First Impressions Casualty

-Samantha Kellman.

-Ah, OK. Jeff Collier, paramedic.

Humble pie. Breakfast, lunch and dinner.

-What, and you don't think I'm owed an apology?

-You joking?

-I supported you through all of that.

-Which I'm grateful for,

but it didn't get either of us very far, did it?

-Thanks for being my "knight in shining armour."

-Hardly.

I just, wondered, you know,

whether we might be able to go for a coffee or something?

Did you know about Rita? Apparently she used to be married.

Husband died.

I want to keep a very tight hold on the reins here, Tess.

That's just what this place needs.

Let's try this one first, eh?

Oh, you'll feel better soon, Evie, I promise...

BABY CRIES

Oh! Mr Knapton, it's me, Rita Freeman - again, sorry.

I'm just ringing to double check today

is the day for all the paperwork.

Oh, that's great. No, I'm just going to do a shift at the hospital,

-but if you give me a ring when it's complete...

-Hey! Break a leg!

You know it's Tess' first day back, don't you?

Er, yeah, that'd be great. OK, thank you, bye!

Who are you and what have you done with my husband?

I've been meaning to do it for months.

Trellis up last weekend, window locks yesterday...

Whatever it is you've done, you're forgiven.

Do you know how amazing you are?

DOORBELL RINGS Hold that thought.

RINGING CONTINUES

Terry! HE SIGHS AND COUGHS

You can go now, yeah?

Girls will be up soon. I want that junkie out of my house.

EX-junkie, thanks very much.

-If you're in trouble, I can help you.

-Thanks, but there's no need.

-Because?

-Because this isn't how it works, Chaz.

Chaz, hey...

QUICK BLAST OF SIREN

Morning, boys.

Morning, Mrs B. I'm loving those shoes.

It's Mrs Beauchamp, and thank you.

Another day at the coalface, are you ready for it?

-Yup. Absolutely.

-Ready, willing and able.

I'd like to see you both in my office in 15.

What do you think that's about?

Perhaps she wants more of your sartorial compliments.

Or it could be another debrief.

-See you at group next week then, yeah?

-Why are you being like this?

This is not a good time, Chaz.

-She doesn't know what you're planning, does she?

-I'm sorting it.

Nobody's going to do business with you, Terry.

And I'll figure something out.

-If I made a few introductions...

-Hey, hey! No.

I don't want you getting involved.

But you don't know what you're doing - at all.

And that's my problem.

"A problem shared is a problem halved."

-You taught me that, remember?

-Mmm...so you do listen?

When it's good advice. You should try it.

Trust me.

-Tess! Welcome back.

-Think I'll recognise the place?

Oh, I don't know. Connie's probably monogrammed the bed pans overnight.

-I thought she was welcome to it.

-She is. Totally.

Anyway, enough about that. How are you? Have you got a game plan?

I wasn't aware I needed one.

-Aren't you going to address the whole Fletch thing?

-Absolutely not.

It would put a stop to the gossip.

I'm here to do the best job I can and I'm going to be professional.

MOBILE PHONE RINGS

Why don't you just give me the basics? I can take it from there.

-OK. Let's start with how much you need.

-Eh?

-Terry, how much do you need?

-100 grand.

You what? 100 grand?!

You got a gambling problem or something?

Yeah, something like that.

You'll need to go for high-end gear - BMWs, Mercedes...Land Rovers.

But they're all kitted out with immobilizers and alarms

-and stuff, aren't they?

-Been doing your homework?

I have, as it happens. This is a big deal for me.

What did you say to me last week?

"Don't wait for your ship to come in, swim out to it."

Ah, sounds about right. Now where we going?

-Getting your feet wet.

-What are you on about?

We're going shopping, big man.

No, it is important, because if we don't get it done today,

we're not going to get it done at all, are we?

Well, I was thinking ivory or snow. Maybe picket fence?

No, they are not all the same, Amy...

-This car is even better.

-Eh?

You're not taking the job of my bridesmaid very seriously, are you?

You need two people, but it's the cleanest way -

no CCTV, no witnesses and you can pick your target.

-Hold on. What if...?

-I'll do the talking. You move over.

I'll meet you on Stanley Street.

-Wait, wait, wait, how will I know when...?

-You'll know.

What the hell?!

-Great, that's just great!

-I'm so sorry. Are you all right?

-What do you think?

-That was totally my fault.

My dad kept telling me to slow down.

Well, I'll need your insurance details, your number.

Yeah, of course. It's my dad's car, so you'll need to get them from him.

No, wait!

Ah!

TYRES SCREECH AND ENGINE ROARS

KNOCK ON DOOR Come in.

-A little pick-me-up.

-Ooh. First of the day, lovely.

How do you look this good before coffee?

So...budgets are the new black,

and WE are very much in the red... and bleeding.

More like haemorrhaging.

So...how about a little challenge to help stem the flow?

There would be rewards, of course.

Either of you up for the challenge?

-Yeah, of course.

-I'm in.

Both of you? Excellent. Well, that's it, thank you very much.

