All Good Things Holby City

'My dad died this morning.'

So I think maybe if I don't tell anybody - it hasn't happened.

My father had a work ethic.

He never took a sick day.

So I finish my shift.

-I'd top myself in AAU without one of these - grim!

-She's in AAU?

Oh, yeah, yeah, she's the new F1.

Go get 'em, tiger!

CT at Holby is over.

They're going to fold it into St James' and make all cardio staff redundant.

-What's the Cardiac Trauma Unit?

-Why, what do you care?

Every cardiac dork in Darwin is talking about CTU, CTU - like it's the best thing since Velcro.

Something Sahira's cooked up.

One in five nurses have been cut and Hanssen has handed you a fifty-grand project

after you insisted you could lead it. So lead it!

-We have to stabilise this bleed fast.

-Is he going to be all right?

Don't sweat it. I don't feel a thing.

-BEEPING

-B/P's dropping.

-Gav...

You'll have to wait out here.

FLATLINE TONE

-Still no output.

-Yeah, let's call it.

-Time of death...

08.48.

Good job, everyone. You did your best.

-I'll tell his wife and daughter.

-Hold up. Who clerked him in?

-We both did.

-Then he's your patient.

Which one of you is going to break the news?

C'mon, I know it sucks, but it is part of the job.

Heads or tails?

-Don't bother. I'll do it.

-You sure?

Yeah, as Mr Spence said, it's a part of the job.

That a girl.

I was just thinking, given your father's recent...

We have a dead body in front of us and you can't even say the word?

I was going to say "passing".

He did not pass anywhere.

He died.

Just like Mr Fletcher over there and just like we all will one day.

Where's the wife and the daughter?

In there.

I'm sorry. Excuse me - I'm in the wrong room.

My money's on a pay increase for the entire staff.

-You really think so?

-Unfortunately for you, it's performance-based, so I think you can expect a pay cut.

Given that the last time we were summoned like this

was to announce redundancies, I wouldn't be so optimistic.

Good morning. Thank you all for coming.

I'll make it short and sharp.

Now THERE'S a good sign.

I do realise this news may come as a something of a shock,

but though given the well-oiled rumour mill at Holby,

I doubt very much of a surprise.

So once the amalgamation of cardiothoracics with St James' is complete,

Darwin staff will be relocated,

with a few remaining here to oversee the running of the Cardiac Trauma Unit.

Thank you for your attention.

Tough break.

Well, that's me and Hanssen's girl taken care of.

-As if there was any doubt.

-Where is Sahira anyway?

Probably cracking open a bottle of bubbly.

-RAPID BEEPING

-Heart's fibrillating. Charge to 100.

Clear!

Elliot.

Are you OK?

Ah. All good things...

Do you know what you're going to do?

-I have an oesophageal rupture scheduled, if you're up for it.

-Elliot...

Severe ITP, delayed several weeks while we worked on his platelet levels. Should be challenging.

One last hurrah before we go our separate ways, eh?

Not the last. Not yet.

According to Hanssen, St James' are willing to offer me

an equivalent role to my one at Holby.

Heaven knows what's waiting for everyone else.

I'll need an underwater seal for the chest drain. a chest x-ray, an echocardiogram and a CT scan.

Your brother's going to be OK.

Is there anyone we can call for you?

And the Cardiac Trauma Unit saves the day once again!

Delighted to hear it. Have you seen Mr Sheldon's CT file? I need a copy for Ric.

-There was a penetration wound to the heart. We stemmed the bleeding on site, then...

-Thank you.

I'm sure it was very exciting, but if you'll excuse me, I have a patient.

One month?

Yep, then it's the start of the relocation lottery for everyone. Except for you and Jac, obviously.

-The Cagney and Lacey of Cardiac Trauma.

-The trial was for everyone.

Why d'you think Hanssen gave you the go-ahead in the first place?

He knew what was coming, and didn't want his favourite girl left out in the cold.

Unlike myself, who's somehow managed to get by on surgical brilliance alone.

-Greg, I'm sorry.

-No need to apologise. Count your blessings.

So what if everyone thinks you're basically Hanssen's poodle?

Speak of the devil.

This is Ms Sahira Shah. She's been heading up the Cardiac Trauma trial.

-Hi.

-Amelia O'Donoghue, Robert Gallagher, William Lynch, from the board at St James'.

