The series is based on Adam Kay’s award-winning international multi-million selling memoir of the same name, which has sold over 2.5 million copies to date and has been translated into 37 languages. The series, which is created, written and executive produced by Kay himself, rejoices in the laugh-out-loud highs, while pulling no punches in its depiction of the gut-wrenching lows of life on a gynaecology and obstetrics ward.
Blisteringly funny and frequently heartbreaking, This Is Going To Hurt remains a stark reminder of the vital role played by the NHS.
Kay’s diaries, scribbled in secret after endless days, sleepless nights and missed weekends, tell the unvarnished truth of life as a doctor working in obstetrics and gynaecology. At times hilarious, at times devastating, This Is Going To Hurt is a 7×45’ series following Adam (Ben Whishaw – A Very English Scandal, Skyfall, London Spy), a doctor who we find wending his way through the ranks of hospital hierarchy, junior enough to suffer the crippling hours, but senior enough to face a constant barrage of terrifying responsibilities. Adam is clinging to his personal life as he is increasingly overwhelmed by stresses at work: the 97-hour weeks, the life-and-death decisions, and all the while knowing the hospital parking meter is earning more than him.
Whishaw is joined by newcomer Ambika Mod as Shruti, a young junior doctor just starting in obstetrics and gynaecology. Naturally bright, diligent and caring, she has everything it takes to be a great doctor, but the job still finds ways to throw her into chaos and doubt.
Michele Austin (Meet the Richardsons, The Casual Vacancy) plays Tracy, a confident, sharp-witted senior midwife and Bafta-nominated Alex Jennings (The Crown, A Very English Scandal, Unforgotten, The Lady In The Van) plays Mr Lockhart, a consultant and Adam’s domineering boss. Kadiff Kirwan (Chewing Gum, This Way Up, The Stranger) plays Julian, Adam’s colleague and professional rival and Ashley McGuire (This Country, Malory Towers, It’s A Sin) plays Miss Houghton, a formidable and forthright consultant who spots potential in Shruti.
Emmy-nominated Dame Harriet Walter (Killing Eve, The Crown, Succession) plays Veronique, Adam’s mother. Rory Fleck Byrne (Harlots, Vita and Virginia, Ghosts) plays Adam’s boyfriend Harry, and Tom Durant-Pritchard (Feel Good, The Windsors, Judy, The Crown) plays Adam’s best friend Greg; his two closest relationships and the ones which feel the brunt of the pressures he faces at work.
Created, written and executive produced by Adam Kay, This Is Going To Hurt is commissioned by Piers Wenger, Director of BBC Drama, is executive produced by Naomi de Pear (Don’t Forget The Driver, Flowers, The Bisexual, The Power) and Jane Featherstone (Chernobyl, Giri/Haji, The Split, The Power) for Sister, James Farrell (Untitled Game Of Thrones Prequel) for Terrible Productions, Mona Qureshi for BBC One, as well as Kristin Jones and Dan McDermott for AMC. Ben Whishaw also serves as Executive Producer.
The series is produced by Holly Pullinger (Don’t Forget The Driver) with Lucy Forbes (In My Skin, The End Of The F***ing World series two) directing the first four episodes and Tom Kingsley (Ghosts, Stath Lets Flats, Pls Like) directing the final three episodes. The international distribution of the series will be handled by BBC Studios.
How does it feel to have the finest actor of his generation playing me? In a career-defining performance? Yeah, it’s OK, I guess.”
Adam Kay is the writer, creator and excutive producer of This Is Going To Hurt
It’s the story of a junior doctor in obstetrics and gynaecology (or brats and twats as it’s known) and the huge impact this job has on his life – both at home and at work.
How did you find the process of adapting your own book to the screen? Is it much the same as the book, or will there be lots of new elements that weren’t in the book?
The nature of the book – hundreds of diary entries in a single person’s voice – meant that a totally direct adaptation would have been something of a one-man sketch show. The TV series expands the world, predominantly in terms of the other characters we meet: from Adam’s family and boyfriend, to his midwife colleagues and other doctors. I’m sure people who have read the book will recognise lots of the scenes and hopefully feel that it’s still as funny, sad and of course repulsive as they remember.
TIGTH feels very different to other hospital set dramas and comedies – what is it about the series that you think sets it apart?
