The Devil Will Come Holby City

George Binns, is it? Business Manager for Surgery?

Present and correct. I will sniff out every last saving possible.

Well, it's over, your non-referral scheme.

I have no more space and an op that's been waiting since this morning.

If we did a regular CT, we'd know exactly where we are with it.

I get to keep my job and you get to keep a decent F1.

I just can't get a handle on you.

Ollie, wait.

If the tumour becomes active...

Then I walk away.

This is an emergency.

I can't take any patients from AAU.

VOICES CLAMOUR

Michael, thank God.

All right Levy, message received! What's the problem?

-OK, we're running at full capacity.

-Course we are.

With a ruptured appendix in a side room.

Louisa Sergeant. Non-specific abdo pain.

Six patients pending surgery. Every bed full.

In for observation. Possible head injury. This is John Price.

Abscess. Waiting on a drain.

-I've had to put a temporary hold on all referrals from the ED.

-What?!

I know. Right.

Bed 8, possible cholecystitis waiting for ultrasound -

all backed up. Bed 5 pancreatitis due in theatre ten minutes ago,

-diverticulitis...

-Levy, whoa! Whoa! Slow down.

Sorry, I'm just... it's just really good to see you.

-All right.

-You know, I thought you'd be at that meeting.

-What meeting?

-The memo?

From Hanssen?

-Oh!

-Michael? Michael?! What are you do...

Michael Spence!

You have got to be kidding me?

Yeah, you're right. Come on.

And where the hell is Eddi?

Do you know how much grief I'm going to get for being this late?

"Hey, McKee! What time d'you call this?"

Oh, don't, it hurts. Thank you.

-What...what are you doing?

-What do you mean?

We're not going in together.

-No, you see, I don't mind people knowing.

-You see I do.

If you'd just set the alarm like I asked you to.

OK, I'll toss you for it. Heads - I'll get the flak. Tails - you do.

Best of three?

Max, no. Max!

Max!

MEDICAL INSTRUCTION MEDIA PLAYS

ALARM BEEPS

-Tara!

-Mr Hope! I'm sorry I'm late.

-Are you all right? You haven't been here all night?

-No. Yes.

Well, I just got waylaid by research. But everything's cool.

I'm cool.

Look, if you find Jac's regime too much,

I could have a quiet word with her or speak with Mr Hanssen?

No! Really, it's fine.

Well, Ms Naylor is on a course today so everything should be a breeze!

Well, enjoy your respite. And if you find yourself struggling,

-let me know.

-I will, thank you.

-Tara?

-Yeah?

-You might want to erm...

Right, yes. Of course, thank you.

Star light, star bright, the first star I see tonight;

I wish I may I wish I might...

Chantelle, what are you doing?

Mr Malick!

A spare for the first person I saw. Where is everyone?

Cheers. Serena's back-to-back ops, Ric's off at some mystery meeting

leaving us to deal with one grumbling gall bladder,

one bunion, two hernias and big thrills... one fatty lipoma.

Oh, yeah. HR dropped that in. Something about a deadline change?

-They need it in by Friday.

-What?

I've not done my CV yet, and the interview...

Hey! What're you on about?

-Permanent position. On Keller.

-Seriously? Nice one!

But I'm not ready!

You'll be fine. It's bureaucracy, that's all.

-They've just got to go through the motions. May I?

-Sure.

It's not as simple as that.

Shanners! Trust the Malick. Stop panicking and fill out the form.

OK. FBC, Us and Es, Amylase and LFTs and group and save clotting.

They'll pull you in for a nice cosy chat and bingo! Bob's your uncle.

But what if he's not my uncle? What if they don't give it to me?

Of course they'll give it to you! That's what I'm saying.

The internal candidate always gets it.

But there's loads of internal candidates.

Pensions, holiday pay. Every agency nurse in Holby'll be

-up for this job!

-Malick. Chantelle My office, 15 minutes, please.

And I love it here.

All right. Well I guess you're just going

to have to prove you're the best nurse for the job then.

So which NHS complaint is it today? Overworked? Underpaid?

-Not enough smiley stickers?

-I've said I was sorry.

-Maybe it's because Chrissie got picked for the netball team over you.

-Whatever.

I see you got away without a scratch.

How often are you late, anyway?

Never. Only when I make very bad life choices.

-You could afford to cut her some slack, you know.

-What?

Eddi. She's exhausted. We all are.

Michael!

Michael!

Seriously. What's the plan?

-We're fine!

-This scheme is just not working.

It ends the moment Keller clears its backlog.

Which is when? Next week? Next month? Next year?

OK, I know it's tough, but it's not much longer.

