You Are Your Only Limit Casualty


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You Are Your Only Limit

Connie's crusade reaches its pinnacle at Elle's hearing. Robyn questions whether she is fit to be a mother.


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It's a leaflet containing all the information for making a complaint.

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I've been called to a MPTS hearing.

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I'm going to have to lessen my dose.

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If I don't, how can I ever be the father Ollie deserves?

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It came, then?

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Good. I must remember to get you a leaving card.

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Doctors like you eventually cost patients their lives,

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but come the tribunal, you're finished.

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PHONE CHIRPS

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PHONE CHIRPS

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CLATTERING

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Grace!

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Why didn't you call me?

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I'm sorry. I thought I could do it on my own.

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Oh, sweetheart. Don't be sorry.

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It's all going to be OK.

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Gracie, you're supposed to be eating breakfast, darling. Grace?

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Anne and Sophie on the ski trip. Alpe D'Huez.

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Alpe D'Huez is so overrated.

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Tell you what,

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next year you and I will be tearing down the slopes of Aspen, Colorado.

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Sweetheart, remember what I said - you are your only limit.

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Anyway, look at how far you've come, all right?

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You can do it.

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Um...right.

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Stop it. It's only for today.

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Do I really have to go?

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-Yes, you do.

-DOORBELL RINGS

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It can't be the taxi. It's too early.

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Sorry, you're just...

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Morning.

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Oi! There you are. That'll wake you up.

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I love you so much right now.

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Lily, Ethan, can I ask you to look after Resus for me, please?

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And Alicia, take over in Cubicles. We'll be back by lunch.

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-Of course, it's the hearing today, isn't it?

-It is, yeah.

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Come on, don't be stupid - of course we're picking you up.

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Just leaving. All right, bye.

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How's Dr Gardner?

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Yeah, she's holding up. Kind of.

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It's all totally unnecessary. It's just shenanigans.

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She'll be fine.

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Yeah. I sincerely hope so.

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This is nuts, this hearing, isn't it?

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We're doctors. We need to be held accountable.

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Yes, one adult and one ten-year-old for kick boxing.

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Kick boxing?

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Later.

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Yes, yes, thank you. Thank you.

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Kick boxing, yoga, family boot camp?

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Life begins at the end of your comfort zone.

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No need to tell me.

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Maybe you're overdoing it.

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Do you not think you should speak to someone about reducing your lithium?

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And say what? "Look, I've got a real problem, Doc.

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"I'd really like to get fit and spend time with my son"?

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I'm just worried for you.

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Really? For me?

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Robyn, you're projecting.

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You're worrying about others when you're terrified yourself,

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which is totally understandable. Motherhood is a daunting prospect.

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And these certainly won't be helping, either.

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Sugar and caffeine make you far more susceptible to stress.

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No, no, no, no!

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Yes, yes, yes, yes, yes!

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What you need is to face your fears.

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It can be very liberating.

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Ah! I think I know just the thing.

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Won't be long.

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Oh, it was epic.

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A really epic night. I wish you were there, mate.

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Ha! Tell me about it, barely keeping it together.

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Just taking little bro to school. Come on, Elliot!

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Shift your backside!

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Cool, give us half an hour. Here, I'll carry it.

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-No! Get off!

-All right, puss-puss. Keep your hair on.

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Don't call me that.

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Ellie? You OK? Mate, your nose.

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Whoa! Hey.

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There's blood in this.

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Perfect timing as usual.

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You could have least let me know.

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You would have tried to put me off.

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Especially today. Come on, Connie.

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The whole hospital is talking about you commandeering the GMC.

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You can't commandeer the GMC. They obviously think there's a case.

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Word is you've tried to make it your personal crusade.

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Crusade?

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People talk, Connie.

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Well, if "people" had a daughter with brain damage who can barely

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get herself to the toilet without falling over,

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perhaps they would rethink things,

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so excuse me if I try and prevent this from happening

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to someone else because that woman...

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Gracie, I'm sorry, sweetheart...

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I didn't...

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DOORBELL RINGS

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Taxi's here.

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Are you serious?

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What?

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You're showing her off!

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I can use my crutches, Mum.

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No, it's fine. It's going to be a long day.

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Let's parade her around in a wheelchair for maximum effect.

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Don't you dare!

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Come on, sweetheart.

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OK, then. Let's do it together.

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I'll come with you.

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"Still not managed to get Charlie in his togs,

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"but when I do, I promise to take a picture.

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"Love, Duffy."

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Also got this for Dr Gardner.

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Hm. Better take that back to Reception.

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She might not be back at all, you know.

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I hear those tribunals can be...

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C'mon, guys. I mean, surely it's just a formality?

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I still can't believe Mrs Beauchamp is doing this to her.

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Really? I can.

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Anyway, concentrate. Blue labels - surgery notes, green labels -

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existing admissions and yellow labels - recent discharges.

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It works a treat.

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-Don't thank me, thank David - it was his idea.

-David's?

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Yeah, he's been really productive lately. Ah, the man himself.

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I was just saying you are on top form.

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Well, I aim to please.

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Oh, yeah? What you up to now?

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This.

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What is that?

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This is baby Alice.

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She cries, she wees, she sleeps, just like the real thing.

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Jo at Maternity said as it was for you,

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she could spare it for the whole day.

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Don't they give them to teenage girls?

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Yeah, to put them off.

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Yes, thank you, both.

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A day with baby Alice - face your fears head on.

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It's OK to be scared.

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I'm not scared. I'm not scared.

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-There we go.

