Common Vector

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0:00:38 > 0:00:39Morning, Red.

0:00:39 > 0:00:42Scarlett. Do anything good last night?

0:00:42 > 0:00:44I went to a public debate about the proposals

0:00:44 > 0:00:47to run a new by-pass through the green belt west of town.

0:00:47 > 0:00:49Lovely(!)

0:00:49 > 0:00:53I cooked a Jamie recipe, re-read the guidelines on Good Clinical Ward Practice

0:00:53 > 0:00:55and watched When Harry Met Sally. Again. Alone.

0:00:55 > 0:00:57And yet your life sounds sadder than mine.

0:00:57 > 0:01:00You are about to debut on my blog.

0:01:02 > 0:01:03Miss Scarlett out of scrubs.

0:01:03 > 0:01:06No! I hate that picture. Take another one.

0:01:06 > 0:01:09Er, no. The peoples needs to see the NHS like it is.

0:01:09 > 0:01:11Bad hair day and all, Red.

0:01:11 > 0:01:12Scarlett!

0:01:24 > 0:01:26KNOCKING ON DOOR

0:01:33 > 0:01:36- Mary, you seen Annie this morning? - No.

0:01:36 > 0:01:37Annie?

0:01:41 > 0:01:42Annie!

0:02:16 > 0:02:17Annie!

0:02:19 > 0:02:20Oh, my God.

0:02:21 > 0:02:22Annie?

0:02:22 > 0:02:24Annie...

0:02:24 > 0:02:26Annie!

0:02:31 > 0:02:35- Morning, Obi-Wan. We are ready to be mentored.- Yeah?

0:02:35 > 0:02:38I've been looking at your charts to see what you haven't been assessed on.

0:02:38 > 0:02:40And, er, oh, look!

0:02:40 > 0:02:42It's says here Staff Nurse Asike

0:02:42 > 0:02:44hasn't tried inserting a catheter.

0:02:44 > 0:02:46Cubicle six. Elderly gent in retention.

0:02:46 > 0:02:51Staff Nurse Conway, if you could make sure all commodes and bed pans are clean, that'd be great.

0:02:51 > 0:02:52Lloyd, with me.

0:03:15 > 0:03:17Oi, what you doing?

0:03:17 > 0:03:19- Agh!- Argh!

0:03:22 > 0:03:25Argh...

0:03:28 > 0:03:31Thanks. Yeah, she's erm... she's in 'ere,

0:03:31 > 0:03:32she's just beside the door.

0:03:32 > 0:03:34Is she going to be all right?

0:03:34 > 0:03:36We'll find out in a minute. What's her name?

0:03:36 > 0:03:39- Annie. - Annie, can you hear me? Annie?

0:03:39 > 0:03:42- Do you live here? - No, I'm a friend. She lives alone with her baby.

0:03:42 > 0:03:45- I'm taking your blood pressure, OK? - Know what happened?

0:03:45 > 0:03:49- No. We spoke last night, she were fine. We were going out with Evie. - Is this Evie? Annie's baby?

0:03:49 > 0:03:52Yeah, yeah, she usually has a sleep about now.

0:03:52 > 0:03:54- She taken anything? - No, not that I know of.

0:03:54 > 0:03:57Come on, Annie. You going to wake up for me?

0:03:57 > 0:04:01OK, we've got a BP 120 over 90, pulse 110, GCS 12.

0:04:03 > 0:04:04Let's take her in.

0:04:13 > 0:04:14Fiona?

0:04:14 > 0:04:15Fi?

0:04:16 > 0:04:18Fiona!

0:04:18 > 0:04:20Are you awake?

0:04:22 > 0:04:24Happy Birthday.

0:04:24 > 0:04:26Come on. Breakfast's ready.

0:04:28 > 0:04:29Come on, you.

0:04:31 > 0:04:33Time to get up.

0:04:37 > 0:04:40- Anything like this ever happened to her before?- Er, not that I know of.

0:04:40 > 0:04:43No obvious head injury, some facial weakness.

0:04:43 > 0:04:47- Has she complained of a blow to the head recently? Or any headaches? - No, not to me.

0:04:47 > 0:04:49- Anything that you know of that could explain this?- No.

0:04:49 > 0:04:52- Does she often drink heavily? - No, she's clean-living.

0:04:52 > 0:04:58OK, I'll need routine bloods, FBC, U and E, LFT, CRG and cultures.

0:04:58 > 0:04:59Er, Linda, an ECG, please,

0:04:59 > 0:05:02and can you find out the waiting time on a CT scan?

0:05:02 > 0:05:04Is it serious? It sounds serious.

0:05:04 > 0:05:07- Could you wait outside? I'll speak to you shortly.- Come with me.

0:05:07 > 0:05:08Can we hang up a litre of saline?

0:05:10 > 0:05:13Aw! Happy birthday, darling!

0:05:23 > 0:05:26Here you go. Open your present.

0:05:26 > 0:05:27Thanks, Mum.

0:05:31 > 0:05:33Oh, it's lovely.

0:05:33 > 0:05:36I kept the receipt in case it didn't fit.

0:05:36 > 0:05:39- I'm sure it'll be fine. - You lost a bit of weight recently,

0:05:39 > 0:05:41so I had to get you a smaller size.

0:05:43 > 0:05:44Ta-da!

0:05:46 > 0:05:48There you go. Eat up.

0:05:49 > 0:05:54So, here's the plan - we're going to start off by getting a proper breakfast

0:05:54 > 0:05:56at that nice place on Brockwell Street.

0:05:56 > 0:06:00And then, we're going to have our hair done and then hit the shops,

0:06:00 > 0:06:01and I've got us booked into a spa.

0:06:01 > 0:06:06And tonight, I've got us a table booked at that nice Italian restaurant that you like.

0:06:13 > 0:06:14Are you OK?

0:06:14 > 0:06:17- It's Chloe, isn't it?- Yeah.

0:06:17 > 0:06:19OK, we're waiting for Annie's test results.

0:06:19 > 0:06:22I'm afraid she might be here for some time.

0:06:22 > 0:06:27- Do you know what childcare provision she has? - Yeah, you're looking at it.

0:06:27 > 0:06:31I'm Evie's godmum. She's with Mary, the next door neighbour, at the moment.

0:06:31 > 0:06:33She baby-sits regular so she's tops.

0:06:33 > 0:06:37- Erm, Dr Winters? There's a slot available for that CT scan.- OK.

0:06:37 > 0:06:41Er, Mac, could you take Ms McLean in Resus through to X-ray?

0:06:41 > 0:06:42Right you are.

0:06:44 > 0:06:46This is Richie. Fell over at the skatepark.

0:06:46 > 0:06:50He's got a fractured right wrist. BP's 120 over 80, pulse 90.

0:06:50 > 0:06:52He's had five of morphine and Entonox.

0:06:52 > 0:06:55He's got good feeling and circulation in his fingers, as well.

0:06:55 > 0:06:58Let's get him in that cubicle there, please, Dixie.

0:06:58 > 0:07:01You're looking pretty hench, mate. Is that what you'd say? Huh?

0:07:01 > 0:07:03Scarlett, with me on this, please.

0:07:03 > 0:07:05Oh, aye. Mentoring the pretty ones, are we?

0:07:05 > 0:07:09I thought she could help translate when you try your teen speak thing.

