This Is Going to Hurt's Ambika Mod: 'I have really bad anxiety'

Ambika Mod with Ben Whishaw in This Is Going to Hurt. Photo / Supplied

Her portrayal of an overwhelmed medic in the hit TV series has won sympathy and turned Ambika Mod into a star.

In late 2019, Ambika Mod was not where she wanted to be. Having graduated with a degree in English from Durham University a couple of years before and with several Edinburgh festivals under her belt, she was auditioning for acting jobs, writing and performing comedy – but only at night. By day she was working in the stock department of John Lewis, then as a PA in the finance department at magazine publisher Conde Nast. She couldn't get an agent. "Nobody was interested – it was really disheartening," she recalls. And she was back home, living with her parents.

She'd have conversations with other creatively minded friends from university also struggling to catch a break. "We're all very intelligent, capable people and we'd be like, we could have been investment bankers; we could have been raking it in," she says with a sigh. "We have friends who are lawyers who are absolutely swimming in money, and you have those moments where you think, what could life have been?"

Today – less than three years and one long pandemic later – Mod may not yet be bathing in £50 notes, but she is basking in rapidly acquired recognition. After the first episode of the BBC series This Is Going to Hurt aired, viewers and critics were quick to praise Ben Whishaw's performance as the caustic protagonist, Adam, but were also asking: "Who's that girl in the scrubs giving as good as she gets?"

Since the adaptation of Adam Kay's bestselling book about his years as a junior doctor in obstetrics and gynaecology – a brutal, bloody and bleakly hilarious depiction of the NHS – Mod's downtrodden senior house officer (SHO), Shruti, has become the overburdened medic the nation wants to kidnap, feed a square meal to and send to bed for a solid week.

Mod, 26, admits to feeling a little overwhelmed by the public reaction. This is her first TV role, "the first time I've been on set for longer than a day", and today, in a studio in East London, only her second photoshoot. The first was for Vogue – not a terrible place to start – as part of a feature titled "The 6 actors set to take over your TV screen in 2022". When she arrived at Vogue House (Conde Nast HQ, her old workplace), "they were like, 'Aren't you … the finance PA?'" she deadpans.

While the ward's registrar, played by Whishaw – a stroke of casting that renders the bullying, imperious Adam impossible to hate on account of him being the voice of Paddington Bear – is, says Mod, "the brains and face of the show, Shruti is the heart and soul".

An amalgam of doctors Kay worked with in his brief and bloody medical career, Shruti Acharya was created specifically for the series. She is diligent to the point of burnout, working 90-hour weeks while making life-and-death decisions on a labour ward and studying for exams. "The immediate feedback has been huge," says Mod. "I've had a lot of messages from people in the NHS, regardless of gender, race, age, saying, 'I was that SHO'; 'I was that junior doctor.'" But, she says, her portrayal is also resonating with viewers who've never pulled on a pair of scrubs. "That rabbit in the headlights, that feeling unsupported, feeling overwhelmed – that experience is so universal. She's so vulnerable. There are Shrutis all over the UK," she says.

There have been other, more specific and surprising aspects of the feedback too. "I even had a message the other day from this Indian teenager, saying, 'I've got really bad acne scarring' – which is quite common for South Asian women – and, 'I've never seen anyone on TV with acne scarring. Thank you so much.'"

The show is not always an easy watch, with gallons of blood and other bodily fluids spilling forth, graphic caesarean sections and suction births (Mod and Whishaw were given a "crash course" in performing surgery, "so if anyone needs to have a baby today …" she offers), and repairing the results of an at-home labiaplasty. I found myself watching most episodes with my legs involuntarily clamped together. Yet it has been the runaway hit of 2022 so far, with more than six million people tuning in to watch the launch episode on BBC1 and iPlayer in the first seven days.

The book was published in 2017, partly in response to Jeremy Hunt's comment that junior doctors were "greedy". Unusually for an author, Kay adapted it himself for television, writing all seven episodes singlehandedly. And, while it is undoubtedly landing with even more impact in the midst of a pandemic, the show is not some anodyne on-screen Clap for Carers; rather a grim portrayal of how the system treats, affects and all too often fails both staff and patients. "Yes, it is critical of the NHS to some degree and of the institutional problems within it. But it's nothing that's not true," says Mod. "It's an underfunded, broken system and the ones that are suffering are the ones on the ground, the million and a half people working for the NHS.

"The biggest compliment I've received is that people working in the NHS feel that they have been listened to and that their experiences have been represented," she says. "More than anything, I hope this show starts a conversation."

