0:00:00 > 0:00:02No, please. Please. No!
0:00:04 > 0:00:07Once you're discharged, straight home. And no more rummaging
0:00:07 > 0:00:09- through bins.- I ain't got a home.
0:00:09 > 0:00:11- Is there a hostel you can go to? - If there's spaces, maybe.
0:00:11 > 0:00:14Then do that. And don't think because I asked that I give a damn.
0:00:14 > 0:00:16You're religious, yeah?
0:00:16 > 0:00:18I suppose this is a bit of a giveaway.
0:00:20 > 0:00:21Do you wear it all the time?
0:00:21 > 0:00:24- First time at work.- Ah. Looks good.
0:00:24 > 0:00:26Ahem.
0:00:28 > 0:00:31I'm fairly sure I told you to find somewhere clean and safe to sleep.
0:00:31 > 0:00:33- Well, did you find somewhere? - What do you care?
0:00:42 > 0:00:43Come on, Derv.
0:00:44 > 0:00:46Come on.
0:02:25 > 0:02:27So take one puff.
0:02:29 > 0:02:31Good. Take another puff.
0:02:34 > 0:02:36- Better?- Thank you.
0:02:36 > 0:02:38Good.
0:02:41 > 0:02:43£7.40, please.
0:02:43 > 0:02:47You can pay us next time. OK?
0:02:49 > 0:02:52Should I not make a living?
0:02:52 > 0:02:54Meshugana.
0:02:54 > 0:02:59- I may be slow, but my ears work just fine.- What?
0:02:59 > 0:03:02- I hear things.- What do you hear?
0:03:02 > 0:03:08I hear there's a lot of nice single women in Florida.
0:03:08 > 0:03:10So you've got two years to get rid of me?
0:03:10 > 0:03:14One year, 11 months and four days.
0:03:16 > 0:03:19I'd rather keep what I have.
0:03:21 > 0:03:24So take your pills and stop getting worked up.
0:03:24 > 0:03:26OK.
0:03:39 > 0:03:41What do you want?
0:03:41 > 0:03:43Is this about Rani?
0:03:50 > 0:03:52You don't ever say her name.
0:03:57 > 0:03:59You will never contact her again.
0:03:59 > 0:04:02If she tries to contact you, you will ignore it.
0:04:02 > 0:04:04Understood?
0:04:06 > 0:04:10- Understood?- Yeah. Can I go, please?
0:04:15 > 0:04:17Of course.
0:04:23 > 0:04:25You're wrong, Jay.
0:04:25 > 0:04:29So the red cabbage and chilli flakes he's got all down him?
0:04:29 > 0:04:31Could be stir-fry.
0:04:31 > 0:04:33What? I'm only saying.
0:04:33 > 0:04:35It's not food.
0:04:35 > 0:04:39- Right, he's losing colour. - He's going into anaphylactic shock. Let's get him to resus.
0:04:42 > 0:04:44You promised.
0:04:44 > 0:04:46- Things change.- But you said.
0:04:46 > 0:04:50- You get away from her. You deal with me.- Come on then, old man.
0:04:50 > 0:04:52No more.
0:04:52 > 0:04:55- Yes, more. - No, we've done everything for you.
0:04:55 > 0:04:57- It's enough. - I decide when it's enough.
0:04:57 > 0:05:00No. Give them nothing, Rachel.
0:05:03 > 0:05:07Give me what I want. Come on, darling. Give it to me, and we're gone. All right?
0:05:07 > 0:05:10- I won't need to come back here again. - That's what you said
0:05:10 > 0:05:13last time.
0:05:24 > 0:05:26You should've gone before we got in the car.
0:05:29 > 0:05:31I gave her the keys. Oh.
0:05:33 > 0:05:35Come on, then.
0:05:46 > 0:05:50- What's going on back there? - I'm coming, I'm coming.
0:06:25 > 0:06:26Great.
0:06:39 > 0:06:40Just great.
0:06:57 > 0:07:00- Can you stand? - Just give me a minute.
0:07:04 > 0:07:05Mendel!
0:07:16 > 0:07:18It's all right.
0:07:20 > 0:07:23This couldn't have happened tomorrow or three days ago?
0:07:23 > 0:07:27Or basically any day that avoids me waking up to an unconscious girl in my houseboat.
0:07:34 > 0:07:36This isn't happening.
0:07:37 > 0:07:41OK. Sats at 91%, BP's still falling.
0:07:41 > 0:07:42OK, talk to me.
0:07:42 > 0:07:46Right, we've given him 0.5 mg of one in 1,000 adrenaline IM.
0:07:46 > 0:07:50- 200 mg hydrocort...- Come on, Mads.
0:07:50 > 0:07:5210 mg chlorphenamine.
0:07:52 > 0:07:54Right, let's bag him and intubate, please.
0:07:54 > 0:07:57Right, can we get a size eight tube and a bougie, please?
0:07:57 > 0:08:00- Mads?- Come on.
0:08:07 > 0:08:09Get another one!
0:08:09 > 0:08:11Vitals?
0:08:11 > 0:08:15Pulse tachy at 120. Sats now 92.
0:08:21 > 0:08:25I'm telling you, darling. Don't argue with me. That bruise wasn't there yesterday.
0:08:25 > 0:08:28There's no obvious cause. I haven't even moved her!
0:08:28 > 0:08:30What do you think, nurse? Any ideas?
0:08:33 > 0:08:34No, I didn't think so.
0:08:36 > 0:08:38Right, come on. Time to go.
0:09:16 > 0:09:17It's OK. I'm a doctor.