0:07:09 > 0:07:11Slide over for me, mate. Nice and easy.

0:07:11 > 0:07:15- There you go, lad.- OK, well done. - Cheers, guys, thank you.

0:07:17 > 0:07:21Right, Richie. I'm Lenny, I'll be one of the doctors.

0:07:21 > 0:07:23- This is Jay, Scarlett. - What happened to you, then?

0:07:23 > 0:07:26I fell from the top of the pole.

0:07:26 > 0:07:30- Oh, aye, what were you trying? 360? - All right, check you out, Tony Hawk.

0:07:30 > 0:07:35- How's your pain? Anything hurting other than your wrist?- No.- No?

0:07:35 > 0:07:36OK.

0:07:36 > 0:07:38Still feeling that OK?

0:07:38 > 0:07:39Yeah.

0:07:39 > 0:07:42Yeah? OK, let's take a look.

0:07:46 > 0:07:49Ah, yeah, you got some clear deformity there, mate.

0:07:49 > 0:07:51I think we should get that wrist X-rayed.

0:07:51 > 0:07:53Let's get it wrapped up again.

0:07:53 > 0:07:55Now, you boys get street names, don't you?

0:07:55 > 0:07:58- What's yours?- Hamer.

0:07:58 > 0:07:59Hamer.

0:07:59 > 0:08:01It's actually supposed to be Hammer,

0:08:01 > 0:08:03but I'm, like, dyslexic so I spelled my tag wrong.

0:08:03 > 0:08:05HE LAUGHS

0:08:05 > 0:08:08- Has someone called your parents? - Yeah.

0:08:08 > 0:08:11Do you know what? I'd be Lionheart.

0:08:11 > 0:08:13Len of the lions.

0:08:13 > 0:08:14That's good.

0:08:14 > 0:08:17Tell you something. I've not had a shot on one of them for ages!

0:08:19 > 0:08:20There we go.

0:08:20 > 0:08:23- Now turn round, come back quicker! - Doing it!

0:08:23 > 0:08:25Oh, smooth! Smooth!

0:08:25 > 0:08:27Oi!

0:08:27 > 0:08:28THEY LAUGH

0:08:28 > 0:08:29Serve you right!

0:08:29 > 0:08:32Don't worry, Staff Nurse Conway is well impressed!

0:08:32 > 0:08:36- Jim Levy. I'm looking for my son, Richie. He's had an accident.- Oh.

0:08:36 > 0:08:37Hi there, Mr Levy.

0:08:37 > 0:08:39I'm, er, Richie's doctor, Lenny.

0:08:39 > 0:08:43We suspect he's broken his wrist but we're taking him up for an X-ray.

0:08:43 > 0:08:45So, erm, I'll show you to his cubicle.

0:08:46 > 0:08:49He's had some pain medication, so he might be a bit woozy,

0:08:49 > 0:08:51but otherwise he's doing great.

0:08:51 > 0:08:52Here's your dad.

0:08:54 > 0:08:58- Sorry, Dad.- Hey, it's all right, Son.- I'll get a porter along in a second.

0:09:05 > 0:09:07Ah, hello, Annie.

0:09:07 > 0:09:11Right, let's see if we can find you a nice quiet corner, shall we?

0:09:11 > 0:09:14Annie! Oh, love, how are you feeling?

0:09:14 > 0:09:18- Where's Evie?- Evie is with Mary, taking her next door.

0:09:18 > 0:09:22The paramedics saw her when they came for you. She's fine.

0:09:22 > 0:09:23What happened?

0:09:23 > 0:09:26Annie McLean's records - she's been on methadone for 12 months.

0:09:26 > 0:09:30- She's on a drug treatment programme? - Cleared all tests so far.

0:09:30 > 0:09:33- The last one was shortly after her baby was born. - Did her bloods come back yet?

0:09:33 > 0:09:35High white cell count and raised CRP.

0:09:35 > 0:09:39Which would suggest inflammation or infection of some kind.

0:09:39 > 0:09:42Dilated pupils are the exact opposite of what we'd expect

0:09:42 > 0:09:44if she was using again or if she'd taken methadone.

0:09:44 > 0:09:47We'll need to wait for the scan results to know more.

0:09:51 > 0:09:53She's going to be all right, isn't she?

0:09:53 > 0:09:57Oh, yes, course she will. You'll be out and about with your boyfriends in no time.

0:09:57 > 0:10:00- Boyfriends!- Will you call Mary and make sure Evie's OK?

0:10:00 > 0:10:02Oh. So, you're not spoken for, then?

0:10:02 > 0:10:05Matter of fact, we're not, mate.

0:10:05 > 0:10:09So, maybe you could find us a nice couple of doctors while we're here?

0:10:09 > 0:10:10I'll do my best.

0:10:13 > 0:10:15Annie, hi. I'm Dr Winters - I treated you earlier.

0:10:15 > 0:10:17- Can you tell me what happened? - I don't remember.

0:10:17 > 0:10:20I'd just got Evie to sleep.

0:10:26 > 0:10:29OK. Annie, can you raise your arms for me?

0:10:29 > 0:10:30Babe, just lift your arms up.

0:10:32 > 0:10:33Oh, I feel sick.

0:10:33 > 0:10:36She's dropped her pulse and pressure.

0:10:36 > 0:10:38We need to get her through to Resus.

0:10:38 > 0:10:39Can we get some help here, please?

0:10:39 > 0:10:4217 - I feel so old.

0:10:42 > 0:10:46You've got your whole life ahead of you, Fi, you know that.

0:10:46 > 0:10:49- You've just got to get better first. - I know. I will.

0:10:51 > 0:10:52Have you thought any more about it?

0:10:54 > 0:10:58Yeah. I just need to be a bit happier first.

0:10:59 > 0:11:02So, what about a boyfriend? Are you seeing anyone?

0:11:03 > 0:11:06- Mum.- What?! You know you can talk to me about that stuff.

0:11:12 > 0:11:13Can I go to the bathroom, now?

0:11:14 > 0:11:17Not yet. You've got to get something to eat first.

0:11:19 > 0:11:22It's a fast-progressing muscle weakness.

0:11:22 > 0:11:25Cranial and peripheral nerves to limbs were fine earlier.

0:11:25 > 0:11:28I need to find out more about her history of drug abuse.

0:11:33 > 0:11:36You didn't tell us that Annie was in a drug treatment programme.

0:11:36 > 0:11:39I didn't think it mattered. We've been clean a year.

0:11:39 > 0:11:43- You're on the programme together? - Yeah. Yeah, at the clinic here.

0:11:43 > 0:11:46Annie, well, she went on methadone cos she was pregnant.

0:11:46 > 0:11:49I tried it, lapsed, so they stuck me on the diamorphine.

0:11:49 > 0:11:52- They went ahead with their drugs clinic?- Charlie runs it.

0:11:52 > 0:11:56- Actually, I'm due a dosage. Do you mind if I...?- That's fine.

0:11:58 > 0:11:59I need a doctor.

0:11:59 > 0:12:02You've come to the right place! Uh, OK, erm...

0:12:02 > 0:12:03Can I get some help here, please?

0:12:05 > 0:12:07- OK, er, this way, Mr...?- Gillings.

0:12:07 > 0:12:12- Chris Gillings. I think I have food poisoning.- Oi!

0:12:20 > 0:12:24Oh, thank you. Here, cheers. Keep the change, thanks.

