What You Wish For Holby City

Please...don't go.

-Why are you taking such an interest?

-Sahira's my friend, I respect her.

I don't want a different life. I want what I have. My family, my friends, my career.

You can still have those things. It's not the '50s, Dan.

-So how did the charity sale go?

-Er...

Did you think I wouldn't notice the boxes in the staff room?

Erm, I-I'll get rid of them.

I'm not sure what you expect me to do, Mr Douglas.

I expect you to do whatever it takes.

You are shafting me for the new girl!

This appointment will be made on how well you match these magic bullets.

-So if I apply for clinical lead?

-May the best man win.

-Just check if the boys are OK?

-They're fine. We saw them 20 minutes ago.

-BLEEPER

-Yeah, you're right.

Ah, CTU.

I'll have to join you later.

Now, you play nice with the other kids, OK?

Sternal wire removal, leg re-suturing after bypass...

No problem.

-..debridement of sternum, vacuum dressing.

-My favourites.

-OK, what's wrong?

-Nothing. Why?

You seem... What is that word? I always forget it. Happy!

-Do I?

-Is there something you want to talk about?

-No.

Hello, psych? I have a registrar on Darwin showing symptoms of acute happiness.

-Can you send someone down?

-I'm in a good mood.

Well, pack it in, will you? It's no fun torturing you with tedious work

if you actually like it.

Morning. I'm Dr Raza, the new anaesthetist.

-You happy about that?

-Absolutely.

-Good man. Nothing wrong with being happy, is there?

BEAT MUSIC PLAYS

I'm just...testing it out.

-What are you doing?

-Not so loud. What time is it?

-Time you got up.

-OK. Just...keep it down, though, yeah?

-Explain.

Night out with the boys... Got a bit out of hand.

-You should tag along sometime.

-I don't think so.

By the time it was winding down there was no point in me going home.

-So you thought you'd crash behind Mr Griffin's desk?

-Mm.

-Don't worry. He's not in today.

-You're lucky it's me that found you.

Who died and made you king?

With Mr Griffin away, it's my responsibility to make sure the ward runs smoothly.

A bone-cracker in charge of a GS ward? Please(!)

Right now, I'd say I was the more responsible one, wouldn't you?

Looks are deceiving, my friend. Once this bag is empty, I'm ready to rock and roll.

Once that bag's empty...

..I'll have finished my rounds.

-Kate, have you seen Miss Shah yet?

-No, sorry.

How's it going?

Fine. No problems.

-So, James, is it?

-Only if you're my mum.

OK, Jim, then?

Atrial septal defect, ostium secundum. Simple patch-and-go.

-He's had his bloods, echo, MRI and a chest X-ray...

-But no cake.

I WAS promised cake.

No respiratory problems, allergies

or history of reactivity to anaesthesia.

-He understands the procedure...

-You'll rip open my chest and stick a plug in my heart.

My work here is done. Your parents here?

-Not yet.

-It's fine. I'm sure they'll get here.

-You're not scheduled for another couple of hours so...

-I thought I was going in now.

-I'd like to go in as soon as.

-I'm sure you would but...

the schedule is, er, pretty fixed, I'm afraid.

But don't worry, we'll get you sorted out. I'll see you as soon as...

-I don't understand why you flaunt it.

-Never had any complaints before.

-It hardly instils confidence.

-Do you know how many of our patients have tattoos these days?

All I'm saying is, you don't see your average consultant with one.

I'm not your average anything.

Hey! Madame Petrenko! What brings you up here?

First day as an F2 assigned to Keller.

-Who is my clinical supervisor?

-You can come along with me.

Oh? Why you?

Well, no offence, but it's going to be a consultant, right?

Frieda? Shall we?

Hey.

Hey.

So, you came back.

Yeah.

Well, it's great to see you.

Thanks.

How come you changed your mind?

You know. Change of circumstances.

-I put you in a few theatre slots.

-I saw.

I thought we'd agreed to keep our distance.

-We're not allowed to work with each other, is that it?

-No, it's just...

What?

Hey.

-Have you two met?

-Yeah, but not formally.

-Yeah... Greg Douglas.

-Rafi.

Good to meet you.

You two...

I just wanted to say welcome back. I'd better...

-Good to see you.

-See you later.

So, good to see me in scrubs again?

As you can see, like AAU, a huge amount of ortho work is diagnostic.

Many of our patients are in great pain so we need them to trust us as quickly as possible.

And you do that by being completely professional and...

as unthreatening as possible.

Have you, um...

..thought about reconsidering your make-up choices?

No.

Fine. Maybe just consider...toning it down a little?