0:09:22 > 0:09:25- Just leave it. I'm fine. - No, you're not.- I am.- You're not.
0:09:25 > 0:09:29- Lenny, just leave me alone. - It's starting to affect your work. - I apologised to Mr Jordan.
0:09:29 > 0:09:31- What about me?- I don't need to explain myself to you.
0:09:31 > 0:09:34Not as a doctor, no. But I kind of thought perhaps as a friend.
0:09:34 > 0:09:37- As a friend, you know to leave me alone.- Right, yeah.
0:09:37 > 0:09:39- You've been saying that for weeks as well.- Exactly.
0:09:39 > 0:09:44All right, so I'll just leave you alone and let you give up your life to some guy who two months ago could
0:09:44 > 0:09:47- not have identified you out of a line-up.- It's not about that.
0:09:47 > 0:09:49- It is.- It isn't.- It is.- It isn't!
0:09:49 > 0:09:51- It is!- Lenny, sod off.
0:09:54 > 0:09:56Just go, please.
0:09:56 > 0:10:01- I'm sorry, I...- Please.
0:10:15 > 0:10:20You might have mentioned you were only a child before I let you collapse in my house.
0:10:23 > 0:10:25Come on!
0:10:25 > 0:10:28SIREN WAILS
0:10:37 > 0:10:40Patient on board!
0:10:40 > 0:10:41Patient on board.
0:11:14 > 0:11:17Here we go, darling. Thank you very much.
0:11:17 > 0:11:19- All right, take your time.- OK.
0:11:19 > 0:11:20- OK, got it?- Yep.
0:11:26 > 0:11:29- OK, take your time. Good girl.- Jeff?
0:11:29 > 0:11:32- Yeah?- Can you and Gary take Mr Lan in, please?- Er, yeah, sure.
0:11:32 > 0:11:35- You all right?- Yeah, yeah. I'm fine.
0:11:35 > 0:11:39If you just want to follow Jeff, he'll take you to where they're going to treat your husband.
0:11:39 > 0:11:41Thanks. Wayne?
0:11:41 > 0:11:43Good luck.
0:11:48 > 0:11:53- Why is she back?- She's a patient.
0:11:53 > 0:11:56- I can take it from here.- Come here.
0:11:56 > 0:11:59Let me help you, OK? Got her?
0:11:59 > 0:12:00Yeah.
0:12:04 > 0:12:07Weapon's still in situ. On arrival GCS was 14, it's now 12.
0:12:07 > 0:12:10- He's had fluids, oxygen, 10 of morphine.- Tess?
0:12:10 > 0:12:13- Middle bed, please.- Thank you.
0:12:13 > 0:12:16- Do we know what happened? - He was pushed. I didn't see.
0:12:16 > 0:12:18- I'm here, darling.- Nearly there.
0:12:20 > 0:12:23- Take care of him. - All right, when you're ready, please.
0:12:25 > 0:12:27- Everybody got some?- Yeah.- On three.
0:12:27 > 0:12:29One, two, three.
0:12:29 > 0:12:33And across gently. One, two, three. OK, good.
0:12:33 > 0:12:36Great. Thank you, Jeff. Have a safe day.
0:12:36 > 0:12:40Right, can I get one unit O negative blood, please, cross-match two units?
0:12:40 > 0:12:42Oh, nasty, yep. OK, let's get a trauma series, please.
0:12:42 > 0:12:45Folks, can we get the ultrasound in here? Linda?
0:12:45 > 0:12:47Er, let's get his history.
0:12:47 > 0:12:50Mr Lan, I'm Mr Jordan. I'm the clinical lead here.
0:12:50 > 0:12:53I'm just going to have a feel around. Tell me if it hurts anywhere.
0:13:02 > 0:13:06Rebecca Matlock. Get her patient number from yesterday's records.
0:13:06 > 0:13:10I still think we should have taken her to resus. They've got the equipment.
0:13:10 > 0:13:13- She's my patient.- OK, let's get her over then.
0:13:13 > 0:13:15On three. One, two, three.
0:13:15 > 0:13:18- I don't understand. - She's my responsibility.
0:13:18 > 0:13:21But this place doesn't work like that.
0:13:21 > 0:13:23Dylan, you're putting her at risk.
0:13:23 > 0:13:27Your patient, the one that you brought in, he's tachy and he's in atrial fibrillation.
0:13:27 > 0:13:32- You saw the monitor. - Even with the anti-coag I'd give him a 50:50 chance at best.
0:13:32 > 0:13:33That's just guesswork.
0:13:33 > 0:13:39The injury, together with the anti-coagulation, is consistent with his condition. This is not guesswork.
0:13:39 > 0:13:42Abdominal injury is a special interest of mine.
0:13:42 > 0:13:43If I can't fix my patient,
0:13:43 > 0:13:47rest assured, I will be the first to say I can't fix my patient.
0:13:47 > 0:13:50- I thought you'd already fixed this patient.- Long story.
0:13:50 > 0:13:53I look forward to hearing it.
0:13:53 > 0:13:56Cheers, Dixie.
0:13:56 > 0:13:59She followed me home. It was late.
0:13:59 > 0:14:03- Did you let her in? - What else was I supposed to do? - You're an idiot.
0:14:03 > 0:14:06Thank you so much.
0:14:34 > 0:14:37- Mads?- Yeah?
0:14:37 > 0:14:39Thank you.
0:14:46 > 0:14:4896 over 64.
0:14:48 > 0:14:51- He's tachy at 120.- Right, thank you.
0:14:51 > 0:14:53His INR's through the roof.