Mr Hanssen's been singing your praises.

That was not what we agreed.

Yes, of course I understand your posi... I don't think that you understand MY position.

I have over 20 years' experience as a senior cardiothoracic consultant.

I don't expect to be treated like an F2.

..Yes. Quite.

Right, this conversation is not over.

Everything OK?

Turns out St James' are not prepared to offer me a role equivalent to my present position.

-Meaning?

-One day of operating time a week.

-One day?

-The rest spent at MDT meetings.

I'm sorry.

-I'm not going to take this lying down.

-What've you got in mind?

Ah...I'm not sure.

What about this oesophageal rupture? It's not far off showcase stuff.

Board members from St James' are here already.

We could ask them to observe me.

Prove to them that I'm not quite ready to be put out to pasture.

I'm not sure that grandstanding is going to be much help in this situation.

Well, if you have another suggestion...

Elliot, I'm just saying...

it'll look like you're clutching at straws.

I am!

Not only is he one of the most gifted surgeons that I've ever known, he's also one of the most respected.

-A fact that seems lost on the management at St James'.

-Which is my fault how?

There has to be a way of achieving trust foundation status without

relegating one of our finest consultants to the duties of an F2.

What do you suggest?

You told me the SHA would be persuaded to keep a cardiothoracic unit at Holby.

I told you it was a possibility, not a certainty.

This afternoon, Mr Hope and I are operating on a patient

with an oesophageal rupture, complicated by severe ITP.

-I'm beside myself with excitement.

-You strung me along. You let me encourage everyone

to get behind this Cardiac Trauma trial

and in the end made me look like some sort of manipulative, Machiavellian bitch.

A little melodramatic, don't you think?

We'd like to invite the board members of St James' to observe the procedure.

What do you think that will achieve?

They'll see for themselves what an asset he is.

-They're on a very tight schedule. Tours, meetings...

-This could be his only chance.

-Fine. I'll have a word. But don't get your hopes up.

-Thank you.

-You led me down the garden path.

-To the sweet smell of continued employment, no?

Could you wait until I'm on the other side?

You made it look like the only reason I'm staying is because I'm the boss's favoured child.

-It's on your own merits.

-That's not what everyone thinks.

-Who cares?

I've already told you, I'm sick and tired of being thought of as "Hanssen's girl".

This is a hospital, not a school playground.

-I suggest you grow up.

-Grow up?

Yes, you'll be forever impeded if you don't give up this naive desire to be loved by everyone.

You'd know that better than anyone!

Yes, I've supported you. Yes, I've kept a watchful eye.

And yes, I gave the go-ahead to the trial in part because I knew it would give you greater job security.

-Rather than throwing it in my face, perhaps a measure of gratitude would be appropriate.

-Gratitude?

Do you mind? I'm busy.

I quit.

You'll have my letter of resignation on your desk by the end of the day.

Aplasia of the sternal head of the pectoralis major.

-Must've been incredibly intricate surgery.

-It was.

Were the serratus anterior and latissimus dorsi muscles absent?

Yep, textbook Poland's Syndrome, along with webbing and shortening of the fingers.

-Symbrachydactyly.

-You know your plastics.

I'm fascinated.

People don't understand - they think it's all boob jobs and face lifts.

-But it's genuinely improving people's lives.

-You're preaching to the choir.

I read your paper on minimising facial scarring.

-Oh, you did, huh?

-You mentioned the psychological counselling patients receive before surgery.

I'd love to hear more about it.

That's a long conversation.

Perhaps over a drink?

Hey.

How'd it go with the wife and daughter?

-Nice one.

-Thank you.

-Well done.

-They'll be writing songs about you.

-I didn't do this to fan my own ego.

-Hats off to you.

Takes balls to give it to the man.

-I stand in awe of your balls. Less impressed with your brains, though.

-Meaning?

She's just jealous. Jac can only dream of being universally adored.

Giving up a good job for people who won't remember my name in a few years

is not my idea of a noble sacrifice.

Believe it or not, not everyone is as self-centred as you.

Here you go.

Thank you, Rosie.

Her name's Rachel.

You're going to need this.

Let's see...

Ingrowing toenail. Tragic. Give that one to Frieda.

Ah, this one looks interesting.

-That's a little above your pay grade.