It's not going to happen.

It just sets a more professional tone, that's all.

Mystery solved. Email just came through.

-Hanssen has assigned me as your supervisor.

-Great!

That's an odd decision.

Mm. A lowly registrar trumps a consultant. The skies will fall.

Erm, probably for the best. Malick and I have worked together before on AAU.

All the more reason to get a fresh perspective,

one that offers more practical professionalism rather than over-the-top grandstanding.

Flair, style, charisma. Alien concept to you, right?

-Just saying, your approach isn't everyone's...

-Your approach isn't anyone's.

-Er, listen, if Hanssen says..

-Never mind Hanssen.

Come on, Frieda. You've been on AAU with Malick before.

Let me show you where the real fun's to be had, hmm?

Hmm.

-Right, what have we got?

-It's a pretty quiet morning, actually.

-You take some blood and I'll take some blood!

-Apart from her, obviously.

Possible concussion. She fainted whist auditioning for some TV talent show.

What have you been up to?

When?

I saw you this morning in the corridor acting shifty.

-How was the interview?

-A formality.

MOBILE RINGS

-Could you turn that off, please?

-Might be them ringing to see where I am.

-Off.

-Thank you.

-You're seriously doing my head in.

Let's start her on a slow IV and keep her under obs.

-So, how was the interview?

-Er, fine, thanks.

-I guess we'll know when we know, right?

-I-I guess.

You didn't even have the nerve to say it to my face.

Human Resources error, I'm afraid. My apologies. I hope you're not too disappointed.

-What? That I didn't get a job I clearly deserve?

-Miss Broadhurst is the right person for the post.

She's more than qualified, efficient, personable, competent...

-It sounds like I'm NOT.

-Believe it or not - thank you -

Miss Broadhurst's appointment is for the good of the department.

-All right, so where does this leave me?

-I'd like you to stay on AAU, please.

Miss Broadhurst has some interesting ideas about overhauling our systems and I'd like to see them implemented.

-I didn't come back to be sidelined.

-I think your inside knowledge may prove an asset, don't you?

Meanwhile, perhaps you should have a word with HR. Their tardiness has caused some embarrassment.

-You've got to be kidding me.

-Nope.

-Her husband?

-Yup.

-On Darwin?

-In the flesh.

Oh, this is too good.

I'm going to have to sell tickets to this car crash.

-Are you still happy?

-Delirious.

Ooh, here they come.

-You're not in theatre?

-No. My patient had the bad manners to die of natural causes two days ago

-and the family only just rang.

-There's a slot free?

-Unless you know a way of raising the dead.

Have you met Rafi?

-Ah! Heard almost nothing about you.

-Ah, so you're Ms Naylor.

-My reputation precedes me.

-It's on your name tag.

-You still want to go early?

-Yeah.

Is that OK? I thought the schedule was fixed?

A slot's just opened up. You want to be in theatre and right now, so do I. You up for it?

Let's just get going, please.

Sign here.

We'll go in a few minutes, OK?

You're taking Jim Wilson into theatre now?

-Don't want him getting too agitated with all this hanging around. You coming?

-Lead the way, sir.

What?!

Nothing.

-You'd reworked the schedule.

-Just keeping my distance, like you asked.

So you're not...angry with me?

-Why would I be?

-Because I should've told you and I didn't.

It's fine.

You know, Hanssen offered him the job.

It had nothing to do with me.

-Hanssen?

-Who else?

Better get in there.

Wait for the muscle spasm to relax,

rotate the arm out till it reaches 35 degrees.

-All in one! Simple, right?

-Got it.

So now we take it out and I put it back in again.

Kidding.

OK.

So much for the demonstrations. Let's move on to the more hands-on stuff. Broad-arm sling, please.

Morning, Mr Davis. So when did the swelling start?

-I don't know. Few days ago, I guess.

-You really walked in on that?

Ambulances are for sick people.

I've got a sore knee.

So, Dr Petrenko, thoughts?

-What are you doing?

-I need to feel to see.

She's a doctor?

OK, ready when you are.

Great, thanks, Rafi. Scalpel.

So, how were your two weeks in Jamaica?

Sahira's the sun-worshipper. Me, I'm all about the winter sports.

Chalk and cheese, then?

Or "opposites attract".

Yeah.

-Great timing.

-What's that?

I heard you were about to pack up off to Nottingham.

Then a job opens up here.

Stroke of luck.

Yeah, it was.

Great.

So some kind of infection, possibly in the knee, possibly not.

Good. So?

So we start IV antibiotic and aspirate the knee in a...

Moving a little fast there. Let's not jump into treatment till we know what we're dealing with.

