Unsafe Haven - Part 1

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0:00:38 > 0:00:40Tara Lo, I'm a new F1.

0:00:40 > 0:00:42I can see you two are going to get along famously.

0:00:42 > 0:00:44I don't understand you.

0:00:44 > 0:00:45Good.

0:00:45 > 0:00:46# If you wanna be my lover

0:00:46 > 0:00:48# You gotta get with my friends... #

0:00:48 > 0:00:49Maybe next time.

0:00:49 > 0:00:52# If you wanna be my lover... #

0:00:52 > 0:00:53LAUGHTER

0:00:53 > 0:00:56- It's rather reckless and unprofessional behaviour. - He asked me for a drink, Luc!

0:00:56 > 0:00:59That is what normal people do when they like each other!

0:01:05 > 0:01:08LUC: 'I did a lot of travelling as a child.'

0:01:10 > 0:01:12'Dragged from here to there, always on the move.'

0:01:15 > 0:01:16'My mother was...

0:01:17 > 0:01:19'My mother was complicated.'

0:01:20 > 0:01:24'So, for a variety of reasons, I spent a lot of my time in and around hospitals.'

0:01:26 > 0:01:29'They became so familiar - long corridors,

0:01:29 > 0:01:33'the smell of antiseptic, soap.'

0:01:33 > 0:01:35'And comfort.

0:01:35 > 0:01:39'That's what I remember the most - a hospital was a place

0:01:39 > 0:01:41'where people made things better.'

0:01:44 > 0:01:46'A hospital was my safe place.'

0:01:47 > 0:01:49HACKING COUGH

0:01:50 > 0:01:52'My haven.'

0:02:04 > 0:02:08CONTINUOUS COUGHING

0:02:08 > 0:02:12Basic standards of respiratory hygiene suggest

0:02:12 > 0:02:16source control measures to prevent patients with respiratory infections

0:02:16 > 0:02:18from transmitting their infection to others.

0:02:18 > 0:02:21Hello? If she won't cover her mouth with her hand,

0:02:21 > 0:02:23perhaps you could persuade her to cover it with a mask.

0:02:23 > 0:02:25Thank you.

0:02:25 > 0:02:28- Where's Eddi when you need her, eh? - I don't know. Not here.

0:02:29 > 0:02:30It was a rhetorical question.

0:02:30 > 0:02:33Well, it shouldn't be, she should be here and she's not.

0:02:33 > 0:02:35- You could call her. - Why would I do that?

0:02:35 > 0:02:37- Well, if you're worried. - I'm not, I'm annoyed.

0:02:37 > 0:02:40- What, that she's not here? - That she's late, yeah.

0:02:40 > 0:02:42Do you want me to call her?

0:02:42 > 0:02:44It's a bit early to panic, isn't it?

0:02:44 > 0:02:45Probably.

0:02:47 > 0:02:49Need some help here!

0:02:51 > 0:02:52'Coffee.

0:02:52 > 0:02:56'The aqua vitae of the junior doctor.

0:02:56 > 0:02:59'Also plays a vital role in the mating ritual

0:02:59 > 0:03:02'of this most fascinating of creatures.'

0:03:03 > 0:03:08Witness the opening manoeuvres of the lesser-spotted CT1

0:03:08 > 0:03:10as he makes his offering.

0:03:12 > 0:03:14The female of the species takes the offering.

0:03:14 > 0:03:17But the act of drinking doesn't necessarily imply

0:03:17 > 0:03:21an acceptance of the mating ritual.

0:03:21 > 0:03:24- WHISPERS:- Valentine and T-Lo? I don't think so.

0:03:24 > 0:03:2720 quid says he's passing the gravy.

0:03:27 > 0:03:28Who says romance is dead?

0:03:30 > 0:03:32- WHISPERS:- OK, you're on.

0:03:34 > 0:03:36They're sharing a muffin.

0:03:38 > 0:03:41- It's worse than we thought. - Doesn't mean anything.

0:03:41 > 0:03:45- It means you owe me 20 quid. - SHE STIFLES A LAUGH

0:03:46 > 0:03:48What do you think that's all about then?

0:03:48 > 0:03:52- What? - Mo and Jonny - just good friends?

0:03:52 > 0:03:54Of course - Ms Effanga, at least,

0:03:54 > 0:03:57isn't silly enough to jeopardise her professionalism

0:03:57 > 0:04:00- by carrying on a doomed workplace relationship.- Yeah.

0:04:03 > 0:04:05COUGHING

0:04:05 > 0:04:08Pulse 105. 38.8, burning up.

0:04:08 > 0:04:09Get off me.

0:04:09 > 0:04:11That's a nasty cough you've got there, Mr...?

0:04:11 > 0:04:13Can we get some oxygen please?

0:04:13 > 0:04:15- Does he have a name?- I dunno.

0:04:15 > 0:04:16Any identification?

0:04:17 > 0:04:19Did you even look?

0:04:19 > 0:04:21What's the point? Look at him, he's a tramp.

0:04:22 > 0:04:23Phone.

0:04:29 > 0:04:33Well, how was I supposed to know? He smells like a brewery and hasn't seen a bath in weeks.

0:04:33 > 0:04:36- Cash, cards... - I think the battery's dead.

0:04:36 > 0:04:38Here we go - Joe Harling.

0:04:38 > 0:04:41Found him in the visitor's car park, I thought he was taking a kip,

0:04:41 > 0:04:43I was going to sling him out until I saw the blood.

0:04:43 > 0:04:44Blood?

0:04:44 > 0:04:46Mr Harling? You have blood on your shirt.

0:04:46 > 0:04:48RETCHING COUGH

0:04:48 > 0:04:50Try and relax.

0:04:50 > 0:04:51We've got you.

0:04:52 > 0:04:56There's fluid on the lungs. Nurse? FBCs, U&E, LFT.

0:04:56 > 0:04:59Try and get him a chest X-ray as soon as possible.

0:04:59 > 0:05:00He's not well, is he?

0:05:00 > 0:05:04Neither will you be if you keep re-infecting with that handkerchief.

0:05:04 > 0:05:06- What have we got? - This is Donna Shale.

0:05:06 > 0:05:09She's 46, cardiac failure with assist device.

0:05:09 > 0:05:11B/P 110 systolic, pulse 100.

0:05:11 > 0:05:13Assist device? What for?

0:05:13 > 0:05:16Dilated Cardiomyopathy. It was fitted just before Christmas last year.

0:05:16 > 0:05:17Here?

0:05:17 > 0:05:19St James's - she's on the transplant list.

0:05:19 > 0:05:21- And you are? - WOMAN: Marcus?

0:05:21 > 0:05:25- ALARMS BEEP - It's going to be OK, I'm right here.

0:05:25 > 0:05:27OK, she's in VF, let's go.

0:05:27 > 0:05:28Oxygen, please.

0:05:33 > 0:05:34Ahem.

0:05:34 > 0:05:37Joe Harling's personal medical records.

0:05:37 > 0:05:40It's not good I'm afraid - first stage COPD.

0:05:40 > 0:05:42- Emphysema? - Diagnosed two years ago.

0:05:42 > 0:05:45Oh, another stunning victory for personal responsibility.

0:05:47 > 0:05:49- So is it time to panic?- What?

0:05:49 > 0:05:51Why don't you just call her?

0:05:51 > 0:05:52Who?

0:05:54 > 0:05:57There was a next of kin - Sandra, his wife.

0:05:57 > 0:05:59- Anyway, I've left a message.- Good.

0:05:59 > 0:06:02So, I'll take him to X-ray, shall I?

0:06:02 > 0:06:05Leave you to do whatever it is you're doing.

0:06:05 > 0:06:07Or not doing.

0:06:07 > 0:06:10You are the man with the camper van?

0:06:10 > 0:06:12Keith, isn't it?

0:06:12 > 0:06:14Shouldn't you be off... securing something?

0:06:14 > 0:06:17Your van - it's causing an obstruction.

0:06:17 > 0:06:19There's no permit, it's a fire hazard.

0:06:19 > 0:06:22I have an understanding with...

0:06:22 > 0:06:24Look, is this conversation going anywhere?

0:06:24 > 0:06:27Look, I've been feeling rough for the last couple of days.

0:06:27 > 0:06:30I was wondering if you could sort me out?

0:06:30 > 0:06:31Rough, how?

0:06:31 > 0:06:34Hot, bad cough, aches and pains, you know...

0:06:34 > 0:06:36Yeah, I do know.

0:06:36 > 0:06:37So, can you help me out then, Doc?

0:06:37 > 0:06:39I can.

