1A patient who is also a doctor, a doctor who is also a patient: that’s Andrea Fanti, played in the three seasons of Doc – Nelle tue mani (“Doc – In Your Hands”, Raiuno, 2020–ongoing) by Luca Argentero. The brilliant if aloof internal-medicine consultant is left with his life in pieces after a bullet to the temple erases twelve years of his memory. One thing is clear: his mission is to look after his patients. Now that he has been one himself, he knows that a patient isn’t just a case on a page but a human being who needs care, attention and a listening ear. Back in the department as a humble assistant, Doc – as they all now call him – discovers the joy of working on the ward, inspiring his team through his empathy and a special approach that blends professional duty and personal spontaneity. Based on the true story of Pierdante Piccioni, a former A&E consultant in Lodi and Codogno (two cities respectively 30 and 60 kilometres southeast of Milan, in the region of Lombardy) who suffered amnesia after a road accident, the series tells of illness as a challenge, an opportunity for change, a chance to seek out a deeper meaning in life. It is the story of a man who loses everything, yet finds a way to reconcile himself with his past, where the hospital becomes the only place he really feels at home.

4This article, then, explores the pandemic’s effect, both direct and indirect, both textual and contextual, on Doc’s entire production and distribution chain at various stages, from writing to producing, from packaging to scheduling the episodes.

1. The shock, the distribution reaction, the production resumption: season one, split in two

7Season one (directed by Jan Maria Michelini and Ciro Visco) was actually broadcast in two sections, because of the countrywide lockdown that shut down production between March 9th and May 3rd, 2020. The first tranche aired from March 26th to April 16th, as a pair of back-to-back weekly episodes, as drama is often scheduled on Italian main channels. The second, however, emerged from October 15th to November 19th, and it was programmed, scheduled and packaged in a quite exceptional way for Italian mainstream TV standards – two weeks with double slots followed by four evenings with a single episode, concluding at 10.40 pm and thus bringing forward the late-night schedule. Calculated to maximise the life of a product that had become a huge hit, the approach was a unique occurrence in the generalist programming of recent years. As head writer Francesco Arlanch explains:

Filming of season one began on September 16th, 2019, […] and we knew from the outset that the first episode would have to air on March 26th, 2020. But then COVID-19 broke out, and the Formello set was frantically closed down on 9 March, barely a fortnight before the series would air. […] Just 13 more days filming and all the episodes would have been ready: the whole season was 95% shot, but without the last 5% we couldn’t wrap.

8After heated internal debate and with Lux Vide’s agreement, broadcaster Rai opted for an emergency expedient: the first eight episodes of Doc would air as scheduled, with the other half to follow when the health situation had improved enough to enable at least a partial return to the set. “It wasn’t an easy decision. The commissioner was very reluctant, as were senior figures at Lux Vide: splitting the first season of an emerging brand-new product, and in particular running the risk of audience rejection at a surreal time when medical dramas didn’t seem the most appropriate genre to offer […],” explains Edoardo Gino, story editor for season one and delegate producer of season two, coordinating all the operating processes from writing through to delivery to the commissioner. Arlanch continues: “Viola [Rispoli] and I, though, were both quite confident: we knew we had created a story of hope, without over-dramatising; […] we knew it wasn’t medically distressing.”

9Gino vividly conveys the mood (and its emotional heft) of this extremely delicate time:

COVID-19 seeped into the production even before it entered the plot. That 9th of March [the day when the entire Italian territory was placed in lockdown], I remember it well: there were two weeks of filming left, we were dog tired, working 15–20 hours a day across two units. We arrived on set in the morning, in a make-believe hospital, and they started giving us real masks: […] we were living a real health emergency. […] And Pierdante Piccioni, ever-present on set in that period, was the A&E consultant at Codogno which, by coincidence, is exactly the place where the first case of COVID-19 outside of China was diagnosed, on 21 February 2020: all told, it was a time of bewilderment and widespread panic.

10Gino’s testimony also brings out more details on how the first eight episodes were tweaked before their March 2020 airing:

We’re used to working to tight deadlines; you’ve always got just a few weeks to film in, so you have to get a move on; […] when shooting was paused and we heard that episode one was confirmed in the schedules for the end of the month, the creative producers of the first tranche of episodes were already at the editing stage. […] Fortunately, we have an in-house editing team at Lux Vide, so we got stuck in, muddling through remotely with the post-production, for us an absolute first. That’s when we discovered Zoom and videocalls; we used WeTransfer to exchange the material, and everything was ready in a few days.

11The highly industrialised production process was clearly a great help, facilitating the finalisation of the first part of the season by the original deadline.

12That this approach and the decision to schedule as planned even in lockdown were correct was proved by the huge success of these first few episodes – the best debut for a prime-time series on Raiuno since 2007, with an impressive 8 million viewers each evening on average. As Arlanch explains,

Albeit serendipitously, we’d ended up fulfilling the public desire to get close to doctors and health workers, to celebrate their heroism and selfless spirit of sacrifice. […] Doc became an epic, in those uncertain, complicated weeks when people came together around the TV. We realised that in Argentero’s character, Fanti, we had a major popular hero on our hands.

