‘I killed a character eating my Shreddies’ | Books | Entertainment

Adam Kay has an admission. “I doubt I was the only person who sat in medical school lectures thinking, ‘That would be a good way to murder someone’,” he grins. “So it was either write about it or take up murdering as a hobby!” We can all be grateful the junior doctor turned bestselling author took up the former. Having walked away from his job in obstetrics and gynaecology 16 years ago in the midst of a crisis of confidence, Kay turned to writing without any great expectations. Seven years later, This Is Going To Hurt, an eye-wateringly honest and darkly funny memoir based on diaries he kept while working 90-hour weeks in the NHS, sold three million copies and was turned into a Bafta-winning TV drama starring Ben Whishaw.

Since then Kay’s juggled stand-up comedy, TV scriptwriting, more memoirs, campaigning and bestselling children’s books. But we’re talking today about A Particularly Nasty Case, his debut crime novel which comes out in paperback on Thursday. It’s laugh-out-loud funny, outrageous and gruesome in equal measure – with some passages best read through your fingers – and fans will love it. Kay’s hero Eitan Rose is a bipolar consultant rheumatologist recently returned to work after a mental health crisis who copes with his job by ingesting liquid cocaine through an inhaler. When one of his colleagues dies in slightly mysterious circumstances, Rose is forced to investigate – even though, truth be told, he didn’t like the victim all that much. The problem is, no one else had raised so much as a peep. “But is he onto something or is the pressure of the job getting to him?” muses Kay.

“I wasn’t in the courtroom to hear the evidence, and I don’t know what to think other than how awful it is for those poor bereaved parents,” he says. “I suspect that people who have vibe-based feelings about the case weighing in only makes it worse for these people going through utter hell.”

Not that Kay is afraid of taking a viewpoint, having become something of a go-to talking head for issues involving junior – now resident – doctors and the NHS since then Health Secretary Matt Hancock first tapped him up for a chat having read This Is Going To Hurt (the NHS subsequently launched a mental health support programme for NHS staff).

Today he remains a fierce supporter of his former colleagues and strongly believes we need to do even more to support mental health among medics – alarmingly, figures reveals one doctor dies by suicide on average every three weeks. “The NHS we rely on is staffed by real people who have all the same problems as the rest of us, but added into the mix are the additional pressures of the NHS,” he says.

“They work in increasingly difficult conditions, often very long hours, with hardly any support, and, like in A Particularly Nasty Case, perhaps with mental health struggles of their own. Something’s got to give. Charities like Doctors in Distress believe, as I do, that suicide is preventable, and are working tirelessly to bring the current horrendous numbers within the NHS down.”

As for making his unlikely sleuth bipolar, Kay thinks it ironic one of the worst places to suffer mental health is if you’re working in the NHS. He has previously stated that the health service is ten years behind the rest of society in its treatment of such conditions in house. “I do feel the stigma of mental illness is slowly starting to lift, generally, although sadly not around bipolar or schizophrenia,” he says. “Isolation breeds fear and intolerance, so whether it’s a professional, a celebrity or an influencer helping people open up, get diagnosed or seek help I’m all for it.”

As for ongoing strike action, and the suggestion the public is losing patience with resident doctors, he tells me: “I still earned a lot more in real terms than doctors today for doing the same job. I support them but pay is only a small part of the problem. If doctors aren’t treated better, even more will leave the country to work in places like Australia where the pay, conditions and weather are better. I’m not sure what happens here when we don’t have any doctors left.”

It’s not quite cosy crime, but neither is it procedural. In fact, Kay, who lives with his TV exec husband James Farrell and their children, Ruby and Ziggy, in Oxfordshire, might have invented a new sub-genre of NHS thriller with a large dose of his trademark dark humour and some social commentary to boot. Inspirations include Agatha Christie, Carl Hiaasen and Patricia Cornwell, who he describes as “masters of the craft” but also “newer geniuses” like Lucy Foley and Chris Whitaker.

