Natural Selection Casualty

Pregnant lady, coming through.

Now he sees the gun.

Now he knows.

He's not smiling now.

MOTOR BIKE REVS

-RADIO:

-Holby Control to 3006, your availability for an emergency over?

-We're on a break.

-Teenager shot at Atlantic House, Farmead Estate.

Caller also says there's a pregnant girl involved! Over.

Isn't there anybody else?

Dixie would like to know if there's anyone else available please, over.

-RTC on the ring road. You're all I've got. Over.

-OK.

3006 responding. On our way, thanks.

Come on, what you gonna do? Not go?

Oi! Eh! That's my sandw...

OK, listen up everyone, please.

Listen up. I've just had a courtesy call from Ambulance dispatch.

We're expecting possible multiple gunshot injuries.

Details are not confirmed, so no specifics. Sam, you're assisting.

-I'm on it.

-Got that?

-Look up, once in a while.

-Why?

What day is it?

-Friday.

-Saturday.

-Oh, yeah... One day closer to my day off.

My phone just says Lundi. Um, Jay. You're a bloke.

I got this as part of some deal I neither wanted nor asked for.

-Set it up for me, could you, please?

-I'm a bit busy, actually.

Couldn't one of these two do it? They don't look very busy.

-Patient in three. Jay's got the casualty card.

-It's my job to assign nurses.

Rules are to Dylan what God is to an atheist.

Right, let's get you comfortable,

and then take a look at your dressing.

SHE RETCHES

-Copper says there's nothing doing.

-Uh! Great.

How many times is that this week?

You know, why give us an unpaid break, but never let us take it?

It's pathetic! Bureaucracy gone mad!

Small minded pettiness!

I wish I had popcorn. This is better than TV!

-Yes, how'd you like getting shot?

-Nothing to it, man.

Let's go.

-She's supposed to wheedle out the fake calls.

-Louise is new.

Come on, give her a break!

The way she acts, you'd think she was ten years in.

Ow!

It's a pregnant girl.

-Cally! I'm sorry.

-You OK, babes?

-No!

Do you need help?

People come in here, they need to know nothing fazes us.

-Our confidence gives them confidence.

-I know that. I'm sorry.

Work on your poker face.

-That guy, there...

-M-hm.

..is on a stag weekend. Drinking game goes wrong, he gets a dart

in his head, he says "I don't want any antibiotics I can't drink on".

-We can give them everything except brains.

-My day would be so much easier without the patients.

-Or meaningless meetings with the Medical Director.

-Oh, Is that today?

Mmm... Hopefully the end of the world will come first.

Are you a doctor?

I don't want to die.

She ain't going to die or nothin'.

Hay. Easy, blood. Just let the woman do her job.

-We'll need to get you assessed.

-At the hospital?

We got a call out about a pregnant girl. Someone being shot...

-Does any of us look shot to you?

-When's your due date?

-Monday.

-She gonna be all right?

-You the baby's father?

-Swear down.

-Does that hurt?

GIRL WINCES OK, if it IS broken, we can get you a cast, for protection.

We're taking her to Holby City ED.

-Can you call Madam and tell her we have a running call, please?

-K?!

That's my baby, bruv.

-We'll race them.

-Safe.

Don't be silly.

-I need a drink. You want one?

-No. Thanks.

-I could do with some money.

-When we get home.

Don't be long.

-This is Esther.

-Yes, we met before.

She presented feeling unwell with a sore throat and a cough.

-OK, let me listen to your breathing.

-Dr Keogh.

-Is that how you're starting. Straight in there?

-What?

Get yourself a bedside manner?

-Hello. What's your name?

-Esther.

Esther, hi, I'm Zoe. This is Dylan.

I know he may seem like a prize grump,

but he does mean well and he will look after you. OK?

-Thanks.

-(How hard was that?)

This is the bed, this is the side of the bed.

D'you mind if I sit? How's that for bedside manners? OK.

Deep breaths for me.

Um, her resps are 28, she's febrile at 38.5,

-so we've given her some paracetamol.

-OK, wide open for me.

OK, your pharynx is impressively inflamed - erythematous

and a little swollen. Let's get a urine sample

and see how that paracetamol brings her temperature down.

-So what's wrong with me?

-Let's wait for the results to come back.

-Is it bad?

-At a push, I would say, you have a sore throat

and a chest infection that sounds a little worse than it is.

-We'll wait for the tests.