Keep up the good work, Dr Hardy, no more breaches.

-Oh, not if I can help it.

-Oh, that's not fighting talk, is it?

-Cal, see if you can awaken his competitive spirit?

-Mm.

-You do know those two hate each other?

-I know.

Ah, now you're here, er... blue or lilac?

-Erm...we can't decide.

-Blue, definitely. Matches his eyes.

Right. Well, I was going with the lilac, but, er...

No, no, blue, blue, definitely blue.

OVER RADIO: 'Control to 3006, emergency call, multi-storey car park

'on the corner of Junction Road, possible assault,

'injuries unknown, police have been informed.'

3006 to control, received, we're on our way, over.

-Tess! Good to have you back.

-Thank you. Was there something else?

Um...yes. Just between us.

A former colleague, Andrea Somerton, is over from the US,

foisting herself on CCU while she sets up a fellowship...

-And she's paying us a visit?

-Oh, undoubtedly, she'll punch in

below stairs once she's finished brown-nosing Guy Self.

I'll make sure she gets a very warm welcome.

Forget the warmth. I want everyone on top of their game.

At best, this department is world-class,

-and I want her to see that.

-'Course.

Thank you. You've probably got lots to get on with, so...

-Mmm.

-Miss breakfast?

-Mmm.

-MOUTH FULL:

-Slept through my alarm, first time in years...

Where'd you get that?

I found it in a cupboard that's being cleared out.

Thought my brother might fancy a game.

-Being a bit literal as usual, Cal.

-Just following orders.

Don't see how a game of chess

-is going to help us with the budget.

-Yeah, not how you play.

How about that?

-Oh, typical.

-How so?

The king-pawn opening -

choosing violent tactics over strategic manoeuvring.

Play nice, you two.

-Oh! There you are.

-What? Am I in trouble?

-Tess is on the warpath.

-Yeah, she wants us to restock the cubicles

and clear all of this backlog.

What backlog? Ah, when did it get so busy?

Well, it's the triple threat, isn't it?

Summer parties, summer holidays...

-Summer loving.

-Ooh!

-Eugh! As if.

-What's got into him?

-It's secret.

-New girlfriend apparently.

-Yeah, until she gets a puncture.

Break time already?

I hope punctuality isn't key to your application, Rita.

-Ash said stick to facts.

-Just as well. And Lofty?

The inventory? Yeah, I'm onto it, yeah.

Don't make me ask you again.

Is it me or is she getting scarier every day?

-Well, I am definitely Team Fletch.

-Robyn!

-Oh, come on!

-Right, OK. Happy hour's on me later.

Yeah, right, like we'll have the time.

I've got a good feeling about today. Rosemary Leaper?

Glad you could keep up!

What just happened? That woman! She could have...

Chill. Look, don't worry. Someone will have found her, called 999.

Yeah, but, how...?

So how long before the police...? I mean, won't they be onto us?

Dunno. Didn't do jacking really. Mostly lifted sat navs, stereos...

What?

I was looking for my next fix, you want 100 grand.

-So what happens next?

-Park her up in your garage,

-wait until the heat dies down.

-LAUGHING:

-No, no.

-"No"?

No! The sooner you make those introductions,

the sooner I can do this without you.

As if! You need me and you know it.

Keys. I'll drive.

She's just being a mate, I'm telling you.

-OK. Eh...what colour are my eyes?

-What?

What colour are my eyes? You've known me for six years.

Ah, here we are.

-I spy with my little eye...

-Oh, come on mate, we don't have time for this.

..something that'll end in tears.

Just as long as something starts, you know?

I don't care how it ends.

And you're happy with that?

-I don't think I have any choice.

-Help me, please, I'm getting married!

Great, that's all we need.

All right, sweetie. I'm Jeff, I'm a paramedic.

-Can you tell me your name?

-My swatches! They've taken my swatches!

Right, you're dealing with that, are you? Marvellous. OK.

Let's have a little look at you, then.

She's giving her team a really hard time

and she practically bit my head off earlier.

-Bit of a train wreck, is she?

-Unbelievable.

SHE SIGHS DISAPPROVINGLY

Hello, are you all right?

Yes...er, no. It's Eve, she's not been well.

Has she got a temperature? Why don't you come in?

-WOMAN:

-I need a doctor!

-I don't want to be a nuisance...

Don't worry, you've come to the right place.

-Better to be safe than sorry. What's your name?

-Rachel.

Rachel Clarkson. I'm her foster mother.

OK, well follow me, Rachel. Don't worry, we don't bite.

-I hear the sibling rivalry's hotting up.

-What's this?

-There's a chess game in the staff room.

-Ah...interesting.

And if Lofty and I were to have a little wager?

-I'm always a safe bet.

-Safe enough to risk your last fiver?

Ah, thank you.

-WOMAN:

-I really want to see someone now!

-Allow me to demonstrate. Lofty.

-Please, please!

-What have we got?

-This is Mia Cornwell, 27 years old.

Bruised and swollen right eye. GCS has been 15 throughout.

-Right, into triage, please.

-My face! You've got to fix my face!

