Time Has Told Me Holby City

All these bright young things.

Makes one feel rather like a dinosaur.

There are going to be some big changes.

As of today, I'm effectively in charge.

Oliver, you can't seriously blame me for Tara's death.

Oh, yes, I can.

You do the thinking, I'll do the talking.

What if I panic?

I'll carry a paper bag.

Don't you think you've had enough?

I'm just getting started.

DOOR SLAMS

Heavy hangs the head that last night wore the crown.

You look like I feel, and I've just finished a double shift.

I take it you were out on the town.

I wouldn't say out on the town exactly.

No. Sorry.

That's OK.

You off home?

Yeah. To the land of nod.

-Goodnight.

-Take care.

Apologies. There was a big RTA. Thanks.

Did you assist?

No, no, no. I'm needed here.

Plus, the police had closed off several of the junctions

before the crash site so I wouldn't have been able to get near anyway.

Must be big?

Yeah, I think so. Air ambulance flew over.

I guess we should be on stand-by.

I doubt it. St James's is nearer.

We may get a one or two patients if they struggle for space,

but we shouldn't really be affected, especially on Keller.

Ah, Professor. Are you here to see me?

Yes, I wanted to talk to you about Dr Valentine.

Behaving himself?

He hasn't arrived as yet.

There's an RTA on the ring road, everyone's running a bit late.

Not everyone.

But that's not the reason that I'm here.

It's with regards to yesterday's little hiccup.

Dr Valentine's decision to ignore his superiors and operate

without your authorisation can hardly be described as a hiccup.

It's uncomfortable, but he appears to be blaming me for Tara's death.

It's fairly clear that Dr Valentine is very troubled.

Understandable, given the circumstances.

Quite. So that's why I thought, with your blessing,

that maybe I should take him under my wing, so to speak.

As much as your heart is in the right place,

Dr Valentine has agreed to professional counselling.

Really?

And I suggest we let them care of him.

Is this working for you? Is it helping?

It's just making me go a bit light-headed.

Meditative breathing techniques can do that.

Just breathe in through the nose...

and out through the mouth. Just helps calms nerves.

I prefer a good cup of tea. Gives me a lift.

You just feel the space between the vertebrae, just extending, reaching,

head floating on top of the spine like a balloon,

and breathing in through the nose and out through the mouth.

You'll be fine today.

Best F1 in the hospital.

Thank you.

I'm not sure Mr Spence would agree, though.

Don't be silly. It was just a blip. Happens to everyone.

I might try this before my next date with Rhys.

We had a lovely night.

We went for cocktails. Have you ever had a Bellini?

No, I can't say that I have.

It went straight to my head, I nearly fell off my stool, I did!

And then we went to a posh restaurant for fat chips.

Amazing.

It was!

In through the nose, and out through the mouth.

You wanted to see me?

Thank you. Yes.

I... I wanted to talk to you about yesterday.

You'd like me to apologise?

No, no, no, not at all.

I just think it might be wise to make a fresh start,

turn over a new leaf, put everything behind us.

Everything?

I think what you need - well, what we both need - is to move forward.

Let me help. I know what you're going through.

Will that be all?

I've got work to do.

First up, we have Marc Greene.

Ileocecal resection resulting from Crohn's.

You'll see from the notes that he had lung cancer some years ago,

and although he's been in remission ever since,

he's now reluctant to have any further medical intervention.

He's had enough?

Not quite.

So why opt for open surgery when it could be done laparoscopically?

Why don't you ask him?

Now, go easy on him, his family and I have had a hard time

persuading him to come into Holby at all.

Good morning, Mr Greene. How are we today?

Not so bad, Mr Griffin. How are you doing?

Very well, thank you.

Marc, my colleague and I were just discussing you.

Ah, I thought my ears were burning.

So?

I just wanted to ask why you'd opted for open surgery

rather than keyhole.

Too much messing about is the easy answer.

I was tree surgeon before I retired.

Now the only trees I do are this lot here. Genealogy.

When I came across a diseased tree,

there was no fancy pruning here and there.

I want straight in with the chainsaw and pollarded it,

hacked it right back.

Same with my lungs, really.

They cut half of those away, and stopped it in its tracks.

This won't cure the Crohn's, Mr Greene.

But after the resection,

you will be able to eat and digest much more easily.

It will improve your quality of life.

You'll do right by me, won't you?

I'll be with you every step of the way.

You carry on without me, I'll be right back.

Is there a problem, Mr Spence?

No.

Serena hasn't spoken to you, has she?

It was noted how AAU had benefited from you being there,

knocking everything into shape.

Are you suggesting I return to AAU more permanently?