0:06:39 > 0:06:41I can tell you you're either going to live or you're going to die.

0:06:41 > 0:06:44But in the meantime, go and see your GP.

0:06:44 > 0:06:45And get rid of that handkerchief!

0:06:47 > 0:06:48Charging to 200.

0:06:48 > 0:06:49Clear.

0:06:49 > 0:06:50No sinus rhythm.

0:06:50 > 0:06:53- Charge to 200 again.- I gave her aspirin, called an ambulance...

0:06:53 > 0:06:55This isn't meant to happen.

0:06:55 > 0:06:59- Doctor Lo, can you take Marcus to the relatives' room?- No!

0:06:59 > 0:07:00In a minute.

0:07:01 > 0:07:03Clear.

0:07:03 > 0:07:05REGULAR BEEPING

0:07:05 > 0:07:07- Sinus rhythm! - She's back, but she's not stable.

0:07:07 > 0:07:12We'll need an IV with 200 milligrams of dopamine in 50 of saline, and a 12 lead.

0:07:12 > 0:07:14Dr Lo, a minute of your time.

0:07:19 > 0:07:21- Ms Effanga, I...- Sssst!

0:07:22 > 0:07:23Phew...

0:07:23 > 0:07:25Is it...the baby?

0:07:25 > 0:07:26No, it's gas.

0:07:26 > 0:07:29Course it's the baby, you pillock.

0:07:29 > 0:07:31Tell me, Dr Lo, which part of your training taught you

0:07:31 > 0:07:33to ignore a direct order from a Registrar?

0:07:33 > 0:07:36- I'm really sorry, I... I wasn't thinking. - No, you weren't.

0:07:36 > 0:07:38It was a slip of the tongue.

0:07:38 > 0:07:40I don't remember inviting you to this party.

0:07:40 > 0:07:44I'll order FBCs, blood cultures, clotting and CT scan - she wasn't disobedient, only...

0:07:44 > 0:07:45Eager.

0:07:45 > 0:07:48- You make her sound like a puppy. - Well...

0:07:49 > 0:07:52I'm not a puppy, and if Dr Valentine is ordering tests

0:07:52 > 0:07:55he might want to consider an echocardiogram.

0:07:57 > 0:07:59Transthoracic or transoesophageal?

0:08:00 > 0:08:01Transthoracic.

0:08:01 > 0:08:03Transoesophageal.

0:08:03 > 0:08:05One-nil to the puppy.

0:08:05 > 0:08:08Right, run your tests, come back to me with your conclusions.

0:08:09 > 0:08:11Jog on.

0:08:15 > 0:08:18Five pints of lager, four vodka lime and soda,

0:08:18 > 0:08:21or one very decent bottle of St Emillion.

0:08:21 > 0:08:22What?

0:08:22 > 0:08:24What I can buy with the 20 quid you owe me.

0:08:24 > 0:08:26Nothing's been proved yet.

0:08:26 > 0:08:29After that display of rampant flirtation?

0:08:29 > 0:08:32What, arguing over types of echo tests is considered flirting, is it?

0:08:32 > 0:08:34All the young kids doing it?

0:08:34 > 0:08:36All the young cardiothoracic doctors.

0:08:36 > 0:08:39One minute it's echo tests, the next, sweaty bodies

0:08:39 > 0:08:42grinding to Barry White tunes up against the ECG machi...

0:08:42 > 0:08:44La-la-la-la, not listening...

0:08:44 > 0:08:46- DEEP VOICE: - We got it together, didn't we?

0:08:46 > 0:08:47Still not listening.

0:08:51 > 0:08:53Morning.

0:08:54 > 0:08:55Just.

0:08:55 > 0:08:57Have I missed anything interesting?

0:08:57 > 0:09:01One accidental stabbing, a couple of alcohol-related falls,

0:09:01 > 0:09:05a 30-a-day man with emphysema, a couple of suspected flu cases,

0:09:05 > 0:09:07oh, and a senior staff nurse not turning up for work -

0:09:07 > 0:09:09that was exciting.

0:09:09 > 0:09:11If you've got anything to say, Mr Hemingway, don't.

0:09:11 > 0:09:14Not today, OK?

0:09:14 > 0:09:17I'm Sandra Harling, I was told my husband was here.

0:09:17 > 0:09:21Yeah, Mr Harling's been taken for a chest X-ray.

0:09:21 > 0:09:23Shouldn't be too long, these are his things.

0:09:23 > 0:09:25- But he's OK? - Well, he's stable.

0:09:25 > 0:09:28He suffered a collapse due to complications with his emphysema.

0:09:28 > 0:09:30- Collapsed where?- Hospital car park, as far as I know.

0:09:30 > 0:09:33Nurse McKee can show you somewhere to wait.

0:09:33 > 0:09:36- Was he drunk? - Almost certainly, I'm afraid.

0:09:36 > 0:09:38Is he a heavy drinker?

0:09:38 > 0:09:40Used to be. Seven years sober.

0:09:40 > 0:09:43- I'm sorry. - I'm just glad he's been found.

0:09:43 > 0:09:47- Found? - He's been missing for a week.

0:09:47 > 0:09:49I reported it to the police yesterday.

0:09:49 > 0:09:52At least now I know what he's been doing all this time.

0:09:52 > 0:09:53'Unfortunately,'

0:09:53 > 0:09:55the tests have confirmed that it's the LVAD,

0:09:55 > 0:09:58the device itself, which is infected.

0:09:58 > 0:10:02It could be any infection you've been exposed to since it was implanted, we just don't know.

0:10:02 > 0:10:07What we do know is that vegetation is clustering around the connectors to your heart.

0:10:07 > 0:10:10The LVAD needs to be removed and replaced.

0:10:10 > 0:10:11Another operation?

0:10:11 > 0:10:15The infection almost certainly caused an electrolyte imbalance

0:10:15 > 0:10:17leading to your cardiac failure this morning.

0:10:17 > 0:10:19It's a ticking bomb.

0:10:19 > 0:10:22Mrs Shale, it's a fairly quick and simple procedure.

0:10:22 > 0:10:25You'll be back home with your son before you know it.

0:10:26 > 0:10:28Marcus isn't my son.

0:10:28 > 0:10:29I'm her boyfriend.

0:10:31 > 0:10:32Oh...

0:10:32 > 0:10:34How nice.

0:10:41 > 0:10:42Well, the good news is

0:10:42 > 0:10:44your emphysema doesn't seem to have got any worse.

0:10:44 > 0:10:48The bad news is, you appear to have contracted pneumonia.

0:10:48 > 0:10:52HE COUGHS Pneumonia? How?

0:10:52 > 0:10:54Well, heavy smoking probably doesn't help.

0:10:55 > 0:10:58I've tried cutting down. Didn't go quite as I'd hoped.

0:10:58 > 0:11:02The six day alcohol binge did you no favours either.

0:11:02 > 0:11:06- Don't judge me. You don't know me. - You're right, I don't know you.

0:11:06 > 0:11:08But I do know a dying man when I see one.

0:11:10 > 0:11:12- Dying?- Uh-huh.

0:11:12 > 0:11:14What I think Mr Hemingway's trying to say is that...

0:11:14 > 0:11:17What Mr Hemingway's trying to say is that

0:11:17 > 0:11:20a couple more days without treatment and you'd almost certainly be dead.

0:11:20 > 0:11:23So, for your own sake, lay off the booze, cut out the cigarettes.

0:11:23 > 0:11:25Your wife's here. She's worried about you, Joe.

0:11:25 > 0:11:27With good reason.

0:11:29 > 0:11:31What happened?

0:11:31 > 0:11:32You look terrible.

0:11:32 > 0:11:35Just got a bit of a cough, that's all.

0:11:35 > 0:11:37HACKING COUGH

0:11:37 > 0:11:39Who is she?

0:11:40 > 0:11:43What? Zoe? Who's Zoe?

0:11:46 > 0:11:49Your phone, Joe, 30-odd missed calls - who is she?

0:11:50 > 0:11:52No one.

0:11:53 > 0:11:55Just leave.

0:11:55 > 0:11:57Get her out of here, please!

0:11:57 > 0:12:00OK, she can have you.

0:12:01 > 0:12:03What's left of you.

0:12:05 > 0:12:07LAUGHTER

0:12:07 > 0:12:08No way! That's brilliant!

0:12:09 > 0:12:11What's so funny?

0:12:11 > 0:12:14The boys were telling just me about their night out.

0:12:14 > 0:12:15Night out? Again?

0:12:15 > 0:12:18Yeah, pure jokes - speed-dating night at the Fluffy Duck.

