Smoke and Mirrors Casualty

SIREN WAILS

HORN BEEPS

-Right, here's one.

-Not now.

What did the paramedic say to the patient

who'd had a stroke on their left-hand side?

BOTH: You're going to be all right!

How do you know when a paramedic has entered the room?

BOTH: Because he tells you so.

I really don't need cheering up.

What's the difference between God and a paramedic?

I don't know. What is the difference between God and a paramedic?

God doesn't have delusions he is a paramedic.

Yeah? That's cos God hasn't met you yet, has he?

Although you carry on with these gags,

it might be sooner than you think.

-Long time no see.

-How is she?

Not good. Quick as you can.

-RADIO:

-'Preparations are underway for a memorial service

'to be held later today commemorating victims

'of the coach crash which killed two pupils at Holby City Academy.

'Shadia Amreen speaking for the family of Ella Amson, 15.'

What about you, Ally? What's on your wish list?

I'm just wishing for a drama free day.

I will. I promise. It can't be any worse than our first day.

'Words cannot express the depth of our loss...'

Seriously? Go on, give us a clue, then.

-Yes! Where are we going?

-What's Captain Awesome done now?

Craig's taking me away next weekend! What do I need to pack?

Message me details. I've got to go. I love you. Bye.

Right, coffee's down. Shift starts in two minutes.

'..survived the crash and her family issued a statement.'

'We are eternally grateful for the entire team

'at Holby City's Emergency Department, the fire crew...' SWITCHES RADIO OFF

-Nice to know we are appreciated, eh?

-Yeah. Yeah, it is.

Listen, today's another day. Forget about yesterday.

Just be prepared for whatever comes through that door.

It doesn't mean you don't care. It just means you're a professional.

Thanks, Charlie.

Sorry about this. Nick insisted.

I'm sure you're fine. I think he just missed our faces, that's all.

She's had UTIs and chest infections,

but I've been able to deal with those here, obviously.

I think we should get her in. There is a good chance

she may be suffering from autonomic dysreflexia.

It's quite common with people with spinal cord injuries.

BP's high, 180/110, and she has been suffering from a nasty headache

-for the last 12 hours, haven't you?

-Yeah.

We'll get you in, administer some antihypertensives,

and see what's causing it. OK? You are going to be fine.

You are going to be fine.

POP MUSIC PLAYS

MOBILE RINGS

'Hey, Hannah.'

Neil. Hang on, I'm just getting dressed.

'Don't go to any trouble on my account.'

There you go. Looking lovely, princess.

Why are you trying to be so disgustingly charming?

Well, I've been called one or the other before,

but never both at the same time. What's new?

Same old. Starting rehearsals for our end-of-term production.

I'd like to come see that. It's about time we caught up.

It's three months away.

Then we need to catch up sooner.

Yeah, the thing is,

you already sort of had your chance to catch up with me.

I'm sorry. I've been busy with coursework.

Let me make it up to you. Maybe we could go for a drink some night. Hannah...

Yeah, I heard you. I don't know, Neil, I'm kind of busy.

-Behind you.

-Yeah, ha-ha.

-Hannah!

SHE SCREAMS

THUDDING

She's passed out!

HE LAUGHS

That's so cool! Take that stupid mask off.

I can't hear you properly.

Pick the camera up. I can't see her.

What should I do?

-It's just a faint. She'll be OK.

-I think we should get help.

-No, look, just get out of there.

-But...

Seriously, Richie. You want to be there when she wakes up?

SIREN BLARES

Grab that for me, please. Hi.

You OK?

Yeah. Autonomic dysreflexia, I think. Pulse 90, BP 200/110.

OK, we've got it from here. Hi, Yvonne.

I'm here. All right.

-Let's get this on.

-Thanks, guys.

PHONE RINGS

'Hey. This is Hannah. Please leave me a message.'

'Which service do you require?'

Ambulance, please.

BP 190/107.

-Good, good, that's coming down.

-Temperature - 38.3.

OK. Can we get Yvonne into a gown? She's a little pyrexial.

She needs some Nifedipine, Zoe.

Start with some tepid sponging to bring her temperature down.

Could we irrigate this catheter?

Nick, let me do this.

