0:00:48 > 0:00:50(Nick.)
0:00:51 > 0:00:53Nick? Nick?
0:00:56 > 0:00:58Have you been here all night? You must be exhausted.
0:00:59 > 0:01:02- I'm fine, Diane.- How is she?
0:01:05 > 0:01:07Nick, I've just been speaking to Dr Earle.
0:01:07 > 0:01:09He says it's in her best interests to...
0:01:11 > 0:01:12To what?
0:01:15 > 0:01:18To stop the drugs today.
0:01:18 > 0:01:20I don't know if she'd want to go on like this.
0:01:20 > 0:01:22I just want to do what's right for her.
0:01:22 > 0:01:25Nick? Are we doing the right thing?
0:01:25 > 0:01:26Where is he?
0:01:32 > 0:01:34- Dr Earl?- Mr Jordan.
0:01:34 > 0:01:36Yvonne's mean arterial pressure is dropping.
0:01:36 > 0:01:38I think we need to increase the inotropes.
0:01:38 > 0:01:41You know there's a limit to what we can achieve with them.
0:01:41 > 0:01:42I think we've reached that limit.
0:01:42 > 0:01:44Well, I'm sorry. I don't feel the same way.
0:01:44 > 0:01:47With respect, you may not have the distance to judge.
0:01:47 > 0:01:49I've already spoken to Mrs Hart.
0:01:49 > 0:01:50Yes, I know you have.
0:01:50 > 0:01:52And I do not appreciate you co-opting the opinions
0:01:52 > 0:01:55of vulnerable relatives just to suit your own agenda.
0:01:55 > 0:01:57I've been caring for Yvonne at home for six months.
0:01:57 > 0:01:59You've had her in here for what, 24 hours?
0:01:59 > 0:02:03So I think I'm better placed than you to judge what's best for her.
0:02:03 > 0:02:05Continue with the activated protein C
0:02:05 > 0:02:08and increase the inotropes to a MAP of at least 70.
0:02:10 > 0:02:12I'm going to look into some additional options.
0:02:12 > 0:02:15I will not give up on her, Diane. I promise you that.
0:02:20 > 0:02:23I'm afraid it's not terribly good news, Lauren.
0:02:24 > 0:02:28Your body's been put under a lot of stress by the illness.
0:02:29 > 0:02:33We need to admit you today and look at some more treatment options.
0:02:33 > 0:02:36I know it's hard going through it all over again.
0:02:36 > 0:02:37I don't want you to give up hope.
0:02:37 > 0:02:40We both know what my chances of recovery are.
0:02:40 > 0:02:42I don't need the platitudes.
0:02:42 > 0:02:44I'm going to speak to St Mary's Hospice.
0:02:44 > 0:02:46When the time comes, I'll go there.
0:02:46 > 0:02:48There's more we can do for you here.
0:02:48 > 0:02:49No, there isn't.
0:03:03 > 0:03:06Steady, steady. Let me do it, let me do it.
0:03:06 > 0:03:10Take your time, take your time. That's it. You all right?
0:03:11 > 0:03:13Have a sit down. I can take a look at you.
0:03:21 > 0:03:24Is it coffee you're having?
0:03:24 > 0:03:25Are you a doctor?
0:03:25 > 0:03:28Yes, I am. Actually, today, I'm just a relative.
0:03:30 > 0:03:33My...partner is...
0:03:33 > 0:03:35- In ITU?- Mmm.
0:03:35 > 0:03:38- What's wrong with her? - Quite a lot, actually.
0:03:38 > 0:03:42- Is she going to make it? - We're hopeful.
0:03:42 > 0:03:46The miserable have no other medicine but only hope.
0:03:48 > 0:03:50Well, it's better than nothing.
0:03:50 > 0:03:55It's far worse. Thanks for the coffee.
0:04:03 > 0:04:07Right, everyone, I'm afraid Tess isn't very well today.
0:04:07 > 0:04:08Bunking off.
0:04:08 > 0:04:13So Linda, you and Robyn in resus, and Lloyd, can I have you and Jamie on cubicles?
0:04:13 > 0:04:17- Sam and Tom in cubicles as well. - I've got a patient in resus I'd like to finish with.
0:04:17 > 0:04:18The blonde? Funny that.
0:04:18 > 0:04:19- Shh.- Fine. More importantly,
0:04:19 > 0:04:22the first person to find my mobile phone will get
0:04:22 > 0:04:23a drink bought for them.
0:04:23 > 0:04:26Sorry I'm late. I was sorting the drip for Mrs Clements.
0:04:26 > 0:04:29We're going to practise suturing after this, if you want to come.
0:04:29 > 0:04:31- I'm kind of busy.- Right.
0:04:31 > 0:04:34- Any word from Nick?- No.- Well, let me know if you hear anything.
0:04:34 > 0:04:35Yeah, I will.
0:04:35 > 0:04:38Right, I need a word with you folks.
0:04:38 > 0:04:42Ally, I'm afraid, has decided that nursing,
0:04:42 > 0:04:46and especially ED nursing, is just not for her.
0:04:46 > 0:04:49So she's taking some time out to decide exactly what it is
0:04:49 > 0:04:50she wants to do.
0:04:50 > 0:04:52But she always wanted to be...
0:04:52 > 0:04:56- Whatever that turns out to be, she won't be coming back here.- Robyn?
0:05:12 > 0:05:15Hi, I ordered a cab about 20 minutes ago.
0:05:15 > 0:05:19- Get in.- No.- Get in.- No.
0:05:19 > 0:05:22Just do it! Get in now!
0:05:31 > 0:05:32Dr Thorne called you, did she?
0:05:32 > 0:05:33What did you expect?
0:05:33 > 0:05:35I'm not going back into the hospital.
0:05:35 > 0:05:37It's not up to you any more.
0:05:49 > 0:05:51Hello? Hello? Hiya.
0:05:51 > 0:05:55- We got a call to this address? - Not me.
0:05:55 > 0:05:58Right, well, is there no-one else it might have been?
0:05:58 > 0:06:00Kids round here have been playing up a bit.
0:06:00 > 0:06:02Sorry you've had a wasted journey.
0:06:05 > 0:06:08Great, another bacon sarnie goes stone cold for nothing.
0:06:11 > 0:06:14Oi! Oi, pack it in!
0:06:23 > 0:06:26Hey, it's all right, stay where you are. Are you all right?
0:06:26 > 0:06:28- Yeah, I'm fine. - What was all that about?
0:06:28 > 0:06:31- Nothing. They're idiots. - Let's have a look at you - oooh.
0:06:32 > 0:06:34You have had a bit of a bump there, mate.
0:06:34 > 0:06:37Think we may have to take you in, get that seen to.
0:06:37 > 0:06:39- You live around here? - Yeah, but no-one's in.
0:06:41 > 0:06:45Fancy a ride in that big yellow taxi, then? Yeah? Good lad.
0:06:46 > 0:06:49Looks like I didn't waste my bacon sarnie after all.
0:06:49 > 0:06:52Thought you were seeing that woman up there?
0:06:52 > 0:06:53Nah. It was a hoax call.
