ICW: Grace Ofori-Attah, showrunner for Malpractice

Coming tomorrow night on ITV1 and ITVX is a brand new series called Malpractice. Set in a hospital, it explores how quickly things can change in the high pressure environment of A&E, and just how hard it can be to be a doctor when things are at their most explosive. Last month I got to watch episode one, and sit down with the showrunner - writer and producer - Grace Ofori-Attah, who is also a fully qualified doctor, to discuss the show.

Brianna (TBP)
Congrats on the show! Weird to start at the end but the scream I screamed at the end of episode 1…what a cliffhanger. The tension built to it perfectly, I’d love to know, how did this idea develop? Did you say “I want to write a medical drama” and go from there, did you have moments that you built a world around? 

Grace Ofori-Attah
My first screenplay I ever wrote was a medical drama. It wasn’t as much a thriller as this one is, but it was a medical drama. And actually I did pull a few of the ideas in this one from that. So there’s one conspiracy that will be revealed in later episodes, so I can't say, but I ran a few of my ideas past Simon at World and yeah, he really liked them so we went from there.

Brianna (TBP)
It's amazing. I think I say quite a lot that BBC and ITV particularly are really good at this kind of drama. But actually, I don't think that's necessarily the full story. They're really good at finding really great writers. How much kind of of your own experience as a doctor did you pull on to, to write this?

Grace Ofori-Attah
So it's heavily influenced by my experience. I was the same level as Ramya when I did my A&E rotation, the character Ramya. And the shooting - well not a shooting, but the gunshot victim that comes in at the beginning, that's based on an experience that I had, when I worked in A&E. There wasn't a gunman waving a gun, but someone came in, dragging a bloodied body and the victim had been shot. And we had to rush them through to resus open up the chest, and it was all very stressful. We didn't have, or I don't know a doctor who is an equivalent of Lucinda, she's a mixture of the various roles that I've been through and various doctors that I've met whilst I've worked. Yeah. And a lot of the experiences she has are based on real things. So a lot of the procedures are procedures that I found the most horrifying.

Brianna (TBP)
Well, I was gonna say there's a series on YouTube, I don't know if you've ever seen it, where it's a it's a doctor, he's an American doctor that watches medical dramas, and basically just reacts in horror at how horrendous the medical scenes are in these dramas. I want to know, do you feel like that when you watch them? And do you think other doctors are going to like, breathe a little sigh of relief when they watch this?

Grace Ofori-Attah
I hope so. I mean, yes, that definitely is a kind of eye roll that happens when you watch some medical procedures on TV. A particular bugbear for people is the chest compressions because it's often like people just very gently pressing, and we know that you need to be - often you use enough force that you break a ribcage. That's the kind of force that happens when you're doing chest compressions. So yeah, we we spent a lot of time trying to get them as medically accurate as possible. Niamh and Phil were brilliant with that. And I sat down with Niamh, went through every medical procedure with her. The nights or evenings before she would film them, we'd go over them again, she had an Oxford medical dictionary that she bought very early on in the process. And she was really brilliant at learning the words and also not just learning the words but wanting to know, why does the doctor do that? Why are you cutting there? What are you trying to achieve with that? Because she is very visual and understanding what the kind of procedures are for and about helps her. I think she's, yeah, she does a really good job feeling like a real senior doctor.

Brianna (TBP)
She does! I think that's so impressive that she put that amount of attention to detail in to making sure she comes across very convincing. Like I've been in and out of hospitals my entire life with chronic illness. So she - I could walk into A&E tomorrow and she could be there like she was really

Grace Ofori-Attah
She’d inspire confidence. Exactly.

Brianna (TBP)
How involved did you get to be in that kind of casting process? Did you get any sort of say in who became the characters that you'd written?

Grace Ofori-Attah
Yeah. So I - anyone that they were looking at or shortlisting, they would always check with me whether they were the appropriate age, you know, for that level of doctor because that was really important. And, yeah, like we did, I was involved in casting decisions, which is really nice. Yeah, really nice. Yeah.

Brianna (TBP)
It's obviously a really difficult time right now for the NHS and doctors in general. And this is obviously a dramatisation like it's, it's over the top. It's very dramatic. But I do think it still does a really wonderful job of kind of explaining to people how much pressure you can be under when you're working in A&E, when you're working in a hospital in general. What do you hope that other doctors that watch this might take away from it and also just general audiences might take away from it.