I’d like to think that no one has made a medical show that’s quite as real before – and not just in terms of the clinical details. I remember watching an episode of Doctor Foster (which I adored) – there was a scene in a surgery and my husband asked me if it was accurate. It was spot on medically, but it didn’t quite explain how a GP had time to have all these dinner parties, let alone run a vigilante detective outfit.
I’ve often thought that medical programmes don’t tend to paint the life of a doctor in three full dimensions, and I think that’s something we’ve achieved really well. I realise I drove Lucy and Tom, our brilliant directors, absolutely bananas with my insistence on keeping things as real as possible – from the font on the hospital posters to the exact model of car that Adam drives – sorry! Also, I’m pretty sure no one has made a medical show that’s quite as disgusting before.
The show is set in 2006, when your diaries were written, but the show feels incredibly resonant with today’s world. What is it about the story and themes you explore that will resonate, and feel important, today?
There’s something of a universality about the life of a medic. I remember from the moment the book came out, I would get emails from doctors all around the world telling me that it could have been set in their hospital in Germany/Goa/Greece/Ghana. And even though some of my diaries were set before today’s medical students were even born, I receive messages from them saying that nothing much has changed (which is a little depressing).
Ultimately, the show is a love letter to the NHS – to my mind the country’s single greatest achievement: healthcare that’s free at the point of service, always based on your clinical need and never based on your bank balance. The NHS only exists because of the 1.4 million people who work there, going far beyond the call of duty to keep the rest of us on the road. The pandemic has reminded us quite how hard they work, quite how much they sacrifice and quite how little slack there is in the system, and This Is Going To Hurt really underlines that.
The show explores the many challenges medics face and the cost they sometimes pay for their choice of career, not just on the wards, but in their own personal lives too. Do you think this portrayal of a career in medicine might surprise people?
My diaries were published in the first place because I wanted people to understand the true nature of a doctor’s job. I think people were definitely surprised: the constant tsunami of bodily fluids, earning less than the hospital parking meter, and the difficulty in maintaining friendships and relationships when you’re working 97-hour weeks.
I certainly didn’t know any of this when I applied to be a doctor in the first place, and I rather wish I had. I’ve had quite a few messages from angry parents telling me that my book has put their children off a career in medicine – I’m pretty sure that if a book put them off being a doctor then being a doctor would have really put them off. The TV show has the capacity to reach a far bigger audience, and really let them know about the huge toll being a doctor takes on the human beings underneath the scrubs.
The show demonstrates how much responsibility and pressure is placed on the shoulders of young medics: “See one, do one, teach one” being a good example. Generally, there’s increasing awareness around mental health and support these days, but do you hope this show will contribute to greater awareness around how these pressures affect our medical professionals in particular?
People will potentially be very surprised about quite how deep the deep end is in medicine, and how steep the learning curve accordingly has to be. I wish I could say that any aspect of this has been exaggerated. By the very nature of the job, there are a lot of ‘bad days’, and on labour ward those bad days can obviously be extremely bad.
The attitude in medicine is very stiff-upper-lip based – you’re a bloody doctor and you bloody get on with it. The book and the show both highlight doctors struggling after difficult incidents. When the book was released, I was contacted by dozens of medics who told me that until they read it they thought they were the first doctor who’d ever cried in the locker room. The truth is that most doctors end up crying in a locker room but no one ever really talks about it. Things have got slightly better since I last did a shift on labour ward, but not better enough, and not fast enough. If the show can help shift the dial a bit on how the NHS deals with the mental wellbeing of its staff that will mean a lot more to me than any awards or viewing figures ever would.
Amid the drama there are lots of hilarious moments too, often side by side. How reflective are these highs and lows of real day to day life on an Obs and Gynae ward? Did the sublime often meet the ridiculous?
I strongly believe that the only honest way to portray life in a hospital is as a comedy-drama. Much as a sitcom could never speak to the urgency and tragedy of life on the wards, nor could a straight drama convey the funny and ridiculous situations that pepper every doctor’s day. You can have a hilarious moment in antenatal clinic that you know you’ll be recounting in pubs for years, and two minutes later you’re telling a patient that you can’t find their baby’s heartbeat – it’s a job of contrasts and constant gear-shifts.
How does it feel to have Ben Whishaw play you in your own TV show?
To have the finest actor of his generation playing me? In a career-defining performance? Yeah, it’s OK, I guess.
How was it working with the rest of the cast? It’s a brilliant range of established talent and newcomers.