0:06:53 > 0:06:56Some people have got a really rubbish sense of humour.
0:06:56 > 0:06:58What's your name, son?
0:06:58 > 0:07:00- Wayne.- Rooney?
0:07:58 > 0:08:01Well, what are our options?
0:08:03 > 0:08:05I don't care what it costs.
0:08:06 > 0:08:10Yes, I have got the money.
0:08:10 > 0:08:13So it's obvious he forced her out.
0:08:13 > 0:08:14Does seem a bit harsh.
0:08:14 > 0:08:17She just needed a bit of encouragement.
0:08:17 > 0:08:19He's just a cynical old bully.
0:08:19 > 0:08:20Robyn, I need you with me.
0:08:20 > 0:08:22Just be a sec.
0:08:22 > 0:08:24"Hashtag hope I never get old"?
0:08:24 > 0:08:26I need to vent. Excuse me.
0:08:26 > 0:08:29- We're here to learn, not slag our bosses off.- Can I have that back?
0:08:29 > 0:08:30You can have it back later.
0:08:30 > 0:08:32I'm sure you've got work to be getting on with.
0:08:32 > 0:08:35Ally's our friend and she's been the victim of bullying.
0:08:35 > 0:08:40If she couldn't cut it, sorry, but it's better she realised sooner rather than later.
0:08:40 > 0:08:42- Look, I know you're upset about the Craig stuff.- I'm sorry?
0:08:42 > 0:08:45It was harsh the way you had to find out.
0:08:45 > 0:08:48This has got nothing to do with that.
0:08:48 > 0:08:50Sorry, Fletch.
0:08:50 > 0:08:53- That's all right. - This is Wayne Gwyn, 11 years old.
0:08:53 > 0:08:56We found him scrapping with other kids on our way back from a hoax call.
0:08:56 > 0:08:58He's got a bit of a laceration and a bump to his forehead.
0:08:58 > 0:09:00But apart from that, he is fine.
0:09:00 > 0:09:03Wasn't KO'd, GCS has been 15. He put up a good fight.
0:09:03 > 0:09:06Not the first time I've had to punch someone.
0:09:06 > 0:09:09- Right, OK. No mum or dad with him? - No, can't get hold of them.
0:09:09 > 0:09:12All right, can you whack him in cubicles? I'll be there in a minute.
0:09:12 > 0:09:16- Yeah. Come on, Wayne, this way, son. - Cheers.- Cheers, Fletch.
0:09:18 > 0:09:20All right, Aoife, we're up.
0:09:25 > 0:09:28Listen, if you need to go and have lunch early or something?
0:09:28 > 0:09:30Why on earth would I want to do that?
0:09:31 > 0:09:33I heard about...your fella.
0:09:36 > 0:09:39We're nurses. We're here to help people with real problems.
0:09:39 > 0:09:41And I intend to be one of the best.
0:09:41 > 0:09:43That's really the only thing I am thinking about.
0:09:45 > 0:09:46Now, maybe we could crack on.
0:10:04 > 0:10:06Higher. Higher. That's it. Quickly...
0:10:06 > 0:10:09back into bed before she sees you. Good lad.
0:10:09 > 0:10:12OK, I've spoken to your mum. She says we can check you over here
0:10:12 > 0:10:14but she wants you straight home afterwards.
0:10:14 > 0:10:16- Here's the doctor now. - OK, what have we got?
0:10:16 > 0:10:18Took a bit of a smack to the head, but his obs are fine.
0:10:18 > 0:10:20I'm thinking Steri-Strips.
0:10:21 > 0:10:24- Any previous history, Fletch?- No.
0:10:26 > 0:10:27Look straight ahead for me.
0:10:27 > 0:10:29I heard there was a paeds case.
0:10:32 > 0:10:33I should probably take a look.
0:10:33 > 0:10:35I thought you were busy in resus.
0:10:35 > 0:10:38OK. Well, I'll leave you to it.
0:10:38 > 0:10:39Is he your ex or something?
0:10:40 > 0:10:42No.
0:10:42 > 0:10:46OK, well, let's clean up his head, Steri-Strip the wound
0:10:46 > 0:10:48- and keep an eye on him.- Are you OK?
0:10:49 > 0:10:50Now, please.
0:10:54 > 0:10:56Sam. Just the person.
0:10:56 > 0:10:58Listen, when you were in the military,
0:10:58 > 0:11:01what was your experience of using low tidal volume ventilation?
0:11:01 > 0:11:04- Um, not a lot, I'm afraid.- No, OK.
0:11:06 > 0:11:08How is she?
0:11:09 > 0:11:11- She's fighting, Sam. - We've missed you, you know.
0:11:11 > 0:11:14This is Lauren Hargreaves. She's 29, collapsed in the street.
0:11:14 > 0:11:17- A passer-by found her. - Hi, Lauren, I'm Dr Hanna.
0:11:17 > 0:11:19Has anything like this ever happened to you before?
0:11:19 > 0:11:22No, I just missed breakfast. Stupid, really.
0:11:22 > 0:11:23I feel fine now.
0:11:23 > 0:11:25Hello again, young lady.
0:11:25 > 0:11:28- Coffee man.- I knew I should have checked you over.
0:11:28 > 0:11:29Honestly. I'm all right.
0:11:31 > 0:11:33Are you going to tell her or shall I?
0:11:41 > 0:11:43What are you doing out of bed?
0:11:43 > 0:11:44Just looking round.
0:11:44 > 0:11:46Well, I need to check your obs.
0:11:46 > 0:11:49Are you feeling sick or dizzy at all?
0:11:49 > 0:11:50Any blurriness in your vision?
0:11:50 > 0:11:52Why?
0:11:52 > 0:11:55It might mean you'd injured yourself more seriously.
0:11:55 > 0:11:57Actually, I do feel a bit sick.
0:12:02 > 0:12:05I think you're fine. I think it's high time you went back to school.
0:12:05 > 0:12:06It's an inset day.
0:12:08 > 0:12:09Is it indeed?
0:12:15 > 0:12:17It looks quite nice, really.
0:12:17 > 0:12:19I mean, it's not Claridge's,
0:12:19 > 0:12:22but it's on the less grim end of the hospice scale.
0:12:22 > 0:12:23It's got a duck pond.
0:12:25 > 0:12:27What's your consultant said?
0:12:27 > 0:12:28We haven't exactly seen eye to eye.
0:12:28 > 0:12:32- What treatment have you had? - The lot.
0:12:32 > 0:12:36Spent the last decade in places like this, with people like you.
0:12:36 > 0:12:38No offence.
0:12:38 > 0:12:41But I should have just spent it on a beach somewhere.
0:12:41 > 0:12:43I know that chemo can be very gruelling, Lauren,
0:12:43 > 0:12:46but even if there's a small chance, it is worth taking.
0:12:48 > 0:12:50I'd like to speak to your consultant.
0:12:50 > 0:12:53I know you're trying to help.
0:12:53 > 0:12:55But I'm not going through it again.
0:12:55 > 0:12:57I'm not going to be readmitted.