-Oh, I'm a fast learner. Please?!

-What are you doing?

-I volunteer to tell the relatives

and you take this opportunity to grab all the good cases and give Frieda the "tragic" ingrown toenail?

-I don't think so.

-Michael...

Tell you what. You two of pair up, you do obs.

This is Dennis Atkins.

55-year-old smoker. Had a triple bypass a few years ago.

He came in presenting with abdominal pain and weight loss.

You think you got the chops? Prove it.

And whoever diagnoses him correctly gets the grand prize - some theatre time today.

Fair enough?

I've got the invoices right here. I ordered five 6-inch refractors - five, not four.

And 12 - that's a one with a two after it - 12 Newtonian reflectors.

You've only sent me eight.

I've got customer back orders up to my neck and if I don't get them out soon, they'll go with someone else.

And so will I, if you don't get your act together.

Bloody South Korean suppliers.

Mr Sheldon, good news.

-Your platelet levels...

-PHONE RINGS

-Unless you're phoning me back to tell me my orders are on their way...

-Mr Sheldon!

Do you mind?

Who's this?

This is Ric Griffin. Our GS consultant.

Now you've been transferred to Keller, he'll be assisting me in repairing your oesophageal rupture.

Which, if I may remind you, was caused by excessive vomiting brought on by excessive stress.

Can I have your GMC number?

-What for?

-So I can look you up. Check out your credentials.

And why would you feel the need to do that?

Don't worry, it's not a black thing, if that's what you're thinking. I asked the same thing from him.

Mr Sheldon was treated by someone in the Philippines who turned out to be less than qualified.

Well, I can assure you in this country and in this hospital...

Stapled haemorrhoidopexy. Do you know what that is?

I am familiar with the procedure.

You don't want one of those going wrong. Had to have the whole thing done again back home.

-Couldn't sit down for...

-I get the picture. I'll get you the number.

-Thank you.

-PHONE RINGS

Excuse me.

As I was saying, your platelet count is now at the optimum level...

Jess. So you are alive.

What?

When was this decided?

All right, all right, but at least let me see you off.

What time's the flight?

She's come back to work too soon.

Sometimes it's the best antidote. Besides, she's been fine the last couple of weeks.

-You think it's just a blip?

-It's not easy delivering bad news the first few times.

-Or any time.

-Which is why she's got to get used to it.

Still can't help but feel she could do with some... I don't know, TLC.

Frieda? TLC? Are you kidding? You know what, leave it to me. I know how to handle Frieda.

I made you copies of Mr Atkins' notes.

Thanks, Frieda.

That's really thoughtful.

Elizabeth, can you order me a taxi for 4.30?

I need it waiting outside the moment I'm out of surgery.

-Pulse is 90.

-Eyes look OK.

Erm, so you say you have pain in your stomach?

-How.

-How often and how severe?

Comes and goes.

Gets worse after I've eaten.

-Looks a little bit distended.

-I can see that.

-What d'you think's wrong?

-Probably just some sort of bug. You'll sort it, won't you?

-BOTH: Yes.

By the way... I thought you'd like to know.

Mr Fletcher thanks you for trying so hard to bring him back.

-Dennis has a gift.

-Oh, I see... umm you see dead people?

Don't see them, as such.

Hear them. Sense them.

OK. We'll order you some tests.

-Couldn't have been easy for you.

-What are you talking about?

How'd it go?

-You did not tell us he was a crackpot.

-Crackpot?

Never mind.

Pulse is normal, eyes are OK, stomach is a little bit distended.

-Diagnosis?

-Diverticulitis.

That would explain why the pain gets worse after he's eaten.

Possible. Frieda?

Renal colic would cause the same symptoms.

Also possible. So what's next?

-Usual bloods, dip urine...

-Chest and abdominal X-rays.

-And in the meantime I/V fluids and...

-and antibiotics.

You're already working together as a team. Completing each other's sentences and everything.

It's too cute. All right, get to it.

How are you coping?

-Coping?

-It's just that I heard Sacha telling Michael that you...

choked with Mr Fletcher's relatives. Which I totally understand. But if there's anything I can do to help?

They were talking about me?

Only out of concern. Michael was saying how he'd try and keep you busy to take your mind off things.

The x-ray shows us that your heart and lungs are fine, but there's still a lot of blood right here.