0:12:20 > 0:12:23- And did you find true love? - Um, no, not exactly.

0:12:23 > 0:12:25They went round the whole room, only to find

0:12:25 > 0:12:28they were best matched to each other - isn't that funny?

0:12:28 > 0:12:30Hilarious. Someone paged me for a consult?

0:12:30 > 0:12:31Yeah.

0:12:31 > 0:12:36Adam Barry, ED referral, possible acute transient synovitis.

0:12:36 > 0:12:38AKA irritable hip.

0:12:38 > 0:12:39My dude's seriously uptight.

0:12:39 > 0:12:41Right up your alley.

0:12:43 > 0:12:47Been feeling pain on and off for the past few days now but...

0:12:47 > 0:12:48HE COUGHS

0:12:48 > 0:12:51..never anything bad enough that Ibuprofen couldn't fix.

0:12:51 > 0:12:54- Until now. - Until last night.

0:12:54 > 0:12:57Could barely walk. Luckily Mum was happy

0:12:57 > 0:12:59to help with the packing, otherwise I'd never be ready.

0:12:59 > 0:13:01Careful with that.

0:13:01 > 0:13:04I get this, like, ear infection sometimes.

0:13:04 > 0:13:06Holiday?

0:13:06 > 0:13:07Trip of a lifetime.

0:13:07 > 0:13:09Flight leaves at midnight, I can't wait.

0:13:09 > 0:13:11I'm just going to have a look at the old leg.

0:13:11 > 0:13:13Ah!

0:13:14 > 0:13:16- Haven't touched you yet. - Anticipation.

0:13:16 > 0:13:1838.9.

0:13:18 > 0:13:20You're burning up.

0:13:20 > 0:13:23Sometimes I get these hot flushes when I'm nervous.

0:13:23 > 0:13:26- Dos that happen a lot? - Beta blockers help.

0:13:26 > 0:13:28Are you taking any other medication?

0:13:28 > 0:13:32Malaria pills. And I came in recently for my travel jabs.

0:13:32 > 0:13:35- Where are you going? - Central and West Africa.

0:13:35 > 0:13:37Volunteer aid worker.

0:13:37 > 0:13:39- It's my gap year.- Right.

0:13:39 > 0:13:42Well, let's see what the X-ray shows up.

0:13:42 > 0:13:43Try not to worry.

0:13:43 > 0:13:46We'll see if we can get you on that flight.

0:13:48 > 0:13:49West Africa?

0:13:49 > 0:13:52He wouldn't survive West Hampstead.

0:13:52 > 0:13:54Well, you never know, it might be the making of him.

0:13:55 > 0:13:56'How nice?'

0:13:56 > 0:13:58Oh, don't.

0:13:58 > 0:14:00What was I supposed to say?

0:14:00 > 0:14:03I guess "how nice" is better than "Yuck, creeparama."

0:14:03 > 0:14:06Creeparama? I've never used that word in my life.

0:14:06 > 0:14:08Think you might have just made it up.

0:14:08 > 0:14:11Besides, it IS nice.

0:14:11 > 0:14:14What's wrong with a May/October relationship?

0:14:14 > 0:14:17Nothing, I guess, it's just not going to last forever, is it?

0:14:17 > 0:14:20Well, nothing lasts forever. It just has to last long enough.

0:14:22 > 0:14:24Donna and I have talked.

0:14:24 > 0:14:27She's ready for the operation.

0:14:27 > 0:14:29Great, I'll grab the consent forms.

0:14:51 > 0:14:53Something wrong?

0:14:53 > 0:14:55Put it this way - there's not a lot right.

0:14:55 > 0:14:58Look, what happened with my wife...

0:14:58 > 0:14:59None of my business. What is my business

0:14:59 > 0:15:03is that your antibiotics don't seem to be making much headway.

0:15:03 > 0:15:06So it's this stuff that's keeping me alive?

0:15:06 > 0:15:08Well, it's meant to, uh...

0:15:08 > 0:15:11It's meant make you feel a little better.

0:15:11 > 0:15:14It's early days, of course, but... Nurse McKee?

0:15:14 > 0:15:18Can we push more broad spectrum antibiotics for Mr Harling, please?

0:15:18 > 0:15:21Two milligrams of co-amoxyclav.

0:15:21 > 0:15:24Of course. Nurse? Can you assist Mr Hemingway please? Thank you.

0:15:26 > 0:15:30- Have I done something to offend her? - Is this a rhetorical question?

0:15:31 > 0:15:32She's probably just busy.

0:15:32 > 0:15:34If you hadn't noticed, we have been filling up.

0:15:34 > 0:15:37- That's three ED referrals with flu symptoms in the last... - It's not flu season.

0:15:37 > 0:15:40Am I supposed to know what it is I've done to upset her?

0:15:40 > 0:15:42She's probably just tired.

0:15:42 > 0:15:45- You know, a bit wrung out from the trip back from Leeds.- Leeds?

0:15:45 > 0:15:46Liam's court appearance.

0:15:48 > 0:15:49She didn't tell you?

0:15:53 > 0:15:55I'm not afraid of the pain.

0:15:56 > 0:15:58I'm not even afraid of dying.

0:15:59 > 0:16:01I'm afraid of being a burden.

0:16:03 > 0:16:05I'm sure Marcus doesn't see it like that.

0:16:05 > 0:16:08No, he wouldn't.

0:16:08 > 0:16:10How did you two meet?

0:16:10 > 0:16:12His mother was my best friend.

0:16:15 > 0:16:17I know how that sounds.

0:16:17 > 0:16:20Then she died, two years ago - MS.

0:16:20 > 0:16:23He nursed her through that, and I was there for her.

0:16:25 > 0:16:26Then I was there for him.

0:16:29 > 0:16:31Swelling in the soft tissue.

0:16:31 > 0:16:34You're thinking septic arthritis?

0:16:34 > 0:16:35- Yeah...- But?

0:16:35 > 0:16:38There's a whole range of other symptoms that

0:16:38 > 0:16:40don't quite support the diagnostic picture.

0:16:40 > 0:16:44Shortness of breath, fever, nasty rash developing on his neck...

0:16:44 > 0:16:47Basically, he's a walking germ factory.

0:16:47 > 0:16:48What are your thoughts?

0:16:48 > 0:16:52Lyme disease. Osteoarthritis. Systemic lupus erythematosus.

0:16:52 > 0:16:56Or it could be septic arthritis and a dose of the flu.

0:16:56 > 0:16:59Either way, poor guy's not going on a gap year trip any time soon.

0:16:59 > 0:17:03Maybe not such a bad thing. He's hardly Bear Grylls, is he?

0:17:03 > 0:17:05- Adam Barry's test results.- Cheers.

0:17:07 > 0:17:09Hmm, elevated CRP, elevated ESR...

0:17:09 > 0:17:12Supports the septic arthritis diagnosis.

0:17:12 > 0:17:13Or any of the others.

0:17:14 > 0:17:16Only one way to make sure.

0:17:17 > 0:17:20You want to do what to my what?

0:17:20 > 0:17:23An ultrasound guided needle aspiration.

0:17:23 > 0:17:26It's a diagnostic test allowing us to take a small amount of fluid

0:17:26 > 0:17:29from the joint and send it away for analysis.

0:17:29 > 0:17:32- OK, But when you say "needles"...? - Look, don't worry.

0:17:32 > 0:17:35Dr Dan here has the safest hands in the business.

0:17:35 > 0:17:36Trust me.

0:17:39 > 0:17:43See? All it takes is a little encouragement.

0:17:43 > 0:17:45And a little obfuscation.

0:17:45 > 0:17:47You moved very quickly away from the subject of needles.

0:17:47 > 0:17:49One step at a time, yeah?

0:17:49 > 0:17:51Is that how you and Simon do things, one step at a time?

0:17:51 > 0:17:53Woah!

0:17:53 > 0:17:55Are you jealous?!

0:17:55 > 0:17:58Don't be ridiculous, I'm nothing of the sort.

0:17:58 > 0:18:01The green-eyed monster with Dr Dan, lovin' it, lovin' it, lovin' it.

0:18:01 > 0:18:03Now you're just being childish.

0:18:03 > 0:18:05All right, I'm sorry, I will stop being childish,

0:18:05 > 0:18:06- if you stop being a coward.- What?

0:18:06 > 0:18:09If you like him, you like him - just ask him out.

0:18:09 > 0:18:10He won't bite.

0:18:10 > 0:18:12Unless you ask.

0:18:16 > 0:18:17Whose are those?