Yvonne, have you got any pain in your lower abdomen?

A little, just overnight.

Yvonne, why didn't you tell me?

Headaches? Blurred vision?

Headaches.

OK, can we arrange a CSU, please? And let's irrigate the catheter.

-Excuse me.

-Sorry, Linda.

All right.

Right, does anyone want to accompany her to hospital?

Any of her mates here? Best friend? What about her family?

Does anybody know them?

Right, well, we're going to be taking her to Holby Hospital

if anyone wants to know.

That's Nick Jordan in Resus? The big boss?

-The one and only.

-Who's the patient?

His partner, Yvonne Rippon. Superintendent Yvonne Rippon.

She's a policewoman?

She was stabbed during the Holby riots. It left her paralysed.

He's been on leave ever since, looking after her.

Hell of a way to return to work.

Right. This is Hannah Spence, 19,

she was found collapsed in her room at Holby College.

GCS was 13, rose to 14 en route. No known previous medical history.

Pulse 60, BP 100/60, sats 98%, BM is six.

OK, Hannah, can you just wiggle your bum over to the other bed

-for me please, love?

-Take your time, sweetheart.

She appeared postictal and has been incontinent of urine.

OK. Hello, Hannah.

My name is Sam, I'm one of the doctors here at the ED.

Can you tell me what happened?

I don't know. I fainted.

Can I get a full set of neuro obs and a repeat BM?

-O2 sats?

-97%.

Right, anything like this ever happened before?

-No.

-Right, you're going to feel a little prick.

We let patients make up their own jokes.

Any family history of collapse?

No.

OK, can I get FBC, U&E, LFTs, an arterial blood gas.

Let's organise an ECG and get her started on a bag of Hartmann's.

Hartmann's.

I'm not happy with this CSU at all.

If it's a UTI, Zoe, it's new, because I have been checking the bag myself

Temperature is 38.8.

-OK, she's gone up 0.5. Let's start her on some IV paracetamol.

-OK.

-Can I have the notes?

-Yeah.

-Thanks.

Your body is just fighting an infection, that's all.

Everything is going to be fine now you're in here.

Nick, would you call my mother?

Please, I want her to know I am in here.

We can organise that for you.

Are you absolutely certain? I mean...

Is there anybody else we can contact for you?

-No, just call my mother.

-Ssh.

-Please, just call her.

-All right.

Tell her that she should be here now.

OK. I'll go and do it now.

You'll be OK for a minute?

Yep.

Is everything OK?

Hmm? Yeah, yeah.

Just not like Yvonne.

She hasn't seen her mother for ten years.

Well, she's feeling vulnerable.

I've been under strict orders not to even let her in at home.

She probably wants all the support she can get.

I don't want her upsetting her.

Well, let's hope that doesn't happen.

Plus, you could do with the support here now.

Yes, but everything Yvonne has said about her -

She's a difficult woman, apparently.

She's a drinker. Well, not just a drinker,

Yvonne says she's an alcoholic.

I don't think she'll help the situation.

But she's next-of-kin. She has to be informed.

If it makes it easier, I can make the call for you.

No, no. If it's what Yvonne wants...

All right to use the office?

Yeah. Of course. And it's still your office.

-Hannah's been taken to hospital.

-She'll be OK.

-What are you doing?

-I'm a film-maker. Film-makers film.

No, film-makers tell stories.

They don't shoot everything that's going on around them.

People only take pictures of the happy stuff.

I shoot real life, then I tell the story.

Anything else is just smoke and mirrors.

We have to tell Hannah the truth.

HE LAUGHS

You haven't really thought this through, have you?

Do you really want to be the guy with a reputation

for hiding in girl's closets while they're dressing?

It was your idea.

Look, I know you've got the hots for Hannah.

-So what?

-But she's really nothing special in bed.

-I'm going to the hospital.

-Don't be stupid.

-I'm fixing this before it gets any worse.

-I'm telling you...

GLASS SHATTERS

HE GROANS

Richie?

KNOCK ON DOOR

-Is everything all right?

-Yeah, he just fell over.

-I'll get an ambulance

-No, no, you don't have to...

I wonder if Craig's messaged me yet.

