Unhinged Casualty

Becoming a bit of a habit, this - hanging around waiting for accidents to happen.

You're a great doctor, Zoe, but...

But I need to be a better clinical lead.

There has been a fire in a care home.

15 elderly patients, one potential cardiac arrest.

I think Dr Hanna thrives on creating chaos.

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

had to wait some time for a cubicle.

Funnily enough, Mrs Beauchamp expresses similar concerns.

You were in an accident?

-It wasn't his fault.

-No, it wasn't my fault.

-Well, why didn't you say?

-He's too busy worrying about his cab being off the road for so long.

-You promised!

-Look, I was going to...

-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.

-Every single day it is emergency and death.

-That's the difference between you and I.

I will NEVER get my head around losing a patient.

-Mrs Beauchamp.

-Mr Self.

Just wondering what level of hell this is?

Oh, I'm sure you're welcome in all of them.

Any particular reason for this chaos?

I'm trying to find out. None of our patients are being admitted upstairs

and cubicles are currently all full so it's bottlenecks out here.

And where is your brave leader, Dr Hanna?

Louise.

She's running late in a very important meeting.

The emergency department figures were very pointedly

left on my desk by the Chairman of the Board.

How annoying. Hope you got to read the newspaper anyway?

How in your vast experience is Dr Hanna coping as clinical lead?

There is a phenomenal amount of traffic through here

with ever-decreasing resources

and the inefficiencies of the NHS dripped down on our heads.

That was a very political answer, Connie.

It was a very political question, Guy.

You know, this ship needs a reliable captain at the helm.

Otherwise it'll sink.

I'd better get on.

MUSIC: "I'm Still in Love With You, Girl" by Alton Ellis

It's OK, Arthur. It's Carly, it's OK. Dinner's ready.

So come on, let's sit down.

Come on - up you get.

There we go.

-MUSIC AND CHATTER

-Oh, it's just some silly little kids having a party.

I'm sure they'll stop soon. I've made you a lovely shepherd's pie.

-No.

-Yes. Please!

-No.

Arthur, please.

I know you're not used to me, but Jenny is poorly,

so we have to learn how to get along now, don't we?

Now, I really need to keep this job. So...

..please?

Yeah.

There we go.

Well, what are we supposed to do?

Oh, yeah. That's great. thanks.

Plastics can't take her.

They say they're full and they don't know who with.

-There. Like new.

-Wow!

I've got a pair of jeans at home that need stitching.

How much do you charge an hour?

Tell plastics they can book her in as an out-patient.

No need for a surgical bed?

Absolutely not. Well done.

PHONE RINGS

Hi, Mum. I got here fine.

We're in the cinema queue.

We're going back to Katy's after.

One sec. Yeah - what?

Keep dem eyes away from me, boy. This gal ain't for you.

You waste man.

Yeah. I'll be home first thing tomorrow.

I've got heaps of homework. Bye.

Excuse me? Excuse me?

Can you tell them to turn it down?

-Otherwise I'll have to phone the police.

-Get a life!

Look at this thing of beauty!

Wow.

This took me all day.

No, no, it's impressive.

Look - perfectly filed admin.

If this is what it'll take to silence the sceptics, then so be it.

You turned down dinner with me for this?

You really need to clarify what you call dinner!

But, yeah, I have to put the ED first, Max, and my own personal satisfaction second.

Just to clarify this personal satisfaction.

-We're talking about filing, right?

-Yeah.

No, don't do that!

MUSIC AND CHATTER

BANG

Here's your spoon. There you go.

Oh, nearly! Not quite. Let's have another go.

Oh, for the love of God!

No. That's dirty!

No, Arthur. No, no, no, no, no.

NO! Stop it!

Arthur! Ow!

Arthur, no!

No! Arthur, please.

Arthur, please! Stop it!

Arthur!

Oh, I'm sorry.

I'm so, so sorry.

Oh, Dr Hanna. Guy Self was looking for you earlier.