Certainly it has done that. Along with praise for the unsparingly graphic portrayal of an obs and gynae ward – or, as Kay calls it, "brats and twats" – has come some fierce criticism: that the show is misogynistic and "riven with hatred for female bodies", "dehumanising" and "diminishing". Milli Hill, founder of the Positive Birth Movement, has said that Kay's book was "blatantly disrespectful towards women. It sums up the misogyny that's baked into maternity care – the idea that any woman who thinks she can control labour or plan for labour is an idiot," and that the series is "women's trauma being played for laughs".

"I definitely hear and understand where those observations are coming from," says Mod, showing more diplomacy than any character in the show musters. "My experience, as a woman having made the show, was that we were as respectful towards women as we could have been," she says. "I think the female characters are really well written, especially Shruti, and we had a female director, producer and exec producers – there were so many women involved in the making of it.

"I've seen a lot of women saying thank you for showing the birthing experience how it really is," she continues.

"So yeah, while I do hear those observations, I can't agree because we really haven't cut any corners when making this show.

"Adam's outlook, his experience, isn't purporting to be universal. This is his specific experience," she adds. So… might it be that Adam could be a bit of a misogynist? Mod laughs a little nervously. "The character, right? Yeah, totally."

Thrilled though she was to kick-start her career with such a plum role, Mod was, simultaneously, "s***ting it". The responsibility of representation weighed heavy on her. "She [Shruti] is a young South Asian woman, she's a child of immigrants, she's working class" – like many NHS workers, in an institution still led by white, middle-class, privately educated men. "I would get really stressed, like, 'Oh my God, did I pitch that right? Is that how it really is?' I would second-guess myself a lot, especially towards the end where there were harder scenes. And representing the mental health story with respect and in a way that was not sensationalised – because things like this are often sensationalised – I felt the weight of that."

Shruti's storyline and its devastating climax is the pivotal point of the show, when black comedy becomes serious drama and the full implications of the pressures on NHS workers are laid bare.

There are, says Mod, myriad reasons doctors feel desperate. "They just don't seem to get help for mental health issues. I don't know whether it's because they don't feel like they can ask for it, but it's definitely not offered to them." For Shruti, she says, things would have been better "if she'd had a social circle, if she'd felt like she was able to be honest with her parents. But I think it's something that's true for a lot of children of immigrants: they feel they live a double life. And the job is very isolating."

Mod herself is open and comfortable discussing mental health. "I have depression and I suffer from really bad anxiety. And so, as well as research, I did draw on a lot of personal experience with Shruti." She's been in therapy for two and a half years. "There were definitely moments in the script where I felt, 'I can relate to that' – especially the shutting down, the numbing, the dissociating. I don't remember a lot of 2019 because I was cut off emotionally from everything."

She and a friend took a show to Edinburgh that summer. "And it did really well, but I look back at that time and I almost don't recognise that person. That's something I used when playing Shruti. Sometimes when you're in that much pain, the only option you have is to cut off. But," she says, "when you cut yourself off from the pain and the hurt and the loneliness, you also cut yourself off from every positive feeling that you could experience. That sort of anhedonia – the lack of pleasure, no matter what you do – is something I experienced."

Mod grew up in Potter's Bar, Hertfordshire, where her mother is an accountant and her father a vet. Like Shruti, she is the child of immigrants – her mother arrived in the UK from India as a young child and her father in his 20s, but she's not clear exactly how we describe that. "Does that make me first or second generation? I get confused."

She attended a selective school and had, since childhood, ambitions to act. "My parents made very clear that, no, that's not going to happen. They said, 'You can do it as an extracurricular activity, you can do it at school to get Ucas points, but not as a career.'" She read English at Durham and got into comedy, joining the Durham Revue, whose alumni include Nish Kumar, Ed Gamble and Nick Mohammed, becoming its president in her final year. She spent consecutive summers at the Edinburgh Fringe. "What a lesson in resilience," she laughs. "When you do a show to an audience and it's silent, and you have to carry on and do it for an hour, you really learn who you are."

Her parents have now "taken stock of what it is I do for a living", even if her mother was, she says, "inconsolable" watching Mod's character's struggle in the show. And a month ago she moved out of their house in Potter's Bar and into a flat in Camberwell, South London, with an actress friend and her 4-month-old puppy, Toddy. "Do you want to see a picture?" she asks, whipping out her phone to find a text from Whishaw who, she says, "is filming in Russia with a lot of strange prosthetics on".

She is single – "Do you know anyone?" – but is committing fully to her career right now anyway.

Landing Shruti was no small deal. "A lot of South Asian roles that I've come across are still very trope-y or stereotyped. I've seen a lot of roles where it's like, she's reliable, competent, caring, really cares about X, Y, Z … and she's playing second fiddle to the more interesting white lead."

But it has also set a standard. "Having played this part, having done this show, I'm not going to settle for those sub-par Indian roles any more," she says. "I'm not going to settle for any old part that gets sent to me."

This is Going to Hurt is coming to TVNZ later this year.

© The Times of London