-She looks tired, Connie.

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Well, she's been working very hard. We both have.

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-Which is why I think this is totally the wrong...

-Please don't start.

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-Mrs Beauchamp!

-Oh, good morning.

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-Good morning.

-Zahira Tahar, GMC representative.

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Sam Strachan. Grace's father.

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Nice to meet you. Sorry, morning sustenance. How are you, Grace?

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As well as can be expected.

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Right.

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So, this is how it's going to work.

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I present the case, enclose statements.

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They'll have read those already.

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Then witnesses, then the main complainant - you.

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Good news is we have O'Shaughnessy

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as chairman so he won't drag his feet.

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Gabriel O'Shaughnessy?

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Kings, London?

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Yes. Have you worked with him?

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No. No. But I certainly know of him.

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I'll see you inside.

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OK. Thank you.

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Dr Gardner.

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Mrs Beauchamp.

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Let's go.

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CRYING

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Come on, good girl.

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Come on, baby.

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Give me a break!

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Think, think, think... Sing! OK! OK, what song...

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Um... # I live my day as if it was the last

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# Live my day as if there was no past

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# Doin' it all night, all summer

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# Doin' it the way I want to

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# Yeah I'm a dance my heart out till the dawn

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# But I won't be done when morning comes

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# Doin' it all night, all summer. #

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Robyn, need you in there - an actual child.

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You, stay.

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Right, this is Elliot Allcott, aged ten.

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He's got severe epistaxis, found blood in his vomit,

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which he potentially swallowed.

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GCS 15, pulse 100, BP 110 over 70.

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The bleeding stopped in the ambo,

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but he won't let us examine him any further.

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Paeds Resus, please. Elliot, I'm Dr Chao.

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Please, I want to go home.

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C'mon, mate. Calm down.

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This is brother Jack, 16.

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Apparently, his dad's not around and his mum's away.

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OK. Hop onto the bed for me.

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Good lad.

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-I'm just going to have a look up your nose...

-No! Get off!

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Ellie, get a grip! He freaks at everything.

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No, I don't.

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It's OK, don't worry. I'm a total wuss!

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Yeah. And this one looks really scary, but she's dead soft.

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-Hilarious. Run along now.

-You're so soft! You're so soft!

-OK!

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Right, has this happened before?

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No. No, never.

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I was dropping him off at school when his nose just went,

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then he chucked up all over the place.

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Has he had a fall recently or a blow to the nose?

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Don't think so, not that I know of. Elliot?

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No, I... I don't know.

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How do you mean? You'd know if you did!

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I'm sorry, I...

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OK, don't worry. It's fine.

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Any allergies? Medical conditions we need to know about?

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No, no, nothing.

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Has your mum been informed?

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She's-she's in an all-day interview in Warwickshire. She went yesterday.

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Uh-oh.

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-Here, let me.

-No! No, get off.

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Ellie! Just let them help you.

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OK, Elliot, how about if you do it and I'll show you how?

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What you do is just pinch that bit, under the bone, that soft bit there.

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OK? Keep pinching there. Good boy.

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Right, now don't tip your head back cos otherwise you're going to

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end up swallowing it all, all right?

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I'm going to put this there and if you need to spit, you can.

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OK?

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I've got this. Why don't you go?

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-I know you've got a million and one patients.

-Thank you.

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Can you try the mother, please?

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I'm going to try to get hold of their GP

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and see if there's any history.

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-Let me know?

-Hm-mm.

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I'm really sorry.

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Hey. Don't be silly. Told you, you just stick with me, kid.

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I thought this was not supposed to be a trial.

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I did say you should have someone representing you.

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I think it just makes you look like you have something to hide.

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I'm entirely capable of explaining myself.

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It's just that being the main complainant,

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I thought it might be beneficial to start off with me.

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I can make a very succinct case.

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What's your view on observers?

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Sorry?

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In theatre when you operate.

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No...

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We'll do it my way.

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OK.

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Ah. Miss Zafar, thank you for coming.

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Just to let you know, I do have a shift this afternoon.

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No worries. You're up first.

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Thank you.

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Are you supposed to be the cavalry?

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I didn't want to come.

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I thought you were all great that day.

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Be a lot of fun, isn't it, all this?

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How are you doing, firecracker?

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You all right?

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Sam.

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I guess he had to go, too.

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-Here we go.

-Goodness me.

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They brought O'Shaughnessy out of hibernation.

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-Hm?

-Oh, he's a pioneering cardiothoracic surgeon.

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He gave a visiting lecture when I was at med school.

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The men shook, the women swooned.

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Morning, everyone.

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Opening proceedings in the case of the medical practitioners tribunal

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brought against Dr L Gardner. MBChB, 1991,

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University of Exeter,

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GMC reference 21343398.

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See. What did I tell you? It's stopped.

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You scared the freakin' life out of me, mate.

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It was like a horror film.

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Right, I'm going to get you into a gown.

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Epic. Posting this. You're going to get so many likes!

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OK. Once we've got you changed,

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I'm going to get Dr Chao in to have another look.

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But I'm OK now. I just want to go.

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We need to know what caused it.

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Oi, has someone been picking on you at school again?

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-Punched you or...

-No!

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He gets a bit hassled at school

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cos he's a bit more sensitive than the rest.

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He's no good at footy, so... Who is it?

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-Is it that prat Jaden?

-No!

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Cos I will go sort him out right now.

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Nothing happened at school!

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But if it has...

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Nothing has! I swear.

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I fell. I did fall.

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When?

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Yesterday. At night.

