Fight the Good Fight Holby City

Welcome to Kiev.

Doctor Tereschenko?

We don't have the equipment, we don't have the resources.

New house, new start and what we definitely don't need...

-..is a remote-controlled helicopter.

-You're learning quickly.

-Good.

Oh, Sacha, you had to move underground.

I just can't get rid of it.

-Pensions won't release money, but we can still buy the house.

-How? We can't afford it.

I'm taking care of it.

We're about to secure funding to make us

a leading hospital for teaching and research.

I have no intention of leaving Holby,

our work here is just beginning.

Mr Hanssen. You're in early.

Worms to be caught, Mr Hope.

-Allow me.

-Ah, thank you very much.

So would these worms have anything to do with your plan

to improve the hospital's teaching status?

Glad to see you've got your finger firmly on the pulse.

Yes, the Vice Chancellor

and I are meeting with the university board this afternoon.

I have to say, some of us are rather surprised

at your sudden zeal for matters of education.

An increased affiliation with the university

will give us the status and funding we need to make pioneering advances

-in medical technology and treatments.

-So it's about money?

No. It's about legacy, excellence and building up our assets.

And in order to do this you need the university to give you...?

£12 million.

You're asking them to give you £12 million

so you can add to your empire?

I'm asking them to give me £12 million

so this hospital, and everyone in it, has a future.

And that one and the trolley too, please.

Come one, guys! I haven't got all day here.

-Where are they taking this equipment?

-If it's off my ward, I really don't care.

I didn't know we were having a clear out.

Streamlining, Elliot. That scanner is older than you are.

-This is in perfect working order.

-Out of date. Obsolete. In the way.

I think we should just hold fire.

You should have discussed this with me.

-We're discussing it now, aren't we?

-I know space is at a premium,

but I am still lead consultant.

PA X-rays.

17cm. Heart's enlarged. High tower pulse.

Mild pyrexia.

-Five milligrams of heparin.

-Good morning.

Good morning. These rosters...

Yes. They're subject to change.

I'm going to have to bump your 3.30, I'm afraid.

Perhaps you could give me a theatre list and an itemised inventory.

I'm really busy, Elliot. I don't have time to make lists.

-We should argue the case with Hanssen.

-He's not to be disturbed.

I'll be there in a minute.

There's an e-mail from him. Somewhere. Amongst that.

VIDEO GAME SOUND EFFECTS

Where did you get a blue ball of fire from?

No, he's supposed to be at home.

-Mobile?

-Switched off.

Maybe something came up?

I'd be the last person to know. He's been acting really strangely.

-This is Sacha we're talking about.

-More strangely than usual.

You don't think he's getting cold feet, do you?

So you've won again. Sudden death decider?

Why not?

PAGERS BLEEP

Keyhole appendectomy.

-Botox and filler.

-Bad luck.

-This way, I'll be richer than Spence.

-And just as insufferable.

Right, the key stays with Eddi. I'd only lose it.

So are we...bonding?

No. Don't think so. I like what you've done with the place, though.

Don't forget. Chrissie doesn't know.

What happens in Fight Club...

What?

Never mind.

HIP-HOP MUSIC PLAYS LOUDLY ON HIS HEADPHONES

Mr Hanssen.

-Good morning, Mr Malick.

-You weren't waiting for me, were you?

-Are you aware that your shift began eleven minutes ago?

-Er...

Do you have an excuse to hand,

or would you like me to give you a moment to make one up?

All right, you got me. I can't lie to you, Mr H.

I overslept. And I missed my train.

I really can't abide tardiness in any form.

This will not happen again.

Definitely not.

Right, thank you.

You see I need my registrars to be here well before I am.

Your registrar?

Yes. I'm the Keller consultant today, and you are my registrar.

Hey! The Dream Team.

I have back-to-back meetings with the university vice chancellor all day

so effectively I need you to be me on the ward.

Oh, well. I can do that. Involves a lot of looming, right?

-And scaring the life out of baby doctors?

-Indeed it does.

Speaking of which, you've three medical students shadowing you.

Should Professor Pawlowski from the university

choose to shine her light on even the darkest corner of our building today,

she will find our capacity for teaching expertise

is being vividly demonstrated by the likes of you.

What do you want me to teach them?

Inspire them, Mr Malick. Mentor them.

So by the end of the day, they'll be standing on their desks

and addressing you as "captain, my captain".

-We have an appointment to see Mr Hope.

-Right.

My father is being admitted today. Petro Zinchenko.

-Z-I-N-C-H...

-No reference, sorry.

He has a heart condition.

-You're sure you've got the right date?

-I have his address. A letter.

Mr Hope. Apparently that's your patient.

Mr Hope. Petro Zinchenko.

-No records.

-I'm sure there's been some breakdown in communication.

THEY SPEAK IN OWN LANGUAGE

We can't find the letter.

It will turn up.

His GP referred him months ago.

Olena.