Aoife, do you mind helping me with this young lady?

-She seems to have walked herself into a door.

-Course.

You know what you should never do?

Leave yourself logged into a personal site on a work computer.

All right, let's take a look at Captain Awesome, then.

The way Aoife talks about him,

it's like he's Ireland's answer to Brad Pitt.

-I've seen him somewhere before.

-Don't tell me you've...?

-No.

-OMG.

-He's not that special.

No, I remember. He's on a dating website that I use.

There, Studmuffin89. I knew I recognised him.

It says he's single

and that his last long-term relationship ended a year ago!

He's not just on this one.

He's on at least two others that I use.

How many dating sites does one person need?

I like options, what can I say?

Anyway, the point is, he's cheating on Aoife!

-Shh! Keep your voice down.

-We have to tell her.

And say what? Maybe she knows. Maybe she lets him do it.

Yeah, right(!)

The autonomic dysreflexia seems to have been relieved.

But temperature and LFT are rising. Her BP's dropped more than

I'd like, and her renal function and urine output are deteriorating.

-I can read obs for myself, Zoe.

-Oh, come on, Nick.

Sorry. I'm sorry.

She's increasingly pyrexial, her Us and Es are abnormal.

She's clearly becoming more septic.

She's got a UTI and we can't ignore what's going on in her chest.

-She's getting hypoxic.

-I accept that, Zoe.

But I've already prescribed broad spectrum antibiotics.

And I agree with that, but, please,

Yvonne is my patient and you're the relative here.

I can handle this. Don't work against me.

Let us do our job.

I will. Unless I can think of something else.

This is Richard Baxter, he's 19.

Found collapsed with a deep laceration to his forehead

and facial injuries.

On arrival, GCS 13, BP 120/80, pulse 80, sats are at 97%.

This is his friend Neil. He was with him when he fell.

What happened, Neil?

-I don't know. He just keeled over.

-Has it happened before?

No. Not that I've seen.

How did he manage to bang the front and the back of his head?

He sort of went backwards first,

cracked it on the corner of a shelf, then forward.

Landed on his face.

Do you know where you are?

Is it the lab?

OK, mate. No, you're in hospital.

OK, let's have him over on three, please. One, two, three.

-That's the way. Thank you.

-Fletch.

-Cheers.

OK, does he prefer Richard, Rick, Richie?

Richie.

OK, Richie. Can you squeeze my hand for me?

OK, do you know what day it is?

11.30.

Let's do a 12-lead, a BM, send off the usual bloods

and let's get a head CT.

Has he been drinking? Is he on anything? It's important.

-I don't know. I don't think so. He might have.

-Which is it?

-Tell Hannah I came to see her.

-No.

15 minute neuros. Let's get that scan ASAP,

and then we are going to move him to cubicles.

So it was Ryan's birthday yesterday

and the celebrations have only just come to an end.

Belated happy Birthday.

You're gorgeous. Hello! He is massive.

Put his fist through a window during a heated discussion

with a barman as to whether he should have any more to drink.

-Police found him sleeping it off.

-Hey, give me a little snog.

We'll get him some IV fluids, regular obs, do a BM stick.

When he's sobered up enough, we'll get him up to X-ray.

-Check for any fractures or retained FBs.

-Hang on.

-Oi, listen.

-Sorry, yes?

Can she look after me, please? I am not being bad, yeah,

but she's much better looking than you.

That may not be such a bad idea

because I'm sure Nurse Hunter, at her age,

has got plenty of experience of dealing with drunken young men.

How do you feel about that?

OK. So where were you when this happened?

I was at Belinda's. Do you know it?

No, never been.

It's wicked. Nice place to get little drinky-poos.

-We should go.

-We?

-Yeah. You're gorgeous.

-You're drunk.

All right, all right. Enough is enough.

What's your name?

-Ally.

-Ally. Ally, Ally, Ally, let's get pally.

-HE BARKS

-All right. Ally, why don't you fetch a gown for Mr Tavistock?

-Where you going? Wait! Hey, where you going?

-Calm down.

I'll wait for you!

Take it easy. Let me have a proper look at this.

Zoe, ITU are still waiting to clear a bed.

Her BP's still dropping, practically in her boots.