Where is he now?

He sprinted for the door when patients started complaining to him.

Will you take this to my office, please?

Who did he speak to?

Of course he did.

Right Zoe, we need to come up with a plan. This is not workable.

-Right, fill me in.

-Cubicles - there are none free.

The wards are all pleading full and not taking transfers.

-Resus is at capacity.

-I've just spoken to the bed managers.

There's been an outbreak of C. diff. They've closed two medical wards.

I think we should divert. At least for a couple of hours.

Breathing space would be very useful.

Divert? That's a bit extreme. We've dealt with worse than this.

Tell you what we'll do. We'll set up a triage in reception

and try and get rid of some timewasters

and I'll put a rocket up management, see if we can't find some beds.

I tried site managers and the wards but no luck.

-Have you tried the on-call exec?

-Not yet.

Well, let's try that.

That's a perfect way of getting a toy confiscated.

I want to lodge a complaint. I want to see someone in charge.

That would be me - Dr Hanna. Hello.

This is Mr Somers. His son Evan has been waiting three hours.

We've been moved from pillar to post. OVER three hours.

-What's wrong with him?

-His eczema's flared up. I wouldn't have brought him in

-but the GP won't see him until Monday.

-I'm really sorry about the wait.

As you can see, we're busier than usual today.

I will fast-track you just to make up for it.

Dr Chao, as soon as you're free, can you deal with Evan, please?

I'm sorry. I have five patients waiting.

Listen, I don't want to seem difficult, but I'm already late for work.

I need it to happen now or not at all.

Let me see what I can do. Take a seat.

Yeah, OK. Roger that, control.

Some old fella's had a fall on the seventh floor.

Yeah, this is it. This is where the reports of a noisy explosion came from.

Police got here quick, didn't they?

-Yeah, well, it's notorious, this place, ain't it.

-Really? It's Shakespeare's Heights.

Well, you can see why Romeo lobbed himself off the balcony now, can't you!

WOLF WHISTLE

She'll have you for breakfast, mate.

Pull your trousers up.

Hello, ambulance service.

Can you watch yourselves, please?

LOUD MUSIC

Tamzin?

Can you hear me, sweetheart? Hello? Can you hear me?

Right, Jeff. There is a lot of drunk and - going off the smell - stoned.

Yeah. Can you do me a favour? Can you take over, please?

Open that window.

Right, let's have a look at you.

This is as old as the Ark, isn't it?

Do you reckon that was the explosion?

No, I think they'd be in a worse state if it was.

-You taken anything other than this, sweetheart?

-Leave me alone.

It's still connected, though. Someone's been playing with that.

How long have you all been here?

What you thinking - carbon monoxide?

Yeah, can't rule it out.

-This lot are going to have to come in.

-Really?

Yeah, I'm going to radio in. They need to send another crew.

They're going to love you, Jeffery.

Yeah, don't they always. 3006 to control.

I'm just going to sit you up.

-You OK?

-Yeah, just been on my feet too long, that's all.

You need to try Pilates or something.

I don't like foreign food.

Oh, you're hilarious.

Can we take his temperature again?

Just going to listen to your chest here, mate - all right?

Has he got asthma?

We've got blue and brown puffers all over the house.

-Sit forward for me. Have you got anything for the eczema?

-Yes.

Steroid creams. We haven't been keeping on top of it, have we, lad?

It's 38 degrees.

OK. Sit yourself back.

-Do you want me to get you something for that?

-Ah, please.

Lily? Got a lad here with a fever of 38 degrees.

-Asthma and eczema.

-Listen, seriously, I don't have a minute, we've got to go.

-It's really important that the doctor has a quick look at him, all right?

-OK. But I can't stay.

I'm going to have to leave him here with you for a bit.

No, I don't want you to.

I'll lose my job if I don't show. Then what?

Listen, we're really under pressure tonight.

It would be hard for us to give Evan the attention he needs. You really should stay.

