Breathless Holby City

Cutting waiting lists is not just Ms Campbell's responsibility, is it?

You know our target spend isn't being met. What do you suggest we cut?

Will you tell Chantelle this is her last day or will I?

Ollie wait...

We have a heart, ETA two and a half hours...

A patient's a patient, a doctor is a doctor.

-Everything else is irrelevant.

-I agree.

Well then... I'm asking you, just for today.

No more emergency referrals. Hmmm?

You closed the ward to non-electives?

-Yes.

-That's interesting. Perhaps you should trail it for longer.

It would certainly improve my throughput...

-And AAU will concur, will they?

-Of course.

PHONE RINGS

ELEVATOR BEEPS

'Doors opening.'

'Lift going down.'

-Dr Lo.

-Mr Hanssen.

-I sense an air of anti-climax there.

-Yeah - I mean - no!

I was just waiting for Ms Naylor

to see if she will have a look at my research project?

Ah, I see. Still on that trajectory, are we?

Absolutely. I thought if she likes it, then she might oversee it.

Let's hope she likes it. You haven't forgotten our appointment this afternoon?

The scan, Dr Lo?

-Oh, of course not! I'm looking forward to it.

-Four o'clock, then.

Ms Naylor. If you have a minute? I was wondering if you could read this?

No. Short stories aren't really my thing.

-It's not a short story, it's a research project.

-Bored now.

Why don't you give it to Dr Valentine?

-He could do with a laugh.

-I was really hoping you would...

read this...

S'cuse me?

Yes?

I'm here to see Mr Hope.

Oh, he's not in today. Do you have an appointment?

Can you get me his number or something...?

-I'm sorry, that's not really allowed.

-But he said he'd help. He said,

-if there was anything that...

-Are you a patient of his?

Alana. My husband was a couple of years ago.

Right, and is he ill again?

No, it's me.

I am.

OK, well in that case you should really just go see your GP...

I have been. I've been in loads, but he doesn't believe me.

-Believe what?

-I've got lung cancer.

How long's Mr Tailforth been with us?

Inguinal hernia? About four days.

He was feeling achy. Mr Griffin thought we should keep him in.

That's what pain relief's for. Get them in, fix them, get them out.

Or "bish, bash, bosh" as they say in some circles.

-Same goes for bays one, five and seven.

-Your wish is my command.

-What about this one? Alfred Stewart.

-The old geezer? He's one of Ric's.

One of his bridge pals?

Gall bladder came out yesterday. Think he's keen to get off though.

Well, let's not disappoint him then.

Which means we can bring forward three electives from tomorrow.

I'll do them this afternoon. Once I'm out of this

dreary Discharge Planning session.

Well, you know what's got two thumbs and a desire for surgery?

-No, I don't.

-This guy!

-I know where to find you!

Still nothing...

-Right... time of death...

-HEART RHYTHM RETURNS

Ha! And the Spence is back in the building!

Nice work, Jesus!

Ye of little faith. Let's get him intubated,

get him out of here,

-send him up to Keller.

-We don't do that anymore.

-Can you clear up here, thank you?

-We don't do WHAT anymore?

Refer up to Keller.

What do you mean we don't refer up to Keller?

We don't send patients up to Keller anymore.

-Non-referral pilot scheme.

-Since when?

-About a week?

Come on! I've only been gone for three!

-Man, I'm sick of Hanssen and his bureaucratic...

-It wasn't him.

-Who was it?

-Ms Campbell.

I think she's in a meeting.

Ollie. Hi.

Hi.

You haven't seen Ms Naylor, have you?

No... Sorry... Erm...

Right.

-Can I help?

-No, it's fine, I'll page her.

-Tell me.

-You're busy.

-No, I've stopped now.

Well, I have this lady over there who thinks she's got lung cancer.

Thinks?

Yeah. She hasn't actually been diagnosed.

Right, does she have any symptoms?

-No. She has a feeling.

-Sounds to me like a time waster. Get rid.

But don't you think we should check her out?

Look if she seems ill, tell her to hassle her GP.

NOT us.

-OK. Right. I will. I'll just go and tell...

-Yeah.

Well, I mean the obvious solution is preoperative assessment. That way...

Mr Spence. Didn't see your name on the list of attendees.

-I need a minute.

-Sorry, my attention appears to be required here.

I'll see you up there. Thank you. How can I help?

-You can tell me what it is you think you're doing?

-A relaxing break then.

It was. Until I got back and find someone tried to sabotage my ward.

-I assume you mean the pilot non-referrals scheme?

-I do.

Bit melodramatic? Your staff seem to like the idea.

Well I don't. It's crass, it's oversimplified.

It's not designed to work this way, we've one theatre and limited beds.

It's going to cripple our resources.

Of course, I'd be delighted to hear all of your feedback

when we come to review the scheme at the end of the pilot period.

-I'll talk to Hanssen.

-No point.

He's all right with this?

Do you think I'd implement such a scheme without getting his approval?

But of course if you don't think you can do it Michael...

-Of course I can. I just don't want to.

-You don't want to enrich

-the hospital's financial outlook?

-Did I say that?

Speed up test results, cut the length of patient stay,

or save the time spent needlessly transferring patients between wards?

-If you'd let me get a word in...

-So, ultimately,

what you're saying is, you don't want to improve Holby?

-Of course I do.

-Well, at least we're agreed on that.

-Mr Stewart?

-Oh!

Always the same.

-Never at the end of a chapter.

