A Life Less Ordinary Casualty

'There's someone so fragile relying on me.

'She knows nothing of who I am.

'That I...'

That I run and I hide

because that's what's in me, Charlie.

-We can keep visiting her as long as she's in here.

-I can't.

Today, I will see my real mum for the first time.

'I will find out if my brother is actually my real brother.

'Chorea movements, dystonia, her speech.

'She's got Huntington's, Charlie.'

Yeah, 50-50 chance she's passed it on, isn't there?

SIREN WAILS

TYRES SQUEAL

HORN BLARES

HORN BLARES

TYRES SQUEAL

HORN BLARES

HE GASPS

HE SPEAKS IN RUSSIAN

I'm going to try and help you.

Where is she?

HE REPLIES IN RUSSIAN

Speak English.

Hold this.

Press hard. Harder!

Tell me where she is!

She's gone.

Hey, hey. Come on, stay with me.

Stay with me, stay with me.

Stay with me! Come on!

Come on.

Come on! Come on, come on.

HE PANTS

Come on! Hey! Come on, stay with me.

HE PANTS

FAINT KNOCKING

Lofty, we're going to need another high-sensitivity troponin

for Mr Chest Pains in cubicle four, please.

The bruiser with needle phobia who tried to break my arm?

That's the one.

You couldn't sling up a litre of dextrose up in cubicle two, could you?

You won't catch me with a hangover.

My body's a temple this year.

Lean, mean, nursing machine.

He reckons he's giving up chocolate and alcohol for the year.

I've got a tenner on the fact that he'll only last a week.

That's not like you.

Fumbling bloods, and giving your patient another dose of hell.

Aw, Lofty's not that bad.

Cal...

Listen, I miss Matilda as well...

Look, Ethan. I'm fine.

OK?

I'm moving on.

You should try to as well.

(OK.)

So, it's not just me getting the cold shoulder, then.

Rang you all over Christmas. You couldn't return one call?

I've been busy, Charlie,

and I've got stuff on my mind, all right?

I have seen this situation, known people...

No, you've known patients,

strangers just passing through for a few hours.

You've got no idea, Charlie. How could you, possibly?

So let's not do this, all right?

Have you told him?

-What, and ruin the start of his new year?

-Cal...

-LOFTY:

-I'm just going to take some bloods.

Right, Mrs Thompson.

Oh, Evelyn, please. Nice to meet you.

It's all right, I have used the hand wash.

Hester Price. I've brought all Evie's medications.

Whoo! Did you rob a pharmacy?

Well, I can e-mail a full list, with all dosages, etc,

if that would help?

-Not as much fun.

-Yeah, but it would save me a few days. Thank you.

At first, I thought it was a pulled muscle.

From Pilates.

And then it shifted and I thought, well, maybe it's a hernia.

Any weakness in the legs?

It's only my polymyalgia, and that's completely burnt out.

That's my miracle.

I used to take lots of steroids...

It's left her with huge muscle weakness.

Does that stop you from lifting your legs?

It usually does.

If Mrs Thompson could answer the questions...

Can you get her sat up, please, Lofty?

Oh...

Oh, it's so nice having a man for a nurse.

It makes complete sense, too, with the lifting.

Haven't you got beautiful eyes?

Can we try again?

SHE GASPS

-It's gone sort of numb.

-What, in both?

-Hmm.

-Right, can you try your right leg?

-No, I can't! I-I can't!

But you can't anyway, Evie.

Sometimes I can.

Which is it?

Right, um...

What about incontinence?

-Have you...

-Oh... No.

OK.

I'll be right back.

Who rattled his cage today?

-Cal...

-I know, I know.

There's some sort of old biddy's charter that gives them

the right to prattle on endlessly

while patients are dying all around.

-No, actually, Cal...

-HESTER COUGHS

..Hester wanted a word with you.

Evie was too embarrassed to tell you, but last night, she...

Well... This would never, ever happen normally.

What are we talking about, exactly?

Ah! Incontinence?

Yes.

Right. Thank you.