0:14:53 > 0:14:56OK, we need to reverse the anticoagulation. Right, listen up.
0:14:56 > 0:15:01Vitamin K and PCC please. Let's repeat the INR every 30 minutes.
0:15:01 > 0:15:05- We need to get this down, otherwise he'll bleed out. OK?- Yep.- Thank you.
0:15:17 > 0:15:19They will want to talk to you.
0:15:19 > 0:15:22I've got nothing to say.
0:15:22 > 0:15:27It's a little late for them to be offering their assistance, don't you think?
0:15:27 > 0:15:30Police protection. Huh!
0:15:30 > 0:15:34We put our faith in a different covenant.
0:15:34 > 0:15:36He guides us.
0:16:02 > 0:16:04Have you got it?
0:16:06 > 0:16:07No more of that hospital crap.
0:16:19 > 0:16:21You do it.
0:17:04 > 0:17:07These fractures are stable. Even yesterday's.
0:17:07 > 0:17:09There's a hell of a lot of them.
0:17:09 > 0:17:13- They're not the cause. - Well, something must have been missed yesterday.- No. No, no, no.
0:17:13 > 0:17:16She's got Cullen's sign, Dylan!
0:17:16 > 0:17:20- Well, she wouldn't have been able to leave the room, let alone walk out of the hospital.- Hmm.
0:17:20 > 0:17:22And all the way to your little boat?
0:17:22 > 0:17:25You know what, I'll guess this is traumatic pancreatitis.
0:17:25 > 0:17:30- I wouldn't have missed that. Come on! - Dylan...- It's not pancreatitis.
0:17:30 > 0:17:32It's not something you would have been looking for, Dylan.
0:17:32 > 0:17:36It's something I would have missed. It's something I would have found.
0:17:36 > 0:17:38She's developing Grey Turner's.
0:17:38 > 0:17:42- Zoe! Of course!- What? What!
0:17:59 > 0:18:02His blood is very thin, it's not clotting as it should.
0:18:02 > 0:18:06Is his GP prescribing and any anti-coagulation tablets at all?
0:18:06 > 0:18:08He doses himself.
0:18:08 > 0:18:1090 over 65. Down by 100.
0:18:10 > 0:18:15He's obviously developed a temporary tamponade with partial clotting.
0:18:15 > 0:18:19Well, that's safe for now. But we do need to stabilise your coagulation, we'll get you up to theatre.
0:18:19 > 0:18:22The surgeons are already aware.
0:18:22 > 0:18:25It's OK. It's fine. Everything'll be all right.
0:18:25 > 0:18:27You'll be asleep.
0:18:27 > 0:18:31It's much more difficult for the people who are awake.
0:18:31 > 0:18:34- Tell them.- What's happening?
0:18:43 > 0:18:45Hey. All right. OK, lie still.
0:18:45 > 0:18:48- Tell me!- Let's get him down.- N- No!
0:18:48 > 0:18:514 milligrams lorazepam, now, please. Quickly.
0:19:08 > 0:19:09Mrs Lan?
0:19:10 > 0:19:12How's your husband?
0:19:12 > 0:19:14See for yourself.
0:19:16 > 0:19:19The emergency call, it was logged as a stabbing?
0:19:19 > 0:19:23And this has been corroborated by the two paramedics who attended?
0:19:23 > 0:19:27- My husband is very ill. This is not the time. - I've been through your case notes.
0:19:27 > 0:19:34- And it says on the 7th January last year, you reported an aggravated assault.- Can I get some air?
0:19:34 > 0:19:37And then, after an arrest was made, you withdrew that complaint?
0:19:37 > 0:19:40That's history.
0:19:40 > 0:19:42A year and a half...
0:19:42 > 0:19:44That's a long time.
0:19:44 > 0:19:45- Thank you.- OK.
0:19:51 > 0:19:53A new face.
0:19:53 > 0:19:55They're all the same.
0:19:55 > 0:19:57What did he mean? A year and a half?
0:19:57 > 0:19:58Today...
0:19:58 > 0:20:00It's not the first time.
0:20:00 > 0:20:03He's come to us many times.
0:20:03 > 0:20:06In our shop... Sometimes our home.
0:20:06 > 0:20:08This has been going on for a year and a half?
0:20:08 > 0:20:11- What about your protection? - He'll get through this.
0:20:11 > 0:20:13We're retiring next year...
0:20:13 > 0:20:17It's all planned.
0:20:17 > 0:20:19It comes down to faith.
0:20:38 > 0:20:40You don't think anyone might miss that?
0:20:40 > 0:20:42CDU should have an ultrasound.
0:20:44 > 0:20:46Her systolic's 106 and dropping.
0:20:46 > 0:20:48You need to send an amylase, Dylan.
0:20:48 > 0:20:52No. Triple A - she has an abdominal aortic aneurism.
0:20:52 > 0:20:56Secondary to malnutrition, more specifically a vitamin deficiency.
0:20:56 > 0:20:58- What's her surname?- Matlock.
0:20:58 > 0:21:01If it's only bled into the aortic wall for the time being we should
0:21:01 > 0:21:03manage it by keeping her blood pressure on the low side.
0:21:03 > 0:21:06- I think she needs...- There is no need, to open her up just yet.
0:21:06 > 0:21:08Gel please.
0:21:08 > 0:21:10Thank you.
0:21:10 > 0:21:12OK, this might feel a little bit cold.
0:21:12 > 0:21:14- OK, fine.- OK.
