The Dying Game Casualty

-It is my department.

-She'd be great back-up.

-Back-up?

-Absolutely.

-Seriously?

-You wouldn't say no.

-Well, a score says you can't.

-40 says I can.

You left your colleagues in the lurch.

You made some really irresponsible decisions.

-But Minor Injuries Unit?

-Consider yourself lucky.

This department is in chaos!

You have to get this sorted. They're on their knees. So am I.

As I'm sure you all know, it's a very special day for one of us.

Good man, Fred. It's Fred's birthday.

100 years old.

Now, Fred has been with us at Forest Glade for, what,

nearly a decade now,

and I'm sure you'll agree, he is living proof of the care

and devotion provided by our staff and facilities.

Happy Birthday, Fred!

# For he's a jolly good fellow

# For he's a jolly good fellow

# For he's a jolly good fellow

# And so say all of us

# And so say all of us And so say all of us

# For he's a jolly good fellow

# For he's a jolly good fellow

# For he's a jolly good fellow

# And so say all of us. #

Fire! Fire!

-FIRE ALARM BLARES

-Get everyone out!

Quick! Get everyone out!

COMMOTION

ALARM CONTINUES AND GLASS SMASHES

I need to extend my credit.

I don't get paid for another three weeks

so I can't give you what I haven't got, can I?

Yeah? Well. OK, ask him and see what he says, all right?

Get back to me.

We're only halfway through this shift and I'm wishing it was over.

-Tell me about it.

-Hi, you all right?

-All right? What are you doing here?

Finished my stint in MIU.

I've come in to check the off-duty, see when I'm next in ED.

-Is Tess on duty?

-Yes, she is. And, er, I'd have brought flowers.

And where am I supposed to put this?

Leather looks good on you. You should wear it more often.

I look like Cat Woman's frumpy sister.

And it smells. Don't you ever get it cleaned?

That's the smell of the open road.

-All right, helmet on.

-Oh.

Here, let me help you.

You look great.

-So how am I going to get on this thing?

-Relax! It'll be fun.

Right, on you get.

Wrap your arms around me.

-Oh, now I see what the plan is.

-Tighter.

I don't want to squash the rose. You know,

most men would just take a girl out for dinner on a second date.

I'm not like most men, am I?

All right, hold on.

AMBULANCE SIREN

Downstairs day room, 15 people. They're all out.

Cavalry's here. Gather round.

Fire started in the downstairs day room.

It's out now so we're good to go in.

Dave, Mac, I'd like you to treat the residents out here.

There's a lot of scared, vulnerable people.

Triage as best you can.

Would you like me to get on to ambulance control?

-See if there's anyone available?

-Yeah, OK, great.

The fire's taken out all the electrics - so that's

the medical and monitoring equipment down, so regular obs, please.

Tamzin, we have a gentleman still inside with a suspected

-cardiac arrest, so that's you and me.

-Yup.

-Let's do this thing.

Thanks, buddy.

3006 to Control - looks like we're on our way to you with 15 patients -

all elderly and infirm, some with mobility issues.

-One with a suspected cardiac arrest. Over.

-Excuse me? It's this way.

-Jeff?

-Control to 3006, received, over.

-OK, thanks.

This way? OK.

-This way! Please!

-All right, love, we're on our way, don't worry.

-OK, sweet pea - through here, yeah?

-We're here.

-Room 50. OK.

-Thank you - 50.

Hello? Ambulance service.

-Clear!

-OK, mind yourself, mate, please. Bit of room.

MONITOR SOUNDS THEN STOPS

-OK, I've got a pulse.

-I did it.

-Are you're the nursing manager?

-Yeah, Colin McKenna.

-What's the patient's name?

-Peter Taper.

-Peter. I'm his wife.

Peter? Peter, can you hear me?

He's OK? He's going to be OK, right?

He's 91 years old. Terminal.

Right, OK, what treatment's he receiving?

Pulse is faint. And thready.

He's receiving end-of-life care.

-Any DNR?

-What's DNR?

No.

There's no pre-planned DNR in place.

I mean, I wouldn't be shocking him otherwise, would I?

No. Could you take this lovely young lady outside for me?

-Oh, I don't want to leave him.

-It's OK.

Peter's going to come right out behind you. I promise.

Thanks.

-Jeff, he's dying.

-Yeah, I know.