0:12:57 > 0:12:58Zoe.
0:13:02 > 0:13:04Your heart rate is very slow.
0:13:04 > 0:13:07Are you on any other medication, beta blockers?
0:13:07 > 0:13:10Right, let's get her bloods sent off straight away, please,
0:13:10 > 0:13:11and pull up her records off Noel.
0:13:11 > 0:13:14Linda, we need to get her into resus now.
0:13:36 > 0:13:38What do you think you're doing?
0:13:38 > 0:13:39- He's obviously a chancer.- Who?
0:13:39 > 0:13:43Wayne. I caught him by a dressing trolley, trying to see what he could loot.
0:13:43 > 0:13:45- What does a kid want from a dressings trolley?- I don't know,
0:13:45 > 0:13:48- whatever he could get. - He's an ill child, Aoife.
0:13:48 > 0:13:50He's skiving off. There's nothing wrong with him.
0:13:50 > 0:13:53He's just vomited and he's complaining of blurred vision.
0:13:53 > 0:13:54We're sending him for a CT.
0:13:55 > 0:13:58Look, I know you're trying to make your mark.
0:13:58 > 0:14:00But as a student nurse, you should learn to watch
0:14:00 > 0:14:02and listen before you try and diagnose.
0:14:02 > 0:14:05Maybe Fletch could show you how to take bloods or something.
0:14:10 > 0:14:14Louise. You used to work in Ambulance Control, didn't you?
0:14:14 > 0:14:15- Yeah.- Someone like you,
0:14:15 > 0:14:17I expect you've still got a lot of clout there.
0:14:17 > 0:14:19What are you after?
0:14:19 > 0:14:21Lauren, this is the executive suite,
0:14:21 > 0:14:23you'll find everything you need in here.
0:14:23 > 0:14:24Could be a reaction to chemo.
0:14:24 > 0:14:26We won't know until we've got her old notes.
0:14:26 > 0:14:28Start her on a cardiac monitor for now.
0:14:28 > 0:14:30- OK.- Diana.
0:14:30 > 0:14:31Dr Hanna.
0:14:31 > 0:14:33How is she?
0:14:33 > 0:14:37- Nick is looking into all sorts of new treatments.- Is he?
0:14:37 > 0:14:39He's found a drug that he thinks will help.
0:14:39 > 0:14:43Something to do with kick-starting her nervous system.
0:14:43 > 0:14:45And does her consultant agree with this?
0:14:45 > 0:14:48He doesn't know the situation as well as Nick does.
0:14:48 > 0:14:50Nick's a brilliant doctor.
0:14:50 > 0:14:52But you need to listen to her consultant as well.
0:14:52 > 0:14:54Make sure you have all the information you need.
0:14:54 > 0:14:56It's very different for you.
0:14:56 > 0:14:58You understand everything that's going on,
0:14:58 > 0:15:01the drugs, the treatments and everything else.
0:15:01 > 0:15:02I have to trust Nick.
0:15:05 > 0:15:06I brought him a sandwich.
0:15:06 > 0:15:08I don't want him to get low blood sugar.
0:15:08 > 0:15:10I'll take it to him. Take a seat.
0:15:10 > 0:15:11Thank you.
0:15:24 > 0:15:27So what are these new treatments you're looking into?
0:15:29 > 0:15:30Diana brought you this.
0:15:34 > 0:15:37Nick, we all know how hard you've tried.
0:15:37 > 0:15:40I know how tired you must be.
0:15:40 > 0:15:43But I think you should just go and be with Yvonne now...
0:15:43 > 0:15:44Don't patronise me, Zoe, please.
0:15:44 > 0:15:48I appreciate your support and I appreciate the way
0:15:48 > 0:15:51you've stepped in to look after the department in my absence.
0:15:51 > 0:15:53But I'm still your senior clinician.
0:15:54 > 0:15:56Please don't forget that.
0:16:02 > 0:16:03How are we doing?
0:16:03 > 0:16:06Blood results have just come through.
0:16:06 > 0:16:10Right. Hi, Lauren. Potassium level's very low, it's 1.8.
0:16:10 > 0:16:12Better get a blood gas.
0:16:12 > 0:16:14Get back to the lab and check her calcium and magnesium.
0:16:14 > 0:16:16- Can you do that?- Yeah.
0:16:16 > 0:16:19Lauren, is there a GP that we can contact for you?
0:16:19 > 0:16:22I don't want my doctors involved.
0:16:22 > 0:16:26OK, let's replace her potassium with a normal saline drip
0:16:26 > 0:16:29of 40 millimoles of KCl over four to six hours.
0:16:29 > 0:16:32- What's that for?- Well, for some reason, your potassium level's low.
0:16:32 > 0:16:35That's probably causing your symptoms, so we're going to put you on a drip.
0:16:35 > 0:16:38What does that mean exactly?
0:16:38 > 0:16:42When your potassium drops too low, you'll become weaker.
0:16:42 > 0:16:43And?
0:16:43 > 0:16:46You could end up with major breathing problems.
0:16:46 > 0:16:48Your heart rhythm could be affected.
0:16:48 > 0:16:49And if it's left untreated,
0:16:49 > 0:16:53it becomes so erratic that you can have a cardiac arrest.
0:16:53 > 0:16:54Then don't treat me.
0:16:54 > 0:16:58- What?- I've had enough of fighting. Look at me.
0:16:59 > 0:17:00I'm done.
0:17:05 > 0:17:07She's here. Lauren's mother has arrived.
0:17:09 > 0:17:12- Hello.- Is she all right?- Yes.
0:17:12 > 0:17:16She has low blood pressure, but we should be able to stabilise it.
0:17:16 > 0:17:18Thank God. Her father's on his way in.
0:17:18 > 0:17:21Well, I'm sorry, but Lauren has asked for some time on her own.
0:17:21 > 0:17:23I'm sure she only needs a few minutes. Nick, would you mind?
0:17:23 > 0:17:26Yes, let me take you through to the relatives' room.
0:17:26 > 0:17:30I'll get someone to make you a cup of tea.
0:17:30 > 0:17:33SHE MOUTHS
0:17:41 > 0:17:45- Here you go. - Thanks. That's very kind.- Thanks.
0:17:48 > 0:17:51They say hot sweet tea for shock, don't they?
0:17:51 > 0:17:54Please try not to worry yourself, She's in very good hands.
0:17:54 > 0:17:57I just wish she wouldn't shut me out like this.
0:17:57 > 0:17:59Well, just give her a bit of time.
0:17:59 > 0:18:03People with terminal diagnosis often deal with it in ways
0:18:03 > 0:18:04that don't always make sense to us.
0:18:04 > 0:18:08Lauren doesn't have a terminal illness.
0:18:08 > 0:18:09How's she doing?
0:18:09 > 0:18:12She's hypokalemic and refusing potassium.
0:18:12 > 0:18:14OK, Lauren. Enough messing about.
0:18:14 > 0:18:17The team need to restore your potassium levels to prevent
0:18:17 > 0:18:19an abnormal cardiac rhythm.
0:18:19 > 0:18:20No.
