0:00:02 > 0:00:04Nietzsche - had something to say about most things.
0:00:04 > 0:00:06From where I stand, the NHS, this hospital, my department,
0:00:06 > 0:00:08it all runs not BECAUSE of people like you,
0:00:08 > 0:00:10but DESPITE people liked you.
0:00:10 > 0:00:13My job is to help patients, isn't it? To saves lives.
0:00:13 > 0:00:15And if I wasn't able to do that with Cal...
0:00:16 > 0:00:17..then what am I even doing here?
0:00:17 > 0:00:20- HEART RATE MONITOR FLATLINES - Do we all agree?
0:00:20 > 0:00:22Time of death...16:25.
0:00:23 > 0:00:27It is with regret that I resign from my post as Medical Director
0:00:27 > 0:00:29with immediate effect.
0:00:29 > 0:00:31SIREN WHOOPS
0:00:31 > 0:00:33You've got some nerve, haven't you?
0:00:34 > 0:00:36Cheers, boys.
0:00:36 > 0:00:37- SAM:- What have we got?
0:00:37 > 0:00:41Stab wound, 19-year-old male. Right, let's get him in.
0:00:41 > 0:00:42Morning!
0:00:44 > 0:00:47This is Shane Johnston, 19 years old...
0:00:47 > 0:00:51Penetrating stab wound to the torso received at 7:30am.
0:00:52 > 0:00:53Extensive blood loss at the scene.
0:00:53 > 0:00:54What you doing here?
0:00:54 > 0:00:57Uh, Lily? With me, please. Straight through to resus.
0:00:57 > 0:01:02Pulse 105, BP 100/50, sats 97, resps 30.
0:01:02 > 0:01:05I've got a bag of saline going in and he's had five of morphine.
0:01:05 > 0:01:06Great, bay three.
0:01:06 > 0:01:09- OK. Morning, how are you?- Fine.
0:01:09 > 0:01:12Uh... We've got this, thanks.
0:01:15 > 0:01:17Hi, can you take this through to Mr Dunham?
0:01:19 > 0:01:20Morning!
0:01:26 > 0:01:28Good morning.
0:01:35 > 0:01:37You look like you've seen a ghost.
0:02:14 > 0:02:16Give me one good reason why I don't call security
0:02:16 > 0:02:18and have you escorted from my office.
0:02:21 > 0:02:23Is this how you treat all your junior doctors?
0:02:24 > 0:02:27- SHE SCOFFS - You wouldn't dare.
0:02:27 > 0:02:30Well, Clinical Fellow, technically, but still.
0:02:30 > 0:02:33No... No, over my dead body.
0:02:33 > 0:02:34Oh, I hope it doesn't come to that.
0:02:34 > 0:02:37- Hanssen would never agree to it anyway, so...- On the contrary,
0:02:37 > 0:02:40when I approached him with the idea, he almost bit my arm off.
0:02:41 > 0:02:42Call him.
0:02:44 > 0:02:45He's waiting to hear from you.
0:02:49 > 0:02:53You would seriously go from Medical Director to a trust grade doctor?
0:02:53 > 0:02:56No, it's too humiliating. What are you playing at?
0:02:56 > 0:02:58Well, it's really very simple.
0:02:58 > 0:03:03The NHS are looking to save money and I'm looking for more...action.
0:03:03 > 0:03:05I see.
0:03:05 > 0:03:07It'd be foolish to turn away someone of my calibre
0:03:07 > 0:03:09just because they happen to be your ex-boss.
0:03:10 > 0:03:12Or is it because I'm your ex?
0:03:12 > 0:03:14Oh, trust me, it's neither.
0:03:16 > 0:03:22OK. Well, I suggest you reacquaint yourself with the rest of the team.
0:03:22 > 0:03:26Show them the calibre they'll be working with.
0:03:27 > 0:03:31Good idea. I'm sure I'll win them over.
0:03:31 > 0:03:35- Eventually.- Good luck. You are SO going to need it.
0:03:35 > 0:03:37It's emergency medicine, Connie.
0:03:37 > 0:03:38How hard can it be?
0:03:38 > 0:03:40Mm!
0:03:42 > 0:03:44TRAIN HORN BLASTS
0:03:49 > 0:03:52TANNOY JINGLE PLAYS
0:03:52 > 0:03:54TANNOY: The train now arriving at platform two
0:03:54 > 0:03:59is the 0800 Central West service to...
0:03:59 > 0:04:02Calling at Melwood Green...
0:04:02 > 0:04:04PHONE RINGS
0:04:08 > 0:04:09Hello, love.
0:04:09 > 0:04:11Hi, where are you?
0:04:11 > 0:04:13I'm at the station.
0:04:13 > 0:04:14Don't get on the train!
0:04:16 > 0:04:18I have to, sweetheart, I can't let them down.
0:04:18 > 0:04:20Well, just wait for me, I'm nearly there!
0:04:20 > 0:04:23- What's happened, is it the baby? - PHONE BLEEPS
0:04:23 > 0:04:25- Steve!- Hello?
0:04:25 > 0:04:27- Hello!- Hello? Helen?
0:04:29 > 0:04:30Uh!
0:04:30 > 0:04:32SHE SIGHS
0:04:32 > 0:04:34- They're coming. - I thought I was imagining it.
0:04:34 > 0:04:36Well, he's probably just here to see Connie, isn't he?
0:04:36 > 0:04:38In scrubs?!
0:04:38 > 0:04:39Tah-dah!
0:04:40 > 0:04:42Maintenance took it down yesterday.
0:04:44 > 0:04:46That goes there.
0:04:46 > 0:04:48Actually, I'll have it.
0:04:48 > 0:04:51Hm... Nice little memento.
0:04:52 > 0:04:54Are you here to apologise?
0:04:54 > 0:04:57As a matter of fact, I'm here to work, Dr Keogh.
0:04:57 > 0:04:58We were told you'd stepped down.
0:04:58 > 0:04:59That's right.
0:04:59 > 0:05:02So, uh, what sort of work are you here to do, then?
0:05:02 > 0:05:05I'm filling the registrar vacancy.
0:05:05 > 0:05:08"The Vacancy"? Is that what we're calling it now?
0:05:08 > 0:05:10- No, I didn't...- A man died, you're calling it a vacancy.
0:05:10 > 0:05:12That's a new low, even for you.
0:05:13 > 0:05:14Welcome to the team.
0:05:22 > 0:05:24- There you are!- You forgot this.
0:05:24 > 0:05:27Is that all? You had me worried!
0:05:27 > 0:05:30Thanks. You look lovely.
0:05:30 > 0:05:34Well, I'm the size of a car, but thanks for saying so.
0:05:35 > 0:05:38- I wish you didn't have to go. - Yeah, well, we need the money, love!
0:05:38 > 0:05:40I know.
0:05:40 > 0:05:42Well, what if I go into labour while you're away?
0:05:42 > 0:05:44I-I was reading about this poor woman...
0:05:44 > 0:05:46Babies are like trains - they never arrive on time.
0:05:47 > 0:05:49- I'd better go. - I could come with you.
0:05:49 > 0:05:51I'll call you later.
0:05:57 > 0:05:59- See ya.- Bye.
0:06:15 > 0:06:16Steve?
0:06:16 > 0:06:18- YELLS:- Steve!
0:06:18 > 0:06:20SAM SIGHS
0:06:22 > 0:06:25Infected leg ulcer, cubicle two.
0:06:25 > 0:06:27Yeah... I could murder a coffee.
0:06:28 > 0:06:32Hey, how about you? Get yourself one too...
0:06:32 > 0:06:35Staffroom. Kettle. Use it.
0:06:39 > 0:06:41Ah...
0:06:41 > 0:06:44Leg ulcer... I've just drained an abscess.
0:06:44 > 0:06:47Who do you bribe to get the most exciting cases around here?
