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Cardiac Arrest (TV series)
Encyclopedia
Cardiac Arrest is a British medical drama series made by World Productions
for BBC One
and first broadcast between 1994 and 1996. The series was controversial due to its depiction of doctors, nurses, and the National Health Service
.
(writing under the pseudonym
John MacUre), a former junior doctor who had worked at a hospital in Wolverhampton
, who drew on his own personal experiences to provide a more visceral, albeit wryly humorous, look at the NHS
in the 1990s. At the time of airing, Mercurio was still working as a doctor.
There was an episode due to be shown on 12 May 1994, however this was replaced with an extended 9 o'clock news programme due to the sudden death of Labour leader John Smith
, who ironically died from a heart attack. (A "heart attack" and a "cardiac arrest" aren't the same thing. A "heart attack", or myocardial infarction, happens when there is an interruption of blood supply to cardiac tissue through the coronary arteries, resulting in death of cardiac tissue. Depending on the location and extent of damage, this may, or may not, cause a cardiac arrest. Conversely, a "cardiac arrest" can have causes other than a myocardial infarction - such as an arrythmia. )
The main protagonist is Dr. Andrew Collin (Andrew Lancel
), an idealistic junior doctor, straight from medical school, and a devout Christian
. The series opens on his first day at work as a house officer
, and in his first scene he proudly admires himself in his white coat, before coming onto the ward, and meeting his new colleague, the frosty but competent SHO
Dr. Claire Maitland (Helen Baxendale
). Andrew is soon aware that he has almost no idea how to be a doctor. The series follows him in his first few months as a doctor, as he deals with one crisis after another and is increasingly disillusioned with the indifferent care given to patients and the expectations of junior doctors. At one point during the first series, he is required to work a 3 day and 3 night shift on call. Claire, who is more cynical and detached, both explains the realities of medical work to Andrew and tries to shield him from the worst abuses.
Claire has the second largest role in series 1. Although her defence mechanisms are generally better than Andrew's and the series seldom shows her as either exhausted or depressed, she claims to Andrew (after euthanising
a patient with an overdose of painkillers) that the emotional demands of being a doctor are just as hard on her. Although Claire is normally frosty, the series reveals that this is her professional mask: she quickly becomes friends with Andrew and eventually takes his side in a conflict against her own lover (Bettencourt). In one episode she plays warmly with the young daughter of a friend. In the final episode of the series this girl is brought into the hospital with a chest injury and dies due to the incompetence of another doctor. Afterwards Andrew finds Claire crying in the nurses' office.
Other characters feature prominently in the series, including Dr. Rajesh Rajah, (Ahsen Bhatti), a pleasant but incompetent house officer in a surgical ward, who is struggling to avoid an arranged marriage whilst indulging in as many sexual relationships as possible. Dr. Monica Broome (Pooky Quesnel
) is a surgical SHO and a new mother, who is desperately trying to hold down her demanding job and pass her fellowship exam, despite constant bullying and sexual harassment by her boss, the villainous Mr. Simon Bettencourt (Danny Webb
). At the end of the series, Monica fails her fellowship exam, and after her husband takes her children away from her to live with his mother in law, she takes her own life
. While this has a major impact on Raj and on the consultant surgeon Mr. Ernest Docherty (Tom Watson
), Bettencourt defends his behaviour unreservedly and shows no remorse.
At the beginning of series 2, Andrew has just returned to the hospital and is now an SHO. To his chagrin, the consultant physician
Dr. Graham Turner (Michael MacKenzie) has a far better relationship with the new house officer Dr. Phil Kirkby (Andrew Clover), whose father went to school with Graham, than he ever did with Andrew. Phil, despite his recent graduation, is a confident aggressive doctor whose faults contrast with Andrew's in the first series. Rather than being nervous and uncertain, in the first days he attempts diagnoses and treatments for which he is undertrained.
Claire remains an SHO, but her skills and academic performance mean that the hospital is shown to be careful not to drive her off to work elsewhere. She is also working under the far more committed and friendly consultant Dr. Barry Yates (Fred Pearson). She has a brief relationship with the new surgical registrar Mr. Cyril "Scissors" Smedley (Peter O'Brien).
At the organisational level a new hospital administrator, Paul Tennant (Nicholas Palliser), demands ever more efficiency from the medical staff, placing Andrew on ear nose and throat
(ENT) duties even though he has no training in the required skills, and instructing Claire to abandon extended resuscitation
of a hypothermia
patient in order to fulfil her clinic duties. While Claire is covering for Andrew one night in Casualty, a haemophiliac man is brought in with a nosebleed and bleeds to death because Claire is not trained in ENT, no trained staff are available and she cannot stop the bleeding. Claire exposes the systemic failures in the hospital to the media and although this is within her rights as a doctor, she is fired on an unrelated technicality. Claire returns to the hospital as a registrar
at the end of the series, after resuscitating a heart attack victim in a pub and being reminded of why she chose to be a doctor.
The hospital soon attracts additional adverse publicity when the anaesthetist
Dr. James Mortimer (Jo Dow
) is diagnosed with AIDS
following the discovery that he has HIV
and a Kaposi's sarcoma
. James is permitted to continue to work as his speciality does not put patients at risk. Some of the staff, particularly Raj, are sympathetic or actively supportive of James. However, the diagnosis is almost immediately leaked to the media by an unidentified party, another scandal ensues, and manager Tennant pressures James to take leave of absence. However, the payout over the death of the haemophilia patient means that the hospital cannot afford for Mr. Docherty to take his planned retirement, and Docherty demands that the pressure on James to take leave or resign be withdrawn in return for his remaining at the hospital.
