Isolated Incident Casualty

I went for a drink with Linda, that's all.

It wasn't a date, it wasn't even a dinner, it was just a drink.

Just the two of you. On your own.

You can cut out the raised eyebrows.

Nothing happened! We had a nice time, it was all very pleasant,

she had two drinks to my one. I paid.

Which makes it a date.

-I pay for yours!

-Steady.

You don't think that she might think that we are...

Listen, I would love to stop and chat but, you know?

(WOMAN) That's it, no more.

DOOR SLAMS

Why do you think she says those things about you?

Nothing to do with you.

You shouldn't be drinking that. Granddad, please!

You're a child, a stupid child!

Every day in my house after school, which I never asked for.

Granddad, stop!

I've brought up my kids, I'm done with being that man,

she looks after you, it's not my problem.

You're not my problem!

What?!

DOOR SLAMS

(DIXIE) We should go, it's Linda's leaving do.

I don't think I can handle the hangover.

Jeff. It's a few pints in the pub!

You are joking, it's Linda! She's demob happy and it's Linda!!

-Go on, it'll be a laugh.

-'Emergency call to 14 Charman Drive...'

-I'll buy the bacon butties in the morning!

-'..female patient, collapsed,

-'possible alcohol overdose.'

-Yeah, 3006 to Control. Received that and on our way over.

Come on, 15 minutes is up.

I could do with the rest of the afternoon,

I've got to write the statement about the baby who nearly died.

Has someone made a complaint? Surely it's just a formality?

-You want to do it for me?

-I could but it'll cost you.

And I'm guessing that won't come cheap!

You know me so well!

Um, Linda, the patient in cubicle three, what was his last BP reading?

150 over 90.

Well, recommend...

Yes, a labetalol infusion. I know, you told me.

You're one of those women, aren't you?

Ordering your boyfriend's food while he's gone to the toilet!

Aren't you my boyfriend?

I know I'm leaving,

but a long-distance relationship can work for the right person.

Linda, we had a really nice time, but...

Relax! I'm joking, it wasn't exactly the night of our lives

and you talk a lot about work.

Well, I'm sorry I don't read Heat Magazine.

Maybe you should. Maybe it might teach you something!

-Have you booked tomorrow off?

-Is it going to be that big a night?

Girl's got to go out in style! It's going to be huge.

-PHONE RINGS

-I'll see what I can do.

The board are getting jumpy about a complaint we've had.

They're chasing me for statements so I might be a little late.

All right, no excuses!

Quickly, please. She is down the end of the garden.

OK, do you know what happened?

My parents were supposed to be looking after her,

I came to pick her up and found her slumped in here.

-OK, is there any medical issue we should know about?

-No.

-What's her name, love?

-Ria.

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

Ria.

Booze, mate.

Oh, no! Dad's cider.

Yeah, that's what I can smell, cider. Ria, come on, darling.

Have you been drinking the cider?

Good girl, we'll get this over your arm.

We'll take her in and get her looked at, all right.

I don't know if you remember but it's Mike's play later on,

I was hoping to get away.

OK, well help me with this one and then get off.

What's the play?

-I don't know but he's being a grumpy camel.

-Shakespeare, then?

You'd think so, the amount of rehearsing.

I wouldn't mind, but he's only got one line.

-Which is?

-"Hello. I'm a grumpy camel."

-Hiya, Tess.

-OK, through to HTC, please.

This is Ria Jones, she is 12 years old.

Found collapsed, intoxicated.

She's been drinking her grandfather's home brew.

GCS 13, no other symptoms or injuries. A few achy muscles though.

Can you come with me to reception while they assess her?

-Sick, feel sick.

-OK. It's all right.

Give your details to Claire then you can see her very soon.

Cheers, mate, see you later.

Right, I'm just going to sit you up now, lovely, all right?

Try and relax. Here you go.

So what do you reckon?

Strong reaction to alcohol!

You the expert on that, are you?

I've had my moments!

SHE VOMITS

All right.

What's that?

Are you all right?

Can you smell that? That's chemical.

Avoid contact with your skin as a precaution,

and double bag your scrubs.

You what?

Zoe, I think we need to isolate a patient,

possible toxic chemical ingestion.

Hang on a second.

Charlie, we've got a 12-year-old girl who's ingested

an unknown noxious substance, she'd also drunk some alcohol

which has masked the smell of the chemical.

Her mum is over there.

Can you have a word and see if she knows what it could be?

