Episode 28 Casualty


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Episode 28

Rash's new-found confidence is tested by a prisoner, who also leads Gem into danger. Bea goes up against confident F1 Eddie for a coveted training course.


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Transcript


LineFromTo

The NHS has its faults, but I just thought after today you would

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see the commitment that I make to it.

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Which is why I've decided to recommend you

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-for a major trauma course.

-Oh.

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You're new, right?

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I am.

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-Gem.

-Rash.

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Before you hang the wrong person, you need to know that...

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I was mentoring him on the cases that were blogged about.

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I can take it from here.

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-Oxygen away, stand clear.

-Clear.

-Shocking.

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She's back in sinus rhythm.

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You animal, you smashed it.

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You didn't dob me in, was it because you still like me?

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I couldn't like you less.

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-Ethan...

-It's Dr Hardy, and that is all I'll ever be to you.

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Get off me! I said get off me!

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Get off me! He jumped on me! He jumped me from behind.

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Right, can we have him restrained a bit more, please?

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Don't touch him.

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-Calm down for me, mate.

-Electric's off, yeah?

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Right, let's see what we've got.

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Right, let's get a better look at you.

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That's a bit forward, innit?

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At least buy me a pint first.

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Resps 20, but shallow. I've got a pulse, but it's irregular.

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I'm worried he's got an arrhythmia.

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Can we get the pads on just in case?

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Blade is still in the wound.

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Right, there's our entry point.

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He's going to need proper medical attention,

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we need to get him to the hospital as well.

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Exit wound is in his left thoracic region.

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-Can you tell me what happened?

-He went for me from behind.

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I fell on it.

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Right, and what about your wrist?

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Must have been from when I fell.

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I'm going to get a tourniquet on your leg.

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-Sam...

-BEEPING

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..he's arrested.

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Come on! Keep up!

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So, now you have finally made it into resus without throwing up,

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there must be someone in this building you want to impress.

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I mean, it's not like you have standards.

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If I wasn't so tired, I'd be offended.

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What about Gem?

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Gem? No! Stop with this, will you?

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Why, did she say something?

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Come on. Race you!

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Hey, Gem. Rash has something he wants to ask you.

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See you inside.

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I hope you're going to have a shower before your shift, Dr Masum?

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Don't be late.

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So impressed right now.

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Yeah. Cool. I'll see you.

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He's in VF.

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We need to shock.

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-Is that a pacemaker?

-We've got to shock anyway.

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Right. Fully charged, everyone clear?

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-Clear.

-Shocking.

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There's no output.

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-Is he alive?

-Right, let's secure his airway with an i-gel.

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If we need the adrenaline, have we got it?

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Yeah, it's in the bag.

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OK.

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Yeah, we're in, we're secure.

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He's still in VF, we need to shock again.

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Charging up.

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Everyone clear?

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Clear.

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Shocking.

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-RADIO:

-3006, 3007 arriving...

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I've got a weak pulse.

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Second unit have just arrived.

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-Get back on him.

-Well done.

-Yeah.

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INMATES JEER AND SHOUT INSULTS

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I'm going to break your legs when you get back here!

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What you looking at?!

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I've made real progress. I've finally pushed through resus

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and now I've been dealing with just bumps and grazes ever since.

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I thought I'd proved myself.

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Come on, I want a slice of the action.

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All right, Bruce Willis, I hear what you're saying.

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There's actually an ambulance heading here now from prison.

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One of the traumas is an inmate.

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Good enough?

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-Prison?

-Mmm.

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Well, do you want it or not?

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-Yeah, yeah, I do.

-All right, cool.

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Do me a favour, find Dr Hardy, give him that.

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I'll meet you at the main entrance.

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I don't suppose you did me one?

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Two sugars, I believe.

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Now that is what a hero looks like.

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-Hide.

-Munroe.

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Oh, there you are.

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Ethan!

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Dr Hardy...

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Two seconds. What is it?

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Well, I've just barely seen you all week.

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I know. Yeah.

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I don't want it to be like this.

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I messed up!

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I don't know what else to say, apart from I'm sorry.

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What I wrote, I never intended you as the target.

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You humiliated me.

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And now you're upset because there's bad blood?

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Is there anything else? Because I'm a bit busy.

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Rash has got your X-rays.

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Right, thank you.

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Almost there.

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Lock up your nurses.

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Well, ours are called Charlie, Jacob and David.

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Once inside, you stay to the left of the trolley, so I can hand

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over to the doctors properly and we'll go straight through to resus.

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-This scar.

-That's an old one.

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-Playground fight?

-Not that old.

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It's from the Falklands.

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-Whoa, really?

-Yeah.

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I'm sorry. These are for Dr Hardy.

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I'll take them. We're treating Frank together.

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Again?

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My Uncle was in the Royal Marines.

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He served there, too.

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-What?

-Oh, nothing.

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Your accent, I just thought...

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Actually, my uncle was English, just like my mum.

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You were right to come in.

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You have a fractured dislocation of the shoulder...

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Hang on. There's a metal foreign body in here.

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It's a bullet.

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It's the one that took me out of action.

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Battle of Goose Green.

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-An actual bullet?

-Yeah.

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Right, thank you.

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OK.

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Thank you, Dr Masum, I'm sure you have patients of your own

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to attend to.

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Yep, of course. Sorry.

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OK, Mr Tennant, orthopaedics are ready for you,

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so we're going to get you up there and back in shipshape, all right?

