Half Empty Holby City

Three weeks before you left, I told you I loved you, remember that?

-What if I said I'm over it?

-What's changed?

Let's just say I was visited by the Ghost of Christmas Future.

What did you see?

A lonely woman looking at the photograph of you, wishing she she'd never let you go.

So, you'll be officially reinstated, as of tomorrow.

-I'd like you to begin work back on Keller please.

-Um, I don't think so.

I'm going to resign.

I think there might be a way to save both of your kidneys.

MUSIC: "21 Seconds" by So Solid Crew

-How's my man doing?

-Looking good, Mr Malick.

-Can I talk to you about...

-I want to check you're still happy with what we're doing.

If you can save both kidneys, I can save him.

I'm happy about it, don't worry. I only get one brother.

And who needs two kidneys?

I know you're busy,

but you did say you'd speak to Mr Spence about his leaving drinks?

Albie's might be a good idea.

I tell you what, why don't I add that to my list, right there at the top?

Thank you!

Mr Malick...

Whose laparoscopic kidney repair is this?

-Mine.

-Yes, I can see your name is on it,

but all I want to know is which consultant is responsible?

-Mr Spence.

-And whose decision was it to do it this way?

And why was this method even discussed?

I can see no good reason for it at all.

It was the patient's choice, Mr Griffin.

He was looking for alternatives and we felt it our duty to convey all the options.

To convey the options, I see.

Well, perhaps you'll be good enough to let Mr Spence know

that I will be speaking with him later. Look,

he was adamant that we save both...kidneys.

-You're all prepared?

-Yeah.

Got my warm ischemic time right down to 18 in the Wet Lab last night.

But...

we may have another problem.

-What's that?

-Mr Griffin might have something to say about this.

What a surprise(!) He never misses an opportunity to question me,

so he's clearly making the most of that while he can.

Could you take this through to the office? Be careful, it's glassware.

-Is she moving in?

-Is this the chocolate fountain?

-Mmm.

-No.

What, not even a lick?

Chrissie, reception called - there's a delivery guy

-wanting to know where he can leave a flock of white doves?

-Very funny.

This is a working hospital, it's not Wedding HQ.

How else am I supposed to accept deliveries if I'm not at home?

-What is that?

-It's my fourth attempt at a seating plan.

I can't sit Jennifer next to Denis,

because their kids won't sit near them,

and if Uncle Jimmy isn't near the toilet, he's going to be worrying all day.

I thought there was another set of glasses somewhere. Now, these rugger bugger boys,

they want to sit together, except there's ten of them and my table is only for eight.

Better you than me.

Mrs Walters, please go back into to bed.

You've got to keep the pressure off that foot.

I'm capturing a typical day in a working hospital.

-Trust me, this is not a typical day.

-I know, I heard. Congratulations.

-Thank you.

-Who's the lucky man?

That would be me.

Can we keep the photography to a minimum?

That's like asking a bee not to buzz.

Excuse me.

-You all right?

-Yes. Just my "to do" list.

You should have said! I could have taken care of some of this.

Last time you booked us dinner, we ended up in the children's section.

-It was fun.

-It's all right. I've got everything under control.

He's got a three-centimetre laceration of the kidney -

if you need to take it out, that's what you do.

Paul is in end-stage renal failure. Adam is the live donor.

He won't be well enough to help his brother for six months, in any case.

He knows that. But he's probably better than on the waiting list.

High pulse, low BP, blood in urine...rapid shallow breathing...

-CT scan showed a brain contusion.

-That's stable, it's OK.

Have you explained what the risks are

-of repairing the kidney, instead of removing it?

-Yes.

Does he understand that removal of the kidney guarantees

that all of the bleeding into the abdomen will stop,

-giving him the best chance of recovering from his injury and from the surgery?

-Yes, he does.

Does he knows what could happen if the repair doesn't hold, if there's a slow bleed...?

-Yes. I've explained everything.

-The danger of infection,

-of renal failure...?

-Yes.

-Of pneumonia?

-Yes.

-Of death?

Yes.

Ric, Adam is determined, that's why we're doing this.

But you're not leading?

No.

Is this about you wanting to leave in some kind of blaze of glory?

No, I think he's ready for it

and he wants to take it on - let's not penalise ambition.

Excuse me. I'm Kip Maxwell, I'm F1. I'm starting my rotation here today.

F1? Right, what's the career plan, Registrar at 50?

-HE CHUCKLES

-I'm looking for...Elliot Hope?

Thank God. He's that way.

Mr Malick, Paul wants to see you. I've just popped him in here.

I'll see you in a minute.

He's weak, breathless and he feels sick.

-He didn't want to worry Jen.

-What's happening, Paul?

-I'm not sure, I think I fainted.

-You have some fluid on your lungs.

-Let me see your hands...

-It was hard to get my shoes on.

I think I need dialysis.

I'm not due until tomorrow, that's not a good sign, is it?

-Where do you go?

-Church Street. I'll need transport.

-Hey. We'll sort it out here.

-I'll call them, shall I?

-Chantelle.

Get a portable dialysis machine and a nurse here right now.

Tell them he's too frail to move. And don't take no for an answer.

You've gone all Malick on me, you're not worried about me, Antoine?

'Bout you? Please, I gave that up years ago.

Then just get on with looking after my brother.

I'll be fine.

Jac, sorry. May I introduce Dr Maxwell to you?

Yes, we've already met.

Unfortunately, I'm fully spoken for as regards mentoring,

as are all the other consultants, except for... So...

-But of course, if you're feeling...

-I'm not "feeling" anything, it's fine.

Right, thanks...

-Well...

-There's no need to make a big thing, Elliot,

I'll let him how lucky he is.

You're both lucky. Kip graduated first in his year.

-Well, that was some time ago!

-Nevertheless...

Dr Maxwell, this is our patient.

Mr Philips was admitted last night with chest pain,

-shortness of breath and a persistent cough.

-Excess sputum?

Headache, tiredness, halitosis.

-What rotation have you just come off?

-The ED.

-Not much left of it. Nothing to do with you, I hope?

-HE CHUCKLES

-No...!

Diagnosis. Treatment Plan.

Morgan, hi, I'm Dr Maxwell. I'll just listen to your chest?

That's a bit sneaky.

Yes, it's here,

the heart's on the right-hand side, so it's dextrocardia,

-situs inversus.

-How come you're such a late starter, Dr Maxwell?

-Kids.

-There's a funny story about that, actually...

-Really(?)

Yes, the edge of the liver is here, on the wrong side,

so it's dextrocardia situs inversus totalis.

-Thank you.

-Well done.

So what's your next move?

Ultrasound, to confirm. Full blood count. Us and Es.

Arterial blood gases... chest X-ray, CT scan.

So find the ultrasound machine. Get a nurse, give instructions.

-I'll be right here waiting for you when you come out.

-I know.

Take care of him.

-All right, ready for you.

-OK. Camera in, please.

Grade One tear with surrounding haematoma... The damage runs deep into the collecting system.

-Maybe I should anchor it with a barbed suture first.

-Sure...

Grab the instruments for Mr Malick, please.