Ah... Mia's getting married in two weeks.

Oh...joy.

Hello, I'm Dr Hanna. Are you down from CCU?

Oh, a doctor who smokes, how refreshingly irresponsible.

I wanted to speak to you about Mrs Austin's wound pains...

You'd expect a bit of pain if I'd cracked your sternum open

-and removed a couple of ribs.

-But I'm concerned it might be misaligned.

It's muscular. Give her some ibuprofen

and arrange an out-patient check up.

-Right, thank you. Very helpful(!)

-Andrea? Ohh...

-Certainly is.

-I thought you were in Boston?

-I arrived a few days ago to sort out a fellowship.

-Oh.

Elliot told me you were down here. I'd never have guessed.

Oh, clinical lead... what can I say?

So you're master of man flu, queen of colds?

I promise you, this is where the action happens.

-Of course, Jack of all trades.

-Shall I show you around my department?

Please, can we have a coffee first?

Oh, God, yes, of course.

OK, try and relax.

-TEARFUL:

-Relax?! Didn't you hear? I'm getting married in two weeks!

And it's our job to make sure you look as beautiful as possible.

-I'll get the dressing.

-Yeah. Just sit forward.

Great. Up on the bed, please.

SHE SOBS

If you could stay still as you possibly can for me.

Everything's ruined! Completely ruined!

That's not true. Dr Knight had a proper shiner a few weeks ago...

look at him now.

SHE BLOWS NOSE

Oh, OK! Unnecessary pressure around the area could cause more

blood vessels to burst, which would give you more discoloration.

-And we wouldn't want that, would we?

-You mean I've made it worse?

Look, there's a lot we can do to lessen the swelling,

but you have to help me help you.

OK? Good.

Let's start with a simple eye exam.

Can you just follow my finger...

and let me know at any time if you see double.

Watch and learn, Lofty, my son. Watch and learn....

Temperature's at 40.

She's lethargic and her heart rate and breathing are up.

Has she been like this for long?

A few days.

OK, we're going to need to take some bloods.

Do you have to? She doesn't like it here.

She's scared.

How have things been at home? Has she been keeping you awake?

I don't sleep much anyway. Look, I'm sure she's fine,

-and you must be busy.

-No. We're not in any rush.

-CONNIE:

-I think the NHS has a lot to offer.

You certainly get what you pay for.

What, unlike the overly expensive, under-productive system in the US?

Socialised medicine doesn't work.

No amount of sophistry or whining will change the fact.

It's good to see you.

Doctor, doctor. Ha! There should be a joke about this...

Dr Knight, meet Andrea Somerton.

She has just set up a centre for aortic disease in the US.

A woman after my own heart.

Mmm, sorry.

So how do you and Mrs B... Beauchamp know each another?

MOBILE PHONE CHIME

We worked together many years ago.

Before Connie became so fond of hard work and elbow grease.

-Mmm.

-Oh, Guy wants a word.

He approved the fellowship, so I'd better play ball.

-You could give me the grand tour later?

-Yeah, of course.

-Shout me lunch?

-Yeah. Bye.

Her white count is 20.

Exactly how long has Eve been running a fever?

-Since Tuesday.

-Did you go and see your GP?

-No.

-A child with a high temperature should be seen by a doctor

-or nurse if you're worried.

-I didn't know that.

I'm sure you will now.

Eve has definitely got an infection. Because she's very hot

and quite dry I'd like to run some tests

and check where the infection is coming from.

Can't you just give her some medicine? Antibiotics or something?

We need to find out whether this is bacterial rather than viral first.

She'll have a chest X-ray

and then we'll perform what's called a lumbar puncture.

-And...should I come with you?

-Yes, if you'd like to.

You can help us get her settled, which is really important.

-OK.

-OK, thanks.

-Where do you think you're going?

-You said everything checked out.

-I don't understand why I can't go.

-You've got a head injury.

So you need to be discharged with a responsible adult.

-Let me call your fiance.

-No! Please! He can't see me like this.

-Oh, come on, Mia...

-I can call my bridesmaid Amy.

OK. Do what you have to do.

What's wrong with this picture?

-Two broken ribs.

-I'll call social services,

and page the child protection paediatrician.

There could be a rational explanation.

There are guidelines in place, Dr Hardy.

Can we just wait and see what Rachel has to say first, please?

OK.

What is it? Is there something wrong?

We're a little concerned about some of the injuries that

-have shown up on Eve's X-ray.

-What kind of injuries?

-She has two broken ribs.

-What? How?

-Has she had any falls recently?

-Falls? She can't walk, so...

-Could she have fallen from her cot?

-No.

-Or down some stairs maybe?

I watch her all the time!

And you're the only person who looks after her?

The agency takes on lots of single mums and dads.

Why are you asking me all these questions?

Because Eve can't tell us what's wrong

or whether she's in any pain,

we just need to know exactly what happened.

I haven't hurt her, if that's what you mean.

We'll need to call a child protection paediatrician

who specialises in these kind of cases,

and they'll come down and they'll examine Eve.

But first we need to work out what's causing Eve's fever.

