Under The Skin Holby City


Under The Skin

Jac pulls out all the stops to try and save baby Freya's life and Oliver makes a decision about his future after a day on Orthopaedics.


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Transcript


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I want to speak to whoever's in charge.

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Sure, that would be me.

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If I don't transfer her here, then where?

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I'm going to tell you this one more time - we are full!

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Giving it large last night to celebrate?

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No, never, not the night before the new job.

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So it's her heart that's not working properly?

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I want to be like you - proper job, proper contract.

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You're so...so sorted.

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I'm not fit to do this, am I? I'm not!

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Do you want another coffee or something?

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So what, did she just walk? What did you say to her?

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-Nothing, I just tried to get her to sign for the MRI.

-Did she?

-No.

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The courts have made you in loco parentis so you do with the scan.

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This is my job now and I'm not going to mess it up.

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Don't do it!

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OK.

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What?

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Don't do what?

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Oh, you shouldn't have, Mr Douglas, I got my own.

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I didn't. And you always do.

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SHE GROANS What are you still doing here?

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Good morning to you too, Ms Naylor. And I actually haven't left yet.

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I think that's my point.

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None of us have, Jac - we've been here since last night.

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-In shifts.

-Why?

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BABY CRIES

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Mr Dolan authorised it, until we get the results of the MRI.

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-I take it the mother isn't back, then?

-No.

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Still no Paeds, no CT beds at St Joseph's.

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I didn't want to move Freya until we knew if she needed specialist care.

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Your guys wanted to hang around, just in case.

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You've got a great team here.

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Hmm, when they're doing the job they're paid to.

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Sahira, chase that scan - this isn't a creche.

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I think I've just established that you're not about to throw yourself off the building.

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Wasn't about to - I'm ruling nothing out now.

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My point is that it's a perfectly logical assumption.

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-That anybody on a roof must be suicidal? Not really.

-Listen, it's out of bounds up here, to everyone.

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-Including you?

-It's less out of bounds to me than it is to you.

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-Why?

-Doesn't matter. What are you doing here?

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I'm trying to be alone for five minutes.

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-Do you want some?

-Are you drunk?

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Shouldn't be by now.

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Oh, I am, however, unreasonably hung-over.

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And therefore suicidal.

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-What?

-I'm simply applying your logic. You know, the roof.

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Listen, smartarse, you don't have to be on the roof to be on your own,

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whereas there is actual logic behind why I'm up here.

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Fine, look, there are four vital ingredients after a big night out.

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One - it's a dirty bacon sandwich. Two - coffee.

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Three - water and Paracetamol. And four - get yourself up as high as you possibly can,

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find the spot where the wind hits you the hardest

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and you take in so much oxygen you almost pass out.

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Three out of four ain't bad.

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It's a bit crude, isn't it?

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In the Philippines, they swear by a breakfast of pickled shrimp, frogs' legs and beetle lava.

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Does it work?

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-I don't know.

-I thought you'd been.

-I have, but I don't drink.

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Why not?

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Well...

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so I don't end up looking like you.

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BEEPING

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Excuse me.

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-Well? MRI results?

-They're on their way.

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Has that been infection screened?

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-I thought they were given plastic toys for a reason.

-And I thought you knew nothing about Paeds.

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It's brand new, Jac.

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The Darwin team chipped in to try and make this place less unfriendly.

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What exactly IS the problem?

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The problem, Peter Pan, is that she shouldn't be here,

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-and nor should you - this is an adult ward.

-So I'm not an adult?

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I don't know what you are,

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but I'm certain this is no place for a six-month-old baby.

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-So it's Freya you're worried about?

-What do you think?

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Well, it's a shame you didn't show the same concern for her mother.

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Oh, I see. So we're only a team when it comes to buying cuddly toys?

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Well, that's... That's fine,

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but if you think I should feel guilty about a mother abandoning her child,

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then you've been awake too long.

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Yep.

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It's fine, I've got it. Thank you.

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Emergency trauma from the ED on its way - blunt trauma to the abdomen.

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Looks like it's going to be another busy one.

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Maybe Mr Hanssen will give us the day off from meeting his targets.

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-You must be from the ED.

-Must I?

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-Blunt trauma to the abdomen?

-No, thanks, I've just eaten.

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What are you doing here?

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Oh, I'm sorry, is it "out of bounds"?

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I'm sorry, it is, actually. You can't just come wandering in...

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-That's supposed to be on display at all times.

-My stomach hurts!

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Her stomach hurts, and evidently, I'm your new registrar.

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We'll be right with you. Sorry, erm...

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-Luc. I'm Sacha Levy.

-Sacha.

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And I'm Senior Staff Nurse McKee.

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Sean, MRI results are in.

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I'm not seeing what you're seeing, but I'm not getting a happy vibe.

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Gerbode's.

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It's a Gerbode's Defect. Quite a rare form of hole in the heart.

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-A very rare form.

-Basically there's a shunt from left to right -

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blood is flowing from Freya's left ventricle into the right atrium.

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-Meaning it's serious?

-And that Nicole was right all along.

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It also means I'll now be taking sole charge of this case on behalf of Darwin.

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MDT meeting in half an hour. I suppose you're invited. You're not.

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-You're taking over? Just like that?

-She's my patient, remember.

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Who, up until now, you didn't give a damn about!

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What are you up to?

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I am trying to ensure that she survives now a potentially life-threatening condition.

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-Objections?

-And you think you're the best person to do that?

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As the only member of the team who's managed to retain any

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kind of professional distance, I think I'm the only person.

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Heard about Freya - had to look Gerbode's up.

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-Who saw that coming?

-Nobody, which is why I'm about to chair an urgent MDT meeting.

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-How's your research going?

-Take a look for yourself. Part one, fully complete.

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Wow. This must have taken all night.

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And this morning, plus WAY too much coffee.

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-I want to make a go of this.