0:18:19 > 0:18:21- You see it, too.- See what?

0:18:21 > 0:18:24- The difference.- Of course.

0:18:24 > 0:18:26This heart is smaller, right?

0:18:26 > 0:18:28Stronger.

0:18:29 > 0:18:34And the ejection fraction on that one is better than that one.

0:18:38 > 0:18:40Yes, of course.

0:18:40 > 0:18:41What's all this about?

0:18:44 > 0:18:45It's the same heart.

0:18:50 > 0:18:52This is the echo of Donna Shale's heart this morning.

0:18:52 > 0:18:55- This is from the three weeks after the LVAD was implanted.- And?

0:18:55 > 0:18:58There's a significant reduction in dilation.

0:18:58 > 0:19:01- As you'd expect - the LVAD's doing its job.- Maybe it's done its job.

0:19:01 > 0:19:04Maybe her heart has recovered.

0:19:05 > 0:19:06I'm listening.

0:19:06 > 0:19:09There are documented cases of LVAD providing enough support

0:19:09 > 0:19:12to the heart to let it rest and effectively recover.

0:19:12 > 0:19:15Even if that's the case, what are you suggesting?

0:19:15 > 0:19:18- The LVAD's infected, we have to remove it.- Yes, but not replace it.

0:19:18 > 0:19:20We need to give the heart the chance to function on its own.

0:19:20 > 0:19:23Give her a whole new life. A normal life.

0:19:23 > 0:19:25KNOCKING

0:19:25 > 0:19:27Time to take your blood pressure.

0:19:27 > 0:19:30- No, there's not enough evidence. - Consider the ejection fraction -

0:19:30 > 0:19:32it's significantly improved, not just in the post LVAD case,

0:19:32 > 0:19:35but in the weeks prior to the device being fitted.

0:19:38 > 0:19:40OK, I'll speak to Mr Hope.

0:19:41 > 0:19:43Ejection fraction, huh?

0:19:43 > 0:19:44That's a good catch.

0:19:48 > 0:19:49Well done.

0:19:49 > 0:19:51HE SIGHS

0:19:52 > 0:19:55Why didn't you tell me about Liam's court appearance?

0:19:55 > 0:19:56If you'd have kept in touch with him,

0:19:56 > 0:19:58he'd have been able to tell you himself.

0:19:58 > 0:20:01I HAVE kept in touch.

0:20:01 > 0:20:03What is wrong with you?

0:20:03 > 0:20:06I mean, sending the occasional link to O-Negative newsletter

0:20:06 > 0:20:09does not constitute staying in touch.

0:20:09 > 0:20:12You know what? I promised myself I wasn't going to do this.

0:20:12 > 0:20:14So I won't.

0:20:14 > 0:20:17Listen, you've got every right to be annoyed, OK?

0:20:18 > 0:20:21This isn't about me. It's about Liam.

0:20:21 > 0:20:23I know, I know. I was his nominated mentor,

0:20:23 > 0:20:26and, um, I just thought they'd call if they needed me.

0:20:27 > 0:20:29They didn't need you.

0:20:30 > 0:20:31Liam needed you.

0:20:31 > 0:20:34You're not supposed to be his friend.

0:20:34 > 0:20:36And I'm not annoyed, Luc, I'm not. I'm...

0:20:37 > 0:20:39I'm just tired.

0:20:40 > 0:20:41Of you.

0:20:42 > 0:20:46And of us, and of this... stupid thing.

0:20:46 > 0:20:48If this is about when...

0:20:50 > 0:20:53If this is about when we kissed, you have to understand...

0:20:53 > 0:20:55I'm tired of trying to understand you, Luc.

0:20:55 > 0:20:59Of wanting to understand you.

0:21:01 > 0:21:03I don't want to do it anymore.

0:21:03 > 0:21:06- Eddi, I didn't mean that I... - Don't.

0:21:07 > 0:21:09OK? Please, just don't.

0:21:09 > 0:21:10KNOCKING

0:21:10 > 0:21:11Not now!

0:21:11 > 0:21:13- It's Joe Harling.- What about him?

0:21:13 > 0:21:15He's refusing treatment.

0:21:27 > 0:21:28Mr Harling.

0:21:28 > 0:21:30Something wrong?

0:21:31 > 0:21:35Put it this way - there's not a lot right.

0:21:35 > 0:21:37Well, there certainly won't be

0:21:37 > 0:21:40unless we get that IV drip back in your arm.

0:21:40 > 0:21:42Not gonna happen.

0:21:42 > 0:21:45I'm not sure you understand the consequences of this action.

0:21:45 > 0:21:47Oh, I think I do.

0:21:47 > 0:21:50Without treatment the pneumonia will cause your lungs

0:21:50 > 0:21:52to slowly fill with fluid.

0:21:52 > 0:21:55This is not only exceedingly painful,

0:21:55 > 0:21:57it's also almost invariably fatal.

0:21:58 > 0:22:00That's the plan.

0:22:04 > 0:22:06There's a chance - a slim chance -

0:22:06 > 0:22:09that the LVAD has allowed your heart to recover

0:22:09 > 0:22:11and it now has the strength to function on its own.

0:22:11 > 0:22:15But her heart was damaged. It stopped this morning.

0:22:15 > 0:22:17How can you now say it's recovered?

0:22:17 > 0:22:20The cardiac failure was caused by an LVAD infection.

0:22:20 > 0:22:21It's separate to the cardiomyopathy.

0:22:21 > 0:22:24Dr Valentine chased up your echoes from St James's.

0:22:24 > 0:22:28- They were enough to convince me that we should at least give this a shot.- Him?

0:22:28 > 0:22:30He's just a kid.

0:22:30 > 0:22:32DONNA: Marcus, it's OK. This is a good thing.

0:22:32 > 0:22:34It's reckless.

0:22:34 > 0:22:36There are risks, as with any surgery.

0:22:36 > 0:22:38But we won't leave there until we're sure

0:22:38 > 0:22:41that the heart is functioning on its own.

0:22:41 > 0:22:43And if there's any problems we'll pop you back on bypass

0:22:43 > 0:22:46- and attach a new LVAD. - What if something goes wrong?

0:22:46 > 0:22:47Who'll picks up the pieces?

0:22:47 > 0:22:48Him?

0:22:50 > 0:22:54At least now we know where we stand. We can manage the risks.

0:22:54 > 0:22:56Please, don't rush into this.

0:22:56 > 0:23:00There's no rush. I've been dreaming about this for over a year.

0:23:00 > 0:23:01Let's do it.

0:23:05 > 0:23:06Good job, Valentine.

0:23:06 > 0:23:09Mr Hope's looking forward to seeing you in theatre at 2:30.

0:23:09 > 0:23:15- Really?!- Your catch, your game. He was very impressed.

0:23:15 > 0:23:16You?

0:23:17 > 0:23:19I'm so jealous. Well done.

0:23:19 > 0:23:20PHONE RINGS

0:23:20 > 0:23:22Yeah, thanks.

0:23:28 > 0:23:29You won.

0:23:29 > 0:23:31He's not tuning her ECG machine.

0:23:31 > 0:23:35- How do you know?- The ejection fraction get? That was Tara's.

0:23:36 > 0:23:39He had a chance to fess up, and he didn't.

0:23:39 > 0:23:41I'm afraid that just ain't very Barry White.

0:23:42 > 0:23:44Disappointing.

0:23:44 > 0:23:45Yeah, it is.

0:23:47 > 0:23:49- Aren't you going to do something? - About what?

0:23:49 > 0:23:50About him.

0:23:52 > 0:23:54- Oh, I am.- What? - I'm waiting.

0:23:54 > 0:23:55Until he dies?

0:23:55 > 0:23:57I'm hoping he'll see sense a little before then.

0:23:57 > 0:24:00- Look, you need to talk to him. - I have.

0:24:00 > 0:24:03Oh, well, if you've described his impending death to him

0:24:03 > 0:24:05in great detail, then that's not talking.

0:24:05 > 0:24:08You need to listen.

0:24:08 > 0:24:09Where are you going?

0:24:09 > 0:24:12- To find Sandra.- His wife? Why?

0:24:19 > 0:24:21What?!

0:24:30 > 0:24:31What do you want?

0:24:31 > 0:24:33To listen.

0:24:34 > 0:24:36What good's that going to do?

0:24:36 > 0:24:37I don't know.

0:24:37 > 0:24:40I was told to do it by someone whose opinion I value.

0:24:40 > 0:24:42Yeah, well, it's too late for that.

0:24:46 > 0:24:50Mr Harling, I have no idea what's going on up here, or in here.

