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A Particularly Nasty Case

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Expected 16 Sep 25
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When a noxious hospital consultant dies of a heart attack, fellow doctor Eitan Rose smells foul play. But nobody else does, including some quite crucial players like the police and the coroner. Eitan's colleagues are already treating him with suspicion following his recent breakdown, and are sceptical of his increasingly wild theories. When another doctor dies in similar circumstances, Eitan becomes convinced there is more to these deaths than meets the eye. Is there really a killer marauding the wards or is Eitan losing the plot?

Deftly told and deathly funny, A Particularly Nasty Case is the unputdownable debut novel from Adam Kay, BAFTA-winning writer and author of multi-million global bestseller This is Going to Hurt.

336 pages, Hardcover

First published August 28, 2025

267 people are currently reading
15548 people want to read

About the author

Adam Kay

59 books3,402 followers
Adam Kay is an award-winning comedian and writer. He previously worked for many years as a junior doctor. His first book "This is Going to Hurt: Secret Diaries of a Junior Doctor" was a Sunday Times number one bestseller for over a year and has sold over two million copies. It has been translated into 37 languages and is winner of four National Book Awards, including Book of the Year, and will be a major new comedy drama for the BBC.

His second book "Twas the Nightshift Before Christmas" was an instant Sunday Times number one bestseller and sold over 500,000 copies in its first few weeks.

"Dear NHS", edited by Adam Kay, was an instant Sunday Times number one with all profits donated to charity. His first children's book "Kay's Anatomy" will be released in October 2020.

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5 stars
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Displaying 1 - 30 of 103 reviews
Profile Image for Sheila.
2,849 reviews90 followers
June 17, 2025
I received a free copy of, A Particularly Nasty Case, by Adam Kay, from the publisher and Netgalley in exchange for an honest review. Eitan thinks a fellow Dr.s death is hinky, but nobody else believes him, until another doctor dies. I thought this was a good read, I could do without the language though.
Profile Image for Linda Galella.
975 reviews77 followers
August 23, 2025
I received a copy for review purposes. All opinions are honest and mine alone.


If you’re looking for a read that will center on a young doctor, a hospital and patients in addition to A PARTICULARLY NASTSY CASE mystery, this is definitely not it.

What you will find between these too many pages is the story of an entitled young doctor with mental health issues. He’s ill mannered, foul mouthed and tortured by events from his youth. Eitan, our doctor, does have a heart, but doesn’t have any idea how to act in polite society. He has no relationship with his family, other than financial, and is tolerated professionally for a variety of reasons. His personal life is a hot mess and I wish it had remained a mystery.

Two of Eitan’s fellow doctors are found dead of apparent heart failure. He’s the only one that suspects foul play but no one believes him because of his behavior and history. He and his partner set out to prove the deaths are murder and Eitan ends up being arrested himself.

It’s only the last few chapters that are remotely interesting with a well held twist. Aside from that, which earned a second star, this was a nasty read I could have done quite well without. Misleading publisher’s blurb, lots of foul language and unnecessary gay groping add to the smarmy feel. Definitely no recommendation from me 📚

Read and Reviewed from a NetGalley eARC via Kindle, with thanks
Profile Image for Rainbow Goth.
305 reviews7 followers
August 26, 2025
From the current reviews, it's clear that I enjoyed this book more than some others. It presents a challenging review because while there were some excellent moments, I did encounter a few significant issues. In the end, I settled on a three-star rating which seems fair.

Having enjoyed Adam Kay's non-fiction, I was eager to dive into his debut novel. I appreciated the in depth exploration of the NHS and the complexities involved in loving a system that often fails both its patients and staff.

The whodunnit aspect was reasonably clever; I initially guessed the killer, but by the end, I had given up on trying to solve it because it could truly have been anyone.

However, the characters left much to be desired. I found it difficult to root for Eitan. While I acknowledge that he was mistreated in a system that often struggles with mental health issues, some of his actions were inexcusable and unethical. It’s hard to believe he could continue practicing after everything.

While I typically don’t mind bad language, here it sometimes felt unnecessary and used for the sake of it, rather than adding to the story.

Overall, I'm glad I read it. I believe some readers will undoubtedly love it, although I think my expectations were set too high given Adam Kay's reputation..

Thanks to the Author, publishers and Netgalley for the ARC of this book
Profile Image for Papillon.
153 reviews
July 25, 2025
Thank you to NetGalley and the publisher for providing me with an ARC of this novel. All my thoughts and opinions are my own.

This book is about a bipolar, drug-addict doctor named Eitan who is his own worst enemy - and has absolutely no business being in hold of an active license.

I don’t think I’ve ever read a book where I felt so indifferent — about /everything/. I wasn’t particularly attached to Eitan. I didn’t wish him well; I didn’t wish him ill. I didn’t hate him; I didn’t like him. There wasn’t a point while reading when I was happy, upset, angry, curious, concerned, scared, amused — nothing.

It tried so incredibly hard to be funny and quirky, that all I could do sometimes was just stare into the invisible camera. The murder mystery is glaringly obvious almost from the moment the person is introduced. I think I lost count on how many times I sighed each time Eitan was playing right into their hands. It was too on the nose.