-CT, please, Robyn.

-Why? Why is this such a big worry?

I'll discuss it with you both.

Please don't tell Evie your worries until you're sure.

She needs to know exactly what's happening to her.

Why upset her about something that may not happen?

I am sorry. Are you Mrs Thompson's next of kin?

I'm her life partner and her lover.

I know her inside out, so please allow me

-to be the judge of how she will best cope with this.

-OK.

With respect, her condition might be very serious,

and I can't conceal important information from her, OK?

HE CLEARS HIS THROAT

Mrs Thompson, hi.

-We're arranging an urgent CT scan for you.

-But why? Hester?

-It's all right.

-Doctor...

There's, um... There's certain conditions I'd like to eliminate.

Is it my spine? I have read somewhere..

The base of your spinal cord might be compressed,

which could explain the unexpected incontinence.

Now, if there is pressure on the nerves,

there's an appreciable danger of paralysis,

and we're going to have to move really fast.

All right... All right, all right.

In your own time, Lofty(!)

She's terrified.

And so is the next patient.

She's got you, our fragrant Lofty and her bestie

fussing and fetching tea for England.

Hester's her partner.

Yup. I know. And it's a beautiful thing.

Let's get on with it, shall we?

Oh...

Hey-hey! It's all right. Are you OK?

I've got that.

I'm sorry. My partner's probably very ill,

and she's just gone for a...a scan.

Try not to get ahead of yourself, you're in the right place.

SHE COUGHS AND GROANS

That sounds rather nasty. Have you got any pain?

-SHE GASPS

-I'm a doctor.

I... I just can't get rid... rid of this cough.

No. OK. Why don't you let me check you over?

No, I can't.

-I've got to get back.

-Look, I'll have a quick listen,

we'll take you for an X-ray.

Really, it won't take long.

OK?

-It's just this way.

-Thank you.

-All right.

SHE MOANS SOFTLY

I'm still here.

SHE MUTTERS

Nice and still.

This shouldn't be happening...

It's an abdominal aortic aneurysm.

Well, that makes sense of the symptoms.

-Did you measure it?

-6cm.

-OK. Show me.

-Right.

Here, this thickening suggests it's actually been leaking already

and then healed over.

Good spot.

Well, that makes for a ticking time bomb.

And very tough for her.

OK.

Talk her through it gently.

This is the cause of your pain, Hester.

You have pleurisy.

It's inflammation of the lung lining.

Don't worry, rest and meds will solve that.

-But you have also fractured a rib.

-Ohh...

Well, there's nothing to do about that, is there?

No. Pain relief and rest.

Oh!

Well, right...

Thank you very much, Doctor, you've been very kind.

Not at all.

Hang on just a moment.

Sorry, Hester.

There might be something else.

Unfortunately, X-rays aren't the best for that sort of thing.

If it's OK, I'd like to do a CT and take some bloods.

There's no need.

Do you think you can see mets?

I'm not sure.

I've been in remission for 12 years.

I thought I had it beaten.

For breast cancer?

Hmm.

Our GP's been treating me for a chest infection

but I sort of knew.

A CT will show us more.

I can get you into an urgent clinic now.

No, no. Thank you. No.

Gosh, I need to think this through.

And my partner mustn't know anything at the moment, please.

No, no, of course.

You should share your worries with your partner, though.

Hester, please, don't do this alone.

Hmm.

-Mrs Thompson, I've got the results from your CT scan.

-Oh.

No, no, not without Hester here.

I'll go and fetch her.

Robyn, we really shouldn't waste any more time.

I need you to listen to me very carefully.

Yes.

Oh, Hester the doctor's got results.

Maybe we're better off not knowing.

OK. Um...

We've found an aneurysm. It's a weakening in the wall of your aorta.

That sounds serious.

-Well, if the aorta were to rupture, then, um...

-I'd die.

Which is why we need the vascular surgeon to review you

and repair it very urgently.

Evie's already had a coronary and two cardiac stents.

At her age and with her health, surely operating is not a good idea?

