She's Electric Holby City

I can announce that Holby City now has Foundation trust in its title.

Indy's been taken ill at nursery. I have to pick him up.

-Please! I'll be there and back in 20 minutes.

-20 minutes, that's it, go.

It's not ideal when a patient can still smell booze on your breath.

You're such an uptight arrogant arse!

Eight car RTA. East Circular.

Two chest traumas for CTU. Where's Sahira?

I'm going to ask to be transferred to a different ward.

Well, there's nothing else to say.

-I thought your son was on the table!

-And I said I'm sorry!

You stupid woman, I thought you were...!

Yes, look it was a mistake, OK? A mistake.

-I've apologised! Can we just, please, forget it?

-Sahira?

You know what? Get lost.

I am fed up of this.

They're on to you, mate.

Other things on your mind?

So I've been two days off the booze. I ate a salad. I looked at a gym on the internet.

Is that what they call detox? So Keller was just crazy-talk then?

Just waiting for HR to pull their finger out.

-Then sayonara, Dr Freakenstein. Morning!

-Incoming.

I'm on it. See? See how chilled out I am?

-MONITOR BEEPS

-That didn't get sent out to maintenance, then?

Just following orders.

I thought you'd...stropped off to Keller?

He's not so bad...

OK. He's terrible. He's the devil.

-Kelly Singh, please.

-That's why we need your sensitive, touchy-feely personality here.

Do HR actually do any work?

SLAMMING AND BANGING

-Well I'm off the fags. What's your excuse?

-Sorry?

-Seem a bit...

-I'm fine.

-Hand them over then.

-I promise you they're accurate.

-Fine tooth comb, Olly.

Greg, if this outpatient turns up,

tell her punctuality is next to godliness.

Which is just one rung below Consultant.

If you've botched this research, arses will be kicked.

Sexual tension, so obvious.

-Them. I'm kidding.

-Not funny.

C'mon. Stop blanking me.

-I'm not!

-Yes you are. What's happened?

Do you really want to know? I mean REALLY want to know?

OK! Fine! I picked up the wrong buggyboard at nursery

and now this stupid cow who's child is the ugliest thug

you've ever seen, is basically accusing me of theft.

I just got confused because our old one was red and...

You're bored!

-No, I just thought it was a home thing.

-Home?

No, that's all fine.

-MONITOR BEEPS He's out of it, I tried but...

-Breathing, but not conscious.

-Gently, please.

-How did he fall?

-On the curb.

-Let's give him some space, thank you.

-Are you the sister?

-Yup. What happened?

-I just don't know.

-Normally, they get up after it's worn off.

-I mean why did you taser him?

He was off his face with a knife. It was a nightmare.

We can take it from here, thank you.

-Who's the point of contact?

-We're all gonna stay, I think.

-Sorry, but too many police, it freaks out my patients.

-Please.

My guys are in bits. Give us a break yeah?

Fine. But we're running this now, OK?

Have we come in on a Saturday? Or did they all just die over New Year?

Lost property for Naylor.

-Mum got confused on the ring road. Bit teary.

-Ah, they're in luck, we're quiet.

You OK? Good...Christmas?

Yes, thank you. You?

-Yeah good. You want to go for drink later or something. Catch up?

-No.

-I've got squash. Ladder match.

-Some other time?

-Is that my 9 o'clock?

-Yep, be nice.

You'll have to be nice. As of now it's my research day.

-Good... Christmas?!

-Everyone knows then?

-I could've told him Chrissie Williams was a right old...

-No wonder he's fronting out.

-Guys, he has a right to some privacy.

-Ha!

There are no secrets at Holby, are there?

Mrs O'Connor, is it? And your daughter Frances?

-I'm very sorry we're so late. Have we missed it?

-I'll make you a space. Galway is it?

Portumna. It's all just so confusing.

Do you know there's not even a sign outside this place?

No grand unveiling.

Evolution not revolution. No need for ceremony.

I see that you've cancelled the Consultants' routine conference.

-They're an ineffective talking shop.

-Rather short notice.

-Why meet unless there's an agenda?

-I don't know.

Perhaps to explain how are you intend to balance the books this year?

A drip-feed of a complex strategy is not appropriate.

We need some candour. It's a simple question.

How do you plan to save money? Which departments are affected?

-Everything is on the table at the moment.

-Talk to us, Henrik.

Don't make this any harder than it needs to be.

I won't be press-ganged. Not by you, not by anyone.

ECG?

Yup. Query cardiac murmur.

-Whack on the head?

-Don't think so, no.

No bruising or evidence of trauma to the head.

Just the 50,000 volts then.

Order a tox screen.

Yeah, teen in a hoodie. no other possible explanation, right?

-The murmur could be OD related. They did say he was...

-Off his face with a knife, yeah.

-Any reason not to take that at face manner?

-There's no track marks?

Doesn't rule out ketamine, speed, cocaine, ecstasy.

Or a diabetic coma or stroke. Or the 50,000 volts?

The most obvious explanations are usually right.

When are you off to Keller?

-SHE SIGHS

-Look at him, he's 16. Does this not bother you?