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-I will call a porter.

-Actually, you can take him.

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-Would you excuse us for a moment?

-Yeah.

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I've cleared it for you to spend this week in Orthopaedics.

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I thought it'd be a good experience for you.

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Before you thank me,

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the head of department there, Ms Alex Broadhurst,

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now she's one of the leading specialists.

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She's brilliant, she doesn't suffer fools

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and she's a real stickler for detail.

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I'm sure I'll get along just fine with Miss Broadhurst.

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-Ms.

-Ms.

-Yes.

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She also happens to teach at the International Trauma Course.

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OK? You haven't heard this from me,

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but she reserves the right to choose one trainee to go with her for free.

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So there is a space up for grabs.

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OK.

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-Thanks.

-Please don't embarrass me.

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Yeah, yeah.

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Enjoy.

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Right, he's 19 and starred up, meaning that he's a young offender

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deemed too dangerous, so they moved him to adult prison.

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You sure you've got this?

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Yeah.

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-Noel, are we good?

-Just one sec.

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-Yep, we're good.

-What's going on?

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Some starred up prisoner and a prison guard have been injured.

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Starred up? You want my advice, don't give him an inch.

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OK, here we go, here we go.

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Rash, you take the stab wound, please.

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Iain, cubicle three, please.

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OK, through here, please.

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Ms Broadhurst?

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It's very simple.

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If it happens again, I'll have no choice but to assume you don't

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know your intergluteal cleft from your olecranon.

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I'll make sure the board assumes the same thing. OK?

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-So sorry for bothering you, I'm...

-Dr Kinsella.

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F1 joining us from ED. Graduate of Swansea.

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Winner of the Contribution to Operations Support Award.

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-I know.

-Well, the pleasure's all mine.

-We'll see.

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And this must be Dr Edward McAllister.

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-Orthopaedic F1.

-Eddie, please.

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Thanks so much for agreeing to us shadowing this week.

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And Dr Kinsella, was it?

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Great that they let you up from the coal-face.

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Oh, have you forgotten something?

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Ah, yes, your patient, Frank Tennant.

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Why don't you and Dr McAllister treat him together?

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One of you can assist in his operation.

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I'll see you on the ward.

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This'll be fun. I didn't realise there'd be competition.

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Oh, come on, don't be coy.

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The International Trauma Course?

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I wasn't being coy.

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I just don't see any competition.

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Everything all right?

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I have to share you.

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Right, this is Tony Hughs, 57 years old.

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At approximately 09:15, he suffered an electric shock

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from an industrial toaster.

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Initially unconscious. However, shortly after arrival,

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he went into VF arrest, OK? He's had two shocks before ROSC,

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he was in respiratory arrest, so he's been ventilated

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and intubated since.

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Entry wound is his right hand.

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Exit, left thoracic region.

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Right, OK, let's get some bloods off then, please.

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Check his FBC, U&Es, CK and clotting.

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Let's repeat the 12 lead, yeah?

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Just one more thing, I think he's got a pacemaker,

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-but that's unconfirmed.

-Oh, right, OK. Duffy, let's get a technician

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down here from the cardiac department, soon as we can, please.

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Sure. I'll contact burns and plastics to let them know about him.

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OK, your heart rate's up.

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Yeah, well...

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I know what they say about prison,

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but it's not every day another bloke tears my trousers off.

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-OK.

-Right, Jack, any numbness?

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Nah.

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-Can you feel this?

-Go easy, mate.

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What you going to do, then? Are you going to cut it out?

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Well, we have to see if it's involved a bone first.

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Do you want to tell me how it happened?

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Not especially.

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Surprise, surprise.

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I was just cleaning up after breakfast.

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He's jumped on me from behind.

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I don't know why.

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All I done was push him off.

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What, you don't believe me...?

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Honestly? No.

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Oh! Sorry, mate! You all right?

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Honestly, that was just a reflex.

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Yeah, I'm OK. We'll do an X-ray to work out exactly what we're

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dealing with here. Excuse me.

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The shoulder is made up of a ball and socket joint.

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So the head of your humerus, the ball, has come out of the socket.

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Not only that, but the shaft has been fractured.

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So the operation will be to put the ball back in the socket

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and to stabilise the fracture using a plate and screws.

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Sounds scary, but it's all pretty much straightforward.

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Yeah, yeah, but it says here the operation includes

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the removal of the bullet.

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-Yes, that is right.

-No, it's not.

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I don't want that.

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I thought you would want it removed.

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I've lived with that bullet for 36 years.

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It's part of me now.

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But purely on medical terms, I mean, with the fresh damage,

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it could inhibit our ability to set the plates,

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or your flexibility after the operation.

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Well, hang on, that's not strictly true, is it?

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Not strictly speaking, no.

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If Frank doesn't want it removed...

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I mean, the man's risked his life for ours, it's his choice.

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Thank you.

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It's not a problem.

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Dr Kinsella, please rework the consent form.

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Dr McAllister, you will assist in theatre.

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OK, so his pacemaker's all right, then.

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That's good, thank you very much.

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Right. OK, can we book him a head CT, please,

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-and arrange a bed on ITU?

-Sure.

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Dr Masum here has had an...

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altercation with our prisoner patient.

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I can't find Dr Hardy, so I was wondering whether you'd be willing

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to take over the treatment, then Dr Masum...

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Oh, right, OK.