-Oh, my God.

-Excuse me.

-Get him into a bed.

-The only bed we have is in HDU.

-Let's get him in there then.

You don't think there is someone else, do you?

What? Sacha?

-You haven't seen him, have you?

-He's not on the ward. No.

He's late for his shift.

Oh. I remember now. Paediatric consult.

He never told me.

You haven't seen him, have you?

Right. I suppose you'll have to do.

No, no, wait.

Bit needle-phobic.

Celine, maybe Botox isn't for you?

I need this.

Really. You don't.

Sweet.

Date this weekend. Got to look my best.

OK.

I found him on this website, you know. Lonely hearts.

I cheated.

Really?

With my profile picture. Algarve. Sun-kissed.

2003.

Right.

Crow's feet. Smoker's lip. Jamie. That's my date.

He's expecting young, line free and single.

How about we close our eyes?

Good.

Smile for me.

And relax.

How long have you had these chest pains?

His English is not good.

My English is better than David Beckham's. A long time.

Worse after I wake up.

-Some days he can barely walk.

-These readings are cause for concern.

It would help if we knew your medical history.

Sorry. You've had a previous procedure?

-He's had a valve put in.

-A long time ago now.

OK, well. You have what we call a heart murmur.

Is that bad?

We'll need to do some more tests. Usual bloods.

Angiogram and an Echo, please.

Let's see if we can track down that medical history.

He's in safe hands.

You see? I said it would be all right.

HE SPEAKS IN OWN LANGUAGE

So how did you do this to yourself?

I fell down some stairs.

Where?

My block. I was just on my way to work.

It was raining, made it slippery.

Council were supposed to fix the lift, like, a year ago.

Really? OK.

So just so you know you are my Malickites and I am the Prof.

I'm the general registrar here on the Keller ward

and this is my domain. So welcome.

As you see there is a bit of vascular compromise.

But how do we know that?

That's right!

Because the arm's a bit cool

and the colour is a little paler than we'd like.

So my reading of the situation is that we could be looking at

a...arterial problem.

What now?

Is everyone in the hospital just going to come and gawp at me?

-Why don't you sell tickets?

-This is your consultant, Mr Hanssen.

I thought you were in a meeting all day.

Evidently the professor is running late.

Yeah. Well, I was just explaining that Matti Grace here has

a arterial compromise with a complication of the cephalic artery. Would you agree?

How did she sustain her injuries?

Hello! I'm right here, you can ask me, you know?

Hello. Yes, I'm well aware of that,

but I'm not convinced your account is reliable.

She fell down some stairs.

Yes, it says that here too.

Full marks for consistency, none for plausibility, I'm afraid.

I'm not convinced that this sort of damage could be caused by a fall.

-Your patient's lying to you.

-Hey, don't call me a liar!

Always assume your patient is lying until it can be proved otherwise.

-PAGER BEEPS

-And there's the professor, at long last.

Will you call orthopaedics? Keep me posted.

I'm a little worried about vascular complications,

so don't rush into anything.

It's a pleasure to meet you face to face, at long last.

I'm so sorry to have kept you waiting.

Not at all.

You're very tolerant. Personally, I can't bear lateness in any form.

But, in my defence, the plane was 43 minutes late in taking off.

Did you read the draft proposal I sent?

I read it on the plane. It's persuasively written.

Thank you.

Obviously, I have some questions.

Mm-hm.

Could you wriggle your fingers for me, please?

And you say you sustained this injury falling down some stairs?

That's right.

Well, I must say, I don't quite know how you landed at this angle.

It's quite an achievement.

My initial examination suggests that the brachialis is intact,

but I'd like to do an exploratory to make sure,

-which you're all welcome to come and watch.

-What's one of them?

-It means we open you up, take a look...

-No way.

I just hurt my arm so give me some painkillers and let me go.

-If I'd broken anything, I think I'd know about it.

-Not necessarily. You see...

-It's all right. We're not going to cut you open right now.

-Right.

Thank you. Someone with an actual brain in his head.

Mr Malick, could we have a word, please? Excuse us.

I'll be right back.

Would you mind not undermining me in front of our students?

-My students.

-YOUR students?

We're worried about vascular complications.

Before you go wading in with your size tens, we need to make sure.

Sorry, Malick, who's "we"?

Me and the Big Dog. The H Man.

Hanssen.

Mr Hanssen doesn't appear to be here right now,

and seeing as I am the only consultant present.

I'm here on his behalf, so he's effectively standing here right now,

and he says, "Don't operate on the lady

"until we've had a proper chance to assess."

-Can I help you?

-Yeah. I'm looking for Matti Grace. They said she'd be in here.

-And you are?

-I'm her uncle.

Aortic stenosis, prosthetic valve failure.

The valve is badly calcified.

My office is full of scrap metal.

I spoke to admissions. No sign of any records.

I thought we'd agreed to throw it all out?

I'm sure there's a valid explanation.