Yeah. No more than usual.

I've worked it out. He's actually a robot.

-C'mon. The doctor's waiting.

-It's fine, no hurry.

C'mon. She's been doing this for a week.

Will you come and talk to the doctor!

So, we're doing one of these hmm?

Heart check. We've been referred from...

-Wyvern South.

-Wyvern?

-It's a special hospital. You know.

-Oh, I see.

-There you go, good girl.

-Good to meet you, Frances.

-Thank you for fitting us in.

-She gets very upset. Don't you?

-I'm OK.

-But they think there's something up with your heart?

-No.

They want to know there isn't. So she can have the treatment.

You know, for getting upset.

-I see. Is that the medication Frances?

-It's not, no.

Not medication. We've done medication! Medication isn't enough!

So she can have the electric, you know...

ECT. Right. I would like to speak to them.

Oh, please, could we not just get on with it?!

We've been up since four. I'm 76!

Absolutely. But it's just not something I've dealt with before.

If you just bear with me for one second.

OK, no mum or home.

So... Ash or Rance? What do we reckon?

-Are we certain it's his phone?

-Why, cos all teenagers are thieves?

Street's still with you is it Eddi?

-He's still not woken up?

-Nope, we're keeping him under observation.

-Waiting for some test results.

-Did you contact the family?

We rang the mum but she's too busy to come in.

-You did tell her he was unconscious, right?

-That's chav-land for you.

-That a technical term?

-Put it this way. We have records on him, even if you don't.

-How long will the tox screen be?

-Can take hours.

Can you push them? I know sisters have ways.

Yeah, but when they come back, we still need to keep them confidential. You know that.

I know. I'm just looking for some help.

You're gonna have to spell that one out.

-I just wanna know what happened.

-Isn't there an independent investigation?

Only if they die, apparently. Sorry, I checked.

That won't happen, will it? He'll wake up, won't he?

-You guys'll sort it.

-I don't know. You tell me. What normally happens when you taser a kid?

-Is that some kind of accusation?

-No. I'm just really surprised that four policeman can't

-take down a teenager any other way.

-What d'you suggest? Ask nicely?!

-That's not what I'm saying.

-You get knife wounds in here, don't you?

I guess, you'd have disarmed him with your razor sharp wit.

This isn't right, OK?

-Yes, restrain him if he's getting larey, but you know...

-What?

Death penalty? Really?

Go on then. Say something sarcastic.

I don't think it'll come to that.

But if it does, it's not clear to me that it's their fault.

So, this is just a slap on the wrists then, yeah?

-Now who's being sarcastic? Do you know the extension for Darwin?

-I'll deal with it.

-A psyche unit needs to do ECT. Need us to OK it, heart-wise.

-OK. And?

-Not something I've come across before.

-Call the psyche unit and talk to them?

-Yeah, I guess I will.

-What do you want me to say?

-I just wanted your take on it.

-Greg. I have so much on.

HE SIGHS Come on. We have to at least mention it.

I'm married woman. I have a family. Please just respect that.

OK. Sorry I spoke.

Sorry guys. Eddi's saying she called five times and no one's picked up?

-She has NOT called five times.

-Some kinda cop case on AAU?

Sorry, I have a possible CABG in bay 1.

Fine. Let's get rolling on Frances O'Connor's ECG.

-But carefully. It needs to be treated sensitively.

-And they put you on it?!

I'm sorry to keep you waiting. As you can see we're kind of busy.

-You look really stressed.

-Tommy!

-I mean busy.

Stressed in a good way. Psyched. Not psyched.

Did they do bloods in ED?

Right. Hannah Shaw, non-specific abdo pain.

This is Mr Hemmingway. I'm nurse McKee.

I'm just going to press your stomach a little.

Sorry. It's nothing. It's basically gone...

-How long've you had this?

-Couple of days.

Three days. She passed out.

-I'm thinking appendicitis.

-Really, he's over-reacting.

Ouch!

-On a scale of one to ten, how painful was that?

-Five?

She's being British, ignore her.

Any idea what could have caused it? Any chance you could be pregnant?

Unlikely as we abstain and she's just had her...

Honestly, if it comes back, I'll go to my GP.

Please, can we just go home? Trust me, I know my body.

-Yeah. Is now a good time to discuss abstinence?

-Nurse McKee.

Transfer to Keller. Appendicitis.

-OK... Call me crazy but should we not wait for the bloods first?

-Why?

Abdo options? Investigate gynae. Pregnancy test?

-Just because she's not sleeping with him...

-Fine.

You can investigate non-specific abdo-pains when you

-take her up to Keller. HR called. You've got your thumbs up.

-Oh, hooray!

Greg's on his way.

OK, I'm off. Listen, warn him about madam.

I can see the cogs working.

-Inspector McKee versus... a real inspector.

-Oh, I'm going to miss you(!)

-If this is sayonara would you ask Malick about my portfolio?

-Yeah.

And will you keep and eye on Kite for me and let me know how it goes?

She's left it to the last minute, as usual.

-Just tick if off on the intranet.

-You know I charge a tenner per tick?