-How you doing, peaches?

Like you said, let's wait for the results to come back.

We'll talk later.

HE HONKS THE HORN

What an idiot!

-D'you live on the estate?

-Around there, yeah.

Well, d'you want me to call your mum?

-We don't get on.

-Well, she'd still want to know you're all right.

Not while I'm with K - she thinks that...

-Well, it don't matter what she thinks.

-She don't like him?

She don't like men, in general.

She ghosted my dad before I was even born.

This little thing is going to know his daddy. Ah!

-Yeah, so long as he's worth knowing.

-K is no waste, man.

I love him.

-Ooh...

-SHE WINCES

-You

-OK? Ah! It hurts!

All right, I'm gonna give you some entonox, for the pain.

-Could be contractions!

-All right, well let's get a wiggle on then!

HE PUTS THE SIRENS ON

-Like your bracelet.

-K got me it.

He said to use it. Something to focus on when it hurts.

Come on! What've you got, ey?

What've you got? Go, go, go, go!

I should radio this in, really, get him done for dangerous driving.

-What've you got, ey! Come on, what've you got!?

-No. Please.

Good girl.

-How do you go about seeing a different doctor?

-Erm...

I'm not sure, I suppose you just ask. Why?

-Oh, I'm just not sure he's the right one for Esther.

-Why not?

He seemed fine.

He might already know what's wrong with me.

-Sometimes mum knows best.

-I don't want any trouble.

The sooner he sees me, the sooner we can go home.

For you, peach doll, I'll let it go.

-She mentioned seeing another doctor.

-Really?

-D'you know that woman?

-Who?

-Er, Esther's mum.

-No, never seen her before.

-I don't think she likes you.

Maybe it's your maverick nature.

I really dislike that word, it belittles everything I do.

-Well, you know what it makes me?

-A pain in the rear end?

-Your straight man.

-Before you came along, I did my own share of mavericking, you know!

-That's not even a word.

Now I'm consigned to standing back and going "wow" on the edges.

Not really my style.

You do have quite an infected throat, and a bit of

a chest infection - so we'll give you some medicine for both of those.

So it's just a chest infection? You're absolutely sure?

-Were you expecting something else?

-What do you mean?

-Is there something you're not telling us?

-No.

A lot of what we do is based on what we can see,

but sometimes we need patients to tell us things. Things we couldn't know just by looking.

-Now, you came in here thinking it was something else, didn't you?

-Mum's got a disease called LAM.

She told me it can be passed from mother to daughter. It can kill you.

-You don't have LAM.

-I find it hard to walk up stairs, just like her.

That's the chest infection. The antibiotics will clear that up.

-But how...

-It's an incredibly rare disease,

and you don't get it until your 30s.

I can't guarantee that you won't get it,

but I promise you, you don't have it now.

If you want, peach doll, we can get a second opinion.

Cos I don't think this man's up to it. You recognise me, don't you?

-No.

-Yes, you do. Course, you do.

Why are you looking at me like that?

I'm trying to figure out why you're pretending to be this girl's mother.

I saw you being sick. Go on. I've got a test for you.

Tess has already had a word. I'm fine.

Look at the pictures and try not to throw up.

OK. Next.

-It was a one off. I can do this.

-No-no-no-no.

You didn't react cos they're only photos,

it's not the same as something right in front of you.

I need to find something really nasty.

OK.

-You took money to pretend to be her mother?

-Don't YOU judge me!

I was doing Esther a favour. I'm her neighbour.

I know what this kid's been through. If it wasn't for me, she wouldn't have been able to come here.

Lying about being a parent doesn't help! It's important we get a patient's full history.

-Have you got his "full history"?

-What's that meant to mean?

-He's a drunk.

-Can we get her out of here?

-His drinking could have killed me. I was gonna sue, but he ran away.

-I think it's best if you leave...

-Now you remember me!

-..or I will call Security.

-Don't let this man anywhere near you!

-OK. Step aside.

-SHE CONTINUES SHOUTING

-Err...sorry about that.

-Um, must've been quite frightening.

-How did you know she wasn't my mum?

Erm, she didn't seem as focused on you as your mum should be.

And... and the way she's breathing. Erm...

-At her age, with LAM that wouldn't have been possible.

-Seriously? Wow.

Esther? How long ago did your mum die?

Six months ago.

-You're not bad at the wheel. But I know the roads.

-You're an idiot.

-This cos you lost?

-We have sirens for a reason, son.