Well, Mr Spence and Mr Malick can cover here on Keller, and perhaps

a stint on AAU might allow you to bring your emergency skills

in line with Medical Staff Committee requirements.

I'm sorry, are you asking me to re-train?

As if I'd ever ask such a thing.

But you know what the Medical Staff Committee are like.

They could, at the drop of a hat, review everyone's training,

then, perhaps they'd see that your emergency medicine

is a little...

..out-dated.

Might be a bit embarrassing for someone of your standing

to be told to update.

Can't keep away from us for long, can you, Mr Griffin?

Just as well. I've got an urgent consult here, please!

I need you over here, Mr Griffin!

Mr Griffin!

Mr Griffin!

Bed eight, please.

Dr Valentine. I've arranged the transfer of a patient.

I wondered if you could assist.

Sorry.

I could give you a hand with that later.

The patient has post-heart transplant complications,

which ties in neatly with a forthcoming lecture

on the history of heart transplants in the UK.

If you were to assist with patient care,

you'd build up a credit towards your CT year one.

OK.

But that's it, just work.

I don't want you counselling me, advising me on anything,

nothing to do with my personal life.

It's just work, OK?

It's a venepuncture.

What is that? I don't understand.

Hiya. Dr Digby just needs to take

a really small blood sample, that's all.

Ooh, this looks interesting. Is it a family tree?

Genealogy.

Beg your pardon?

Yes, it's a family tree.

Like I said. Hey, are you related to anyone famous?

I haven't found anybody yet.

I have a cousin who got through to boot camp on The X Factor.

Yes, it's in. Thank you.

Digs, could you take Mrs Anderson's bloods?

We need to get them over to the path lab ASAP.

Digby? I've got a couple of jobs for you.

Dr Digby's helping me with my lists.

Sorry, I need him. You'll manage.

When did this start, Adam?

Couple of days ago.

Pains. Shooting pains.

Chest, arms, shoulders, everywhere.

You had your transplant, what, two years ago?

Up in Scotland.

I take it you're on top of your post-transplant meds?

Yeah. Yeah.

OK. Well, these complications sometimes appear

and we don't know why.

OK. 20mg frusemide IV now, please.

The usual bloods, cardiac enzyme, echo, angiogram

and a duplex ultrasound, please. Thank you.

The heart's packing up?

Your heart is our likeliest suspect, yes.

Aye. I thought so.

But let's not get ahead of ourselves.

We'll get these tests done, then see where we're at.

It's OK. You're in safe hands here. We'll take good care of you.

Yeah?

You'll be all right.

Adam's notes are a little on the thin side. All a bit strange, isn't it?

Dance with me, doctor.

I'm afraid my dancing days are over.

You're never too old to dance. Margot Fonteyn was in her forties.

Hello again, Sally.

Oh, hello there, sweetheart!

The doctor won't dance with me, but you will, won't you?

Oh, I would love to, but I'm just a wee bit busy at the minute.

I danced with Nureyev, you know.

We know, Sally, you've told us that before.

Why don't we find you a bed, and I'll get Mr Griffin to come

-and take a look at that wrist of yours.

-Lovely.

We're even busier than the last time you were here,

so we would really appreciate it if...

If I rushed patients in and out?

The thing is, there's not many consultancy roles around, you know?

And with Mr Griffin swapping places with Mr Spence,

it's going to be even harder for me to break through.

I mean, Nath, how am I supposed to move up on the career ladder?

I'm sorry, here I am going on and on,

and you're trying to deal with your mum.

It's fine.

How's she doing?

Ah, you know. I'm going to see her tonight.

Would you like me to come?

That'd be great.

I'll let you know when I'm leaving.

See you later.

Oliver, any more news?

Yes, I spoke to the donor register,

they're going to send you through the history on Adam's heart.

And then we'll have more information on the heart

than we have on the patient.

Hello, again.

I'd just like to have a little chat about your medical history.

I spoke with your consultant,

and she says that in the last 18 months, you've failed to attend

any of your follow-up appointments.

Aye.

Any particular reason?

Well, I moved down here, yeah.

And you didn't return for any follow-up assessments?

It's too far away.

Well, I imagine that the hospital would have given you

the option to transfer somewhere else.

No.

They have tried to contact you on several occasions,

through your GP and...

Maybe they did, maybe they didn't.

I don't know. I didn't get any letters or anything.

OK. Right. We'll be back when we've your results. Thank you.

I'm not sure we're getting the full story here.

Would you have a little chat with him? See if he'll tell you anything?

Me?

I don't seem to be getting anywhere.

OK.

Thank you.

Mr Griffin?

Jonathan Ferry, full-thickness wound suffered in the RTA.