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I got up to go to the loo and fell.

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But I was there.

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I called you but you were busy.

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Busy?

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Yeah, with your party.

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The music was really loud,

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and you were all shouting and laughing. I did try.

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It was just a few mates, honest.

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OK. Can I have a word, please?

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So it isn't just the Grace Beauchamp case which brings us here.

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We'll go into that in some detail.

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It's also recent events that Dr Gardner was involved in,

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as witnessed in statements 1A, 1B, 1C...

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Why hasn't she got a legal representation?

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I guess she underestimated what she's up against.

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..which clearly demonstrate impairment of fitness to practise.

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I'd like to call our first witness, if I may.

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Agency Staff Nurse Amira Zafar.

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But I swear we didn't even have the music on that loud.

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I don't get it. And there weren't that many people.

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And there weren't that many drinks, either?

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Cos you'd be surprised, after a few,

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the music tends to go up a notch.

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I am 16. I'm allowed a drink.

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Yeah - under supervision!

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Look, it's not that I don't know what it's like,

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but your mum left you in charge.

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Did she even know you were having a party?

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But it was an accident. It could have happened any time.

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But it didn't. It happened on your watch.

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-What do you think she's going to say?

-You don't have to tell her.

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Anything could have happened to him.

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-We can't hide it from her!

-Please, just let me do it.

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She's had it really tough since Dad left,

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and she was really excited about this interview, and now I...

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now I wrecked it for her.

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I know I messed up. I just want to tell her myself.

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Thank you. You're a star.

0:16:590:17:01

So, at that point, you came back and told Dr Gardner

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that CT were ready for Grace?

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-Yes.

-Did you say anything else?

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I asked her if she wanted me to call an anaesthetist.

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So you actually prompted her. And her reply?

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She said that Grace was supporting her airway

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and didn't need to be intubated.

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Right.

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Next thing, Grace Beauchamp deteriorated,

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vomited in the scanner and had to be rushed back to Resus,

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where she was attended by yourself,

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Cardiothoracic Consultant Jac Naylor, Dr Dylan Keogh,

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Sister Lisa Duffin

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and Senior Charge Nurse Charlie Fairhead - is that right?

0:17:440:17:47

Yes.

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How did Dr Gardner react on seeing Grace?

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She proceeded to intubate her.

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In how many attempts?

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It was in fact two.

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How did she seem at the time?

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Well, obviously under pressure. It had been a terrible day.

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There had been an explosion, a helicopter crashed...

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What were the reactions of the other staff?

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I know this was some time ago,

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but I can't stress the importance of this more strongly.

0:18:120:18:16

Did any of the other clinicians ask why Grace wasn't intubated?

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Dr Keogh.

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Dr Gardner said that Grace was supporting her airway

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at the time so there was no need.

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And his response?

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He said... "Well, she's certainly not supporting her airway now."

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If he had a fall, that could explain the nosebleed.

0:18:490:18:51

-He still seems really nervous, though.

-Hm.

0:18:510:18:54

We've got three people waiting on discharge.

0:18:540:18:56

Coming.

0:18:560:18:57

Let's move him to Cubicles, take obs and bloods and monitor him.

0:18:570:19:00

So far, so good.

0:19:000:19:02

Is Jack annoyed with me?

0:19:040:19:06

Of course not.

0:19:060:19:08

He probably feels rotten that you hurt yourself and he wasn't there.

0:19:080:19:13

I got him into trouble, haven't I?

0:19:130:19:14

You told the truth. That's the right thing to do.

0:19:140:19:17

That is the truth, isn't?

0:19:190:19:21

Course.

0:19:210:19:23

Elliot?

0:19:240:19:26

-Where's my backpack?

-Whi...

0:19:260:19:27

My backpack! One I take to school. Does Jack have it?

0:19:270:19:30

I don't know. I haven't seen...

0:19:300:19:32

It's black and green, got a football on it. I need it.

0:19:320:19:34

It's got all my stuff - my keys, my iPod. Mum will kill me!

0:19:340:19:38

OK, don't upset yourself, all right? You'll set your nose off.

0:19:380:19:42

I'll go and ask the paramedics, OK?

0:19:430:19:45

Ah, David, any news?

0:19:460:19:49

No, none.

0:19:490:19:50

Dr Chao, I'm telling you the colour coding's been so successful

0:19:500:19:53

I'm thinking of re-organising the pharmacy lists that way.

0:19:530:19:58

What? I'm just saying!

0:19:580:20:01

Congratulations, by the way.

0:20:020:20:04

David tells me she's got a right pair of lungs on her.

0:20:040:20:08

The baby. Don't tell me you've ditched her already?

0:20:080:20:10

Ha-ha, funny. Elliot Allcott's lost his backpack.

0:20:100:20:13

Can you have a check for me, please?

0:20:130:20:15

-Yeah.

-He's got a point.

0:20:150:20:16

When was the last time you checked on her?

0:20:160:20:18

I'm going, now.

0:20:180:20:20

Good luck, by the way. We're all rooting for you!

0:20:200:20:23

I bet you'd lock yours in a cupboard, wouldn't you?

0:20:230:20:25

Sparkling wit.

0:20:250:20:27

Hey, listen, I'm seeing Gem next week, so thank you.

0:20:270:20:30

Ooh, Max, the kid in Paeds Resus - Cubicles, please.

0:20:310:20:34

Yeah, sure. Listen, go and see Noel.

0:20:340:20:37

There's something you might want to come in on.

0:20:370:20:39

CRYING

0:21:020:21:05

So you were clearly taken aback at Dr Gardner's answer?