0:06:47 > 0:06:49JACOB CHUCKLES
0:06:49 > 0:06:51So, would you like me to go and cause a pile-up
0:06:51 > 0:06:53so you can have an interesting day at work?
0:06:53 > 0:06:57I'm just saying that minor injuries probably isn't the best use
0:06:57 > 0:06:58of my time or talents, that's all.
0:06:58 > 0:07:00And as Clinical Nurse Manager,
0:07:00 > 0:07:02they're probably not the best use of mine.
0:07:02 > 0:07:03But then, I don't pick and choose.
0:07:05 > 0:07:06We treat whatever comes our way.
0:07:08 > 0:07:10Get used to it.
0:07:15 > 0:07:17- Helen? - SHE KNOCKS ON CARRIAGE
0:07:17 > 0:07:19DOOR RATTLES
0:07:19 > 0:07:21Oh!
0:07:21 > 0:07:22Helen!
0:07:23 > 0:07:25Are you all right?
0:07:26 > 0:07:27Oh...
0:07:27 > 0:07:29Oh!
0:07:30 > 0:07:31Steve!
0:07:31 > 0:07:34TRAIN POWERS UP, HE WINCES
0:07:34 > 0:07:36HE PANTS
0:07:39 > 0:07:41BREATHING EASES
0:07:43 > 0:07:45Ah, good morning, Dr Keogh.
0:07:45 > 0:07:49- Morning.- Uh, Dr... Dr Keogh... Ah, if you recall...
0:07:49 > 0:07:50You-You said...
0:07:50 > 0:07:53Well, perhaps at a time more convenient to you, of course,
0:07:53 > 0:07:55cos you're a busy man and I appreciate that, so...
0:07:55 > 0:07:57David, can you cut to the chase? I'm losing the will to live here!
0:07:57 > 0:08:02Well, you said...you'd help me... tick the box.
0:08:02 > 0:08:04Oh, right, yeah. Yeah.
0:08:04 > 0:08:07Well, we-we-we were going to move onto work next.
0:08:08 > 0:08:10- Yes, yeah, we were, weren't we? - Mm, yes.
0:08:10 > 0:08:13Um, OK, right. Well, I'll... I'll have a word with Jacob
0:08:13 > 0:08:15about having a word with you about promotion.
0:08:15 > 0:08:18- Well, I'm not interested in promotion.- No?
0:08:18 > 0:08:21No, that's-that's not how I view work.
0:08:21 > 0:08:23Well, how DO you view work?
0:08:23 > 0:08:26Well, it's-it's all about the patients and their care.
0:08:27 > 0:08:29Yeah, patient care.
0:08:29 > 0:08:31OK, well, it's a bit difficult to quantify, isn't it?
0:08:31 > 0:08:33But, you know, whatever peels your banana.
0:08:33 > 0:08:35I'll, um... I'll see what I can think of.
0:08:35 > 0:08:37- Ah, well, thank you. Thank you. - Yeah, OK.
0:08:37 > 0:08:38Yeah, yeah, yeah, yeah!
0:08:41 > 0:08:44- STEVE YELLS:- Helen! - Stop! Stop the train, stop!
0:08:45 > 0:08:47- WHISTLE BLASTS - Stop!
0:08:48 > 0:08:51STOP! Stop the train!
0:08:51 > 0:08:53HE GROANS
0:08:53 > 0:08:56- BRAKES SCREECH - Aah!- No!
0:08:56 > 0:08:59HE SCREAMS OUT IN PAIN
0:09:00 > 0:09:02TANNOY JINGLE PLAYS
0:09:02 > 0:09:06Hello, mate. My name's Iain, I'm a paramedic. Can you hear me?
0:09:08 > 0:09:10- What's his name? - Steven. Steven Crompton.
0:09:11 > 0:09:13All right. Steven?
0:09:13 > 0:09:14I'm going to have a look at this leg for you
0:09:14 > 0:09:16while the fire boys work on getting you out, OK?
0:09:18 > 0:09:19Let's start him on ten of morphine.
0:09:19 > 0:09:24- Helen. Helen.- I'm right here. I'm right here, love.
0:09:24 > 0:09:26- Aah! - STEVE YELLS IN PAIN
0:09:26 > 0:09:27All right, mate.
0:09:29 > 0:09:33Right. This could take some time. Let's get a team out here pronto.
0:09:34 > 0:09:36What, am I his PA?
0:09:36 > 0:09:38I bet that's how he became Medical Director,
0:09:38 > 0:09:40- by throwing his weight around... - Lou.
0:09:47 > 0:09:49- This is going well. - What did you expect?
0:09:49 > 0:09:51Well, is a little love too much to ask?
0:09:51 > 0:09:53You're kidding, right?
0:09:53 > 0:09:54Yeah, you know, until recently,
0:09:54 > 0:09:57I was the most senior medic IN this organisation...
0:09:57 > 0:09:59Who wanted to sack half of this department, including me!
0:09:59 > 0:10:02Yeah, I was doing my job. I'm not a bad person.
0:10:02 > 0:10:05You know what? I'm a real softie underneath once you get to know me.
0:10:05 > 0:10:07Aw! You're not seriously trying to flirt with me, are you?
0:10:07 > 0:10:09PHONE RINGS
0:10:09 > 0:10:11Sam Strachan.
0:10:11 > 0:10:13Yes, this is Holby City ED.
0:10:15 > 0:10:18Uh, yep. Mm-hm. How many casualties?
0:10:18 > 0:10:19- Well? - WHISPERS: Wait.
0:10:20 > 0:10:24Yeah. Great. Yeah, there'll be someone there shortly.
0:10:24 > 0:10:26- What is it? - Entrapment - Holby West.
0:10:26 > 0:10:29- OK, Jacob, I am going to get my things...- No, I'll do it.
0:10:29 > 0:10:31Sam, it's your first day. If I were you...
0:10:31 > 0:10:32Yeah, well, you're not me
0:10:32 > 0:10:35and, I mean, no offensive, but I'm an experienced trauma surgeon,
0:10:35 > 0:10:38so for THIS case, I AM the best doctor this department has.
0:10:38 > 0:10:41- Wow!- You know what? You're right. You should go.
0:10:41 > 0:10:43Yes! Glad someone agrees.
0:10:43 > 0:10:46You know what? Just nice to get a breath of fresh air. Thank you.
0:10:48 > 0:10:50Pudding, what was that - "You should go"?
0:10:50 > 0:10:52No, no, no, trust me, Connie will be all over this.
0:10:52 > 0:10:55If he makes a single mistake, it'll be his last.
0:10:55 > 0:10:56Except I don't think he makes mistakes.
0:10:56 > 0:10:58Huh, want to bet?
0:10:59 > 0:11:02JACOB CHUCKLES
0:11:02 > 0:11:03- Excuse me, please!- Madam!
0:11:03 > 0:11:05- Priority coming through! - You're not supp...
0:11:05 > 0:11:08Nurse! Yes, you! I'm having a cardiac event.
0:11:08 > 0:11:11Probably an acute myocardial infarction.
0:11:11 > 0:11:13- Yes, please do have a seat! - Oh, that's better.
0:11:13 > 0:11:15David, David, David. I'll have a look.
0:11:15 > 0:11:16Hello there. Hello.
0:11:16 > 0:11:19If it is an MI, you did very well to get here unassisted, is that what happened?
0:11:19 > 0:11:23Excuse me, my pulse is resting at 105,
0:11:23 > 0:11:27I have retrosternal chest pains, constricted breath,
0:11:27 > 0:11:29I'm 70 years old...
0:11:29 > 0:11:32If it is not a heart attack, then what is it?
0:11:32 > 0:11:34Well, no, I didn't say that, but I do need to have a look at you.
0:11:34 > 0:11:36Well, then, get busy!
