It’s been a slow start to the theatre new term: summer runs are being prolonged to save money and new options have been two-star meagre. That has however highlighted the few serious West End productions which have proved durable enough to run into the autumn and Dr Semmelweis at the Harold Pinter Theatre stands out — not least for being the re-telling of a story of Ignaz Semmelweis, a largely forgotten German-Hungarian doctor who systemised antisceptic procedures on maternity wards.

Based on an original idea by Mark Rylance and co-written with Stephen Brown, the result explores the life of a maverick medic overseeing births of poor women in crowded conditions and puzzling over the causes of puerperal fever, rampant killer of so many patients.

he channels the intensity of a dysfunctional outsider, shattering staid certainties as he butts heads with class-conscious, doctor-obsessed Vienna

If it seems blindingly obvious now that “scrubbing up” helps prevent infections, it was far from so at the time. Semmelweis’s method of observing contrasting death rates of two neighbouring maternity wards in Vienna General Hospital to analyse why far fewer women died after “street births’” (giving birth outside the wards rather than risk admission) than in the worst-performing ward would now qualify as “cross-silo” thinking and observational savvy.

Lacking the academic credentials and research base to prove his hypothesis however, he was largely mocked by the “gods in white coats” — until a successive generation of students set about rescuing his reputation. By that time however, his own mental health was in irretrievable decline. If you want to be driven (literally) mad by incompetence, the medical world is a good place to start.

Rylance, is best known for bringing the roistering Rooster Byron to life in Jerusalem. Here too, he channels the intensity of a dysfunctional outsider, shattering staid certainties as he butts heads with class-conscious, doctor-obsessed Vienna. You can see why Rylance, whose politics are on the class war side of leftiness, warms to a figure who fell victim of snobbery, driven into frustrated, counter-productive rage by arrogant elites.

Semmelweis’s story is told backwards: we meet him in self-imposed exile from medicine, with younger colleagues turning up out of the blue (echoes of Greek drama), urging him to return to the fray and vindicate his methods. It does not work out well: the tetchy, driven doctor dies of a gangrenous wound, probably after a beating in the asylum he was committed to for dubious reasons, It was the sort of avoidable death he had devoted his career to preventing.

Tom Morris directed the production first when at the Bristol Old Vic, as theatres were staggering back from the bludgeon of the pandemic, so we might well read the commonsensical lesson of the story to be that preventative measures are a sine qua non of progressive thinking. Inconveniently, real-life Rylance embraces the crankier end of conspiracy theories: he initially refused the Covid vaccine for reasons bordering on the paranoid and believes that a potion of garlic and vitamin C helped him “sail through” a run of Jerusalem.

More recklessly, he embraces alternative treatments for cancer on the grounds that “the body knows how to heal itself”, which makes as much sense as saying that nature will sort out childbirth without antiseptic precautions. Semmelweis, whose teardowns of mutton-headed opponents bring dramatic fireworks to a story over-heavy on exposition, would hardly have had much truck with such 21st century hokum.

Rylance portrays Semmelweis as nervy and erratic, characteristics which will lead to his isolation and incarceration. Has he succumbed to insanity — or merely accepted the role of outsider to emphasise his defiant loneliness?

A split stage allows us to watch a showreel of the protagonist’s life, with ghostly dance representations of the women he could not save (delicate, expressive choreography by Antonia Franceschi is one of the joys of the evening and allows expressionist renderings of the autopsies he conducted to ascertain the cause of fatalities).

We get Schubert’s Death and the Maiden thrown in which will move some audiences and come across to others as veering to the hammy side. Morris, who co-directed the National Theatre’s equine puppetfest, War Horse, is a director who draws emotion in bold colours.

Given the limitations of the “flashback” technique, it’s questionable whether this play would work without Rylance’s ability to charm and disconcert his audiences. Very few lead actors however can make a pretty standard script compelling — or indeed lure audiences to pay hefty West End prices for tale about a forgotten innovator.

Say what you like about repressive imperial Vienna, but it bequeathed an extraordinary body of plays about barriers to social progress, sexual politics and enough medical dramas to supply plotlines for decades of ER and Casualty to the end of time.

The Doctor which I reviewed in The Critic last year, had an astringent Juliet Stevenson in the role of a consultant, hounded on social media over a clash between the demands of faith and abortion rights. That was Robert Icke’s reworking of Schnitzler’s provocative 1912 work, Professor Bernhardi, for the cancel-culture era. The shadow of Lucy Letby’s murder spree and egregious failures in maternity care that stalk the health service today inevitably spring to mind. So does the sense of gratitude to a neglected hero who, like a lot of awkward people, asked the “wrong” questions — and was right.

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This article is taken from the October 2023 issue of The Critic. To get the full magazine why not subscribe? Right now we’re offering five issues for just £10.