come and see us. You'd be hard pushed to think that it's a job that people would do for
them money. There are a lot more efficient ways of turning your straight a's and your exams into cold hard cash than going via six years of medical school then teen years on the wards.
To make your way up to the top.
Because it's only when you hit the top of the tree and you know you're a consultant that you.
Have the opportunity.
I mean, there are lots of doctors who earn a very very very good wage, but I don't think any of them are people who don't have to work hard. I don't know certainly in the UK, if you want the doctors who earn the big money, who have the second homes and have the fancy cars, are people who do their NHS job and then spend their evenings and
weekends doing private medicine. For some reason, over the last few years, there's been a lot of anti doctor sentiment in the UK media, like you have to wait two months to see your GP ther appointments only eight minutes.
We're being told these mean gps.
Who are They've all got five helicopters each and in a house in Hawaii. They're not the people who are to blame that you have to wait this length of time. The people to blame are the people who aren't employing enough gps. Because these gps work as hard as they can, and I know loads of my friends are GPS, as my family GPS. It's heartbreaking for them how long these
waiting lists are. But the problem is there aren't enough of them, and the governments should be should be investing the resources to give people the you know what they need, rather than you know what are essentially client media of the government blaming the doctors. And a very easy thing for them to say is look at this doctor who's got a ferrari.
When they decided or they or you decided to make a series of your book, which is on STAN, the streaming service STAN in Australia here and a Canadian might of mind said it's one of the best series he's ever seen. Oh wow, how much say did you have in the casting of yourself?
I had a lot of say.
I was very and basically everyone was agreed that there was sort of only one person who could play it, and we've been talking about Ben Wishaw from the very It's so weird having this discussion. It's like one of these standard dinner party questions who would play you in a thing of your life?
And then we're sitting.
Around the table and was like, well, it's got to be by and so all our eggs were in that basket and we were like, well, this is a bit stressful because I hadn't finished the script yet. I hadn't finished I wasn't ready to take it to him yet. But so we brought on this an amazing casting director because there's obviously we needed one for all the other
tons of parts. Brought on the amazing Nina Gold whose loads of Bafter winning shows in the past, and and we're like, okay, so first question, who's the short.
List for this part? And she was like, well, it's got to be Ben wish or doesn't it.
So anyway, that was a lot of pressure, but luckily he loved the script, he agreed, he agreed, and we sat down for a nice lunch and by the end of it, he was on board. And I'm so glad he was because he is the most fantastic actor. The way he can do the comedy and the drama.
It's a bit like you.
Well, no portrayal of a health service can be just comedy or just drama.
That won't be a fair reflection of what it is.
It has to have a bit of both, and he can do them both so well.
And also he's such a sympathetic character.
I wrote the tele version of me very different to real me because if I'd have just written some sort of like superhero, you know, brilliant, lovely doctor, that's not a drama that's not enjoyable to what I wanted to show someone who's a bit of an asshole.
Who was you know, you could see why he was like that because.
The pressures on him, but ultimately wasn't very well behaved, and he played that with such I don't know, with such charm that I don't think he sort of ended up being haterable and in the wrong hands he could have been. And the other thing to say about Ben is I know an awful lot of actors, and I've worked with a lot of them. You normally have to choose between having a good actor or a nice actor, and Ben is one of the relatively shortness who is both very good and very nice.
Good on you, Ben, I wanted to ask if you could tell the story as a result of the series, you know how we were saying that that things have kind of changed, or you've brought a lot of stuff to public attention, if you could share the story of the tree that was planted.
Oh of course.
So as well as the character being different in this series, to real me, the storyline of the series couldn't.
Just be, you know, directly of my what's in the in the book.
And I decided, when trying to turn this into it like an arc over a full series, that I wanted to focus on the mental health of.
Doctors. And it's you know, a bit of a.