But without any DNR in place we're obliged to keep him going

till we get him to the ED, aren't we? Nice.

Charlie, er...

Where are those breach reports from last month?

-Guy Self has been asking me for them.

-On the computer, as usual.

Right, OK, erm..

-You finally read it, then?

-Every word - twice.

It's really good. Thank you.

Listen, about what you said.

You were right. I need to take charge of the department more...

And you're a great doctor, Zoe, but...

But I need to be a better clinical lead.

Hi, Charlie. I just needed to talk to you about the quarterly

drug expenditure - I think I've found some savings.

Great. Always open to new ideas.

Ah, Brie and grape?

-Mmm.

-Lovely.

I've never understood why anyone would put fruit in a sandwich.

Well, we all know you're a man of simple taste, Cal.

-Ah, thank you very much.

-Yeah, just that, please.

Oh, ah, I've forgotten my money, hold on. Cal..?

Maggie, can you put that by for me? I'll be back in a bit.

Dr Knight.

-Dr Chao.

-Haven't seen you around this past couple of days.

Ah, you know how it is. Work, work, work.

Any interesting cases?

I can be interested in anything for about an hour.

That's why I became an ED doctor.

I had a fascinating multiple fractures patient yesterday.

He was practically folded in half.

-Sounds lovely.

-I can show you the X-rays if you want.

What are you doing after work?

I've really got to catch up on some sleep.

-We can do that.

-OK.

Last time you wore me out. So...

I just need a quiet night in. We'll do it again soon though.

Promise.

Yeeeyy! Hahahaha! Hold on!

Picking up some speed!

Shouldn't your back-up generator have kicked in by now?

Yeah, I was just about to get that serviced.

You know how it is in the healthcare business.

Never enough time, not enough resources.

-Even in the private sector?

-Jeff, we need to get a move on.

I'll see you in the hospital, Norah. Peter'll be OK.

-What's up?

-There's been a fire in a care home.

15 elderly patients, one potential cardiac arrest.

Start clearing cubicles of minors and warn Reception, please.

They're a mixture of acute and care-of-the-elderly.

The more that we can place in the rest of the hospital, the less will have to wait here.

That's a lot of beds to find in an hour,

we should split with another hospital.

Well, that depends on their bed states.

-Some of them are coming here whatever we do.

-Yeah.

Look, if you'd have been around a couple of thousand years ago, Tess,

baby Jesus wouldn't have been born in a stable.

Do what you do - Max. Max.

I need all the help I can get.

-I owe you.

-OK, but I'm keeping a list.

POLICE SIREN BLARES

Hold on! Hold on tight!

-Whohooah!

-Amil!

Wheheyyy!

THEY LAUGH

All right, lost him.

ENGINE SPLUTTERS AND DIES

-Sonja.

-My arm.

-You're all right.

-My arm.

-You're OK.

-OOWW!

-OK, easy! Easy!

-Ow!

Oh come on, mate! Get a move on, will ya?

How does being blind and deaf qualify you for a driving licence?!

BP's in his boots, Jeff. We need to get a move on, mate.

We'll be as quick as we can, all right, Norah?

-HEART MONITOR BLEEPS

-We've got no output, Jeff!

Peter! Wake up, love - it's me.

Pulse is VT, Jeff!

Norah, you need to let go because I need to shock him. Sit back.

-Still no pulse, I'm starting CPR.

-OK, all right.

-60 seconds, we'll be there!

-One, two, three, four.

One, two, three, four.

RIBS CRUNCH

-Oh, God!

-It's all right, Norah - that sometimes happens.

I'm so sorry, sweetheart.

Who do we have here?

This is Alice from Forest Glade Nursing Home.

-She's 80 years old.

-OK. Hello, Alice, I'm Mrs Beauchamp.

But you can call me Connie. I'm one of the doctors here.

-Can you tell me what happened?

-No.

-No. OK.

She was in the room where the fire broke out,

but there are no visible signs of injury or smoke inhalation.

With your permission, Alice, I'd like to check you over,

and then I think I'll prescribe a good strong cup of tea and some biscuits.

-I need to help with the beds.

-Yeah, that's fine, I've got this.

Lofty.

I know we need to talk before I come back officially,

but under the circumstances I'd like to volunteer for duty.

-Get yourself changed.

-OK.

-But we still need to have that talk when this is all over.

-Look forward to it.

-You're going to love this.