They give us priority, cos we have patients in an emergency.

In this case, this patient happens to be your girlfriend.

You put her, us and yourself at risk. Like I said, you're an idiot.

-K!

-Baby I'm sorry.

I just got a red rush up my head.

-You OK?

-I'm fine.

-The pain's gone now. We're all cool, right?

-Yeah, yeah, we're cool.

Next time though I'll call the police.

This is Cally Bryant, she's 18, forty weeks pregnant.

Her due date's on Monday. She's trapped her hand in a car door.

-On the bed, please.

-Let's get you comfortable.

BP's 130 over 85. Thought she was having contractions,

-but it's probably just Braxton Hicks.

-Braxton what?

I need to take a look, so if we could have some privacy, please?

OK, Cally, you look after yourself. You...

-You make sure you take care of her, All right?

-All right, Ma. Whatever.

D'you want to step to the other side of the curtain. Mate, if you just some with me.

You want me to take a look at something for you?

-You trying to come on to me?

-Problem with your shoulder?

-I'm cool.

-OK.

-You got a second?

-Um, yeah?

-Need a favour.

-Ah, what can I get you?

Something nasty.

-I got something all swollen I need you to look at, nurse.

-Please!

-She ain't got no magnifying glass!

-Take my pulse. I feel well dizzy.

-Oi, oi, oi!

-OK...

-What man?

-Everything all right?

Yes, Mr Jordan.

Oh, I'm sorry, you're brain dead.

-Ha ha! Nice.

-OK, hey, allow it, bruv...

OK, I need something really gross...

No sign of the baby yet. Can you let me know when her x-rays are back?

And, in the meantime I'd like a full blood count, clotting, Us and Es,

LFTs and dipstick her urine.

-She's complaining of blurred vision and a headache. Keep an eye on her BP.

-Yeah. Right away, boss.

And then we can be on our way.

-You made yourself unavailable to control.

-You what?

-We came across a running call.

-Suspected fractured hand.

Jeff told me she was with her boyfriend. He had a car.

You don't think he could have given her a lift?

We haven't enough jobs booked in and you bring in minor injuries?!

We were on our way back from a hoax call, which you took! You should question your own

-decisions before you have a pop at ours.

-I followed protocol.

Then don't take us off our unpaid meal breaks, that's protocol for you,

and it's a joint union/management protocol at that.

-You should thank me, skipping a meal would do you the world of good.

-Hah!

Oh, that's very mature, that is! So what, we're in the playground now?!

Tell you what, Louise, you come back to me when you've grown up, eh?!

Cally's having her hand x-rayed. So, seeing as how we go five minutes...

And no, I am not coming on to you. OK?

Something's wrong with your shoulder.

-You may as well let me look at it, while you're here.

-I said I'm fine! I don't need you touching me.

You don't remember me, do you?

I helped look after your sister.

-Um, can I ask, er... why isn't your father here?

-Sorry?

Well, your mum's been dead for six months um,

and, you're not in care...?

-No. And I don't want to be.

-So... Why isn't your dad here?

-He's working.

-Right, so he left you on your own?

Stop lying to me, Esther. You're being...

-After Mum...he just... went all quiet.

-So he's grieving?

-Well, that's understandable.

-We're OK. I look after him.

-We're like a team.

-Then why isn't he here?

-What's that for?

-It's to call your dad.

-Why?

He has to come and get you. We can't let you leave without him,

-or I could call social services for you?

-No!

Dad will come.

Whoa. That's impressive. Except it's infected.

Yeah. I thought so. Rae did it, she's good,

but a bit sloppy when it comes to keeping things clean.

Well, I can dress it for you, some antibiotics will clear up the rest.

-You want something for the pain.

-No, I'm good.

-You were at that

-DVD place. Still working there?

-It's been, bit of a haze, you know?

Sorry... So is this finished now?

It's just the space where my baby's name's gonna go.

After my sis if it's a girl. She raised me. So, due respect.

The police ever find the dealer?

They didn't look too hard.

Your sister wasn't the only one who died, that batch was lethal.

Far as the cops were concerned, it's just one more dead junkie.

You're about to be a dad. Something to focus on, right?

Believe.

Me and Cal, it's meant to be. Three is the magic number right?

Just gotta lay sis' ghost to rest first.

What's that mean?

Just cos the police ain't interested...

-There's other ways.

-Meaning what, man?

OK. So you do know who the dealer was?