0:21:050:21:09

Well, no. I wouldn't say that.

0:21:090:21:11

We were all under a lot of pressure that day.

0:21:110:21:14

There was a major incident.

0:21:140:21:16

Granted.

0:21:160:21:17

But it does seem like you didn't find Dr Gardner's explanation

0:21:170:21:20

satisfactory at the time?

0:21:200:21:21

-She's not looking good. I'm taking her out.

-Just hold on.

0:21:210:21:24

It's a grey area.

0:21:240:21:25

Dr Keogh, given the same presentation,

0:21:250:21:28

would you have intubated?

0:21:280:21:30

I...

0:21:330:21:34

I don't believe you.

0:21:340:21:35

Yes or no, Dr Keogh?

0:21:350:21:37

Yes.

0:21:420:21:44

Thank you.

0:21:440:21:45

I'd like to proceed to the complainant, Mrs Connie Beauchamp.

0:21:460:21:50

# Doin' it all night, all summer Doin' it the way I want to. #

0:21:550:22:00

Oh, c'mon on! Please! Shh, shh, shh.

0:22:000:22:03

Jez called, he found a rucksack?

0:22:050:22:07

That thing is really loud. It might need changing.

0:22:070:22:11

Can you describe, as Grace's mother, what her daily challenges are?

0:22:150:22:19

Well, her motor skills are significantly impaired.

0:22:190:22:23

She needs near-constant assistance even with the smallest of tasks.

0:22:230:22:27

For example, yesterday she fell on her way to the bathroom.

0:22:270:22:32

She has to endure a gruelling daily exercise routine,

0:22:320:22:37

not to mention the emotional and psychological damage -

0:22:370:22:40

missing out on her education, her social life.

0:22:400:22:44

And you had no idea this was all preventable?

0:22:440:22:46

No. None whatsoever,

0:22:460:22:48

not until I requested, repeatedly requested,

0:22:480:22:51

the notes did I realise there was a case of gross medical negligence.

0:22:510:22:56

And can I just clarify that I'm here not solely as a parent,

0:22:560:23:01

but also as an ED consultant and as such

0:23:010:23:04

recognise when a colleague is just not capable.

0:23:040:23:07

Are you referring to...

0:23:070:23:08

Dr Gardner may be a competent physician

0:23:080:23:10

when things are going well, but she cannot handle the pressure,

0:23:100:23:13

and that makes her a liability.

0:23:130:23:16

From the very first day she arrived, late,

0:23:160:23:19

following an accident en-route,

0:23:190:23:21

to the latest fiasco with a patient...

0:23:210:23:24

If I may just stop your flow there for a moment, Mrs Beauchamp.

0:23:240:23:27

You are, I presume, referring to the incident with Jamison Francis?

0:23:270:23:31

Yes, I am.

0:23:310:23:33

Hm.

0:23:330:23:34

It is not my place as the tribunal chair to interject.

0:23:340:23:40

In fact, it is strictly forbidden.

0:23:400:23:43

However, I feel compelled.

0:23:440:23:47

You have been a consultant for how many years?

0:23:470:23:52

More than I care count.

0:23:520:23:54

Not an ED consultant, though?

0:23:540:23:56

-Well...

-In that time, I'm sure you must have been on the receiving end

0:23:560:24:00

of quite a lot of - excuse my language - crap from patients?

0:24:000:24:06

Yes, I have.

0:24:060:24:08

Hm. Not all of it, I hope, for justified reasons?

0:24:080:24:13

Well...

0:24:130:24:15

You ever reacted back?

0:24:150:24:18

I may have.

0:24:230:24:25

But I have never confronted a colleague inebriated

0:24:250:24:28

and embarrassed myself.

0:24:280:24:30

Are you saying Dr Gardner...

0:24:300:24:33

Cornered me at a wedding reception and threatened me, with I quote,

0:24:330:24:38

"I'm ready for a fight" and "watch this space."

0:24:380:24:43

Is the girl not well?

0:24:430:24:44

No, she isn't.

0:24:450:24:47

Let's break.

0:24:470:24:49

I imagine you'd want to be with your daughter.

0:24:490:24:52

Hang on a minute - how come Max got three to one

0:24:550:24:58

and now it's two to one?

0:24:580:24:59

Sorry, mate, situation is fluid - the odds changed from this morning.

0:24:590:25:02

I'll take it. They're still good.

0:25:020:25:04

Poor Robyn. This is cruel, this.

0:25:040:25:06

I mean, I'll put two quid on.

0:25:070:25:09

Fiver for me. She'll do it.

0:25:090:25:11

Guys. Guys.

0:25:130:25:15

-Hey.

-Hey. I found it. It got kicked under the seat.

0:25:160:25:20

Ah. Thanks. What's going on?

0:25:200:25:23

Oh, we're just checking about Dr Gardner, but no news.

0:25:230:25:26

Hey, it's all in good fun, you know.

0:25:300:25:32

I've had enough. She's not well.

0:25:340:25:36

Well, she's clearly better than she was.

0:25:360:25:38

How can anyone get better in this atmosphere?

0:25:380:25:41

You clearly care more about this tribunal than anything else.

0:25:410:25:44

Do you think this is good for her,

0:25:440:25:45

seeing her father tear strips out of her mother?

0:25:450:25:48

Come on, Connie, you know

0:25:480:25:49

in the corner of your mind you've gone too far.

0:25:490:25:51

You're just lashing out. It's happened. It's done.