I’m actually floored about how nothing really intrigued me or completely put me off of the book - although the casual drug use left a sour taste in my mouth. I can recite this book from start to finish, so it wasn’t a matter of not comprehending or paying attention to what I read. But there’s not a single emotion I can attach to any of it. I had half a mind to reread it to see if I felt differently a second time, but the mere idea of doing so was the only point in which I felt /anything/ towards this book other than apathy.
Profile Image for Ella.
112 reviews2 followers
August 2, 2025
A big thank you to NetGalley and Orion for the eARC in exchange for an honest review!

Dr Eitan Rose is back at work after some time off. The time off being a manic episode that led to a relationship breakdown, being sectioned, and generally not having a great time. But he’s back, working as a consultant in the NHS, and nothing will ruin his fresh start. Except maybe the sudden and suspicious death of a colleague. Surely he can pass his return to work supervision and solve a murder or two, right?

As someone who deeply loved Adam Kay’s previous work, I was very excited to receive a copy of his debut novel. The writing was full of Kay’s cynical wit and sharp one-liners, and as a doctor, I thoroughly enjoyed the NHS setting (and the jokes at its expense). Eitan himself was an interesting character. Dealing with returning to work following his bipolar relapse, helped along with some nasal spray (which may or may not contain cocaine), and generally being quite the bundle of chaos, Eitan is a complex protagonist whose saving grace is wearing his heart on his sleeve and genuinely - in his own way - trying to do the best he can. Our secondary characters were all pretty strong, with Margaret becoming an absolute favourite of mine in the latter half of the book. The plot was paced well, with enough intrigue to get me hooked, although I did solve the murder mystery pretty early on, but the whole thing was such a romp that I didn’t feel particularly miffed about getting it right. Sometimes, I prefer to guess the twist and it make sense, than be blindsided with something illogical.

I think the strength of this book - like the rest of Kay’s work - lies in the absolute love for the NHS. It’s a complicated thing, really, to have so much emotion tied up in this broken system. As a doctor working in mental health, I appreciated the book highlighting the specific struggles within psychiatry, as well as having a main character who was both a doctor and someone with a mental health condition. Due to all the murdery business, we didn’t get into much of the clinical stuff, but the glimpses we did get showed Eitan as a passionate, knowledgeable, and caring doctor, which I appreciated.

I think overall, I had a fun time. This was a wild romp through the hospital corridors paired a decent murder mystery. For real thriller lovers, this may come as a disappointment, but for those who love a bit of medical drama, you should have a great time with this!

3.5 🌟
Profile Image for Imlac.
366 reviews3 followers
July 21, 2025
As readers of This is Going to Hurt: Secret Diaries of a Junior Doctor know, Adam Kay is very funny. There were scenes in A Particularly Nasty Case that had me laughing uncontrollably. He is also witty, with a great ear for what people actually say.

This is more a romp than a mystery. The plot is just an excuse to get his protagonist into scrapes and escapades. Still, I enjoyed this and am glad to have read it.
Profile Image for Nick.
71 reviews1 follower
August 4, 2025
Ever since It’s Going To Hurt, I have read everything Adam Kay has written. So when I heard he was turning his hand to fiction, I was already sold.

Spoiler: he absolutely nailed it!!!

From start to finish, A Particularly Nasty Case had me howling. Adam’s razor-sharp wit, perfectly timed one-liners, and his uncanny ability to tackle serious topics (like mental health stigma) with both humour and heart is UNMATCHED!

This isn’t your average crime novel — it’s a laugh-out-loud, tea-through-the-nose (yes this happened to me), twisty, brilliantly bonkers whodunnit with brains and belly laughs. The plot is smart, the characters unforgettable, and the punchlines? Immaculate.

I genuinely loved this book and am already hoping this is the start of a whole new Kay-era.
Profile Image for Lizzie.
11 reviews2 followers
August 3, 2025
A big thank you to NetGalley and Orion for the eARC in exchange for an honest review!

I loved Adam’s first book - this is going to hurt. It is well worth remembering that this is a fiction book and so very different genre. This focuses on a consultants return to work after a relapse of his mental illness. He then becomes a murder mystery sleuth when 2 shocking deaths occur by a surprising murderer. Adam’s love of the NHS still shines through and I’m sure we can all relate to how he portrays some of the characters. I managed to read it in a day. I wouldn’t say it was gripping but I did want to find out what happened. A dark sense of humour, being aware addiction is mentioned and being unbothered about swearing is required. Which is fine for me, I did chuckle at points in the book. I was concerned that it wasn’t helping the stigma of mental health however it was better towards the end of the book and I understand it was part of the plot.

Overall a good first entry into the fiction world.
Profile Image for Kimmy C.
559 reviews9 followers
September 3, 2025
Personally and professionally troubled doctor, Eitan Rose returns to work - then a couple of Very Important Doctors die suddenly, with a similar apparent cause. Eitan smells a rat, but given he had accessibility and reason, not too many of the professionals (police, coroners, hospital administrators) are listening to him. Add to that his recent extended time off for mental health issues, a long-embedded trauma, and all of a sudden, the reader is along for the very non-linear investigation. Featuring a plethora of puns, this first novel by the noted hospital memoir doctor Adam Kay (This Is Going To Hurt, amongst others) is an amusing and twisting crime read.
15 reviews
July 29, 2025
I received a free copy of this book through NatGalley.