The cast is an absolute dream – from acting royalty, like the incomparable Harriet Walter, to tomorrow’s superstars like Ambika Mod, who it’s almost impossible to believe is in her first role. Nina Gold and Martin Ware, our brilliant casting directors, have done a simply astonishing job – every single member of the cast brings drama and comedy in bucketloads, and it all adds up to what I think is a very honest and recognisable portrait of the NHS.
Do you think any former colleagues or patients will recognise themselves in any characters or situations in the show?
I rather hope that no patients will recognise themselves, because I don’t particularly want to end up in prison for breaking their confidentiality. Although I guess that would make my diaries more interesting for the next few years.
What do you hope audiences take away from the series? And how do you hope the 1.4 million people working in the NHS respond to the show?
I hope they laugh, I hope they cry, and I hope they realise more than ever what an amazing and precious thing we have in the NHS and how much more we need to do to look after the people who work there. For the brilliant people who work in the NHS, I hope they feel that I’ve done their story justice.
Interview with Ben Whishaw
I find the way Adam writes himself extremely interesting because it’s so naked. He doesn’t really try to make himself look better than he is. In fact, he seems to go to pains to really show all his flaws and failings.”
Tell us, in a nutshell, what This Is Going To Hurt is about.
It’s based on a book by Adam Kay comprised of his diaries that he kept during the years he was a doctor for the NHS. He’s adapted it into a seven-part series. It’s a kind of reflection on his experiences of his time on the wards back in 2006 when he was working for the NHS.
My character Adam Kay is a junior doctor when we meet him, trying to keep afloat in a system that is unrelenting. He’s someone who’s really trying to do good but also deal with his own flaws, foibles, shortcomings and failings, which is really interesting because I think when you go into a hospital or when you are dealing with a doctor, you think they are superhuman in some way, and I love that this character is all too human really.
Were you aware of the book before taking on the role?
I must be the only person in the country who hadn’t heard of it before I got sent it and before I met Adam, which is a bit embarrassing! But I certainly know it now.
The book has some very funny moments and also some very serious and sad moments. Can audiences expect the same from the show?
Yes. I think that with this show and with the book, the two go hand in hand. A lot of the humour that’s in the show is just drawn directly from real life stuff that happened to Adam. And to a degree, a lot of the jokes are Adam’s way of coping, I suppose, with the pressures of being a doctor.
How does the fictional Adam differ from the real Adam Kay?
Well, that’s a good question. I’m not really sure! I find the way he writes himself extremely interesting because it’s so naked, in a sense. He doesn’t really try to make himself look better than he is. In fact, he seems to go to pains to really show all his flaws and failings and so on.
What drives your character Adam, and why does he keep working for the NHS?
It’s a complicated question. I think partly he comes from a long line of doctors and I think it was what was expected of him as a young person. There’s so much that goes into training to become a doctor and it takes up so much of your life. So you get to a certain stage and you have done nothing else other than medicine, it’s the only thing you can do, it’s become your entire existence. I think there’s a really genuine wish to do something useful, to be of service to people. I think that is really a sincere part of his drive.
The sets have a very particular look that make it different from other hospital dramas. Could you tell us a bit about that?
Yeah, I just think they’ve done the most incredible job of making it feel like you’re in a real hospital. It’s so detailed. You almost feel like you can smell it. I don’t know about you, but whenever I go into a hospital, it makes me feel a certain strange array of sensations. Partly dread, I don’t know. And I get the same feeling when I walk on here. I don’t quite know how they’ve done it. It’s a sort of magic trick.
Can you tell us about working with directors Lucy and Tom and why they were right to tell this story?
I feel enormously grateful to Lucy and Tom, because they’ve managed to strike this incredible balance between the comic elements and the serious, sad and more painful elements of the story. It’s such a hard tightrope to tread and they’ve both managed to keep both things alive and both things feeling real. That was not apparent to me how that would work when I read the script. I didn’t know how we would do it.
Have you been given any basic medical training?
Yes, but really very basic. It’s been so interesting. We’ve learned how to do Caesareans. I had no idea that it was as basic a process as it is. You literally take a scalpel and slice through the flesh and then you literally put your hands in and pull the muscles apart and then you shove your fist in and grab the baby. Things like that are extraordinary. I have to thank the three medical advisors who’ve been on hand constantly – Nikki and Seb and Ruth – they’ve just been wonderful. They’ve been here every day to answer any questions that anyone has about any aspect of how anything here would work in reality. And that’s been amazing.