The second major medical error in the series contrasts Turner's treatment of his junior staff with Docherty's protection of James. At the end of the second last episode of the series, Running On Vapours, Phil is attempting to draw up chemotherapy
doses for a patient on the evening of Christmas Day despite being untrained. He cannot contact a pharmacist
, consults with Andrew, who is also untrained in the matter, and finally rings a drunken Dr. Turner at home, who advises him to draw up the treatment. Phil gets the dose wrong and the patient dies of anaphylactic shock
. Turner and Tennant both advise Phil to take full blame for the incident and to deny that he sought Turner's opinion, and assure him that in return he will not suffer damage to his career. Phil does so, but the inquest returns a finding of unlawful killing
and refers it for a possible manslaughter
prosecution.
patient and as a result, pursues families of accident victims about organ donation
. Raj becomes affected by the diagnosis of a baby severely injured by shaking
and Scissors operates unsuccessfully on a woman injured by a drunk driver and attempts to kill the driver by neglect.
In series 3, the hospital has another new house officer, Dr. Liz Reid (Caroline Trowbridge). Liz is different from both Andrew and Phil: she is shown to be not answering pages, leaving work in the middle of the day for errands, asking the nurses and orderlies to do procedures for her, blaming colleagues for her own constant mistakes, frequently sighing and rolling her eyes in response to Claire and Andrew's requests and charming her way out of trouble. Claire has little respect for Liz. Their new boss, medical consultant Dr. Sarah Hudson (Selina Cadell
), reprimands Claire for frightening Liz with her open contempt: however, Hudson also later confronts Liz over the latter's habit of blaming mistakes on colleagues. Towards the end of the series Claire describes Liz as "mad". Liz eventually breaks down at the end of a very long shift and smashes her bleep to pieces, and Andrew breaks into her room to find her crying and screaming at the broken pieces.
Turner's position becomes less secure. Dr. Hudson assures Claire that Turner's neglect of his duties at the hospital in favour of his private practice has not gone unnoticed. Soon an audit into consultants' attendance begins but the junior doctors quickly find that Turner, as head of the consultant's committee, was forewarned. When Turner advises Andrew to attempt the insertion of a temporary pacemaker
even though he has only seen it done once, Andrew has to call Claire in. Claire and Andrew make sure the hospital knows that Claire had to come in, off duty and slightly drunk, due to Turner's negligence. Tennant soon has to unofficially caution Turner about his approach to his duties. Phil, now a surgical house officer and facing continual taunting from his new boss Mr. Adrian DeVries (Jack Fortune) about his supposed incompetence, begins to aggressively suggest to Turner that he should be the one facing manslaughter charges over the Series 2 chemotherapy death. Docherty decides to stand against Turner as head of the consultants' committee. Phil confesses the story to Docherty and Docherty brokers a deal with the hospital in which records of the accident are lost and Phil cannot be charged, in return for Turner being removed as head of the committee.
There are continuing public scandals about patient care at the hospital. The hospital has written letters to all patients cared for by James warning them of their possible HIV exposure. The outrage of the patients places further pressure on James to resign. Sister Jackie Landers (Ellen Thomas
) speaks on television about bad patient care and is severely reprimanded by Tennant. However, soon Staff Nurse Julie Novac (Jacquetta May
) makes similar comments to reporters, and Tennant ends up suspended over her remarks: it is revealed that she is Tennant's estranged wife and that he has protected her to his own cost. After being reinstated following Phil's exoneration, Tennant attempts to have Julie's new partner, Scissors Smedley, fired over procedural errors he committed when casualty was understaffed, and fails to protect James from false accusations of child abuse. When Julie finds out both that Scissors had not told her about Tennant's manipulations, and that he had failed to confide in her that his neglect of the drink driver was due to his own wife's death in a similar accident, she breaks up with him.
James's HIV infection also has an impact on Andrew. Andrew has begun an affair with Staff Nurse Caroline Richards (Jayne MacKenzie), whom he dated briefly in Series 1. Caroline's ex-lover Luke was also a partner of James's and Luke has tested positive for HIV, leaving Caroline at risk and Andrew needing to explain to his wife why he might have an infection. After Caroline tests negative, Andrew repeatedly refuses to leave his wife, and Caroline eventually leaves him. At the end of series she reveals to him that she is pregnant.
Towards the end of the series, Adrian DeVries's son, Steven, with whom he had been forming a relationship following the break-up of his marriage to the boy's mother, is brought in seriously injured after being hit by a car. DeVries and his team do their utmost to save Steven's life, but sadly to no avail. DeVries is left in tears.
In the last episode of the series, Liz is in a psychiatric ward following a suicide attempt. Another psychiatric patient is roaming the hospital pretending to be a locum and murdering patients with drug overdoses. He breaks into Liz's room while Andrew is visiting her, and stabs Andrew with a needle containing insulin
. Raj rescues Andrew and the casualty team, assisted by the newly reunited Claire and Scissors, attempt to treat him. The series closes with the team carrying a convulsing
Andrew towards a resuscitation room.
Cardiac Arrest is stark in its portrayal of racist attitudes, which are depicted as endemic throughout the health service. In one episode, an Indian locum
who is clearly incompetent is assumed to be so, not because of his deeds, but because he is Indian. In Series 3, Raj is not chosen for a GP
training scheme to Docherty's surprise: DeVries calmly reveals that doctors with "foreign" names are never chosen.
Raj is often shown arguing with his mother on the telephone about his arranged marriage.