0:21:22 > 0:21:26- How is he?- We think that reversing the anti-coagulation has
0:21:26 > 0:21:29- caused a clot to form in his brain. - You think he's had another stroke?
0:21:31 > 0:21:34Can you still operate on him?
0:21:34 > 0:21:39With the wound stable, the priority is a head scan, as soon as that's done we'll get him up to surgery.
0:21:39 > 0:21:42We've fast bleeped the stroke team and we're all on stand-by
0:21:42 > 0:21:45so as soon as we can, we'll get him up, OK? Thank you, Tess.
0:21:46 > 0:21:49Would you like to see him?
0:21:57 > 0:22:01Mind your backs. Excuse me. Thank you.
0:22:01 > 0:22:03OK, mate. Can you hear me?
0:22:07 > 0:22:11- Ooh, hello. Hello, hello.- Drugs.
0:22:13 > 0:22:15There seems to be some free fluid around the peritoneal space.
0:22:15 > 0:22:17It's unclear. Could be an intramural bleed.
0:22:17 > 0:22:20We need to visualise the aorta. Look, her bruising's getting worse.
0:22:20 > 0:22:23- We need to get her full history. - No, we need to get her to Resus.
0:22:23 > 0:22:26She's holding the key to this, I'm sure of it.
0:22:26 > 0:22:29- Hi!- You are a liar.- Dylan!
0:22:29 > 0:22:31What happened to you yesterday?
0:22:31 > 0:22:34If you want me to save your life, you're going to have to tell me.
0:22:34 > 0:22:35Or, don't tell me and you'll die.
0:22:35 > 0:22:38- I told you, I got mugged.- I'd say you've got until about two o'clock.
0:22:38 > 0:22:40- That's enough, Dr Keogh! - He punched me.
0:22:40 > 0:22:42- No.- Is this your bedside manner?
0:22:42 > 0:22:45Tell me the words I want to hear.
0:22:45 > 0:22:46Itold you the truth.
0:22:46 > 0:22:48- No. Wrong. Try again.- Dylan...
0:22:48 > 0:22:50There is something you're not telling me.
0:22:50 > 0:22:53- Where do all these old injuries come from?- I really don't know what you're on about.
0:22:53 > 0:22:55You need to start trusting me.
0:22:55 > 0:22:58If you don't tell me what I need to know, I can't save you.
0:22:58 > 0:23:00- Dylan... Listen to me.- Right. Fine.
0:23:02 > 0:23:04What are you testing for now, hmm?
0:23:04 > 0:23:07Lipase, Trypsin and Amylase.
0:23:07 > 0:23:09Oh, so you are testing for pancreatitis?
0:23:09 > 0:23:13- No, I'm testing against pancreatitis. - What she needs is an abdominal CT and to get to resus, now!
0:23:13 > 0:23:15It doesn't matter because it isn't pancreatitis.
0:23:15 > 0:23:17How do you know that?
0:23:20 > 0:23:23Why did you steal my wallet?
0:23:23 > 0:23:24I had £700 in there.
0:23:24 > 0:23:29- I wasn't going to take all of it. I just needed 340 quid.- Why?
0:23:29 > 0:23:32Found a flat. I can get away from him once and for...
0:23:32 > 0:23:35- Pressure's dropping.- Right, I can handle this. We need her notes.
0:23:35 > 0:23:37Stop. Dylan, we can't keep her here any more.
0:23:37 > 0:23:41There's something that we're missing, I know it. It's something important.
0:23:41 > 0:23:43I can't... The key to this is in her history.
0:23:43 > 0:23:47- Stop this!- We need to get the notes from where she was last treated.
0:23:47 > 0:23:48Yeah. You'll need that.
0:23:55 > 0:23:57Is this why you didn't want to sign her in? She is 15!
0:23:59 > 0:24:01No-one will blame you, Dylan.
0:24:01 > 0:24:03Up to right now, no-one will blame you.
0:24:03 > 0:24:07But if you keep her here any longer, they will.
0:24:07 > 0:24:10Just get me her old notes. Please.
0:24:20 > 0:24:21Shouldn't be long now.
0:24:27 > 0:24:29We do need to talk, Mrs Lan.
0:24:34 > 0:24:36Not here.
0:24:43 > 0:24:48- Whatever he said to you.- Who? - You know now that it's not true.
0:24:48 > 0:24:51All the promises, all the reassurances.
0:24:51 > 0:24:53Do you know what I've learnt?
0:24:53 > 0:24:57I've learnt that, at some point, when things don't quite go to plan,
0:24:57 > 0:25:00they bite the hand that feeds them.
0:25:00 > 0:25:03- Every time.- Lenny. Sister Bateman. I need your help.
0:25:07 > 0:25:09Right, go with the Lorazepam.
0:25:09 > 0:25:12Sats dropping, 88%... Right.
0:25:14 > 0:25:17We need to get the stroke team here now!
0:25:17 > 0:25:18Is that in yet?
0:25:18 > 0:25:19Yep.
0:25:19 > 0:25:22Get his head scanned and get him up to theatre.
0:25:22 > 0:25:24- I know they're backed up. - Tough!
0:25:26 > 0:25:27Good to go. Go!
0:25:53 > 0:25:56Hi, er...Rani. It's...
0:25:56 > 0:25:58It's Mads.
0:25:59 > 0:26:02St Barts have faxed over her casualty notes.
0:26:02 > 0:26:04Where's the rest of them?
0:26:04 > 0:26:05There isn't any more.
0:26:05 > 0:26:09It can't be. She's got dozens of old injuries! This says she's only been in three times!
0:26:09 > 0:26:12- There must be another hospital! - Dylan.
