I'm Sticking with You Holby City

Isn't there another ward I can go to?

Michael, what are you doing?

My job.

Each one of these patients has suffered at the hands of this ridiculous referral scheme.

That is simply not true.

All right, Ritchie, you're on the move.

I wouldn't want you to miss your auntie's birthday

any more than I'd miss my brother's do.

So apparently I need your permission before I dump my patient 50 miles up the road.

We can't let him die in the back of this van.

I want you to phone up the hospital, tell them to get a crash team ready.

There's been a complication with Michael Spence's patient.

Get up. Come on, let's take a look.

Almost like a real person.

Ah, thought you might be here.

I suppose the postmortem will shed a light on quite a few things.

Will it?

Michael, this wasn't your fault.

You're damn right it wasn't.

Right - ED treated her for hypothermia and dehydration

but detected arrhythmia and a heart murmur.

So no ID? Did we speak to the police?

Drawn a blank so far.

Tried calling last few numbers dialled on her phone but got nowhere.

-Sorry. You got my message?

-Yeah. Got a chest drain. Leave you to it, yeah?

-Flat tyre.

-That's a pain.

-So what we got?

-Jane Doe.

Found unconscious by the allotments outside Farmead.

Can't be more than, what...? 16?

Well, that is the age for it.

Well, she doesn't smell of booze and there's no track marks

but we're still waiting on tox.

Let's get FBC's, U's and E's, an echo and a head CT.

And see if you get anywhere with next of kin. No joy so far.

-So... Survived it then?

-What's that?

The barby. Your brother's thing.

'Course I did. Big girl, me.

How 'bout you? Was it good?

Yeah. She was made up, my auntie. Shock nearly killed her, though.

-Bit too old for surprises.

-Brilliant.

All right. Best get on with these then.

So you're suspending the non-referral policy?

I have little choice in the circumstances.

-But you're not suspending Mr Spence?

-Not yet, no.

So the fact that he is a loose cannon with a chequered history,

who defies policy, bullies his colleagues

and is ultimately responsible for the death of a patient...

And you're asserting all the above on what grounds?

There is a right way of doing this - an internal investigation.

I'd like to see incident reports from all relevant members of staff

by end of play.

Let's establish precisely what happened

before we bring out the firing squad.

Brain scan's clear, tox is totally clear as is her urine.

Is that The Girl With No Name?

So, the arrhythmia must be down to some sort of infection.

Got hold of anyone yet?

Get this - last number on her phone called her dad.

15 times. Nice(!)

I left a message.

Plot thickens. Infective endocarditis?

Thanks, I'm on it.

Start her on IV antibiotics, and chase up that echo.

Now would be just fab.

Must have been one hell of a party - his auntie's.

He's still in second gear.

-Who?

-Jonny.

-How was your weekend?

-Wild. All night bender with the gals.

-Really?

-No.

Whilst you two were downing punch

and counting cousins I was booked into a 5 star boutique hotel.

Spa, flat screen telly, Egyptian linen, breakfast in bed.

All with my favourite person - me.

She's waking up.

So...Jessica? Anything like this ever occurred before?

Was anyone with you? A friend?

A boyfriend?

You just blacked out?

B/P 90 over 62, sats 92, temperature at 37.8.

So, you said you got hold of my dad?

Yeah, it's just going straight to voicemail.

Is there anywhere else he might be?

-Work?

-No, he works from home. Try the house number.

Is there anyone else we can call? Your mum?

No, she, er...passed away last year. Just me and him.

OK, I'll give this a try.

My necklace... Where's my necklace?!

They must have taken it off when you were admitted. It's OK, I'll look.

It's a necklace with a ring...

Yeah, that looks like it.

-Would you like some help?

-Yeah.

It's pretty. Was it your mum's?

-Engagement ring.

-It's nice.

-Look, I have to go, I need to be at school.

-Whoa, steady on, I can't let you do that.

Look, Jessica listen.

Your echo and blood results indicate you have an infection in your heart.

It's treatable but it's not common. Not at your age.

-I'm afraid you have to stay here for the moment.

-But...

-No buts.

You'll be gone five minutes and then back here in an ambulance.

Is this about your dad?

We'll track him down. I promise.

So they'll do the postmortem and then what?

You'd think Binns would be out on his ass

but his type of microbe tends to be super resistant.

Well, something's shifting anyways.

They've suspended the non-referral scheme.

What?! Let me read that.

We've got two referrals from the ED, bloods are back for bed five

and Mr Gorman in bed six needs an urgent CT scan.

Hey. This is good. This is the beginning of the end.

Leave me out of it, I just want to do my job.

Eddi, we did nothing wrong. You know that, don't you?

Can you please take a look at her? We've got an ED overspill.

Orla?

What you doing here? We go way back.

What's up? You in pain?

-Since when?

-A while.

