It has become a British habit to criticise the NHS. But it can’t be that bad, can it? In its unflinching examination of the pressures faced by doctors in NHS hospitals, the result of three months of research by playwright and director Nina Raine, Tiger Country’s unfortunate conclusion is that it is.
Events unfold through the eyes of newly qualified Senior House Officer (SOH) Emily (Ruth Everett). Like us, she is a newbie to this busy London hospital, posted there after working in a care home for the elderly in Brighton. At first she is eager to learn and determinedly conscientious. After all, getting it right or wrong is the difference between life and death. But gradually Raine shows us exactly what pressure this places on doctors. Emily considers every success merely an averted failure, and feels her decisions like a pain in the chest.
She is surrounded by more experienced doctors who have become hardened to life and death by the untold pressures upon them: lack of resources, long hours, petty bureaucracy, hospital politics, competing egos. Being jaded and cynical, we learn, is the only way to survive. “Try not to care so much,” Emily is told. In other words, accept that you will make mistakes and people will die.
Through her characters Raine covers a wide spectrum of issues. Mark (Pip Carter) is the ambitious surgical SHO who feels bullied by his Registrar, Vashti (Thusitha Jayasundera), who in turn reveals something of the sexual and racial barriers she has had to fight to get to where she is. House Officer Rebecca (Sharon Duncan-Brewster) is the seemingly heartless medic who laughs at Emily’s eagerness, while SHO James (Henry Lloyd-Hughes) has learnt to cope by switching his mind off when his shift ends, leaving his patients behind in a way which his girlfriend Emily cannot.
But from time to time Raine pierces the tough wall each of her characters has built. Registrar John (Adam James) shows how even experienced doctors are not immune to emotion when it turns out he is facing a health crisis of his own. Meanwhile tough-as-nails Vashti is humanised when her own aunt becomes the victim of another doctor’s sloppy work. Doctors do care, says Raine, they have just learnt to hide it well.
Played in-the-round on a transformed Hampstead theatre stage, the play puts the audience at the heart of Tiger Country – an evocative term for the life and death jungle of surgery. It is, indeed, a jungle in there, Raine implies, and medics must survive it as best they can. But what about the patients? Gripping and provocative, the play leaves you with a sense of how precarious it all is, how your fate, as a patient, depends on how much sleep your doctor has had, when their shift ends, and whether they have the right medicine in the right tray at the right time. It is a scary and all-too believable conclusion.
CB