The address she gave me? Holby British Legion.

-Oh, they're Russians.

-Or Ukrainian.

They're obviously health tourists.

He needs treatment.

Well, he's not getting it here.

Elliot, come on. They're playing you.

They might've as well turned up with their violins.

So where do you suggest I send him?

The airport?

-Were you going to tell me you'd come here?

-It's nothing serious.

It's serious enough they've got you in a hospital bed.

They're just being over-cautious.

They don't even know what they're doing.

Who told you I was here?

You weren't answering your phone, so I called your work.

I should've been the first person you called, Matti. The first person.

I just didn't want to worry you.

-Are you thinking what I am thinking?

-I very much doubt it.

There's something wrong with this situation.

-I don't like the look of it.

-Why would that be?

A patient in her condition saying she fell down some stairs,

half an hour later, some doggy bloke turns up claiming to be her uncle.

Maybe he IS her uncle.

-Excuse me.

-Ah, Lleucu. Could you see if theatre's free?

I'd like to do an exploratory operation on Ms Grace.

Actually, before you do that, can you page Mr Hanssen for me, please?

Consultant.

Mr Hanssen's registrar.

-I'll page him for you right away.

-Thank you. You left me no choice.

Right then, my Malickites.

Time for a recap on what we've learned today.

-You're coming to the end of your first quarter as a foundation trust.

-We are.

And your board will want to see evidence of innovation,

especially in terms of new revenue sources.

I expect they will.

So it would really help your cause if you could wheel me in

as some sort of deus ex machina with my big bag of university cash.

Although I question your turn of phrase,

I can't dispute the point.

But it's not my board of governors

-we need to convince this afternoon, is it?

-"WE need to convince"?

I take your presence here as an encouraging sign.

You may take it as a sign that I'm prepared to listen,

but I can't guarantee that I'll back you

until I see evidence that you have the resources to turn Holby

into a fully-fledged teaching hospital.

You haven't been entirely honest with me.

You would never have seen us.

So where are you from really?

From Kiev.

My father was diagnosed at Kiev Hospital. Dr Tereschenko.

Nadiya Tereschenko.

-You met her at Christmas.

-Yes. Yes, I did.

-The doctors there...

-..have limited resources.

We heard about your work.

-He needs an operation.

-I know.

-However...

-They gave me three months.

You could save him.

That doesn't change the fact that you lied to me.

We came all this way.

My daughter is very persuasive.

Yes. Ukrainians often are.

So...you will help?

There is a common misconception that the NHS is free.

However, inevitably, somebody has to pay.

We can pay.

1,000.

It's all we have.

As Mr Malick has already explained, if there is any vascular compromise,

then rushing her to theatre will exacerbate the situation.

Just like I said.

-I still don't think we should wait.

-Mr Hamilton, I've made my decision.

We give her ten milligrams of morphine,

we book a MRI, and we wait.

You'll all be familiar, I'm sure, with the expression fools rush in.

-You the gaffer?

-If by gaffer you mean director of surgery, yes.

Matti's been in here two hours

and so far all you've seemed to do is argue among yourselves.

-At this precise moment, our plan is to wait and see.

-Let me get this straight.

-You have no idea what's wrong with her.

-That's a reasonable summary, yes.

Now if you excuse me, I have an important meeting to attend to.

From now on, you will page me only if it's critical. Understood?

-And make sure she stays right there.

-Right you are, boss.

-You want to know what this is really about?

-What?

-Them.

They're using you like a guinea pig so they can teach their students.

If they were really worried, they'd be cutting you open right now.

Yeah.

We'll get you back. Ice bath, painkillers. That's all you need.

We're getting you out of here.

-You sure?

-Hey. Don't you go falling apart on me, girl. Not now.

Not today. You understand?

Psst!

Did you get the key?

You mean this key. That you lent to Mr Hemingway?

-That'll be the one.

-You showed him our den.

I needed someone to play with.

How could you, Sacha?

Where have you been? I've been looking for you everywhere.

No phone calls, no e-mail.

Switched off. All morning.

-That paediatric consult.

-Yes.

-Have I upset you?

-Whatever gave you that impression?

I just feel there's something going on here.

Right. Here's the thing.

Celine Hawkurst. Brought down from Holbycare.

Shortness of breath. Constricted airways.

B/P 70 systolic. Pulse 150.

-Possible anaphylactic shock. Which bed?

-Bed four.

What have you done to me?!

Left ventricular hypertrophy.

His aorta is mashed. It's sticking to the chest wall.

-Which means?

-You couldn't go in with a straightforward replacement.

We'd need to do a specialist transapical procedure.

No, it's too risky. The valve is already compromised.

-Left thoracotomy. Needle. Guide wire.

-Surely this is just academic?

For once in his life, Valentine's actually talking sense.

We can't just discharge him.

Elliot, here is a reality check for you. You need a team.

Equipment. A modicum of foresight. Not to mention £30,000.