And we wonder why we're performing averagely in training.

-I was only joking, Mr Hanssen. It's only a fiver.

-One way to generate income, I suppose.

Nurse McKee, welcome to the ward.

What delights have you brought with you?

Non-specific abdominal pain. How interesting.

-That's a funny one though.

-How so?

She's down playing the pain, wants to go home, usual stuff.

-Mr Malick?

-Waiting on bloods. Abdomen is tender, possible causes

are caecal tumour, diverticulitis, chrons as well as pelvic disease.

-Throw everything at it.

-First rule, rule out nothing.

Is that what they taught at St Ignatius?

They kicked your Cambridge butt on University Challenge!

-Hannah Shaw. May I?

-Are you Henrik Hanssen?

-Ouch! Sorry.

-Yes. Appendicitis.

Let's book a slot as soon as we can, please.

-Does this mean heart damage?

-Could be.

-Oh right. What could have caused that d'you think?

Who knows. Could be nothing.

Could be an anomaly, a quirk of the machine.

Any chance of a heads up though? I've got to brief my boss.

Look, I don't want to sound like an arse but you know I can't tell you.

-Patient confidentiality.

-I understand. Sorry.

MONITOR BEEPS BP's gone down.

-And has the delay made that worse?

-Delay.

-Getting to see the consultant?

-Right, I am very experienced in this but...

-But?

-But I'm not a consultant.

Wow. So he still hasn't been seen by a senior person? Is that normal?

Depends on your definition of... It's part of a diagnostic process.

So that's a no to the consultant.

-Yes, but it's not unusual at this stage.

-I'm not saying it is.

I'm just trying to get all the facts about his care.

In case there needs to be an investigation.

-It's really quiet in here.

-Mmm. Peaks and troughs. New Year.

-It's a madhouse downstairs.

-Hmm.

-No. In a good way.

You'll really like it here.

Not so frantic. You really get to chat to the patients and make friends.

And you get to know all about their lives, shoulder to cry on.

Well at least there aren't any senior registrars to annoy me.

-Exactly. Mr Malick's a real softie. Once you get to know him.

-PHONE RINGS

AAU. Erm... Keller.

Greg, it's Eddi.

Sorry... Err... I need to speak to someone about being operated on?

She said what?!

-Absolutely. We're just fixing your slot now.

-OK, fine.

-Sorry, I don't think it's my appendix.

-Right.

Have you got my notes yet?

Don't think so, we're still waiting for the GP to send them over.

I need to talk to someone senior before anyone sees them.

Someone who deals with patient confidentiality?

I'm sorry to sound so mysterious. It's just...

Don't apologise. We get all sorts. Nurse McKee...

-Obviously she's playing a game.

-I don't know, just thought I'd flag it up.

I know police, OK? I used to live with one. They don't like to get the blame.

Are we certain that blame needs to be apportioned?

-Well they fried a 16-year-old.

-It's not illegal.

-Doesn't make it right though?

-It's not really our call, is it?

He's not even on your ward.

Look, I'm just trying to finish what I started.

You seem to have a slightly negative view of our friends in the emergency services.

-Like I say, I used to live with one.

-That interesting insight aside,

I suggest we follow the disclosure of information protocol.

Have they accused Mr McMahon of a serious crime?

-No, they're holding back.

-And he's not a current threat?

Then at this point, we are not obliged to tell them anything.

We don't want to prejudice their internal investigation

-and if you sense they're trying to do that...

-Not sense, she basically asked me.

Therefore we should proceed with caution until the situation becomes clear.

-Mr Douglas, will you cascade this strategy?

-Yep.

-What did you see on the ECG?

-Delta wave was abnormal.

Ask Ms Shah to take a look at it.

-She wrote a piece for the BMJ on the delta wave.

-I know that.

Can't you go back down and monitor him? He's on his own.

No can do. I have another patient waiting. SHE SIGHS

-There's a patient here who needs to talk to her.

-Yes, OK. I'll tell Eddi when I see her.

But I guess she's not that eager to be hanging out on AAU recently.

-Her and Luc are like...

-Fire signs. I'll try the ladies.

-Dr Petrenko. How's your portfolio coming along?

-Very well, thank you.

It seems to have been left rather to the last minute. Not ideal.

-Henrik, we're on for lunch. See you at one.

-Lunch?

I told your PA that you'd insisted. I don't want to be underhand but...

-Then don't be.

-We need to sit down face to face

and talk about any plans in an open and transparent way.

Believe me when I say at the moment, everything is under review.

-Are you surprised when we said we find it hard to trust you?

-Who's 'we' Mr Griffin? Who is this 'we'?

-I've taken the liberty of inviting a one or two of other clinical leads to join us for lunch.

-How delightful.

Even you can't stonewall all of us.

Hannah Shaw. White Blood count's normal.

Bit unusual for appendicitis, huh?

I would expect them to be raised, yes.

Immuno compromised. So my money's on with child.

Obviously a possibility.

I'll hold her down, you do it.

I'm sorry, if she's refusing I can't force her.

Please. She doesn't mean it, she just, she says things!

Sorry, that took longer than I thought. How did we get on?

