No Goodbyes Casualty

Hasn't anyone been keeping the pressure on?

Course we have.

Right. I need, er, lignocaine with adrenaline.

Are you OK? Shall I get Zoe?

Suction, please.

Whoa, whoa, whoa! That's a nasty arterial bleed.

Can you pass me the syringe?

Ruth, are you with us? We've got to stem this.

Right. Out, please.

Come on! I'm not having it. Now, please!

No, come on!

Can we get some help here, please? Thank you.

Right, what's going on?

Thanks, Sam.

If you'd just like to enter your PIN.

I'm afraid your card's been declined. Sorry.

Do you have another I could try?

Yeah, I think so.

Martin!

-How did she do it?

-She caught her head on a metal shelf.

OK. Keep the swabs on while I take a bite.

Can we get some better light in here, please?

OK.

Let the dog see the rabbit.

And that...

is how you do it.

Good. Neatly done.

Keep her under obs for a couple of hours, then send her home.

Just a minute!

What's the mechanism of injury?

-She fell and cracked her head on a shelf.

-She fell - exactly.

And how did she fall?

She tripped?

Her potassium level is 2.0, she's underweight,

so I would say she's got an eating disorder.

She needs admitting,

an ECG and a psych review.

OK?

Otherwise next time, it'll take more than clever stitching to fix her up.

Right. OK.

Some cases in the ED, Dr Nicholls, will be subtler than you're used to.

Look at the whole person and don't be afraid to ask for help.

It's like he's got a special power or something. It freaks me out.

You know, I don't get it. I can salvage a limb under fire,

THIS cannot be beyond me.

Ah, don't worry about it. You'll get used to it.

Um, listen, we're about to clean up Mrs Thorne,

if you want to practise?

You're all right, thanks.

OK! Right then, buddy,

what's the most important thing to remember about a patient like this?

Neuro obs in case of head injury.

Look, I was hoping we could cover fluid management in trauma today, actually.

OK, I'll be testing you in five minutes, all right?

Hey.

-Look at the state of you. Come here.

-No. People will see, Jay.

So? Let them!

Come here.

So what was all that about in resus, eh?

Well, I didn't have much breakfast, so...

You're a rubbish liar, you know that? What's up?

I've just been feeling...

erm...

..wrong.

What kind of wrong?

I think the lithium's stopped working.

OK. Don't panic.

Go and talk to Mr Jordan.

Maybe get your levels checked again.

I thought I got it under control, Jay.

Hey, it's going to be all right.

She has some kind of eating disorder.

Well, how should I know? I'm a doctor, not a bloody agony aunt!

-Who said you could move this patient?

-I did.

I'm in the middle of arranging a referral.

Well, take it up with Jordan. I think he thought you could do with a hand.

Well, I can take it from here, thanks. Let's get her upstairs.

Don't be afraid to ask for help, Dr Nichols.

Hello, babes!

look what I got.

I said I'd get it, didn't I?

Hello, Debbie.

How are you?

All right. How are you?

Not too shabby.

Packed in the fags.

You got a few minutes?

Er, thought it might be good if we had a bit of a chat.

Take a seat.

So...

-how have you both been getting on?

-Good. We're both good.

Has, er, Rhys seen anything of his dad lately?

That's a lot to cope with on your own, isn't it?

We're fine.

I know you missed a few appointments with Rhys's health visitor recently?

She got the times mixed up.

Did she?

I can, erm... check if she's free today?

-I've got to go, actually. I said I'd meet a friend.

-You know you can't miss these appointments.

-It's important to check his development.

-I know. I've just been really busy!

-What's going on?

-Nothing, I told you!

-I thought you trusted me and you'd tell me if something was wrong.

-I've not done anything.

No-one suggested you'd done anything.

Should I be worried, Debbie?

I've got to go, sorry.

Wait.

Wait!

And your levels are normal?

Yeah, there's new symptoms. Erm...

Nausea, my temperature's spiking.

I think I might be reacting to the lithium.

What's your appetite like?

I can't really keep anything down.

Erm...

And I just feel...

weepy.

There is something else it could be.