If you don't tell them, I will.

It's a rare procedure.

I've never seen one done.

Brilliantly conceived.

Shame our hands are tied.

OK. Look, I appreciate it's frustrating,

-but you need to trust that we know what we're doing here.

-Give me a reason to.

We've got a MRI scan in an hour that'll tell us what we're looking at.

We've waited long enough. Sign the form and let's go.

You can't just discharge her.

-I know what's best for her.

-With all due respect, I don't think you do.

-Get out of my face, please.

-Listen, just...

-I'm asking politely.

-Mr Grace, will you take your niece back to her bed NOW, please.

-It's fine. I've got this.

-I will call security, if I have to.

-Security?!

-Matti, you know you don't have to go anywhere you don't want to.

-I know.

-I can arrange for you to talk to a nurse. In private.

-What do you mean?

For God's sake, Len. Just tell him.

Matti's the number four ranked female welterweight

boxer in the country.

As well as being her uncle, I'm also her trainer.

You're lucky she's in a good mood,

she could beat the crap out of you right now.

Why didn't you just say so?

We never met a doctor who didn't want to see our sport banned,

especially when it comes to girls. We don't like being judged,

so it generally makes life easier to just avoid the subject.

I can only apologise.

Don't bother. I want to see your boss. The tall guy. Now.

Who are you proposing as your clinical skills lead?

Clinical skills lead? That's the sort of detail that...

I'd hardly call it a detail.

We're talking about the first point of contact for students.

The person who'll be setting the curriculum, providing a role model.

We need to give the board an idea of the person

who will be dealing with the students on a day-to-day basis.

-PAGER BEEPS

-Get this right and everything else will fall into place.

I'm needed on the ward, I'm afraid.

Not a problem. I'll accompany you.

I'd be fascinated to see you in action.

MOBILE PHONE RINGS

-Oh, would you excuse me for one moment, please?

-Certainly.

I gather you're trying to secure an early departure for your niece?

Yeah, we're leaving right now.

But before I go, I'd like you to know

that your bone man here needs to learn some manners.

I apologise if your experience here has been less than satisfactory, but...

Less than satisfactory? You keep her here two hours,

you get different doctors to push and prod her

while those three stand gawping at her.

You can't tell me what's wrong with her, we wait and see,

and then posh boy here accuses me of beating up my niece.

It was a misunderstanding. I've apologised.

How was I supposed to know she was a lady boxer?

Right, as far as I'm concerned she should remain here

until we know exactly what's wrong with her.

Let's fast-track the MRI. Get onto it.

Already on it.

-Mr Hamilton, a word with you if I may? ..Excuse me.

-Right.

-Dan Hamilton?

-Professor Pav!

-I didn't know you worked here?

Yeah, I've been here just over a year now.

Orthopaedic consultant, believe it or not!

-Dan captained our university rugby 15.

-Prof Pav was my hall tutor.

Sterling touchline support every home game.

-We've still not beaten your season as captain.

-You're just saying that.

I wish I was! I still remember that match you played against...

-Mr Hanssen, the MRI's free right now.

-Very good.

The rash isn't uniform. Facial paralysis. Blisters round the ears.

You think it's something else?

I've no idea what it is, but I'd better put it right.

Thank you.

Permission to come aboard?

Right, a botulinum allergy is fairly rare.

-She's complaining of earache.

-I've gone a bit deaf.

-Face feel numb?

-Well, it would, wouldn't it?

One side? Both sides?

-This side.

-Any nausea. Vertigo?

-Bit dizzy, but...

-But what?

I have been all week.

You really should've been honest with me, Celine.

You wouldn't have done the job.

Right, let's do a PCR, OK?

-Botox?

-Well, you know. Botox. Filler.

Light lipo. Gets rather addictive.

-You're moonlighting?

-I was going to tell you.

As if I'd care?

It's demeaning, Chrissie. It's not a side line I'm particularly proud of.

-So why the hell are you doing it?

-Well, it pays well.

The house. The future. Everything you wanted.

Mr Hanssen! Sorry. I'd like to convene

-a multidisciplinary meeting...

-Not today, out of the question.

-I know you're busy...

-Is the patient critical?

-As things stand, he's stable.

-Then why are we having this conversation?

-But his condition will only get worse.

-Mr Hope, rules are rules. As a non-EU citizen,

-he forfeits the right to surgery.

-Without a valve, his prospects are very bleak.

-Which is regrettable.

-I'm not sure I can let him leave.

-It's not your decision to make.

-Hospital policy!

-NHS policy.

You comfortable in there, Matti?

I'm stuck in a giant metal tube.

-Comfortable isn't the first word I'd use.

-You won't be in there long, OK?

If this is all clear, you'll let me go?

If it's all clear, I'll call you the taxi myself.

Keep calm, keep your arm absolutely still, please.

-All right, begin, Mr Malick.

-But even if this is all clear,

there's no way you'll fight tonight. You know that, right?