This book had me smiling from the dedication and then the first line had me hooked.
The author has written a witty and very thoughtful book. From the laugh out loud bits to the observations on how we as a society treat mental illness especially those who are bipolar and to how we all deal with the loss of a loved one.
It has medical terms but these are used as plot points and as humorous interludes (and you don’t even need any knowledge of biology to follow the plot.)
I highly recommend this book if you like a crime book that is a bit different.
Profile Image for Chrys.
1,213 reviews14 followers
July 26, 2025
I was hoping for something that was far removed from what I got. Worst main character I’ve encountered in a long time and reading some other reviews made me decide not to waste my time.
Love this author’s nonfiction but this was not for me.
7 reviews
July 6, 2025
As a student in the medical field, I adored this book. The nerd in me loved the little golden nuggets of medical references (I mean a dermatologist named Stephen St. Johnson?? Was I reading too much into it thinking that this was a reference to Stevens-Johnson Syndrome? Maybe. Also, maybe not!).

I really enjoyed reading Dr. Eitan Rose somewhat blunder through his own version of a murder investigation utilizing his doctor approach (e.g. "The first step in reaching a diagnosis was taking a careful patient history" as he tries to glean information from one of his potential murder suspects) even as it got progressively more unhinged. I especially enjoyed it when Dr. Rose's cheeky side would come through the evidence excerpts.

It was a fun and easy to read although sometimes (maybe twice) my mind did wander from the text. I did really appreciate the point being made about the stigma surrounding mental health issues in the healthcare profession and the resulting lack of proper psychiatric help. My favorite line on this topic was this: *talking about lack of research and development in psychiatry* "Ultimately, it stemmed from a deep-rooted stigma that she'd always felt was one of medicine's greatest cruelties" (I sent the paragraph to my future-psychiatrist friend and she loved it.).

Thank you to Hachette Book Group/Little, Brown and Company for the opportunity to read and review this book!

Also, a disclaimer like this one that was in the beginning of the book: "Any resemblance to actual persons, living or dead, is completely intentional." always warrants a read in my opinion :D This was the first book by Adam Kay that I've read and I have heard great things about This is Going to Hurt so I will be checking that out as well!

Here's what I said on TikTok about it: https://www.tiktok.com/@sbuggymoo/vid...
Profile Image for •mikaela• :).
166 reviews10 followers
August 25, 2025
✨ARC Review✨

A funny, witty suspenseful book about murder, mystery and mayhem. 👀

I really enjoyed this! Some parts had me giggling, others had me going 'oh no, do not do THAT!' and making me cringe. Plenty of funny banter, lots of medical words to digest, and of course a murder mystery. Was a fun rainy day read. 😇
Profile Image for Jen.
1,659 reviews62 followers
August 3, 2025
Dr Eitan (rhymes with spray tan) Rose is having a very troubling time. Newly back at work after a period of extended leave (euphemism for breakdown), he finds himself subject to Management supervision, in this case St Jude's Medical Director, Douglas Moran, a man who doesn't particularly like Eitan and isn't afraid to show it. The feeling is somewhat mutual and, following a series of missteps - including Eitan being caught in a somewhat compromising situation in Moran's office, there is every likelihood that Eitan's return to work will be depressingly short lived. Until fate intervenes and Moran suffers an unexpected, and ultimately fatal, cardiac arrest. You'd think that in his shoes, Eitan would just thank his lucky stars and move on. But Eitan is not like most other people, and begins to suspect foul play. Cue a rather garbled investigation as Eitan, and his new paramour, Cole seek to prove there was more to Moran's death than meets the eye.

Now, I'm going to be honest, I wasn't at the time of reading, and am still not quite now, sure what I make of Eitan. I wasn't not engaged in his life and his fate, and his actions and comments were not without humour. The more we learn about him, the more the reasons for that become clear and his behaviour makes a strange kind of sense. As his general good demeanour and endearing bedside manner, at least for most patients, gives way to a more frantic kind of mania, his erratic thought processes and actions do make it hard to always be on his side. There is something almost slapstick about some of the situations he finds himself in - compromised at both work and during a view of Moran's open casket - that has an air of Carry On Doctor, and all I was waiting for was someone to shout 'Ooh Matron' from the wings. Not that I have a problem with that. I really rather enjoyed the Carry on films of yore.

This is a comedic crime novel, if, indeed, a crime has actually been committed. It's hard to necessarily know how much of this mystery is a crime, and how much a result of Eitan's particularly active, and unusual, imagination. It's not cosy crime - too much swearing, (non graphic) sex, and casual drug use for the book to fall into that sub-genre, and I wouldn't be expecting anything of that kind from this author. But it is a very clever look at how a particular medical condition could cloud Eitan's judgment, as well as make people around Eitan, doubt how much he could be trusted. And, in that respect, Eitan's long suffering friends, newly suffering partner, and various assorted colleagues, really do represent the way in which society as a whole might prejudge, and dismiss, someone with Eitan's concerns. But, and I like what Adam kay has done here, in highlighting Eitan's long suffering friends, including his former partner, Mo, he has shown that there are decent people out there. Those who stick by Eitan through thick and thin, believing him where most rational thinking people might not, even if they don't buy all of his theories.