0:24:50 > 0:24:53What I do know is that what you're doing -

0:24:53 > 0:24:57committing suicide via hospital - is not very pleasant.

0:24:57 > 0:24:59For me, for my staff or for my patients.

0:25:03 > 0:25:04I know.

0:25:04 > 0:25:06And I'm sorry.

0:25:06 > 0:25:08But it's not about you.

0:25:09 > 0:25:12You just have to take my word on that, it's just...

0:25:12 > 0:25:13COUGHING

0:25:13 > 0:25:16It's just how it has to be.

0:25:16 > 0:25:17Why?

0:25:17 > 0:25:21Please, we want to help. That's what we do.

0:25:21 > 0:25:23No, not always.

0:25:23 > 0:25:26You say you do, but you don't.

0:25:35 > 0:25:37I'm sorry but rules are rules.

0:25:37 > 0:25:40This is a designated fire exit route, you can't just sit here...

0:25:40 > 0:25:42- Sandra?- Do you know this lady? - Yeah.

0:25:42 > 0:25:44Well, will you tell her?

0:25:45 > 0:25:47How is he?

0:25:47 > 0:25:50SHE SIGHS

0:25:53 > 0:25:55He needs you.

0:25:55 > 0:25:56HE COUGHS VIOLENTLY

0:25:56 > 0:25:58Are you all right?

0:25:59 > 0:26:03Why don't you get yourself over to AAU and ask for Mr Levy?

0:26:16 > 0:26:17Needle?

0:26:18 > 0:26:19How we going?

0:26:20 > 0:26:23- Great. - Nervous again?

0:26:23 > 0:26:25Yeah, just a bit.

0:26:25 > 0:26:27Tell me...

0:26:27 > 0:26:30..do you know much about Central Africa?

0:26:30 > 0:26:31This and that.

0:26:31 > 0:26:34I read Heart of Darkness, by Conrad.

0:26:34 > 0:26:37Actually, I just watched the film Apocalypse Now.

0:26:37 > 0:26:39It's based on Heart of Darkness.

0:26:39 > 0:26:41Right.

0:26:43 > 0:26:46You do understand that this trip is...

0:26:46 > 0:26:48Oh!

0:26:48 > 0:26:50Oh.

0:26:51 > 0:26:53Let's face it makes our lives easier.

0:26:53 > 0:26:55Like putty in your hands.

0:26:56 > 0:26:58- How you settling in?- Pretty good.

0:27:01 > 0:27:03You and Malick seem to be getting on very well.

0:27:03 > 0:27:07Yeah, he's great. He showing me a few places to hang out.

0:27:08 > 0:27:10We haven't really had a chance to catch up, have we?

0:27:10 > 0:27:12No, we haven't.

0:27:13 > 0:27:17- Sorry about that. - That's all right.

0:27:17 > 0:27:20- You're busy.- It's not that. I mean, I am busy, but...

0:27:22 > 0:27:24Maybe we should get a beer.

0:27:24 > 0:27:26Maybe we should. Any place in mind?

0:27:26 > 0:27:27Not really.

0:27:27 > 0:27:31Probably not the sort of places you and Malick have been going.

0:27:33 > 0:27:35- Meaning what?- You know.

0:27:35 > 0:27:38Fluffy Duck. The mind boggles.

0:27:38 > 0:27:39Hmm.

0:27:39 > 0:27:41Well, it's just a bar, Dan, like any other.

0:27:41 > 0:27:44Well, it's not really, though, is it?

0:27:45 > 0:27:48Yes, it is, actually.

0:27:50 > 0:27:53Look I've got stuff I should be doing so...

0:28:07 > 0:28:09Mr Hanssen, please.

0:28:10 > 0:28:12Yes, I'll hold.

0:28:21 > 0:28:23Tell me what's going on?

0:28:24 > 0:28:25I can't explain.

0:28:26 > 0:28:29Please go, I don't want you seeing me like this.

0:28:32 > 0:28:34Not until you start talking to me.

0:28:38 > 0:28:40Hello.

0:28:40 > 0:28:42Are you stalking me?

0:28:42 > 0:28:45- I've been told to ask for Mr Levy, all right?- Levy.

0:28:45 > 0:28:49Well, he's not under the desk, ergo, he's not here.

0:28:49 > 0:28:51You're still here.

0:28:51 > 0:28:53Look, I feel like hell, aches, pains, headache...

0:28:53 > 0:28:55OK, just take this.

0:28:56 > 0:28:58It should make you feel a bit better.

0:28:58 > 0:29:01Go home, get some rest.

0:29:01 > 0:29:03Look, I can't just leave work.

0:29:03 > 0:29:05Doctor's orders.

0:29:05 > 0:29:06Go!

0:29:10 > 0:29:13Come on, come on, come on... This is ridiculous.

0:29:13 > 0:29:16Did she say anything to you about him coming here as an outpatient?

0:29:16 > 0:29:19- No. Here? - Well, not here-here, on Keller.

0:29:19 > 0:29:22- He's on Hanssen's list. - For what?

0:29:22 > 0:29:24I don't know. I'm going to find out.

0:29:29 > 0:29:32COUGHING WEAKLY

0:29:32 > 0:29:35How exciting to be in theatre with Mr Hope.

0:29:35 > 0:29:38- Not that exciting. - The procedure is.

0:29:38 > 0:29:42- Yeah, I suppose so. - Now you're just rubbing it in.

0:29:50 > 0:29:52Mr Hope, Ms Effanga.

0:29:52 > 0:29:55Dr Valentine, I expect you're looking forward to seeing this through.

0:29:55 > 0:29:56Very much so.

0:29:56 > 0:29:59I was wondering if it would be possible for Dr Lo to scrub in.

0:29:59 > 0:30:01Mmm, she's very junior, even for an F1.

0:30:01 > 0:30:04- Did she put you up to this? - No, not at all.

0:30:04 > 0:30:07Truth is, she deserves to be included in this as much as me.

0:30:07 > 0:30:09If not more so.

0:30:09 > 0:30:11She spotted the connection to the Ejection Fraction.

0:30:11 > 0:30:13I put it together, but...

0:30:14 > 0:30:16Look, she deserves this.

0:30:16 > 0:30:18She can have my place.

0:30:18 > 0:30:21I don't see why we can't fit another one in.

0:30:21 > 0:30:23As long as she's seen and not heard, understood?

0:30:23 > 0:30:25Yes, of course.

0:30:35 > 0:30:37- He fessed up?- Yep.

0:30:37 > 0:30:39- Faith restored.- Yep.

0:30:41 > 0:30:43Where's the rest?

0:30:43 > 0:30:45No, the bet's still on.

0:30:45 > 0:30:47Just cos he's honest doesn't mean he's hot to trot.

0:30:49 > 0:30:55Yes, here it is. Joe Harling. Outpatient. Mr Henrik Hanssen.

0:30:55 > 0:30:59Yeah, I've got that bit. Could you tell me what was here for?

0:30:59 > 0:31:00OK. Tests.

0:31:00 > 0:31:03OK, lung function test.

0:31:03 > 0:31:05ABO blood group compatibility.

0:31:05 > 0:31:07- HLA blood grouping compatibility. - Hang on...

0:31:07 > 0:31:10He was in for transplant compatibility testing?

0:31:10 > 0:31:13That's right. For possible kidney donation.

0:31:13 > 0:31:15There's nothing wrong with his kidneys.

0:31:15 > 0:31:17No. He was testing to be a donor.

0:31:28 > 0:31:30Can I help you?

0:31:30 > 0:31:32- I'm looking for Joe Harling. - He's in that bed there.

0:31:38 > 0:31:39You must be Zoe.

0:31:42 > 0:31:45WHEEZING Zoe, what are you doing here?

0:31:45 > 0:31:47I called her.

0:31:47 > 0:31:49I can't believe this is your girlfriend.

0:31:49 > 0:31:52She's not his girlfriend. Is she?

0:31:54 > 0:31:56She's my daughter!

0:32:02 > 0:32:05You know, I never had a gap year. Wasn't really done when I was at Uni.

0:32:05 > 0:32:08What made you choose West Africa?

0:32:09 > 0:32:11I met this girl.

0:32:11 > 0:32:15She's already out there. We got chatting. I got carried away.

0:32:15 > 0:32:19- Before I knew it...- You'd donated a year to charity.- Yeah.

0:32:19 > 0:32:21I just hope it's worth it.

0:32:21 > 0:32:23Sorry about earlier.

0:32:23 > 0:32:25- Needles, yeah.- It's all right.

0:32:25 > 0:32:28- We got what we needed. - It's bad, isn't it?

