What is your background?

I trained as a doctor and specialised in anaesthesia/ITU. After working in the NHS for 8 years I stepped away from clinical practice and worked for a medical defence organisation. Suddenly finding myself in a nine to five job was the catalyst to start thinking about other things in life. I trained as an actor and I’ve juggled a portfolio career ever since- acting, directing and writing alongside working as an anaesthetist in the NHS.

I was at drama school when the pandemic struck. On the Friday I was doing a clown workshop, then on the Sunday I was working a hospital shift in anaesthetics and had to put my hospital’s first Covid patient onto a ventilator in ITU. It was a strange dichotomy. After lockdown, I went back to the NHS full time for a few months and worked in ITU and anaesthetics for the first wave.

As well as being medical adviser I also play Neil in episode one. Breathtaking was a collision of my two worlds in a way that I doubt will ever happen again.

Did you know Dr Rachel Clarke and her book Breathtaking before this came along?

I was aware of Rachel and knew about her social media presence and wider advocacy work but I hadn’t read her books. I don’t tend to read medical memoirs and similar- it’s the same with medical TV dramas, they’re not particularly on my radar. I think it’s the same for a lot of medics.

I fed into some of the early Breathtaking scripts- Rachel, Prasanna Puwanarajah and Jed Mercurio consulted a lot of people in different specialities. They were very authentic which of course reflects the writers’ experiences of working in healthcare. I’ve certainly looked at it all and thought, ‘Well, this has either happened to me or I’ve heard about these events happening to colleagues elsewhere’. It’s all there.

What did your role as lead medical advisor entail?

Essentially the job was to oversee the day-to-day implementation of the scripts in a medical context. I worked with a junior doctor, Dr Andrew Cinnamond, and an ITU nurse to ensure that the machines, the supporting artists, the various bits of medical paraphernalia and the environment were as accurate and realistic as possible. We liaised extensively with the the art department, costume, and hair and make-up.

On top of this we also worked with the cast to get the culture and tone right, because the NHS is so much more than buildings and equipment. We dug deep into the scenes to understand the types of people that work in the NHS, the interactions, the hierarchies between different departments and status. The fine behavioural details are what I hope will make Breathtaking come alive, particularly for the NHS staff watching.

As we moved in post-production, I was involved in advising on the medical elements of the edits, and in the visual effects and sound design. We didn’t leave any element to chance- every bleep sound, telephone ring tone and oxygen hissing was carefully considered and placed.

How did you work with the actors?

We held a medical boot camp before we started filming to do some crash course medicine, clinical skills, patient examinations and to rehearse the complex medical sequences. The cast were sponge-like in wanting to understand all nuances, the hospital environment, the hierarchies and the way people communicate. They were so open to work with and to the tiny tweaks, even on-the-fly between takes where there’s just a few seconds to adjust something. Joanne Froggatt fully immersed herself in the process and towards the end of the shoot was even coming up with bits of ad hoc medical dialogue herself.

There were very few hard and fast “this is how it was” situations. Medicine is like that- there are often a variety of options and nuances in the way a situation might be handled or how a medical sequence might play out.

We had to be careful not to tread on the acting itself or on the director’s notes, but found a space in which to fine tune the medical behaviours, the tone of communication between colleagues or with patients, the way somebody takes off PPE, how they might handle a piece of equipment, how they might make physical contact with a patient. Being an actor myself gave me some shortcuts to finesse these elements. Standing at the monitors, I had moments of looking at the cast and thinking, ‘These people have been doing this a long time.’ They are just fantastic.

Can you tell us about the hospital set and the medical equipment?

Ashleigh Jeffer’s brilliant set was constructed in an old university building in Belfast over three floors, so that we had an Emergency Department, a medical ward and an ITU. We shot almost chronologically, and so construction and design of the ITU was ongoing whilst we were shooting scenes downstairs in the ED. The level of detail was astonishing- scuffed walls, posters, clutter- it was an immersive experience and this allowed the director to shoot long sequences and follow the action through the clinical areas.

We had to source a large amount of technical equipment- ventilators, CPAP machines and monitors- especially for the ITU. And then we had to consider how the actors and supporting artists interacted with that environment in an authentic way. The props department were hugely inventive, for example cutting off tubes and laryngoscopes in order to appear that they were fully inserted, or cutting discreet holes in the tight-fitting CPAP masks so that the actors could breath normally.