I'd say that the pacing of this book is just abut right, a good amount of time spent in setting up Eitan's history and establishing all of the main players in his life. Did I trust everyone in Eitan's circle of friends? No. Did the author employ a few misdirection techniques to throw us off the scent? Absolutely. Did they work ...? Well, yes and no. I was always suspicious of a certain character in this story for perhaps the very reason I would always champion his friends Mo and Fiona, who accept Eitan for who he is. I really kind of liked the pair of them, and as a threesome they do make for a very entertaining team. But Eitan's true saviour comes from a very unexpected place, and I like what the author did there. With all that happens in this book, they way in which they get to the truth, saving more than just Eitan's reputation, worked really well, leading to an ending that brought a smile to my face, in spite of the actual tragedy that precipitates it. Just about forgivable from the list of fiction no-nos given how it comes about.

A little bit manic and more comedy than mystery, this book entertained to the last page, even if I wasn't always in tune with the central character.
Profile Image for Ludditus.
269 reviews17 followers
September 5, 2025
At about 20% in the book, I was on the verge of abandoning it. It was not the “foul language” (as many snowflakes, all women or “assigned women at birth,” commented here), but the overall story and the writing style.

But then, only 2-3% more in the book, it started to become interesting. Then I became a victim of the author's manipulation.

The book has three parts. Part One is told by the main character, Eitan Rose. At the end of it, I thought that I knew who the murderer was. I was wrong.

Part Two is told by another character. It was written so that the reader now has a different suspect, but at the same time it's carefully crafted to hide other crucial facts.

Part Three is told by a third character and is a bit rushed in my opinion. The denouement needed a bit more detail and realism.

Either way, I had my (strong!) suspicions, and I was right. I couldn't possibly know all the details, and I'm still not satisfied with the motivation. But the thing is that all the red herrings couldn't hide the fact that, given the scarcity of the characters, there was only one possible explanation. And, indeed, that was it.

Now, what bothered me, beyond the clumsy start, is that I'm not aware how amorous relationships work in masculine gay couples. I avoid movies that are centered around gay love stories, simply because this isn't interesting to me. I also skipped gay romance novels. But this is a crime novel, and the sexual aspects are secondary, so I wanted to give it a try. Fortunately, the author himself is gay, so I trust him that the behavior of the gay characters was natural and believable. I still could not tell, because I don't know how this works, except that I don't want anything turgid anywhere near my anus.

What really pissed me off, however, was that Eitan was such a complete idiot. There were countless occasions where he literally was a dumb fuck. OK, once, twice… but that many times?! Bipolar disorders aren't a universal excuse, you know.

The medical terms (again, look up the author's background) and the horror of the NHS (I don't know why, but to me the British society is a horror movie in itself) are definite positives for me.

I won't mention any acronyms, medicines, or medical conditions, but here's an excerpt that's quite unique:
– Entered my office, 4th floor admin corridor, at 1840.
– Dr Rose and one other individual present.
– Other individual – male, approximately 6ft in height, approx age 25, muscular build, blond hair, blue eyes, clean shaven, trousers and undergarments removed.
– Dr Rose was stood behind my desk wearing a shirt. Trousers and undergarments around his ankles.
– Other individual bent forward over my desk in front of Dr Rose, hips flexed to 90 degrees.
– Dr Rose and other individual seemingly engaged in anopenetrative sexual intercourse, with other individual the anoreceptive partner.
– Dr Rose disengaged from apparent coitus immediately after I entered the room.
– Both parties reconstituted their clothing.
– The other individual exited the room, penis tumescent.
– Left office at 1842.

Eitan Rose is a stupid cunt (the term shows up six times in the book as a qualifier for males). But the book was not bad.
Profile Image for Donna.
154 reviews5 followers
July 12, 2025
Eitan Rose was given a suspension of his license that was rescinded after a medical tribunal heard his case. A consulting rheumatologist at one of London's National Health Service hospitals, Rose's bipolar syndrome kicked in when a patient of his died, even though he wasn't responsible for the death. In his manic states, Rosen would go off his meds and off the rails. His antics would notch up to eleven, much to the displeasure of Dr. Morgan, his medical director, who couldn't stand him (the feeling was mutual.) After he returned from his enforced rest period, Rose went back to seeing patients, which he loved to do, but was shadowed by the medical director who made sure to continue to beat him down. After losing his live-in boyfriend, his spirits were raised when Cole, a hospital porter, put the make on him and encouraged some truly bad behavior after hours in the medical director's office Unfortunately the director returned and caught them at it, and he vowed to report Rose and end his career for good. After a sleepless night, he showed up at the hospital ready to be disgraced, but it wasn't to be. Amazingly, Dr. Morgan died of a massive heart attack that night, even though he had a normal EKG and stress test just the week before. Instead of wallowing in happiness and gratitude for his reprieve, Rose suspected something was not right and began his own investigation when no one would listen to his concerns.
With Rose as a wired Sherlock and Cole as his long suffering Watson, the pair delve into the many ways Morgan could be killed and the many suspects who wouldn't mind him dead. But as his manic behavior became more and more unhinged, the medical staff and police started believing that Morgan might have been murdered-and Rose was beginning to look more like the prime suspect. What is even worse, Morgan's replacement for medical director is next on the hit list and Rose still can't solve this particularly nasty case.
This is a book that does it all-it's hysterically laugh-out-loud funny while, at the same time very sad. Rose is a young doctor with multiple problems; beside his bipolar syndrome he is gay, his family can't accept it,and his beloved sister's death might have been partly his fault. His interactions with his best friends keep him anchored to a degree but he can't help making bad decisions and regretting them later. This is Adam Kay's debut mystery novel but he certainly knows his way around writing. When he was a doctor, he kept a secret diary of his trials as a young resident, which was published as This is Going to Hurt, and subsequently made into an award winning AMC TV series. Like Serge Storms in Tim Dorsey's Florida novels, Eitan Rose is a very flawed but darkly humorous character who makes a very interesting detective. Hope to read more of Kay's mysteries soon.
82 reviews5 followers
June 21, 2025
This book follows Eitan Rose, a doctor that is returning to work after an unspecified medical leave, related to his mental health. We soon learn that in addition to whatever is wrong clinically, Eitan is still grieving the loss of his beloved sister, Elodie, nearly 20yrs ago. He blames current supervising doctor, Douglas Moran, but also blames himself to the extent that he remains perpetually in the head space of a troubled college student - living in a windowless basement, showing up to work hungover, and repeatedly using a medical inhaler that is filled with cocaine rather than antihistamines, sold to him by the on staff pharmacist. That being said, he actually enjoys helping his patients and looks forward to getting back to work.

