Sandra Bernhard, Leicester Square Theatre, London

The real test of stand-up stamina – to keep your heels on

One thing's for sure: the lady has staying power. Twenty-one years after she broke out with her one-woman off-Broadway show Without You I'm Nothing, Sandra Bernhard, right, is back with an updated reprise for a West End run. A 120-minute reprise. With no interval. Quite an ask. The question was: could she keep going for the full two hours while perched atop those heels?

Mouthy, obnoxious and, frankly, shoutingly loud is how British audiences remember Bernhard: as the rumoured lover of Madonna or from her stint as Nancy Bartlett in Roseanne. But that finished more than a decade ago. Mouthy she certainly remains, with well-directed bitches at celebrities from Joan Collins ("As I leant in to kiss her she looked as if she'd just smelled shit") to Simon Cowell ("I would have leapt off that stage and stabbed him in the neck" she reasons, had she been on any one of the high-trousered one's reality shows). But obnoxious she isn't.

This show is part stand-up (brought up to the minute with many a Twitter reference, not to mention the previous night's Britain's Got Talent and a stinging barb to a country that believes a fat Greek father and son dancing badly is entertainment – "The kid's already diabetic!"); part rock concert (with surprisingly good vocals and a wonderful Whitesnake moment); and part wistful reminiscences of a childhood in Flint, Michigan. And throughout Bernhard comes across as charismatic, endearing and as energetic as a person of half her 54 years.

And shoutingly loud? Well, the singing occasionally lapses into bellowing, but the quieter numbers, notably "Me and Mrs Jones" (complete with comedy face-pulling), are surprisingly tender. The presence of the songs themselves, however, is a little strange. The opening number of Christina Aguilera's "Beautiful" is apposite for someone whose acting chops (proved in Martin Scorsese's The King of Comedy) appear to have been ignored by Hollywood because of her quirky looks, but often the musical interludes seem more an opportunity to take a rest from telling her story than being integral to it.

Which brings us to that autobiographical story. It is hard not to warm to tales from Bernhard's childhood of gleefully watching ambulances sliding into each other on the ice-glazed roads of Flint, or her fantasies of a Wasp-ish life. But a clash of cultures becomes apparent as the evening wears on and she draws more and more on American references that, frankly, go right over the head of half the audience, that half being the Brits.

The Americans lapped up her comments about A-Rod holding up a Torah (Alex Rodriguez, the non-Jewish baseball star in question, recently started studying Kabbalah) and an exercise guru who might have been called Paula Trott, but then again might not.

Did she last the course? The last 30 minutes started to drag, with Bernhard taking frequent recourse to her notes, but 90 minutes of entertainment – at times laugh-out-loud funny – is about 45 minutes more than stand-ups usually deliver. And to have done it all in those heels is an impressive feat indeed. No pun intended.

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