Episode 17 Casualty

-CRASH, GLASS BREAKS Robyn!

-Get Charlotte out.

I need you to run the ED in my absence.

I'm never in charge of anything.

Well, I've never had chemo, before so..

I don't think you're fit to practise.

-Connie, are you all right?

-Fine.

HOUSE PHONE RINGS

'Please leave a message after the tone.'

'Mrs Beauchamp, Hanssen here. A number of staff are ill.

'Please report to the ED immediately.

'You may catch your flight to America this evening, as agreed.

'I'll try your mobile.'

MOBILE PHONE RINGS

See? The ladies love a beige pulling pad.

You'd never guess what happened here.

They've done a really good job. Haven't they, Robyn?

It looks great.

No way, no way.

Scrooge may be on annual leave, but her spies are everywhere, all right?

Thanks.

Noel, you need to get that tree set up

and put some sparkle on it. It's Christmas.

New security measures are in place, as you can see.

-Hang on a minute. I thought you were on holiday?

-Yeah...

-New hair?

-I'm just going to put in a shift before I go to the States.

OK.

You've just had a round of chemotherapy. You shouldn't be here.

Hanssen didn't give me much choice.

Right. Noel, take this to my office.

You're back. How are you?

I'm all right, thanks, Charlie. However, unknown female.

I reckon she's about 25. GCS 14, resps 21, heart rate 90,

-Cubicles?

-BM 4.2. BP 100/60.

She was found collapsed outside a supermarket at the bottom

of Turpine Road.

She's been down there scavenging food a lot this week,

according to the manager. IV access

established and we've started her on fluids.

-Lesions and dehydrated.

-Mrs Beauchamp.

You see, a simple malnutrition case.

Oh...

Oh, nice. Something you ate?

Funny. Dave, any news on when this extra staff Hanssen promised us?

-Mrs Beauchamp has just come back.

-Ah, good. And where's Jacob?

He's gone to Dubai. You didn't know?

It's David, by the way.

Is Charlie Fairhead about? He's a nurse. Smug. Bit up himself.

Are you a patient?

What's that to you, Dolly?

I'm afraid you can't stay here if you're not.

Dad's chest pains came on about an hour ago.

He's been living with us since he got ill. He's got COPD.

Pain?

I haven't felt pain since I was shot in the buttock in 1965.

-He was in agony 15 minutes ago.

-Any danger of some service here?

Or do we need to read Rambo's life story first?

Oh, you can read, can you?

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

Do you know where you are?

-All right.

-Right let's have Us and Es, LFTs, FBCs, please.

-Charlie, a patient called Sally's asking for you.

-Sally Hodge?

-Uh-huh.

-I'll be out as soon as I can.

What's your name?

I've really got to go. Do you have any painkillers?

OK, where's the pain?

Oh, oh.

-All right, not to worry.

-OK.

Just get hold of this.

It's undigested so it's an upper GI bleed.

Let's have four units of cross match, please.

-OK, that's not a simple malnutrition case.

-Sh.

Just go home.

Robyn? You're OK with moving back into the house, right?

Not now, Max.

Hey, do you need a big, strong man to help you move your stuff in?

We work in the same building, Glen, that is about it.

Ah, look at that. It's for Charlotte.

Problem?

Sorry, no.

It's just nice to know that other people care for her.

Robyn, this gentleman has COPD and chest pain,

so he needs a peak flow test, obs and an ECG, please.

Claude, Claude Maynard.

Dylan, we've still got two cases we haven't cleared yet.

Oh, dear.

My sentiments exactly, madam. There's naff all wrong with me.

He thought he was dying earlier.

OK. Well, let's get you into a bed, then, shall we?

And we'll see, OK?

Just got to call Jo. Be back in a sec, Dad.

Thanks. Endoscopy suite's ready when we are.

OK, thanks.

Just did the airport app thing. Paul's plane's landed.

Robyn's room wasn't cleared this morning.

-She's not going anywhere, is she?

-Of course she's not.

That's my daughter's Christmas present.

-Are you going to call the police?

-It's my daughter's.

-This isn't me. I'm not a thief.

-No? Who are you, then, hmm?

I've a right to know, seeing as you're just about to steal from me.

-What's your name?

-I'm so sorry. I've really got to get back.

Your name. Get back where?