-I think that's my decision.

-Is it? Or is it your uncle's?

-You don't know my uncle.

-OK.

Well, this woman that did this to you, did you land any on her at all?

It wasn't a woman.

Come again?

This girl I'm fighting tonight -

the Hungarian - she's big.

There's only four other girls who train at my gym.

None of them are anywhere near her build.

So who did you fight?

I got this guy - Danny.

We only did three rounds.

Dare I ask what kind of a man gets into a boxing ring with a woman?

He was doing it to help me. To build my strength.

I begged him, OK?

Your uncle know about this?

He'd go nuts.

Then he won't want you to fight tonight, in your condition.

You don't understand.

Tonight... Tonight means everything.

We've been training for this for years.

I'm not going to let him down.

Not now.

I'm very sorry.

We, um...

We don't have the time, resources or finances to treat you.

HE SIGHS

-If it were my decision...

-But he's getting weaker.

-You can see.

-But I can refer you to patient liaison.

-They will speak to you....

-He'll never make it back to Kiev!

-HE SPEAKS UKRANIAN

-You're just going to let him die?

-I am very sorry.

-Very sorry? Not my problem!

Fine!

-You want us to leave...

-Sorry! HEART MONITOR BEEPS

-You're making my position difficult! This has to stay.

-Olena! Olena!

-I'm very sorry.

-But he is taking up a bed, no?! I trusted you!

SHE GASPS

Olena!

Ramsey Hunt Syndrome. Similar virus to the one that causes shingles.

-It was nothing to do with the Botox?

-Off the hook.

-Hardly.

Well, I'd like to do a neurological assessment

just to be on the safe side.

My husband...

My ex-husband.

He's getting married again.

And I thought, "Maybe I'll go. Show you I've moved on."

Ten years younger.

SHE SOBS I'll show you.

How did the MRI go?

There does seem to be some evidence of a ruptured tendon and a haematoma

and given that the arm circulation has improved,

you may go ahead with the exploratory.

-Thank you.

-I've asked Mr Malick

to accompany you, just to get a general surgical perspective.

Right.

Oh, Mr Hanssen?

Prof Pavs... Professor Pawlowski.

I understand it's all very hush-hush, but she tells me

-I'm your first choice for clinical lead.

-Does she indeed?

And I just wanted to say thank you.

For your faith in me. I won't let you down.

Any idea where the professor is right now?

'It's my father you should worry about.'

You could have concussion.

Can you, um...?

-When did you last eat?

-I can't remember.

That's not helping anyone.

How can I eat? With him like this?

I am sick with worry.

Every day, I have to watch him suffer.

He was always so strong, always looked after me.

Now I have to look after him.

Is your mother living in Kiev?

-She died. When I was small.

-I'm sorry.

My father is all I have left.

Tell her I'm trying to be as reasonable as I can, but...

if the proposal hasn't materialised by Friday,

then the conversation is basically over.

All right.

Thanks. OK, bye.

So how did your scan thing go? Is her outlook bleak or sunny?

How well do you know Mr Hamilton?

Pretty well. Since he was a fresher.

He's a phenomenal fly-half. Have you ever seen him play?

-No.

-Not a rugby man?

-No, in my experience, it's a rather brutal, thuggish and pointless pursuit.

I would've thought you might have appreciated it on a tactical level.

You strike me as someone who enjoys strategy.

So I gather we've offered Mr Hamilton the Clinical Skills Lead?

It wasn't an official offer.

-I merely asked...

-It might have been courteous to discuss this with me

-before broaching the subject.

-It was a hypothetical question.

As Director of Surgery,

I decide who we appoint in positions of such responsibility.

At the moment, this is all hypothetical.

There is no Clinical Skills Lead, there is no pre-registration centre

and there is no £12 million.

All you have is an idea -

an idea which you need me to back.

Papa.

Right, I think what you both need now is some peace and quiet.

I'll, erm... I'll get you some food.

You, I'm afraid, Mr Zinchenko, are nil by mouth.

If...you're going to be prepped for surgery.

-I knew you would help us.

-It is good news.

-Well...

-You can thank me when this is over.

-So when do we do this operation?

This procedure will take a while to organise.

I have been waiting for ever. I can wait a little longer.

I'd better get the ball rolling.

TO HIMSELF: Before I change my mind.

'You said the scan would tell us what's wrong with her.'

We said it'd tell us IF anything was wrong. We need to take her to theatre...

-Are you serious?

-I'm absolutely serious.

He strikes me as rather rude and aggressive.

No, I call it "driven and challenging".

-Are you trying to make a point here?

-What point would that be?

-Well...

Well done. Absolutely right, Helen. A ruptured tendon.

So when I take her to theatre, I'll perform a blunt finger dissection.

We could take a photograph of that little scene right now

and put it on the cover of our investment prospectus. Dan!

Do you have any idea what a vascular complication might mean to her?