-Since you're enjoying it so much,

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can I have the second part by the end of the day?

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-I'd really like to read the opening sections together.

-OK, well...

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Excellent.

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Thank you all for coming. This won't take long.

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You all know why we're here.

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Now, because Gerbode's affects the membranous ventricular septum close to...

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-I didn't realise tickets were being sold.

-Don't mind us.

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-I made it clear to Ms Shah that I'll be taking this case forward.

-And I did put it to Mr Hope

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that there's no point having an MDT meeting with half the T missing.

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Especially as Mr Douglas and I have Paeds experience.

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Unlike you, Ms Naylor.

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-I thought you were in theatre all day?

-Hmm, so did I.

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Should we get on with it?

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-Why didn't you tell me?

-About what?

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-Will you make sure it's all all right?

-Of course.

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Have you been in a fight, Karen? Has someone hurt you?

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I just want to make sure it's all all right...

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that I can have a baby.

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Are you pregnant?

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No..

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but I will be.

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If it's all all right, I will be.

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Will you make sure it's all all right?

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I don't care how long it takes.

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I just need to make sure that I can...

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Have a baby. Got it.

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Look, Karen, you've got two doctors and the best nurse in the hospital

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looking after you, so we'll find out what's going on, don't worry.

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Had I been a girl, apparently I'd have been a Karen.

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Your parents are big Carpenters' fans, too?

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Right, what do you think?

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Nurse?

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-Yeah?

-Thoughts?

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Chest X-ray, FBC's, U's and E's and a liver function test, Doctor.

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Oh... I was actually talking about the Carpenters, but...

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Yeah. What she said.

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Therefore the fastest and most effective fix is to insert a patch...

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That's... Sorry to interrupt, Ms Naylor,

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that's a very risky procedure.

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Has there been any discussion

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on whether this patient should even actually be treated at Holby?

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Not since her diagnosis.

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The patient is already at Holby. Plus the Paeds unit at Oxford

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has closed and St Joe's has got more kids than Neverland.

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There's absolutely... QUACKING

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-QUACKING STOPS

-Sorry.

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HE CLEARS HIS THROAT

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There's no reason why Darwin shouldn't have a Paeds CT facility.

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All we have to do is show we can handle it, and I can.

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For the record, if you check my current CV,

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-you'll see there's plenty of Paeds CT experience on there.

-Yes, sure,

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-but what Freya really needs is her mother.

-I tend to agree.

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I don't think we should be rushing into such a high risk procedure yet, especially without Mum here.

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You can live without a dysfunctional mother, but not a functioning heart,

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and it could deteriorate rapidly at any time. What about the pressure on pulmonary circulation?

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-Monitor her until there's evidence of hypertension.

-So we can wait?

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I think so, for the time being, yes.

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OK. Thank you.

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Hang on, you want to leave an unexploded bomb in a baby's chest when we could deal with it today?

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-We could do, but...

-She's already got severe pulmonary hypertension.

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Right? What's the pressure?

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I don't know - we haven't done another Echo since the diagnosis.

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Well, then you should do, obviously.

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But the pressure would need to be as low as 50

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-to warrant even considering taking such a gamble.

-Obviously.

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Good.

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-No symptoms suggesting head injury, but she does seem rather...

-Simple.

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-What?

-So her being desperate to have a baby makes her simple?

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I thought we were in the business of compassion.

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You might be - I'm in the business of trauma.

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Meaning you bring it, or treat it?

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Meaning my post here is funded on the basis that I carry out

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research into trauma medicine, not pretend to be a social worker.

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You're here on a hip?

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Wow. Impressive.

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I thought you two were supposed to be discussing Karen Ashley?

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-I'll do what I can on her history.

-That's not a nurse's job.

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-No, but I'm not a normal nurse.

-That's true, actually.

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And like Karen Carpenter said, "I won't last a day without you."

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-So what are we saying, ruptured spleen?

-Ruptured spleen.

-Ruptured...spleen.

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I want the full scan sent to my office as a priority, OK?

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-Ms Naylor?

-Can it wait?

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Bit of a problem, actually.

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To finish the next section, I need to corroborate our polytrauma figures with data from Orthopaedics.

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-And?

-No-one from Ortho is available today. So...

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what do I do?

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-Ms Naylor?

-Doctor Valentine, one of the reasons I wanted to work with you on this

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was I was hoping, when circumstances demanded,

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that you'd step up and take the initiative.

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Leave it to me.

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-Who says I don't know what it's like to have children?

-Well, you can forget about this one.

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-What?

-I spoke to St Joseph's again, called in a few favours.

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-They'll have a bed for Freya first thing tomorrow.

-Tomorrow might be too late.

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If I didn't know you better, Ms Naylor,

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I'd say you were hoping Freya's that sick.

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Top priority.

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So what do you think of the new guy, then?

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Scalpel, please. Thank you.

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He seems all right. Suction.

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Oh, I don't like the look of that.

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Tumours?

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Well, could be, but...

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Sorry, can you ask Mr Hemingway to pop in, please?

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He's still just a registrar, Sacha. you're supposed to be equals.

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I wish!

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-He's a Fellow in Trauma and Vascular, do you know what that means?

-He's twice as annoying?

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He does seem a little... diffident.

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Does that mean superior?

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-It's not easy being the new boy. We should give him a chance.

-Should we?

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Blunt forceps, please.

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Greeting Mr H.

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Now, I don't think that's just Karen's spleen that's a problem. What do you think?

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About what, specifically?

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Well...the tumours.

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They definitely are. Yes.

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Cancerous?

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Well, I'll finish up and send one to oncology.

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OK. Is that all?

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-Did you get any more of her history?

-I've been a bit busy.

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You might want to start with Her Majesty's Hotel Group. Those are prison tattoos.

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Wow! How do you know that?

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I did a twelve stretch in Belmarsh...

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Well? What do you think?

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You haven't heard, have you? Not listened to the radio today?