Mr Griffin. You won't remember me, I came to see you over a year ago.

I'm on your list for a vascular reconstruction.

Yes, Mr Ferry, yep. Do you mind if I take a look?

Be my guest.

Can I have some gloves, please?

So you were involved in the crash?

The police talked to me about it,

I told them it had nothing to do with me.

It was some idiot hurtling past, must've been 100 miles an hour.

So we haven't yet had the pleasure of your company

for the vascular reconstruction?

It was cancelled. Twice.

My apologies.

Not at all. These things, out of one's own control, do happen.

Well, I don't see any debris in the wound,

but we won't know for sure unless we do a laparotomy.

An operation?

Yes. Would you mind prepping Mr Ferry, please?

I won't be leaving today?

I'm afraid not.

If you need to let anybody know that you're here,

I suggest you make those calls now.

I don't have a mobile phone.

I know I should have, but I'm a bit of a dinosaur, you see.

Is there a payphone I can use?

Yes. Nurse Carter.

Would you mind helping Mr Ferry, please?

He needs to make some calls.

I'm a secretary now, am I?

Don't push your luck, Nurse Carter.

Adam, is there anyone you'd like us to call?

Let them know you're here? Family...?

No.

There isn't anyone? Or you don't want me to call anyone?

You see, I've got to put someone's name down here, in case of emergency.

Kenny. My brother.

Just put his name in here, his address, yours overleaf.

Thank you.

I don't want him contacted.

He'll be here before you know it. On at me, like always -

telling me what to do and that.

I won't call him.

What's going to happen to me? You going to cut me open?

Let's just wait for the results of the tests, shall we?

And if they confirm what you think?

If the arteries are significantly blocked, then yes,

the safest option would be a coronary bypass.

OK. I don't want that. I won't consent to that.

I've had enough... enough operations, hospitals...

Is that why you didn't go to any of the follow-up appointments?

Adam?

Why?

I don't know. I just...

I stopped feeling like me.

I was like a rat in a lab, you know?

Tests, medicines, consultations.

Everyone doing something to me, telling me what I can and can't do.

Get off, will you!

OK, OK.

Calm down.

You all right?

Aye.

-Thanks, Kate.

-Sorry, hen.

Just under a bit of pressure, you know...

It can't be easy...

It's all talk, they don't listen.

They don't have the time.

And they're all experts on heart transplants, you know,

and none of them have had one.

I have.

They don't listen. Nobody does.

I will.

Let me help you.

Yeah?

Yeah.

Tell me what you need.

There's... something...

Yes?

Can you take it out?

Take what out?

This. Take out the heart. Please.

I'm steady on my feet, usually.

You were a ballet dancer, weren't you?

Nobody could touch my fishdive. I was the best in the business.

Have you had anything at all to drink today, Sally?

A little cider, that's all. I'm trying to stop, you see.

Ow! Don't manhandle me so!

Did you hit your head, when you fell?

I certainly did not hit my head.

I didn't fall, I tripped.

Must've been a loose paving stone.

Hey, I could put in a claim, couldn't I?

I can't afford not to.

Well, you'll understand, darling, being a nurse.

You're all skint as I am.

Well, I think it's just sprained,

but let's do an X-ray anyway, just to be on the safe side.

Agency, aren't you?

No, I'm permanent now.

-Are you?

-Good for you!

Don't look too excited now(!)

That girl's a sweetheart, do you hear?

Mr Ferry. I've been thinking.

Since we're putting you under for the laparotomy,

I could do your vascular reconstruction at the same time.

It would mean a longer stay in the short-term,

but you wouldn't have to come in twice.

How would you feel about that?

My business and I would be overjoyed, Mr Griffin!

I rather thought that might be the case.

Ah, just the man.

Did you get my message?

Indeed.

With Mr Griffin transferring to AAU, I thought this could be a good time

to discuss the possibility of expanding my role.

I couldn't agree more.

To consultant?

Absolutely.

PAGER BEEPS

And the more students you successfully mentor

in your capacity as Clinical Skills Tutor, the better.

It means the scales will be weighted in your favour

when a consultant role does become available.

And, fortunately for you, we have a new F1 - Dr Copeland.

I'm sure Mr Malick will take care of you from here on in.

Sorry, I really do have to deal with this.

Have fun.

Dominic.

Pleased to meet you.

We have kind of met before.

At Albie's?

Oh right, yeah. Yeah, of course.

I'm just really excited to be here.

Take out his heart?!

He said it remembers things.

The heart remembers things?

Its previous life.

He says it's still in pain from the death of the donor.

Cellular memory.

The idea that organs other than the brain,

are alive with memories of a previous life, as it were.