-Sure. Mrs...?

-Jones.

Tess, yes. There should be some glasses and face masks in there,

put them on in case she vomits again.

I'll send someone in to assess her as soon as I can.

Continue with the fluids - high-concentration O2

and we'll need bloods and a full tox screen.

Mrs Jones, hiya, I'm Charge Nurse Fairhead.

I don't understand what's happening. Why can't I see her?

Well, hopefully you'll be able to soon. From her symptoms,

it seems your daughter has ingested something toxic.

I wondered whether you might be able to help us

find out what that is.

Toxic, what are you talking about?

Nicola, how is she?

Why weren't you there? How could this have happened?

I'm so sorry, I only left her for a moment!

You shouldn't have left her at all, not with him!

He's given her something, I know he has.

Sorry, could we carry on this conversation in the office?

And I will give you an update on Ria's situation.

And her breathing is becoming more laboured. Thanks.

Did she say how long the fresh scrubs were going to be?

Ria, are you OK?

What?

Kisses?

They were a present, all right!

I don't want to know.

SHE COUGHS, VOMITS

Here you go, sweetheart.

I want a blood gas ASAP.

How long ago did she ingest the substance?

One hour, two at the most.

And can you give these to Fletch, he got caught in the splash zone.

He brews his own cider.

And that's the only thing you could see she'd drunk?

It makes David sick all the time.

As in violently ill?

Hangover stuff.

You knew things were that bad and you left her in the house!

I couldn't stay, I'm sorry. I couldn't stay.

Kisses?

Let's just save the jokes until later, eh! Thank you.

She's maintaining a decent airway but she's tachycardic

and has just had a small hematemesis.

I'm concerned about her airway.

There's widespread creps in both lungs.

And she is steadily dropping her SATS.

-Any muscle fasciculation?

-Yes.

-Dyspnoea?

Her wheezing is getting worse.

Constricted pupils, extreme salivation and lacrimation.

Organophosphorus poisoning?

Let's transfer her to Resus. There is a free bed now.

She might vomit en-route. We're in a dependency room, we should do it here.

Why take the risk?

We don't know what she's taken, we'd have to decontaminate.

-Fletch, you decent?

-Yes, as I'll ever be.

0.02 milligram per kg body weight of atropine given as an IV bolus.

You OK?

Yeah.

TEENAGERS LAUGH

Whoa, check her out. Look at the body on that.

So you'll give me your number, yeah? Hey, I'm talking to you.

Don't try and walk away when I'm talking to you.

Where you going? You going to the bus stop?

We was going to go to the bus stop. You may as well wait with us.

Don't you want to wait with us? With me?

Lads, lads, come on. I think she'd prefer it if you left her alone!

-Was I asking you?

-I'm just saying, she only wants to get home.

-With me, if she's lucky!

-Are you all right, love?

Just go.

What is that? Are you blocking me?

You want her for yourself, is that it?

What is it? You her dad or something?

Did I say we were done here?

What's her BP?

70 over 50, rapidly dropping.

Respiratory rate?

Also dropping.

Why's the air-con off?

The spread of fumes.

Did Zoe order that?

No, I did. A precaution, I suppose!

It's too hot in here.

MACHINE BEEPS

What have we got? Tom?

She's more tachycardic and throwing off the odd VE.

You hiding in there? Come on.

Get away, get away or I'll call the police!

ENGINE STARTS

THEY LAUGH

Oi, no. Leave it alone.

Get away.

TYRES SCREECH

CRASHING

Stop the van! Let me out.

Stop the van. I'm warning you!

This ain't safe.

Let me out, please.

Please stop the van!

She's fitting. She's in respiratory arrest.

-We should have gone to Resus.

-Let's start bagging ventilation.

Let's secure her airway and set up for a RSI.

-I need ketamine and SUX please, Fletch.

-Yep.

-You OK to run this?

-Yeah, I'm good.

Zoe. She has gone into respiratory arrest.

Put Tom on.

-Tom. I got Zoe for you.

-Yeah.

-Got it?

-Yeah.

Tom. This is sounding like organophosphorus poisoning,

Has she been given the atropine?

Yeah. Intravenously at ten-minute intervals.

Was there any improvement in her symptoms

before the respiratory arrest?

Tom, speak to me.

-Not that I could see.

-Right, I'm coming through.

-OK, you ready, Tom?

-Yep.

Cricoid on. Ketamine going in.

SUX going in.

In.