0:26:12 > 0:26:13I can fix this!
0:26:13 > 0:26:14No, you can't!
0:26:14 > 0:26:16She's in hypovolemic shock and needs to go to resus.
0:26:16 > 0:26:19- I just need to find the source! - No! You've tried.
0:26:19 > 0:26:21Damn it!
0:26:21 > 0:26:22Tarik!
0:26:22 > 0:26:23Damn it!
0:26:23 > 0:26:24Resus.
0:26:25 > 0:26:26Look, I'll take her.
0:26:26 > 0:26:29No! No, no, no, no. Very kind of you.
0:26:29 > 0:26:31I can do this.
0:26:31 > 0:26:32Dylan.
0:26:39 > 0:26:41You need to hang on to those.
0:26:42 > 0:26:45The answer is in the history. I remain sure of it!
0:26:51 > 0:26:54She's not on the computer. She's not in the department.
0:26:54 > 0:26:56Dr Keogh?
0:26:58 > 0:27:01I can't fix this patient.
0:27:01 > 0:27:03Don't just stand there! Let's get her through!
0:27:03 > 0:27:06Who is she? Where did she come from?
0:27:06 > 0:27:09She came in yesterday. She discharged herself.
0:27:09 > 0:27:11She spent the night at mine. She's 15 by the way.
0:27:11 > 0:27:13And I missed something.
0:27:13 > 0:27:1415?
0:27:14 > 0:27:16All right, I missed a couple of things.
0:27:16 > 0:27:17On my count. One, two, three.
0:27:17 > 0:27:19What have you established?
0:27:19 > 0:27:21She has a bleed of unconfirmed source.
0:27:21 > 0:27:25Although initially stable, her blood pressure is now falling.
0:27:25 > 0:27:26Ultrasound was inconclusive.
0:27:26 > 0:27:29She's has Grey Turner's as well as Cullen's sign.
0:27:29 > 0:27:32Dr Hanna has been urging me to bring her in.
0:27:32 > 0:27:34I prefer to solve a situation on my own.
0:27:34 > 0:27:37To be fair I am normally spectacularly good at it.
0:27:37 > 0:27:39On this occasion, it seems, that was not the case.
0:27:39 > 0:27:44Your actions reflect on the department, Dr Keogh, on all of us.
0:27:44 > 0:27:48We're a team. You should act responsibly - as a team!
0:27:51 > 0:27:52Hang on. Nick.
0:27:52 > 0:27:56I will accept your resignation with immediate affect. Now get out!
0:27:56 > 0:27:57Zoe.
0:28:05 > 0:28:06Lenny?
0:28:06 > 0:28:07Ah, Mads.
0:28:07 > 0:28:11Listen, I was thinking, maybe I would like to start this day again.
0:28:11 > 0:28:13There's something I'd like to tell you.
0:28:13 > 0:28:14What's that?
0:28:14 > 0:28:16That night.
0:28:16 > 0:28:20That night when we all went out for that drink and...
0:28:20 > 0:28:22I got into the minicab.
0:28:22 > 0:28:24Mm-hm.
0:28:24 > 0:28:25On my way home...
0:28:28 > 0:28:30On my way home, I was attacked.
0:28:30 > 0:28:32You...?
0:28:49 > 0:28:51BP 82 over 47. She's tachycardic.
0:28:51 > 0:28:53OK. We're up next.
0:28:53 > 0:28:55No, forget the CT. We haven't got time.
0:28:55 > 0:28:57She's deteriorating badly.
0:28:57 > 0:28:59She needs a laparotomy. Call Keller.
0:28:59 > 0:29:01Get a general surgeon on stand-by.
0:29:01 > 0:29:05This is a pancreatic bleed until someone tells me otherwise.
0:29:14 > 0:29:15How's he doing?
0:29:15 > 0:29:17He's being scanned. It doesn't look good.
0:29:17 > 0:29:19I'm very sorry.
0:29:19 > 0:29:22GCS was 8 on arrival BP 120 over 67.
0:29:22 > 0:29:25Pupils were pinpoint.
0:29:25 > 0:29:28Evidence of IV drugs use. Administered oxygen.
0:29:28 > 0:29:300.8 milligrams Naloxone, repeated twice.
0:29:31 > 0:29:32And?
0:29:32 > 0:29:35GCS rose briefly to 12 then back down to eight.
0:29:35 > 0:29:38Breathing's been shallow and irregular throughout.
0:29:38 > 0:29:39Even with all the naloxone?
0:29:39 > 0:29:41Yep. 'Fraid so.
0:29:41 > 0:29:44Let's get him over please, ladies and gents.
0:29:44 > 0:29:46On three. One, two, three.
0:29:46 > 0:29:48And over, one, two, three.
0:29:48 > 0:29:50Sats at 86%.
0:29:56 > 0:29:58Oh, hello. How's the old man doing?
0:30:02 > 0:30:04Get that a lot with women.
0:30:04 > 0:30:05Not from this one, Jeffrey.
0:30:05 > 0:30:08S'pose you heard about Wonder Doc? Off again apparently.
0:30:08 > 0:30:10- Why?- Oh, I dunno.
0:30:10 > 0:30:13Some patient he tried to cure all by himself. Didn't quite work out.
0:30:13 > 0:30:15Good riddance I say.
0:30:15 > 0:30:16Jeff.
0:30:16 > 0:30:18He deserves it, Dix. He's dangerous.
0:30:18 > 0:30:19Ah, come on, mate.
0:30:19 > 0:30:21After everything that's happened.
