Want to write a memoir? Adam Kay’s hugely entertaining This is Going to Hurt is part of a new trend of immersive memoirs with a message. But what does it take to write and publish one?
11–14 minutes to read
The highlight of this year’s London Book Fair for me was a session called ‘Memoirs that Matter’, with Adam Kay. Adam is the author of the bestselling This is Going to Hurt: Secret Diaries of a Junior Doctor – which won the Books Are My Bag readers’ choice award in 2017. The session was chaired by Chris Doyle, senior commissioning editor at his publisher, Picador. The other panellists were: Cathryn Summerhayes, his agent at Curtis Brown; and Rosamund de la Hey, of Scottish independent bookseller The Mainstreet Trading Company, and president of the Bookseller’s Association.
I recently finished listening to the audiobook, and now understand why everyone’s been recommending it to me. It’s laugh-out-loud funny (you might want to avoid listening to it on your daily commute) – but also frequently shocking, occasionally upsetting and has a political message. Adam is now a comedy writer, script editor and performer – and it shows. This is Going to Hurt was a comedy show before it was a book.
But before all that, Adam was a doctor. The memoir documents his six years as a junior doctor between 2004 and 2010. Once he no longer needed to keep his medical paperwork, he began clearing it out – but kept his ‘reflective practice’ notes – which form the basis of the book.
There was some discussion at this year’s audiobook-heavy Quantum Conference about when it makes sense for an author to read their own work. Memoir was highlighted as an example of where this can work well, with the right author. Adam is one of those authors. His delivery – even (especially) the footnotes – enhances the experience.
We had a flavour if this during the session, when Adam read a couple of extracts. To avoid spoilers, I shall just call these ‘Kinder Surprise’ (which was received with much hilarity); and ‘Upsetting Patient Diagnosis’ (which wasn’t).
There is considerably more light than shade in the book. Nonetheless, I arrived at the Book Fair the previous day a bit discombobulated, as I’d been listening to it on my way in and had just got to the ‘…and that’s why I’m no longer a doctor’ part. The ‘…that’s why there are no more jokes in this book’ part.
Adam was spotted by a publisher at the Edinburgh Fringe, when This is Going to Hurt was still s a show. Chris Doyle saw it in 2016. He says: “For the first 55 minutes the audience laughed – and then this thing happened at the end, and I’ve never seen such a dramatic reversal.” His colleague Francesca Main had already seen show earlier in year and wanted to turn it into a book. Yet Adam initially left the serious ending out of the show in previews. People enjoyed it, but he had some feedback that it didn’t really have an ending. “It did, but I didn’t want to talk about it,” says Adam. “Six or seven years had elapsed, and I had never really talked about it. The first time my parents knew about why I left medicine was when they read in it hardback.”
It has an ending now. It gets serious, campaigning even – and ends with an open letter to the Health Secretary (who, at the time of writing, is still Jeremy Hunt). The book lures you in with the comedy – then hits you with: ‘right, now I’ve got your attention, THIS is what I actually want to say.’
I wouldn’t have published the book if I didn’t want to affect a bit of change.
– Adam Kay
Adam was initially motivated to write a memoir by the treatment of junior doctors in the UK. They were coming under fire from politicians at the time – being accused of being greedy and in it for the money. Anyone who has read the book cannot possibly believe that characterisation of junior doctors – and that’s the point. Adam may not be able to influence politicians but, by better informing the public, they are less likely to swallow government propaganda. He thought that: “If people knew what [being a junior doctor]meant, hour by hour, no one in their right mind would agree with what they’re being fed by politicians.” He adds: “I wouldn’t have published the book if I didn’t want to affect a bit of change.”
What is a memoir? And what is a ‘memoir that matters’?
These elements – an immersive memoir with a message, which is communicated with a lightness of touch and freedom of form – is part of a growing trend. They are books that are entertaining, emotional and informative, written by someone who’s done something extraordinary and has something to say about it – and they do something to affect change in society. This is a trend that you need to be aware of if you want to write a memoir.
Chris Doyle opened the session by asking each panellist to name a memoir that matters to them. Their choices were:
Rosamund de la Hey: Educated by Tara Westover. It’s a combination of personal story/journey, beautifully written, with enormous heart. In other hands it could have been a misery memoir – in which case I wouldn’t have been interested. It’s the quality of the writing and the context that caught my attention. Tara was brought up in an extreme Mormon family in Idaho – and ended up with doctorate from Cambridge. As bookseller, it’s very easy to get it across to customers. It’s a dream sell, like Adam’s. As an ex-publicist, I think it’s easier to market non-fiction than fiction – because you have more ‘hooks’.
It’s easier to market non-fiction than fiction – because you have more ‘hooks’.