0:25:510:25:55

You trying to screw over a colleague isn't going to help things.

0:25:550:25:59

-This is making you look really bad.

-Oh, I'll be the judge of that.

0:25:590:26:02

Can I go to the toilet?

0:26:020:26:03

Yes, darling, of course.

0:26:050:26:07

See? See how she's progressed?

0:26:090:26:12

Yes, of course I can see that.

0:26:120:26:14

Well, where's your support? Not there.

0:26:140:26:17

That's nothing new, is it?

0:26:170:26:18

Dr Gardner.

0:26:180:26:20

I'm sorry, this is really unfair.

0:26:200:26:22

It's OK, really.

0:26:220:26:24

You need to be strong.

0:26:280:26:30

Hm. They put words in your mouth, don't they?

0:26:320:26:35

They certainly do.

0:26:350:26:37

Well, I dare say it won't be any consolation,

0:26:380:26:41

but I do know how it feels.

0:26:410:26:44

Thanks, Dylan.

0:26:450:26:47

We're going to head back to base, but just text me, OK?

0:26:470:26:51

Come here.

0:26:510:26:52

Don't be a hero.

0:26:550:26:57

RINGING

0:27:010:27:04

Hi, lovely.

0:27:100:27:12

No, no, no, no, it's fine.

0:27:120:27:13

This is the one, right?

0:27:150:27:17

How's Alice? Putting on weight?

0:27:170:27:19

Sleeping through? Only joking.

0:27:190:27:20

Right, let's just check that everything's in here.

0:27:200:27:23

No, I'll do it!

0:27:230:27:25

Wow! Blue hair!

0:27:280:27:30

They didn't make them like that in my day.

0:27:300:27:33

She's not mine. They're...Macy's. She goes to my school.

0:27:330:27:38

She asked me to look after them for her.

0:27:380:27:41

OK.

0:27:410:27:42

Yeah, so I'm just looking after them.

0:27:420:27:45

Can I have my bag, please?

0:27:450:27:47

Elliot, are you OK? You're looking a bit peaky.

0:27:500:27:53

You are a bit hot.

0:27:550:27:56

Look what I got for you, bro - your fave.

0:27:580:28:00

Old Granny here likes her tea and biscuits.

0:28:000:28:02

Right, no arguments now, come on.

0:28:020:28:05

38.7. You are running a fever.

0:28:080:28:11

A fever?

0:28:110:28:12

Yeah. I'm going to go and get the doctor.

0:28:120:28:14

Argh!

0:28:320:28:35

A temperature suggests an infection. Has he been ill before?

0:28:410:28:45

Well, no, he hasn't said.

0:28:450:28:46

I just want to go home. Why can't I go home?

0:28:460:28:49

We're just trying to help you, sweetie.

0:28:490:28:51

I'd really like to examine your nose, Elliot.

0:28:510:28:54

I'm sorry, mate. You've had it your way,

0:28:540:28:55

-now you've got to let the doc have a look.

-I just want to go home!

0:28:550:28:58

It won't take a second.

0:28:580:29:00

Elliot, cut it out!

0:29:000:29:01

Just...do it.

0:29:010:29:03

OK?

0:29:030:29:04

Good boy.

0:29:050:29:07

Yup, definitely an infection.

0:29:100:29:12

Full of gunk.

0:29:120:29:13

Where's Mum? I want my mum.

0:29:130:29:15

Yes, where's Mum?

0:29:150:29:17

I...

0:29:200:29:22

What's going on?

0:29:220:29:23

No, no, it's just like I said. It's ticking boxes.

0:29:250:29:28

Yeah. Yeah, OK, I'll speak to you later. Bye.

0:29:310:29:34

Grace!

0:29:450:29:47

Grace?! Help!

0:29:470:29:48

I need some help in here!

0:29:480:29:51

It's OK, Grace, I've got you.

0:29:510:29:53

Try and stay nice and still for me.

0:29:570:29:59

No, no, no, no, no!

0:30:010:30:03

Somebody help me!

0:30:030:30:05

Dial 999, NOW!

0:30:090:30:11

Grace! Gra...

0:30:130:30:15

Let me get this straight -

0:30:150:30:16

you took his word that he was going to call his mum?

0:30:160:30:18

Yeah! He's a good kid.

0:30:180:30:20

He's a teenager who was left in charge and messed up.

0:30:200:30:23

I don't believe you sometimes.

0:30:230:30:25

They're kids. It was a party - these things just happen.

0:30:250:30:27

Yes! Kids! We're the adults,

0:30:270:30:29

and now he's ill and his mum's not even on her way.

0:30:290:30:32

How would you feel?

0:30:320:30:33

Right. 500 milligrams of paracetamol and let's start him

0:30:330:30:37

on oral broad spectrum antibiotics, and take half hourly obs.

0:30:370:30:40

You, with me. Let's call your mum.

0:30:400:30:43

She's in the ladies' toilet.

0:30:490:30:50

Would you please give me some room?

0:30:560:30:58

She had a fit, punctured her carotid artery,

0:31:000:31:03

ambulance is on its way.

0:31:030:31:04

Wh-wh-what happened?

0:31:040:31:06

Looks like she broke the mirror. We need to stop the haemorrhage.

0:31:060:31:09

Excuse me! Grace!

0:31:090:31:11

-What the hell happened?

-She had a fit.

0:31:110:31:13

A fit? I told you, didn't I?

0:31:130:31:14

Not now.

0:31:140:31:16

Go outside - find me a medical bag.

0:31:160:31:18

This building is full of medics! I need a Foley catheter.