-I'll bring her back first thing tomorrow.

-No.

-In three hours, she'll be in the ring.

What is wrong with you? You know why she's here with those injuries?

She's so scared of you, she took a beating from some guy named Danny

-than let you down.

-What are you talking about?

You really want to help her, why don't you just leave?

Twice, I cancelled that treatment. Cold feet.

Dr Levy was so reassuring.

They do go the extra mile on Holbycare.

All I wanted was a fresh start.

Going to your ex's wedding is hardly the best way to go about it.

Just try and relax.

Sacha, do you want to move in with me or not?

-Yes, I want to move in with you.

-Then what's the problem?

Um...

What?

Yes, er, well, I'd need the valve as soon as possible.

Er, well...do your best.

Thank you.

You're insane. Impressive delaying tactics, though.

-I doubt she fainted on purpose.

-You're breaking all the rules.

-Feels quite liberating.

-Hanssen's going to flip.

Hanssen's busy. He's not going to know. Unless somebody tells him.

I'm a bitch, not a snitch.

Don't tell me you took a bribe?

No, it's her life savings. She left it here for safekeeping.

This little envelope of money is just enough to pay for a scrub nurse.

-If you saw the situation in Kiev...

-Spare me the sob story, Elliot.

You want to jeopardise what's left of your career? Fine. Just leave me out of it.

Do you know? I once knew a Jac Naylor who would've jumped at this.

A covert operation?

Ground-breaking surgery.

-If I assist you, then this ward has to see some changes.

-I could really do with you in there.

-This junk goes first.

-DOOR OPENS

What is it, Valentine?

Mr Hope, I think you should check on your patient.

So, after we hit them with your financial models for 2013-14,

we go into case studies and personnel,

potential lecturers,

and mentors...

Mr Hamilton always strikes me

as someone who's very happy to wear an old school tie.

At what point exactly did you decide to make him your designated poster boy?

-I don't think that's a relevant question.

-What is the relevant one, then?

The only relevant question as I see it is does he fit the brand?

Brand?

We're not selling anaemic coffee drinks to the great unwashed here.

No. We're selling an education. We want them to choose us.

Which is why you need me. If we become a leading teaching hospital,

-you'll rise up the university league tables...

-Oh, come on!

You have far more riding on this than I do.

-Oh?

-I'd guess that your job may very well depend on it.

Your board will be here in 19 minutes.

Now, I don't want to have to tell them that the meeting's off,

that we have irreconcilable differences, but if I have to, I shall.

Just as I suspected... we have a ruptured tendon.

What were you expecting?

-A round of applause?

-Merely trying to involve my students in this.

-YOUR students?

-Yes, well, it is my operation after all.

Now pay attention, Hamiltonians, I'm now going to suture

the two ends of the broken tendon - the proximal end and the distal end.

Wow. It's like watching a movie with the director's commentary, isn't it?

What are you talking about? Make yourself useful and bend the elbow at 45 degrees.

A real boring movie at that.

Well, you don't actually need to be here.

-I'm perfectly capable of doing without GS backup.

-Really? Great!

I reckon the Malickites deserve something more interesting

than a blunt finger dissection. Right, my friends.

As fascinating as it may be to watch an orthopod wiggle his finger around

in a patient's arm, wouldn't you rather see some...real medicine?

-Malick, I need you to look at this.

-One sec.

Jeez!

Don't go away, people.

This just got interesting.

-Bad pain.

-Bradycardia...

-Sats are dropping.

Hypotension. Borderline LVF. Let's give him some nitroglycerine.

Start him on the dopamine infusion. We'll try and make you more comfortable.

How can he be comfortable? He's dying.

Right, let's chase up that valve.

SHE SPREAKS UKRANIAN

I need suction. I can't see.

-OK, I see it.

-We looking at a bundle?

No. It's a bleed from the cephalic artery.

I'll need to make the incision bigger. I can't get access.

Malickites, come on, you're not going to see anything from there.

Scrub up and get in.

-You sure that's such a good idea?

-How are they going to learn if they don't have a ringside seat?

Unfortunate turn of phrase.

Yeah. Sorry, Matti. More suction.

It's no good. Give me retractors.

Can we page Mr Hanssen, please?

-Hanssen?

-Yup. He's the consultant and this is his patient.

-He's not available.

-What are you talking about?

He's due in a meeting any minute.

Hanssen is not going to prioritise a room full of suits over a patient.

-It's a very important meeting.

-What do you know about it?

Just page him!

-We'll bring his operation forward.

-You needed to prepare?

-His condition has rather caught up with us.

If we don't do this now, he is going to die.

-Mr Hope, I'll make sure theatre's prepped for you.

-Right, thank you.

-Olena!

HE SPEAKS UKRANIAN

He says he believes in you.

We'll do our best.

Thank you, Dr Hope.

Mr Hope, um...

My mother isn't dead. She ran off to Donetsk.