Mate, I gave you a leaflet on bereavement last time.

Yeah, it made a nice roach, ta.

PHONE RINGS

-Hello?

-Dad. It's me.

-Where are you?

-I'm at the hospital.

-What?!?

-It's OK. Stay calm. I'm fine.

-Wha...

I- I- I, I don't understand.

My breathing got worse. This morning I could hardly bring the shopping home.

-Esther, I said I would get the shopping.

-I was worried.

-About what?

I thought maybe I've got what mum had.

Oh, baby...

-Sweetie, no, you can't. It's not possible.

-I know that now.

It's just a chest infection. That's all.

Dad... I want to come home.

I need you to come and get me. It's OK, you can do it.

Erm, get a cab. I'll pay.

They won't let me come home unless you're here to collect me.

They even mentioned Social Services.

-OK.

-Don't think too hard about it.

Just walk out. Be strong. Like you told me to be at the funeral.

-You can do it, Dad. I know you can.

-OK.

-And Dad?

-Yep?

Hurry up. I love you.

He's on his way. So you won't need to call Social Services.

-Well, if your dad's coming, then we won't need to.

-He is.

OK, then. Good.

They going to let you out or what? Joolz will be there at four.

-And for, like, 20 minutes. It's now or never.

-I know this.

You keep on saying it like I don't know.

-Hey, you've nothing to be stressed about, babes.

-It's just money.

-We don't need to rob dealers. We can get the money other ways.

-What?

-Like working in DVD rental for ever?

-Rae, now wait outside, yeah?

Scudge up.

Look, I don't care about the money either.

Yeah, it'll do us right, you me and the little one.

But you know that's not why I'm taking down Joolz.

-I know, but K we're gonna be...

-He KILLED my sister.

It was a bad bundle and he knew it.

I'm scared.

There's nothing to be scared of. Don't you see?

The way we're playing it is, you walk in, with your big proud belly.

Won't kick off. Not with you there.

This is all I want.

You, me, our baby.

-All this gangster stuff, it's not me, K.

-Me neither.

Look, soon as this is over, me and you are out of the life.

Money for the baby. Tracy's score settled. We're set for good.

-Believe.

-I want to.

Three's the magic number.

Hey, hold up! Antibiotics. Finish the course, even if the infection clears up.

-Yeah, yeah.

-And if you decide you wanna talk, come see me, all right?

-Maybe we should wait, they ain't said I can go yet.

-We can't wait.

Besides, what they gonna say? Baby's not ready. Your hand's strapped up.

-They'll just keep us hanging around.

-So cool, let's go see Joolz.

-Joolz?

-As in Joolz Culley?

-What of it?

-Who's Joolz Culley?

-Nobody.

-Nothing to do with you. Back off!

-All right!

-I'm gonna kick off!

-Whoa, easy!

-Is there a problem?

No problem, Mr Jordan. It's under control.

We've already established one of you is brain dead.

Shall we make it a pair? Ah, no, in actual fact, better still...

-Security please.

-Another time, blue boy.

-Let him go, Staff Nurse Asike.

-Yeah, nurse.

-This is Jordan, in the ED, yeah.

Guy like Joolz, he'll take care of you.

Yeah, we'll see about that.

This guy? Is he a dealer?

Joolz Culley is THE dealer on the estate,

-everyone from my ends knows that.

-I think they're gonna do something to him, you know?

Don't even sweat it. It's natural selection...

One piece of street scum takes out another. One less to worry about.

Cally?

Hey, I'm glad I saw ya. There you go.

-Didn't realise...

-Cal, let's go.

You OK, sweetheart?

I'm gonna take care of her, don't worry about that.

Where's Cally?

-Didn't you discharge her?

-No. No, her platelets are through the floor.

It looks like Hellp Syndrome.

OK. Let me see if I've got any contact details for her.

When she does go into labour she'd better pray she's near a hospital.

MOBILE RINGS

Your dad's still not here?

No petrol, he had to catch a bus.

You're very bright. But so am I. He's not coming, is he?

He took care of me and my mum, right until she died. Now it's my turn.

No, that's still your dad's job.

-And if he can't do it, there's loads of help.

-We're all right.

Hi, Esther, this is Jenny. She's a social worker.

-Um...I'm dealing with this!

-I don't need a social worker. Why?

We had to inform them. It's called a duty of care, which Dr Keogh knows.

-But you said... You ARE a liar!

-Er, a word, please.