The... Argh!

It's OK.

All right. Sit down.

Right, is there someone I can call for you?

I don't have anyone.

No-one at all? No family, no friends...?

There's no-one.

I burnt my bridges years ago

when I was stupid enough to pick a bloke over them all.

Right, do you want me to call him?

That's the last thing I want you to do.

I left him, OK? And now I've nowhere to live.

-I need to go.

-Go where?

To a squat. OK?!

OK, right. Why don't you talk to social services?

Talking is not going to help. Does talking solve all your problems?

Mine neither.

Listen, you are vomiting blood, do you understand?

-We need to treat you now.

-No!

Look, we just need to run some tests. Please, I'll do them

as quickly as possible.

-And you'll be there?

-Yeah, I'll be there.

I promise.

Oh, no. I don't want to be treated by the fruitcake who tried

to kidnap me. Just get me Charlie Fairhead.

I'm much better now, thank you for asking.

Charlie has been assigned to a different case.

I believe you've a headache, is that right?

Well, why don't you assign yourself to sticking that bumbag

up your bum and just get me Charlie?

Ms Hodge. Tone down the language a little, please.

The technician will pass a lead down into your stomach

and it will...show a live feed...

Connie?

What's wrong with her?

-You OK?

-Yeah.

Robyn, what's the problem with the house?

Nothing.

Right, are we all OK? Any more chest pains?

Good Lord, do I have to tap it out in morse code?

I have no pain.

My son's been some time.

Everything all right?

Connie had to step out of the endoscopy. She looked really unwell.

Is Mrs Beauchamp coming back or not?

She won't be long.

-Why don't I take a look at your arm...

-No.

-..and we can have a chat?

-Really, it would help us a great deal if we could...

-Forget it.

..find out a bit about you.

-She won't be long, really.

-Can you get off me?!

Excuse me. Sorry. Argh.

No, no, no, no, no, no. Can't do that in here.

Can you just pop it in the staff room with the rest of it?

OK, David. That's fine.

OK, Miss Hodge, I see you've recently completed

a course of treatment for breast cancer.

Have you had any word over whether that's been successful or not?

-No.

-No, OK.

Well, your CT doesn't really give us any indication why you would

have a headache, so I think what we'll do is send you home for now...

-Doctor, I...

-Yup.

My fingers are going numb now. Me head's splitting.

The pain's spread.

Sorry I've been gone so long, Mags.

I've missed you.

-You can get off now.

-Thanks.

-Hello, baby!

Look at the beautiful tree, Tommy.

Look at these twinkly lights.

Mummy's sorry to have been gone so long.

I'm so, so sorry.

I saw that the door was open

and I thought a missing relative might have snuck in.

Yeah, no. I've not seen anyone.

Thanks.

Anyway, have a nice Christmas with Grace.

I bet she's really excited to see you.

This must be what Buckingham Palace looks like at Christmas.

What do you think, Mrs B?

Your endoscopy patient has self-discharged.

Oh, I bet she has. And you've just let her go?

No, she wouldn't go through the procedure without you, apparently.

-You left her waiting for 40 minutes.

-40 minutes?

Yep. You being here, hiding your illness, it's not safe.

-I will tell Hanssen the truth if I have to.

-I beg your pardon?

You've just put a vulnerable patient's life in danger.

What happened back there?

Nothing, it was just that virus that's going around so...

I'm going to go home.

-Well, that is a good idea. You look dreadful.

-Yeah.

I take it you've heard about the malnutrition patient?

-Yeah, we need to find her.

-We don't even have a name.

Well, she was picked up by Turpine Road, so maybe she lives there.

She said she lived in a squat.

Iain, Iain, can you send a unit back up to Turpine Road?

My patient might be there.

Might? We barely have enough units for the blue light calls,

-Mrs Beauchamp, I'm sorry.

-Could do with some help here!

OK, enough. You're doing more harm than good.

Go home. Get some rest.

Thank you.

Ms Hodge, I've conducted another neuro exam there

and I'm still no closer to understanding your unusual symptoms.

If I could just speak with Charlie?

Charlie, I suspect, is otherwise occupied.

Your pain seems manageable, so why don't you go home?

Ms Hodge, we really are very, very busy today.

Hi. Mrs Beauchamp has gone home ill, so we are a doctor down again.

