Unsilenced Casualty

Have a fantastic holiday.

I've never even been on a plane before.

I know about cutting.

Is that why you don't want to go on holiday?

Are you worried about being circumcised?

It's meant.

-FGM.

-You think she is at risk?

I asked her outright.

LOUD CHATTERING, MUSIC

Friday night special. The patient's Tamasha Kamil.

She was so desperate not to go on holiday tonight

she had a panic attack and tried to re-break her wrist.

That's her family over there.

Do we know why she didn't want to go?

Tess thinks they were going to send her for an illegal operation.

So you kept her in overnight to miss the flight?

I wasn't satisfied she was fit to fly.

It would have been negligent to let her go.

We can't police patients' lives like that.

But who is going to cover the costs of these? They're non-refundable!

That's not our responsibility.

This is incompetence. She could have been seen in half the time!

Can I help?

-Mum's upset about the tickets.

-Can I go and see Tam again?

SHE GROANS

What's the matter?

Your daughter has a urine infection. We've put her on antibiotics.

Over here. Is the baby OK?

Baby's fine. But she needs some rest.

PHONE RINGS

Sit down. No more worrying. Look after her. Look after Tamasha.

This is good news!

GLASS SHATTERS

Right, girls! Out! Now!

Thank you, ladies, this is a hospital, not a discotheque!

Friday evening rush hour.

Going to be a bit of a bit of a wait, I'm afraid.

Resp rate is good. His O2 SATS are good.

Your colour's good, think you are going to be fine, mate.

See, I'm OK. Go.

It's my birthday today. I'm late for my other half.

Yeah? My birthday, too. She going to throw you a party?

Dinner in, actually. Me and her.

New bird. Likes to keep him to herself.

Sounds like she knows what she wants! As, indeed, do I.

So, Jeffrey, can I have my present, please?

-No.

-Oh, go on.

-Fat chance.

Right, I will go and find out what's happening.

I'm in a spot of bother there, as it goes.

Organised these tickets online for a concert. Moody website.

Failed to deliver and it's sold out now.

What's the gig?

Oh, I don't know, some old German nonsense.

Lieberdust or something, she likes them. Sell out theatre, it seems.

I've still got a few connections.

Right. It's going to be another ten minutes.

OK, do you want to stay here and I'll just go and book us in?

OK. Lovely.

Mum's the word, fellas. Mum's the word.

Shouldn't be too long.

We'll move you to a cubicle as soon as we can.

We need to get these beds turned round quicker.

Yeah, I know.

Hi, Tamasha, I'm Dr Ashford. How are you doing?

Much better, thank you.

Excellent, because the film shows

your wrist fracture's in a good position. How's the headache?

It's much better, too, thank you.

Good, so all we need to look into

is what caused your breathing difficulties earlier.

Can you sit forward for me, please?

Great. OK, nice deep breath.

INHALES

I hear you missed your flight.

It's not her fault. Granny's trying to fix things anyway.

-What do you mean?

-It's a secret.

Tell her you don't mind, tell her it's off for this year.

Tell her you don't want it.

But I do want it. I want to be like you.

Safi. Quick. Come on!

Safi!

OK, back in a sec.

-Think you've made a mistake.

-I don't think so.

We're wasting time and resources.

And from what I've just heard, there's nothing...

There's a backup of ambulances. And they are moaning.

-Can you have a word?

-Sure.

-Zoe.

-She stays here for now.

So I tried that website for you. No luck, I'm afraid.

OK, I'm going to have to switch to plan B, aren't I?

You can't get us a corner of the staffroom, could you?

-Bottle of bubbly, little bit of a cake.

-Yeah. Why not?

And can we get cubicle two up to Geriatrics,

call Gynae for cubicle three and can we transfer cubicle seven to Paeds?

-Jeff, how is it going out there?

-You know, still backed up.

What have you got?

60-year-old male, collapsed at home with chest pains.

Get him into Resus.

36 Cloudsley Gardens. Like I said, it's just my granddaughter.

She's 11. I'll be with her. Thank you.

