Adam Kay's Debut Bombshell: A Particularly Nasty Case Is a Scorching Instant Classic You Won't Put Down

Adam Kay, the ex-doctor who turned his hospital war stories into bestseller gold, just tried fiction for the first time with 'A Particularly Nasty Case'. The crime at the center is exactly what the title promises, but the book itself is fast, funny, and very easy to burn through. It is also properly smart without talking down to you, and more about people than puzzle-box tricks.

The setup

Our lead is Eitan Rose, a talented doctor who genuinely loves the work, even if his own brain keeps getting in the way. When we meet him, he is fresh off a breakup, dodging therapy like it is a sport, and still haunted by the death of his sister back when he was in training. Then his boss dies unexpectedly. Eitan smells foul play and decides he is going to prove it.

As he digs in, he also starts falling for Cole, who is as charming as Eitan is prickly. And then more deaths crop up with the same unnerving pattern, pushing Eitan toward a truth that is, yes, devastating.

How Kay plays it

This is a clean, sleek murder mystery, and the medical angle is baked in without turning the book into a lecture. Kay cleverly surrounds his doctor with people who do not speak fluent hospital, so whenever we need an explanation, it arrives in plain English. No eye-glazing jargon dumps, just enough to make the clues make sense.

Perspective switcheroo

Where the book really clicks is in its character work and how it shifts point of view. We start close to Eitan, whose voice has a dry, sometimes sardonic edge. But as his mental health frays and the investigation turns toward him, Kay hands the narrative to Eitan’s new boyfriend, Cole, and later to Margaret, a colleague who is beautifully drawn in her own right.

It is not just a stylistic trick. The switches mirror Eitan’s isolation. As he pulls inward, we lose access to him too. By the time he becomes the obvious suspect, that distance makes us question how much we can trust him — and whether he is even innocent.

Kay’s voice: gallows humor that actually works

If you have read 'This Is Going to Hurt', you know Kay’s superpower: the snap from bleak to funny without ever feeling crass. That same knack is all over this book. The tonal whiplash feels like real life, and it gives Eitan’s voice a lived-in authenticity rather than a writerly gloss.

Does Kay push it too far sometimes? There is a sequence at a wake — if you know, you know — that absolutely lands as comedy, but it also grazes the edge of plausibility. Some readers will raise an eyebrow; it is a fair reaction. The thing is, it is executed with such confidence that it is hard to stay mad at it.

The takeaway

• It is a character-driven, medical-tinged mystery that stays clear and propulsive.
• Eitan Rose is compelling precisely because he is capable and messy at once.
• The perspective shifts to Cole and then to Margaret are both elegant and purposeful — they heighten the emotional stakes and the suspense.
• Kay’s humor is the signature: sharp, humane, never cheap, and it balances the darkness beautifully.
• One big comic swing (the 'wake scene') might test your realism threshold, but it is undeniably funny.

Bottom line: the crimes are nasty, the reading experience is not. Kay may have stopped saving lives, but on the page he is dispatching characters with surgical precision and a surprising amount of heart. It is a pleasure to be back in his world — fiction suits him.