We're going to have to start her on pressors. OK.

I want to change the treatment regime. Activated protein C.

I don't think that's appropriate.

I know we have stocks. I know they're expensive.

I know they only qualify in extreme cases.

But I think this counts, don't you?

Nick, it's got nothing to do with money.

It wouldn't matter who she is. I wouldn't be advocating those drugs.

Why not? We're the NHS.

Because I couldn't be sure they would work and neither would you.

The likelihood of this drug having any therapeutic effect

in Yvonne's case is minimal.

Zoe, please, please, don't make this a personal favour.

It's our job to try and save lives by all and any means necessary.

We have the means, and they're necessary today.

OK, I'll do it. But this is against my clinical judgement.

CT can take us now, Fletch.

What year it is, Richie?

2010.

Richie's had quite a bang to the head.

He's shaken up his frontal lobe, which is the part of the brain

where your inhibitions and personality is stored.

-Will he recover?

-I want to see test results to be sure.

But the chances are it'll fix itself over the next few hours.

His brain's like a computer re-booting at the moment.

So he needs lots of rest and we'll wait and see what the scan tells us.

Hi, Hannah.

How are your periods? Regular?

No.

Did you take anything? Drugs?

I'm not like that. I don't smoke, I don't drink much alcohol.

I think the other students think I'm a bit weird.

Is there anyone you would like me to call? Parents? Friends?

Not...really. I'll call them when I feel a bit better.

OK. So what do you remember about the collapse?

It seems like a dream. I remember I was getting dressed.

Then something...

I thought something touched me. Behind me.

Like there was someone there. Then I don't remember anything

until the ambulance got there.

So you think there was someone in the room with you?

I don't know. I don't know where they would have got in.

My room's small. No-one could come in without me knowing.

There doesn't seem to be any marks or bruising.

Maybe I imagined it. Maybe there's something wrong with my brain.

Well, that's what we're going to find out.

I'll keep you under observation for a while, run more tests.

Don't worry. We'll get to the bottom of this.

Is there a bathroom I can use?

I'll ask the nurse to get you a bed-pan.

No, I'd really... I'd rather...

OK. I'll take you off the monitor.

Imagine the movies you could make if you could see inside people's heads.

Hannah? Can I get some help here, please?

-Hannah? Can you hear me? Hannah?

-Can you get a chair?

Can you hear me? Let's move her into cubicles.

-She with us?

-Yes, she is coming around.

All right, darling. Let's get you up.

There we go, into the chair, Hannah.

That's it. Just behind you. There we go. OK. You with us?

Right, we are doing fine.

OK, guys, let's get her back on the bed, please.

Right, let's get the monitors back on.

OK, Hannah. Try and stay with us.

I can't believe the only time she was off the monitor she collapses.

-Hannah, stay with us, please.

-Hannah!

How are you feeling, Richie? You can rest a while now.

-Look straight ahead for me, please.

-Where's Hannah?

Never mind Hannah, mate. You need rest.

-You're in hospital, Richie. Just take it easy.

-Tell me. Was I?

Just try and relax for me. Nice deep breathes.

Pulse 65, BP 110/70.

What year is it again, Richie?

-2011.

-It's getting closer.

Hannah, when you fell, you hit your head.

-Can you tell me where it hurts?

-Hannah!

It's too noisy. Can't you move him somewhere quieter?

Once he's more stable. Look, why don't you go and get a coffee?

There is a cafe at reception

and we'll come and get you when we need you.

-Come on. I'll show you.

-Thanks.

OK. Hannah, Hannah, try and stay awake for me.

Right, I'll call the radiologist and, Charlie,

can you see if CT has a slot for me?

Hannah!

-Hannah! Hannah.

-Calm down for me.

-Can we talk?

-I know I can.

About our patients.

STEADY BEEPING

Thanks.

Yvonne, I've called Diana.

She's on her way.

We've got you on the very best medication.

Pressors to keep your blood pressure up and plenty of antibiotics.

And I've started you on activated protein C,

which will help your body fight the infection.

Well, look at those stats. Heart rate 80, BP 100/74,

sats a beautiful 96%.

Just relax and let me fix you.

Everything is going to be OK.