-Toothache?

Didn't you try telling him how desperately we need

-these beds for the care home patients?

-Yeah.

-And he said...?

He said he saw the triage nurse over three hours ago,

and because we only offered him advice and analgesia,

he's insisting he's not moving until he sees a doctor.

-Right. I think I know just the one.

-I've cleared my patient. Next?

-End-of-life patient coming in.

-Oh, right,

I'm on hold trying to get this patient a bed.

Yeah, Charlie, we're on.

Hi. Name, please?

-Amil.

-Er, no, her name.

-Sonja.

-Sonja Egan - she's in a lot of pain.

-OK, take a seat -

someone will come and see you soon, yeah?

-Rita!

-Sonja? What are you doing here?

-She needs a doctor.

-Rita?

-It's OK, I've got it.

-I'll catch you later, OK?

-Do you want to come with me?

-OK, this is Peter Taper, he's 91.

When we arrived he was in cardiac arrest.

He was shocked out of VF by the care home nursing manager.

Developed pulseless VT in the ambo -

he's had 150 joules without effect.

Been unconscious for some time with no output. Query fracture ribs

during CPR, unable to get venous access en route.

Charlie, this is Norah, Peter's wife.

-Please save him.

-I think it might be best

if we were to pop you in the relatives' room for the moment.

-No, no! I'm going to stay with Peter.

-OK. That's fine.

This is Bec, she'll look after you.

Now don't be afraid to leave if you need to or want to, OK?

-Don't worry about Peter.

-How long's it been?

-Erm... Arrival to here, around 15 minutes.

-Stop CPR.

He's still in VT, stand by to shock.

Charging.

OK, stand clear.

Shocking.

OK. Rita, can you start CPR?

-Steady, thanks.

-Thanks. I looked like Michelin man in that.

Wow. How did that happen, Sonja?

She fell off my bike. It's all my fault. I was trying to impress her.

-Not known each other long?

-No.

-Maybe next time, go for the safe option? Restaurant?

-What did I say?

-I'm joking. I loved every minute.

-Really?

No-one could call you predictable.

OK. Can you feel that? And that?

All of them? Give it a wiggle. That's good.

Hopefully that means there's no nerve damage,

but we'll need an X-ray to make sure there's no fractures.

Can't you just take it out?

It's possible it might need surgical removal.

-We'll get you some pain relief in the meantime.

-Oh.

-Let's give her 5 milligrams of morphine.

-So you know Rita?

I was a receptionist at her old ED.

-We were famous for our karaoke double-act.

-Hm. Sounds like her.

OK. I'll be right back with your pain relief.

Just keep pressure on that. OK.

Oh, dear! It was probably going quite well until he smashed her up on a bike ride.

-Not everyone has our easy charm with the ladies.

-Speaking of which...

-You owe me 40 quid.

-You didn't...?

-I'm afraid I did.

-Really?

-Yep.

-Come on.

-You know what? Lily really should know better.

-Yeah.

OK. Stop a second.

He's been asystolic for ten minutes now.

I don't think we can do any more. Are we agreed?

Time of death, 14.50.

No. No. Please. Please, there must be something else.

I'm so sorry.

But... But I'm not ready.

Sorry, Norah.

Mr McKenna said he'd be OK.

Why don't you come say goodbye?

Oh, Peter. Peter.

Peter.

-Jeff. Why did you even start CPR?

-Well, we didn't.

It was the nursing manager, McKenna.

There was a care plan in place, but no DNR.

I mean, the whole set-up was a joke.

They managed to set fire to the place with a birthday cake,

that blew the electrics.

There was no back-up generator.

He hadn't had it serviced, apparently. Pathetic.

It's not right. A man of his age should have been allowed to pass over peacefully.

Yeah.

It looks like you've had some recent dental work, Mr Griffiths?

-Yes. A root filling.

-It may have become infected.

I can give you some pain relief to take home, and if you

call your dentist I'm sure he'll fit you in for an emergency appointment.

No. There must be a dentist here somewhere.

We have an on-call dentist,

but this is not an emergency. I don't think they will see you.

I can give you a list of NHS dentists if you want?

-I'm in pain.

-Yes, I understand that...

-Unbearable pain.

And I'm prescribing you analgesics to take care of that.

Look, I can't sleep. I can't think. I can't eat.

But you really need to see your own dentist.

