by Adam Kay
Game on. I am already privately composing my quote for the press and deciding which way I should stand for the photographer. Do I even have a best side? Should I ask them to airbrush my dark circles or leave them in for that ‘tired yet valiant doctor’ authenticity?
I’d forgotten, however, that nothing ever goes to plan on labour ward. They should translate that into Latin, make it the motto of the Royal College of Obstetricians and Gynaecologists and chisel it above every delivery suite doorway. You can’t guarantee there’ll be time for a shit or a sandwich during your shift, so I don’t know why I thought this stood a chance of working out. Cue a post-partum haemorrhage on the postnatal ward, a ventouse in room four and a patient’s boyfriend in room nine having an episode of micturition syncope.* It was half one by the time I delivered the little bastards.
Maybe next year – I certainly don’t need a clairvoyant to tell me I’ll be working.†
* Fainting while having a piss is surprisingly common in men, and usually nothing to worry about. Lots of guys wake up on a bathroom floor with an Armitage-Shanks-shaped dent in their forehead, wondering why their knob’s hanging out but they still have their wallet and car keys. See also coital cephalgia: a terrible headache at the point of orgasm that makes patients think they’ve had an aneurysm.
† But I wasn’t. The year that followed showed me what my limits were, and tested me far beyond them. By the next Christmas I was already on my way out of the profession.
One Final Christmas
There’s always something not quite right about other people’s Christmases. My partner J and I alternate families – one year on, one year off – moaning about how wrong everything is.
J’s family start the day with a Buck’s Fizz at breakfast, which is plainly deranged. We’re not at an airport. The rest of the breakfast is, for some unintelligible reason, made up of a variety pack of cereals, so he and his (grown adult, I should add) siblings can fight over the same two little boxes. Presents are disseminated – a stocking containing a hundred tiny bits of tat rather than a nice, quick, single gift. Each item in the stocking, even if it’s a vodka miniature, is intricately wrapped and adorned with a fucking bow, except for some reason the tangerine and the apple. An apple? The first time I saw one being produced from the toe of a stocking, I assumed it was for the horse that was about to trot in, because by that point nothing would have surprised me.
They sit in a circle like they are about to summon Jesus himself to cook the sprouts, then – in reverse-age order – open one present at a time, a process that takes three hours even with a strong tailwind. Lunch is served at what should be dinnertime and involves starters. Who needs starters? Hurry up and get me my potatoes. And what the fuck is bread sauce? And why does it look like watered-down loft insulation? Dessert has to wait – even though it’s basically Boxing Day by now – because first it’s the sixteen-round quiz that I have spent every evening for the last fortnight watching J painstakingly assemble.
Luckily, this year we are spending Christmas at my family’s house so everything is entirely nice, normal and proper. J somehow can’t get his head round this and is constantly complaining that no one’s performing a trombone solo while the turkey is carved, or whatever bullshit his family do.
I realize Christmas is partly about creating your own traditions, so I’ve squeezed a new one into our family. Every year we bring our nieces and nephews presents they adore (to ensure we’re always their favourite uncles) and their parents hate (because ahahaha). We’ve done the toys that reach jet-engine decibels, toys so messy they’ve resulted in the repainting of walls and incineration of rugs, and toys that take a thousand parent-hours of construction – but this year we’ve really excelled ourselves. Each of the four Junior Kays gets an eight-foot-tall, wonderfully cuddly teddy bear, a good ten times the volume of an average six-year-old. The kids are naturally in love at first sight, while my brothers struggle to calculate how these gigantic velour mutants will fit in their houses, let alone their cars, and begin plotting my urgent death.
My sister Sophie spent last night working on labour ward* and emerges from bed just in time for ‘celebration ice cream’ – the perfectly normal concoction my mother makes every year with candied fruit and rum. I conduct a full-blown autopsy of everything that happened on her shift: the caesareans, the ventouses, the patient who burst her stitches on the postnatal ward, the news from A&E about the woman who collapsed at midnight mass (she said she’d been praying too hard; toxicology said she’d been drinking out of her hip flask even harder). My brother has to dash off to his out-of-hours GP session, so I go upstairs for my entirely normal afternoon nap slightly earlier than usual, to ensure I have enough energy for the traditional – and again, absolutely normal – midnight viewing of Silence of the Lambs.
J follows me upstairs and crouches next to me as I plomp down onto the bed. He doesn’t say anything, just stares at me for a while, his eyes gleaming, the beginnings of a smile.
‘What?’ I say. ‘It’s perfectly fine to go to bed halfway through Christmas Day.’