0:12:29 > 0:12:31- Feel better now?- Yeah.

0:12:32 > 0:12:34Thanks, Mum. It was a lovely breakfast.

0:12:34 > 0:12:37Right, well, we'll go and have our hair done.

0:12:37 > 0:12:38Then we'll go shop!

0:12:40 > 0:12:41Let's get you on the bed.

0:12:41 > 0:12:44Mr Gillings, this is Dylan, one of the doctors.

0:12:44 > 0:12:47HE WRETCHES

0:12:47 > 0:12:49I ate some dodgy prawns last night.

0:12:49 > 0:12:52That new seafood restaurant in Edwalton - J. Shaw's.

0:12:52 > 0:12:54Oh, right. Any reaction to shellfish before?

0:12:54 > 0:12:57- No.- He's hypercardic.

0:12:57 > 0:12:59Burning up a bit. Erm, how was Shaw's?

0:12:59 > 0:13:02Apart from the whole "they might have poisoned you" thing?

0:13:02 > 0:13:05All right, keep still. You have much to drink?

0:13:05 > 0:13:07Just wine.

0:13:07 > 0:13:08- A bottle.- I'm not much of a playboy,

0:13:08 > 0:13:11but if Sister Bateman were to take pity on me for example,

0:13:11 > 0:13:14I wouldn't want to poison her on the first date.

0:13:14 > 0:13:1538.1.

0:13:15 > 0:13:18- That's warm-ish. Any diarrhoea, Chris?- That, too.

0:13:19 > 0:13:23OK, erm, let's get a drip up, routine bloods

0:13:23 > 0:13:24and a, er, stool sample.

0:13:24 > 0:13:27I'm going to keep you in for observation.

0:13:27 > 0:13:31Just try to relax. Let it come out by whatever means.

0:13:31 > 0:13:33I'll leave Mr Gillings with you, Sister.

0:13:35 > 0:13:36Hey.

0:13:37 > 0:13:39No, I can't. I'm shopping with my mum.

0:13:41 > 0:13:43No, I can't tonight, I'm busy.

0:13:43 > 0:13:45Yeah.

0:13:45 > 0:13:48Erm, you know what, I'll give you a call later, OK?

0:13:50 > 0:13:52They can't fit us in for another hour.

0:13:52 > 0:13:56- So, do you fancy grabbing a coffee? - Yeah, I could do with sitting down.

0:13:56 > 0:13:58- You OK?- Yeah.

0:13:58 > 0:14:00Let's find a cafe, then.

0:14:05 > 0:14:08So, er, who was that on the phone?

0:14:08 > 0:14:11Just a friend. Just wishing me happy birthday.

0:14:11 > 0:14:14Oh, that's nice. Which one?

0:14:15 > 0:14:16Phil.

0:14:18 > 0:14:21- He says he's got a birthday present for me, as well.- Phil?

0:14:21 > 0:14:24How can he afford that?

0:14:24 > 0:14:26He can bring it round the house when I'm there, OK?

0:14:26 > 0:14:28Yeah, I know, Mum.

0:14:28 > 0:14:29Good.

0:14:30 > 0:14:32That top will look gorgeous.

0:14:32 > 0:14:35Then, we've just got to get you a coat and we'll be finished.

0:14:36 > 0:14:37Fiona!

0:14:38 > 0:14:40Oh, Fiona!

0:14:40 > 0:14:42Oh, oh!

0:14:42 > 0:14:45Fiona! Fiona!

0:14:45 > 0:14:46Oh, my God.

0:14:46 > 0:14:48Help! Somebody help me!

0:14:49 > 0:14:51OK, got your X-rays back, mate.

0:14:51 > 0:14:54You got a badly displaced fracture of the distal radius

0:14:54 > 0:14:58and ulna with a significant dorsal angulation.

0:14:58 > 0:15:01OK, in short, erm, you've buggered your wrist right up.

0:15:01 > 0:15:04- We can, however, fix it...- Mum.

0:15:05 > 0:15:07I came as soon as I got Dad's message.

0:15:07 > 0:15:09Sorry, Doctor. Go on.

0:15:09 > 0:15:13No, it's fine. I was saying we can, however, fix it, but you'll need an operation.

0:15:13 > 0:15:16- Will I have scars? - I'm afraid so.- Cool.

0:15:18 > 0:15:21- Let's have a look.- I've referred you to the orthopaedic surgeons.

0:15:21 > 0:15:26They'll take a look at you and the anaesthetist will talk you through what he'll do.

0:15:26 > 0:15:28Looks a bit sore. We'll clean it up for you.

0:15:28 > 0:15:29All right.

0:15:31 > 0:15:34This is Fiona Reardon, 17, took a tumble in town.

0:15:34 > 0:15:37KO'd briefly for about 30 seconds, GCS was 14 when we got there,

0:15:37 > 0:15:41BP's 110 over 90, pulse 80 and SATS at 97 per cent.

0:15:41 > 0:15:45- She's got a nasty deep cut on the back of her head. - OK, let's get her across.

0:15:45 > 0:15:46Right, when you're ready, please.

0:15:46 > 0:15:49Everybody got some? On three - one, two, three.

0:15:50 > 0:15:53- This is Fiona's mum, Jane. - Is she going to be OK?

0:15:53 > 0:15:57- Can you tell me what happened? - She just fell down the stairs.

0:15:57 > 0:16:00- Fiona, can you hear me? - It's her birthday, as well.

0:16:00 > 0:16:02- She's only 17.- Pupils are reactive - that's good.- Mum!

0:16:02 > 0:16:06- Fiona, can you hear me?- I'm here. Let the doctors look at you.

0:16:06 > 0:16:09- Heart rate 82.- OK, let's get some fluids up and I want bloods,

0:16:09 > 0:16:11FBC, U&E, glucose, group and save.

0:16:11 > 0:16:14- I fell. - I know, you gave me a right fright.

0:16:14 > 0:16:18- Nice deep breaths for me, Fiona. - You must have slipped.

0:16:18 > 0:16:20Good. Can you keep an eye on oxygen SATS?

0:16:20 > 0:16:22- Let's log-roll her. - You're doing brilliantly.

0:16:22 > 0:16:26Call X-ray. I want portable films of chest and pelvis, then we'll go for a CT.

0:16:28 > 0:16:30Let's just get this on.

0:16:30 > 0:16:32HE GASPS

0:16:32 > 0:16:35Er, sudden onset respiratory problems, staccato speech.

0:16:35 > 0:16:39- He's dropped his BP.- You've never had a reaction like this?- No!

0:16:39 > 0:16:41What about family members?

0:16:41 > 0:16:44Oxygen saturation 90 per cent and falling.

0:16:44 > 0:16:47No freckling, no heart murmurs. This is odd.

0:16:47 > 0:16:50His chest sounds clear, his lungs are normal, but his breathing's off.

0:16:50 > 0:16:52Let's get him to Resus.

0:16:53 > 0:16:57- So, this operation - it'll be a general anaesthetic, right?- Yeah.

0:16:58 > 0:17:02Do you do tests first to make sure there's no allergies to anaesthetic?

0:17:02 > 0:17:04Well, no, no. Reactions are extremely rare,

0:17:04 > 0:17:09so even if anything happened, the anaesthetist would change up the cocktail of drugs,

0:17:09 > 0:17:12and perform a thing called a modified rapid-sequence induction.