-I'm doing my job. So you can lose that tone, thank you.

-I want my dad!

-Jenny will contact him.

-You couldn't give us another half an hour?!

-I hate you!

-Esther. It's not the doctor's fault.

-Yes, it is!

I hate you!

Ah, Dylan. The...

-What if he doesn't come?

-He will.

Oy!

-Where's Dylan gone?

-I think he had a meeting with the Medical Director.

Sorry, Doc.

His name's Mr Robinson, and he doesn't mind you having a look

but he's due for transfer to AAU, so we won't have long.

-Have a look at what?

-If you thought an amputated leg was bad,

wait till you see this guy's armpit.

-I've not seen it myself, but I hear it's disgusting.

-Yeah.

-I'm not sure I can do this.

-Course you can.

-OK!

-Excuse me?

-What's going on?

-Erm, is this a private party or can anyone join in?

Thank you, Mr Robinson.

Um, a porter will be along shortly to transfer you to the ward.

Oh!

SHE GROANS

Aaargh, K!

-Babes...

-I'm not lying.

Look, ten minutes.

-We're in, we're out.

-I think it's coming.

My sister was in labour for about two days. She slept in between.

-Good for her!

-If you don't come, then we're all gonna die.

Mmm... Dylan, it's me.

I've just had to head off our Medical Director.

Apparently you didn't turn up for your meeting.

Get back here soon or it'll be both our necks on the line.

Where are you?!

-Mr White?

-Who are you?

-So. Is Esther all right?

-No, actually.

-She's very scared. Right now she's with Social Services.

-No. Please.

She needs you and you are sitting here, in your own mess of grief.

It's hard to lose a wife, but you still have a little girl.

A very scared little girl who has gone out of her way to protect you.

-It's time you started protecting her.

-Yes. I know.

Right well, come on then let's go.

HE GASPS AND PANTS

HE BREAKS DOWN

Enjoying your break, are ya?

-How long have you got?

-30 minutes.

Well, how about you go back in there and man the phone in your own time?

Oh, we feel the same. But we keep getting call-outs.

I'm monitored, too.

My job's on the line, if I can't get an ambulance to an accident, how does that reflect on me?

-It's not all about you.

-Sit out your breaks. Ignore your calls. If you can do that, fair play to you.

Now, the government make these cut backs without really

thinking things through. If we don't sit out our breaks,

then management can't see that the system is broken.

If we do, then we're seen as mercenaries,

-who don't really care about people in need.

-You're talking to the wrong person,

take your moans upstairs. I'm just doing my job.

Sod this.

From now on, if we get a call when we're on a break, we don't go.

Simple as.

-HE GASPS

-I'm going to cup my hands over your mouth

and I want you to breathe in very slowly for me.

Slowly, slowly.

And out. Slowly.

HE STOPS GASPING

Good, good and in slowly.

Slowly, that's it.

-Good. Excellent.

-HIS BREATHING SLOWS

LOUD MUSIC COMING FROM THE FLAT

You walk in first,

I'm right behind you.

DOOR BELL RINGS

LOUD MUSIC PLAYS IN THE LIVING ROOM

What's the address of the emergency?

Tell me exactly what happened. Shots fired and a pregnant girl?

We had this same hoax call this morning.

If it's too dangerous to stay there, go and call us from somewhere safe.

Is the attacker still around? Are you with the victim now? OK, I'm organising help for you now,

stay on the line and I'll tell you exactly what to do next.

Holby control to 3010, shots fired again on Farmead Estate,

injuries and number of casualties unknown. Over.

I know you're 15 minutes away!

SHE SIGHS

Sorry. You're all I've got.

I couldn't face my friends,

my neighbours.

Just... awkward silence,

not knowing what to say.

Even worse, them saying the wrong thing.

Just became easier to stay in.

Before long I couldn't leave the house.

Then it was the funeral.

HE SIGHS HEAVILY

My heart banging.

-The room spinning.

-They're panic attacks.

Not at all uncommon after what you've been through.

Poor Esther,

me leaning on her.

This is Diazepam.

It should help to calm the anxiety. And once that's out of the way,

-you can start to think more clearly.

-Will it get me to Esther?

-Yes.

-Please.

-This is only the first step,

you need to take whatever help is on offer.

-Esther needs you to look after her.

-I know.

I'm sorry for your loss.

SIREN BLARES

Holby control to 3010, three victims, one pregnant,

all received, sending back-up now.