0:30:21 > 0:30:23Blimey, what are you thinking?
0:30:23 > 0:30:27I'm thinking that our wanting him to suffer won't bring Polly back.
0:30:27 > 0:30:29It ain't going to change anything.
0:30:29 > 0:30:31- It clearly hasn't changed him, has it?- Maybe.
0:30:31 > 0:30:33And what's that supposed to mean?
0:30:33 > 0:30:37I'm just saying none of us have offered him the warm hand of welcome back.
0:30:37 > 0:30:39Well, blimey! He's really got to you, in't he?
0:30:39 > 0:30:41What's not to like?
0:30:41 > 0:30:43He's intelligent, confident, good looking.
0:30:43 > 0:30:45I think I quite fancy him really.
0:30:46 > 0:30:49No! I'm joking! Obviously!
0:30:49 > 0:30:53Right, you go on. I'll see you in five minutes.
0:30:53 > 0:30:54Yep. See ya.
0:31:18 > 0:31:20I just heard what happened.
0:31:22 > 0:31:25You shouldn't have let me bring her in here. I did tell you.
0:31:25 > 0:31:29You were trying to do the right thing by your patient.
0:31:29 > 0:31:31You sure about that?
0:31:33 > 0:31:35You know Pol?
0:31:36 > 0:31:37It wasn't your fault, OK?
0:31:37 > 0:31:41That's not what your colleague thinks. He wanted to reposition my nose.
0:31:41 > 0:31:44Jeff was upset. We all were.
0:31:44 > 0:31:46And she was killed by my patient.
0:31:46 > 0:31:48And you weren't to know.
0:31:48 > 0:31:51I think that's the point. Don't you?
0:31:51 > 0:31:52I just...
0:31:52 > 0:31:54I don't like them very much. Patients.
0:31:54 > 0:31:57I don't know, I....
0:31:57 > 0:32:01I don't care, I don't have feelings about them one way or the other.
0:32:07 > 0:32:09You've quit, right?
0:32:11 > 0:32:13So what's all this then?
0:32:18 > 0:32:20Blood results.
0:32:20 > 0:32:21Right.
0:32:23 > 0:32:25I don't get it.
0:32:25 > 0:32:28His sats and respiratory rate keep falling.
0:32:28 > 0:32:32Right, let's go again. Another 0.8 milligrams of Naloxone, please.
0:32:32 > 0:32:34Something isn't right.
0:32:34 > 0:32:38You can stop this here you know, Rachel. You can end the suffering.
0:32:38 > 0:32:39What do you want from me?
0:32:39 > 0:32:42I want a name. Come on.
0:32:43 > 0:32:46We both know who did this to your husband.
0:32:47 > 0:32:51Tell me, why do you care so much?
0:32:51 > 0:32:52We don't know each another.
0:32:52 > 0:32:55You talk of my pain. What do you know of my pain?
0:32:55 > 0:32:57I've done this job a long time.
0:32:57 > 0:32:58I'm sure.
0:32:59 > 0:33:02I like putting bad people behind bars.
0:33:02 > 0:33:04Excuse me, Mrs Lan, coming through.
0:33:06 > 0:33:09Linda, will you let theatre know that Mr Lan's ready to go up.
0:33:09 > 0:33:13The problem is, long after you've moved on to bigger and better things,
0:33:13 > 0:33:16we're left dealing with the consequences.
0:33:19 > 0:33:21The effects of a stroke are unpredictable.
0:33:21 > 0:33:23Could he recover, in time?
0:33:23 > 0:33:26Yes, I have seen some recovery with the right care and support.
0:33:26 > 0:33:27At least he has that.
0:33:27 > 0:33:31The problem is, when blood is prevented from getting to parts of the brain...
0:33:33 > 0:33:36When a cubicle becomes free, we'll get you in there.
0:33:36 > 0:33:40The stroke team have reviewed him. They'll see him when he's back from theatre.
0:33:40 > 0:33:42Right, we'll leave you in peace.
0:33:42 > 0:33:44Sure you're OK?
0:33:46 > 0:33:50You're all right, mate. You're OK.
0:33:53 > 0:33:54Let's see.
0:33:54 > 0:33:56PATIENT WHEEZES AND COUGHS
0:33:56 > 0:33:58OK. Let's get you up a bit.
0:33:59 > 0:34:03My name is Dr Lyons. You collapsed earlier and your breathing's still erratic.
0:34:03 > 0:34:05Can you tell me what you've taken.
0:34:05 > 0:34:07Methadone.
0:34:07 > 0:34:08OK. Anything else?
0:34:10 > 0:34:11Are you sure?
0:34:12 > 0:34:15All right. Any underlying conditions we should be aware of?
0:34:16 > 0:34:19Right, you're not very well at the moment.
0:34:19 > 0:34:23You're not breathing properly. Without the right treatment, you'll have a respiratory arrest.
0:34:23 > 0:34:26There's not much more we can do, do you understand?
0:34:30 > 0:34:33We'll have to just hope that whatever he's taken wears off.
0:34:34 > 0:34:36I'll be back in a second.
0:34:36 > 0:34:39Do urine tox screen and repeat blood gas.
0:34:39 > 0:34:40OK.
0:34:53 > 0:34:55I did this to you..
0:34:57 > 0:34:59- You don't understand. - Let me go.
0:34:59 > 0:35:03- You shouldn't have come to the shop. - My girlfriend...- You're a bad boy.
0:35:03 > 0:35:06- What are you doing? - Let me go.- Let her go.
0:35:06 > 0:35:07It's my girlfriend as well!