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What? Actually, no need.

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Spare me the boring details. I wish I got to choose my patients.

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-Colleagues too, for that matter.

-Thank you.

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Duffy, can we give him some saline, please?

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Can we chase up the bloods and keep an eye on his potassium levels?

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Thank you for this.

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He needs a urinary catheter inserting, as well,

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so you can do that.

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Thanks.

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Right, this is you.

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Doctor'll be in shortly.

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Play nice, he might even get you a cup of tea.

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You reckon, yeah? Hot drinks and me don't really go that well together.

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Ask old Keith here. He's got the scars.

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Well, I can promise you the bed's more comfy than you're used to.

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And you'd know, yeah? Listen, give me a break.

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I did some time in Featherfields, so, yeah, I would know.

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Featherfields? What for?

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Stole a car. Someone got injured.

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Ancient history now.

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What about you?

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I was into my cars too for a bit.

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But I was put away for violent robbery and assault.

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What, that's supposed to impress me?

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It weren't like that.

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I was just a dumb kid.

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I was sleeping on the streets.

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I ended up breaking into this house for a bit of cash.

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I didn't know the owner was still in.

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They fell down the stairs.

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Not fun, is it, inside?

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Free food, free board.

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Can't be that bad.

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Even now? Adult prison?

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Easiest time I ever did.

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Do they let you have visitors?

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Who?! Nobody gives a monkeys about me.

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Why, are you offering?

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What, so you mean you don't speak to anyone?

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Well, my Uncle Phil, but...

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..he's in some old people's home now, so...

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I just keep myself to myself. Safer that way.

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From the other prisoners?

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From everyone.

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What do you mean?

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Prisoners aren't the only ones inside, are they?

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Do you mean that other guard?

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Hello, Mr MacLellan.

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My name's Dr Keogh.

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What happened to the other one?

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I've no idea. Now, the good news is that the stab wound,

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the blade hasn't involved the bone.

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So I'm going to send you for a CT and angiogram just to make sure

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the artery...

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Can't we just cut out all this foreplay, just pull it out?

0:18:040:18:07

Yeah, if you enjoy the idea of bleeding to death.

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No? OK, well, in the meantime, shall we have a look at this

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other wound, yeah?

0:18:140:18:16

Right, OK, well, that needs cleaning and closing.

0:18:180:18:22

Not sure why that's not been done. I'll do that.

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-How did you get this?

-When I slipped.

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Right. And these other bruises?

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Forget it, yeah? It's old news.

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OK, fair enough.

0:18:330:18:34

Come closer, Dr Kinsella, you're missing all the fun.

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So, we can clearly see how the plate is stabilising the fracture.

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Suction, please.

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And there's our infamous bullet.

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Very lucky man.

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A centimetre or two to the left, it would have

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severed his cephalic vein.

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-And it's safe to set a plate that close?

-Uh-huh.

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Right. Dr McAllister, I'd like you to do the final screw

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and close him up.

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Nice and neat please,

0:19:070:19:08

I'll be checking back the images on the intensifier.

0:19:080:19:11

Listen, do you mind taking this?

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What?

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I didn't want to make a massive deal about it,

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but one of my contact lenses is giving me a bit of grief.

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I don't honestly think it matters which of us does it.

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Besides, I know you're desperate.

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-What happened?

-The drill bit chipped on something.

0:19:500:19:53

-Chipped on what?

-I don't know!

0:19:530:19:55

He's bleeding. Suction, quick.

0:19:550:19:57

Is it the cephalic vein?

0:19:590:20:01

I don't know.

0:20:010:20:03

Oh, wait, there it is.

0:20:030:20:04

OK, it's fine.

0:20:040:20:05

-We better get Ms Broadhurst.

-Are you kidding? No.

0:20:070:20:10

Look, I've got the pieces.

0:20:110:20:14

That's all of them.

0:20:140:20:16

Vitals still stable.

0:20:160:20:17

No harm done.

0:20:170:20:19

All I'm saying is, the cuts, the bruises,

0:20:230:20:26

the cagey way he was answering you, it all fits.

0:20:260:20:28

Yeah, but the bruises could have just as easily been

0:20:280:20:31

caused by another inmate as the guard.

0:20:310:20:33

He's scared of them. You can see he was anxious.

0:20:330:20:35

Well, couldn't he have said something? He's a big boy.

0:20:350:20:38

-Boys.

-Huh?

0:20:380:20:39

"One cannot bring up boys to be eagles

0:20:390:20:41

"and expect them to be sparrows."

0:20:410:20:43

That means if men are forced into being...

0:20:440:20:46

Yeah, yeah, yeah. I know what the words mean, Noel, thanks.

0:20:460:20:49

The prison guard, Tony Hughs.

0:20:500:20:53

Maybe he caused this.

0:20:530:20:54

I feel like that's what he was trying to tell me.

0:20:540:20:56

No matter what you feel, Gem,

0:20:560:20:59

it's not our job to go delving about in the underworld, all right?

0:20:590:21:02

We simply don't have the time.

0:21:020:21:03

Now, can't you just stick to porting and shuffling things

0:21:030:21:07

backwards and forwards? Whatever.

0:21:070:21:09

Honestly, you should see this guy.

0:21:120:21:13

I swear the term punch-me-face was designed with him

0:21:130:21:16

specifically in mind.

0:21:160:21:17

Well, I'm sorry you're not enjoying the leisurely pace of Orthopaedics.