Well, um, it's all highly complex, Mrs Thompson.

The general anaesthetic, the operation itself,

at your age, all contain enormous uncertainty.

But...

..it gives you a chance you simply won't have if the aneurysm bursts,

and it will burst, without question, very soon.

So operating really is your only hope.

The surgeon will be down shortly to talk to you, OK?

Yeah...

Hmm. This morning was just another day.

Well, you'd had a terrible night.

But it was over.

And you brought me some tea and you held me,

and we were going to do something.

We were going to come here, and then go home...

..finish off the bottle of red and House Of Cards.

I'm going to leave you, Hes.

Don't be silly.

I'm going to die, Hester.

No, no. He said they they can operate.

It's all happening too quickly.

They could put me on a trolley and wheel me away

and we'd say goodbye, and it could be for the last time.

I can't bear it, Hes.

How could we let this happen?

We won't. We won't.

No. No! We'll say stop.

Stop this!

We'll say, "Thank you very much, we're going home."

The painkillers are working so it can't be that bad.

It's like Thelma And Louise!

Come on, get my clothes. We can order a takeaway.

Yes. All right. All right. We need to talk this through carefully.

Cal, you better come. It's Evie Thompson.

-She's dressed, and they're leaving.

-What? She can't.

I need to go home, Doctor.

Mrs Thompson, standing up, walking, the car journey,

they are all hugely risky.

At our age, going to sleep at night is a risk, Doctor, believe me.

There's no point trying to persuade her.

-I do understand.

-See, I don't think you do.

If you knew more about it, you'd feel better.

I can stay with you, we can answer your questions.

No. You make a lovely nurse.

And thank you for your time, Doctor.

Actually, there is ALWAYS a choice.

HE SIGHS

All right?

Tell me...tell me honestly -

do you see any abnormal movement?

Stop this.

"Insomnia, irritability, mood swings..."

Well, now, don't mistake your own personality for symptoms.

You are going home unwell.

I've seen enough of this to back that up.

You need time to think.

Right...here's the really great thing about Huntington's.

The test doesn't actually tell you when it's going to begin.

So you have to just sit back and wait for it,

and when it does finally start to demolish you, guess what?

They have no idea how long it's going to take to finish you off.

You are under a massive amount of stress.

You know that.

For you own sake and everyone else's, please just go home.

So what, now I can't do my job?

You didn't think to consult me before discharging Mrs Thompson?

-Hmm?

-She was adamant.

Did you try talking to her? Try a different approach?

She knew the score, so she made her decision, Connie.

Helping patients achieve good endings

is as much part of our job as saving lives, Dr Knight.

Young or old, they can't process bad news.

They freeze, they panic and they want to run away.

And you have just let her do that.

So, why don't you...ring her up

-and apologise for your inadequate junior doctor?

-Agh!

It's not all about you And, yes, I will call her.

Go on, Charlie. Why don't you...

..give me some of that really great advice of yours?

Right.

You push off home or you get back to work.

That's my advice.

MUSIC IN CAR: Dancing Queen by ABBA

# You can dance, you can jive

# Having the time of your life... #

MUSIC STOPS

# ..Ba-ba-ba... #

'My name is Luke, I'm 17 years old.

'I live with Mum and Dad, and my mum has Huntington's disease.

'Come on, wake up.

'Huntington's disease is caused by a faulty gene

'which affects the central-nervous system,

'causing the brain cells to de-generate over time.

'A wrong decision every now and again.'

Right, what's next? A box set? Catch up?

Or a movie?

-Oh, something with gorgeous George, before he got married.

-Aw.

PHONE RINGS

Oh... Leave it.

Please.

'Please leave your message after the tone.'

ANSWERING MACHINE BEEPS

'This is Connie Beauchamp.

'I'm lead consultant in the Emergency Department

'at Holby City Hospital.

'There's no gentle way to say this, Evelyn.

'You should be in hospital where we can help you, where we can...'

ANSWERING MACHINE BEEPS

Maybe she's right.

But you agreed?