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As I've just finished explaining, I have been rather busy.

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After being all over the media for all the wrong reasons,

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the local news is now carrying a report about our foundling.

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It's a small story so far,

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but how long before it becomes a big one about how we lost the mother?

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Nobody 'lost' the mother, she walked out.

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And surely you can see that this is an opportunity.

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To create some publicity instead of being fearful of it.

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What exactly do you want, Ms Naylor?

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-To operate. Today.

-I see.

-Do you?

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'Holby Performs Miracle Op on Abandoned Baby' can you see that?

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I can see 'Motherless Infant Dies at Crisis Hospital' and it doesn't bear thinking about.

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Why are you talking to me about this and not your colleagues on Darwin?

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Because I'm being undermined by bleeding hearts and a nursemaid in a novelty watch.

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You're signing off surgery and I know I can rely on you not to let your heart rule your head.

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Incidentally, if you're still overseeing theatre lists,

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several of the team were saying they're light today.

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Mr Hope in particular.

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It's a simple patch...

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How simple?

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I'm not saying it's totally without risk,

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but operating is no more dangerous than not.

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And yet my understanding is that 'not' was the decision of the MDT.

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Unless the Echo showed pulmonary pressure around 50.

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And did it?

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Yes. It did.

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Still in a lot of pain?

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Is everything OK? Will I still be able to have a baby?

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You ruptured your spleen, Karen, but we successfully repaired it.

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I used to have a baby once...you know.

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Really?

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-That's Matty.

-He's lovely.

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Yeah. But I wasn't quite... ready to have a baby.

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That's what they said. And they was right, really...

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So they took him away and... Anyhow.

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Matty's happy and I'm ready

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to have a baby now, I am. Aren't I?

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I'm going to grab one of the doctors who will bring you up to

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speed with everything that's going on.

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And I'll get you something for your pain, OK?

0:19:100:19:12

I think you're wrong, you know. About the prison.

0:19:210:19:23

I've called them all. Social services will get back to me. But from what she said about her son...

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She's bred already?

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He was taken away.

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Have you had a complete sympathy bypass?

0:19:340:19:37

-Would it affect her diagnosis either way?

-Maybe not.

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But judging people on this ward too quickly could be a big mistake, trust me.

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-And what about her actual physical health anything on that?

-She's breathless and still in pain.

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Someone still needs to tell her the news.

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Do they? If someone told me I was going to die I'd hope they had irrefutable evidence first.

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-That's a prescription pad.

-No wonder they made you a Fellow.

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Double Fellow. You don't check with a doctor before prescribing?

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Not always.

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Even after a big night out?

0:20:050:20:07

No, Mr Hemingway . Not even then.

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I gave Mrs Morgan her injection. Do you want to see?

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-Is there anything to see?

-No.

-Right. I'll leave it then.

0:20:150:20:19

You working with us today? Cool! How's that poor kiddie doing?

0:20:220:20:27

She's under Ms Naylor's care so I'm sure she'll be fine. Excuse me.

0:20:270:20:31

I must say it all seems very laid-back, compared to what I'm used to.

0:20:340:20:38

With Jac as your mentor, Camp Bastion would probably feel like Center Parcs to you.

0:20:380:20:43

Perhaps it's the difference between disciplines. Othopaedics being that much less demanding.

0:20:430:20:49

Do me a favour. Forget what Miss Naylor says and make up your own mind,

0:20:490:20:53

-if only in the name of research.

-Absolutely.

0:20:530:20:55

I mean, some would look at you two with your matching flowers

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and think you was a couple - but not me.

0:20:590:21:01

Kenny, this is Doctor Valentine.

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Pleased to meet you, I'm sure.

0:21:030:21:06

Mr Tolson was a passenger on a motorbike doing 60 miles an hour. Then he wasn't. How are you feeling?

0:21:060:21:11

Right as rain, man.

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I'm looking at all these sick people wondering what I'm doing here. You needn't worry about me.

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-Flesh wound!

-Femur's fractured, obviously.

0:21:190:21:22

The ED cleaned it up but while we wait on X-rays we'll need the exposed tissue cut away.

0:21:220:21:27

-What, you want me to do it?

-You did say you'd help.

0:21:270:21:30

OK. Fine.

0:21:300:21:31

On my own?

0:21:340:21:35

Don't worry, flower - I'll be here.

0:21:370:21:41

MONITOR BEEPS QUICKLY

0:21:410:21:42

Karen? Karen? Karen, can you hear me?

0:21:420:21:47

Karen, I need you to take nice big deep breaths for me, OK? Karen?

0:21:480:21:54

-Can you hear me? What did you give her?

-Morphine but not very much. Karen?

0:21:540:21:57

Doesn't tend to matter if you're allergic.

0:21:570:22:00

What do we give for opioid OD?

0:22:000:22:01

Naloxalone but... there's no mention of allergies in her notes.

0:22:010:22:04

-Karen?

-We should probably still try and save her life, don't you think?

0:22:040:22:08

They think they've come to prep my patient for theatre.

0:22:160:22:21

I meant to get here first. Stop, for a second.

0:22:210:22:23

-But you didn't... Freya's going to St Joseph's.

-I'm afraid not.

0:22:230:22:26

-The Echo suggested we can't hold off the repair after all.

-But Mr Hope told you to wait.

0:22:260:22:31

And Mr Hanssen's decided otherwise.

0:22:310:22:33

Look, I'm sorry I didn't tell you sooner but I will keep you fully updated from now on.

0:22:330:22:37

Fully updated? I'm her consultant! One of her consultants.

0:22:370:22:42

I'm trying to apologise here. Ask around and see how often that happens.

0:22:420:22:45

-A few hours ago you couldn't wait to get rid of us.

-What can I say, you're a grower.

0:22:450:22:50

You know what I think, Ms Naylor? I think you're prejudiced.

0:22:500:22:53

What?