-I'll alert the ED, over.

-Where's that?

-Same place as this morning.

-This time it wasn't a hoax. Pregnant girl, two men.

-Cally?

-Why didn't you shout us?

-You were on a break.

-Yeah, but...

You made it perfectly clear. I allocated it to 3010, and they got there as soon as they could.

-Were we closer?

-I was just doing what you asked.

-Are they alive?

-Unconfirmed.

-Right, well, we'll provide back up.

3003 are closer now. And I want you to transport a patient from the ED.

-3010, are you on the scene?

-3010 on scene.

There are three casualties. Repeat.

Three casualties. No sign of pregnant woman. Over.

SOBBING

OK. Stay calm, stay calm, look, you're going to be all right.

-Everything will be fine. Breathe deeply.

-Please....

Dr Nicholls. OK, listen up, everyone.

We've got three gunshot victims coming in. And a usual, I want us all ready.

You're with me on this and it is confirmed.

SHE GROANS

TYRES SCREECH

SHE GROANS

3006 to Control, there's an RTC outside the ED entrance.

-We are in attendance now. Cal? Cally, are you hurt?

-Help!

-OK.

SHE SCREAMS

-She's trapped, Jeff! OK. OK, sweetheart.

-All right, kid.

-We're gonna get you out of there as soon as we can, all right?

-My baby!

-What, now?

-It's coming!

-OK.

-OK!

-All right, all right, nice and easy.

-SHE SCREAMS

-3006 to Control, we have a pregnant girl trapped in her car.

-OK.

-We need the fire service with cutting equipment.

-There's a lot of blood.

-Right, we need some entonox!

-That's it!

-CALLY GROANS

Some sterile gauzes, a shed load of inco pads and some IV access please, Jeff.

-Cally?

-I'm just going to cut your leggings now.

We found out that she has Hellp Syndrome. She could bleed out.

-My name's Tess. What's your name?

-I'm guessing it's close.

-It's coming!

-There's no time to cut her out.

-I'm just put something on your arm.

-I'm delivering this baby.

-We need blood.

-CALLY SCREAMS

Listen up, I've been updated.

Young male aged 20, gunshot wound to the arm and abdomen just below the lower right rib.

Dr Lyons, Jay and I will take that one.

Sam, you've got the second major lead, another male,

-20, gunshot wound to the abdomen. There's a third but she's DOA.

-I need blood.

-Trauma in the car park.

-You need a hand?

-Er... No thanks.

-We've got it covered.

-OK... Look sharp!

-K? K, it's Jay.

Where's Cally?

OK, the second incoming arrested at the scene.

-Paramedics have intubated and they should be with us shortly.

-Great.

Well done, Cally, you're doing really well.

SHE SCREAMS

OK, take that in your hand for me please, when you can.

Breathe on that nice and easy and slow your breathing down.

-OK, let's get X-ray, please. Chest and abdomen.

-BP's 70 and dropping.

Let's get some fluids in him and some more O-neg blood, please.

-I'll talk to theatre.

-He's about to be a Dad. Where's his girlfriend?

-Cally! S-sorry, sorry...sorry.

-HE GASPS

You can tell her yourself, as soon as we fix you up, mate.

Just breathe, breathe easy... HE COUGHS

Peripheries cool and shut down.

Very thready pulse, abdomen tense...

Obvious entry wound to lower abdo.

-I can't get a BP. Pulse is very weak.

-He's hypovolaemic.

-Must have hit a major vessel.

-Shall I call theatre?

-He hasn't got that long. I have to do a laparotomy to isolate the bleed.

-Here in resus?!

If we wait for him to be taken upstairs, he won't make it.

Get me a general set and sterile gown - be ready to assist.

-SHE SCREAMS

-Can you feel the head?

-Yeah.

Yeah, but I can barely see it for the blood.

She's in second stage already.

-OK, sweetheart, keep breathing, good girl.

-The BP is dropping.

-OK, I'll push the fluids.

-Cally? Where's your bracelet?

-Come on, use that, use that, darling and focus for me.

-Make it stop!

-Take a bit of that. There you go.

-Good girl. Good girl.

SHE SCREAMS

Good girl, well done. Well done. OK, take a rest.

-OK, good girl.

-Next contraction!

-K! Where are you?

-Deep breath!

-Oh, sweetheart.

OK. Stand by with suction.

It's definitely two shots, we've got the through and through on the arm

and we've got an entry only on upper right quadrant just below the ribs.