0:35:07 > 0:35:10Please! Please! Let go!
0:35:10 > 0:35:13Let go! Let go. You OK?
0:35:13 > 0:35:14You're not listening to me.
0:35:14 > 0:35:17HE COUGHS Please.
0:35:17 > 0:35:20She's pregnant.
0:35:20 > 0:35:22Just calm yourself down.
0:35:26 > 0:35:30BP's still falling and she's peripherally shut down.
0:35:30 > 0:35:31That's it, we've run out of time.
0:35:31 > 0:35:34I'll have to do the operation down here.
0:35:34 > 0:35:37Tess, you get a urinary catheter in, please? Zoe?
0:35:37 > 0:35:39If a theatre becomes available
0:35:39 > 0:35:42before I make the incision, we'll take her directly up, OK?
0:35:42 > 0:35:45- Good. Let's get on with it. - I'll put a central line in.
0:35:58 > 0:36:00I need an ambulance, please.
0:36:06 > 0:36:09- Hey. - Did you remember?
0:36:09 > 0:36:13- Skimmed milk, yes. - It'll save your life.
0:36:13 > 0:36:14I hardly think that's likely.
0:36:14 > 0:36:16'Holby Control to 3004.'
0:36:19 > 0:36:213004 receiving, over.
0:36:21 > 0:36:24'We've got an anonymous call reporting an overdose on Farmead.'
0:36:24 > 0:36:25Wouldn't be the first time.
0:36:25 > 0:36:28'34 Mandela Heights. A young female. Pregnant. Over..'
0:36:28 > 0:36:32Take that for us, now. Thank you.
0:36:42 > 0:36:46- Ah. Dr Keogh? - Neil.- Noel.
0:36:46 > 0:36:49Good. Yes, what can I do for you?
0:36:49 > 0:36:50Blood results.
0:36:55 > 0:36:58Amylase. Electrolytes, all normal.
0:36:58 > 0:37:00- That's good isn't it? - Er, no.
0:37:04 > 0:37:06Of course. The gel.
0:37:07 > 0:37:10Of course. Thank you, Nigel.
0:37:10 > 0:37:13It's Noel.
0:37:17 > 0:37:19- I know what's wrong with her. - Out, please.
0:37:19 > 0:37:23- This patient is sterile! - Listen, her bloods. - We've seen her amylase.
0:37:23 > 0:37:26- It doesn't mean anything. - The bleeding came from somewhere.
0:37:26 > 0:37:29- We know where her bleed comes from. - I didn't just test her amylase.
0:37:29 > 0:37:32I tested her lipase and her trypsin. All perfectly normal.
0:37:32 > 0:37:35If you go by the modified Glasgow criteria
0:37:35 > 0:37:38even by Ranson's criteria, she does not have pancreatitis.
0:37:38 > 0:37:41I told you the answer was right under my nose!
0:37:41 > 0:37:43The ultrasound gel.
0:37:43 > 0:37:45It's always cold.
0:37:45 > 0:37:47Patient's always react in the same way.
0:37:47 > 0:37:49Contraction of the small muscles.
0:37:50 > 0:37:52- And?- Hers didn't contract.
0:37:52 > 0:37:55I noticed at the time, I didn't think anything of it.
0:37:55 > 0:37:57And your point being?
0:37:57 > 0:37:59She didn't know how she got old injuries.
0:37:59 > 0:38:02There's a reason she's only been to hospital three times.
0:38:02 > 0:38:04She didn't know how she got them
0:38:04 > 0:38:07because she never knew she had them in the first place.
0:38:07 > 0:38:09She has congenital analgesia.
0:38:09 > 0:38:12She hasn't felt pain since birth.
0:38:12 > 0:38:14We didn't think to look for a leg injury
0:38:14 > 0:38:16because she was walking fine.
0:38:16 > 0:38:18I even sprang her hips. No response.
0:38:20 > 0:38:23I think she has a fractured acetabulum.
0:38:23 > 0:38:25This would have worn away at the common femoral artery.
0:38:25 > 0:38:29This could have caused a retroperitoneal bleed.
0:38:29 > 0:38:31She is bleeding into the retroperitoneal space, so...
0:38:31 > 0:38:34- It's obviously incredibly unstable. - OK.
0:38:34 > 0:38:36Thank you. We'll take it from here.
0:38:39 > 0:38:41Cancel the general surgeon. It doesn't change anything.
0:38:43 > 0:38:45No, it doesn't.
0:38:45 > 0:38:47Get an orthopaedic and vascular surgeon on standby.
0:38:47 > 0:38:51Wake up, darling.
0:38:51 > 0:38:53Please.
0:38:56 > 0:38:57Mrs Lan?
0:39:08 > 0:39:11He swore to us. No more visits.
0:39:11 > 0:39:14He should never have been there.
0:39:14 > 0:39:19- What happened?- Mendel had enough.
0:39:19 > 0:39:21"No more," he said.
0:39:21 > 0:39:24I could've stopped him.
0:39:24 > 0:39:27Why?
0:39:27 > 0:39:31All you had to do was keep quiet.
0:39:31 > 0:39:33Sometimes it's hard to keep quiet.
0:39:33 > 0:39:39- Nothing is harder than this. - Did you make the right choice?
0:39:39 > 0:39:41Should you have gone to the police?
0:39:41 > 0:39:45This all started because Mendel went to the police.
0:39:45 > 0:39:48After our very first visit.
0:39:48 > 0:39:52They made an arrest, assured us we'd be protected,
0:39:52 > 0:39:55but he was out within a week pending trial.