-So we'll start with the lumbar puncture.

-And then?

We'll take some more X-rays, a CT scan of her brain,

an eye exam and some clinical photographs if we need to.

No, please, she's so tiny.

Perhaps it's best if you wait in the relatives' room.

Can I take her? Gently does it.

-EVE GRIZZLES

-It's OK.

-So how much do you think we'll get for it?

-He said 800.

800?! It's worth ten times that at least.

Yeah, probably, if it was yours to sell.

I reckon we shouldn't settle for anything less than 12.

SHE SCOFFS

I don't think Al's the haggling type.

-What do you mean by that?

-Chill out, yeah?

Oh, no, look...

Just relax.

Yeah, easy for you.

TYRES SCREECH

Relax!

SIREN WAILS

Terry! Wait, stop!

The bike, Terry! Watch the bike!

TERRY COUGHS

Terry.

Terry, what's wrong? What the hell is wrong with you?!

Terry! Just breathe!

Terry...

Terry, look out!

TERRY!

SIREN STOPS

I know you're driving, but I just wanted to say

I'm going to try and get some beauty sleep while I wait for the doctor.

I don't want bags as well as bruises. Just call me when you get here, OK?

OK, doctor will be waiting in cubicle three for him.

-Tess, can I have a word?

-It's not a good time.

Well, it hasn't been for the last few weeks.

Is a bit of privacy too much to ask for?

-See what I mean?

-She's all right with me.

Oh, that's very helpful(!)

OK, needle's in the right place.

Oh, you're doing really well, sweetheart...really well.

EVE CRIES GENTLY

-Pressure's 19.

-How's it looking?

-It's clear.

-Would you mind taking her for her skeletal survey now, please?

-Mm-hmm.

I just need to plan my next move.

Right, Terry, that's you, my son. Next stop - Holby ED, OK?

Finally, here come the cavalry!

You all right? What've we got?

It's the beemer from the car jacking.

-Can you take care of the partner in crime, please?

-Yeah, were they KO'd?

No, far from it. Singing like a canary.

Nice. Hiya, love. I'm Tamzin, I'm a paramedic.

Whatever. I told the others, I'm fine.

I just want to talk to the police properly, on record.

-All right, you'll get your turn.

-I need to talk to them now!

Calm down! It can wait until we get to the hospital.

But they need to know this is all my fault, all of it!

OK! I'm going to treat you first,

I don't want you to say anything you might regret, all right?

Just try and keep calm for me. Thank you.

Come on, mate, it's not brain surgery.

Shouldn't you be out there scaling the coalface?

Erm...nope. I'm still waiting on cardiology.

If I mirror your move... then it's all about how you respond.

Well done.

Rachel said Eve was scared. So Eve could be mirroring Rachel.

Where are you going?

The nine-month-old presenting with a fever.

Ah, you're still dealing with

-the kid with the runny nose?

-It's complicated.

Cal, incoming RTC, two minutes.

I thought you were due to start that grand tour?

What better place to start than Resus? Alison, with me, please.

Hello.

I'm sorry. I should have told you where I was.

That's OK. Shall we get a cup of tea or something?

OK.

You said that Eve didn't like being in hospital.

Why do you think that is?

It's just a bit claustrophobic, you know...hard to breathe.

Did you happen to spend any time in hospital when you were a child?

More recent. Leukaemia. I got the all clear eight months ago.

Right, so not long before you started looking after Eve?

-She was my celebration.

-And how have you been feeling since?

OK. I'm OK.

Good. Do you mind if...? You haven't had any symptoms at all?

My blood count's normal. My doctor said I'm fine!

Your pulse is very fast, Rachel.

What is it that you're frightened of?

Can you come through to my office, please?

All right, what have we got?

Terry French. Driver of a car involved in an RTC.

Car hit a stationary vehicle.

Air bag deployed, so he's got bruising to his chest,

decreased breath sounds on the right-hand side.

BP is 108 over 72. Pulse 120. Resps 28 and sats are 92%.

-OK.

-OK.

-All right, straight through to Resus please.

-Thank you.

-There you are.

-Erm, we're going to have to skip lunch.

-What've you got?

RTC, two casualties. You're welcome to watch the guys in action.

-Thank you.

-Looks like a meat and potatoes case.

That's the beauty of this place -

you never know what comes through the door.

The Forrest Gump school of thought.

OK, everybody ready? Three, two , one - there we go.

That's great. Thanks, guys.

TERRY GROANS

Oh, right. Tenderness in the chest wall.

Decreased sound on right side.

Dullness to percussion.

OK, he's tachypneic, resps at 30.

Right, let's get the chest X-ray in please,

I'd like an ECG, FBCs, Us and Es, and I may need a chest drain.

Can we call the lab? I'd like four units of cross-matched,

as soon as possible, please.

OK, this is Charlotte Chandler, 18, passenger in the RTC.

GCS has been 15 throughout, pulse 80, BP 130 over 85,

sats 98, she's lost approximately 250ml of blood at the scene.

-CHAZ:

-I want to talk to the police!

-Any analgesia?