I want to save my father. I'll do whatever it takes.

-Did you tell them that the valve isn't here?

-It will be.

If this Mr Malick is the marvel you claim him to be, why does he ask for your help every five minutes?

-I should point out Mr Hamilton is in theatre with him.

-Then surely they can cope without you?

When a patient's health is at stake, everything else becomes secondary.

Start without me. I'll be back as soon as I can.

How do you know you still have my backing?

Surely there are some major questions still to resolve?

-Just one, I think.

-So what's your answer?

Am I going to back you in there or not?

Are you going to throw away a £12 million deal on a point of principle?

Hmm. I'll tell them you have my full backing.

The thing about keyhole surgery is... I always wish I had smaller hands.

Amazing, really, how things have developed.

OK, that is the sheath in. Thank you.

-Any news on the valve yet?

-No.

-Come on, Valentine...

-Right.

We're here today to talk about a very exciting new era

of collaboration between the hospital and our university.

Now, unfortunately, Mr Hanssen is needed in theatre,

but hopefully, he'll be joining us shortly.

Rather a lot of people in here.

Mr Malick thought our students deserved a closer look.

-Quite right too. So why am I here?

-The brachial artery's impeded.

-Embolism?

-Mm-hm.

-But there's something else too.

I told Mr Malick not to page you. I know you have an urgent meeting with the board.

Be quiet, please, Mr Hamilton. What is this something else I should know about, Mr Malick?

She has these markings on her back and her abdomen's slightly distended.

Which tells us what?

An internal bleed, I guess, but how?

-We won't know till we open her up...

-MACHINE BEEPS

BP's through the floor.

ELLIOT: Thank you.

-How's it looking to you?

-We should consider bypass.

That's impossible.

Right. I think we're ready for the valve now.

SHE SIGHS

So everyone knew, except me. Scheming behind my back.

-It wasn't like that, Chrissie.

-No?

-It is none of my business.

You were more than happy to cover for him.

At the moment, I'm just getting grief from both sides.

I thought he was happy.

He is happy, OK? And he wants to make you happy.

So what's his problem?

Well, he's a bloke. He's Sacha.

He lucked out with you. He's just really feeling the pressure.

Am I really that hard to live up to?

It might save time if you actually said all of this to Sacha.

Yes, I know. If I could find him. He's disappeared again.

-Balloon's in position.

-You realise you're still a soft touch.

Well, sometimes, a soft touch is exactly what is needed.

-Expand, please.

-Tell that to Hanssen. This guy saw you coming.

Now for the tricky bit.

At least he crashed. Now it's legit. Whole different ball game.

-You pull this off, we can only look good

-Arrhythmia.

-ALARM BEEPS

-He's in VF.

All right, compressions. Fluid and cross match!

-Adrenaline! 100% oxygen, please!

-Pushing fluids...

-No change.

-We'll have to use paddles.

-Not yet.

-Page the on-call perfusionist.

-No.

Bypass is too risky! Take over, please.

The valve isn't deploying properly. If I could just...

Elliot, let me, let me.

ALARM CONTINUES

-There. That's got it.

-ALARM STOPS

Sats back up.

Well done.

Let's get the guide wire out.

-There's a leak.

-Damn it!

-Just a small one.

-We'll have to open him up.

-No. He'll never survive.

What do you suggest we do, Elliot? Come on, this is your operation!

-Elliot!

-Right...

The bleed may clot itself. Let's pack it.

Take five minutes to consider our options.

Elliot?

Five minutes and I cut him open! More packs.

Right, suction, let's pack it.

-I've found the clot!

-If we don't stem this bleeding,

we'll have to mobilise the whole liver. Pull the wound up.

BP's dropping.

OK, can I get two bulldog clips, please?

Small bowel and mesentery fine. No other points of bleeding there.

Malickites, see how I'm clipping off the artery here?

Pancreas and aorta fine.

Ah, there we have it. That's what we're looking for.

-Mr Malick, please.

-Dan, can you?

-Yeah, sure, if you can...

-Yeah.

-Got it.

-Got it.

-So what do we have, Mr Malick?

A tear in the liver.

-A tear in the liver. Good. Packs, please!

-Suction.

Diathermy for Mr Malick, please.

-Do you think you can cauterise it?

-Oh, it's a mess.

I'm going to have to resect part of it.

Right.

-Well, I think you can both take it from here.

-Yup.

-Sure.

He's stable, but still in theatre.

So what are you doing out here?

Thinking.

Complications.

My father did not want to come. He wanted to stay in Kiev.

But he needed the operation.

We couldn't pay.

My family were always poor. We could never afford to buy new things.

My father always used to say,

"The longer something has been around, the longer it will last."

Do you know, my office is full of outmoded machines.

-The hospital wants to throw them away.

-Why? Do they not work?

Some people consider them old-fashioned.

I do not understand why people think like that.

If something works, then why not use it?

-Thank you.

-What for?