First sign that he might not be returning to everything normal, is that cat loving Margaret has been moved into his office, along with her desk and cat posters. 2nd sign, Dr Moran will be sitting in on all of his patient visits, looking for signs that he isn't ready to be back at work. The same Moran that failed at saving Elodie all those years ago. Needless to say things don't go well. But before Moran can report Eitan, thus ruining his career, Moran turns up dead. Even better, Eitan meets the very attractive, Cole. Maybe things are finally going his way. They are not.

The book is told from Eitan's confused point of view, alternating from manic ranting to paranoia; then from Margaret's calmer point of view, having already been revealed as a bit of a dark horse, she still somewhat unexpectedly believes Eitan when he says Moran was murdered, despite a lack of evidence. And finally we get Cole's point of view. The sweet, simple, guy that's in over his head, dealing with a man in the throes of some sort of mental breakdown....or is he?

Much like books where a woman is dismissed because she's a woman, until it is proven that she was right all along, this book hinges a great deal on the prejudices society has against those who suffer from mental illnesses, even those in the medical field are quick to write Eitan off as a degenerate loser, rather than someone suffering from a medical crisis. The more he struggles, the more they take his actions to be deliberate and wanton. There is also a fair amount of classism in the hospital hierarchy which also comes to into play.

In the end, the who done it was less surprising than the why they done it. I did appreciate that the author gave us an Epilogue where we learn that Eitan is finally in a better place and actually dealing with his mental health issues.
Profile Image for Martin Evans.
74 reviews3 followers
August 28, 2025
⭐⭐⭐⭐ | Twisted, wicked, and laugh out loud funny... with a touch of "what the actual f*ck?"

I received a free copy from Hachette Australia, thank you so much for sending it my way!

This was not your average murder mystery. This was a deranged, darkly comic, and oddly cathartic read that had me cackling in one moment and shouting WHAT THE ACTUAL FCK* in the next.

Mental health meets murder... and mayhem

At the centre of the chaos is Dr Eitan Rose, a consultant returning to work after a mental health relapse, only to stumble into a series of suspicious deaths that no one else seems to take seriously. Is he spiraling, or is there a killer on the loose?

That’s the question driving this book, and it’s delivered with Adam Kay’s signature cocktail of sharp satire, irreverent humour, and razor-edged insight. Think This is Going to Hurt meets Knives Out, but with more NHS burnout and existential dread.

What I loved:

- Adam Kay’s voice is immaculate. His one-liners land like scalpels, cutting through the tension with perfect timing.
- The tone straddles the line between comedy and tragedy so well. It’s tongue-in-cheek, but never disrespectful.
- Eitan is a riot. Vindictive, petty, brutally honest and yet deeply human. As someone who also enjoys a bit of passive-aggressive sass when irritated, I felt seen.
- The commentary on mental health stigma and the absurdity of underfunded healthcare is brilliantly woven in. It never feels preachy, just pointed.
- The plot twists? Unhinged. In the best way.

But just a heads-up... This is not your typical cozy mystery or neatly-plotted procedural. It’s messy. It’s chaotic. It thrives in the grey areas. If you're looking for classic detective fiction, this might throw you, but if you're open to a sharp and slightly unhinged ride, you’ll be rewarded.

Final thoughts: This was a wild, weird, and wonderful debut. Adam Kay proves he’s just as masterful at fiction as he is with memoirs. A Particularly Nasty Case is equal parts mental health reflection, NHS critique, murder mystery, and chaotic gay energy, and I loved (almost) every minute of it.

Verdict: 4 stars
Read it if you like: Dry humour, sarcastic narrators, This is Going to Hurt, unreliable sleuths, and murder with a side of mental breakdowns.
392 reviews
June 27, 2025
Did I or did I not enjoy A Pecularly Nasty Case? I’m still ambivalent. There is no doubt that Adam Kay knows how to pen a novel. He is an excellent author. The book is witty throughout, sad at times, full of great dialogue, but generally too scattershot for my taste. I found it difficult to accept the outrageous behavior of so many of the characters; particularly those working in a hospital. We are offered a main character who is a bipolar gay doctor with mental, drinking, and drug problems. He is basically a recovering everything and not much good at any of it. Does he deserves our support and empathy as he faces life’s challenges? No. To me there wasn’t much to like about our anti-hero, Eitan Rose, other than the few sections where it was clear he cared about his patients. Most of the other characters weren’t particularly likeable either. But the prose and snappy dialogue did keep me reading on.