OK, we are ready.

BP's 60 over 40.

Tom. Tom, are you OK?

Yes.

The cyanosis is worsening.

Tom, we've got to get on with it.

OK, pause procedure, I'll take over bagging ventilation.

Excuse me. Thank you.

Let's start again. Suction please, Fletch, and a seven-tube.

Tom.

HE PANTS

HE GROANS

SIREN WAILS

-Hello, mate.

-SCREAMING FROM TRUCK

I'm Dixie, I'm a paramedic. Can you tell me your name?

-There is another one in there.

-Do you want to deal with it?

That's a pretty nasty cut you have got.

You are going to be all right.

Let's do something about that bleeding, eh!

HE SCREAMS

Help me, please. Help me!

OK. Where does it hurt, mate?

I can't feel my arm, I can't move it.

I need to move some of this stuff. Bear with me.

I need some help here.

3006 to Holby Control, request fire service

and second ambulance at Westbroke Avenue. Over.

'This is Holby Control, request acknowledged.'

Keep her oxygen levels up and maintain the atropine.

I will get her attached to the ventilator.

Good, the priority is to get her moved up to ITU.

I'll chase for a bed ASAP.

But if there is any delay, I'll try and arrange an anaesthetic

and paeds review down here. Can we get a chest X-ray?

OK, can the family see her?

We still don't know what she ingested,

so it's best to get this place decontaminated first.

Oh right, that'd be my job, would it?

You've been in close contact, why put the cleaners at risk?

We're being abandoned in the danger zone?! Typical management.

Nursing's a vocation, you do it for the love of helping, remember!

I got covered in chemical vomit, I'm sure she's trying to figure out

a way to invalidate my insurance claim!

Nah, she's looking for ways to hold you responsible!

Charming! Blame the contaminated ones!

Sam. What happened to Tom?

His glasses misted up. It was hot in there.

That shouldn't happen.

Standard issue equipment, no air-con, go figure.

You got an explanation?

The room was too small. We should have moved through to Resus.

So claustrophobia now, is that it?

Course not. I was hot, I got dizzy.

Tom. You froze. It looked like you had a panic attack.

Tess and Fletch might keep this to themselves.

But I've had to just lie to Zoe.

Some crap about your glasses misting up.

Tom, what is it? You can tell me.

I haven't been sleeping, that's all.

It's just...that baby I'm writing the statement about.

That's just a formality, you did nothing wrong.

I came close. Normally I'm fine. I don't know why.

I lie awake thinking about what could have happened.

Well, if you need to speak to someone, talk it out.

No, it's just stress. It came at the worst possible moment.

I've got to write a statement in response to the complaint,

I've got a meeting with the Trust, however informal they say it is...

Tom. Just come here.

It's OK.

Is this the first panic attack you've had?

Yeah. And the last.

I've got to go.

Won't be long now, mate.

We have to make sure that this stuff is stable.

So it doesn't come down on you when we get you out.

I want my mum. I'm cold.

It's all right. Someone will call her for you, OK?

I never asked you your name, son.

Scott.

Scott. Wrap this round you. How old are you, mate?

14.

14. Blimey, I bet you'll have no problem

when you want to start getting in pubs and all that.

I was always proper young looking

when I was a kid, you know, bit of a short arse.

I used to get asked for my ID all the time.

Bit embarrassing, really, especially when you were with a young lady.

Then I went bald, get into a pub no problem.

I just can't pull a bird for love nor money.

Am I going to die?

No, son, not today. Not if I can help it.

Charlie, any word on the grandfather yet?

No, nothing, he's not answering his phone.

Neighbour says he hasn't been near the place.

The police found this bottle at the scene.

They think it most likely contained the chemical

-she swallowed in addition to the cider.

-I see, right.

They want to send it to the labs for analysis,

but we know that is going to take ages.

Can you talk to the family, see if it jogs their memory.

OK. Yes, I will.

I heard the crash, But I didn't know he was in there.

Don't worry about that now, we need to look at your head.

Is he going to be OK? No-one's telling me anything.

We don't know any more than you right now.

If I'd known he was in there, I would have...

What if he doesn't make it through? I need to know what's going on.

Please, just try and relax.

Right, they are going to jack up the load.

The problem is the source of the bleed is where his arm's trapped.

So it could be stemming a major bleed.

Exactly. I can move his head and I've checked his neck,

-so I don't think it's his C-spine.

-How's his BP?

Stable but he's tachy.

