Writer, comedian and former doctor Adam Kay has written three books based on his time in the UK’s National Health Service to great acclaim. His first, This Is Going to Hurt, sold more than three million copies and was turned into a TV series. So it was a natural move to further employ his experience for a novel, in this case a murder-mystery. Eitan Rose is a consultant rheumatologist who’s just back at work after enforced health leave following a relapse of his bipolar disorder, which had him mistaking a patient for Ed Sheeran and insisting they perform Shape of You in the waiting room – among other lapses in judgement.
His nemesis, medical director Dr Moran, is still out to get him, though, and it looks as if Eitan will be out on his ear after Moran discovers him having sex with his new boyfriend, Cole, in the medical director’s office. But then Moran is dead from a sudden heart attack and it looks as if Eitan’s career has been saved.
But wait, hadn’t Moran just been given a clean bill of health? Suspecting foul play, Eitan, aided by Cole, starts an aside in amateur sleuthing, which is further fuelled by the death of Moran’s successor, Annabel Stein.
At the beginning of the story, Eitan says he’s not an idiot – he has the exam results to prove it – it’s just that he does stupid things. But that disclaimer is not enough to explain his many inexplicably dumb moves, such as seemingly molesting Moran’s body at his funeral in an effort to discover the cause of death. As A-grade idiotic stunts pile up, readers’ suspension of disbelief will be stretched, and it’s not relieved by rather tired attempts at humour along the way.
Saying that, there are some genuinely funny moments. A report from the consultant in occupational medicine on Eitan’s fitness to work, in which Eitan apparently called him “Back Pain Betty” and “not a real doctor”, is hilarious.
Kay revels in the dark side of life at a dysfunctional hospital: there’s the pharmacist on the back stairs dealing cocaine in antihistamine spray bottles to staff, and the black mould and loose electrical fittings in the waiting rooms.
Eitan’s shaky mental health is thoroughly probed, with the guilt he carries following the death of his sister many years before playing out in numerous self-sabotaging moments.
The real murderer of the piece is easily detected a long time before the final denouement, but even so, this part is nicely done when the “human cardigan”, a motherly fellow consultant in rheumatology, steps in and takes charge.
I hope Kay makes another attempt at a novel using his insider knowledge of the British public health system. But next time, I hope he relaxes and tries not quite so hard to be funny, remembering that this is a book and not the telly – even though he’s a screenwriter now. He’s a former doctor with a gift for comedy and a lot to say that’s still worth hearing.
A Particularly Nasty Case, by Adam Kay (Hachette, $37.99), is out now.
