Dr Semmelweis @ Harold Pinter Theatre, London
To hand sanitise or not hand sanitise — that is the question… In a poignant, passionate and creative production, this play explores the life and tragic death of pioneer scientist Ignaz Semmelweis (Mark Rylance). A Hungarian in Austria he realises that the maternity clinic in the General Hospital he’s working in has a problem — high maternal deaths in the ward where doctors work, with significantly lower numbers in the ward run by midwives. No one, until Ignaz Semmelweis, has thought to ask or research this issue — no-one even sees a problem, and it’s not until he gets a number crunching assistant that he can start to practically address the issue thoroughly.
Using dancers and musicians on stage as well as a ‘dance of death’ ballet theme, we follow Semmelweis through his research and his discoveries. The responsibility of not being listened to by the established medical profession weighs heavily on him (shown by him being haunted by dead ‘mothers’). At the time most medical research is done by using the live patients as observational guinea pigs and through autopsy — beyond washing, no-one in Western medicine really deals with bacteria. Which turns out to be the reason why so many women are dying in or after childbirth — the doctors in this prestigious hospital are not washing their hands thoroughly or practicing proper sanitation. As now, washing hands literally saves lives!
Using a wider ensemble cast, we see Semmelweis gate crash a ballet (and he and his colleagues chat to each other from theatre boxes as well as climbing in and out of them). Motivated by making women’s lives better and literally saving lives, Semmelweis pioneers hand sanitation in one ward and begins to establish theories of bacteriology. His greater issue is getting everyone on side (from patrons to the medical establishment) and his friends and colleagues as he doesn’t yet have all the answers. And won’t until Lister comes along forty years later.
Distressingly Semmelweis experiences mental distress and breakdown, before being conveniently being sectioned into an asylum. On one hand this hopefully therapeutic treatment should keep himself and others safe. On the other hand it doesn’t seem to as we see him debased (with tied hands), and beaten in trying to escape his asylum prison. Ironically and disturbingly he dies of septic wounds; the scourge he spent his life and exhausted his mental and emotional health in trying to defeat.
It is incredibly engrossing as the dead mothers keep coming back to Semmelweis in conversation, in remembrance, joining him in dance as he fights to save them from death and suffering, even inspiring his furious letter writing campaign to the medical establishment to get them on board (and lambasting them as murderers if they don’t). Another engaging feature is that the whole play is delivered as a conversation between Semmelweis and his pregnant wife — his research and discoveries have a personal edge too.
Where it falls flat is the ending — Semmelweis’s wife berates him for his rage and anger; she and his colleagues then speak more tenderly to him about being a bridge for others and being more persuasive than confrontational. His side of things (beyond Rylance’s shouting episodes) is never explored — more could have been said about him being the trailblazer, the person who does know things people don’t know, for whom it literally is life and death. I think this point that he does have a point, a real mission; that lives were being needlessly lost through lack of obvious care (i.e. hand sanitation) is a bit skirted over at this point as Semmelweis’s wife basically tells him to calm down and keep his hair on. But women who were voiceless, unseen and unheard (begging to avoid the doctors ward — literally) were suddenly seen, and heard and given public voice by Semmelweis and his sense of care and duty toward them was overpowering. Either the lack of understanding here or social concern or emotional concern for her husband’s well-being should have been emphasised more here as it comes across as uncaring towards those lost lives and those suffering and that he’s sort of making a fuss for no reason. Really it’s more that he’s not socially savvy or a political player and doesn’t navigate communicating his research and persuading his patrons to do the right thing smoothly or astutely. (He does have more support than I realised he had).
In a throw away comment a scientific revolution, a miracle is dismissed as just science — but it was revolutionary and took faith to see and believe in. Semmelweis’s ethical and moral dilemma about getting people to do the right thing because it’s the right thing to do could have been made more of here (and linked to COVID-19 public health, doing things for the good and benefit of others). How much evidence is enough evidence? And what is negligence, when does duty of care turn into murder? How culpable are public health professionals?
Stampeding through Semmelweis’s breakdown and emotional and mental distress, suddenly he’s broken, dies of infection and the last word goes to his wife and the breathy dead mothers/dancers. More was needed here to make us care — we saw his passion in getting everyone on board and making difference in his letter writing campaign, but his own distress was less effectively stage and handled. After all, we should care about him! (At the same time I wholeheartedly applaud bringing his wife as a main character and showing what it was like to live with him and how she tried to care for her husband in his suffering).
The staging was impressive — using a balcony for the musicians, taking over the theatre boxes at points, moving beds on for the hospital setting and an empty trolley for the autopsies. Having said that, if you are in a bargain or restricted view seat — beware! Unless you’re at the front of a balcony, views really are restricted as much of the action is very front centre stage and an hanging blocks the view of the balcony on the higher levels. There is the very real danger that you end up paying to hear not see a play, unless you pay a small fortune for a more expensive seat. It’s something the production needs to think about — I wonder if the National Theatre or Barbican would have been an overall better venue as so much of the play depends on being able to see everything. I came away feeling less emotionally connected than perhaps I should have been due to the restricted view challenges although I did get to see Mark Rylance throughout by sitting like Picasso painting! Up at the top of the theatre it also felt that there were sound issues too as Rylance sounded quite quiet and flat at points and it was hard to hear some of the actors, and it can be disconcerting to hear not see the musicians at points…
Comments about Semmelweis being revolutionary are made by himself and his colleagues — a bit more politics could have been brought into this setting as we’re in 1848 times. I’d also like to have seen the mistake made by the nurse who doesn’t wash her hands on one occasion and ends up infecting and effectively killing eight patients explored a bit more. Hinted at (although never fully explored) is the battle for hearts and minds in public health — having experienced our own hygiene and hand washing battles through COVID-19, I feel that more could have been said here. Semmelweis is accused of being a fanatic, a fake news spreader, and his nurse ally mentions how her hands are being damaged by the strong sanitising solution they use to wash with. Our public health battles are very real and very similar here — more links could have been made; although it does do well in exploring how class and patronage leads to exceptionalism and tiers of rules.
I did enjoy the staging though — during one of the doctor’s lectures Jude Owusu came up into the balcony and asked startling questions of the scientist. He also said nice things to the audience on heading back up the perilously steep staircase. I appreciated very much being told to take care. The ensemble cast (particularly Jude Owusu as a colleague who dies of an infection) were excellent and wow, Pauline McLynn as the well-qualified nurse Anna Müller, makes some pointed comments about women and their limited access to medical professionalism at the time.
For more of Dr Semmelweis’s extraordinary life — https://en.wikipedia.org/wiki/Ignaz_Semmelweis
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