The death of two senior doctors at the hospital, St Jude’s, turns Eitan and new friend, Cole, into screwball detectives of sorts as Eitan is convinced their deaths were not from natural causes. He steps over the line on numerous occasions along with Cole (now his lover) to prove both doctors were murdered. Eitan and Cole’s amateurish sleuthing efforts leave them in hot water time after time. Some of the scenes are laugh out funny, others fall flat. Eitan once again ends up suspended, and a prime suspect. Eventually the murderer, to no one’s surprise, is unmasked. Eitan seems to understand his erratic behavior is hurtful to himself and those close to him and plans to chart a new course. This madcap adventure was enjoyable if I suspended my thoughts about the medical profession, hospitals, and inept law enforcement. Fortunately I was able to.

My thanks to Little, Brown and Company/Mulholland Books and NetGalley for the opportunity to read and review this entertaining work.
Profile Image for Nadine.
171 reviews7 followers
August 28, 2025
A Particularly Nasty Case
Adam Kay

‘Had he performed sex-club CPR last night or was that a bus-shelter dream?’

If you haven’t read Adam Kay before, the standout feature of his books is his remarkable wit. His intelligence, banter and prose are immensely impressive. Told so captivatingly and let entirely understandable even with no medical knowledge. He is a storyteller that will have you laughing out loud and shocked in equal measure.

“I'm saying you need to make an appointment with Diana Deluxe,” said Cole.
'To thrash it out?'
'To thrash it out.'

This book was humorous and poignant. With a fun mystery to solve and wild adventures along the way.

‘He fired a quick email off to Nina to sort it out, then briely polished his halo, before it immediately tarnished and flaked.’

I loved it. This Is Going To Hurt is still up there with my all time favourite reads so it’s completely fair to say I’d read anything he writes and rest assured I’ll likely love it.

‘He'd finally told the truth in that toilet cubicle - Cole really was too good for him, and you don't
keep a puppy in the same cage as a wolf.
'Do you want to chat?' asked the puppy.
The wolf resisted the urge to look at his watch. Don't ruin this, he told himself.’

When a toxic hospital consultant dies of a heart attack, fellow doctor Eitan Rose smells foul play. Nobody else does though, including some quite crucial players like the police and the coroner.

'But I reckon I've gone as far as I can with this.'
'But you're so close!' protested Eitan.
'To what? Getting killed or molested?'
Eitan stared incredulously at Cole. 'To a confession!'

As Eitan refuses to let it drop, he launches a chaotic investigation that is of increasing concern to friends and colleagues watching on. Is Eitan spiralling out of control? Is he making a career-ending mistake or could there genuinely be a killer stalking the wards?

'It's the illness that is selfish, not the individual',
Profile Image for LauraBeach123.
56 reviews
August 11, 2025
⭐️⭐️⭐️.5, rounded up for the chapter titles

This quirky murder mystery is split into three parts (plus an epilogue), each told by a different narrator, and it’s as much about the eccentric characters as it is about the actual mystery killer.

Part 1 introduces us to Eitan, a hilariously unreliable bipolar gay rheumatologist who becomes convinced his horrible, cheating miserable boss was murdered. He launches the most endearingly inept inappropriate investigation imaginable. When a second doctor dies, it gets a bit more real for him.

Part 2 shifts to his hot hospital porter love interest, who not only joins in the sleuthing but also seems to be the only thing keeping Eitan’s life from completely unraveling.

Part 3 belongs to their office mate — a sweet but slightly unhinged cat lady — whose perspective adds a surprisingly tender touch.

The humor really shines through in the chapter titles (clever wordplays on beloved childhood books, Disney songs and pop culture) and in the author’s knack for comparisons. Some gems:
• “Password system insisted on both numbers and letters, upper case and lower case, and as many characters as Game of Thrones.”
• “Clearly nobody in Ocean’s Eleven had particularly bad IBS.”
• “Cock of the walk to coq au vin in a couple of months.”

While there are plenty of laughs and charming moments, the pacing occasionally drags, and the mystery isn’t hard to solve, there aren’t many red herrings, so it’s more about confirming your suspicions and uncovering the “why” than being shocked by the “who.” And seeing how far and inappropriate our Eitan will go to confirm suspicions.

Overall, this is a light, funny read with eccentric characters and witty writing.
Profile Image for Laura.
1,043 reviews78 followers
August 31, 2025
I really enjoyed Adam Kay’s other books so was looking forward to reading a novel by the same author with the same trademark humour.

A Particularly Nasty Case starts with a bang, and is entertaining from the off - although I did feel the humour felt a bit too much at the start, like the author was trying to force in loads of quips whether they were needed or not. However, as the book continued I felt that the humour settled in, and this book became what was a genuinely funny novel for me - one that I found myself looking forward to picking back up and continuing.

The storyline follows doctor Eitan, as he discovers a senior doctor at his hospital has a heart attack in what he deems to be suspicious circumstances. He decides to find out more about whether any foul play was involved. Along with his new boyfriend Cole, Eitan gets into all sorts of scrapes and crazy situations in the name of investigating.