0:17:12 > 0:17:15No, of course. You know what you're doing.

0:17:15 > 0:17:17Sorry. Thank you, Doctor.

0:17:17 > 0:17:18All right.

0:17:18 > 0:17:20Right, then. Scarlett will clean this up

0:17:20 > 0:17:24and I get to mark her for her expertise in wound care.

0:17:24 > 0:17:27- I'm just going to go for a... - I'll join you.

0:17:28 > 0:17:31- When you're ready, Staff Nurse Conway.- Thank you.

0:17:33 > 0:17:37Can you do me a favour? Can you take a pic on my mobile? I want to show my mates.

0:17:37 > 0:17:39Yeah, sure.

0:17:39 > 0:17:42We'll take a pic of you with the pretty nurse. They'll be well impressed.

0:17:42 > 0:17:45Scarlett, if you could take it, that'd be great!

0:17:52 > 0:17:55- Brilliant. My mates will love that. - Did you do this when you fell?

0:17:55 > 0:17:58I don't remember. I suppose so.

0:17:58 > 0:18:01There's no dirt in it. What did you land on?

0:18:01 > 0:18:03It all happened fast.

0:18:03 > 0:18:06But the bloke... He kind of pushed me down the pole.

0:18:06 > 0:18:07I thought you just took a spill.

0:18:07 > 0:18:11- Someone pushed you?- Junkie on the rob. We've seen him around.

0:18:11 > 0:18:14It's just a scratch, isn't it?

0:18:14 > 0:18:16Yeah. I need to talk to Dr Lyons, OK?

0:18:19 > 0:18:22Didn't you make him take his helmet with him this morning?

0:18:22 > 0:18:24Oh, God. If he'd landed on his head...

0:18:27 > 0:18:29Do you have to do that?

0:18:30 > 0:18:34Can we not do this today, please? We're here for Richie.

0:18:34 > 0:18:38Were you thinking of Richie when you fell into bed with her?

0:18:40 > 0:18:45SIREN WAILS

0:18:49 > 0:18:52OK. Unknown male found collapsed in the street

0:18:52 > 0:18:55displaying clear signs of habitual IV drug use.

0:18:55 > 0:18:59His GCS was eight, his resps are six.

0:18:59 > 0:19:03OK, let's get him over. On three - one, two, three. OK.

0:19:03 > 0:19:05Pupils...

0:19:06 > 0:19:08..are dilated.

0:19:08 > 0:19:10Erm, OK, can we get his clothes off, please?

0:19:10 > 0:19:13Let's get the monitoring on as soon as.

0:19:18 > 0:19:20Mrs Reardon, we need to clear the room for X-ray.

0:19:20 > 0:19:22Let me take you to the Relatives' Room.

0:19:22 > 0:19:24Is she going to be OK?

0:19:24 > 0:19:27Dr Winters is still assessing, but Fiona took a nasty tumble.

0:19:27 > 0:19:31There's the possibility of concussion. She'll have a nasty headache.

0:19:31 > 0:19:35So, it's definitely a head injury? There's nothing else wrong with her?

0:19:35 > 0:19:38The X-ray and CT scan will tell us for sure, OK?

0:19:38 > 0:19:39Thank you.

0:19:39 > 0:19:41Could I have a quick word, please?

0:19:45 > 0:19:50Right, erm, we think Richie might have got himself a needlestick injury at the skatepark.

0:19:50 > 0:19:53- Oh, my God.- It was a junkie trying to steal from the kids' bags -

0:19:53 > 0:19:56that's what caused him to fall in the first place.

0:19:56 > 0:19:58So, it could have given him an infection?

0:19:58 > 0:20:01Well, it doesn't normally develop this fast.

0:20:01 > 0:20:03Erm, we've cleaned out the wound and...

0:20:03 > 0:20:07All right, look, the greatest risks from a needlestick injury

0:20:07 > 0:20:10are HIV, Hepatitis B and Hepatitis C.

0:20:10 > 0:20:15But the odds are well in Richie's favour. We've taken baseline bloods,

0:20:15 > 0:20:18we'll make sure that Richie's GP follows up in three months' time.

0:20:18 > 0:20:21- We have to wait for three months? - I'm sorry.

0:20:21 > 0:20:24If it's any consolation, the junkie would have to be in a right state

0:20:24 > 0:20:27for Richie to actually catch anything.

0:20:27 > 0:20:30All right, mate. There you go.

0:20:30 > 0:20:33OK, he's gone into cardiac arrest. PEA. Can we start CPR?

0:20:33 > 0:20:36One milligram of adrenalin, IV and another litre of saline, please.

0:20:36 > 0:20:38You all right?

0:20:49 > 0:20:51I see you got your fix, then.

0:20:51 > 0:20:54I'm sensing your disapproval of my best efforts to turn my life around.

0:20:54 > 0:20:57Just because it's free, doesn't make you not a junkie.

0:20:59 > 0:21:03We do all the counselling, but we had it bad.

0:21:03 > 0:21:06Working on the streets, you know what I'm saying?

0:21:06 > 0:21:07Working girls.

0:21:08 > 0:21:10I'll just erm, put, er...

0:21:12 > 0:21:15You're still a little feverish. As you're still nil by mouth,

0:21:15 > 0:21:18I need you to roll over onto your side, please.

0:21:18 > 0:21:20- Bad luck, mate.- I'm fine.

0:21:22 > 0:21:24I advise you to take your medicine

0:21:24 > 0:21:26until we find out what's wrong with you.

0:21:31 > 0:21:32Just relax.

0:21:34 > 0:21:36It's only uncomfortable for a little while.

0:21:40 > 0:21:43- What have you done here? - Nothing. It's just a scratch.

0:21:45 > 0:21:47Given the amount of drugs Richie's on,

0:21:47 > 0:21:49isn't it dangerous to operate?

0:21:49 > 0:21:54It's still critical that we reduce the fracture at the earliest opportunity.

0:21:54 > 0:21:58If you have specific concerns, I can have the anaesthetist talk you through it.

0:21:58 > 0:22:00Yeah, maybe I should. I just, erm...

0:22:02 > 0:22:05He's my only child, you know?

0:22:05 > 0:22:08And with this scratch, it all seems to be...

0:22:09 > 0:22:11..complicated.

0:22:11 > 0:22:14If you have information that's germane to Richie's treatment,

0:22:14 > 0:22:15you need to tell me.

0:22:18 > 0:22:21Richie's father suffers from malignant hyperpyrexia.

0:22:22 > 0:22:23I understand it's hereditary.

0:22:23 > 0:22:26Yeah, 50 per cent of the time, yeah.

0:22:26 > 0:22:29But that's not a problem. If he does have it, theatre can cope.

0:22:29 > 0:22:32Why didn't you tell me about this before?

0:22:33 > 0:22:36- Because Jim's not Richie's father. - OK.

0:22:36 > 0:22:37And he doesn't know.

0:22:37 > 0:22:39Ah.

0:22:45 > 0:22:47OK. Thank you.

0:22:47 > 0:22:51He's got an output - that's as healthy as this gentleman's ever likely to be.

0:22:51 > 0:22:55- Well done, everyone. Did we get an ID or next of kin? - They just said no.

0:22:55 > 0:22:59- Right, unknown male it is. - So, Ambulance Control have called.

