George Bernard Shaw’s 1906 medical ethics drama The Doctor’s Dilemma had a lot to live up to as the last time I was in the Lyttelton at the National Theatre was for the superlative The Last of the Haussmans, one of my favourite plays of the year so far, but though it didn’t quite scale those heights for me, it did emerge as a most satisfying night at the theatre. Shaw’s play centres on the newly ennobled Sir Colenso Ridgeon, a doctor who has discovered a new cure for tuberculosis but only has limited space on his trial. When the beautiful Jennifer Dubedat pleads for the inclusion of her talented artist husband, he is torn as his penniless colleague Dr Blenkinsop is also suffering from the disease and so Ridgeon and his colleagues gather to assess and discuss who is the worthier candidate for treatment.
Peter McKintosh’s set design is an effective triumph and ingenious to the extent that it garnered a round of applause at one point (although it will be slightly less surprising to those that saw this play). It possesses the requisite austere grandeur in all its incarnations of artists’ garrets, Richmond eateries, Bond Street art galleries and Harley Street salons into which Nadia Fall places her talented cast. Genevieve O’Reilly brings a stunning self-possessed statuesque dignity to Jennifer, almost too reserved until the devastating turbulence of the final act reveals all she has been concealing, Tom Burke dances across the stage with a quicksilver lightness as the manipulative Dubedat whose artistic talent has to be weighed against his problematic morals and Aden Gillett (who should always wear a full beard, always) is magnificent as Sir Colenso, pondering the titular dilemma with an aptly detached manner as befits his finely aristocratic bearing.
The world of turn-of-the-century medicine is cleverly elucidated both by Shaw in his writing and by Fall’s clear-sighted production. Malcolm Sinclair, David Calder and Robert Portal make an excellent trio of supporting doctors, the running joke about surgeons is highly illuminating (as well as amusing) in the completely different perceptions of surgery at this time. Derek Hutchinson as the impoverished, virtuous Blenkinsop avoids too much earnestness in his portrayal of a doctor who has to balance the needs of his patients with his own need to survive, raising interesting thoughts about the ethics of profit-making doctoring and there’s a great early cameo from Maggie McCarthy as an all-knowing housekeeper.
I ended up really enjoying The Doctor’s Dilemma, and this was mainly due to the powerhouse that is the fifth and final act, simply drawn but powerfully played, it truly humanises all that has gone before and really contextualises the lofty ethical debate in the effects it has on day-to-day lives. That debate is perhaps sometimes a little overlong but with the NHS being dismantled in front of our very eyes, its central issues of the decisions that have to be made by doctors and the factors that weigh on their mind when the equitable principles of the state service are not present, come into play with a frightening resonance and all the more forcefully for not being lumped into a tiresomely updated version.