The Bottom Line Holby City

I'm never getting booked here again, am I?

I'm not going to stop hiring her. I'm giving her a three-month renewal.

Thank you!

Think you're the only straight guy I've ever kissed? Think again.

I know the person who's going to get hurt by you the most is Chrissie.

This is not a turf war.

Darwin is big enough for both of us.

-We can co-exist.

-You are helping her bid against Plastics for funding.

If the CTU pitch is a threat to Plastics,

then it makes it a lot easier for us to know exactly what CTU are up to.

-You're a mole.

-To Shah and Naylor and the Cardiac Trauma Unit.

-Thank you.

-That way I know exactly how and when to sabotage it.

-Bracia!

-Bracia!

Adam and Wojtek. Voit-zec?

-Surnames don't roll off the tongue that easily.

-Gloves, please.

-My fault!

-Try not to speak.

The morphine in these two, I'm surprised they can speak at all.

-Help Wojtek!

-Keep the mask on. It'll help you breathe.

-Cholera!

BP 70 over 50. High tower pulse. Mild pyrexia. Hb seven.

-What went into his abdomen?

-When the paramedics got to them, they were literally locked together.

Ribs took the brunt. Cage is no longer an accurate description.

-Always looks after me. The big bear.

-Tile slipped.

-We fell.

-He saved me.

-Lie still.

-X-ray confirms rib fracture.

-His breathing is laboured.

-HE SPEAKS POLISH

-Pneumothorax.

-I'll get you one later!

-What did he say?

-He said he wants coffee. Typical Pole.

-I thought "wodka" was the national addiction.

-Racist!

My colleagues are going to put a tube in to ease your breathing.

Today seems to be the day for cardiothoracic trauma.

Obviously, it's just a feasibility study.

-Obviously.

-I stayed up all night.

And brought it in on your day off.

Can't fault your enthusiasm. But I must say some of your case studies are a little long in the tooth.

You don't miss a trick, do you?

There's a conference on trauma management in Oxford today. I'm heading there now.

Let's hope you glean something more convincing while you're there.

I've had an offer from Newcastle.

If CT's doomed, what's to keep me here?

Honestly, I feel more like a glorified secretary than a ward sister.

Can you believe I'm expected to run AAU as well as Keller, as if I haven't got enough to do?

-"Yes, Chrissie, you ARE a miracle worker."

-Hmmm?

-Oh, God. Hit me with it.

-C minus.

Bordering on D for disappointment.

Were you a teacher in a former life or something?

Hey, don't shoot the messenger.

Short of eating the textbook, I don't know what more I can do.

Diagnostics are your Kryptonite, AKA your downfall.

Dan's been trying to help me.

You'll be fine.

You just need to focus.

-Are you OK?

-Mock OSCI.

I'm not exactly teacher's pet.

That's just Malick. He's a sadist, not happy unless he's made at least one nurse cry per shift.

No, he's right. All this revision we're doing, none of it's going in.

What you need is a nice glass of wine, feet up, relax and then we'll go through it all again.

I don't think that's exactly what Malick had in mind.

-But there is something you could do if you want to help me.

-Name it.

Babysit?

-Unless you...

-No, no. Of course I will.

Evie Thompson?

-Yes, ankle fracture?

-Quick MOT and we can release her to the wild.

-Right. Let's do it.

Really you should talk to my agent first.

The photos are for the specialists.

Means I can put a nice, fresh dressing on it keep their grubby mitts out.

You have nice touch.

Can't take the credit, really. It's the pain killers.

Can you get an update on Adam from Darwin, please?

Wojtek was asking about his friend.

I'm pleased with the way Chantelle is settling in.

Ah, thanks.

-Oh, thanks a lot(!)

-What?

-Sister Williams.

Apparently a post-it note's an adequate replacement for a meeting.

-I'm sure Chrissie's got a perfectly good reason for not coming down.

-Yeah - they're called stairs.

-Are you implying she's lazy?

-As if I'd say that about the mother of your child.

-Gutless, maybe. It seems that we have no need for an agency nurse any more.

-Chantelle?

Mm. Her hourly rate's too high for an ornament, so...

You've only just fought for her to stay.

I know, the power I wield, it's frightening(!)

Oh, and I'm so not in the mood for tears!

Or hugs... I don't do hugs.

Maybe I should tell her? It might be a bit more...

Don't finish that sentence.

-I wasn't going to.

-Excellent.

Do us a favour though - don't drag your feet.

'I'm just going to check your circulation.'

Oh!

-Are you all right?

-It's a twinge I get now and then.

Seemed more that a twinge to me.

Excuse us.

-Think I should call Malick?

-We could leave a note for her GP.

She doesn't seem the type to seek help, does she?