GP booked me an ultrasound in a couple of weeks but...

it just got worse.

So why didn't you call me?

Hang on, I'll get your notes.

I need Orla's notes.

Look who's here.

Brilliant(!)

So it's dead in the water, huh?

Excuse me?

Your non-referral scheme. Shame it took a person in a body bag.

A real nice person, remember?

Yes.

And a grave error of judgement by a physician who should know better.

Right, incident reports.

Mr Hanssen wants them back by the end of the day.

-Mine will be in way before then.

-Oh, I look forward to it.

As you were.

So, the non-transfer policy is on hold,

pending a full investigation into Friday's events.

Now, I know that an unexpected death is always upsetting

but I would just like to say how very impressed I am

with the way you've all handled this.

You've stuck to the system and tried to make it work.

As far as I'm concerned, we've done nothing wrong.

So, really, well done.

Right, let's get on with what we're here for, shall we?

Yup. Fun and games(!)

Well, that's good we can transfer again.

No? Isn't it?

Sorry, I don't get it.

Guess who's going to end up with the overspill?

And under a magnifying glass?

Who? Oh. Us?

Got there in the end.

You'll have to fill out one of these Ritchie Mooney incident reports.

-By end of day, please.

-Oh, but he wasn't my patient.

It's nothing to worry about.

Just your version of events. We all have to do one.

Thank you.

Eek! I'm glad I don't have to do one.

I hate all that times and numbers and what happened before what.

And I wouldn't want to relive it all.

I'd start thinking, "Maybe if I did this or what if I'd done that?"

Now, can you could do the pharmacy lists for me, please?

Can't believe he hung around all day and then just...

Sorry.

Sorry, I didn't...

-You're probably still cut up about it.

-I'm fine.

Now, let's do what Ms Campbell said.

We've got a lot of work to do, let's get on with it.

-Can you just email it?

-An infection in her heart? She was fine when she left...

We're still waiting on some tests.

-This is Ms Effanga. This is David - Jessica's father.

-She was fine when she left for school this morning.

She didn't leave for school. She was found by the allotments in the early hours.

The allotments?

Dad!

I'm sure I heard the door go this morning.

I tried to call you.

How... How serious is it?

It's OK... It's just antibiotics.

We'll be back in a bit.

Talk about a glittering career in MI5.

There's something going on but we'll pretend there isn't.

Well, you should know.

Excuse me?

Don't be shy, go on. What was that?

All right then. You and Naylor.

This weekend. I know.

I saw the text on your phone last week.

Right. OK.

OK? I thought I was your mate,

not your mum that you have to go round lying to.

-Chill out, will you?

-Me?

I'm not the one who invented a surprise party for my ailing auntie just so I can get my leg over.

I mean, talk about cliche.

Look, don't go over the top.

I am sorry I lied to you, all right, but...

it's early days and we, just wanted to keep it under wraps.

Well, thanks for the vote of confidence.

-We just want to...

-"We". That's sweet.

-She... Jessica, she can't breathe very well.

-Ultrasound. Now.

Nurse? Nurse! >

-Is it always like this in here?

-That's how I like it?

SHE MOANS IN PAIN

It's pretty tender there. This been going on for a while?

Can't believe you didn't call me.

We haven't been in touch for a while.

-Michael, can you look at these? They're urgent.

-Yeah.

Keller. Keller. And Keller.

What? They can't stay down here forever and we are allowed to do our job now.

That's going to go down like a lead balloon.

Tough. They got a problem with it, they can come see me.

Oh, let's runs some IV fluids, B/P cuff, pulse oxymeter,

FBC's, U's and E's, full bloods and urine output.

Oh, and let's book an ultrasound. Urgently.

OK.

Michael, I can come back. I'm not at death's door.

No way. Are you kidding me?

In fact, I'm going to chase that ultrasound myself.

Right, I'm afraid the infection has caused a leak in your heart.

We call it mitral regurgitation.

You'll need an operation to repair it.

Operation? Can't you...

-prescribe something?

-Sometimes, yes.

But this leak is a bit too serious.

What we need to do is fit you with a new valve and you'll be good as new.

-How soon?

-Soon as.

It's a very straightforward procedure.

I've done it hundreds of times.

And...during the operation will you...?

Will you have to give me blood?

-We will have your blood type on stand by should you...

-No.

Yes.

Well...that's the point.

I can't take blood.

We're Witnesses. Jehovah's Witnesses.

OK? I will be as quick as I can.

Hey, take as long as you want. Been here before once or twice.

Anyway am I getting the presidential treatment just because you fancy me

or are you trying to make a point?

Well, I think that's obvious.

It's cos I fancy you.

What's going on?

I presume it's all to do with that jumped up twerp

who waltzed in here earlier.

I love it when you talk dirty.

No, come on.

-And don't bother with the official version, Bob told me everything.