0:18:20 > 0:18:23You do realise there isn't a hospice in the country
0:18:23 > 0:18:25that would admit you as an in-patient, don't you?
0:18:25 > 0:18:27Why not?
0:18:27 > 0:18:30There are people who are really dying in this hospital.
0:18:30 > 0:18:31It's an affront to them.
0:18:31 > 0:18:33Not to mention the dozens of professionals who have
0:18:33 > 0:18:35already had to save your life.
0:18:35 > 0:18:36Nick, what's going on?
0:18:38 > 0:18:40I'm giving Lauren a medical reality check.
0:18:40 > 0:18:44I've fought this illness for the majority of my life.
0:18:44 > 0:18:48My body's giving up. I can't fight it any more.
0:18:48 > 0:18:50Well?
0:18:52 > 0:18:56She doesn't have cancer, Zoe. She's anorexic.
0:19:04 > 0:19:07She's only 29, and she's had 16 acute admissions,
0:19:07 > 0:19:11four prolonged stays in eating disorder units, and stints on ITU.
0:19:11 > 0:19:13She's spent longer in here than out.
0:19:13 > 0:19:16Including one stint of six months under a section three.
0:19:16 > 0:19:19And taking into account her anorexia, there is a risk
0:19:19 > 0:19:21she'll develop ventricular tachyarrhythmia.
0:19:21 > 0:19:25Plus the calcium and magnesium deficiency. We've got to be careful with the IV fluids.
0:19:25 > 0:19:27Too much, and we'll put her at risk of heart failure.
0:19:27 > 0:19:30OK. I'm going to contact psych for when she really digs her heels in.
0:19:30 > 0:19:32- Sectioning? - I hope it won't come to that.
0:19:32 > 0:19:34Who's the best person to speak to up there?
0:19:34 > 0:19:37Nick, she's an adult with capacity and you know it.
0:19:37 > 0:19:40As long as we're satisfied that she understands and retains
0:19:40 > 0:19:44the information that we are giving her, we can't force anything on her.
0:19:44 > 0:19:47You could try putting it before a judge.
0:19:47 > 0:19:49Charlie, we've got hours, not days.
0:19:50 > 0:19:53What will happen if she keeps refusing the drugs?
0:19:55 > 0:19:57There's a chance she will die.
0:19:57 > 0:19:59How big a chance?
0:19:59 > 0:20:01Sorry, can I just steal you for a moment?
0:20:01 > 0:20:04It would be really helpful if I could complete her history.
0:20:04 > 0:20:06Thanks. Yes, you don't need to worry.
0:20:06 > 0:20:09We'll sort it all out this end. Yes. It's Nurse O'Reilly.
0:20:11 > 0:20:12You're an angel.
0:20:12 > 0:20:15Easy. They love me there. What do you want it for, anyway?
0:20:15 > 0:20:16I'm about to find out.
0:20:18 > 0:20:20CT's clean as a whistle.
0:20:21 > 0:20:24That shouldn't be on. Whose is it?
0:20:24 > 0:20:26It's me. I asked Louise to get the number
0:20:26 > 0:20:28that made the hoax call this morning.
0:20:28 > 0:20:30The one that Jeff and Dixie got called to.
0:20:30 > 0:20:31- Is this true?- No.
0:20:31 > 0:20:35You know, the scan we did doesn't show anything wrong.
0:20:35 > 0:20:36- You really got those symptoms?- Yeah.
0:20:36 > 0:20:40I think you made yourself sick so that we'd think you were really ill.
0:20:40 > 0:20:43So we'd make you stay longer. Am I right?
0:20:48 > 0:20:50I've also spoken to Wayne's head teacher.
0:20:50 > 0:20:55He said Wayne's got a record of truancy and disruption. He's missed 15 school days this year.
0:20:55 > 0:20:56You don't know nothing about me.
0:20:56 > 0:20:58Wayne, I'm going to need to check your pockets.
0:20:58 > 0:21:02- Get stuffed, you nosy cow. - Wayne, why have you got these?
0:21:04 > 0:21:05Mac! Grab him, will ya?
0:21:05 > 0:21:06Hey, come here.
0:21:08 > 0:21:09Are you all right?
0:21:12 > 0:21:14It started when she was about 13.
0:21:14 > 0:21:18Was there some sort of trigger which you can remember, something that...?
0:21:18 > 0:21:20I almost wish there had been.
0:21:20 > 0:21:24It would have made it easier to understand.
0:21:24 > 0:21:26But she was such a happy little girl.
0:21:26 > 0:21:29Least, I thought she was. Ah, it's my husband.
0:21:30 > 0:21:32Where is she?
0:21:32 > 0:21:33She's in the resus room.
0:21:33 > 0:21:34Is she all right?
0:21:34 > 0:21:36- She won't let me in. - Haven't you spoken to her?
0:21:36 > 0:21:39- What have you done to yourself? - Cracked my head on the mantelpiece.
0:21:39 > 0:21:43- It's still bleeding.- For God's sake, woman.- I should take a look at that.
0:21:43 > 0:21:45Can you tell me who's in charge, please?
0:21:45 > 0:21:47I want to discuss my daughter's treatment.
0:21:49 > 0:21:53I'm sorry. He's upset.
0:21:53 > 0:21:54What's going on with that kid?
0:21:54 > 0:21:55He's been dealt with.
0:21:55 > 0:21:58Really? I just saw him leaving.
0:21:58 > 0:22:00- It's under control.- What happened?
0:22:00 > 0:22:03He lied about his symptoms, stole a lot of syringes
0:22:03 > 0:22:05and, well, you know, I sorted it.
0:22:05 > 0:22:07Sorry, Doc, he legged it before I could stop him.
0:22:07 > 0:22:09But he dropped this, though.
0:22:09 > 0:22:12Out of date prescription in the name of Karen Gwyn?
0:22:12 > 0:22:14Thank you.
0:22:14 > 0:22:16Well, what exactly is the treatment plan?
0:22:16 > 0:22:19We have to respect her patient confidentiality.
0:22:19 > 0:22:21Come on. I'm her father.
0:22:21 > 0:22:23- I know, and I'm sorry. - Look, you know what she's like.
0:22:23 > 0:22:25She just needs a bit of time.
0:22:25 > 0:22:27I do know what she's like.
0:22:27 > 0:22:28She can't be trusted on her own.
0:22:28 > 0:22:31Lauren has made it very clear that she doesn't want any visitors.
0:22:31 > 0:22:33If you want to wait in the relatives' area...
0:22:33 > 0:22:37Why don't I take this gentleman into a cubicle and sort that out?
0:22:39 > 0:22:41Could I speak to Dr Singh, please?
0:22:41 > 0:22:44Yeah I'm trying to track down a patient
0:22:44 > 0:22:46under the name of Karen Gwyn.
0:22:46 > 0:22:49Not easy, the first time you get a mouthful like that.
0:22:49 > 0:22:53It's fine. Really. All in a day's work here.
0:22:55 > 0:22:57It's all right to be upset, you know.
0:22:57 > 0:23:01I'm not upset. I'm just glad we got it sorted.