If you wait in Reception,

our nurse will bring you your medication and you can go home.

-No.

-Excuse me?

-I'm not going anywhere.

Your job is to look after me - my taxes pay your wages.

On that basis, as a taxpayer myself I pay my own wages.

Fetch me a pair of pliers.

If he wants his tooth removed, I'll do it myself.

Colin McKenna, the Nursing Manager.

Hi, I'm Dr Hanna.

We are trying to admit all the patients as soon as possible.

Unfortunately Peter Taper passed away.

-It wasn't a good death.

-Rita.

-I'm sorry?

Peter shouldn't have had to make the ambulance ride.

Rita, why don't you help Tess over there, please?

Sorry. It's a little fraught in here today.

We need one more doctor and at least one more nurse.

Well, Martin isn't picking up his phone.

-Try asking the elderly care team see if they can help us out.

-Yes.

Zoe, we shouldn't be holding elderly patients in reception.

I'm aware of that, Connie. We're trying to manage the numbers.

Managing the numbers is only part of it.

It's about quality of care.

How are we doing?

Mac, can you talk me through this one?

OK. This is Margaret Johnson, 85 years old, involved in a fire.

No obvious injuries.

GCS 14 on arrival, no improvement en route.

BP 110/80, pulse 90, SATS 92%.

Is that everything?

She also has Alzheimer's.

Let's get her straight to resus. I'll take this one.

Yes, I would like to file an insurance claim.

Excuse me, is there anybody with Margaret?

-Any visitors or relatives?

-Not really.

What does that mean? Not really?

Forest Glade Nursing Home, yes. We've had a fire.

Margaret? I'm Rita, I'm a nurse.

I'm going to check you over, OK?

Could you just give us a minute, Mac?

Sweetheart, can you squeeze my hand if you can hear me.

That's great.

You're in hospital, everything is fine, we're looking after you.

But I'll be losing money for as long as we have to close.

Excuse me, take that outside.

Guy. Hello. Bad news travels fast. No, we can cope.

I think Dr Hanna thrives on creating chaos, I'll knock it

back into shape - don't worry.

No, really. That's not necessary.

If you want, you can have a look for yourself, but...

Mrs Beauchamp, can we have some help over here?

Sorry, Guy, I've got to go.

Airway clear - no sign of smoke inhalation.

Let's continue with the O2.

OK, so this lady must have someone come to see her.

Who do you notify in case of an emergency?

Her healthcare's paid for out of her own assets.

I remember a visit from another little old dear

a couple of times but with Margaret's Alzheimer's,

she wouldn't even know she was here anyway.

OK. Can I have her contact details, please?

The Fire Service are still securing the place.

-I won't be able to get back in till tomorrow sometime.

-Of course.

It was more important for you to get your insurance policy as you

walked out the door, rather than the next-of-kin contact list.

I'm a qualified nurse, you know. I provide a good service.

It's not a service, it's a duty of care. You appear to have forgotten that.

Can we get her into a gown, please?

Peter Taper should have died comfortably in bed, not in here.

I'm sorry, but who the hell do you think you are?

-What's going on here?

-Get your pit-bull off me.

What's wrong with you people?

My husband was fine until he came in here.

Can I have a word outside, Rita?

What's wrong with you?

I checked with Peter Taper's doctor about his care plan.

There was no DNR agreed. So McKenna's hands are tied.

-It's inhumane.

-Rita, humans don't die easily.

They cling on until the very last second, you know that.

Sometimes they don't want a DNR. That's their decision.

Not McKenna's, not mine, not yours.

As far as we're concerned, he is the only known contact of Margaret's,

so you treat him like you would any grieving relative. OK?

-I want you to take five minutes.

-I just...

Just take five minutes, please.

..I'm sending my patient up now.

Move them to ITU if you need to.

Oh, you're joking. Oh, come on!

I'll take you to the relatives room.

Norah. I'm so sorry.

-I just think Peter could have died more peacefully.

-Yes, he should.

That paramedic even broke Peter's rib while she was treating him.

Unfortunately, that is not uncommon in elderly patients.

But nobody explained anything to me.

Those ambulance people were talking about a DNR.

I don't even know what that means.

OK. So a DNR stands for do not attempt resuscitation.

It's a legal order that patients can sign that says

they don't want extensive intervention if they're dying.

Didn't Mr McKenna discuss this with you?

No. No, I don't think so.

