How to write authentically as an NHS doctor (without getting struck off)
BY Benji Waterhouse
14th May 2025
NHS Consultant psychiatrist and award-winning comedian Benji Waterhouse studied on several of our online writing courses, including our five-day intensive online memoir course in 2020 and our London-based Writing TV Drama – Three Months course in 2022. His debut book You Don't Have to Be Mad to Work Here was an instant Sunday Times bestseller, and is out in paperback this week.
Read on to discover Benji's approach to writing from life and his advice for aspiring memoir writers.
'Do you have any crazy stories?'
When people find out I’m an NHS psychiatrist, they usually either ask: 'do you have lots of crazy stories?' (yes), 'is it scary working with schizophrenics?' (no, and they’re people with schizophrenia) and 'are you reading my mind?' (I think you’re confusing me with a psychic).
To try and bust these damaging and cartoonish myths about patients, staff and practices, I set about writing my first book You Don't Have to Be Mad to Work Here; a fly-on-the-padded-wall account of my decade working in NHS psychiatry (there’s another one, we don’t really have padded-walls).
Below is what I learnt from the writing process, with support from Curtis Brown Creative, to help you start telling your own stories.
Finding the stories that matter
A diary may be authentic – but most average days are not thriller material. Nor are the traditional big days necessarily the best (consider your last New Year’s Eve).
Our excellent CBC tutor Cathy Rentzenbrink taught us that instead of writing chronologically, to sketch a timeline of our lives and note all the memorable, funny or formative incidents along it.
These can be your building blocks for the wider story.
'Show, don’t tell' – turning facts into feeling
I wanted to sound the alarm on the crisis in mental healthcare – to deplore how services get just 13% of NHS funding despite accounting for 28% of the disease burden; how psychiatric beds have gone from 70,000 in the 80s to 18,000 now.
But newspapers cover statistics. Memoirists need to make people feel what those numbers mean for patients and staff.
To show my compassion fatigue in the epilogue we flash-forward to me as a burnt-out senior psychiatrist on-call at 4am, trying to bounce a referral because the patient jumped off the 'wrong side' of Suicide Bridge ('that bridge divides the north and south Crisis teams; we’re the north one').
Then to make the reader feel outraged at the cold reality of NHS ‘care,’ in chapter 1 we rewind to my first day as an idealistic newbie when I’m shocked to discover that a suicidal woman who is considering jumping from her bedroom window is discharged by my boss because 'she only lives on the second floor.'
Using humour as a Trojan Horse
They say laugher is the best medicine (although for chlamydia you should probably start with penicillin). For this reason, the NHS workforce run on gallows humour, along with strong tea. If you can find some lightness amongst the darkness, a reader can even tolerate reading about heavy subject matter like suicide and schizophrenia.
But the tone must be sensitive. Never make a patient the butt of a joke. Instead I focussed on the NHS, psychiatry’s ignorance or my own incompetence. For example, I tell one story about when I was trying to detain someone against their will; and I was so tired that on the section papers I accidentally mixed-up the box for the patient’s name and my own and technically sectioned myself.
Writing about real people – without ruining their lives
How do you let readers onto the locked ward – without losing your GMC registration? The answer is anonymisation.
When writing about 'Graham' with the Messiah complex, I changed all identifying details – name, age, gender, ethnicity, and added some red herrings. He wasn’t really admitted after trying to walk on water at the local swimming baths, but it’s just the sort of thing that would happen, when people’s actions are driven by delusional ideas.
All the characters in the book are composites from the thousands of patients I’ve met over my career. I wanted to humanise the people beneath their diagnoses and show they are so much more than their illnesses. I think they feel real and it’s nice when readers ask me how certain characters are doing now. So far the only complaints I’ve had from patients have been for not including their stories in my book.
Writing about family – without ruining Christmas lunch
For balance, I also explore my own psychology in relation to my lovably dysfunctional family. If you’re including home truths, talk to your family early. My relatives vetoed or softened plenty, and I let them read drafts which helps to avoid lawsuits and awkward family gatherings. Your juiciest, most jaw-dropping stories might make for a gripping read, but consider boundaries - moral, legal, and emotional – before writing your ‘tell all’ memoir.
Memory is also notoriously slippery – we embellish, we edit, we repress. Try to corroborate real or misremembered memories with family. Sometimes you’ll confront your parents about your lifelong trauma from being left behind at Legoland and they’ll look bemused and say 'we never took you to Legoland. That was your cousin.'
Editing with an audience
I host a storytelling night called The Moth in London where the audience can be an invaluable, brutally honest editor. Consider testing your stories aloud too; on stage or to loved ones, and listen out for their reactions. Laughing = funny. Gasps or tears = emotional investment. Snoring = maybe cut that 20-page chapter on amendments to the Mental Health Act 1983. Alternatively, read aloud to yourself and if you’re bored, imagine your reader. Then edit, edit, edit.
Was it worth it?
Writing a book is hard work, and you have to sacrifice time you should probably be spending with family, friends or partners (it’s probably no coincidence I’m no longer with my girlfriend in the book Esther). But there are joys: landing a Curtis Brown agent, watching your book go to auction, selling the television rights. The pinnacle was being number two in the Sunday Times bestseller list which felt amazing. For about 10 minutes.
But what nobody tells you is that these glossy moments pass in a flash. I was once reflecting on this strange feeling of underwhelm with a more experienced author who said ‘look Benji I know it may not feel like it now, but in a few months you’ll look back on all these nice reviews and achievements . . . and you still won’t feel anything at all!’
In the end what endures – and really nourishes you, trite as it sounds – is connecting with readers and the creative process itself. Working out what you think about things. Turning painful memories into beautiful sentences. Seeing someone laughing as they read your book on the tube. Receiving messages from strangers saying they now feel less alone. Ultimately, I sense that’s what writing is all about.
5 practical tips for writing an NHS (or any) memoir
- Start a timeline: Map your life or career for moments that raise your heart rate – good and bad.
- Show, don’t tell: Turn stats or issues into stories; make the abstract concrete.
- Anonymise fiercely: Change all identifiable details and combine characters to protect privacy and yourself.
- Ask for feedback: Read aloud, test on unsuspecting friends or at open mics – listen for the awkward silences.
- Stay human: Show humour where you can. But above all, empathy.
You Don’t Have to Be Mad to Work Here – A Psychiatrist’s Life, published by Vintage, is out in paperback now and Benji is currently touring.
The books linked in this blog can be found on our Bookshop.org shop front. Curtis Brown Creative receive 10% whenever someone buys from our bookshop.org page.