-Hey.

I only called him to let off steam, not to enlist your legal counsel.

Nonetheless it's my job and I'm good at it.

Plus. Losing a patient. That leaves a dent.

Well, I thank you for the offer but it's all under control.

See anything?

Too many adhesions blocking the view.

Yup. Endometrial and surgical. They blocked the IVF too.

Bob told me what happened in Brazil.

How it all fell through at the last minute. I'm very sorry about that.

You know, they tell you to expect it.

It's hard when you learn their names, see photo's,

then it doesn't work out.

I guess some things are just not meant to happen.

SHE WINCES IN PAIN

You OK? We're going to sort this out.

I'm going to get your blood test results.

-You hang in there.

-OK.

Yeah, Ms Effanga. She knows me well.

As soon as. Today if possible.

16-year-old girl, that's right.

Thank you.

-This Jessica?

-Yup.

I'm transferring her.

-Why?

-Because. In my opinion, she'd be better off somewhere else.

Where you going?

-Clear it with your girlfriend. If that's OK with you?

-Mind if I join you?

'Course not. I've got nothing to hide.

Can you call Intermediary Care, she should have been gone ages ago.

Do not let them muck you about.

No! 50 feet?! That's so brave.

Oh, I don't know. It's just what we do.

-Don't tell me. AAU.

-Sam Mckenzie - 22.

Fell from 50 feet. Broken ribs, fractured wrists

-and really nasty lacerations.

-Right, let's get him into bay four.

Sam's a fireman.

Get it? He's a fireman. Fireman Sam!

Doesn't Daniel watch Fireman Sam? I love Fireman Sam.

Daniel is two. What's your excuse?

Right, this cut looks like

it's going to need to be debrided in theatre,

-so you might have to wait a bit.

-Oh, no worries. I'm pumped full of morphine as it is.

-HE SPLUTTERS

-Noisy, isn't it?

Let's do this, shall we? That's better.

Right, I'll be right back.

-30 minute obs, please.

-Aw, he's lovely. Isn't he lovely?

-Yes, he's lovely.

-You know he had a fall rescuing someone.

Really? What, you mean he didn't jump off a building for no reason?

Why would he?

I give up.

30 minute obs, keep on top of his fluid and his pain relief.

Hello. We do have other patients.

Sorry. Of course. Sorry.

-We don't have all the up-to-date equipment for a bloodless.

-Well, I can sort out a cell saver machine.

-Yeah, but not in time.

-Yes. In time.

Do we really want to take a chance on a high risk, high profile,

highly specialised case after last week's debacle on AAU?

I don't even see why we should go there

when I'm sure Kate Morgan at St John's will take her. It's her thing.

Obviously, it's your call but, just for the record,

I'm uncomfortable with doing bloodless.

Fine. Whatever.

Wow. Swift and decisive.

I'm doing the best for Jessica, believe it or not.

The girl's not a parcel.

You should at least talk her through her options?

Yes, the image is very unclear.

She's in a lot of pain.

-And the bloods don't add up so I want you to take a look.

-OK.

Orla, this is Sacha Levy. Surgeon extraordinaire.

Two of you. I'm honoured.

May I?

-Have they topped up your pain relief?

-Yes.

-Any more and I'll be seeing rabbits.

-OK, so I think we have two options.

Either we're looking at a bowel obstruction,

or more likely appendicitis.

So, a laparoscopy?

That's exactly what I was thinking. And a referral to Keller.

Do you want a second signature?

Yes, sir.

-Well, I'm glad to be of help.

-Well, that's that, then.

I'll arrange for a theatre slot. Do you want me to call Bob for you?

No. I'll... I'll do that.

Nice move(!)

Don't you think you should be keeping a little bit of a low profile?

Did I come up with a scheme that cost a patient's life?

Fair enough. I just hope you know what you're doing.

Cos this type of thing - it can easily blow up in your face.

So, I'd,... have to go to London?

Can't you do it here?

-We could. Traditionally.

-No, I don't want that.

-OK.

St John's has specialist equipment

and Ms Morgan is an expert in the field.

But... what do they have that you don't?

It's called a cell saver machine.

It basically collects any blood you lose during the operation,

holds it, filters it and re-infuses it back into you.

You do understand the difference? The risks.

If you have a bleed in surgery,

circulating your own blood may not be as effective.

Effective?

At making up for the blood you're losing.

-At the rate you're losing it.

-You mean at keeping me alive?

Yes.

-Jessica.

-Yes. I understand.

I do.

OK. We'll put the wheels in motion.

-OK. What's going on?

-What do you mean?

You know I could have got you that machine and you never even gave me a chance.

Look, I know it's risky but so is moving her.

-Not on the same scale.

-Not like you to duck a challenge.

Well, maybe you don't know me as well as you think you do.

You don't approve, do you? Because they're joveys.