See you later.

-Yes? Yes!

-Mum!

Here's the route.

Stop worrying, Mum, he's got sat-nav!

Where are they going?

It's not the way we planned it, but at least it'll be done.

What, here?

There's no way we could afford another plane ticket.

SHE GASPS

I need to go home.

SHE MOANS

I need to lie down.

Oh, my God. Mum, you are bleeding.

Help. Help!

Mike Eaton, 60 years old, collapsed at home with chest pains.

He's had 300mg aspirin and GTN.

Pain has subsided now and his ECG is normal.

She's 32 weeks pregnant.

I'd rather not share my room with her.

She's got women's business going on. Shouldn't we give her privacy?

Chest pains, brought in by ambulance.

You need to stay in Resus, I'm afraid.

I'm feeling so much better now.

It's often like this, isn't it, Andy?

It often calms down when we get to hospital.

Maybe the stuff they give him in the ambulance sorts him out.

Look, we need to run some tests to can rule out

the possibility of cardiac trouble, OK?

She's 32 weeks. We need to do an internal examination.

-Can we put up some screens, please?

-Please. No.

She didn't want to be examined before when I saw her.

But things have changed now, Hannan.

I don't want to have my baby in hospital.

So, Hannan, we do need to examine you now.

Let's give the labour ward a heads up

and can we page the Obstetric Reg?

OK, Hannan, is there anyone we can contact for you?

My husband is abroad.

I'll try Granny.

No. Leave them. I'm OK. You're here.

Give Mum some space. Robyn, can you get Tamasha out of here?

We will let you know when she is ready.

Come on. Let's go and get you a cup of tea.

SHE MOANS

Tess. How does she present?

Can we get her notes, please? She had a UTI.

Microscopic haematuria and dysuria and was given Trimethoprim.

OK. Do we know about her antenatal care?

She wasn't in the system.

OK, Hannan.

I'm going to give you a quick internal examination just to

make sure your cervix is dilating.

The first two weren't born in the UK and the third was a home birth

delivered by a midwife from the community.

You're OK, Hannan. The doctor will be very gentle.

I can't examine her. She's closed.

Hannan, you're going to have to help me out here.

This isn't something that we deal with that often.

I'm going to need to ask you a few questions.

Sorry to interrupt, but Tamasha's going. I can't stop her.

It's really important that she stays. We are OK here.

Start on the first unit of blood, get an ultrasound sorted,

keep her on half-hourly obs, Linda, and I'll be right back.

I explained she can't just leave.

Tamasha, where are you going?

You need to be reviewed before you're discharged.

Thanks, Robyn. I'll have a word with her alone.

Why are you going? You're safe here. The flight's gone.

You don't have anything to worry about.

-I need a word.

-Not now.

-Urgently.

She's already been circumcised.

What?

It's the little sister that's at risk.

Looks like Tamasha was flying out as a chaperone.

I tried to tell you earlier.

Was it your sister who was due to have the operation?

Are you worried that someone might take her on another flight?

As long as you're a patient in this hospital,

I can help you and your sister.

In here, your wellbeing is my responsibility.

But if you leave, I can't.

How can you help?

It's against the law for a girl to leave the country, if you know it's

with the intention of having them circumcised for non-medical reasons.

We'll tell the authorities to explain this to your family.

-Change their minds.

-It wouldn't work.

Yes, it would. Because they would understand it was a criminal act.

You've made the right decision.

We'll give you something to eat. I'll be right back.

-Tamasha's agreed to talk to Social Services.

-Great.

SHE MOANS LOUDLY

Absolutely normal.

She always behaves in front of uniforms.

I just want to check you and the baby.

I want to discharge myself.

Seems you've a bit of a habit of doing that.

St James' sent over his notes.

Admitted four times in the last 12 months.

And left before the second troponin tests.

We can't give you a proper diagnosis

if you don't see the treatment through.

Really? No-one explained that, did they, Andy?

I'm feeling better,

so I thought I was doing you a favour, freeing up a bed.