So we'll hang in there, show we can hack it.

EDDI: Can I get some help here?!

This is Susie Harbord. She was admitted this morning.

There's no pulse, get her on her back.

No, nothing. You? OK, let's get a crash trolley. Where are her notes?

-I don't know.

-Someone better find them.

All right, she's back. Hook her up to a monitor, run blood gases

and let's find her a goddamn bed!

There are no beds. So, like I said, what's the plan?

See what you're striving for is the perfect balance of longevity,

stability and accuracy.

Too little wing span, you won't catch the glide.

Too much,

you crash and burn as in life, Ollie, it's all about the choices.

Ollie!

-Hi.

-Hi.

Whip out your cocktail umbrellas. You're entering a Naylor-free zone!

Ah! Interesting you should bring that up, Dr Valentine.

Jac swung by on the way to St James's. She left you these.

Oh and these.

Hello.

She's outdone herself this time. Four pacing wire removals,

ten surgical preparations,

audit of data on all those treated for atrial fibrilation

-in the last 6 months.

-It's for Tara.

It's a Jac Naylor to-do list.

I see.

Well with Mo tied up with a transplant all day,

I'm taking on Jac's surgical list.

Oliver, can I rely on you for pre-ops?

Wait, there's no need! She's asked me to do this.

-Tara, I...

-It's fine. I can handle it.

Refills for her espresso machine?

Oliver, keep an eye on her, will you?

Regrettable not to see you at this morning's meeting.

-Well, we are very busy - sorry.

-What can I do for you, Mr Spence?

As you know, AAU has gone to great lengths to ensure

the smooth-running of this non-referrals scheme.

However, in recent days...

Following the rather precipitous departure of Sister Williams to Keller?

The current system is unsustainable.

-You proposing to throw in the towel?

-No. That's not what I'm saying.

We need more resources.

It's seems rather inopportune on the last day of the scheme.

Nice to be kept informed.

Mr Spence, the purpose of this morning's meeting was to formally

announce a new appointment.

George Binns. Our new business manager of surgery.

His primary objective will be

the assessment of each ward in terms of cost effectiveness,

with the aim of determining

how available funds should be distributed across the hospital.

Funds! OK.

If you're struggling to make the scheme work...

No. What's one more day, right?

Good. I think Mr Binns is aiming to be with you in around 27 minutes.

-I trust AAU will be ready for inspection?

-Absolutely.

I'm sure you two will get on famously.

Pre-assessment questionnaire.

To be completed in time for the ward appraisal.

Yet another completely pointless waste of resources.

-Mr Griffin...

-Well, "Boy George" is due in at 12. Got no head nurse.

Only one consultant for the whole floor.

Well, he'll just have to take us as he finds us.

I was thinking, if there's anything I can do to take the pressure off?

Extra jobs - the sort of thing Chrissie would be doing.

I could be like Super Nurse! Flying in, sorting it all out!

Only till she starts of course.

It's just...well, I've decided to apply for the permanent job.

And it just seems like the kind of thing...

OK, well, if you think you could handle the ward round?

-Make sure everything runs smoothly?

-Definitely! No problem. Thank you!

I have an out-patients clinic.

Nice one, Super Nurse(!)

Right then. Let's get cracking.

Tills?

Jellica!

DELIGHTED SQUEALS

So, I have good news everybody. I've just spoken to Hanssen and

learned not only is today the final day of the non-referral scheme...

Thank goodness.

..but Holby has a new appointment. George Binns, Business Manager

-aka the money man.

-So?

So in 25 minutes, Mr Binns will be down to conduct a ward appraisal

-so I need you to pull out the stops.

-I don't get it.

-What don't you get?

-Why are we trying to impress him? Why not admit we're struggling?

Mr Levy, a moment of your time.

Imagine yourself as a Bank Manager. Who are you going to give a loan to?

Mr Levy or me?

See? Trust me.

I speak these people's language. Only way to win is to play the game.

So, let's get started.

Sorry.

-We haven't the lift, Squadron Leader! We're going to lose her!

-Eject. Eject.

Sorry.

-You all right?

-Fine.

Good. Jac's TOF has arrived.

She's had her MRI and she's awaiting assessment.

And we've run an echo on the pulmonary valve.

-So, ready when you are.

-OK.

Right, thank you.

Tara, did you get a chance to sort the angio for bed seven?

It's OK. I'll sort it.

Wait! Ollie, I...

Tara?

Right, here we go. Susie Harbord, 48, terminal stomach cancer -

collapsed, vomiting blood, in a department store.

And look at this.

She's a patient of Ric's.

-That's unfortunate timing.

