Warning: this article contains major spoilers for episode six of BBC’s This Is Going To Hurt and discusses suicide.

Whether you’re a boxset binge-watcher or a weekly episode savourer, there’s one drama that’s kept everyone talking these past couple of months. This Is Going To Hurt may not initially strike everyone as their series ‘cup of tea’ but its discussions on topical issues – interspersed with some pretty dark humour – provide us with laughs, full-body cringes and confused head shakes in equal supply.

This upcoming episode of the Adam Kay adaptation, however, is one to take very seriously.

While there are some serious life lessons throughout the previous episodes, one character has shined bright within this chaotic series: Shruti Acharya. The softly-spoken, timid junior doctor is played by comedian Ambika Mod and is undoubtedly our favourite character of the series, not least because she’s relatable to us all.

That’s what makes episode six all the more painful to watch. 

Whether you’ve read the book or just watched the show, there’s no denying that what this BBC series manages to capture so well is the sheer exhaustion of everyone working in the NHS.

It’s something we’ve come to expect whenever we see Shruti on the screen. In episode four, she confided in Ms Houghton (Ashley McGuire) and admitted: “I just feel so incompetent there. The whole time, you know? Like a total fraud. And I’m lying to my parents because they are so proud of what they think I’ve achieved.

“No one tells you how upsetting it is […] I just feel so constantly overwhelmed.”

Up until that point, we’d witnessed Shruti’s confidence rise after delivering triplets but that short monologue was a raw window into her mind. One that Houghton dismissed by underlining the same sentiment Shruti knew doctors would: it’s all part of the job.

Even so, over the course of the next two episodes, we feel like Shruti is getting a handle on her job – perhaps with a quiet kind of resolution until her exam results come back. Episode six is Shruti’s episode and she excels in an unapologetic way we haven’t seen of her before.  

While Adam (Ben Whishaw) is tending to private patients during a day shift, Shruti is left to tend to medical emergencies and man the ward as the sole doctor on call. She takes a new doctor under her wing, providing him with the same cut-throat guidance Adam did with her but also a gentleness that is just innate within her.

She breaks the rules – something she wouldn’t have dreamed of doing previously – to give a patient an ultrasound and discovers an ectopic pregnancy which needs immediate attention. Her handling of the situation – as well as the surprise appearance from one of Adam’s private patients – is weirdly emotional. After watching Shruti navigate the minefield of medicine with severe impostor syndrome, you can’t help but feel proud at what she’s capable of. It’s a sentiment that Adam shares and is sure to tell her in an unusually close moment between the pair.

“Is it wrong for me to feel proud? You’re so… good,” he gushes.

But Shruti isn’t really listening – her mind is elsewhere and it’s after this moment (that should be one of happiness and excitement), that you see she’s completely and utterly exhausted. She appears vacant, numb and even when telling Adam she passed her exams, doesn’t smile. 

Throughout the series, we’ve become used to Adam breaking the fourth wall and talking directly to us – it is a story told from his perspective, after all. But as Shruti walks away from Adam and the hospital, she stares blankly into the camera and says: “I’m sorry. I really did try.”

What comes next is a new day and Adam’s return to work but, on arriving back in the ward, he notices that all the nurses are crying. “Adam, I don’t know what she was thinking,” Tracy (Michele Austin) cries.

In another scene, we see a police car drive up to Shruti’s parents’ home and in those last few silent scenes, you’re left in little else but quiet shock as you realise that Shruti has taken her own life.

Shruti’s suicide is a character arc that may surprise you but viewers have been quick to outline how relatable the plotline is for many NHS workers. Even in an age – and work environment – that you assume would be able to spot the signs of depression, Shruti’s determination at work allowed her mental illness to go undetected. 

It’s something the viewer is never made aware of either, but all the signs are there. Even her last line of the series is an apology – just another underlining of her care for those around her, rather than herself.

Adam’s constant belittling of Shruti is a reminder of the need to remain kind at all times. While we may know not to “judge a book by its cover”, the notion of making time and space for someone’s problems can often be overlooked. Shruti spoke about the need for support in episode four and hindsight can be a wonderful thing.

While this episode required several tissues to mop away our tears and the kind of heartache that’s only reserved for superb TV characters like Shruti, there’s an overarching message at the heart of it. In the chaos of work and life, we can’t forget the importance of frank conversations around depression, medication or seeking professional help and sometimes it does take a heartbreaking plotline like Shruti’s to remind us.

This Is Going To Hurt is available to watch on BBC iPlayer now, with episodes airing weekly on Tuesdays on BBC One at 9pm. 

If you need to talk to someone, Samaritans are available 24 hours a day, 365 days a year. Call for free on 116 123, email jo@samaritans.org or visit samaritans.org to find your nearest branch.

Images: BBC