Which means we'll have to take you back into theatre to get rid of it.

Nothing to worry about, mate.

Just a patch-up job.

-Ain't that right?

-More or less.

-How'd it happen?

-Kitemare.

-Kitemare?

I was doing a back spin loop.

Wind caught the sail. Sent me flying on to a fence post on the beach.

How long before emergency services arrived?

We were there within 12 minutes, sutured the bleeding on site and brought him back to Cardiac Trauma.

-Impressive.

-Are you sure there's no-one we can contact for you?

No.

-Your parents, maybe?

-We don't have any.

Tell you what. I'll have a gifted surgeon take a look at that for you.

Doctor Valentine.

We have an emergency procedure.

There's a tear on the superior aspect. I suggest 4.0 prolene, interrupted stitches.

Careful with that. Sick, ain't it?

So I'm a seamstress now, am I?

Seamster. Don't knock it - could be your next job.

Right. I think we've seen enough here. Good luck.

-Why did you give me this case?

-What?

Is it because you felt sorry for me?

What the hell are you talking about?

You don't give me the case because you feel pity.

You give me the case because you think I'm a good doctor,

because you trust me and because you think I've got what it takes.

I don't want it any other way.

Looks like it's just you and me.

-What's going on?

-We need to improve your brother's INR level before we can operate.

-INR?

-You're on Warfarin, right, Gavin?

-What's that?

-It's for my heart.

I get arrhythmia sometimes. It's nothing serious.

-Why didn't you tell me?

-It's nothing.

-Er, Keira, two units of FFP and vitamin K, and continue with the blood and fluids, please.

-Don't.

-I've got to.

-Have you forgotten what he's like?

-It's been two years.

-And?

-What happens if you die?

-I'm not going to die.

What happens if you do?

How's it going with Mr Crackpot?

Just ordering the chest and abdominal x-rays now, which I've no doubt will prove diverticulitis.

Not that it really matters now, of course.

Test results for Mr Atkins?

Like I said.

-Doesn't really matter now.

-Mm-hmm.

-Mr Atkins' urine test result came back with a trace of blood.

-So?

-Which suggests renal colic, as I thought.

-You're not on the case any more.

-You want back in now you've got a shot at theatre time? Doesn't work like that.

-I'm sorry.

That's not going to cut it.

-I over-reacted.

-Yeah, you did.

-It's not going to happen again.

You're not going to jump down my neck in half an hour and accuse me of feeling sorry for you?

-OK, it was my mistake.

-Yeah, damn right it was.

-Look, either you're here to work or you take compassionate leave. What's it going to be?

-I'm here.

All right, run a CT IVP. If it comes back positive, book him in for a nephrolithotomy.

And she says, "Lay off the doughnuts.

"You'll never find yourself a wife if you let yourself go."

Oh, that's so her!

-Can you believe this? My Auntie Flo is still a grouchy old bag.

-Unbelievable.

I'm sorry, Frieda. that was insensitive.

It's OK, Mr Levy. I'll get over it.

-I don't suppose you'd like a reading?

-Your urine test suggests you have renal colic.

But there's still a chance you might have diverticulitis.

It's a digestive disease found in the large intestine.

I don't need to know the details. Matters of the physical self are your department, not mine.

-How are you feeling?

-Transcendent.

Your father's here.

He's eager to make contact.

So you like to eavesdrop?

You could call it that, I suppose.

Eavesdropping on the spirit world.

Yeah. Throw in a few cold readings and some high probability guesses,

and I'm sure you could put on a hell of a show.

-Have you always been so closed-minded?

-Oh, I'm very open-minded.

-Just not to the point when my brain falls out.

-Maybe we should all calm down.

He says he misses you. He's very proud of what you've achieved in this country.

And he knows that you love him very much.

Is that supposed to impress me?

He likes his music.

Plays the guitar.

Mr Atkins, while you're here, perhaps it's best if you refrain from contacting the spirit world.

He has a kind face.

He's smiling. He says he's glad you keep the family photo he sent you by your bed.

It makes him feel close to you,

-and he wishes you...

-Stop it.

-Maybe he really is psychic.

-Yeah, you told him those things.

How would I know anything about your dad?

If it makes you feel uncomfortable, I don't mind taking over.

BEEPING Doctor, please!