I only wanted what was best for Peter.

Mr McKenna promised that he would take good care of him.

Of course.

Thank you, Norah.

Do you think he should have had one?

-One of those DNR things?

-Only Peter could have decided that.

Let's go.

-That looks tricky.

-Trust me - I know how to tie a girl up in knots.

He's as bad as you.

-Hi, Sonja. We got your X-rays back.

-Ah, ouch.

We're going to have to send you off to theatre, I'm afraid.

The way the wood's splintered inside means we'll have to clean it out surgically.

In the meantime, can you get Sonja a gown

while I talk to the orthopaedic surgeons?

And let's get some antibiotics into her -

1.2 grams of co-amoxiclav IV and a tetanus booster.

Rita. I'll be here overnight now.

-Give us a chance to catch up when your shift's over.

-Overnight?

You got a wife and kids to get back to?

-No, I just don't want to be in the way.

-Don't be silly.

What about you, Rita? Any kids yet? How's Mark?

Is he still dragging you down White Hart Lane every other weekend?

Rita's husband was a big Spurs fan.

No. No, I didn't.

We should all got to get together some night.

He's dead.

Mark's dead.

Rita, I'm so sorry...

Would you excuse me?

I feel terrible, I didn't know.

Let's not worry about that for now, let's concentrate on you.

-We need to get you into this.

-I can manage myself.

OK.

Hey, how's she doing?

Pulse, BP, SATS are all fluctuating. She is basically trending downwards.

I spoke to Norah about why Peter didn't have a DNR in place.

-OK, and...?

-She said McKenna never discussed it with them.

He said there was nothing agreed,

but he didn't half seem shifty about it.

You don't make any money from the residents once they're dead, do you?

-MARGARET GROANS

-All right, Margaret.

OK, she's burning up.

Jeff, can you find McKenna for me, please?

I need to know everything about this woman's medical history.

OK, I'll do it now.

Sats are 95%.

Date of birth?

7/6/...1914?

Fred, I think you're playing with us.

A good-looking young man like you couldn't possibly be 100 years old.

-I can.

-Prove it.

Oh, you have got it! Look at this.

-That's from the Queen?

-Yeah.

Get to be 100, you get congratulations from the Palace.

I'm so adding that to my bucket list.

Well, I would love to offer you champagne,

-but unfortunately, we've only got tea.

-Oh.

I know. Maybe next time.

I've got an idea.

I managed to get your dentist on the phone.

She tells me she prescribed the appropriate pain relief

following your recent dental work.

Well, it's not working, is it? I don't care what they say.

Let me have a look again.

Have you been drinking?

-No, I haven't.

-I can smell it on your breath.

And I don't need to be a doctor to work that out.

Well, since you haven't been helping me,

I've been self-medicating for pain relief.

Whisky numbs a painful tooth. Everybody knows that.

An entire flask? Your tooth is not that big.

I'll keep this safe for you until later.

HE SIGHS

I'm told you were looking for me.

Yeah. I need a full medical history.

She's 85 years old. How long have you got?

-That's not helpful, McKenna.

-It's Mr McKenna.

Right, Rita.

She's pyrexic at 38.5.

OK, let's hang up another bag of saline,

give her a gram of paracetamol, and I'll do a venous blood gas.

She has a history of acute UTIs. We need to do a dip test.

FBCs, U and Es, and a urinalysis, please.

Yes, I know, we've got it, thank you.

-And one gram of amoxicillin IV.

-Only trying to help.

I am a fully qualified nurse.

Yeah, you said that, but it takes more than qualifications

-to be a nurse.

-Rita!

I'm sorry, but he didn't even tell Norah

that a DNR was a possibility for her husband!

Yeah. that's because it was something

I knew she wouldn't even consider.

I might not.

But he might have.

I sorry, I forgot my handbag.

Norah, lots of people would have given up on Peter long before I did.

My Peter fought in the war.

Serious action in France and in Burma.

He was no coward.

He knew the difference between a good death and a bad death.

Norah...

You should have given him the choice.

He should have died more peacefully.

Alison, can you help Norah back to the relatives' room, please?

Rita, I need that urinalysis.

-I never had you down as a drinker, Dr Chao.

-I'm not.

-I don't even like wine gums.

-Everything in moderation, eh?

Are we going to talk?

-About what?

-About what?!