-I mean, that's what this is about so why don't you just stay so?

-Look,

do I like the idea of letting someone bleed to death rather than have a simple blood transfusion?

No - kind of goes against everything we're taught but that's not what this is...

But you're not being judgemental or anything.

Never had you down for one of those.

-"One of those"?

-Liberal fanatic. Everything black and white.

-Trying to make yourself feel better, are you?

-What for?

-Lying to me.

Move on already. You make out like I've committed third degree murder.

We've already wasted enough air on this. Just book an ambulance.

Sure. Whatever. I mean, you're obviously right.

I don't know what you mean. Eddi, let me know when they come back with a slot.

Of course you do. You've been referring to Keller like crazy.

In the last hour alone - possible splenectomy,

suspected strangulated hernia and now suspected appendicitis.

Michael, we don't have the beds.

Well, I can't send them packing. We don't do that anymore.

What happened on Friday didn't just happen to you.

-We've all got to live with it.

-Yeah, that's the point.

This isn't helping, we're all suffering.

We've all got to fill the reports in.

Well, I suggest you write it as it is

because I'm going to make it very plain and simple

and there will be no doubt as to what happened and why.

Good for you.

Just don't take it out on the rest of us.

Mr Spence.

A word.

For you? Anytime.

Kate Morgan is well known for blood conservation techniques.

-She's the best.

-Thank you.

-I know it's difficult.

-Dad...

-Jessica?

-Hang on, stop, stop.

-What? What is it?

-Oxygen levels are dropping.

-Jessica?

She's crashing! We need to get her back. Get the Crash Team. Now.

Come here! Good girl.

No! No!

Are you OK?

Yes, I... I must have nodded off, I...

I think you had a bad dream. You sounded upset.

No, no, I'm fine.

-Chantelle. A word, please.

-I'll be right back.

I don't know if I've made myself clear but the overload is killing us.

-We don't have time for you to be chatting up patients.

-I wasn't.

I wasn't.

I think he's in a lot of pain, much more than he's saying.

Maybe we should get Serena to have a look at him.

Let me see.

Yeah, he does have a fever. It could be sepsis.

Get Serena. She needs to take him in now.

Charging to 160. Clear.

-Oh my...!

-Push 1ml of adrenaline. Charging again.

And clear.

Back in sinus. She's back with us.

I'm sorry... I-I need to get some air.

-Ollie, get a TOE.

-What? Is this...?

-Yes, Jessica Whitten.

Was going to St John's for a bloodless mitral valve repair

-but she's just crashed so she's not going anywhere.

-OK.

We need a TOE and a theatre slot.

-OK, give us a chance. Where's Jonny? Isn't he...?

-Change of plan.

He's in theatre with Jac.

Right. Great(!)

Jessica? How you feeling?

Where's...? Where's my dad?

It's just rumour has it you're going off piste

and sending the world and his wife to Keller.

What do you want, Binns?

-Think about what you're doing. It won't do you any favours.

-Ah, you're thinking of me?

-You are a good surgeon.

-Thank you.

You are of value to this hospital and I've never pretended otherwise.

Let me stop you right there.

I have nothing to say to you, George. It'll all be in my report.

And you're so confident you won't be a lone voice?

Absolutely.

Everyone knows that scheme was a disaster waiting to happen.

Everyone also knows that you could have transferred Ritchie Mooney but decided against it,

that you forced him on other wards, that you coerced a nurse to help you ferry him

-in what can only be described as...

-I was trying to save his life.

Well, that's your take on it. Other people may see it differently.

That appendectomy. The patient's a friends of yours, isn't she?

People talk, you see.

They're not impressed you're rushing a mate through.

I'm scared, George.

Have it your way.

But don't assume everyone here will back you up.

It's time you stopped believing your own hype.

SHE BLOWS

So, this trans oesopha...?

Transesophageal echo.

We put a camera down your throat

so we can get a closer look at your heart.

It's done under local anaesthetic so it's not too horrible

and it'll give us a better idea of where to go from here.

Look, your dad will be back soon, I'm sure.

Think he had a bit of a shock. Probably needed a minute.

You're really worried about him, aren't you?

It's just...

since Mum died... I don't think he can...

He's started drinking.

He thinks I don't know but I do. Mum had an allotment.

That's where he goes.

He usually comes back around 11 but...

last night he didn't and I got so worried.

He was OK to begin with.

People round us were...so great.

That's how it is in the congregation.

Everyone rallies round. And then...

Everyone gets back to their own lives?

She said I have to look after him. That men are much weaker than women.

-That's a heavy weight to carry.

-I'll be OK.

It's just, Dad...

sometimes I think he's afraid that if he gets over her...

it means he never really loved her you know.

Right, 30 minute obs, keep the IV antibiotics

and 5ml of morphine. I'm going to have to leave you.