Malick, Evie Thompson. Abdominal pain.

Hi, Evie. I'm Mr Malick, could you point to where the pain is exactly?

I'm fine, honestly.

-I'm sure you are, but if you'd just let me examine you.

-No.

Thank you. This is why I hate hospitals.

Your body's not your own.

Why don't I let Sister Williams take the lead?

Sometimes you got to ditch the text book altogether.

More comfortable behind closed doors.

Henrik!

Sir Fraser.

You get taller every time I see you. What do you do at night, hang yourself up by your toes?

SIR FRASER CHUCKLES

You've been racing through that book. I'm very impressed.

I'm a slow reader, takes ages for it to sink in.

Are biographies your thing?

I find myself drawn to strong women.

Poor Catherine. Live life as she did

and you're bound to attract unwelcome attention,

but a lot of the rumours are false.

They say she died having intimate relations with a horse.

And I thought it sounded boring.

This wasn't in your notes.

It was a long time ago.

I'm only interested from a medical point of view.

Anything else is none of my business.

So, what's the dealio?

D'you get the stone to bleed?

See, this is what's gets me. You flunk the written,

but when it comes to the practical, you're all over it,

-like Superwoman. So what's next?

-CT scan.

-I like your style.

Not bad for starters, but where's the meat?

Well, a hospital is a living organism...

you can't simply cut off heads and legs and expect it to continue running smoothly.

What significant cuts have you actually made?

-Connie Beauchamp, Mark Williams, Joseph Byrne...

-No, no, no.

-They all resigned.

-Well, that's how it looked.

I appointed you as the Grim Slicer to bring Holby to FT status within a year. You've had nine months.

Your books still don't balance.

It's not simply your reputation at stake here.

If you want to stay captain of this ship, you've got to start plugging gaping holes.

There's your intra-abdominal mass.

Might not be as serious as it looks.

Your spot, Chrissie, so do you want to take the patient through the options?

-Can I help you?

-Ah, yes.

Aged ex-pat in search of fallen kin!

-Sandy? What on earth?

-Your neighbour e-mailed about your nose dive,

-and I hopped on the first plane.

-And you got him through customs?

Name's Rolf. Good for hugs.

-Sweet.

-Must you?

Oh, dear. Looks as though I've missed all the fun.

Well, we haven't quite finished yet.

Why, what's wrong?

Your sister's health I need to discuss with her in private,

so if you wouldn't mind waiting downstairs?

Oh, my God, it's cancer. Isn't it?

You can see why I don't tell her anything.

I've come from Sydney to see my only living relative and you won't even tell me if you're dying or not.

-You are such a drama queen!

-I just want to know what's going on!

OK, ladies. There is nothing to tell at this stage,

so why don't you go downstairs, have a coffee, refuel?

I can only imagine how tired you must be after that journey.

Can I get you anything?

Stubborn old goat.

You'll look after her, won't you?

Of course.

Back in a sec.

Neat diplomacy.

I get enough practice keeping you two apart.

There are others ways of achieving FT status besides cuts. New initiatives.

If you're talking about Plastics, I've read Angus's report.

-I don't just mean...

-The figures look promising,

but I don't see how they affect the efficiency of any other department.

Perhaps you should see the way we work.

So, what's going on here then?

This is, er, the Polish roofer you saw in AAU?

Of course. Our brothers from Gdansk.

Actually, they're not brothers and they're from Gdynia.

Right, smashing. I'll be with the Chief Bean Counter.

Is that Sir Fraser Anderson?

Yes, indeed it is. So now, what's our plan for the patient, please?

It's a complicated case. We'll need to liaise with General and Plastics.

-Chest reconstruction?

-Eventually.

He's got severe skin and muscle damage, but we'll need to stabilise him internally first.

I bumped into Sahira downstairs. She mentioned you were considering her cardiac trauma study.

-Alongside other strategies.

-Can't imagine any other hospital in the region having the skills

to deal with a patient as mashed up as this guy.

-Once you're stable we'll discuss reconstruction on your ribs.

-Can't build a roof without the rafters.

Good morning, my name's Hanssen, Director of Surgery.

I'll be overseeing your care. We met downstairs.

-Well, the good news is we can rebuild him.

-Conference room. Ten minutes, please.

This is what I love about this country.

So many pretty girls wanting to mother me.

Polish girls are beautiful. Met one when I was training, Gizela,

lovely skin and her accent... Wonder what she's up to now?

The pretty ones come here.

How long have you been working in England?

-Six years.

-Wow!

That's a long time away from home.

Do you miss it? Are you going to go back?

Funny, I thought I would miss home, but you get used to it.

We planned it together, me and Adam.