-Sorry.

Just checking we're OK to let you go. Obs fine. B/P's good.

-Hmmm.

-What?

Slight increase in temperature, nothing to worry about. How you feeling?

Right as rain.

Good. Mind if I take a quick look? See how you're healing?

Lynn?

Actually it's Nurse Lane, Mr Stewart.

-It says it here on my badge.

-Memory's a sieve.

-I'm just going to lift up your top.

-Hold these for me.

STOMACH RUMBLES

S'cuse me.

-You slimming or something?

-What?

Never diss a free meal, that's my rule.

Oh, it's just, you know...

that healthy stuff goes right through me.

I'll wait 'til I get home. Sausages or something.

Fair enough. Don't want you wasting away on us.

Looking sweet, Alfred. Get you clean dressings to take away with you,

-but other than that, you're good to go.

-There you go.

Couldn't call me a cab if you've got a sec, could you? 43 Hunt View.

I'll bring the phone and the book over.

Oi! Do you mind?

I've got to sort out my things out for going!

Better do as the man says.

I'm not going until I've spoken to someone.

Look, I'm sorry - there's nothing else I can do.

-I can call you a taxi?

-I don't want a taxi!

I want to talk to your supervisor. Where's he?

-She's busy.

-Someone else then. I mean it.

-I'm not going.

-I've asked you nicely. Please don't make me call security.

Go on - do it.

-See if I... Care.

-Are you OK?

-I can't breathe!

-Crash team!

-Wh-what is it?

-I think your lung's collapsed. Try to stay calm.

-Deep breaths.

-Move. What have we got?

Suspected Pneumothorax. Absent breath sounds in the left cavity.

-She's tachycardic.

-An erratic pulse.

-Get her to theatre. We need to reinflate.

-Can I assist?

No. You chase up the notes and look after that.

BABY CRIES

Five years at med school.

-Well?

-We're going with it. For now.

-You don't seem very enthused?

Keeping an open-mind. What have we got?

Jade Walker. She's 23. Front passenger in an RTC.

RTC? Great.

There's more coming. She's complaining

of abdominal pains. Slightly tachycardic, systolic 80, hypotensive.

-Let's push fluids.

-Bet I look like a right dog's dinner?

You look mint. Try to keep calm. Will she be all right?

I want to run a CT scan. We'll know more soon.

-The scan's going to take a while. Let's get your head looked at.

-Aye... but...

-Get your face looked at! I'm not hanging around with an ugger.

-Let's go.

Notes, please.

-How was it?

-Well, she'll live. We managed to

reinflate the lung and she's now the owner of an intercostal drain.

I left a message with her GP,

called her next of kin and Rihanna's in the creche.

-Ah! She's gone into children's entertainment, has she?

-Rihanna's the baby!

Speaking of which, does anyone know how Ms Effanga's getting on?

-Haven't heard.

-I can't believe you pretty much

delivered her baby. Talk about exciting.

Yes, there are certain collegial boundaries one shouldn't cross.

That was one of them.

Oh, erm.

I thought you could use a coffee. And a muffin.

A banana one.

Thank you.

I should probably get off.

Sure. Actually, Ollie, I wanted to ask you,

I wrote this thing and I was wondering if you would have a read.

It's not very long. It's just that Ms Naylor said she wouldn't.

-One of Ms Naylor's cast-offs, am I?

-No, I didn't mean...

-It's fine, it's fine.

-Sorry to butt in.

-How can I help?

-Joking. I was just joking.

-Yeah.

I'm Kevin Cooke. They said my wife's in here.

Alana, she's got our daughter.

Yes, Mr Cooke, I'm Dr Lo, we spoke on the phone.

Will she be all right? What's happened?

We think she's going to be fine. I can take you to see her.

So why's she in here?

Your wife is under the impression that she's got lung cancer.

Right.

-But she's in a good...

-I need to see my daughter. Now.

Please.

-Did you get my taxi?

-Yes, it's on its way, Mr Stewart.

-So if you'd just like to wait in reception.

-Right, well.

See you.

-Take it easy.

-Bye.

-Wait, what about your dressing?

-Plasters at home, thanks.

-Mr Stewart, I think you should take...

-Oh, ow. Oh.

-Mr Stewart?

-Oh. Ooh. Ow.

You all right? Easy, easy.

-There you go.

-Take a seat.

-I'm fine, I'm fine.

I've just been off my feet for a few days, that's all.

-Mr Stewart, you're not leaving us already, are you?

-Actually, yeah, he was.

You're shipshape, aren't you?

-Get him back into bed please, Chantelle.

-There's no need, really.

-Now.

Care to explain why you're discharging a patient

-when he's still clearly unwell?

-Look, before you start,

-he was fine a minute ago, all right?

-What's the rush?

We needed the bed. Ms Campbell wanted to push forward

some of the electives, keep things moving.

Look, he's fine, I'm telling you.

-He has a raised temperature.

-Only half a degree, it was nothing.

Or possibly a sign of infection.

With all due respect, Mr Griffin, I think you're being overcautious.

When did you become so blase about patient care?

Hey, I'm just being efficient.

If you'd taken the time to get to know your patient,

then you would have discovered that Mr Stewart is a widower,

who should have had this procedure five months ago.

-Well, why didn't he?

-Because his wife died.

He's still adjusting. He keeps forgetting his appointments

because he's not used to looking after himself.

And if you'd sent him home, who knows what would have happened.

Hey, I've missed you. I've missed you so much.