-Nick.

-Hello, stranger. Look at you. I love your hair.

-Ah, thank you.

-Nice change.

How is she doing?

Needing pressors and broad spectrum antibiotics.

But I think we're in the clear. I did say the protein C would help.

I'm still not convinced this treatment is appropriate

or doing Yvonne any good.

Any changes could be purely coincidental.

She's a fighter, Zoe. She'll get though it, I'm telling you.

Why don't you take a break, go home, get some sleep?

No, no. Her mother's on the way. I'll grab a coffee.

How's she really doing?

Her BP is still dependant on inotropes

and we're having to keep increasing the infusion rates.

I'm worried it might be fulminant sepsis

and she's developing a lobar pneumonia.

Her other organs are going to start to struggle soon.

So we're managing everything for her with drugs

-and Nick's not seeing it, is he?

-No.

-Your patient Hannah, is she from Holby College?

-Why?

Because mine is and I think he's talking about her.

-Saying what?

-Nothing much, just her name. What's her story?

She's collapsed twice. I'm trying to get to the bottom of why. Yours?

He's concussed, but nothing significant on the scan.

What are you not telling me, Sam?

She thinks someone was behind her when she collapsed the first time.

You mean she was hit?

There's no evident of a head injury. No marks, no scratches.

Don't you think it's odd, two patients from the same halls?

Yeah, I do.

Keep the obs going, see what they say when they're more alert.

Got any plans tonight?

Yeah.

Coursework?

Yeah. I'm studying film. It's going to be up online soon.

It's like nothing anyone has ever done before.

What's it about?

It's hard to explain. You'll have to wait and see.

-I'm Neil Redd.

-Dr Nicholls.

Neil, your mate Richie, I thought I heard him asking about my patient.

-I recognise her. Hannah Spence.

-Yeah, do you know her?

-Just to say hello to.

-Do you know if Richie saw Hannah this morning?

I don't know. He didn't say anything.

Well, Richie does carry a bit of a torch for Hannah.

Fancies her, I mean. Can I see her?

Not just yet. I'll keep you posted.

Ally. Ally.

Ally, come on, man. Ally!

-Ally, hello, here. Hi!

-What's up?

I want to have a little chat. Close the curtain.

What do you need?

-I'd like to have a little chat with you. Come in.

-I'm busy.

Well, take a little break.

If you come in, no-one will know, will they? Shhhh! Come.

Just rest and let the fluids work.

You still need sobering up, Mr Tavistock.

Mr Tavi...? Call me Ryan.

Alcohol don't even touch me. I'm fine. Look at me!

Ally, don't do me like that. Come here.

Oh, come on, man.

What kind of place is this? I'm going home.

How are you feeling, Richie?

Um... Yeah.

-What year is it?

-2012.

We're getting closer each time

so that means you must be getting better.

You're very pretty.

Thanks very much. Neil's here. You know Neil, right?

He's been looking after you.

Neil?

He's improving but we are going to keep monitoring.

Where's Hannah? Hannah's here?

Mate, you really have to let this go.

I've been busting my butt protecting you here.

You were just playing a joke, but Hannah got hurt.

She's OK now. The doctors will fix her.

But you can't tell anybody. They'd arrest you, man.

Trust me, Richie.

It'll all be OK. I'm looking after everything.

We're need to make a decision on this. Do we tell her?

-Tell who what?

-BOTH: Nothing.

Sorry. It's out there now. We have a responsibility as your mentors.

Linda, your trainee has a secret that she will not share with me.

And I'm concerned, deeply concerned, that this could have

something to do with one of our patients.

-No, it's not. I promise.

-I won't know that until you tell me, will I?

He does have a point.

We think Aoife's boyfriend might be cheating on her.

La-la-la! Didn't hear it.

-Yeah, go on.

-Her boyfriend's been using dating web sites.

-Stay out of it. Say nothing.

-I think you should tell her.

Thanks. You've been a great help(!)

-Fletch! Where's my ECG? I want a 12-lead.

-Sorry.

I'll sort that. Chance to show Jamie how it's done.

-Ah, good man.

-Jamie.

You know your friend is here today. Richie.

Richie? Richie Baxter? Is he OK?

