Dr Semmelweis is a remarkable theatrical event

Playwright Stephen Brown, actor Sir Mark Rylance and director, Tom Morris have collaborated to deliver a remarkable theatrical event. To call Dr Semmelweis a play would be a misdescription. An oversimplification. Underselling a momentous evening which blended words, music and dance.

The drama about the nineteenth century Hungarian doctor, Ignaz Semmelweis, whose research into bacterial infection offered the potential for saving, literally, millions of mothers then dying needlessly in maternity wards was intensely moving.

I will start with the music, as it was surprisingly neglected in the programme and has been little referred to in other comment pieces I have read. Adrian Sutton is the composer. The Olivier Award-winning Sutton is no stranger to stage musical accompaniment. He wrote the atmospheric score for War Horse. An ideal choice for Semmelweis.

He relied on Schubert’s Death and the Maiden string quartet as his score’s foundation. Written in 1824 when Schubert already knew he was dying, this was a brilliant, poignant choice of Sutton’s for a play about premature, unnecessary death. 

As an accompaniment to the choreography by Antonia Franceschi, of Balanchine’s New York City Ballet, whose dancers represented the spirits of mother who had died needlessly, it provided swooping, tender musical passages to accompany their interactions with the characters. 

The Salome quartet, accompanied by two solo violins, a viola, and a cello, moved stealthily around the stage and auditorium enhancing the intense emotions of the dancers, some writhing in death throes. No punches pulled. 

But there is more to it than that. The courage of Sutton’s choice of Schubert’s valedictory work is remarkable. Two years ago, he was diagnosed with incurable cancer. At the time he wrote, “A devastating flash flood recently swept away the pleasant landscape of my imagined future: an incurable cancer diagnosis. Bastard.” 

Since receiving the life-altering news, Sutton has embarked on an almost-orgy of creation. On June 28, he produced a full concert of his music, titled Seize the Day, including a twenty-five-minute violin concerto – a nagging ambition – which he embarked on post-diagnosis. He has certainly seized the day with his Semmelweis score. 

The ballet sequences in Semmelweis are remarkable interludes, sweeping all the characters together, representing “joy, grief, sorrow, empathy and hope – for starters”, in Franceschi’s own words. I have never thought of the words, “dance” and “Rylance” at the same moment, but he gamely threw himself into the choreography when frequently required. Sutton’s contribution in bringing these deep sentiments to musical life cannot be overstated.

“There is a word of fear that I shall pronounce when I utter the name of Puerperal Fever, for there is almost no acute disease that is more terrible than this”. So wrote Charles Delucena Meigs, Professor of Midwifery and the Diseases of Women and Children, Jefferson Medical College, 1851. The scourge of post partem fatalities depriving the new-born of their mothers knew no national boundaries. It was treated as an unavoidable phenomenon.

Until, that is Ignaz Semmelweis, a talented Hungarian physician working in Vienna where he was looked down upon for being Hungarian, cottoned on to the fact that the death rate in maternity wards run by doctors who also worked on cadavers was far higher than that in the ward run by midwives, who didn’t. With a flash of insight, Semmelweis realised that the doctors had “something” on their hands which was killing their patients.

Wash your hands and the bedclothes and death rates would plummet. This play is about the struggles he faced to overcome the orthodoxy that claimed a set of new windows in the doctors’ ward recommended by some moribund commission would do the trick. 

And about the inferior status of women, seen by the nineteenth century European establishment as being fit only to bring up children and care for their husbands. Midwives were tolerated. The idea of women being doctors was laughable.

Rylance, who has an eye for spotting unlikely heroes, fingered Semmelweis as a play-worthy character and in discussions with director, Tom Morris it became clear that the bone-headedness of the nineteenth century rang true today. This could be the tale of a medical hero resonating down the ages. 

The playwright, Stephen Brown, ensured that it is. He has delivered a taught drama which flows from Semmelweis’ complex character and frequent inability to contain his emotions. Brown has a penchant for getting inside the heads of difficult characters. Future Me, 2007, dramatised the prison treatment of a lawyer convicted of sexual offences. In 2017, Occupational Hazards, told the tale of Rory Stewart’s experiences as a senior coalition official in Iraq. 

Delivering anything from the quicksilver Stewart is an occupational hazard. The twenty-first century Stewart of Arabia, Cumbria, London Mayoral candidacy and Tory leadership aspiration is a tough pin-down. But Brown seems to have reined him in, at least for a short period of coherence. 

Semmelweis took us on a journey from aggrieved clinician, slighted academic, despairing husband and father, rude observer of royalty, on to the tipping point of sanity. The evening never had a dull moment. Brown had given Rylance a sufficient supply of ironical one-liners, passed on, in confidence, to the audience, to leaven the sense of tragedy of his character’s final failure.

Covid proved that the twenty-first century is no stranger to wildly conflicting medical opinions. The need for regular, extensive headline-grabbing public inquiries into the all too frequent failings of hospitals, suppliers of blood and deliverers of care to the vulnerable – naming but a few – remind us that any smug complacency in observing the plight of the nineteenth century Dr Semmelweis confronting Puerperal Fever is misplaced.

That is why this is truly a play for today. There are probably Dr Semmelweis’s in every health care system. They might not behave as dramatically as Mark Rylance, but we are in debt to the honoured actor for making his point so well. May Dr Semmelweis’s everywhere take courage.

Rylance, his fellow cast members, and the whole team responsible for this astonishing work sent their sell-out audiences home to think afresh. Which, I think, was the whole point. Whatever will Sir Mark Rylance think of next?

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