0:22:59 > 0:23:04We've got three similar collapses en route. People seem to be dropping in the streets.

0:23:04 > 0:23:09- This is Larry Foster, 62, works in the bookies, became disorientated. - I've got this.

0:23:09 > 0:23:12- Slurred speech and breathing difficulties.- Did he go out for dinner?

0:23:12 > 0:23:16- He lives alone, apparently. - We might be looking at an outbreak.

0:23:16 > 0:23:18Dr Winters, I need to show you something.

0:23:18 > 0:23:21- It's about Annie McLean. - In a moment.- Check him for muscle weakness.

0:23:21 > 0:23:23Yes, thank you, Dr Keogh.

0:23:33 > 0:23:35Hello, it's Dr Keogh here,

0:23:35 > 0:23:38from the Emergency Department at Holby City Hospital.

0:23:38 > 0:23:42Hello. Erm, I want an honest answer to this question -

0:23:42 > 0:23:45have you had any complaints of food poisoning

0:23:45 > 0:23:47since last night's service?

0:23:47 > 0:23:49No, I'm not accusing, I'm asking.

0:23:49 > 0:23:52No, you sure? No-one? No?

0:23:52 > 0:23:54OK, thank you. Oh, erm, yes, in that case,

0:23:54 > 0:23:57can I make a reservation, please, for this evening?

0:23:57 > 0:23:58Eight o'clock.

0:23:59 > 0:24:01Yeah, Keogh.

0:24:01 > 0:24:02No, Key-oh.

0:24:04 > 0:24:06No, just for one. Unless you accept dogs? No?

0:24:06 > 0:24:08No, no. OK. All right. Thank you.

0:24:08 > 0:24:12Erm, the patient that you wanted to talk to Ruth about -

0:24:12 > 0:24:13is she one of them?

0:24:13 > 0:24:14One of who?

0:24:14 > 0:24:17One of our peculiar neurological cases?

0:24:17 > 0:24:19Yeah. I found a wound that we didn't know about.

0:24:22 > 0:24:26Hello. I'm Dr Keogh. I'm very good at fixing people. Roll over, love.

0:24:26 > 0:24:29The other doctor was a lot nicer.

0:24:30 > 0:24:33Come on, Annie. We're not going to hurt you.

0:24:42 > 0:24:44Right.

0:24:44 > 0:24:47Nurse Thingy, with me, please.

0:24:52 > 0:24:54He's not big on bedside manner, is he?

0:24:55 > 0:24:57We're missing something.

0:24:57 > 0:24:59A lot of today's intake share a common vector.

0:24:59 > 0:25:03We are dealing with different symptoms across a range of patients

0:25:03 > 0:25:05and no-one has any idea what's wrong.

0:25:05 > 0:25:07We need to figure out what we're dealing with.

0:25:08 > 0:25:10Spread the word.

0:25:12 > 0:25:15The chances of you having anything more than just a bit of a bug

0:25:15 > 0:25:17are so slim they're practically anorexic.

0:25:17 > 0:25:21So, I can go home tonight?

0:25:22 > 0:25:25- What?- Erm, you'll have to stay in tonight, darling.

0:25:25 > 0:25:28Don't worry, you'll hardly notice. You'll be asleep.

0:25:28 > 0:25:30But it's only lunchtime.

0:25:30 > 0:25:33Mightn't he recover by this evening? Don't want to clog your beds up.

0:25:33 > 0:25:38That's very kind of you. No, er, different people react in different ways to anaesthetic.

0:25:38 > 0:25:43- Sometimes it takes longer to recover.- There's not something in his test results

0:25:43 > 0:25:47- that makes you think the operation's going to be complicated, is there? - No.

0:25:47 > 0:25:51- It's all perfectly standard. - What is?- Uh, erm...

0:25:53 > 0:25:54Right, OK, erm...

0:25:55 > 0:25:59I have reason to believe that you may have a condition

0:25:59 > 0:26:00called hyperpyrexia.

0:26:00 > 0:26:03It's nothing to worry about, it's nothing dangerous,

0:26:03 > 0:26:07but you might take a bit longer to recover after an operation,

0:26:07 > 0:26:11and it means that we need to keep an eye on you in case of any potential fevers.

0:26:11 > 0:26:12"Reason to believe"?

0:26:12 > 0:26:16It... It came up in an observation.

0:26:16 > 0:26:18There is one thing you guys need to know.

0:26:18 > 0:26:20In 50 per cent of cases,

0:26:20 > 0:26:22this can be handed on to the offspring.

0:26:22 > 0:26:25Which means when little Richie-boy here

0:26:25 > 0:26:27hands you two a pair of grandchildren,

0:26:27 > 0:26:30it's going to be your job to let the paediatricians know

0:26:30 > 0:26:33- about this condition. - It's hereditary?

0:26:33 > 0:26:36Yeah, I mean, like I say, half the time.

0:26:36 > 0:26:40I mean, it only takes one parent to... For it to pass on.

0:26:42 > 0:26:44But Carol and I don't... Are you sure?

0:26:46 > 0:26:49Excuse me, Dr Lyons. Emergency staff meeting.

0:26:50 > 0:26:51Right.

0:26:53 > 0:26:55I'm really sorry, erm...

0:26:57 > 0:27:00I'm going to have to speak to my colleagues. I'll be right back.

0:27:06 > 0:27:07Right.

0:27:07 > 0:27:08We're in trouble, here.

0:27:11 > 0:27:14OK, erm, we have a problem.

0:27:14 > 0:27:17This department sees what, erm, 200 patients a day?

0:27:17 > 0:27:21Broken limbs, heart attacks, things stuck up strange orifices.

0:27:21 > 0:27:24And yet, today, we have four patients admitted

0:27:24 > 0:27:28and three more on the way, displaying hugely different yet entirely similar symptoms.

0:27:28 > 0:27:32My food poisoning comes in with the, erm, usual problems

0:27:32 > 0:27:34and within an hour,

0:27:34 > 0:27:38he's experiencing respiratory difficulties and limb weakness.

0:27:38 > 0:27:40- Your Miss Maclane...?- McLean.

0:27:40 > 0:27:43..comes in, looks like a stroke, rallies under treatment,

0:27:43 > 0:27:47and then she develops another case of muscle weakness.

0:27:47 > 0:27:50Your run-of-the-mill boy comes off his skateboard,

0:27:50 > 0:27:52breaks his wrist - he's developed an infection.

0:27:52 > 0:27:56- I know why.- What about your elderly patient, the one you just admitted?

0:27:56 > 0:27:58Neurological irregularities - he's gone for a CT.

0:27:58 > 0:28:01See, we're burning through the scans today.

0:28:01 > 0:28:02What do they all have in common?

0:28:02 > 0:28:06We're looking at a range of ages, socioeconomic groups.

0:28:06 > 0:28:08Hold on, you say you know why?

0:28:08 > 0:28:09Well, yeah.

0:28:09 > 0:28:11My patient got a needlestick injury.

0:28:11 > 0:28:14I mean, we've done all the baseline bloods

0:28:14 > 0:28:17but, you know, the wound itself got inflamed pretty fast.

0:28:27 > 0:28:29Take a look at that wound.

0:28:29 > 0:28:33It's badly infected. It'll need incision and drainage.

0:28:33 > 0:28:36- How did you get the wound, Annie? - I don't remember.