0:22:530:22:55

You think you can change your mind whenever you like and Paeds is so far beneath your CT throne,

0:22:550:23:01

I'll roll over for my belly to be tickled. What did you think I meant?

0:23:010:23:05

I'm simply want what's best for the patient.

0:23:050:23:07

-For Freya.

-For Freya, yes.

0:23:070:23:09

I might not know as much as you about hearts - but I know about kids.

0:23:110:23:15

-And I'm telling you, you need me.

-You're right. I do.

0:23:150:23:19

I need you to put a line in her foot.

0:23:210:23:23

Hence the rare apology. We'll see about this.

0:23:270:23:31

I could have handled it.

0:23:370:23:39

What? Are you saying I couldn't?

0:23:400:23:42

I wasn't aware my lips moved at all.

0:23:420:23:44

For the record, however, I do prefer to take my own systems with me when I move on to a new hospital -

0:23:440:23:50

and that includes doing my own patient notes and order prescriptions.

0:23:500:23:54

Luc, sorry Eddi only does extra as a favour to the doctors.

0:23:540:24:00

It just makes our lives easier, that's all.

0:24:000:24:02

Not yours, I'm sure.

0:24:020:24:03

Damn it! This is all much smaller than the equipment I'm used to.

0:24:060:24:10

But fortunately, I'm a professional and able to adapt.

0:24:100:24:13

So, this is what's called a peripheral line, OK?

0:24:130:24:17

I'm going to explain what I'm doing as I would to any other patient

0:24:170:24:20

because unlike some people, I'm not going to change the way I do my job

0:24:200:24:24

just because you can't ask questions.

0:24:240:24:26

Or because you're on your own.

0:24:260:24:28

Not least because as far as I'm concerned, you're better off that way.

0:24:280:24:32

Not that I'm completely indifferent to the fact that in hindsight,

0:24:320:24:35

maybe I could have handled the situation

0:24:350:24:37

with your mother a little...differently.

0:24:370:24:42

But we all have to get over that.

0:24:420:24:44

And frankly, I'm starting to see why she ran.

0:24:440:24:46

You're not the most scintillating company, are you?

0:24:460:24:50

Gotcha!

0:24:510:24:53

Don't start that.

0:24:540:24:57

If you think a smile

0:24:570:24:58

or what's more likely to be an involuntary digestive reaction

0:24:580:25:01

is going to make me think twice about cutting you open,

0:25:010:25:05

then you're every bit as naive as you look.

0:25:050:25:07

You won't take it from me, will you?

0:25:220:25:24

How long did you keep him?

0:25:240:25:26

Only the day! That was all.

0:25:260:25:29

Three years for one day.

0:25:290:25:31

What, in prison?

0:25:310:25:32

And how long do you think that 24 hours felt to Matty's real Mum?

0:25:340:25:37

Karen?

0:25:380:25:40

Pull the curtain.

0:25:420:25:44

Please!

0:25:440:25:45

Who are they?

0:25:480:25:49

It's Matty, Matty's family.

0:25:490:25:52

But how would they know you were going to be here?

0:25:530:25:55

Did they attack you?

0:25:550:25:57

No, but them who did...

0:25:570:25:58

The women on the bus, I shouldn't have got on, they'd have told them.

0:25:590:26:04

-So now they're looking for you?

-No.

0:26:040:26:07

Um, those men at the desk, were they talking about Karen?

0:26:070:26:12

-Have they gone?

-No and yes.

0:26:120:26:14

-Miriam?

-Yeah?

0:26:160:26:18

I'm not meant to say.

0:26:210:26:23

I'm not.

0:26:240:26:25

Miriam Gainsborough. Released yesterday with a new name and address

0:26:270:26:31

on the opposite side of town

0:26:310:26:32

and instructions not to tell anybody anything.

0:26:320:26:35

-So she's two people.

-Aren't we all?

0:26:350:26:37

I take it the police have been called now we know it was assault?

0:26:380:26:42

It's all in hand, professor.

0:26:420:26:43

You're on AAU now, we get all sorts down here.

0:26:430:26:46

But there's nothing we can't handle. Right, Mr Levy?

0:26:460:26:49

Right, let's chase oncology, let's get hold of Miriam's records,

0:26:490:26:52

call psych down to take a look at her

0:26:520:26:54

and I think it's time we told her what we know.

0:26:540:26:57

And get her out of here as soon as possible.

0:26:590:27:03

Whatever she's done, she's served her time,

0:27:030:27:05

She's almost certainly going to die.

0:27:050:27:07

Have you had a complete sympathy bypass?

0:27:070:27:10

My sympathy is with the little boy and his real family,

0:27:100:27:13

not the weirdo that tried to run off with him.

0:27:130:27:16

But as you're so suddenly interested, you can go tell her. Can't you?

0:27:160:27:19

Let me know if you need anymore pain relief.

0:27:270:27:29

No, you go for it, mate, I don't feel pain.

0:27:290:27:32

Certainly not afraid of needles.

0:27:330:27:35

-Lilly-Rose your wife?

-Daughter. No, I'm single. And available.

0:27:430:27:48

Thank you.

0:27:510:27:53

How old is she?

0:27:530:27:54

She'd be four. Have you not got any tattoos?

0:27:540:27:58

No, it's not really my style.

0:27:580:28:00

Oh, ho-ho! Why not?

0:28:000:28:02

Quite, remember, Oliver - open minds today.

0:28:020:28:04

Now, Kenny, we've got a plan. We're going to get you to theatre,

0:28:040:28:07

saw off the bit of bone that's sticking out

0:28:070:28:09

and hammer whatever's left back in, OK?

0:28:090:28:11

-Yup.

-Really?

0:28:110:28:14

No, Dr Valentine, not really.