0:23:01 > 0:23:03Make sure that's folded over.
0:23:04 > 0:23:06Do you have an address for Wayne?
0:23:06 > 0:23:08- Why's that?- Need to send someone round there.
0:23:08 > 0:23:12- I think there might be a problem with the mother. - What sort of problem?
0:23:12 > 0:23:13She was on peritoneal dialysis.
0:23:13 > 0:23:15But she hasn't seen her GP in six weeks.
0:23:18 > 0:23:19Very good.
0:23:26 > 0:23:29- Mum?- You should be in school.
0:23:29 > 0:23:31Just popped home for a minute.
0:23:32 > 0:23:35What have you done to your face?
0:23:35 > 0:23:36I fell over.
0:23:39 > 0:23:40What's all this?
0:23:41 > 0:23:43- Answer me, then! - You need clean stuff.
0:23:45 > 0:23:49I know it was you that called the ambulance this morning.
0:23:49 > 0:23:52You're ill, Mum. You need to go to the doctor's.
0:23:52 > 0:23:53I'm a bit better today.
0:23:56 > 0:23:58Listen to me, Wayne.
0:23:58 > 0:24:00I know we don't always have it easy.
0:24:01 > 0:24:04I wish I could do the things that other mums do.
0:24:04 > 0:24:06Take you to the park and stuff.
0:24:06 > 0:24:08It's fine, I like going on my own.
0:24:09 > 0:24:12They might not see it like that. They might think...
0:24:12 > 0:24:14I can't be your mum any more.
0:24:14 > 0:24:19We've got to learn to manage on our own. Leave it.
0:24:21 > 0:24:22Mum.
0:24:27 > 0:24:34Show me. Multiple ectopics. OK, Lauren, you've made your point.
0:24:34 > 0:24:37We are going to treat you. Start the potassium, please, Linda.
0:24:37 > 0:24:40- Just a slow infusion over eight to 12 hours.- No.
0:24:40 > 0:24:44Lauren, if we don't treat you soon, two things are going to happen -
0:24:44 > 0:24:47respiratory failure or cardiac arrest, which could prove fatal.
0:24:47 > 0:24:48Do you understand that?
0:24:48 > 0:24:53Yes. I do. I want this all recorded in my notes.
0:24:53 > 0:24:54Is there something I could sign?
0:24:54 > 0:24:59Yes, if you really want to, but understand that if you arrest,
0:24:59 > 0:25:01- we won't be able to resuscitate you. - I know.
0:25:01 > 0:25:02Lauren, listen to me.
0:25:02 > 0:25:05I've seen a lot of people die in this room,
0:25:05 > 0:25:09A lot of parents having to watch their children dying.
0:25:10 > 0:25:13And it's always ugly. Very ugly.
0:25:15 > 0:25:16If you choose to do that -
0:25:16 > 0:25:19if you actually CHOOSE to put somebody through that -
0:25:19 > 0:25:22that is an act of immense selfishness.
0:25:22 > 0:25:25Do you think I chose to end up like this?
0:25:25 > 0:25:29Well, let's ask somebody with inoperable cancer.
0:25:29 > 0:25:31I think you know what the answer would be.
0:25:31 > 0:25:33Lauren, why don't we stabilise you?
0:25:33 > 0:25:35And then we can discuss other treatments.
0:25:35 > 0:25:39Do you know what the "other treatments" are?
0:25:39 > 0:25:41I was sectioned last year.
0:25:41 > 0:25:45I was sedated and fed through a tube in my nose.
0:25:46 > 0:25:49I spent three months barely conscious,
0:25:49 > 0:25:51staring up at a hospital ceiling.
0:25:53 > 0:25:55When I woke up, I was two stone heavier
0:25:55 > 0:25:57and I thought I was going to go mad.
0:25:59 > 0:26:02I lost all the weight within a few months.
0:26:04 > 0:26:08I cannot go through that again.
0:26:08 > 0:26:12I cannot live my life like this. THIS is not life.
0:26:16 > 0:26:18Lauren. Lauren, please, look at me.
0:26:18 > 0:26:20Listen, please.
0:26:22 > 0:26:26You must understand that the way you see your body is irrational.
0:26:26 > 0:26:32I-It's just wrong and we can help you see things differently.
0:26:32 > 0:26:36We all have our private delusions. You should know that.
0:26:37 > 0:26:39That's not the same thing.
0:26:39 > 0:26:41It's exactly the same thing.
0:26:42 > 0:26:47I do realise that other people don't see themselves in this way.
0:26:47 > 0:26:50If there was a pill to make me normal, I'd take two.
0:26:51 > 0:26:56But there isn't. So don't tell me I have a choice.
0:26:56 > 0:26:59- MONITOR BEEPS - BP's dropping.
0:27:01 > 0:27:03I don't feel much pulse.
0:27:05 > 0:27:10- OK, pulse back.- Non-sustained VT. She's back in sinus now.
0:27:10 > 0:27:13Lauren, please. This will only get worse.
0:27:17 > 0:27:21This is pretty deep. Must have been a nasty whack.
0:27:21 > 0:27:22Will it need stitches?
0:27:22 > 0:27:26It's a bit...close to the eye for comfort.
0:27:26 > 0:27:29I think I need to get plastics to have a look.
0:27:29 > 0:27:31How long will that take?
0:27:31 > 0:27:34Well, it could be a while. We'll need to refer you.
0:27:34 > 0:27:35No, I need to stay with Lauren.
0:27:35 > 0:27:37I can stay with her.
0:27:37 > 0:27:40You're too soft with her. Always have been.
0:27:40 > 0:27:41If you'd been stronger when she was a child,
0:27:41 > 0:27:44none of this would have happened.
0:27:44 > 0:27:48Anorexia doesn't always have a cause as such. It's a mental illness.
0:27:48 > 0:27:51Everyone keeps saying. But all she needs to do is eat.
0:27:53 > 0:27:56Right, I'll put in a call to plastics.
0:27:56 > 0:27:59You do understand what's happening to you, don't you, Lauren?
0:27:59 > 0:28:02You may lose consciousness soon, you can still change your mind.
0:28:02 > 0:28:04I won't change my mind.
0:28:04 > 0:28:07- OK, let's make her comfortable, please.- Zoe, please, wait.
0:28:07 > 0:28:09We have to respect her wishes. She's made it very clear.
0:28:09 > 0:28:13- What's going on? - I'm afraid Lauren has refused any further active intervention.
0:28:13 > 0:28:15- What?!- I'm sorry, Dad.
0:28:15 > 0:28:17- Surely she can't be allowed to do this?- I'm afraid she can.
0:28:17 > 0:28:20Then she should be sectioned. Treated for her own good.
0:28:20 > 0:28:25I told you this morning, Dad. I can't do this any more.
0:28:25 > 0:28:26I want you to leave now.
0:28:26 > 0:28:28Please...she's being ridiculous.
0:28:28 > 0:28:32No, no, she's an adult and capable of making her own decisions.
0:28:32 > 0:28:35She's decided she doesn't want to see you and that she wants you to leave.