-But if we wait the infection could cause further damage.

-And if we treat without diagnosis,

-WE could cause damage.

-I still think we should...

-Are you a student?

No. I'm an F2.

Foundation Year 2.

-Then he's your boss, right?

-Not so much a boss, Mr Davies. More a benevolent god.

Either way, he outranks you, love. So what he says goes, right?

It's your knee...love(!)

Fine. We'll take some blood, do an MRI so we know what we're dealing with.

Don't worry, we'll have you back on your feet in no time.

Yeah, well, that'd be great. I've got a fitness test coming up for the Paras.

I've been out for a little while.

-We'll come back to you when we know more.

-Thanks, doc.

I appreciate it.

Perfect example. A more...professional approach would've put him at ease.

What do you mean? I was professional. I AM professional.

I mean your look might've been a bit off-putting, that's all, to him.

Look, I need to be in theatre. You'll run those tests?

Yeah, do you think they'll let me in to the lab...like this?

-Congratulations.

-Thank you.

-I hope there are no hard feelings.

-You wanted to see me.

-Take a seat.

-So how's it going?

-Slowly but surely. I can't believe how antiquated this rota system is.

And yet, strangely, somehow it works.

They might as well use carrier pigeons

Well, you'll be happy to know that we're on top of throughput.

Six discharges in the last half hour.

That's why I wanted to see you.

I've been talking to Mr Hanssen

and I think it would be a good idea to appoint a second lead.

Double that throughput by means of a cascade, if you will.

Really? Like a second-in-command?

-Yeah.

-Job's not getting too tough for you already, is it?

New department, new structure.

The patient throughput is only going to increase exponentially, we need to re-group accordingly.

Couldn't agree more.

-That's great, because...

-Good luck with that.

What do you mean?

You'll need to find someone who's happy to play second fiddle.

-Not many consultants fit that profile.

-That's not what it is...

-Look...

I did a DOS job-share before you even heard of this hospital.

Sometimes it does not take two to tango.

I'll take that as a no, shall I?

4-0 Prolene with pledget.

So...

have you been away from work for long?

About a year and a half.

Doing the whole house husband thing?

Yep.

Good for you.

You didn't feel a bit...

Emasculated?

No.

I loved it.

Great.

You met Jac, then?

She seems like a pussycat. I don't know what Sahira's going on about.

Dread to think what she's said about me.

I can't say she's ever mentioned you, actually.

Right. Patch is in place.

-Excuse me?

-Yes.

We're looking for our son, Jim.

James Wilson.

He's having surgery today.

James Wilson.

Oh, yes. He's in theatre, right now actually.

-Now?

-He's not due in for another hour.

-Well, he is in there.

-Who agreed to that?

Why weren't we informed?

OK, the heart is closed.

Thank you, Mr Douglas.

Who consented for this procedure?

The patient. Why?

His parents have just arrived. How old is he?

-16.

-And you assessed he was competent to sign his own consent?

Yes. I did.

Problem?

No. No, your patient, your call.

You won't mind explaining that to his parents, though?

Let me get my hands out of their son's chest

and I'll pop right out for a chat. OK?

-I'm just going to get my lunch.

-I'm free, I'll go with you.

-We can go to the all-you-can-eat place.

-Ah, no.

I've already got mine.

Chrissie made it for me.

What have you got?

Er...Tuna Nicoise.

It's all right. I'll just grab something and sit with you.

That'd be nice.

But actually, I wouldn't mind a bit of "me" time. Maybe another day.

HE COUGHS

Are you OK?

-Fine, thanks.

-You don't look OK.

-You don't need to worry about me, love.

-It's my job...love.

All-time record temperature.

You keep that up, I will have to treat that knee.

I don't feel so bad, honestly.

Seriously?

Seriously - no.

I'll wait for your boss to get back, thanks, Elvira.

My name, hello, is Dr Petrenko.

And I'm Sergeant Howard Davies and I'm telling you to back off, OK?

Beating.

OK. Coming off the bypass.

Nice flying with you, Dr Raza.

Likewise.

Administering protamine.

MONITORS BLEEP

-He's bradycardic. Is he connected to the ventilator?

-Of course.

Let's start hand-bagging him.

-His pressure's very high. I'm on 100% FI02.

-Pulmonary oedema?

-I don't know.

-Get him back on bypass - now.

-Thank you. Ah, Ms Shah, welcome back.

-Thank you.

-Dr Raza settling in well?

-Yes. He's fine.

He's in Darwin 1 with Mr Douglas as we speak.

Is he? Well, I'm sure they'll get along famously.