0:39:55 > 0:39:57They didn't care.
0:39:57 > 0:39:58He paid us another visit.
0:39:58 > 0:40:01He was angry - very.
0:40:01 > 0:40:05He pushed me. I fell.
0:40:05 > 0:40:08Whilst I was in the hospital, Mendel dropped the case.
0:40:10 > 0:40:15If we'd done what he wanted that first time,
0:40:15 > 0:40:16he would've gone away.
0:40:21 > 0:40:24OK, let's, er, get up there as quickly as you can, please.
0:40:24 > 0:40:27- I'll get the lift, Zoe. - OK.
0:40:27 > 0:40:28Where's Dylan?
0:40:28 > 0:40:29Dr Keogh has lost his job
0:40:29 > 0:40:32because you stayed with him last night, Becca.
0:40:32 > 0:40:36Will you tell me exactly what happened? Please.
0:40:36 > 0:40:39- He took me in.- And?
0:40:39 > 0:40:43And nothing, he stayed in his crappy car. He insisted on it.
0:40:43 > 0:40:45- Mr Jordan.- Yeah.
0:40:48 > 0:40:49Mads? This came for you.
0:40:49 > 0:40:52- Thank you.- All right.
0:41:17 > 0:41:18You all right?
0:41:23 > 0:41:25- Here. I want to come with you, OK? - Where?
0:41:25 > 0:41:27To the police, when you go.
0:41:27 > 0:41:29I'm not going to the police.
0:41:30 > 0:41:33Mads! The guy's got to be punished!
0:41:33 > 0:41:36I don't want it to become a part of my life and it will.
0:41:36 > 0:41:39- You have a responsibility. - Don't tell me about my responsibility.
0:41:39 > 0:41:41The guy assaulted you.
0:41:41 > 0:41:45- And I want to move on with my life. - So why come to me?
0:41:45 > 0:41:47Because... I wanted you to know.
0:41:47 > 0:41:49Please, Lenny, I need you to respect my wishes.
0:41:54 > 0:41:56I don't like the idea of someone hurting you
0:41:56 > 0:41:59- and getting away with it. - But that is my wish.
0:41:59 > 0:42:01I just want to forget about it. Please.
0:42:04 > 0:42:09On arrival Mother's GCS was 8, pulse 56, BP 98 over 48.
0:42:09 > 0:42:13GCS raised back to 10. Gave her 1.2 milligrams of Naloxone.
0:42:13 > 0:42:15She responded after three shots, GCS came up to 10,
0:42:15 > 0:42:18then it went back down to 8.
0:42:18 > 0:42:20Get the foetal heart monitor over, please.
0:42:20 > 0:42:22That's my girlfriend.
0:42:22 > 0:42:24Is she going to be all right?
0:42:24 > 0:42:25That depends, young man.
0:42:25 > 0:42:27And what about the baby?
0:42:27 > 0:42:29You need to tell us what you've taken.
0:42:29 > 0:42:33Look, I can't. She can.
0:42:34 > 0:42:36Do you know these people?
0:42:37 > 0:42:39I thought it was for him.
0:42:39 > 0:42:43If we're going to save them, we need to know what they've been given.
0:42:46 > 0:42:49I introduced Azactam into the methadone.
0:42:51 > 0:42:53The effects would be masked.
0:42:53 > 0:42:56It would appear to be a methadone overdose,
0:42:56 > 0:42:59- and the standard treatment... - Wouldn't work.
0:42:59 > 0:43:01No wonder the Naloxone had no effect.
0:43:01 > 0:43:04Wayne, we need to amend their treatment regime.
0:43:04 > 0:43:08Keep a close eye on their GCS and respiratory effort,
0:43:08 > 0:43:12start them both on Flumazenil straightaway, please.
0:43:12 > 0:43:15- Will it affect the baby? - Everyone's chances will be better,
0:43:15 > 0:43:16now we know what we are treating.
0:44:18 > 0:44:21She's out of surgery.
0:44:21 > 0:44:23You very likely saved her life today
0:44:23 > 0:44:26But you also put her life at risk.
0:44:27 > 0:44:30There you go. Don't do it again.
0:44:34 > 0:44:36Shortest resignation in history.
0:44:37 > 0:44:39Have I you to thank for that?
0:44:41 > 0:44:44I'd offer you out for a drink, but we know it would end in sex.
0:44:44 > 0:44:47How about we just start off as friends, yeah?
0:44:47 > 0:44:50- With the possibility of sex later on. - Oh, of course(!)
0:44:50 > 0:44:52Oh, does that mean I get to go in this?
0:44:52 > 0:44:55- Well, I... I have to really like a woman.- Shame.
0:44:55 > 0:44:57Awesome air-conditioning system.
0:44:57 > 0:45:01I can tell, clearly. One day, hmm.
0:45:01 > 0:45:04- Well, see you tomorrow then. - Can't wait.
0:45:11 > 0:45:13- Stop waggling. - Stop looking.
0:46:12 > 0:46:14I think she would like to start her day again.
0:46:21 > 0:46:22He'll carry on, Lenny.
0:46:23 > 0:46:24I know that now.
0:46:24 > 0:46:27As long as no-one says anything he'll just...
0:46:28 > 0:46:30What would you like to do?
0:46:35 > 0:46:38Will you come with me?
0:46:39 > 0:46:41Yeah. If you're sure, then yeah.
0:46:48 > 0:46:49Mads?
0:47:23 > 0:47:26Subtitles by Red Bee Media Ltd
0:47:26 > 0:47:30E-mail subtitling@bbc.co.uk