0:31:180:31:20

-Catheter?

-I need it now! Go!

0:31:200:31:22

Hold her head.

0:31:240:31:25

We need to stop the bleeding.

0:31:250:31:27

Connie!

0:31:270:31:29

Here you go.

0:31:370:31:39

Your mum will be here soon.

0:31:390:31:41

He's going to hate me now, Jack. She's going to hit the roof.

0:31:420:31:46

She's going to ground him for a month.

0:31:460:31:48

Well, at least now we know it's not his fault.

0:31:480:31:51

The nose bleed.

0:31:510:31:53

But-but I did fall. I'm not lying!

0:31:530:31:55

Well, you don't get an infection like that from a fall.

0:31:550:31:58

I can't remember anything else! I don't know!

0:31:580:32:02

Oh, hang on.

0:32:020:32:04

Don't sniff it up!

0:32:040:32:06

Elliot! Elliot?!

0:32:060:32:08

OK, I've left a message. What's happening?

0:32:080:32:10

He's choking! He can't breathe!

0:32:100:32:12

Elliot?

0:32:120:32:13

Right, I'm just going to have a look. Open your mouth.

0:32:140:32:17

Come on, just open up for me. Yup, OK.

0:32:170:32:19

Let's get him to Resus, please.

0:32:190:32:21

I'm here, baby. I'm here.

0:32:210:32:23

All right, try not to move.

0:32:230:32:24

-Where are they?

-Probably in traffic. Catheter?

0:32:240:32:27

-OK.

-I'm going to go and see where they are.

0:32:290:32:32

Hold her head.

0:32:320:32:33

-What are you doing?!

-I'm going to tamponade the wound with it.

0:32:330:32:36

-No.

-Just maintain pressure on the wound. I need to insert the tip.

0:32:360:32:39

No, no, you're going to kill her!

0:32:390:32:40

Trust me. For once in your life, do as you're told!

0:32:400:32:44

It's OK. It's going to be OK.

0:32:510:32:53

I need a laryngoscope and Magill forceps, please.

0:32:530:32:56

He's losing consciousness.

0:32:560:32:58

Words can be easily misconstrued.

0:32:580:33:00

Unfortunately, I think I may have got her into

0:33:000:33:03

a little bit of hot water.

0:33:030:33:05

She might be able to claw it back.

0:33:050:33:07

Jacob! Sam Strachan just called. Grace has been hurt.

0:33:070:33:11

There's an ambulance on its way there.

0:33:110:33:14

OK, that's as far as it'll go. Syringe? Come on!

0:33:140:33:17

OK, this is going to work. This is going to work.

0:33:180:33:22

Yep, it's working. I need to clamp it.

0:33:240:33:26

See if there are any artery clamps in the bag?

0:33:260:33:29

Connie!

0:33:310:33:32

Right, she's in here. This way.

0:33:330:33:35

Not a minute too soon, lads.

0:33:350:33:38

Right, what have we got?

0:33:380:33:39

This is Grace Beauchamp, 11 years old,

0:33:390:33:41

witnessed tonic-clonic seizures with a neck wound caused by broken glass.

0:33:410:33:44

Uncontrolled arterial haemorrhage

0:33:440:33:46

from the wound despite direct pressure,

0:33:460:33:47

so inserted a Foley catheter to tamponade the bleeding.

0:33:470:33:50

Fitting has now stopped. Airway appears clear.

0:33:500:33:53

OK. Mrs Beauchamp, let me take over there. There we go.

0:33:530:33:57

-Jez?

-Yeah?

-I want oxygen and a line in quick, please.

0:33:580:34:01

OK, I'm on it.

0:34:010:34:02

Hold his head for me, please.

0:34:060:34:08

Laryngoscope.

0:34:080:34:09

OK.

0:34:120:34:14

I can see something.

0:34:140:34:15

It's stuck. OK.

0:34:160:34:18

OK.

0:34:220:34:24

Got it.

0:34:240:34:26

-He's not breathing!

-Suction, please.

0:34:260:34:28

HE GASPS

0:34:300:34:31

Oh, good. Good. He's responding.

0:34:310:34:33

We got it just in time.

0:34:330:34:35

What is it?

0:34:350:34:36

All right? OK.

0:34:360:34:38

It looks like a shoe?

0:34:410:34:42

A doll's shoe.

0:34:440:34:45

11-year-old female, Grace Beauchamp, witnessed tonic-clonic seizures

0:34:470:34:51

with penetrating neck wound, which is now under control.

0:34:510:34:54

She was unconscious on arrival, with significant blood loss.

0:34:540:34:58

It's OK, Gracie, we got you.

0:34:580:35:00

Resp rate 28, pulse 140 and thready, BP 90/60.

0:35:000:35:04

She required boluses of IV saline en-route to maintain her BP.

0:35:040:35:07

No further fitting.

0:35:070:35:09

OK, let's get another line in then, please, and cross-match four units.

0:35:090:35:13

We'll stand by with some tranexamic acid.

0:35:130:35:16

Can we do a venous blood gas as well?

0:35:160:35:17

Did she have a fit, then?

0:35:170:35:19

Yeah. Smashed a mirror with her crutches, and then fell.

0:35:190:35:23

OK. Let's query head injury then, folks.

0:35:230:35:26

Cross on three, when we're ready. One, two, three.

0:35:260:35:29

Grace? Grace, can you hear me?

0:35:300:35:33

OK, she's not supporting her own airway, is she?

0:35:330:35:35

So, let's intubate before the CT. Stand by for an RSI.

