In a way I was annoyed that I already knew the general premise of the recent Netflix film, The Good Nurse.

But that’s the catch-22 of film promotion, I guess. How do you know what you want to watch until you have a sense of what it’s about? I think my ideal scenario is to employ a minion who knows me and my obsessions well, and then his/her job is to watch everything and then give me a run down of what I should get into – without telling me anything about their plots etc. Contact me to apply for the post; remuneration minimal, if not aspirational. Hey ho.

Anyway, to The Good Nurse. It’s a simple plot (despite all I said, spoilers inevitable I’m afraid; watch the movie before reading on) and it’s (essentially) a true story. It’s a gripping film but not the greatest film. The two leads give remarkable performances: perfect casting, both sympathetic in different ways, Eddie Redmayne (as Charlie Cullen) particularly good at keeping just the right side of creepy. It is nuanced enough to convey:

  • BOTH why people are incredulous about suspicions he is up to something untoward; he has moments of genuine kindness and care, not least for Jessica Chastain’s character (Amy), although these are certainly conflicted. He evidently needs advocates and supporters, so one might dismiss these relationships as groomed and manipulated for his own protection. That’s certainly there in the performance too, but it’s too facile and convenient to dismiss him as a thoroughbred monster.
  • AND why some might have suspicions about him in the first place. There is something a little off, a social angularity, perhaps, a rather irritating, nasally drawl. But perhaps his angularity is simply why he does a vocational job in ICU, doing night shifts. Perhaps it’s where he’s best suited and happiest.

Passing The Buck

This is the point of the film, in the end. We discover that Redmayne’s character has worked previously in perhaps 8 or 9 hospitals from which he was quietly fired and moved on after questions started being raised about his behaviour. The problem was constantly shifted somewhere else. And indeed, he gets fired from the current job on the pathetic basis that there were discrepancies in his application form. It is a reflection on the state of USA healthcare that hospitals’ primary concern is always money and lawsuits rather than any dangers faced by future patients. It did make me grateful for the NHS to say the least – where the scenario of going from institution to institution is much less likely (although there have certainly been some horrific cases within individual places, like Harold Shipman and allegedly Lucy Letby).

It took Amy’s dogged determination and righteous indignation to ensure everything came to light (even though the potential risks she faced were vast, not to mention the challenge of countering the impediments thrown down by hospital management).

But I have found myself chewing on a several creative decisions made for the film (dir. by Tobias Lindholm, co-writer of the brilliant Danish political show Borgen), the accumulation of which made it incredibly affecting and effective.

  • Muted colour palette: even though we’re not constantly on the IC unit nightshift, its lighting and colours seep out into every scene. We rarely see or experience sunshine.
  • Muted sound world: if you have ever visited an ICU, the calmness is one of the first things to strike you. Of course this gets interrupted by sudden bursts of intense activity in emergencies. But most of the time, it is a world of lowered voices, quiet busyness and the odd bleeps and movements of machines. This is true of the movie too. If memory serves (and I’ve not checked, because it is revealing even if I’m wrong), there is little music and there are perhaps only 3 times when someone raises their voice. So each time it happens, it is genuinely shocking. Each indicates a key plot development.

The overwhelming tone therefore is various types control: self-control (the need for nurses to suppress their own needs for the sake of their care, but more negatively in Redmayne’s character in order to protect himself); social control (to get away with things, Cullen must exercise some degree control over his working environment); medical control (eg managing patient symptoms, checks on drug regimes etc); corporate control (the sinister presence of hospital lawyers). The grim irony being that in the end, that the systems designed to protect patients primarily end up only protecting the management.

A Few Observations

Why mention all this?

  • Cullen was good at his job. Amy gradually relied on him because he was a good nurse. This meant that countless people, the majority even, had only positive experiences of his care (Amy included). This prompts reflection on the Myth of Homogeneity: the difficulty that whistleblowers have when reporting on somebody who is widely loved or respected. So often, people assume that if I have a good experience of someone, then everyone must do. So survivors don’t get believed. Simple as that.
  • Cullen’s horrors were invisible and ingeniously concealed. It’s no accident that his tool of choice was a clear liquid. Very hard to spot, even harder to prove. Those with suspicions faced insurmountable hurdles to show that there was anything to investigate. Move along everybody; nothing to see here; move along, please.
  • We never get simplistic explanations for what Cullen did. In fact, we don’t really get anything. Presumably that’s because the real Cullen never has. The film drops a few hints (eg something to do with his mother, inevitably!), but they’re speculative. And the script has Cullen say at the end that he did what he did ‘because nobody stopped me.’ Which, of course, is no explanation at all. This is no bad thing. The film doesn’t give easy answers.
  • Truth was too dangerous and unpalatable to pursue, especially because it might bring ruin and even institutional collapse. Think of what an extraordinary ecosystem that a hospital is: the vast workforce, the suppliers and contractors, the economic benefits for whole neighbourhoods, and that’s before you consider the incredible stories of restorative or palliative care. Is it worth risking all of that just to tell the truth about some rogue actor or bad apple? No – we’ll shuffle him/her off the field of action; let it be somebody else’s problem.

If the cap fits...?

Does any of this sound at all familiar?

There are differences, undoubtedly. But I’ve heard of several cases where people who have been investigated for abuses (strenuously denied) and been shuffled off, or resigned pre-emptively. But they then get jobs in other churches!! I do believe in redemption. I do believe in reconciliation. I do believe in forgiveness.

But I also know that these are all incredibly hard. And that for them to be even remotely authentic and real, there must at the very least be deep engagement with what survivors say. What

I also know is that this can NEVER be the mealy-mouthed, PR-spun, statements that get offered to dismiss or belittle others’ concerns. Even when a presbytery nods an appointment through, or a bishop renews someone’s licence…

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