We wanted to come, earn money and...

and go back.

We did the first part and it's been good, so we just stayed.

Should see Adam and me...

..we don't have to speak.

We know...

..in here and in here.

-Ah, that's so lovely.

-Chantelle?

Poor guy. Look, that's the third time he's chucked up already. And he's complaining of chest pains.

Well, we'll keep him monitored.

He's sweaty and hypotensive. Could you take another look, to be on the safe side?

We make good the liver, spleen and colon and move on to the lungs.

-I thought this was YOUR patient?

-He's been liberated, apparently.

-Everything in one operation?

-Since we have the facility.

-Plastics included?

We spend two hours screwing ribs and creating flaps only to discover some internal trauma has been missed.

It surprises me to hear myself say this, but I agree with Sunil.

-No faith in your own abilities?

-There's a high degree of uncertainty in this case.

Precisely why it would be valuable

-to have the relevant disciplines to hand, wouldn't you say?

-I don't get it.

Is this some new drive to save on theatre time?

Efficiency is always a consideration, yes.

Ah, Sir Fraser, may I introduce our plastic surgeons

Mr Michael Spence, Mr Sunil Bhatti?

I gather you've read our business plan.

This is our most experienced cardiothoracic surgeon, Mr Elliot Hope.

Henrik thinks I ought to see the product in action before he takes you to market.

We've had an elective cancel, so if you wanted to do a diagnostic laparoscopy, you can.

Why not open her up and dive straight in?

Elderly patient, less intrusive till we're sure.

Now you're cooking, Sister Williams.

Why didn't you show me some of this before?

I got you a cappuccino.

I don't think that's a good idea.

Why not? Is she nil by mouth or something?

You see what I'm up against.

-You really must let me do something about your hair.

-My hair?

-There's nothing wrong with my hair.

-At least let me give it a comb.

We're going order some more tests, OK? As soon as a slot is available.

-Bed seven. Catheter will need a check.

-In a sec.

My third husband was a hairdresser. Turned out to be gay.

HE LAUGHS

Throw stones in Sydney these days, you're bound to hit one eventually.

Mind you. They're the best friend a girl could have.

-Very loyal. Very open.

-Sandy!

No-one wants to hear this rubbish.

You're absolutely right, Sis. Right, why don't you tell me what's been going on?

None of your business, that's what.

-So how long is all this going to take?

-I'm afraid that's very hard to say.

-You do realise what Hanssen is doing here?

-Clearly he thinks Plastics

is the best way to sell a multi-discipline trauma package.

The real money is in a stand-alone unit.

If you're serious about making this work, you have to fight our corner.

Chief Exec of the SHA and you let him walk out with CT.

If Sir Fraser is interested in observing Plastics, we have an elective scheduled at mid-day.

Yes, I've cancelled it. You won't have time for both.

-I assume you'll assist me with the general surgery?

-No, I'm going to work on the reconstruction.

Myself excluded, you are the best general surgeon here at Holby.

At least, that's the impression I've given Sir Fraser

and I'm sure he'd prefer to see us all batting for the same team.

I can't imagine being away from my family for more than a month.

You are not a free spirit like me.

I plan on going travelling one day. A lot of my friends from nursing college are already doing it.

I'd like to go to Australia, but it's so far away I worry I'd miss my family too much.

Adam is my family.

We have known each other for a long time.

And at least I got to choose him.

I didn't have that option with my real family.

Well, you got the best of both worlds, haven't you?

My mum's my best friend. She totally supported me through nursing college.

-She knew it was all I wanted to do.

-You didn't fancy being a pop star? Got the looks.

You haven't heard my voice. Strangled cats, Mum says.

-Chantelle?

-Actually, I did want to be a vet once but I knew I wouldn't cope when the animals died.

Mr Levy, how can I help?

I wanted to...

..say...that the ECG's not really showing anything,

so perhaps we should hurry up those x-rays.

-I reckon that doctor fancies you.

-Mr Levy?

You haven't noticed the way he keeps looking at you?

No, silly. He's got to be, like, my dad's age.

He's presenting atrial fibrillation, palpitations and his stats are increasingly erratic.

-How is Wojtek?

-It's you I'm worried about at the moment.

I warned him. Had enough. So tired, can't concentrate.

-He said you saved his life.

-He's crashing.

So what clever dick in ED given him a potion we don't know about?

-I'll check.

-What about a tox screen?

Charging. 100. Clear.

Charge again. 100. Clear.

-He's back.

-He was clerked on AAU.

Well, he is your patient.

It'd be a shame to loose him before the big operation.

-Why don't you go and find yourself a nice hotel?

-Whatever for?

As soon as they've finished doing whatever they're doing here, I'll come and stay with you.

