Maternal instincts

Maternal instincts

February 6, 2023


Playwright-turned-screenwriter Jacqui Honess-Martin recalls the inspiration behind her first television series, Maternal, and discusses how the final scene of episode one juggled a key character arc with an emotional punch.

Maternal is the story of three women returning to NHS frontline medicine after maternity leave. Catherine (Lara Pulver) is a general and trauma surgeon, Helen (Lisa McGrillis) is an acute medic and Maryam (Parminder Nagra) is a paediatric registrar.

I went back to work full time when my first child was six months old, returning to a job I loved in an industry that prided itself on inclusion whilst my husband was at home with our baby. I couldn’t believe how hard I found it.

Jacqui Honess-Martin

Gradually, after the initial shock wore off and things didn’t dramatically improve, I shared my experience with my friend, with a baby born within six weeks of my own, who also went back to work full time after six months. She also happens to be a consultant paediatric cardiologist.

We laughed as we traded stories of trying to pump breastmilk in cleaning cupboards, sleep deprivation, childcare chaos, endless rounds of illnesses, rows with our partners and decimated professional confidence. As someone working in the arts, I listened in awe as she described treating very sick new-borns just months after having her own.

I will never forget her answer when I asked her if becoming a mother had changed her as a doctor. She said her emotional connection to patients and families at times felt overwhelming, threatening her meticulously constructed professional boundaries. However, despite this, or perhaps because of it, she felt being a mother made her a better doctor.

And so Maternal was conceived, along with the first-season story arc for one of my three lead characters. Maryam is a paediatrician, walking that same tightrope of emotional connections versus professionalism that my friend so memorably described to me. On her first shift back at work, Edward, a four-year-old patient in her charge, dies. The ensuing investigation and the impact on Maryam’s already fragile mental health and confidence plays out over the next six episodes.

Lara Pulver plays Catherine, a general and trauma surgeon

In the final scene of the first episode, we see Maryam arrive at home, checking in on her own sleeping child. As she watches her little boy sleep, she weeps and we flash back to see Edward’s death for the first time. Intercut with this are flashes of the opening scene of the episode, a dream sequence in which Maryam finds herself running through empty hospital corridors in her pyjamas.

I knew the episode needed to end with the audience learning of Edward’s death whilst also landing the emotional beat of how this death impacts Maryam as a mother. However, constructing a plausible timeline for the medicine across all three of the women’s storylines seemed, for a long time, impossible.

At the top of part four, we leave Maryam realising the seriousness of Edward’s condition, we revisit her when she is beginning CPR. Before the episode ends, Helen must finish her shift and drive home and Catherine goes into and comes out of surgery, performing an operation which takes five hours. Edward’s decline from the moment they start CPR to his death would be a maximum of 30 minutes.

After endless card shuffling, the only solution I could find was to see Edward’s death and then, hours later, see how it affects Maryam. It didn’t land the moment as I had hoped.

Maryam (Parminder Nagra) treats the young Edward (D’Vante Hart)

The way we told Maryam’s story transformed once I started working closely with series lead director James Griffiths. At one of our first meetings, James talked me through a visual language for each of the women, the camera and shot choices that would define them. Maryam would be shot using handheld cameras, a specific shot over her shoulder would signal a crisis in her anxiety. James picked up on my mention of hands in the script, Maryam tensing and opening her fists, clutching things, her hands shaking, whilst also using her hands to heal and save. This visual language for Maryam’s mental health crisis became as integral to the storytelling as the words on the page.

Discovering this new palette coincided with me redrafting the penultimate episode and encountering a similar timeline challenge – medicine takes so much longer in real life than we are used to seeing on TV! I was also looking for more ways for us to get into Maryam’s head and understand the moments of rupture within her mental health. I had resisted the use of flashback initially; it felt too associated with the language of PTSD. But when I realised I could use flashback to tell a story out of sequence in episode five and get inside Maryam’s head at the same time I rushed back to use the same structure to redraft episode one.

Lisa McGrillis, Parminder Nagra and Lara Pulver brought their experiences as mothers to their roles

James must take credit for the stunning opening of Maternal: a dream sequence in which Maryam discovers herself in a hospital corridor, in her pyjamas, sprinting after a bleeping pager whilst we hear Agnes Obel’s elegant and enigmatic music. There is perhaps an ambiguity to it when we first see it, Maryam’s running is potentially heroic. As the action plays out, and the way James used this sequence in that final scene, confirms it as a glimpse into Maryam’s worst nightmare. An emergency she is ill prepared for and powerless to prevent.

Of course, the final scene was shot across two locations on different days. At Maryam’s house, the crew were lucky enough to catch our two-year-old playing Sami whilst he was having a nap, so we really are watching a sleeping child. (I loved hearing the whispered ‘cuts’ and ‘actions’ on the rushes as our fabulous crew tiptoe round, desperate not to wake him!)

Parminder’s performance in that final scene is incredible. All three of our outstanding female leads are mothers, and we laughed about how life imitated art as we navigated childcare dilemmas across production. I know there were moments when all three found that connection to their characters as mothers vital and I think, for Parminder, this was one.

I wasn’t on set when they shot Edward’s death. Part of me wanted to be there to offer morale support, but in the end I knew I would find it too hard to watch. When I wrote the scene, my baby was just two. When we shot it, he, like Edward, was four. D’Vante Hart, who played Edward, and his father Darren Hart, who played his dad in the show, were outstanding. D’Vante was so relaxed (or perhaps bored) on set that most of what you see of him lying on a gurney unconscious is him fast asleep. The prosthetic, made by Davy Jones and his team, that was swapped in once the medicine became more intrusive and serious was an incredible replica.

We were incredibly lucky to have one of our medical script consultants on set that day. Dr Kiran Rahim is a battle-worn paediatric registrar working in Hackney, London. She is also a mother of three. Shooting paused for a moment when she had to step out. She and everyone on set that day were affected by what they were shooting. You can see it on screen.

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