He's had an accident, but he's stable.

He is suffering from concussion. Did you see him this morning?

No.

He was brought in by a friend. Neil. Neil...?

Neil Redd. I was on the phone to him this morning when I collapsed.

He must have called the ambulance.

He didn't say.

OK, well, let's sort you out for an ECG. Same as last time.

And, hopefully, we will be able to see what's going on.

Jamie and Lloyd will help set that up. OK? Thank you.

Mrs Rippon? Nick Jordan.

Mrs Hart. I haven't been Mrs Rippon for a long time. Diana.

-How do you do? Thanks for coming.

-How is she?

I've been trying to get in contact with her since the accident

but she doesn't return my calls.

Yes, I know that. It was Yvonne that actually asked me to call you today.

It's been quite tough, you know. We've had good days, bad days.

-What's happening?

-Well, Yvonne's developed an infection

which has to be treated here in the hospital.

It's only a concern because of her particular form of paralysis.

Paralysis? Is this permanent?

We are managing it and she's putting up a fight.

Are you treating her yourself?

Yes and no, but the staff here are excellent.

Can I see her?

Of course you can, she's through here.

Sam. Hannah's 12-lead.

Thank you, Lloyd.

You wanted me?

Yeah, did you know that Richie's friend was the one

who called the ambulance for Hannah?

They were on the phone together when she collapsed.

He didn't say anything.

Doesn't that strike you as odd? Can I get a second opinion?

Sinus rhythm.

Rate 60, normal axis, normal PR interval.

You think my patient had something to do

with your patient's first collapse?

Well, out of the three of them,

I think at least one knows more than they're letting on.

Look at this.

QT interval, about 500 milliseconds.

Long QT syndrome.

We've not documented a tachyarrhythmia?

No. She was off the monitor the second time she collapsed.

That's a pity.

You know, Neil's story about how Richie got his injuries,

it doesn't quite square up.

And there's something else.

Thanks, Linda.

Oh, Yvonne. Oh, darling. Mummy's here.

There's no school today.

It's just the infection. Diana, this is Dr Hanna.

-This is Diana Hart, Yvonne's mother.

-What time is it?

It's 10.45, my love.

There's no school on Saturday.

Just rest now. Nick and I are right here. We'll talk later.

-Sats have dropped.

-It's minimal. She's maintaining a much better BP.

Her vital signs are deteriorating. You must see that!

There is not much change.

You need to take her mum outside. I need to intubate.

-No.

-Yes, Nick.

-Zoe, no. Zoe, she's fine.

-Ketamine, sucs...

-Can you fast bleep ITU consultant, please?

-Mum...

MACHINES BEEP RAPIDLY

It's OK. Let them do their job.

OK, sats are still falling, she's going into respiratory arrest.

SHE GASPS FOR BREATH

Ally!

Ally, hello.

Ally, hello. I'm over here. Can you come here?

Ally! Hello! Oi!

Ally, I got a problem.

Ally, look, my thing has come out! Can you help me, please?

Ally, hello! Oi, look, is this important or what?

Ally, hello! Come on, man. I'm getting wet.

Oh, fine, then. You know what? I'll do it.

I thought you said she was improving.

She is, she is, don't worry. It's entirely standard, Diana.

-We do it all the time here.

-I've got a good feel of her larynx. Tube.

We just... It's controlling her breathing.

Let's secure the tube, inflate the cuff

and start the propofol infusion.

Zoe's is a very good doctor.

Tell ITU they're taking this patient now,

even if I have to wheel her there myself.

Excellent work, Zoe. Well done.

Yvonne will be fine.

-Ow!

-Sorry.

You don't know what you're doing, do you?

Listen, listen, you are no good at this.

You haven't got a clue.

Yes, you just need to stay still.

I don't want to get you in trouble, yeah. I tell you what,

if you're really nice to me...

All right, mate. Don't you worry, we have got this all in hand here.

Can you close that off?

I think he's sobered up enough now to do without the fluids.

Why don't you take a little break? I'll sort this.

Hey, listen, if you want my advice, yeah,

you need to get this place sorted out.

I've been here for I don't know how long. I want to go.