So if you give me the key, I'll go there straightaway.

I'm not having you going through my drawers!

I'm not interested in your knickers.

Used to read my diary, remember?

I was ten years old! And that was only because you wouldn't tell me anything.

That should have told you something.

Evie, you are my sister,

is it so strange that I want to be in your life?

-She's a nightmare.

-Theatre's booked for 2:30.

If I can get cover, can I scrub in? You said you wanted me

to be more hands-on if I want to get that A...

Whoa, you know who the locum consultant is?

-Latimer?

-AKA the Countess.

She freaks at a stray hair, never mind a stray nurse.

Exactly, and I could see the sharp end of a scalpel just for asking.

But, because it's you, I'll see what I can do.

-You're the best!

-I know.

-Any news on that x-ray?

-No. I'm just on the phone to them now.

You'd think I was asking them to commit a crime, they make me feel so bad for asking to fast track.

Well, maybe I should try. Would that help?

-Yeah, if you like.

-Oh, no.

-You can hang up and I'll maybe call from my office.

-Don't be silly, may as well hold while I've got them.

Do you mind if I talk to you about something while you hold?

Sure. Go ahead.

I wanted to discuss your...

Hello? Yes. Oh, that's great.

I'll pop down and get it, make it quicker. You're a star!

I take it back, they're amazing. Bless 'em. Back in a min.

Take a look, just as I thought.

-When is my operation?

-Mr Sawicki,

-Are you taking any medication you haven't mentioned to us?

-I don't understand.

Did you take anything before the accident? Drugs, I mean. More precisely, methamphetamine?

-What is that?

-Speed.

-It's in your blood. I'd like to know how it got there, please.

-I don't...

-I don't think you really appreciate how serious this could have been, for all of us.

The fact that you kept this from us means you could have died.

I came here to make some money to go back home. I'm not some kid doing drugs.

-You said you're extremely tired. "One last job to finish."

-Yes, I had some coffee.

Mr Hanssen, Sir Fraser's just rung wanting to know when we're going into theatre.

-He's got an important meeting, apparently.

-Tell him, 30 minutes, please.

-You're going to go through with this?

-Any decent anaesthetist can cope with a dose of amphetamines.

Really? Raised BP, heart issues? This is an unstable patient with multiple issues.

God knows what's going on internally and he's lying about his history.

Which is why he needs a multi-discipline team.

-I've got the sales pitch.

-What's your point?

If I was putting on a show for the Master of the Universe, I'd choose firmer ground.

If this goes chest up, it's not just the patient that's flatlining.

The business plan for Plastics is rock solid.

I'm not going to stand by while you try to bolster some whim of Sahira's.

If you think for a moment I would compromise a patient's health

for the sake of personal politics...

See you on the ice.

Good book?

Why don't we play a game? I spy?

-We're not children.

-You wouldn't play with me even then.

-I'm reading.

It's a problem downstairs isn't it?

Why do you have to know everything?

For goodness sake, we're old ladies now.

Most of what we've got we're past using.

In fact, most of what you've got you never used in the first place, so why be so coy?

Ow!

How's Terence?

Only, last time you paid me an unscheduled visit was when Nigel left you for Elena.

Terry is in rude health.

I reckon he's gone back to his elderly mother.

Otherwise, you'd be at home in Sydney, annoying him.

Hey.

Get there early in case she makes you scrub twice. She likes it to hurt.

And you might want to check this out.

-Malick. What did you tell her?

-Just a little PR, no biggie.

-Malick.

-IQ off the chart, A's across the board - basically you're an unsung genius.

-Malick!

-I've marked the section. It's cool.

-50 pages!

Hey, I've not worn my bullet proof vest today, so don't let me down, all right?

Oh, and you might want to tone down the war paint.

-Excuse me?

-Don't get me wrong, you look great, you look hot.

But in theatre, the Countess, she's more into the no-time-for-mirrors chic.

Divorced?

Caught hubby with a care assistant in a cupboard.

-Ugly.

-Terrible business.

-Have you checked the drainage, bed four? Negative suction?

-On my list.

-You all right?

-Oh, I'm grand.

Is it all right if I nip downstairs in a bit?

It was 3-for-2 on mags this morning and it's a special on women who marry gay men.

-Er, sure, yeah, why not?

-Thanks!

Something tells me Little Miss Sunshine still has a job?

-I'm waiting for the right moment.

-Chicken.

-You can't just bowl in, timing is everything.

-I agree.

-We are doing it my way, yes?

-Yes. But if it's not done by the end of the day,

-it's you going back to Sister Williams, OK? Not me.

-Yes, I know.

I don't know why I'm finding it so hard. I've done it before.

It's just she seems very settled and very happy. And she's good.