0:28:140:28:16

I'm going to insert a guide wire and nail the femur back into place,

0:28:160:28:20

then perform a graft using skin from the other thigh

0:28:200:28:23

and gluing it over the top. You should be able to walk normally

0:28:230:28:26

with some physio and you'll only lose

0:28:260:28:27

a bit of that tattoo. Still you seem to have plenty of others.

0:28:270:28:31

I lose the tattoo?

0:28:310:28:33

Think of it more as gaining a leg.

0:28:330:28:34

I thought you'd just stitch it up and it'd heal.

0:28:340:28:38

-It's not that quite simple...

-No, it's not.

0:28:380:28:41

Sorry, fellas, I can't do it, I won't do it.

0:28:410:28:44

Karen, Mr Hemingway is going to bring you up to date

0:28:470:28:51

on where we're at.

0:28:510:28:52

Oh.

0:28:520:28:53

Right.

0:29:020:29:03

I...I think, she didn't understand me.

0:29:030:29:08

Before, I mean.

0:29:100:29:11

I meant it was three years in prison for one day with Matty.

0:29:110:29:17

I don't mean it was wrong.

0:29:190:29:21

I meant it was worth it.

0:29:230:29:25

Even when I got beat up by other girls

0:29:250:29:29

or when Lenuta coughed all night,

0:29:290:29:31

or...Matty's picture in the cell...

0:29:310:29:34

I could still remember him laughing.

0:29:380:29:41

I never would have hurt him, you know.

0:29:440:29:47

'So he does this Yoda thing'

0:29:470:29:50

where he just stands there

0:29:500:29:52

and scratches his chin and asks everybody else what they think.

0:29:520:29:56

But what has he actually come up with?

0:29:560:29:58

OK, from now on,

0:30:010:30:02

we make him come up with the answers for himself, OK?

0:30:020:30:05

Where's Elliot?

0:30:150:30:16

Stuck in theatre for the rest of his natural life -

0:30:160:30:19

Hanssen redid the theatre lists, for some reason...

0:30:190:30:21

It's not Freya, is it?

0:30:210:30:23

What about her?

0:30:230:30:25

You heard Hanssen green-lit surgery?

0:30:250:30:28

Yeah, we were wondering how you bewitched him.

0:30:280:30:31

You should know. I need a second surgeon to assist.

0:30:310:30:34

And you thought Elliot would change his mind?

0:30:340:30:36

-I had to ask, now Dr Dolan's signed off...

-"Dr Dolan", is it?

0:30:360:30:40

What happened to Peter Pan?

0:30:400:30:42

Come on, Jac, is Sean growing on you?

0:30:430:30:46

-Oh, come on! Jac Naylor is not giving up that easily.

-Wait...

0:30:480:30:53

-Before you both assume you know my mind...

-What are you doing?

0:30:540:30:57

Pulmonary pressure was 50, right?

0:30:580:31:00

Might be worth checking again.

0:31:000:31:02

It doesn't matter. What are we going to do? Wait till she needs a heart and lung transplant?

0:31:020:31:06

Although, I might never trust Ms Naylor's motives, her judgement's never far wrong.

0:31:060:31:11

-Are you sure about this?

-Are YOU sure about this?

0:31:110:31:14

Oh, Mr Hemingway, will you be accompanying your patient to Keller?

0:31:220:31:27

In there? With them?

0:31:270:31:29

I'm sorry, our Fellows-only lift is out of order at the moment.

0:31:290:31:32

Um...you go, I'll phone.

0:31:330:31:38

So...you don't like lifts?

0:31:440:31:47

What's to like?

0:31:490:31:50

-How did she take it?

-Who?

0:31:510:31:53

Karen Nashley.

0:31:540:31:55

-Oh, I didn't tell her.

-Why not?

0:31:550:31:58

Well, I wanted to run a few more tests

0:31:580:32:00

in light of her breathing difficulties.

0:32:000:32:03

What do you think?

0:32:030:32:04

Freya Winter...

0:32:080:32:10

Yes, approved and dated.

0:32:100:32:11

I asked Dr Dolan to inform me when you're closing.

0:32:110:32:16

Only when I came to see you earlier, I may have...

0:32:160:32:19

downplayed the risks.

0:32:190:32:21

Oh, yes, of course you did.

0:32:210:32:23

Sorry?

0:32:230:32:24

Well, I may not be a CT surgeon,

0:32:240:32:26

but contrary to your default assumption,

0:32:260:32:29

that doesn't make me a complete idiot.

0:32:290:32:32

I've factored in your spin, as I do in the majority of our exchanges.

0:32:320:32:36

Why, has something changed since we last spoke?

0:32:380:32:40

Because I'm backing your judgement, Ms Naylor.

0:32:420:32:44

If you've any concerns

0:32:440:32:46

about whether this is the right course of action or not,

0:32:460:32:48

I expect you to speak up, it's child's life at stake.

0:32:480:32:51

I know what's at stake.

0:32:510:32:53

So has anything changed?

0:32:550:32:56

Nothing significant.

0:32:560:32:59

The thing is, it's all very well

0:33:010:33:03

saying you could never run off and leave your baby,

0:33:030:33:05

but you don't know until you're in that person's shoes really, do you?

0:33:050:33:09

Then again, when I have a baby, I'm not letting it out of my sight.

0:33:090:33:13

How about you, do you like children?

0:33:130:33:15

He said "would".

0:33:160:33:18

You said "would".

0:33:250:33:26

When I asked how old your daughter was, you said, "She would be four".

0:33:260:33:32

-So?

-Past tense. As if you don't...see her any more.

0:33:320:33:35

Kenny...why is that?

0:33:370:33:41

She was stillborn.

0:33:480:33:49

I won't have it covered up.

0:33:540:33:55

Kenny...what if Mr Hamilton can do the graft...

0:33:590:34:06

..and keep at least her name intact?

0:34:080:34:10

Don't worry, there's always more bodies in a Paeds theatre,

0:34:310:34:34

just don't take chances with kids.

0:34:340:34:36

Thank you. Um, excuse me.