We're not being fobbed off any more. That woman said she'd see us quickly.

Dr Hanna? I'll see if she's available.

-Whatever. It just needs sorting, quick.

-OK.

-OK, sweetheart.

-I love a girl in uniform.

You're very original, mate.

You wouldn't know what to do with it. Get a move on.

Right, Tamzin.

Let's go and sort this fella on the seventh floor, shall we?

-Jeff!

-Yeah.

Excuse me.

Hello. Jeff! Jeff!

Tamzin?

It's all right! He's conscious. You're all right.

I thought he was dead.

Right, Zoe. Take a deep breath - you're not going to like this.

St James's are closing down their ED. They're diverting everyone.

They can't possibly be under more pressure than we are, surely!

That's what they say.

We're receiving all the ambulances for the region.

What are our options?

My advice is call St James's.

The problem may not be as bad as they say.

We'll only waste more time arguing with them that we should be putting into the patients.

Er, Zoe. Heads-up from ambulance control.

There's been a possible gas leak at a flat

involving a group of partying kids.

They're possibly - definitely - sending them in here for tests.

OK. We can handle this. Let's get all hands on deck.

-Gather the team round Admin. I want to address everyone.

-Zoe, I really need you!

Sorry, I'm coming. Louise, don't ask any questions. Just find out who's available

this evening to come in, yeah? OK.

Charlie, can you put more pressure on the wards?

Yes, I will get on to them.

Mr Somers, and he wants to leave.

Mr Somers! I am so sorry.

He says he's feeling better and I've got no choice. There's a boat load

of Romanians queueing up to do my job at half the price.

-Would you see us on the streets for a bit of eczema?

-Why don't you let us fully examine him first?

-Listen!

We lost his mum last year and ever since, he's been nothing but poorly

and you lot have been nothing but useless.

I'll take care of him, like I always have to.

-You'll be leaving against our advice.

-Yeah, yeah.

I can't physically force him to stay, Fletch.

Right, let's have a look at you.

Why are the ambulances stacking up out here?

Just heard over the radio - St James's is closed,

so they're delivering all their patients here.

It'll be a long night, babe.

So we'll have plenty of time for a nice chat.

Right, let's have a bit of a look at you here, shall we?

Whoa, whoa, whoa! All right, then.

OK - listen up, everyone.

I know it's a crowded night, but it's just about to get worse.

We're already under pressure with the closing of St James's

but we have a large group of partygoers about to descend upon us

with potential CO poisoning.

Are they all going to need admission?

No, most will be "walking worried".

So what we're going to do is we're going to set up

a "see and treat" clinic at triage.

I'll do that myself with Charlie and Lily.

What's the order of the assessment you'd like us to follow?

I want a venous blood gas on everybody,

to assess their carboxyhaemoglobin levels.

We can run those ourselves in under five minutes each.

You have no cubicle space left. How do you propose treating those who need immediate medical intervention?

While we're waiting for cubicle space, we're going to have to keep

patients on trolleys and give them some O2 as an interim measure.

Unless anybody else has a better idea.

Right, let's get to it.

Thanks.

You shouldn't be here.

I checked the off-duty. You actually shouldn't be here.

It's fine.

You're either out of pocket or avoiding home. Or it's both.

-Which one is it?

-Look, it's fine. I'm covering.

And pretty good job as well, eh?

This is Arthur Swanley. 84 years old, he's got a laceration to the back of his head. He's had a fall.

All his obs are normal, though, but he does have a history of dementia.

I'm sorry, I'm not triaging minors.

OK, well, who is and where are they?

-I'm not sure. But I can find out.

-Thing is, we can't really leave Arthur out in the corridor, can we?

I know, but we're stacked up in cubicles and we're right back up in the corridors.

Right. Appreciate that, Robyn, but Arthur needs treatment.

OK, I'll see what I can do. OK?

Right, OK. Follow me, then.