No, I tried but it was refused.

On my count - on three, two, one.

-OK.

-Thank you.

-Hi, Charlotte, I'm Dr Hanna.

Let's get some routine bloods and fluids please,

I want Us and Es, LFTs, FBCs, group and save, glucose and a beta hCG.

-Where are the police?

-Try and keep still for me, yeah?

Nice deep breath?

OK, let's look in those eyes.

Pupils equal and reactive. Right...

-What's she still hanging around for?

-Mrs Beauchamp's friend?

Oh, of course she is.

All right, we have a pleural effusion on the right side,

a small pneumothorax, cannonball metastases

and two fractured ribs. Could be a malignant effusion,

could be a haemothorax from the chest trauma.

Definitely needs draining. Can we have the chest drain set in, please?

Lungs are seriously compromised.

Can we see if we can find some old notes as well?

The skeletal survey shows what's called a bucket handle fracture.

Which is a very worrying injury in young children.

-Can you explain that, Rachel?

-No.

This isn't right. This isn't what's supposed to happen.

-Sorry, how do you mean?

-Things are supposed to get better.

My life starts now.

You mean, since your all clear?

I've got everything I want. I'm well.

Well enough to care for someone else.

And has Eve been given the kind of care she needs?

I panicked when she got ill.

I.. I was scared it was something bad.

I didn't know what to do.

Maybe that's why the cancer stopped me having a baby of my own.

These results suggest that Eve is at significant risk

of harm in your care.

You don't want me to have her.

We'll have to update social services and let Mrs Beauchamp know.

Ah! How are we doing?

Can I finish making my statement now or what?

-She's been charm personified.

-Shut it, gimp!

-Thanks.

-Is that her or the head injury talking?

-Well, CT was clear, so...

-It's a fair assessment then.

-Funny.

Yeah, careful, you don't want his new girlfriend to hear you say that.

-New girlfriend?

-Lofty thinks she works here,

explains why he's signing up for extra shifts.

-Wow. Desperate.

-Again, thanks.

Extra shifts, eh? Well, you'll have to keep me posted.

Robyn is on the case.

Ah, right, now, do you want me to give you a hand with this?

-No, got it.

-Oh, very keen, aren't you?

-Just doing my job.

-Senior staff nurse Freeman

does have a nice ring to it.

Yes, unfortunately colon cancer has a nasty habit

of metastasizing to the lung.

Erm...I see you've been referred to Mrs Williams.

Have you scheduled an appointment?

I'm sorry, I can't seem to find anything in here.

I decided against it.

-You went with a different oncologist?

-No.

Right, well, I know your GP

will have talked you through your options.

And although there is no cure at this stage,

chemo and radiotherapy can control growth, and relieve the symptoms.

I've got other priorities right now.

Sorry, er... Mr French's wife is at Reception.

OK, Lofty, would you bring her up to speed?

I'm sure your wife will want to be part of this conversation.

Excuse me? No, I'd rather my wife

wasn't informed of my condition, thank you.

Sorry, are you saying she doesn't know about your diagnosis?

No. And I'd like to keep it that way, thank you.

-You want me to lie?

-Lofty, thank you.

Mr French, I would strongly advise against...

-It's his decision.

-Andrea, please.

Not all your patients need spoon-feeding, Connie.

Mr French, are you in any pain?

Do you have any symptoms my team need to know about?

I feel OK. Perfectly fine. Thank you.

Right, take the ibuprofen every four hours,

it'll help lower your temperature and reduce inflammation.

Sorry, Lily, have you seen Mrs Beauchamp?

In Resus with some hotshot heart surgeon...and your brother.

-Right.

-Any breaches?

-Maybe.

-Come on, Ethan.

Mrs Beauchamp promised rewards if we hit our targets.

Yeah, well, whatever happened to slow and steady

-winning the race, eh?

-That's a fairy tale.

Thanks, but no, thanks.

Actually, I've got to run something

-by Mrs Beauchamp.

-Oh, OK, yeah, she'll love that(!)

Why don't you get her to tie your shoelaces while you're at it?

I wish you'd be a little more tactful in front of my team.

Oh, please, tact is for people who lack wit.

-Should we go straight to lunch?

-Excuse me. Sorry.

Ethan. Meet Andrea Somerton.

-Ravenous cardiothoracic surgeon.

-What can I do for you?

-I have a child protection issue.

-Ah, cherry on the cake.

Sorry, I'm going to have to take this.

-I know, duty calls.

-Erm, Cal?

Yeah, I've got this.

So...when will I stage my intervention now?

-Oh. It'll have to be dinner.

-Somewhere expensive?

-Oh, exorbitant.

-ANDREA CHUCKLES

Right, Dr Hardy.

Yeah, I have a nine-month-old possible NAI with broken ribs

and a bucket handle fracture of the femur.

She's been with the same foster mother for the past four months.

And did she offer any plausible explanation?

No, not yet, but...

No buts, Dr Hardy. We can't ignore three broken ribs

and a fractured femur in a nine-month-old.

I take it you've spoken to the child protection registrar?