-Mr Atkins, can you hear me?

-What happened?

-He just passed out.

-FLATLINE TONE

-Crash trolley!

Hey, Tom.

Are you sure you don't have anyone you'd like me to call?

Just my dad.

-He says he's in recovery.

-And do you think he means it?

Seems like it.

But...

Gav always got the worst of it.

You have no reason to feel guilty.

None of this is your fault.

Charge to 200.

He's in VT. Stand clear.

-What happened?

-We don't know.

-What do you mean? How can you not know?

What's important is that he's stable now. His heart is beating. OK?

-What were his obs before this?

-BP was a little high.

-I'm going to order a mesenteric angiogram.

I want obs every ten minutes.

His heart stopped.

We'll start by making an incision across the lower abdomen

and pulling the stomach back up towards the oesophagus.

Fairly routine stuff.

Any particular reason you felt the need to invite us all to watch?

The patient's blood condition makes this a particularly challenging procedure.

We only have one chance to repair the rupture, otherwise the patient

may be left with long-term feeding and digestive issues.

I'm not eating through a tube.

-Or carrying one of those bags around full of my own...

-What do you do, Mr Sheldon?

Got my own business. Telescopes.

-I'm partial to a bit of star-gazing myself.

-Don't see the point myself.

Just balls of fire and lumps of rock, aren't they?

You should see how much some of these geeks pay for a top-of-the-range scope.

They're loaded. I'm telling you, the nerds will inherit the Earth.

Let's get started on the pre-op checks.

Sorry, I can't do this. Thank you.

Is there anyone I can call for you?

I noticed from your medical records here you have two daughters listed as your next of kin.

Nah, don't need to bother them with this. They don't live local.

Both got families, jobs.

OK.

Nurse, can we have type-specific blood? Two units, platelets, please.

And we'll see you in theatre in about an hour.

Good.

An hour?

-Yes, is there a problem?

-We were under the impression you were operating right now.

-We've a meeting with the Holby board from three to four.

-Ah.

-Well, I suppose we could postpone...

-Please don't on our account.

Well, his platelet count's up to 150 from 60.

Another hour wouldn't make much difference. Would it?

No.

Very well. We'll see you at four.

Good. Are you sure that's all right?

Of course.

What's this?

Obs are stable.

The transfusion and fluids seem to be working.

We can get you back into theatre.

So, what? You're penpals now?

You don't actually believe any of this, do you? I'm deleting this rubbish.

-He'll beat the crap out of you, just like he did me.

-He never touched me.

And why do you think that was?

Maybe it's better you talk about this later.

Look, I know you're scared.

But think about our future.

You invite that thing back into our lives,

-how long before he finds a way to screw it up?

-I don't care.

-You don't care?

-It's not just up to you.

-Well, if you don't like it, you know what you can do.

-Right. All done.

As you can see, I've added interrupted stitches.

-Get away from me.

-Fine.

Once we get the results of the mesenteric angiogram, we'll have

a much better idea of what caused you to deteriorate so suddenly.

What did you see?

-Sorry?

-Did you see the light?

The tunnel?

Yes.

Yes, of course.

Doctors, you're both wrong.

Looks like you're going to have to draw straws for theatre time.

Finally. Now I've become your star patient,

I'm getting the service I'm entitled to.

You're entitled to exactly the same service as any other patient.

Not according to the suits.

They can't wait to see what's going on in here.

I'm a marvel of bloody science, I am.

Yes. You certainly are a marvel.

What was that? Was that a dig?

You ought to start showing me some respect.

And where's that GMC number? For all I know, you could be a chiropodist.

I want to see a licence to practise.

I've ordered a copy and when it arrives, I'll be sure to ask one of our proctologists to deliver it.

-That is not respect.

-You want some respect?

You try showing some first.

I have been perfectly respectful.

You have been rude, selfish, ungrateful, you've been arrogant...

You can't talk to me like that. I pay your wages.

What makes it all the more gratifying for me, personally,

is that treating you means I'm going to miss seeing my daughter before she flies off out of the country.

Not that I'd expect you to care or even understand the sacrifice,

given the total absence of any family by your bedside.

The blood vessels supplying the bowel are blocked, that's causing you pain after you eat.

The blood supply can't compensate, which is giving you the ischemia.

So, what happens now?

