Saturday, 29 January 2011


24/1/11, Hampstead

3 hrs. Best thing we've seen so far this year. By Nina Raine, whose Tribes we saw just the other week at the Royal Court, and who is clearly planning on being as prolific as her dad Craig.

A slice of life in today's NHS, set among the junior doctors and consultants in A&E and a range of other specialisms in some big London hospital. Lots of short scenes played with tremendous energy, book-ended with vigorously mimed scenes of emergency room life familiar from the likes of ER and Casualty. Strongly-drawn characters, especially the women, including a dedicated newbie (Ruth Everett) falling out of love with her boyfriend (Pip Carter), another doctor (who relaxes after a taxing nightshift with a can of beer and an episode of Doctors at 9am) and a mid-career British Asian surgeon (Thusitha Jayasundera -- from Holby City!) who has sacrificed family and personal life for career, and bullies and snaps at her juniors. Some good jokes as well as moving moments. A big cast (I counted 14 including ASMs with the odd line) made to seem bigger still by effective doubling. Played on a traverse stage lined with that blue lino they have in hospitals, curtained areas and nurses' stations at either end of the traverse; much of the action involving hospital beds, wheelchairs, surgical trolleys wheeled on and off with elan. Raine herself directed, presiding over some fine naturalistic TV-style acting and one misplaced performance by Nicolas Tennant as a senior surgeon: he's a good actor but his approach in this play was far too mannered.
At the heart of the play lay the question of how far doctors should care. The newbie cares too much, desperately trying to resuscitate a young women brought in with a heart attack; the more experienced members of the team are used to the idea that patients sometimes die, but she is not yet inured. The surgeon cares about her work and career and standards but not, you feel, about the patients, who are merely so much meat -- until, that is, her aunt is brought in for a routine operation which goes wrong thanks to the incompetence of the consultant on whom she is dependant for her own promotion. At the end of the play we see her breaking the news to an elderly cancer patient (an actor in a hospital soap!) that his condition is incurable; she leaves weeping.
Much of the subject matter was predictable: overworked, exhausted juniors; the doctor diagnosed with cancer ("heal thyself"); the arrogant professional. But some of it was surprising. Like the sexism, not just among the old hands but among the young men. Can that be right? Dr T said it was -- and generally gave the play a thumbs up for verisimilitude though with reservations about detail. In particular she said the old problem of exhausted junior doctors making stupid, perhaps lethal errors after too many hours on call had been replaced by a new one: everyone works sensible hours, so they go home at the end of their shifts, handing over to a new team, which means the doctors are fresher but (unless the handovers are very good indeed) there's often no continuity in a patient's treatment, with each new batch of nurses and doctors coming on with no clear idea of the case history and having to start afresh each day, with sometimes predictably unfortunate consequences.
Michael Billington in The Guardian lamented that the play wasn't "political" enough: that it didn't focus sufficiently on the dire state of the NHS. I think he was wrong. Firstly because Raine didn't set out to write that kind of play, but rather an ensemble, slice-of-life piece that touched on many issues. And secondly because there was quite a lot of politics: the play talked about rationing treatment, about the difficulty of getting properly trained staff, and about the way in which the NHS is kept afloat by the "voluntary overtime" of doctors. Indeed a rant on that subject towards the end prompted a spontaneous round of applause from the audience: clearly there were a lot of hospital doctors in the audience.
One false note: an elderly woman is brought in with a stroke, unable to say anything except "Yes" and "No". A little later she has recovered her speech but not her wits and wanders through the hospital looking at the audience and asking "who are all these people?" It was an unnecessary breach of the fourth wall (or whatever the traverse equivalent is).

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