Ridiculous, I know, but believers like to make a case for it,

particularly when it's an emotive organ like the heart.

They cite feelings after the end of a relationship,

heartbreak, heartache and so forth.

If that's what he truly believes and he's refusing treatment,

then we need to get a psych consult in to see him.

No.

Sorry, Professor, with the greatest respect, I don't think a psych

evaluation would be at all beneficial for this patient at this time.

And what leads you to that conclusion?

I've talked to...

I've listened to Adam.

He's fed up with people talking at him.

Please, leave it with me.

I think I could get through to him.

If it's cellular memory, we need a psychiatric evaluation,

no ifs or buts.

You know best.

The on-call psychiatrist is coming to see you.

-To talk.

-To listen.

-How do you know?

-I don't.

Just give them a chance, they might be able to help.

Nah.

They won't listen, they just judge.

-I can't trust anyone.

-You can trust me.

Did you call my brother?

You asked me not to.

Thanks.

Can I tell you something?

You can't repeat it.

If you do, they'll lock me up, they'll think I'm tapped.

You can trust me.

This... This isn't kind.

This is hateful. It's pure evil.

-You don't know that.

-I do.

Oh, I do.

It's brimming with violence, I know it because I feel it.

Ever since they stuffed it into me, I've felt hurt.

I've wanted to cause hurt, I've wanted to hurt people, you know?

This... this is a heart of a murderer.

And that's why it has to come out. It has to die so no-one else will.

If it dies, then you die.

I know.

Hairline scaphoid fracture.

This should really have been sorted out in the ED.

Nurse Carter will pop your wrist into plaster,

and then you can be on your way.

Oh, please don't.

Have you seen anyone trying to do an arabesque

with a plaster on their arm?

I trust you're OK with that?

I think I can manage.

Are you keeping me in?

That won't be necessary.

Oh, please? It's bitterly cold outside

and I hate it when my muscles all seize up and... oh!

Are you OK, Sally?

I've had a little accident. I'm so sorry.

It's OK. You're not the first and you won't be the last.

We'll get you sorted out, OK?

-Are you heading into theatre now?

-Yeah.

OK, I'm a little worried.

Zoe in the ED called, she said they're really stretched.

What if more casualties from the RTA are brought in?

I seriously doubt they'll be sent here.

St James's is the receiving hospital.

You can always page me if it's an emergency.

-Get off me!

-Please, Sally...

I said get off me!

I'll be back before you know it.

Hi.

I'm looking for Professor Hope?

Yes?

Sharon Kozinsky.

You called for a psych consult?

Ah, yes!

What've you got?

A post-heart transplant patient

believes his heart has cellular memory.

You told him it was bull, right?

I don't think I was quite so dismissive.

You should know there's a clock on this.

-The sooner we get him into theatre, the better.

-OK.

How would you describe his general mood?

Placid? Prone to violence?

He strikes me as very detached, although quite calm.

Perhaps you'll be able to shed more light on Adam's state of mind.

He seems fine.

Sorry, Dr Valentine, Sharon Kozinsky - psychiatrist.

Have you two met before?

Not exactly. Where's the patient?

Bay two.

Call my secretary, and we'll rearrange, OK?

What was all that about?

Dr Kozinsky is my bereavement counsellor.

Thanks. Thanks a lot.

So, this next patient has Crohn's.

I read the paper you wrote on Crohn's.

-In med school. One of my lecturer's gave it me to read.

-Right.

The theory that an overly-sterile world helped create diseases

like Crohn's and the suggestion of the deliberate infestation

of patients with parasitic worms - it's brilliant.

Thank you. Well, Mr Greene is in for a ileocecal resection

which we've planned as open surgery that I, the Malick,

will perform in Mr Griffin's absence.

Maybe you'd like to sit in, see how it's done?

-Definitely.

-Great.

Whoa, where's my patient?

Er, a pre-op abdominal CT. I think Mr Spence sent him.

Hey, have you got Mrs Anderson's bloods back from the path lab yet?

Oh, sorry. I have been a bit tied up with Mr Spence's errands.

What's that?

What?

Dr Digby?

You sent Dr Digby to get California Rolls?

These are Hawaiian, you philistine.

He's supposed to be on the ward.

Well, you can manage, can't you?

Of course I can manage. That's not...

Look, the next generation of doctors

aren't going to learn how to save lives by getting sushi orders.

You never seen the Karate Kid?

What?! Have you seriously lost your...

Hang on, Malick, we've all had our fun,

but don't let your mouth get you in trouble.

Digby is learning to take orders from higher up the chain of command.

A lesson that we could all learn, don't you think?