A Particularly Nasty Case is great fun, but the storyline is ridiculous. It’s a riotous blend of slapstick scenes, sarcasm and snarky comments. Don’t read this if you’re wanting a realistic, believable storyline - but it’s this is a humorous book, so it’s all in the name of comedy! It’s an easy, entertaining read with a real mix of characters.

I have to say, I still can’t quite decide what I think of Eitan. I wouldn’t say he’s particularly likeable in how he treats people, but he does come out with some funny comments. The book also deals with mental health in a frank and open way - not just how it affects those directly affected but also the person’s friends too.

I’d recommend A Particularly Nasty Case for anyone looking for a fun, humorous read with an element of mystery added in.
221 reviews
August 7, 2025
I haven't read the author's previous work so I am judging this on this book alone and its good. I enjoyed it, but aside from Margaret I didn't really like any of the characters.

I didn't find it funny persay. There was a lot of swearing in it, and I'm not one of those people who finds swearing on its own funny. I actually found the book upsetting at times with its very powerful depiction of mental health, the stigma around it and the way in which people are treated because of it. Yeah, Eitan went off the deep end and did some really crazy stuff but he was pushed to that crazy because he was being constantly ignored and dismissed, purely because of his mental health struggles. The author really captured that well and did a fab job in getting us inside the mind of someone in the middle of a manic episode.

The mystery itself was pretty good, I really enjoyed the little insets between chapters of internet searches, emails, text chains etc that helped set the scene a little more. When it came down to it, there was really only one person it could have been, but I felt the second half struggled a little without any viable suspects, Eitan went through a couple of people and then the mystery just hovered. In story, there was a really good reason for that, but the reader knows that reason is wrong, so it was a little annoying to not have any alt suspects lined up.

Overall fairly entertaining if hard going at times.

~Thank you to NetGalley for the ARC in return for an honest review~
Profile Image for Selena.
199 reviews7 followers
July 3, 2025
Dr Eitan Rose has a lot on his plate. After a leave of absence for mental health reasons, the night before his first day back sees him caught in a messy scenario at a gay club. It results in an uncomfortable return to work under the supervision of his nemesis, Douglas Moran. But when senior personnel start dropping dead, Eitan smells something amiss and is determined to prove it. Aided by new love interest, Cole (a hospital porter - see what he did there?), a student diet and the wrong drugs, Eitan manages to get himself into increasingly madcap and farcical situations during his investigations. Friends and colleagues become more and more concerned that it's all one massive bipolar episode.

This feels like One Foot In The Grave/Fawlty Towers, with a touch of Bridget Jones, but set in a hospital, featuring a good dose of swearing. (That last sentence is a compliment.) The writing has Adam Kay all over it; it reads well - sharp, colourful, with plenty of good turns of phrase. Much of it is from Eitan's perspective, which can feel chaotic, although some very dodgy judgment choices become more plausible if you consider he might be off his medication. But things are rounded out when we also hear from Cole and Eitan's colleague, Margaret. The main thread takes a break via the occasional meal (at questionable eateries) with close friends Mo (also Eitan's ex) and Fiona, and excerpts from various documents fill in Eitan's history. The tone's light but still manages to tackle the prejudices faced by people with mental illness, as well as the strains on the NHS. And despite Eitan's cynicism, he genuinely loves his work and cares about his patients, reminiscent of Kay himself in his non-fiction. As for the crime element, I guessed the who, if not the why, but it's a good ending, perhaps sowing the seeds for more adventures with an investigative duo? If you liked This is Going to Hurt and are in the mood for witty medical crime, go for it. I thoroughly enjoyed it.
Profile Image for Joan.
2,849 reviews51 followers
July 6, 2025
Review of Digital Galley

On his first day back at St. Jude’s, Eitan Rose is feeling less than prepared, thanks to an impressive hangover. His office has been turned upside down and a co-worker has been moved in . . . along with her cat posters. Then he learns that the supervising doctor, Douglas Moran, will be sitting in on his patient visits.

However, his hoped-for quiet sojourn on the roof resulted in a rather pleasant meeting with Cole.

But Eitan has no idea what is waiting for him.

=========

There are many laugh-out-loud moments sprinkled throughout this dark comedic mystery tale. The characters, mostly unlikeable, are prone to outrageous behaviors, leaving readers wondering exactly what is going on in the hospital. But when two doctors at the hospital die, Eitan and Cole turn into amateur detectives, often with hilarious results. In spite of it, though, the murderer is ultimately identified.

Sadly, many used Eitan’s bipolar disorder to justify their decision to ignore him when they’d decided that was easier than dealing with what he was saying.

Unfortunately, the unnecessary overuse of a particularly offensive expletive is likely to offend many readers and lowers the rating for this book.

I received a free copy of this eBook from Little, Brown and Company / Mulholland Books and NetGalley and am voluntarily leaving this review.
#AParticularlyNastyCase #NetGalley
Profile Image for Jackie Sunday.
776 reviews46 followers
August 13, 2025
A deadly heart attack could be a result of someone’s health condition. But what if it doesn’t quite add up exactly? This is a fast-paced thriller with a doctor who decides to investigate not one but two murders.

While reading, there were parts I really enjoyed. Dr. Eitan Rose was a consultant rheumatologist at a hospital in London. I found it fascinating to follow him on rounds with patients although it left me with a lot of questions. It also had me thinking about certain types of heart attacks.