But what if we're wrong?

What if it kills me?

I've got, what, days, months,

maybe even a year,

and that's time to spend together here.

That's the only time that I want.

We could do all the things we enjoy.

Spend my pension.

Drink champagne.

Go to St Ives, stop dieting.

Get married.

Over my dead body.

Which is no longer funny.

SHE CHUCKLES

How will you be?

Well, your cooking was never great(!)

There's something I need to tell you, Evie.

Oh...

Pour me some more.

SHE GASPS

Sounds serious.

Come on, then.

Ooh...

Now...

You're the love of my life, Evie.

Oh, don't be soft. I told you, don't say things like that.

How did it take so long for us to find each other?

Oh, don't, love.

You have to hold something back.

I can't.

And I don't want us to.

So let's not.

MUSIC BLARES OUT

Hey.

-Is this guy...

-You want time with her?

How long?

Come on, I'll see you home.

THEY SPEAK IN RUSSIAN

You don't pay...you don't have.

Hey! Here.

-<

-I want to see everybody up on the dance floor!

-<

-Join the bride and groom. Show them how it's done, people. Come on!

MUSIC: Rocket Man by Elton John

# And I think it's gonna be a long, long time

# Till touchdown brings me round again to find

# I'm not the man they think I am at home

# Oh, no, no, no

# I'm a rocket man

# Rocket man, burning out his fuse up here alone

# And I think it's gonna be a long, long time

# Till touchdown brings me round again to find

# I'm not the man they think I am at home

# Oh, no, no, no

# I'm a rocket man

# Rocket man, burning out his fuse up here alone

# And I think it's gonna be a long, long time

# And I think it's gonna be a long, long time

# And I think it's gonna be a long, long time... #

HE GROANS

Do you want me to cook?

-What time is it?

-Nine.

Oh, I've got to work

-But it's Saturday.

-Yes, still work.

Do you think I would do that?

Is she yours?

No.

She's beautiful.

Please don't.

So, that guy last night, your pimp.

What's he got over you?

Why were you so scared?

Maybe you weren't.

Maybe you were just playing me.

Don't you dare judge me.

I thought you were different.

You have no idea.

Just look at your lovely life!

You've got a life, too, Katya, so do something about it.

Look, he's a scumbag pimp.

Just leave him.

Oh, clever doctor Cal, you think you know everything,

but you will never know, never!

Tell me, then. Huh?

What it's like to be scared! Scared every minute, every day.

How could you?

SHE GASPS

Evie!

It...it's happening again...

-..only it's much worse.

-I'll get the painkillers.

I've had as many as I can.

SHE GASPS

It...it started again, like they said.

We can't do this.

But we decided.

No, not like this.

Not with you in this terrible pain.

You need help, Evie.

Not in an ambulance, please.

Oh, my darling.

Oh, please.

CAR APPROACHES

SIREN WAILS

TYRES SQUEAL

HORN BLARES

TYRES SQUEAL

HORN BLARES

Here we go. It's not too bumpy, is it?

I'm sorry, darling.

HORN BLARES

TYRES SQUEAL

SHE SCREAMS

HESTER GROANS

EVIE GROANS

Evie? Oh, my love!

Oh, Hest...

Hold on, lovely. Hold on.

OK. Try and...try and open the door for me.

-I can't.

-OK. Try one more time. Come on.

-I can't...

Open the door.

I'm trying...

OK. Can you undo your seat belt?

No. I can't.

OK.

SHE GASPS

-I know you.

-Dr Knight.

-Please, please, will you help Evie?

-OK. Are you injured?

-No, I don't think so.

-OK. Talk to me.

It's all right, Evie.

He's coming.

No...

Leave me, please, it's over.

It's not over. I'm getting you out.

-I'm dying.

-You are alive and kicking,

-and you are coming back to the hospital with me.

-No...

-Yes, you are.

-It's over, Hester. I'm done.

All right. Evie. Evie! Look at me. Look at me.

Focus!

Right. There we go.

You're not dead, dying or done.