Ah, yes, yes, I have, he's on his way.

Sorry, did you say three broken ribs?

Non displaced fracture of the second, third and eighth rib.

Right... This is a chest X-ray that I took earlier today

when I was screening for sepsis, with the eighth rib still intact.

-You're sure this is hers?

-Absolutely positive.

Excuse me.

Well, if both sets were taken today,

then the third fracture happened while she was here.

Did you press on her chest?

Yes, we had to hold her while we were performing a lumbar puncture.

OK, we could be looking at osteo imperfecta.

But there were no clinical signs, no features to indicate...

They'll confirm the diagnosis when she gets upstairs, just hold off on any further action, OK?

I'm OK, love, honestly.

Did you want some privacy so you two can talk?

It's not him that wants talking to.

-Where is she?

-Oh, Kayleigh, please...

You get too involved, with her especially.

She doesn't have anybody else, love.

And what about your daughters?

Do you ever stop and think about them?

Charlotte Chandler, I want to see her.

-I don't think that's...

-Your husband needs you here.

He needs his head read. That girl is nothing but trouble.

We could grab you a chair... nice cup of tea?

Oh, forget it! I'll find her myself.

-Robyn, could you stop her, please?

-Mrs French! Mrs French!

The police should be dealing with this, all right?

Nice try, mate, but it's really none of your business.

-Ow!

-OK. It's OK.

You think you've got me all figured out, don't you?

Not at all.

For your information, I've got a job, a flat, a car.

I'm not who you think I am.

-Why do you care what I think?

-Nice one.

-Fancy yourself as a therapist?

-No, I'm just trying to understand.

A family history of addiction, abuse, neglect,

-other traumatic experiences in childhood.

-OK.

But I'm clean now.

-I'm getting "help."

-Good, I'm glad to hear it.

Mrs French, please, leave this to the police!

You! Stay away from my husband!

-And this is...?

-My key worker's wife.

And I'm not leaving until she admits it was all her fault.

I will! I've been trying to!

I was in trouble. I needed his help.

Oh, for a change(!)

He didn't want anything to do with it.

-And you'll say all this to the police?

-As soon as I can.

OK, I just need another ten minutes here.

-Robyn, could you give me a hand?

-Yeah. I'll be straight back.

Let's go get you a nice hot drink or something, OK?

Did you hear that? She'll never change, they never do.

He makes no money, works all hours. Why? For what?

Sorry for the delay. We had to run a few more tests.

Hasn't she been through enough?

We believe Eve has a condition called osteogenesis imperfecta,

-or brittle bone disease.

-What?

It's a genetic condition that causes the bones to be very weak

and thin, so they can fracture easily.

Will she be OK?

Well, it's a chronic condition, which means it can't be cured,

but it is treatable.

-It also means...

-That you thought I'd done something wrong, but I haven't.

I am sorry.

-OK, guys, I need to have a word with Mr French.

-Sure.

Let's hope she can talk some sense into him.

Ah, it's got to be his decision.

Whatever happened to in sickness and in health?

It got complicated.

How are you feeling?

Yeah, I've been better.

OK, I'm going to be brutally honest with you, Mr French,

because I've seen the way this could go.

You could experience confusion, fatigue, extreme pain...

The contents of the bowel could spill into your abdomen

and cause mass infection.

-Your lung capacity reduced to the point of suffocation...

-What?

If you refuse medical advice and medical intervention,

you need to do so in the full knowledge

-of what's likely to happen.

-What kind of doctor are you?

The kind that wants the best for her patients.

Are you religious or something?

As I said, Mr French, palliative care can give you

a better quality of life and ease the pain.

If you have no care for yourself, think about your wife

and what you are about to put her through.

Eve will need to be admitted, so she'll stay overnight at least.

If she is diagnosed with OI she'll then

be referred to orthopaedics as well as

metabolic and genetic specialists.

Rachel, does...?

Are you all right?

Rachel?

-You spoke to her?

-I hope they lock her up and throw away the key.

What, what...? What did she say?

-Easy, easy.

-She's making a statement.

She's telling them it was all her idea.

No, no, wait, you've got to stop her, please.

-Please...

-HE WHEEZES

Why? Why would I...? What is it about her, Terry?

Who is she to you?

-Sats only 90%.

-Right, let's repeat the blood gases.

Can I get another CT and an echo please?

Sorry. Does he have a history of heart problems?

No, nothing like that. I thought it was his lungs?

So what kind of trouble are you in?

Must be pretty bad to pull a stunt like that in broad daylight

with your drugs counsellor.

It was a choice car, good spec, no witnesses.

And it was all your idea?

-Like I said.

-So why weren't you driving?

Must have been hard to get Terry behind the wheel.

Whatever. Yeah, it was.

And you think the police will buy your story?

-Don't see why not.

-You must owe him a lot.

Yeah, sure, I was blind and now I can see.

-Oh, come on - the job, the car...

-I'm a valuable member of society!

It's hard isn't it? Moving forwards, forgiving yourself?

-Like you know.

-She knows. She started from scratch

when her husband died. She's brave and amazing.