. Raj and James — who is actually a bisexual man with many male partners — have a "babe alert" system whereby they page other male doctors to come and ogle attractive female patients admitted to casualty. When Claire suggests to a female nurse that she would support a sexual harassment case that the nurse could make against James, the nurse replies that she would lose her job over it.
Andrew is rapidly seen as being the most put-upon person in the hospital. Nurses will not flush venous lines: Andrew must do it. Porters will not transport blood specimens: Andrew must do it. Every menial job seems to default to him, and he rapidly runs out of patience. After three days of continuous duty, Andrew is speaking to a patient's family, breaking bad news. One male relative stands up to Andrew in a threatening manner and says "What sort of doctor are you? You couldn't even be bothered to shave before you came to work today!"
Early in the first series Mr. Docherty is portrayed as pleasant and cheerful, but also bumbling and incompetent, frequently requiring to be rescued by Monica. He often loses his way in the middle of a sentence. His characterisation changes slowly as the series progresses. Both of the younger surgical consultants, Bettencourt and DeVries, are portrayed as aggressive bullies. Dr. Yates is portrayed as a sympathetic character and Dr. Hudson is portrayed as a no-nonsense yet scrupulously fair character.
In Series 2 and 3 Tennant is primarily interested in protecting his own job, and that of his ally Dr. Turner, and in improving hospital metrics such as outpatient waiting times, rather than improving working conditions for staff, or care for patients.
Many nurses have suggestive nicknames, such as "Nurse White-Coat" (Joyce Falconer
), so called because she would apparently sleep with "anyone in a white coat".
or even M*A*S*H), Cardiac Arrest portrays junior hospital medicine as an unending parade of sexual adventure for the staff, partly because longer term relationships are placed under enormous stress by their working hours. Very few characters are in stable relationships. In the first series, among the junior doctors only Monica is married. Later, even this relationship breaks down, and Monica eventually takes her own life. By the second series, Andrew is married but shortly begins an affair with his old girlfriend Caroline. Claire has relationships with several of the surgeons: Simon Bettencourt, Cyril Smedley and Adrian DeVries.
practices in medical training when Bettencourt tries to defend his treatment of Monica by saying that he went through a similar process.
Junior medicine is portrayed as a school of hard knocks, where junior doctors achieve success and skill over the corpses of their mistakes. They achieve promotions and status by underhand means. No-one is supportive to anyone else's problems.
. They had envisaged creating a sitcom set in a hospital, but when Jed Mecurio responded to their advertisement for a writer the show became a portrait of the NHS from the perspective of junior doctors. It was filmed on location at Ruchill
Hospital in Glasgow
.
, black comedy
and soap opera
.
however complained that it portrayed nurses as witless and callous. Virginia Bottomley
, the Health Secretary
at the time of airing, described it as closer to a Carry On
film than a drama. During the height of the controversy Jed Mercurio wrote a letter to the newsletter accompanying the British Medical Journal
claiming that most of his criticism came from "retired old consultants", but says he has since decided that much of the controversy was a media creation.
Creator Jed Mercurio later went on to devise another controversial medical drama for the BBC in 2004: Bodies
.
Injokes
The names of wards in the fictional hospital follow a theme of killer doctors and anatomical terms for skin around the genitals. Killer doctor ward names include 'Crippen
' (the ward that the bulk of the drama centres around), 'Lecter
' and 'Mengele
' Ward. 'Dartos' (name of skin sac around the testicles) and 'Frenulum' (skin that attaches the penis to the body) are also ward names mentioned.
Cameo
Jed Mercurio the creator and writer of Cardiac Arrest also is credited as a technical advisor in the first series and stars briefly in a cameo in series 3 where he plays a friend of Raj's called Baz.
World Productions
World Productions is a British television production company, founded in the early 1990s by acclaimed producer Tony Garnett. The company's first major series was the police drama Between The Lines , and throughout the decade they went on to produce a succession of highly successful drama series...
for BBC One
BBC One
BBC One is the flagship television channel of the British Broadcasting Corporation in the United Kingdom. It was launched on 2 November 1936 as the BBC Television Service, and was the world's first regular television service with a high level of image resolution...
and first broadcast between 1994 and 1996. The series was controversial due to its depiction of doctors, nurses, and the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
.
Creation
The series was created by Jed MercurioJed Mercurio
Jed Mercurio is a British author; TV and film producer and medical doctor-Biography:Jed Mercurio is a British writer who also writes under the name John MacUre. He created the television series Cardiac Arrest and Bodies and the sci-fi miniseries Invasion: Earth...
(writing under the pseudonym
Pseudonym
A pseudonym is a name that a person assumes for a particular purpose and that differs from his or her original orthonym...
John MacUre), a former junior doctor who had worked at a hospital in Wolverhampton
Wolverhampton
Wolverhampton is a city and metropolitan borough in the West Midlands, England. For Eurostat purposes Walsall and Wolverhampton is a NUTS 3 region and is one of five boroughs or unitary districts that comprise the "West Midlands" NUTS 2 region...
, who drew on his own personal experiences to provide a more visceral, albeit wryly humorous, look at the NHS
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
in the 1990s. At the time of airing, Mercurio was still working as a doctor.
There was an episode due to be shown on 12 May 1994, however this was replaced with an extended 9 o'clock news programme due to the sudden death of Labour leader John Smith
John Smith (UK politician)
John Smith was a British Labour Party politician who served as Leader of the Labour Party from July 1992 until his sudden death from a heart attack in May 1994...