Naturally, he’s drawn on his own experiences, though he jokes: “It would be wrong of me to use people I’ve met to populate the cast of incompetent, devious, and unpleasant characters in my novels, or use thinly veiled versions of my enemies as murder victims – but that doesn’t mean I don’t regularly do it!”

He continues: “The setting is based on my time as a doctor and the twists are something I’ve had in my head for years and have been itching to write about.” As for the pitch black humour, like many in the emergency services, Kay believes it’s a way of coping when facing trauma on an almost daily basis. “Working in health, you care for patients, but you also code switch regularly. One minute you might be delivering good news to a patient, the next you’re calling time of death,” he says.

“Humour is a coping mechanism for most people but the contrast can be starker when it’s a matter of life and death. It’s like an emotion regulator.” Readers will find out for themselves whether Rose is on a wild goose chase or not but, it’s safe to say, killing does seem to come naturally to Kay. “It’s actively encouraged in crime writing – not so much in my old job,” he smiles.

“Being a doctor makes you face the fragility of life, so it’s quite something to be a crime writer and look at characters as dispensable – but it’s probably for the best that I didn’t ever have to balance both jobs at once!”

Joking aside, we have had some medical serial killers – West Yorkshire GP Harold Shipman, who murdered an estimated 250 patients over three decades, springs to mind. As does the recent Lucy Letby case. Thankfully both are exceptions, he insists. “The reason these cases become such big news is they’re extraordinarily rare and there’s something shocking about a person who you trust with your life actually ending it maliciously,” says Kay, who deftly sidesteps my next question over Letby’s potential innocence (a vociferous social media campaign claims the ex-neonatal nurse, who was convicted of murdering seven babies and the attempted murder of seven more at the Countess of Chester Hospital, might be victim of a miscarriage of justice).

Back to his books and he admits the move from memoir to fiction has been liberating in some senses. “Real life is real life – there are two sides to every story, and you can choose how to spin it, but you can’t really change the ending. Fiction is definitely more freeing, but it’s still bound by certain rules and structures that readers expect; and knitting a plot together so it’s truly satisfying is a bit like playing 3D Chess on a tightrope,” he says.

Kay wrote the TV adaptation of This Is Going To Hurt, and his husband produced it. Ditto his bestselling Dexter Proctor children’s series. Next up is Dexter Procter and the Case of the Disappearing Doctor, which is being made for the BBC. It sounds like every author’s dream, although seeing himself played on-screen by Ben Whishaw was a slightly surreal experience.

“Ben’s a genius – one of the country’s very finest actors, and a lovely man too. Watching him on screen was a bit like looking in the mirror – although it has been quite a while since I cleaned my mirrors,” he jokes. Kay was “desperately sad” at the death of Jilly Cooper aged 88 in October last year having struck up a friendship with the author of Riders and Rivals after meeting at a book event over a glass of champagne ten years ago.

“Jilly was perhaps my most unlikely pen pal. It seems impossible that she is really gone – such a huge loss,” he says. “Any time I wrote something, she’d send me sweet little notes on dog-based cards with pens of varying colours. She was very funny and a genius. Truly, a one-off.”

Next month he’s one of the stars of the Theakston Old Peculier Crime Writing Festival, supported by the Daily Express, in Harrogate. “It’s funny to see the town overrun with avid fans of menace and murder, and meet the writers behind these gruesome tales, most of whom are very sweet and show little to no serial-killer vibes,” he says. “I can’t wait.” Kay’s currently working on a sequel to A Particularly Nasty Case. “It’s going quite well; I killed off a creepy character before I’d even finished my Shreddies this morning,” he adds.

Would he ever consider returning to medicine,” I wonder? He adds with a smile: “When I’ve reached my sell-by date as an author I dare say I’ll be back in some capacity, probably around wellbeing rather than operating, as future NHS patients will no doubt be pleased to hear.”

• A Particularly Nasty Case by Adam Kay (Orion, £10.99) is published on Thursday [july 2]. Adam will be appearing at the Theakston Old Peculier Crime Writing Festival in Harrogate on July 24. Visit harrogateinternationalfestivals.com for more information and tickets