‘No, not that – although no, it isn’t,’ says J. ‘You miss it, don’t you?’
I prop myself up in bed and look at him.
‘I saw your face when you were talking to Sophie,’ he continues. ‘You miss working in hospital over Christmas!’
I laugh a little too hard, before saying, ‘Of course not!’
But we both know I do. I really, really do.
* She works in obs and gynae, which makes me suspect she didn’t read my last book.
Alternative Christmas Message
I think there’s room for a new tradition at this time of year. Or we could just elbow out an old one. Watching Her Maj peer into the autocue for ten minutes of plummy platitudes, maybe. The globally resented Boxing Day walk, accompanied by relatives who are trying to be jolly despite the vengeful, constant throat-punch of a near-fatal hangover. Or Christmas pudding – that claggy nightmare where the six-pence is the most edible part. Slosh on some extra brandy and let’s burn that sultana dungheap down for good.
My proposal would be to find some way of acknowledging the fact that at Christmas, half a million NHS staff will be spending the day at work – from porters to physios to pharmacists – and the majority who aren’t will soon be sacrificing their Boxing Days and New Year’s Eves. Working on the front line, invisible to most of us, while we calculate whether we can physically manage to consume any more brie. (Yes, just eat it with a grape and it’s practically a health food.)
Maybe as we sit around in our party hats, about to risk our lives on a half-defrosted King Prawn Ring, we can bow our heads in prayer. Not to thank the god who, let’s be honest, has probably done more harm than good every single week since that very busy first one. But instead to thank the people without whom we might not all be here; the people who will finally get home at midnight and pick at leftovers from the fridge while you’ve long surrendered your senses to a carbohydrate coma.
Better still, let them know you’re grateful. It’s easier than you’d think to make an NHS employee’s day, especially at Christmas. Send a card to your GP, to the outpatient clinic you visited, or the ward you were on. They will remember you (it might take a moment because they meet a lot of people) and your message might just turn a bad day into a reminder of why they do their job.
If you’ve been lucky enough to enjoy optimum health and haven’t needed the services of the NHS, remember that your invincibility is on a timer and your good fortune can be shared in other ways. Make a donation to your local neonatal unit or a hospice or medical charity*. Give blood. Join the Organ Donation Register.
If you don’t have the energy or the means to help in those ways, there is still something you can do for the beleaguered staff missing Christmas Day at home. Stop sticking root vegetables, remote controls, chocolate wrappers, fairy lights – or indeed anything else that’s irretrievable and inanimate (or, god help us, animate) – up your internal cavit
ies for one day a year. It’s only twenty-four hours, guys, and you’ll make all their Christmases come at once.
* I’m an ambassador for the wonderful Lullaby Trust, who support families bereaved of babies and young children, and fund research into infant death. Any size of donation makes a real difference to their crucial work.
Acknowledgements
To my most fantastic editor, Francesca Main. Without you, terrible nonsense.
To my peerless, fearless and oh-my-god-so-tolerant agents, Cath Summerhayes and Jess Cooper. Without you, chaos.
To my husband, James – the cleverest, most handsome, most annoying, most wonderful person I know. Without you, nothing.
To everyone who bought my last book and those who stuck around for the difficult second album. More of an EP, I guess? To every bookshop, bookseller and library who got it to the readers.
To my family, especially my grandma, who I wish I’d thanked in my last book so she could have seen it. Drifting in and out of lucidity in her final days, she asked how it had sold. When I said it had done well, she replied, ‘Maybe the Great British public aren’t so stupid after all.’ To Naomi and Stewart; Marc, Shazia, Noah and Zareen; Dan, Annie, Lenny and Sidney; Sophie and Rauri.
To Steph von Reiswitz for the inventive, ingenious illustrations. I adore them.
To the amazing help, reminders, and reassurances from Drs Gibson, Heeps, Jones, Wozniak, van Hegan, Rehman, Laycock, Hughes-Roberts, Biswas, Bayliss, Webster and Knight.
To everyone involved in taking This is Going to Hurt to stage and screen – especially James Seabright, Annie Cullum, Lee Martin, Hannah Godfrey, Naomi de Pear, Holly Pullinger and Jane Featherstone. To word wizards Justin Myers, Karl Webster and Dan Swimer.
To my publicity supergroup of Dusty Miller and Emma Bravo.
To my uniquely supportive friend Mo Khan, who speaks at international medical conferences and ends every lecture by plugging my books. To Susie Dent for telling me it was OK to keep the word ‘tatterdemalion’.
