Published on: 24 January 2023 in Industry

Crossing The Thin Green Line: Steve Hughes on directing an improvised episode of Casualty

Reading time: 13 minutes and 57 seconds

In December of 2022, the BBC aired an acclaimed episode of Casualty, boldly highlighting the real-life challenges faced by paramedics on a daily basis.

But the episode was noteworthy for its craft, as well as its content: helmed by Directors UK member Steve Hughes, this was Casualty’s first ever improvised episode.

We spoke to Steve about how he introduced a new way of working to a cast of actors already well-established in their roles, the challenges an improvisational approach brings to shooting and editing, and the phenomenal response the episode has received.

If you haven’t already, you can watch the episode — Thin Green Line — on iPlayer here.

How did you first become attached to the episode?

I’ve worked on the show, on and off, for 12 years now. I’ve been lucky enough to be asked to do some of the bigger episodes and stories, and have killed off many major characters over the years! I think particularly after the success of the COVID episode we did, which won the BAFTA, they had been thinking about doing this improvised episode – Casualty has always been great at breaking the format. So I met with Jon Sen, the Executive Producer, who said that I would be the one tell this story — not least because of my editorial experience and working relationships with the actors.

Once you were attached to the episodes, what were the first steps you had to take?

As with all jobs, the most important thing is getting the script right – and that was a different process this time. Even though there was no dialogue, we really wanted to get it solid. We had a very strong backbone already from a writer called Steve McAteer, so we worked in collaboration with him over the prep period, and planned the episode very clearly so that we knew all the story beats would be there when it was time to shoot. The result was a document that was very different to the usual thing you get, it was almost like a short story – each scene was a short precis of what the story beats were, then it was up to myself and the actors to get those across.

There’s a real authenticity to the episode – what research did you do before shooting?

Casualty has a support network of people who work for the NHS that it can call on, so we had specific conversations with paramedics – “would this happen, how would this happen?” – and we did want it to feel a bit less sensational. Normally, Casualty has these brilliant big openings with a big stunt. The tool of improvisation that we were using was going to make it feel more authentic, and we wanted the story to match. We took out any series plotlines that had been running, and decided against running a conventional stunt scene. We almost wanted to make the episode that happens between those traditional episodes

We would ask paramedics specifically what they would do in different situations. For example in the knife scene, the paramedic was originally going to take the knife off the patient – but after consulting the paramedics, the more realistic option was to not enter until the patient had dropped the knife. It was a more interesting way of doing it. We didn’t want people to watch it and feel unconvinced by anything, and I’ve had dozens of paramedics message me since the episode to tell me how real it seemed.

While we were shooting, we always had two paramedics with us, who would suggest things that the actors would say to the patients – which was really valuable. This episode has a bit less actual medicine than the average Casualty episode, because that’s obviously much harder to improvise. It was much more of a character piece.

How did you approach the actors? They’re playing characters that they inhabit regularly and are really familiar with, and then you arrive with a whole new approach.

Those conversations had happened before I started, so they knew an improvised episode was coming. Then, the first week I started, I got the four main paramedics into the ambulance station and we talked about how it was going to work. I had already done Suspects, the Channel 5 drama, in a similar way, so it was about explaining the process and allaying any fears – which would have been completely understandable, because it can feel like there’s no safety net. But there is, and there’s also more freedom.

We did an exercise to warm up and just demonstrate some normality. It was just the characters having a cup of tea before a shift, talking about what they’d been up to the night before. Because they knew their characters better than anybody they could slip right into it, and they found it gave them some real freedom. It was exciting.

With the guest parts, we just ran a simple rehearsal and helped them with any medical questions. It was just about establishing trust. They knew with me there, having done this sort of thing before, that I wasn’t going to make them look stupid – and I’d make it a positive experience, too. It’s important to make the shoot fun. The drama belongs on screen, not behind the camera.

Did you have time to rehearse?

We didn’t rehearse before the shoot. There was talk about rehearsing together for a week, but we agreed that would be the wrong approach for this. Potentially, everyone would have effectively ended up creating their own sort of play, and gone to set trying to remember what they did. Whereas, one of the joys of doing the episode in this way, is it’s as much about reacting as it is acting – living moment to moment, and bringing that to the screen.

Does improvisation effect the way you give notes, or are you trying to hold back on that to preserve the spontaneity?

Generally the way scenes would work is: everyone would read the blurb of the story beats, then we would talk a bit about the point of the scene, and how it should makes us feel. Then I’d throw out a few stepping-stones to get through the scene. So, for example: treat the injuries, notice this, take them to hospital. With notes, I would always suggest adding things rather than taking away, because I knew if I needed to I could take things out in the edit, without overloading them. So, in terms of notes it was a very simple process. We would only tend to shoot most scenes two to three times and then move on to the next.

What was your schedule for shooting the episode?

Normally for an episode of Casualty you make a 50-minute episode in ten days. We had an extra day on this because of the number of moves – we had a large guest cast, lots of locations and some night shoots in the middle. There was a pleasing pace to it. Normally, when you’re doing a drama you tend to cover things in a certain way, but this was a completely different way of working. We didn’t have to get wide shots, or details. You save time that way, but you also take longer with all the location moves.

Tell us more about the visual choices you made for this episode.