-Sorry.

-It's fine.

-I haven't seen her in two weeks.

-You've been away?

No.

-It was her mum.

-Where did she go? Somewhere nice?

-Your guess is as good as mine.

-She just left?

She hasn't been herself.

-Ah, the cancer.

-It's like...

-it's like she wants to have it.

-Has she said anything about her GP?

He found nothing wrong with her, but she's convinced.

I keep telling her it's all in her head.

-Not this time.

-What do you mean?

-Your wife suffered from a spontaneous pneumothorax.

-A what?

A collapsed lung. It's probably nothing to worry about.

-Is it to do with...you know?

-We're waiting to find out.

38, you're burning up, man.

Could you do this later, son? I'm getting a bit tired.

-What are you listening to, Mr Stewart?

-WERE.

-What WERE you listening to?

-What were you listening to?

-Ah, you wouldn't know it.

-Try me.

-Denise Mina.

The Paddy Meehan crime novels, set in the mean streets of Glasgow.

-How'd you know that?

-I'm more of a Peter James man myself.

-You know, the Roy Grace series set in...

-Brighton. Yeah, I know it.

Blood, guts and intrigue, eh?

You're turning out to be quite a mystery yourself, Mr Stewart.

I'm quite straight forward, me. Ow.

-That wasn't just a dizzy spell before, was it?

-Ah.

A bit of indigestion, that's all. It'll pass.

Glass of ginger cordial would fix it, but I'll get that at home.

How long have you been feeling the stomach pains?

-It's nothing. Don't worry yourself.

-It's my job to worry.

-Ah. Middle of last night.

-Why didn't you say something?

Well, I wanted to get home. I'm running low on tapes.

Not that it matters much now cos the thing's bust.

Mr Malick knows a thing or two about technology, don't you, Mr Malick?

Do I?

Let's see if he can't get you fixed up.

I think that bit goes on there.

Cheers.

Alana's X-rays. Anything?

No hyperinflation or increase in anteroposterior diameter.

-So, no, nothing.

-She was so sure.

-Hi, yeah.

I'm here.

And that was two weeks ago?

Right, well, I appreciate it. Thanks for your time.

Cheers.

Well, that was her GP. Says she's made 19 appointments

in the last four months.

What happened to people looking things up on Wikipedia?

-Did he do anything to help her?

-He diagnosed her with postnatal

depression three and a half months ago.

So that's why she's been acting so weird.

That why she thinks she's got cancer.

-Unless it's a side effect of her medication.

-Not likely.

-Why?

-She hasn't picked up any of her prescriptions.

I need you to scrub in on Mr Barnes, 15 minutes.

He's willing to believe you're qualified,

-but wants to see my diploma certificate.

-SHE LAUGHS

-I think he's gone for a coffee.

-Sorry?

-Your boyfriend.

-He's not my boyfriend.

-Sorry, my mistake.

-Where's my bag? Have you seen it?

-Yeah, I'll get it for you.

-How are you doing?

-Fine.

-How's the pain?

Yeah, it's fine.

Hi, babe. Can you hear me? It's Jade.

No, I'm not going to make it.

Car crash. Well, no, cos they said they want

to keep me in for observation or something.

I know, babe. I was looking forward to seeing you too.

I've got to go. Bye.

-Got you this.

-I'm not a toddler.

I know you're not a toddler.

I'd like to see a toddler walk about in the shoes you wear.

-Who was that?

-Just me mam.

-Hm.

-Nurse?

-I'll get you some pain relief.

You all right, pet? Here, here. Tell Ron.

-Ron?

-Hi, Ron Bear.

What are you saying?

I'm saying, all going well, Mrs Cooke,

-you should be out of here in a couple of days.

-But, no.

What about my lung?

Most of the time, a spontaneous pneumothorax does what it says on the tin, it occurs spontaneously.

It can happen to anyone, at any time, for no particular reason.

But it's something else. I know it is.

Well, obviously, we hope that's not the case.

But we'll keep you monitored, we'll rule out aortic dissection,

-cystic fibrosis, asthma.

-I don't have asthma.

And I'm pretty sure you don't have cancer either.

It's a good thing.

Lan.

What happened? What's the matter with you?

What's he doing here? I don't want him near me.

-Try and stay calm, Mrs Cooke.

-I want him to go.

He wants to take my baby.

Where did you go, love? You had me worried sick.

Why didn't you phone?

-Give her to me.

-Lan, please.

I want my baby.

Perhaps you should give her the baby for now.

-Dr Lo, show Mr Cooke to the Relative's Room, please.

-Sure.

See you later, love.

THE BABY GURGLES

It's amazing how he conceals it. Death after death after death.

Yeah, well, sounds like a good book.

You know what, I'll be back in a bit.

How's he doing?

No change. Still burning up, bit of abdominal pain.

But he's not so ill that he couldn't spend the last 30 minutes

telling me his top 20 fiction kills of all time.

Wouldn't think it, would you? Sweet, old man with a terrifying mind.

Hey, did you know the average body count for a crime novel is 8.38?

In terms of his health, are there any clues?

Mr Malick, Mr Griffin.

Someone's stolen Mrs Farnham's chocolates off her bedside table.

What?

Dark Selection. She hadn't even opened them yet.

Could she have mislaid them?

Like Mr Black's biscuits or Mrs Murray's grapes?

Yesterday, someone stole my cherry yoghurt out the fridge.

Hm-mm. Er, sorry, Channers, that might have been me.