-Yeah.

OK, let's give her eight units, run some FBC.

I'm going to go talk to her.

Susie, morning. Remember me?

Mmmmm. I thought so. East Coast.

South. Florida.

Not Miami though.

Jacksonville, maybe? Your parents are...

Punjabi. Nice party piece.

Do you want to run me through what happened?

All I can remember is throwing up on the Debenhams carpet.

-That's not the done thing apparently.

-Any vomiting since?

-No.

-That's good. Any dizziness, shortness of breath?

-No.

OK, I think that your tumour has developed a bleed,

so I'm going to rig you up to this IV...

And what about Mr Griffin?

He's due to remove half my stomach tomorrow.

-Yeah, I've seen.

-It's purely for cosmetic purposes.

I'm just trying to keep the weight down, that's all.

Let's just tackle this bleed first and let's see what happens.

-Mr Spence?

-Yeah?

Palm Beach?

Not even close!

Endearing as it is,

this compulsion to propel yourself into an early grave,

maybe it's time you broke the habit? Let me talk to Elliot.

NO!

No.

Thank you for trying to help. But I'm fine.

I just skipped breakfast and overdid it a bit, that's all.

Please don't tell anyone about this.

Well take a look at the figures and then get back to me.

I need to know pretty soon.

Hello, mate, you still there?

Sorry, you can't use that in here.

Hold on a sec.

The percentage of medical devices affected - four.

Within a one meter radius,

so unless you're fitted with a pacemaker,

I don't think we have a problem.

Yeah, mate, I'm going to have to call you back.

Hi. I'm here to see Jac Naylor.

He's due to perform my PFO later? Jai Barbosa.

Well...

I'm afraid Ms Naylor isn't available today.

Professor Hope, our lead surgeon will be operating

and until then I'll be looking after you.

Dr Tara Lo. F1.

She got to be kidding me, right?

May I?

-She looks knackered, don't you think?

-No, I don't.

-I wouldn't like to...

-How long did you say you've been here?

-Not long.

Come on, you're practically permanent.

-She will be soon, in fact.

-I'm applying for a permanent job.

Here?

Right!

-How do you two know each other?

-College.

-You're a nurse?

-No way!

Just the smell of this place makes my stomach turn. No.

-Child-care course. Until I dropped out.

-Jellica met someone.

How's Dean? Are you two still...?

Out of his bonus. We've postponed it to get the house done.

You should see it. A-ma-zing. Wedding's in spring.

-And any plans for...?

-Yeah, three boys, one girl.

Your faces! I do know you can't plan.

I don't care which flavour.

OK! Well, we'll order a scan to make sure there's been no change.

Meanwhile, I'll leave you two to reminisce.

So, bagged yourself a cute doctor yet?

Oh, no! I'm not his type.

I don't have the right bits.

Are you serious?

Serious.

I did Susie's obs. She is very weak.

Thank you.

Right, beds three and eight just need meds, they're free to go.

We're reinstating referrals from the ED.

What if Susie's still bleeding?

-Won't know till she's fully transfused.

-If so the partial gastrectomy...

-Would solve it. I am aware of it.

-No more tumour, no more bleed.

-What's your point, Sacha?

-Well, we should send her up to Keller.

-A referral.

-Yes.

-No.

-She's Ric's patient, she'd only be

a day early for an op she's due to have anyway.

I think she's an exception.

We're abiding by the system. There are no...

Excellent!

Good, healthy debate between colleagues. Loving it!

Sorry! George Binns. Business Manager.

Sorry. Binns, George.

Sorry!

So, who're we talking about?

So Tara Lo - F1.

What's the F stand for?

Foundation. I'm in my first year postgraduate.

Meaning they've only just let you loose on real humans?

-I suppose you could say that.

-Great.

Well, let's just hope I don't do anything stupid.

Look, I really need you to stop that.

No can do, Tara Lo. I've got a trade open.

Hey!

Right, so any recent changes? Shortness of breath?

-Skin discolouration?

-No.

-OK. You haven't coughed up any blood?

No difficulty passing stools?

-No. What...

-Right! Everything seems fine.

Nurse Maconie, I'd like to order FBCs, ECG, echo and angiogram

and we'll take it from there.

I get it. Still differences of opinion.

Tricky when some colleagues aren't as quick to get on board as the rest of us.

Look, it's not that Sacha's not on board, it's just he's...

Know what I think, Mike? Classic test case.

Referral versus non-referral.

I monitor its progress over the course of my visit.

Get to see the scheme in action. Judge for myself.

Look, I really think I could find you a more representative, no,

-better test case.

-No. I like this one.