If you'll excuse me, I'd like to go and check on my patients.

Oh, I meant to ask you.

Would you like to assist me on the ileocecal resection?

Assist you?

Marc Greene is on Mr Griffin's list, he left me in charge.

He's my patient.

No, he's mine. I'm the clinical lead.

Wax on, wax off.

Yes, I'd be grateful if you could adjust the list slightly,

the by-pass has become more pressing.

Yes, thank you.

Is she going to be much longer?

Can't wait for her to get off the ward?

I take it you missing this morning's appointment

wasn't entirely accidental?

I was running late. There was an RTA that...

..happened some time after your scheduled session.

You do realise that Mr Hanssen made has your counselling sessions

a condition of your continuing employment?

ALARM BEEPS

Excuse me.

OK, BP's dropped. We need to squeeze some fluids in.

Kate grab me a pressure bag, would you? Thank you.

We're really up against it now.

I'm making some progress here. Five more minutes.

I don't want this to become an emergency procedure.

I understand what you're saying.

We need to get him in now.

Five minutes?

Come on.

Five minutes, that's it.

Professor!

All this talking's holding us up. We need to treat him now.

-I know what I'm doing.

-Do you?

No, no, no. It's fine. I've got to go.

I'm so sorry to call you down, Ms Campbell, but it's a pneumothorax.

All of this is from the RTA?

Multiple pile up. St James's can't cope with the numbers.

Where's Mr Griffin?

In theatre. I've paged him but he must be tied up.

I'm sorry, but I know I'm not authorised to do chest drains.

Oh, there's no need to apologise.

You did the right thing in calling for me. Could you assist?

2% local anaesthetic, please.

And when you have a moment of calm, Nurse Carter, can you assess our

latest arrival and let Keller know we'll be sending this gentlemen up?

Yes, Ms Campbell.

I'm sure Mr Griffin will be back with us soon enough.

Yeah.

What are you doing on my computer?

Giving Adam what he wants.

-And what's that?

-The truth.

He thinks the heart has come from a murderer,

he thinks it's evil, making him violent.

When did he tell you this?

Didn't you think it was relevant to pass on?

Dr Kozinsky is with him...

I told you to leave it with me. He trusts me.

That's why I didn't betray him.

We need to convince him that the heart isn't evil,

and then he'll consent.

The donor was a 23-year-old schoolteacher,

innocent victim of a drink-driver.

We are not at liberty to divulge donor information.

Adam could trace the family.

And?

Well, imagine the affect it might have on their grief.

Or how comforting it could be,

knowing that because of her death other lives were saved.

No. There are laws in place to protect...

Surely it's worth breaking the rules if someone is about to die.

No, it's never OK to do that.

Oliver? Where are you going?

He needs the truth.

I don't have to do anything!

Why won't you listen to me? I want this out.

I don't think you do, not really.

I do!

Could all of this be about you missing the attention?

People rushing around worrying about you.

You don't know anything.

Why else would you deliberately make yourself ill?

-Take it out!

-Adam, don't.

-It's evil! It's the heart of a murderer!

-No.

Don't do this.

The donor killed, the heart made them do it

and now it wants me to do the same!

-You're wrong.

-Dr Valentine!

Murdered their family, and took their own life.

I know it, I feel it.

-Adam, the donor was 23 years old.

-Get out of here!

Adam, listen to me.

If you do not leave immediately, I will call Mr Hanssen.

What's going on?

It wasn't anything as dark as your imagination has conjured up.

Could I have a word?

Please. Believe me.

-Professor?

-OK.

I'll consent.

You can do your bypass. I'll do it.

Right. We'll get you prepped for theatre.

You were going to tell him, weren't you?

Organ recipients cannot know anything about the donors.

It's completely unethical and very dangerous.

It didn't happen, so there's no point arguing about it.

Oliver, he's consented.

-Call security!

-Adam!

It's a murderer's heart! I told you, didn't I?

It's the heart of a murderer.

Why else would he stop you from telling me?

Let's get him to theatre now!

Charge to 200. Clear.

Mr Griffin, there you are.

Mr Griffin! Quick, there's something wrong!

OK. I thought I asked you to discharge Darcey Bussell?

Yes, sorry.

Sats are falling.

Right, could be a severe neck trauma, could be a clot.

Cricothyrotomy kit, please.

Charge to 200. Clear.

Mr Griffin! Patient needs intubating now.

Erm... er...

-OK, I'll be right there.

-Mr Griffin?

-Keep him stable.

-Mr Griffin?

There are several fragments of glass here.

I don't need to tell you how careful we have to be.

If they move, we could end up causing further complications.

Speed and precision are our watchwords.

