The True Story of This is Going to Hurt: Adam Kay, Junior Doctor, and His Return to Australia
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The journey of Adam Kay, from working strenuous shifts in the UK’s National Health Service (NHS) to becoming a global literary and comedy sensation, is a powerful testament to the necessity of bearing witness to professional stress and institutional pressures. Kay’s work, centered around his memoir This is Going to Hurt, offers an unflinchingly honest, dark, and often hilarious glimpse into the grueling reality faced by junior doctors. The book, which has sold over 3 million copies worldwide and been translated into 37 languages, quickly became a phenomenon. Its success led to a 2022 hit television show starring Ben Whishaw, which garnered critical acclaim, including four BAFTA TV Awards. Now, following a sold-out tour in 2024, Kay is returning to Australia in 2025 with his one-man stage show, This is Going to Hurt: Secret Diaries of a Junior Doctor, excited to share more comical stories from his time on the ward with Australian crowds.
The Raw Reality of the NHS
Adam Richard Kay, born in 1980, followed in his doctor father’s footsteps, studying medicine at Imperial College London and graduating with an MBBS degree in 2004. Shortly thereafter, he began working as a doctor at Ealing Hospital, specializing in the obstetrics and gynaecology (O&G) department. For about six years, Kay maintained diary entries detailing the highs and lows of his day-to-day experiences. These entries, which began on August 3, 2004, ultimately formed the foundation of his 2017 memoir, This is Going to Hurt.
The core narrative of both the book and its television adaptation revolves around the tremendous strain placed upon junior doctors. Kay wrote extensively about the gruelling workload, coupled with the mistreatment and neglect he often had to endure. The medical drama series successfully portrays the hectic lives of practitioners struggling within an understaffed and overcrowded medical system. Scenes like the character Adam (Whishaw) waking up in his car after an overnight shift immediately plunge viewers into the chaos and pressure endemic to the NHS. The show consistently highlights the dichotomy medical practitioners face, torn between delivering professional duties and finding time to recuperate, showing how this pressure seeps into their personal relationships.
The Ethical Choice to Fictionalize
While the memoir serves as an authentic foundation for the screen adaptation, Kay confirmed that numerous narrative elements in the show are fictional additions. The nature of the book—hundreds of diary entries written in a single person’s voice—meant that a direct adaptation would have risked being merely a "one-man sketch show," according to Kay. To expand the world and explore other perspectives, the TV series introduced fictional characters and plot threads.
A key change involves the creation of the junior doctor Shruti Acharya, a character derived from the experiences of the numerous junior doctors Kay worked with over the years. Furthermore, locations were dramatized; the fictional St. Clare’s Hospital, where much of the action occurs, is based on the real-life Ealing Hospital in West London.
In the original diary entries, Kay had adopted an intentional practice of anonymizing individuals. He referred to his co-workers by their designation and his partner as “H”. Kay explained that this was a deliberate decision in the book, stating that identifying colleagues or patients would have resulted in severe consequences, such as being struck off the GMC (General Medical Council) or even legal trouble. The adaptation provided the creative flexibility needed to believably recreate a complex hospital environment while protecting the identities central to the real stories.
The Traumatic Turning Point
Adam Kay continued working diligently as a doctor until a catastrophic event on December 5, 2010, changed his trajectory forever. This incident forms the final diary entry recorded in his memoir, This is Going to Hurt. Kay described having to perform a complicated caesarean section on a patient carrying her first baby. The surgery was tragically complicated by an undiagnosed placenta praevia. Despite his best efforts, the baby was delivered stillborn, and the patient had to be rushed to the Intensive Care Unit due to heavy haemorrhaging.
Following this trauma, Kay reportedly began displaying symptoms of post-traumatic stress disorder. Just a few months after this devastating event, Adam made the decision to quit the medical profession. Although he had left medicine, it wasn't until 2016 that he was formally informed that he would no longer be able to work as a doctor. This development, coupled with the increasingly worsening working conditions for doctors, prompted him to revisit his diary entries with a new purpose: to bring the doctor’s perspective to the public eye. Thus, both the memoir and the subsequent television adaptation are fuelled by the urgent concerns regarding the real-life struggles faced by doctors in the UK.