0:21:170:21:20

What is that supposed to mean?

0:21:200:21:22

It's not exactly fun, us picking up your slack.

0:21:220:21:24

Oh, is that what everyone has been saying?

0:21:240:21:27

No, it's not you they're annoyed with.

0:21:270:21:29

It's our elusive Clinical Lead. Seriously, I never see the guy

0:21:290:21:32

unless he's in my face shouting about something.

0:21:320:21:34

Well, he's got a lot on.

0:21:340:21:36

It's not his fault you wimped out on a patient because he scared you.

0:21:360:21:39

He nearly broke my nose!

0:21:390:21:41

You should do one thing outside your comfort zone every day.

0:21:410:21:44

Case in point.

0:21:460:21:47

-Have you asked her out yet?

-Give it a rest.

0:21:480:21:51

This isn't sixth form.

0:21:510:21:52

She might say no.

0:21:540:21:55

Rash, sometimes I think I'm more of a man than you'll ever be.

0:21:570:22:00

Dr Munroe, did you arrange for Dr Masum

0:22:070:22:10

-and Dr Keogh to switch patients?

-Yeah.

0:22:100:22:12

You didn't think to check with me?

0:22:130:22:15

Sorry. I couldn't find you,

0:22:150:22:16

so I thought I would just solve the problem,

0:22:160:22:18

instead of handing it over.

0:22:180:22:19

OK, this works, for the record. So, next time, use it, yeah?

0:22:190:22:22

Everything all right?

0:22:260:22:27

Yes, fine, thank you.

0:22:280:22:29

You know, if you're struggling, your team might moan,

0:22:300:22:35

but they will pick up the slack.

0:22:350:22:37

I appreciate your concern, I do.

0:22:370:22:39

But I could really do without the fatherly pep talk right now, OK?

0:22:390:22:42

Well...

0:22:420:22:43

OK, maybe I could do without having to soak up all the grief

0:22:430:22:49

that you've been handing out to your team.

0:22:490:22:52

So it looks like we're both having to deal with things

0:22:520:22:54

that we don't particularly want to today, doesn't it?

0:22:540:22:57

Sorry?

0:22:570:22:58

I know it's her.

0:23:010:23:03

The blogger.

0:23:040:23:06

Just because she let you down doesn't mean they all have.

0:23:070:23:09

They won't trust you until you learn to trust them.

0:23:090:23:12

As for Alicia...

0:23:120:23:14

well, I think maybe it's time you made it official.

0:23:140:23:17

Either that, or just suck it up and move on.

0:23:170:23:21

OK. You can either wait outside the doors there or, if you'd prefer,

0:23:310:23:34

with the radiographer. All right?

0:23:340:23:36

Are you claustrophobic at all?

0:23:380:23:39

You mean, am I used to confined spaces?

0:23:400:23:42

Yeah, I see, I see. That's very good.

0:23:460:23:49

If you haul yourself on to the bed for me.

0:23:490:23:51

The radiographer will be in just a moment to talk you through

0:23:510:23:54

the final points of the procedure.

0:23:540:23:56

I could listen to this guy for hours.

0:23:560:23:58

-What's this?

-No idea.

0:24:020:24:04

You just dropped it.

0:24:050:24:08

Just chuck it.

0:24:080:24:09

And forget about it, all right?

0:24:090:24:10

Can you just lie back for me, please?

0:24:150:24:17

How you feeling, Frank?

0:24:200:24:21

Like I've gone ten rounds.

0:24:210:24:23

Thirsty, bit dizzy.

0:24:250:24:27

Did you feel like this before the fall?

0:24:270:24:30

Not really.

0:24:300:24:32

Your red blood cell count is low.

0:24:320:24:34

You know, I'm going to do some bloods for U&E's.

0:24:340:24:38

Really? Well, I mean, he has just had major surgery.

0:24:380:24:41

-It's enough to make anyone dizzy.

-Better safe than sorry.

0:24:410:24:44

Do the bloods.

0:24:460:24:47

Good work today Dr McAllister. Very neat.

0:24:470:24:50

I expect it to heal nicely.

0:24:500:24:51

I'll pop by later. Keep an eye on him, please.

0:24:520:24:54

Excuse me. Call of nature.

0:24:570:24:59

Dr Masum. I've been looking for you.

0:25:060:25:08

You have? Well, here I am.

0:25:080:25:10

-It's kind of delicate.

-OK.

0:25:120:25:14

You can call me Rash, by the way. I should have said that before. OK.

0:25:160:25:20

OK. I think Jack might be up to something.

0:25:220:25:24

Jack?

0:25:240:25:26

The prisoner.

0:25:260:25:28

You've seen the cuts on his wrist, he's got these old bruises.

0:25:280:25:31

And he kind of hinted the prison guard you're treating has

0:25:310:25:34

been abusing him.

0:25:340:25:35

Look, I don't know what he's up to, but he dropped this.

0:25:360:25:39

He trusted me to keep it a secret.

0:25:390:25:41

But if something happens, I don't want people thinking I'm involved.

0:25:410:25:45

Dr Masum? We need you in here.

0:25:450:25:47

Just one minute. I'll go see to this.

0:25:470:25:50

-He's regained consciousness.

-OK.

0:25:540:25:56

OK, let's sit you up.

0:26:010:26:04

Nice and easy.

0:26:040:26:06

That's it.