To the dozens of people on the credits pages that follow. I’m proud to join the small band of authors who formally recognize every single person involved in making a book happen. One day this will be standard practice rather than something new and ‘quirky’. Also, it really helps with the word count.
EDITORIAL
Publisher Paul Baggaley
Editor and Associate Publisher Francesca Main
Assistant Editor Gillian Fitzgerald-Kelly
Editorial Administrative Assistant Roshani Moorjani
MANAGEMENT
Managing Director Anthony Forbes-Watson
Sales and Brand Director Anna Bond
International Director Jonathan Atkins
Finance Director Lara Borlenghi
Publisher, Macmillan Adult Books Jeremy Trevathan
Digital and Communications Director Sara Lloyd
Publishing Operations Director James Long
FINANCE
Finance Director, Adult Publishing Jo Mower
CONTRACTS
Head of Contracts Clare Miller
Senior Contracts Executive Marta Dziurosz
AUDIO
Audio Publishing Director Rebecca Lloyd
Audio Publishing Executive Laura Marlow
EDITORIAL MANAGEMENT
Associate Publisher Sophie Brewer
Managing Editor Laura Carr
Junior Desk Editor Chloe May
Copy-Editors Charlotte Atyeo, Penny Isaac
Proofreader Fraser Crichton
Editorial Consultant Justin Myers
Medical Advisor Caroline Knight
DESIGN
Art and Design Director James Annal
Design Manager Ami Smithson
Jacket Photograph and Product Designer Kiseung Lee
Author Photograph Idil Sukan
Illustrator Stephanie von Reiswitz
Studio Manager Lloyd Jones
Artworker Alex Fowler
PRODUCTION
Head of Adult Production Simon Rhodes
Senior Production Controller Charlie Tonner
Production Assistant Giacomo Russo
Text Design Manager Lindsay Nash
Typesetter Palimpsest Book Production Ltd
LEGAL
Head of Legal Annie LaPaz
MARKETING & COMMUNICATIONS
Communications Director, Picador Emma Bravo
Publicist Dusty Miller
Head of Marketing, Picador Katie Bowden
Senior Communications and Events Executive Rachel Mellor
Publicist, Ireland Cormac Kinsella
BRAND MANAGEMENT
Senior Brand Manager Charlotte Williams
Senior Brand Executive Jade Tolley
Brand Assistant Molly Robinson
UK SALES
David Adamson Lucy Hine
Richard Baker Christine Jones
Andrew Belshaw Lucy Jones
Katie Bradburn Rebecca Kellaway
Emily Bromfield Clare Lawler
Ruth Brooks Gillian MacKay
Kate Bullows Holly Martin
Tom Clancy Rory O’Brien
Sarah Clarke Alexandra Payne
Stuart Dwyer Guy Raphael
Bríd Enright Siobhan Slattery
Julia Finnegan Toby Watson
Richard Green Keren Western
INTERNATIONAL SALES
Rachel Graves Laura Ricchetti
Stacey Hamilton Emily Scorer
Daniel Jenkins Lucie Uwarow
Louis Patel Leanne Williams
RIGHTS
Rights Director Jon Mitchell
Senior Rights Manager Anna Shora
Rights Manager Emma Winter
Rights Assistant Hannah Dualeh
DIGITAL MARKETING
Marketing and Communications Director Lee Dibble
Senior Metadata and Content Manager Eleanor Jones
Metadata Executive Marisa Davies
Audience Manager Andy Joannou
Digital Publishing Executive Alex Ellis
OPERATIONS
Operations Manager Kerry Pretty
Operations Administrator Josh Craig
PRINTERS
Senior Account Director James Longman
Team Leader Karen Goddard
About the Author
ADAM KAY is an award-winning comedian and author of the million-copy bestseller This is Going to Hurt. He previously worked as a junior doctor, which is hopefully clear by now. He lives in London.
First published 2019 by Picador
This electronic edition first published 2019 by Picador
an imprint of Pan Macmillan
The Smithson, 6 Briset Street, London, EC1M 5NR
Associated companies throughout the world
www.panmacmillan.com
ISBN 978-1-5290-1859-2
Copyright © Adam Kay 2019
Jacket photograph and product design © Kiseung Lee
Author photograph © Idil Sukan
Design: Ami Smithson, Picador Art Department
The right of Adam Kay to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988.
You may not copy, store, distribute, transmit, reproduce or otherwise make available this publication (or any part of it) in any form, or by any means (electronic, digital, optical, mechanical, photocopying, recording or otherwise), without the prior written permission of the publisher. Any person who does any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damage.
A CIP catalogue record for this book is available from the British Library.
Illustrations by Stephanie von Reiswitz
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