0:28:35 > 0:28:37Please, just treat her.
0:28:37 > 0:28:39Sorry, you'll have to leave.
0:28:42 > 0:28:44KNOCK ON DOOR
0:28:47 > 0:28:49Wayne? HE KNOCKS AGAIN
0:28:49 > 0:28:52It's Jeff from the ambulance. Can you open the door?
0:28:52 > 0:28:54Keep quiet. They'll get bored and go away.
0:28:54 > 0:28:55You're not in any trouble.
0:28:57 > 0:29:00Come on, son, I know you're in there. We just want to help.
0:29:00 > 0:29:01We need to have a word with your mum.
0:29:01 > 0:29:04- Get rid of them. - She's not in! Go away!
0:29:08 > 0:29:09Right the thing is, mate,
0:29:09 > 0:29:12we know she's missed some of her appointments at the clinic.
0:29:12 > 0:29:14If you let us in, we can help you - we can help your mum, too.
0:29:14 > 0:29:17I said get rid of them. Now!
0:29:17 > 0:29:18You can't come in.
0:29:18 > 0:29:21Look, I know your mum's on dialysis.
0:29:21 > 0:29:24Well, someone must have been helping her with it every day.
0:29:24 > 0:29:26Yeah, well, I like doing it.
0:29:26 > 0:29:28That must be pretty tough.
0:29:28 > 0:29:32I reckon if your mum's not had her dialysis checked for a bit,
0:29:32 > 0:29:35she's going to be a bit poorly by now. Am I right?
0:29:35 > 0:29:38You're ill, Mum. They want to help you.
0:29:44 > 0:29:46No, Wayne. Don't you dare.
0:29:46 > 0:29:48Don't you dare open that door!
0:29:50 > 0:29:51Good lad.
0:29:52 > 0:29:53JEFF: Well done, young man.
0:29:55 > 0:29:58OK, Karen. My name's Dixie, I'm a paramedic.
0:29:58 > 0:30:00I'm just going to take a little look at you, darling.
0:30:00 > 0:30:02I'm not going to the hospital.
0:30:02 > 0:30:05I think you've got an infection, you need to get it treated.
0:30:05 > 0:30:07- You told them. - They just want to help you.
0:30:07 > 0:30:08You lied!
0:30:08 > 0:30:09DOOR BUZZES
0:30:13 > 0:30:14How's she doing?
0:30:14 > 0:30:16Not very good, I'm afraid. BP's down to 70.
0:30:16 > 0:30:18Have you increased the pressors?
0:30:18 > 0:30:20She's been on double-strength for the last hour.
0:30:20 > 0:30:22Right, and what about the activated protein C?
0:30:22 > 0:30:25We did try it. We both know it's not helping.
0:30:25 > 0:30:29There's been no improvement. She's simply too ill.
0:30:29 > 0:30:31I don't know how it works up here, Dr Earl,
0:30:31 > 0:30:34but in the ED, we don't deny patients treatment because they're too ill.
0:30:34 > 0:30:37I gave it against my clinical judgement. On your insistence.
0:30:37 > 0:30:40I've been treating Yvonne since she first became injured.
0:30:40 > 0:30:42We almost lost her before we even got her here.
0:30:42 > 0:30:44I had to open her up in the back of an ambulance
0:30:44 > 0:30:46and do an emergency thoracotomy I massaged her heart,
0:30:46 > 0:30:49I got it going again, when people like you would have...given up.
0:30:51 > 0:30:52Mrs Hart?
0:30:54 > 0:30:56Nick knows better than any of us what's best for her.
0:30:56 > 0:30:59- Increase the adrenaline. - OK, please calm down.- Do it now.
0:30:59 > 0:31:01- Mr Jordan?- Yes?
0:31:01 > 0:31:03Dr Hanna said I'd find you here.
0:31:06 > 0:31:09I understand your wife is very sick.
0:31:09 > 0:31:12I wonder if we might help each other.
0:31:12 > 0:31:14I saw you in there with that doctor.
0:31:14 > 0:31:16We're the same, you and I.
0:31:16 > 0:31:19Men like us don't let things beat us. We fix them.
0:31:20 > 0:31:23I'm a wealthy man, Mr Jordan.
0:31:23 > 0:31:26The NHS is no good to you now. She needs the best.
0:31:27 > 0:31:30We can get her transferred -
0:31:30 > 0:31:34private hospitals, clinical trials, the US, whatever it takes.
0:31:38 > 0:31:42Lauren needs help. She doesn't know what she's doing.
0:31:43 > 0:31:45So...
0:31:45 > 0:31:50you want me to sedate your daughter and treat her against her will?
0:31:51 > 0:31:53No-one need know.
0:31:57 > 0:31:58I'd take care of everything.
0:32:04 > 0:32:07That was your tenth birthday party.
0:32:09 > 0:32:10Do you remember?
0:32:11 > 0:32:13Mum...
0:32:13 > 0:32:16Look at you. Such a little tomboy.
0:32:16 > 0:32:18Mum...
0:32:18 > 0:32:20I'm sorry.
0:32:20 > 0:32:22I just can't help remembering.
0:32:24 > 0:32:27You deserved a better daughter.
0:32:27 > 0:32:28I just want this one back.
0:32:35 > 0:32:37This is Karen Gwyn, 42.
0:32:37 > 0:32:40She's got a known history of diabetes, on CAPD.
0:32:40 > 0:32:44Abdomen's tender. The kit she was using was in a bit of a state.
0:32:44 > 0:32:49Pulse is 120, BP's 110 over 65. She's confused and combative.
0:32:49 > 0:32:51Great, OK. Let's take her through to HDC, please.
0:32:51 > 0:32:53I want to go home, Wayne, take me home...
0:32:53 > 0:32:56Listen, Karen, just relax, you're here now, let us help you, all right?
0:32:56 > 0:32:59We may need to look into some emergency foster care.
0:33:04 > 0:33:06HEART MONITOR BEEPS
0:33:14 > 0:33:16Is everything OK?
0:33:17 > 0:33:18Nick?
0:33:23 > 0:33:26What did that man want?
0:33:26 > 0:33:28He wanted me to help his daughter.
0:33:28 > 0:33:29Are you going to?
0:33:29 > 0:33:31No, not in the way he wanted.
0:33:33 > 0:33:35He's just desperate, you know?
0:33:41 > 0:33:43The kind of desperation that makes you try anything,
0:33:43 > 0:33:47if it could just buy you a bit more time.
0:33:47 > 0:33:49- No, Nick.- I'm sorry, Diana.
0:33:49 > 0:33:53You don't get to make this decision. I am her mother.
0:33:53 > 0:33:55You don't get to make this decision on your own.
0:33:55 > 0:33:58Diana. The sepsis has spread through her body.
0:33:58 > 0:34:01Her systemic reaction to the infection
0:34:01 > 0:34:04means her organs are not getting enough oxygen. They're just...
0:34:04 > 0:34:06shutting down.
0:34:06 > 0:34:10Her lungs, her-her liver, her kidneys.
0:34:10 > 0:34:12Her heart. They're...