Absolutely.

Very well.

-You're sure you didn't disconnect him from the ventilator?

-Did you hear an alarm?

-No.

Then he was ventilated. Look - pulmonary oedema.

Did you give him something?

-I gave him lots of things!

-Blood?

-He didn't need it.

-An allergic reaction.

-Possibly the protamine, but he doesn't have any allergies.

Well, clearly he does, because he's just gone into anaphylactic shock.

OK, look, let me bring him off bypass slowly,

this time without the protamine, and get him up to ITU.

Fine.

I'll go and speak to his parents.

Mr Hamilton is in theatre. I can't get hold of him, he's ignoring me.

The labs are backed up, it'll be an hour at least,

and the soldier is getting worse.

What makes you think it's septic arthritis?

Look at him. His temperature is through roof, he's tachycardic.

No-one reacts like that to just a sore knee.

OK. Well, if you were on the AAU and he was your patient,

what would you do?

I wouldn't hesitate. I'd make the call.

Then make the call.

Bed seven - happy, hourly obs. Bed six has been moved to Keller.

Bed five is waiting on meds

and bed three is free to go when his prescription arrives.

New arrival from the ED in five minutes,

I suggest we put him in bed two.

"Thank you, Nurse McKee." Oh, you're very welcome, Mr Spence.

Hourly obs on seven, let's check the meds on five and when three comes in, I'll do the work.

-Is there an echo here?

-Thanks.

-Looks like you've got everything under control.

-Yep. AAU. Michael Spence.

-I'm still here, you know?

Yes, bed four, we haven't forgotten about you. Just wait a little longer

-and I promise you'll be out of here.

-I'd better be.

You want to take credit for the work, why don't you try doing some?

-Mr and Mrs Wilson?

-Yes?

-This is Mr Douglas. He...

-I operated on Jim.

-Is something wrong?

The operation to repair the hole in his heart went absolutely fine,

but as we took him off heart bypass,

he had some kind of reaction - his lungs filled with fluid.

-What caused it?

-We can't say for sure yet.

It could be any number of things -

blood pressure or an allergy. We're not sure.

He's not allergic to any drugs. Not that I'm aware of.

-He's allergic to seafood.

-That wouldn't be it, would it?

It might give us something to go on. He's being moved to ITU now.

-Is he going to be OK?

-He'll be fine.

We'll let you know as soon as you can see him.

Excuse me.

Greg.

What's happening?

I am going to drain some liquid from your knee to confirm infection.

-Where's Mr Hamilton?

-Mr Hamilton is in the theatre.

-It's OK. Mr Malick signed it off.

-I'm not happy about this.

Do you want some help with pain?

Is that necessary?

-A big tough guy like you?

-I don't like them, OK?

I want to wait for Mr Hamilton.

If I don't do this now and I mean right now, you might lose your leg.

Do you understand?

# I'm on the edge of glory

# And I'm hanging on a moment of truth

# Out on the edge of glory... #

OK, no concussion. Your BP's back to normal so you are free to go.

Yes! Finally!

Go. Be a star.

One hour to go.

I can still make it. No thanks to you.

Hey. I admire your ambition, I really do.

But you know it's never really about talent, right?

The winners of these shows, they have one hit then disappear?

So what? They get noticed, don't they?

Everyone knows who they are. People scream at them in the streets.

I've just got to prove I'm better than anyone else.

Nurse, she's good to go.

-James!

-He's still very groggy. He won't be able to talk for a while.

So, what happens next?

We need to watch him closely now to see how he responds to the drugs.

We'll see if the bleeding clots within the next hour.

-Do you know what caused this?

-We're trying to find out.

Mr Douglas? Dr Raza? My office. Now.

There you go. You're doing good.

So, soldier boy, have you seen a lot of action?

My fair share. Kosovo, Iraq, Afghanistan.

-Do you like that kind of life?

-Yeah, course. Why wouldn't I?

-Go on, then. Ask me.

-Ask you what?

-If I've killed anybody. That's what people always want to know.

-I don't.

I work in medicine. We kill people all the time.

There you go. That wasn't so bad.

And now, we will see...

-What is it?

-Nothing. I just need to do it again.

Ow!

What's happening?

-It won't be a second.

-Ow!

-This is all yours.

-Hey, right on time.

Always. Like a well-oiled Swiss watch.

So, how's it going with Lady Petrenko?

You think she's converted to the exciting ways of the orthopod?

She's seeing the benefits of an ordered, straightforward approach

-to dealing with patients, if that's what you mean.

-You say potato.

My patients, my mentee.