, who ironically died from a heart attack. (A "heart attack" and a "cardiac arrest" aren't the same thing. A "heart attack", or myocardial infarction, happens when there is an interruption of blood supply to cardiac tissue through the coronary arteries, resulting in death of cardiac tissue. Depending on the location and extent of damage, this may, or may not, cause a cardiac arrest. Conversely, a "cardiac arrest" can have causes other than a myocardial infarction - such as an arrythmia. )
Series 1
Series 1 follows events in two separate wards of the same hospital, one medical and one surgical, largely through the eyes of junior doctors. Series 1 has six episodes and was originally broadcast between 21 April 1994 and 2 June 1994.The main protagonist is Dr. Andrew Collin (Andrew Lancel
Andrew Lancel
Andrew Lancel is an English actor. He is best known for his current role as Frank Foster in the long-running ITV soap opera Coronation Street, and formerly in his role as DI Neil Manson in The Bill.-Biography:...
), an idealistic junior doctor, straight from medical school, and a devout Christian
Christian
A Christian is a person who adheres to Christianity, an Abrahamic, monotheistic religion based on the life and teachings of Jesus of Nazareth as recorded in the Canonical gospels and the letters of the New Testament...
. The series opens on his first day at work as a house officer
Pre-registration house officer
Pre-registration house officer , often known as a houseman or house officer, was until 2005 the only job open to medical graduates in the United Kingdom who had just passed their final examinations at medical school and had received their medical degrees.Newly-qualified doctors are only allowed...
, and in his first scene he proudly admires himself in his white coat, before coming onto the ward, and meeting his new colleague, the frosty but competent SHO
Senior house officer
A senior house officer is a junior doctor undergoing training within a certain speciality in the British National Health Service or in the Republic of Ireland. SHOs are supervised by consultants and registrars, who oversee their training and are their designated clinical supervisors...
Dr. Claire Maitland (Helen Baxendale
Helen Baxendale
Helen Victoria Baxendale is an English actress of stage and television, possibly best-known for her roles in Cold Feet, Friends and Cardiac Arrest.-Early life:...
). Andrew is soon aware that he has almost no idea how to be a doctor. The series follows him in his first few months as a doctor, as he deals with one crisis after another and is increasingly disillusioned with the indifferent care given to patients and the expectations of junior doctors. At one point during the first series, he is required to work a 3 day and 3 night shift on call. Claire, who is more cynical and detached, both explains the realities of medical work to Andrew and tries to shield him from the worst abuses.
Claire has the second largest role in series 1. Although her defence mechanisms are generally better than Andrew's and the series seldom shows her as either exhausted or depressed, she claims to Andrew (after euthanising
Euthanasia
Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering....
a patient with an overdose of painkillers) that the emotional demands of being a doctor are just as hard on her. Although Claire is normally frosty, the series reveals that this is her professional mask: she quickly becomes friends with Andrew and eventually takes his side in a conflict against her own lover (Bettencourt). In one episode she plays warmly with the young daughter of a friend. In the final episode of the series this girl is brought into the hospital with a chest injury and dies due to the incompetence of another doctor. Afterwards Andrew finds Claire crying in the nurses' office.
Other characters feature prominently in the series, including Dr. Rajesh Rajah, (Ahsen Bhatti), a pleasant but incompetent house officer in a surgical ward, who is struggling to avoid an arranged marriage whilst indulging in as many sexual relationships as possible. Dr. Monica Broome (Pooky Quesnel
Pooky Quesnel
Joanna Quesnel, known professionally as Pooky Quesnel, is an English actress, screenwriter and singer.-Background:Quesnel was raised in Eccles, Lancashire, along with her six siblings. She read English at Oxford University before spending a year at drama school...
) is a surgical SHO and a new mother, who is desperately trying to hold down her demanding job and pass her fellowship exam, despite constant bullying and sexual harassment by her boss, the villainous Mr. Simon Bettencourt (Danny Webb
Danny Webb (actor)
Danny Webb is a British television and film actor. He may be best known for his role as the prisoner Morse in Alien 3. He has appeared in many famous British television programmes including The Young Indiana Jones Chronicles, Emmerdale Farm, Our Friends in the North, A Touch of Frost, Agatha...
). At the end of the series, Monica fails her fellowship exam, and after her husband takes her children away from her to live with his mother in law, she takes her own life
Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
. While this has a major impact on Raj and on the consultant surgeon Mr. Ernest Docherty (Tom Watson
Tom Watson (actor)
Tom Watson was a Scottish-born stage, television and film actor.- Early life :Thomas Welsh Watson was born on the 21 March 1932 at Auchinleck, Ayrshire, Scotland. His family subsequently moving to Cambuslang, Lanarkshire, he attended the Hamilton Academy school where he excelled in amateur dramatics...
), Bettencourt defends his behaviour unreservedly and shows no remorse.
Series 2
In series 2 the viewpoint of the series expands to the administrative level, with the demands for effiency by the administration shown to directly and indirectly lead to a number of needless deaths. Series 2 has eight episodes and was originally broadcast between 19 April 1995 and 7 June 1995.At the beginning of series 2, Andrew has just returned to the hospital and is now an SHO. To his chagrin, the consultant physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
Dr. Graham Turner (Michael MacKenzie) has a far better relationship with the new house officer Dr. Phil Kirkby (Andrew Clover), whose father went to school with Graham, than he ever did with Andrew. Phil, despite his recent graduation, is a confident aggressive doctor whose faults contrast with Andrew's in the first series. Rather than being nervous and uncertain, in the first days he attempts diagnoses and treatments for which he is undertrained.