0:11:37 > 0:11:39Right. If you get a "thank you" from this one,
0:11:39 > 0:11:40you can tick the box, all right?
0:11:40 > 0:11:44Come on! I'm having a heart attack, I haven't got all day!
0:11:44 > 0:11:46- OK. Shall we go through here?- Yeah.
0:11:46 > 0:11:49Excuse me, excuse me. Coming through. Thank you.
0:11:49 > 0:11:52Excuse me. Hiya, cheers, thanks.
0:11:52 > 0:11:55- You again. - Oh, well, it's your lucky day, eh?!
0:11:55 > 0:11:59- What have we got? - Steven Crompton, 34 years old.
0:11:59 > 0:12:02He fell from a stationary train which then shuntered forward.
0:12:02 > 0:12:07GCS 14, pulse 94, resps 18. His BP's 90 systolic.
0:12:07 > 0:12:11- Analgesia?- 20mg of morphine, but the pain's nowhere near controlled.
0:12:11 > 0:12:16No. Steven? It's all right. My name's Sam.
0:12:16 > 0:12:18I'm going to make you more comfortable, OK?
0:12:18 > 0:12:21Have they made any attempt to move the train yet?
0:12:21 > 0:12:23Uh, they can't without further injury.
0:12:23 > 0:12:24The step's the problem,
0:12:24 > 0:12:26we don't know if it's embedded or just pinning him.
0:12:26 > 0:12:28It's my fault!
0:12:28 > 0:12:31Oh, this is Helen, Steven's wife. Her dress got caught in the door.
0:12:31 > 0:12:34She took a tumble, Steven tried to help, and that's when he fell.
0:12:34 > 0:12:37Well... He forgot his wallet, so I took it to him on the train.
0:12:37 > 0:12:41I wish I didn't wear this stupid dress! I nearly didn't, but...
0:12:42 > 0:12:44Is it your first baby?
0:12:45 > 0:12:47- Yeah.- Boy or girl?
0:12:47 > 0:12:49Don't know.
0:12:49 > 0:12:50Don't mind.
0:12:51 > 0:12:53Steve's convinced it's a boy.
0:12:53 > 0:12:56He plays Sunday League football...
0:12:56 > 0:12:58Can't wait for a kickaround with his son.
0:12:59 > 0:13:00There you go.
0:13:01 > 0:13:03So, uh...
0:13:04 > 0:13:05..how do the fire crew get him out?
0:13:05 > 0:13:08The fire boys are saying they can use a hydraulic spreader
0:13:08 > 0:13:10to push the train away from the platform,
0:13:10 > 0:13:13but that could make the carriage unstable.
0:13:13 > 0:13:14Or?
0:13:14 > 0:13:16They cut the step away - if we've got time.
0:13:16 > 0:13:18Oh, if they do that, they may as well just...
0:13:18 > 0:13:20- Whoa, whoa, whoa... - You mean amputate it, don't you?
0:13:22 > 0:13:24Look, Helen, we need to get him out as quickly as possible.
0:13:24 > 0:13:27- No, don't...- The more we delay it, the worse the outcome.
0:13:27 > 0:13:30No. No, you can't, please, I'm begging you.
0:13:30 > 0:13:32He's going to be a dad! Don't, please!
0:13:34 > 0:13:37All right. I'll talk to the fire crew.
0:13:37 > 0:13:39Oh, by the way, we do have an audience.
0:13:40 > 0:13:42Oi!
0:13:43 > 0:13:47- All right, Steven... Nice and calm, mate, you're going to be fine. - CHAINSAW BUZZES
0:13:47 > 0:13:51- Are you on any medication, Mrs Patel?- Furosemide, hypertension.
0:13:51 > 0:13:53OK, is it well controlled?
0:13:53 > 0:13:55Well, not today, obviously!
0:13:57 > 0:13:59Right. Um...
0:13:59 > 0:14:01OK, well, it doesn't look like an obvious cardiac event,
0:14:01 > 0:14:04your heart rate's hovering about, uh, 103.
0:14:04 > 0:14:05Blood pressure's very high,
0:14:05 > 0:14:08you've got a slight arrhythmia I'd like to get to the bottom of, so...
0:14:08 > 0:14:11- Um, full bloods and troponin, then, please, David.- OK, sure.
0:14:11 > 0:14:14HEART RATE MONITOR BLEEPS
0:14:14 > 0:14:17All this bleep, bleep, bleeping...
0:14:17 > 0:14:19When I first trained, we used our eyes and our ears.
0:14:19 > 0:14:22- You were a doctor?- Nurse.
0:14:22 > 0:14:27I came here in 1964. Spent my whole career in the NHS.
0:14:27 > 0:14:29Without these machines, you wouldn't know what to do, eh?
0:14:29 > 0:14:32And all this modern holistic rubbish -
0:14:32 > 0:14:34"treating the whole person"...
0:14:34 > 0:14:36Hah! Whole load of hippy nonsense.
0:14:36 > 0:14:38Nursing is about discipline, discipline,
0:14:38 > 0:14:40discipline!
0:14:41 > 0:14:42SHE TUTS
0:14:42 > 0:14:44Sorry.
0:14:45 > 0:14:48Is there, um, anyone I can call for you, Sanjeedah?
0:14:48 > 0:14:51Only call my children when I'm dead already.
0:14:51 > 0:14:53Busy people, important jobs.
0:14:54 > 0:14:56Did any of them follow in your footsteps?
0:14:57 > 0:14:59Why don't you mind your business, eh?
0:15:01 > 0:15:05Oh, um, sorry, uh, to...
0:15:05 > 0:15:06- HELEN:- Thank you.
0:15:12 > 0:15:18No pedal pulse. Foot's white, cold. Evidence of compartment syndrome.
0:15:18 > 0:15:19What does that mean?
0:15:19 > 0:15:22It means the circulation to the leg is severely compromised
0:15:22 > 0:15:24and if it's left untreated for much longer,
0:15:24 > 0:15:27then the lack of blood supply may mean loss of limb.
0:15:27 > 0:15:30So, you're... You're saying that he's going to lose that anyway?
0:15:31 > 0:15:33I'm saying the only thing we can do is operate to relieve
0:15:33 > 0:15:36the pressure, but we are a long way from a theatre.
0:15:36 > 0:15:39- We just won't make it. - Well, then, just do it here, now.
0:15:40 > 0:15:43- No, he'll lose way too much blood. - Can you at least try?
0:15:44 > 0:15:48SAM INHALES DEEPLY It's a risk...
0:15:48 > 0:15:49What else do you need?
0:15:49 > 0:15:52A sterile environment, a well-trained surgical team.
0:15:55 > 0:15:58Oh, what the hell - you lot will do.
0:15:58 > 0:15:59Thank you.
0:15:59 > 0:16:03- Ever assisted a fasciotomy? - Not on a train platform, no!
0:16:03 > 0:16:05- Armed Forces, right?- Yeah.
0:16:05 > 0:16:08Yeah, well, this should be a walk in the park for you.
0:16:15 > 0:16:17- The kids... - That's the ketamine talking.
0:16:17 > 0:16:20- The kids...- The baby's fine, love. We're right here.
0:16:21 > 0:16:23OK, scalpel.
0:16:26 > 0:16:28- TV BLARES - Toast is ready.
0:16:28 > 0:16:31Come on, can you move your bowls, please?
0:16:31 > 0:16:32Come on!
0:16:32 > 0:16:36- TV:- ..Who is expected to be taken by ambulance to Holby City Hospital.
0:16:36 > 0:16:37His condition is said to be stable.
0:16:37 > 0:16:39The train station is closed on all platforms...
0:16:39 > 0:16:43- Get your coats on. Come on, now, get your coats.- Why?
0:16:43 > 0:16:45We've... We've got to go. Just, come on.
0:16:45 > 0:16:46Right, OK. Scissors.