La-la-la! I can't hear you, Sacha.

Chantelle. Before you head downstairs Mr Levy would like a word, please.

In the office. He's got something important he needs to discuss.

Suction.

There's a tear in the right lobe and subcapsular haematoma.

Surgicel, please.

We're going to need to suture this fast to prevent decompensation.

This precisely illustrates the problem we're up against...

a talented surgeon like Mr Spence holding stitches for another department

when he could be far more profitably employed working with me, 24/7.

Would you like to sit down?

-Maybe not.

-Is this about the nail varnish I spilt in the locker room?

-No.

-Thank you.

-I know I can be a bit messy,

but I can sort that. I just need it pointing out every now and again.

No, Chantelle, it's not that at all.

In fact, your work here has been of an incredibly high standard.

And I for one have loved having you around.

-You have?

-Of course! That smile...

brighten up any room.

-Mr Levy, I think I know where this is going...

-You do?

PAGER BEEPS

Can we do this later?

Sorry.

Everything all right?

Yeah, fine.

Sandy, what are you doing?

-Appendicitis? I thought it was something serious.

-This is private.

-Can't help yourself can you?

-What a relief. You silly sausage, Why didn't you want me to know that?

You don't understand.

-I think it's time you went.

-Went? Went where?

I came here to help you. Why do you keep fighting me?

I don't want your fussing!

I'm perfectly happy as I am.

I care about you, Evie, I can't just switch that off.

We're sisters!

I think she just needs to be on her own for a minute.

She doesn't need that. Really.

-Thank you.

-There's a lot of blood.

How much longer, people?

Our patron is displaying dangerous symptoms.

Clamp, please.

-Three-oh, PDS mounted, please.

-We could have rebuilt Birmingham in the time this is taking.

Once Mr Hope has repaired the lungs you can get on with your reconstruction.

Is everything OK?

-You'd better hurry this up. Our patient's waking up.

-Is this the methamphetamine?

-What methamphetamine?

-It's not the methamphetamine! Give me the stitch. Keep him under as long as you can.

Clamp.

So, diagnostic laparoscopy to confirm acute appendicitis

in elderly patient. Question one. How many incisions?

-Sorry?

-Ports in the stomach for examination tubes otherwise known

as "trocars". Come on, Chris, this is page one stuff.

Er, OK, this must be logical. Just give me a second.

-Have you actually read this?

-All right, one for the camera, one for the tools?

I don't mean to pile on the pressure, but this isn't just your neck on the line.

So I suggest you stop winging it.

-I have to take these results to Mr Piper before he goes home.

-Mr Piper?

Yes, in bed three.

Look, like someone's been pulling your chain.

-You're maxxed on anaesthesia.

-Apply positive pressure.

Damn.

-This is embarrassing.

-We have to secure the lungs before we can pack the wound.

You don't have any more time.

-Apply positive pressure again, please.

-Damn!

Not again!

-He's good.

-Good. OK.

-Not quite the state-of-the-art reconstruction we hoped to show.

-Tactical retreat.

-The patient is stabilised...

-You're going to give up in front of Sir Fraser?

Meanwhile, precious staff standing idly by.

Anyone would think Holby had money to burn.

So much for teamwork.

We've been bowled out before we could play our best strokes.

'Hold on, Dan.'

-What?

-Haven't you got something to tell me?

-What's Malick said?

He just pointed something out...

Don't listen to him, Chrissie. He's full of it.

-Does that explain Mr Piper then?

-What?

You chased me for his blood test even though he'd been discharged.

I'm glad you think it's funny. It's my career on the line.

-I'm not laughing.

-You know I'm in theatre with Malick this afternoon?

Must've slipped my mind. I'm sorry.

Am I forgiven?

-I'm busy.

-It was just a kiss.

-Sorry, I'm just a bit stressed.

-Don't I know it?

-Don't be like that.

-Sure it's me you want to talk to, not Malick?

Oh, my God...are you jealous?

-You have been spending a lot of time with him.

-And?

Haven't gone off me, have you?

Come here.

-Does that answer your question?

-Not entirely, no.

-I can't do this.

-Why not?

-I'm working.

-Won't take long.

-Well, there's an incentive...

You know what I mean!

I've got an hour before my op.

Then why are even debating this?

If you could e-mail me the figures, that would be great.

All-righty.

I warned you not to trust the Swede.

It's too late to schedule another op, and I doubt Sir Fraser is in the mood even if we could.

Do not despair, my friend.

How is your patient?

Stable.

After this morning's fiasco, I was expecting worse.

Mr Bhatti and Mr Spence tell me you cancelled their mid-day elective

in favour of this charade.