Your aneurysm hasn't ruptured yet, it can't have done.

You'd be dead by now if it had.

You...used my name...

It's the only way to get you to listen.

My pain...

The aneurysm's probably leaking.

-We need to get you out of here.

-Ohh...

-OK.

Can you move? SIRENS APPROACH

-No, I think my leg is broken.

-Right.

-Let's get you out now.

-OK.

-OK.

-Agh!

-Let's go.

Come on, mate, let's get you out of here.

-No, it's fine.

-Come on, this thing could go up any minute.

-No wait.

Get out.

-Hello?

-Get out!

Iain, Iain, Iain, Iain, Iain, Iain, it's me.

Hello. Can you hear me, love? Hello?

-Hello?

-You all right?

-Yeah. I am fine, I'm fine.

Wait.

-Dix!

-All right, Evie?

SHE MOANS

Cal?

What's going on, bud?

We got a potential leaking aneurism in the back,

and the seatbelt is stuck in the front.

Right, we need to get them out of here sharpish.

All right, sweetheart.

-We are going to take great care of you.

-Thank you.

There's no more time. We need to go now.

-Nearly there, nearly there.

-Cal, we need to get a move on.

I got it, let's go, go, go.

Steady. We've got query fractured right tib and fib, all right?

THEY ALL SHOUT

Keep going!

Right.

SHE GASPS

-Evie!

-It's OK.

Right, let's try and sit you up.

-Cal, get out!

-Evie!

-Cal!

-Look at me, look at me.

Look! We're going to get you out of here, OK?

-Yeah? Stay with me. Whatever you do, look at me.

-Yes.

-Nice and calm, stay with me.

-I am.

-That's good.

-Yes, yes.

All right. That's it, one more.

Stay with me.

I got you, sweetheart. Up you get.

-I need you to sit here for me, please.

-There we go, we've done it.

-Here we go.

-Yes.

-Now, I am going to swing your legs around.

Good girl. Nearly there, nearly there.

Go. Just go, go.

SHE MOANS

Cal.

Cal. Cal!

Cal. Cal, sweetheart, talk to me.

Cal? Cal!

Thank you. Thank you, mate(!) You all right? You OK?

Yeah?

No! What are you doing?

No, bud, come back here.

-Cal, come on, come away. Cal, come on, away.

-Someone's in there.

-What, in there?

-Yeah.

No, come on, we've got to move.

-Ohh!

-Katya! Hey!

Come on. All right?

Hey, come on. You're all right.

-Cal, come on, let's go.

-Stay with me.

-Let's go now.

-Stay with me. OK.

-OK? You got her?

-Yes, I got her.

-OK, OK. OK.

-Come on.

HE GROANS

All right, come on.

..O neg and cross-match ten, please.

Evelyn, I'm Mrs Beauchamp, I'll be looking after you.

Can we get better access and analgesia in, please?

She's a bit short of breath.

-I'll keep an eye on her sats.

-Yes, please.

Let's do something about the pain.

Can we titrate ten more of morphine, and some Ondansetron, please?

There's really no need for you to be here, Dr Knight.

Hester's doing OK. I'd really like to be here.

-Right, I need a trauma line.

-OK.

Can we let the vascular surgeon know?

I'll get consent once we stabilise her.

Right, we're going to need FBCs, U and Es,

glucose, clotting and LFTs, please.

Can you let Transfusion know we need two units of FFP as well?

BP's in her boots. She's in shock.

Are you ready?

Yes, I'm ready.

SHE MOANS

MONITOR BEEPS

She's very flat.

Just keep looking for the vein, you'll find it.

SHE MOANS

-CONNIE:

-Yep.

-I need to be with Evie.

-I think you've fractured your sternum.

-It's why you're struggling with your breathing.

-Partly...

Hester...

You'll talk to her again, I promise.

Hes... Hester...

(Have you told her yet?)

No. I couldn't.

I need to be with her.

Please...

Ethan, let's get the trolley over.

OK, let's do this.

OK, gently, though, please.