I don't know what's going on internally, obviously.

OK, shall we get on with this?

OK, Scott. We are going to move you in a minute.

When we do, there will be a rush of blood to your nerve endings,

which means you could have a bit of pain. You understand?

The important thing is to stay as calm as you possibly can.

OK, then let's do this, yeah?

OK - inflate.

Inflate.

HE SCREAMS

Whoa, whoa, whoa. I got a bleep!

OK, mate, don't worry.

I will get you out.

OK, let's get this collar off.

OK, can you look to the left for me and to the right?

That's all good. OK, I am going to sit you up,

take a look at your wound.

Yep, that's still bleeding slightly.

We'll get you a fresh dressing, get the wound cleaned up

and then it needs suturing.

All right. Let's get this cleaned up.

Are you OK?

It was outside my father's house.

Those kids...they made his life hell.

They can't hurt you now.

They were just kids! Kids!

Doesn't matter how old they were.

I tried. They were hassling this young girl, I tried.

I could see him looking down on me.

Disappointed.

I let him down.

-Would you like some water?

-Yes, please.

Here you go.

Thank you.

You stood up to them. Not many people would have done that.

Thanks.

-Charlie.

-Yeah.

The paramedics have picked up a man close to where they found Ria.

He's also presenting with similar symptoms.

He's dizzy, drunk, vomiting.

Plus he has a persistent nose bleed. It could be our missing grandfather.

You are thinking chemical poisoning?

We'll it's hard to tell. I'm sending Tom in to assess.

Did the family know what was inside that bottle?

No, no idea.

-Well, maybe we should ask this guy. Maybe he knows.

-Sure.

The driver of the van is all patched up and ready for you to assess.

Is he being quite lucid? Any signs of concussion?

Emotionally, he's all over the place.

He was cleaning out his dad's house before the kids attacked him.

Just the facts, Linda, not his life story!

Heartless as well as boring. No wonder you're divorced.

Nice. Nice!

Medically, his GCS is still 14.

Thank you. I'll see him as soon as I can.

The other lad from the van accident is on his way in.

He's crushed his arm but we don't know the full extent of the damage.

But what sort of childhood did he have?

You know, in case it's relevant!

I'm clearly missing an in-joke.

And by the sounds of it, not a very good one!

He's due any minute now.

Do you think you're funny?

A little.

You better watch it, I might un-invite you to my leaving drinks!

Professional focus now, Linda! We've got a serious injury coming in.

You go robbing from the back of a van, you deserve all you get.

Straight to cubicles.

David, I'm sorry. I'm so sorry. I did this to you.

What has Ria taken, Dad? She drank something in your shed.

Excuse me. Give us a moment with David.

Ria? What's happened to Ria?

Nice and easy. Thank you very much.

We are just going to raise the bed up. Thanks, Charlie.

OK, lay back down gently.

What's happened to Ria? What's happened to her?

Right, David, it's really important that you listen to me.

We need to know what you've been drinking and what made you vomit.

You're granddaughter has been admitted with chemical poisoning.

We suspect she has been drinking what's in this bottle.

Do you remember what was in it?

BP's 120 over 80.

-My head's pounding.

-The ECG is normal.

Did you get hit in the face? Is that why your nose is bleeding?

And I see Elaine said sorry. Did she do this to you?

Did you have an argument, is that it?

And did little Ria see the argument?

Elaine left, I took it out on little Ri...Ria.

And she drank some cider.

And then she drank whatever was in this bottle.

Do you remember what you kept in here?

A spray, for the trees, pesticide.

I got it from a bloke down the pub, he's got his own farm.

Can you remember what the pesticide was called?

I don't know. Ma...mathoxo...

Malathion?

Yeah, I think so. Is little Ri...Ri...?

She's in a critical condition, I'm afraid, but she is stable.

David, this is really important,

can you tell me, did you drink any of this?

No. No.

Hi, Ash. This is Scott Lambert, 14 years old. Involved in an RTC.

He was caught under some heavy cabinets in the back of a van

for about 20 minutes.

Badly displaced compound fracture of the right radius and ulna

and exposed bone.

GCS 15 throughout. BP 96/60, pulse 100, SATS of 98%.

He's had 2.5 of morphine and 100mls of saline.

Thanks, Jeff.

I'm Linda and this is Dr Ashford,

we're going to get you through to Resus, OK?

Steady and lift. Thanks, Jeff.

He did this to me! He knew I was in there.

