Former doctor Adam Kay has already hit the best-seller lists with his award-winning memoir This is Going to Hurt, which exposed the horrors and absurdities of the high-pressure, stressful and exhausting existence of a junior doctor inside Britain’s National Health Service (NHS).
This was made into an excellent TV series by the BBC, with Ben Whishaw in the lead role. When I saw the author being interviewed on UK television, he explained that he had received a lot of positive feedback from other health professionals. They were grateful for the accuracy with which he portrayed the stresses of their jobs, the unrelenting pressure, and the need to make life and death decisions while mentally and physically exhausted.
Kay has also performed as a comedian and singer, written TV scripts and now he has turned to fiction writing, with a debut comedy novel that features a plot that is (we can only hope) too absurd even for the NHS.
The lead character is a consultant rheumatologist, Eitan Rose, and at one stage we are helpfully informed that his first name “rhymes with spray tan”.
Like the author, Eitan is gay, bipolar and has a penchant for drugs. As the novel begins, he is about to return to hospital work after an enforced leave of absence.
The narrative begins on the eve of that return to duty, with the doctor saving the life of a heart attack victim in a gay sauna, which is far from the only farcical episode in this fast-paced page turner.
Murders ensue and, though Eitan attempts to get to the bottom of them (in one case literally getting to the bottom), he finds himself being framed.
Without giving away any more of the plot, it’s a cleverly crafted tale, though I did spot whodunnit far earlier than I would normally do when reading a crime novel.
Kay has cleverly created a main character who is full of faults, but is not so terrible that he loses the sympathy of the reader. And the author does have an impressive turn of phrase, especially when his target is the bureaucratic absurdity of the NHS.
For example, his description of a shabby hospital waiting room: “It did, however, have a TV screen, to remind patients which century they were in. Please note that appointment times are indicative and you should not expect to be seen at this point, it announced — he almost respected the hospital’s decision to distance itself from the concept of time rather than employ enough staff.”
Eitan lives in a tiny flat in London’s upmarket Sloane Square, which lacks a fully equipped kitchen. This gives the author another chance to poke fun at his character: “Eitan gestured to the hotplate on the kitchen work surface. He’d bought it from a camping supplies shop, and it did the job perfectly well. The job being to sit there unused while he ordered Domino’s.”
Meanwhile, and staying on the food theme, I loved this bitchy response to an underwhelming gift to the host of a dinner party: “Cole hugged her on the doorstep and handed over a bottle of lowest-common-denominator red wine. ‘Oh, that’s so kind of you, dear.’ She’d probably be able to use it in a beef casserole at some point.”
I really do hope that, just as he was the screenwriter for the TV adaptation of This is Going to Hurt, Kay will be persuaded to turn this debut novel into a TV series.
Meanwhile, it would also be good to know that, as he has created such a delightfully flawed and comic character, there will be more novels featuring Dr Eitan Rose.
Certainly, it is useful to have such a talented and witty writer who can shine an authoritative spotlight on the flaws of the administratively top-heavy NHS.
In fiction, and also from the old Carry On films and other film and TV dramas, hospital life has often provided a rich vein of material for comedy writers. Maybe it is comforting to be able to laugh at something we all fear — the prospect of serious illness, and even death.
Maybe books such as A Particularly Nasty Case can help us all deal with these fears and concerns. Things may not be as frightening if there is also a tinge of comic absurdity about them.
Being published in 2025, this book won’t shock many people, though it might not be to everyone’s taste. It certainly would have been banned by the apartheid censors in the old SA.
However, I found it an easy, speedy, enjoyable read, and it might be an excellent choice for a holiday read, though you might not want to gift it to Ouma if you want to stay in her will.
I am happy to share my diagnosis: A Particularly Nasty Case is a particularly enjoyable read.
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