A real television doctor

Daren Francis is a consultant general surgeon and a general surgical adviser for the BBC medical drama series Holby City. He stays out of the limelight, but Rebecca Chellaswamy finds that he has a vital role

I think I decided I wanted to do surgery in my senior surgical attachment at medical school. All the doctors that I was working with were really nice, and I thought they really seemed to be making a difference to their patients. Working with a good group of people can have a massive impact on your career plans. You start to think, "That person seems happy. I wouldn't mind living my life like they live theirs." I've since further specialised in laparoscopic surgery.

I haven't found it that difficult. It is quite difficult to take a step back and look objectively at what we do as doctors because it's what we train for and it's all we know. It's basically all I've done since I was 18.

Doctors watch medical dramas for the medicine, not for the drama: they try to guess the diagnosis. Colleagues watching Holby can be supercritical about the medicine. But since I've been involved with the show I've realised that it's not trying to be a medical education programme. It's not trying to teach how to do cardiopulmonary resuscitation or a certain operation correctly. It's a drama. But Holby City does set its standards for medical accuracy high, and they take it seriously.

Being a medical adviser is a big commitment, and it's something which is always done out of hours. I read a lot of the scripts in the evenings. The meetings in which we discuss the details of the episodes with the director and the production, design, and prosthetics teams are in the evenings. And on top of that we have to be available for phone call consultations with the researchers to discuss upcoming storylines.

The writers come up with a storyline for the episode, and you have to make the medicine fit. It can be tricky, and there has to be a bit of give and take on each side. We all work together—the producers, writers, researchers, and medical advisers. You don't always need high tech medicine to make an episode exciting—the medicine isn't the crux, it's the drama. As medical advisers we have a responsibility to the show, but we also have a medical responsibility to the viewer. You have to make sure that you keep your responsibility as a doctor and not give people watching the show the wrong impression.

The actors who've been in the show for a long while play out their medical roles well, knowing how to hold instruments in theatre and that sort of thing. They want to come across as realistically as possible, so they rely on the on-set medical adviser to make sure that their actions look real. All the advisers work as a team—the surgical advisers, the cardiothoracic adviser, and the nursing advisers. The director or the actors consult us when they want information or guidance.

It gives you an insight into the world of television, you're working as part of a big team of people to produce a finished article, and it's a good contrast with the sort of work you do day to day. When you see it on television and it's a good episode, there's a sense of satisfaction that is different to the sense of satisfaction that you get in medicine.

Especially as a surgeon, complications happen—if not, you're not doing enough operations. But when a complication occurs, it stays with you for a long, long time and has an impact almost every day. Colleagues help, but the only real healer is time. The highs are when you do something, and it goes really well, and the patient leaves hospital, and they thank you.

Some days I'm driving home, and I think, "This is the best job in the world." Other days I think, "I wish I'd never done this." It's a good career; it combines a lot of different things, and you can always find a niche in medicine. On balance, yes, looking at the pros, cons, risks, and benefits, and what it's given me.

If you have a choice, always go for a job in a place with a friendly atmosphere, with good supportive colleagues. No one's perfect; you're going to have complications; you're going to make mistakes; but if you've got good colleagues it makes those bad times so much easier. It's incredibly valuable to have someone more experienced sitting down with you after something hasn't gone right to tell you, "It's not your fault," or even, "It is your fault, but these things happen, its part and parcel of the job. You're going to beat yourself up about it for a while, but it's happened to us all." Medicine is very much a team effort.

Competing interests: None declared

       

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