Dr. Rose was previously on leave to get help with his bipolar disorder. The hospital gave him time to rest and then with meds he would be okay to work with supervision. One medical professional in the story said that thousands of doctors are bipolar. I looked it up. Of course, there’s no evidence of this.

Yet, I just wanted to scream at times at Dr. Rose for things he said and actions he took which got him into trouble. He was gay with a romantic partner which fit the category of diversity. There were twists and turns but with the clues half way, I was able to figure out the mystery. The story was captivating with a satisfactory ending.

My thanks to Mulholland Books and NetGalley for allowing me to read an advanced copy of this book with an expected release date of September 16, 2025.
Profile Image for Emma Davies.
13 reviews
September 1, 2025
Rounded up from 3.5 stars

I have previously read Kay’s non-fiction, semi-autobiographical books and absolutely adored them so as soon as I heard about this I preordered it. Whilst I don’t feel that it lived up to the other books, it definitely wasn’t bad.

The writing itself is super quick and easy to read. It’s clearly and chronologically written, which makes it easy to follow without too much brain power. There is a fair bit of profanity here but that really shouldn’t come as a surprise to anyone who’s read Kay’s other works. It’s personally not something that bothered me, but if you’re sensitive to f-bombs or the c-word then this probably isn’t for you. Kay also uses current trends and topics in his humour which is great, although will probably make the book seem dated in a few years.

The characters are mainly unlikeable, but im a sucker for a shitty main character so I quite enjoyed it. Eitan does (sort of) have some redeeming qualities, especially towards the end. But mostly people suck (which honestly reflects life so 💁🏻‍♀️)

My main gripe is that by the time the “twist” came I had already worked out who it was, so I didn’t have that “oh my god” moment that I’ve experienced in some other thrillers that I’ve read.

Overall I did enjoy this book. I would probably recommend it, and I can see myself coming back when I want an easy but still entertaining read
Profile Image for Tori.
111 reviews
September 3, 2025
3.5* rounded up

Eitan is just returning to work from a long suspension after a mental health crisis. Faced with the stigma of his diagnosis and his well known past at the hospital he works at, he's not looking forward to starting up again under the watchful eyes of a superior he dislikes. But when a high ranking doctor winds up dead, he can't shake the feeling that something is off and this might not be a death of natural causes. So begins his personal investigation even as those around him think he's slipping and starting to go a little mad.

At first I wasn't sure if I would enjoy this book. Eitan is an incredibly frustrating character to read from and about. At every turn he makes choices that just get him further into trouble. He continually sabotages himself, (which he is well aware of... he just can't stop!) That being said, it is kind of the point of his arc. He DOESN'T take good care of himself. I'm so glad I stuck with the book though because WOW it was a ride!

I had my suspicions early on who the murderer was, but again and again things would happen to throw me off the scent and make me question what I thought I knew.

Overall it was a fun and satisfying mystery while also shedding light on mental illness and the stigmas surrounding it.

Thanks to NetGalley and the publisher for an early copy!
Profile Image for Dogsandbooksanddogsandbooks.
761 reviews43 followers
July 25, 2025
Thank you to Mulholland Books and Netgalley for an early electronic copy. All opinions are my own.

A dr returning to work post mental health break becomes embroiled in a double murder and several instantaneous hookups. And drug deals. And another mental health break. More drugs. And more mentions of mental health. Lots of witty banter but it loss its glow when it's mentioned that the dr. is in a mania phase.

There is a lot going on here that is serious, wrapped up in a funny guy's riffs on his profession (health), drugs being doled out by the resident pharmacist, and then the evil corporate boss. I kinda started to lose the funny vibe when our protagonist, Eitan, seems consumed to destroy himself with his erratic behaviors. Eitan has suffered a terrible loss at one point so seems to suffer PTSD, he's gay without parental acceptance, he's bipolar and has had suicidal ideologies and appears to be in a manic stage through much of the book. It was hard to laugh at the destructive behaviors for me.

Overall, I would have liked PNC to have taken a stronger line to mental health in health care workers. Or, rely less on that serious issue and focus more on the funny. Even the murders took a backseat to the ping ponging of the main character's shenanigans.

Profile Image for Hannah.
480 reviews9 followers
August 22, 2025
Doctor Eitan Rose suspects foul play when a fellow doctor seems to die in mysterious circumstances. However, when he raises the alarm others are sceptical due to his recent breakdown. When a second doctor also suffers a similar fate, Eitan becomes convinced something is not right. Is he correct that there is something sinister at play?

When I saw this book I was excited and knew I had to read it. I really enjoy a medical thriller and have enjoyed this author’s writing in some of his non fiction offerings. When starting this I enjoyed the witty, sarcastic ramblings of the main character, however as the book wore on it became a bit excessive and ever so slightly tedious. Saying that, I think the dark comedy made this book work, especially exploring the hospital etiquette and mental health stigma, and I found a lot of the scenarios that the characters found themselves in entertaining.

It took a while for the mystery element to start but it was a fun ride to get there. I have to admit that I did find this predictable and guessed almost straight away the outcome, however overall I still found this an enjoyable, clever story and would definitely read more by this author. 3.5 stars rounded down. Thanks to NetGalley and the publisher for this copy in return for an honest review.
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