Now if you'll excuse me,

I have a couple of calls to field then I can join you onsite?

I look forward to working with you, Mr Spence.

Michael, Michael!

-So, what's going on?

-Don't ask.

Don't listen to her. I think you look great.

It's OK.

It used to worry me what she thought, but not anymore.

-These places drive me crazy.

-I could call someone if you like.

Your mum or Dean, to come sit with you.

Mum's in Crete, Dean's on business. Been bumped for this already.

Just figured it'd happen again.

We've got a new system. It's bump-proof apparently.

Don't you ever get bored?

Hmm...no. There's always something happening. Like you turning up!

Oh... It's just routine screening. We do it before every op.

Screening? For what?

Just to check for disorders, infections, anaemia.

-And we'll run a urine test, to make sure you're not pregnant.

-I'm not.

Right.

Are you sure?

Cos, you know, if you were...

Jellica?

-When was your last period?

-Few weeks, months, maybe.

I don't know. They've always been all over the place.

OK. Well, we'll get this done and then we can know for sure.

Susie! What can I do for you?

I'd like to be referred to Mr Griffin.

Can I ask why?

I'm so sorry. I'm sure that you're very, very competent

and you do have my full confidence.

It's just that he's been treating me for the past three years

and he knows my condition inside out.

-I'd just feel much happier if I could see him.

-I do understand,

but unfortunately, that is not going to be possible today.

But why not? Whenever I've had a compl...

Susie, this is George Binns. He is Holby's business manager.

Business manager? Whoa.

So, it's not about the patients at all anymore, then?

On the contrary, Susie.

I see my role as ensuring more effective and efficient patient care

by matching resources to specialties

to maximise treatment options.

I'm sorry. I...

I can't quite get past the fact I've got shirts older than you.

What did you just say?

That better patient care is my primary concern.

Susie, I do understand

that in the past you would have been referred directly to Mr Griffin,

but currently, we are trialling a new system...

-Trialling?

-..whereby AAU deals with all cases in-house.

Your transfusion is almost complete

so let's wait for the results of the blood count,

confirm the bleed has stopped

and with any luck, you'll be out of here by lunchtime, OK?

She's fantastic!

She's opinionated, she's got views on her own treatment.

Mike, we couldn't have picked a better test case! I'm so excited.

Tara, I took the liberty of lending you a hand.

Discharge summaries? What...?

-What part of "I don't need your help" did you not understand?

-Come on...

Seriously, Ollie! How do you think this makes me look?

-To Ms Naylor or to Mr Hope?

-Tara!

Just back off, OK?

-ALARM BEEPS What?

-B/P's spiking.

HE GROANS

OK, he's hypertensive.

-He needs an IV GTN infusion.

-Man!

-Mr Barbosa, have you a family history of high blood pressure?

-What?

Have you ever experienced an episode like this before?

No! No, nothing!

HE WINCES

Could you sit back?

Right, keep an eye on him, and run a full tox screen when you're ready.

Tara!

Echo results.

She's what?

-Moody, missed periods...

-OK, I get the picture.

She never thought to take a test? Save us the grief of bringing her in?

Seems like she's just not engaging with it.

All right, Sherlock. If she is, we won't be operating today.

The list'll be up the spout, Serena will be spitting venom,

so let's just get it sorted, shall we?

Malick, I'm due to meet the kid in an hour.

You'll have that questionnaire done, yes?

You don't have to take it, you know.

Eh?

Being bossed around all the time?

Oh, Mr Malick? No, he's really nice. Really. Supportive.

He's helping me with my application form.

Aw! You haven't changed a bit.

So, with an increase in staff, better equipment, a second theatre -

the dream of becoming a regional centre of excellence becomes a viable option.

Bluffer's Guide to creating an empire. You OK?

No, and all this sucking up is not helping my head.

-I've got something that might help.

-Hand it over, then.

I can't give it to you here on the ward.

OK.

-Michael, you should take a look at these.

-Not right now.

It's Susie Harbord's results.

Haemoglobin level of 5. She's still bleeding.

-All right, we're going to have to get her into theatre.

-Down here?

Yeah. Will you let the anaesthetist know and notify Ms Harbord?

-Thank you. So...

-No.

I'm up to my eyes and she's your patient.

I think if anyone's going to tell her, it should be you.

This better be good, Max! I'm so busy! I've got so much work to do.

It's not like it'll get better just cos you're on contract.

If they don't appreciate you now...

Why didn't you tell us you might be pregnant?

We've had couple of false alarms before. I didn't want to...

I miss a period. Dean gets excited, I take a test. Then when it...

-Are you two OK?

