Life Support, BBC1, Mondays at 9 30 pm, 19 July to 23 August
This new drama series offers a package tour of the major issues in medical ethics. A large old inner city Scottish hospital has employed a clinical ethicist, and there—in the time honoured phrase—the trouble begins. The central character, Katherine Doone, is 30-something, clever, forceful, committed, and quite hard not to watch. In her dealings with the lumpen consultariat she variously simmers, flounces, and erupts. With patients and relatives, she is all charm and insight, and—it goes without saying—a far better communicator than any of her medical colleagues. You know when she is thinking serious ethics because her brow furrows and her lips purse. Off duty, she is troubled and vulnerable, a mystery on the local singles scene. In short, the ideal ethicist for a controversial medical drama series.
With three episodes down and three to go, we have learned a lot. Dilemmas arise in the care of patients with brain damage and quadriplegia, refractory childhood leukaemia, and a lady solicitor with obstetric complications, particularly when those most closely involved disagree. Doctors, naturally insensitive to such issues, are suspicious of clinical ethicists and say things like, “I need a clinical ethicist like I need a hole in the head,” but will eventually be won over, if not in this episode then perhaps in the next.
A juicy first helping, shot in the middle of Glasgow’s monsoon season, encompassed the end of the ethicist’s long affair with a lawyer, a confrontation in a lecture theatre between our feisty heroine and a sceptical colleague (though it would clearly be unwise to rule out a romance in episode five), and the resolution of the dilemma about the quadriplegic and brain damaged patient when the patient’s staff nurse girlfriend administers a fatal dose of intravenous potassium.
Episode two offered an update on acute leukaemia in children, the role of a bone marrow transplant, and the difficulties of a second transplant. The patient, a decent wee Celtic supporter with a shrewd view of his plight, needed an overkeen consultant and a mum and dad who dumbly disagreed about treatment to raise the necessary ethical wind. Fortunately, all three were present, getting it completely wrong until our heroine swept in, communicating brilliantly with all concerned and saving the day.
Episode three brought us the awful problems arising from a serious overdose of plot thickener, with the staff nurse coming to trial, our ethicist appearing as a witness to be cross examined by her about-to-be-ex-husband, and her dad—played by Richard Wilson in a luscious legal role—leading for the defence. An everyday story of Glasgow justice? Why not? Suspend your disbelief, all ye who enter here, and sit on your sofas pretending stuff like this could actually happen.
“I’m an ethicist. I’m always going to upset somebody,” she tells her chief executive in an interview convened because, in the course of events leading up to and including the trial, she may have Gone Too Far. In truth, it’s nowhere near as subtle as that: she’s Gone Over The Top, and so has the whole series. That, I suppose, is why I will continue to watch. And also for an answer to the central question: what on earth is this woman, professionally at loose and socially on the sniff in the Wild West of Scottish medicine, about to bring down upon herself? And for the lovely Glasgow townscapes, and for the minor characters. Medical authenticity is signalled by the usual stuff: the blur of pale blue pyjamas and steely jawed lack of emotion at every emergency, the bleeps that go off only at critical stages in conversations and relationships, and the endless ringing of telephones that no one ever answers.
KEN MELLIN/BBC
And medical ethical authenticity? Well, that’s a bit trickier. Few NHS hospitals employ lay clinical ethicists, probably for reasons this series first outlines then strongly reinforces; and the demands of television drama for character and conflict may have far outweighed such slender realities as exist. But what might the viewer on the Clapham sofa deduce about medical ethics from watching Life Support? Perhaps just the old familiar lessons: that we doctors get into trouble when we don’t think about things from the patient’s point of view, more trouble when we don’t explain things, and most of all when we don’t listen. But is an expensive, overplotted, and sometimes frankly clunky drama series the best way to get that simple message across?
A possible alternative was in there struggling to get out. Close observers of the doings of Rab C Nesbitt, the Govan philosopher, will have spotted in the cast a number of his friends and associates, and Richard Wilson, too, hinted at what might be done. So why not just admit it, and hire Rikki Fulton, alias the Rev I M Jolly, as hospital chaplain, and perhaps even Jo Brand as director of nursing, and make a virtue of going over the top, because a decent medical ethical sitcom could do more for the cause of enlightenment than hours of this solemn, pompous fluff—chiefly by letting public and professionals laugh together, honestly and openly, at the pain, the absurdity, and the ultimate futility of so much of what we do when we are only trying to help.