This arm is clinically fractured but it's uncomplicated.

-The belly seems fine.

-So why isn't he improving on fluids?

-The bullet is in the left shoulder.

-I thought it went through the abdomen to the right.

-No. The abdomen's fine. No pneumothorax.

So, how can a bullet enter the abdomen, miss the liver,

nick the underside of the ribs, and end up on the left shoulder? Because

it's gone through the pericardium. He's tamponading. We need to tap it.

Let's set up, please, quickly.

Looks like a large pulsatile bleed. The superior mesenteric artery.

I'm going to clip the vessel.

Stop what you are doing, right now, please!

I've done it before, soldier in the same state. Abdominal gunshot wound. There was no time to waste.

You're not in the army now!

We have surgeons far better qualified than you to make decisions!

Staff nurse Conway, will you please call the surgeons

and tell them they have an urgent case to take to theatre.

Go and assist, please.

-She seems like she's doing fine.

-(Go watch her).

OK. Pulse rate is coming down.

Let's get some light in here, see how he's doing.

Well, you stopped the bleed so you've done something right.

OK. Let's get him upstairs.

-Carefully, but quickly, he's still unstable and shocked.

-Dr Nicholls?

-Don't you ever put me in this position again!

-He's arrested.

-MONITORS BEEP

OK, get me a thoracotomy set, quick as you can, please!

OK, darling! Right, the head's crowning. SHE SCREAMS

That's great, Cally, you're doing great!

-Take a break! All right. And on the next one, a big push,

-OK? Oh...

I'm making a left lateral thoracotomy,

ready with the rib spreaders, please, Jay.

MONITORS BEEP CONTINUOUSLY

Still in PEA.

All right. Get ready with the suction, please.

That's it.

Can't see anything yet.

OK. And again.

Yeah.

He's nicked the ventricle. OK, suture, please.

Right.

All right, let's see.

No...

He's not perfusing.

OK, starting cardiac massage.

RHYTHMIC BEEPING ON THE MONITOR

I've got a pulse.

Way to go, Nicky J...

Mr Jordan.

FLATLINE BEEP

Ahh... We go again.

CALLY SCREAMS Come on, Cally, you can do this!

One last push, darling! SHE SCREAMS

There we go! Hey! Look, you did it!

You have done it, darling! Well done, that woman, you've done it!

Ha ha ha! There we go!

HEART MONITOR FLATLINES

All right, thank you.

Come on.

All right.

-HE SIGHS

-No...

OK. I'm gonna call it, all right?

Time of death, 17.13. Thanks, everyone.

-Oh, well done you!

-You did brilliantly.

-Yeah, let's go!

-OK, can we get her out of here, please?

-What is it?

-It's a boy.

-I did it.

-Yeah! Yeah, you did.

K's going to be so proud!

-Dixie, we need you out of there.

-I'm staying put, Ruth!

OK, fellas, you can start cutting. OK, darling.

-Daddy!

-Esther!

Where the hell have you been?!

You left the house?

Yeah, I'm OK. It's gonna be OK.

I shouldn't have come here with Saskia.

Well, you were trying to protect me. I'm so proud of you, baby.

But it's my turn to look after you now. OK?

Did you do that?

About two years ago, Saskia, that woman, erm,

came in to the A&E department of the hospital I was working in,

needing an emergency appendectomy.

So, she's waiting for surgery, nil by mouth,

I catch her drinking. So I give her both barrels,

about ruining surgery lists, not respecting

her health. I say, if you can have a drink, why can't I?

-Why not make a party of it?

-You didn't?

I was off shift. I was on my way to the pub anyway,

figured I could make the point to her. Well, uh,

it's wasn't her, it was me, want... needing a drink.

So she saw you drinking in the hospital?

All hell broke loose, next thing I know I'm suspended - all my recent

patients being reviewed, I walked away to three days I can't remember.

-Then I got sober, no easy task, haven't had a drink since.

-Wow.

Full of surprises, you, aren't you? Wonder what I'll find out tomorrow?

Are you sure you want to see him?

I need to.

Say goodbye.

I'll give you a minute.

He's called Kyle.

After you.

-Look, even if we got there five minutes earlier.

-We don't know that.

His injuries were beyond minutes, mate.

I let my feelings for Louise get in the way of me doing my job.

I let her rile me.

It wasn't your fault.

You tell that to that baby in years to come.

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