Welcome to the NHS!” Ben Whishaw’s permanently exhausted junior doctor Adam trills to the camera while being pushed through the hospital corridors on a gurney, squatting over a woman who is mid-labour and experiencing an umbilical cord prolapse. He is, as his unflappable colleague Tracy puts it, “holding the cord inside”, or, in Adam’s more graphic turn of phrase, “wearing her like Kermit the Frog.”
Only a few minutes earlier, he’d woken up in his car, too tired to drive home from his last shift and now late for the next. He delivers the baby by caesarean section wearing yesterday’s jumper, or as his stony-faced consultant Mr Lockhart (Alex Jennings) puts it, making the phrase sound like some particularly heinous swear word, “in casual wear.”
This opening sequence – chaotic, funny, deeply, deeply stressful, and littered with deadpan fourth wall-breaking from Whishaw’s character – immediately sets the tone of This Is Going To Hurt, BBC One’s superlative adaptation of Adam Kay’s wildly successful medical memoir. Everyone working on the obs and gynae ward (nicknamed “brats and t**ts”) of this London hospital is completely knackered, over-stretched and under-resourced; no one is deified because of their job – they are just fallible people flailing around, trying to do the right thing in unenviable, frustrating circumstances. Births are not miraculous but mundane – “same s**t, different vagina.”
The pace is necessarily relentless, each episode cramming in a steady stream of medical incidents ranging from the ridiculous (a Kinder egg being retrieved from… I’ll leave you to fill in the blanks) to the tragic. One catastrophic mistake leaves Adam reeling, replaying the event in his mind over and over until the images constantly intrude on the most banal of everyday actions. These tonal shifts might have ended up a bit “Alton Towers” – to borrow a phrase from Adam, criticising medical student Shruti (Ambika Mod) for crashing the aforementioned gurney into the walls like a dodgem – in less assured hands, but Whishaw is such an engaging performer that the whole thing feels effortlessly authentic.
He’s our anchor in the whirlwind of the ward, but the ensemble cast is similarly impressive. There is a camaraderie of sorts between Adam and his colleagues, expressed either in secret codes (mostly used to disguise the fact they’re asking for someone to do the coffee run rather than a medical procedure) or a sort of performative sniping. Just as Mr Lockhart puts Adam in his place with a string of withering one-liners (“You can’t have cared for her that well or she wouldn’t have died,” is his matter-of-fact retort when Adam asks whether he can break protocol and attend the funeral of one elderly patient he’d “really cared” for), he in turn takes out his frustrations on Shruti, though their relationship eventually thaws. “Friends?” Adam asks after one particularly gruelling shift. “Colleagues,” she answers emphatically.
Mod, a standout in her first major TV role, plays Shruti with a nervous energy and a keenness to please that we can see turning to disillusionment and pragmatism in real time, while Kadiff Kirwan is enjoyably superior as Adam’s peer Julian, who never wastes an opportunity to remind our protagonist that he is just an “acting” registrar, and not doing a particular convincing job at it.
Set in 2006, when the real Kay was working as a junior doctor, there are enjoyable flashes of nostalgia in the show’s mid-Noughties backdrop, from the chunky Nokia phones and their glitchy ringtones to the soundtrack (yes, that is a Libertines album track you hear) and clips of Preston and Chantelle falling in love on Celebrity Big Brother.
Yet Kay certainly doesn’t romanticise the near past. Adam lives with his partner Harry (Rory Fleck Byrne), but doesn’t correct his colleagues when they ask about his girlfriend; he is also yet to properly talk about his sexuality with his mum, played glacially by Harriet Walter (her character is not quite as pathologically chilly as Succession’s Caroline Collingwood, but she’s not far off).
Kay has described the show as “a love letter to the NHS”. Thankfully it’s not a soppy Valentine’s card but a deeply nuanced tribute that’s by turns horribly funny, heartbreakingly sad and righteously angry. This series, delivered by another institution we often take for granted, deserves to be just as big a hit as his book.
This Is Going To Hurt begins on BBC One and BBC iPlayer on February 8 at 9pm