0:26:060:26:07

Steady, steady.

0:26:070:26:09

Here, see if you can manage some water, OK?

0:26:090:26:12

-Jack...?

-Yeah, he's here.

0:26:120:26:15

You're in Holby City Emergency Department, OK?

0:26:150:26:17

Is he... Is he all right?

0:26:170:26:20

Jack? Yeah, he's fine.

0:26:200:26:23

Tony, do you remember what happened?

0:26:230:26:26

Yeah. He... He was trying to harm himself.

0:26:260:26:30

So he finished his breakfast duties, then went off to make a phone call.

0:26:500:26:54

Next thing I know, he's back in the kitchen with a knife to his wrist.

0:26:540:26:57

I was obviously worried, so I tried to grab him from behind.

0:26:570:27:01

So why would he do that?

0:27:010:27:02

When he first arrived with us, he was jugged.

0:27:040:27:06

-Jugged?

-Scalding water poured down your back.

0:27:060:27:09

The poor lad gets a kicking every other day, to be honest.

0:27:110:27:13

He probably thinks I'm following him around.

0:27:130:27:15

I'm not, I'm just trying to look out for him.

0:27:150:27:18

We just don't have the resources

0:27:180:27:19

to monitor the inmates properly, you know.

0:27:190:27:21

Has he ever raised a complaint?

0:27:210:27:23

No, that would be asking for help.

0:27:250:27:26

Some family members will, but Jack hasn't got any.

0:27:270:27:30

-No family at all?

-None that I've ever seen.

0:27:300:27:32

This phone call that he made, can you find out who it was to?

0:27:350:27:38

I can try, if you can find me a phone.

0:27:380:27:40

Tony, his injuries would seem to suggest that he wasn't trying

0:27:400:27:43

to kill himself.

0:27:430:27:44

Well, what then?

0:27:440:27:46

I'm only telling you what I saw.

0:27:460:27:47

Broadhurst was asking after you. I covered.

0:27:510:27:54

-What you doing?

-Something's not right.

0:27:540:27:57

Frank is dizzy, his blood pressure's up,

0:27:570:28:00

-he's complaining of a headache. I just don't know why.

-Here.

0:28:000:28:03

That supposed to make everything better, is it?

0:28:040:28:07

Look, I know I took credit for the surgery,

0:28:070:28:09

but what else could I do?

0:28:090:28:10

Correcting her would have made us both look bad...

0:28:100:28:13

You are just like every other privately-educated boy

0:28:130:28:15

in medical school.

0:28:150:28:17

You're completely lost in a conversation

0:28:170:28:19

-unless you're sticking the knife in.

-Wow, that's a generalisation.

0:28:190:28:22

Yeah, but it's true though, isn't it?

0:28:220:28:24

Do you ever stop to think about things from someone else's

0:28:250:28:27

point of view?

0:28:270:28:29

Ms Broadhurst is a first generation British Pakistani who grew up on

0:28:290:28:32

a council estate.

0:28:320:28:34

She's clawed her way up through the system despite men like me.

0:28:340:28:38

She looks at me and sees the enemy.

0:28:380:28:41

So, yeah, I want to impress her.

0:28:410:28:42

And if you need to hear me say it, then, I'm sorry.

0:28:450:28:47

None of us can help who we are.

0:28:490:28:51

Please, Noel? Two minutes?

0:28:560:28:59

Look, I'm sorry, Gem.

0:28:590:29:00

If Dr Hardy catches you doing personal work on hospital computers,

0:29:000:29:03

it's going to be little lovely old me

0:29:030:29:05

that gets it in the neck and not you.

0:29:050:29:06

-You'd take the wrap for me?

-Well, it would be my responsibility.

0:29:080:29:10

Hold on, I wouldn't have much of a choice, would I?

0:29:100:29:13

That is so kind of you.

0:29:130:29:14

-Thank you. I appreciate it.

-Well, you're welcome, I guess.

0:29:160:29:19

-Yes, madam?

-Cheers, Noel.

0:29:190:29:21

Thanks.

0:29:230:29:24

Can you please take a seat and I'll get someone to look at you

0:29:240:29:27

as soon as they're available.

0:29:270:29:29

Hello!

0:29:360:29:38

Iain, are you here, mate?

0:29:380:29:39

Hey.

0:29:410:29:43

What are you... What are you doing?

0:29:430:29:45

-Oil change.

-Nice.

0:29:450:29:47

Bit of TLC on the old girl?

0:29:470:29:49

Yeah. Well, she's done more miles than the rest.

0:29:510:29:53

She's not due a service for another month, so I thought

0:29:530:29:55

I'd top her up... Pass us that semi synth, will you?

0:29:550:29:58

Yeah, sure.

0:29:580:29:59

-Coffee?

-Nice one.

-Here you are.

0:30:020:30:04

That's windscreen washer fluid.

0:30:070:30:08

-Yeah, I know, I was just...

-What do you want, Rash?

0:30:080:30:11

I wanted to ask about Jack, the prisoner from this morning.

0:30:130:30:17

It's a bit delicate, but did he seem suicidal to you?

0:30:170:30:21

Sam dealt with that one. But I didn't notice nowt unusual.

0:30:210:30:24

I wouldn't say suicidal.

0:30:240:30:26

Actually, he was more compliant than I expected.

0:30:260:30:28

Ah, Dr Kinsella. I was just talking to Dr McAllister.