We had two cameras for most of the shoot – though we had a single camera for just a couple of days, for the smaller locations. Lighting-wise, we tried to use natural light as much as possible. I had a rough roadmap of where I wanted things to take place, what would be best visually, and I gently suggested that to the actors – “maybe stand over here”, etc. But we would give the actors freedom to move, and we reacted. Everything was handheld except for a few rigs in the ambulances, and that gave us that freedom to capture that.

What was the most challenging scene to direct, and how did you achieve it?

The most challenging scene was also, I think, the strongest. There is a CPR scene with a middle-aged guy who’s had a heart attack, and the paramedics gets there late. I related to that scene personally, because my Dad died of a heart attack. I felt a responsibility to make this as authentic as possible, because people go through this on a daily basis. I didn’t want it to be heightened or schmaltzy, I think that would do it an injustice. I thought a lot about what I wanted the scene to feel like, and speaking to the paramedics, they highlighted a feeling of exhaustion, that it took a long time. So it was about making the scene feel brutal and hard to watch.

I explained my personal story to the actors, and I think they took some of that energy for their performance. When we were shooting the scene, I found myself almost unable to look at the monitor. Not because of the connection with my Dad, but because it felt almost like I was invading someone’s personal space. At the end of each of the takes, the paramedics would say the hairs stood up on the their necks. It was exactly right.

So, in a way, it was quite simple to shoot. They got it right from the first take. What it was saying about paramedics in that situation is that they’re playing a rigged game, in a way – they did everything they could, but they were affected by outside factors, which people don’t always understand. When people would come into the edit and ask if they could watch a bit of the episode, that was the scene I always showed them. It sounds pretentious, but when you’re a director you’re looking for something true – and that was the most truthful scene I’ve ever shot.

Did any scenes present any further technical challenges you had to deal with?

The very first scene we shot was probably the most terrifying for everybody. This was the scene where Teddy went to his flat and was presented with a man with a knife, having a breakdown. We’d all talked about the improvised approach, now this was the day we all turned up and actually had to do it.

I deliberately kept the actors separate from each other, they hadn’t met in make-up in the morning. We’d kept the actor who plays the patient, Lucas Button, in a van away from it all. We had it so that Milo Clarke, who plays Teddy, didn’t know what to expect. There was only one way he could get to the door, so I knew how we could shoot that. I wanted everything to be as reactive as possible, so instead of shooting two cameras on one actor and two cameras on the other, we had two cameras back to back, so one was facing Lucas and one was facing Milo. When they’re speaking to each other, those are the natural reactions. We had to curb that instinct to make the shot pretty. I was saying, no: we can be messy, we can go the wrong side of the line. If it feels too pretty it feels safe, like a normal drama, and that was the opposite of what we wanted. So, it took a couple of takes at first to get that right.

We also didn’t know how long the improvisation should go on for. The early rehearsal was over twenty minutes, and it was brilliant stuff — but we’re clearly not going to have a twenty minute scene. I’m from an editing background originally, and I knew I’d be able to take out whole sections in the edit. I was editing in my head as we went along. One of my only notes to the actors was that they could change as many words as they wanted, but they needed to follow the positions of where they’d moved to so I could cut it together. But they all understood that anyway. With that scene, of course the tension of the knife confrontation is great to have – but I was really fascinated by the pastoral care that followed from the paramedics. You really felt like they were listening. I was so proud of everyone involved, they really pulled it off.

So, that was a challenging first day, but exhilarating too. Michael Stevenson (who plays Iain) messaged Jon Sen on the first evening saying he was buzzing, and Milo was saying it was one of the most fun days he’s ever had on a set.

What was it like editing an episode like this?

The edit still happened conventionally, to a point. I worked with a fantastic editor called Joe Marshall, who would give us regular assemblies. Whatever we shot on Monday he would edit on Tuesday. He would provide a cut with the long version of all the scenes, so our first assembly was an hour and a half. So, twice as long as we needed it to be, but still in a great position – we had to cut lots of great stuff, but we had to constrain the episode as a whole. Then when I came into the edit at the end of the shoot, we had a little more time. Normally you would have two or three days to do a director’s cut on an episode, but we had just over a week, because it was a case of really honing in on the scene.

Of course, because it was improvised, continuity was a challenge – but if something just didn’t quite fit together, we sort of didn’t mind, as long as the overall feel and tone was correct. It was still handheld, it felt real. We only lost three short scenes out of the whole episode, everything else was just paring down what was there. It was all about getting it down to time, and when we showed it to the execs they were happy and we knew we had something special.  

Tell us about the response you’ve had to the episode.

I was very confident about the episode when we finished it. Then we had a screening for real life paramedics in Cardiff, and the response was absolutely incredible. People were crying, and we got a standing ovation. The medics we spoke to afterwards shook my hand, and said that this was really going to help people see what the life of a real paramedic was like. When the episode went out, like all directors I had a paranoid sift through the Twitter feed! It was overwhelmingly positive, and the responses were exactly what we were after: that it was tough to watch, and it felt real. I’ve even had people I don’t know contact me through social media just to say that they appreciated us telling the story, and that we did it justice. That means so much to me, and the whole Casualty team. 

The Thin Green Line is available to watch on iPlayer here.

Photos: BBC. 

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