I have a strangulated hernia waiting.

I really appreciate this.

Yeah, and next time I would really appreciate seeing the patient

before you present me with a fate accompli.

I didn't want to take any chances today.

OK, fair enough.

Oh, joy(!)

-What do you want, Michael? I haven't written it yet.

-I want to know where you stand.

-In the middle of a war zone, evidently.

-I'm not kidding, Serena.

Ultimately this is an AAU issue and you're head of AAU.

-Don't pass the buck. You signed his transfer.

-Yes,

in good faith and I never dreamt you'd try and deliver him in the back of a van.

-I had no other choice.

-Well, that's for you to think about.

Serena. Non referral doesn't work. You know that,

I know you know that and we both know you were influenced to support it so get real.

No, you GET REAL.

This is a multi-disciplinary hospital, Michael.

There's no such thing as a perfect system.

In the real world, we make real compromises.

And then try and live with them.

MO: I really, really appreciate it, Professor Hope.

If they agree, I'll send a courier.

I so owe you one, thanks.

Mr Whitten. I was coming to look for you.

I was...I had to make some calls.

Don't get me wrong. I'm sorry for your loss.

But you are the adult and she is the child.

You lost your wife but she lost her mother.

And she's ill, scared, on her own

and facing the prospect of a major operation.

Now, I'm sorry to be blunt but you need to man up.

PAGER BLEEPS

Excuse me.

All finished. Well done.

SHE COUGHS

-Sore?

-Just a bit.

Let's take a look.

-OK...

-That OK didn't sound too good.

Hey. It'll be fine.

Right, your mitral valve is infected.

We have to replace it and it can't wait.

I'm not well enough to go to London, am I?

You think this is mad, don't you?

-What?

-The whole...blood thing. Insisting on it like that.

You don't get it.

It's not my place to say.

"Anyone shedding man's blood,

"by man will his own blood be shed, for in God's image he made man."

I'm not a Witness cos my mum and dad said I have to be.

I believe it.

And it means...I'm not alone.

I won't change my mind.

You still look a bit pale and sweaty.

Look, I'm sure it's nothing. When can I get out of here?

Not just yet, I'm afraid.

His B/Ps up and his heart rate.

And what's this? This rash.

Have you ever had this before?

Never seen it.

Are you allergic to anything?

No.

Is there anything you want to tell us?

Could I have FBC's,

U's and E's, LFT's, glucose and an abdominal ultrasound, please?

What?

-You heard. Not taking any chances.

-But he's already had all of those.

Well, they've obviously missed something which we are not going to.

Kate, I cannot thank you enough.

Yep, we'll consent and prep her and she'll be ready and waiting for you.

Brilliant, thanks, Kate.

Well, here it is. Professor Hope has ways and means.

He truly is the main man.

Mr Whitten.

Is that it?

So, she's totally dependant on that thing.

Yes.

What's going on with...?

Sorry, I didn't realise you were...?

It's OK.

I was just leaving.

-I heard. So it's going ahead here.

-It is.

And presumably you'll be doing the honours.

No, I'm not.

-Still digging your heels, are you?

-Look, get off my back, yeah?

-Kate Morgan's on her way, all right?

-So?

You could take her in now, help her,

but you'd rather drag a consultant from London.

On a point of principle?

-That's exactly what I'm going to do cos that's the type of person I am, right?

-Well, why then?

What's the great, overwhelming reason that you won't get your finger out?

Because the last time I did it my patient died.

That a good enough reason for you?

I don't get it - we lose people all the time.

Yes, but this one was down to me.

We were understaffed and I pushed for it. It was my fault.

I had no idea.

Something else you didn't know about me.

So, guess what?

There are no slots for electives at the moment and we may have to wait.

Campbell's fighting back, huh?

I mean can you believe it, she's calling it an AAU issue?

She just trying to wash her hands of the whole thing. I mean...

-What?

-What? What do you want me to say?

You think this is right?

I think. We could have handled it better.

OK. I get it. Someone's got to take the hit.

-That's not what I meant.

-It's fine.

-Michael, that's not what I meant.

It's all right.

-Orla.

-Hey.

We're backed up in theatre so it's going to be a little bit of a wait.

Bob's on his way?

Yeah... Yeah, he had to pick some stuff up.

You OK?

-Yeah, I'm all right.

-Things getting out of hand?

-There're just trying to screw me over.

-I meant what I said. Let me help.

Michael, we've been here before. You thought you'd never live the plastics down.

-Yeah, I know. I owe you big time for that.

-You certainly do.

-You just need to rest right now.

-Why don't you get me all the paperwork you have.

I can go over it.

Michael, now.

Shift.

All right, all right, I'm shifting.

SHE SCREAMS IN PAIN

Eddi?

All right. OK, we're not going to do the laparoscopy, we don't have time.

We're going to do an open procedure. Prep theatre.