0:30:360:30:38

I wondered if you'd both join me for dinner tonight at my club?

0:30:380:30:42

Great. Thanks.

0:30:420:30:44

FRANK SCREAMS IN PAIN

0:30:440:30:45

Help me, would you?

0:30:450:30:47

Lie him back.

0:30:470:30:48

Who are you people? Get out of my house.

0:30:520:30:55

Frank, you're in hospital.

0:30:550:30:56

Distended abdomen. What are our differential diagnoses?

0:30:580:31:01

Some kind of bowel obstruction.

0:31:010:31:03

I ran a blood test.

0:31:030:31:05

He does have high levels of sodium and potassium.

0:31:050:31:07

Lead.

0:31:090:31:11

It could be lead poisoning.

0:31:110:31:13

I know it's really unusual, but the bullet...

0:31:130:31:15

OK. Let's make him comfortable

0:31:150:31:17

and get the lab to run a toxicology screen on the bloods.

0:31:170:31:20

If positive, what then?

0:31:200:31:21

Increase his IV fluids?

0:31:230:31:24

He'll need a nasogastric tube and possibly chelation.

0:31:260:31:28

Good. Run the tests, quickly.

0:31:280:31:31

That's right. According to the information I have

0:31:330:31:36

from Stonehurst Prison, the inmate Jack MacLellon made a call

0:31:360:31:38

to this number at 9:05 this morning?

0:31:380:31:41

Yeah, sure I'll hold.

0:31:410:31:42

Sorry, Dr Masum. Can you give these to Gem for me, please?

0:31:420:31:45

Yeah, sure.

0:31:450:31:46

Noel, hang on, did you say these were for Gem?

0:31:460:31:49

Yeah, it's some info about Anders Hospice, Knott Way.

0:31:490:31:53

-She was looking it up earlier.

-Why?

0:31:530:31:55

I'm on the phone to them right now.

0:31:550:31:57

Yep. Yes, that's right,

0:31:570:32:00

we're treating Mr MacLellan here at Holby City ED.

0:32:000:32:04

Well, it's a little unorthodox,

0:32:040:32:06

but it may have a bearing on our treatment.

0:32:060:32:08

I was wondering if you could tell me what the

0:32:080:32:10

nature of his call to you was?

0:32:100:32:12

When was this?

0:32:150:32:16

OK.

0:32:190:32:20

No, no that's been very helpful. Thank you.

0:32:200:32:22

-Duffy, have you seen Gem or Dr Hardy?

-No.

0:32:300:32:33

OK, we need to find them.

0:32:330:32:34

Dr Masum!

0:32:360:32:38

-He's arresting.

-OK, let's bring the bed down.

0:32:380:32:40

It must be his pacemaker.

0:32:440:32:45

Hang on.

0:32:500:32:52

He's in PEA arrest.

0:32:530:32:55

I need to see his previous ECG readings.

0:32:550:32:57

I did his ECG five minutes ago.

0:32:570:32:58

Right, there! At the end of each set. Tall tented T-waves.

0:33:000:33:03

-It's hyperkalaemia.

-You're sure?

0:33:030:33:05

Yeah, from the electrocution.

0:33:050:33:06

His muscles contracted, myoglobin's released.

0:33:060:33:08

OK, we're going to need to flood his heart with calcium to

0:33:080:33:11

protect against the effects.

0:33:110:33:12

Can we get 10ml of 10% calcium chloride,

0:33:120:33:14

followed by ten units of insulin and a bag of dextrose?

0:33:140:33:17

-OK.

-OK. Two...

0:33:170:33:19

Hang on, before you put the cuffs on...

0:33:260:33:29

we're going to move you in a minute, actually.

0:33:290:33:32

Oi, listen, can I get one of them bottles?

0:33:320:33:35

I've got to spend a penny.

0:33:350:33:37

Yeah, yeah, you can have this one.

0:33:370:33:40

Now, your CT and angiogram came back clear, there's no damage to the

0:33:400:33:43

artery, so, miraculously, theatre is clear at the moment.

0:33:430:33:46

We're going to prep you for surgery.

0:33:460:33:48

Do you have any allergies that we need to know about?

0:33:480:33:50

-Are you on any medication?

-No, why?

0:33:500:33:52

-You're not putting me to sleep, are you?

-Well, yeah.

0:33:520:33:54

It's a complex surgical procedure

0:33:540:33:56

and we need to give you a general anaesthetic.

0:33:560:33:58

I don't want that.

0:33:580:33:59

Well, with the best will in the world, there's not really a choice,

0:33:590:34:02

unless you want to lose the use of that leg entirely?

0:34:020:34:05

No, didn't think so.

0:34:070:34:08

Look, can I get some privacy?

0:34:100:34:12

Yes, yeah, yeah, of course. You do what you need to do,

0:34:120:34:15

let us do what we need to do,

0:34:150:34:16

and we'll have you back in your cell in no time at all, all right?

0:34:160:34:19

Now, I need to have a quick word with you in terms of protocol

0:34:190:34:22

about the procedure we're about to do.

0:34:220:34:25

Would you mind coming with me?

0:34:250:34:27

Calcium chloride going in.

0:34:310:34:33

-Come on, come on. Keep it coming.

-Yeah.

0:34:330:34:35

OK, pulse check.

0:34:390:34:41

I'm getting an output. Rate about 70. Nice work.

