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The opening scene of This is Going to Hurtpretty much sets the tone for the whole show.

After jerking awake in his car, acting registrar on the Obstetrics and Gynaecology ward of a UK hospital, Adam Kay (Ben Whishaw), hurries into work only to find a pregnant woman close to giving birth on the steps. He struggles to help her up to the ward in time, nearly gets stuck in a lift, and finishes the whole hectic encounter covered in blood before receiving a sardonic dressing down from his boss while standing naked in the hospital toilets.

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The whole sequence is funny, shocking, dramatic, and the perfect introduction to a show that doesn't shy away from warts-and-all chaos of the National Health Service.

Adapted by Kay himself from the author's hit non-fiction book, This is Going to Hurt: Secret Diaries of a Junior Doctor, the show follows our protagonist as he struggles to balance his personal life with the demands of an incredibly draining and harrowing job. The NHS is a system that appears constantly at breaking point, with a physically crumbling hospital building playing home to an overworked and exhausted staff running on coffee and minimal support. (Kay's book covers his career from 2004 to 2010, so the pandemic doesn't come into it.)

The End of the F***ing Worlddirector Lucy Forbes perfectly captures the chaos and fatigue of Kay's experiences, with shots of him slumping sideways in car seats and nightclubs, and montages showing blood-spattered scrubs being thrown into the same bin, over and over again, in a relentless cycle of weary trauma.

Sounds heavy, doesn't it? Well, it isn't. Or at least, it isn't completely. In order to review This is Going to Hurtwe were given the first four episodes to watch, and one of the show's greatest strengths is the way it delicately balances drama and comedy throughout. Along with plenty of if-you-didn't-laugh-you'd-cry moments there's also a constant stream of amusing dialogue, as the staff banter and bicker with each other, getting through the day by leaning heavily into deadpan (and often gallows) humour.

"I had a patient die today," says Kay at one point to his superior, Mr. Lockhart (played with a brilliant upper-middle-class sarcasm by Alex Jennings). "Someone I really cared for."

"Well, you can't have cared for her that well if she died," comes the quick response.

Kay's writing is full of sharp moments like this, with his protagonist constantly sparring with patients, superiors, and colleagues alike. Midwife Tracy (Michele Austin) is more than a match for him in this regard, as is junior doctor Shruti (Ambika Mod), who grows in confidence as the series progresses. Harry (Rory Fleck-Byrne), meanwhile, is a solid and dependable force as Adam's partner, struggling to break through his shell in order to get him to open up about life in the hospital while navigating issues in their own relationship (Adam's icy parents, who he's yet to come out to, being one of them).

This, ultimately, is the main thread running through This is Going to Hurt: the massive toll the job takes on the personal lives of staff, and how the struggle to maintain a personal life can then impact the job itself. It's a vicious cycle.

"Always used to reckon I was good at medicine and bad at the other stuff," Kay mutters at one point. "Not feeling great at either right now."

Despite his flaws, though, and those of people around him, the characters are so well-drawn we can't help but root for them, watching as they navigate the highs and lows of a world that's overloaded with every emotional extreme you could imagine.

This is Going to Hurtis streaming on BBC iPlayer in the UK, and AMC+ in the U.S.

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