Unbelievable!

Right, Arthur. I'm going to leave you here, mate, to try and get you sorted. I'll be right back. Zoe?

I got an old gentleman here. He's got a scalp laceration.

-Looks like I'm going to have to leave him in reception. Is that all right?

-Yeah, we're full. Sorry.

Louise - any joy with the on-call exec?

I tried. I've called three times but she hasn't answered her bleep.

Give me her number.

Right.

OK, Charlie. Anything?

Yes. They say they can't discharge in the middle of the night.

They've got a couple of elective surgery beds but they're reluctant to give them up.

Well, they need to give us them. Can you call them back?

Yeah, I will, I will. Just give me a minute. All right, all right, you mob.

Until I can get cubicle space, I got nothing.

-But virtually every ambulance we've got is blotted up outside, with patients on board.

-I know.

So if we have a cardiac arrest ten minutes from here,

-tell me how that person isn't going to die.

-We haven't got any options.

-Arguing the toss isn't going to help.

-I'm not arguing.

-I don't want to end up the front cover of tomorrow's newspaper, that's all.

-Can I help? Jeff, Jeff.

Yes, you can, please. Arthur Swanley. He's outside.

Perhaps you can look at him for me. Thank you.

Yeah, can I get some help in here, please?

You go. I'll take care of this.

And call Guy. He needs to know what's going on.

Ethan, thank you so much for coming in at such short notice.

-No problem.

-What happened?

We couldn't get her on a trolley. Pulse 80, resps, 22,

-Max, can we get a trolley, please?

-Sats 97%. She's been drinking - confused but conscious.

Can you hear me? What's her name?

Paramedics couldn't say.

They found her collapsed in the bath next to the faulty CO boiler.

-Right, let's get her onto the trolley and straight into Resus.

-Dr Hanna?

-Yes, I'm coming.

Right, Ethan - Resus is all yours.

-Really?

-Is that a problem?

-No. Not at all!

-Good.

-Yes.

-Up you come.

Can I get a toilet break? Will you be all right with him?

Can you hold him still, please?

Be good, Arthur. The doctor's here.

I don't think he likes me.

How long have you worked with him?

I'd say about three hours. It's not going well, is it?

I'm just going to look into your eyes.

No, Arthur.

It's all right. Hey, hey, hey!

Steady, old boy.

We're just trying to make sure you're OK. All right?

You're an old war horse, aren't you?

You remind me of my dad. It's good to see a fighter.

He's very aggressive. The agency didn't tell me that.

I'm used to dementia patients, but nothing like this.

He's scared and defensive.

Have you tried to contact his next of kin?

I tried phoning the agency, but no-one's answering.

How did he fall?

There was an explosion outside or something. I was in the next room.

All right, I am going to get one of our nurses to change that dressing

and then we'll get you out of here as soon as we can.

I can't take him back alone.

It's not safe, I'm not properly trained. Please. Can he just stay here?

I've got the F2 on medical take on the phone. Someone needs to get this.

I will call them straight back, thank you.

I'll have the Care For The Elderly team look into it.

I apologise for having to treat you in reception, Mr Swanley.

All right? Good boy.

-Excuse me - could you stay with him just for a moment? I'm desperate for a wee.

-No.

Excuse me. Could you watch Arthur a moment?

-I'm not sure I can.

-I need some replacement O2 cylinders.

-Please. Thank you so much.

-Max! Now!

Sorry, could you keep an eye on him for a minute?

No self-respecting hospital would do that to a patient.

I have an 84-year-old with dementia

who shouldn't be made to wait in a corridor.

I am still speaking.

You can't put outliers in one of Dr Mangot's beds?

Let me remind you, they're not his beds.

I'm not asking you to put Mr Swanley in his spare room.

Get back to him and let me know when I can transfer my patient.

Hi. We're ready for your mum, if you want to bring her through.

So let me get this right - you're refusing treatment?

Can I ask why? You can talk to me.

