That working as an A&E doctor affords Kwame Asante a raft of amusing tales of misadventure is virtually a given since human idiocy and capacity for self-harm, particularly regarding sexual matters and Covid denial, knows few bounds.

Yet when he recounts his answer to the question he’s most routinely asked about his job – what he most frequently finds up patients’ rectums – his world-weary response offers more insight than you might imagine.

Asante wouldn’t be the first medic-turned-comic with a jaded view of his vocation and recourse to gallows humour to cope. But he gets his most profound laughs from filtering his professional and personal life through the prism of his race and Christian upbringing, being of Ghanaian heritage, raised in a strict Catholic household in south-east London.

A&E doctors don’t do small talk, needing to cut to the chase of an incident, so he dispenses with the usual introductions to play a game. The audience is split into two teams, with one group as the patients coming up with a bizarre ailment and the others as the hospital, trying its best to respond.

A bit of fun that risks some wag in the crowd getting the first big chuckle of the hour, it nevertheless sets the tone of finding humour in degradation and gets the crowd on board, even as it emphasises the spirit of confrontation that will underpin much of what follows.

Asante’s inclination towards comedy may have begun at school, where his refusal to accept his faith-based sex education marked him out as a free-thinker, even if he didn’t quite have the satirical wit to savage the teaching at the time. The joke was truly on him, though, when he came of age, the residual guilt of something he didn’t believe in still putting him off his stroke.

His traditional mother also has issues with him living with his partner, unmarried and potentially shouldering the greater burden of childcare if they have kids. Still, he appreciates that this clash represents progress, with them having already overcome another, arguably bigger stumbling block. And he can put it into the context of mores changing over time, envisioning an hilarious future scenario where his son puts him in a similar position of consternation.

And maybe God does have the last word, at least on matters of life and death, if not sexuality. Asante is sceptical about the praise heaped on his hospital’s chaplain when he deploys standard CPR, implying the acclaim and feeling of spiritual empowerment he receives is slightly bogus. But it inspires a very funny image of ministers of various faiths competing to administer to bodies as well as souls.

Notwithstanding an endearing child patient who conflates Asante’s ethnicity with his occupation, suggesting a harmonious post-race world, the comedian has had to be philosophical about the fact that as a big, black man, he’s sometimes been exploited or overlooked.

He recognises that as a younger doctor, a psychiatrist racially profiled him to deal with a dangerous patient. And in his personal life, he’s needed to remind at least one date that not every one has the luxury of pursuing someone too ardently.

Appreciable grit in otherwise wryly delivered anecdotes, these identity signifier routines truly elevate the hour to mature storytelling, enlightening and putting Asante’s specific experiences into broader contexts. 

A diversion into an angry, online commentator on the cusp of divorce and his Amazon purchase history feels a bit intrusive and an unnecessary departure from the autobiographical core. But it’s the only real blip in an otherwise really strong narrative.

• Kwame Asante: Living In Sin is on at Pleasance Courtyarrd at 4.45pm