Adam Kay on comedy, medicine and memoirs

"I quite enjoy the fact," says Adam Kay, "that it makes people assume they'll be getting the lowest common denominator smut. I wasn't sure people would come to see a former doctor reading from his diaries and going into a polemic about the NHS."

The medical themes within Kay's show are rather well concealed by its provocative title, Fingering A Minor on the Piano. Though he needn't have worried anyone would stay away. It was undoubtedly one of the best shows at the 2016 Edinburgh Fringe, and deserving of all its acclaim. After its recent sell-out run at Soho Theatre, Kay now brings the show to Leeds Comedy Festival.

And, with regard to polemics, it isn't a show that feels political. Both the day-to-day realities of being a doctor, and the wider social context, are woven through the hour with subtlety. It's a fun show too, with lots of Kay's medically adapted lyrics from popular songs, and diary entries which often record his more memorable encounters with patients. Described in vivid and visceral detail, certain stories sear into the memory. After hearing one tale, men may never remove a pair of gloves from their hands again, not without a swoop of unease in more private peripheries.

But, little by little, Kay reveals the side of life as a doctor we don't see, or expect. "People don't think of doctors as being normal people, with friends, relationships and with a house that they go to."

Solidarity with junior doctors

Kay's grounded experience helps us to appreciate what was at stake in the junior doctors' dispute last year. "The strike was because the government were imposing a new contract on junior doctors," he says. "It was making working conditions significantly worse. But, the way the government sold it, it was all about money."

He adds: "As if doctors were being greedy – and that's the thing that stuck in my craw.

"It became obvious that politicians have a loud voice and doctors have a quiet one. Plan A with my show was just to amplify the doctors' voice a bit. You don't go into medicine because you're greedy. People going into medicine have good A-Levels, and a choice of any number of careers. Some that pay a lot more money. It sounds corny, but doctors go into medicine because they want to help people.

"When you go to work for 14 hours, and you come home exhausted, covered in blood, and your mind can't switch off, at least you know you have made a difference."

A rewarding outcome for the show is the feedback Kay has received from those still working in the field.

"I didn't notice any difference in how doctors react to comedy," he says. "But, they would come up to me and say, 'I wish more people knew what doctors go through'. It was one of my favourite things about the Fringe. Colleagues who are still in medicine told me I was performing a useful function."

When truth is stranger than fiction

Kay is a prolific script editor and writer for TV. His prison-set sitcom Crims, co-written with Dan Swimer, premiered on BBC Three in 2015. Has he never wanted to write a medical comedy or drama for the small screen?

"When I made my transition from doctor to a writer, I deliberately didn't talk about medicine," he says. "But the reaction I've had now has been amazing. The majority of my adult life has been in medical school or working as a doctor. I guess good comedy comes from the heart and it was truthful to me and my life."

Medical series aren't renowned for their truthfulness, though – would he find that difficult?

"Artistic licence is always taken. If I was a dectective watching Line of Duty I dare say I'd be screaming at the telly. If you watch any sitcom you can quite easily say, well that wouldn't happen in real life. But you suspend disbelief. And, actually, sometimes you go to work and it's even more ridiculous...

"In fact there was a scene in House MD – which I greatly enjoyed – where a woman had asthma. House asked her to demonstrate her inhaler technique. She sprayed it on her neck like it was Chanel.

"Now, that seems ridiculous. But, I had a patient who had an inhaler for a dog-hair allergy. She sprayed the inhaler on the dog. And then another patient – and this was before you could buy the morning-after pill over the counter – told me she'd slept with three guys the night before. She then asked if one pill would be enough."

This Is Going to Hurt 

Also on the back of Fingering A Minor on the Piano, Picador are publishing Kay's diaries. This Is Going to Hurt is set for release in September.

"I wasn't expecting [a publishing offer] at all," he admits. "It hadn't occurred to me, but as soon as it was suggested, it did make sense. And once again, it can spread the story to a bigger audience than I could hope to achieve by standing up on a stage saying it to a couple of hundred people a pop. With 80,000 words for my day-to-day witterings as a doctor, I can hopefully get an idea of what it's really like across.

"I think it's a great genre," he says of popular medical literature. "For a lot of doctors it'd be a bit of a busman's holiday. But my favourite is Atul Gawande, who is an American surgeon and now a very popular writer. He writes beautifully and accessibly about what it's like to be a doctor. And at the end of last year I read When Breath Becomes Air by Paul Kalanithi.

"This makes my book sound very worthy," he says, pausing for a moment to remember these books are not comedic. "I hope my writing style is funny, and I present it in a vaguely readable way."

While confidentiality is carefully ensured, does Kay ever feel uncomfortable telling stories about patients, just on the level that the original consultation wasn't a set-up for a comedy anecdote?

"Do I feel I'm using people for routines? Yes, there's no getting away from the fact that if I recount a story, even though it is all anonymised, I am using it for my gain to get a laugh and to sell tickets.

"But, for every one thing where a patient says something stupid there's maybe five where I have done so. I was very conscious of [that when] putting the show together, and particularly the book. It isn't just an episode of 'Patients Say the Funniest Things'. Every story is there for a reason, which paints a picture of a life in medicine. I hope that does a bigger thing, or a good thing for the medical profession." 

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Adam Kay: Fingering A Minor on the Piano is at Leeds Comedy Festival, The Wardrobe, 3 Jun, 6pm

This Is Going to Hurt will be published by Picador on 7 Sep