Shouldn't really be on that in here, mate.

This test we've done on you, troponin,

takes two hours to come through.

Once we have the results, we need to run another similar test.

HANNAN SCREAMS

Two hours?

-We might be able to move you after the tests.

-You're a gem.

Brilliant, Jimmi, nice one.

Dad. Looks like Jimmi can sort something out.

Do us a favour, will you?

Tell that paramedic I can help him out. We need a little chat.

Right.

PHONE BEEPS

It's Fiona.

HE COUGHS

Got him wrapped round his little finger.

Seems nice enough to me.

Come on. He's a world-class manipulator, that fella!

Hannan, when I examined you, there was keloid scarring.

As if you've been circumcised and resutured. Am I correct?

Let's have a listen.

ULTRASOUND TICKS

Baby's fine.

OK, let's have a look.

I'm pretty sure you're in labour, Hannan,

but because you're closed, I can't tell how dilated you are.

Do we know what's causing the bleed?

A placental abruption, maybe, but without an exam, I can't be certain.

Can you call Obstetrics and update them?

-They should be on their way down!

-I don't understand.

The placenta's meant to be fixed but yours is breaking away.

My obstetric placement wasn't a waste of time, then?

-Breaking?

-Detaching.

It means the placenta's maybe detaching earlier than it should.

SHE MOANS

OK, let's get more pain relief and then we'll transfer you upstairs

to Gynae, where you'll get the specialist care that you need.

I want my daughter.

OK. Robyn, can you go and get Tamasha, please?

What do you mean by "closed?"

-FGM.

-What?

-Later. Get Tamasha.

Sorry.

Granny? Safi?!

-What are you doing?

-Where are they?

Thought you were all going on holiday!

-You've got to help me.

-What happened to your arm?

They're going to circumcise Safi. Here. Somewhere in Holby. Tonight.

What?

Can Tamasha Kamil come to reception, please?

What does FGM stands for?

Female Genital Mutilation. Why?

Hiya!

Before you ask, I've already ordered a cake. And balloons.

-You lifesaver.

-Jeff.

-Yeah.

Got a message from the bloke you brought in earlier

-with chest pains.

-Oh yeah?

Listen, I wouldn't trust him. He's a dodgy old tout.

-I know that.

-If it's tickets you're after, I might know someone.

I'm all right, thanks. All right.

You can't just tip out Granny's stuff like that.

Look for a doctor with a UK address.

I didn't know you were against it.

It's not something I talk about.

When you were ill that time on holiday.

Was that when you had it done?

Did it hurt?

It never stops hurting.

Dr Abasi?

-Let's go.

-Wait. How?

-Mum's car.

-She'll kill me.

Girls die from this operation! We've got to stop him.

Look, Tamasha!

Where's Tamasha?

We'll get her sent up to you.

Dr Hanna. I put out a call and I looked everywhere,

but I can't find Tamasha. She's gone.

Sara, up to bed, come on. Come on. Hi. Can I help?

-I'm looking for Dr Abasi.

-What do you want?

He treats our community privately sometimes.

You've got the wrong person.

My husband doesn't work as a doctor in this country.

-CAR LOCK BEEPS

-Is that him?

Dr Abasi?

I'm the sister of one of the girls you're operating on tonight.

Not now. Not here. Call me, eh?

What's going on?

Just a mix-up. See you later.

I don't have your number!

What's his number?

You tell me what you want from him before I give you anything.

Follow him!

Stop or I'll call the police.

Go on. You'll be doing me a favour.

Quick.

There he is! Quick, cut him off.

Can't we just call the police?

No, we can't. Go on.

Accelerate! Go on.

HORN BEEPS

HORN BEEPS

Pull over.

HORN BEEPS

Get ahead and cut him off.

I can't find fifth gear. Come on, come on.

I don't understand.

She had just agreed for me to call Social Services.

-Are you sure?

-I called them.

She didn't want what had happened to her to happen to her sister.

Did she actively engage in the conversation

or just passively agree?