0:34:12 > 0:34:13They're all gone.
0:34:19 > 0:34:21You let me believe you could save her!
0:34:21 > 0:34:23You just couldn't let her go.
0:34:23 > 0:34:27I had to try everything I could.
0:34:27 > 0:34:28When everyone else was giving up,
0:34:28 > 0:34:32I thought they were just being weak, but they were being realistic.
0:34:32 > 0:34:35You...promised...me!
0:34:45 > 0:34:47Diffuse abdominal tenderness.
0:34:47 > 0:34:49Looks like a spontaneous bacterial peritonitis,
0:34:49 > 0:34:52could be caused by the infected PD catheter.
0:34:52 > 0:34:54OK, let's get her some fluid in,
0:34:54 > 0:34:57and I want FBC, U&E, CRP, cultures and a venous blood gas.
0:34:57 > 0:35:00No...I don't want to stay here. Get off me.
0:35:00 > 0:35:02I know. Try and stay calm for us, Karen.
0:35:02 > 0:35:05- I'm also going to need an abdo scan. - I want to go home.
0:35:05 > 0:35:08I know. Just breathe nice and deeply for me.
0:35:08 > 0:35:10KAREN BREATHES DEEPLY
0:35:13 > 0:35:14KAREN WHIMPERS
0:35:15 > 0:35:19HEART MONITORS BEEP
0:35:22 > 0:35:24HE SIGHS
0:35:30 > 0:35:33HE WHISPERS
0:35:37 > 0:35:39OK, let's go get you a drink.
0:35:39 > 0:35:41No, I'm staying here.
0:35:41 > 0:35:43You can't stay here, Wayne.
0:35:43 > 0:35:46I said I'm staying here!
0:35:48 > 0:35:51Please, I just want to go home.
0:35:51 > 0:35:54Karen, just try and relax, right? We're going to make you feel better.
0:35:54 > 0:35:56She's going to need a gram and half of Cefuroxime
0:35:56 > 0:35:58and 500 of Metronidazole.
0:35:58 > 0:36:00Can we set up for an ascitic tap as well, please?
0:36:00 > 0:36:02I'm really sorry, Wayne. We're just trying to help.
0:36:02 > 0:36:03We're on your side, you know.
0:36:03 > 0:36:06Yeah, right(!) You just like telling people what to do!
0:36:07 > 0:36:10Um...what's going on?
0:36:10 > 0:36:11I want to stay with my mum.
0:36:11 > 0:36:12OK, why don't you give me that?
0:36:12 > 0:36:15No. I'm not going into care!
0:36:15 > 0:36:19Look, I know that must be really scary
0:36:19 > 0:36:22and it's got to be horrible seeing your mum like this. But...
0:36:22 > 0:36:25When did she stop wanting to go out?
0:36:25 > 0:36:26Ages ago.
0:36:27 > 0:36:30Right, I think she's got something called agoraphobia
0:36:30 > 0:36:33- and that's something that means she...- I know what it means.
0:36:33 > 0:36:36Of course you do. That's because you know a lot of things, don't you?
0:36:36 > 0:36:40And, basically, you've been doing our job, but all on your own.
0:36:40 > 0:36:42You must be knackered.
0:36:42 > 0:36:45- Is she going to die?- No.
0:36:45 > 0:36:47And that's because you've been too good a nurse.
0:36:49 > 0:36:51Why don't you let me take that?
0:36:57 > 0:36:58Good lad.
0:37:00 > 0:37:02Why don't you go and have a break?
0:37:08 > 0:37:12Right, it'll just take a minute for that...
0:37:12 > 0:37:14anaesthetic to work its way through.
0:37:14 > 0:37:17And then I'll need you to be very, very still, all right?
0:37:17 > 0:37:18OK.
0:37:19 > 0:37:23I don't know why she doesn't let us help her.
0:37:23 > 0:37:24Well...
0:37:24 > 0:37:29just imagine you're on a ship and it gets wrecked,
0:37:29 > 0:37:30and you end up in the water.
0:37:30 > 0:37:34And it's cold and it's dark and it's stormy...
0:37:34 > 0:37:36and you've got one lifebelt.
0:37:37 > 0:37:40Then you hear someone shouting, "Just swim towards me...
0:37:42 > 0:37:44"..but you got to let go of the lifebelt."
0:37:47 > 0:37:50How easy would you find it to let go?
0:37:51 > 0:37:52You see...
0:37:54 > 0:37:57..the anorexia is her lifebelt.
0:37:57 > 0:37:58She can't let go.
0:37:58 > 0:38:01She can't trust anyone who tells her to.
0:38:07 > 0:38:09It really isn't your fault.
0:38:10 > 0:38:12- How's Lauren?- She's the same.
0:38:18 > 0:38:20Right, young lady. This is what's going to happen.
0:38:22 > 0:38:27We're going to treat you and you're going to recover.
0:38:27 > 0:38:30You're young, you've got your whole life ahead of you.
0:38:30 > 0:38:32I understand that you need to believe that.
0:38:34 > 0:38:37But the reality is not everyone gets better.
0:38:37 > 0:38:38I know.
0:38:40 > 0:38:44I've just had to stop the medication of my partner.
0:38:44 > 0:38:45HE SNIFFS
0:38:47 > 0:38:50She died...ten minutes ago.
0:38:53 > 0:38:57Hardest thing I've ever done. But it was real. It had to be faced.
0:39:00 > 0:39:03And the reality for you is that you're alive.
0:39:03 > 0:39:04Your body WANTS to live.
0:39:08 > 0:39:12You're going to let us treat you, and you are going to live.
0:39:15 > 0:39:16I don't care how hard it is.
0:39:18 > 0:39:20You will not delude yourself any more.
0:39:28 > 0:39:30Can you get Zoe and Charlie, please?
0:39:33 > 0:39:34Have we got consent?
0:39:34 > 0:39:35Yes, Zoe.
0:39:36 > 0:39:37We have consent.
0:39:39 > 0:39:41Charlie, you're needed in resus.
0:39:41 > 0:39:44- Right.- What's going on?
0:39:44 > 0:39:46She's back in VT, and this time it's sustained.
0:39:48 > 0:39:51Still in VT. Linda, stand by with atropine, please
0:39:51 > 0:39:54- 150, Zoe.- On it.
0:39:55 > 0:39:56Everyone clear?
0:39:56 > 0:39:59- Shocking. - DEFIBRILLATOR DISCHARGES
0:39:59 > 0:40:02Mm...she's out of VT but she's still bradycardic.
0:40:02 > 0:40:04OK. Try 600 micrograms, Linda.
0:40:04 > 0:40:07We'll need a mobile intensifier down from the cath lab, please,
0:40:07 > 0:40:09and a radiographer. She'll need a temporary pacing wire.
0:40:09 > 0:40:12Got an output but it's not good, still no ABP.
0:40:12 > 0:40:14She's not responding to the atropine.
0:40:14 > 0:40:16No, OK. Let's use an external pacer, please.
0:40:16 > 0:40:19That should stabilise her until I can get the wire in.