About your views on warfarin versus novel oral anticoagulants

for atrial fibrillation. What do you think I am talking about?!

Like I said, Lily - everything in moderation.

Everything OK?

-What are you doing?

-Right now?

Praying for this shift to end.

No, I mean with Lily. What's going on?

Nothing. I think that's her problem.

Will you say sorry to Rita for me?

I didn't mean to upset her.

Don't worry. Rita will be fine.

OK, that's your antibiotics.

So, how long've you two been together, then?

-AT THE SAME TIME: Early days.

-We're not exactly together.

I'm still...wooing her.

BOTH: Wooing?

-This is what you call wooing?

-Nah, good man.

Right, tetanus coming up. You'll feel a sharp scratch...now.

You all right there?

Did you hurt that in the crash? Do you want me to have a look?

-Nah, nah, it's fine. Just an itch.

-OK.

Well, I'm going to leave you to woo her some more.

But I'm leaving the curtain open, all right?

Rita. You all right?

I'm fine, Fletch.

Let's not, please. It was a long time ago.

OK. But...you know,

if you do want to talk about it.

I'm sorry. Another time, OK?

-OK.

-It's not you. I'm just cranky. I haven't eaten all day.

That blinking machine, it swallowed all my money

and it's given me nothing in return.

-It's not my day.

-OK. Here.

-Oh, no, no.

-Get yourself something to eat.

-Sure?

-Course.

Pay you back tomorrow?

-Guy!

-Hello, Zoe.

If you're looking for the breach reports,

I'm sorry, but we have been really busy.

Yes, I can see that.

Actually, I'm not here about the reports.

No?

It's been brought to my attention that some of the care home residents

that have been brought in today

have had to wait some time for a cubicle.

Funnily enough, Mrs Beauchamp expressed similar concerns.

But you will be happy to know that we have found beds

for all the care home residents and they're getting treated as we speak.

There was one death. Frankly, I'm questioning whether

he should even have made it onto the ambulance.

Apart from that, everything is in hand.

Good. Sounds like you don't need my help.

So, I'm going to let you get back to doing what you do best.

HE GASPS

HE RETCHES

OK, we've got two care home patients in resus, one left in cubicles,

and all the rest have gone up to wards.

Thanks for holding the fort, you two. You've done a great job.

Hey, we're not just employed for our good looks, you know.

-Ha!

-Especially not you.

What did Guy want?

Guy? He wanted to share your thoughts

on the inadvertent holding pattern that we had in reception earlier.

Well, I'm sure you see just the one death

as a small victory under the circumstances.

-It'll be two before the day's out.

-Excuse me?

This is an emergency department, Connie. It's not the Keller Ward.

-Darwin.

-We don't have time to play office politics.

-Maybe you should.

-Every single day it is emergency and death.

Once you get your head round that, you and me will get on just fine.

-Excuse me.

-The difference between us,

-I will never get my head around losing a patient.

-This is not the place for this.

-Oh, really?

Thank you, Connie.

I know. I know.

Sonja?

-She's having a snooze.

-You sure you're all right with that ankle?

Yeah, yeah. Since she's going to be in theatre and out of it

and all that, I might shoot off now and come back in the morning.

Sonja, can you hear me?

I need some help in here!

-What's wrong?

-Hang on.

-What's going on?

She's not responding to physical or verbal stimulus. Excuse me.

Pin-prick pupils. Let's get her to resus, please.

-What's going on?

-Did Sonja take any drugs earlier today?

-What?

-Be honest with me, Amil?

-No! We just went for a bike ride.

Can you keep an eye on him for me, please?

Right, guys, she's displaying signs of an opiate overdose.

Let's give her 400 of naloxone and, Fletch, can you do an ECG?

Yep.

How did we not know about this?

She hasn't said anything.

Probably because her brand-new boyfriend's been there

the whole time and it's only their second date.

I'll get the surgeons to release her theatre spot.

We'll need a full medical history before we pass her over to them.

Margaret's dip test proved positive for nitrates,

haematuria and leucocytes.

Let's make her as comfortable as we can.

There's not much more we can do for her.

You were right about him,

but McKenna's not who we need to focus our attention on right now.

It's Margaret.

We'll deal with him later, OK? I'll sort out some pain relief.

Margaret? It's me again.

I know I go on a bit, but I'd love to hear some more about you.

Is there anything we can do for you? Is there anyone I can contact?

