The Beach doctor

Debashis Singh talks to Dr Nick Imm, a general practitioner registrar and doctor on the set of the film The Beach

It is Friday night in London's Chinatown. It is raining. I am sitting in a swanky Thai restaurant trying to tease out some morsel of Hollywood gossip from Dr Nick Imm, a 29 year old general practitioner who can boast to being Leonardo diCaprio's doctor when he worked on the film The Beach. Unfortunately, the residents of the tiny Cornish fishing village in which he works have mixed up their Leonardo diCaprio films and this has resulted in them misguidedly and rather flatteringly referring to him as "the Titanic doctor."

When Nick first read Alex Garland's novel in 1997, he was so impressed with the way in which it captured the whole travelling experience that he sent copies to people with whom he went backpacking after he graduated. At that time he did not have a clue that in just over a year's time he would be working on a film based on that very book.

The offer to work on the film came out of the blue from a doctor he had met when he worked in Zimbabwe for Raleigh International (a youth development charity). "I was in Australia at the time and I was cooking a meal, and the phone rang and it was this guy from Raleigh. He said 'Nick, would you like to work on a film set in Thailand for four months beginning in January?' I accepted. After I put the phone down, my flatmate asked, 'Who was that?' and I just said 'Just this guy offering me a job as Leonardo DiCaprio's doctor in Thailand.' " It took some time for his flatmate to believe him. "It was all a bit bizarre really," he recalls.

After brushing up his tropical medicine, advanced trauma life support (ATLS), and intubating skills and packing his medical bag with supplies (particularly antibiotics and the morning-after pill, neither of which are widely available in Thailand) he flew out to Phuket with John Hodge the scriptwriter and ex-medical SHO against a background of controversy. Protestors were claiming that the film crew was causing environmental damage. "I was quite concerned because I am quite an environmentalist myself and I thought if it was as bad as it was portrayed in the press then I would resign and come home. I was pleased to find that it was all blown out of proportion and the claims they made just didn't happen."

"The role of the unit doctor is part general practitioner with a lot of minor ailments and a bit of counselling … for some of these actresses it is the first time they have been away from home. It is also part expedition medic, in that you have to be able to treat trauma on site. It sounds like a complete bargain job, and it is really. But it's also hard work, in that you are the only medic there and most of the time not able to contact anybody else. You are looking after 350 very different people from the superstars down to the Thai carpenters, and it is important to treat them all the same. It is also very long hours and you are with the same people for four months - there is no escape."

The film was set in several different locations. Shooting initially began on the idyllic island and national park of Ko Phi Phi Leh where all the beach scenes were shot. A typical day for Nick would comprise waking up at 4.30 am and going down to the quay for a noodle breakfast. He used the hour it took for them to reach the island by boat to conduct a general clinic. Once on the island shooting would go from 7 am until 7 pm with an hour for lunch. They would get home at 9 pm. "Usually there would be someone with a medical complaint, and quite a lot of the cast brought their children with them so if they were ill the only time you could see them was back in the evening." Nick would then go to bed at around 11 pm and then be up again at 4.30 am the next day. That was the routine for six days a week.

"It was only a week into filming that problems began. We were on the island and my walkie-talkie buzzed, telling me a patient was ill. We had to take them to the other end of the island where there was a speed boat waiting for any such emergency to take us to Phuket. Having to treat dangerously ill patients in the 40 minutes it took to reach Phuket was very scary. At times I thought 'This is a nightmare.' Often I would be getting all these emails saying 'Nick, why do you get these crazy jobs where you never do any work?' And I would be thinking 'No, this is terrible.' Luckily all my patients remained well or recovered quickly, while I recovered in the hotel bar."

The second location was Khao Yai National Park, north of Bangkok, which was used for the waterfall and jungle scenes. The series of waterfall jumps performed by stuntmen was also quite nerve wracking. "They had to jump 70 feet down and also had to jump 10 meters out to clear a ledge otherwise they would definitely come to grief. So at the bottom of the waterfall there is me and my nurse, guys with spinal boards floating in the water and divers under water and people in dinghies all waiting for this catastrophe to happen. They did it once and I thought 'Great. Thank goodness that's done' and the director says, 'Oh, shall we do it again?' and the stuntmen get paid per jump so they just can't wait to do it again. They did it six times... it was a very long afternoon."

On the static sets at Krabi (which was used to recreate Bangkok) and Phuket (in which the beach community and the interior of the island were filmed) Nick would pay a morning visit to the different crews in turn to see if there were any problems and check the filming schedule to see if anything dangerous was being filmed that day. "As a medic you are not part of the cast, and you are also an unusual part of the production team so that people from both those groups would use you to bounce their ideas off." As a result, he would often be used for many varied roles including that of Leonardo DiCaprio's body double. "One minute you'd be looking at a sore throat, the next minute you would be treating a child with infective eczema, and the next minute you would be discussing with the stuntmen whether they wanted to make a clearing in the woods for an emergency helicopter to land."

One of the highlights for Nick was meeting so many talented people doing jobs one can not imagine existing. "There is a guy that makes the prosthetic legs. He would spend four months making a silicone leg. They are just amazing... so lifelike. He puts each individual hair in by hand. He would say, 'Dr Nick, where do you put the arteries to spurt the blood out from?' They actually filmed it very graphically and they actually cut some of the worst bits out to make it a 15 [certificate]. We would look through the anatomy books and decide where the artery was supposed to be and how far the blood would spurt."

As we leave the restaurant and head through Chinatown he tells me, "The skills I learnt most were logistical planning and people management. The medicine that is involved isn't that mind-blowing, but trying to organise it while you are on a desert island, treating people through an interpreter and with a limited drug supply - that's the skill."

Debashis Singhm, fourth year medical student, University of Leicester
Email: debsingh@hotmail.com


studentBMJ 2000;08:259-302 August ISSN 0966-6494