0:35:350:35:40

Can we get 2mgs of lorazepam, please,

0:35:400:35:43

and somebody notify the vascular surgeons.

0:35:430:35:46

A doll's shoe?

0:35:470:35:49

Yes. It must have been stuck up his nasal cavity for some time,

0:35:490:35:52

causing infection and bleeding, and swallowing the blood made you vomit.

0:35:520:35:56

And just then, you inhaled it and choked on it.

0:35:560:35:58

It is really small, you know.

0:35:580:36:00

You could have easily inhaled it by mistake, I suppose.

0:36:000:36:03

Sorry, Dr Chao, I've got Mrs Allcott on the phone for you.

0:36:030:36:06

OK. You're not getting out of this. C'mon.

0:36:060:36:10

The dolls aren't Macy's, are they?

0:36:130:36:16

Sweetheart, did you feel you had to keep it a secret?

0:36:170:36:22

Mum knows, but she promised she wouldn't tell anyone,

0:36:220:36:26

but a while ago Jack came into the room and I panicked.

0:36:260:36:30

I just...

0:36:300:36:33

Shoved it up your nose?

0:36:330:36:35

Then I tried to get it out but I think I was just pushing it in more.

0:36:350:36:39

Why didn't you tell us?

0:36:390:36:41

Cos Jack, he'll hate me.

0:36:410:36:43

No, he won't.

0:36:430:36:44

He will! I'm nothing like him.

0:36:440:36:47

I'm not sporty. I'm not clever.

0:36:470:36:49

Hey, join the club!

0:36:490:36:51

Do you know what my gran used to say?

0:36:510:36:54

You are who you are,

0:36:540:36:56

and you have to accept it because everybody else is taken.

0:36:560:37:00

The thing is, the more you hide it, the worse it's going to get.

0:37:010:37:06

He won't mind. He loves you.

0:37:060:37:09

She didn't take it too badly. The doc's having a word.

0:37:110:37:15

But you, the minute you're better,

0:37:150:37:17

I'm going to whoop your backside, you monkey.

0:37:170:37:19

Getting me into trouble like this with your,

0:37:190:37:21

"I fell and you didn't hear." What was all that about?

0:37:210:37:24

-Because I...

-What?

0:37:240:37:26

Cos you didn't want to say you had a doll's shoe stuck up your nose?

0:37:260:37:29

Fair enough. I wouldn't, either.

0:37:290:37:31

The thing is, Jack...

0:37:310:37:32

..I play with them. Dolls.

0:37:350:37:39

Course you do.

0:37:390:37:40

Don't take a genius to work out you was hiding something in that bag.

0:37:400:37:44

I looked inside.

0:37:440:37:46

Nothing gets past the Jackmeister.

0:37:460:37:48

You give me another scare like this

0:37:480:37:50

and I'll shove the other one up there myself.

0:37:500:37:52

Come here.

0:37:520:37:53

OK, um...

0:38:020:38:04

The good news is that the scan shows there's no new head injuries.

0:38:040:38:08

I do think you might want to prepare yourselves

0:38:080:38:10

for the possibility that Grace may have developed epilepsy.

0:38:100:38:13

As you know, it's a possible delayed outcome of the original head injury.

0:38:130:38:19

Was she complaining of headaches today or looking peaky?

0:38:190:38:22

She certainly wasn't 100%, no.

0:38:220:38:25

Watch your back.

0:38:250:38:26

Well, we've sent the scan to neurology and the vascular surgeons

0:38:260:38:31

are taking her up to theatre now.

0:38:310:38:33

I'm confident because of the timely and excellent care

0:38:330:38:37

she received at the scene that the damage was minimal,

0:38:370:38:40

but I'll keep you updated, obviously.

0:38:400:38:42

Sam.

0:38:460:38:48

I begged you. I warned you.

0:38:510:38:55

But there's no getting through to you, is there?

0:38:570:39:00

You're so blinkered.

0:39:000:39:04

So caught up in your own bitterness.

0:39:040:39:06

It's because of you she's back in that theatre, no-one else.

0:39:100:39:13

I don't want to think

0:39:130:39:14

what would have happened if Dr Gardner hadn't found her.

0:39:140:39:18

And I'll tell you one thing for sure - when she wakes up...

0:39:200:39:24

..things are going to change, and I mean change.

0:39:260:39:30

Connie.

0:39:410:39:43

Come on.

0:39:460:39:48

You need some air.

0:39:480:39:50

How's Grace?

0:40:030:40:05

She has just gone up to theatre. She'll be OK.

0:40:050:40:08

Robyn? Mrs Allcott should be here in a couple of hours.

0:40:110:40:14

I'm sorry. You were right.

0:40:140:40:16

We're not here to be their friends. We have a responsibility.

0:40:160:40:18

WAILING

0:40:180:40:21

Is that coming from in here?

0:40:210:40:23

Sorry, Robyn, my phone went off.

0:40:240:40:27

Anyone hurt?

0:40:270:40:29

No, I think we'll survive. Is this yours?

0:40:290:40:32

Turn it off, please.

0:40:320:40:34

You win, fair and square.

0:40:340:40:36

Thank you!

0:40:360:40:38

Wait? What?

0:40:380:40:40

Well, there may have been a little bet going on.

0:40:410:40:45

Robyn...

0:40:480:40:49

Thanks a lot. Cheers, mate.

0:40:520:40:54

I shouldn't have taken her there today.

0:41:070:41:10

Maybe today just shouldn't have happened.