Frances has reservations with the machine.

No she doesn't, she just says she does. Look. She likes you.

Give her bit of jackeen charm.

Ten minutes, I promise, we'll be out of your way!

OK. Give me a sec and I'll be right with you.

Taser kid. What d'ya reckon? I'm thinking WPW.

Yeah. Probably. Ask Sahira. She's the delta wave obsessive.

Ah! She's in theatre. I'm consulting the consultant.

And I'm do not disturb. It's research day.

C'mon. I gotta help out this little ol' lady.

I ring-fence seven hours and now everyone wants a piece of me.

So hope it's gynae. He's gonna love that.

-Big mistake to underestimate him.

-What's he doing on the ward anyway?

Shouldn't he be kissing babies or making speeches or whatever?

-You'd think so.

-Run down of the situation please. Go.

We're waiting on the enterogram,

-and ultrasound but the pain is increasing.

-It's not increasing.

I am surmising that you are medical students. First years.

-Yes! How did you know?

-Your top.

In which case I will forgive your glaring error not to start with the patient history.

Course, sure, um...

Come on, St Vincents, you've buzzed so you must answer.

-No history of these symptoms, have you, baby?

-Not really. Sorry.

-What about family history?

-Unknown because she was adopted.

It's not a secret. Nothing is with Tommy.

You think that's relevant? Psychosomatic?

-Because of the abandonment?

-No.

-Tommy!

-Sorry.

-Why do you think it's not your appendix?

Because. I do. Sorry.

-Is the sister around? I'd rather talk to a woman.

-Alright.

Is it gynaecological?

-Nurse McKee?

-Vanished in a puff of smoke!

Ring her on her mobile, please,

and ask her to return immediately to talk to Hannah Shaw?

-Already done it. Shall I cancel the appendectomy slot?

-No,

it's definitely her appendix, in fact bring the slot forward, please.

Francis, can I sit down?

Yeah.

Is it this machine or all machines?

Just this one. I don't like hearing my own heart.

So basically Hanssen agreed with me.

Only tell them what's completely necessary.

That sounds like an extremely wise and brilliant strategy.

Thanks for eschewing the wonders of modern technology to tell me in person.

-Any joy with any family?

-I believe they're working on it.

-Hey. Have you guys found Kite any representation yet?

-Nope.

-Are you planning on it?

-Sorry, you want me to keep you up to speed? I thought we weren't doing that.

-I'm just looking out for my patient.

-We're not the bad guys here.

-I didn't say that.

-Knife, public place, off his face.

-Easiest option.

There WERE no other options. It was a split second decision. Like the kind you make all the time.

-Yeah, but ours are generally about getting them out of hospital.

-What's your beef?

-I'm just playing devil's advocate.

-Why?

-Because no one else is. That's all.

-You're needed on Keller.

Chantelle wants you to speak to a girl, there's a boyfriend problem.

-What?

-It's urgent.

-Urgent as in urgent or urgent as in Chantelle's saying it's urgent?

-It is Hanssen's case, apparently.

-Couldn't keep away?

-OK. will you let me know when the tox comes back?

MONITOR BEEPS

-Is it broken?

-It's not even attached to him! It's fine.

I told someone to get this chucked out! Can you please just let us do our job?!

-No, you know what? I've had it.

-There really is nothing to worry about.

We need a senior person here to deal with this. I'm not happy!

Rhythm's normal. We're just giving him time to recover, OK?

Let's err on the side of caution and Page Mr Douglas or Ms Shah? See where they've got to?

I'll give you bit of advice. Page both of them. Really big up the crisis.

It's the only way you can get people to do any work round here!

HEART MONITOR BEEPS We can turn it down. Or up.

But if you listen long enough, it's like the background.

Your heart is not gonna stop because you're listening.

Thank you. I know that.

I know everyone's trying to help.

She's not paranoid. She just gets nervous.

Not like some of them going round thinking they're the Virgin Mary.

Careful, the wind'll change.

-HIS HEART RATE INCREASES

-Oh, for heaven's sake!

-Technical hitch there, ladies.

-Less charm, more signing our piece of paper.

-Taser kid's deteriorated.

-OK, can you take over here, please?

No, don't go running off again. Not when we're getting somewhere.

-I have to, there's an emergency.

-This is an emergency.

If it was, I wouldn't leave!

This our punishment, is it? For being late? Get the runaround.

-Not at all.

-Oh don't mind us.

We're used to being treated like dirt, aren't we Franny?

Let him go, Mum!

Oliver's here is the best F2 in this hospital, he'll do you a great job.

-F2. Is that like some sort of trainee?

-Sort of.

Mum, leave it!

So you're not even properly qualified? Typical!

-Where you headed?

-AAU.

-Ah. Me too.

-Greg!

Oh, for God's sake. Get over yourself.

Shoddy facilities, lack of a consultant, trainee staff.

Not to mention your obstructiveness

and the obvious antagonism between you and the doctor.

-Trained in observation.

-There is nothing shoddy about my ward.

FIRE ALARM RINGS

No, I didn't arrange this either. ALARM BLARES

Don't be daft!