What? So you think I can transform - sprout wings and fly?

I think you should talk to Terry, before you talk to the police.

-Why? You think he'll change my mind?

-Maybe.

But the two of you definitely need to work on your story.

OK, what've we got?

The CT shows that there are small tumour deposits in myocardium

and what looks like a pericardial effusion.

And this could be either malignant or traumatic.

Tumour? What tumour?

The echo confirms a large area of fluid around the heart

and echo dense material within it.

-This is compromising his heart function.

-Cardio shock?

-Mmm.

His BP's falling and his pulse is becoming rapid and weak.

We'll need to drain the effusion.

A percutaneous drain will probably block.

So he will need a pleuropericardial window to stop it re-accumulating.

In the meantime, we'll need to support his circulation.

How do you suppose we do that?

It's unconventional, but an IABP would

certainly stabilise him so we can get him to theatre.

-What? Here in the ED?

-Mmm. I've done it dozens of times.

-OK. You're the boss.

-Watch and learn, Cal, this is what

-my experience brings to the table.

-Mrs Beauchamp, please...

I'm going to insert an intra-aortic balloon pump to increase

the oxygen supply to your husband's heart.

And that will make him better?

It will certainly buy us some time. All right, Lofty?

Would you take Mrs French to the relatives' room, please?

Tess. Sorry to interrupt. I, erm...

I wanted to apologise for this morning...and for this afternoon.

And I'm just wondering if...

-Does this involve the Hope and Anchor?

-Yeah.

I'd like to buy you a drink.

Not part of my game plan, I'm afraid.

Right. Is this part of the whole being professional thing?

Yeah, part of the whole being professional thing, exactly.

You're not going to want to miss this. Mrs Beauchamp's doing an IABP.

-What, in Resus?

-Yeah. Where else?

Ridiculous.

Are you opposed to the clinical lead showcasing her skills?

No, she's just showboating to her cardiologist friend in there.

I'm sorry. I don't know...

I can't explain it.

But you're feeling a bit better?

Maybe I just needed some fresh air.

Do you mind, you mentioned that you had trouble sleeping?

-That's nothing new.

-When did that start?

A few years ago. With the chemo.

And it hasn't improved at all?

I know, it sounds stupid.

Now that there's nothing to worry about, I shouldn't be...

Are you having any bad dreams?

About anything in particular?

It sounds silly.

About the chemo, the radiation...

about going through it over again.

Sometimes it's all I can think about.

How does it make you feel?

Helpless. I get this tightness in my chest.

I know it doesn't make any sense.

Actually, it does.

Cancer sufferers are at risk from post-traumatic stress disorder.

Isn't that what soldiers get?

The shock of having a life-threatening disease

can leave the same kind of scar.

This may also explain what's happened with Eve.

I doubt that.

One of the symptoms of PTSD is the avoidance of people, events,

places that are connected with the trauma.

Which is why perhaps you put off seeking medical treatment

and why you were reluctant for Eve to have any tests.

-You see, the detachment...

-I'm so sorry.

No, If I'm right about this, the very fact that you came here today

proves how much you care about Eve.

Scalpel please. First...

..we puncture the femoral artery.

Sorry, Terry, you may feel a little bit of pressure here.

And then we feed the guide wire up to the ascending aorta.

Screen on, please. Make sure it goes over the aortic arch.

Screen off, please.

Remove the needle and then insert the introducer sheath over the wire.

Again, you may feel a little bit of pressure, Terry.

Lovely. Remove the dilator.

And finally we feed the balloon catheter over the wire

and up to the descending aorta. Screen on, please.

Screen off.

All right, balloon's in place, that's lovely.

OK, let's remove the guide wire.

Attach those to the pump, please.

Aspirate?

Screen on. Screen off. Perfect. All right.

The balloon catheter is programmed to inflate

and deflate in relation to the cardiac cycle.

-So it assists with every heartbeat.

-And he'll get a normal blood flow?

We have just reversed the pathophysiology of a failing heart.

So the results can be seen in a matter of beats, yes.

All right, Terry, well done.

The balloon is in place and I'm happy with that.

OK?

-Come on through.

-I'm not sure what to...

Look, she's delicate, but she's not made of glass, OK?

Hi, there.

I've missed you.

Eve's a very special baby.

Things will be different... now that I know something's wrong.

Rachel, it's not just about Eve.

I'll get help. I'll do whatever you want.

It's not like a broken bone, unfortunately.

We don't know how long you'll take to heal.

I just want what's best for her.

I started the celebrations too soon, didn't I?

No. Your remission is an amazing achievement.

But I can't take her back.

I'm not ready.

I'll let social services know.

EVE COOS

Thank you, Dr Hardy. For making it...

For making ME make sense.

You take your time, OK? It's important to say a proper goodbye.

No, Dave, we can't just reschedule. It's the one with the balconies.

Look, let's just forget it, then, yeah?

SHE SIGHS

Right, what do you think?

Ah, well, mate, you look like a young...

Steve McQueen...ish.

-What time does happy hour start?

-Ah, 15 minutes.