I wish...

Could you not do it?

I'm sorry.

Lost a bit of her mojo, today, the effervescent Ms Effanga.

Go on, spit it out.

Oh, it's nothing.

She found out about the weekend thing and she's not very pleased.

Well she'll have to get over it.

ALARM BLEEPS

-5ml of diazepam.

-No, no, no, no!

-B/P dropping, sats at 82/

-Jessica. Jessica, can you hear me?

-What the hell happened?

-She crashed. You need to take her in, now.

But Morgan's on her way.

I don't care if she's being beamed over. We're not taking a chance cos you've lost your mojo today.

You're a surgeon. We have a theatre ready and waiting. You're taking her in and you're doing it now.

Everyone's just protecting their own interests. Divide and rule.

Binns is getting exactly what he wanted.

Well, it's human nature, I'm afraid. Everyone wants to keep their jobs.

Right.

Appendix is clear. Bowel seems fine.

Wait a minute. Ovarian torsion. Right hand side.

Blood supply is cut off.

Page Gynaecology, please.

Did you not request a Gynae consult when she was on the ward?

There's no point now, is there? This ovary needs to come out.

It's strangulated and necrotic. We can't wait for Gynae.

Scissors, please.

-You haven't asked us to call anyone.

-Yeah, I don't want anyone here.

I call a friend - maybe from the station? -

No, I'm fine honestly.

It's just if there's anything you need or anything you want to talk through.

Look, I just said it's fine! I just said, didn't I?

What's going on? Something wrong?

-Nothing.

-It's fine... Everything's fine.

What are you doing?

Nothing, I... You know, I think there's something bothering him.

-When I asked him before if there's anything he...

-That's it, OK.

Just got and chase up that scan for me, please.

But I just think maybe we don't need to run all these tests.

-Is that your expert opinion?

-It's just a feeling.

A "feeling"?

Don't look at me like that. I'm not simple.

Really, I have had enough drama for today.

Well, maybe you need to think about how you speak to people.

Excuse me?!

Because you've been looking down your nose all day at me today and...

-frankly, I don't think I should take this anymore.

-Take what?

Running a happy ship?

-I've never seen such dense adhesions.

-Yeah, but we're finally getting somewhere.

Right.

-What the...?

-What?

Hang on. Did you not test for pregnancy?

Why would I?

She's 47, perimenopausal,

with a long history of infertility and failed IVF treatments. Come on.

Well, you should have.

You're kidding me.

Nope. Her uterus is large and soft and very vascular.

No way.

Yes way. I'd say she's about 12 weeks gone.

Will you keep it safe for me?

I'm not scared, you know.

I know she's looking over me.

See, I...could have fallen away...

but I've not abandoned the straight path.

Like she said. And now she's with me.

Yeah.

You promise...no bloods?

No bloods.

-Nice work.

-2.O Prolene.

You pull it off every time, you.

Knock it off. I thought it was appendicitis.

Yeah. But you knew she had to come in.

If you hadn't, she wouldn't have made it till tomorrow.

As for the baby, let's not even go there.

Where's this going?

I just don't want you to throw your career away like this, you know.

Such a tragic waste.

So I should keep my head down and play the game like everyone else?

The game is rigged anyway. I say don't play at all.

But what about the game behind the game?

Michael, we're here for one reason and one reason only. We're surgeons,

we're not politicians. Let's just do what we're good at.

My wife, she...she came in for a check up, you know.

And that was it - just one check up And it was all over.

I mean, it took a few months but...

No amount of blood could have saved her.

No amount of anything.

She'd hate what's happened to me.

It's my fault that Jessica is in there. No-one else's.

I'm sure that's not the case.

The thought of it - on her own, lying on some cold pavement...

Now really isn't the time to...

She was looking for me.

What if something happens in there? What if she needs blood?

Things go wrong.

She'll be fine. Ms Effanga is an excellent surgeon.

A surgeon who never wanted to do this operation.

No, this is wrong.

No, you tell her. You tell her that I want to give Jessica blood.

-I can't. Jessica's given her consent. It's what she wanted.

-Then, I'll tell her.

I'm not going to let you in there.

You just get out of my way. I know my rights.

Diathermy, please.

Thank you.

We have a problem.

-What?

-The father wants you to use blood.

-But she doesn't want it!

-Well, he's had a change of heart and he's threatening legal action.

-Tell him it's too late.

I have. He's on his way to Naylor's office now.

This isn't happening. Keep her under. I'll be right back.

The last thing we need right now is another body bag and a front page spread.

What about what she wants?

-I thought you didn't want to do this operation - that you didn't feel comfortable.

-Exactly.

You were the one going on about the risks.

Yeah, but we've started now. I can do it, I know I can.

I. Don't. Want. To take the risk. Are you hearing me?!

But I promised Jessica. this is important to her.

