Review of the BBC adaptation of Adam Kay's memoirs, starring Ben Whishaw

Given just how many dramas and comedies are set in hospitals, it’s surprising that there hasn’t been one quite like This Is Going To Hurt before.

This powerful yet funny screen adaptation of Adam Kay’s remarkable medical diaries brings to the fore the unremitting, exhausting pressure of the job: from both its life-and-death responsibilities and the sheer workload of medics on the front line of a service perpetually teetering on the precipice of collapse.

It could be grim viewing were it not for the weatherbeaten humanity of the Kay character – and the dry, dark wit he uses to help cope with the hourly adversity. Like the health service itself, the demands placed upon him have taken their toll and rendered him flawed. He’s undoubtedly become emotionally detached, especially from his eminently patient boyfriend Harry and his NHS trainee Shruti – and Kay doesn’t flinch from exposing his own shortcomings.

The brilliantly cast Ben Whishaw, sallow through sleep deprivation, perfectly encapsulates a man constantly running on empty, yet always being asked to find more. He’s never given time to give his patients in obstetrics and gynaecology (aka ‘brats and twats’) the attention they need, nor any support for the mental toll the job takes. There’s one crisis after another all the time, but it’s less high drama, more of a trudge.

Whishaw gives the impression Adam treats the insecure Shruti so badly and arrogantly as that’s how he was taught himself, and by now has become at least partially inured to this stressful life. To this day, the aloof consultant Mr Lockhart (Alex Jennings) treats Adam like an idiot, while demanding ever more of him. Never complaining is all part of the job.

As Shruti, Ambika Mod is a breakout: vulnerable and out of her depth, yet determined to concede. The mantra on the wards is ‘see one, do one, teach one’ – the techniques for each procedure passed down quickly, whether the newcomer is ready for the extra responsibility or not. Like Whishaw, Mod conveys a lot with a little. She needs to: every character is too knackered for the big gestures.

All this makes This Is Going To Hurt sound like a gritty portrait of the miserable reality of an NHS ward, the health service counterpoint to the Martin Freeman police drama The Responder. The show’s visual palette, as washed out as the characters, lends that atmosphere too.

But humour is the other foundation of this nuanced show, and it’s often very funny. Many of the best laughs come from taking the mystique out of the medicine, such as in the panic-ridden opening sequence that sets the breathless mood. As Adam tries to hold a patient’s prolapsed umbilical cord, he describes himself ’wearing her like Kermit the Frog’.

Adam’s asides to the viewer at home add to the intimate connection to the character and offer opportunities for sardonic wisecracks at every unfortunate situation he faces. It worked for the very different Fleabag, after all. This – along with a cracking but unintrusive soundtrack, true to the 2006 setting – makes the production as classy as the writing and performance.

It’s quite the trick directors Lucy Forbes and Tom Kingsley pull off to deploy such obviously filmic techniques yet keep authenticity as the defining feel of the show. Although this adaptation was in the pipeline long before the pandemic, it feels like an even more vital window on the daily realities of the health service now we have come to realise just how much we need it, if that wasn’t apparent before, and how fragile a behemoth it is, despite all the ‘clap-for-carers’ style political platitudes about protecting ‘our’ NHS.

Review date: 8 Feb 2022
Reviewed by: Steve Bennett