A Particularly Nasty Case review: Adam Kay's debut novel is an instant classic with searing commentary

Adam Kay's debut novel A Particularly Nasty Case may boast an unpleasant crime at its centre, but the book itself is a funny, charming and extremely readable piece of fiction.

The former doctor-turned-bestselling author pushes his medical background to thrilling new limits in this smart (but not patronising), character-driven mystery. No longer saving lives, Kay now kills off his characters with chilling precision and serious flair.

The story centres around Eitan Rose, a talented doctor who loves his job but his mental health often blocks him from performing it. When we meet him, he’s reeling from a breakup and resisting therapy—coping, but clearly adrift and haunted by the trauma of losing his sister when he was in training. When his boss dies unexpectedly, Eitan suspects foul-play and sets off on a mission to prove it's the case.

While he's investigating (and falling in love with the charming Cole at the same time), more deaths in a similar fashion lead the inquisitive doctor to uncover the devastating truth.

As a murder mystery, A Particularly Nasty Case is a slick offering, with the overtly medical tones to the investigation never getting in the way too much. In fact, Kay introduces characters who may not be as versed in medical ins and outs as he is to ensure there's a hearty amount of explanation which never feels patronising or alienating.

Where the book really shines is in the characterisation and the use of perspectives. Readers first follow Eitan and his witty (sometimes sardonic) ways, but as his mental health deteriorates and he becomes the obvious name in the investigation, Kay makes the savvy move to switch perspectives to Eitan's new boyfriend, Cole, before switching once more to his (gorgeously-crafted) colleague, Margaret.

The transitions are more than stylish – they add to the isolation Eitan is feeling, but also what those around him are feeling. As his mental illness causes him to withdraw into himself, he becomes as distant to the readers as he does to the other characters. That distance works vert effectively when he becomes the main suspect – the reader feels disconnected from him, making us question his reliability—and perhaps his innocence.

The biggest strength of Kay's writing, and what is now cemented as his signature style, is his humour. His ability to pivot seamlessly from moments of emotional darkness to unexpected levity is unmatched. Not one part of this is crass or unwanted – Kay's skill offers a realism often lost when authors attempt to do the same. It’s this tonal flexibility that gives the book such richness, while also giving Eitan’s voice so much authenticity.

Kay does, however, push his comedy chops to the limit with some certain scenarios which call the realism he's worked hard to build up into question (the wake scene... if you know, you know). Though it did elicit a true belly laugh and it's hard to fault it, some readers might find his flirting with plausibility harder to stomach, and you could forgive them for feeling that way. But it's hard to begrudge such a comedic moment when it's done with such flair.

Throughout the novel otherwise, Kay balances light and dark with precision, a theme that runs liberally in his non-fiction bestseller, This is Going to Hurt. That's life, after all. And Kay has made a business portraying every facet of it, warts and all. Why would he change that in his fiction? Though the crimes at the centre of this book at particularly nasty, nothing about Kay's debut fiction is unpleasant. In fact, it's a pleasure to be immersed into his world once more.

For this month’s midweek treat, Joanna sat down and read A Particularly Nasty Case, a murder mystery with all the classic elements of a crime novel. She paired it with a classic Mozzarella pizza from Dr. Oetker Ristorante.

For all the latest RT Book Club news, interviews, Q&As with the authors, reviews of previous books and more, visit The Radio Times Book Club sponsored by Dr. Oetker Ristorante.

You can purchase A Particularly Nasty Case by Adam Kay, our book of the month, at the Radio Times Shop.