Debbie!

Dr Patel's going to have your head on a spike.

It's only one night.

What shirt are you wearing?

I bought you that on our honeymoon.

I found it when I was sorting through the chest.

-Remembered how much you used to fancy me in it.

-Is that right?

You're only human, love!

I found a lot of old bits.

Old photos and things.

We could look through them together.

I love this music.

FRANK SINATRA PLAYS ON RADIO

Debbie!

Debbie!

Debbie, please!

-What's going on?

-You won't believe me.

What won't I believe, Debbie?

I haven't hurt him. I swear.

-Well, what's wrong with him?

-I don't know!

Oh! Someone's had an accident.

What?

Are you all right?

Ow! It's my arm! It's my arm!

I'm sorry. Is Rhys OK?

-I think so. You'll look after him, won't you?

-Why? Where are you going?

I'm sorry.

Can you tell me your name?

Tom.

I've got some medical things in the car.

-You haven't got a cigarette, have you?

-Sorry, no.

Now just try and keep still, OK?

David?

I'm sorry, love.

You'll be all right in a minute. Here.

Spoken to Jordan?

Er...no, I didn't have time.

Ruth, this is important.

Mm. Er... Did you, er...

call Mrs Mason's GP about her prescription?

-Um, yeah, I did.

-Good.

-Oh.

-This is David Northwick, collapsed with shortness of breath,

-known heart failure.

-OK.

You OK with this, Ruth?

-Yeah, fine. Let's get him into HDC.

-Dr Keogh, what do we have here?

Dislocated shoulder, some superficial abrasions.

-Straight through to Resus, please.

-Have you found Debbie yet?

-Who's Debbie?

-Debbie, girl from the crash.

-Her baby - something's wrong.

-Right, let's deal with you first.

Reports of a girl bleeding from her abdomen,

last seen Brockwell Hill, name of Debbie.

3006 to Control, received, we're on our way.

BABY CRIES

OK.

OK.

Oh... Oh, no - what's mummy done?

Silly mummy.

Stupid mummy!

Well, here we go. You want to do the honours?

-Nah. You go.

-All right, then - do us a favour, will you?

You radio it in, please, make yourself useful.

3006 to Control.

Debbie?

You all right?

Leave us alone. We're OK.

Come on, sweetheart. We both know you're not, don't we? Eh?

OK. He's bradycardic at 40.

BP's 87 systolic.

OK, let's try 50mg of Atropine.

Staff nurse Asike, can you ask Noel to track down his hospital records, please?

We're on our way to Plymouth. Sort of second honeymoon.

I'm afraid he's not well enough to go anywhere.

Dirty weekend might do him good?

Could you call X-ray, please, and keep the oxygen on.

I'm sure you'll get him up and running again.

Um, no response to atropine. Heart rate's now 35.

This is Debbie, 19, involved in an RTC.

She wasn't hit by the vehicle but she fell. She's got abrasions to her abdomen.

And this is Rhys, who's uninjured, which is good,

cos he's a little cracker.

-Give him to me.

-We need to check him over first, OK?

-If you take him, I'll batter you.

-We need to find out if there's any injuries we can't see.

-I'm not even joking!

-All right, what's the commotion here?

Paeds Resus, please, Jeff.

Give him to me! Stealing him!

It's all right. We're trying to help your baby. He's not far away.

Zoe, can you find out what's going on here and deal with it quickly?

I'll take her if you like.

Fine.

All yours. Dixie will fill you in.

Great. I'm Dr Nicholls. Let's get you into a cubicle.

-There's nothing wrong with me.

-Hm. Someone else's blood, is it?

-Whatever!

Look, I don't think you realise but I'm trying to help you.

Until you get me Rhys back, I'm. Not. Moving.

All right?

-I'm asking you nicely.

-I told you I don't want your help.

OK. Fine. You sit there.

For all you know you could be suffering from some internal injury,

and when you're in intensive care, who'll look after your baby then?

-Woah! Easy!

-She thinks we've kidnapped her baby.

You HAVE kidnapped him, you stuck-up cow!

