Mark Rylance as Dr Semmelweis
battling Maternal Mortality
“We are the doctors of the modern age. We are marching into battle.”
A supporter of Dr Semmelweis
This is a timely play.
It reminds us of how– only 200 hundred years ago – death and disease in the form of puerperal fever freely wandered maternity units. Until Hungarian Doctor Ignaz Semmelweis challenged the accepted practice that allowed it. He supplemented surgical observation with statistical analysis, experiment, and postulated the existence of invisible agents of death and disease. A critical moment in the separation of medical science from surgery, but a step too far for many of his contemporaries.
Semmelweis was ignored, discredited and ostracised, but finally vindicated like Galileo, who only changed our view of the Solar System while Semmelweis’s reforms saved the lives of countless mothers and babies. Mark Rylance is determined that his story is heard, especially since our time is one of pandemic, official unpreparedness, and scepticism about how best to deal with it. A time when people died in droves because we did not initially understand Covid and were unable to control transmission. Our determined Clinical staff and scientists got us through. Some politicians might try to claim credit but we have seen how institutional inertia can kill when faced with a new threat. Not due to clinical failure but because of poor planning, funding, and provision.
But how best to dramatise? How to humanise a central character who is stubborn, tormented and his own worst enemy? Mark Rylance and Stephen Brown have avoided the well-made play model of Ibsen’s Enemy of the People and produced something closer to a Seventeenth Century masque with tableaux, music, and dance. Spectacle, in short.
And quite a spectacle it is at times with performers filling the stage, climbing down walls, and swaying in the boxes. Dancers, tightly choreographed by Antonia Francheschi, represent Semmelweis’s aspirations, his fears, and the ghosts who pursue him to his death. Death himself appears and cruelly decimates the dancers. The powerful music is credited to Adrian Sutton, (though I can’t help feeling it owes something to the aptly-named “Death and the Maiden” written by some Viennese chap) with the String Quartet players gamely carrying their instruments around as part of the action without missing a note. Everyone navigates the stage without mishap, despite the apparently random appearances of an over-sized doorway.
It is hard for the text to match the eloquence of dance and music and it doesn’t seem to try. We are treated to Brechtian alienation as actors chat to audience in the boxes. Anachronistic Shavian witticisms and an echo of Sybil Fawlty’s “He’s from Barcelona” may also be deliberate but the loud belly laughs they evoke from some of the audience are a little too alienating when we have just been watching women die in agony.
The text should also explain what points Semmelweis is actually making, or not making. But the fine details of inferential statistics, experimental design, and bacteriology can easily be lost in all the action. Nor are the main characters – Semmelweis apart – fully realised by their words. His foe is just a foe. His supporters are supporters. “Build a bridge to express yourself to opponents,” they say. And then repeat, “Yes, build a bridge to your opponents. That’s what you should do.” Amanda Wilkin’s Mrs Semmelweis is the devoted, supportive, distressed wife who says, “I love you.” Then, “I love you.” Then later, “Don’t leave me.” “Don’t leave me.” Mere repetition often fails.
Roseanna Anderson as the philanthropic Maria-Teresa whom Semmelweis treats with self-destructive disrespect, has all the presence for a Princess but is barely on stage before she is whisked off again. Pauline McLynn’s Nurse Müller also has little to say, even in her painful farewell scene with the man she has done so much to support.
Mark Rylance is powerful as Semmelweis and gives heat to the proceedings but the man himself remains an enigma to the end. That he is moved by the fate of Chrissy Brooke’s Lisa Elstein is beyond doubt. But can he really put lives at risk without compunction by experimenting with changing ward staff? No informed consent here. Why does he ignore his father’s funeral? And why does he become his own worst enemy by offending those whose help he needs? Is he broken by years of unjust opposition or is his stubbornness somehow already wired in? We don’t know and there may be no way of knowing. His decline is rapid, almost perfunctory.
But following last year’s Shropshire maternity scandal and the Care Quality Commission’s finding that “Nearly half of all NHS hospital maternity services covered so far by a national inspection programme have been rated as substandard” (Observer, 9 July 2023) we plainly need more Semmelweis’s.
An exciting and thought-provoking evening. But perhaps the images that remain will be of the confident young Semmelweis promising Lisa that she will be safe as he leads her off to her death. The older Semmelweis hunched in his straight jacket with his jailer/nurses hefting their clubs. Is that suppression of a maverick or misguided treatment? Most painful perhaps, the ballet sequences showing the Ghosts of those killed by medical science and who now haunt Semmelweis himself.
Perhaps he should have thought to ask the Midwives why their ward had such a low death rate. But then surgery was a man’s profession and men, I am reliably informed, don’t have babies.
Production Notes
Dr Semmelweis
Written by Stephen Brown with Mark Rylance
Directed by Tom Morris
Cast
Starring:
Mark Rylance
Felix Hayes
Roseanna Anderson
Suzy Halstead
Joshua Ben-Tovim
Megumi Eda
Zoe Arshamian
Ewan Black
Chrissy Brooke
Pauline McLynn
Jude Owusu
Oxana Panchenko
Millie Thomas
Max Westwell
Amanda Wilkin
Alan Williams
Daniel York Loh
Creatives
Director: Tom Morris
Designer: Ti Green
Lighting Designer: Richard Howell
Choreography: Antonia Franceschi
Sound Designer: Jon Nicholls
Music: Adrian Sutton
Information
Running Time: Two hours 50 minutes including an interval
Booking to 7th October 2023
Theatre:
Harold Pinter
Panton Street
London SW1Y 4SW
Tube : Piccadilly Circus
Telephone: 03330 096 690
Website: haroldpintertheatre.co.uk
Reviewed by Brian Clover at the Harold Pinter Theatre
at a preview performance on 8th July 2023