Lifeline

Southwark Playhouse Elephant

A beautiful score featuring many uplifting songs. Whilst it informs audiences about the growing concerns about antimicrobial resistance, it doesn't tell them what they can do to help prevent it.

Theatre rarely blends into my work life, and with this show, the two have combined. This will be a deep review.

This review is written by a proud Pharmacy Technician who helps patients understand how to correctly take their medicine every working day. I go above and beyond to ensure that they understand the importance of taking their antibiotics correctly and for the full course, as per the doctor's instructions. This is a part of antimicrobial stewardship (helping to protect antibiotics). As a person who works in the field and with patients every day, I know how important it is that the person you are helping understands the information you are giving and that they don't feel overloaded. It's teamwork. Antibiotics are something I am interested in and feel passionate about protecting and using correctly. Whilst my understanding of microbiology (specifics/study of microorganisms) and pharmacology (how the medicine works) is limited due to where I am in my training and the limitations of my role in pharmacy. I know you are possibly wondering about the relevance of this, and the point is: I do not feel the audience was left with any information about what they can do to prevent antimicrobial resistance, and the blame was placed outside of the healthcare setting, out of the audience's control. I can very passionately say there is so much YOU can do and that the healthcare community can and are doing to help the fight against resistance. So, whilst this is a review, I will also be telling you in an understandable way what you can do to help fight antimicrobial resistance.

Before we go into specifics, this show had a standout cast of actors. Particularly, Jess, who is played by Maz McGinlay. She effortlessly uses her voice to show the struggle of her character and shows great pain and passion. Her character arc is clear, and she clearly understands her character well, the pressure she is under and the sacrifices Jess has made for the sake of her career that wear her down. There is a stunning moment between Jess and Dr Sarah, played by Hannah Visocchi, where they are both having a break, and they share a chocolate bar. This clearly presents the bond that healthcare professionals form through working together for long hours, caring for each other through the pressures of work, mixed with life and what you do to help pick you up. It is a real moment that all healthcare workers can relate to and find so much beauty/positivity in. It was difficult to concentrate on the great theatre elements, as the story was disjointed, moments felt unneeded/disconnected from the story, and the information was lacking. I found myself feeling strongly about some of the opinions shared due to the nature of the subject, but at the end of the day, I think every audience member will receive the information given to them differently.

'Lifeline' is a fantastic concept for a musical because it talks about a real and scary problem in the world of medication. The music and lyrics by Robin Hiley are incredible, uplifting and set the scene. The music has a very folk/Gaelic tone, which is enchanting and infectious. The show is all about antimicrobial resistance, which basically happens when viruses, bacteria, etc., become stronger than antibiotics, and this means that the common antibiotics that we have all used at least once in our lives become ineffective. This is an ongoing area that the NHS have been tackling for a very long time. 'Lifeline' has blended the story of the man who discovered penicillin, Alexander Fleming (the man who ignited my interest in medicine), and a doctor in the present day who faces the sudden sickness of a loved one that develops into a resistant infection. The two stories are played side by side to show how far medicine has come, but also how this worry has always been there. The cast includes a chorus of healthcare professionals who work in different areas of healthcare, whether they are doctors, pharmacists, scientists, or work for pharmaceutical companies. This is a moving choice and builds emotion within the audience. However, whilst the show mentions medical jargon several times, the show is sadly not the most patient-friendly. If anything, it informs the audience of this quite scary problem and then leaves them with the idea that it's going on all around them, and that healthcare professionals, the government, and scientists are dealing with this issue. When the truth is that this is something every single person on this earth can help with. It's as small as giving your leftover, unneeded medication to pharmacies so it can be disposed of properly, finishing your course of antibiotics as directed by a doctor and not stopping when it suits you, investigating your antibiotic allergies to ensure that you are genuinely allergic (this can affect the choices of antibiotics) and learning when antibiotics are needed.