Claire remains an SHO, but her skills and academic performance mean that the hospital is shown to be careful not to drive her off to work elsewhere. She is also working under the far more committed and friendly consultant Dr. Barry Yates (Fred Pearson). She has a brief relationship with the new surgical registrar Mr. Cyril "Scissors" Smedley (Peter O'Brien).
At the organisational level a new hospital administrator, Paul Tennant (Nicholas Palliser), demands ever more efficiency from the medical staff, placing Andrew on ear nose and throat
Otolaryngology
Otolaryngology or ENT is the branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders....
(ENT) duties even though he has no training in the required skills, and instructing Claire to abandon extended resuscitation
Cardiopulmonary resuscitation
Cardiopulmonary resuscitation is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive...
of a hypothermia
Hypothermia
Hypothermia is a condition in which core temperature drops below the required temperature for normal metabolism and body functions which is defined as . Body temperature is usually maintained near a constant level of through biologic homeostasis or thermoregulation...
patient in order to fulfil her clinic duties. While Claire is covering for Andrew one night in Casualty, a haemophiliac man is brought in with a nosebleed and bleeds to death because Claire is not trained in ENT, no trained staff are available and she cannot stop the bleeding. Claire exposes the systemic failures in the hospital to the media and although this is within her rights as a doctor, she is fired on an unrelated technicality. Claire returns to the hospital as a registrar
Specialist registrar
A Specialist Registrar or SpR is a doctor in the United Kingdom and Republic of Ireland who is receiving advanced training in a specialist field of medicine in order eventually to become a consultant...
at the end of the series, after resuscitating a heart attack victim in a pub and being reminded of why she chose to be a doctor.
The hospital soon attracts additional adverse publicity when the anaesthetist
Anesthesiologist
An anesthesiologist or anaesthetist is a physician trained in anesthesia and peri-operative medicine....
Dr. James Mortimer (Jo Dow
Jonathan Dow
Jonathan Dow is a British actor. He joined the National Youth Theatre at the age of 14, and after finishing his A levels he trained at the Guildhall Drama School. His first big television role was as Under Secretary Tim in No Job for a Lady with Penelope Keith.He has also appeared as P.C....
) is diagnosed with AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
following the discovery that he has HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
and a Kaposi's sarcoma
Kaposi's sarcoma
Kaposi's sarcoma is a tumor caused by Human herpesvirus 8 , also known as Kaposi's sarcoma-associated herpesvirus . It was originally described by Moritz Kaposi , a Hungarian dermatologist practicing at the University of Vienna in 1872. It became more widely known as one of the AIDS defining...
. James is permitted to continue to work as his speciality does not put patients at risk. Some of the staff, particularly Raj, are sympathetic or actively supportive of James. However, the diagnosis is almost immediately leaked to the media by an unidentified party, another scandal ensues, and manager Tennant pressures James to take leave of absence. However, the payout over the death of the haemophilia patient means that the hospital cannot afford for Mr. Docherty to take his planned retirement, and Docherty demands that the pressure on James to take leave or resign be withdrawn in return for his remaining at the hospital.
The second major medical error in the series contrasts Turner's treatment of his junior staff with Docherty's protection of James. At the end of the second last episode of the series, Running On Vapours, Phil is attempting to draw up chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
doses for a patient on the evening of Christmas Day despite being untrained. He cannot contact a pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...
, consults with Andrew, who is also untrained in the matter, and finally rings a drunken Dr. Turner at home, who advises him to draw up the treatment. Phil gets the dose wrong and the patient dies of anaphylactic shock
Anaphylaxis
Anaphylaxis is defined as "a serious allergic reaction that is rapid in onset and may cause death". It typically results in a number of symptoms including throat swelling, an itchy rash, and low blood pressure...
. Turner and Tennant both advise Phil to take full blame for the incident and to deny that he sought Turner's opinion, and assure him that in return he will not suffer damage to his career. Phil does so, but the inquest returns a finding of unlawful killing
Unlawful killing
In English law unlawful killing is a verdict that can be returned by an inquest in England and Wales when someone has been killed by one or several unknown persons. The verdict means that the killing was done without lawful excuse and in breach of criminal law. This includes murder, manslaughter,...
and refers it for a possible manslaughter
Manslaughter
Manslaughter is a legal term for the killing of a human being, in a manner considered by law as less culpable than murder. The distinction between murder and manslaughter is said to have first been made by the Ancient Athenian lawmaker Dracon in the 7th century BC.The law generally differentiates...
prosecution.
Series 3
Series 3 has thirteen episodes and was originally broadcast between 2 April 1996 and 25 June 1996. In the third series there is more focus on the patients and the doctors' extended interactions with them. Claire has a friendly relationship with a regular dialysisDialysis
In medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure...
patient and as a result, pursues families of accident victims about organ donation
Organ donation
Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient in need of a transplantation. Transplantable organs and tissues are removed in a surgical procedure following a determination, based on the donor's medical and...
. Raj becomes affected by the diagnosis of a baby severely injured by shaking
Shaken baby syndrome
Shaken baby syndrome is a triad of medical symptoms: subdural hematoma, retinal hemorrhage, and brain swelling from which doctors, consistent with current medical understanding, infer child abuse caused by intentional shaking...
and Scissors operates unsuccessfully on a woman injured by a drunk driver and attempts to kill the driver by neglect.