But the chocolate, no way. Got to watch this bad boy.

Well, she knows who it was, anyway.

-Who?

-Hold on, before we go pointing any fingers,

let's make sure we've got all the facts first.

-She saw him do it.

-Saw who?

Alfred.

-Ready?

-You better have a look at these first.

-It's Jade's scan results.

-Ah.

All right, well, then Mr Barnes is next after that.

Apparently, his suspicions extend to consultants.

Do I look like the kind of guy who buys a doctorate off the Internet?

-Don't answer that. Jade.

-What is it?

-You have a ruptured spleen.

-What do you do with one of them, then?

Well, we operate. As soon as possible. Do you mind if I?

-Ah!

-Severely distended.

But I don't want an operation. I just want to go.

I'm sorry, we don't have a choice.

We're going to have to do this right now.

Michael, Mr Barnes is ready when you are.

Please, could you knock him out?

He's been asking to see my qualifications all morning.

-You as well?

-Is he stable?

-Yeah, just about.

-Is she having it or not?

-Yes. Give me a minute.

-Michael, you said I was first.

-And she's tachycardic.

-You could try sending her up to Keller.

Right, let's get Jade into theatre. Now. Warn Anaesthetics.

Can we get some help over here, please?

The thing's still bust.

An allegation has been made and I have to follow it up.

I'm sure you understand my position.

Sound keeps going. It's not the batteries

cos they're new in.

Mr Stewart, to help us resolve the situation quickly and painlessly,

would you mind if we took a quick look through your possessions?

Well, I would, if you don't mind. They're private.

Come on, Al. It's like in your books,

process of elimination and all that. You know the rules,

you practically wrote them.

-Mr Stewart?

-Pass it here.

Dark selection.

I'll take these back to Mrs Farnham.

It won't happen again.

-That it, then?

-Actually, no. Come on, Alfredo.

This is not like you, looting some old lady's sweets.

Had you down as the detective, not the culprit.

Rule number one. Subvert expectation.

Skipping meals, is that rule number two?

Not eating your food, nicking other people's. What's going on?

-I don't like it.

-What? The food here?

It's not my thing. Healthy stuff.

I told you, it goes through me like a bullet.

-When was the last time you had a proper meal, Mr Stewart?

-Dunno.

-There was those biscuits.

-And?

Well, then, looks like we've found the source of your tummy ache.

ALANA EXHALES

Good.

-BEEP BEEP

-What does it say?

That everything is normal.

No.

It can't be.

But it's not right.

-I can't do this.

-What do you mean?

-Alana?

-This morning. In some grotty hostel.

White pills.

I was this close.

-But you didn't.

-Couldn't, could I?

What about Rihanna?

Listen, there are people you can talk to.

What do you think I've been trying to do?

Alana, why haven't you been taking your medication?

The paroxetine.

Because I don't have postnatal depression.

-It's something else.

-How can you be so sure?

Because...

There is something inside me. It's...

It's like a weed,

creeping all over me.

I can feel it.

It's strangling me.

What do you think this is? IKEA? No, we do not have any more beds.

-What happened here?

-ED didn't tell us it was a coach, did they?

Cut to, seven more incoming.

Right, you've got a dislocated shoulder and whiplash in seven.

Head injury in nine. And a suspected ruptured appendix in four.

Oh, and there's him.

It was all going so well, wasn't it?

-Mr Spence? How's she doing?

-She's OK, she's in recovery,

but I do have to warn you, we had some complications,

so we're still waiting to see how that's going to shape up.

-No chance of her getting out of here today?

-No, I'm afraid not.

-She's a canny lass, like.

-Hm?

I like her.

Just a bit tricky, like. Best mate's little sister and all that.

-Ah, so he's not a fan, then?

-Gary?

He'd probably batter us.

I was going to, you know,

ask her out, like, properly, in Cardiff.

Should be there now. Couple of days away,

nice meal, few beers, couple of tea lights, the lot.

-Double room as a surprise.

-Two singles, man.

I've got some boundaries.

Ah, Chrissie, will you transfer Jade from the Recovery Room to the Ward?

-No, we don't have any room for her.

-What?

-You know what, that's it. Transfer her up to Keller.

-Finally.

This is going to sound mad, but Alana Cooke,

I think there's more to it than just a collapsed lung.

She's completely terrified, there must be a reason for it.

-She has postnatal depression.

-I know her results didn't show anything up,

but I just think someone should listen to her properly,

-you know, look into it more.

-Whatever you think.

-OK, well, thanks for the support.

-What? I didn't say anything.

-No, it's fine. I got the disdain from here.

-I didn't say anything.

-Is there a problem?

-No, no problem.

-Well, obviously there is.

You've been off with me ever since....

Oh.

If it's about what happened the other week.

What about it?

Y...

You know. Us...

..nearly kissing.

-Me running away.

-Oh, that?!

-Yes! That!

I'm sorry.

I've got a lot on my mind at the moment.

Can we just pretend it never happened?

No.

Oh.

No, I'm the one who should be apologising.

I've been an idiot.

No, you haven't. It's me. I was weird. I do that.

-You are quite weird.

-SHE LAUGHS

Erm...

All right.

So am I wasting my time?

With Alana, I mean, the patient.

No, I meant what I said. Do what you think.

-Right.

-Go with your gut.

Hey. Good meeting?

Lots of going forward, place shaping and blue sky thinking.

I've forgotten what the meeting was even about. You all right here?