– Rosamund de la Hey
Cathryn Summerhayes: My Mad Dad: The Diary of an Unravelling Mind by Robyn Hollingworth. It’s a personal diary by young woman who had the start of very good fashion career in London when she got a call to say father had been diagnosed with Alzheimer’s. She decided to move back and become a carer. There are lots of ups – but there’s also the tragedy of realising you’re losing the person who raised you. It matters because our understanding of mental health – depression, degenerative illnesses – is currently in the spotlight. It’s a problem for the NHS and our ageing population.
Adam Kay: At the moment I’m reading lot of memoirs that DON’T matter – people keep sending them in – and not everyone has an interesting story. But one I can’t stop thinking about is Cathy Rentznbrink’s The Last Act of Love – an extraordinary story about her brother who’s involved in a traffic accident and is left in a ‘persistent vegetative state’. On the face of it’s a harrowing misery memoir – but it’s told with an extraordinary lightness, and it’s funny. It stuck with me.
All of these fit Chris Dolye’s two key criteria that define a memoir:
- Fluid in form. A memoir is not the cradle-to-grave account you might expect in an autobiography or biography. It’s more a focused slice of life. A memoir can be fluid in form, about a small area, attached to a particular topic. It moves around more. For example, Helen Macdonald’s H is for Hawk is about grief – getting over the death of her father by training of a goshawk – but it is also interspersed with a biography of T.H. White.
- Written by extraordinary ordinary people. People who write a memoir are not celebrities or famous people. They are extraordinary ordinary people. They’re doing something really amazing but not somebody who already has an audience, such as a world-renowned actor. In the case of The Secret Barrister, even the editor doesn’t know who the writer is. What maters in account of daily life in court.
Cathryn Summerhayes agreed that memoir used to be more autobiographical, but is now more fluid. It has changed. Rosamund de la Hey cited Maggie O’Farrell’s I Am, I Am, I Am: Seventeen Brushes With Death as something with a very fragmentary structure – but the form gives license for that to work.
People writing memoirs are extraordinary ordinary people.
– Chris Doyle, Picador
Extraordinary ordinary people is key to the total immediacy of the genre. We may think we know about being a doctor, a barrister or a carer – but a memoir gives the opportunity for somebody to explain that world to you from the inside.
The real difference, according to Doyle, is that this new genre is about having something to say. It’s all well and good that it gives an insight into world of junior doctor, barrister etc. – but it’s more than just prying in and vicariously seeing what someone else done. It’s taking us into a world but seeking some kind of change – which can be small-scale human-to-human change, or more societal change. Adam Kay’s is a perfect example – complete with a letter to Jeremy Hunt. Two things are key:
- Campaigning. A desire to see change in the world. Rosamund de la Hey mentioned Sally Magnusson’s Where Memories Go: Why dementia changes everything, her memoir about caring for her mother. This has a campaigning message and has led to her charity Playlist for Life.
- No sugar-coating. In This is Going to Hurt, we get the full blood, sweat and tears – among other bolidy fluids – and see things playing out in real time, such as Adam waking up on Christmas morning having fallen asleep in his car. In My Mad Dad we see Robyn not being able to communicate with her father that mother is dying too.
“It’s really immediate, in your face,” says Summerhayes. “By not sugar-coating it we’re all becoming activists because it motivates us to want to see change.” We’re being asked: Do you realise how bad it is for junior doctors? Do you realise how bad the legal system is?” Doyle agrees: “That openness, opening of the self, emotional honesty, is new.”
Overcoming the resistance to write a memoir
Adam felt comfortable on stage, telling 150 people a night what he thought of Jeremy Hunt – but initially resisted the invitation to write a memoir. He had something to say – but didn’t feel he was able to say it. “I’m not the sort of person who writes a book,” he says. “I’d read lots of books about how to write a book – and they all said you have to read lots and lots of books. I don’t, so I felt unqualified. It took a long time to get over that.”
I’m sure this is an anxiety that many of us have – but Adam’s experience is a lesson in going your own way and telling your own story in the way you want to. It helps that he can write, of course. “These opportunities don’t come along often as an agent,” says Summerhayes. “What sets it apart from many submissions is he’s an incredibly good writer. And I’m sucker for diaries.”
Changing form from stage show to book had it’s challenges. The structure is different in the book to the stage show, as it explains the different roles and levels of seniority – house officer, senior house office, registrar, consultant. There is also an opportunity to explain in more detail than a 70-minute show allows, through the use of footnotes – which are done especialy well. And people want to know the detail. Adam credits his agent with having a huge input in the creative process from first to final draft. “The outtakes were spectacular!” she says.
If you want to write a memoir, you need to get over these anxieties – but it clearly helps having a supportive, creative team around you.
Marketing a memoir
Memoir offers a greater than usual opportunity to involve you as an author – because it is about your own life. You are the ‘product’ as much as your book. Adam spoke at a dinner after the Scottish Booksellers Association conference. This was a slot of only three minutes – but the format suited the book well. “From that moment it became a chain reaction,” says de la Hey. “As a bookseller we’re given hundreds of proofs, and we simply can’t read them all. To get ‘cut through’ is key.”
