Twas the Nightshift Before Christmas by Adam Kay review – more matchless stories from A&E

<span>Photograph: Andy Hall/The Observer</span>
Photograph: Andy Hall/The Observer

The most common reasons why Adam Kay omitted stories from his 2017 memoir, This Is Going to Hurt, were that they were “too disgusting” or “too Christmassy”. That book is now a global bestseller, and Kay a celebrated author whose gory and shocking anecdotes have drawn attention to the struggling NHS and its overstretched staff. His new book is going to hurt with tinsel on top.

Obstetrics and gynaecology on Christmas Day (and Kay worked six of them) is the same bloody mess, but more so. Hospitals are understaffed and medics exhausted but babies don’t stop coming, alcohol doesn’t help anything, A&E is full of abandoned grannies and “elderly patients who’ve gone full Jenga on the ice, shattering their hips like bags of biscuits”, and patients just won’t stop inserting objects into intimate places from which world-weary medics have to remove them.

There is plenty here for fans of the “disgusting”: the woman who used peanut butter as a lubricant, only to discover that her nut allergy affected her; the man who “desiccated himself to the human equivalent of a Ryvita” by going to a Christmas party as a turkey, wrapped in tinfoil; the woman subjected to Johnny Mathis during a forceps delivery who yelled at the radio: “No, Johnny. That is not what happens when a child is born.”

There’s also the time when Kay loudly set off his novelty Christmas tie while breaking the worst news to a family. And when he carried out a late termination of a pregnancy to save a woman’s life – a story he kept from his first book because he couldn’t face thinking about it again. It is horribly upsetting, and Kay doesn’t hold back. It’s incidents like this – and the lack of care that the NHS shows staff who have to cope with them – that led to his leaving medicine.

Kay is equally outspoken about the politics of the NHS: the “evil” health secretaries, the underinvestment, the stupid efficiency initiatives (from scrubs dispensers to voice-activated switchboards) and the damage done by spending one’s entire career in an “emotional brace position”. But the worst part is how relationships outside work buckle under the pressure.

A career in medicine is not just for life, it’s for Christmas, and this year half a million NHS staff will be spending the day at work. They’ll be working Christmas miracles; the least the rest of us can do is read this funny, sympathetic and eye-opening book, be overwhelmed with gratitude, and avoid off-label uses of condiments at least until the new year.

• Twas the Night Before Christmas is published by Picador (£9.99). To order a copy go to Free UK p&p over £15.

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