Gently.

Just keep your oxygen on for me, please, Hester.

If her systolic hits 90, we can go. How are we doing with Theatre?

-They're ready.

-All right. We need to get her straight up.

-Can we just have one minute?

-No. We're short of time.

-They need this.

-No, the surgeons are waiting.

It may be all they have.

Be really quick about it. Go.

Let's get a bit closer. Closer.

There we go. OK, Hester...

..you can talk to her. She'll hear you.

Evie?

Darling?

Oh, my dear love.

It was always yes, sweetheart.

You are...everything.

I am really sorry. We need to go.

Goodbye, my love.

I'll see you soon.

-CONNIE:

-Let's go.

No, Dr Knight.

You stay here, you need a full examination.

Dr Hardy, help with Evelyn, please.

The surgeons are waiting.

OK, well, sats are looking better.

OK, great.

Whoa, you just survived an exploding car and saved three lives.

I got lucky.

Well, stay lucky. Let's clean the forehead and get some dressing on.

Then the police can have a word.

Um...

Could you...

Could you make them wait?

What are you talking about?

I'm not ready to...

Just say it, Cal.

OK, look, I had a skinful last night and I didn't get to bed till three...

-What, you think you were drunk?

-No, I was fine to drive.

Really?

Yeah...

I don't know.

I hadn't eaten, so I can't be sure but...

It doesn't take much to tip a breathalyser, does it?

Look, I didn't cause the crash,

but what if I'm just over?

I can't risk it. This is my whole career we're talking about.

All right, let's talk this through...

I can't lose my job, Charlie.

Look, the girl was in danger.

I didn't stop to think it through.

He tried to kill her.

-You believe me, yeah?

-Look, you know it's not about that, Cal.

Come on, Jacob, mate.

We can't shield you, you know that.

Smoke inhalation can be quite nasty,

so let's keep you in under obs for a couple of hours.

Let's get some saline into him, plenty of rehydration and oxygen.

I'll tell the police they can wait.

Yeah. Good call.

-Fine.

-Mm-hm.

The girl you saved is about to be moved up to the ward

if you want to go and see her.

Thank you.

OK.

You've always got to go one better, don't you?

Nice one.

So, sweet cheeks,

we're more alike than I thought.

He saved three lives in terrifying circumstances,

so I think he deserves the benefit of the doubt.

See?

You really are just a pussycat.

Don't tell anyone.

Did he...die?

Yeah.

So I'm free?

Look...

..he had you trapped.

I didn't think it through.

No, you were right.

I had to leave him.

You need to get yourself a visa.

I was thinking, maybe I can...

No, Cal.

Thank you, but Nikolai stole my life.

And I just gave in.

So now I have to turn this around.

However hard...

..I need to be in control.

And I have to do this by myself.

Do you understand?

Yeah, I do.

Hey, have you got a moment?

Ethan, what's wrong?

I'm really sorry, Cal.

Evie?

HE SIGHS She died in Theatre?

-She didn't get actually get there.

-Oh!

-She went into PEA.

There was nothing we could do.

I'll break it to Hester, if you like.

No, I should do it.

HOARSELY: You... You both knew it would be soon.

How did you face that?

My cancer...

..made time so intense...

..so real.

I learnt to stop wasting what I had...

Maybe that's easier if you're older.

None of us knows how long we have.

I'm not as brave as you.

That's not what I saw today.

That was different.

To be frightened, yet still be brave,

that's real courage.

It's all over now.

You need to get some rest.

Stay with me.

Please?

Ahem. That's a tenner you owe me.

I thought we needed cheering up.

Yeah, you're right. We can start tomorrow.

Cheers, Babe.

Hey, Cal.

-Hey.

-They want you back in bed.

Right.

Hester?

Is she all right?

She's dead.

But... Her breathing wasn't good but it wasn't critical.

But she wasn't in any distress!

What have we missed?

I think she just decided to go.

She said it was over.

Oh, Cal.

If anything had happened to you...

No, look at me. You are not on your own.

Come here.