by Paul Hayes

Casualty, series twenty-two, episode "Sex and Death", BBC1, Saturday 9^th February 2008, 8.35-9.25pm

When did Casualty suddenly become good again?

I hadn’t watched an episode of the BBC’s venerable old doc-drama warhorse since I reviewed an episode for a column last March. That was the Comic Relief special, co-written by Richard Curtis, and I can’t say that I was overly impressed.

I had intended not to review two different episodes from the same programme in this little series of internet missives for as long as possible, but it calls to the unlikely candidate of Casualty to be the first series to enjoy such a dubious honour simply through the sheer quality of the fifty minutes of television its producers presented to us last Saturday.

Yes, I honestly feel that "Sex and Death" may be one of the best episodes of the regular British drama series that has been broadcast in the last five years.

I am not, as you will have gathered, a regular viewer of Casualty, but this episode was built up as an ‘event’ in the Radio Times preview, who seemed to think it was something a bit special. I flipped over out of interest during the adverts in something else I was watching on Saturday, and it did seem to be at least an interesting storyline, so earlier this week I sat myself down at the computer and downloaded the show via the BBC iPlayer. And I am very glad indeed that I did.

For those of us who haven’t been following the series, there was a handy recap at the beginning to bring everything up to speed – Ruth is a young, newly-qualified doctor working in the A&E department (sorry ‘ED’ is what they’re calling it these days. Bah!) at Holby. She’s stressed and overworked and hard on herself and has had family problems, and finally this all mounted up on her until she was found hanging in the cliffhanger to last week’s episode.

Which is where we come in here – although not immediately, writer Mark Catley leaves a pause, not showing us the full drama of desperate colleagues cutting her down and attempting to revive her, probably for the best. Instead, we leap forward to see the department’s consultant, Harry, reading Ruth’s diary. How and why he managed to get hold of this, never mind the moral and ethical points of his reading of it, are matters which are completely ignored by the episode. But I can live with that – this is, after all, about Ruth and what led up to her decision to hang herself, not everything that came before it.

Harry is the latest in a long line of Casualty consultants who all come from broadly the same mould – middle-aged man, sometimes stern, sometimes concerned and fatherly, sometimes allowing their stuffiness to get in the way of effective interpersonal relations and staff management. Even for someone who hadn’t watched an episode of Casualty for ten or twenty years, the familiar characters types are all present – young gobby nurses, patient female doctors, and the buddy-buddy paramedic team. The only thing missing is Charlie, who evidently finally buggered off for good back at Christmas without so much as a buy-your-leave.

That said, it is a different series in one distinctive factor – the look. After years of – barring an unsuccessful experiment back in 1993 – being one of the last video-look prime time drama series, Casualty sometime in 2007 finally went all progressive on us. Literally. It’s not shot in film-look HD, something that takes a bit of getting used to for an old-school Casualty viewer. It’s still a bit cheap and cheerful – you’d never think for a moment it was film, and it doesn’t even look as good as the filmised SD video of Doctor Who – but it definitely gives it a very different visual feel. Not worse than the old video look, necessarily, but different.

However, it’s not the cameras or the clever video processing software that make a show decent – it’s the script, and this one was a cracker. Ruth’s story is told in flashback as Harry reads through the pages of her diary, with few interruptions into the world of her shocked colleagues, post-hanging. There are a few scenes in a pub that seem to serve mainly to keep the ongoing storylines of the personal lives of the other characters simmering away, and some unnecessary comedy bollocks with the two paramedics – the only real mis-step of the script – but for the most part this is Ruth’s story.

It always sounds terribly crass when someone compares a half-decent one-off episode of something like EastEnders or Casualty to "a modern Play for Today", but that is the most tempting description to use. The main group of supporting characters introduced to us through Ruth’s diary are mostly, as far as I can tell, one-offs introduced for this episode. Ruth’s hidden life, which her colleagues knew nothing about, and which of course is the main point of the episode – they didn’t know her at all. They couldn’t help her. They didn’t see the side she kept hidden.

But you can’t hide much in a busy casualty department, so Catley’s script cleverly takes Ruth out of the main ferment of her working life and into interludes both above and below. Below is Histology, looking through microscopes down in the Holby basement, where she by chance comes to befriend the little den of sadly stereotypical but kindly geeks who live down there, and who become the closest thing she ever seems to possess to a group of friends.

Above is a patient upstairs on a cancer ward, a doctor herself, whom Ruth befriends after accidentally just blithely handing over her unfortunate test results to her, not having realised she was the patient. (The doctor in this case, incidentally, is Caroline Lamngrishe, who must have a whole slew of portraits up in the attic – she’s better preserved than the HMS Victory).

So Ruth’s life, her sad, trying-too-hard, desperate for acceptance existence weaves its way between these two escape routes from the trials and tribulations of A&E (yeah, I know), although we do get some flashbacks to what I think are clips from previous episodes of her working in the department. While you can criticise Ruth for some of her thinking – why did she think ‘Dr Doom’ was coming onto her, for goodness sake? – overall you just become incredibly sad for her and everything she’s had to take. If the pressures she’s under are any kind of real reflection of what genuine young doctors face – and I suspect they are – then it makes you wonder why there isn’t more rage and indignation at the state we have reduced these vital people to in this country of ours.

But the wheels keep turning. The show goes on – even Ruth goes on, as seen at the conclusion of the episode, although it’s not clear if she has a genuine chance of survival or whether she is being kept alive for organ donation or something of that kind. It’s surprisingly emotional, especially for someone who didn’t know the character at all before coming to this episode, and I find myself really hoping that they did get to her in time, and that she does recover.

And you know what? I think I’m going to watch the next episode, to find out what happens, and to see if they can maintain anything like this quality. And that’s not something I’ve thought about Casualty for a very long time indeed.