It isn’t often that we review a television programme on St Emlyn’s. In fact I think this may be the first time, but I was so struck by this film and the valuable learning points for those of us working in Emergency Medicine that I wanted to share it with you and to encourage those we are able to access it to watch it.
Who is Tony Slattery?
Those of us of a certain age will remember Tony Slattery from his almost obiquitous presencded on our television screens in the late ’80s and early ’90s. A member of the Cambridge Footlights group, that included Stephen Fry, Hugh Laurie and Emma Thompson amongst others, he shot to fame as part of the “Whose Line is it Anyway” team that become a regular part of my Friday evening’s viewing.
Quick witted and quietly clever he seemed a bit like the naughty school boy, always happy to make a slightly risque joke if there was a chance of it eliciting a chuckle from the audience.
And then, without us really noticing he disappeared off our screens. Where has he been for the last quarter of a century? This programme goes some way to answering that question.
What Happened to Tony Slattery?
The programme charts his rise and precipitous fall, from ever present personality to absent alcoholic and cocaine user. By his side throughout is the ever loving presence of Mark, his partner, who describes the “many Tonys” that he has known and that could change on a day by day, sometimes minute by minute, basis.
He was a heavy user of cocaine until the “Millenium”, when it seems he just stopped, but alcohol has been a daily constant. He recognises that he has depression, and has indeed been on antidepressents for years (which his GP describes as being his version of a diabetic’s insulin: he cannot live without them).
The programme seeks to help Tony to discover just what the psychological diagnosis is that has eluded him, and seemingly those around him, for decades.
What’s the Matter with Tony Slattery?
Throughout the programme we follow Tony and Mark as they seek answers to just “what the matter” is with him. We learn about the (oft missed) diagnosis of Bipolar Disorder, (something that both Mark and Tony suspect he has and he almost seems to want at points), but this is discounted. He may, however, be “on the spectrum” with regular “ups and downs”.
We observe a consultation with Professor Julia Sinclair, an expert in Addiction Disorders, who points out that if he was able to stop taking cocaine, why could Tony never see himself stopping drinking. Perhaps an obvious question, but one that seemed to strike home.
Late in the programme we discover something traumatic about Tony’s past, that almost makes you wonder how he was ever able to be funny. But it most certainly goes some way to explain some of the later problems he has experienced.
Why should you watch it?
As I sat observing the decline of a hero from a different time of my life I was reminded of countless patients who I have seen in the Emergency Department. Some who have been labelled as “frequent flyers” or “heartsinks” or “just an alcoholic” and I was struck by an immense sadness. Each of them was never born an alcoholic or cocaine user. As they took their first breath, their life could hold the same exciting possibility as any other. Yet the world can be cruel and difficult and very, very sad.
When you see that patient, who has been so casually labelled, on the short stay ward round, try to see past the person today, to who they once were and chart the journey to how they got there. Almost all the time there will be stories of incredibly sadness or abuse (as Tony reveals near the end of the film, in perhaps the most shocking moment, “it wasn’t pleasant…. being f**ked up the arse at the age of eight”). And as he reminds us, in a glimpse of that rather clever word play for which he was famous,
“No one in their right mind decides to be mentally ill”
It is also a stark reminder of how alcohol can be a coping mechanism to “dull the pain”, but how it can also destroy your mind. Here was a once articulate man, at times, struggling to find his words. In fact, the major conclusion, which perhaps Tony didn’t want to hear, was there wasn’t the unifying psychiatric diagnosis that he had been yearning for, for which he could take medication and perhaps be cured, but that it had to start with him deciding to live without alcohol. And then trying to live without (or with less) booze.
So why would I write about this on a blogsite for emergency medical staff? Perhaps the “take home” messages are these: always, always see the whole person in front of you, not just the drugs, alcohol or chronic pain; try to remember that no one wants to be in an Emergency Department and “frequent flyers” do not earn air miles and your dismissive label was years or trauma, sadness and distress in the making; and that these things can affect any of us. Even the most succesful, smart, funny and famous.
I wish Tony and Mark well on their journey. I fear it will not be easy, but they can be rest assured that the programme has made at least one person think and reflect on their practice to hopefully help others like them in the future.
Horizon 2020: What’s the Matter with Tony Slattery? is available on BBC iPlayer until 14th June 2020. It was filmed, produced and directed by Claire Richards.
PS I’m not the only one who thought it was rather good…