0:16:49 > 0:16:51Uh...
0:16:51 > 0:16:53We don't have a retractor, you're going to have to hold it open.
0:16:53 > 0:16:54Yeah.
0:16:57 > 0:16:58Yeah, OK.
0:17:00 > 0:17:01Perfect.
0:17:02 > 0:17:04Avoid the peroneal nerve.
0:17:06 > 0:17:07Got it.
0:17:07 > 0:17:12Right. OK. This is where it gets messy.
0:17:20 > 0:17:23- Ah, damn, it's bleeding. - What happened?
0:17:23 > 0:17:26Uh, I caught a vein. A pretty big one.
0:17:26 > 0:17:28Heart rate's climbing - 110.
0:17:30 > 0:17:35Ah, I can't see. Uh... Your phone, the torch on your phone...
0:17:40 > 0:17:41Come on.
0:17:42 > 0:17:44Right, there it is. Right, clip...
0:17:51 > 0:17:53SNIPPING GROANS: Got it.
0:17:54 > 0:17:56OK, right, we need to pack this
0:17:56 > 0:17:59and get him to the ED as quickly as possible.
0:18:01 > 0:18:03HE EXHALES DEEPLY
0:18:03 > 0:18:05- So, are you in or are you out?- Yeah, go on, put me down for a fiver.
0:18:05 > 0:18:08- All right.- Although, you know I don't approve of gambling.
0:18:08 > 0:18:12- Well, I do.- Then I have a solid gold opportunity. Odds are 2-1.
0:18:12 > 0:18:14OK, I'm in. Oh, hold on, odds on what?
0:18:14 > 0:18:17- Well, Sam loses his job by the end of the day.- Why?
0:18:17 > 0:18:19He went on a shout without Connie's permission.
0:18:19 > 0:18:23- INHALES:- OK, I'm in for...five? No, no, no, make it ten.
0:18:23 > 0:18:25- Uh-huh.- No, no, make it an even 15.
0:18:25 > 0:18:28- Mm.- No, I can't afford 15. - You know what? Take this.
0:18:29 > 0:18:33Got it! Right, Steven Crompton, 34 years old.
0:18:33 > 0:18:35Ten past eight, his lower leg was crushed between a train
0:18:35 > 0:18:38and a platform for approximately 45 minutes.
0:18:38 > 0:18:40GCS 14 until ketamine sedation.
0:18:40 > 0:18:44Pulse 94, BP 119/64, sats 98%.
0:18:44 > 0:18:46He's had 20 of morphine, 80 of ketamine.
0:18:46 > 0:18:49Fire Service extracted him before Mr Strachan performed
0:18:49 > 0:18:50a fasciotomy at the scene.
0:18:50 > 0:18:52Did he now?
0:18:52 > 0:18:56- And since then perfusion to the left limb has significantly improved. - D'you know what? No, not now.
0:18:57 > 0:18:59- Blood loss?- Less than a unit.
0:18:59 > 0:19:01Lucky for you!
0:19:01 > 0:19:03Right, Steven, nice and steady, mate,
0:19:03 > 0:19:04can you transfer yourself across?
0:19:04 > 0:19:06STEVEN GROANS
0:19:10 > 0:19:11Mm...
0:19:12 > 0:19:15Knee feels doughy.
0:19:15 > 0:19:17Possible tibial plateau fracture
0:19:17 > 0:19:19and we have extensive soft tissue damage.
0:19:19 > 0:19:22Let's have full bloods, cross-match three units.
0:19:22 > 0:19:25Duffy, we'll do chest and pelvic X-ray here and send him down for tib/fib views.
0:19:25 > 0:19:27OK, let's call the anaesthetist
0:19:27 > 0:19:30and confirm with on-call surgeons that they're ready for us.
0:19:31 > 0:19:34I saved this man from a life-changing injury.
0:19:34 > 0:19:37- And exactly how many lower-limb fasciotomies have you done? - I've seen several.
0:19:37 > 0:19:39So you improvised with little support
0:19:39 > 0:19:41and barely the right equipment?
0:19:41 > 0:19:46- Oh, but he was amazing, wasn't he? - Yeah, it was pretty impressive.
0:19:47 > 0:19:49- It was nothing.- So I see.
0:19:49 > 0:19:53Surgeons are aware, they'll be down as soon as they're free.
0:19:53 > 0:19:56- How long?- They can't say. - It's OK. He's stable.
0:19:56 > 0:19:58- Ooh... - SHE WINCES
0:19:58 > 0:20:01- You all right? - Yeah... It's just a twinge.
0:20:01 > 0:20:03I've had a few recently, they don't last long.
0:20:03 > 0:20:06- I take it you checked her over? - Iain did. She was fine.
0:20:06 > 0:20:08- Do it again. - No, I will stay with my patient.
0:20:08 > 0:20:09He's MY patient now.
0:20:10 > 0:20:15- Duffy, go with him, please. - Fine. OK, Helen, this way.
0:20:17 > 0:20:19SHE EXHALES DEEPLY
0:20:21 > 0:20:24Right, well, we've had your bloods results back, um...
0:20:24 > 0:20:28Your potassium's a little low, so... Nothing too drastic.
0:20:28 > 0:20:31I'm wondering if you're not just a little dehydrated.
0:20:31 > 0:20:33- Have you been fasting for Ramadan? - Of course.
0:20:33 > 0:20:35You know you don't have to at your age?
0:20:35 > 0:20:37I've done it all my life, I'm not going to stop now.
0:20:38 > 0:20:42- Uh... Litre of saline, please. - Yes, I'm on it.
0:20:42 > 0:20:46Saline. I'd rather have a cup of tea... Here. There.
0:20:46 > 0:20:48- Bag?- Mm.
0:20:50 > 0:20:51There you are.
0:20:53 > 0:20:57Ah, yes, I think we can stretch to a cuppa.
0:20:58 > 0:21:00Is your... Is your breathing a little... A little laboured?
0:21:00 > 0:21:04- Not sure if it's just me, huh! - What are you going to do about it?
0:21:04 > 0:21:07Uh... Bear with me. Bear with me.
0:21:11 > 0:21:14Is, um...? Can I...?
0:21:20 > 0:21:26- You're googling my symptoms, eh? - Ha! Well, um, that's not...
0:21:26 > 0:21:31Well, this is... It's a very highly respected online diagnostic tool.
0:21:31 > 0:21:33- What you need is this.- What's that?
0:21:35 > 0:21:37Nursing manual published in 1966. I...
0:21:37 > 0:21:40- DYLAN CHUCKLES - I think I'll stick with Google
0:21:40 > 0:21:41if it's all the same to you.
0:21:41 > 0:21:48Um... Right, OK. Uh, let's have an eGFR.
0:21:48 > 0:21:50Um, a urine dipstick and...
0:21:50 > 0:21:52check her lipids.
0:21:52 > 0:21:54And, David, this might take a little bit of time,
0:21:54 > 0:21:56- so you should be looking to getting her a bed as well.- Right.
0:21:56 > 0:22:00In my day, a consultant was a walking encyclopaedia.
0:22:00 > 0:22:03- They were revered!- Right, well, I'm sorry I'm not a god.
0:22:06 > 0:22:07BABY'S HEARTBEAT PULSES
0:22:07 > 0:22:09Sounds healthy and strong.
0:22:09 > 0:22:12It's wonderful, I could listen to it all day.
0:22:12 > 0:22:14- Ha!- Do you have kids?
0:22:14 > 0:22:18A daughter who's 11 going on 17. Knows it all already.
0:22:18 > 0:22:21- Ah, that never changes! - Mm, yeah!- Hm.
0:22:21 > 0:22:24But in all honesty, she is the light of my life.
0:22:24 > 0:22:25Hm. Well, she's lucky.
0:22:26 > 0:22:28I can tell you're a good dad.