0:34:430:34:47

OK, let's get him on some IV dextrose

0:34:480:34:50

and get a cardiologist down here as quick as we can.

0:34:500:34:53

I'll be back in a minute.

0:34:530:34:54

I think I know what you're planning and you need to stop right now.

0:35:000:35:03

-What're you doing?!

-Don't make a sound.

0:35:030:35:05

You're helping me out of here.

0:35:050:35:07

Please.

0:35:090:35:10

It's...for him to wake up and find himself restrained...

0:35:100:35:13

Dr Keogh, have you seen Gem?

0:35:130:35:15

Gem?

0:35:150:35:17

Hang on.

0:35:170:35:18

It's never going to happen.

0:35:250:35:27

Get me to that car park, yeah?

0:35:290:35:31

Gem. Everything all right?

0:35:370:35:39

-Yeah, good. Cheers, mate.

-Yeah, we're fine.

0:35:390:35:41

Noel. Noel, has Gem been through here?

0:35:440:35:46

Yeah, she's just got in a lift with that prisoner guy.

0:35:460:35:48

-He took Gem.

-What?

-Noel, we have to find her!

0:35:480:35:51

You won't get far like this.

0:35:540:35:56

Come on, come on!

0:35:560:35:58

You need to get that leg seen to.

0:35:580:36:00

Excuse me, excuse me.

0:36:010:36:03

-Dr Masum?

-Sorry!

0:36:030:36:05

I'm telling you, you won't.

0:36:050:36:07

Argh!

0:36:070:36:08

Give me that, give me that.

0:36:130:36:14

Get in, go!

0:36:220:36:24

Listen, I just need half an hour, that's all.

0:36:300:36:32

This isn't going to work. They know you know you've gone,

0:36:360:36:38

-they'll come after us.

-What, you think I don't know that?!

0:36:380:36:41

Please!

0:36:410:36:42

There she is!

0:36:480:36:49

Jack, stop, stop!

0:36:520:36:54

-Get back! You let us go!

-OK!

-I'll cut her! I swear I'll do it!

0:37:040:37:08

OK, OK. Let's just take a breath, all right?

0:37:080:37:10

-Listen, we're driving out of here, all right? No fuss!

-Rash...

0:37:100:37:13

-Listen, I know where you're going...

-Get back!

0:37:150:37:17

-I know where you're going and I know why.

-Just back off!

0:37:170:37:19

The Anders Home, the hospice.

0:37:190:37:21

Jack, it's too late, OK?

0:37:210:37:24

Your uncle, he's dead.

0:37:240:37:27

You spoke to them this morning. He'd had a stroke. I know.

0:37:300:37:33

But he passed away.

0:37:330:37:35

Two hours ago.

0:37:360:37:37

I know it doesn't change things, but they said he didn't suffer...

0:37:400:37:44

in the end.

0:37:440:37:45

I just wanted to say goodbye.

0:37:460:37:48

I know.

0:37:490:37:50

I'm really sorry, OK?

0:37:530:37:56

It's all right, OK? It's OK.

0:38:020:38:03

Lead poisoning?

0:38:100:38:13

After all these years?

0:38:130:38:14

Toxicology confirms it.

0:38:140:38:17

I mean, the bullet could have been aggravated by the fracture.

0:38:170:38:19

We don't know.

0:38:190:38:20

We can treat you for the poisoning.

0:38:220:38:24

But the surgeon agrees, it has to come out.

0:38:240:38:26

I know it's important to you.

0:38:260:38:28

Oh, you know nothing.

0:38:290:38:30

You know how I told you my uncle fought in the Falklands?

0:38:320:38:36

What I didn't tell you was that he died there.

0:38:360:38:38

I think it would have been a real honour for men like him

0:38:400:38:43

to know that you've moved on.

0:38:430:38:44

Look, if you don't let us take it out, there's a real chance

0:38:460:38:49

it's going to cause you further serious discomfort.

0:38:490:38:51

It already causes me discomfort.

0:38:510:38:53

It hurts...

0:38:550:38:56

When it's damp or cold, it hurts.

0:38:570:39:00

That's why I keep it.

0:39:020:39:03

You have any idea what I did at the Battle of Goose Green?

0:39:060:39:09

I hid.

0:39:110:39:14

First sign of incoming fire, I just froze.

0:39:150:39:20

Hardly got any shots away.

0:39:210:39:23

And then one came and hit me in the back.

0:39:240:39:27

And it was over.

0:39:280:39:30

And the relief...

0:39:320:39:34

Do you think that makes you any less of a man?

0:39:370:39:39

This thing is the only reason I've been able to live with myself.

0:39:440:39:49

Do you know what I think?

0:39:510:39:53

It's time to stop hiding.

0:39:530:39:55

You seen Dr Hardy? I need him to sign these off.

0:39:590:40:02

I think he's in a meeting.

0:40:020:40:04

Honestly, he makes this impossible.

0:40:050:40:07

Is that why you wrote all that stuff on the blog?

0:40:110:40:14

And no, I haven't told anyone else yet.

0:40:140:40:17

Why on earth did you do that?

0:40:200:40:22

You must have known he would take a lot of that personally.

0:40:220:40:25

I don't know.

0:40:250:40:27

I felt helpless and angry, and it was an outlet.

0:40:290:40:33

It was on impulse and then it just took on a life of its own.

0:40:360:40:40

Look, I know I've hurt people.