All right, calm down. Airway's obviously clear.

I want him done, I want him done for what he did.

Just try and keep calm.

Can we clear C-spine, please?

Get X-rays done so we can remove the collar.

IV lines, oxygen and IV analgesia - 2.5mg of morphine, antibiotics.

-And can someone do bloods, please.

-Yep.

I can't feel my hand, why can't I feel my hand?

-Is it your whole hand?

-Fingers, I can't feel my fingers at all.

OK, let me see.

The right radius has definitely gone, ulna exposed.

Let's get some views on that as soon as possible.

He's killed my arm, hasn't he? That bloke's killed my arm.

They rang me and told me he was here. So I want to see him.

You can see him.

I just need to speak to a nurse and find out where he is.

Oi, be careful.

Do you want to wait outside in the cold?

Then pack that in, you little munchkin.

Linda, you're dealing with Scott Lambert, right?

This is his mother, she wants to see him.

You can't stop me seeing my son!

No, no one's going to do that. If you'd like to take a seat,

I can talk you through what's happening.

We've identified the chemical and we know there's no further

risk of contamination, so you can see her in a minute.

She ingested Malathion pesticide, so you can take the masks off.

Let's start on IV Pralidoxime at 30mg per kg body weight

given slowly to back up the atropine.

The chest film shows some consolidation.

So we're looking at an early inhalation pneumonia.

She also has raised CK levels on the blood.

ETA on the transfer?

Not quick enough. I'm going to chase it up now.

Is she going to be all right?

What's happened to Ria is very serious.

And she is not out of the woods yet.

She had a respiratory arrest and she may also have damaged

her airway oesophagus and maybe her stomach.

I won't forgive him for this, he should never have left her.

Well, to have caused this much damage,

Ria will have swallowed quite a large quantity.

So it wasn't an accident? Did she do this on purpose?

I wouldn't like to speculate but in my opinion

she may well need psychological AND physical rehabilitation.

Just lots of support

David. Is he OK?

He's being treated for his minor injures now.

-Can I see him?

-Mum! I need you, Ria needs you.

You can see him. Excuse me.

Charlie. Have you seen Zoe?

You sure you don't mean Linda?

I want a second opinion on this X-ray.

It's the young lad who got trapped in the van.

Scott Lambert.

He's got compound fractures to his right radius and ulna,

with serious neurovascular compromise.

If we don't reduce the fracture here he could lose his arm.

I was hoping Zoe was around to help me pull it.

Right, well, if I see her, I'll tell her to come and find you.

We are talking about Zoe?

Unless you want us to be talking about someone else.

Zoe will do just fine, thank you very much.

Whoa! Calm down, boys! It's not a playground.

I'd take all the sweets out of the vending machines, if I were you.

Right, you lot! I have asked you enough times. Up against that wall.

Oldest there! Youngest one there!

I am not going to ask you again, come on.

Oi! What's happening to the other bloke, the driver?

-He's recovering from a nasty cut.

-Is he being arrested?

What for?

Scott's mates have been texting me, said it was dangerous driving.

Look! Have a look at this!

Did they tell you what they did to him? How scared he was?

I don't business, love the guys a nutter,

he knew my Scotty was in the back, did it on purpose.

Right, well, I just need to worry about getting him better.

We're good to go. Is that his mum?

Yep. She's just got three lively kids with her.

Right, pack it in! I am not going to ask you again!

This is silly, I'm all right. She whacked me and I deserved it.

From your loss of blood, it looks like more than a whack.

Well, I more than deserved it.

Just look this way for me, please.

And the other way.

Have you had any other symptoms recently?

A cold that she calls man-flu, aching muscles she calls laziness.

OK, I'm going to send you off for a CT to rule out any haemorrhaging

and take some bloods to rule out any clotting.

It's stopped now. I'll be all right.

Whoa.

OK, how much have you drunk today, mate?

Four, five pints.

I'm a little concerned about your alcohol intake.

And would you mind having a chat to Charlie, he's our senior nurse.

No, no, I'm fine.

It's just that you are obviously not happy with the way things are right now.

And your family are very concerned.

I think it would be a good idea.

He's your patient, but a scan just feels unnecessary.

-He's got a reduced GCS.

-Or he is just drunk?

He's had headaches recently, blurred vision.

It just feels over-cautious.

-Like I'm panicking?

-I didn't say that.

If you want to send him for a scan just to be on the safe side.

It's not a precaution.