Look, I am sure your mammogram will come back clear.

I'll let you get dressed.

Merry Christmas.

SHE TAKES SHALLOW BREATHS

Hello?

Hello?

COUGHING

BABY CRIES

Hello?

BABY CRIES

Hello, I'm a doctor from Holby City Hospital...

Oh...

Oh, you're cold, aren't you? All right, sweetheart.

Let's look after Mummy, shall we?

Oh...

All right. Mummy's going to be fine.

Let's get you warm.

I'm Mrs Beauchamp from the ED. Do you remember me?

Hello?

I'm just going to call for an ambulance.

There's no service. I'll be right back.

Right. OK, sweetheart.

Let's keep you nice and warm.

OK. Right. Come on.

Hello? FAST BEEPING

Hello. Can you... Hello, can you...

Oh...

Sorry...sorry.

OK.

Hello?

Hello, yes...

SHE SCREAMS

BABY CRIES

OK.

It's OK.

CRYING CONTINUES

All right. All right.

I know, I know.

OK.

Help!

OK...

BABY CRIES

Oh, come on.

Come on. Oh!

CRYING CONTINUES

It's OK, it's OK.

Help!

BABY CRIES IN DISTANCE

Hey, want a hand?

I told Charlie that you were desperate to move back to the house

-so he's packed your bags for you ready.

-What?

No, I'm not ready to move back yet. You had no right to do that.

I'm joking.

The thought of you moving back to the house where Charlotte

nearly died makes me sick too.

I thought I'd be fine when I went back.

But the visit this morning...

I don't want to constantly be reminded of a fire.

And I don't want to live like a student.

Charlotte deserves a proper home.

I know, I know.

There you go. You've made your point. Well done.

You don't have to move back there.

Look, I'm here to help. OK? I want to be part of the team.

You can always spend Christmas with my lot.

There's always a spare seat at the table. Oh, it's magic.

And all the kids. There's nothing like it, is there?

Family time.

Shut up, shut up! Will you listen to yourself?

"The kids, the family, the magic of Christmas."

It's enough to make me vomit.

Ms Hodge. I thought you'd gone home.

Yes, I was on my way. But this old eejit...

Can I call somebody for you? A friend or a neighbour...?

Good Lord, any neighbour of this hysteric

would have emigrated years ago.

Claude, I've had a good look at your results.

I can't see any evidence that your COPD is deteriorating.

Strike up the band! Can I go home now?

Yes, certainly. Where's your son?

He stepped out a while ago to make a phone call.

-OK, have you tried to call him?

-His phone's switched off.

Don't suppose you saw any suitcases in the hall this morning?

One or two. Why?

Really?

OK, I don't think there's any easy way to say this, Claude.

It looks as though that your family have abandoned you

to our care for Christmas.

BABY CRIES Sh...

Please!

There's a baby dying down here.

Please...

I'm dying.

-Dylan.

-Mm-hm?

You can't just tell him he's been abandoned and then walk away.

I'm not doing that. I'm trying to call his son at the moment.

What do you want me to do? Arrange for carol singers to come in

and rearrange some old classics? We Wish You A Solitary Christmas?

Don't Come All Ye Faithful?

I've got to go and speak to the old people's unit after this.

He can't be on a ward at Christmas.

He's clearly too frail to go home alone.

His family have abandoned him.

I'd say there is zero chance of social care finding him a bed.

Maybe his son just got lost?

Mmm. Well, his son's phone sounds like it's currently overseas.

I've got to go and speak to them upstairs.

I always thought Barry and Jo liked me living with them.

For now, we're going to take you up

to what we call the older people's unit.

We can go to the vending machine, get some treats to take upstairs?

They must have been planning this for weeks.

I can't go home any more, can I?

Oh, you poor thing.

BANGING

-Paramedics!

-Hello!

-Hello?

-Hello! Help!

Mrs Beauchamp?

WEAKLY: The malnutrition case from this morning is upstairs.

Suspected perforated ulcer.

And this... This little one's unresponsive.

-Hello?

-I'm going to come down, OK?

Hello, it's the paramedics.

Hello? Hello? Can you hear me?

Hello?

Argh. It's locked. Just bear with me.

3006 to control.

Can we have fire and rescue to help with a extraction?