0:40:19 > 0:40:21Linda, temporary pacing pack, 6-French femoral lead.
0:40:21 > 0:40:24- Charlie, will you take over here, please?- Yeah.
0:40:24 > 0:40:25Let's get her intubated.
0:40:25 > 0:40:27Are you sure this is the right environment?
0:40:27 > 0:40:29No, no. No time. We do it here and now. I'll get scrubbed up.
0:40:29 > 0:40:32OK, let's get the RSI sorted. I'll intubate.
0:40:33 > 0:40:36Something's going on in resus. Come and watch?
0:40:36 > 0:40:38I have notes that need writing up.
0:40:38 > 0:40:39Come on, we might learn something.
0:40:39 > 0:40:41Thanks but I'm kind of busy.
0:40:48 > 0:40:50OK. Screen, Zoe.
0:40:51 > 0:40:54Follow the lead up, please. Slowly. Nice and slowly.
0:40:58 > 0:41:00Slowly.
0:41:00 > 0:41:01Nice and steady.
0:41:03 > 0:41:06OK, stop. That's it.
0:41:06 > 0:41:09Right, we're in the right atrium.
0:41:09 > 0:41:12Move the intensifier to the left, please.
0:41:18 > 0:41:20Multiple ectopics.
0:41:20 > 0:41:22And that's OK.
0:41:22 > 0:41:23We're in the RV.
0:41:25 > 0:41:27OK. Switch off, please.
0:41:27 > 0:41:29Let's connect up, Charlie.
0:41:31 > 0:41:35Now we are going to pace at 60... at four volts.
0:41:35 > 0:41:37- Pacing spikes. - PACEMAKER BEEPS
0:41:37 > 0:41:39- I've got a good pulse.- Good.
0:41:41 > 0:41:44Good. Let's check the threshold. Leave it at 60.
0:41:44 > 0:41:47Bring the voltage down to three volts.
0:41:47 > 0:41:48Three volts.
0:41:48 > 0:41:50Pacing.
0:41:50 > 0:41:53- Two volts.- Pacing.
0:41:53 > 0:41:55- One volt.- Pacing.
0:41:55 > 0:41:56PACEMAKER BEEPS
0:41:56 > 0:42:01Good. OK, now bring it down 0.1 volts at a time until I tell you to stop.
0:42:01 > 0:42:02Point nine.
0:42:02 > 0:42:05Pacing.
0:42:05 > 0:42:07- Point eight.- Pacing.
0:42:07 > 0:42:08Point seven.
0:42:08 > 0:42:09Pacing.
0:42:09 > 0:42:11- Point six.- No, no, we've lost it.
0:42:11 > 0:42:13OK, take it back up to four.
0:42:13 > 0:42:16The threshold is 0.7, Charlie.
0:42:17 > 0:42:20Good. PACEMAKER BEEPS
0:42:20 > 0:42:22Good.
0:42:22 > 0:42:25OK. Let's pace her at VVI 70 at four volts, please.
0:42:27 > 0:42:31Thank you, everyone. Can someone get onto cardiology, please?
0:42:31 > 0:42:33She'll need to go through to CCU.
0:42:33 > 0:42:35Linda, she'll need potassium...
0:42:35 > 0:42:39and probably some magnesium as well. Thanks, everyone.
0:43:18 > 0:43:19HE SNIFFS
0:43:21 > 0:43:23HE SOBS
0:43:41 > 0:43:43Sorry. I'm just taking a minute.
0:43:43 > 0:43:45It's a long minute.
0:43:45 > 0:43:48I thought you'd be in there, watching all the action.
0:43:51 > 0:43:54I just don't know if I'll ever be able to do it myself.
0:43:54 > 0:43:57Of course you will. I mean, you told me yourself -
0:43:57 > 0:43:59- you're going to be one of the best, ain't you?- Yeah.
0:44:01 > 0:44:02I always knew I would be.
0:44:04 > 0:44:06Just like I knew I'd marry Craig
0:44:06 > 0:44:08and have three kids by the time I'm 30,
0:44:08 > 0:44:11and live in a big house in Wicklow.
0:44:12 > 0:44:14Turns out I didn't know anything.
0:44:17 > 0:44:19Listen...
0:44:19 > 0:44:21I'd be more worried if you thought you did.
0:44:24 > 0:44:25This job's hard.
0:44:27 > 0:44:28There's why they pay us so much money!
0:44:28 > 0:44:29HE CHUCKLES
0:44:31 > 0:44:33You're a good girl.
0:44:34 > 0:44:36I'm really pleased you're on my team.
0:44:38 > 0:44:40Now...
0:44:41 > 0:44:44..are you going to come and talk to Karen?
0:44:48 > 0:44:50Hi.
0:44:50 > 0:44:52Is Wayne OK?
0:44:52 > 0:44:54The social worker's coming now.
0:44:55 > 0:44:57Is he going to be taken into care?
0:45:02 > 0:45:06He might be. Temporarily, at least. But nobody wants that.
0:45:06 > 0:45:08They want to help keep him with you.
0:45:08 > 0:45:10They say that but they don't, not really.
0:45:10 > 0:45:12They do, Karen.
0:45:12 > 0:45:15But you have to help yourself.
0:45:15 > 0:45:17We'll sort out all the referrals for you -
0:45:17 > 0:45:21for mental health and for the practical stuff, too.
0:45:21 > 0:45:22This isn't going to go away by itself.
0:45:22 > 0:45:26And it's certainly not going to go away if you close the curtains on us.
0:45:26 > 0:45:29I wanted to be a good mum.
0:45:29 > 0:45:31There's still time.
0:45:31 > 0:45:35But you can't do it by yourself. And...
0:45:35 > 0:45:36neither can Wayne.
0:45:38 > 0:45:40You need to let him be a little boy again.
0:45:42 > 0:45:44WAYNE LAUGHS
0:45:46 > 0:45:49What was that thing they did with the wire today?
0:45:49 > 0:45:51Transvenous pacing.
0:45:51 > 0:45:54I don't know how you remember it all when the pressure's on like that.
0:45:54 > 0:45:56Well, I have been doing it since before you were born.
0:45:56 > 0:45:58Maybe it's something we can try tomorrow?
0:45:58 > 0:46:01I think you've got a few more basics to cover first.
0:46:01 > 0:46:03See ya.
0:46:06 > 0:46:07You coming for a drink? I owe you one.
0:46:07 > 0:46:09I can't. I've got to get back for the kids.
0:46:09 > 0:46:12- Maybe another time, then? - I'm going to hold you to that.
0:46:15 > 0:46:18Be careful. He's your boss.
0:46:18 > 0:46:19And he's married.
0:46:44 > 0:46:46It's funny. She looks so young.
0:46:47 > 0:46:49Like when she was a little girl.
0:46:54 > 0:46:56What was she like when she was a child?
0:46:58 > 0:46:59She never cried.
0:47:02 > 0:47:04Not even when she was little.
0:47:06 > 0:47:07She was never scared.
0:47:16 > 0:47:18Tell me something else about her.
0:47:35 > 0:47:38Subtitles by Red Bee Media Ltd