It's a hunch that something else is causing the bleeding.

I want to rule out a haemorrhage and do further tests.

-I can't back you on a hunch.

-On the facts I've given you?

I'd release him. Tell him to be nice to his wife.

How's that statement? I want to read it before the meeting.

-I'm on it.

-Today, please. What's the latest on the grandfather?

I'm a little worried about his GCS,

so I'm sending him for a CT and doing bloods.

OK, keep me posted.

You know what you're doing, I'm sure you're right.

Oh wow, that sounds great.

(MOUTHS) Sorry.

(MOUTHS) It's OK.

I know, mate! I'm really sorry.

I did try to come but there was a really sick girl at work,

and she needed Daddy's help.

How did it go, mate? Did you remember your line?

Yep.

"Hello, I'm a very grumpy camel."

HE LAUGHS

Sounds great, mate.

Listen, is Mummy there? She's what? Too busy, is she!

Yeah. OK. Love you, bye! They get bored, they hang up!

The world might be a better place if grown ups did the same!

Sorry you had to miss it.

It's OK. I mean, he was all right about it.

But you never really know what's they're bottling up, do you?

Finally, transfer to ITU.

OK, Scott. We've given you some Midazolam, which is a sedative,

and morphine to block the pain,

so as we manipulate the arm, you shouldn't feel a thing.

It's OK, honey.

I'm going to pull on his arm, gentle traction to ease it round.

OK.

OK, I've got it.

Have you got any sensation in your fingers, Scott?

No.

Pulse?

No radial pulse.

No pulse! So what does that mean?

He's lost the blood supply to his wrist.

-You ready?

-Yeah.

HE MOANS LOUDLY

What are you doing? You're hurting him!

It's OK.

I'm lengthening out the bone in order to manipulate it round.

So we can slot it back.

BONES CRACK

What was that? Is that his bones?

Maintain traction.

OK, that's done it. Pulse?

There we go, a healthy pulse

Great. Let's get a saline pack and vac splint on that and then we will

do another X-ray to recheck, if we're happy we'll put a backslab on.

He will still need surgery to repair the internal breaks.

Good job.

(MOUTHS) What?

-Saline pack.

-Yep.

You silly boy. How could that man do this to you?

Because he was terrified.

And you think he wasn't?!

Linda!

Don't worry, honey, we're going to get him. We're going to get him.

I know it's her last day,

but do you think Linda is getting too involved in this one?

-I think she's got it under control.

-Yeah?

-PHONE RINGS

-Tess, I'm coming through.

What did the scans show?

Wow.

The radiologist is concerned that it might be a malignant growth

in the paranasal sinuses.

Causing the headaches, cold-like symptoms, the nose bleeds.

I'll tell him we're concerned, refer him to ENT,

but it's most likely the early stages of sinus cancer.

What do I know? Good spot.

Yeah, well, I could do without the next bit.

Delivering the bad news?

If I didn't have this statement to write,

-and the meeting to prep for...

-I'll do it, Just give me the notes.

Tea and sympathy. I could do with the practice!

Now she has been transferred, I should find David,

tell him where we'll be.

He's still your father.

Darling, we love Ria so much, but looking after her everyday,

with your dad like he is, it's too much.

So what am I supposed to do?

I don't know.

I don't know how you can show your face.

I-I wanted to see Ria.

She doesn't need you. We don't need you.

I don't want you anywhere near my daughter.

And if you're going to defend him, the same goes for you as well.

Dr Nicholls, Sam. I've been talking to my colleague, Dr Kent.

And we have the results of your CT scan.

I'd like to go through them with you.

If that's OK. Now a good time?

Follow me.

Are the police here for the driver of the van?

RTC, they're waiting for a police surgeon to do bloods.

Has Scott's mum made an allegation against him?

I didn't ask them, and they wouldn't tell me if I did.

Playing the victim like that.

It's in the hands of the police now, Linda.

First they hassle him on the street

and now they're throwing accusations at him.

If he's in the clear, there's nothing to worry about.

What is this? Team reasonable? You two a double act?

-Is that a problem?

-No, but it's a little dull.

ZOE LAUGHS

-Do you find that funny?

-Yeah.

You knew he was in the van, he was shouting and you did nothing.

-They were stealing stuff.

-You shouldn't be in here.

-Did you see him take anything?

-I need you to leave.

I'm not going anywhere until he admits it.

I need you to leave, now!

-He said he looked you in the eye, begged you to stop.