Thanks. Do you have epilepsy? Bitten your tongue?

How are we doing here?

We are very drunk and a little aggressive.

You ever seen it so busy?

I pride myself on being unflappable. Panic never solves anything.

You seen this?

Could be bulimia. Let's start with some fluids.

HE GASPS

No. No more excuses. I'm running out of ways of expressing how urgent

this will be if I don't move patients in the next hour.

Do you understand?

I've got a problem.

Great, cos I don't have enough.

Trolley patient, elderly lady, needs the toilet.

Faster, Lofty.

I can't make her use a bed pan in public.

Improvise.

Improvise?

Well done. Good call.

Let's get some food in you.

Can you breathe OK?

Where's your puffer?

Here.

It's the right one, isn't it? Blue?

We're doing OK, aren't we, Evan?

I get to keep my job,

and you get a better night's sleep than you would in the hospital.

Good lad.

Excuse me, have you seen the man in this wheelchair?

Excuse me, I'm looking for an Arthur Swanley - S.W.A.N.L.E.Y.

I can't find him anywhere.

-He's gone.

-What do you mean, gone?

I just went to the loo, I left him with him.

No, I told you I couldn't. I got called away.

Put a call out for Arthur Swanley. Check all CCTV, please.

Get looking for him!

Her blood gas showed carboxyhaemoglobin's fine.

Rest of the bloods are normal too.

Sweetheart. I'm Rita. I'm a nurse in Holby City Hospital.

Darling, you were found in the toilet at a party.

The paramedics were called out to an explosion.

Do you remember anything about what happened?

Sweetheart, what's your name?

I ain't telling you. You waste.

We've just had an elderly patient with dementia go walkabout.

Well, that's not necessarily our fault.

No, it is entirely our fault.

When the place is this busy and not under control,

that's when mistakes happen.

Zoe, this is a big problem.

Connie, this is a solution.

If I feel conditions aren't safe for the patients,

I will have to call Guy.

Fine. Call him. What's he going to do? Undermine me?

Shout at the staff? That will help.

What we need to do is to stick together, Connie.

Come on, we'll find the patient.

Someone will see him and we'll fix him. That's what we do.

We clearly need to do it better.

-There's nothing.

-Why was he left alone?

I had to go to the loo. I left him with him.

-Is this true, Max?

-Of course not. I asked the woman next to him to keep an eye on him.

-We don't need this. Not tonight.

-Hold on. You told me to get the O2.

I couldn't exactly say no. And I am really sorry

-but I clearly told you I couldn't look after him.

-I didn't hear you.

We need to sort this out, but our priority is to find the patient.

-What's his name?

-Arthur Swanley.

Just so we're clear, I'm a porter, not a nurse.

Max, save it. Just help find the patient.

GASPING

You OK?

Evan! Are you OK?

What's up?

Take some of your puffer.

It's...it's run out.

Why didn't you say?

I...don't...want...you... to lose your job.

What are you like? Sit yourself there. Stay there, stay there.

GASPING

Hi. It's my son, Evan.

He's got asthma and all his inhalers have run out.

He's on a repeat prescription. The blue one. The salbutamol.

Is there any way that you could bring an inhaler over here?

That someone could bring an inhaler over here?

It's an emergency.

I'm sorry.

Stop saying sorry.

Arthur?

Arthur!

Arthur!

Arthur!

Arthur? Does he wander off a lot?

-I don't know.

-Don't you think you should know?

-I'm on cover!

Arthur?

Sorry I got you in trouble.

It's OK.

-Your boss is a battle-axe.

-She's fine.

It's not your fault if she's not put enough staff on, is it?

Listen, we're in the same boat.

Guess who's going to get it if we don't find Arthur.

It's never the bosses, is it?

Yeah, I know.

-Arthur!

-Arthur?

CAR HORNS

-Right, no more messing. What's your home address?

-Why?

You going to beef cos I ain't from your ends?

