I’m going to hospital a lot at the moment,” an elderly woman sitting next to me confided during the interval of Nina Raine’s needle-sharp play about the NHS. “It makes you a bit worried, doesn’t it?” Though I didn’t say it, yes, actually, it does.

First staged at Hampstead in 2011, now rewritten and revived in a production that’s again directed by Raine herself, Tiger Country is enough to drain the colour from the face of anyone braving the palpitating heart of our health-care system. Instances of mishaps, oversights, staff shortages, deficient equipment, defective temperaments and deaths abound, as it tries to evoke hospital-life with a more probing quest for the truth than you get on soaps like Holby City and Casualty.

That’s not to say that it ends up resembling a dossier of damning evidence or the sort of exposé that would grace a front-page. Firstly, it allows considerable room for passing comedy; and secondly, Raine, who has researched the subject first-hand, in detail, is interested in underlying structures not the sort of pre-fab clichés that invite political point-scoring.

She alights on the paradox that the NHS functions better by admitting that it’s fallible; and that the best way of caring for patients might lie in learning not to care too much or the human cost is too great.

The emphasis throughout is on the staff and how they come to terms with this disillusioning state of affairs. Patients, slabs of meat to surgeons, figure in mainly non-naturalistic ways, conjured by our imaginations when the medics, dressed in surgical kit, gather round trolleys and perform tense, tightly drilled procedures.

The 14-strong cast serve the fast-trundling script with unflinching dedication, hustling and bustling in and out of a mock-up hospital environment that ranges the audience on either side as if at an old operating theatre.

Indira Varma stands out as the single, sexless and driven urology registrar Vashti, slowly winning your admiration as her reserve starts to make sense as a means of self-preservation. Her counterpoint is Ruth Everett’s Emily, a newcomer to the world of A&E, who knows gut-instincts are good, but can’t then stop her emotions from spilling out – engulfing her relationship with her charming, level-headed medic boyfriend James.

A shot of gloom for the festive period? Yes, but while this NHS check-up isn’t the jolliest show in town, it flaunts the fact that Hampstead is now in rude good health.

It’s the first day in A&E for Emily, a junior doctor. “You’re new,” a colleague notes. “You’re still worrying about people dying.” Everything Emily encounters chips away at caring: snarling colleagues, unsystematic systems, wonky operating tables and the need to assess the unknowable under impossible pressure. No wonder she’s in danger of “losing patience with the patients”. Nina Raine’s fascinating 2011 play returns in her own forensic, finely choreographed production, which occasionally slides into a woozy dream state: perfect for these sleep-deprived medics. The show is mostly recast, but Lizzie Clachan’s design is still excellent, as is Ruth Everett’s eager-eyed Emily, bobbing about with concern and ambition. Amid the brief scenes and multiple characters, a story about an abrasive surgeon (Indira Varma, her jaw sharp with irritation) reinforces the sense that an NHS running on goodwill and inertia will see its brightest and best walk reluctantly away.

Hampstead Theatre rounds off a highly successful year with this welcome revival of Tiger Country, Nina Raine’s insightful, meticulously researched and deeply engrossing play set in the A&E department of an over-stretched and under-funded NHS hospital. It was a sell-out hit in 2011 and returns, medically updated, in the author’s whirling and balletically well-drilled production.

A crack 14-strong cast evoke the hectic pace and the psychological strains of working in this pressurised environment. “There isn’t enough NHS,” declares one young doctor and, accordingly, there are no limits, he argues, to how far it would exploit its conscience-stricken staff, if the medics were fool enough to let it.

We see how Ruth Everett’s Emily, 24 year old newcomer to the team, gradually loses her idealism to exhaustion and bitter experience of practical limits and bureaucracy. Indira Varma’s ambitious, prickly Vashti comes to resent how, because of the profession’s predominantly public school ethos, she’s felt the need to turn herself into a parody of a white male toff.

I’d remembered the wit and astringency of piece but had forgotten how moving it is – in its sensitive depiction, say, of a doctor forced to confront his own mortality. Strongly recommended.

 

The idealistic junior doctor; the lazy, curmudgeonly nurse; the beautiful, snippy registrar. They’re familiar characters, stepping regularly across striplit wards in Casualty and Holby City, but brought to fully realised life in this superb play, written and directed by Nina Raine.

First seen at Hampstead in 2011, Raine’s play is a remarkable exercise in verisimilitude. Across a couple of hours, via a versatile in-the-round set and some canny visual effects courtesy of designers Lizzie Clachan and Neil Austin, we are niftily transported from the theatre to a London NHS hospital.

