Three years after its first season, French series Hippocrate (Interns) returns as its young doctors find themselves dealing with A&E patients in a flooded hospital. Director Thomas Lilti tells DQ about ramping up the tension in this ultra-realistic medical drama.
As a doctor, Thomas Lilti knows first-hand the challenges and pressures facing medical professionals working on the wards of a busy hospital. As a director, he has also sought to replicate that experience on screen.
In 2014, he created and directed the film Hippocrate, which saw the daily life of a hospital through the eyes of an intern. Then in 2018, the idea behind the feature was brought to the small screen in a Canal+ series of the same name (known as Interns in English), which followed three inexperienced junior doctors working at Hôpital Poincaré. The first season saw them work together to manage and care for the hospital’s patients as many of the more experienced medical team were placed into quarantine.
Three years on, the series is now airing its second season, with Alyson (Alice Belaïdi), Hugo (Zacharie Chasseriaud) and Chloé (Louise Bourgoin) facing mounting personal problems at a time when the hospital’s emergency ward is flooded, leaving them to support an influx of people in their general medicine department.
Creator and director Lilti also writes the series with Anaïs Carpita and Claude Le Pape. Hippocrate is produced by 31 Juin Films and distributed by StudioCanal, with a cast that also includes Karim Leklou, Bouli Lanners, Anne Consigny and Geraldine Nakache.
Here, Lilti tells DQ about the challenge of developing the second season of the show, his ambitions to create an ultra-realistic medical series and how the high emotions of the characters and the situations they face create a thrilling, intense arena for drama.
It’s been three years since season one aired. How did season two develop during that time?
It took a long time to write season two because we wanted to pick up the characters where we’d left them, but also to introduce something new. We wanted to avoid repetition between the two seasons. This one had to be different. I wanted it to be more radical, with a stronger pace and greater tension. That’s why I set the story in the A&E unit. And because I shoot the episodes myself, we can’t get on with the writing once we’re filming. Season two took 127 days to shoot and was interrupted for three months by the first lockdown in the spring of 2020. For all those reasons, it took a long time to get it off the ground.
How did you react to the way season one was received?
Season one was a big hit with audiences and critics. I was really glad to have achieved my goal: an ultra-realistic, politically relevant series about behind-the-scenes hospital life, with a strong narrative thread. But the flip side was that I felt a lot of pressure to deliver in season two. I was afraid of disappointing, of being repetitive, of just spinning out the characters like any other series. So I took the time to reflect on what really mattered to me: to convey the reality of work in the extraordinary, challenging healthcare profession.
What lessons did you learn from season one and how has that changed your approach in season two?
The main lesson I learned about making a series was that you must never cheat your viewers. The characters belong to them, even more so than in a film. My characters had to stay true to their evolution in season one. They’re the reason viewers want to follow the stories I tell. Nothing is possible without this strong sense of identification – but anything is possible if you’re interested in the characters, if you get attached to them and care about them.
Season one also taught me how satisfying it is to mix the narrative with realism – a potent combination that makes for a series that is both entertaining and thought-provoking about the world we live in.
Can you remind us where we left the characters in season one and tell us what awaits them in the upcoming episodes?
By the end of season one, the characters had been changed by their experiences, so I wanted to pick them up where I’d left them. Chloe was seriously ill and was about to have a heart operation. She returns in season two with a side-effect: her left hand is paralysed. She was a great doctor but now she no longer feels up to the task. She’s lost confidence and is uncertain of ever regaining her former skills. Will she overcome her handicap? Will she learn to be more empathetic towards others?
At the end of season one, we also discovered Arben wasn’t a qualified doctor and had been lying for years. He was forced to leave the hospital. But medicine is his whole life and he’ll find a way back – especially at a time when hospitals are struggling and understaffed. He embodies the question of what makes a good doctor: is it his skills or his qualifications?
Hugo and Alyson are continuing their internship, but at the start of season two they’re faced with an unexpected drama: taking charge of the A&E unit. Hugo realises he isn’t cut out for this fast-paced environment, whereas Alyson embraces this new challenge, which is a revelation to her. Will the relationship they’d built up in season one survive this new adventure, which seems to be creating a distance between them?