Grace Ofori-Attah
So I think for me as a doctor watching it, I would want other doctors to take away that there are versions on TV of their jobs that are realistic, that you can see the pressure that they're under, you can understand the pressure. I don't think there are many medical shows that really cover what it's like to be investigated. And whilst you're still working and that process, just being there in the background, and, you know, you're meant to just be carrying on and doing your job. So I hope doctors watching feel heard. I mean that sounds, yeah, cliche. But yeah, but it's a really authentic representation of a junior doctors experience. And I hope audiences who are watching it, think, Oh, my God, I didn't realise it was that bad. I knew it could be bad, or it could be busy and pressured. But I didn't realise it was that bad. That's what I would love for people who are watching it, to realise and whilst it is a drama, a lot of the stuff in there is real. You know, if anything when I was, you know, we'd be on site, I'd say to Phil, we need more patients in the background, we need people on trolleys we need, you know, it needs to look busier, it needs to look more stressful actually. When you're watching it I think people find it quite stressful as it is!

Brianna (TBP)
I literally felt I was like, Oh, my God, why is my heart like racing, like, calm down B it's just television.

Grace Ofori-Attah
Yeah, it's just a regular day in the office.

Brianna (TBP)
So what made you decide that you wanted to write, because obviously, being a doctor, you're making a huge difference in people's lives. So why the change.

Grace Ofori-Attah
So I have always written like, since I was a little child, all my family would receive really probably quite boring short stories I’d written and forced on people. But I wanted - I've always loved writing. And I think as a doctor, there are more similarities between medicine and writing than are immediately obvious. I think you deal in medicine, in people's stories you try, it's detective work. You get given a set of circumstances, and then you're trying to figure out why is this happening? What caused it and then you want to try and find the solution and conclusion to that story for them. And they're often very dramatic stories. It's the worst moment of someone's life, and you're there trying to fix that for them. In medicine, I have also realised the power of arts and, you know, patients will come into a clinic and you’ll have been telling them, please, please take this drug, it will really help your blood pressure or whatever. And then their favourite actor on EastEnders, you know, the character has had a stroke or something, and they're like, Oh, my God, I need that medication you are talking about. So there is a power that the arts have to speak to people. And I mean, not that I only write so that I can get promotional health lectures out there, but I think the desire to get messages out there that can change lives or influence lives is the thing that doctors, yeah, doctors do. And I think you can probably reach a lot more people in a medical therapeutic sense through TV and Film.

Brianna (TBP)
Thank you. So my final question, slightly separate to the show, but it's something I asked everyone is what does being Black mean to you?

Grace Ofori-Attah
Oh my gosh. In the context of TV writing, or just generally?

Brianna (TBP)
Just however you want to interpret the question.

Grace Ofori-Attah
What does it mean it to me? I mean, it's my identity. It is, like my every waking experience. And yeah, it's a huge part of the way I view the world and the way the world views me.

Brianna (TBP)
And then, in terms of in TV, and in film, and in writing, how has it kind of shaped the stories that you want to tell?

Grace Ofori-Attah
Um, I think - how did it shape the stories - I mean a very personal feeling about being a black woman is that I think we are often at the bottom of the social pile, and there are low expectations. I felt that at medical school, I felt that as a doctor, I felt that every time I had to go to see a patient, I had to brace myself for their reaction to me and some inevitable questions about my education and my background. And I think that in writing, I want to address some of that. I think in Malpractice, I mean, I had some discussions about whether I wanted the role of Lucinda to be a black female doctor. But for me, that's a whole other story. I couldn't have a Black Lucinda, who has the storyline that we have, and it not be due to the colour of her skin. So I think being a black female doctor, in hospitals in the UK is a very specific story and not one that I - not to say that this is a trivial story, because it's dramatic and heightened, but that's a different story. So it's one I probably will eventually tell, but it's not, it’s not this story. I think it's yeah, I mean, that goes into all sorts of reasons as to why I left medicine and why I do writing instead. But then also, I think, in the TV industry, there are, there are their own issues. I think, as a female black writer, I think I'm probably - and you might know more so than me - only the third show runner, like person who has written and created their own show, Black female in the history of TV in this country.

Brianna (TBP)
Yeah. I think that's correct. Yeah.

Grace Ofori-Attah
Michaela Coel, Abby Ajayi , and she had to go to LA and Marcus Shonda Rhimes. She was in her own show, which seems insane. And then I think me, and that's, I think that's it. I don't know that there are any others. And I definitely felt in this process that people would doubt my ability to write my own show. I felt like I would, you know, and it's, and it's not to do with me or to do it. Well, it's just it's an inherent thing. It's like, Are you sure you can write your own show? So I'm really proud that I wrote all the episodes myself. Are you sure you can produce your own show? I'm like, I dunno, I'm gonna try. But once the doubt is voiced, it makes you feel like oh, gosh, I can't do that. It's like an extra hurdle. So yeah, I think being a Black woman definitely influences everything I do.

Brianna (TBP)
Thank you for sharing that. And you know what? Anyone that tries to doubt you from now on, they got no legs to stand on. Because this is bloody brilliant. And I cannot wait to watch the rest of it. It's so good. You've done such an amazing job. So yeah. Thank you for your time and enjoy the rest of this. Like soak it all in. I know it can be a little bit overwhelming, but it's your baby and you did it and people love it. So congratulations!