0:22:29 > 0:22:32Not that I know what a good dad looks like.
0:22:33 > 0:22:34One who's there for a start...
0:22:36 > 0:22:38- I never knew mine. - I'm sorry to hear that.
0:22:38 > 0:22:42Hm. But everything's going to be different for this little one.
0:22:42 > 0:22:45Steve's going to stop working away so much.
0:22:45 > 0:22:47He's going to be right here with us.
0:22:49 > 0:22:50That's good. Thank you, Duffy.
0:22:50 > 0:22:53Well, I'm sure you'll make wonderful parents.
0:22:55 > 0:22:57OK. Good.
0:22:57 > 0:23:01If you want to just rest here for a little while...
0:23:01 > 0:23:03I'll be back shortly, OK?
0:23:03 > 0:23:04I hid his wallet.
0:23:06 > 0:23:08I just...
0:23:10 > 0:23:14I just wanted it all to be perfect, right from the start.
0:23:14 > 0:23:16Both of us there when the baby came.
0:23:16 > 0:23:19I just thought I'd turn it into this stupid romantic gesture -
0:23:19 > 0:23:23just take the wallet to the station, jump on the train and go with him.
0:23:25 > 0:23:26Sorry.
0:23:26 > 0:23:28No, it's OK.
0:23:30 > 0:23:32It's all right, you know?
0:23:33 > 0:23:34Everything will be all right.
0:23:34 > 0:23:37Look at that, somebody's bet 50 quid against.
0:23:37 > 0:23:39Hey! I've been looking for that everywhere!
0:23:39 > 0:23:44- Who was it?- AN Other. Ahh! So what do they know that you don't?
0:23:44 > 0:23:47That he won't lose his job, he's far too well connected.
0:23:47 > 0:23:49But he's arrogant. That's how errors are made.
0:23:49 > 0:23:52- Well, I think he's rather wonderful. - ELLE SCOFFS
0:23:52 > 0:23:54- With the patients, I mean!- Uh-huh!
0:23:54 > 0:23:57He makes them feel safe and at home. In good hands.
0:23:57 > 0:24:01- After that, they're putty in his. - Mm. I could do with some of that.
0:24:01 > 0:24:03She's right. You should've seen him today.
0:24:03 > 0:24:05I'd trust him with MY life.
0:24:05 > 0:24:06I can't believe you're defending him.
0:24:06 > 0:24:08Well, I guess that's just another difference
0:24:08 > 0:24:10between me and you, isn't it?
0:24:10 > 0:24:13- What's that supposed to mean? - Forget it.
0:24:13 > 0:24:15- DAVID:- Ah, yes, hello. Sanjeedah Patel.
0:24:17 > 0:24:18P-A-T-E-L...
0:24:19 > 0:24:23Yes, I was wondering if you had any contact details for her children?
0:24:23 > 0:24:26No, no, no, she, uh... She does.
0:24:28 > 0:24:30What, none at all?
0:24:33 > 0:24:36I-I see. I see... No, no, no, that's fine, that's fine.
0:24:36 > 0:24:39Um, no, thank you. Thank you... Uh, sorry for troubling you.
0:24:44 > 0:24:47Can somebody please tell me what is going on?
0:24:47 > 0:24:51Steven is his name, Steven Crompton. Why can't I see him?!
0:24:51 > 0:24:53Noel, is everything all right?
0:24:53 > 0:24:55Um, this is Judith. Um, she wants to see Steven.
0:24:55 > 0:24:57There was an accident at the train station.
0:24:57 > 0:24:59The news said they'd brought him here.
0:24:59 > 0:25:01- Yes, are you a relative? - I'm his wife.
0:25:02 > 0:25:04Sorry, his...ex-wife?
0:25:04 > 0:25:07No! I'm his WIFE wife, so can I see him, please?
0:25:07 > 0:25:09Where is he?
0:25:10 > 0:25:12Um, I'm sorry, could you just...?
0:25:12 > 0:25:15I'll need to ask you for patient security, um...
0:25:15 > 0:25:18Do you happen to have any identification on you?
0:25:18 > 0:25:20My name's Judith Crompton.
0:25:21 > 0:25:24I'm not just some random nutter, I'm his wife.
0:25:24 > 0:25:26Please, where is he?
0:25:26 > 0:25:28He's being treated and, uh...
0:25:28 > 0:25:32In fact, Noel, would you mind taking Mrs Crompton to the relatives' room?
0:25:32 > 0:25:34And I'll find out what's going on.
0:25:34 > 0:25:35Finally! Thank you.
0:25:35 > 0:25:39- Sorry. Um, this way, please. - Come on, girls.
0:25:39 > 0:25:40It's just through here...
0:25:45 > 0:25:48- If, um, you need anything, just give me a shout.- Thank you.
0:25:49 > 0:25:50Hi.
0:25:58 > 0:26:00- Where is she?- I've sent her to the relatives' room.
0:26:02 > 0:26:04Her husband wants to see her.
0:26:07 > 0:26:10It's a lovely necklace. Where d'you get it?
0:26:11 > 0:26:14Oh, it was a gift from my husband.
0:26:14 > 0:26:16Oh.
0:26:18 > 0:26:20I hope they don't keep you waiting much longer,
0:26:20 > 0:26:22especially not in your condition.
0:26:23 > 0:26:27- Are you here to have a baby? - Oh, not today.
0:26:27 > 0:26:29Our daddy's poorly.
0:26:29 > 0:26:32Oh, sorry to hear that. What's the matter with him?
0:26:32 > 0:26:35- He fell off a train. - A train?! Well...
0:26:37 > 0:26:41Oh... Um, Helen, he's-he's asking for you.
0:26:42 > 0:26:43- Bye.- Bye!
0:26:49 > 0:26:52HEART RATE MONITOR BLEEPS STEADILY
0:26:58 > 0:27:00Any news?
0:27:00 > 0:27:06Um... Well, uh, doesn't seem to be any sign of any kidney dysfunction,
0:27:06 > 0:27:09your, uh, cholesterol's normal.
0:27:09 > 0:27:14No MI, no kidney dysfunction, no heart problem.
0:27:14 > 0:27:17Not a good day for you, Doctor, eh?
0:27:17 > 0:27:19Well, I've had worse.
0:27:19 > 0:27:22Um... Oh. Sorry. Should I...?
0:27:22 > 0:27:24No, come in, come in, come in.
0:27:24 > 0:27:25Right, um...
0:27:27 > 0:27:29Sanjeedah...
0:27:30 > 0:27:33I've spoken to your GP.
0:27:34 > 0:27:38I know your children... won't be coming.
0:27:39 > 0:27:41But I'm here for you.
0:27:41 > 0:27:43You had no right!
0:27:43 > 0:27:45But wait, I'm sorry, look, hang-hang-hang on.
0:27:45 > 0:27:47I want to make a complaint about this nurse.
0:27:47 > 0:27:52First of all, he can't say boo to a goose and then he snoops on me!
0:27:52 > 0:27:55- Well, you seemed like you needed company.- I don't need your pity.
0:27:55 > 0:27:58And as for this doctor... he's useless, hopeless!
0:27:58 > 0:28:02Wait, wait-wait a... Just wait a minute.
0:28:02 > 0:28:04I'm tired of waiting!
0:28:04 > 0:28:07You don't know what's wrong with me, do you, eh?
0:28:07 > 0:28:09- I could die waiting.- Dr Keogh?
0:28:09 > 0:28:10- Is that what you want?- Dr Keogh?
0:28:10 > 0:28:12- You want me to die, huh...- Dr Keogh!
0:28:12 > 0:28:15- Is that what you want?- Dr Keogh? - You want me to die?!
0:28:15 > 0:28:19- Oh, no, no, no, it's all right, it's all right, it's all right. You just...- Wait a minute...
0:28:19 > 0:28:22- Oh.- On the bed...