0:28:36 > 0:28:38- How's the methadone working out for you?- Yeah, great.

0:28:38 > 0:28:41- I'm proud of her. - Can't be easy being a single mother.

0:28:41 > 0:28:44I think I'm just run down, you know?

0:28:44 > 0:28:45Look at me, Annie.

0:28:45 > 0:28:47Annie? Look at me.

0:28:47 > 0:28:49At me!

0:28:55 > 0:28:58Now, I've only got a dog. I know how hard that can be.

0:28:58 > 0:29:02You have to feed them, wash them, make sure that they're looked after

0:29:02 > 0:29:05if you're going away for too long. Sometimes, they won't sleep,

0:29:05 > 0:29:08they think they've heard a mouse scratching around.

0:29:08 > 0:29:10I can only imagine, it must be twice as hard.

0:29:10 > 0:29:13- Dr Keogh. - You know what I'm getting at.

0:29:15 > 0:29:17Have you told us everything we need to know

0:29:17 > 0:29:19to diagnose your condition?

0:29:19 > 0:29:22It doesn't mean you're a junkie again.

0:29:22 > 0:29:25Just means you've had a relapse and we can help you with that.

0:29:27 > 0:29:31- It's just been really difficult. - Annie!

0:29:31 > 0:29:35It's easier for you - you're on diamorphine.

0:29:36 > 0:29:38I kept clean for Evie but...

0:29:40 > 0:29:42..it's so hard.

0:29:42 > 0:29:46- You've been injecting here, right? - Just a couple of times. But it got sore.

0:29:46 > 0:29:49I don't know, the needle, maybe.

0:29:49 > 0:29:53It's hard to keep the house clean these days.

0:30:11 > 0:30:14- What are you doing? - Having an internal monologue about little pricks.

0:30:16 > 0:30:19- I think I've got to the bottom of your condition.- You have?

0:30:21 > 0:30:22Ah!

0:30:24 > 0:30:26Why do you inject yourself in the foot?

0:30:26 > 0:30:30It's normally only long-term junkies that do that.

0:30:33 > 0:30:34I lost my business...

0:30:35 > 0:30:37..and then my house and wife.

0:30:37 > 0:30:39I wasn't in a good place.

0:30:39 > 0:30:42It became, erm, a means of survival.

0:30:42 > 0:30:47Look, I've cut right down. It's only an occasional thing.

0:30:47 > 0:30:49It's never only an occasional thing.

0:30:54 > 0:30:57My latest intake, elderly man, needle marks all over his arms.

0:30:57 > 0:30:59My man's been injecting, as well.

0:31:01 > 0:31:02Oh, that's it.

0:31:03 > 0:31:06The dilated pupils, that's what threw us off.

0:31:06 > 0:31:08Clostridium botulinum.

0:31:08 > 0:31:11- Botulism?- All our patients, some are hiding it better than others,

0:31:11 > 0:31:13but they're intravenous drug users.

0:31:13 > 0:31:17Their heroin has been infected at source, probably by bacteria in the soil.

0:31:17 > 0:31:20If you do not know the appropriate treatment, look it up.

0:31:20 > 0:31:24Tess, organize blood and stool samples for all suspected cases,

0:31:24 > 0:31:27and put in a call for emergency supplies of botulinum toxin.

0:31:27 > 0:31:30We're heading towards a public health emergency

0:31:30 > 0:31:33so I'll warn management and check capacity in Intensive Care.

0:31:33 > 0:31:35You'll be fine, darling.

0:31:35 > 0:31:36OK, Mum.

0:31:38 > 0:31:39See you in a bit, Son.

0:31:39 > 0:31:43If it is botulism that Richie's picked up from the needlestick,

0:31:43 > 0:31:45the anti-toxin will take care of it in no time.

0:31:47 > 0:31:50Erm, he's going to be out for some hours, now,

0:31:50 > 0:31:53so, why don't you two go and get a cup of tea or something?

0:31:53 > 0:31:56- No, you're all right. - We want to be here when he wakes.

0:31:56 > 0:31:59- However long it takes.- OK.

0:32:10 > 0:32:11He's still my son.

0:32:11 > 0:32:13It changes nothing.

0:32:15 > 0:32:17All this time you knew...

0:32:19 > 0:32:20..and you were so...

0:32:21 > 0:32:24..unforgiving when I made the same mistake.

0:32:24 > 0:32:26I can't help how I felt.

0:32:26 > 0:32:27Nor could I.

0:32:30 > 0:32:31So, what are we going to do?

0:32:31 > 0:32:34For now, Richie needs us.

0:32:34 > 0:32:36And as for the future...

0:32:36 > 0:32:38I don't know, Carol. I don't know.

0:32:38 > 0:32:41Whatever the living arrangements, I'll always be his dad.

0:32:49 > 0:32:52Hey, we're going to be here a while.

0:32:53 > 0:32:55Want to play charades?

0:32:55 > 0:32:58SHE LAUGHS

0:33:03 > 0:33:05He's going to be OK, isn't he?

0:33:05 > 0:33:07Come here.

0:33:09 > 0:33:11In every way. Yes.

0:33:12 > 0:33:14Can you let the mother know?

0:33:14 > 0:33:19- Linda, we need to give Annie McLean her penicillin and metronidazole. - OK.

0:33:19 > 0:33:22Mrs Reardon, Fiona's CT scans show no problems in the skull

0:33:22 > 0:33:24- and there are no fractures. - Oh, thank God.

0:33:24 > 0:33:27She's taking it easy now. Rest is best.

0:33:27 > 0:33:30OK. Thanks for letting me know.

0:33:30 > 0:33:32Erm, is there a chapel in the hospital?

0:33:32 > 0:33:35- I just, you know... - I'll show you how to get there.

0:33:36 > 0:33:39Just stop it now, come on, just stop worrying about it.

0:33:39 > 0:33:42Now you've had Evie, maybe they'll put you on diamorphine.

0:33:42 > 0:33:46- That stuff isn't just handed out like sweets, you know.- Thank you.

0:33:46 > 0:33:51OK, we think we've discovered what the problem is. You may be infected with botulism.

0:33:51 > 0:33:52Botulism?

0:33:52 > 0:33:55You're lucky you only started injecting a few days ago.

0:33:55 > 0:33:58We'll need specific tests to confirm the diagnosis,

0:33:58 > 0:33:59but in the meantime,

0:33:59 > 0:34:01I'll put you on antibiotics to treat the infection.

0:34:01 > 0:34:04You've no allergy to penicillin, right?

0:34:04 > 0:34:06What's the matter, babe? What is it?

0:34:08 > 0:34:11Evie. I've been breastfeeding Evie.

0:34:11 > 0:34:13You breastfed your baby whilst injecting?

0:34:15 > 0:34:18Well, the bacteria can't be passed on through breast milk.

0:34:18 > 0:34:20But heroin can.

0:34:22 > 0:34:25I don't... Yeah, just once.

0:34:25 > 0:34:29Erm, last night...

0:34:29 > 0:34:33This morning before... Before this happened to me.

0:34:33 > 0:34:35- Can you let Dr Keogh know?- Yeah.

0:34:39 > 0:34:41Check the neighbour's.

0:34:49 > 0:34:51- Control, this is 3004. - Control receiving.

0:34:51 > 0:34:53The neighbour's not in.

0:34:53 > 0:34:55Annie needs to tell us where she might have taken Evie.