I'm afraid I've no idea what you're saying.

So what? I ain't talking to you, you waste.

Look, just because you talk like some big gangster doesn't deny

the fact that you're a actually a vulnerable young girl.

So let's drop the scary act, OK? You're underweight

and if I don't get some details now, you're going to slip

through the system, and I won't let that happen.

Just say the word, and I can call someone for you.

OK, mystery man, let's play the yes-or-no game.

You don't want treatment?

Are you in pain?

Is there anything I can say that will get you to cooperate?

-I'm leaving.

-No, you need to stay where you are. Social services have assessed you.

-We can't let you go off on your own.

-You can't keep me here.

As well as being underweight you are displaying signs of bulimia nervosa.

Do you know what that is?

We see a lot of young girls like that,

unable to help themselves. She's just scared, I imagine.

What will happen...what, if she doesn't help herself?

Long-term health issues. Care system.

Prison...worse.

Fair to say she's still being resistant.

We'll have to move her out. Can we get the relatives' room cleared?

-She can't go far without her clothes.

-Exactly.

Pervert.

Unflappable?

Unflappable.

OK, John. Good.

"Holby control to 3006. 3 Medallion Mansions. Mare Street.

"Male child with possible breathing difficulty."

3006 to Control. Received that, we're on our way. Over.

-You OK?

-Yeah. It's Dave.

We had plans this weekend, but he's forgot he's on a stag do.

He's away quite a lot, isn't he?

Yeah, I suppose he is.

He's got me a spa day to make up for it.

Ah, that old chestnut. He's guilty.

-He hasn't got anything to be guilty for!

-Maybe not.

But deep down he knows he's not giving you enough of what you need.

And what is it that I need, Jeffrey?

A bit more TLC!

I tell you something,

if you were my fiancee, I wouldn't leave you alone for five minutes!

Whoa, Jeff!

WHIMPERING

Hello, hello, can you hear me? Jeff, it's the guy from before.

All right, I'll radio in.

Can you squeeze my hand, please?

3006 to control. We've come across a running call.

An elderly male. Looks like he has a bit of a head injury.

Can you send another ambulance to our original shout, please? Over.

-All right, don't worry. We'll get you sorted, all right?

-Grab the kit. I'll be back.

Try to relax for me, please. Try to relax for me.

This is Arthur. We picked him up as a running call.

He might have been KO'd. His GCS was 15 when we got there.

All right, mate. BPs 180 over 100, pulse 100. Sats are 97.

Given him 750 of saline so far.

All right. Can you let Dr Hanna know we've retrieved our missing patient?

Arthur, we've been looking for you. Where was he found?

We found him on the side of the road in a gutter.

What?

OK, mate. Nearly there.

-He's going to need a head CT.

-You'll never give him a CT without sedating him.

-All right, Arthur.

We're going to lower you down and lift you over. One, two, three.

All right, well done. We need to get a second IV line in,

-blood gasses, clotting, LFTs, Us and Es.

-Thank you.

Small dose of midazolam.

He's frightened out of his wits.

I feel sorry for him. He shouldn't have had me looking after him. He needs people he knows.

Wasn't there something at the house to calm him down?

-You'll do. I need you to hold him down.

-I'm really not allowed.

-Now, please.

Ow! It's all right, I'll take the blame.

Just need to give him some kind of chance. All right, Arthur.

OK, team?

All right, nearly there.

No, Arthur. Come on. We nearly had it then.

Come on, it's all right.

MUSIC: "I'm Still in Love With You, Girl" by Alton Ellis

# I'm still in love with you, girl

Sorry, I should have thought earlier. We'd never be in this mess.

Hey! You like the music, Arthur?

Good music.

It's good to have you with us.

Let me go.

Let me go.

Let me go.

I believe you recently had some bad news?

Stage four gastric adenocarcinoma.

Which I assume is the cause of your symptoms.

