Do Theatre have developed a theatre language that is both evocative and visually beautiful. Audiences have come to expect a lot from them. In this production, physical expertise and visual clowning combine to parody Soviet insane asylums. Upside Down begins with a furious and macabre castration of a patient by a Chaplinesque doctor and his busty assistant, played brilliantly by Alexandr Bondarev and Irina Koslova – the execution of which is performed with perfect precision, almost losing its horror it is so well choreographed.

There follows a series of vignettes and episodes from hospital life with the doctors and patients reversing and changing roles throughout, creating a mish-mash of cheeky and humorous incidents with axes and ballet tutus. A mysterious cupboard from which the characters emerge on a regular basis, covered in blood, features throughout and the piece integrates small catches of text and a hilarious rendition of a song perfectly performed with an irony of which the Russians would be proud. One very striking moment in the piece was a solo sur pointe performed by Evgeny Kozlov whose bony and butohesque body was extenuated by the wooden point shoes – had the image of the male swan not been already stale in our minds from Adventures in Motion Pictures' Swan Lake, this would have been a spectacularly strong moment.

Another very compelling part was a duet between the two men which was moving and strong in its simple rendition of a mutual male respect and love – wonderfully undercut by the knowledge that before long one would be patient and one would be doctor but the timelessness of the bond between them rendered itself a cut above the day to day drudge of asylum life.