In series 3, the hospital has another new house officer, Dr. Liz Reid (Caroline Trowbridge). Liz is different from both Andrew and Phil: she is shown to be not answering pages, leaving work in the middle of the day for errands, asking the nurses and orderlies to do procedures for her, blaming colleagues for her own constant mistakes, frequently sighing and rolling her eyes in response to Claire and Andrew's requests and charming her way out of trouble. Claire has little respect for Liz. Their new boss, medical consultant Dr. Sarah Hudson (Selina Cadell
Selina Cadell
Selina Cadell is an English actress. She is the sister of the late actor Simon Cadell and granddaughter of the actress Jean Cadell.....
), reprimands Claire for frightening Liz with her open contempt: however, Hudson also later confronts Liz over the latter's habit of blaming mistakes on colleagues. Towards the end of the series Claire describes Liz as "mad". Liz eventually breaks down at the end of a very long shift and smashes her bleep to pieces, and Andrew breaks into her room to find her crying and screaming at the broken pieces.
Turner's position becomes less secure. Dr. Hudson assures Claire that Turner's neglect of his duties at the hospital in favour of his private practice has not gone unnoticed. Soon an audit into consultants' attendance begins but the junior doctors quickly find that Turner, as head of the consultant's committee, was forewarned. When Turner advises Andrew to attempt the insertion of a temporary pacemaker
Pacemaker
An artificial pacemaker is a medical device that uses electrical impulses to regulate the beating of the heart.Pacemaker may also refer to:-Medicine:...
even though he has only seen it done once, Andrew has to call Claire in. Claire and Andrew make sure the hospital knows that Claire had to come in, off duty and slightly drunk, due to Turner's negligence. Tennant soon has to unofficially caution Turner about his approach to his duties. Phil, now a surgical house officer and facing continual taunting from his new boss Mr. Adrian DeVries (Jack Fortune) about his supposed incompetence, begins to aggressively suggest to Turner that he should be the one facing manslaughter charges over the Series 2 chemotherapy death. Docherty decides to stand against Turner as head of the consultants' committee. Phil confesses the story to Docherty and Docherty brokers a deal with the hospital in which records of the accident are lost and Phil cannot be charged, in return for Turner being removed as head of the committee.
There are continuing public scandals about patient care at the hospital. The hospital has written letters to all patients cared for by James warning them of their possible HIV exposure. The outrage of the patients places further pressure on James to resign. Sister Jackie Landers (Ellen Thomas
Ellen Thomas
Ellen Thomas is an American activist who has been the primary support person for the vigil in front of the White House against nuclear weapons for over a decade. She first became involved with the vigil on April 13, 1984. The daughter of a U.S. Marine, Thomas grew up in California and became...
) speaks on television about bad patient care and is severely reprimanded by Tennant. However, soon Staff Nurse Julie Novac (Jacquetta May
Jacquetta May
Jacquetta May is a British actress, writer and theatre director.The Kent born actress worked in theatre for ten years after leaving Bristol University, with one short television role as a vengeful wife in the ITV police drama The Bill...
) makes similar comments to reporters, and Tennant ends up suspended over her remarks: it is revealed that she is Tennant's estranged wife and that he has protected her to his own cost. After being reinstated following Phil's exoneration, Tennant attempts to have Julie's new partner, Scissors Smedley, fired over procedural errors he committed when casualty was understaffed, and fails to protect James from false accusations of child abuse. When Julie finds out both that Scissors had not told her about Tennant's manipulations, and that he had failed to confide in her that his neglect of the drink driver was due to his own wife's death in a similar accident, she breaks up with him.
James's HIV infection also has an impact on Andrew. Andrew has begun an affair with Staff Nurse Caroline Richards (Jayne MacKenzie), whom he dated briefly in Series 1. Caroline's ex-lover Luke was also a partner of James's and Luke has tested positive for HIV, leaving Caroline at risk and Andrew needing to explain to his wife why he might have an infection. After Caroline tests negative, Andrew repeatedly refuses to leave his wife, and Caroline eventually leaves him. At the end of series she reveals to him that she is pregnant.
Towards the end of the series, Adrian DeVries's son, Steven, with whom he had been forming a relationship following the break-up of his marriage to the boy's mother, is brought in seriously injured after being hit by a car. DeVries and his team do their utmost to save Steven's life, but sadly to no avail. DeVries is left in tears.
In the last episode of the series, Liz is in a psychiatric ward following a suicide attempt. Another psychiatric patient is roaming the hospital pretending to be a locum and murdering patients with drug overdoses. He breaks into Liz's room while Andrew is visiting her, and stabs Andrew with a needle containing insulin
Insulin
Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....
. Raj rescues Andrew and the casualty team, assisted by the newly reunited Claire and Scissors, attempt to treat him. The series closes with the team carrying a convulsing
Convulsion
A convulsion is a medical condition where body muscles contract and relax rapidly and repeatedly, resulting in an uncontrolled shaking of the body. Because a convulsion is often a symptom of an epileptic seizure, the term convulsion is sometimes used as a synonym for seizure...
Andrew towards a resuscitation room.
Themes
Although billed as a comedy, and darkly humorous in many respects, Cardiac Arrest explores several disturbing themes. It demolishes many cherished concepts of healthcare one after the other, and throws political correctness out of the window. It attracted complaints from many quarters during its airing, although (predictably) enjoyed huge support amongst junior doctors.Racism
- Andrew: "Mrs. Singh doesn't speak any English."