-Yeah! Fine!

It's just, um, wedding nerves. I've not been sleeping well

and it's like the closer it gets, the worse I look.

Dean says it's stress...

stopping me.

But I'm all right!

Well, it shouldn't take long. I'll get them back soon as I can.

OK. Whatever.

Susie.

It's due in six weeks.

-It's my third grandchild.

-Wow, three?

-I haven't met the other two yet.

-Why's that?

My daughter lives in the US.

Went looking for her father - Captain America.

-Only child?

-Yep. Met a boy. Got pregnant.

Same old, same old. Except hers has stuck around.

With all this nonsense and her being constantly pregnant,

I've not seen her in four years.

Susie, your test results have come back.

-Your tumour has not stopped bleeding.

-Little blighter.

I'm going to have to operate. A gastroscopy.

You've had it before as exploratory. I'll go in, locate the bleed,

-inject it with adrenalin and stop it.

-What about tomorrow?

I'm afraid that means the partial gastrectomy will have to be delayed.

-No.

-Susie, I understand...

No! No. No. No. You don't. You don't understand.

That's one-way. It my last hurrah!

It's the birth of my grandchild.

Mr Spence, I can't eat. I can barely drink.

Without tomorrow's operation, I won't be able to fly.

With a bleed like this, if you refuse treatment,

-you are risking your health.

-"My health"? I like that!

Why can't you do it instead of Mr Griffin?

It's the tumour that's bleeding. If you can take that away...

This is a complex and time-consuming procedure.

AAU only has one theatre. It's for emergency operations only.

I can go in and stop the bleed - that's it.

OK?

There's something odd about Mr Barbosa's echo.

I'm not even sure why he's in here.

It looks inoperable.

It looks like classic Naylor.

Handing an F1 the pre-ops of an apparently inoperable case.

She's probably got a little stash of files somewhere -

Missing links, volumes 1 to 8.

You think?

It does SOUND like something Ms Naylor would do.

I know, I'm on my way, OK? As soon as I can.

Tara?

Should you be in here?

There was a discrepancy with some test results. So I thought...

Right. Have you talked to Oliver about this?

-Yes. But he was busy.

-He said that?

PHONE BEEPS Mm-hm.

I need to get a move on. Let's talk about this later.

All clear, then?

Yeah. Odd, though. All those symptoms.

Hormone imbalance, maybe.

-She needs to see her doctor.

-Are there no tests we could run?

Look, I get it. She's an old mate

-but to be a good nurse, you have to stay objective.

-I do know that!

-Whatever's going on with her doesn't affect the op.

-Yeah, I know

-but...

-Chantelle! Tight schedule, business manager on the way.

You've more pressing stuff to do.

So let's just get her sorted and when she's home,

she can book in to see her GP.

I suppose if there was to be an exception,

-you could see how Susie Harbord might be it.

-Ah.

But you and I, Mike, we're seeing the bigger picture.

It's a shame, though, to miss the birth of her grandchild.

But given that, statistically speaking,

the percentage of female admissions

of grand-parenting age averages at 28.6,

we'd potentially be looking at a whole bunch of exceptional grannies.

-You're leaving?

-Ward appraisal on Keller.

Mike! I have a heart too.

It's for the greater good. Pleasure working with you.

And if you could check on that scan.

Uh...do you want to give me a break?

I've been run off my feet all morning.

Uh... Good luck with the operation!

Thanks.

You think it's more cost-effective for him if I survive this or not?

She's barely older than me.

She still looks in better nick, though.

Sacha.

For the sake of one day.

-Mr Spence?

-Yeah.

-Do you have children?

-Yes, I do. Three girls and one boy.

In the States.

Do anything, wouldn't you? To save them a moment's pain.

You know, Susie, flights go both ways.

She's seven-and-a-half months pregnant.

It's so hard on the phone. You must know what that's like.

All those children screaming in the background.

She's always so wound up or she's just plain exhausted and...

I just haven't been able...

You haven't told her, have you?

Tills! So, what were you talking about earlier

with Dr What's-his-name?

We were just talking about your symptoms. Nothing to worry about.

Mr Malick thinks you may have a hormone imbalance.

What does that mean?

You'll have to speak to your own doctor.

If it's some "imbalance", does that mean they can do something about it?

-I don't know...

-Give me drugs or...

-I'll have to speak to Mr Malick.

-No!

I don't want to talk to him. I want to talk to you!

-I thought we were friends.

-We are.

I want to know what's happening to me!

-If you can do something about it!

-I...

-Just tell me what it is!

I think it COULD be early menopause.

You cow.

You evil, jealous little cow!