Doctor-Turned-Comedian: A New Career Trajectory
Kay had always possessed a deep interest in the creative arts, even while practicing medicine. Before graduating in 2004, he was involved in performance arts, starting with medical school shows in 1998. He co-founded the parody music band Amateur Transplants, which achieved national success when their song "London Underground" became a chartbuster in 2005.
After leaving medicine, Kay transitioned fully into the creative industry, finding professional success as a writer and comedian. He co-created the BBC Three show ‘Crims’ (released in 2015) and wrote for shows like ‘Very British Problems’. He was recognized as a talented musician, winning Best Musical Variety Act at the 2014 London Cabaret Awards.
Following the release of This is Going to Hurt in 2017, his career as a storyteller exploded. The book held its position as the Sunday Times number one bestseller for over a year and earned him New Writer of the Year at the UK’s National Book Awards of 2018, where the memoir was also named Book of the Year. Since this debut, Kay has written a further nine books, including ‘Twas the Nightshift before Christmas and Dear NHS: 100 Stories to Say Thank You, which engages with similar themes.
Global Acclaim and Screen Adaptation
The critical reception to Kay’s work solidified his position as a crucial voice addressing medical burnout. The television adaptation, This Is Going To Hurt, was a massive success, praised for its realism in portraying the NHS and its ability to blend dark humor with emotional depth. The limited BBC series achieved a staggering 96% critics' score on Rotten Tomatoes and collected four BAFTA TV Awards. Despite the clear public appetite for more content, Kay remained firm in his decision not to rush a renewal, stating he had spent years thinking about the series and didn’t want to hastily create another one a year later.
Bringing the Diaries Live to Australia
In addition to his literary success, Kay has toured the globe as a stand-up comedian. His breakthrough one-man show, also titled This is Going to Hurt, has been a consistent hit, selling out shows for six years straight at the Edinburgh Festival Fringe. He was also the best-selling act at the 2023 Edinburgh Fringe.
Following a previous sold-out tour in 2024, Kay is eager to return to Australian shores in 2025 for an extended tour. The Adam Kay This is Going to Hurt: Secret Diaries of a Junior Doctor 2025 Australian Tour commences on Saturday, April 12, at The Story House in Geelong. He will then head to Melbourne for the Melbourne International Comedy Festival (April 15-20).
The tour continues across the country, with dates scheduled for Hobart (April 22), Adelaide’s Norwood Concert Hall on Wednesday, April 23, Canberra (April 25), and Thirroul (April 26). The final stretch of the tour includes shows in Newcastle (April 28), Sydney (April 29), Perth (May 3), and concludes at the Brisbane Powerhouse on Wednesday, May 7. Tickets for all shows are currently on sale via BOHM Presents.
🔖 Key Takeaways
Adam Kay’s work, particularly This is Going to Hurt, serves as an essential narrative detailing the struggles of a Junior Doctor within the NHS.
🗝️ Based in Reality, Expanded for Art: The television series and stage show are based on Kay’s authentic diary entries from his six years in obstetrics and gynaecology, but fictional elements—such as characters like Shruti Acharya and locations—were added to enrich the storytelling and protect real identities.
🗝️ The High Cost of Duty: Kay’s medical career concluded after a traumatic incident in 2010 led to symptoms of PTSD, prompting him to quit the profession and later use his diaries to advocate for doctors facing gruelling working conditions.
🗝️ Creative Transition: Since leaving medicine, Kay has achieved significant success as a writer and comedian, with his memoir becoming a multi-million-copy bestseller and a BAFTA-winning television show.
🗝️ Australian Return: Kay is bringing his acclaimed one-man stage show, This is Going to Hurt: Secret Diaries of a Junior Doctor, back to Australia for an extended run in April and May 2025, following a successful sold-out tour the previous year.
Kay’s ability to transition from the harrowing high-pressure environment of the emergency ward to the demanding stage of stand-up comedy demonstrates a profound resilience, using humor and honesty as the ultimate tools to process trauma and drive awareness. His journey mirrors the way a pressure cooker, once cooled, allows the steam to escape—but only after the profound intensity of the heat has done its transformative work.
🌐 External sources
Keywords: This is Going to Hurt
This is Going to Hurt
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