Comedian, writer and one-time obstetrician, Adam Kay, sold 1.5 million copies of his debut book, This Is Going To Hurt. Drawing on the diaries he penned while working as a junior doctor, the book was celebrated for being funny and poignant, insightful and incisive. It's no surprise then that he returned to these diaries for his second book, 'Twas The Nightshift Before Christmas. Adam joined Ray D'Arcy to chat about the pressures of working in the medical profession and how humour exists even in the darkest of places.
Ray began by asking Adam to reflect on the success of This Is Going To Hurt.
"It's basically a love letter to all of the doctors, nurses and healthcare professionals and I can only think its success is because that love is shared by all of us. Plus, I guess we all like disgusting stories about objects in orifices."
Readers with a penchant for such tales will be pleased to learn that 'Twas The Nightshift Before Christmas features its fair share of festive foreign objects ending up in places they were never designed to go.
The serious side of Adam's writing focuses on the lack of support that exists for those on the front lines of busy emergency departments, crowded wards and exhausting working hours. Indeed, Adam believes that he suffered from post-traumatic stress disorder following the incident that ultimately led to him walking away from the profession. Although Adam doesn’t go into the detail of the event on afternoon radio, readers of This Is Going To Hurt will know that the death of a patient and her newborn baby were at the heart of this decision. Ray was shocked to learn that there was no supportive, de-briefing process after such a traumatic incident.
"You're right to be incredulous. It stands to reason that this should be the normal thing, but actually there's a culture that runs so deep in medicine that you don't talk about these things."
Aside from the stress of particularly traumatic cases, communicating bad news to patients and their loved ones is part and parcel of being a doctor and a skill that has to be learned, largely on the job. Adam shared one of his first experiences of this.
"I write at one point about seeing a lady in her 90s in what was quite clearly her final hours. She asked me a question I'd never been asked before which was, 'am I dying?', which slightly knocked me for six. The answer was, yes she was, but I couldn't actually say it. I changed the subject and she asked me again and I lied and I said no. That was haunting me for the rest of the shift and so I decided I was going to pop back and actually speak to her honestly and properly, but by the time I got back to her ward she had already gone. I do think we need to get better about being honest about death. I did the wrong thing then. I should have been honest. I was asked and I lied."
Of course, there are few human experiences that are utterly without humour, and in the next breath Adam told Ray about how a Christmas tie went rogue at a decidedly sombre moment, bringing some much needed levity to the situation. You can listen to that anecdote – and more – here.
'Twas The Nightshift Before Christmas is published by Picador.
Jan Ní Fhlanagáin
Photo credit Idil Sukan