Spoiler to say that it's it's a storyline that it's around suicide of healthcare professionals, which is a very big problem, not just the UK, but but worldwide. And at the end of the series, there's a memorial scene where a tree is planted outside the hospital and a plaque goes in the ground. And we shot the exteriors of the
of the series. The interiors were in a studio, but the extraors were in a real hospital in West London, ealing Hospital, and I had a whole load of messages on social media afterwards and people getting in touch with the production company or the TV station or whatever to say that they'd looked round the grounds, they'd recognized the HOFB and looked for the for the tree, and then they realized that it was just a just a proper and I felt silly, and I got in touch with
the charity, UK based charity called Doctors in Distress. I'm proud to be a patron of who exists to decrease suicides amongst healthcare professionals.
Which is it an epidemic? It's an epidemic, isn't it.
The numbers are unthinkable, so UK numbers. But in the UK, every three weeks one doctor takes their own life. In the UK, every single week, one nurse takes their own life. And that's just two of the huge jigsaw of professions.
And I know, you know, having toured in Australia previously, coming coming back again shortly, and I've talked to you know, if your numbers are equally shocking, you know, it's one of the single biggest risks you can have for a suicide rate is working one of these professions in Australia. And so anyway, this charity Doctors in Distress, said that there was no more memorial in the UK to healthcare staff we've lost their life to suicide because of stigma
and shame and taboo. This thing that I think should be like a it's a national scandal, it should be a headline every time that happens. Every time just gets brushed under the carpet. So I got back in touch with ealing hospital and said can we come back and can we plant a tree that will stay there? And they said yes very kindly, and that became the first ever memorial in the UK to healthcare staff we've lost
their lives in this way. And since then we've been around another couple of dozen hospitals, plants a couple of dozen trees, and I mean, it's not going to do anything in and of itself, it's just a tree. But I think it potentially does two things. So it's a memorial to people who must never be forgotten. That's a
very important thing. But secondly, surely the first step in resolving a problem, whatever it is, has to be admitting that the problem even exists in the in the first place, and I think hopefully this goes some way towards achieving that because this is a this is an issue that isn't talked about by the profession.
And it needs to be.
Adam Kay, thank you for sharing yourself with us on no filter.
Thanks for having me.
Is laughter the best medicine or medicine.
Medicine is the best medicine. But laughter is very important. And I love writing books and I love hearing the people who've enjoyed it. But I also love getting back to my to my roots and getting on stage because then the laughter comes immediately. I'm dead excited about coming back to Australia with this is going to hurt, which is happening shortly. And I'll tell you the best thing about it for me, it's not actually I lied then.
It's not actually the bit on stage. It's the bit afterwards where I sit in that sit at a desk and people have brought their books along and or buy books or whatever, and I sign I signed copies and actually get to speak to people who've got their own stories from working in these environments or being a patient, and a very weird thing that's happened in the last year or so, and that this won't happen on tour
in Australia. But it's happened. It's happened quite a few times in the UK, and three times now that i've I've say, who can I sign this to it? And they tell me, and they said, and point to their sort of teenager with them and say, you're not going to remember this person, but you delivered them seventeen years ago. So I've now I'm now in the amazing situation. It's a great business model. Actually, is it delivering your own.
Your own audience, you're an audience.
Yeah, so definitely Penicillin et cetera best medicine. But laughter is a very important way to decompress. And I suspect if it wasn't for laughter, that be a lot fewer people working on their wards.
Thanks Adam, kay, we look forward to seeing you in Australia.
Thank you for having me. I can't wait.
Oh. I love how honest Adam is. His willingness to lay everything there has not only sparked important conversations, but has even led to meaningful changes in how we and in the UK they think about the healthcare system. If you want to hear more from Adam, he's currently touring Australia with his stand up show, a performance that, much like his book, balances comedy and tragedy in equal measure.
It's raw, it's hilarious, it's really moving. It's a glimpse into the realities of medicine, told with his signature wit with included links in the show notes so you can grab tickets and experience it for yourself. The executiveget user of No Filter is Nama Brown. Senior producer is Grace Ruvre. Sound design is by Jacob Brown and I am your host Kate lane Brook. Back with you next week.