Look, whatever. All I'm trying to say is,

Petrenko's a lone wolf. She works well on her own.

You need to let her express herself a bit. Give her some learning room.

I think I know what's best for the students in my care.

But thanks for all the advice.

Any time.

The procedure was fine. He was ventilated and off bypass.

I administered protamine to reverse the heparin.

-That's when all hell broke loose.

-He went into pulmonary oedema.

Due to an allergic reaction?

-James told me he had no allergies.

-So?

His parents say he's allergic to seafood.

Protamine is a fish derivative. It caused the anaphylactic shock.

-I'm aware what protamine does. Are you?

-I asked him specifically - do you have allergies?

-And he said no.

-Then, either he lied to you or he's an idiot.

-He's not an idiot.

-Then someone's lying.

What's his condition now?

-He's stable...

-No protamine, no reversal of the heparin.

-So, he could bleed out?

-Yeah.

SHE SIGHS

I'm going into theatre. When I come out, I want someone to blame.

I want that kid turning cartwheels. Are we clear?

-Rafi?

-Not now.

I asked you to stop. Now, stop. I'm warning you.

It's OK. I'm going to take the needle out

-and try it again.

-I said stop!

What's going on in here?

-I'm just trying to finish this procedure.

-Get out!

-Get this circus freak away from me.

-Hold on just one second.

-Look what she's done to me!

-Mr Davies, please calm down.

What's happening?

His condition worsened, so I decided to aspirate the knee.

I just don't seem to find the right spot.

-Don't know what you're doing, more like. Bloody amateur!

-All right.

That's enough.

So, I put the needle in, but nothing came out,

-so I tried again and...

-I see.

Well, you've started the procedure, obviously, I'll have to finish it.

Dr Petrenko, please carry on with your other duties.

-But Dan...

-Now, Frieda.

-If you let that pasty-faced bitch near me one more time, I'll...

-All right, that's it.

Now, lie back and let me complete the procedure.

Maybe we can get to the bottom of what's actually happening here.

-Hey, how was your tuna Nicoise?

-Hmmm?

-Your lunch?

-Oh, yeah, great.

-Fishy, you know.

-What's in your hand?

-Nothing.

The other hand.

Show me.

What is that for?

So, it was the allergy that caused the complications?

-Most likely, yeah.

-Aren't you supposed to know about things like that?

-James told me he didn't have any allergies.

-Why would he do that?

Perhaps he forgot.

-I really don't know.

-I still don't understand what he was doing in surgery in the first place.

Weren't we supposed to sign a consent form or something?

Well, Mr Douglas decided that James was competent enough to sign his own consent.

-Without asking us.

-Yes.

-Well, I want to talk to Mr Douglas.

-Dad, don't.

-Darling, don't try to speak.

It's OK, son. Don't worry. You're going to be fine.

There's a lot of blood coming from the chest drain.

The hydrocortisone isn't working. I asked him about allergies.

No, I know. I know.

-Look, it's nothing, really.

-Then show me nothing.

SHE LAUGHS

Oh, Sacha, you've had to move underground.

Are you keeping that?

I've had some very formative moments in that chair,

during the dark, lonely divorce days.

-I just can't get rid of it.

-It's not just a chair, though, is it?

There are boxes and boxes of stuff, Sacha.

-The house isn't that big, you know, and...

-Chrissie needs space for all of her shoes.

Look, just say, "Chrissie, darling, this is my stuff and I'm keeping it.

"It goes, I go."

Then I'd go.

I thought marriage was supposed to be about honesty and openness.

All right, Oprah! It is.

I figure I'll just reintroduce things one at a time

-and hope she doesn't notice.

-Good luck with that.

-Thank you.

Just don't tell anyone. Pl...

I specifically told you to wait for his test results before treatment!

-Was there pus in the knee?

-That's not the point.

There was, right? So, he had septic arthritis,

like I told you.

-I take it that was your first aspiration.

-Second.

The reason nothing came out was that you missed the soft tissue

and scraped the underside of his knee cap with the needle.

I gave you a clear instruction which you disobeyed.

-That's simply not how things are done.

-But you were in surgery!

And the patient was getting worse and worse.

What am I supposed to do?

OK, I appreciate you were putting the patient first.

Next time...

..make more of an effort to get my attention.

OK, fine.

Fine.

Well, he'll need an arthroscopic washout and probably debridement.

-We'll get him into theatre.

-We?

-Of course. No hard feelings.

Let's get prepped.

What do you think of his state of mind?

Angry.

Still doesn't justify his actions.

James Wilson is still bleeding out and hydrocortisone isn't working.

We'll have to take him back in. I'll need you to scrub in.