I'm used to people doing what I tell them to do.

Right. Go gently. She's frightened.

Hey, he's just in there, OK? They just need to check him over.

I want to stay with him.

OK, I'm going to do you a deal.

Give me three minutes to look over you and then we'll go and see Rhys.

Two.

Done.

What about different drugs? Surely there are other things you can try?

Well, we'll continue trying to get a response from the atropine.

So he might pick up again?

We've, er... We've got this hotel booked.

Mrs Northwick, please, erm...

Has your husband's prognosis been properly explained to you?

They said it could be weeks, even months.

Given his profound bradycardia, and shortness of breath,

I don't think it will be weeks.

I'm sorry.

I've spoken to the cardiology team and they're of the same opinion.

We can make him more comfortable.

Comfortable?

There's really not much to be gained from more invasive treatment.

Palliative care is our main focus now.

Dr Winters.

I'm afraid that's not good enough.

You've been lucky.

Few abrasions and mainly superficial.

We'll do a scan, though, just to make sure.

I know you've obviously got stuff going on you don't want to talk to me about.

30 seconds gone!

It's OK, you don't have to tell me. I'm not very good at that anyway.

But I do know a bit about fear.

I know that your pupils dilate when you're frightened. Dead giveaway.

It's an old fight or flight response. You can't hide it.

Can't hide it any more than you can your heart rate,

which is about 95 at the moment.

-What are you frightened of?

-What? Nothing!

You might be able to lie but your body can't.

-They're going to take him away from me!

-What?

Can I borrow you for a minute?

-Can't it wait?

-You need to see this now.

Two minutes.

-So, have you put me down for that ATNC course yet?

-Hm?

Come on, man! We've been in cubicles all week.

We should be learning new skills every day.

New skills. OK. Mac, you busy, mate?

Lloyd here wants to extend his skill set.

Do you mind if he hangs with you for a while?

Well, yeah. Well, I'm, er, pretty busy, but I've always got time to, er...to teach.

You are a gent.

Right...

Hey! Want to grab some lunch?

Er, no, sorry, Jay. I'm going to try externally pacing Mr Northwick.

-Erm, is that a good idea?

-We'll need the pads front to back to give the best chance of capture.

That's not what I... Listen, why don't we grab a...

OK, this is going to hurt quite a bit so I'll give you something to take the edge off...

Wait. What's going on in there?

Er, don't know. Girl stuff.

-Can you get Debbie in here, please?

-Debbie? Who?

-Debbie from the accident! Can you get her in here, please?

-Oh. Are you her boyfriend?

No. Social worker. Ah! Ah!

We can do it with just the entonox, if you'd prefer.

OK, right.

If you just lie back and think of England.

Wales. Argh! Ah-ha! Ah!

OK. Thank you, Nurse.

They're old bruises, sustained over a period of time.

-He moves about a lot! He's started crawling.

-You don't get bruises like that from just moving about.

Tell me what's going on, Debbie.

-I know it looks bad.

-Yeah!

I don't know if I'm holding him wrong or putting him in his cot funny.

-Tom knows something's up.

-And that's why you ran this morning?

-He already thinks I'm rubbish.

-I'm sure he doesn't.

It's much harder than you think!

I thought I'd just sort of know what to do.

But I haven't done this on purpose. I swear on my life...

(Please, you've got to help me.)

OK, this is an external pacing machine.

It will pass a current through your chest and stop your heart beating so slowly.

-I thought maybe we could just go home?

-No, not yet.

-OK.

Now, put your mask back on.

I'm going to discuss your treatment plan with Dr Winters.

I'm sorry, shouldn't we talk about this with Mr Northwick?

Can you just get this started, please?

-So what now?

-Run some bloods, see if there's any reason for the bruising,

-and if not, well, you have to call social services.

-I'm on it.

-Now, are you're OK doing this on your own?

-Of course.

These cases can be a nightmare. Trust me.

If we get it wrong, God help us.

-Just give me an hour.

-OK.

HE BREATHES ERRATICALLY

Look at those...old man legs.

I've seen worse.

HE STRUGGLES TO BREATHE

You should've seen me in my heyday.