-Eddi said it was urgent.

-Eddi always does!

Don't panic, Mr Mannering!

Everyone calm down! The back-up generator will kick in.

-There we go.

-OK, Cagney or Lacey. What's the plan?

-I'm thinking.

-Who do we throw out of the balloon?

-I'm running this OK?

-OK.

Can I have my key team, please, evacuation procedure.

We're going to decamp to the south wing then assess every patient when we get there.

-Is it not risky to move him?

-Would you rather let the batteries run flat?

-Are you sure this is entirely wise?

-Better idea?

-Maintenance.

You have heard of them then?!

I actually want this sorted before Easter.

All right, team. Half a league onward!

It's quicker down through the morgue. C'mon, they'd eat me first.

Don't.

OK. Thank you. Message from maintenance.

There's been an explosion on AAU.

The whole of AAU has been plunged into darkness.

Or something like that. But don't worry, Eddi's there.

Right, I'll go down there. What's the fax?

GP notes for Hannah Shaw.

She did say she wanted them kept confidential.

I was going to wait for nurse McKee.

GROANING

-She's getting worse.

-Evidently.

Hannah, I have your notes.

Would you let me look at them, please?

Yes! OK, yes. Sorry, I'm so sorry.

All right, fluids and page anaesthetics. It's peritonitis.

-What?!

-Burst appendix.

-Yes, I know what it is, mate.

Right. Clear theatre. And tell Nurse McKee she's missed her opportunity to speak to her patient.

-Brilliant idea, this.

-Stop talking.

-Follow the light, Eddi. Give in to it.

-No, I can hear something.

-What?

Can I have a bit of quiet please! Quiet!

MONITOR ALARM BEEPS

If that's the broken one, someone is going to get sacked!

HIS BREATHING LABOURS

-OK, this time rhythm is disrupted.

-Bag, please. Can you chase cardiac?

You massage, I'll bag.

DOOR BANGS How is this my fault?

-I don't know. But every time I'm with you things get chaotic!

-PHONE RINGS

Hello, sorry. We're on our way.

-Greg's got us trapped. One second.

-SWITCHES ON SPEAKER PHONE

-OK.

-The patient's in VF Sahira. We're in the corridor.

-Have you got a crash bag?

-Yeah, we've got a crash bag.

Greg did you see anything on the ECG we should know about?

-You sure he's in VF?

-Can you hear that?

We've got a de fib. Should we go for it?

-Greg, anything on the ECG?

-Jac's got it. I don't think so.

Should we do this? You happy?

-Shock then. 50mg IV lignocaine.

-Is he going to die?

Nope. Charge to 200. Stand back. Stand back! Clear.

-Sinus.

-Sure?

-Sinus.

-OK.

MONITOR ALARMS AGAIN

-Sahira, no air to the left side, I'm presuming.

-Pneumothorax.

-Yep.

-Needle.

-Needle...

Give me your hand.

1... 2... 3...

We agree this is the second space? Yeah?

Yeah. Do it.

HE GASPS FOR AIR

MONITOR STOPS He's very faint.

-Check his neck? Is it bulging.

-Yes. Tamponade?

-Yeah, could be.

-OK, theatre.

-No lift. Stairs.

Thoractomy for Miss Shah. We've ruled out stroke and diabetes

but a cardiac event meant we had to resuscitate.

-How did this happen?

-The cardiac massage resulted in a pneumothorax.

And did that happen because you moved him?

-There were no good options. We HAD to move wards.

-Split second decision, was it?

-Yeah, that's the one.

-Let's see how that plays out for you.

That a threat?

Nice of you to finally get here. What were you up to down there?

Oh, get lost, Eddi!

Hey, come on, she was kidding. C'mon, no one's thinking anything.

There is NOTHING to think, OK? Nothing! Will you just shut up!

Sorry, power cut. We're re- triaging in the South wing.

-It's tiny ward, not ideal, are you happy with that?

-Excellent plan B.

Pity you couldn't be in two places at once though.

-I'm know, I got sucked in.

-Yes.

I did query it when HR said you wanted to escape the hurly burley.

Nurse Lane did contact you, didn't she?

Yes. I thought...it doesn't matter.

-What did I miss?

-The obvious. The question is why?

-What's the diagnostic golden rule?

-Look at the history.

No. Occam's Razor. The simplest answer is usually correct.

OK. Stable WBCs. Unusual, ergo, look at other options.

-No, think laterally. She's immuno-compromised? Not pregnant.

-No...transplant?

-Look, if you know, just tell us.

-But then how would you ever learn for yourself?

Ah, Mr Griffin. I'm afraid I have to cancel lunch.

-I'm showing Mr Malick an Appendectomy.

-I've done like 30 of those!

-This one has a twist!

-Well, there wasn't a problem before we came here.

-It's a minor irregularity.

-Says the trainee.

-And her BP is a little high.

-Because you're making her nervous.

-That's it. I want to go home!

Please, I am really not happy for you to leave.

It's my choice!

I don't have to stay anywhere or do anything I don't want!

Oh, here she goes.

Just sign the form, we'll leave, get this day over with!