When my daughter goes into nodding mode

-I know she's plotting something.

-Same.

I explained to her, as long as she was a patient at this hospital,

we could help her.

We could get the authorities involved. That it was a crime.

And who were the criminals?

Her family.

Did she agree to turn her mother and grandmother over to the authorities?

No, that is why we can't get involved.

Until SHE talks to Social Services, there's nothing anyone can do.

It's too culturally sensitive!

That is such a liberal get-out clause.

If a little, white, middle-class girl came back from her

summer holiday with her fingertip cut off,

would that be OK? We'd get involved then, wouldn't we?

There's no cultural precedent for that, it's not comparable.

-I'd call the Social. Straight up.

-I'd call it abuse.

And that is what the law calls this!

So why do we stand by and do nothing?

Because it's complex! Her mother wouldn't call it that.

She'd call it tradition.

I still think we had the chance to do something. And we missed it!

We're medics. There's only so much we can do.

This is one for the politicians.

Quicker!

HORN BEEPS

Look what you are making me do.

Accelerate, go on.

Tamasha, what's wrong with you?

TYRES SCREECH

Quicker.

CAR ACCELERATES

-Go on, go on.

-You are crazy.

-It's for Safi, go on.

Move your car.

Criminal.

No. Tamasha, what is wrong with you? Get off the steering wheel!

No! What are you doing? Get off the wheel.

Get off the wheel, Tamasha!

Watch out!

Well, Mr Eaton, in a few hours, we'll finally be able to give you

the proper diagnosis you've been waiting for.

All right, Jeff.

All right. Hey, you all right? Apparently, you got a message.

If you can get around my mate's before midnight, they're yours.

'3009. Emergency call. RTC on southbound 8378.

'Three casualties. Injuries unknown.'

That's not going to happen.

We'll pick them up for you, if you like, for a bit extra.

I'll do you a deal. 200 quid, the lot.

Daylight robbery, mate.

You try and get them for less.

You're on.

Jeffery, we got a shout, love.

OK, I'm on my way. It'll be at reception.

You hear that, son? Can you get to Jimmi?

I promised her I'd stop doing this.

She doesn't approve of me.

She just likes things legit.

HE COUGHS

She's very proper. You know, very la-di-dah.

PHONE BEEPS

It's Fiona. She's coming in.

SIRENS WAIL

-What's happened?

-He can't move!

OK. Let's have a look. Hello, darling, my name is Dixie.

Can you tell me your name?

Rashaad. He's my brother.

OK, can you remember what happened, Rashaad?

My neck. I can't move my neck.

I'm Jeff, I'm a paramedic. Can you hear me? OK, easy.

Can you tell me your name?

Can you wiggle your fingers and toes for me? Right, good lad.

Now I need you to stay nice and still, going to

immobilise your neck, then we'll take you to hospital, OK?

Dixie. We've got an entrapment here, mate.

Right. We've got reinforcements on the way, sweet.

Is he alive? I need to know. Is he still alive?

OK, mate, let's have a little look at you. Listen to me.

HE SOBS AND MOANS

We're going to make you as comfortable as we possibly can.

Try to work out the best way to get you out, right?

We did it.

He's alive, but there's no way he's going anywhere tonight.

We've got an RTC coming through, can we clear Resus as quick as we can?

-All right, Doc, is this the gentleman for Gellar?

-Yeah.

He's had normal chest X-ray, normal zero ECG.

Normal bloods, just waiting on the second troponin results.

-If they are good, he can go.

-What about his abdo pain?

He presented with chest pains.

He can follow up the abdominal with his GP.

He won't, though. And in a couple of months he'll be right back here.

Give him some credence. I'm sure he wants to get better.

I don't think so.

He'd be lost without his ill health to control his family.

Hey, I need my bag.

-Move him somewhere near triage?

-OK.

Where you going?

I don't want her to see me.

PHONE RINGS

Hello, sweetheart.

Andy?

Andy had to dash out. Left his phone.

He'll be back if you wait in reception. I'm not allowed visitors.