I'd have broken your heart.

I'll give you a tip.

Don't get old.

HE BREATHES IN SHARPLY

Is this too painful for you? Do you want some more pain relief?

No, it's not...too bad.

I...I'm sure it's doing me good.

HE WINCES IN PAIN

Argh! It's doing Caitlin good, anyway.

How are you both coping?

Oh, pretty well.

Obviously...a few mixed feelings, you know.

HE CONTINUES TO STRUGGLE TO BREATHE

I've had...enough of it all now...really.

But I'm afraid... Caitlin's finding it a bit...

..tricky.

She'd like me to hang on, I think.

HE GASPS IN PAIN

It's OK.

Right, this isn't capturing and we've already gone up to the maximum current.

-Can't you turn the blasted thing off?!

-Yes.

HE GASPS IN PAIN AGAIN

I'd like to try a pacing wire. It involves inserting a wire into your groin

-and feeding it up to your heart.

-Can I talk to you for a minute, please?

-Should we be doing all this?

-There's a chance it could improve his output.

Really? What sort of chance?

Look, we have to show them we're doing everything we can.

But he will die, probably in the next day or two, whether we do the wire or not. Isn't he?

-It's hard to say.

-Isn't he?

OK, yes! But this is the only treatment option left. We can't just give up.

Maybe more invasive intervention is not what he needs. Maybe there's better ways to spend the time.

-It's what they want.

-Is it? Or is it what Caitlin wants?

Have you even spoken to David about this?

Just get him to Resus and prep for the procedure, please.

So, as I've shown you, nice straight back,

bend the knees and lift.

I've lifted boxes before, I promise you.

Yeah, and don't forget, if you have to turn, don't twist but...

-..pivot.

-Remember, don't twist...

Pivot.

Lloyd? Sorry to interrupt. Can I borrow you for a second?

Ah, we are in the middle of a training session.

-If she needs me.

-Won't be long.

-Oh, take as long as you want.

So, has Dr Winters talked you through what's going to happen now?

I think Caitlin's been through it with her.

She seems pretty genned up on the medicine, eh?

She likes...having something practical to do.

Thanks, guys.

While...she's not here...

..it's not going to be long now, is it?

No.

I thought not.

It's all right.

You don't have to worry about upsetting me.

HE BREATHES SHARPLY

It's the sort of thing you wonder about all your life, isn't it?

What you'll be doing...at the end.

HE TAKES SHORT BREATHS

It's looking a bit short on...champagne and dancing girls.

You know what?

You don't have to be in here.

-Not if you don't want.

-What?

Has anyone actually discussed your treatment properly with you?

Caitlin's looking after all that...

I mean, what YOU want, David, and where YOU want to be.

What treatment you want to receive and for exactly how long.

You can make these decisions.

-Have you sorted the local?

-Can you just give us a minute?

We haven't really got time for this.

If you want to,

you can agree with the hospital exactly when enough is enough.

Caitlin...needs me to keep going.

I know.

You want to protect her.

What do you think, Ruth?

The clinical picture is...quite complex.

We don't know how you'll respond to the pacing.

Just talk to her.

O-K. We'll transfer you over to cubicles for a couple of hours

and then you can go home, chill out.

Chill out?

Yes, chill out. Have a long bath, listen to some Michael Buble.

-Whatever it is people do.

-Wha...?

I've got a crisis brewing with an unpredictable teenage mother.

-I'm not going to go home and have a bath.

-Right.

-I can see you're obviously of a delicate state of mind.

-What?

A-Are you always like this, yeah?

Like what?

So unengaged.

Erm, I think you'll find it's "supremely unruffled".

Mm. I've worked with a lot of people like you.

I could give you a number, if you like.

Right, OK. Done.

OK, leukaemia.

Doubtful, luckily.

Anaemia?

Liver failure?

Low platelet count, idiopathic thrombocytopenic purpura.

Could be. OK, let's get these off to the lab quickly.

Well done.

He must like you.

Normally hates injections.

We're being very gentle.

Can I hold him?

Yeah. Go on.