0:28:23 > 0:28:27- Dr Keogh? - I was... I'm... I'm so sorry.
0:28:27 > 0:28:30No, no, wait, wait, Dr... Dr Keogh!
0:28:32 > 0:28:34Was anyone else injured on that train?
0:28:34 > 0:28:36Train? Uh, why?
0:28:36 > 0:28:39Well, it's just that that little girl, she said that her dad had...
0:28:39 > 0:28:41Yes, yes, I-I think she was confused, you know.
0:28:41 > 0:28:42Um, had seen it on the news
0:28:42 > 0:28:46when that man was there with his phone, taking mobile phone footage.
0:28:46 > 0:28:47Right.
0:28:47 > 0:28:49- Hm.- Helen.- Steve!
0:28:50 > 0:28:52You're famous now, you're on the telly!
0:28:52 > 0:28:54Am I?
0:28:54 > 0:28:56HE CHUCKLES NERVOUSLY
0:28:56 > 0:28:59Listen, could you keep everyone else away?
0:28:59 > 0:29:00I don't want any visitors.
0:29:00 > 0:29:02Just want it to be you and me.
0:29:09 > 0:29:11Really? Just talk me through it.
0:29:11 > 0:29:14Sanjeedah Patel, 70 years old, presented with central chest pains,
0:29:14 > 0:29:15tachycardia and a lightness of breath.
0:29:15 > 0:29:18- So WHERE is Dr Keogh, then? - Like I said, I don't know!
0:29:18 > 0:29:20OK, she's in VT, BP's dropped, she's compromised.
0:29:20 > 0:29:23We need to cardiovert her. Nurse, find me Dr Keogh - now, please.
0:29:23 > 0:29:26Let's move her to HDC.
0:29:26 > 0:29:29HE PANTS
0:29:35 > 0:29:37PHONE RINGS, HE EXHALES DEEPLY
0:29:39 > 0:29:42PANTING CONTINUES
0:29:44 > 0:29:47PHONE CONTINUES TO RING
0:29:54 > 0:29:56Oh... Thanks.
0:29:59 > 0:30:02I hear you're having quite a day of it.
0:30:02 > 0:30:03Mm, I wouldn't know where to begin.
0:30:05 > 0:30:06Try me.
0:30:09 > 0:30:14Well, for one, I'm keeping something from a patient.
0:30:15 > 0:30:19- Ah. The doctor's dilemma.- Mm.
0:30:19 > 0:30:22How much should we tell them?
0:30:23 > 0:30:24It's not a simple one, that.
0:30:26 > 0:30:29It's a question of your own judgment in the end, isn't it?
0:30:29 > 0:30:33One thing I have learned over 30 years is...
0:30:33 > 0:30:36honesty really is the best policy.
0:30:37 > 0:30:39Good luck.
0:30:42 > 0:30:44What's going on?
0:30:45 > 0:30:48Oh, sorry, Helen, you... You shouldn't be in here.
0:30:48 > 0:30:49What aren't you telling me?
0:30:52 > 0:30:56Uh, I think you need to speak to your husband.
0:30:56 > 0:30:59Oh, for goodness' sake, I'm just about to have his baby.
0:31:00 > 0:31:02Tell me!
0:31:04 > 0:31:06He's married to someone else as well.
0:31:08 > 0:31:10What are you talking about?
0:31:11 > 0:31:12He's got two wives, Helen.
0:31:13 > 0:31:15Another wife?
0:31:15 > 0:31:19Yes, her name's Judith. She's here, you... You've met her.
0:31:19 > 0:31:21SHE GASPS
0:31:21 > 0:31:22A train accident.
0:31:24 > 0:31:25No...
0:31:26 > 0:31:28No! Oh!
0:31:28 > 0:31:29- Um...- Oh!
0:31:29 > 0:31:32Uh, whoa, whoa. SHE PANTS
0:31:33 > 0:31:36Sanjeedah? Sanjeedah, I'm right here.
0:31:36 > 0:31:39Dr Gardner's just going to sedate you for a little while,
0:31:39 > 0:31:40but don't worry, you won't feel a thing.
0:31:40 > 0:31:43That's 5ml IV propofol in.
0:31:49 > 0:31:50- Good. You ready?- Mm.
0:31:50 > 0:31:52Start with 150, please.
0:31:52 > 0:31:54Stand clear for 150 synchronised shock, please...
0:31:54 > 0:31:56- ELECTRIC PULSING - And shocking...
0:31:57 > 0:32:00- Come on.- She's still in VT.
0:32:01 > 0:32:04SHE YELLS IN PAIN OK, that's it, that's right, deep breaths!
0:32:04 > 0:32:06- What the...?- Just deep breaths. Look, hold my hand.
0:32:06 > 0:32:08- What's going on?!- She's in labour!
0:32:08 > 0:32:10Clearly, but why are you dealing with it in here on your own?!
0:32:10 > 0:32:14Uh... Because... Look, it's under control. It's just happened.
0:32:14 > 0:32:16SHE YELLS Whoa, whoa, whoa. OK.
0:32:16 > 0:32:18So you've called Obstetrics?
0:32:18 > 0:32:20No, isn't that what you do?
0:32:22 > 0:32:24SHE PANTS Um, OK, that's it.
0:32:24 > 0:32:26Yes, just concentrate on your breathing.
0:32:26 > 0:32:29- ELECTRIC PULSING - And again, stand clear at 150 and shocking...
0:32:34 > 0:32:35And again.
0:32:36 > 0:32:41- ELECTRIC PULSING - Stand clear at...200 and shocking...
0:32:41 > 0:32:43HEART RATE MONITOR BLEEPS STEADILY
0:32:43 > 0:32:46And we have sinus rhythm. Well done. Repeat the 12 lead, please.
0:32:51 > 0:32:53Nice work, David.
0:32:54 > 0:32:56Uh, any sign of Dr Keogh?
0:32:56 > 0:32:57OK.
0:32:58 > 0:33:01Well, wherever he is, let's hope it was really important.
0:33:01 > 0:33:03How long has she been in labour?
0:33:03 > 0:33:06- Uh, 20 minutes? I know as much as you do. - I thought you'd checked her over.
0:33:06 > 0:33:08Yes, and you discharged her to the relatives' room.
0:33:08 > 0:33:10Stay out! Let's give her some Entonox, please.
0:33:10 > 0:33:13- What's happening, is the baby coming? - HELEN GROANS WITH PAIN
0:33:13 > 0:33:15It's fine, she'll be fine. Right, we need to get you up on the bed.
0:33:15 > 0:33:18- All right? I'm just going to check you over.- Helen?
0:33:18 > 0:33:21- Easy as you can, that's it. - There we go.- Hels?
0:33:21 > 0:33:22SHE PANTS
0:33:23 > 0:33:25HELEN WAILS
0:33:25 > 0:33:30OK. Nice, deep breaths. That's it, you can hold it.
0:33:31 > 0:33:33Right, she's fully dilated.
0:33:34 > 0:33:37Uh, let's get onto Obs, tell them we have a precipitous delivery.
0:33:37 > 0:33:40It's too late to transfer, so we'll deliver the baby here.
0:33:40 > 0:33:43But we have an experienced midwife leading. All right? I'll assist.
0:33:43 > 0:33:45- Are you sure?- Yep.
0:33:45 > 0:33:47OK. Um, she's booked in at St James's,
0:33:47 > 0:33:50so let's have the notes sent over - QUICKLY, please.
0:33:50 > 0:33:54Helen? Helen? It's time for you to push for me, OK?
0:33:54 > 0:33:58On three. One, two...
0:33:58 > 0:33:59SHE GROANS
0:33:59 > 0:34:02HE PANTS
0:34:05 > 0:34:07KNOCKING ON CUBICLE DOOR
0:34:09 > 0:34:10Everything OK?