What are you like?

I'm not a well man.

I know. You need a check-up from the neck up!

-Doors, please.

-Number two.

This is Muraya. He was involved in an RTC.

Car collided with another car containing teenagers.

He was pinned to his seat by the steering column.

They intentionally drove me off the road.

Large open wound to his groin.

GCS has been 15 throughout. BP is 140 over 90, pulse 90,

and SATS are at 95%.

OK, let's cross match him for four units.

-Ready one, two, three.

-Can we get an abdo CT ASAP?

Wait. I need to pee.

OK, let's get a urine bottle over, please, and lose the clothes.

No, I'm all right.

HE SCREAMS

No. You've got open wounds here. Careful. Careful, careful.

You have got some trauma to your genital area.

What is it? Tell me!

We have to be systematic in our examination.

Airway's good. All clear.

My As and Bs are fine. Skip to the Cs!

What's wrong with my pelvis? I'm a doctor. Be technical.

-I can handle it.

-Where do you practise?

I don't. Not in the UK. Not yet. I'm waiting for my medical papers.

Looks like your little friend got herself into more trouble.

Can you finish off the initial assessments?

This is Rashaad, he was a second driver in the road traffic accident.

He's complaining of severe back pain

and loss of sensation in both his arms.

-Tamasha, are you OK?

-That's my brother.

She refused treatment at the scene,

but we're checked her in anyway just to be on the safe side.

Sam, go on.

BP 120 over 80.

He's been given ten of morphine and O2 therapy.

He has got severe pain and swelling in the lower back

and bruising and tenderness in the neck.

We are going to need a CT of his head and neck.

Great, go ahead with that. You come with me.

Why did you go? I wanted to help.

I know. I'm sorry. Thank you.

How's your sister?

She's fine, thank you. Everything is sorted.

How is my mother?

She's upstairs on Gynae.

I can get someone to take you up to see her.

I know you. You tell me. Why were you following my husband?

Excuse me, please let go of her.

I just need to know why she wanted to speak with my husband.

-Watch her for a minute, please.

-Stay with that child.

What's been going on, Muraya?

Excuse me, who are you?

I'm his wife. The question is, who is she?

Tell them.

It was an interview for a medical-related job.

Liar.

-Hang on. OK. What was the job?

-I'm don't know, I didn't get there.

He was going to operate on my sister.

-What are you talking about?

-He was going to a cutting.

If we hadn't stopped him, he would have circumcised my sister tonight.

I got it all worked out.

What time did the doctor tell you he was going to be here?

He should have been here at least an hour ago.

He is usually a very reliable man, he is usually very good.

Always on time. OK.

Which charity was that with?

'Hi. I can't get to the phone, please leave me a message.'

Tamasha, I'm scared.

The real doctor hasn't come yet

and Granny says they're going to do it anyway, the old-fashioned way.

I don't want it. Please help me.

PHONE BEEPS

I'll be in in a moment.

Hi, Hannan

What's happened. Something's happened?

No-one is seriously injured.

But I'm afraid to say that she and your son had a car accident.

What?

Rashaad is in Resus. He's conscious and stable.

He had some neck pain, so we're doing a CT scan.

-I've got to go. I'm sorry, Mum.

-Tamasha? What's going on?

-Look, you need to stay on bed rest.

-I need to see my son.

He's in good hands. I'll go and see what's going on.

You just stay up here.

You need to look after yourself and the baby.

20 minutes my father-in-law has been in the corridor

-waiting for a cubicle!

-Where can I find Zoe Hanna?

-Excuse me! Can you wait your turn?

-Cubicle seven is free.

She is over there in CT.

We've actually had the second troponin test results back

and it's excluded the possibility of a cardiac trouble.

So you're free to go.

But it keeps happening. Something must be causing it.

We want a diagnosis.

History of indigestion, epigastric pain and he's sore over his liver.

Don't you think it could all be booze-related?

Blame it on the patient when you can't fix it.

At best, it's gastritis or an ulcer. At worst, pancreatitis.