0:34:55 > 0:34:58Local parks, playgroups, shops, cafes?

0:34:58 > 0:35:00And alert the local plod. We need to find her.

0:35:00 > 0:35:02- Understood. Control out.- Let's go.

0:35:05 > 0:35:07FRANTIC BEEPING

0:35:07 > 0:35:08She's fitting.

0:35:08 > 0:35:10Oxygen on, get her on her side.

0:35:10 > 0:35:15- OK, come on, Fiona. Can you draw up four milligrams of Lorazepam? - Lorazepam, right.

0:35:15 > 0:35:18And let X-ray know that she'll need an urgent CT

0:35:18 > 0:35:20as soon as we stabilise her. Tess.

0:35:20 > 0:35:22Four milligrams, done.

0:35:23 > 0:35:25This cannula's very positional.

0:35:25 > 0:35:27OK, good.

0:35:29 > 0:35:32Right, let's get some suction!

0:35:32 > 0:35:35Pulse has dropped to 40, oxygen saturations 80 per cent and falling.

0:35:35 > 0:35:37BP unrecordable.

0:35:38 > 0:35:39Pulse now only 30.

0:35:39 > 0:35:42She's very cyanosed, can you see that? And bradycardic.

0:35:42 > 0:35:44I can't get an output, anything there?

0:35:44 > 0:35:46She's arrested, let's start CPR.

0:35:46 > 0:35:48Tess, can you put a bigger line in?

0:35:48 > 0:35:51BEEPING

0:35:56 > 0:35:58Ruth? She's another one.

0:36:06 > 0:36:07She's got to be somewhere.

0:36:12 > 0:36:14Sorry, I thought you were someone else.

0:36:20 > 0:36:21Omar!

0:36:23 > 0:36:27- Mary? Mary, hiya. Do you remember us from this morning?- Yeah.

0:36:27 > 0:36:28OK, Annie's fine.

0:36:28 > 0:36:31- It's Evie we need to check over, OK? - Why?

0:36:31 > 0:36:34Don't worry, it's nothing you've done at all. Is she all right?

0:36:39 > 0:36:40Signs of opioid intoxication.

0:36:42 > 0:36:44She's got pin-prick pupils. We need to take her.

0:36:44 > 0:36:46- Alert ED. - OK, do you want to come with us?

0:36:48 > 0:36:50Hold.

0:36:50 > 0:36:52No, no pulse, still PEA.

0:36:52 > 0:36:55Carry on. Can you get some adrenaline standing by?

0:36:55 > 0:36:58Scarlett, you can take over after me.

0:36:58 > 0:37:00- Where's the mother? - She's not back from the chapel.

0:37:03 > 0:37:06She's had 60 micrograms of Naloxone,

0:37:06 > 0:37:09made good response, some spontaneous crying,

0:37:09 > 0:37:12- maintaining respiratory rate and saturations. - OK, on the bed there, please.

0:37:12 > 0:37:14Come on, Fiona.

0:37:15 > 0:37:17No, I've got nothing. Recommence.

0:37:21 > 0:37:23- Evie!- Annie!

0:37:23 > 0:37:26- Let the doctors do their job. - Do me a blood sugar, please.

0:37:26 > 0:37:28Is she OK?

0:37:33 > 0:37:35Is she OK?!

0:37:35 > 0:37:37I should have seen this morning.

0:37:37 > 0:37:39Just, she was sleeping peacefully.

0:37:39 > 0:37:43- She was drugged up. There's no way you could have known. - We'll check the pulse.

0:37:44 > 0:37:48OK, erm... This child,

0:37:48 > 0:37:53appears to be functioning in a normal baby way.

0:37:56 > 0:37:57Thank you.

0:37:58 > 0:38:00Oh, God, thank God.

0:38:00 > 0:38:03Oh, hello.

0:38:05 > 0:38:07Thank God.

0:38:07 > 0:38:10BEEPING

0:38:16 > 0:38:17Two minutes.

0:38:21 > 0:38:24She's still asystolic. Ruth, I think we should stop.

0:38:24 > 0:38:26OK, you're right.

0:38:28 > 0:38:31Time of death, er...

0:38:31 > 0:38:3314:17.

0:38:34 > 0:38:38I'll go through all this with both of you. You did really well.

0:38:40 > 0:38:44Lloyd, can you get some wipes and a clean gown?

0:38:44 > 0:38:47Let's clean her up before Mum sees her.

0:38:47 > 0:38:49Scarlett, let's clear away all the equipment.

0:38:57 > 0:39:00Nurse, did you get the X-ray?

0:39:00 > 0:39:03- Can I see Fiona now?- Er, no.

0:39:03 > 0:39:05I mean, erm, to both.

0:39:05 > 0:39:06Well, has she woken up yet?

0:39:08 > 0:39:11Mrs Reardon, I, er... I don't know how to...

0:39:11 > 0:39:13Sorry.

0:39:16 > 0:39:19- Fiona's no longer with us. - What do you mean?

0:39:19 > 0:39:21- Has she been transferred somewhere? - No.

0:39:21 > 0:39:23I mean, there was a problem.

0:39:23 > 0:39:25What sort of problem?

0:39:25 > 0:39:27- With the X-ray?- Fiona's...

0:39:31 > 0:39:33- We lost her. - What? Has she walked out?

0:39:33 > 0:39:36You have no idea. If she's on the streets on her own...

0:39:36 > 0:39:39- I've been protecting her from that. - No, I don't mean...

0:39:41 > 0:39:42Fiona died.

0:39:43 > 0:39:45I'm sorry.

0:39:45 > 0:39:46No.

0:39:47 > 0:39:49What do you mean?

0:39:49 > 0:39:51What happened?

0:39:51 > 0:39:52Fiona started fitting.

0:39:52 > 0:39:54We tried stabilising her,

0:39:54 > 0:39:57but she kept vomiting in her oxygen mask.

0:39:57 > 0:39:59We ventilated her, performed CPR,

0:39:59 > 0:40:02did everything we could, but she didn't make it.

0:40:02 > 0:40:06It looks she may have been using heroin. I'm sorry.

0:40:06 > 0:40:09OK, Staff Nurse Asike, thank you. I'll take over here.

0:40:09 > 0:40:11Mrs... I'm sorry, I don't know your name.

0:40:13 > 0:40:14Jane Reardon.

0:40:16 > 0:40:17My daughter's just died.

0:40:17 > 0:40:19OK.

0:40:20 > 0:40:23I'm so sorry, Mrs Reardon.

0:40:23 > 0:40:25Let me take you to see her, OK?

0:40:44 > 0:40:50I'm sorry, Mrs Reardon. Is there someone we can call for you?

0:40:55 > 0:40:57I never thought it would end like this.

0:40:58 > 0:41:01A fall down the stairs.

0:41:01 > 0:41:02I am sorry.

0:41:05 > 0:41:07Did you know that Fiona was using heroin?

0:41:11 > 0:41:13It's why her father left.

0:41:14 > 0:41:16He couldn't cope.

0:41:16 > 0:41:18I was looking after her, helping her.

0:41:18 > 0:41:20It's been two years, now.

0:41:21 > 0:41:24She couldn't have overdosed.

0:41:24 > 0:41:29- Addicts can be very resourceful about finding the means and opportunity to inject.- No.