0:32:28 > 0:32:31I wouldn't say it's bad. But it is urgent.

0:32:31 > 0:32:35- You have septic arthritis. - Arthritis? I'm only 20!

0:32:35 > 0:32:38Septic arthritis is caused by bacteria,

0:32:38 > 0:32:41- it's not quite what you're thinking.- What kind of bacteria?

0:32:41 > 0:32:44We won't know until we get the results. We took a sample of the pus

0:32:44 > 0:32:45during the aspiration.

0:32:47 > 0:32:50Well, the details aren't important right now.

0:32:50 > 0:32:53What is important is that we get you into theatre ASAP.

0:32:55 > 0:32:57I'm not going to make my flight, am I?

0:32:57 > 0:33:02No, Adam, you're not going to make your flight to deepest darkest Africa.

0:33:02 > 0:33:05Tell you what, mate, give me your tickets and info

0:33:05 > 0:33:07and I'll see if they'll change your dates.

0:33:07 > 0:33:09- Really? That's...- Oh, come on.

0:33:09 > 0:33:12Can we just drop the whole Africa thing? Let's be real here.

0:33:12 > 0:33:14You're not going to Africa. Not now. Not ever.

0:33:14 > 0:33:19You can't stand pain, needles or minor skin irritations.

0:33:19 > 0:33:23There couldn't possibly be a less suitable place on this earth for you to go.

0:33:23 > 0:33:28- You're not an intrepid explorer. You're a geek.- Mr Hamilton!

0:33:33 > 0:33:36- You're donating a kidney to your daughter?- Correction.

0:33:36 > 0:33:38WAS donating a kidney.

0:33:38 > 0:33:41- Seems to have gone off the radar.- Let's just slow down.

0:33:41 > 0:33:43Do you want a potted family history?

0:33:44 > 0:33:46Dad gets mum pregnant.

0:33:46 > 0:33:49Zoe gets born. Zoe gets sick.

0:33:49 > 0:33:51Dad leaves Mum.

0:33:51 > 0:33:53Mum dies.

0:33:55 > 0:33:57Zoe gets sick again.

0:33:57 > 0:33:59Zoe finds Dad.

0:33:59 > 0:34:01Dad promises to help.

0:34:01 > 0:34:03Dad doesn't.

0:34:04 > 0:34:06- What happened?- I don't know.

0:34:06 > 0:34:10Mr Hanssen, my consultant,

0:34:10 > 0:34:15just said that Dad had "proved an unreliable and unsafe candidate".

0:34:17 > 0:34:20Unreliable and unsafe.

0:34:20 > 0:34:22- Perfect.- Joe!

0:34:23 > 0:34:26It was the fags!

0:34:26 > 0:34:28Hanssen said I had to quit.

0:34:28 > 0:34:30Cos of the emphysema.

0:34:31 > 0:34:33I tried!

0:34:33 > 0:34:34HE SOBS

0:34:34 > 0:34:37I didn't know what to do, so I...

0:34:37 > 0:34:39You had a drink.

0:34:40 > 0:34:42Well, hate to break the reunion up, but I've got to go.

0:34:44 > 0:34:47He's all yours. Have a nice life.

0:34:47 > 0:34:49Wait! You can't just walk away.

0:34:49 > 0:34:51I can and I will.

0:34:51 > 0:34:55If he wants to kill himself, fine.

0:34:55 > 0:34:58None of this, whatever's going on here, has anything to do with me.

0:34:58 > 0:35:03That isn't true, I'm afraid. This has everything to do with you.

0:35:03 > 0:35:05- Doesn't it? - What are you talking about?

0:35:05 > 0:35:08Your father was refused donor status

0:35:08 > 0:35:11because of the risk to his own health in the event of a transplant.

0:35:12 > 0:35:16That obstacle is overcome if he's dead.

0:35:18 > 0:35:19It's the only way.

0:35:21 > 0:35:22No...

0:35:23 > 0:35:25No.

0:35:29 > 0:35:33This time, I'm going to talk. You're going to listen.

0:35:35 > 0:35:37Boy, that was some speech you made back there.

0:35:37 > 0:35:41Attempting to remove all the infected material.

0:35:41 > 0:35:44- Yeah, you really showed him. - All right, you've made your point.

0:35:44 > 0:35:48Not as forcefully as you just made yours.

0:35:48 > 0:35:52MONITOR ALARM BEEPS Sats are dropping.

0:35:52 > 0:35:53Push fluids.

0:35:59 > 0:36:00BEEPING CONTINUES

0:36:00 > 0:36:04I just wanted him to see reason, face facts.

0:36:04 > 0:36:05Yeah, right.

0:36:08 > 0:36:10- He's congested. - What do you mean?

0:36:10 > 0:36:14His lungs are filling up with fluid.

0:36:14 > 0:36:17Something is going on here! SECOND ALARM BEEPS

0:36:17 > 0:36:19I don't know what you've done.

0:36:19 > 0:36:21What pain you caused your daughter,

0:36:21 > 0:36:24what guilt you feel. What I do know is this finishes now.

0:36:24 > 0:36:26It's not going to work.

0:36:26 > 0:36:31Even if you died today, there is no way Zoe would accept this...gift.

0:36:31 > 0:36:35It's a poisoned chalice. Surely you have to see that?

0:36:37 > 0:36:38Joe?

0:36:44 > 0:36:48All right, I'm going to restart your treatment.

0:36:48 > 0:36:50Hopefully that will save your life.

0:36:50 > 0:36:52And if your family come back,

0:36:52 > 0:36:55I suggest you do whatever it takes to earn their forgiveness.

0:36:55 > 0:36:58That's entirely up to you, of course.

0:36:58 > 0:37:01Nurse McKee, I need an IV push of Amoxicillin.

0:37:01 > 0:37:03Let's get him on some steroids.

0:37:07 > 0:37:09HE WHEEZES AND COUGHS

0:37:11 > 0:37:15I know there's always a risk of bacterial infection

0:37:15 > 0:37:17with devices like these,

0:37:17 > 0:37:21but...I've never seen it quite this bad before.

0:37:21 > 0:37:24- Was it a problem with the device itself, do you think?- Hmmm.

0:37:24 > 0:37:28Not likely. It's possible Ms Shale has been

0:37:28 > 0:37:33taking incorrect doses of her antibiotics and furosemide.

0:37:33 > 0:37:36Check with her GP, will you? This really shouldn't happen.

0:37:36 > 0:37:39OK, it's clear.

0:37:39 > 0:37:414.O Prolene. Thank you.

0:37:41 > 0:37:44Replacement device standing by.

0:37:45 > 0:37:48Dr Valentine, what do you think?

0:37:50 > 0:37:53Should we give this heart a second chance?

0:37:53 > 0:37:55BP's dropping steadily.

0:37:55 > 0:37:57Why isn't he responding?

0:37:58 > 0:38:01Excuse me.

0:38:02 > 0:38:07Um...you're right not to try and understand me.

0:38:08 > 0:38:11I know I kissed you, but I have no idea why.

0:38:11 > 0:38:15So you're right to keep things distant...professional.

0:38:15 > 0:38:17It's better for both of us.

0:38:19 > 0:38:20OK.

0:38:20 > 0:38:24- COUGHING AND WHEEZING - Dad?!

0:38:29 > 0:38:32- Shouldn't he be getting better by now?!- Yes, he should.

0:38:32 > 0:38:34- Then why isn't he? - I have no idea.

0:38:39 > 0:38:42So...you did it.

0:38:43 > 0:38:45You healed her.

0:38:45 > 0:38:47She healed herself. I just helped spot it.

0:38:47 > 0:38:50Mr Hope was concerned about bacterial level on the LVAD.

0:38:50 > 0:38:53He wanted me to follow up on medication through Donna's GP.

0:38:53 > 0:38:55Have you got a contact number I could have?

0:38:57 > 0:39:00Of course. I'll just get it for you.

0:39:00 > 0:39:01Thank you.

0:39:06 > 0:39:08It's turned into some sort of day.

0:39:12 > 0:39:14What's that?

0:39:14 > 0:39:17Joe Harling's liver function test results.

0:39:17 > 0:39:19That's unusual.

0:39:19 > 0:39:23- I've never seen results like that for pneumonia.- Neither have I.

0:39:26 > 0:39:28- TB?- No, I don't think so.

0:39:31 > 0:39:34Tell me, you've been handing out flu treatment all day, haven't you?

0:39:34 > 0:39:36- Yeah.- Any effect?

0:39:36 > 0:39:37Some.