-Great. Should we get warmed up?

-Hey, hang on!

You're supposed to be going out with your fiance.

Yeah, I was, Jeff, but he's cancelled.

-Because he's busy at work, apparently.

-Whoa, it's happy hour.

You can't go to happy hour with a mush like that, can you?

-Watch me.

-No, you can't, I'll come with you.

Don't even think about it, Jeff.

You are going to go out with that Samantha

and just show her what a kind, caring, amazing guy you are.

-Yeah, but...

-No buts, Jeff.

Come on then, Mac. I'm buying.

Right, well, let the pina see the colada.

I wanted to check you were all right. They said it would be OK.

-I hope this is the last time.

-Don't worry, I'm long gone.

-I can't let you do this, Chaz.

-It's no biggie.

It was me.

-All of it.

-Right, so why's she confessed?

Because she's a recovering drug addict who doesn't know her worth.

I shouldn't have got you involved.

Um...we're on the clock here, so...

So, thanks for the offer, Chaz,

but I really do need to set the record straight.

-Can we have just a minute, please?

-Of course.

-Thank you.

What's going on, Terry?

I've got cancer.

Right, OK...

so you and your junkie friend stole a car because you've got cancer?

Do we need the doctor back in here?

-Kayleigh, please...

-No, can't you see that doesn't make sense?

I've got six months.

I got two teenage girls and a house that isn't paid for.

-I was just trying to sort things out, love.

-Six months?

Yeah.

What about chemotherapy? Radiotherapy?

Ah, no, it's too late.

-Six months?

-I'm so sorry.

Why didn't you tell me?

Because that would have made it real.

What can I do?

-There's nothing anyone can do.

-There must be something.

You can hold my hand...

and you can tell me you love me...

SHE SOBS

Tamzin and Big Mac are in the pub already.

Oh, hurry up, Rita.

ALL: Hey!

-What's the matter, Max, you thirsty?

-If you're buying.

-Oh, I'm buying.

-Then I'm thirsty.

-I'll see you in five.

So, who won the chess game in the end?

It was put on hold because of Mrs Beauchamp's surgery.

Hang on, maybe we should invite her along?

-Have you lost your mind?

-Nah, I'll be back in a bit.

Right! Beer waits for no man. Come on, we're away!

Help me, please!

That's Mia. One of Cal's patients.

Help me, please! I need a doctor!

Hello. Mia, I'm Dr Hardy. What's happened?

Where's Dr Knight? I need to see Dr Knight.

Let's get you a chair first and see if we can slow that breathing down.

My bridesmaid's still in London. She quit...by text.

I want you to breathe slowly through your nose for five seconds.

-He said he'd make me beautiful.

-OK, in...

I'll put your pint on ice, mate.

Ethan, you all right here?

You must be sick of this place, all those extra shifts.

Yeah, listen, about that...

-TOGETHER: I needed the money.

-You needed the money.

No, tomorrow is not good enough. Well, then I want you to

send it to me as soon as you get it. Thank you. All yours.

Are you sure? Your puppy dog's waiting for you out there.

I hear you fitted an IABP in Resus today.

-Yes, I did.

-Was that for my benefit?

Hardly. Andrea, this is the front line. My expertise saves lives.

Oh, spare me. Neither of us became doctors to save lives.

It was about power, ambition, making the right connections.

And my being here makes an enormous difference to this department.

-So would a new coffee machine.

-True, yes.

This isn't the right place for you, Connie.

You're losing your edge, going soft.

You may prefer your patients anaesthetized...

My point exactly! You never used to concern yourself

with your patients or your precious team.

Speaking of which, you'd better throw the schnauzer a bone.

-Miss Somerton.

-She's all yours, Fido.

This had better be good, Dr Knight.

I just thought you and Andrea would like to join us over the road.

Celebrate another first for the ED since you stepped up?

It's been a real inspiration working under you today and I just...

Dr Knight, what happened? You said you'd come back and see me.

-This your patient?

-I'm getting married in two weeks.

Dr Hardy, what do you see?

Don't be shy.

-Periorbital haematoma and oedema.

-Causes?

-Base of skull and orbital floor fractures.

-Cubicles, please.

Dr Knight, in your haste to move on to the next patient, did you

run a CT or any facial views to rule out the possibility of a fracture?

-Dr Knight?

-No.

-No.

You're a malpractice suit waiting to happen.

Dr Hardy, would you mind staying behind

-and helping your brother out with this mess?

-Yes, of course.

Right, I will see you in my office

first thing in the morning, and don't be late.

-You shouldn't have done that, mate.

-Done what?

Sacrificed your queen.

Hello? Sorry about that, it's packed in there,

just having a quick drink to celebrate.

What do you mean, he's not signed the papers?

He can't defend it, there is no defence, he knows that.

-Rita? Is everything OK?

-Yeah, it's fine.

Only we're finally getting served and you said...

Two minutes, just give me two minutes.

No. No, no, no, no, no. No. No. You tell him no, OK?

I refuse to be dragged back through the courts.

I want this over. I want my life back.

I want a divorce!