- Claire: "Then screw her. I'm not a frigging vet." (smiles at Mrs. Singh and exits)
Cardiac Arrest is stark in its portrayal of racist attitudes, which are depicted as endemic throughout the health service. In one episode, an Indian locum
Locum
Locum, short for the Latin phrase locum tenens , is a person who temporarily fulfills the duties of another. For example, a locum doctor is a doctor who works in the place of the regular doctor when that doctor is absent, or when a hospital/practice is short-staffed...
who is clearly incompetent is assumed to be so, not because of his deeds, but because he is Indian. In Series 3, Raj is not chosen for a GP
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...
training scheme to Docherty's surprise: DeVries calmly reveals that doctors with "foreign" names are never chosen.
Raj is often shown arguing with his mother on the telephone about his arranged marriage.
Sexism
Female patients and staff are portrayed as subject to continual sexual harassmentSexual harassment
Sexual harassment, is intimidation, bullying or coercion of a sexual nature, or the unwelcome or inappropriate promise of rewards in exchange for sexual favors. In some contexts or circumstances, sexual harassment is illegal. It includes a range of behavior from seemingly mild transgressions and...
. Raj and James — who is actually a bisexual man with many male partners — have a "babe alert" system whereby they page other male doctors to come and ogle attractive female patients admitted to casualty. When Claire suggests to a female nurse that she would support a sexual harassment case that the nurse could make against James, the nurse replies that she would lose her job over it.
Homophobia
When the media reveals that James has AIDS, Raj is sympathetic and unsurprised by the revelation of James's sexuality, saying merely that he assumes James acquired HIV via "unprotected sex with an infected woman... or man." He then goes on to explain that he has known for some time and knows that James had to be secretive given the pervasive homophobia of the medical system and community. James is later falsely accused of child abuse after a man who recognised him from media coverage of his infection sees him feeling for a pulse in his son's leg. The father is openly and aggressively homophobic.Junior doctors
In an early scene, we see several junior doctors smoking in the doctors office, and Claire commenting that soon someone will say it gives you cancer. This is just one scene where doctors are depicted as acting very far from their cherished public persona.Andrew is rapidly seen as being the most put-upon person in the hospital. Nurses will not flush venous lines: Andrew must do it. Porters will not transport blood specimens: Andrew must do it. Every menial job seems to default to him, and he rapidly runs out of patience. After three days of continuous duty, Andrew is speaking to a patient's family, breaking bad news. One male relative stands up to Andrew in a threatening manner and says "What sort of doctor are you? You couldn't even be bothered to shave before you came to work today!"
Consultants
Andrew's consultant, Dr. Turner, at first seems friendly and approachable. However, he never appears on the ward, leaving the treatment of patients to Claire. We see him chatting on the telephone about his golf fixtures. Later he attempts to persuade (an exhausted and desperate) Andrew to forego his holiday, bribing him with a good reference for his next job. Finally, he attempts to have Phil take the blame for a medical error that kills a patient.Early in the first series Mr. Docherty is portrayed as pleasant and cheerful, but also bumbling and incompetent, frequently requiring to be rescued by Monica. He often loses his way in the middle of a sentence. His characterisation changes slowly as the series progresses. Both of the younger surgical consultants, Bettencourt and DeVries, are portrayed as aggressive bullies. Dr. Yates is portrayed as a sympathetic character and Dr. Hudson is portrayed as a no-nonsense yet scrupulously fair character.
Managers
Managers are portrayed with considerable venom. The Series 1 hospital manager is portrayed as uncaring and dismissive, even of Andrew's most desperate complaints of abuse:- Manager: "Your contract states that in emergencies you are expected to come to work."
- Andrew: "I fail to see how a holiday I booked six weeks ago can be called an emergency!"
- Manager: "Hospital managers are accustomed to the disaffection of junior medical staff."
In Series 2 and 3 Tennant is primarily interested in protecting his own job, and that of his ally Dr. Turner, and in improving hospital metrics such as outpatient waiting times, rather than improving working conditions for staff, or care for patients.
Nurses
In Series 1, nurses attract perhaps the cruellest depiction of all. Instead of saintly angels cooling the fevered brow, nurses are frequently shown as gossiping, conniving women, chatting at the nurses' station while ill patients languish without attention, or Andrew fumbles around, hopelessly busy and in great need of assistance. In Series 2 and 3 senior nurses become participants in storylines and are treated with less caricature.Many nurses have suggestive nicknames, such as "Nurse White-Coat" (Joyce Falconer
Joyce Falconer
Joyce Falconer, born in 1969, was raised in a housing scheme in Torry, which is across the River Dee from Aberdeen fish market. Educated at Tullos Primary and Torry Academy where her natural talents for performing and music were encouraged....
), so called because she would apparently sleep with "anyone in a white coat".
Medical ethos
In common with other medical dramas, (such as The House of GodThe House of God
The House of God is a satirical novel by Samuel Shem , published in 1978. It portrays the psychological harm done to medical interns during the course of medical internship in the early 1970s.-Storyline:...
or even M*A*S*H), Cardiac Arrest portrays junior hospital medicine as an unending parade of sexual adventure for the staff, partly because longer term relationships are placed under enormous stress by their working hours. Very few characters are in stable relationships. In the first series, among the junior doctors only Monica is married. Later, even this relationship breaks down, and Monica eventually takes her own life. By the second series, Andrew is married but shortly begins an affair with his old girlfriend Caroline. Claire has relationships with several of the surgeons: Simon Bettencourt, Cyril Smedley and Adrian DeVries.
Training
The series is extremely critical of medical training. Claire and Mr. Docherty, both sympathetic characters, repeatedly discuss in detail that medical training is unduly demanding of junior doctors and that both the knowledge and training needed are increasing without recognition or appropriate supervision. At the end of the first series Docherty directly addresses the question of hazingHazing
Hazing is a term used to describe various ritual and other activities involving harassment, abuse or humiliation used as a way of initiating a person into a group....
practices in medical training when Bettencourt tries to defend his treatment of Monica by saying that he went through a similar process.