Simple facial reconstruction versus life-saving operation...

a straight-forward clinical decision.

As Director of Surgery, it's the sort I make everyday.

Did clinical need make you push on with complicated surgery

when you knew the patient was a drug addict?

A trace of amphetamine wouldn't have led to the events we witnessed in theatre today.

So what did?

I don't know.

I don't know what game you're playing, but I don't like being toyed with.

I came here today to find out why you've failed to bring this hospital to F/T status.

Instead you waste my time with this "razzle dazzle".

-Worse, you put a patient at risk.

-That is not...

Everything I have done today has been in the patient's interest.

I hope, for your sake, he makes it.

'I'm sorry,'

I didn't mean to pry, but when I heard you had a fall...

I mean, you don't say anything much in those letters of yours.

I just wanted to make sure you were OK.

Well, now you know. I can look after myself.

Talk to me. Evie? EVIE GROANS

Help! Somebody! Quickly!

She's in terrible pain, give her something, please.

Evie? Where's the pain? I'm going to have to look, all right?

-SHE CRIES OUT

-Your abdomen is badly distended.

Where's Sister Williams?

Dan, this is really bad...

I know, but what's ten minutes?

MAN SHOUTS

I wouldn't... Please, just lie completely still.

You're stable.

But you will need further surgery.

-In the meantime, we've covered your open chest with a Vacuum Assisted Closure.

-A what?

We wrap the wound in cling film

and then we use a pump to suck out the air to try to keep it sterile.

But I thought...fix me...

one operation.

I wake up wrapped like...

I don't know...

Well, there was a problem.

-We couldn't keep you under anaesthetic.

-I want to go home.

Am I going to die?

I promise that I'll do everything in my power to help you.

Aren't you supposed to be in AAU?

Theatre's not booked for ages. PAGER BEEPS

I don't want you to be late.

Nothing on here.

PAGER BEEPS

I don't believe it!

Is that his bag?

Do I take it Sahira's seed fell on stony ground?

Shame if it did. Because I for one would love to keep working here.

Then I suggest you focus on saving this patient.

You think that will make a difference...

-in the grand scheme of things?

-We're in the business of saving lives.

It'd be nice if we could demonstrate that.

-No clues in Adam's history as to what caused him to wake up?

-It'll be there.

Still don't think it was the speed?

Now would you like to explain this?

Let me put this as clearly as I can.

Without further surgery, you will die.

But you will not be going back under anaesthetic

until we find out why you woke up during your operation.

You're the doctor, you tell me.

How much of this stuff have you been taking?

You left this in the ambulance.

That's not mine.

Addressed to you.

But it's not my bag. It's Wojtek's.

I'm still worried about Wojtek...

-he's not right.

-So am I,

-but there's nothing confirmed in his X-ray.

-A word with your patient, please.

Mr Nowak, there's no time for niceties, I'm afraid.

I have your close friend and colleague, Adam, upstairs, dying on one of my wards,

-I'd like to know why you gave him amphetamines?

-I don't understand.

Your bag, your drugs.

His blood.

Do you want your friend to die?

I just put it in his coffee.

Without him knowing?

So Adam wasn't lying.

He's complaining he's tired.

So you spiked his drink?

-Some friend.

-No, I do it for him. Because I care...

We must work.

-How long have you been doing this?

-Don't know... A few months.

Since he started slowing down.

Talking about going home to Sopot...

So, you were looking out for number one.

No. He was always hungry,

always off in a dream, yawning,

..sore neck... he get caught, he loses his job.

I thought if I could... like you say, perk him up.

-Get him through this bad patch.

-So you gave him speed?

People do this all the time.

So what harm can it do?

I think we've heard enough. Thank you.

Right, Mr Nowak. I'm going to take you into theatre and fix this leg.

Don't worry, you're in good hands.

How could he do that?

So how is a certain agency nurse taking the news then?

OK. All right. I admit defeat.

-You do it.

-No way.

Will you just get on with it, Sacha?

Well, I've had some sneaky assignations in my time,

but not when I've been responsible for a ward full of sick people.

So where is my sister now?

Or have you been too busy groping doctors to keep tabs?

-Thank you.

-She's having her appendix out,

she should have been finished by now!

-It's nothing to worry about.

-But I do worry.

Look, I know that I annoy her

and that she likes to keep herself to herself.

She's the only person in this world that I've ever really cared about.

There I go. Talking rubbish again.

I should go back to Oz -

out of sight, out of mind.

I'm sure that's not what she really wants.

So you would tell me if there was anything wrong?

There's nothing wrong.

It's an exploratory procedure, but it's a bit complicated

because of the lesions from the Caesarean.

Caesarean?!

I'd like to examine your neck, if I may.

It's the only part that's actually not in agony.