3006 to control.

I need a second unit on hot response to 17 Turpine Road.

I've got two casualties, one baby, hypothermic and unresponsive.

One female, mid-twenties, with a query internal bleed.

Tell me exactly what you need.

Adrenaline. IV access and 10% glucose.

Ready?

Mrs Beauchamp!

There you go.

Whatever you fancy.

I'll just be a second.

Listen, there's no rush for you to move out, because Paul's visiting.

You know? So, you'll stay?

It's Charlotte's first Christmas.

I need her to spend it in her own home.

OK, you've got somewhere sorted then?

I have been having a look. So there's that one...

Oh, dear, does His Lordship need help with buttons?

Will there just be you and the cockroaches left

-when they drop the bomb?

-Don't let that rot your teeth.

If you have any teeth left, that is.

Why can't they sell nice single malts in these things?

Christmas without a drop? And they say the trenches were hell.

I know where we can get some booze.

It's not far away.

..and then there's that one.

Hopefully, something half decent will turn up.

Let's hope your patient does too.

Stand aside. Judo chop!

We used to stash contraband in plain sight on the barracks.

Would you look at that!

SHE LAUGHS GLEEFULLY

-SIREN

-ETA one minute.

He's hypoglycemic. We need to gain access and correct this.

Glucose.

Argh, I can't find a vein.

Try the Hypostop. Give it to me.

He's not breathing. Checking pulse.

He's stopped breathing. Resus team standing by, please.

He is struggling. BVM.

Jaw thrust.

Kim. Kim?

You've lost a lot of blood. You have peritinitis,

so you're going to need a blood transfusion. Do you understand?

Where's Tommy?

The other paramedic crew's getting him out.

They had to do some work on him at the scene.

Kim, he won't be far behind. I promise.

I should have given him to the social as soon as we were homeless.

He said this would happen if we left.

He said Tommy would suffer. I'm a useless, useless mother.

Hey, Kim, who said that? Who said that, Tommy's father?

He's got a temper.

Tommy wouldn't be able to take it.

A baby can't take a punch.

Right, he looks to be nine months old.

Hypothermic, hypoglycaemic, no IV/IO access, so we tried Hypostop

-but BM is still one...

-Louise, Mrs Beauchamp is a patient.

-Book her in, please.

-..heart rate 140.

We need 10% IV dextrose, 2ml per kilo

-and warmed IV fluids.

-Bay three, please.

I'll take you upstairs to theatre soon to repair the bleed.

KIM SQUEALS

-Can you just relax your arm?

-No, no, you need to keep this on.

-Get a paeds anaesthetist in.

-Connie? You don't look well.

-Tommy!

-No, no. Relax your arm.

-Where's the anaesthetist?

You need to finish your blood transfusion.

They're working on him now. He'll be fine.

Just relax. It's all right.

He'll be fine. There he is. All right? Just relax.

-I don't want her to do that!

-No, no...

What are you staring at?

Where's the anaesthetist...?

You haven't seen an old guy in a wheelchair, have you?

You've lost an old guy in a wheelchair? How?

Dylan's going to kill me.

Well, we can't have that happening, can we? It's Christmas.

I'll help you, come on.

Will you try a drop of that?

To the Queen!

What are you doing, you silly old fool?

Madam, you're the one flinging yourself at a soldier

like some wanton Jezebel.

Cover!

You haven't seen a patient in a wheelchair, have you?

-Robyn's lost one.

-Another one?

-It's the same one, I hope, isn't it?

Oh, perhaps not. You know what these frail old men are like.

It can be difficult to keep up with them.

I heard about your family abandoning you.

I'm sorry.

Christmas is not a good time to be alone.

Didn't abandon me. Nonsense.

I thought they liked me living with them.

I don't quite see where I go from here.

You'll get used to it.

It gets easier.

See, I have never had anybody, myself.

It must be a terrible shock for you.

I suppose...we could be stuck with each other now?

I don't understand what's causing this. Pulse is steady.

But she's sweaty, feels feverish.

OK, let's get a chest X-ray, ECG, FBC, blood and urine cultures,

and echo and let's intubate.

Actually, forget intubation. She's coming round. Connie, Connie.

-FAST BEEPING

-She's gone into AF.

She's tachycardic at 190. Pulse weak and thready.