This emergency could so easily have been avoided.

By telling the truth.

You're not thinking straight.

Suction.

I understand that there are rules,

but when it's a matter of life and death...

There is no justification for breaking the law.

Please excuse the interruption.

Mr Hanssen?

I have been informed of a security incident on Darwin.

Is that the patient in question?

Yes, it is.

Can I see you both in my office when you're done, please.

Mr Griffin?

Right, let's get him transferred. ITU.

-You really should look where you're going.

-Please!

An apology wouldn't go amiss.

Not now, Sally.

-Doctor, I...

-Will you get out of here! Now!

Everything all right?

Yeah, I just need to locate the right spot...

It's just there.

The swelling made it harder to locate.

Thank you.

Was there a problem with the laparotomy?

You seemed to be in theatre for some time.

Small complication.

Everything's fine now.

Good.

Mr Malick, we've got a bit of a problem.

Mr Spence is waiting for him in theatre.

Er, Mr Greene?

That American doctor was here giving it all this and that,

telling me he's going to do the op his way, a quick in-and-out thing.

Well, if he doesn't care, why should I? I'm off.

Look, you can't. We had a surgical plan, yes, but...

Yes, we did.

But it's my body, and we'll do what I say, OK?

And I don't want any cameras stuck in it.

Mr Spence was right, keyhole would be quicker and you'd be home...

I have given you my reasons, drastic surgery does the job.

Please, Mr Greene, I'm going to be in there with you, and I'll...

Oh, yeah, you're going to be in there.

I'm not.

I'm sorry, but in all honesty, I didn't want any of this.

Don't you want to finish researching your family tree?

It's called genealogy, and it's a serious business,

identifying all the links, heads of lines, and the...

well, the chain of command.

You're not really interested, are you?

Don't worry, darling. I mean, you're not on your own.

Look, Mr Greene, please. If you don't have this treatment...

I'll die. I know.

But I've done cancer

and I don't want to do that again, thank you very much.

So Crohn's will suit fine.

That's the way I want to go, without a fight.

I want to slip gently away.

And what if you don't slip gently away?

The seriously affected part of your bowel could perforate.

You'd need emergency treatment,

and you've no idea what they'll do to you.

Go through with this and you're still in control, Mr Greene.

You know what's going to happen, and you know it'll be all right.

And maybe, instead of putting your forefathers on there,

you could add your great-grandchildren?

The next lines?

Oliver, would you accompany Mr Usborne to HDU, please?

Dr Valentine is out of control.

The patient is through the worst, that's the most important thing.

This could have been avoided.

Well, the way you handled Adam wasn't exactly...

I didn't have all the facts!

The patient said he told you his heart was evil, a murderer's heart.

If I'd known that, I would have handled him differently.

Why would you keep that from me?

Fine, I'll go to Mr Hanssen, see if he can get to the bottom of this.

Wait. Please.

Things are quite difficult for Dr Valentine at the moment.

He's having to deal with very complex issues.

I am trying to handle him as sensitively as possible.

I ask you, purely looking out for Dr Valentine's best interests,

not to report this to Mr Hanssen.

People lives are at stake, Professor Hope.

You changed Marc Greene's procedure?

Yeah, you got a problem with that?

The patient did.

He was on his way out of here until Mr Malick managed to talk him down.

Who's this guy?

I'm Dr Copeland. I'm a new F1.

Look, why would anyone have a problem with laparoscopic procedure

as opposed to open surgery?

The recovery time's way quicker, I thought he'd be happy about it.

Mr Griffin and the patient made a surgery plan and you changed it.

It's the first I've heard of it.

Welcome back, Mr Ferry.

The procedure went well.

There was a slight complication with the reconstruction,

but you should be back on your feet in no time.

Thank you for going the extra mile.

It just goes to show...

All the newspapers, saying things are going downhill...

Not everything is.

Happy to help. You'll soon be back at work.

What little there is.

No use for me any more. Watch maker.

I specialise in pocket watches.

Everyone seems to tell the time from their mobile phones these days.

I still use a wristwatch.

That's a nice piece.

Yeah.

It's not without its problems.

KNOCK AT DOOR

Sorry to interrupt.

You need me?

Mrs Wainwright's chest drain?

I'll be through shortly.

We kind of need you now.

I'll be with you as soon as I've finished with Mr Ferry, thank you.

Hi.

You fixed it?

We had to.

You know I'll do it again.

I'll keep on going until I get it out.

Adam.

I can't tell you anything about the donor, it's against the law.

But I can tell you there's no history of violence in the notes.

You have to believe me.

What is important is the donor carried a card,

and all of their organs were donated.

Your heart's a gift.

You have to respect that gift and live a life.

