I suspect Suranne Jones’ Gemma Foster suffered from a few hangovers during her ethics lectures when she was a medical student. Or maybe she just wasn’t paying attention.

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Because in this second episode, it was not enough for her to break patient confidentiality once (telling the wife of her patient that he had a brain tumour). Oh no. She then did it a second time, swapping patients so she could treat Jodie Comer’s Kate – someone she knew was her husband’s lover.

Then she blackmailed her former colleague Jack (Robert Pugh) into getting treatment for his boozing. But let's park that.

Who can blame her? She had just found out that her husband Simon (Bertie Carvel) had long been having an affair with the daughter of one of their friends. And that everyone in their small community seemed to know about it.

The fun and games started when Simon came back – drunk – from a birthday barbecue and didn’t even notice the telltale suitcases in the hall. Not even when he tripped over them. Even if he and Gemma repair their relationship, it is probably not something they will laugh about in years to come.

“Remember the time I got away with being kicked out after my affair because I didn’t even notice the suitcases… What larks!”

He knows how to get away with murder, but I wouldn’t bet against Gemma. Unbeknown to Simon, she is armed with the knowledge of his unfaithfulness, something that enabled her to test her wayward spouse later in the episode.

“I think you’re having an affair,” she said, adding that she could potentially get over the extra-marital relationship but the lying would be a deal-breaker. So what did he do? He lied again.

(He also lied to his son earlier in the episode when he came down obviously hungover and said with a knowing wink “didn’t touch a drop”. It was a nice touch, demonstrating how he glides effortlessly along the scale of fibs with the virtuosity of a violinist).

But why didn’t she just tell him that she knew what he was up to?

It may seem unconvincing at first, this idea that she wouldn’t want to knock his block off straight away, but there are intimations that Gemma is a cold fish and is more than capable of scheming to suit her own ends. (Perhaps they are well suited as a couple after all).

This was demonstrated when she switched patients to examine Kate. It allowed her to study her husband’s lover close up, tormenting herself with the sight of the young flesh and curves that her husband apparently enjoys on a regular basis.

She is also someone capable of remarkable self-control, accumulating evidence, none more deadly and devastating than the knowledge of Kate’s pregnancy. But she is treading on dangerous ground. One suspects that this violation of professional ethics may well come back to haunt her when Simon’s affair explodes into the open.

And then there was the bar room scene where she encounters Anwar (Navin Chowdhry) and finds out that, as she suspected during his aborted visit to her surgery, he does have a brain tumour. So what does she do? She uses his phone when he is in the loo to call his wife and tell her about his illness.

Yes, Gemma’s behaviour is highly inconsistent and erratic but, thanks to Suranne Jones’ excellent performance, we see it as the fallout of severe stress. Her world has fallen apart, she doesn’t know what to do, the old certainties and rules have gone out of the window. I, for one, buy it.

Because from beginning to end, this was a fabulously dramatic and involving episode where the tension prickled with the force of a hundred hypodermic syringes.

There was never a dull moment as lie upon lie slowly unpeeled or stacked up and Gemma’s machinations took shape. It’s still hard to know where she’s going with all this but her decision to get Ros to tell Kate to tell Simon that Kate is pregnant (did you follow that? That’s infidelity for you, folks) has set things up nicely for episode three.

Kate is keeping the baby. But I wouldn’t bet on Simon keeping his wife for much longer…

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First look at Suranne Jones and Bertie Carvel in BBC1 thriller Doctor Foster

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