I often do my best writing when I’m trying to work out why I feel uncomfortable about something. By forcing myself to fully explore an issue – to consider it from as many sides as possible – my position and why I occupy it become clearer to me. We should, I think, have the courage to examine the blind spots of even our most beloved works of popular culture, and I must confess to being surprised by the accusations of misogyny levelled at the BBC adaptation of Adam Kay’s best-selling memoir This Is Going To Hurt. It’s only human to get a little defensive when things you love are criticised; it can be hard to hear “that thing you like is bad, actually” – especially when you consider yourself to have a decent radar for the problematic. It makes you wonder what you’ve missed. I don’t think this is a bad thing. It’s important to interrogate your stances on things, to know why you think what you think.
It’s also important to correctly identify the tone and message of a story before you deem it misogynistic and offensive.
Of course, just because I’m a strident feminist who found Kay’s book incredibly funny and profoundly moving, it doesn’t mean it’s not offensive. I can see how, if you’ve gone through a traumatic birth experience under NHS care, you might want to give the series a miss. I can also see that the ink-black, puerile humour isn’t for everyone. But headlines such as This Is Going To Hurt: misogyny on the maternity ward? and This is Going to Hurt could turn a generation of women off having children seem to be something of an overreaction. Just because something’s not for you, it doesn’t mean it’s fundamentally discriminatory.
Ages ago, I wrote about ‘big stories’ and ‘small stories’ – the idea that every work of fiction essentially has two plots: its big plot, and its small plot. Take The Dig, for example, which I watched recently: its ‘small’ story is about the discovery of the Sutton Hoo, but its ‘big’ story is about coming to terms with death. I’ve only seen the first episode of This Is Going To Hurt – not due to anything other than a lack of time – and while I found it a stressful watch, it also made me laugh out loud several times, much like its source material. It seems obvious to me that the point of the series – its ‘big’ story, if you like – is about doing an impossibly demanding job in a struggling organisation.
In a Guardian piece about the criticism the show has faced, author of The Positive Birth Book Milli Hill is quoted as saying, “you’re not seeing anything of the women’s stories, you just see them as body parts in the background. It shouldn’t be him who’s the hero at the centre of the story, it should be the women who get to tell their version of events”.
Firstly, if you think Adam has depicted himself as a hero, then I don’t know what to tell you – if you haven’t clocked that his “aren’t I great?” asides are dripping with irony as a mask for self-doubt, then you’re not reading the book or the show in the way they are meant to be read. And anyone who’s ever worked in customer service can surely relate to the feeling of sometimes finding the general public an inconvenience – this is the medical version of that.
And secondly, much as it irritates me to defend a white male writer against accusations of misogyny: this story isn’t about the women. It may be set in a maternity ward, but what it’s about is the terror and strain of being a fallible human man whose medical degree and scrubs make scared, vulnerable people treat him like a god they’re being given no choice but to trust. Calling for the show to “tell women’s stories” is calling for it to be a different show entirely. You might as well ask for it to have more dinosaurs in it. Or more sharks. Or a spaceship.
It is right to question how we represent people in popular culture, especially members of minority and oppressed groups. It is right that we strive to avoid dealing in cliché and trope. But it is also right that we criticise stories on the basis of what they are, rather than what they are not.
I understand that it’s not unreasonable to want a show set in maternity ward to give the patients at least some airtime, but this isn’t a documentary. The book is a memoir by one male former doctor; it’s not an NHS report. The series is based on that memoir, which means scriptwriters have adapted it for television. Television comedy-drama adheres to rules – of narrative, of characterisation, of dialogue. No rule of narrative requires you to always tell both sides.
Later in the aforementioned Guardian piece, writer Harriet Sherwood reports that “[some] pregnant women said on social media that they had been advised by their midwives not to watch the series”. Does this mean anything whatsoever? I imagine midwives advise against watching Eraserhead while pregnant too. I tend to avoid most medical dramas and films involving any kind of body horror, as I’m incredibly squeamish and extremely anxious about health-related things. I don’t think they shouldn’t exist; not everything is for everyone, and that’s fine. If you’re personally feeling deficient in women-centred birth stories, may I direct you to Call The Midwife, One Born Every Minute, and indeed all of Mumsnet.
What makes an entertaining memoir and comedy-drama is often slight exaggeration, a little carefully deployed heightening and amplifying. Could it be that when the tone of the show seems extreme, it’s being done for effect? Could it be that in demanding jobs of all types, coal-dark humour is how you find the will to clock in for another day? Could it be that doctors might have to shut off their emotional involvement with their patients, because if they didn’t, their jobs might break them even faster than working in an understaffed, creaking system reasonably would?
Could it be that the final point above is what Kay spends a book and a series trying to tell you?
It is true that there are so many women’s voices we haven’t heard yet. And not just women – we still need more diversity across the board when it comes to whose stories get told. That is not in dispute. It is also true that that maternity services, and indeed how we treat pregnant people in general, need radical change. In a few years’ time, I might well be attempting to have babies myself, but everything I hear about pregnancy, birth, and the way expectant parents are treated in the UK makes me question my desire to have children. This is so obviously a societal problem – which has structural, political, and yes, of course misogynist elements. But are we really going to pin the blame for all of that on one doctor-turned-writer? Or are we going to grow up, and learn to kick up?
The last lines of an already-powerful closing chapter of Kay’s book should, if nothing else has, make his intentions clear: “Even though they’ve got a stethoscope round their neck and a decent line in gallows humour, they’re still just that teenager who arbitrarily put a tick next to ‘medicine’ on their UCAS form. Just a human as fragile as anyone.” These are not the words of a man who doesn’t care.
Join the dots: you do not write a book that’s essentially a howl of anguish at the way the governments of the last 10-15 years have treated the NHS and its staff if all you have is disdain for the people who passed through your care. You do not tell this story if you aren’t painfully aware of the soft, breakable, bleeding humanity on both sides of the curtain, and aren’t doing what you can to advocate for it.