In The Sick of It: Medical mayhem and a call from the frontline to save our health service

CAN two actors singlehandedly save the healthcare system? This is the question being asked by Ballymoney-born playwright Adam McGuigan in his latest show, In the Sick of It, which is currently doing the rounds at this year’s Edinburgh Fringe Festival.

The show continues on from Adam’s previous project, In Our Own Words, which was initiated by Dr Sue Gibbons and saw him and co-creator Kemi Coker working with clinical psychologists in three London NHS trusts and four care homes.

“I’d been working in London with the Whittington Health Trust, mostly with cancer patients,” explains Adam, who won an Innovation Excellence award from Macmillan for his work.

“We would interview them about their experience of receiving treatment in the hospital and then perform it back to people who might be able to empathise or get something from it.

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“But then Covid happened and all of our face-to-face stuff stopped, so the team asked if I would come in and do the same thing but with staff.

“I came into the hospital in April 2020 and started doing interviews and having conversations with staff. It was just very powerful to hear how porters, cleaners and all these people who were still going out into the community whenever everybody else was told to stay at home were coping.

“Hearing and acknowledging their stories felt very important.”

However, this is not the first time Adam, has used theatre to connect and inform people.

“After drama school I ended up living in Zambia for 10 years,” says the now artistic director of Wake The Beast Theatre company.

“I set up a theatre company called Barefeet which helped young people living on the streets get involved with drama, theatre, music, acrobatics - the arts in general, really.

“I’ve always had an interest in using theatre as a way of engaging people who might not have had the opportunity otherwise.”

More than 500 verbatim interviews with NHS and social care staff form the basis of the new performance, which aims to highlight both their exhaustion and defiance in relation to the struggling healthcare system.

As a result of these interviews the piece is able to explore the deeper issues affecting those working in the health service such as the deployment of staff onto intensive care wards with little advance notice or training, having to deal with the pressure from additional caseloads and feeling burnt-out.

“People get very upset because it’s very moving but it’s also encouraging,” says Adam. “There’s a sense of togetherness and reassurance because people start to realise they aren’t facing theses stresses alone.”

The show also highlights different coping mechanisms, from wellness sessions and listening to the Fresh Prince of Bel Air on repeat to the palliative care nurses who every Friday at 5pm host the ‘last chance saloon’ in their office where they have a commemorative drink together.

“It all sounds very serious but there’s so much humour and that dark, gallows humour that people had really came through,” explains Adam. “The human spirit is amazing and that’s something we’ve really tried to incorporate into the piece.”

“It makes people smile because people are able to recognise themselves or their colleagues in that ability to persevere and to bounce back, and although that’s unfortunately a necessity when working in healthcare it’s also very inspiring.”

Adam and Kemi, who star in the show, have been documenting the experience of healthcare workers for the last four-and-a-half years and in 2023 took the performance to the Houses of Parliament after the support for staff wellbeing was cut.

“We were trying to advocate for staff wellbeing because although there’s humour in the stories they’re also hard hitting,” says Adam.

“That’s when we thought we’d maybe reached the end of the journey especially because in the beginning nobody wanted to put their name to it.

“But somewhere along the way that’s totally changed and what we’ve been hearing over the last few months are things like, ‘I wish my sister or husband or daughter could see this’, because we were able to present it in a way that was fun but also showing the real situation as well.”

It was this reaction that encouraged the duo to take the show to the Fringe.

“We took the notion that instead of going through the process of trying to get programmed in a theatre or where we would tour we thought we could do it quickly at the Edinburgh festival, try and galvanise a big audience and amplify these stories and help spread the word.”

It’s important to note that the focus is not just on the pandemic or the testimonies of doctors and nurses but also healthcare staff working places such as prisons or the wheelchair service.

“I never thought about the wheelchair service. I didn’t even really know what they did or just how important that was for people,” Adam confesses.

We ask loads of the staff, ‘What are things that you think members of the public could do?’ and number one is be nice when you go to A&E or the doctors and things don’t work out – it’s not the staff’s fault, it’s systemic, so by shouting at people or being abusive it’s making staff retainment more precarious

—  Adam McGuigan

The production aims to paint a bigger picture of a service that had been underfunded, under-resourced and under water long before 2020.

“Wes Streeting, the health secretary just said that the NHS is broken so what we’re doing feels more relevant than ever,” he adds.

“We’re working with the British Psychological Society’s campaign to advocate for mental health and wellbeing support for social care and NHS staff, so it’s part of a bigger campaign.”

He hopes the performance will also inspire both patients and the public to be more mindful when it comes to how they treat healthcare workers.

“We ask loads of the staff, ‘What are things that you think members of the public could do?’ and number one is be nice when you go to A&E or the doctors and things don’t work out – it’s not the staff’s fault, it’s systemic, so by shouting at people or being abusive it’s making staff retainment more precarious,” says Adam.

“If people want to get more involved they could write to MPs and other representatives and keep abreast with what’s going on but there’s a whole spectrum in between.

“We don’t want to leave people without hope or with the idea that there’s nothing we can do, the lovely invitation at the end is that we can all be part of the solution and the conversation.

Although he admits that realistically it is impossible for two actors to singlehandedly save the NHS, he hopes In The Sick Of It goes some way in helping us appreciate it more.

“I also think it’s important to remind people that there is an amazing service from birth to death that is free,” says Adam. “We’re so lucky and we don’t know what’ve got and when it’s gone it’s going to be gone.

“It feels very important to put a spotlight on the people who are doing so much but also to say that the onus is on us because if we let it go it’ll be very hard to get back again.”