What does she know? She's a child. I'm her father.

-It's a bit late for that now, isn't it?

-Excuse me?!

-Mo.

Unbelievable. Who do you think you are?

Does my daughter stand a better chance of survival with or without the transfusion?

There's a possibility that it might improve if transfusion was an option.

She will hate you if you do this to her.

But she'll be alive.

I'll take the chance. She's 16. She's still a minor.

I could get a court order and you will be in so much trouble.

All of you.

Ditch the cell saver machine. As of now, you're not doing a bloodless.

PAGER BLEEPS

Look, what exactly have I missed? What's with the U-turn?

What are you are you trying to prove?

I'm not trying to prove anything.

You could have fooled me.

Is this really what you think of me?

I don't know what to think anymore. I don't know what's happening with you today.

What's happening with me?! What's happening with you?

Yes, I know, I know, I lied to you but...

you have to tell me what's going on. Mo. Please.

The only thing that's kept this girl going is her faith.

She's totally on her own in this. And I know what that feels like.

You're not on your own. I'm here.

I gave her my word, Jonny.

I can't let her down.

So, no appendicitis?

Nope. We had to remove one of your ovaries but...

But what?

This may come as a bit of a shock.

It certainly did to me.

It's good news.

You...are pregnant.

You're about 12 weeks.

So, congratulations, I'm very happy for you.

What?!

I know, I don't know how you did it but you have defied the science...

Oh, God!

Am I missing something here? I thought you'd be elated.

I just...

I don't know.

I'm just a bit shocked. I...

Sorry, I just feel like I've been hit by a two-ton truck.

Sure. You should get some rest. We'll talk later.

So I assume we're preparing for a blood transfusion now, yes?

-Er, we'll take care of that. You go on a break.

-What?

I wouldn't want to get you in trouble.

Technically, you'd be an accessory.

I see.

-Technically.

-Right.

I wasn't privy to any conversation that happened outside this room

so, technically, you just came in here and got on with it.

Didn't you?

'Course we did.

OK, let's go.

Hey, Bob! It's Michael.

Where are you?

Birmingham?

Er, didn't you get Orla's message?

Do you think she's still upset with me?

She's never upset with anyone for very long.

Well. I may be the exception.

Well, you got so much on your plate in here.

-It's probably quite stressful.

-No more stressful than your job.

I don't know. I bet you get all sorts in here.

It's all about saving lives, isn't it?

-I suppose you...

-Do you ever get used to it?

I mean, if you don't...? If you fail?

What happened today?

My first time. My first casualty.

This rash, you see,

it's when I get stressed. Sorry, I should have said, I know, but...

It's all right, you're embarrassed?

They train you for it but we all make mistakes.

I suppose, thing is, you can't save everyone, can you?

Eddi, where did Orla go?

-Er, Obs And Gynea.

-Why?

She said she needed to discuss her options.

OK, thank you. Mrs Bhatajee has a bed in urology,

and Mr Barnsby is on his way to the discharge bay.

Great, thank you.

And I'm sorry.

I've been horrible to you today.

Oh, oh - I wouldn't say that.

You were right. There was something going on with him.

He lost someone on the job for the first time today.

Aww! Aw, poor guy!

And I think he's mortified about having a go at you.

Oh.

So maybe you could put his mind at rest.

Oh, yeah, yeah, of course.

Right. Nearly there.

Scissors, please, thank you.

That's it.

-Good to go?

-Let's take her off bypass.

She's bleeding.

One of the sutures gave way.

-Start filtering, quickly. 2.0 Vicryl.

-Swabs, please.

Come on, Jessica, come on, come on, come on!

I just spoke to Bob.

-Suction and packs.

-Platelets are low.

-I can't see a thing. How we doing?

-B/P still down.

Mo, you're OK. You have to fix that suture again.

No, no, no, the machine is not working.

-It's not fast enough. I can't do it. Get Professor Hope.

-Mo, Look at the machine.

Look at it! It's on top of it. It's not failing.

-It's happening again, Jonny.

-No, it isn't.

-I'm going to lose her.

-Just breathe.

OK, OK, OK - what's that song you like?

-What?!

-You know...

-HE SINGS:

-# I'm sticking with you

# Cos I'm made out of glue. #

Mo, look at me. Look at me.

SHE SINGS: # Anything that you might do

-# I'm going to do too. #

-Keep going.

# You held up a stagecoach in the rain

# In the rain. #

Thank you, Dr Valentine. # And I'm doing the same

# I'm sticking with you

# Cos I'm made out of glue. #

B/P up. She's stabilizing.

Why didn't you tell me?

I don't know. I felt humiliated, maybe.

How long?

Few months.

It wasn't... It didn't have anything to do with us?

What, because of one kiss?

Yeah, but what a kiss.

True.

But, sorry. No.

Although...it was probably the beginning of the end.