Well, I'm not taking him home with that!

Why don't I see if I can arrange an outpatient's OGD

to rule out the ulcer and get an amylase done?

Yeah, all yours, then.

Right. This way.

Nice and still for me now, Rashaad.

Dr Hanna.

Your brother is very lucky.

He only has a very small fracture to his neck.

You said you would help me. Will you?

Yes, let's get him back into Resus and admit him.

Can we refer him to the Ortho's?

-Do you have a car?

-Why?

-Can you take me to my sister?

-Now? No.

-Listen!

-I'm mid shift.

-Listen.

'Tamasha. I'm scared.

'The real doctor hasn't come yet

'and Granny says they're going to do it anyway, the old-fashioned way.

'I don't want it. Please help me.'

Tamasha, I'm sorry.

I had it done the old-fashioned way. Do you know what that is?

They did it to me with a razor. No anaesthetic.

SHE PANTS

SHE MOANS

I'm going to give you some analgesia and refer you to the urologist.

The ultrasound confirms there has been bruising

and damage to the urethra.

That's where your wee comes from, isn't it?

That's correct. It's part of the urinary tract.

Can you fix that for him, then?

It's really a matter for the urologist.

Could I have an urgent word, please?

Excuse me.

I'm going to have to disappear for a bit. Can you cover for me?

It's the busiest night of the week.

This is well beyond your remit as a doctor.

Maybe. But it's well within the spirit of the Hippocratic Oath.

I really can't support you in this, Zoe.

I'm not asking you to.

I just need you to keep things running smoothly until I get back.

What is the address?

I don't know what you're talking about.

Listen, Dr Abasi, I'm not going to shop you,

because that's beyond my remit as a doctor.

However, I do want to help this girl find her little sister.

So tell me the address.

Can we have that here now?

Quick. Take her up in the service lift at the back, please.

Can I have some help here, please?

Hello, Hannan?

Don't try to talk, but squeeze my hand if you can hear me.

Pulse is 120 and thready, resps 30.

We need to get some fluids into her. Can we get her into HDC, please?

She has suspected placental abruption.

-She's booked into theatre.

-What's she doing down here?

Shall I beep Zoe?

No point. Just update the Gynae team.

Let's get her out of here. Get that over here.

OK.

One, two, three.

ALARM

-That's all we need.

-OK. Yeah.

Lloyd, can you supervise the evacuation

and wait for the fire service?

OK, you've got a choice.

Either I can drop you at the address,

and you can sort it out with your Granny and your sister yourself...

I couldn't. They wouldn't listen to me. Please come in with me.

If I come, you have to agree that I can inform the police.

We need a police escort or I can't get involved, Tamasha.

It's up to you.

Sorry. You can't be in here. All visitors outside!

I can't find Mike. He's not in his bay.

Hello. Hello. Are you all right in there?

We are coming in.

What are you like?!

Right, come on.

-What?

-Out you go.

We're using valuable resources to help you

and you're not helping yourself.

I'm missing the race.

We'll refer him to an alcohol support worker to discuss

getting him off the booze.

Here you are. Go on.

Victimisation, this is. Can't even have a quiet fag.

What number was it?

43.

OK.

Now, if your sister is in here, the police will join us. You OK?

Yes?

I'm so sorry to bother you. We're looking for Safi Camille.

I don't know anyone of that name.

Can you leave, please?

He's a piece of work.

I know who has it! It's in my mum's phone.

-She typed it into her pathfinder.

-Excellent.

Baby's heart rate has dropped.

BP still falling and she is tachycardic.

Let's get her onto her side.

I think we might be looking at foetal distress.

PHONE RINGS

Keep pushing those fluids through.

-Hello.

-Where are you?

I'm with Tamasha. I need a favour.

The doctor gave the wrong address.

We think the right address is in her mum's phone, under maps.

Can you take a look for me?

Gloves. Can we prepare her, please?

I want to do an internal examination.

Hello? Hello?

Hannan, we think your labour is progressing quickly.

We need to get someone down here now. What about the registrar?