We'll need to shock her.

Charlie, change places. I do not like the look of this.

-Sats are dropping.

-OK.

Charging to 150. Sync on. Everybody clear. Shocking.

Still in AF. Let's go anterior-posterior.

Got it? Charging to 150.

Sync on. Everybody clear.

Shocking.

I think you should consider an infection.

Ethan, if you know something, will you please speak up?

Yeah, um... Mrs Beauchamp...

She's just finished her second cycle of chemotherapy.

She has a left atrial leiomyosarcoma.

OK, team.

CT scan chest, abdo, pelvis, head with contrast

if renal function will allow.

She's still in AF. Charging to 200... Sync on. Everybody clear.

Shocking.

Back in sinus rhythm. We have a pulse.

Let's get a 12-lead ECG before we move her.

SINGING I wouldn't want to spend Christmas on my own on a ward.

So lonely, isn't it?

-What are you doing for Christmas?

-Oh, nothing special.

If you want to pop around to the house, or wherever I am...

Really?

THEY SING GOOD KING WENCESLAS

# When a poor man came in sight

-# Gathering winter fuel. #

-Guys!

You nearly got me in trouble.

You found them, did you? Come on, Claude.

-Upstairs, they're waiting.

-And I've something waiting for you.

OK, have you been drinking?

Yes. Three types.

Oh, don't, doctor. Not a hospital bed.

Wait, hang on. Maybe you could go home if Sally's looking after him?

-Why not?

-Superb idea!

You don't know each other, do you? No, no, they're strangers.

We could keep each other company.

The poor woman's on her lonesome for Christmas too.

-Don't!

-She just told me. Hear the pain in her voice.

She's not got a soul in the world.

Who do you think you're spouting this rubbish about?

-I'm only trying to help.

-I don't need your help! Stupid fool.

OK, he's deteriorating. What's his temperature?

Not good. 34 degrees.

Blood sugar was 2.8. He's had warm fluids intraosseously

and another 20ml of 10% dextrose.

But he really needs to warm up.

Come on. Come on, little guy.

Louise?

Blood sugar is 4.7.

OK, the dextrose is working.

Good. Tommy's getting better.

Kim, when you're ready, let's have a talk with social services together.

No. Tell them Tommy needs to go into care today.

What? Come on. You've got this far. You know, you can get help.

I'm giving him up. It's done.

You said I need to go upstairs?

Let's go.

Dylan, come on, it's Christmas.

Well, is it Christmas? Well, praise be!

What shall I do, dangle some tinsel over the dying and they shall walk?

Shall we let loose the reindeer and glitter into resus?

Sorry, am I the only one to have noticed that we're bursting

at the seams today?

Have you heard about Connie?

Oh, you've turned up at last, have you?

Well, I came looking for you

but you seemed a bit busy with your boyfriend.

-So the headache got sorted?

-I didn't have a headache!

What's this?

Just a minute.

Oncology results?

"Following your course of radiotherapy..."

...tumour's shrunk...

You're cancer-free.

That's fantastic.

Sorry...

you came here today to share this with me?

Who else have I got to share it with?

Just leaving the house to attend these appointments,

that was a great achievement. You should be proud of yourself.

-Don't patronise me, man-nurse.

-No, that wasn't my attention.

Look...

whatever your regrets, this is your new life.

Things can change.

-You don't have to be alone.

-Charlie. Connie's waking up.

Right.

Sorry, I have to go.

I know. I know.

This is a new chance at happiness. You grab it.

Wait.

If the poor kid's going to spend his first Christmas in care,

then he at least deserves a present.

Didn't you work out that was from Santa, then?

Urgh, I am really not in the mood for that.

Oh, come on, it's Christmas.

Yeah, and all that's good for is getting people's hopes up.

But guess what, you're still just a sweet old man whose family

just doesn't want to know, or you've got cancer

or you're barely a year old and you're going into care.

Life's not all bad, you know.

I'm really looking forward to seeing Charlotte's face

when she opens her presents.

Yeah, about that...

I'm just going to bring her round to yours

-for a couple of hours Christmas morning.

-Oh.

I was looking forward to seeing you too.

Just because we've been getting on today,

please don't get any ideas.

Why can't it just be simple?

I still love you, Robyn.

Great.

Good for you.