Whilst watching the show, it did not feel that the setting truly captured the pressure and expectations of healthcare staff. The patients were quite easy-going and patient, when the reality of the NHS is that it's busy, time-pressured, filled with patients who want to leave and not always enough staff to meet the number of patients. The audience didn't truly feel that feeling of faces looking at you, expecting help, waiting, and you have no power to give it to them straight away, like you wish you could. The patients have their backs to the audience at times, as it's delivered in a way that is lightly pleading, not time pressured, and needing help. The storyline felt spoon-fed to the audience, when the spoon feeding should have been the information on antibiotics and the terms used. There was more emphasis on the personal lives of the healthcare professional characters than on the patient stories, which is upsetting, because the patients are the most important part of the story. I know you're thinking the main character is a patient, but do we not think that he was given more emphasis and help because the characters had a personal connection to him? On that same note, I am not sure how many of you listened to the moment when the staff were treating him, saying they needed to send him to the ICU and isolate him so no other patients are at risk of being exposed to the resistant bacteria. Remember, some patients are unwell, and their immune systems are low, and their bodies may not be strong enough to fight the pathogens. Can we talk about how none of the staff are wearing masks when treating the patient with a resistant infection, and the doctor, Jess, is in the room with the patient, holding his hand and kissing him and in her scrubs. She is also a paediatric doctor, which means she would go back to work treating sick children in those same clothes when she was exposed. Take your minds back to COVID when people were unable to visit their families in the hospital to ensure no spread, and some people even had to say goodbye to their loved ones over FaceTime. Just imagine how difficult that scene would have been if she were not allowed in the room to spend those moments with him.

In terms of set design by Abby Clarke, the set is minimal, but it does mimic hospital colours

and setting. The bottles on the wall were a great choice in reminding the audience that the show is about medicine and how we are trying to find the right medicine. It's not always the same for every patient, and it's great that they are just plain brown bottles. I was intrigued to see that there was a lactulose oral solution bottle amongst the bottles, and it stood out. I thought this could have been used in part of the story; however, it was not, and its relevance is still unclear. Whilst this may seem picky, it's a commonly used medication that is also available over the counter, so some audience members may pick up on it. Sure, it may be used as part of someone's treatment, I mean, some antibiotics could cause bowel changes. I think I'd have been impressed if it were omeprazole or lanzoprazole, as they are commonly used alongside antibiotics to treat a certain infection. Also, at the end, each healthcare professional one by one introduced themselves and what they do; it was incredible to have people from so many different backgrounds, and some spoke in their own language. However, the translation on the screen behind the cast was tiny and obstructed. Meaning it was hard to see and small, so also difficult for those with a lack of sight. This is an opportunity for the audience to learn something about antimicrobials from the healthcare professionals, but it was so difficult to read translations and an abundance of language was used, that if an audience member has not been in a healthcare setting, they wouldn't understand. This made the end drag and the energy drop. This is information that would be beneficial for it to be put in a free pamphlet for the audience, because if the information is wordy, they will have it on a sheet and not have to remember it, then when they get home, they can look into it. So many great ideas not well executed.

'Lifeline' has an abundance of potential to be something beautiful and life-changing; it's had so much hard work, research and passion put into it. I think from a healthcare professional's point of view, it is easy to spot where things have slipped, and whilst it's well received from those outside of the healthcare realm, seeing a show that has got such a huge range of professionals working on, funding and putting the show together, it's interesting that it lacks 'patient-friendly' language. This was a show that I was excited for and even wanted to be a part of, due to my passion for fighting anti-microbial resistance, my love for Flemming and also since some of the songs were my most listened to on Spotify. It's hard to see such an incredible thing being presented in a way that doesn't give audiences the tools to help tackle the problem, and missing integral bits of information about the healthcare system. I have hope that this show still can be something beautiful. It just needs to be re-visited and looking into what the audience has learnt from watching the show, how it has made them feel about resistance, and their understanding of the story. At the end of the day, there should be more emphasis on the patient stories and journeys, just like in the working environment, that is where you learn the most and what you connect with the most. There is so much love and importance in this show; it's such a great platform to inform and educate, and it needs to be used more wisely, and the most important information is more understandable to all.

I just want to make it clear, I am not by any means an expert in this area, and I am very passionate about this show. Whilst this may seem like a nitpicky review, the things talked about are really important details. It is so important that the audience understands the gravity of the subject, the information given, how they can get involved and not being given something that makes them fearful. We all have a role in fighting antimicrobial resistance, and being educated in a way that is clear for all viewers is so integral. It's such a delicate subject because it affects us all.