Please.

Looks nice.

Sopot... Paris by sea.

-I had a girlfriend, in Gdynia.

-Kasia?

We said if we ever had enough to buy a place in Sopot,

we would.

I came to England with Wojtek...

..and she married someone else.

Says her marriage broke down.

Now I want to go home.

You said before the accident, you were feeling very tired?

It was hard to be enthusiastic about anything.

Any tremors in your hands?

Sometimes. Only when I'm hungry.

Could be the speed, judging by the symptoms.

I'd like to order a portable neck scan.

Today would be good(!)

Life.

Always the race.

We had quite a party in theatre. Mid-line laparotomy and frozen section.

-You should have been there.

-I was on a break.

-No. I put my neck on the line for you.

How was I to know you were going to rush Evie in?

Sandy. Sandy.

-Evie's not well enough.

-Why didn't you tell me you've had a baby?

Oh, this just gets better and better!

How could you not tell me something like that!?

It was years ago.

I would have come back. I would have supported you. Anything...

I didn't want to talk about it then...

..and I don't want to talk about it now.

All these years, I could have been an auntie.

When are you going to get it into your silly little head?!

It's not about you!

It was never about you!

Right.

I'll be on my way, then.

You know,

I used to admire you.

I thought you were untouchable.

But I know better now. You're a coward.

You don't say anything to anybody

because you don't want anyone to know that you've got feelings.

Still nothing to say?

No...

Well, I'll send you a postcard.

Wouldn't want to lose touch.

-Leg's all fixed. Circulation good. Still worried about his B/P though.

-We'll keep an eye.

His temperature's up and he doesn't look good. Some kind of internal infection?

Could it be oesophageal perforation?

Fits the symptoms. Chest trauma, nausea,

-problems breathing, and I could feel bubbles under the skin.

-It's a possibility.

But we've done a repeat scan and an X-ray and I can't see anything.

Sorry, did I say too much?

Listen, Chantelle,

about that. We never did finish that chat.

I'm really excited about the opportunity.

What I meant to say was unfortunately...

this is your last shift.

What?

I'm sorry, but we no longer have the resources for an agency nurse.

MACHINE BEEPS, MAN WHIMPERS

Wojtek, can you hear me? Wojtek!

Looks like septic shock. Get a crash team.

Chantelle!

Transfer Wojtek into Darwin theatre, please.

-Hyper?

-Thyroidism. It causes the gland in your neck to enlarge.

The old neck tell.

The problems we had in theatre were the result of what we call a thyroid storm.

Your condition also explains the shaking hands and the fatigue you were experiencing.

Nothing to do with the drugs Wojtek gave me?

They would have masked your symptoms, which is possibly why

-you haven't been diagnosed before.

-MACHINE BEEPS

-Mr Sawicki?

-Another thyroid storm?

-He's not pinking.

B/P's on the floor.

-He must be bleeding internally.

-From where? We stitched everything.

Right. Theatre, fast as we can. We've got him this far, let's not lose him now.

A couple of your stitches have come out.

I'm sorry I wasn't there for you.

-Sandy doesn't know what she's talking about.

-Maybe she was hurt.

SHE'S hurt! That's rich...

She doesn't have to take it so personally.

I've never told anyone.

There's nothing special about HER.

These secrets always come out in the end.

Evie, you know it wasn't appendicitis, don't you?

We had to remove a large mass from your abdomen.

-You think it's serious, don't you?

-The surgeon did a frozen section.

It's been sent to the lab for tests, and depending on the results,

you may need some help and support.

I'm not like my little sister.

Never needed anyone.

If you keep things inside they stay small,

they don't get blown up, don't get raked over.

And Sandy always had enough dramas for the two of us.

So no...

..I'm content as I am.

That's the trouble with books,

they're not so good for hugs.

Sandy's downstairs waiting for her taxi...

I could always make sure it didn't turn up.

She doesn't need to know why.

Wojtek's come round and they're taking him up to Darwin theatre for surgery.

You were right. He had a hole in his oesophagus.

Even though I couldn't see it.

I meant what I said, Chantelle, you've got great instincts.

-I'm gutted to lose you.

-Look, I've had it up to here with being sweet-talked.

First Wojtek, now you...

-why couldn't you just be honest with me?

-You're right, I'm sorry...

I work hard and I think I'm pretty good at what I do.

Why don't people take me seriously?

Look, I absolutely do take you seriously.

And your leaving here is in no way a reflection on how hard you work.

I wish all agency staff were as brilliant as you.

It's rare, and I know that wherever you go,

you are going to fit in fantastically.

I know. And I know I need to get used to moving around.

That's what agency nurses do, I suppose.

