Nurse JackieJackie Peyton (The Sopranos’ Edie Falco) kicks off season 4 of this rightly award-winning show with her life spiralling out of control. Her years of painkiller misuse are finally catching up on her and she reluctantly checks into rehab, trying to keep this 28 day sojourn a secret from her hospital bosses, husband and children. Jackie undoubtedly wants to be well and as her stay in rehab ends she needs to be able to function clean and sober while still contending with her daughters, coping with her new boss and dealing with her divorce.

*****

Nurse Jackie has enough elements from other shows to run the risk of sounding more derivative than it is. Its half-hour running time coupled with a blend of comedy, drama and pathos makes it sound like Scrubs, but it has none of the wackiness or affectation of that show. The constant references to Vicodin and the protagonist’s painkiller misuse makes this sound like House without the differential diagnoses, but it is very much its own creature and such comparisons sell it short.

Falco is incredible in the title role, a perfect blend of dysfunction, humanity, moral goodness, compassion and self-destruction, able to turn on a dime from aggressive confrontation to heart-warming tenderness. The rest of the cast, including Peter Facinelli, the patriarch of the Cullens from Twilight (though his funny, subtle, puppy-dog performance is as far from Cullen Snr as you could imagine), Bobby Cannavale as the new hospital boss, Paul Schulze as a dishevelled pharmacologist, Eve Best, Merritt Wever and the rest are a wonder to behold, a ready rapport as doctors and nurses now comfortably established and character identities now firmly delineated.

Over familiarity has not reduced the supporting cast to caricatures, each still feeling fully realised rather than a set up for a punchline. Facinelli’s attempts at an English accent produce genuine belly laughs and although the patients remain for the most part the butt of jokes, there is plenty of moving drama to be mined here as well as Nurse Jackie navigates recovery, accountability, consequences and a battle for her daughters.

At only ten episodes, this season does feel like it is over before it gets started, but on further reflection the format feels right, with the pacing working well and the combination of shorter and longer term storylines being covered in just the right amount of detail. Relationship ups and downs, developing pregnancies and efficiency drives all get their place. Cannavale’s new doctor, initially seeming to be an obvious foil for Jackie and a one-dimensional efficiency and ruthlessness machine, convincingly moves through an affecting arc relating to his strained relationship with his son and his own ability to be flexible and accommodating.  The hardships of life are presented with enough honesty to be realistic and affecting, without the show disappearing into a pit of miserablism. An excellent show fully deserving of our attention. You can get it here from 25th February 2013.

[Rating:4/5]

Extras: Not much – a couple of cast interviews that don’t add much.

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