We'll remove the area of the bowel that's serviced by the damaged vessels. But determining

which areas have good and bad blood supply isn't easy. Given the vascular disease to the heart

-and the previous triple bypass you had, anaesthesia carries a very high risk.

-High risk?

I'm not going to sugar-coat it.

This is a complicated surgery. And, like any invasive procedure, it carries some risk.

-But if we don't operate...

-Could I die?

-We're going to do everything we can.

-Could I die?

-I can't make you any guarantees.

But you do need this operation.

And time is not on our side.

Do you understand what I'm saying to you?

OK. Then we can go ahead?

-Try not to worry. Mr Spence would be the first one to tell you he's the best.

-She's not lying.

OK. Right, I want IV fluids and let's continue obs.

Which one of you is joining me in theatre?

All right. Call it. Heads or tails?

-Tails.

-Tails.

Heads.

Congratulations.

-Gavin, I really need to get you into theatre now.

-Not until I see my brother.

Your echocardiogram shows blood accumulating around the heart...

-I don't care.

-It's compressing it, making it harder for it to beat.

-If I don't get you into theatre now...

-I gave up everything for him. A-levels, a career.

I work 12 hours a day in a factory to care for him.

And you whisper a few words in his ear and get him to throw it all away.

I didn't tell him what to do. I just listened to him.

-You're saying I don't?

-Maybe he's old enough to make his own decisions.

You don't know anything about it.

I know that if I don't get you into theatre soon, you will die.

Where will that leave your brother then?

So, where's Jess off to?

She's going to see her mother,

in Jamaica.

Bit sudden.

Well, you know Jess. When she gets an idea...

How long's she going for?

Indefinitely.

Look, we can postpone Mr Sheldon's operation for another couple of hours.

-The board won't wait that long.

-That's not important.

-Elliot, it's a kind gesture...

It's not a gesture.

BEEPING

My heart. It's racing.

What's happening?

If you're here to change my mind, don't bother.

Wouldn't dream of it.

I've had a look at the call-out notes for your patient, exemplary job, if I may say so.

I've made a few suggestions for improvements, notes in the margins.

Well, hopefully they'll prove useful to your successor.

You didn't think because you're abandoning the Cardiac Trauma trial, I would let it go to waste?

-Of course not.

-In fact, I've already put in a request for cover from St James's.

This is for me, I believe.

-My letter of resignation.

-Thank you.

What was it like?

-What?

-The light. The other side. What did it feel like?

It was...

Did you see Cathleen?

What? Tell me.

-There was...

-Go on...

-Nothing.

-What do you mean, nothing?

-Nothing.

-But you must have seen something?

-Grace, please. Not now.

-You must have seen her.

I didn't see anyone.

-All right, but maybe she saw you. Ask her.

-Please. Grace...

-Ask her!

-I can't perform for you 24/7.

-Perform?

-What do you mean, perform?

-I'm sorry.

I don't understand.

I just wanted to help you. Help everyone.

What are you saying?

-No...

-I wanted it to be true.

I half convinced myself it was.

I was afraid if you knew, you'd...

What? I'd what?

Sometimes it feels like it's the only reason you're with me.

Extending the original incision...

down to the sternum.

-I don't need a running commentary. I can see what you're doing.

-It helps me focus.

Inserting the retractor.

Opening the retractor.

Yes, yes, all right.

Suction.

Diaphragm's pushed upwards.

Feels distended.

BP's dropping. 50 over 30.

-Heart rate's 140.

-We need a GS surgeon.

Something's going on with the abdomen. Page Mr Hanssen.

-What happened?

-Your heart did a few somersaults.

-You're stabilised now.

-Probably you that did it.

Shouting at me like a maniac.

I did not shout.

You raised your voice.

I'm sorry.

I know it's going to sound funny, but...

If you experienced any other symptoms, I do need to know.

I saw stars.

Shooting stars.

Occupational hazard, I guess.

You seen them this time of year?

The Perseids meteor shower?

No, I don't think I have.

Amazing.

My daughters,

they used to love them when they was kids.

"There's another one, Daddy. There's another one."

-"Make a wish, make a wish."

-When did you last see them?

I don't know.

I'm not exactly a candidate for father of the year.

Who is?

Don't worry about me. Meet her at the airport.

Kiss her goodbye. I'll be here when you get back.