13It was the added value of synchronised, shared media consumption in response to the pressing need for collective storytelling that was felt at that time: “In the midst of an emergency of that magnitude, […] we managed to tap into the spirit of the time; paradoxically, that historical coincidence played in our favour” (Gino). The partial dovetailing, in the prevailing themes at least, between the real and the diegetic world added unexpected significance for the audience to the events depicted on screen. As one example among many, the “Not today” monologue in S01E12, filmed in January 2020, became a sort of lockdown hymn to the doctors’ and nurses’ spirit of resistance, gaining its own currency on social media and online. The monologue, vaguely inspired by a Game of Thrones landmark scene, captures the emotional and ethical core of the medical profession: in the midst of a medical emergency, in the face of death, overwhelming struggle, and despair, Andrea Fanti urges his whole team to stand firm instead, declaring in passionate voice: “We must look death in the face and say: not today!” In this speech, medicine is not just a science, but also a daily act of courage and resistance, and it works as a reminder that being a doctor means stepping between patients and death, no matter how hopeless things seem. It goes without saying that such an encouragement inevitably took on added semantic nuances when aired during the height of the pandemic, lending itself to a strong informal digital circulation.

14The second half of season one also achieved remarkable numbers – an average 31.9% share, peaking at 40% for the final episode – but before it could be aired, they realised they had to conclude a job that was still unfinished, both on the production side and (for certain details) in the writing: “Before it could go out in October 2020, we had to finish the season. Because of lockdown, we were short of about an hour of footage, which isn’t much in percentage terms, but it was enough to stymie the whole project” (Gino). So, in July 2020, the cast returned to the Formello set for ten days to make up the deficit:

There was a mix of optimism and concern; everything was new, from masks and tests to handwash and distancing. In the meantime, costs had risen; […] the application of strict safety measures and protocols to protect the crew was a major drain on the budget, so we had to make some inevitable cuts and compromises (Arlanch).

15Kisses and hugs were written out or revisited, sometimes with stand-ins, as were group shots and crowd scenes: “we never changed the sense of a scene, not significantly at least; we tweaked the writing and simplified a few things, with the director’s agreement: […] with the sanitary measures in force, we had to hurry, so we did what we could to reduce the number of shooting days” (Gino).

2. The pandemic entering the script: season two

18Arlanch and Rispoli focused first on the “bible”, drafting the characters’ story arcs over the course of the series then for each episode and each character, from the central figure to the supporting roles. Only then was a full writers’ room set up – including the head writers and the episode writers, together with the editor and assistant editors – to work up the medical storylines for each episode and at least two drafts of the script. “On one hand, we had to develop Fanti’s amnesia; on the other, we’d been asked for a concept for a procedural series, with a replicable web of conflicts […] primed for a story of doctor–patient relationships. […] We worked on a formula that could combine tones of melodrama and mystery with a set-up a bit like X-Files,” Arlanch explains.

And there’s a very strong component of romance. […] Even the choice of internal medicine as the department was no coincidence: we realised that the lever for the entire narrative arc could be a never-resolved tension between an empathetic treatment approach, where the patient is best-placed to self-diagnose, and a data-based method, where tests and reports are king. […] It’s a mechanism with potentially unlimited use (Arlanch).

20On one side, the investigative genius of the medical team; on the other, the value of listening and support – a source here of misunderstanding and contention, including with the hospital management and the clinical leads:

We were fascinated with the idea of diagnosis as being completed via continual reference to the patient’s history and bio; […] it’s the concept of narrative medicine that we were introduced to by professor Raffaele Landolfi, consultant at the Policlinico Gemelli and our medical adviser throughout the writing of the series (Arlanch).

• 16 For a discussion on the inclusion or omission of COVID-19 in Italian serial narratives, see Stefani (...)

We started writing the second season in March 2020 with the health emergency in full swing. Many of the people we spoke to urged us not to use the pandemic in the plot as the series played out, as if to pretend it had never existed. But Viola and I believed we couldn’t not talk about or acknowledge it […]. Reality had overtaken fantasy, and we were all shaken to the core: Doc was set in Milan, an epicentre of the outbreak, so expunging it would have turned the show into science fiction. […] If you’re making a medical drama set in contemporary Lombardy, you have no choice16.

23Season two was therefore structured around a dual pre- and post-pandemic timeframe. The script did not dwell on the critical phase of the health emergency, which was condensed into a single episode (S02E08), entitled Cane blu (blue dog). The episode is a flashback set in March 2020, during Italy’s first Covid-19 wave; it depicts the hospital’s transformation into a Covid-only ward, showing the emotional and physical toll on Andrea and his team, working through severe staff shortages, equipment scarcity, and moral dilemmas. The episode powerfully stages the pandemic’s chaos and trauma, culminating in the death of a beloved character and revealing the origin of the phrase “cane blu” as a symbol of hope. Other than this special episode, the second season looked ahead to a gradual return to normal:

We wanted to show the new post-pandemic life, but there was a huge underlying problem: during the writing, when we realised we wouldn’t be coming out of it any time soon, we wondered several times what kind of world would await us, if and when it all blew over; […] there was a risk of seeming dated or of underestimating what the medium-term knock-on effects of the toughest parts of the emergency would be (Arlanch).