0:34:470:34:50

-What are you after?

-Answers.

0:34:500:34:53

Oh, no. No, it's not, is it?

0:34:530:34:55

Do you know, I probably only know for sure till I open the envelope.

0:34:550:34:59

Well?

0:35:020:35:04

I did some work in Macedonia last year

0:35:050:35:07

and saw the rise in reported cases there.

0:35:070:35:09

It's the same across the whole of Eastern Europe.

0:35:090:35:11

You mentioned breathlessness,

0:35:110:35:13

but it was when Karen said she'd shared cell with a Romanian

0:35:130:35:16

who kept coughing through the night...

0:35:160:35:17

Do you know, other places I've worked,

0:35:170:35:19

when we found out that one of our patients wasn't actually dying,

0:35:190:35:22

that was generally viewed as good news.

0:35:220:35:24

Oh, and at these other places,

0:35:240:35:26

did you tell your colleagues when you were testing for TB?

0:35:260:35:29

Usually, if they seemed even remotely interested.

0:35:290:35:31

It's the intra-abdominal strain - rare but a mild case,

0:35:310:35:36

she'll be fine. What's the matter?

0:35:360:35:38

Mm, nothing. No.

0:35:380:35:39

I've only got an infectious disease from medieval times

0:35:390:35:42

on an open ward on the same day that our director of surgery

0:35:420:35:45

is doing a health and safety drive. No, I'm fine.

0:35:450:35:48

Are you still hung-over?

0:35:480:35:49

-Do you do this deliberately?

-What?

0:35:490:35:52

Don't worry, I'll handle it.

0:35:540:35:56

You know about hearts, remember?

0:36:150:36:17

The corridor and entire ward, please.

0:36:360:36:40

And absolutely no new admissions till they've disinfected.

0:36:400:36:43

Oh, for... Do you know what,

0:36:430:36:45

I should have known you'd thought you were an exception.

0:36:450:36:48

No, I just don't like having my face covered.

0:36:480:36:50

Um, also I have to say, I think you're massively over-reacting.

0:36:500:36:55

What's the likelihood of anybody being infected

0:36:550:36:58

in such a short space of time?

0:36:580:36:59

-That is not the point, Mr Hanssen...

-I'll give him a call, shall I?

-No, no.

0:36:590:37:05

We call absolutely no-one, I can handle this.

0:37:050:37:08

-Are you OK?

-I'm fine.

0:37:090:37:13

-Karen, you are going in a room on your own for a while.

-Is this my fault? I don't understand.

0:37:130:37:18

No, no. It's not your fault. I'll come and talk to you in a minute.

0:37:180:37:22

Basically, it could be a lot worse.

0:37:220:37:23

I'm not so sure about that.

0:37:250:37:27

Come on, cheer up. It's only until the testing kits arrive.

0:37:290:37:34

Surely we can stand being stuck together till then?

0:37:340:37:37

We could...sing a few Carpenters songs, take our minds off it?

0:37:370:37:41

-This is ridiculous.

-It may be, but it's also hospital policy.

0:37:410:37:45

Can we at least have the door ajar?

0:37:450:37:48

-How is that isolation?

-We've Only Just Begun?

0:37:480:37:51

If I'd known TB was a possibility,

0:37:510:37:53

I'd line up a negative pressure room and all this would be unnecessary.

0:37:530:37:56

-It's still unnecessary.

-Agreed.

-Well, then, why are we here?

0:37:560:37:59

And why do we all have to be in one small room?

0:37:590:38:02

-Questions, questions. I told you, didn't I?

-Goodbye To Love?

0:38:020:38:05

Told him what?

0:38:050:38:06

Oh. I don't know, Mr Levy, what do you think?

0:38:060:38:09

Oh, I wonder, Nurse McKee...

0:38:090:38:10

You say just enough so that we do all the work

0:38:100:38:13

and get to the answers ourselves. You've been doing it all day.

0:38:130:38:16

-I've done it my whole career.

-He admits it.

-It's the best way I know of retaining knowledge.

0:38:160:38:21

Being told something's fine, but you'll have to be told again.

0:38:210:38:25

-If you get there yourself, it tends to stick.

-Socratic learning.

0:38:250:38:29

What the hell are you doing?

0:38:310:38:32

Now who's asking questions?

0:38:320:38:35

-You know what, sod this. I'm going in with Karen.

-Eddi, don't.

-Yes, good idea.

0:38:350:38:39

Ready for the patch.

0:38:480:38:49

Saline.

0:39:060:39:09

Off bypass.

0:39:240:39:25

Right...I'm done.

0:40:020:40:05

That means you can go now?

0:40:080:40:09

Don't want to be around me, do you?

0:40:120:40:14

Because of what I done?

0:40:140:40:16

It doesn't matter what I think. Or anyone else, in the end.

0:40:160:40:20

Like I said, after a few months of treatment

0:40:200:40:23

you're going to be fine. You know what that means, don't you?

0:40:230:40:27

It means you're free.

0:40:290:40:31

People might think they know who you are,

0:40:310:40:34

but you're free to be who you want when you want now.

0:40:340:40:36

You could be two different people at the same time if that's what you like.

0:40:370:40:41

Have a baby if that's what you need.

0:40:410:40:42

No-one's never said nothing like that to me before, they haven't.

0:40:440:40:48

So, it went well?

0:41:090:41:10

She didn't say, I'm sure she would have done if it hadn't.

0:41:100:41:13

How's it going down there?

0:41:170:41:18

Not great, to be honest.

0:41:180:41:20

Doesn't seem to be going in by itself.

0:41:200:41:22

Nurse? Bring out Dylys!

0:41:230:41:26

Right.

0:41:390:41:41

Mr Hamilton?!

0:41:410:41:42

HE LAUGHS

0:41:420:41:44

OK, OK, consider my preconceptions truly smashed.

0:41:500:41:55

You need to loosen up.