-All under control.

-Good.

-So you won't mind if I pop down to AAU, see how they're getting on?

-No worries.

Hear that, Blondie? The Malick's calling the shots.

So these abdominal pains for Mr Stewart

are down to him not eating, right?

Epigastric cramps could be behind it,

but let's cover all the bases.

Chantelle, would you make him a protein shake, please?

-And make sure that he drinks it.

-Strawberry, chocolate or banana?

-Why don't you ask him?

-I think we've got vanilla too.

-Let's do an ECHO, make sure there's anything untoward.

-I'm on it.

Oh, see if you can track down his menu cards from the kitchen.

Any particular reason?

He might have a possible food allergy or intolerance.

But if he hasn't had any solids since he...

-Let's not rule anything out.

-You're the boss!

Jade!

-Where's she going?

-You can go with her. I'm transferring her upstairs.

Eddi, will you tell Mr Barnes that it's party time.

Thank you.

-What happened?

-She did.

OK, Michael. What's the problem?

Well, it's over. Your non-referral scheme. It's done.

-Oh, please, don't fight me on this.

-Aye, she's a scary lass, like.

-Sorry, who are you?

-I'm waiting for her.

Would you mind going and waiting in the corridor?

Have you forgotten our chat?

Oh, you mean the one where you basically told me to go deal?

I thought you said you were being open-minded?

Look, it's not working. I've got no more space

and I have an op that has been waiting since this morning.

-Maybe you're just not doing it properly.

-Oh, right.

Patient list, please. Thank you.

Well, this is wrong for a start. Whiplash?

Don't be a baby.

Facial abrasions, give them a plaster.

Davidson and Jennings. Where are they?

Four and six.

Get them up in Outpatients. Off you go.

-What's wrong with her?

-Bowel perforation.

-She might need a resection.

-Stick her in the side room for now.

-Well, she still needs to be informed.

-And?

I'm due in theatre. I can't tell her and do a laparotomy at the same time.

I'm good, but I'm not that good.

Fine, give me ten minutes to clear my list and I'll deal with her.

-You, go and do your op.

-Fine.

-Lovely.

-Come on.

-Easy-peasy.

-Mr Cooke, I wanted to ask...

-How's Alana?

She's, well...stable.

I wanted to ask...

Will she be able to come home then? If she wants to.

-Yeah.

-Great.

That's great.

Does she talk about it a lot?

-The cancer.

-I know it's not her fault.

But it's...

-it's constant.

-Did you notice any physical symptoms?

It weren't a symptom as such, just...

stomach ache.

But you know how people get when they're uptight.

Especially her with this.

So she's been having abdominal pain?

She's that worried, it's hurting her.

Look, whatever it is, just make her better. Please.

Yeah.

-I'm not going back in.

-We're hoping it won't come to that.

But if it does, we'll be performing what's called a full resection.

What's that?

The removal of all or part of the bowel.

-It's a relatively straight forward...

-All of it?

-Can you give us another one?

-No.

It means a colostomy bag might be an option.

No. No way. I'm not having that.

It's not a done deal. We'll keep you monitored.

-See how your condition improves.

-Whatever.

-Jade.

-Get off me.

Nurse McKee will be in to see how you're getting on.

-Jade.

-Did you not hear me? Shut up. You're in my ear constantly.

Can you just leave me alone for one minute?

Please, just let me run some more tests.

Look, the X-ray's were clear. The lung function tests were normal.

We've got a patient suffering from postnatal depression,

where one of the main symptoms is health anxiety

and you want us to run further tests.

Do the words red rag and bull mean anything to you, Dr Lo?

But I spoke to her husband. She's been experiencing abdominal pains.

-He thinks it's down to stress, but...

-It probably is, psychosomatic.

But I think it's linked.

Stomach pains, behavioural problems, collapsed lung,

-it's all connected.

-Well, how?

-I don't know.

-Wrong answer. That's nowhere near good enough.

-Sometimes you just know.

-And you're an authority because...?

-I'm not, I just...

-Look, until there's concrete evidence

that we're dealing with anything

other than a spontaneous pneumothorax,

-I don't want to hear it. Just keep her on obs.

-I...

SHE EXHALES

-Mr Hanssen?

-Let's hope that horologagnosia

isn't a further symptom of your condition, Dr Lo.

-Sorry?

-The inability to tell the time.

-I am so sorry.

-You have five minutes.

-Tinkerbell. Have you seen the Griffmeister on your travels?

-Not for a bit.

When you do, tell him I'm going off piste for a bit, all right?

-Off piste?

-Yeah, Serena rang. She wants me to do her electives.

-What about Alfred?

-I think it's a bit more important

than Mr Griffin's care in the community project, don't you?

Oh, wait, he's here, you can tell him yourself.

Chantelle, do we have Mr Stewart's ultrasound results yet?

Oh, yes, they are here.

OK. Thank you.

What is it?

Some kind of mass in the stomach.

-Oh, no.

-Yeah, we're going to need to book a theatre as soon as possible.

-Sure.

-And can you notify Mr Malick that we'll be needing

-to take Mr Stewart into theatre?

-Malick says he's piste off to go and do

something more important than your care in the community.

-I mean...

-He said that?

Err. Sort of.

Right.

Second thoughts, don't bother telling him.

Are you leaving already? Just starting to get along.

I'm sure you'll cope.

Oh, and Mrs Rogerson needs a pancreatic tumour resection.

Soon as you can. Possible sepsis due to perforation.