0:40:430:40:44

Are you going to tell anyone?

0:40:480:40:50

Well, they have a right to know.

0:40:500:40:52

Though, I don't see how that would help anyone.

0:40:530:40:55

It's not been easy here lately.

0:40:570:40:58

But the one who'll be feeling that most is Ethan.

0:40:590:41:03

Thanks.

0:41:220:41:25

Sorry, sorry.

0:41:250:41:26

Bit rich from Frank today, don't you think?

0:41:270:41:30

All those years he had everyone believe he was a war hero.

0:41:300:41:33

-I thought he was pretty brave, actually.

-Brave?

0:41:350:41:38

Telling the truth.

0:41:380:41:40

It's hard living with something like that.

0:41:400:41:42

I don't quite know why you're defending him.

0:41:430:41:46

It's not like he made treating him easy.

0:41:460:41:47

I mean, the guy patently hid the fact he had all the

0:41:470:41:50

symptoms of lead poisoning.

0:41:500:41:51

Well, we don't know that for sure, do we?

0:41:510:41:53

I mean, the poisoning could have been

0:41:570:41:59

exacerbated by the complications in surgery.

0:41:590:42:02

Perhaps one of you should explain?

0:42:050:42:08

In his surgery, you asked Eddie to do the final screw.

0:42:100:42:13

But I did it instead.

0:42:150:42:16

Why?

0:42:160:42:18

I asked her to.

0:42:200:42:22

I was excited.

0:42:220:42:24

But the drill slipped, causing some damage.

0:42:240:42:27

We recovered the fragments...

0:42:270:42:28

But, in retrospect, you think it may have aggravated the bullet

0:42:280:42:31

and exacerbated his lead poisoning?

0:42:310:42:33

And neither of you thought to tell me about it?

0:42:360:42:38

We didn't want to create a complication where we didn't

0:42:380:42:40

think it was necessary. I mean...

0:42:400:42:42

We were thinking about the International Trauma Course.

0:42:420:42:45

We both wanted to join you.

0:42:450:42:47

We were just trying to impress.

0:42:470:42:49

Well.

0:42:530:42:54

There it is.

0:42:580:42:59

Shall we eat?

0:43:010:43:02

OK, people, can you just move back, please?

0:43:130:43:15

Just move back across the line. Thank you very much.

0:43:150:43:18

Jack, I did ask about viewing your uncle's body.

0:43:180:43:21

Yeah, well...

0:43:210:43:22

I should have just asked for compassionate release

0:43:220:43:25

as soon as I heard.

0:43:250:43:27

I just thought that with my record...

0:43:270:43:29

I don't know.

0:43:290:43:31

-I just...

-Just don't like asking for help?

0:43:320:43:35

Look, I know you've had it tough inside,

0:43:350:43:37

but it seems like Tony's got your back.

0:43:370:43:40

There you go.

0:43:400:43:41

Every cloud...

0:43:410:43:43

I'm sorry about your nose, yeah?

0:43:440:43:46

Forget about it.

0:43:480:43:50

Check you out, tough guy.

0:43:500:43:53

My office, 9am tomorrow.

0:44:110:44:13

-We'll talk more. Goodnight both of you.

-Night.

0:44:130:44:15

I know it was Eddie who asked you to take over,

0:44:550:44:58

and to hide your mistake.

0:44:580:44:59

How? And the fact you played along makes you just as culpable.

0:44:590:45:03

You're confident in your actions, but it's not enough.

0:45:050:45:09

You have to trust in your judgment.

0:45:090:45:11

Some will play the game, pass blame, score points,

0:45:110:45:14

but it's not the only way.

0:45:140:45:15

I see something in you, Dr Kinsella.

0:45:170:45:20

Get some rest.

0:45:200:45:21

The competition isn't over yet.

0:45:220:45:24

Well, I'm sorry to say you won't be left with any battle scars

0:45:320:45:34

to brag about. Pity.

0:45:340:45:36

The old mug could do with a bit of character.

0:45:360:45:38

Oh, I don't know. I'd say it's already pretty characterful.

0:45:380:45:42

In a good way, I mean.

0:45:420:45:43

Right.

0:45:450:45:46

-I'm a bit shaky. Is that normal?

-Yeah.

0:45:490:45:51

You've suffered a shock.

0:45:510:45:53

You release adrenaline,

0:45:530:45:54

your blood pressure, your heart rate goes up.

0:45:540:45:56

Lots of endorphins released.

0:45:560:45:58

It can play tricks on your mind.

0:45:580:46:00

Make you do strange things.

0:46:000:46:02

What do you recommend I do?

0:46:040:46:06

Officially? An early night, lots of water to keep yourself hydrated.

0:46:070:46:11

Unofficially, a massive glass of wine.

0:46:120:46:15

Are you asking me out for a drink, Dr Masum?

0:46:170:46:19

I'm just kidding.

0:46:210:46:23

Well, I'm all done.

0:46:260:46:28

Good to go. Police are happy to speak to you tomorrow.

0:46:280:46:30

Thank you so much, Rash, I owe you one.

0:46:300:46:33

Come on you.

0:46:330:46:34

Have a nice evening.

0:46:370:46:39

-See you tomorrow.

-You too.

0:46:390:46:41

Rash?

0:46:420:46:43

What I said before about the running...

0:46:450:46:47

..I take it back.

0:46:500:46:52

Today I was impressed.

0:46:520:46:54