MOBILE RINGS

Hi, Mum.

-SHE SOBS

-No, it's all gone wrong...

'Where are you taking me?'

Theatre one was prepped for another patient and is ready, or we can wait for Theatre two.

We're taking your slot, Miss Naylor. You'll have to wait for Theatre Two.

-Why does that never work when I say anything?

-Adam?

Why did you stop me from going to Kasia?

-He can go before me.

-No.

-I want nothing from him any more.

Bracia.

Bracia?

Bracia don't lie and cheat each other.

Brothers trust each other to do the good thing.

You are not my friend any more.

-Pressure's still dropping.

-BEEPING

-Please. Please, help him!

-Right, get him through.

I knew... I knew he wanted to go home...

..but we've got this life together.

We've always done things together...

..since we were kids,

First job...

I just can't imagine working with anyone else. Do you understand?

When we're working together...

..no words.

Nothing.

Like two hands on the same man.

Cogs working, turning the same machine.

Pity Sir Fraser isn't here to witness this.

He'd know what multi-trauma surgery is all about.

Nothing like it.

Perfect.

Little shard of the tibia,

-must have been covering the tamponade.

-Wojtek's?

Little daggers in the blood stream,

cutting his veins to ribbons.

Wojtek's literally killing him from within.

Oi! Where have you been?

Trying to apologise to Chantelle.

Maybe you should ask Sister Williams to do that?

Blimey! I've got an idea!

Wait here!

Don't use them all at once!

PHONE RINGS

PHONE CONTINUES TO RING

Mr Hanssen's phone.

I'll tell him you called.

That was Ms Shah. Would this be the same Ms Shah you worked with in London,

Colchester and Southampton?

Yes, it would,

and her proposal on a new cardiac trauma project is something I'd like to discuss with you,

-if I may.

-Well, it's clear what you've been trying to do today,

if it wasn't blindingly obvious before.

HE SCOFFS

Real-life trauma rarely confines itself to neat departments as defined by the SHA.

-You've illustrated the point, in a way.

-I'm glad we're beginning to see things eye to eye.

-I'm not so sure.

-A multi-discipline team saved a man's life today.

At what cost?

These are figures Mr Bhatti put together for me.

They show what it will cost when they eventually get to do

the reconstruction on your patient... as opposed to what we can charge for the op, the profit margin is clear.

Compare that to CT costs today, the wasted theatre time, delays...

-They're justifiable. The man had hyper-thyroidism.

-Whatever that is, it doesn't change the figures.

The world has changed.

Corporate Britain.

Business rules.

We believe in the NHS because we want a healthy work force,

but beyond a certain pay scale, it becomes uneconomic.

I understand if you have certain loyalties.

-No, it is not...

-I'm not a medic.

I don't get the same esoteric highs you share with your colleagues.

All that interests me is the bottom line.

And if you want to stay in charge here.

That's all that should concern you.

No. I'll tell her. OK. Right. Bye.

-Chantelle?

-I'm sorry about earlier. I just I got upset and...

No. Listen. I hope you don't mind, but I've just been talking to Sister Williams.

She's been looking at her budget on Keller. And...

if you'll forgive us for mucking you around...we've found you a job.

Oh, my God, this isn't a trick, is it?

No. You can start tomorrow as an agency nurse,

then apply for the permanent post if she can clear it.

That is unless, of course,

you had your heart set on watching Homes Under The Hammer?

-That was just a "thank you" hug.

-Obviously.

Mum!

You'll never guess what?!

Some days you've just got to step up.

Sister Williams!

Yes, Malick.

Evie's results. It was cancer.

Thanks to your spot, we got in early.

With the right treatment, she stands a very good chance.

Look... Whatever you've been juggling today,

you saved a life.

Thanks.

-Blueberries and prawns.

-What?

Feeds the brain when revising.

Works for me.

I feel things are moving our way.

-I wouldn't be too confident.

-How did it go?

Grade A ammunition, still in its grease-proof wrapper.

As I'm sure you're all aware, Sir Fraser and I

have been discussing the future of Darwin Ward today.

Well, I have to tell you, that no final decisions have been made yet.

It's popular to say, in these belt-tightening times, that we're all in this together.

Not a sentiment I strictly adhere to...

Evie, I've got the results...

..and it is cancer,

but...Evie,

we got in early.

'Sometimes new partnerships have to be forged...'

'..sometimes there has to be a parting of the ways...'

'We must choose our battles very carefully...

'and accept what we cannot change.'

Which is why I am asking you to prepare for the likely amalgamation

of cardiothoracics with St James's.

For the time being, we will only take elective patients onto Darwin.

All other patients must be referred to St James' please.

I don't think I need to tell you where the future of Darwin might lie.

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