No. Not till Mr Douglas has seen it.

-Oh, he's not coming back. Too busy chatting up nurses!

-His other case became critical.

-This is critical!

-Mum. Please.

Look, if you don't tell us the full story.

-Over it again and again! All they make you do!

-We can't accurately assess the problem...

Repeat until you're blue in the face but never listen!

ECT's the only thing that works on her!

You told me it was her first one.

She's had it before, three times and much better she was!

-This delay, it's like a living hell.

-Mrs O'Connor, I'm sorry, I'm lost.

She keeps trying to top herself.

Can we at least get some music on in here please?

MUSIC STARTS

I'm thinking this is a WPW in the heart.

-Jac's got the ECG, but can you take a look at it again before you go?

-Sure.

You really have dire taste in music.

-I'll do you a down-load, something decent.

-I like this album. It's a gift from Rafi.

-Shall I close?

-No. I'll finish. Actually I don't even need you here.

You can go to the ward, if you like.

Great bonding with you. Banter. Good times.

Can't get enough(!)

-Reckon this is why she applied for medicine.

-We all have our reasons.

You're not gonna ditch the connection with the uni are you?

That's Mr Griffin speculating.

Can you blame him? Leave a void, it gets filled.

Let's just say it's an obvious target for restructuring.

It's expensive, it's time-consuming.

And occasionally it is our commitment that's lackadaisical.

So we cut back, we focus on our strengths.

Screw the next generation.

Not a moral issue. It's just we're not attracting the high-fliers.

Not even local ones.

-That'll change when they have to live at home cos of the fees.

-MOBILE BEEPS

Look, I just don't see the point in ditching the one bit we all like.

Even you seem to enjoy it.

Look, I have said time and time again, it's all under review.

I will not be pushed into premature disclosure.

Ha! Mr Griffin's sent an all-staffer.

Apparently you're addressing a meeting at 5:15!

Mate, I need you on the ward. It's all kicking off.

Of course it is. Sorry about that, I was in theatre.

-He says she's having a heart attack.

-I didn't say that, I said...

Atrial fibrillation. It's an irregular heartbeat.

-No immediate danger but...

-Can she still have the, you know?

-Not until we fix this first.

-When, when can you do that?!

I'd need to monitor her for at least 48 hours.

But we can't wait any longer! Why can no one understand that?!

Why do I have to shout!

Frances has tried to take her own life. Hence the urgency.

-Look at me! Not the nurse! Look at me!

-OK.

-Were you operating on Mr McMahon?

-Yes.

-Have you got any news I can pass on to his family?

-We're moving him to ITU.

-What happened, was it carrying him up the stairs?

-That couldn't have helped...

-Doing CPR in the dark?

It could be the emergency intervention on AAU or...

One of the other doctor saw something on the ECG didn't he? What was that?

-I haven't had looked at the ECG yet.

-So there was another delay?

-Things have been chaotic

but we're investigating a congenital factor. WPW syndrome.

-Syndrome? So like a birth defect?

-I haven't had a look yet, but...

-Okay, you know we're not giving out that information...

-What?

-Hanssen's decision, pending internal procedures.

-Why didn't you tell me!

Because every time I try to speak, you tell me to shut up!

-Come on, I'm kinda a doctor.

-Makes no difference.

I just want to see how they missed something so obvious.

-Her WBCS were inconclusive.

-Can I see?

-No!

And I'm only saying this to you because you are kinda a doctor. 'Go away!'

Off the ward, out the hospital, where ever, yeah.

Just, give the patient a breather - first rule.

Do you know something?

She told you she's going to break up with me?

-Like I care.

-Oh, you're dead mean.

He's only trying to help.

Chantelle, I'm NOT trying to sabotage love's young dream, OK?

-What you going to say?

-No idea.

Times like these I'm glad I'm not a senior nurse!

Does Hanssen know?

Mmm. Course he does. He knows everything.

Frances!

If she's having one of her melt downs, I can't cope.

-What d'you reckon. SVT?

-If it is we're going to have to do something about it now.

I'll see if I can get her a slot in theatre and fix this today.

No, we just need to get home now, before it all gets more out of hand.

I need to get her heart rhythm back to normal.

Four hours we've been here, just for a stupid piece of paper!

This our punishment, is it? My fault, isn't it?!

-No one's saying that!

-1974. Mother cold.

Query, question mark. 1983, Mother over-bearing.

1996. Mother seems over-committed.

Who's the only who's looking out for her, eh? It's muggins here! Mother!

-I'm seventy six!

-Listen to me, OK!

If she has any more of these upsets, the heart problem could get worse.

You've got to trust me to sort this out for you.

No! It's all the same!

They always pretend to care when you start shouting. Well, I've had enough!

Keep them here, keep her occupied I'll see if I can get us a slot.

OK, we need to sort this out. Come on, we need to communicate.

-Before we make a bigger cock-up and one of us gets sacked.

-It wouldn't matter. I'm leaving.

-Since when?

-Rafi's been offered a job at St Ignatius.

And I think it'd be good for him to say yes.

-Have you told Hanssen?