The action passes in a series of quick-fire vignettes, punctuated by bursts of choreographed movement. These are not only practical in function, facilitating the rotation of props, but they also underpin the play’s fundamental examination of the hospital as a community where doctors and patients are forced to pull together in the face of exhaustion, dysfunctional bureaucracy and increasingly scant resources.

Raine’s cast, only two of whom were in the original production, is first-rate, fully embodying a set of characters who might so easily have tumbled headfirst into cliche.Indira Varma fully convinces as ice-queen registrar Vashti, and Ruth Everett beautifully conveys the terrible journey from innocence to experience of young doctor Emily, but this is a hugely impressive collective effort. So too is Raine’s grasp of medical procedures and terminology.

There are a few moments in which the issues seem to briefly take precedence over the characters, but this remains a highly authoritative, emotionally intelligent examination of both the best and the worst aspects of our NHS and the people who dedicate their lives to it.

‘Try not to care so much,’ says a senior doctor to a junior one in Nina Raine’s remarkable play ‘Tiger Country’. In a hospital, you’d expect caring must surely be the thing. But the line is actually one of several moments that deftly demonstrate how, in that environment, not caring is the only way to survive.

Raine’s play is a window onto the daily life of UK hospital medical staff. It is partly about the NHS as a whole, but it is mainly about how and why doctors and nurses do what they do, and how easy it is for their jobs to entirely consume their lives.

Set mainly in A&E, the characters and storylines in ‘Tiger Country’ come thick and fast. Though nurses and patients enrich the storylines and provide sub-plot strands, the focus is the doctors. Ruth Everett is excellent as fresh junior Emily who hasn’t yet lost her first patient, while Indira Varma is Vashti, an uptight, frustrated registrar who is trying to counter her male-heavy surroundings by being a super bitch. One doctor has a lump in his neck, another will do whatever he can to get his promotion.

The play is, by turns, very funny, terribly sad and – especially in the moments during surgery – horribly squirm-inducing. Raine also directs this superbly put together revival, staged in-the-round on Hampstead’s main stage. Beds, computers and heart monitors come in and are swiftly wheeled off in a mind-boggling number of complex scene changes. It’s Lizzie Clachan’s sparse, realistic designs that make these work. There are dance routines to pop music during the changes, which lightens the mood and enhances the sense of the mayhem. It’s so fluid that it is genuinely easy to forget that we’re watching a play and not the real thing.

‘Tiger Country’ is a subtle but robust portrait of what modern medicine means. It lays bare the stresses and strains the NHS is under and doesn’t shy away from posing that the institution, and therefore everyone who works within it, is in dire need of some TLC of their own.

Nina Raine’s evocative docu-play, which returns to Hampstead following a highly successful premiere in 2011, is far from the usual festive fare found in theatres up and down the land at this time of year.

In fact, at a time when hospitals are usually at their busiest, it makes for a thoroughly depressing diagnosis of the state of our NHS and its staff, of whom my own wife is one. And its central message, reiterated several times, is a sobering one; that in order to survive in such a high-pressure environment you need to learn to stop caring.

The talented ensemble is precisely choreographed by Raine, who also directs, to ensure that a cross-section of departments and staff get their moment in the spotlight, even if the emotional core is provided primarily by two female doctors.

One is the ideological young Emily (Ruth Everett), who in an especially harrowing scene attempts to resuscitate a young woman of similar age long after she’s died. The other is Vashti (Indira Varma), a driven registrar on the brink of promotion whose faith in her career is tested when her aunt is admitted as a patient.

Other characters of note include a doctor dealing with his own medical dramas (Alastair Mackenzie), a junior surgeon who carries himself like a contestant on The Apprentice (Nick Hendrix) and Emily’s smooth-talking boyfriend (Luke Thompson), who is forced to deliver some home truths when the stress gets too much.

Raine, who has reworked the text for this revival, has clearly done an epic amount of research, and it’s telling that my wife – who has an eagle eye for medical errors in drama – could find very little to fault. In fact she attested to the fact that, as evenings at the theatre go, it felt more like working overtime. Even the title is a very ‘insider’ reference – it’s an area of the brain in which the slightest slip of the scalpel can have serious repercussions.

As Beth Steel did similarly on this stage in Wonderland, which evoked the world of Thatcher-era mining, Raine wants to show us the reality of life at the coalface of modern medicine. And in that she’s entirely successful; this should be compulsory viewing both for medical students and government ministers.