0:41:150:41:17

Looking for someone to blame is only going to make everything worse.

0:41:210:41:25

The only person at fault in this whole thing is Stephanie Sims.

0:41:250:41:29

She was the one that ran you off the road.

0:41:300:41:33

I tried going after her and look where that got me.

0:41:330:41:36

Nowhere.

0:41:360:41:38

She's a good doctor, Elle.

0:41:430:41:45

And this is going to destroy her.

0:41:450:41:47

That's not right, and you know it.

0:41:490:41:51

And trying to make this a personal thing between you and her,

0:41:520:41:55

like a crusade... Though, it's not too late.

0:41:550:41:58

You can go back to the hearing, you can say... What?

0:42:000:42:04

You're the one that called Sam, aren't you?

0:42:060:42:10

What else was I supposed to do?

0:42:110:42:13

Connie!

0:42:160:42:17

CLEARS HIS THROAT

0:42:230:42:25

Touch my coffee and you're a dead man.

0:42:250:42:27

I was only trying to help, you know?

0:42:270:42:29

Say what you want, but a day with baby Alice...

0:42:300:42:33

I never thought I'd say this, but you are talking way too much.

0:42:330:42:37

The bet...

0:42:380:42:39

It was just a bit of fun.

0:42:410:42:43

Of course, and I'd understand, wouldn't I?

0:42:430:42:46

Cos I'm the fun one, the silly one, the one who has to be

0:42:460:42:49

everyone's friend, the one who can't even look after a fake baby.

0:42:490:42:53

What chance have I got with the real thing?

0:42:540:42:57

She just took off, not in a good place.

0:43:010:43:03

And Connie in a bad place,

0:43:030:43:05

when she feels like she's got nothing to lose - she's lethal.

0:43:050:43:09

Mrs Beauchamp.

0:43:270:43:29

How's your daughter?

0:43:350:43:36

She's in theatre.

0:43:380:43:39

And you're here?

0:43:410:43:42

Her father's with her.

0:43:440:43:46

I see.

0:43:480:43:49

So you've, um...come to finish what you started.

0:43:510:43:56

Deliver the killer blow.

0:44:000:44:01

-ELEVATOR:

-'Doors opening.'

0:44:030:44:05

You're kicking me in the face, and it's really not nice.

0:44:200:44:23

I just need your help. Oh, no!

0:44:230:44:26

Get the stiletto out of my eye!

0:44:260:44:28

Give me back my power-pack.

0:44:280:44:29

Right. Let's try to resume from where we left off.

0:44:290:44:34

Actually...

0:44:360:44:39

..let's not resume.

0:44:400:44:42

The reason I'm here, the only reason I'm here today,

0:44:450:44:49

is my daughter Grace.

0:44:490:44:51

She is in theatre as we speak...

0:44:540:44:56

..having her carotid artery put back together,

0:44:580:45:00

a perilous enough procedure,

0:45:000:45:05

and one that could have been worse

0:45:050:45:08

if it were not for Dr Gardner.

0:45:080:45:11

I blamed her for taking my little girl away from me...

0:45:120:45:18

and I now acknowledge that was motivated by grief...and anger.

0:45:180:45:24

But today...

0:45:260:45:27

..she gave my daughter back to me.

0:45:310:45:34

I was wrong about her.

0:45:360:45:38

Peace offering?

0:45:470:45:49

But there's also this.

0:45:540:45:56

The guys felt really bad so they put all the sweepstake money

0:45:580:46:01

together to get you a little present.

0:46:010:46:03

A spa day?

0:46:030:46:04

I know you're scared...

0:46:060:46:09

but you don't have to do this on your own.

0:46:090:46:11

We're all here to help.

0:46:110:46:13

I could say the same to you, you know.

0:46:140:46:17

Sure.

0:46:170:46:18

Sure? So, you'll see someone? About your medication?

0:46:180:46:22

Yeah, yeah, yeah.

0:46:220:46:24

Yes. I'll make sure I talk to someone.

0:46:240:46:27

Ah. Are we forgiven?

0:46:270:46:30

This is very expensive.

0:46:300:46:32

Just how many other people were in on this?

0:46:320:46:35

Actually, I don't want to know.

0:46:350:46:37

Best policy!

0:46:370:46:39

She what?

0:46:390:46:40

Elle just called me. Apparently, she's retracted it all.

0:46:400:46:44

They've adjourned for today,

0:46:440:46:46

but word is it'll probably all come to nothing now.

0:46:460:46:50

Well, that calls for a celebration drink.

0:46:500:46:53

Connie Beauchamp. Never a dull moment.

0:46:530:46:55

No. Never.

0:46:550:46:57

Good luck, Mrs Beauchamp. I hope Grace gets better soon.

0:46:590:47:02

Thank you.

0:47:020:47:03

Dr Gardner?

0:47:050:47:08

How's Grace?

0:47:140:47:16

She's in recovery. I'm on my way to see her now.

0:47:190:47:23

Please make no mistake - I would have intubated.

0:47:240:47:28

But you're a good doctor - a great doctor.

0:47:290:47:34

But I'm no clinical lead.

0:47:360:47:38

I'm seeing Hanssen tomorrow morning.

0:47:400:47:42

I came back into medicine for the patients.

0:47:420:47:46

As for the rest of it, oh... It's all yours.

0:47:460:47:49

Holby City Hospital, please.

0:47:530:47:55

Holby City Hospital, please.

0:48:130:48:15

I'd like to request a visiting order, please.

0:48:230:48:26

Stephanie Sims.

0:48:280:48:30