I know it sounds crazy but I've been doing some research...

You can't bear it, can you?

Stuck here, day in day out, yacking on about how fab it is

when actually all you are is some jumped-up skivvy

-mopping up other people's sh...

-Hey!

-Calm down. Whatever Chantelle said...

-She SAID I've got the menopause!

And what would you know?

Too busy flirting with every man in here to bother with someone like me!

You! I want to make a complaint.

Against her!

Excuse me.

-Are we taking Susie in?

-Nope.

-What then?

-I need 10 mills of Vitamin K, and a FFP transfusion.

We're going to help her keep that elective and make that flight.

Hang on, hang on. What about George?

Well, Mr Binns is gone, Sacha! And what the eye doesn't see...

Susie!

Change of plan.

I'm going to start you on a clotting agent

and a plasma transfusion to stem the bleed,

-so you can make tomorrow's operation on Keller.

-Really?

Now, I want to be absolutely clear,

there is no guarantee that this is going to work.

And I'm only doing this on the proviso

that should your condition deteriorate at all,

you will progress directly to theatre, do not pass go.

-Do you understand?

-Yes. Thank you.

-You're welcome.

-Michael?

-Yeah.

There's been an RTA. We have five casualties coming from the ED.

Perfect.

Ms Effanga?

-Tara.

-Sorry to bother you. It's just,

I've been debating the best course of action for a patient.

-Right...

-He's supposed to be a standard PFO

but his echo results have come back showing what looks like

an inoperable right to left shunt.

You want me to tell you what to do.

-Well, is he cyanotic?

-No.

-You've run an angio?

-Yes, and there are no blockages.

Have you checked whether the arterial blood is still oxygenated?

So how do you do that?

Blood gas sample?

-From the radial artery.

-Great!

-That's what I thought.

-You'll need supervising.

If Professor Hope isn't available, ask Oliver. Understood?

No worries, Ric. You go and deal with your...little problem.

I'll drop you a line R-E rescheduling.

A diagnosis?

No consulting.

No medical back-up.

Added to which, you saw fit

to discuss a colleague's private life with a patient.

I never meant...

I tried to talk to Mr Malick about Angelica, but he said not to worry.

But you knew better?

Mr Griffin, will this affect my job application?

Let's take things one step at a time.

I'm right, you know.

She has all the symptoms.

Missed periods, mood swings, hot flushes.

I think she suspects it too

and if we let her leave without checking, she won't go to her GP.

I'm sure of it. So I don't care about the job

and I'm not bothered about the black mark next to my name.

Right now, she's our patient, and we have a duty to try and help.

Chantelle, why don't you take a long lunch?

Come back when you've cooled down.

Malick.

I think we should order those tests.

You're the boss.

ERROR BEEP

MORE ERROR BEEPS

Coming through!

OK, Stewart Lacy. Driver of the van.

-Put him in bed 8, please. I'll get Michael to assess him.

-Thanks, Eddi.

-Hello, George!

-What?

-Long time no see!

-Hey, George! Couldn't stay away?

Problem on Keller, so I thought

I'd nip back and check out how my test case is...

Oh. I thought she'd be under the knife by now.

Yeah, influx of critical cases, only one theatre.

-Afraid that's just the way things are here.

-Right.

-Michael.

-Yes.

-We need you, bed 8.

Nurse McKee, Susie is due in theatre next - right?

Oh, yeah. She's heading in now.

OK, great. Ah! Max, you're just about to scrub in.

-Actually, I was...

-Excellent!

-Sorry, bed...

-8.

-8. George.

Let's get her into the side room.

-OK.

-What was that about?

-I'll tell you later.

You know, George, I got the feel

that Sacha was just coming around to the non-referrals schemes.

-Perhaps he'd benefit if you talked him through the numbers.

-Of course!

Great! I'd like that very much.

Great, why don't you guys do that in my office?

OK, Mr Barbosa, I need to test your oxygen levels.

I'll insert a needle into your wrist

-and take a sample of your blood from your artery.

-How long will it take?

About five minutes. I must warn you it can hurt

so I can give you an injection to numb the pain, if you'd like?

I'll live.

Aren't I supposed to have some kind of chaperone? Protect my virtue?

It's pretty routine.

-AAU?

-You are really getting the royal treatment, Susie.

-EDDI:

-Michael?

-Her B/P's dropped slightly.

-Yeah.

-How long before theatre's ready?

-Couple of hours at least.

-What about the anaesthetic room?

-No. It's full.

There's always Keller.

All right, give me ten minutes.

-Ow!

-OK, it's fine, just relax.

What you trying to do to me?

Is everything all right?