Is it fair to say that...your continued silence and refusal to be

treated is because of the seriousness of your prognosis?

John, I don't specialise in oncology,

and I can only imagine the level of pain you're in,

but I have been around cancer a lot

and no-one is beyond help.

Let me treat you, or at least help you get onto a ward.

Please! You mustn't just give in.

OK.

HE FITS

Stop! Stop, Stop.

Pupil's blown.

Right, let's get him back into Resus. Coming through.

BP's 200 over 110. He's bradycardic and his breathing's irregular.

Could be an intracranial bleed. We need to call the neurosurgeons. Dr Hardy?

-Yes.

-Help, please.

-Yes, course.

We're going for a rapid sequence induction.

Should we? He indicated he wanted to be allowed to die.

-Was he of sound mind?

-He said "Let me go".

He could have meant "Get off me".

Please try. It was my fault.

He grabbed me and I had to fight him off. It's how he fell.

And it's how he ended up in here.

So please just do everything you can to save him.

We continue.

SIREN WAILS

I thought we'd have sorted this by now.

I tell you what, give us the paperwork.

I'll pop in and see if we can get somebody to look at him out here.

He's not settling, is he?

That's two minutes.

BREATHLESS: Come on, Arthur, you do it for us.

Right, the neurosurgery team are on their way.

I think they've had a wasted journey.

You take over.

What?

SIREN WAILS

OK, got it.

Let's get him straight into Resus. I told you to stay.

-His inhaler ran out.

-He's very, very hot.

Mind your backs, please, folks, coming through.

Come on, out of the way, please.

I think it's meningitis.

What did you just say it was? What's up with him?

It's suspected meningitis.

The best thing you can do is hang back

and let us get him sorted. All right?

Right, this is meningococcal septicaemia,

we need to be fast and efficient here, guys, yeah?

I need some cefotaxime 80mg.

And I need a BM and can we get some fluids in, 20mg.

-Charlie, we need to get a line in. How are we doing?

-Not looking good.

No, we're going to struggle to find a vein here.

-Stand by with the IO gun.

-Yeah.

BEEP

How long?

-How long?

-I'm not sure, sorry.

About an hour.

BEEP CONTINUES

Call the neurosurgeons.

Time of death, 12:33.

(Good night, old man.)

Right, we should talk.

When you said you had to fight him off...

No, I didn't mean like hit him.

There was a big bang and he lost the plot.

I tried to get him off me and he lost balance.

Well, the graze on his scalp doesn't factor in his death, so...

-I will have to put it in my report, what you said.

-That's fair enough.

You should never have been asked to care for him.

Tell me about it.

I will also be very clear about what happened here tonight.

Sorry?

You're not the only one at fault.

This emergency department failed him.

He should have never been left in a wheelchair unsupervised.

Basically, he shouldn't have died.

Wouldn't that mean you get into trouble?

Not me, personally, no.

If I were you, I would find somewhere else to work from.

Yeah. Thanks.

Hey.

-You did your best for him.

-Yeah.

So did the hospital. That won't stop people getting into trouble.

We just do what we're told.

This is Carly Dobie.

I'm leaving a message to let you know what happened tonight.

I should never have been sent to that job.

Oi!

I'm getting naked here.

What is it with everyone?

I don't need help.

I just need to enjoy my thing.

Nothing a bit of lippy can't fix. Now, move.

HE COUGHS

Get off me.

Look at the state of you! You couldn't stop me if you tried!

I want to go.

Aargh!

RAPID BEEPING

-Anything?

-No, let's give him another milligram of adrenaline, please.

They're doing everything they can for him, you know.

I didn't think he was this bad. I wouldn't have left.

They kept us waiting. And I have to work.

It isn't just my fault.

RAPID BEEPING

-BEEP

-That's VF.

OK, let's stand by to shock.

OK, charging, stand clear.

Shocking.

Nothing. Let's go again. Charlie, resume CPR.

Right, charging, stand clear. Shocking.