-Not yet.

-I have a meeting with him at five.

-Well. Congratulations.

-Is that it?

-Fine by me. Whatever you want.

Where're you going now?!

It's going to be OK.

-Read the notes?

-Yep.

-You know she wanted to talk to you?

Yes, I've been made aware of that. I got the wrong end of the stick.

-I thought it was a girly chat not a massive case history.

-Well on my ward...

-Like you were so on top of it-?

-Oh! I knew it'd be like this at first.

-You'll bicker and then you become great friends!

-GROANING

It's OK, Hannah, it's the pethidine. You've had your appendix taken out.

Did they see I'm HIV positive?

Yeah... We've guessed that you already knew.

Birth mother transmission. Not...

not 'my fault'. Do all the staff know?

Only the ones directly involved with your care.

That's my medical career over then. When are you going to dob me in?

-I wasn't planning to.

-Don't you have to?

I don't know. I need to discuss it with Mr Hanssen.

Oh, no hurry(!) Only my future ruined!

I know it might feel like that. But medicine is amazing!

They'll probably have a cure for it by this time next year!

I'm such an idiot! I just thought...

Next time, more Googling, OK? That's the vaccine.

Cure's like 20 years away.

-Well...she'll still be under 40?

-Urgh.

-I'm just trying to be nice.

It's not about being nice, Chantelle!

If it was, it would be easy! Easier.

SVT, OK, let's get her prepped and into theatre.

It's too late. They're going home.

Oh, for the love of God!

Mrs O'Connor, please, this is ridiculous!

No, we have our dignity. I told you. It's all talk.

-Doesn't care. Not deep down.

-Fine, but this is not my fault!

I am not taking responsibility for this!

I'm sorry I wasn't at your beck and call? I'm sorry I wasn't exactly what you hoped for?

Is that what you want?!

Thank you! I feel a lot better now!

Err...excuse me?

I'm sorry, I thought you were 'do not disturb'. Come tsunami or fracas on the ward.

I'm not doing this for me.

It's for Oliver, so he doesn't make complete idiots of us all

-with his bonkers results.

-And?

-They're not that bonkers actually, but only because I checked.

-Not that I'll tell him that.

-Alpha-brackets minus

Alpha-brackets minus. Slash beta plus plus.

You can always tell a St Batholomew's alumnus.

Yes, grind them down until they do it your way. Never did me any harm.

Quite the inspirational pedagogue.

What's the point of learning it all if you can't pass it on in a really harsh way?

-May I take this?

-Plus! I'm not charging you extra for my one on one tutorial,

so basically, me sitting here is making you money.

-And the ECG on Mr McMahon?

-Oh, yes. Definitely undetected WPW.

Well, it's not broken, you big jessie.

Only cos she had the element of surprise, we're clear on that, right?

-Decked by a woman. Low as it gets.

-My fault.

Got distracted. The usual.

-A nurse.

-Kinda.

We've all been there.

Has yours nicked off to Oz with the village idiot?

Not yet, but it'll come.

Be like me. Completely professional in the face of romantic disaster.

Doesn't matter anyway. It's over.

She's leaving.

-Mutual decision? Or did you chuck her?

-Dunno.

Can you get it back?

I don't think so. It's too broken.

Do you have to tell St Vincents?

It depends on how responsibly you take your condition.

I don't take risks. This was a one-off. Please!

I don't want to be shunted off to be a GP or a psyche just yet!

General practice can be very interesting.

Sitting around all day listening to people's problems? You'd do it, would you?

How are you managing transmission issues?

Easy. Abstinence.

Well, not easy.

-You're not going to tell him are you?

-No.

But it may be that a lack of transparency could back-fire.

At least if you tell him, you'll be in charge of it.

Yes. Gives you back the initiative. Before it becomes a crisis.

Sensitively handled, well done.

She's a big softie really! Just like Mr Malick!

You seem to have found yourself a fan.

Not really. Look, I completely messed everything up today

It was me who referred it as an abdo pain - not Mr Hemmingway.

He saw it was an appendix right away.

I just thought there was more to it than that.

In which case you were both right and make an excellent team.

Perhaps you should go back down there.

More hands on is more my kind of thing.

Telephone Mr Hemmingway. See if he'll take you back.

PHONE RINGS

Miss Shah?

Has he woken up?

Tell her I'll be right over.

The tox screen's back. I'll bring it down. OK.

-Do you feel the electricity between us?

-Hilarious.

Charge 100.

Stand Clear.

-Nice one.

-Almost like I do it for a living.

Victory from the jaws and all that.

Something to fill the time.

-You're Mr Hanssen, aren't you?

-Trained in observation, I see.

I just want to give you the heads up.

I'm really sorry but I've made a formal complaint against the staff and the care here.

-Ah, a pre-emptive strike.

-The treatment has been chaotic.

The treatment, I'm sure, was beyond reproach.

Which is more than can be said for your duplicitous attempt to extract confidential patient information.

-I'm not having people's careers ruined by other people's mistakes...

-Your officer's careers or yours?

All of us.

I trained these guys, if they mess up, I do. I don't ditch them at the first sign of trouble.