0:41:29 > 0:41:33She's been with me all day. I know she didn't overdose.

0:41:33 > 0:41:35You've made a mistake.

0:41:35 > 0:41:37You didn't diagnose her condition properly.

0:41:37 > 0:41:40- I'm going to get a solicitor. - I understand you're upset.

0:41:42 > 0:41:45We believe there's a batch of heroin infected with botulism.

0:41:45 > 0:41:48No. The heroin did not kill her!

0:41:52 > 0:41:54She only had one small fix this morning.

0:41:54 > 0:41:56Wait, you knew she injected?

0:41:56 > 0:41:58And I know she didn't have any overnight

0:41:58 > 0:42:01because I make sure her bedroom's secure.

0:42:01 > 0:42:04- You knew and you didn't tell us?! - Can you leave us, please?

0:42:13 > 0:42:15I've been reducing her fixes.

0:42:16 > 0:42:18She was getting better!

0:42:18 > 0:42:20You supplied her with drugs.

0:42:20 > 0:42:22Do you have children?

0:42:22 > 0:42:26No. Well, my love for my daughter was unconditional.

0:42:26 > 0:42:27That's how it works.

0:42:27 > 0:42:30Soon after she started using, she disappeared for a month.

0:42:31 > 0:42:34If I hadn't brought her back, helped her,

0:42:34 > 0:42:38she'd have been on the streets and I was protecting her from all that.

0:42:38 > 0:42:40That's not wrong, is it?

0:42:40 > 0:42:44She fell, the heroin didn't kill her. It couldn't have.

0:42:46 > 0:42:47I was so careful.

0:42:50 > 0:42:52The post-mortem will tell us that for sure.

0:42:55 > 0:42:57- What were you thinking, man? - She took me by surprise.

0:42:57 > 0:43:00- You don't give a relative those details.- I didn't think.

0:43:00 > 0:43:03You don't have the experience or the seniority

0:43:03 > 0:43:05to be breaking news to relatives yet.

0:43:05 > 0:43:07When in doubt, keep your mouth shut

0:43:07 > 0:43:09and always wait for a senior nurse or a doctor.

0:43:11 > 0:43:15When she's calmed down, I want you to apologise to Mrs Reardon

0:43:15 > 0:43:17and hope that she doesn't sue us for emotional distress.

0:43:17 > 0:43:20I'm not apologising. She killed her daughter.

0:43:20 > 0:43:23We don't know that. She wasn't trying to kill her,

0:43:23 > 0:43:26- she was trying to cure her. - You can't agree with what she did.

0:43:26 > 0:43:29- You're getting too emotionally involved.- You're damn right I am!

0:43:29 > 0:43:32When I told her it was a head injury, she was relieved.

0:43:32 > 0:43:35She was protecting herself by not telling us about the junk.

0:43:35 > 0:43:37That was manslaughter.

0:43:42 > 0:43:44If you learn one thing today, learn this.

0:43:44 > 0:43:48God, the universe, is determined to kill humans

0:43:48 > 0:43:49by any and all means necessary.

0:43:49 > 0:43:52You're going to see that every day for the rest of your career.

0:43:52 > 0:43:55If you get angry about it, it'll eat you alive.

0:43:57 > 0:43:59Shift's not over. Get back to work.

0:44:04 > 0:44:07I, erm, I brought you some of these.

0:44:07 > 0:44:09Oh, thank you.

0:44:09 > 0:44:11Oh, and erm, and this.

0:44:11 > 0:44:14HE LAUGHS IN A GOOFY MANNER

0:44:15 > 0:44:19They've given you plenty of formula, so you won't need to, erm...

0:44:21 > 0:44:22Well, you know.

0:44:22 > 0:44:24So, what's your name, anyway?

0:44:24 > 0:44:26Er, round here they call me Big Mac.

0:44:26 > 0:44:29Big Mac, eh?

0:44:29 > 0:44:32Well, Big Mac, you've been so lovely to us.

0:44:32 > 0:44:35Not like that Nurse Andrews. She's been a right mardy with me.

0:44:35 > 0:44:37She's not a bad girl. Maybe, you know,

0:44:37 > 0:44:40she's having a bit of a bad day.

0:44:40 > 0:44:42Anyway, you'll be all right. Get plenty of rest.

0:44:42 > 0:44:44Oh, I'm resting.

0:44:44 > 0:44:47This is the most restful few hours I've had in months.

0:44:47 > 0:44:50You know, when I get out, promise me a girls' night in.

0:44:50 > 0:44:55DVD and takeaway. I can't remember the last time I saw a movie.

0:45:07 > 0:45:11- I've never been present at a death before.- Me neither.

0:45:13 > 0:45:16If nothing else, I'm glad we crossed that bridge together.

0:45:24 > 0:45:27I don't want these. You're about Fiona's size.

0:45:27 > 0:45:29Oh, no. I can't.

0:45:31 > 0:45:35- I know nurses don't get paid very much.- I just don't think it's...

0:45:35 > 0:45:39Thank you. We'll donate them to the hospital charity shop.

0:45:46 > 0:45:48So, this drug clinic of yours...

0:45:48 > 0:45:51After today, do you still think it's a good idea

0:45:51 > 0:45:53to hand out free drugs to junkies?

0:45:53 > 0:45:56Yes. More than ever. And it's not drugs, it's medication.

0:45:56 > 0:45:58But look what happened.

0:45:58 > 0:46:02Annie McLean used us to provide her with enough methadone to see her through her pregnancy,

0:46:02 > 0:46:05and then she's straight back on the hard stuff.

0:46:06 > 0:46:09Look, Annie had a relapse.

0:46:09 > 0:46:13It's probably due to the pressure of bringing up her baby on her own.

0:46:13 > 0:46:14It happens.

0:46:14 > 0:46:16Don't bother with the lecture.

0:46:16 > 0:46:18It's self-inflicted sickness.

0:46:18 > 0:46:22Annie's learnt her lesson. She doesn't need criticism.

0:46:22 > 0:46:25She needs support, from us.

0:46:25 > 0:46:26Which, by the way, is our job.

0:46:26 > 0:46:28Thanks.

0:46:34 > 0:46:36- Evening, ladies.- More meds?

0:46:36 > 0:46:38The best medicine of all.

0:46:42 > 0:46:43Laughter! Pick one.

0:46:44 > 0:46:49I couldn't get you a takeaway - that's against hospital regulations, however...

0:46:50 > 0:46:54..our vending machine has an excellent choice.

0:46:54 > 0:46:57Is this where the cool kids are hanging out tonight?

0:46:57 > 0:47:00- Oh, yeah, definitely that one. - No, no, no.- Oh, come on.

0:47:00 > 0:47:03No, no, no, no. What are you talking about? Have you seen that?

0:47:03 > 0:47:06I just wanted to check that you and Evie were comfortable.

0:47:06 > 0:47:08I can see that you are.

0:47:08 > 0:47:10Would you like to hold Evie?

0:47:10 > 0:47:11Yeah.

0:47:13 > 0:47:14Come on.

0:47:14 > 0:47:18Look, let's do it by show of hands. Who wants this one?

0:47:20 > 0:47:22Budge over, budge over!

0:47:24 > 0:47:25Crisps, anyone?

0:47:57 > 0:48:00Subtitles by Red Bee Media Ltd

0:48:00 > 0:48:03E-mail subtitling@bbc.co.uk