Trusting me.

MACHINE BEEPS Sorry to have kept you.

-Four minutes and 59 seconds.

-Still bleeding.

-Right.

-OK, well, I'm going to suture. Prolene, please.

-No.

With the ventricle in that state, you'll tear it apart.

Have you got other suggestions?

I'd like to try something. May I? Thank you.

As you rightly pointed out, Ms Naylor,

the patient's aorta is stuck to the chest wall.

-We're running out of time here, Elliot.

-Bit parts. All mashed up.

-And?

-Fibular, please.

-What the hell are you doing?

Something incredibly simple.

Epithelial cell glue, please.

Cell glue? You're going to glue him back together?

Well, the oldies are the goodies, as my mother used to say.

Let's see if that does the trick.

It's holding.

BEEPING STOPS Appears to be.

Right. Give it five minutes. Wash it through with saline.

Remove the scope and the tube. No need for drains.

Good, right. Thank you.

'In many ways, the Clinical Skills Lead will be'

one of the most vital figures in our students' education.

Good afternoon, my name's Henrik Hanssen,

I'm Director of Surgery and Consultant General Surgeon.

Forgive me for being so late and for my attire.

I come hotfoot from theatre. As Professor Pawlowski has no doubt explained,

what we are proposing here is not just about classroom learning, it's about hands-on experience.

Now, I'm aware these presentations can be a little...dry,

so I thought who better to explain what life here will be like than three of our students?

-You found me, then.

-This is where you've been hiding?

-Well, here and Holbycare.

-I thought you'd thrown all this stuff away.

Hadn't quite got round to it.

Sacha...

It was just a room to store stuff first, you know, and then...

it became...

Somewhere to get away from me?

Somewhere I could be myself.

I'm not trying to change you.

I do want to move in with you.

I've never wanted anything more in my life.

Well, then somehow, somewhere, we'll find room for all this stuff.

Shame, actually, I was getting quite attached to the place.

Then you better go and lock the door?

You mean...?

Oh!

You'd better get ready, cos I am a demon with one of these things.

COMPUTER GAME SOUND EFFECTS BLARE

-He isn't out of the woods yet.

-He'll be OK.

I know he will.

I didn't say thank you to you.

Ah, um...Dyakuyu?

-Dyakuyu.

-You're welcome.

Thank you.

Well, as I hoped, our young colleagues have just proved

we have the capacity to share our expertise.

But more than that, I believe it is our duty.

I believe it's time to secure our legacy.

Which is why I'm delighted that we have the full backing of your vice-chancellor.

Absolutely. And now, to continue where I left off...

as Clinical Skills Lead, we are proposing Mr Dan Hamilton.

Along with Antoine Malick.

As our young students have just said,

both surgeons have the qualities the role requires

and, together, they make a formidable team.

It seems almost impossible to choose between them.

Wouldn't you agree, Professor?

MACHINE SQUEAKS AND WHIRRS

Right, a deal's a deal. I want this crud out of my office.

In the car park, in the basement, just not here.

I thought I might send it to Kiev.

Kiev?

Hmm. Clearly, they need it more than we do.

Well if it stops them coming over here...

'They said she had an operation on her liver?'

Is she OK?

We'll know a lot more tomorrow.

So what happens now?

Like I said, we'll know a lot more with time.

There's a possibility we may have to consider dialysis, but...

hopefully, the liver might be able to regenerate itself.

She begged me to take her on, you know? I'd never taught a girl before.

Took her two years, but... eventually she wore me down.

HE LAUGHS SOFTLY How?

Her dad - my brother -

he's a complete waste of space. Left her when she was 12 years old

and she just folded in on herself.

-So you taught her to fight?

-I taught her discipline.

I taught her to think for herself, to use her strength, you know.

If she'd won tonight, she could have made some money,

you know, some real money.

Escaped.

That's why I pushed her.

And yeah, maybe I pushed her too hard, but...

But it was always for her. Always.

Well...

..I'm sure she knows that.

'Doors opening. Lift going down.'

Ah, Mr Hope. I'm glad I ran into you.

-Excuse me.

-Actually, I'm in a bit of a hurry...

-The operation.

-Went well, thank you.

-The patient's condition deteriorated

-and you were forced to proceed with the surgery?

-Something like that.

-The valve had already been ordered.

-Well...

-Directly countermanding the instructions I gave you.

Mr Hanssen, if I am to be of continued value to this hospital,

I really must insist on a small measure of autonomy.

It's the only way I can do my job!

Right. Well, I shall consider that request and bear it in mind.

'Doors closing.'

I thought we were playing on the same team.

Of course we are.

In my experience, people very rarely live up to their reputations,

-but I'm glad to say, you may actually have exceeded yours.

-I shall take that as a compliment.

I'm looking forward to working with you on this.

You strike me as a man who isn't used to failure.

And if you can't make a success of this place,

it would be a very public failure.

It would.

We'll speak soon.

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