-Come on.

You're going to pay.

You know your son harassed a young woman on the street and

-that man stepped in to help her.

-He's 14.

Old enough to scare the hell out of someone!

They're all like that at his age.

So you've never been called to the school because of a fight?

Has he been driven home in a police car yet?

Don't act like you know the first thing about my family.

No, but I know about teenage boys, I see them in here all the time.

And if you don't get a grip of your son, he's going to get worse.

Nice one.

I don't know why I let myself get so involved.

That's what good nurses do.

You can add patronising to your list as well.

I would like to know what they've said to the police.

Well, she's not going to tell you.

No, but they might.

Can tell it's your last day.

And if we drive past a field of sheep,

I tell him they're woolly pigs!

That's cruel! What if he repeats it at school?!

Sausages are pink bananas, broccoli are shrunken trees.

And where does wind comes from?

Wind farms?

See, now you're getting it!

SHE LAUGHS

It means a lot to you, being a dad, doesn't it?

Of course it does.

But that is kind of all I am at home.

-Parenting's a full time job.

-Absolutely.

But when your wife has stopped using your first name

and only refers to you as Dad,

you know you've got the balance wrong.

It can't be that bad.

You want to go there?

Sorry to interrupt.

Fletch, do you put a hashtag at the start of a tweet, or the end?

Like I would know!

Please, I need some advice.

Go on.

Thank you.

-Go on then.

-I need advice on how to stop three little brats

from ripping up my reception.

-And you need a hashtag for that?

-I'm reaching out to my followers.

I didn't know you did all that!

How about, hashtag - someone needs to stop me whacking a kid!

Have you tried just being nice to them?

CHILDREN SHOUT, CHATTER

It's OK. We'll fight this.

It's quite often the case with men of your generation,

the nagging pain or persistent symptom goes on unaddressed

and is only discovered during an emergency admission,

often when it's too late, but we've caught this early.

I've been telling him to see a doctor.

I never would have gone.

With these early scans, and the description of your symptoms.

I think we've been very lucky.

So you can treat it?

I'll refer you to ENT.

But we've got a very good chance of beating this.

Thank you, Doctor.

I'll give you some time.

What is it?

The boys are saying he was aggressive towards them,

driving like a nutter and he stank of booze.

-A blood test will prove that.

-Did he seem drunk to you?

You said he was emotional, he was cleaning his dad's house.

Maybe he had a drink to say goodbye.

He's the victim in this, not that kid.

-So what do you want to do?

-Talk to him.

Is there any medical reason the driver's still taking up a bed?

His GCS is still 14,

so I thought I would keep him in for obs for a bit longer.

OK.

You've got five minutes. OK.

How's she doing?

If she was so unhappy,

if she knew how bad things were between my mum and dad,

why didn't she talk to me?

She's a kid. It's hard.

Am I that bad a mother that she can't turn to me?

I don't think you can't blame yourself for what happened.

I blame him.

I don't think you should do that either.

Was he always a drinker?

So when you were growing up, was he there for you?

His drinking has become a problem, but the way I see it,

he's doing exactly the same thing as Ria.

He's so frustrated with where he is in life at the moment that

rather than talking about it, or ask for help,

he just reaches for a bottle of cider.

I saw you sitting there, looking at your little girl,

with your heart breaking because you wanted to help her so much.

Do you think he feels any differently when he looks at you?

Sam, the grandfather, Tom's hunch, that was good.

-Something else was behind the nose bleed.

-Good call.

Any reason why you delivered the news?

It's just he's busy writing out the report,

the one you're so desperate for.

Ah, right. Diazepam?

For David. Tom's patient. He's struggling a bit.

I'm referring him to a GP for depression as well as ENT

to establish the nature of the lesion.

-Tough day for that family.

-Yeah.

I'm sorry...for letting you down.

I think you should be aware they've had the chance to

get their story straight.

Which is?

You were drunk, driving recklessly

and you turned the van deliberately to injure him.

Had you been drinking?

No.

If you'd seen the look in his eyes, the threats he was making.

In the van? You said you couldn't see him.

I was so angry with him, with myself.

I could see how young he was and yet I was still scared.

I wanted to see him suffer.

Do to him what he does to other people, make the little...

Do you know when you tell the police that,

they could do you for attempted murder.

If that's what they want to call it.

I can't focus.

I know that it's stupid, I know I did nothing wrong.

I know this meeting is lip service to the process.