BABY COOS

BABY GRIZZLES

-I got to go.

-Yes, I can see you're a live-wire, aren't you?

-Um, I need you to sign a disclaimer for me.

-Yeah, fax it to me.

-You were holding him during the crash, weren't you?

-Yeah.

Can I see your hands?

Can I come in?

Please don't say anything about the bruises.

How are you both?

Fine, we're both fine.

Rhys wasn't hurt in the accident, was he?

No, he got off very lightly.

So what are you doing now?

Er, I'm just taking some routine bloods.

How's your arm?

Oh, fine. My shot putting days are over.

-So, er, what are the blood tests for?

-A number of things, really.

BABY CRIES

-Sh-sh-sh, Rhys.

-What's going on?

-Nothing!

BABY CONTINUES TO CRY

If you could just step outside, I'll explain everything we're doing.

OK, shall I have him? Whoa! Whoa...

Just take him, all right!

BABY SCREAMS

-Debbie!

-I think you'd better tell me what's going on.

BABY CRIES

OK, so the wire will go in through the femoral vein.

-Can you get the Lignocaine ready?

-Can you just...just wait a minute, OK?

My darling...

..when I...put that shirt on this morning...

..I thought somehow I might feel more like myself.

It didn't work.

What do you mean?

I'm taking 25 pills four times a-a day.

They've thrown everything they've got at me.

I think someone up there's... telling me to call it a day.

(Not yet.)

You! You put him up to this.

You should have told me sooner. I knew something was wrong.

She's frightened. She knew we wouldn't believe her.

She acts on impulse, OK. She's unpredictable.

But lashing out like that? Well, what am I to think?

Jordan's on the warpath. We have to sort this out now.

I looked at her hands and wrists. When she fell she had a nasty knock to the abdomen

but she didn't put her hand out to break her fall. She just clung onto Rhys.

Her instinct is to protect him. I don't think she would try to hurt him.

-But clearly she can't cope. I've got to think of Rhys' safety.

-Mm.

OK, well, we're running a lot of tests.

Let's...hope they throw something up.

I hope for both their sakes you're right. Keep me posted, OK?

-If you could just prioritise it, please.

-Ar-are you in charge here?

Yes. Sorry, I'll call you back.

Nick Jordan, Clinical Lead.

-Your nurse is sabotaging my husband's treatment.

-Sorry?

He's putting ideas in his head.

He's in a very suggestible, vulnerable state.

What's going on?

-We've got it under control.

-Mr Northwick is considering whether or not

-to continue aggressive intervention.

-You are manipulating him.

-Well, let's ask Mr Northwick, shall we?

-I'm sorry.

-I'm so tired.

-Of course you're tired, because you need treatment!

He's sick and confused. He doesn't know what he wants.

He is capable of making his own decisions.

You can't just give up! I'll sue you, I'll sue the hospital!

You... I can't believe you'd give in so easily.

Just try...for a little longer.

For me.

Continue...the treatment.

You are aware that pacing may not have any long-term benefits?

Ruth?

The pacing wire will, er, stimulate the heart rate temporarily.

But I'm afraid it won't help significantly... with the breathlessness...

..or the pain.

-HE CHUCKLES

-That's all right.

We knew that anyway, didn't we?

Yes.

I'm sorry.

I'm really sorry.

Ruth.

Ruth, take a break please. Go on.

Jay, go with her.

Just talk to her, find out what's going on. Go on.

Are you absolutely certain this is what you want?

I want...to carry on.

-Let's, er... Shall we get some lunch?

-No!

Come on, out with it.

You spoke to Mr Jordan?

Er! Six inches apart at all times, please!

About that patient?

Right.

Ruth, what did he say?

He said that...she needs further tests.

What tests?

Beta-HCG.

OK, well...I think that as her nurse, I should take care of that.

-Right. I'll, erm... I'll let you know when I get the results.

-Great, thanks.

-Did you tell Tom about the bruises?

-I had to.

God, I've messed everything up again! I am so rubbish at this!

-I don't think you're rubbish.

-Yeah, you do! Rhys'd be better off in care anyway.