His father wants to speak to you. Why did you rush him into theatre this morning?

It was a routine procedure. The slot came free.

Come on, Greg. I didn't tell you about Rafi,

so you spat the dummy out, took me off the theatre schedule

and moved his op, right? Tell me I'm wrong.

-How have I become the bad guy?

-This isn't Rafi's fault.

It isn't my fault, either. I'm doing my best, OK?

And I'm just trying to protect my husband.

So, do you know Jones, your mouthy wannabe?

Er, yeah, I discharged her earlier.

And she knew about this before she left?

-Will you...?

-No, not a chance. It's your problem.

Great. Just make sure Ms Broadhurst doesn't hear about this.

Doesn't hear about what?

-He wanted to go in earlier?

-He was pretty insistent.

-But he's only 16.

Which is old enough to make that call.

The anaesthetist said that James didn't tell him about his allergy.

-Why wouldn't he say anything?

-I really don't know.

The drugs haven't stabilised him as we would have liked.

He's bleeding internally. We're taking him back into theatre.

-Again?

-Jan, it'll be OK.

Once he stops bleeding, he should be fine.

-See? He'll be fine.

-I warned you this morning.

I wanted to be here first thing

and if we had been, none of this would have happened.

Can we not do this now?

Why not? Embarrassed, are you?

Just give us a minute.

So, Dr Petrenko was right. You do have septic arthritis.

-She's not touching me again.

-I'll be performing the procedure. Your knee will be fine,

but I'm afraid you will miss that fitness test.

I've waited this long. What's a few more weeks?

Howard... I tracked down your records.

Hang on. Why would you do that?

-Your reaction earlier was...

-Completely justified under the circumstances.

You assaulted a medical professional.

If you so much as breathe in the wrong direction,

I will call the police and have you charged. According to your records,

you're not on medical leave. You were medically discharged two years ago.

-Right. Well, that's not true.

-Why would your records say otherwise?

-No idea.

I'm a serving NCO and am free to return as soon as I'm fit

which, if you pull your finger out and fix my knee, I will be.

-Why would you lie about something as serious as this?

-Who says I'm lying?

It's not my fault if someone's messed up my records. If you don't believe me,

just call my wife and ask her. She'll tell you.

I'm sorry, I tried that.

I'm afraid she's not prepared to visit.

She confirmed everything.

You're no longer a serving member of the Army.

You understand that anything you say to me

will be in the strictest of confidence?

-If there's anything you want to say...

-I don't need a priest, I need a doctor.

-Howard.

I don't want to talk about it.

-Of course. We'll take you into theatre in a few minutes, OK?

-Fine.

-All set?

-Absolutely.

-He signed a consent form?

-Yeah, he's been tamed.

-Good.

Hey, I left the place tidy for you.

-Makes a change.

-You got something nice and exciting for Petrenko's first ortho op?

An arthroscopic washout and debridement.

Exciting. So, the aspiration proved you right?

Yeah, it was septic arthritis.

-Good call. We were right to go ahead.

-I'm sorry, what?

My girl's got killer instincts. Mind you, she learned from the best!

Hey.

-Where's mum and dad?

-Went outside for some air.

-How did they look?

-What do you mean?

Well, did they look like a couple?

-Of course.

-Good.

-Why good?

They've been fighting a lot lately.

Did you tell Dr Raza about your allergy?

Not sure. Can't remember.

I need you to think. This is very important.

When he asked if you had any allergies, what did you say?

I didn't want to hold things up.

So, you didn't tell him?

-Didn't think it mattered.

-Well, it does.

James, you didn't... Why did you want to bring the operation forward?

I knew they'd be late. Dad's always working.

Figured that if they came in and saw me all laid out,

might be a bit shocked. It would push them closer together.

I signed you off as competent because I thought you were an intelligent,

mature guy who could make his own decisions.

-You should have told Dr Raza everything.

-I didn't think.

No, you didn't.

So, Dr Petrenko, what do your killer instincts tell us

we see on the monitor?

It looks like lateral condyle.

Wrong. That's the medial condyle.

Oh, of course.

Instinct isn't everything, then? Despite what Mr Malick says.

I don't understand.

You consulted with Mr Malick over my patient?

Again, not how we do things, Dr Petrenko.

-OK, thank you. The ED did not get her mobile number.

-Home address?

-Terrific.

-I called the guys in the show. They left hours ago.

-But did she go back?

-The guy says they all look the same.

So, how do we find her?

-She'll figure it out for herself before too long.

-Do you think that's a satisfactory outcome?

It's a joke. What are you looking for?

-This was a simple mistake.

