Adam Kay, the bestselling author and former junior doctor, has released his debut crime novel, A Particularly Nasty Case, in paperback on July 2, 2026. The book combines laugh-out-loud humour, gruesome details, and a sharp critique of the NHS, drawing on Kay's own experiences in medicine.
The Premise: A Bipolar Doctor as Detective
The novel's protagonist, Eitan Rose, is a bipolar consultant rheumatologist who returns to work after a mental health crisis and copes by ingesting liquid cocaine through an inhaler. When a colleague dies under mysterious circumstances, Rose investigates, despite having disliked the victim. Kay poses the central question: "But is he onto something or is the pressure of the job getting to him?"
From Memoir to Fiction: A Liberating Shift
Kay, known for his memoir This Is Going to Hurt, which sold three million copies and was adapted into a BAFTA-winning TV drama starring Ben Whishaw, admits that writing fiction is more freeing than memoir. "Real life is real life – there are two sides to every story, and you can choose how to spin it, but you can't really change the ending. Fiction is definitely more freeing, but it's still bound by certain rules and structures that readers expect; and knitting a plot together so it's truly satisfying is a bit like playing 3D Chess on a tightrope," he says.
Mental Health in the NHS: A Stark Reality
Kay remains a fierce advocate for NHS staff mental health. He highlights that one doctor dies by suicide on average every three weeks. "The NHS we rely on is staffed by real people who have all the same problems as the rest of us, but added into the mix are the additional pressures of the NHS," he explains. He supports charities like Doctors in Distress, which believe suicide is preventable and work to reduce the current horrendous numbers within the NHS.
Dark Humour as a Coping Mechanism
Kay's trademark dark humour is present throughout the novel. He notes that humour is a coping mechanism for many in the emergency services. "Working in health, you care for patients, but you also code switch regularly. One minute you might be delivering good news to a patient, the next you're calling time of death," he says. "Humour is a coping mechanism for most people but the contrast can be starker when it's a matter of life and death. It's like an emotion regulator."
Influences and Inspirations
Kay cites Agatha Christie, Carl Hiaasen, Patricia Cornwell, Lucy Foley, and Chris Whitaker as inspirations. He jokes that he draws on his own experiences, saying, "It would be wrong of me to use people I've met to populate the cast of incompetent, devious, and unpleasant characters in my novels, or use thinly veiled versions of my enemies as murder victims – but that doesn't mean I don't regularly do it!"
Medical Serial Killers: Rare Exceptions
When asked about real-life medical serial killers like Harold Shipman and Lucy Letby, Kay insists they are rare exceptions. "The reason these cases become such big news is they're extraordinarily rare and there's something shocking about a person who you trust with your life actually ending it maliciously," he says. He deftly sidesteps questions about Letby's potential innocence, noting that a vociferous social media campaign claims she might be a victim of a miscarriage of justice.
Upcoming Projects and Appearances
Kay is currently working on a sequel to A Particularly Nasty Case. He jokes, "It's going quite well; I killed off a creepy character before I'd even finished my Shreddies this morning." He will also appear at the Theakston Old Peculier Crime Writing Festival in Harrogate on July 24, supported by the Daily Express. A Particularly Nasty Case by Adam Kay (Orion, £10.99) is published on Thursday, July 2.