-Let me have a look at that.

-Just leave it, would ya!

I told Tom I don't think you're to blame for the bruises.

I told him that I think you're a great mum.

And that you love Rhys.

Really?

Promised I'd help, didn't I?

Mate, you've got to help me out.

Ah! There you are.

We never finished your briefing on moving hazardous materials.

Sorry, Mac, Jay here needed me.

-Hm?

-I was saying that you needed me for that...urgent case.

Right, obviously not.

Now then, clinical waste falls into three very distinct categories...

Ruth, I've got the test results for that patient of yours.

Oh?

It's positive, Ruth.

It's positive.

That's great, I'll pass the news on. Thank you.

-What, you've got to be kidding me, right?

-Mr Jordan says to come. It's David.

MACHINE BEEPS

He's gone into VF. Standing by to shock.

Charging to 150. Out of the way.

Shocking.

-Oh...

-I'll take over.

-(Should we be doing this?)

-You heard what he said. The patient clearly wants to continue treatment.

-HE GROANS

-OK, OK.

He's in heart block.

OK, Mrs Northwick,

your husband will most likely suffer another cardiac arrest.

Do you want us to resuscitate?

Yes, I do.

It will become increasingly distressing for him

and you need to accept this might not be the best course of treatment.

No, I don't accept it.

He's barely maintaining his sats on oxygen,

his latest Echo showed his injection fraction was dismal.

His prognosis is poor.

OK, just let me know, whatever you need.

He doesn't need me any more. He needs nursing now. Good nursing.

This patient needs you to be focused.

Now, whatever else is going on...

don't let him down.

-Blood results came for you.

-Thanks.

-How's it all going? All right?

-Wonderful.

Trickier than you think, aren't they, patients?

So unpredictable. Personally, I'd lobotomise the lot of them.

It's all under control but thanks for the insight.

We ran a thorough range of tests.

Do they show anything that might be causing the bruising?

They don't.

And in your opinion...

are the injuries accidental or non-accidental?

I don't believe for a second that Debbie would hurt Rhys.

But...I've got no other explanation.

-I just feel like we must be overlooking something.

-Debbie's been through a lot in her own life.

So, what happens next?

Admit Rhys to Paediatrics and get Debbie's consent to take him into care

-while we investigate.

-And if she doesn't consent?

We go to court.

Today.

Er, yellow bags are for clinical waste only.

We don't take them unless they're full.

We have a saying. Er, if it's yellow let it mellow.

-Right see, that's how we remember.

-Look, mate...

I know you mean well and everything but seriously,

this is not a good use of my time.

I'm just going to go now, OK?

Right you are.

He's deteriorated, so we'll hang onto him for the mean time. OK, thanks.

That is two hours of my life I will never get back. Thanks(!)

You wanted a challenge, you've got one. The doctors can't do much for David now but we can, OK?

I want a bed prepped with a pressure mattress, hourly pressure area and mouth care.

Ruth, make sure he's written up on fluids, decent analgesia and anti-emetics.

And we'll need a syringe driver.

-Where are you going?

-To find Caitlin.

BABY CRIES

You told him I did it.

-No, Debbie, I didn't.

-You said you'd help me.

-Look, I promise I tried.

-You're a liar!

-OK, come on. Come with me.

-She said she'd help me!

Let's talk about this outside. Come on, Debbie. Come on. Come on.

If I could just talk to her calmly.

-I really don't think that's a good idea.

-But...I want to help her.

-You've done your best.

SHE CRIES

Damn it!

Are you going to ask nicely?

Caitlin.

Go away.

No.

No.

Not unless you want to break my fingers.

You need to be in there with him.

We're not ready.

What are you doing in here? What is all this stuff?

They're always coming up with something.

Again, like you mean it.

Please, Dr Keogh, will you help me with my problem?

And?

I can't do it without you.

What have you ruled out so far?

No, I need everything.

Every...every GP referral letter, every hospital record,

-every PE sick note.

-On the baby?

No, on Debbie, you oaf!

You've been looking in the wrong place!

You've done all this yourself?

