Black Hole Sign is a complex piece of theatre set one full night in Accident and Emergency, the backdrop for a tragedy that could so easily have been avoided. Understaffed and overworked NHS staff must cope with a gaping and widening hole in their roof. From the nurse in charge, her colleagues, a porter and attending patients, their evening starts comically but ends with a tragic event that brings them in front of a disciplinary panel.
Written by Uma Nada-Rajah, who is a practising nurse, the play has authenticity at its heart. Presenting patients, however, are stock characters: the dying man, the self-harming young person, the delirious elderly woman, the obnoxious demanding man who has a spike in his posterior.
There is much comicality to be derived from their interactions with the frazzled nurse in charge, the nurse working to the higher standards of why people enter a care profession, the working-class porter with a heart of gold and the student nurse who has more drive and ambition than skill or sense. All are recognisable; perhaps a little too much so. The two sides of this drama – patients and care staff – are drawn from experience, but without a full understanding of why they all ended up at A&E on such a night as this.
Their evening begins with noticing the hole. Through this visual metaphor, which gets bigger as the issues get increasingly more complex, the holes in practice gape too – though they don’t quite extend beyond the footlights. It is clear early on that this troubled staff have a number of patients likely to test their capabilities. The major challenge of the evening becomes dealing with these patients which include a patient near his death, whilst the nurse in charge, Crea played admirably by Helen Logan, doesn’t have the cover to allow her colleague, Anj [Dani Heron], to be at his bedside whilst he slips away.
Help arrives in the form of student nurse, [Betty Valencia], and Anj is able to sneakily slip in and out of giving care, but gaps begin to appear: this included a student nurse administering ketamine when it ought not to be, a delirious patient, Tersia, [Ann Louise Ross], off wandering. By the dawn, two people have lost their lives and the hearing – which happens in the spotlight throughout the production – shows interviews with the characters as flashforward, teasing the ending.
In any profession which is undervalued and undersourced, with staff struggling to cope, mistakes are likely to happen. When they do, there are many mixed emotions – we may enjoy the puncturing of pomposity when an obnoxious character gets their comeuppance, but also worry, what if it had been our relative?
Our six actors are well-drilled: Martin Docherty and Beruce Khan make up the numbers, and the interactions are always managed with a real truth to tell. However they feel like characters in search of depth. It’s all a bit back to front. They tease a backstory whilst delivering a serious message, rather than delivering a backstory to illuminate a serious message.
Technically the set is both highly functional and creative. The doubling of the enclosed spaces of cubicles and the wide-open spaces of hospital forecourts is impressive.
The message that our creaking NHS is in a tragic state hits as we understand that the staff we trust with our loved ones are knackered. We know it has suffered from years of chronic underfunding and a ‘make do and mend’ mantra, whilst management cut the front line as an ‘efficiency drive’. Black Hole Sign reflects a National Health Service is on its knees. Not because the nation doesn’t care, but because the tiredness is not just in the creaking trolleys or in the paint peeling off from the walls, but that the very edifice is held up by creaking, groaning, and overwrought nursing and medical staff.
Black Hole Sign is a very worthy piece of drama, and it shows great promise, but its authenticity needs theatricality for it to be effective.
Black Hole Sign, Tron Theatre 19th September till 4th October, then Traverse 8th till 18th October
Tickets for Black Hole Sign at Tron Theatre
Tickets for Black Hole Sign at Traverse Theatre
Reviewed 23rd September 2025 at Tron Theatre
Photo credit: Laurence Winram
