Adam Kay argues the NHS is the UK’s greatest institution but “one of the worst employers”
The debut novel of former doctor Adam Kay is a medical mystery that shines a stark light on the NHS today.

This article first appeared in Radio Times magazine.
“Hopefully everyone out there thinks I look like Ben Whishaw,” says Adam Kay. And it’s quite possible they do: Whishaw played Kay in the BBC’s 2022 adaptation of his mega-selling medical memoir This Is Going to Hurt. “My main criterion when casting it was ‘extremely handsome’,” admits Kay.
But he’s less concerned with the looks of the leading man in any screen version of his new book – and first novel – A Particularly Nasty Case. “There’s only 20 per cent of me in [the main character] Eitan,” explains the author. “He’s a very messy doctor, and I like to think that I wasn’t quite that messy.”
“Messy” may be an understatement though: in the darkly funny thriller, Eitan is a consultant rheumatologist (“the least sexy part of medicine”), returning to work after time off with a bipolar condition, who becomes convinced that his manager’s death from a heart attack was actually murder. “So it starts not as a ‘whodunnit’ but as an ‘ifdunnit’,” says Kay.
If you think that sounds far-fetched, think again. Kay writes with all the authority of a man who spent six years as an NHS doctor before becoming a writer, but nevertheless had a team of “medical advisers” check the manuscript. “I’m 15 years out of the game now – it would be a major roll of the dice asking me for medical advice – so I got some clever friends of mine to read the book and flag anything they thought wouldn’t work. Worryingly, they gave it a clean bill of health.”

It was important for Kay to get the science right, he says (and he admiringly mentions Agatha Christie “because as a trained pharmacist, all the poison knowledge in her books is absolutely spot-on”).
But what about the human side? Doctors don’t really do away with their rivals, do they? “Well, I hope I wasn’t the only student at medical school who listened to lectures and thought, ‘Oh, well that would be quite a good way to kill someone.’ Luckily, I had just about enough morals to never go through with it, even though I do have lots of enemies!”
In an era where there has been much discussion about burnout and its impact on NHS staff, with millions of workdays lost each year due to anxiety, stress and depression, should we be worried about the mental health of our medics, though?
“Obviously it’s a very live debate… Doctors are extremely bad at looking after their own mental health. They’re told they have to be tough: ‘You’re a bloody doctor, and you bloody just get on with it.’ But the suicide rates among medical professionals are extraordinarily high. One doctor takes their life in the UK every three weeks, and one healthcare professional takes their life every single week.
“The NHS, I think, is the greatest institution we have in this country, but it’s probably also one of the worst employers. It’s a good decade behind the rest of society in terms of how it looks after staff who are struggling with their own health, particularly their own mental health.”
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Serious issues are glanced at in the book, then, but it’s driven by a propulsive page-turner of a plot and littered with laugh-out-loud lines and peep-between-your-fingers scenes of NHS craziness. “It’s certainly not cosy crime,” confirms Kay. “It opens in a gay sauna and doesn’t stop from there.”
Correspondingly – and, perhaps, appropriately – he offers a health warning of sorts: “Given that my body of work now goes from picture-books for three-year-olds all the way up to murder books for adults, I think it’s increasingly important that parents ensure they pick up the right Adam Kay book in the shop. Otherwise the kids are going to get a very different bedtime story…”
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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.
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