0:34:12 > 0:34:13Is she dead?
0:34:13 > 0:34:18No! No, no, Dr Gardner's with her, she's in safe hands.
0:34:20 > 0:34:21Safer than mine!
0:34:21 > 0:34:23No, no, that's, um, that's not what I meant.
0:34:23 > 0:34:25Um...
0:34:28 > 0:34:30You know...
0:34:31 > 0:34:32Cal's death...
0:34:35 > 0:34:36It wasn't your fault.
0:34:38 > 0:34:40You're a good doctor.
0:34:41 > 0:34:42One of the best.
0:34:44 > 0:34:47But there wasn't anything you could have done...
0:34:47 > 0:34:48to save him.
0:34:51 > 0:34:53Not you, not...
0:34:55 > 0:34:56Not anyone.
0:34:57 > 0:34:59I-I just wanted you to know that.
0:34:59 > 0:35:01That's all.
0:35:07 > 0:35:11That's it. One more push for me. Nearly there.
0:35:11 > 0:35:14- SOBS:- I can't! I can't! - You can, I know you can.
0:35:14 > 0:35:16What, you mean like Judith did?!
0:35:16 > 0:35:17What?
0:35:18 > 0:35:22Helen... Helen, it wasn't something I planned.
0:35:22 > 0:35:24- How could you do it? - YELLS:- Get him away from me!
0:35:24 > 0:35:27- Shhh, shhh, shhh. - HELEN GROANS
0:35:27 > 0:35:30That's baby's shoulders, Helen, almost there.
0:35:30 > 0:35:3210 IU of IM oxytocin, please.
0:35:32 > 0:35:35All right, just one last push for me.
0:35:35 > 0:35:37HELEN GROANS
0:35:37 > 0:35:38Yeah!
0:35:38 > 0:35:41- That's it, well done. - BABY WAILS
0:35:41 > 0:35:43Is it a boy? HELEN PANTS
0:35:50 > 0:35:52He's right here.
0:35:52 > 0:35:54Oh, hello!
0:35:54 > 0:35:56Hello!
0:35:56 > 0:35:59There he is!
0:36:00 > 0:36:01- CONNIE:- Aw!
0:36:03 > 0:36:04That was fast.
0:36:04 > 0:36:07All right, let's keep an eye on mother and baby.
0:36:07 > 0:36:09Once the placenta's been delivered,
0:36:09 > 0:36:12let's have IV oxytocin and obs every ten.
0:36:12 > 0:36:15- OK.- All right, congratulations.
0:36:17 > 0:36:18All under control.
0:36:20 > 0:36:22No thanks to you.
0:36:22 > 0:36:24BABY WAILS
0:36:35 > 0:36:37Right, how are we doing?
0:36:37 > 0:36:39I feel wretched.
0:36:39 > 0:36:42Well, come on, there's got to be something else going on here, hasn't there?
0:36:42 > 0:36:45Um... Have you eaten or drunk anything unusual?
0:36:45 > 0:36:46- Dr Keogh?- Yeah?
0:36:46 > 0:36:48- The fasting.- Oh, yeah, the fasting.
0:36:48 > 0:36:52Hang on, hang on. Just...wait a minute.
0:36:55 > 0:36:58- May I? - Well, you know all my secrets.
0:36:58 > 0:37:00What are you looking for, David, drugs?
0:37:00 > 0:37:04- Hah! Doctor, I'm 70 years old. - You'd be surprised.
0:37:04 > 0:37:06- What's that, then?- Liquorice.
0:37:07 > 0:37:09Liquorice... Oh, hang on...
0:37:11 > 0:37:13Potassium - 2.5.
0:37:13 > 0:37:18- OK, um, how much of that have you drunk?- I don't know, why?
0:37:18 > 0:37:20Because if you've drunk enough of it,
0:37:20 > 0:37:22I might suggest that you've got liquorice poisoning.
0:37:22 > 0:37:24Is that real?
0:37:24 > 0:37:27Yes, David, of course it's real. It's an appetite suppressant.
0:37:27 > 0:37:29Were you using it to help you fast, yeah?
0:37:29 > 0:37:32It can elevate blood pressure, it can cause hypokalemia,
0:37:32 > 0:37:34cardiac arrhythmia...
0:37:34 > 0:37:35Sometimes even death.
0:37:35 > 0:37:38I'm a little surprised I didn't notice it, but...
0:37:38 > 0:37:40better late than never, I suppose.
0:37:40 > 0:37:42So, what are you going to do about it?
0:37:42 > 0:37:44Well, potassium, that's what you need, isn't it?
0:37:44 > 0:37:4720 millimoles in a litre of saline over three hours, please.
0:37:47 > 0:37:49- Sure thing. High five?- Ah, no.
0:37:49 > 0:37:53- Ah, now that sounds much more like it.- Yes.
0:37:55 > 0:37:57Hm.
0:37:57 > 0:37:59BABY CRIES
0:38:02 > 0:38:06So all those times you were away, you said you were at work,
0:38:06 > 0:38:08but you had another wife.
0:38:09 > 0:38:12Why couldn't you just have an affair like a normal person?!
0:38:12 > 0:38:13It's not like that.
0:38:15 > 0:38:17I couldn't believe someone like you would even look twice at me.
0:38:17 > 0:38:19What, so it's my fault?!
0:38:20 > 0:38:25I just wanted someone to have a proper family with,
0:38:25 > 0:38:27someone who'd look after us.
0:38:28 > 0:38:33- I should've known. I'm so stupid. - It's not your fault, Helen.
0:38:35 > 0:38:37Oh...
0:38:39 > 0:38:42Oh, she's bleeding out, Duffy. We need to lie you back down.
0:38:42 > 0:38:47- Let's get the lines in.- What's happening?- Pulse 123, BP 105/55.
0:38:47 > 0:38:53OK, let's cross-match four units, get some O-neg. Line and fluids up.
0:38:53 > 0:38:56We'll start with the IV oxytocin. Wait, I'll do it.
0:38:56 > 0:38:57Oh, Mr Strachan!
0:38:57 > 0:39:00- While you call Mrs Beauchamp back. I need some help.- Good!
0:39:02 > 0:39:03So, what's the prognosis?
0:39:03 > 0:39:07It's very good. I anticipate you'll make a full recovery.
0:39:07 > 0:39:08But you'll be keeping me in for a while?
0:39:08 > 0:39:12Uh, no, I wouldn't have thought so. Once your blood pressure comes down, we'll send you home.
0:39:12 > 0:39:14Um, tomorrow, in all likelihood.
0:39:14 > 0:39:17Oh. As soon as that?
0:39:17 > 0:39:21You know, it takes an awful lot of liquorice to poison yourself.
0:39:21 > 0:39:22What made you drink so much?
0:39:24 > 0:39:26Every evening I make a big pot.
0:39:27 > 0:39:29Right, well, you don't have to drink it all!
0:39:31 > 0:39:33There's no-one to share it with.
0:39:42 > 0:39:43Thank you.
0:39:49 > 0:39:51- Steve... - It's all right, you don't need him.
0:39:51 > 0:39:54- I can't do this alone. - I'm still here, Helen.
0:39:54 > 0:39:55I can't see him, I can't...
0:39:55 > 0:39:57Helen, you're going to be all right, it's OK.
0:39:57 > 0:40:00You listen to me, you focus on yourself, OK?
0:40:00 > 0:40:01You can do this all by yourself.
0:40:01 > 0:40:04- I'm dizzy. - DUFFY:- Heart rate climbing.
0:40:04 > 0:40:08- Helen?- Airway's clear. BOTH:- Continue the massage.
0:40:08 > 0:40:12- Helen. Helen?- Let's get the bed - head down, please.
0:40:13 > 0:40:14What's happening?
0:40:14 > 0:40:16- DUFFY:- Pressure - 84/40.