It's OK, Tom.

If I'm not thinking about the baby,

I'm thinking about the poor girl in there with chemical poisoning

or the grandfather in there with a tumour the size of a golf ball.

Look, why don't you ask for some time off?

I don't want to do that.

No-one would say anything, you're a good doctor, you proved that today.

I just need to sleep. To unwind.

I think you should take these.

Diazepam?

I'm concerned about you, I think you should take one.

If it gets you though the meeting,

if it helps you write the statement,

if it gets you through the day - it's a short term solution.

What about the long term?

You have me.

OK.

I'm sorry if my attitude wasn't very professional.

I can see how scared you must have been in the back of the van.

Thanks for what you did, you know, my arm and that.

What you thanking her for? She only did her job.

Mum!

She would have blamed you for this if she could.

Look, I've said I'm sorry. And your son did terrify Mr Kebble.

What Scott did was kids' stuff, what he did was criminal.

I hope they lock him up.

All right. Take care.

That was brave, apologising like that.

I just hope it makes him think twice in the future.

It's nice that you care. I'm going to miss you, Linda.

Britney and Joe are lucky to have you.

At the end of the day, they're my family.

Linda. I'm not sure if I am going to be able to make tonight.

-I am a bit tired, mate.

-Fletch, don't you dare.

HE LAUGHS

-I'm not buying my own drinks though!

-All right.

Her passion for the job is incredible.

Honestly, she really took my breath away today.

She's quite a woman.

Well you need to tell her how you feel, before she leaves.

You're right, I will.

So it's 8.00 tonight, yeah?

Yeah. 8.00 it is.

Linda, you are going to have to give me a minute.

I've just got stuff I have to do first. OK.

No problem.

-You think she heard?

-Absolutely.

-You think she bought it?

Without a doubt.

That one's a rabbit, that's a lion.

And this one is a lion eating the rabbit with blood and gore

and everything. And they're all for me?

Yes!

-There you are, a natural mum!

-Not a chance.

-Drinks?

-Yes, please!

You stuck in here for the night?

This pile of paperwork has no respect for the fact that

we've been saving lives all afternoon.

So I can't tempt you to come out for a drink to

celebrate our decontamination and sending Linda off then?

I'll give her my goodbyes in a minute.

She's not going to let you get away with that!

I really need to get this done.

All right. Another night.

Is that a good idea?

Because of...?

What happened.

And what could happen?

Would that be such a bad thing?

No. We can't do this here.

We can't do it at all.

-Here you go.

-Cheers, Charlie.

-So is Tess not coming?

No, she said she had a lot on!

How did you let her get away with that?

I didn't! Can you give her a call and tell her to get here now.

I've just seen her, she was pretty manic.

All right, but I'll be having a word.

The statement was a fair and honest account of what happened,

can we discuss this tomorrow please?

Thank you. I promise you, that's the last work phone call tonight.

I heard you and Ash talking.

"Tell her how you feel before it's too late."

-What sort of advice is that?

-That was a private conversation.

Zoe, I can't handle it if he gets all serious of me.

It'll ruin my night.

Can't me and you just go somewhere have a girlie night.

Just me and you.

Linda!

Right, I am just going to be straight with him

and tell him that it's not going to happen.

I'm glad I caught you on your own. Have you got a minute?

Yeah, look, Ash...I think you're great and that,

and we have a laugh at work but I just...

What?

THEY LAUGH

-What?!

-I can't do this.

-Do what?

-You're useless.

Oh, you cow.

SHE LAUGHS What goes around...

That's it, you are totally uninvited tonight.

Come on! Let me buy you one drink!

Yeah, all right. I want a bottle of champagne!

-A bottle of champagne.

-Yes, go on. A bottle.

You heard the lady, a bottle of champagne.

-Sorry, couldn't resist.

-Look at you two! Quite the pair!

What's that supposed to mean?

I can see some chemistry bubbling away there!

As if!

Patronising, boring, talks about work all the time,

he could be your perfect bloke!

Right, enough of this. Cut the chat and drink your drink!

I'm going to miss this!

My little girl's not well.

-You can't just stand here.

-Wait!

Let's do a runner!

Oi you, wait there!

Can't you just pull it out? I'll do it if you like!

I want to see you, Tess.

I know you got this RCM thing tonight.

We would have the whole night together.

We have run every test and I think we need to consider

non-medical reasons for what is happening.

-What is your evidence?

-Something doesn't feel right.

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