You don't have to think.

Just listen to your heart.

Hello.

All right?

What can I do for you?

Purse?

Going to open it, OK?

Margaret, is that you on the left?

How hot were you, Margaret?

Who's that on the right?

Jenny.

Jenny your friend?

You want me to contact Jenny?

Margaret, how am I going to do that?

Is she in here? OK.

You hang on for me. I'll be back in a minute, OK?

(Good work.)

-RETCHING

-Lily...

Oh!

Mr Griffiths.

Want to tell me about this?

What is it doing here?

Do you really think you're the first person ever to try

drinking the hand gel in hospital for its alcohol content?

Well, it was a first for me, I'll admit it.

-Much rather have a decent malt.

-What else have you taken?

-Remind me what medication you're on.

-I don't know what it's called!

-Metro...metro dazzle, or something.

-Metronidazole.

Show me.

They're not working. They just make me sick.

It's not the pills making you sick, it's the alcohol.

And there's no way a dentist gave you these without telling you

to abstain from alcohol during the course of treatment.

Doctors always say that. Nobody ever takes any notice.

What, and being sick didn't make you think otherwise?

All you're doing is throwing up the medication straightaway.

No wonder your tooth is getting worse.

Take it out and I'll be fine.

Mr Griffiths, the NHS is not in the practice

of whipping out healthy body parts

just so you can go on killing yourself with alcohol pain-free.

What we can do is help you recover.

Regard your dental abscess as a warning from your body.

It doesn't like what you're doing.

I can prescribe you diazepam to help with the withdrawal symptoms,

and recommend you to a programme

that will help you cut down your alcohol intake gradually.

Would you like me to enrol you?

Yeah. It's killing me, isn't it?

Yeah, OK.

Good.

Doctor?

Thank you.

-Long day?

-Aren't they always?

Do you want to talk about it?

Alcoholic abusing prescription meds.

-Old story.

-I meant if you ever need to talk about Cal, then I'm here.

Why would I need to talk about him?

I just know how... unreliable my brother can be.

I'm not relying on Dr Knight for anything.

No, no, of course not...

And I hope he isn't going round telling people otherwise.

No, it's just me.

You?

No, I didn't mean...

Sorry, I meant, I saw you together and I know what he's like,

how he can upset people.

I'm really sorry if I got this wrong.

Tell you one good thing about throwing up antibac -

at least it's sterile vomit.

-Do you think he'll ever give up the drink?

-Yeah, course he will.

He knows he'll have Lily to answer to if he doesn't.

If you ordered me off the booze,

I'd have a fridge full of mineral water

faster than you could say "ventricular tachycardia".

Anyway, lovely to chat as always, but yes, things to do.

-Hey, what are you doing with that?

-Orders from above.

It's for Fred, the old boy who got his telegram from the Queen today.

-We need to put 100 candles on it.

-100?!

-Right, come on, then. You too.

-It's what Her Majesty would want.

-Did you hear about Rita?

-Hear what?

Apparently she used to be married. Husband died.

Oh, mate, that's terrible.

Seriously?

-What?

-After what happened today?

You're going to put 100 candles on a cake

-and light them in here?

-It was his idea.

-You only need three anyway.

-Three?

Think about it.

-Lofty? Shall we have that chat now?

-I was hoping you'd say that.

I know.

To tell you the truth, Jenny, even if you left right now,

I don't think you'd be here in time.

I want her to know that she's not alone

and for you to know how sorry I am that this news has come too late.

I would put you on the phone to her,

but we just don't have that facility in resus.

I'm so sorry. I will pass your message on.

Bye.

-Everything all right?

-Elderly patient in resus.

Spent most of her life in a same-sex relationship,

and now her partner's family have put her

in their local home, which is miles away.

I'm just trying to find them some closure.

Oh, no! Whose cake is that? I'm starving.

-If you're 100, it's yours.

-HE LAUGHS

Listen...I've only just heard about your husband.

I'm really sorry.

Thank you, Noel. I prefer not to talk about it.

Course...

-Can I have a mobile phone top-up, please, Maggie?

-Oh, yeah.

Right, well, we are going to need to take a full medical history.

-Could you excuse us?

-No. Stay.

You need to know this.

Are you sure?

Yeah.

I like you, Amil...

-Do you?

-Yeah.

-I just wanted to know that you liked me too, before I told you...

-Course.