Yes, thank you, Nurse Maconie.

I'm going to try it one more time.

-Ah!

-Right.

We'll try a different route.

US market opens in ten, Doc. I need you to speed this up.

OK...

We'll go for the femoral artery in your thigh.

-As long as you're careful down there.

-Yes. Of course.

Oh!

ALARM BEEPS

Aagh!

Get off me!

What's going on?

-What were you doing?

-A blood gas sample.

From the femoral artery?

What size needle were you using?

Right, looks like there's a tear. Let's get him into theatre.

What happened?

I need you to scrub in.

-Professor Hope, I...

-Take a break, Dr Lo. OK? Let's go.

HE YELLS IN PAIN

Hey, Ric, I need some help.

I'm in the middle of something, Michael.

I've got a patient I want you to look at.

A referral? We don't do referrals.

No, it's not a referral. Susie Harbord, her B/P's dropping.

Are you telling me that she's an emergency?

Not yet, but I don't want to wait till it is.

Look, I'll be done here in about half an hour. Bring her up then.

All right, great.

-Binns is all over this, so let's keep it under the radar?

-Obviously.

-Hey, Max!

-Huh?

I thought you were operating?

-Yep.

-On Susie.

So...?

Yeah, you might want to check with Michael Spence on that.

I think he's in there.

Nurse McKee?

Suction.

Vascular clamp, please.

I thought I told you to keep an eye out.

5-0 prolene.

Yet I find her alone and unsupervised,

attempting a blood gas sample from the wrong artery

with the wrong needle.

Why did you refuse to help?

I don't know.

It'll be a mark on your record, I'm afraid, Dr Valentine.

All right. Page the perfusionist, please. Thank you.

Suction, please.

Ollie, I... Wait!

I get it, you want to do it all on your own.

-Come on, Michael.

-Sacha, how is she?

-B/P's still dropping.

-I've just spoken to Ric. He's ready for us in ten minutes.

-Michael!

Michael...

-George!

-It seems Ms Harbord took a wrong turning.

Why was I led to believe she was in theatre?

It was a snap decision. Based on some last-minute drug test,

we opted to delay the surgery in favour of a less expensive

- and less invasive - drugs option, which we...

How long's she been like this?

Couple of minutes. Sacha's been trying to call you.

SUSIE RETCHES Susie?

All right, all right.

Sacha! OK,

let's get eight units cross-matched and draw adrenaline for the scope.

-We'll need to do this here.

-Here? But...

-Shall I page the anaesthetist?

-No, no time.

What's the protocol? Shouldn't someone contact Mr Hanssen?

You listen to me. We're out of options and out of time,

so you contact whoever you got to,

but in the meantime, you either suck it up or you get out!

You're saying you think she's right?

We'd just like to rule it out.

I was surprised to see her here, if I'm honest.

We used to lay bets at college.

See how long she'd last before she broke a nail and dropped out.

She's kidding herself, right? About the job.

Chantelle's a great nurse, and she'll get the job, no matter what you do.

-I don't think I like your tone.

-And I don't care.

Now if you'll excuse me, I've a male nurse I need to flirt with.

Easy. Take it easy, Susie, we're almost done.

Keep her steady, keep her steady.

Where the hell is it? Goddamn it!

There.

Yeah! Gotcha, you little...

So where's it all coming from?

SUSIE CHOKES

Stay with us, Susie, you'll be OK.

-B/P's dropped again.

-Damn it!

Adrenaline?

-Got it?

-Yep.

-OK.

Go, go.

All right, just a minute.

Yes! Great. Excellent! That's done it.

Good work, you guys. So...

OK.

Nice one, Michael.

It wasn't Doctor Valentine's fault.

He never refused to help. I decided to go it alone.

Why?

OK, I think we should set up a meeting with Mr Hanssen.

No!

I understand your ambition, and I respect it.

But Darwin is a difficult specialist ward

-and clearly you are not...

-But I was scared!

-Of what?

That you'd think I couldn't hack it.

You risked the health of a patient.

You messed up. I'm sorry, but you put yourself under too much pressure

-and unless...

-Please!

I know I should have asked for help and I didn't

but I've learnt so much from you and Ms Naylor and Dr Valentine.

I don't want to go to another ward.

I promise this will never, ever happen again.

We were forced to postpone Mr Barbosa's PFO.

And I understand it was you who ordered the tox report.

Enough cocaine in his system to keep an '80s rock band very happy.

I was reluctant to take the risk.

Good work, Dr Lo.

We'll agree to keep today to ourselves.

OK.

HE SIGHS

COUGHING, RETCHING

George?

Is that you in there?