-Which happened because...

Go on.

-There's efficient throughput and there's you making a point.

-So, you think I discharged her

cos I was trying to get one over on you?

I don't have an issue with you, Michael. It's about the work.

It always has to be about the work.

We've stopped the bleeding. The heparin should have worn off, so it shouldn't be a problem.

-We know everything this time?

-Of course. We're sorry.

-Please. There's no need. Let's just get him better.

-Why didn't you tell them?

-Don't shout at him!

-(I wasn't shouting.)

-We'll see you in a little while.

This the kid with the death wish? It appears you're in the clear, Dr Raza.

-I'll take that as a grovelling apology.

-Hanssen will be pleased.

Can't have his new appointment sacked on day one.

Greg, so your decision

to give this kid competence and bring the surgery forwards was...?

Not the best choice I've ever made, yeah.

That's an understatement on a monumental scale.

I'll leave you to play happy families.

Great. Thanks a lot.

Good, you're awake. The operation went well.

Good. Thank you.

Rest and a few physio sessions, and the knee should be OK.

-In the meantime, can I arrange for...?

-No.

But you don't know what I was going to say.

A psych consult, right? No, thanks.

-We all need a little help from time to time.

-I know what I need.

I need it to be two years ago.

Howard, I understand it must be hard to adjust.

When you've been in an institution for a long time, you'll miss the structure.

Everything made sense back then. Simpler, you know?

These days I don't know what to do, don't know who I am.

So...I kid myself.

I kid myself I'm still in the Army.

I'm sorry. If there's anything I can do...

You've looked after me, doc. I appreciate that.

I'll see you back on the ward.

So, you deliberately told my F2 to perform a procedure I'd vetoed?

The right procedure.

-And if the aspiration had caused an infection?

-It didn't, though, did it?

Conveniently for you.

-She came to me. I made the call you should have made earlier.

-That's not the point!

-What is your problem, Dan?

-It was my case, my F2, my call!

Get over it. It's done. You can cry about it or move on.

Any luck?

No. I got nothing.

For all I know, Janelle Jones isn't even her real name. I am out of ideas.

She called this phone at lunchtime.

It's ringing.

Hi, is that Janelle?

Janelle, it's Michael Spence from Holby City.

Yes, the cocky Yank.

Look, I need you to come back to the hospital. There's something I need to discuss with you.

-Multiple bleeds, pericardium, sternum.

-Suction, please.

-The heparin still hasn't worn off.

-Platelets and plasma, please.

-Pack him.

-He needs a factor shot.

Mr Douglas?

Mr Hanssen. What can we do for you?

I wonder if you'd mind talking me through the procedure, please?

We're attempting to repair bleeds in the patient's thorax.

-How did the patient get into this condition?

-Well...

Mr Douglas has his hands full saving the patient's life right now.

-Dr Raza. Nice to see you.

-Pleasure is all mine.

Kind. Mr Douglas, the patient presented with...

Atrial septal defect. There were complications from the first procedure.

Owing to...?

Circumstances beyond anyone's control. Even yours, Mr Hanssen.

I do hope that the circumstances are now very much under control.

Yeah.

He's going to be fine.

Very glad to hear it. I'll leave you to your labours.

He hasn't changed.

MONITOR BLEEPS

BP's still dropping. Diathermy.

God damn it!

Hello?

Eddi?

All right, you've got some great stuff down here, Sacha.

-I mean, Chrissie is going to love it!

-What are you doing?

I'm on my break. I figured I'd get a bit more peace and quiet down here.

I'm sorry, how did you get in?!

Your security system's not that hot.

You really should invest in a decent padlock, you know.

I've got five minutes. Game of foosball?

What's up with you? Scared I'm going to beat you?

Not exactly.

Sacha, where did you get all this junk?

All right, thank you.

If you want this to be the best teaching hospital

then there has to be rules and hierarchy

and it has to work, otherwise all you have is anarchy.

I gave an instruction to an F2 and she went to a registrar

and deliberately disobeyed me.

With no consequences to the patient's wellbeing.

-That's not the point!

-You really want me to do this?

-Absolutely.

-Very well.

OK, I think we got it.

BP's rising.

Let's start closing him up.

-Nice job.

-Thanks.

-So much for a simple patch and go!

-I never thought I'd say it,

-but it's easier being at home with the boys.

-What?!

The fuss you used to make about how difficult it is looking after them!

I may have been exaggerating a tiny bit to earn a few brownie points.

-Would you mind finish closing up? I need to...

-You OK?

I'm fine. It's just been a long day. I just need to get some air.

2-0 prolene.