You trusted me before, Adam. I'm asking you to trust me now.

This is the truth.

Nurse Carter, you needed me?

Not any more. Thank you, Mr Griffin.

Serena.

You were with a patient.

The laparotomy and vascular reconstruction patient.

I saw the theatre list.

Mr Ferry was booked in for a vascular reconstruction

which had been cancelled twice,

so I took the opportunity to do it while I had him in theatre.

A vascular reconstruction is not an AAU procedure.

I thought it made sense to do it, while he was here.

Surely you heard me yesterday

when I said you were to do AAU procedures only?

You, of all people, should be happy

to have the pressure taken off Keller's lists.

Oh, come on, Ric.

You and I both know that AAU should be just for emergencies, OK?

KNOCK AT DOOR

Come in.

Apologies, I was with a patient.

As I said, there was a combination of many factors.

Such as?

The instability of the patient's mental health, violent tendencies.

We had very little information.

So the patient volunteered nothing?

No. We had no way of knowing how volatile he could be.

I shouldn't imagine a full inquiry would be necessary?

Well, I have to assess if there is sufficient grounds

for such an investigation,

and I would be negligent in my duties if I failed to do so.

Is there anything you'd like to add?

So our guy doesn't like the idea of laparoscopic surgery,

he prefers to opt for open surgery instead, which is pretty strange.

But what is stranger than that is that you didn't tell me.

Too busy spitting out your dummy to talk?

It wasn't a choice, I just...

Forgot?

In the heat of the moment, yeah.

I'm sorry.

Well, maybe you should concentrate more on your patients

and less on your ambition.

Vital information was withheld from me.

That information would have had a direct bearing

on the way I approached the patient.

Nonetheless, I think your approach left a lot to be desired.

And you are qualified to assess my skills based on what, exactly?

You provoked the patient into becoming more agitated.

And, like I've said already said,

had I been made aware of the full facts,

I would have handled him differently.

Dr Kozinsky, what was the information and who withheld it?

Certain staff were aware of the patient's belief

that his heart was making him act violently.

Don't be coy, Dr Kozinsky. I need to know who, please.

I believe the patient confided in Dr Valentine in the first instance.

In the first instance?

I imagine he thinks he is acting in Dr Valentine's best interests,

but I think you need to speak to Professor Hope.

I have concerns that their personal relationship is compromising his

otherwise excellent judgement.

B/P's dropping.

Bleed in there somewhere.

There seems to be a lot of blood in the peritoneal cavity.

Yeah. More suction.

We need to open him up.

I really don't want to put him through

any more unnecessary suffering.

Can't locate the source of the bleed.

All right, knife, please.

It's got to be round here somewhere.

There's a lot of blood in here.

B/P's falling!

The port has injured the abdominal wall.

It's pierced the inferior epigastric artery.

The incision's too small.

Stick with it, you're almost there.

Yep, OK. Retractor, Malick.

There, got it! 2-0 vicryl.

That's beautiful. Sorry, if you don't mind me saying so.

No, I don't mind at all.

More suction.

B/P's stabilising.

Good work, Mr Spence.

Mr Griffin.

Professor Hope.

Mind if I join you?

Please do.

Tough day?

Oh, you know.

You?

Same.

Can't see anything. Light pollution.

You have to go right out into the middle of nowhere

to really see the night sky.

It doesn't seem all that long ago that you could catch

a pepper of stars out here.

Not any more.

Just aeroplanes speeding above us now.

It's progress, Elliot.

You can't get left behind.

According to certain people, I'm in danger of becoming outdated.

I have to update my emergency skills.

Is this your move to AAU?

Apparently, it's a young man's game.

Nonsense.

In a sky full of aeroplanes, there are still stars up there.

Over here, quickly, she's collapsed!

Can you get some help?

SHE GROANS

So, you live to fight another day, Mr Greene.

Yeah, thanks to a little light pruning.

Now, there's plenty of time to fill in the rest of the boxes.

It's not about completing it.

It's about learning, the process of discovery.

Why would I want to rush that?

If you'll excuse us.

Thank you so much for today, Mr Malick.

I was wondering if I could bring in my own thesis on Crohn's

for you to look at?

Also, I noticed you've got a cholecystectomy booked in

for tomorrow morning I would love to assist you on.

-I've just got such little time...

-Whoa, slow down.

You heard the man. There's no rush, all right?

I know, I know.

I just think there's so much I can learn from you.

PAGER BEEPS

See you.

It's OK, Sally.

One of her pupils is blown.

I think we're looking at a subdural haematoma.

We can't be sure until we have a CT.

I've paged neurosurgery. But they're backed up in emergency cases, too.