That's a five-hour procedure.

-I can't be off the ward that long.

-Cod liver oil,

good for the joints, all that standing up.

You're going to make me beg, aren't you?

Please, stay.

Fine. Anything to help.

Hey, man, you've got to put money in it.

-Sorry, mate. Miles away.

-Decisions, decisions.

I was going to buy her a packet of Chewits, then I thought,

-she's nil by mouth, isn't she?

-How's she taking it all?

Says I'm irritating her.

Ha-ha.

Sometimes women mistake irritation for attraction.

Not this one.

Well, you'll get a more honest respond

if you just tell her how you feel.

-You think?

-Hm-mm.

-EDDI CLEARS HER THROAT

-Did you just tell him to go for it with Cheryl Cole in there?

Yeah, he just needed a shove in the right direction.

-Where? Up the garden path?

-What?

Can you not see that she's totally leading him on?

She's fluttering her eyelashes, so she can get all her own way.

-Ah, come on, he'd see right through that.

-You didn't.

I've been feeling amazing. No symptoms.

Just completely normal.

I shouldn't have to remind you

-of the importance of remaining stationary.

-Course.

Sorry.

Dr Lo.

Sorry.

I promise I'll keep still.

I get the distinct sense that your mind is on other things.

Oh, no, not really.

Well, there is this patient. She has these symptoms.

I think it warrants further investigation, like a scan.

But Ms Naylor says we should do nothing.

Well, Ms Naylor is a highly proficient clinician.

-Yes, obviously, I didn't mean ...

-And imaging can prove

a fruitless pursuit if one isn't clear of its aim.

-Yes.

-As in your case, had we not been aware of the astrocytoma's size,

how could we possibly know if it has progressed?

Of course.

And has it?

Your scan's clear, Dr Lo. No change.

HE CLEARS HIS THROAT

Here comes the moment, Ron.

-Found you a magazine then, eh?

-One of the nurses.

That was nice of them.

-I can't do this.

-Aye, you can. I'll help you.

I'm disgusting. Who's going to want us like this?

I would.

-Haway, you desperate?

-I'm serious.

I've seen you with your head down the toilet and I'm still here.

-Not in the mood for this, babe.

-Last couple of months, I've started

looking at you different. More than a mate, like.

What? Here's me thinking we're mates and, all this time,

you've been dribbling over us like a stalker.

-You know what I'm talking about.

-I don't.

-You do, we're a house on fire.

All the banter and that. Well, I'm not imagining it.

I know you feel something towards us.

Yeah, sick at the thought.

How come you were going to go away with us, if you're so freaked out?

-Maybe I needed the lift.

-To Cardiff? What for?

Well, it certainly wasn't for the scenery, that's for sure.

What then?

A lad?

Here we are, reunited at last.

-Newcastle's best double act since Ant and Dec.

-Excuse us.

-Hey, you all right?

-Fine.

-I still don't like the look of this abdomen.

-Three hundred crunches a day that one.

-It's distended.

-There's nowt wrong with us.

-Hey.

-Hi.

I was thinking, we don't actually know what we're looking for

with Alana, do we?

So why not do some research into what we think it might be?

-You know, like work backwards.

-There you are.

There is a pile of admin over there that needs filing.

And when you've done that, I need you to collect stool samples

from bays six and nine.

-It's a crap job, but someone's got to do it.

-Ms Naylor?

Do you think if someone threw water over her, she'd actually melt?

Pass me the hose.

Well, there goes that idea.

Well, unless...

-What?

-Unless someone covered for you, let's you get on with it.

-Someone?

-Yup, someone.

That'd be me.

-Really?

-Why not?

Thank you.

You won't regret it.

It's fine.

SHE GIGGLES

Why's he still here?

-You should be in bed.

-Why's he still here?

I said I didn't want him here. I told them.

-Look, he's just trying to help.

-No, he isn't.

He doesn't trust me with her. He wants to take Rihanna.

But you lot won't listen.

Jade?

Jade, open the door.

Michael!

Jade, I do not have time for this today.

I have other patients I have to treat as well. Open the door.

-Leave me alone.

-What's up?

Come on. Jade.

Where is she?

Who?

St Trinian's.

Dunno. I think she might be labelling some stool samples.

Really?

Yeah, I was just going to check on...

I'm on it.

SHE SIGHS

Ah, I...

-Ms Naylor, I think I'm on to something.

-Yeah, not now.

Alana and Rihanna have gone missing. We've got to find them.

She is not looking good. Come on, Jade, open the door.

He'll think I'm a freak.

-Look, Scottie is a good guy. Just give him a chance.

-Not him.

Rhys.

-Obviously there's another man.

-Boyfriend?

-I don't know.

Jade, who's Rhys?

He phoned my mam's house about six months ago.

He was doing a survey and I answered.

-Cold caller, well, that's different.

-I was upset

about...

something.

And I just started crying down the phone like some idiot.

Then he phoned back the next week, to see if I was all right.

-He was just easy to talk to.

-Have you ever met him?

That's what Cardiff was meant to be.

Hmmm. Ah. It's boiling in here.

Look, have you ever seen a photo?

We didn't. Just voices.

See, there you go. It's your personality he's interested in.

You guys have been talking for six months, he's never even seen you.

Come on, Jade, open the door.

Take the brake off the bed. Please, let us in.

Ah.

-Great, good girl, excellent.

-It feels really...

Ah.

She's gone into septic shock.