With the hospital flooded and the emergency ward moved, what opportunities did this present to you in terms of story and character development?
I used the A&E admissions into the General Medicine Department to give the second season a stronger pace. Everything happens fast. The hospital is flooded; the characters are submerged, as if they’re on a sinking ship. Season two has the feel of a disaster film – the characters are all battling to save the hospital with ludicrously insufficient resources.
Having to deal with such a challenge reveals individual strengths and weaknesses. The group is under terrible stress and the situation is difficult, but collective action is always the best solution. The A&E admissions were also a way of making the series even more political and realistic, because the casualty department reflects the world outside the hospital. When the outside world is struggling, so is A&E. In light of the current pandemic, the series shows something that everyone has realised: we need to take care of our carers.
What are the origins of the series – how did your film, Hippocrates: Diary of a French Doctor, influence the show?
It all began with the success of the film, which was released in 2014. But I’d long wanted to make a hospital series. I’d always dreamed of showing the ups and downs, the doubts and fears of hospital life. The film laid the foundations of the series: showing hospital life from the perspective of junior doctors. I wanted to show the harsh reality of the hospital world and the young people who battle to keep it alive. That was the stance I’d taken in the film. Then the series became a work in its own right and took on a scope the film didn’t have.
Did you have other offers to work in television before this?
I’d already worked in television as a screenwriter. I’d written episodes of the teen series Coeur Océan – a far cry from Hippocrates, but very instructive. Nonetheless, I’ve learned a lot during the making of this series.
How did your experiences as a doctor inform the story and the characters?
Almost everything in the series reflects my personal experiences as a junior doctor. I draw inspiration from reality. I think I unconsciously recorded everything I experienced when I was working. Without those experiences, I would never have been able to make a series like this. The character of Arben, for example, was largely inspired by a foreign doctor I knew, who taught me a lot.
How does the series push the traditional boundaries of medical dramas, which are still extremely popular the world over?
That’s a tough question. The strength of the series is that it shows what really goes on behind the scenes at a hospital. The caregivers aren’t heroes; they’re ordinary people confronted with terrible things, and they never pretend it’s easy. They’re full of doubts, always wondering whether they’re the right person for the job. That’s what makes the series special – it’s very realistic but it also has a gripping storyline, because the characters’ jobs cause intense emotions. Two things strike you when you watch the series: not only that healthcare professionals have very difficult jobs, but also that those jobs are supremely motivational and meaningful.
How does your role as director influence your work in the writing room? What is that process like?
At the writing stage, I surround myself with trusted writers who know the characters and the spirit of the series as well as I do. There’s a constant exchange of ideas in the writers room. We write the loglines and synopses together. The first versions with dialogue are written by screenwriters with my help, and then I write the final versions myself. I keep doing a lot of writing during shooting, at weekends and in the evenings. The last two episodes of season two were written during the lockdown in March 2020.
How would you describe the visual style of the series? How did you use the camera to achieve the show’s sense of realism?
When I’m directing, I focus on gestures and expressions. I want to understand what the characters are feeling at any given moment. I also want to maintain the pace. The camera and the actors are always moving. On the rare occasions when the pace slows, it’s like a breath of fresh air for viewers, like coming up to the surface after being underwater.
How do you like to work with actors on set?
I try to give them as much leeway as possible to find the right tone and emotion. I sometimes do dozens of takes to give the actors a chance to let themselves go. I often show them gestures that they can copy. I give them time to try and try again. After hours of shooting, they’re exhausted, just like the characters they’re playing. It helps them strike the right tone in the various situations.
Where was the series filmed? What are the practical challenges of recreating a working hospital?
We shot in a disused building at a real hospital. The studious, focused on-set atmosphere owes a lot to the presence of real carers in the buildings around us. To recreate a realistic hospital, I rely on my associates – production designer, director of photography, costume director, prop director – to achieve realism in the smallest details. Nothing is left to chance. Extras are another key aspect. There are a lot of extras in season two so the corridors are always full, and that adds a lot to the sense of realism.