I've also paged St James's, but they won't be here for 20 minutes.

She hasn't got 20 minutes.

I think you've done pretty well, considering.

You reckon?

You're still here, aren't you?

Aye.

Just about.

Now, you've got to keep working, Adam.

You need to get some support, not just family and friends,

but professional support, as well.

OK.

Looks like you've got another visitor.

I love the attention.

See you soon.

Hi, Oliver. The session that you missed this morning?

I've rearranged it for after your shift.

Mr Hanssen requires that I report on your attendance.

Like at school.

Or at work if it's a condition of your ongoing employment.

I will call him if I have to.

You won't get any special dispensation from me.

I'm not your Professor friend, OK?

You all right?

Don't let her give you a hard time. You stood by me, you were solid.

I don't know if anyone's told you how long you'll be here.

A couple of days, they reckon, then down to a ward.

Back home before I know it.

And I think, as much as it pains me in one way,

I need to go home, proper, like.

Back to Scotland.

You won't be by yourself.

No. I got my pals and my family.

Your brother?

Aye.

Give him a ring, will you?

I know you want to.

Craniotome, please.

'Ric. Is this advisable?'

By the time neurosurgery get here, she could be dead.

I think that constitutes an emergency, don't you?

You drip saline while I drill.

Suction.

She had a large bleed inside her skull

which has compressed the brain,

making it look like she was inebriated

when she hadn't drunk that much.

OK, I'm going to need a rongeur.

Everything pointed to her being drunk, she has history.

She said she hadn't drunk that much,

not enough to put her in the state she was in.

I should've listened to her.

Vital signs are improving.

Warm saline wash-out.

Makes a change from your usual day on Keller.

Just a little.

Well, thank you. I'm really pleased I was here.

Nurse Carter.

Mr Griffin.

I just wanted to say congratulations on your appointment.

Thank you.

That was quite something.

Was that a compliment?

Well, shows you're not beyond the excitement of emergency medicine.

Not bad for a dinosaur, eh?

Look, I know that the Medical Staff Committee,

may want me to jump through a few hoops...

No time like the present.

Yes, so I may as well get it over and done with.

You'll update?

Yes. I'll find a course at a different hospital.

That might prove a bit embarrassing for us, as a teaching hospital,

to be seen sending one of our consultants elsewhere.

So what do you suggest?

Well, you could always update here...

under my supervision?

-Under your supervision?

-Yeah.

Fine. I'm sure it won't be too taxing.

Well, don't worry.

Discretion is my middle name.

Oh, I meant to ask, how's the back?

It's strangely better.

It was a sporting injury. Athletic, not arthritic.

Thank you so much, Mr Malick, it's been amazing.

A good first day, then?

The best! It's been epic.

Same time tomorrow?

You bet!

Hey. I'm so sorry for running a little late,

I've just had a bit of a day of it, you know how it is.

Yeah.

Want to get a drink?

We're going to see my mother.

I know, I just meant a drink first, a quick break from the heavy stuff?

You know what, you go for a drink and I'll go and see my mother.

Wait!

Nathan!

Leave it! Just leave it, yeah?

Hey.

I was thinking about everyone chipping in to help with Adam,

and I think it'd be best if everyone left Oliver to me.

By everyone, I take it you mean me?

I don't want any waters muddying.

I disagree.

Course you do, you're a nice guy.

But you can't keep him in bubble wrap his entire life, you know.

It's not as simple as that.

Death of your partner isn't something that can be just worked through.

When did you lose your wife?

Who told you that?

You did.

Just now.

Then you know what it's like.

Sometimes you don't want to talk to the person right in front of you.

Do you?

Friends can't say it as it is. They dress it up.

Caring, loving, protecting.

Sometimes a little bit of straight talking

is really what's needed to speed things along.

I may not a psychiatrist...

I may not be able to help him,

but I know Oliver,

and I am absolutely certain that your approach

is the last thing that he needs right now.

Hello, Sally.

Somebody will be here soon to take you to the neurosurgery ward.

I shouldn't have discharged you earlier,

I should have listened to you.

And I'm sorry I shouted at you.

It's all right, darling.

You said that you were trying to stop drinking.

I know it can be difficult to do alone, so I hope you don't mind,

I've made an appointment for you with our alcohol dependency unit.

If I stop drinking, I won't have any vices left.

All right if I start smoking?

I wouldn't recommend it.

I imagine you were quite the dancer.

Back in the day.

Fonteyn was sick, and I had to go on for her.

When Nureyev lifted me in his arms, I touched heaven.

I doubt they'd let just anyone understudy Margot Fonteyn.

I wasn't just anyone.

I know.

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