Laughter is the best medicine

He's now spent longer talking about medicine than he did practising. Former doctor turned comedian Adam Kay might have some distance, but he's still dialled right into the good and bad of medical life.

Being a writer and comedian now means a much lower volume of bodily fluids splashing on his clothes, at least until he became a father. While in the hospital trenches, Kay was acutely aware of the pressures of the job itself and, since stepping away, the societal pressures and absurdities have become more obvious.

In particular, the harmful idea that doctors are superhuman, infallible and should be expected to cope with any amount of trauma without support.

Britain's 12th favourite doctor, BAFTA-winning author, TV writer and comedian returns to Perth in November with his live show Twas the Nightshift Before Christmas.

While everyone else will be unwrapping presents, Kay will be offering a heartfelt and hilarious tribute to the doctors, nurses and healthcare workers who spend the holiday season on the front line.

Packed with anecdotes from life on the wards, Kay recounts the unforgettable Christmases spent delivering babies, treating bizarre festive injuries and retrieving everything from baubles and chocolate wrappers to remote controls and fairy lights from places they were never meant to be.

"I guess I've always tried to find the joke in serious things that have happened to me - I'm not everyone's favourite funeral companion, let's just say," he says. "As a fairly private person, putting myself out there - especially talking about how I'd struggled - was deeply uncomfortable. At first, I was saying things on stage that I'd never told my friends or family before, but the more I spoke about it, the better I felt. I guess I was doing my own therapy.

"Comedy has been liberating in the sense that I can use my experiences not just to get laughs but make those in a similar situation hopefully feel less alone. It's still fairly mortifying when I think about some of the stuff I've released into the world that can't ever be taken back."

Kay's work has helped expose the emotional cost of medicine to people outside the profession.

He doesn't know if he found it more surprising or depressing that as soon as his book This is Going to Hurt was released, he got hundreds of messages from doctors, generally at the start of their careers, telling him that until they read his book they thought they were the first doctor who'd ever cried in the locker room.

"I had also assumed that the book was quite particular to the NHS, so it was a huge surprise to find out that it resonated with readers around the world. And again, slightly depressing that the system is screwed whether you live in Portsmouth, Paris or Perth."

The comedian suggests most workplaces have their in-jokes and shared horrors. While he's spent the last decade sharing doctors' gallows humour with the public, he says you can never totally understand it until you've relied on it as your pressure valve to get through a particularly awful day. No amount of diaries can ever fully translate that.

Comedy requires vulnerability, uncertainty, showing emotion, yet these are often the qualities that medicine asks doctors to suppress to make them better doctors. Kay believes there's a lot of truth in that idea.

"You can't be a good doctor, in fact shouldn't be a doctor, without empathy. But nobody wants their doctor to burst into tears by the bedside and so you find yourself putting up all these barriers.

"In my experience, doctors often overshoot with the barriers in order to protect themselves and in the process they lose a bit of what drew them to the job in the first place."

A strong sense of perspective is the most helpful skill he was bequeathed by his former profession. These days a crappy day at work doesn't come close to what a bad day means to a doctor.

He still rates a room full of doctors as a tough group to crack.

"My audiences seem to be roughly 30% medics. This has the huge benefit for any doctors coming along that, should there be a medical emergency during the show, there are another couple of hundred people who can deal with it instead of you."

Adam Kay is at the Regal Theatre on 30 November.