Season Reviews, TV

THIS IS GOING TO HURT makes you feel the pain, humour and tragedy of modern British healthcare

Have we reached the point yet where we can collectively agree that the ‘clap for the NHS’ phenomenon during the height of the Covid pandemic was a tokenistic gesture at best? This Is Going to Hurt really brings home how unintentionally insulting our efforts were.

Not that Adam Kay’s adaptation of his best-selling memoir of the same name directly covers these events, or even references Covid, but across seven episodes it rather brilliantly brings home the stark reality of just what the National Health Service does on a daily basis. To say doctors, nurses, clinical staff and more go above and beyond is an incredible understatement. Kay’s series presents them, undoubtedly accurately, as modern heroes fighting against a system driving them into the ground.

One might suspect the resulting series would be a highly depressing journey through the darkest corners of hospital life but This Is Going to Hurt is no bleak episode of Casualty or existential hour of Holby City. Kay’s show manages to accomplish what his memoir did in balancing the melancholic and downright despairing with the deeply hilarious. His series can veer from razor sharp wit all the way to tragic, shocking consequences in a heartbeat, and does so without ever missing a step.

It is, quite simply, one of the finest depictions of the NHS we have perhaps ever seen on screen.

All of us who are British reading this undoubtedly have our stories about how the NHS have served us or our families from one time or another.

I will never forget just how incredible the staff of Great Western Hospital in Swindon were when my wife was struck down with a burst appendicitis and suffered several weeks of agony-fuelled care, or the team at Queen Elizabeth hospital in Birmingham who comforted me during the genuinely unpleasant experience of an endoscopy (trust me, you really don’t want one), one of the most undignified invasive tests imaginable. It was brief but they were so relaxing and kind. This isn’t exceptional. This is every day. This is second nature for those who work in the NHS.

Kay wrote his memoir after giving up the profession, able to have the distance in which he could relay many of his remarkable stories with a comical, analytic and truthful distance, and he parlays that into seven terrific scripts that attach a dramatic narrative to the stories he stored up over the years. This Is Going to Hurt characterises him, Adam, in the form of Ben Whishaw, whose performance here is nothing short of award-winning. If he doesn’t at least get a BAFTA nomination, there is no justice.

Whishaw manages to neatly convey an obstetrician who on the one hand is capable of breathtaking arrogance while on the other displays constant stress-laden anxiety and engenders deep sympathy on the audience’s behalf. Adam can be grumpy, mercurial, cocksure and brilliant, but he also displays great humility in the face of a near-fatal delivery—based on a calculation he got wrong thanks to his punishing work schedule—that runs through the entire season. A prematurely delivered baby becomes his white whale and his tether to a career he both adores and despises, one that frequently threatens to destroy what life he does have beyond the hospital.

A major dramatic device that helps Adam’s portrayal as our flawed protagonist is in how Kay has him break the fourth wall, frequently in asides addressing us as the voyeurs of a personal, broken world. He says to us what he wants to say to fellow staff and patients—indeed in one episode he does say unvarnished thoughts to a patient, mistakenly thinking he’s addressing us—and it helps draw us into his thought process and situation. This is naturally reminiscent of Fleabag, which both rocketed Phoebe Waller-Bridge to superstardom and revived the fourth wall breaking trope as confessor and accessory. 

This Is Going to Hurt in that sense doesn’t break new ground or revive a tradition but the trope works well in humanising Adam even at his worst points.

Kay’s series could have seemed trite in attempting to balance traditional hospital drama narratives with a personal arc for Adam, but they are both intertwined in terms of what the series is truly saying. 

Adam’s two key relationships in the show are with Harry (Rory Fleck Byrne), his flat mate turned boyfriend, who he slowly begins to lose due the intense pressures of working for the NHS and an underlying class divide which becomes a broader problem, and also with junior doctor Shruti (Ambika Mod), a talented young obstetrician who struggles to define herself under Adam’s obsessive, intense wing, and if Adam serves as the window into this world, Shruti is the beating heart of it who represents its vulnerability. She is too played, by Mod, with a real adeptness.

Truth is, This Is Going to Hurt really does live up to the title. Kay’s stories are some of the finest written drama and comedy on the BBC in recent times, not to mention how unbearably tense his drama can be. The show never shies away from the graphic reality of what the NHS do, the impact of which is by degrees sometimes shockingly funny but also deeply haunting and even skirting horror in places. You will laugh like a drain and gasp in shock. You will also, routinely, be punched square in the gut. Especially in the penultimate episode which delivers one of the most devastating twists you could imagine, one that entirely wrong foots you. The series shows the true cost of a system which is rigged to break people.

Crucially, however, Kay always points the finger of blame where it should be. Government ministers and departments starving the NHS for finding; elitist consultants driving around in Aston Martin’s and barely doing any work themselves while a skeleton crew to all the work; the fallacy of private care, which presents a stunning and luxurious front but once the surface is picked lacks the basic elements needed to help people; and frequent baptisms of fire for barely-trained young staff thrown into life and death situations at the deep end. Yet Kay makes sure we understand, beneath this, how valuable both the NHS, and the tireless staff who keep it going, is.

What hurts the most about This Is Going to Hurt is just how much these compassionate, skilled people should not be working so hard to ensure a basic human right. Though supremely well produced on all levels and throughly entertaining, Adam Kay gives us a manifesto for why we shouldn’t just protect the NHS at all costs, but demand better care is taken of it.

★ ★ ★ ★ ★

DIRECTORS: Lucy Forbes & Tom Kingsley

WRITER: Adam Kay

CAST: Ben Whishaw, Ambika Mod, Alex Jennings, Rory Fleck Byrne, Michele Austin, Harriet Walter

STUDIO/DISTRIBUTOR: BBC

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