It’s like a hospital is this little system of rules and hierarchies and it’s quite mysterious; obviously if you go in as a patient you don’t have the time to understand what it is that’s going on, but there’s so much going on between the people that make the whole thing work that’s fascinating. Tiny details but that’s one of the things I’ve really loved.
Have you been squeamish at all with all the blood and gore?
I’ve been ok. Usually, I can detach because I know it’s not real – but having said that there was someone in A&E here, a supporting artist who was just being wheeled through the back of a shot but he had a broken leg, I suppose. And it was an incredible piece of prosthetics because you saw the bone jutting out of his shin and it really, really gave me a very visceral reaction.
In the book, there are some pretty crazy and unusual situations and stories that happen to Adam. Can audiences expect the same in the show?
Yeah, definitely. A lot of the diary entries that are in the book crop up in the show. Sometimes literally. We see that it’s something Adam is going through in his day to day work. Or they become sort of anecdotes that Adam tells in some situation or other. So yeah, lots of those are here. The greatest hits are all here, I think.
You mentioned the caesareans, but are there any other operations or procedures that stand out for you?
Some of the funniest ones have been when, in the gynaecology ward, having to remove various items from various orifices. They’ve been very funny and memorable. There was also a scene that I particularly love when a woman wants to eat her own placenta because she’s read that it’s a good thing for her and the baby, and, well, it gets messy.
What realities do you think the show portrays about what it’s like to work for the NHS?
Adam Kay is really interested in showing the toll it takes on people’s mental health, emotional life, and personal life when you’re a doctor. I had no idea, really, of the pressures that these people are under. So while it is hopefully very funny at times. It has a really serious agenda, politically and socially and everything else.
And what are the challenges that young doctors face when they attempt to have any sort of normal or healthy relationship?
A lot of it is to do with how you navigate having to essentially detach from your emotions, because as a medic obviously you can’t be profoundly emotionally affected by every situation you deal with. At the same time, you can’t be entirely devoid of feeling. So navigating this is profoundly difficult and there’s no, or very little or negligible, support in that way for doctors. It’s all those sorts of questions: how do you share what’s happened in your day with your partner? Is it right to load it on someone else? It’s so heavy, but what do you do with it? And how can you the barrier down? And what if once you let the barrier down, you can’t keep going… and all of those sorts of things.
Can you tell us about Adam and Harry’s relationship?
I hope that something we’ve managed to convey is that they do love each other. They’re good for each other. It seems to be working in some way between them. Certainly, Harry seems to lighten up Adam, soften him a little bit, but it’s hard and the job takes its toll on the relationship.
And what about Adam’s relationship with his parents? What’s that like?
In the show, I guess, he feels like he’s never good enough for his mother. Nothing he has ever done or will ever do will satisfy her, and will never get the response from her that he longs to get. I think it’s how a lot of people feel about their relationship with their parents. So, I think it’s a really amazingly drawn element in the script.
And what about Adam and Shruti’s relationship? Can you tell us about that?
That’s one of my favourite parts of the show. I think in some ways it’s the centre of the show. I guess Adam is Shruti’s boss, sort of. And he really lets her know that at times. It’s very tenderly drawn, though. As I say it’s really the heart of the show. It’s mainly wonderful to me because I absolutely adore the actress that plays Shruti. Her name is Ambika Mod and she’s amazing. I’m just blown away by her!
Can you tell us about the concept of ‘see one, do one, teach one’?
See one, do one, teach one is apparently a teaching method. Say you watch a procedure once, and then you have to do that procedure, and then you have to pass on that knowledge to someone else. And there’s hardly often very little more to it than that. Yeah, you’re literally thrown into the deep end. The challenge to people, not only in terms of their knowledge and skills and everything, but emotionally and in their nervous system, is how you cope with everything that’s coming at you, is just extraordinary.
For a number of reasons this show feels particularly timely and resonant – would you agree?
Yeah, I think it’s a time when we’ve all been more aware than normal, probably, of just how much we owe to the people who work for the NHS. The extraordinary work they do and what they sacrifice to do it. I think we’re all still reeling from the last couple of years. But certainly, I feel like in making the show, there’s a real sense of purpose amongst the cast and crew and everyone. This feels like something important to do in a sense.