I did explain, didn't I?

This is a first for me.

Obstetrics say the surgeon and the registrar are tied up with

the triplets, but they can send down the F1, or we can wait ten minutes.

Are they still on the line?

We can't wait ten minutes.

We've have to get the baby out.

This woman has severe anatomical complications due to FGM.

She's haemorrhaging internally

and we're struggling to keep her BP high enough.

If we don't get the baby out now, neither of them will survive.

She needs an emergency caesarean. Get someone down here. Now.

Do me a favour. Get her phone out of her bag.

Look up the last address on her pathfinder and text it to Zoe.

Gloves.

Tess, you are a star. We've got it. We've got it.

Right, let's go.

All right, folks, if you would like to step back inside.

We have been given the all clear. Thank you.

You can all go back in.

-Sweetheart. Look, I am so sorry.

-Where have you been?

-Do you have the tickets?

-What tickets?!

He...he wanted double.

Couldn't you get him down?

-Oi.

-You promised!

Please. It's my birthday.

I know. I've got a present for you.

I've been waiting to give it to you all night.

Open it!

You're pregnant?

Sweetheart.

Congratulations, Grandad.

Take your time. I'll sort your old man out.

Is he going to be OK?

Yeah. There's nothing wrong with him he can't sort out for himself

with a bit of our help.

The more you give him, the more he'll take. You know it.

You've got enough on your plate.

Best thing you can do for him is make him

take responsibility for himself.

Keep it. It's yours.

That's not yours to give away, is it?

Labour costs. Not that it's your business!

I've come to see my sister Safi and my Granny.

Try the back room.

Have you seen a girl called Safi here?

We believe there are children here who may be at risk of serious harm.

We have located a girl in the living room.

Oh, my God! I didn't know this was illegal.

Right, let's have everyone in the living room.

Wait there, madam. Thank you.

-Is everything OK here?

-Everything is fine.

Check through there.

-Bathroom's clear.

-Kitchen's clear.

I need somebody in here.

You OK?

Check the bin.

-Don't go upstairs.

-Safi. Safi.

Dr Hanna.

You are under arrest on suspicion of genital mutilation to this girl.

Get my bag. And call an ambulance.

What are their names?

Jasmine and Nina.

OK, Jasmine, Nina. I'm Zoe and I'm a doctor.

I'm here to help you. Can you tell me what happened?

The bed's wet. I think Nina's wet the bed.

OK, can we get Jasmine out of here, please?

Nina. I'm going to make you feel more comfortable.

OK, can you wash this out and fill it with hot water?

I found her.

Tamasha. I thought you weren't coming.

Of course I was. Are you OK?

Can you check that the ambulance is en route? She's tachycardic.

She's lost a lot of blood.

I'm going to have to get some fluids into her.

I want you to run some saline through here.

-Can you pass me this when I ask for it?

-Yeah.

This wouldn't have happened if the doctor had turned up.

OK, Nina.

She's lost too much blood.

I'm going to have to go for a femoral or try the neck.

-Let's try the neck.

-Will she be OK?

OK, Nina.

GRANNY PRAYS QUIETLY

Yeah, I'm in. Can you take that?

OK, Nina.

OK. Hold this up here and let it run through.

I'll try and get another line in.

We good to go?

Yeah.

Have you done many of these?

Not as many as I'd like to feel comfortable. You?

I've assisted at enough to feel confident.

Clamp.

Protractor.

I'm going to cut through the uterine wall.

Suction.

Can we be ready to receive the baby, please?

HE PANTS

HE GRUNTS

Clamp. Another clamp.

OK, let's take out the placenta.

OK, that's the tricky bit done.

Now to stop the bleeding and put her back together.

Keep those packs coming. Cover those bleeding vessels.

BABY CRIES

I'm sorry for the delay. What have we got?

Massive haemorrhage. I've done an emergency caesarean.

Theatre are ready, so she's all yours.

We've got an ambulance coming in any moment with a child

suffering from trauma and haemorrhage from a circumcision.