Something for you to look forward to.

I'm sorry.

The things I said.

I got a bit carried away.

-Showing off in front of your girlfriend?

-Something like that.

Do you even believe in afterlife?

Not now.

-How can I?

-You've only been gone for about a minute.

Maybe the journey takes a little longer.

-Thought you didn't believe in that.

-I don't.

Wouldn't you want to see your father again?

-Of course.

-Then why wouldn't you...

Believe in Heaven?

Cosmic consciousness?

What do I do, spin the wheel and choose an afterlife?

Some do. It helps.

So, why do they need you?

Sometimes it's to say things they couldn't while their loved ones were still alive.

Sometimes it's just to say goodbye.

But mostly, it's just to feel less alone.

-What do you want?

-Dennis is about to go into the theatre.

-Good luck to him.

-Are you just going to walk away?

That's right.

18 months down the drain.

My longest relationship. Can you believe that?

Why do you care, anyway?

You were right. He's a charlatan.

-I'm better off without him.

-He could die.

He took advantage of me.

All of those messages from my sister.

Making me feel so... connected.

To what?

Nothing. A fantasy.

Your sister was not a fantasy.

She lived. She existed.

-I miss her.

-I know.

Pack it. I can't see a thing. We've got to get on top of this. Good.

Looks like a tear to the liver. Why wasn't this picked up on the CT scan?

It was too small. And the Warfarin just made it worse.

Put your hand there for me.

Push hard. Clips, and more suction.

Diathermy.

Cauterising the tear.

20 vicryl, if you would.

He's stabilising.

-Right. I believe Ms Naylor and I can continue from here.

-What?

Two consultants is more than enough to deal with this patient from now on. Wouldn't you agree?

-He's my patient.

-Our patient.

Precisely. I'm sure you'll find some work to be getting on with while we finish up here.

Oh, by the way. St James' got back to me.

They've got a CT Registrar with Cardiac Trauma experience

who's very keen on a transfer to Holby. So, looks like everything will work out quite well.

Where is he?

He's been rushed into theatre.

- Why? What happened? - He went into AF.

Retractors.

Don't give them to me. You're a surgeon, not a scrub nurse.

Ah, Petrenko. He's your patient, too. Scrub in.

Ah, you're here. Good. Could you just give me one minute, please?

Should I cancel your taxi?

No. Go. To hell with them.

-Are you sure?

-I'll tell them we're postponing.

-If you leave now, you can still meet her at the airport.

-Thank you.

-I'm terribly sorry, I'm afraid we'll have to postpone.

-Oh, for goodness' sake!

OK, we're need to resect the damaged part of the bowel.

-You want to try?

-Yes.

One at a time. Frieda?

He's a dinosaur. A relic.

He'll be lucky if he gets one hour of operating time per week, let alone one day.

Excuse me.

-Scalpel.

-Mop Doctor Petrenko's brow, please.

OK. You're doing well.

-Oh, God!

-OK, it's all right. Take it easy.

Here, just use another clip.

Well, at least we know he's got a good blood supply.

I can't get it in the right place.

-I can do it.

-No. Here, I'll hold it.

-Get the clip on there.

-He's lost a lot of blood.

Take it easy. It's all right.

-I can't do it.

-OK. It's all right, no problem.

Take a break. Let Sacha know I need a little hand in theatre.

OK, another clip.

Guess some people just can't hack it.

Hey, give her a break. Her father just died.

OK, we're ready.

Let's open him up.

Knife, please.

No news yet.

But the bowel resection is going well.

I will update you as soon as I know more.

Please, don't go.

I suppose you're used to it.

-Used to what?

-All of this.

Anxious relatives. The prospect of...

When my sister... When...

I didn't think I'd ever get over it.

The pain, it was...

like an open wound.

Until I found Dennis

and he made everything go away.

Made everything soft, warm.

-Blither, blither!

-Problem?

It's full of adhesions.

We'll have to do an Ivor-Lewis.

And end up with a risky anastomosis?

I don't see that we have any other choice.

I've got an idea.

We take some of the pleura of the lung and rotate it with its own blood supply. Then patch it

to the lower end of the oesophagus with interrupted sutures.

Then the stomach won't have to be mobilised.

Brilliant.

Right.

So, in lay terms, what we...

Dead.