Uh...

Look, I'm sorry about what happened back there.

Things got a little heated

and I probably said a few things that I'm going to inevitably regret.

TOILET FLUSHES

You OK?

I have to write my report right now,

but I'm just not used to seeing things like that back there.

But what you did, it was a reminder of why we're all here

and it was incredible.

We should talk.

Join us? An hour or so? Hanssen's office.

Yeah. Sure. My pleasure.

Back for more blood, are we?

-Mr Barbosa, I owe you...

-Look, I grew up with girls like you.

Daddy in the Consulate, was he? Straight As.

Perfect little life.

Whatever it takes, eh, Dr Lo?

Cocaine? Before a heart operation?

Worst case, it's a bit of a headache.

-There was no need to postpone.

-You need help.

It's recreational, that's all.

You should ask for it. Before it's too late.

Jonny, have you seen Ollie?

Come in.

Ah, Mr Spence.

Man of the hour. You appear, with today's heroic exploits,

to have single-handedly impressed our new business manager

more than the rest of the hospital put together. Congratulations.

-Thank you.

-Michael.

We've been reviewing the figures for the past few weeks,

since the non-referral scheme was introduced,

and I'm pleased to tell you

that based on AAU's performance, we've taken the decision

to implement the scheme on a permanent basis from today.

Uh, right.

This is cutting-edge territory. Only one other hospital in the country

operates a system that's even vaguely similar.

-But it's quite clearly the way of the future!

-OK, great.

So, in terms of extra resources...?

That's just the thing. You don't need them.

-What you guys achieved today was...

-Wait a minute.

You were there. You saw what happened.

But you pulled it off!

-Are you signing off on this?

-Keller's cost-effectiveness has risen

by 15%, Mr Spence. I would be failing in my job

-if I were to ignore that fact.

-Guys, come on!

This damn scheme doesn't work!

You saw how close I came to losing a patient in there!

Perhaps it's best not to dwell too heavily on what happened today.

Maybe it wasn't the non-referral scheme at fault. In fact,

if you adhered to it, who knows how much simpler things could have been?

Michael, what happened with the emergency?

Forget about it. It's sorted out.

Better class of carbs down here?

You have to kick the machine to get it out. I thought it might help.

-Chantelle...

-Mr Griffin...

I should have never spoke to you like I did.

I should never have said anything to Angelica

and if I'm honest...

..I don't think I'm cut out to be a nurse on Keller.

You're not proposing to leave us to the mercies of a stranger?

We ran some tests on your friend.

It seems it is YOU who's owed an apology.

She'll be angry. She'll think I don't care enough.

That I'm avoiding coming.

I'm sorry.

Don't be. You did everything that you could. I do appreciate that.

Maybe...after the birth,

I could pay for them all to come over here.

Visit their granny.

Believe anything, won't you? If you want it enough.

Hello, love! How're you feeling? It's me.

Guys? Could I have a moment of your time?

I just got word that AAU will receive no additional funding.

Not bad for a girl, eh?

I spoke to Elliot. Thanks.

How did it go in the end?

I'm amazed you survived it at all.

Yeah, well, I think I might just tell her the dog ate it.

I've got an idea. Come on.

I spent hours online.

Looking up the symptoms.

Trying new sites that might say something different.

I just couldn't...

-How are you doing?

-OK.

-Chantelle, can I have a word, please?

-Excuse me? Sorry.

The complaint I made earlier...

Is it too late to take it back?

No.

That's fine.

Malick and I have been talking, and we're agreed

that retaining our best nurse should be our priority this week

so we were thinking, maybe some informal interview coaching?

Aw, Mr Griffin. I'd love that!

-All right, well, my office, whenever you're ready.

-Oh...

Maybe tomorrow.

They really rate you, your colleagues.

I could still call Dean. I'm sure he'd come back.

That's all he ever talks about.

When we have kids.

There's still a chance you could conceive, you know.

And if not, there are other options.

-You're not a bad nurse, you know?

-Aw, thanks!

It's what we're here for.

OK...

Right!

That's actually very... How did you get so good at this?

I locked myself in a room till I perfected it. I was five.

Figures.

You're sure you're OK with this?

Yeah, I made a copy earlier.

-Are you ready?

-Yeah.

On your marks...

Get set...

BOTH: GO!

Michael! You met the new wonder boy, then?

-How long have you known?

-Known what?

-Don't give me that.

-That the non-referral scheme was going to be permanent?

-What?

Did you plan it from day one?

-I've no idea what you're talking about.

-I've been there, Serena.

Business first. Always an eye on the profits.

Trust me, there's only one way this is going to end.

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