0:41:550:41:58

Whatever we do, we're at our best when we're enjoying ourselves.

0:41:580:42:02

I think we make a pretty good team.

0:42:020:42:04

It's good, honest work. I think you've rather enjoyed getting your hands dirty.

0:42:040:42:08

Seriously, I never knew the orthopaedics could be this much...

0:42:080:42:11

Like this.

0:42:150:42:16

-So why not stay?

-What?

0:42:160:42:18

I told you, I'm an F2 down.

0:42:180:42:19

Unless you're happy being Jac's lacky.

0:42:190:42:22

Here's to Darwin's first official Paeds CT procedure.

0:42:340:42:39

How does it feel?

0:42:390:42:41

Honestly? The same as after every other procedure.

0:42:420:42:46

Which is why, if ever the axe should fall here,

0:42:460:42:48

you could always make the switch to Paediatrics full-time.

0:42:480:42:51

-I thought I lacked empathy.

-There are more important qualities.

0:42:520:42:55

After I left you to put the line in Freya, I thought,

0:42:550:42:58

"She'll never be able to sink a knife in to her now."

0:42:580:43:02

Now Sahira may be handy up there,

0:43:020:43:05

but she wouldn't last five minutes on my ward.

0:43:050:43:07

Ms Shah might be misguided, but she does genuinely care about Freya.

0:43:070:43:11

And not because she sees an opportunity to get her name

0:43:110:43:14

on a sexy procedure.

0:43:140:43:15

But because she sees a vulnerable child all alone in a place

0:43:150:43:19

where everybody needs somebody.

0:43:190:43:21

If you really think there are more important qualities than that,

0:43:220:43:25

then I pity your patients. And you.

0:43:250:43:27

I'm sorry.

0:43:350:43:36

Therapeutic hypothermia - stages one and two,

0:44:000:44:02

-fully completed with relevant orthopaedic data.

-Right. Great.

0:44:020:44:06

I actually told you a bit of a white lie when I saw you earlier...

0:44:060:44:09

-Just in my pigeonhole, please.

-You wanted it immediately.

0:44:090:44:12

I'm not going to have time today after all.

0:44:120:44:14

-Ms Naylor...

-Just put it in the pigeonhole, please.

0:44:140:44:18

And take that poppy off while you're at it.

0:44:180:44:22

Ms Naylor, a word, please, in the office.

0:44:220:44:25

Don't worry, little one.

0:45:130:45:15

The thing I'm wondering is...

0:45:380:45:40

were you really attacked?

0:45:400:45:43

Were you?

0:45:450:45:46

This wasn't your nearest hospital, was it?

0:45:480:45:50

No.

0:45:510:45:52

Do you listen to the radio?

0:45:550:45:56

I listen to the radio. You listen to the radio?

0:45:560:45:59

Is that where you heard about her?

0:46:010:46:02

You'll never be nearer to a door than me, I'm afraid.

0:46:070:46:10

Don't be scared.

0:46:120:46:13

I understand.

0:46:130:46:14

Not the desire for a baby necessarily, but that's only biological,

0:46:160:46:20

and possibly one of the least interesting things about us.

0:46:200:46:24

But the horror of being alone,

0:46:240:46:26

of having no-one to love or to love you back,

0:46:260:46:28

I don't have to share that to understand...

0:46:280:46:32

..to really understand,

0:46:330:46:36

to walk up an awful lot of stairs to tell you that it's all right.

0:46:360:46:39

It really is.

0:46:410:46:43

SHE SOBS It's all right.

0:46:530:46:57

FREYA CRIES, MACHINES BEEP

0:47:080:47:13

And calling me out of theatre for a five-minute consultation

0:47:130:47:16

was totally out of the question?

0:47:160:47:17

-Yes.

-Because?

0:47:170:47:20

I've told you - because Mr Douglas offered to assist.

0:47:200:47:23

You should still have consulted me, and we both know why you didn't.

0:47:230:47:26

Really? Why's that?

0:47:260:47:29

I came to congratulate Ms Naylor but is there a problem?

0:47:290:47:32

You could say that.

0:47:320:47:34

I've done nothing wrong, and I don't need your permission to operate, Elliot.

0:47:340:47:38

It's Freya.

0:47:380:47:39

-BP?

-60 systolic, still dropping.

0:47:420:47:44

And she's tachycardic.

0:47:440:47:46

-How long?

-I was talking to social services.

-How long?

-No more than ten minutes.

0:47:460:47:50

-What happened?

-It can only be a bleed.

0:47:500:47:52

Then we need to open her back up. What choice do we have?

0:47:520:47:56

Ms Naylor?

0:47:560:47:58

Ms Naylor?

0:47:580:48:00

-Would you like Mr Hope to take over?

-No! This is down to me. Page the anaesthetist.

0:48:020:48:06

FREYA CRIES

0:48:060:48:08

How are you feeling? Any pain?

0:48:220:48:24

Told you, I don't feel it.

0:48:240:48:27

And the leg?

0:48:280:48:29

Haven't seen it yet.

0:48:310:48:33

All seems fairly satisfactory.

0:48:560:48:57

You'll heal in no time.

0:48:590:49:02

Ah, Luc, where have you been?

0:49:210:49:24

-They got her - Karen, Miriam, whatever, the police got her.

-Good.

0:49:240:49:28

-Has something happened?

-Nothing that I couldn't handle.

0:49:280:49:31

While you were in the library, I was on the phone to the police

0:49:310:49:34

stopping the baby on Darwin from being abducted by your mate.

0:49:340:49:38

It seems Karen isn't quite the reformed character you'd hoped.

0:49:380:49:41

How is the poor little mite?

0:49:430:49:45

Back in theatre now. What do you think about that, Socrates?

0:49:450:49:48

Oh come off it, you've been trying to undermine me all day,

0:49:490:49:53

with your clever comments, constant questioning and doing your own thing.