I'm up most nights, on the internet.

But he doesn't even bother with it now.

I...I do all this and he won't even try new treatments.

-Clinical trials aren't going to help him now.

-You don't know that.

They've got him back. They got return of circulation, got his heart going again.

If they fitted a pacemaker, that would fix the bradycardia. We just need time...

Caitlin...

..his heart's reached the end of its natural course.

It's going to stop beating soon.

We'll move him to a really comfortable bed.

Lots of pillows. No doctors rushing around him. It'll be quiet. OK?

It'll be really quiet and he won't be in any pain.

-You don't know that.

-Yes, I do.

UTIs, dodgy tooth extraction...

There's nothing.

Low birth weight, kept in for three days with post-partum bleed. What was that about a tooth extraction?

Er, attended St James' ED with post-op bleeding.

Er, tendency to mucosal haemorrhage.

-Von Willebrand's! Didn't she arrive with an abdominal injury?

-Yeah, but the scan was clear.

-It won't be now. Tess, where's Debbie?

-I was about to ask you the same thing.

We need to find her. She'll be bleeding.

Let's get you up.

-I wish we could do more.

-I know.

-How are they doing?

-Really well, yeah.

Look, I'm sorry about freaking out earlier.

It's OK. It's a bit of a shock for me too.

Yeah.

I mean, obviously it's a ridiculous idea.

Obviously.

Well, we've not been back together that long and...

we're hardly ideal parent material.

As if we could ever be a normal couple.

Don't know what I was thinking.

Voicemail.

Someone left this.

Debbie,

look, we think we might have found the reason for Rhys' bruising.

You've got to tell us where you are.

PHONE BLEEPS

-Can you, er, help me with something, please?

-Yeah.

We need Big Mac.

PHONE RINGS

Debbie?

OK, Debbie, where are you?

Debbie!

Debbie. OK, Debbie, Debbie, wake up!

-She's tachycardic and shut down.

-We'll need a central line.

I think there's free fluid in the abdomen.

OK, Tess, give me the fast scanner, please, and four units of O neg?

I don't see why I should. You couldn't escape from me quick enough earlier.

-Ah, don't think I didn't notice.

-Sorry, Mac.

I just wanted to, you know, be getting on with the big stuff.

Ah, right, the big stuff. Well, don't let me hold you up.

Oh... Look, please?

You're the only one who'll be able to do it and we really need your help.

She's shocked.

Pulse 120, rest 30.

-Yes, free fluid in the abdomen.

-Ten mils 1% lignocaine?

-I've got it.

It's OK.

OK.

Let's get her a chest X-ray, push through the O neg

-and get her up to theatre.

-Great.

Has she spiked his coffee?

It's a hereditary bleeding disorder.

-And that would cause Rhys' bruising?

-Yup.

Though it's not confirmed yet.

We do need to run a few specialist blood tests first.

Well, I'll have to arrange foster care while we wait for the results.

-Really? I-I thought...

-Thank you for all your help.

Can I give you a hand with that?

What have you got? Oh. Nicotine patches.

There are better ways of relaxing, you know.

-Have you tried meditation? Or yoga?

-Thank you. Thank you very much.

-It is Von Willebrand's, you know.

-Thought you had to do a test?

-It's not the sort of thing I get wrong.

-Debbie should be with her baby.

-I can't take the risk.

You can, and you should.

Not such a cynic as you make out, are you?

A momentary lapse.

I've still got that number if you want it!

What's going on?

-You'll see.

-Ah, could someone get the lights for me, please?

I remember that party.

Ha! You got so drunk you were sick in next door's rose bed.

They didn't speak to us for a month.

Look at those boots! Those ridiculous Cuban heels!

I told...Scarlett here I was a heartbreaker.

There we go.

Very smart.

I have to go and have a scan done.

Can you look after him for a bit?

Course I can.

How's the pain relief? Is there anything else I can do?

No, I think we've got it covered.

Thank you both so much for trying to help him.

He's a lovely boy.

Treasure him.

Oh, no, we're not, erm... I mean we're...

Actually, we're having a baby.

Wonderful.

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