The ITU was particularly challenging as it has a huge amount of technical equipment and we needed to allow room for the number of beds and patients to expand over the timeline. Ventilators require pipes, supplies of oxygen, medical air- they are intelligent machines and need a patient to be attached to look like they are working. Of course we couldn’t do this so our medical equipment supplier devised some clever work arounds with hidden make-shift lungs underneath the set.

In Breathtaking the medicine really drives the story and so the monitors have to display some very specific physiology in terms of blood oxygen saturations and waveforms on screens etc. The actors and supporting artists playing patients thankfully weren’t unwell with Covid, but this meant that when attached to our live machines they weren’t going to display the physiology we needed. We brought in the visual effects team to finesse these elements in post production. We were also able to tweak the colour grading to ensure that cyanosed patients (those with low oxygen levels) had the right skin tones.

We wanted the CPR (Cardiopulmonary Resuscitation) sequences to be visceral. In-hospital cardiac arrests can be quite fraught and chest compressions are often not depicted accurately on television. We used a “chest rig” which comprised a sunken bed to allow the actor to lie beneath a protective prosthetic chest and allow us to do CPR. It was very affecting to see it in action.

Did filming bring back memories for you?

The thing that most took me back to the pandemic was putting on PPE (Personal Protective Equipment) again. I play an emergency doctor called Neil in episode one who is involved in the resuscitation of the first Covid patient. It’d been a while since I’d had to put on the full gown, visor and tight-fitting mask- the sensation and the smell of the material was very evocative.

It was really useful to be able to step into the acting side and sense the set and the story in an immersive way. It helped me discover what the cast would need in order to feel in the moment, because it’s never quite the same going through the motions of something medical when fundamentally you know it’s not real.

We see the impact on staff having to wear tight fitting masks for long periods...

Rachel Clarke was keen that the skin damage caused by masks was represented accurately on screen. She liaised in advance with Maria Moore, our hair and make-up designer. There were different levels of PPE skin markings from light pressure and redness, moving on to the more serious damage and skin breakdown. Part of our role was to be very specific about how this translated into the storyline as we moved through the script and people were wearing PPE for longer periods of time.

Breathtaking pays tribute to health care staff who lost their lives. People who went to work knowing Covid could kill them?

Many healthcare staff lost their lives and sadly it was no exception at my hospital. This affected staff greatly- caring for your own adds an additional layer of complexity and responsibility. It’s hard now to cast our minds back to how it felt- we didn’t understand the disease and we were unvaccinated. People dealt with that in different ways and there was a huge amount of anxiety. I think Breathtaking also shows the domestic side of this in both Abbey’s and Ant’s storylines- the stress on family dynamics.

The cast reflects the diverse nature of the NHS...

Breathtaking reflects the very diverse nature of the NHS throughout the country and it’s brilliant to see global majority characters at the forefront of the stories both staff and patients. That’s really important to reflect. We have a huge number of incredibly skilled and passionate people from overseas who come to work in the NHS and have made the UK their home. Whilst the story is set in London, it’s something that we benefit from throughout the country.

Breathtaking reveals the many acts of kindness by NHS staff when dealing with seriously ill and dying patients?

The small acts of kindness are a way of getting some control back in an NHS where it can often feel difficult to influence your day-to-day. They are very beautifully laid out in the script. Those things really do happen in the NHS- it’s often said that the system runs on goodwill and over the years I’ve come to realise that the personalities working within it are the essential glue. We cannot underestimate that- the more it is undermined, eroded or taken for granted I think we are at real risk of losing it.

We got very statistical during the pandemic but Breathtaking distils the numbers into individual stories which illustrate the wider context.

A lot of people found it very challenging after Covid and have since left the NHS. The emotional and mental impact is still here today. The concentration of cases, of very severe clinical situations in a very short space of time, was unprecedented. I’d been a doctor for 15 years at the beginning of the pandemic and I’d seen my fair share of stuff, but it was something else to experience that sudden influx of seriously ill cases, some of which remain with me now and I think about often.

What does it mean to you to have been involved in bringing Breathtaking to the screen?

I’m incredibly grateful to Jed, Prasanna and Rachel for bringing me on board- it’s been a very personally relevant and important project. There’s a huge power in television drama and I’ve just wanted to reflect everything as accurately as possible to do the script and the wider story justice.