OA 2024 Issue 05

This article appeared in the July 2023 edition of the Alleynian


Upon that note, the value of our NHS cannot be overstated, said Adam, arguing that it should be above political partisanship and ambition. His vision is that the whole machinery of government should rally behind our NHS, regardless of the colour of rosettes worn by individual party politicians. Anyone who has read his book, or watched the BBC series, knows that Adam is a talented writer. Having interviewed him, I can see that his work has all the more potency for having been fuelled by such a politically charged set of issues. When I set out to write this piece, I was aware that I needed to capture the essence of Adam’s unconventional wisdom – and that, whilst this could not be an- inclusive narrative of that evening, it was important that it hold true to his convictions. I also needed to do all of this without alienating the potential medics (and their parents) within the Alleynian’s readership!

healthcare professional working in the NHS takes their own life. Once in every three weeks, an NHS doctor takes their own life.’ Adam was emphatic in his criticism of the culture of ‑emotional repression that seems to have been embedded in the training and early years of doctors’ lives, through medical school and beyond. The stiff-upper-lip mentality that appears still to be worryingly prevalent surely has no place in a profession predicated on care, he suggested. This is one of Adam’s real areas of passion: provision of support for the mental wellbeing of doctors. And when the opportunity presented itself to him, Adam was instrumental in the establishing, for the first time, of a helpline and support system for doctors, with the aid of then Health Secretary, turned reality TV star, Matt Hancock. That this incredibly important matter is close to Adam’s heart, and is born out of his own experience, is evident in all that he has done since leaving medicine. Sometimes, as he said himself, you can make more of a difference on the outside than you can on the inside. Moving into current times, Adam voiced the concerns, which he shares with many, surrounding the crisis facing the future of our NHS through chronic underfunding. ‘It’s difficult to guess where this is going to go,’ he said: ‘Where is the game going to go when you’re playing against an idiot?’ The last 12 years have seen pay and conditions within the NHS continually eroded, to the point that junior doctors face a drop in wages of around 25% in real terms and our nurses are having to frequent food banks. The recent industrial action, therefore, is no real surprise. As a former medic, Adam was clear: they are not actually asking for a pay rise; they are asking for restoration! It’s never just about the money – it’s about valuing the invaluable.

EXPLORING THE SCIENCE OF WORDS AND THE ART OF MEDICINE Zaki Kabir (Year 12) looks back on interviewing Adam Kay OA about the varied aspects of his life as a doctor and a writer

of intelligence. It’s all about communication. It’s about having that connection, that rapport.’ When you stop to consider the realities of working within the NHS, this comment raises certain questions. Limiting the pool of potential candidates to the privately educated, for example, or to those who have access to the right work experience through family friends, prevents recruitment of the right mix of people. Does playing the trombone or being captain of the rugby Firsts really predispose one to excellence in the medical profession? As I listened to Adam’s eloquent, if rather comical, suggestion that the ability to play myriad instruments (brass, woodwind or otherwise) does not mean that you are necessarily able to hold a decent conversation with a patient, I have to say I found myself compelled to agree. Would it not be more efficacious to ensure those seeking to embark upon a career in medicine have the mental fortitude, resilience and emotional intelligence required to essentially deal in matters of life and death on a daily basis, as Adam argued? ‘Ask our future doctors,’ he mused, ‘how they are going to be able to break bad news to a patient.’ He added, as a telling analogy: ‘If you want to be a train driver, you’d be asked what you’d do if someone jumped in front of your train.’ Here we find the emotional and ethical underpinning for Adam’s book, This is Going to Hurt , and the driving force behind its success, as well as the success of the BBC drama on which it is based. Adam’s focus on the mental health of healthcare providers throws into the spotlight a long-overlooked issue, which in itself is an outrage and an unspeakable tragedy. As he said during the course of our interview, ‘Every week, one

Adam Kay’s is a name with which many of us, across different walks of life, will be familiar. A medic by training, he then went on to eschew the direction on which he had set out and walk a completely different path. Meeting him prior to our interview, I was immediately struck by his unique perspective and unaffected outlook on life. Our discussion was wide-ranging, encompassing the NHS, the wellbeing of current medics and the future of the healthcare workforce, as well as the rights and wrongs of the selection of prospective medical students. Though the conversation covered the breadth of his career to date, we started off close to home, with his stretch at the College. He described himself as inhabiting the ‘niche of the unpopular’. He did, however, find camaraderie through his stint at the Alleynian, where, under the stewardship of Tony Binns, a warm and social atmosphere was created – a legacy that those of us involved in the Alleynian to this day would still attest to. He spoke appreciatively of the opportunities Dulwich afforded him. However, upon reflection, he commented that those opportunities perhaps had little relevance or relation to his future career in medicine. We moved on to the topic of the medical school application process and how, in his opinion, this was not, and to a degree is still not, conducive to finding and producing the best of doctors. Commenting on the expectation that successful candidates will have taken part in a range of co-curricular activities as well as achieving a string of exemplary academic results, Adam concluded that the process appears to be weighted in favour of a particular, privileged, stratum of the population. ‘Medicine,’ he argued, ‘actually needs a minimum level

Adam was emphatic in his criticism of the culture of emotional repression that seems to have been embedded in the training and early years of doctors’ lives

Adam’s focus on the mental health of healthcare providers throws into the spotlight a long-overlooked issue

It feels right to end this piece with a wry comment by Adam on some recent reactions to his book:

‘I get complaints sometimes from parents or grandparents, telling me that my book has put their child or grandchild off being a doctor. Good! If that’s going to put them off being a doctor, then being a doctor is really going to put them off being a doctor!’

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