25In essence, acknowledging that it would have been impossible to keep the pandemic out of the narrative, both the storyline and the scripts left it inevitably in the background, as an element of the past still widely echoing in the present. It was left to some specific episodes and flashbacks to reveal what happened and what people wanted to forget about its hardest days (including a character’s death). Gino comments, “In effect, the challenge was to recount a generalised trauma as it unfolded; in the second season, we embraced the desire to leave the dark times behind, by processing a kind of collective mourning.” Like season one, then, season two of Doc also echoed a widespread sentiment against a common foe, mediating the crisis and offering a way to reconcile with the hospital setting by spotlighting a profession and a view of life steeped in humanity and sensitivity, and doing so in an inspirational and aspirational way. The story’s unifying power and the script’s ability to interpret the real world without triggering anxiety thus made it possible to change the focus of the second season’s narrative arc, while repeating the success of the first one. And these choices allowed the third season, as the following ones, to continue the narratives without addressing the pandemic emergency again.

Conclusions. Three levels of pandemic impact

26At a time when television – like many other sectors of Italian society – was under trying restrictions, as the health emergency dropped a major caesura in TV’s rhythm, the first two seasons of Doc far exceeded expectations by establishing the series as an enduring national brand and a major draw across diverse audience segments. Rooted in everyday life, instilled with a gripping, shared imaginary, and driven by positive plotlines steeped in courage, mutual support and a thirst for a better future, Doc was seen as a story for and about everyone. It confirmed linear television’s continued role in Italy as an instrument of social cohesion, both in the darkest moments of the emergency and on the long road out of it, an even more uncertain and unstable time. Over and above the structural motives whereby medical dramas traditionally play on their inherently intense, emotive, angst-inducing nature, the scenario in which Doc was written and created only augmented the title’s emotional potential, fulfilling a tacit audience need.

27In this sense, as the interviews with key figures in the writing and production make clear, the pandemic affected the project on at least three operational levels. First, early on, Covid-19 had a major impact on the post-production of season one, on the decision to distribute it in two distinct scheduling blocks, and inevitably on how and when the audience first encountered it. A script completed well before airing, and well before a completely unexpected lockdown, turned out fortuitously to be the perfect tonic. It fulfilled the need for diversion and entertainment, the desire for a positive representation of the doctors and nurses in the news (in a possible world without distancing where masks were used only for the usual hospital purposes) and the yearning for a shared discourse and a moment of communal gathering for audiences shut up in their homes.

28Second, as season one was being finalised (July 2020), the pandemic made a dramatic entrance on set, as social rules and norms were enforced that would have been unthinkable only a few months before. Alongside the operational rethink, albeit confined to the small number of scenes required to complete those already filmed before the crisis hit, the pandemic made its presence felt for the first time in the scriptwriting too; alterations and simplifications were made to lighten the load and ease the pressure of working in tough conditions. And third, the pandemic also seeped into the most creative dimension of the production of season two – the writing of the scripts in their many nuanced layers. Here, the impact was felt in everything from the devising of the set-up and the season story arc to the narrative structure and the sprinkling of hints and references in the script, reaching a crescendo in a special episode (S02E08) that tried to resolve all the questions that had arisen before, building a sense of anticipation.

29This triad of influences was down to a remarkable coming-together of the on-screen (representation), off-screen (real world) and in-front-of-screen (TV audience) dimensions, fostering a strong connection between the production aspects and the more creative components of the television “machine”, in a continual interplay of reality and fiction that was pivotal to the product’s success. From an industrial perspective, the hugely disruptive pandemic emergency initially forced a radical rethink of the entire production chain. The result, with Doc, was effectively an opportunity, albeit a somewhat delicate one, to align with the spirit of the times and with the audience’s needs, leveraging the small screen’s natural propensity to interpret current affairs. Moreover, presenting the pandemic as part of the story allowed the series to establish itself as a truly global product that could be exported into several markets, as it enabled viewers to identify with an experience of global import with which Italy was strongly linked.

30In conclusion, an observer cannot but note how, in hindsight, the hospital microcosm depicted in the series (already an effective vehicle for and an intensifier of emotion) became bound up for a while with the hopes, fears and expectations of the other restricted settings – both the production stronghold at Formello, near Rome, and the living rooms of the audience couped up at home in front of the TV all across Italy. These three kinds of closed environment, imaginary and very real, found themselves aligned for a while in a story and its (at least partly) therapeutic power in a dark and fearful time.

The authors have jointly planned, developed and discussed the article and the underlying research. In detail, Luca Barra has written sections 2 and 4; Emiliano Rossi, sections 1 and 3.