-His girlfriend still here?

-In there.

I'm going to go tell her.

No.

-I'll do it.

-Frieda?

-Please. Let me do it.

-You sure?

I'm sorry you didn't get to see Jess off.

I'm sorry that the board members of St James's had the attention span of

pimpled adolescents. They don't deserve you, Elliot.

Do you know what I'll miss most?

This.

No suits, no politics.

Just surgery.

The sheer joy of it.

The transcendence of it.

The human body in all its intricate, frustrating,

bewildering, imperfect beauty.

That's what I'll miss most.

They've done everything they could.

I'm sorry.

If you'd like to see him, I'll take you.

He's here.

Snacking between meals.

It's a guilty pleasure.

-Try a fruit bar.

-Nah.

-Fruit's not a snack.

-Says the doctor.

-So, how'd it go with Mr Atkins' girlfriend? What's her name?

-Grace.

It went fine. I think she took it pretty well.

-And how did you take it?

-What?

How did you take it?

Frieda.

This isn't me feeling sorry for you or pitying you,

or whatever else runs through that head of yours.

I know what it's like to lose your father.

So, if you want to talk,

I'm here.

The operation went well.

But because of the trauma, there's always a chance that your heart could become more irritable in the future.

So, my heart's always going to be weak?

Yes.

-Call him.

-You sure?

Yeah.

If he's changed,

if he really has,

I'll know it the minute I set eyes on him.

Elliot?

I'm sorry.

I doubt there's anything anyone could've done.

Rumour has it that you've handed in your notice.

-Yes.

-I won't presume to question your reasons, but...

speaking as someone whose surgery days may soon be at an end,

don't let anything stop you doing what you love.

Is there some reason you're hovering outside my office like a nervous young schoolgirl?

Look, I've thought a lot today about the decision I made this morning.

-You understand it was a reckless, impulsive action, and you'd like to keep your job?

-Something like that.

I'm sorry, I thought I made myself clear. The position is filled.

Now, may I enter, or are you going to play the door game again?

-Is this some sort of test or punishment?

-No. It's not a prank.

It's real life. Don't you like it?

Look, I understand that you must feel offended.

-It's nothing to do with my personal feelings.

-Really?

-No, but you explain to me, Ms Shah,

why should I keep on a member of staff who finds her position so disposable, so inconsequential,

that she's prepared to throw it away at a moment's notice?

And, in the process, abandon the Cardiac Trauma trial that she started?

Maybe you shouldn't.

So, that's that, then.

We agreed from the start that you wouldn't show me favouritism.

But you have. And I admit, there have been times when I've been grateful for it.

Took advantage, even.

What's your point?

My point is that I'm not the only one to blame here.

All right. What do you suggest we do?

I think we should draw a line under this and move on.

-Forget it ever happened?

-No.

But make sure it never happens again.

Right. I'll put a call in to St James's, cancel the transfer.

Thank you.

-Is there something else?

-Well, it's just it's getting late, and you said St James's were already arranging...

You never made that call in the first place.

Goodnight, Ms Shah. See you tomorrow.

-How do you feel?

-Like roadkill.

Well, you'll be pleased to hear that the operation went well. Better than we'd hoped.

You should begin to see some real improvements in three days.

-Thank you.

-Actually, it's Mr Hope that you should thank.

-But I don't know where he's got to.

-You see your girl off, then?

No.

But I'll call her when she lands.

Make sure you do.

They probably don't even have the same numbers any more.

You won't know unless you try.

Couldn't make me a cuppa, could you?

Don't push your luck.

-We're all off to the pub. You coming?

-I can't. I've got work to do.

Come on, it's kind of in your honour. You're everybody's hero.

Another time, maybe.

You make a noble sacrifice, and then refuse to bask in its glory.

I'll never understand you.

-Ollie, you coming or are you too busy with your arts and crafts?

-I'm finished.

-Good lad.

Have fun.

# By the cracks of the skin, I climbed to the top

# I climbed the tree to see the world

# When the gusts came around to blow me down

# I held on as tightly as you held on to me

# I held on as tightly as you held on to me

# Cos I built a home for you

# For me

# Until it disappeared

# From me

# From you

# And now

# It's time to leave

# And turn... #

Goodbye.

# To dust... #

Jess?

Hi, it's Dad. Woah!

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