0:39:39 > 0:39:41Actually, very little.

0:39:41 > 0:39:42Apart from pain relief.

0:39:42 > 0:39:44COUGHING IN THE BACKGROUND

0:39:46 > 0:39:48SHE COUGHS

0:40:01 > 0:40:04- What's wrong?- Liver's enlarged.

0:40:04 > 0:40:07I want sputum tests for all patients exhibiting flu-like symptoms.

0:40:07 > 0:40:09- The lab has to drop everything else. - Where are you going?!

0:40:12 > 0:40:15Theatre was amazing, I'm so glad I was there.

0:40:17 > 0:40:21- Here you go. Name's Dr Raja. It's all on there.- Thank you.

0:40:23 > 0:40:26- What's next?- For me, a phone call to a GP.

0:40:26 > 0:40:29For you, post-op meds. Cardiac output needs to be monitored.

0:40:29 > 0:40:33- We need to push prophylactics. But be careful with the penicillin. - PAGER BEEPS

0:40:33 > 0:40:36Just wait for me. Check her vital signs, OK?

0:40:40 > 0:40:43She'll come round soon.

0:40:43 > 0:40:46Shouldn't you be getting on with the post-op meds?

0:40:46 > 0:40:48- Chance of infection. - Yes. We're going to mitigate

0:40:48 > 0:40:52any post-op infection with a course of antibiotics.

0:40:52 > 0:40:54Sometime this week?

0:41:18 > 0:41:20One moment, please, Mr Hemingway.

0:41:21 > 0:41:23Thank you.

0:41:37 > 0:41:39SHE GROANS WEAKLY

0:41:39 > 0:41:40SHE GASPS

0:41:49 > 0:41:52Yes, I'm holding for Dr Raja.

0:41:52 > 0:41:55About Donna Shale. Thank you.

0:41:56 > 0:41:58Anything I can help you with?

0:41:58 > 0:42:00GASPING

0:42:00 > 0:42:02ALARM BEEPS

0:42:04 > 0:42:07- Excuse me. - She's tachycardic.

0:42:07 > 0:42:09She just woke up choking!

0:42:12 > 0:42:15Larynx is constricted. Oxygen, please.

0:42:15 > 0:42:18- What did you do?- What you told me. - I told you to wait.

0:42:18 > 0:42:19SHE GASPS AND GROANS

0:42:19 > 0:42:22- Prophylactic antibiotics. - Benzylpenicillin?

0:42:24 > 0:42:26- She's hypotensive. - She's allergic.

0:42:26 > 0:42:29- SHE GASPS - Do something!

0:42:29 > 0:42:31What the hell is going on?!

0:42:34 > 0:42:36Mr Harling presented with pneumonia,

0:42:36 > 0:42:38complicated by his existing conditions.

0:42:38 > 0:42:41Broad spectrum antibiotics had no effect whatsoever.

0:42:41 > 0:42:44Come to the point, please, Mr Hemingway.

0:42:44 > 0:42:48I ordered a liver function test. The result was deranged.

0:42:49 > 0:42:53- I palpated his abdomen. - Enlarged?

0:42:53 > 0:42:56We have a ward full of patients presenting with flu-like symptoms.

0:42:56 > 0:42:58I've ordered sputum tests.

0:43:00 > 0:43:04- You suspect Legionnaire's Disease? - Yes, sir.

0:43:05 > 0:43:06An outbreak.

0:43:08 > 0:43:09ALARM BEEPS IV adrenaline.

0:43:09 > 0:43:11- I'm sorry.- Not now.

0:43:12 > 0:43:14- It was my fault. - I said be quiet.

0:43:18 > 0:43:20Hydrocortisone?

0:43:20 > 0:43:23Well, if her heart can cope with this little incursion...

0:43:26 > 0:43:28ALARMS STOP

0:43:28 > 0:43:31OK, the shots are doing the job.

0:43:31 > 0:43:32Keep her on oxygen. Ten minute obs.

0:43:32 > 0:43:35- Half hourly gases.- That's it? She's going to be OK?

0:43:35 > 0:43:40- She'll be fine.- How do you expect me to trust you after that?

0:43:40 > 0:43:42There WILL be an investigation.

0:43:42 > 0:43:46These two don't come anywhere near her again. Understand?

0:43:50 > 0:43:52Mr Hope's office, end of the day.

0:43:58 > 0:44:01We will remain calm at all times.

0:44:01 > 0:44:04An outbreak is not official until two or more notifications are linked

0:44:04 > 0:44:07in place and time, and the history is consistent with Legionnella.

0:44:07 > 0:44:09I can cross check FBCs.

0:44:09 > 0:44:12I'll call a major incident. Inform the other wards, please.

0:44:12 > 0:44:14Let's test everyone with pulmonary symptoms.

0:44:14 > 0:44:16Sputum tests are on their way to the lab.

0:44:16 > 0:44:18Good.

0:44:18 > 0:44:21It's imperative that we locate the source of the infection.

0:44:21 > 0:44:23Clearly it's linked to the Borough.

0:44:23 > 0:44:26We'll need continuity of movement for all confirmed cases.

0:44:26 > 0:44:29Excuse me, there's something really wrong.

0:44:30 > 0:44:32HE GASPS AND WHEEZES

0:44:32 > 0:44:35- Sats are dropping. - Dad! Come on, Dad!

0:44:35 > 0:44:37- ALARM BEEPS - He's tachycardic.

0:44:37 > 0:44:40Nurse McKee, will you take the family members to the waiting area, please?

0:44:42 > 0:44:47The first rule - always check the notes. What have I done?

0:44:47 > 0:44:50- Made a mistake, that's all. - I could have killed her.

0:44:50 > 0:44:53- What am I going to do?- Nothing. Let me do the talking.

0:44:53 > 0:44:57- You can't keep protecting me. - I'm not protecting you, I'm protecting both of us.

0:44:57 > 0:44:58What is it?

0:44:58 > 0:45:01These prescriptions haven't been collected.

0:45:01 > 0:45:05- Donna Shale's LVAD medication, hasn't been taken in weeks.- Why?

0:45:05 > 0:45:08That doesn't make any sense. That would just make her ill.

0:45:10 > 0:45:12- Adrenaline given. - BP 50 systolic. Sats 78%.

0:45:12 > 0:45:14Defib. Charge 200.

0:45:15 > 0:45:17OK.

0:45:17 > 0:45:18Charged. Stand clear.

0:45:20 > 0:45:22- Charge to 360.- Charging again. Stand clear.

0:45:24 > 0:45:25Come on, come on!

0:45:25 > 0:45:29Donna Shale hasn't been taking her medication. Marcus is her carer.

0:45:29 > 0:45:32You need to be very careful what accusations you're making.

0:45:32 > 0:45:35- You think he's hurting her? Why?- I think he loves her.

0:45:35 > 0:45:41Can't bear the thought of losing her. How better to control someone than to have them utterly dependent on you?

0:45:41 > 0:45:42- Valentine...- Just think about it.

0:45:42 > 0:45:45Think about his reaction to her being free of the LVAD.

0:45:45 > 0:45:48Compare that with how perfectly happy he was

0:45:48 > 0:45:51- when we were simply replacing it.- It makes him a bit needy.

0:45:51 > 0:45:53- Maybe a bit weird. But not dangerous.- OK.

0:45:53 > 0:45:57When you gave Donna her post-op meds, Marcus was there, right?

0:45:57 > 0:46:01- Yeah. What...?- Did he say anything to you? Speak at all.- No.

0:46:01 > 0:46:04- Actually, he kind of...hurried me up.- And he saw you. He saw the meds.

0:46:04 > 0:46:06- He saw the penicillin.- Yeah.

0:46:06 > 0:46:08So a carer who controls her medication...

0:46:08 > 0:46:12With an encyclopaedic knowledge of his girlfriend's condition.

0:46:12 > 0:46:14Would know she was allergic to penicillin.

0:46:15 > 0:46:18Call security.

0:46:18 > 0:46:20- MONITORS BEEP - Charge 360.- Clear.

0:46:23 > 0:46:24Come on! Come on! Come on!

0:46:31 > 0:46:33- Come on!- Luke...

0:46:33 > 0:46:35- Luke.- Come on.

0:46:35 > 0:46:37- Luke. - HEART MONITOR FLATLINES

0:46:56 > 0:46:58You've spoken to Dr Raja.

0:47:03 > 0:47:07Donna and I made the decision together.

0:47:07 > 0:47:09To come off the meds.

0:47:09 > 0:47:13- It was what she wanted. - It's what you told her she wanted.