Well fortunately for us, you and him, he'll make a full recovery.

Obviously he'll be subject to more tests and support to treat the congenital problem.

Birth defect. Could it have been set off by drugs or...?

Well. Let's wait for the tox screen, shall we? That's one version.

Rather more plausible in my way of thinking than you blaming my ward sister.

But the impact of the tasering is more or less negligible.

Not negligible. Impossible to prove.

Well. It's all down to the inquiry then. I'll refer it.

Always best to be transparent.

Especially when you know it'll go your way.

We got the rhythmn back to normal. When you go back to Wyvern,

they'll let you know when she can have the ECT.

Thank you. Now this fellah is a gentleman.

-You're not married, are you?

-No. Not yet.

Because my Franny is a very nice girl once you get to know her.

Sorry for all the delays. Crazy day.

Well you've not had me arrested so I suppose we're quits.

I don't know what devil came over me.

My mam'd do the same.

It's just the thought of losing her.

I just have this sick feeling. All the time.

I just think, what if I wake and she's not there?

I have to go and check, like she's a baby.

Just the thought of not seeing her. I go half mad.

You get me?

If you need to go, I'll deal with that.

-I'm not leaving you alone with her.

-Mate, don't be so chicken.

Find the girl. Say what you have to say. Go on.

Alright, lads. I'm guessing you're here for Kite McMahon, right?

Can you wait outside and I'll see what I can do.

-I'm sorry, can we help you?

-I very much doubt that.

-That's AAU property, I could have you thrown out...

-For?

Being bad tempered? Irritating? Interfering? Want me to carry on?

Actually, Mr Hanssen insisted I came down here.

He seems to think I am the right person to deal with

this temporary situation- and just AAU in general.

You seem to be assigning me to the rectal exam in bed 5,

followed by the very tempting manual extraction for the constipated 45-year-old in bed 4...

-It's good to be back.

-To be honest it feels like it never went away. And you've misspelled extraction.

Made you look.

-Freakenstein.

-C'mon, he was good in the dark.

-Cause he's scared of daylight.

-Admit it, you missed us.

-You, maybe. Him, never.

-OW!

Mr Jenkins, this time I mean it.

You do it again, and I'm going to get very angry. And you're not going to like me when I'm angry...

How did it pan out with the appendicitis?

-If you know, why are you asking me?

-Do you know that I know?

OK! I give in! This time, you were right. Well done you for just doing your job!

-Tox screen back?

-Yup.

-And...?

-SHE SIGHS

-A large quantity of MDMA was found in his system, yes.

The most obvious answers are usually the right ones.

-Did you learn that golden rule in the Ukraine?

-The rectal exam is waiting.

Wait.

Don't do it. Don't resign.

-Why not?

-Just don't.

I need you to give me a reason.

You picked up the wrong buggyboard at the nursery

and now this stupid cow who's kid is the ugliest thug you've ever seen

is basically accusing you of theft. You just made a mistake because the old one was red.

You say your favourite colour is green but you won't wear it out

and you worry scrubs make your skin tone look sickly.

You know you should bake with marge not butter

because it tastes better but you just can't justify the trans fats to yourself.

You say your favourite music is James Brown

but actually it's James Blunt, you hate cats, but love Shetland ponies.

You constantly hum theme tunes from Cbeebies and once, when I was up all

night after the night on the booze, I heard one and I thought of you.

Everything you say... I listen to it.

Please, don't go.

Can you stop that a minute.

One sec.

You might drop it.

Are you breaking up with me?

No.

Because whatever happens. That's the last thing I want.

Are we the only ones who give a damn about what's going to happen to this hospital?

I'd say so. Apart from Mr H of course?

You've seen his lovely email, haven't you?

Woohoo!

I know you're pleased to be back but it's a bit OTT, don't you think?

Have you seen this?

Hanssen? 'Moving forward Q3 2012 targets...do I have to?

-Just look at it.

-Autumn.

Ambitions include the achieving of an excellence

-rating in teaching which will be supported by an investment into...

-AAU!

-Are you sure this isn't a hoax?

-Yeah. It's from the man himself.

-Maybe there's a catch?

-Don't think so.

We're in line to get more funds, which means better equipment,

-no more power cuts.

-Shame, I prefer to work in the dark.

-Do you have dog's hearing or something?

-No, I just look for signs.

Double the intake, entice foreign fees,

strengthen the affiliation to the University.

Focus on the Socratic method of teaching.

Socratic as in dialog, question and answer?

It's very interesting coming from someone who's actively

avoided any kind of discussion all day.

It is a valuable teaching instrument in medicine, but not one

I would advocate in running a large institution, or indeed a ward,

which requires strong, decisive, leadership. Wouldn't you agree?

And why this goal? It's not the easiest to achieve.

Revenue streams. League tables. The usual managerial clap trap.

And of course the chance to mould young minds in your own image.

-Catch your nurse?

-Yep.

And you showed her who's boss and now she's crawling back.

-You know, like I would.

-Maybe. Hard to tell.

It is me or is it not so cold?

What's cold is beers. Let's go.

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