You let me think you were dead.

And I still have to go through absolutely everything all by myself.

I'll pick Charlotte up from yours later.

You all right? Good.

How's the baby?

-Out of the woods.

-Ah, good.

But his mum's decided to put him up for adoption.

Oh, no.

Oh, dear.

This damn flu.

I'm sorry, Connie. Ethan told us.

Who else knows?

Well, the whole team was gathered round.

Can you give us some space, please?

Can I at least ask that my medical notes are handled

with at least some resemblance of privacy?

I know, I know.

I'll keep a tight grip on things. Don't worry.

-You were in AF, I had to say something.

-Don't.

Just call me a cab for the airport.

We have to transfer you to HDU.

I'm sorry. We'll know more once the scans have been reported

and the blood cultures have come through, obviously.

But you've got a low-grade pyrexia, your CRP is elevated.

Your white cell count is depressed,

-probably because of the chemo...

-OK, yeah, yeah. All right. I get it.

-I've got an infection.

-Yeah.

I found this in your office.

I know how disappointing it is that you are not going to be spending

Christmas with your daughter.

Maybe now's the time to tell Grace.

Can you leave now?

Thank you.

-Merry Christmas, mate.

-Merry Christmas.

Listen, I don't think me working here was a good idea.

So what are you doing to do, just pack it in?

Come back, turn Robyn's world upside down, then disappear again?

I honestly don't think she'd care.

-Max, can I borrow you, please? For Mrs Beauchamp.

-Yeah, sure.

Of course she'd care.

You're the love of her life.

I'm sure your family will be back soon.

Do you want to spend Christmas here or not?

Let's spin the wheels!

You can see nothing. You'll remember nothing.

Look away!

-Sally. Wait!

-Beep-beep!

Let them go.

They'll never catch us!

I hear you're putting your boy into care.

You should try and sort something out with the social services.

Please. Stop talking.

You'll regret it if you don't try.

I've been trying for weeks.

Did you not go to them when you left your ex?

No.

They'd call him.

What? Of course they wouldn't.

And neither would we.

You left a violent man for the sake of your son.

You left hospital when you were seriously ill

for the sake of your son.

You're a good mother.

OK?

Don't think by giving your son up, you're helping him.

All he really wants is you.

-Merry Christmas.

-Merry Christmas!

-Merry Christmas, guys.

-Merry Christmas.

-Merry Christmas.

-Merry Christmas.

This doesn't feel right, guys, with Mrs B being ill.

I think this has pretty much blown a hole through Christmas for the team.

Listen, everybody. Listen a minute.

I know it's been a rough couple of weeks. And now this blow.

It's never easy when it's one of our own.

Especially when the one in question happens to be

stubborn as a mule, and doesn't really know what's good for her.

But she's in capable hands now. We know that.

And she wouldn't want us moping around feeling sorry for her.

We definitely know that.

So come on, it's Christmas.

I'll buy the first round. I'll see you over there.

Thank you.

KNOCK ON DOOR

-Hiya.

-Hiya.

I'd better be quick.

I want to get our stuff packed before tea so Charlie and Duffy

-can have a nice evening with Paul.

-OK, sure. Come in.

Too much?

Listen. I'm going to move in with Max and Alicia.

So take this place. Give Charlotte a first Christmas to remember.

No, this is your home.

Yeah, and you two are all that matters to me, so...

You did all this for me?

Yes! I'd do anything for you.

Everything I've done, even when I've messed up, it's been for you.

Live here with us.

You don't have to do that.

Yes, I do.

Sorry. Too soon?

-It's all right. Don't worry about it.

-No.

No, I'm sorry...for being ungrateful

when you gave me Charlotte's pressie. From Santa?

That wasn't from me.

-Thanks, Charlie.

-Thanks, Charlie.

-She's here.

-Oh.

There you go.

OK, thank you.

Right, to Mrs Beauchamp.

ALL: To Mrs Beauchamp.

Merry Christmas, Mrs B.

'Hi, this is Grace. You know what to do.'

'BEEP'

Hello, sweetheart.

I hope you get this message before you get to the airport.

I'm so sorry, darling.

I'm not going to be able to make it this Christmas.

Something's come up at work.

Merry Christmas, sweetheart.

I love you.

You don't have to say anything.

But I'm here, OK?