We have to get her into theatre now.

Can I get some help in here? What about Serena?

She's still operating.

-Well?

-No sign. What do you think we should do?

-Can I just...

-Shh.

Well, I think we're going to have to phone the police.

Alana.

Mrs Cooke, where's the baby?

Where's Rihanna? What have you done with her?

-Lan, what have you done?

-You're not having her.

Ah.

ALANA RETCHES

Dr Lo, look after Mr Cooke, please.

-I think I know what's wrong with her.

-Just do it. Call security. We need to find that baby.

SNIFFLING

BABY GURGLES

Got you a T-shirt.

Sorry, it was all I could find.

Why's she vomiting blood?

I should have taken her back to that GP.

Made him listen, instead of just...

Instead of what?

The day before she went off.

I told her I was going to leave.

Take Rihanna. Just let her get on with it.

I had my bag packed and everything.

She was ruining us.

What's wrong with her?

We're working on it.

PAGER BEEPS

Sorry, I better...

They've found Rihanna.

Excuse me.

HE SIGHS

# Vyssan lull

# Mina kara sma

# Pa himlen manga stajrnor ga

# Stralarna de dansa Pa manens bojda bro

# Och dimmorna de svava pa dunlatt silversko

# Och... #

It is customary for one to knock when entering another's abode.

-Yeah, sorry, of course. The door was ajar.

-Take the child, please.

Although my job description is diverse enough

to include pastoral care of my staff,

it does not extend to wayward infants.

-Was that Swedish?

-Thank you, Dr Lo.

Hey, I need the room.

I was just about to deliver Mrs Rogerson's tumour.

-Not the best time.

-How long are you going to be?

-Another hour. Give or take.

-No.

No good. I have a patient in crisis.

-Do it on the ward.

-She needs a bowel resection.

You know, if I was able to transfer to Keller when I wanted to,

we wouldn't be in this mess. So what do you want me to do?

Surely a man of your experience can come up with a solution.

Yeah, sure, maybe I'll operate on her in the Anaesthetics Room.

Ooh, good idea.

This stinks.

So we've ruled out aortic dissection.

Results are all clear.

We've got to be missing something.

Could it be COPD?

-Arterial blood gases, what did they say?

-All clear.

Oh. That was a bit of a long shot anyway.

Unless she neglected to mention that she spends a significant chunk

-of her life down a coal mine.

-SHE LAUGHS

Actually, I think Dr Lo might've been working on something.

When exactly was this?

I thought it was worth pursuing.

Go on then.

I think Alana is suffering from a condition called LAM.

-Full name, lymphangioleiomyomatosis.

-I've never heard of it.

That's because it only affects one woman in a million.

It happens when abnormal cells, like muscle, start to grow

on organs such as lungs, liver, kidney, brain.

Oh, look.

Hm-mm.

It also accounts for her abdominal pains, pneumothorax

-and even her behavioural...

-Shh.

So what do you think?

-I'd personally recommend a full body CT.

-Would you now?

And an MRI.

But that's only because that's what it says in the book.

Well, we've got nothing else to go on. Book her in.

MACHINE BEEPS

I can't figure out where it's coming from. Adrenalin's not working.

She's going into DIC. BP's still dropping.

Acidosis is getting worse. Come on.

-What about your patient?

-Stable, unlike yours.

Got it. Put your hand here, press hard.

-You should pack it, try to stabilise.

-My thoughts exactly.

Aw, so we are on the same page.

Not entirely. All right, let's see if she stabilises.

-Let's prep 2-0 Vicryl please.

-Come on, Michael,

What would you've been doing today

if you'd been referring this all up to Keller? Handing out lollipops?

I think my remit's a little bit more involved than that.

If you say so.

Tell me, how many ops would you have done on a normal day,

-minus my input?

-Can't put a number on it.

-Humour me.

-One or two.

-If you're lucky.

And here you are with a pancreatic tumour removal

and a bowel resection, virtually side by side.

-And totally against protocol.

-Where's your sense of adventure?

Wouldn't you prefer to spend your days

like this rather than sitting in your office spinning on your chair?

He does do that sometimes.

Just saying.

Admit it. You're enjoying this.

Poor woman.

Lungs, kidney, stomach.

Absolutely riddled.

-Nice work, St Trinian's.

-Not so useless after all.

Let's get her down to imaging for an MRI.

Wow.

I haven't seen Naylor that excited since...

Well, actually, ever.

Nice one, Lo.

Erm.

-I'm sorry. That was, that was...

-Yup.

Tara.

He is a sucker for punishment, that one.

Hi.

How's she doing?

Well, we had to take her back in.

Has she, you know, the thing?

Yeah. You can go and see her if you like.

-She's not a bitch, you know.

-No-one said that she is.

We've spent a lot of time together since Gary....

her brother,

he died, a year ago.

Best mate.

Drunk driver.

We never really talk about it, you know?

Just dance around it, like lasses with their handbags.

I know she can be a bit touchy with us,

but she doesn't mean it.

-Mrs Cooke.

-Yeah?

We've got your results. It's not good news, I'm afraid.

Please, don't send me home.

The imaging showed numerous cystic shadows in your lungs,

your abdomen and a frontal lobe tumour of the brain.

-What? Cancer?

-No, it's not cancer.

These specific findings lead us to consider a very rare condition,

lymphangioleiomyomatosis.

-I'm sorry it's not better news.

-No, it's...

..it's fine.

-How, how bad is it?