Adam also did a ton of work to promote the book. It helps that he had a show before the book – and he’s been the length and breadth of country twice over – and treats every event with same respect. As an author, you have to work hard at getting the word out about your book, including using social media. Adam is “flying the flag because he has a cause,” says Summerhayes. “I didn’t want to be the reason the book failed!” says Adam.
That ’cause’ is what should make marketing a ‘memoir that matters’ easier than some other books, though. It’s genuine. “It’s not every author who can hold their book up with pride and say ‘this is my story and this is why I wrote it'” says Summerhayes. It’s why there’s been a diminishing in sales of ghosted memoirs. They just don’t feel authentic – and authenticity is what readers want.
What is the future of memoir?
A couple of questions from the audience touched on the future of memoir.
Chris Doyle: From an editorial point of view, it’s the freedom of it – you can almost do anything you like. For example Helen Macdonald’s H is for Hawk would sound like a mess in most editorial meetings – but it’s extraordinary. The more of these books that succeed in different ways gives us more confidence. The only criteria is: can the writer pull it off?
Cathryn Summerhayes: Beware of the trend to over-share on social media. A lot of these books are 100 pages that have enormous impact. The biggest fear when reading submissions is: are they salacious? Are they overplaying terrible things? It’s the same with literary fiction – you don’t want it to be over-written.
The only criteria is: can the writer pull it off?
– Chris Doyle, Picador
Q. With the rise of #TimesUp and #MeToo, are you expecting to see more survivor stories – such as Helen Walmsley Johnson’s coercive control memoir Look What You made Me Do – and does that bring with it another raft of potential legal issues?
Cathryn Summerhayes: I’m seeing a ton of that in submissions. I have to think about what’s going to work in a crowded market. There might be 30 titles in the window, all of which I want to read; if there’s another 50, will I want to read them too? I’ve been offered a lot of medical memoirs – but have only published two, and one of those was by a vet. I need to know: why are they telling them? Have they enough of a reach to be important to a bigger, more general readership? It has to be something unique. Pubishers are publishing fewer books – and booksellers are selling fewer books.
Rosamund de la Hay: There’s finite shelf space, so the selection process is quite brutal. It’s usually about the quality of writing, combined with the story. It may sound obvious, but it’s true.
Chris Doyle: From a legal point of view, as a publisher you’re not trying to silence anyone’s story – but if it goes wrong you could be on the line for a lot of money; so you have to walk the line between freedom of expression and corporate responsibility.
It’s about the quality of writing, combined with the story.
– Rosamund de la Hay, President of the BA
As with any genre, it doesn’t pay to ‘write to market’. All you can do as a writer is write what you want to write, write it as well as you can – and hope that someone else wants to read it. Authenticity is key, and your unique voice is what people want. But this new trend, this sub-genre of ‘memoirs that matter’, means that we have greater freedom than ever to tell our own stories in our own way. The only requirement is having something to say – and being able to say it well enough.
Six ways to write a memoir that matters
Here are the takeaways I got from the session, which you can apply to your own memoir writing:
- Have something to say. You don’t have to be famous to write a memoir. You just have to have something to say.
- Choose an angle. Don’t tell us your whole life story from cradle to grave – this isn’t autobiography. Choose an angle, a ‘slice of life’, a topic, an issue.
- Get creative. Be playful with form. Adam Kay’s This is Going to Hurt is mostly in the form of a diary. Nina Stibbe’s Love, Nina is in the form of letters home to her sister. Helen Macdonald’s H is for Hawk is a mashup of overcoming grief through falconry in the present, flashbacks to childhood in the past – and a biography of T.H. White. One of the most unusual memoirs in terms of structure in recent years – but it totally works, is beautifully written – and it won major awards.
- Keep it light. The misery memoir boom is over – and is actually off-putting to many agents and publishers now. Don’t hold back – but don’t over-share or over-write either. Get to the emotional honesty of what you want to say – but don’t overplay terrible events to be sensational or salacious for the sake of it. Humour and a lightness of touch are well-received – and this is possible even with the darkest of subjects – such as Cathy Rentzenbrink’s The Last Act of Love.
- Be aware of legal issues – but not yet. There’s a hilarious legal disclaimer at the start of Adam’s book – but it obviously required a legal read (then again, who is going to admit to being Kinder Suprise Woman?) However, don’t worry too much about legal issues during the creative writing process. Write what you want to write, then consider any legal issues that it might throw up, and seek advice. (This was discussed at a separate session at the London Book Fair.)
- Get out there. As authors, we all have to get involved with the promotion of our books these days. If you’re writing memoir, you surely have an advantage: you have a strong belief in your book (think of the reasons you’re writing a memoir in the first place); and you are the product as much as your book. This can be daunting: you may feel you’re being judged not just on your writing but on your life! But it gives you a unique opportunity to connect with your readers.
This is Going to Hurt by Adam Kay is published in paperback on 19 April 2018.