0:40:16 > 0:40:17Thanks.
0:40:17 > 0:40:21Let's put up the two units of cross-match straightaway, please and, uh...
0:40:21 > 0:40:230.5mg of Ergometrine, please.
0:40:23 > 0:40:25- DUFFY:- OK, Helen.
0:40:25 > 0:40:27Once this goes in you'll start to feel much better.
0:40:29 > 0:40:31Sanjeedah.
0:40:31 > 0:40:35Hi. I-I thought I'd just pop in and...see how you are.
0:40:37 > 0:40:42I've carried this book for 51 years and it's been a good friend to me.
0:40:43 > 0:40:45Now it is yours.
0:40:46 > 0:40:48Really?
0:40:48 > 0:40:49Thank you.
0:40:49 > 0:40:50Turn to page 112.
0:40:53 > 0:40:5411... 112.
0:40:56 > 0:40:58Liquorice, excessive consumption of,
0:40:58 > 0:41:03can lead to hypokalemia and its attendant complications.
0:41:03 > 0:41:05I thought I knew the book backwards.
0:41:06 > 0:41:12Tell your Dr Keogh we keep learning every day.
0:41:12 > 0:41:14Yes, we do, don't we?
0:41:17 > 0:41:21Although... I'm a very slow learner.
0:41:21 > 0:41:23Perhaps you could talk me through the book?
0:41:23 > 0:41:28We-We could start this Sunday, if you like? Uh, 2pm, say?
0:41:28 > 0:41:29I'll make a pot of tea!
0:41:29 > 0:41:31Though perhaps not liquorice.
0:41:31 > 0:41:33DAVID LAUGHS
0:41:33 > 0:41:34Thank you.
0:41:35 > 0:41:37Tell them we'll be another minute.
0:41:41 > 0:41:43Can't hold Judith off for ever, Steven.
0:41:44 > 0:41:45Tell her I can't see her.
0:41:47 > 0:41:48You coward.
0:41:49 > 0:41:52What do you know about my life? What could you POSSIBLY know?
0:41:52 > 0:41:55You tell me, Steven, because I'm dying to hear -
0:41:55 > 0:41:59when were you thinking of telling Helen that you're a bigamist?
0:41:59 > 0:42:03- Five years from now? Ten?- Stop it!
0:42:03 > 0:42:06Bring her in, she deserves to know the truth.
0:42:06 > 0:42:07Please, don't.
0:42:10 > 0:42:12BABY WHINES
0:42:15 > 0:42:17HE SIGHS
0:42:21 > 0:42:23- Daddy!- Hey! Amy.
0:42:26 > 0:42:29Don't worry, girls, Daddy's going to be just fine.
0:42:35 > 0:42:37I was so worried about you!
0:42:37 > 0:42:40What were you doing in Holby? I thought you were in Kettering.
0:42:40 > 0:42:41Um...
0:42:43 > 0:42:44Oh, sorry, love.
0:42:44 > 0:42:48You don't have to explain, I'm just so glad that you're OK.
0:42:55 > 0:42:59Hm. Yeah, you've done well. I mean, not just with the patient.
0:43:01 > 0:43:02What about love?
0:43:04 > 0:43:07- Yeah, what about it? - That's next on the list.
0:43:08 > 0:43:11How on earth am I ever going to tick that box?
0:43:13 > 0:43:15Any... Any ideas? Any...thoughts?
0:43:17 > 0:43:19Right, girls, Daddy needs to get some rest,
0:43:19 > 0:43:22so we'll see him again tomorrow, OK?
0:43:22 > 0:43:25- Will you call me if you need anything?- Yeah.- I love you.
0:43:27 > 0:43:29Say it back, then.
0:43:29 > 0:43:30Love you, too.
0:43:32 > 0:43:34I'm about to take Steve up to theatre,
0:43:34 > 0:43:35is there anything you'd like to say first?
0:43:37 > 0:43:38Bye, Daddy!
0:43:40 > 0:43:41Bye, good luck.
0:43:48 > 0:43:49Why didn't you say anything?
0:43:51 > 0:43:52The girls.
0:43:53 > 0:43:58- Thank you.- Don't you thank me. Don't you ever dare.
0:43:59 > 0:44:00Can I hold him?
0:44:14 > 0:44:15- It's OK. - BABY WHINES
0:44:21 > 0:44:22Oh!
0:44:23 > 0:44:24Oh, look.
0:44:25 > 0:44:27Oh, look, he's so perfect.
0:44:29 > 0:44:31I mean, this is all I've ever wanted.
0:44:33 > 0:44:34Was any of it real?
0:44:36 > 0:44:37The love, Helen.
0:44:39 > 0:44:41- I love you!- I don't believe you.
0:44:42 > 0:44:44I don't believe you.
0:44:45 > 0:44:50- Sorry, we need to take you up to theatre, so...- Oh... OK.
0:44:51 > 0:44:52OK.
0:45:00 > 0:45:01Thanks.
0:45:03 > 0:45:05Cherish that memory, Steve...
0:45:06 > 0:45:09..cos it's the last time you're ever going to see him.
0:45:11 > 0:45:13We don't need you.
0:45:14 > 0:45:18- I'd rather live alone than live a lie.- Helen, please...
0:45:18 > 0:45:19I'll be watching you.
0:45:19 > 0:45:22You'd better be nice to that family,
0:45:22 > 0:45:25cos if I ever find out that you've pulled the same stunt again,
0:45:25 > 0:45:28I won't hesitate to tell her AND the police.
0:45:28 > 0:45:30- Do you understand?- I'm sorry.
0:45:36 > 0:45:41Don't worry, little one. Mummy's here. Yeah.
0:45:43 > 0:45:45SHE SOBS
0:45:45 > 0:45:46Mummy's here.
0:46:15 > 0:46:16Come in.
0:46:24 > 0:46:27I imagine that's a memo to Hanssen,
0:46:27 > 0:46:29telling him I took an unnecessary risk...
0:46:31 > 0:46:33..then I breached patient confidentiality and...
0:46:36 > 0:46:37May I?
0:46:43 > 0:46:45"Mr Strachan's lack of professionalism
0:46:45 > 0:46:49"has left the Trust open to complaint and litigation."
0:46:52 > 0:46:54Have you sent it?
0:46:55 > 0:46:56Not yet, no.
0:46:57 > 0:47:00Connie, if you agree not to send it...
0:47:03 > 0:47:04..I'll move on.
0:47:05 > 0:47:07Quietly.
0:47:12 > 0:47:17You frustrate me, Sam, you really do because you're a good doctor.
0:47:17 > 0:47:19I mean, there's no question about that.
0:47:19 > 0:47:22But you have always overestimated your ability
0:47:22 > 0:47:25and underestimated the risk - always.
0:47:28 > 0:47:29Having said that...
0:47:31 > 0:47:35..this department is lacking your certain skill set, so...
0:47:36 > 0:47:37..you can stay.
0:47:38 > 0:47:39On one condition.
0:47:41 > 0:47:44- Which is? - Leave your ego at the door.
0:47:45 > 0:47:46Understand?
0:47:47 > 0:47:49Right, I need my office back now, go on.
0:47:54 > 0:47:55Sam?
0:47:56 > 0:47:58Don't expect an easy ride.
0:48:04 > 0:48:05Noel.
0:48:07 > 0:48:11Actually, guys, you can put my winnings into a kitty for the pub.
0:48:12 > 0:48:14YOUR winnings?
0:48:14 > 0:48:15Drinks are on AN Other.
0:48:19 > 0:48:20Well done, you.
0:48:20 > 0:48:23LAUGHTER
0:48:23 > 0:48:25Doctor.
0:48:25 > 0:48:26Thanks!
0:48:28 > 0:48:30Jacob.
0:48:30 > 0:48:31Fresh start?
0:48:32 > 0:48:33OK.