I'm going to send you to X-ray now and depending on the results,

we'll tell you when we think you should go.

You want my advice? Learn to keep your hands to yourself.

If you don't, I'll get two big 16-stone security guys in here

-who will make sure that you do, all right?

-All right.

CAMERA BEEPS

I came to see how you are.

Don't. I look terrible.

It's a hospital. You're allowed to look terrible.

What happened?

I don't know. Did you call the ambulance?

Yeah. Then I came to look for you, but they'd already picked you up.

You didn't call the police?

Police? No. Why?

-The man behind me.

-Oh, God. I'd forgot about that.

Did you see him? Who was he?

Hannah, I'm so, so sorry.

That was a joke. There was no-one behind you.

-I was just winding you up.

-But...

Ohh.

I don't know what's happening to me.

Is everything all right?

Yes. Yes.

-Could I have a word with Hannah alone, please?

-Of course.

We think we have a better idea of what's going on.

I've got your results here.

-Can we talk a minute?

-This is your ECG trace...

I need to ask you a few questions about Richie's injury.

-For his records.

-Yeah. Of course.

-Follow me.

And you have a long QT interval.

Sometimes your heart beats too fast.

You experience short bursts of tachycardia.

All of these things could be causing these episodes.

-How did I get that?

-You were probably born with it.

I've transferred you to the cardiologists,

they'll get an echo and they will monitor you to try and catch an attack.

If I'm right, and I'm pretty sure I am,

this can all be treated with beta-blockers.

Why has it come on now?

Some people don't get an attack until they are in their 30s.

But it can be triggered by stress or extreme emotion.

Like finding someone in your room.

SHE SIGHS

What?

I think...I think I imagined that.

I was on the video call to Neil at the time.

He didn't see anybody.

There's also something else.

You may not be aware, but you're pregnant.

Pregnant? That's impossible. I haven't...

It's been months.

I couldn't...

Nothing happened.

Tell me.

At Halloween. We were drunk.

-But we just fell asleep.

-We?

Neil. Neil and I slept together.

You and Neil?

We just slept. It never happened again.

Can I...can I speak to him?

Yeah. I think that would be a good idea.

Is this Neil's?

I think so.

Richie's going to be fine. In the next couple of days, he's going to remember everything

that's happened to him.

There is something I don't get. If he passed out falling backwards,

even if he hit something on the way down,

his body wouldn't change direction.

His weight would still carry him back and down.

-You're good with computers, aren't you?

-Has it crashed?

No, it's this web site. Does it link to anything?

There might be a root directory hidden underneath. Let me.

There you go.

Great thanks. OK.

Um...what are we watching?

Oh, no, no, no, no, no.

When she was a little girl, we used to play this game.

She'd bring me my medicine.

"More medicine for Mummy, darling."

Of course, it wasn't medicine. It was vodka and tonic.

She could mix one perfectly by the time she was ten.

Diana, you don't have to explain this to me.

No, I want you to know.

What she never knew was how much I needed the medication

to dull the pain.

I think she was probably a lot wiser than you gave her credit for.

I mean, the physical pain inflicted on me by her father.

Gone by the time she was 16, but I still needed my "medicine".

She left home by the time she was 17.

It took a while but...

I stopped drinking, I met Mr Hart,

and my life has been very, very different since Yvonne last saw me.

That's what I want her to know. That's why I kept calling you.

She'll be OK, won't she?

I promise.

You all right?

Hannah, when you were with Neil at Halloween,

you had one of your episodes.

You passed out. Neil didn't care. He just carried on.

He filmed it all. I think you should talk to the police.

That's what he does. He films everything.

Richie.

You look beautiful. You always do. Sorry. Bump to the head.

Apparently the bit that normally controls inhibitions

is down for a while.

This morning, that was me in your wardrobe.

-Neil said I imagined that!

-It was only meant to be a joke.

I didn't think he was going to film it.

What?

He's scopophilic - the love of watching things.

Basically, a voyeur.

I didn't mean to scare you.

-Richie. Neil did that to you, right?

-Where is he now?

He just left.

Where you off to?

I want to talk to him while my inhibitions are still down.

Fair enough.

What?

Shouldn't you be in bed?

Shouldn't you be in therapy?