BEEPING REGULATES

-Sinus rhythm and a decent pulse.

-Right, get onto paediatric ICU,

this is one patient they are going to take.

BEEPING CONTINUES

Ethan.

Are you all right?

You know the patient, John, what colour would you say his blood was?

Is that a trick question?

No, but if gastric adenocarcinoma was causing the bleeding,

I would have expected it to be darker and flecked.

And if was haematemesis,

then it wasn't looking like coffee ground vomit.

-I'm still drinking, but thank you.

-Excuse me. Sorry to interrupt.

I'm Imogen. Immy.

-You need to see the man.

-Which man?

He's done something really bad to himself. He's not well at all.

John. John, can you hear me?

-All right, I need to have a look at you, OK?

-I'll give you a hand.

Imogen, isn't it? What happened?

He needs to look in the man's mouth.

Can you open your mouth for me, please?

The blood isn't from your tumour, is it? You're hiding something.

Please.

-Flappable. Very much flappable.

-Why?

-At the flats, there was a report of an explosion.

-Yeah.

I think I know what that was.

Hey, thanks, guys. We'll follow him up shortly.

-See you later.

-He's in safe hands.

Meningitis is a very tricky disease to diagnose

before any clinical symptoms develop.

And I really wish that I'd had the chance

to fully examine your son earlier.

But I totally appreciate that you were made to wait

an inordinate amount of time.

And I can't say that we'd have been able to detect anything then anyway.

But I do understand if you want to make a complaint about the wait.

I only ask that you implicate me, not my staff.

Just me. Dr Hanna.

-Clinical...

-Thank you.

I just want to say thank you.

Crikey. Night of the living dead.

Yeah. Literally.

Shut up!

-Is that a bullet?

-Police found it in the stairwell.

When it went off, to everyone hearing it,

-it sounded like an explosion.

-Did he make it?

Oh. Stupidest question of the day. Sorry.

Surgery don't know how he was still alive. I don't think he did.

He was pretty surprised to have an extra couple of hours.

Well, I'm pleased he did. He got Immy to see sense.

Yeah.

-What a challenging night. Well done, everyone.

-Is the child OK?

He's stable. Hopefully he'll pull through.

Our PICU have a great success rate with meningitis.

It's nights like these that the vulnerable slip through the cracks.

And considering, we did everything we could, we did well.

You're dammed if you do, damned if you don't, Zoe.

Anyway, I'm going for some breakfast.

-Does anyone want to join me?

-I wish. I'm back on in a minute.

-I've got paperwork to do.

-Ditto. Sorry.

About Mr Swanley, it was unfortunate.

No, Zoe, it was more than that.

Thank you for your help tonight, Max, it was much appreciated.

That's OK.

You know, somebody once told me

that their favourite meal of the day is breakfast.

Yeah, well.

-How's he doing?

-I wanted to get the doctor's name. I can't remember it.

I've got to prove what happened, for work.

They want to sack me for abandoning my post.

It was Dr Hanna that treated him. They can do that? They can sack you?

Probably. Who cares?

As long as my little lad's all right, they can do what they want.

Yeah.

It's only money, isn't it?

Hello, Nat. Yeah, I'm coming home. Can you wait in for me?

There's something I really need to talk to you about.

Yeah, I've been a proper wally, love.

SHE SIGHS DEEPLY

So, nobody noticed a journalist taking photographs?

Guy, you could have driven a bus through reception

and we wouldn't have noticed.

But at least it saves me from telling you what happened.

How did it get so bad?

I mean, there were no major incidents,

no major road accidents, no adverse weather...

You know what, it would have been better if there were.

At least we would have had extra resources, priority over beds,

more staff.

Tonight, a man died because of poor managerial decisions.

And what would you have done?

Diverted.

-Then, no dead patient and no headline.

-(Right.)

Is this you offering to captain the ship?

I have to go.

Connie?

I cannot let this happen again.