Yes, well, clearly there have been some differences of opinion

regarding procedure and chain of command today.

Which is regrettable, but since there is no real harm done,

-I won't take the matter any further.

-What?

Today should have been a chance to demonstrate how different approaches

across disciplines can lead to a robust clinical environment.

-Absolutely.

-Different approaches only work

when they have a rigid support structure, there have to be rules.

And there are. But as someone more learned than me once mused,

rules are made to be broken.

Now, if you'll excuse me.

Mr Hanssen! I don't think they fully comprehend the implications...

Mr Hamilton,

I think Dr Petrenko will be better suited to Mr Malick's mentorship

as I originally intended.

So, how did it go? You went back, right?

They rejected me. Laughed at me. All of them.

-I felt like an idiot.

-That is a bummer. But never mind.

I'm sure you'll have plenty more chances.

It's not that. My mum's face. When I tell her.

Janelle, I know why you fainted today...

I thought it was just nerves?

-You've been putting on some weight recently, correct?

-A bit, yeah.

-And you've not been eating very much?

-Sometimes.

I ain't no anorexic, though!

No, I know you're not. Janelle, you are pregnant.

-I'm what?

-The combination of your baby's needs

and you not eating means that you faint whenever you get nervous.

-I'm going to have a baby?

-Yes.

Unfortunately I didn't receive your results until after you left.

-I don't want you to worry. We will help you to decide what to do.

-That's brilliant!

-Is it?

-You're not messing with me? I'm really pregnant?

-Swear to God?

-Yeah. Word of honour.

I've always, always wanted this! A baby! My own baby!

Um...Janelle, this is a huge responsibility.

Having a baby will change your life.

I don't care about that! This baby needs me.

Mum's going to be made up!

I mean, you've got to grow up sometime, haven't you?

Thank you. Thank you! You two can be my baby's godparents!

OK. Let's just take this one step at the time.

COUPLE ARGUE

-Mr Douglas. I take it the patient pulled through?

-Yes.

Good.

Hard to tear one's gaze away, rather like a motorway accident.

Mind you, the urge to intervene is profound.

Sadly, though, in my experience

the complexities of other people's relationships

are rather like high explosives.

Not to be tampered with.

Wouldn't you agree?

-I diagnosed correctly.

-You did good.

-So what's his problem?

-Look, just let it go.

No. I want to know.

It's not about you, all right?

No. It's not, it's about you.

So, is it you he doesn't like specifically?

Or is it all general surgeons?

He's just stressed about the job. Don't take it personally. I don't.

We all get those days. So come on, Miss Cohen awaits.

-Mr Davies, you should be off your feet.

-Don't worry. I will be when I get home.

-I'd prefer if you stayed till morning.

-No, I'm out of here.

Howard, stop.

-At least...

-What is it with you?!

You fixed my knee. I said thank you. Your job's done. Now let me go.

You know this isn't about your knee.

-There's support for you, if you'll take it.

-You got a time machine, doc?

You have to move on.

Apologise to Morticia for me.

You'll have to stay in hospital for a few weeks at least. There's a chance of infection.

And respiratory problems.

-So you may need to be ventilated to help you breathe.

-Wow.

-Yeah.

If you want to worry your parents into staying together,

at least now you don't have to lie to do it.

-I don't want them to be unhappy, that's all.

-I know that.

This morning I gave you competency because I thought you were

a mature guy who could make his own decisions.

I still think that.

Hey, just wanted to say thank you

-for helping me find the girl.

-You're welcome.

-So Hanssen's OK'd a second lead?

-That's right.

He agreed that AAU needs two heads across it. Job's too big otherwise.

Right - so you've appointed someone?

Not yet - although I know you're not interested.

Said anything to Hanssen?

I'm seeing him tomorrow.

You know, I was thinking, I might be willing to reconsider your offer.

With your new ideas and my experience...

I thought committee-style leadership wasn't your thing?

I'm warming to the idea.

Hey, Dan, you got to check this out!

The guy was so drunk he swallowed every one of his mates' car keys!

-Try putting him on a saline IV.

-Come on!

-I think you can both handle it without me.

-Dan!

-I'm going home.

-Hi.

-Hi. Are you OK?

Yeah. Listen, there's something I need to say to you.

It was my screw-up that got us into this mess today.

I'm really sorry.

Thanks, but no harm done in the end, right?

OK, well...

-See you later.

-Count on it.

-Greg...I just wanted to...

-It's OK.

There's nothing to talk about. Rafi's a good guy. I like him.

Just wanted to say thank you for being so understanding today.

Come on. Home time.

Are you getting in?

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