Breathless: gripping drama shows a Spanish hospital on life support

The harsh realities of modern life keep spilling through the doors of the Joaquin Sorolla public hospital in creator and co-writer Carlos Montero’s eight-part series, Breathless (originally Respira, 2024, Netflix). In another context, the setting might be presented as idyllic – the hospital is located in the municipality of Valencia, on the picturesque east coast of Spain, overlooking the Mediterranean – but almost before a word is spoken, the stresses are clear.

A hand-held camera plunges viewers into the corridor chaos inside the hospital as a steady stream of the ailing and injured seek help, the overload left to wait their turn on gurneys in the bustling hallways. Then a group of banner-carrying activists burst in to protest about their inability to gain access to proper health services, the embodiment of a plight that will be familiar to viewers everywhere.

Dr Jesica Donoso (Blanca Suarez) and Dr Pilar Amaro (Aitana Sanchez-Gijón) in Breathless.Credit: Carla Oset/Netflix

What follows is a series of crises in which the world beyond the hospital doors intersects with the everyday state of emergency that exists inside them: food poisoning at a fair; a prison fire stemming from a riot; a “cold drop” deluge that bodes disaster (“Every time it rains, two of our operating rooms start leaking”). This is a story about a public health system on life support.

Its primary focus is on how the staff inside the hospital go about dealing with the situation and with the fallout from the competing pressures. Their work isn’t only about caring for those in need; it’s also about dealing with the quandaries that await them whenever they clock on for the day. And the most critical of these soon emerges: whether or not they should abandon their posts, and their patients, to go on strike as part of their campaign to compel the hospital to operate more efficiently and do what it’s supposed to be doing.

As Montero told Variety late last month, “The initial idea for the show came from that paradox, that dilemma: that to save the health care system as a whole you may have to abandon the patients.” And by episode four, matters have come to a head, with charismatic oncologist Dr Nestor Moa (Borja Luna) proposing a full work stoppage until the authorities – the government of the municipality under President Patricia Segura (Najwa Nimri), and the hospital authorities led by head administrator Lluis Bonet (Alfonso Bassave) – agree to adopt appropriate measures to improve conditions.

President Patricia Segura (Najwa Nimri) and resident Biel (Manu Ríos).Credit: Carla Oset/Netflix

The rebellious spirit of El Cid, the Castilian knight who reigned over Valencia in medieval times, is still around in the form of the noble Dr Moa. But the war he’s waging is of a different order from those fought by his predecessor. “This is about fighting for public healthcare,” he tells the gathered doctors and the residents in their charge.

Still, they’re divided over whether or not to follow his lead. Some reasonably take the view that the Hippocratic oath prohibits such action, while others support him, arguing that they need to give priority to the bigger picture, to the belief that the refusal of treatment now could lead to improvements of patient welfare in the long run.

To its credit, Breathless doesn’t take sides here, clearly laying out the issues to do with the proposed strike and acknowledging the consequences, but insisting that such complicated situations don’t allow for simple conclusions. That, despite the instruction from chief surgeon, Dr Pilar Amaro (Aitana Sanchez-Gijon) – “No politics in the operating room” – there’s no escaping the fact that politics is at work everywhere in the hospital.

Equally, the series keeps its distance from the debate about what might actually be the best kind of future for Joaquin Sorolla, providing the various spokespeople with ample platforms on which to make their case but holding back from passing judgment on their positions.

Dr Pilar Amaro (Aitana Sanchez-Gijon) and her son (Rafa Verdugo) in Breathless.Credit: Carla Oset/Netflix

For President Segura, whose situation is further complicated by the fact that she’s also involved in a struggle for power inside her own government, the solution lies in privatisation, although she prefers to call it “externalisation”. Dr Noa sees this as a case of right-wing wrong-headedness, while a committed ally, gynaecologist Dr Leonor Santapau (known as Leo and played by Ana Rayo), goes further, dismissing the proposal as nothing more than a gambit for “a f---ing neoliberal experiment”.

Beyond the strike about the conditions at the hospital, though, are the choices the doctors have to make to disentangle themselves from the complications attached to their professional and personal lives and to the responsibilities that go with them. When Dr Amaro discovers that her son (Rafa Verdugo) has been admitted after overdosing, she summons a reluctant Dr Jesica Donoso (Blanca Suarez), who’s in the middle of an emergency operation, to treat him. The resident who’s been assisting her, coincidentally her brother Rodrigo (Victor Sainz) – there are a lot of coincidences in Breathless – is then left to complete the surgery.

When an emergency arises, he finds himself in an impossible situation which, despite the reassuring words of a supportive doctor – “What happened to you is normal” – leads to consequences that are tragic for all concerned. It’s clear from early on that this is a series that isn’t going to pull its punches.

The need to bend the rules is an unwritten rule at the hospital, a way of getting the job done when the system seems to be conspiring against such a goal, officially frowned upon but also understood. After ER doctor Rocio Fuster (Macarena de Rueda) and resident May (Marwa Bakhat) take it upon themselves to remove a braindead patient from the ICU in order to perform a caesarean to save her unborn child, Amaro admonishes them. But she also understands that they’ve done what they had to do.

Ethical issues pervade Breathless, along with a pressing sense of urgency. No problems are easily solved, everything seems to happen in a rush and everyone is constantly on edge, the hand-held camerawork, jump-cutting and forward tracking shots along the hospital corridors bringing a jittery restlessness to unfolding events. Private moments between the staff, most notably the secret affairs between staff members, are also fraught, constantly under threat of interruption. There is a soapie side here, but strategic attempts are made to incorporate it into the drama’s wider concerns.

Montero insistently and intricately winds together his characters’ personal lives and the circumstances in the hospital, even if the dramatic licence taken to establish the point sometimes stretches credibility. The president is diagnosed with breast cancer in the first episode and subsequently becomes a patient of bitter rival Nestor. The link between Leo and the rape victim whom she supportively examines in the second episode turns out to be far more than a professional one. Rocio and May have more in common than their shared concern for the life of a patient’s baby.

The hospital’s wards, offices and locker-rooms frequently serve as the sites for personal confrontations between the staff. One single-take scene conjures up an especially amusing variation on this strategy as, across an ER bed, a resident seeks romantic advice from a colleague who’s sewing up a cut on a patient’s forehead (and who’s played by Manu Rios, who also stars in Montero’s long-running high school series, Elite, also showing on Netflix). When he fails to respond at one point, the patient inserts himself into the exchange, taking over the role of counsellor.

Like all hospital series bent on establishing the authenticity of their situations, Breathless loads its characters’ exchanges with specialist terminology. Here we eavesdrop on staff in the maternity ward talking about “the Kristeller manoeuvre” and “placental abruption”, and oncologists discussing “spontaneous hepatic haemorrhage” and “metastasis”. I think someone also mentions “the Pringle manoeuvre”.

The series comes to a close with a cliffhanger ending of such proportions that the writers and cast must’ve been in little doubt that a second season had been commissioned. And although many returning series lose sight of what originally made them work, there’s good reason to be optimistic about this one.

Breathless screens on Netflix.

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