The urologist has found a type V urethral injury with

extravasation of contrast material from the distal bulbous urethra.

Does that make sense?

Can you put that in English?

Look, I'm your wife. It's going to affect me too.

Tell her.

-In the worst case scenario...

-Which this may not come to.

We are looking at possible incontinence.

And possible erectile dysfunction.

Except your husband may make a full recovery.

Unlike the girls he was going to operate on.

Your hospital allows a woman to choose an operation

to kill their five-month-old foetus.

Why won't it allow let the same women to choose

to circumcise her child?

Where's the logic?

You can't compare the two things.

I have, and people do.

It's not the same thing.

This is Nina, she's 11 years old, she's sustained a significant bleed.

Luckily, there was a doctor at the scene that was able to

administer fluids, so she'd had 500 of saline so far.

OK. Thank you. Let's get her in.

Can we get some O-Neg into her urgently, please?

Bleeding's subsided now. She's got good venous access.

OK, can we call surgeons and theatre, please?

I'm serious though, Ash, if Zoe hadn't been there,

I don't think she would have made it.

-Tess. Thank you for the address.

-I was only doing what I was asked.

Hi, Nina. I'm Dr Ashford. I am just going to check you over, OK.

He's walked!

With my money!

I did warn you, mate.

HE SIGHS

Got his results. Mild pancreatitis.

That's what you get if you run for half a century

on fags and booze, right.

He said you'd given him the all clear.

He didn't want a diagnosis.

Would mean leaving the whole lifestyle behind, wouldn't it?

At least we know for next time. Good job.

The police want to talk to you, Dr Abasi.

You would have done it, wouldn't you? If you hadn't crashed.

All the women in my family have had it done.

Not your sisters?

But they are not religious.

It's not about religion.

It's about our culture. For them, it is a positive thing.

It might not be for us, but it does not mean it is wrong.

Of course it is wrong. Look...

Would you do it to her?

HE SOBS

I would like a taxi, please.

Yeah.

Dixie. All right.

Yeah. Hi...um...look, I've got a bit of a confession to make.

-I know I promised to...

-You haven't got the tickets, have you?

-Well...

-Jeff, sorry for the late delivery, mate.

Happy birthday, princess.

I love you, kid.

Cheers, mate.

Hey, Mac, look at this!

You owe me £100.

Eh? Oh, great. You've saved my marriage, but broke the bank!

There you are! A skinny bloke came by earlier.

-Left this for you.

-Happy days.

Looks like the son came good, didn't it?

Five of those are mine, aren't they?

Come on, then. Five minutes!

Come on, five minutes.

Cheers, mate.

This way, she's just through there.

Look, there's Tamasha.

-Go on.

-Come with me.

I have to get back down to the ED.

Thank you. I'm so glad she's not like me.

If I was your sister, I'd want to be just like you.

I'm so glad, she's still...intact.

Tamasha. Your spirit is intact. And that's what counts.

You're a survivor.

You have strength and beauty, and determination.

You're a very special young woman.

Right, looks like it's just me and you for my birthday breakfast.

Yeah, sorry about that. Do us a favour, will you?

I've left my keys in the back of the ambo.

-You couldn't grab them for me, could you?

-Oh, Jeffery!

THEY CHEER

# Happy birthday to you

# Happy birthday to you

# Happy birthday, dear Dixie

# Happy birthday to you. #

THEY CHEER

Thank you very much.

-How is she?

-Stable. But a mess.

She'll get the specialist care she needs on Paeds.

You shouldn't have left me mid-shift like that.

Listen, after everything that's gone on...

What if we'd lost Hannan Kamil?

We didn't, did we? And at the end of the day...

Let me finish! I was going to say, despite all that,

you did an extraordinary thing tonight.

I'm really proud to be working with you.

HORN BEEPS

All right.

SHE SCREAMS

Dix! Dixie, I need some help here.

He's my dad. It's my dad.

Jeffery, I'm standing you down. You are no longer on duty.

Subtitles by Red Bee Media Ltd