What?

I'm guessing you're probably on quite strong pain relief.

Co-codamols?

-So we overdosed on you with morphine.

-Yes.

-You did what?

-It wasn't their fault.

I should have said, but you were here the whole time -

which is lovely, and thank you...

Look. I have no idea what any of you are talking about.

My mother died of cancer. My grandma too.

They both had the same thing.

Breast cancer.

So, I've had an elective double mastectomy three months ago.

Mastectomy.

That's...

that's...

-Both of them?

-Yeah.

I've been having reconstructive surgery too.

-A few more months and I'll be fully healed.

-How many?

Two, three...

It's my birthday in three months.

Now I know what I want for it.

Are you sure you don't have a wife and kids at home?

Look, since we're being honest...

It's nothing serious, I swear.

Bloke was beating up on his girlfriend outside the pub one night

and somewhere in all the kerfuffle, he got a broken nose

and I got a year's community order and a nightly curfew.

I should have been home by seven.

I'll be nicked now for breaching my conditions.

-You've risked getting arrested to be here with me?

-Sorry.

I was going to tell you...

Look, I can't promise anything, but I could talk to the police,

-explain the circumstances.

-Yeah?

I can try.

But I'd give them a call pretty sharpish

-before they come looking for you.

-Yeah.

Yeah, I'll do that right now.

So what do you say?

I'll still have you if you'll still have me.

Jenny?

It's Rita Freeman again, from Holby City?

I've had an idea.

Zoe, can I just...?

Margaret? Margaret, love...

I've got Jenny on the phone for you.

OK, Jenny, I'm going to put her on.

She probably won't speak to you, but she can definitely hear you, OK?

CONTINUOUS BEEP

(She's gone.)

She was smiling. She definitely heard you.

PHONE RINGS OFF

Excuse me, sorry. You seem in a bit of a hurry to get away.

I need to check in with the care home again,

see how soon we can get the facilities

-up and running again for our residents.

-No.

-No?

-There isn't a single resident

that will be setting foot in your home again.

I have no idea what you're talking about.

You're not providing palliative care for your patients.

You are simply maintaining them.

Nonsense.

I have years of experience.

I can do the job just as well as you.

Do you know what the only difference is?

-I'm better paid.

-Yeah, you're better paid because you're keeping

your residents alive and squeezing every last penny out of them.

-How dare you!

-Oh, we dare.

Nursing is a vocation, it's not a job.

-Nobody becomes a nurse to get rich, Mr McKenna.

-I don't know where the money goes.

You didn't even get the back-up generator serviced!

-This has nothing to do with you!

-It's got everything to do with us.

Peter Taper had a bad death today, and that was your fault.

Because had he been under our care,

yes, he may have died a few days earlier,

but his wife would have been prepared

and he would have been prepared.

They would have got the ending that they deserved.

Margaret Johnson just died now with joy in her eyes,

and that is because Rita cared.

That wouldn't have happened in your home.

Right, so you let them die and you're blaming that on me?

No. We saved them from suffering. We're blaming that on you.

Better start looking for a new job. And not in the health industry,

because I will be reporting you

to the Care Quality Commission and the Nursing Council.

You won't be treating any patients again.

Hey, he's here.

# For he's a jolly good fellow For he's a jolly good fellow

# For he's a jolly good fellow...

# And so say all of us. #

THEY CHEER

There you go. One, two, three...

THEY CHEER AND APPLAUD

-Will be good to have him back.

-Sorry?

Lofty. I told him he needed to shape up,

but he's the only one who would be thoughtful enough to arrange this.

-Night, Tess.

-Oh, yeah. Goodnight.

I've already told you, I don't get paid for three weeks.

When I get it, you'll get it.

Long day?

-I have never felt so old and tired.

-No, come on.

Oh, don't start being nice to me, not now, Max.

I was going to say terrible, but there you are.

That's more like it.

Listen, thanks for today, for staying. I do owe you.

-Like I said, I'm keeping a list.

-See you tomorrow.

-Zoe...

-Mm-hm?

I think you look amazing.

-I thought you were giving up?

-I was.

-Connie? About earlier...

-Oh, forget it.

-Really?

-Yeah, forget it. I have.

-Good.

I thought you weren't going to make it.

So did I.

Really, Zoe is... that department is so disorganised.

You look like someone who could do with a drink.

And you look like someone who's buying.