A gritty crime drama based on Dublin’s criminal underworld: It depicts the drug addiction, squalor and violence of organised crime that has grown in post-boom Ireland. Darren Treacy returns to Dublin from Spain, spending time there while trying to avoid the Gardaí in Ireland for gun possession. Darren’s brother Robbie is released from Cloverhill prison. While waiting to be collected Robbie is killed outside a newsagents in a drive-by shooting. Catastrophic events ignite tension among the drug gang, family and friends must live with the consequences.

This is a brief summary of the start of Love/Hate, the TV drama which we either love or…not. The summary could well, with a few name and detail changes, serve as part of the social history section of several of my patients’ medical records. Indeed, I have (for now) decided not to watch season four because it seems far too close to home – or should I say work? 

It is a brilliant, if all too real depiction of another side of Dublin life, which we middle-class professional types find fascinating and from which we might feel quite detached if we were not (like me) deeply involved in the lives of people like Darren, Nidge, Darren’s mother and sisters and aunt, uncle and baby nephew, etc.

Individuals just like these amazingly well written and consummately acted characters populate our waiting rooms and our consulting rooms in inner city practices. Some are villains and are involved in, or were responsible for, the most appalling crimes of violence, cruelty and drug dealing. Most are victims of this terrible culture of addiction, crime and death. Many we will not see again and their medical records are archived under RIP. 

From the outside of this inner city culture, looking in, it must seem that these characters lack some of the qualities and sensitivities which make ‘normal’ people like you and me tick. They must be devoid of feelings, emotions and honour. However, life – human life – is much more complex than that. Most of those caught up in this milieu of addiction, crime and murder have been reared in communities that have generational links with deprivation, poverty and very poor health – mostly originating in the old inner city tenements. 

Free will and the individual’s ability to judge what is right and what is wrong are part of my belief system and no excuses can be made for cruelty, violence and amoral selfishness. However, explanations for why this destructive behaviour is prevalent in historically deprived communities can be found when considering social and local history.

Gerry has recently attended my practice because of his alcohol use, his anger, depression and his separation from family and home. He is homeless. Gerry’s two sons are heroin addicts and minor dealers in the inner city and he has tried to help them on countless occasions to stop drugs; he has beggared himself by enabling them to pay off drug debts for which they would otherwise have been shot. He feels broken and he thinks this is why he drinks. 

As a child Gerry was sent to an industrial school aged eight where he was physically and sexually abused. Living in a tenement with eight children, his mother could not cope and relinquished him, until he was 14, to the ‘Brothers’. The father was an unemployed docker who drank heavily.

This tearful, intelligent and sensitive man in his 60s was involved in minor crime in his youth but got a job with the Corporation and had a happy family life until his sons became addicted and involved in the drug gangland. His drinking destroyed his marriage and cost him his employment.

Gerry’s wife Deirdre also attends the practice and she is being treated for depression and anxiety. One of her addicted sons is living with her and the other young man is in Spain ‘working in a bar’. Her nephew was shot dead in a pub two years ago and she is terrified the same will happen to her own boys. The mainstay of her life is that her married daughter owns a hairdresser’s and has three small children, having escaped the inner city drug/crime scene.

Obviously, Gerry and Deirdre are composite characters but they and their sons represent dozens of people who I have had the privilege to meet as a GP and who demonstrate all the varieties of personality, humour, creativity, sensitivity and weakness, coldness and warmth that are prevalent in any human population. But they have lived under burdens that most of us have not had to shoulder.

Perhaps I will get a box set of Love/Hate at some future date… could be useful for tutorials with my registrar!