Junior medicine is portrayed as a school of hard knocks, where junior doctors achieve success and skill over the corpses of their mistakes. They achieve promotions and status by underhand means. No-one is supportive to anyone else's problems.
Production
Cardiac Arrest was produced by Island WorldIsland World
Island World was a film company formed in 1988. They originally produced anime, but then over the years made live action films. It shut down in 1995 after producing The Cure.-Films:*Dominion Tank Police*Chôjin densetsu Urotsukidôji...
. They had envisaged creating a sitcom set in a hospital, but when Jed Mecurio responded to their advertisement for a writer the show became a portrait of the NHS from the perspective of junior doctors. It was filmed on location at Ruchill
Ruchill
Ruchill is a district in the city of Glasgow. It lies within the Canal Ward of North Glasgow in the area between the Maryhill and Possilpark areas of the city. It has traditionally been characterised by a high degree of deprivation and social problems...
Hospital in Glasgow
Glasgow
Glasgow is the largest city in Scotland and third most populous in the United Kingdom. The city is situated on the River Clyde in the country's west central lowlands...
.
Critical
Critics note that the comparatively short first series is uneven in tone, partly because it attempts to span three genres: dramaDrama
Drama is the specific mode of fiction represented in performance. The term comes from a Greek word meaning "action" , which is derived from "to do","to act" . The enactment of drama in theatre, performed by actors on a stage before an audience, presupposes collaborative modes of production and a...
, black comedy
Black comedy
A black comedy, or dark comedy, is a comic work that employs black humor or gallows humor. The definition of black humor is problematic; it has been argued that it corresponds to the earlier concept of gallows humor; and that, as humor has been defined since Freud as a comedic act that anesthetizes...
and soap opera
Soap opera
A soap opera, sometimes called "soap" for short, is an ongoing, episodic work of dramatic fiction presented in serial format on radio or as television programming. The name soap opera stems from the original dramatic serials broadcast on radio that had soap manufacturers, such as Procter & Gamble,...
.
Medical community
Doctors were reported as finding the series to be representative of life in an NHS hospital. In a 1999 survey of British doctors' attitude to television depiction of their profession, 15% of doctors voted for Claire Maitland as the fictional doctor they would most like to be compared with. When the series had not yet been released on DVD, an online forum for doctors ran a campaign for its release. The Royal College of NursingRoyal College of Nursing
The Royal College of Nursing is a union membership organisation with over 395,000 members in the United Kingdom. It was founded in 1916, receiving its Royal Charter in 1928, Queen Elizabeth II is the patron...
however complained that it portrayed nurses as witless and callous. Virginia Bottomley
Virginia Bottomley
Virginia Bottomley, Baroness Bottomley of Nettlestone, PC, DL is a British Conservative Party politician. She was a Member of Parliament in the House of Commons from 1984 to 2005. She was raised to the peerage in 2005...
, the Health Secretary
Health Secretary
Health secretary can refer to:*The Cabinet Secretary for Health and Wellbeing, Scotland*The Secretary of State for Health, United Kingdom...
at the time of airing, described it as closer to a Carry On
Carry On films
The Carry On films are a series of low-budget British comedy films, directed by Gerald Thomas and produced by Peter Rogers. They are an energetic mix of parody, farce, slapstick and double entendres....
film than a drama. During the height of the controversy Jed Mercurio wrote a letter to the newsletter accompanying the British Medical Journal
British Medical Journal
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...
claiming that most of his criticism came from "retired old consultants", but says he has since decided that much of the controversy was a media creation.
Followup
The complete series was released as a 5-disc DVD set, Cardiac Arrest: The Complete Collection, on 16 April 2007. The DVD contains all three series, but no extras such as commentary.Creator Jed Mercurio later went on to devise another controversial medical drama for the BBC in 2004: Bodies
Bodies (TV series)
Bodies is a BAFTA-nominated British television medical drama produced by Hat Trick Productions for the BBC. Created by Jed Mercurio, the series began in 2004 and is based on his book Bodies. The first series debuted on BBC Three as the channel at this time was trying to break out into hour-long...
.
Injokes
The names of wards in the fictional hospital follow a theme of killer doctors and anatomical terms for skin around the genitals. Killer doctor ward names include 'Crippen
Hawley Harvey Crippen
Hawley Harvey Crippen , usually known as Dr. Crippen, was an American homeopathic physician hanged in Pentonville Prison, London, on November 23, 1910, for the murder of his wife, Cora Henrietta Crippen...
' (the ward that the bulk of the drama centres around), 'Lecter
Hannibal Lecter
Hannibal Lecter M.D. is a fictional character in a series of horror novels by Thomas Harris and in the films adapted from them.Lecter was introduced in the 1981 thriller novel Red Dragon as a brilliant psychiatrist and cannibalistic serial killer...
' and 'Mengele
Josef Mengele
Josef Rudolf Mengele , also known as the Angel of Death was a German SS officer and a physician in the Nazi concentration camp Auschwitz-Birkenau. He earned doctorates in anthropology from Munich University and in medicine from Frankfurt University...
' Ward. 'Dartos' (name of skin sac around the testicles) and 'Frenulum' (skin that attaches the penis to the body) are also ward names mentioned.
Cameo
Jed Mercurio the creator and writer of Cardiac Arrest also is credited as a technical advisor in the first series and stars briefly in a cameo in series 3 where he plays a friend of Raj's called Baz.