0:49:530:49:56

But when it really mattered, I stayed in control

0:49:560:49:59

and as a result, saved a child's life. Hopefully.

0:49:590:50:03

And prevented a TB epidemic.

0:50:030:50:06

Excellent. You really do run a very tight ship, Nurse McKee.

0:50:060:50:11

Suction, please.

0:50:170:50:19

The fact there's a bleed doesn't mean she shouldn't have had surgery.

0:50:220:50:25

And stopping the bleed doesn't mean she will live through it.

0:50:250:50:29

-It was still the right call.

-This is not an inquest, Mr Douglas!

0:50:290:50:33

Yet.

0:50:330:50:35

Keep 100% oxygen.

0:50:410:50:43

-BP?

-No, still falling.

0:50:440:50:46

-Come on!

-She's going into VF.

-Paddles!

0:50:470:50:50

-Jac?

-No.

0:51:180:51:21

Mr Hope?

0:51:520:51:54

She's going to be fine.

0:51:570:51:59

'Jac was incredible in there.'

0:52:020:52:04

I've never known anyone take so long scrubbing in and out as you.

0:52:130:52:18

Lots of sins to wash away.

0:52:180:52:20

Ah, not today.

0:52:200:52:22

Listen...

0:52:230:52:24

what I said before about empathy...

0:52:240:52:28

what you did in there was...

0:52:280:52:29

I did my job, Sean.

0:52:290:52:31

We all did. Let's just leave it at that, OK?

0:52:310:52:34

You called me Sean.

0:52:370:52:39

-Tell anyone and I'll deny it.

-Tell them what,

0:52:390:52:42

that it's not just Freya's heart that's bigger than it looks?

0:52:420:52:46

Save it for the ten year olds.

0:52:460:52:48

Maybe I'll see you downstairs sometime...Ms Naylor?

0:52:500:52:53

Excuse me.

0:52:530:52:55

HE CHUCKLES

0:52:590:53:01

-HE COUGHS

-Nurse?

0:53:040:53:07

You can come in, you know.

0:53:080:53:11

Oh, there's no need. It's only...

0:53:110:53:13

tomorrow morning...

0:53:130:53:16

I won't be on the roof.

0:53:160:53:17

Right. OK.

0:53:170:53:20

-It's a big roof.

-It's not big enough.

0:53:200:53:23

-I really need to talk to you.

-And I really can't right now.

0:53:440:53:47

Let's just catch up first thing, OK?

0:53:470:53:51

No, actually, not OK. I haven't slept for two days.

0:53:510:53:54

All the more reason to postpone this.

0:53:540:53:56

You had plenty of time to talk yesterday - I wonder why that was.

0:53:560:53:59

-It's not that I don't have time for you, it's...

-Something better came up. Yes, I get it.

0:53:590:54:03

-You said that we were going to work together on this. You said it was vital.

-It is, and we will.

0:54:030:54:08

-I don't believe you.

-Well, that's your choice.

0:54:080:54:12

-Just don't make any decisions on the research until...

-It's too late.

0:54:120:54:16

You told me to show initiative - well, I have a new mentor.

0:54:160:54:19

-What?

-Mr Hamilton.

0:54:190:54:21

You're not serious?

0:54:240:54:25

Oliver, moving to Orthopaedics from CT is like choosing

0:54:290:54:33

to play for West Bromwich Albion over Barcelona

0:54:330:54:36

because you like the shirt better - it's absurd.

0:54:360:54:39

It's MY decision.

0:54:390:54:40

To be mediocre instead of the best? That's what you've decided?

0:54:400:54:45

What do you think you're going to learn as a bone monkey?

0:54:450:54:48

Whatever it is, I'll learn it by doing, not wasting my life waiting for crumbs from your table.

0:54:480:54:53

-Think you'll make a difference gluing bones back together?

-Yes, I do, and I'll have fun doing it.

0:54:530:54:59

This could ruin your career.

0:54:590:55:01

You don't care about my career. You don't care about ME at all!

0:55:010:55:05

All you're worried about is whether I'm going to tell tales on you. Well, I'm not.

0:55:050:55:09

I'm sick and tired of never knowing where I stand with you,

0:55:110:55:15

trying to work out WHY you do the things that you do.

0:55:150:55:20

I don't think you even know yourself.

0:55:210:55:25

So if being the best is being like you,

0:55:250:55:28

well...

0:55:280:55:29

..I'll settle for mediocrity.

0:55:310:55:33

Then you and Mr Hamilton should be the perfect fit.

0:55:350:55:38

I hope you'll be very happy together.

0:55:380:55:41

QUACKING

0:55:490:55:52

# All bodies break

0:56:180:56:24

# And the blood just spills and spills

0:56:240:56:29

# But here we sit debating that

0:56:290:56:36

# It's just a shame

0:56:390:56:46

# My hand just kills and kills

0:56:460:56:50

# There's gotta be an end to that

0:56:520:56:59

# There's gotta be an end to that. #

0:57:250:57:32

Subtitles by Red Bee Media Ltd

0:58:110:58:15

E-mail [email protected]

0:58:150:58:18

When baby Freya's test results reveal a very rare heart condition known as Gerbodes, Jac goes against Elliot's instructions and decides to perform a potentially life-threatening procedure. As the operation draws closer Jac begins to question the validity of her decision. The operation goes ahead and proves successful, until baby Freya develops a bleed and Jac has to step up and save her life in an emergency second procedure. A new senior registrar with some unorthodox methods ruffles Eddi's feathers and sparks begin to fly. Baby Freya's safety is compromised when a patient on AAU turns out to have been jailed for kidnapping a child. Whilst in prison the patient contracted a form of TB which causes Eddi to put the whole of AAU on lock down. In order to complete a section of his research Oliver must gather data from Orthopaedics. Dan is an F2 down so Oliver offers to lend a hand, but after seeing Dan's teaching methods, he begins to consider his future on Darwin.


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