You're a bit cocky for a bloke I have film evidence of

hiding in girls' wardrobes.

You're a bit cocky for a bloke who filmed himself committing rape.

You're a strange, lonely little Peeping Tom with your stupid films.

What you did to Hannah, that bit of film,

that's going to the police.

How's Yvonne doing?

Not good. I just had to intubate. She's going to ITU shortly.

So it's just the ventilator keeping her going.

Poor Nick. How's he taking it?

He's not.

I just heard him promising Yvonne's mother that all is going to be fine.

Not even Nick Jordan can bring people back from the dead.

I would have let her go by now, Tess.

Well, all you can do is tell him the truth.

But what about Yvonne's mum? He's giving her false hope.

It's like he doesn't understand it.

If anyone can get through to him, it's you.

Wait. Richie...

Just tell them the truth.

Tell them what you told me. It'll be OK.

I will. I'm here for you.

Ally? Could I have a word?

You want to talk about it?

I'm sorry. I should have found one of the other nurses.

No, I didn't mean that.

I meant, Mr Tavistock was trying to take advantage.

How do you feel about that?

Used.

Well, the only mistake you made with this particular patient

was not keeping a professional distance.

I won't do that again.

You have to decide case by case, really.

The funny thing about being a nurse,

you can come into this place one day full of the joys of spring

and you meet a gentleman like Mr Tavistock

and you go home heartbroken.

And come in the next day feeling down in the dumps and you witness

an act of profound human kindness

and you go home on cloud nine.

After three years, I know all that.

My mum was a nurse.

And my grandma.

But that doesn't mean I have to be, does it?

No, no, it doesn't.

I can't...forget at the end of shift. It won't go away.

Those kids in that coach crash last week...

Ally, you're a good nurse.

I think you could be a great nurse. That was one day.

One bad day.

It's not just that. It's just not me.

Not only emergency nursing but nursing in general.

I mean, I tried. It wasn't wrong of me to do that.

I tried and that's the main thing

because I wouldn't have known otherwise.

Take some time. Think about it. Talk to me, talk to Tess.

I have thought about it, it's all I've thought about.

My mind's made up.

I don't know how I'm going to tell the others.

-Where's Ally got to?

-Maybe she's still talking to Charlie.

He's on her case a bit, isn't he?

PHONES ALL VIBRATE

Please, don't be work. I really need sleep.

-Mine's from Ally.

-Me too.

-And me.

"I've left. Don't worry, all good. Will call. Explain soon. xxx."

What does she mean, she's left?

Has Charlie kicked her off the department?

He can't do that. She still has three months of placement left.

Straight to voicemail.

Hi, Ally. What happened? We're all here waiting for you. Are you OK?

-We love you.

-Call me.

Give us a call as soon as you can. Bye.

What a week.

-I'm going to call Craig.

-No! Wait.

-I'll only be two minutes.

-No.

I... We... There's something we have to tell you. Well, me.

-I found out.

-Found out what?

You know I do this internet dating?

-Oh, no.

-Yeah.

Charlie's on it? Has he seen your profile?

No, not Charlie, babe.

Craig.

I don't get it. What's the punch line?

He's on dating websites. He says he's been single for a year.

No, that's a mistake, we're getting married.

I've had a word with ITU. They are going to move her now.

-OK, thank you.

-Where's Diana?

She's gone to phone her husband.

Nick, you know this is still very much touch and go.

She's still alive, Zoe.

You're going against everything you know.

You're giving the mother false hope.

-And you're giving up too easily.

-What are you going to do?

Keep Yvonne on a noradrenaline infusion 24 hours a day?

If that's what it takes.

Listen to yourself. How many times have you been in this position?

How many times have you called it because you knew

the patient's quality of life would be meaningless?

-That was different.

-No. It's not different.

They were all human beings with sons and daughters and parents

-and people who loved them too.

-That's rich coming from you.

The only reason we're standing here having this conversation

is because you once forged my signature on a consent form for brain surgery.

They had all given up on me. You didn't.

This is exactly the same. I will not give up on Yvonne.

Oh, God. I'm frightened, Zoe.

I know.

If she's still alive, I've got something.

If I let her go...

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