0:47:13 > 0:47:15The beta blockers made her dizzy.

0:47:15 > 0:47:18They were keeping her alive, protecting her.

0:47:18 > 0:47:19Why?

0:47:19 > 0:47:22Her hands were always cold. She couldn't taste her food.

0:47:24 > 0:47:25We reduced the doses gradually.

0:47:25 > 0:47:30Furosemide 40mg, two times daily after breakfast and after lunch.

0:47:30 > 0:47:34Amiodarone 200mg, one times daily.

0:47:34 > 0:47:38Bisoprolol 2.5mg.

0:47:38 > 0:47:40She hated the taste of that one.

0:47:41 > 0:47:44We kept her on the Warfarin.

0:47:44 > 0:47:46The diuretics.

0:47:46 > 0:47:49Kept her monitored. The nausea stopped.

0:47:50 > 0:47:53- The nightmares.- Well, one nightmare's going to stop.

0:47:54 > 0:47:56You won't keep us apart.

0:47:58 > 0:47:59She needs me.

0:48:01 > 0:48:04You might not understand that, but she does.

0:48:15 > 0:48:18Yuck! Creeparama.

0:48:18 > 0:48:20Couldn't have said it better myself.

0:48:58 > 0:49:00I'll give you some space.

0:49:07 > 0:49:10The sputum test results are starting to come back.

0:49:10 > 0:49:14Joe Harling and another patient have been confirmed.

0:49:14 > 0:49:16It's definitely Legionnaire's.

0:49:20 > 0:49:24- So he's OK? - Well, the septic arthritis is fine.

0:49:24 > 0:49:28- But...?- We don't know. His lungs are full of fluid.- He's stable...

0:49:28 > 0:49:30- for now.- Maybe it's this mystery disease.

0:49:30 > 0:49:34There's all sorts of rumours about some disease sweeping through AAU.

0:49:34 > 0:49:36This is not West Africa!

0:49:36 > 0:49:38What's that supposed to mean?

0:49:38 > 0:49:41Ladies and gentleman, a word, please.

0:49:43 > 0:49:46I'm afraid to report there's been an outbreak of Legionnaire's disease,

0:49:46 > 0:49:50many of the victims of which are turning up here at Holby.

0:49:50 > 0:49:51Told you it was that mystery disease!

0:49:51 > 0:49:54There's nothing mysterious about it, Nurse Lane.

0:49:54 > 0:49:57The general public has an understandable, if often erroneous,

0:49:57 > 0:50:00negative view of the legionella bacillus. But let's not create a major panic.

0:50:00 > 0:50:03I would however advise you, Mr Hamilton, to check all your patients.

0:50:03 > 0:50:09- Just as a precautionary measure. - Adam.- Chills...cough...fever.

0:50:09 > 0:50:12Poor guy. Only been in hospital twice.

0:50:12 > 0:50:14First time for holiday jabs. The second to be told

0:50:14 > 0:50:17- he's got Legionnaire's. - When was he here for the first time?

0:50:17 > 0:50:21- About six days ago.- That's three people.- Possibly four.

0:50:21 > 0:50:24Er, the security guard, Keith, I sent him home.

0:50:24 > 0:50:26That's four cases - two confirmed.

0:50:26 > 0:50:28They all have at least one location in common

0:50:28 > 0:50:32- during the incubation period. - Which is?- Here.

0:50:33 > 0:50:35Holby could be the source.

0:50:38 > 0:50:44So...the small matter of Donna Shale going into anaphylactic shock.

0:50:44 > 0:50:47- If anyone's to blame, it's me. - I didn't really listen...

0:50:47 > 0:50:49I suggest you get your stories straight.

0:50:49 > 0:50:52I didn't read the notes. I wasn't paying attention.

0:50:52 > 0:50:54Distracted by your heroics in theatre.

0:50:55 > 0:50:58What if the patient wants to make a complaint?

0:50:59 > 0:51:01Anything to add, Dr Lo?

0:51:05 > 0:51:07Go on, get out.

0:51:08 > 0:51:11Not so fast, blue eyes. We're not finished.

0:51:14 > 0:51:16I'll need you to fill in an incident form.

0:51:19 > 0:51:22- This is going on record? - I can't pretend it didn't happen.

0:51:24 > 0:51:29You know, an F1 makes mistakes. The rest of us can't afford to.

0:51:29 > 0:51:34Keep personal feelings off the ward. They compromise professionalism.

0:51:40 > 0:51:42Legionnaire's disease?

0:51:42 > 0:51:43I know it must come as a shock

0:51:43 > 0:51:46but you should know that it's treatable.

0:51:46 > 0:51:48Legionnaire's disease?

0:51:48 > 0:51:51I did try to sort out your ticket, but it just wasn't possible.

0:51:52 > 0:51:55Legionnaire's disease.

0:51:55 > 0:51:57Sorry.

0:51:58 > 0:52:01It's OK. You were right.

0:52:01 > 0:52:03Been dreading it, if I'm honest.

0:52:03 > 0:52:06The food. The flies.

0:52:07 > 0:52:08The heat.

0:52:10 > 0:52:11I wouldn't last five minutes.

0:52:21 > 0:52:25- I don't know about you, but I could use a drink.- Or ten.- It's a date.

0:52:26 > 0:52:28A date?!

0:52:31 > 0:52:32OK.

0:52:32 > 0:52:34Just give me five minutes.

0:52:49 > 0:52:55- So...what did she say? - Oh, you know, nothing.

0:52:55 > 0:52:57Donna Shale's obs.

0:52:57 > 0:52:59Should have been done five minutes ago.

0:53:17 > 0:53:19Did you see something I didn't?

0:53:21 > 0:53:25I just saw a guy hurt someone he wants to protect.

0:53:27 > 0:53:29He might not know it yet,

0:53:29 > 0:53:32but if that isn't love, I don't know what is.

0:53:37 > 0:53:41There have been three more confirmed cases in the last hour.

0:53:41 > 0:53:43The hospital is the suspected source of the outbreak,

0:53:43 > 0:53:47so all precautions for staff and patients need to be taken, please.

0:53:47 > 0:53:50We're prescribing macrolide and fluoroquinolone

0:53:50 > 0:53:54and following Mr Hanssen's major incident protocols.

0:53:54 > 0:53:55Anyone with flu-like symptoms

0:53:55 > 0:54:00is to be given a sputum test immediately and given lab priority.

0:54:10 > 0:54:12He's taking it very badly.

0:54:12 > 0:54:16- I know.- And he won't want to talk about it.

0:54:16 > 0:54:17No.

0:54:37 > 0:54:40I don't want to talk about it.

0:54:40 > 0:54:42I know.

0:54:42 > 0:54:46- That's not why I'm here, Luc. - Then why are you here?

0:54:50 > 0:54:52Hm?

0:54:53 > 0:54:55- HE SIGHS - I'm sorry.

0:55:01 > 0:55:05I did a lot of travelling as a child. Dragged from here to there.

0:55:05 > 0:55:07Always on the move. My mother was...

0:55:07 > 0:55:09HE SIGHS

0:55:09 > 0:55:13My mother was...complicated. So, for a variety of reasons,

0:55:13 > 0:55:15we spent a lot of my time in and around hospitals.

0:55:16 > 0:55:20They became so familiar to me. The long corridors.

0:55:20 > 0:55:23The smell of disinfectant, soap.

0:55:23 > 0:55:25And comfort.

0:55:25 > 0:55:27That's what I really remember.

0:55:27 > 0:55:31A hospital was a place where people made things better.

0:55:33 > 0:55:34Where strangers helped you.

0:55:37 > 0:55:39A Hospital was my safe place.

0:55:40 > 0:55:43A haven.

0:55:44 > 0:55:46And now?

0:55:46 > 0:55:49It's not a safe place for these people, is it?

0:55:49 > 0:55:51I didn't help them.

0:55:51 > 0:55:55Luc, this isn't your fault. It's no-one's fault.

0:55:55 > 0:55:57They haven't found him, you know, Keith. The security guard.

0:55:57 > 0:56:00They've tried his home. Everything.

0:56:00 > 0:56:03Luc... One man's dead. A father, a husband.

0:56:03 > 0:56:05All because I didn't see it, I wasn't good enough.

0:56:05 > 0:56:09- It's not your fault. - I need to fix it.- OK.

0:56:11 > 0:56:14- I need to fix it.- Tomorrow. Huh?

0:56:14 > 0:56:17- I need to...- Tomorrow.

0:56:19 > 0:56:21- I need...- So do I.

0:56:42 > 0:56:46Subtitles by Red Bee Media Ltd