-It's treatable, but not curable.

We'll start you on a course of hormone therapy straight away.

We will need to consider a lung transplant at some point.

You're sure that's what it is?

We'll take you back into theatre and get a sample,

but I'm pretty confident that the results will confirm our suspicions, yes.

Thank you so much.

OK.

You believed me.

-But I didn't.

-Kev. They know what's wrong with me.

-You were sick all along and I didn't...

-It doesn't matter now.

-I thought you were making it up.

-Kev, whatever's happened...

-I wasn't there.

-But you're here now.

-You're better off,

-the pair of you. I'm so sorry.

-Kev!

Don't. Wait!

Mr Griffin, how was the operation?

-Fine, Chantelle, thanks. Can I?

-Yeah. Mr Stewart going to be OK?

-Hm-mm.

-Alfredo? What? You had to operate?

-He had a lump on his stomach.

-Really? You didn't mention it.

Oh, well, it was all a bit of a rush.

Right. So, this procedure, what was it?

Investigatory laparoscopy.

OK. Well, what did you find?

-Perforated Meckel's diverticulum.

-He has something that unusual

and you didn't tell me, I would've loved to jump in on that.

Well, I assumed that your attention was elsewhere.

What's that supposed to mean?

You can't pick and choose your cases, Malick.

This is a hospital, not a fast food joint,

like your friend Ms Campbell seems to think.

Yeah? Well, at least with her I know what I'm getting.

Here. Your menu cards.

Maybe you should take a look.

Hmmm.

-Hey. How you feeling?

-It feels...

-It's going into me!

-No, no. Jade, Jade.

-That is the colostomy bag.

-No!

It's OK, it's not necessarily permanent. Scottie!

-JADE SOBS

-Why are you still here?

Gary would've wanted us to look after you.

Smashing job I've done of that, eh?

I've been a nasty cow.

Aye, well, I haven't exactly been on my best behaviour either.

I wish he was still here.

I know, pet.

I'm glad he can't see us like this.

Disgusting.

Well, he'd tell you to shut your mouth for saying that.

Mr Cooke, this is Dr Lo from Holby City.

Alana's been asking for you. Please, come back.

I know you think you've let her down, but you haven't.

Please, just... Please, don't do this.

-Hey.

-Hi.

-Sorry, what was that?

-What?

-You kissed me.

-Shh.

-What? Are you worried about it? Naylor?

I don't think your romantic encounters are particularly high

-on her list of priorities.

-This is not a romantic...

-Again, you kissed me.

-Yeah, I know, I was there.

Seriously, what is this?

-I don't know.

-Is it something, or am I just...?

-Yeah. No. I mean, I don't know...

-Maybe we should just

-go out for a drink or something.

-Well, maybe we should.

-After work?

-After work is good for me.

-Good.

Good.

HE GROANS GENTLY

Erm.

Hospital library. It's set in Edinburgh.

-Same sort of thing.

-Oh. Oh, that is good of you.

Not something I've ever considered trying.

Brilliant things, the words just wash over you,

like it's in your head.

Your menu cards.

Red cabbage with pineapple jelly.

Tomato soup with horseradish sauce.

Carrots with custard. Not particularly appetising.

When I was young, you were brought up to eat what you were given.

It can't have been easy, not knowing how to read.

Well, Rose did all that stuff, post, bills,

all that stuff.

Rose isn't here. It takes time to adjust.

I don't want to adjust.

No, cos I still have that split second when she's there,

in my head,

shaking hers because she doesn't approve and it's glorious.

-Why did you never learn?

-Oh.

I-I managed.

-What about now?

-If you're suggesting I go back to school,

it's a bit late for that now.

I mean, me sitting amongst a bunch of teeny boppers

at 78 years of age, in all those little seats.

I'm not suggesting that you need to do anything wild,

just admit, once in a while, that you need some help,

now that Rose isn't here to keep an eye on you.

She did that.

Ha.

She slept with one eye open, she said.

Well, now you're going to have to start doing it for yourself.

What's wrong with your face?

Oh, nothing, I'm just really grateful for this opportunity.

I really appreciate it.

So this little science project of yours,

the one you were banging on about this morning.

Severe acute rejection.

-Do you still need someone to oversee it?

-Yeah.

Well, I suppose it wouldn't be too much of an ordeal

-for me to run my eyes over it.

-That would be amazing.

It's like I've given a Labrador a biscuit.

How's tonight?

Tonight?

Yes. Got somewhere better you need to be?

Erm.

No, tonight is great.

Good.

Oh, Michael, I'm on my way to give Hanssen an update,

wanted to hear your thoughts, positive ones, preferably.

By the way, I thought you were rather marvellous today.

Look, I excel under pressure.

But that pressure is not a luxury that we can't afford

cos we don't have the resources.

Now, today we had an extra pair of hands,

but we can't always count on that.

You could, Hanssen's practically throwing money around,

to the transplant unit.

Yeah, but that money's already allotted.

There's always more. What about the elective funds from Keller?

He can't spend it all on sushi and bonsai trees, can he?

So, can I tell him I have your approval?

You really think he's going to go for it?

I don't doubt it for a second.

Doctor.

-Mr Cooke.

-Can I see her?

Sure. This way.

Lan?

I'm so sorry.

I'm sorry.

-I've got you, girl. I've got you.

-HE SOBS

St Trinian's, homework club.

PHONE BEEPS

HE SIGHS

Dr Lo, are you coming or not?

Yeah.

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