And the baby?

Not his.

Brief encounter at work.

Very brief.

Can you believe it? After all this time.

Anyway, he's having one. With her.

I guess he told you.

I can't blame him really. After a while...

you keep trying and failing and... it just pollutes everything.

We were miserable. He had to get out. We both did.

So what now?

I don't want a baby on my own. I'm forty-bloody-seven.

It's not how it was supposed to happen.

So you're going to give up the thing you wanted most

just cos you've got to do it on your own?

Say it like it is, why don't you.

I don't know.

You know, I never knew I wanted a baby until we had one.

And now...they're the one thing in the world that makes me feel there's a point to it all.

< Paula Yates?

Just...think about it, OK?

Thing is it was a 50 foot drop.

I just... Think I lost my footing.

-Oh, my...!

-I kept saying to her, "Come here. Good girl. Come here."

Then just when I thought I had her...

You ... You really don't have to...

And she had these big blue eyes

and that gorgeous ginger colour.

-Gathering the evidence?

-I already have yours, I believe.

I haven't had a chance to look yet.

Yeah, I think you will be pleasantly surprised.

-How so?

-I'm playing the long game, not the blame game.

-Meaning?

No finger pointing. Isn't that what you want?

I want to be able to gather the facts and make an informed decision so that

I can try to prevent tragedies such as this from ever happening again.

As strange as it may sound, I want the truth.

I'll leave you to it.

We did it.

We sure did.

Want to go tell her dad the good news?

-You're the one who pulled it off.

-Shut up! Oh, heads up.

Well, I can tell by your beaming faces that you've gone ahead

and performed a bloodless operation.

Look, Jac...

Don't call me Jac.

I can only assume the shine will wear off

when you're facing the mother of all lawsuits

and a father who has to tell his daughter that he let her down.

Best of luck with that, guys.

-You know what? You are going to make a great mother.

-Thank you.

-Another place, another time, huh?

-Yeah. I would have held on to you.

Oh, I don't know if I'd wish that on you.

Stop torturing yourself.

You couldn't have saved him. You tried everything.

-I'm not too sure about that.

-Michael, don't go there.

Don't let the politics and all the power games swallow you up.

I know you and you would do anything for your patients.

Time and time again. Anything.

It's not even like you have a choice in the matter - it's just who you are.

Promise me you'll never change.

I don't know, is honesty the best policy?

-Oh, sorry - forgot who I was asking.

-I'd say let's just wing it.

Yeah, you would do.

-Bow to the master.

-Yeah right.

-OK, you tell him then, smarty-pants.

-Thanks(!)

You're the registrar.

-Yeah and you owe me.

-You what?! You owe me.

She's awake.

We are shafted.

Come on.

Hey, sitting up already. That's what we like to see. Fast healer.

Thank you for everything.

So...in theatre?

A few bumps in the road but all's well that ends well.

She was looking after me. Told you.

-You did.

-I knew you'd keep your promise.

A kitten?!

He had her, lost his footing and dropped her.

Don't cats land on their feet?

She did.

And?

He landed on top of her.

You mean he crushed her?

Mm-hmm.

You're kidding me.

That is priceless.

Oh, come on, it is sad.

Yes, it certainly is.

Oh, I think it's sweet. Men who like pets are meant to like babies.

Oh.

He asked me out.

That's lovely. Go for it.

Just make sure you take a crash helmet.

Then again he did kill a kitten.

-Well, not intentionally.

-But what if he never gets over it?

What if I never get over it?

Yeah, good point. You're doomed.

Do you think so?

Oh, absolutely. Move on.

As tragic as it is, let him go.

Yeah. Yeah, you're right.

It's very sad but it's the right thing to do.

Thanks. I'm glad we had this chat.

That's why we love her.

SHE GIGGLES

KNOCK ON DOOR Come in.

Mr Spence. Perfect timing. I was about to read your...

I think you'll find this is a far more comprehensive overview.

I see.

Do you mind if I...?

You take care now.

Hey, Binns.

I'll see you around, yeah?

-Nothing yet?

-Nothing.

-Reckon we got away with it?

-I don't know but I can't take much more of this cloak and dagger stuff.

-Mo, I wouldn't...

It's work. I'm trying to get back into the swing of things.

I'll just get to the point.

I need to know what you're going to tell Jessica.

Nothing.

Nothing?

What would be the point?

Don't get me wrong, I don't agree with what you did.

But who am I to judge you? I'm the one with the crisis of faith.

So?

Best get on to the Law Society.

Jack's going to have a field day.

Oh, no, you're kidding. He's going to go ahead and sue, even...

Oh, you cow!

# I'm sticking with you Cos I'm made out of glue. #

Oh! # Anything that you might do

# I'm going to do too

-# You held up a stage coach in the rain

-In the rain

# I'm doing the same... #

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