0:00:39 > 0:00:43Certain senior consultants have been invited to
0:00:43 > 0:00:45interview for the post of Acting CEO.
0:00:45 > 0:00:47I need to keep my personal life separate form work.
0:00:47 > 0:00:49You're dumping me?
0:00:49 > 0:00:51- Stay.- No, I will hurt you.
0:00:51 > 0:00:52Er, who are you?
0:00:52 > 0:00:56Lilah Birdwood, your new CT1. Nurse, could you get me scrubs?
0:00:58 > 0:01:00Lilah, how does Monday sound to you?
0:01:00 > 0:01:05- Monday? - To start working with me on Keller?
0:01:05 > 0:01:07External Acting CEO, I mean really?
0:01:07 > 0:01:11Letting us make fools of ourselves like that, I'm spiting feathers.
0:01:11 > 0:01:13Have you got any idea who they appointed?
0:01:15 > 0:01:19A real dragon, stickler for the rules, loves power,
0:01:19 > 0:01:20lacks insights.
0:01:20 > 0:01:24- What else you heard? - Take a guess.
0:01:24 > 0:01:27- Used to be a nurse.- Bingo.
0:01:27 > 0:01:28Well, look at it this way -
0:01:28 > 0:01:31we loose a brilliant clinician and surgeon and gain a nurse manager.
0:01:31 > 0:01:35- Just what we need. - Abso-freaking-lutely.
0:01:35 > 0:01:36So when's the grand unveiling?
0:01:36 > 0:01:39Oh, I imagine I'll get an e-mail any second now.
0:01:39 > 0:01:42Whoever it is better not try to tell me how to run my ward.
0:01:42 > 0:01:44Hail Caesar.
0:01:46 > 0:01:49I'm not having some jumped up nurse manager trying to
0:01:49 > 0:01:51stick their nose into...
0:01:51 > 0:01:53Look at this backlog.
0:01:53 > 0:01:56Ahh. I take it we've got Dr Birdwood.
0:01:56 > 0:01:59Ah, yes, she's joining us. I should have mentioned it earlier.
0:01:59 > 0:02:03- Morning.- But anyway we need all the help we can get.
0:02:03 > 0:02:06Two emergency laparotomies. Going to have to cancel half the rota.
0:02:06 > 0:02:11GI bleed from an endoscopy to theatre, two enhanced HDU patients.
0:02:11 > 0:02:14I'm dealing with the bleed and HDU patients.
0:02:14 > 0:02:17He's being transferred and the coagulation is under control.
0:02:17 > 0:02:18So you can crack on in theatre.
0:02:18 > 0:02:22Sorry, we're chocka. Can't fit anyone in, OK?
0:02:22 > 0:02:24- Sorry.- No rush.
0:02:24 > 0:02:26Sent your lecture to the medical students,
0:02:26 > 0:02:29contacted Plastics for tissue viability for Mrs Gregg
0:02:29 > 0:02:32and submitted your list for tomorrow.
0:02:32 > 0:02:35So what time did you get in this morning?
0:02:36 > 0:02:40So, the rounds. Small cases first and major second?
0:02:40 > 0:02:43Finally. Madhouse. How can I help?
0:02:43 > 0:02:46Actually, I'm just waiting to talk to Mr Griffin.
0:02:46 > 0:02:47I just didn't want to disturb.
0:02:47 > 0:02:50It so great to finally meet you.
0:02:50 > 0:02:52Imelda Cousins. Acting CEO.
0:02:55 > 0:02:58I was just thinking I might tag along for the rounds.
0:02:58 > 0:02:59You don't mind, do you?
0:03:00 > 0:03:02Oh, this is too good. OK.
0:03:02 > 0:03:04Head Of Nursing at Royal Chiswick,
0:03:04 > 0:03:08Consultant Nurse For Special Projects at Nottingham City Council.
0:03:08 > 0:03:10I've certainly never come across her.
0:03:10 > 0:03:12What hole did they drag her out of?
0:03:12 > 0:03:18Oh, I know, a nurse. The lowest form of human existence.
0:03:18 > 0:03:19Joking. I know you love us really.
0:03:21 > 0:03:25Anyways, whilst I've got you both together we have an urgent referral.
0:03:25 > 0:03:29Billy Lovell, 16, congenital transposition of the great arteries.
0:03:29 > 0:03:34Had a Baffle Procedure at two months and has been in and out of Paeds ever since
0:03:34 > 0:03:37but now that he's come of age we've inherited him.
0:03:37 > 0:03:39Count me out. I'm in theatre all day.
0:03:39 > 0:03:40All yours.
0:03:41 > 0:03:44Professor Hope, Mrs Gemmel's been prepped.
0:03:44 > 0:03:46- Ah, thank you. - Is tonight's still on?
0:03:46 > 0:03:48Oh, yeah, baby.
0:03:48 > 0:03:51- You do know half the hospital's coming, right?- Don't look at me.
0:03:51 > 0:03:55I mentioned it to, like, three people and the whole thing just suddenly got out of hand.
0:03:55 > 0:03:58What's that? The Annual Freemason Society Assembly?
0:03:58 > 0:04:00No. My birthday.
0:04:02 > 0:04:04- It's just drinks. You're welcome to join us.- I can't. I've got plans.
0:04:04 > 0:04:09- So has our great leader made an appearance yet?- Nope.
0:04:09 > 0:04:11Been a while since I've been told what to do
0:04:11 > 0:04:13by some anal control freak who knows nothing about my job.
0:04:13 > 0:04:16Really? I'm quite used to it.
0:04:16 > 0:04:18Whoa, what's the matter with you today?
0:04:18 > 0:04:20You lost your sense of humour?
0:04:20 > 0:04:22Oh, yeah...the kid.
0:04:22 > 0:04:26He has Asperger's. Quite high up on the scale. Thought you'd want to know.
0:04:26 > 0:04:28Cheer up, mate.
0:04:30 > 0:04:31Knock-knock.
0:04:35 > 0:04:39Day 201 of my captivity. Daylight is but a long forgotten dream.
0:04:39 > 0:04:42Food is scarce so I eat my shoes.
0:04:45 > 0:04:46So, breaking news.
0:04:46 > 0:04:49There's a new girl in town. I've heard.
0:04:49 > 0:04:51So you planning on emerging at some point?
0:04:53 > 0:04:54What?
0:04:54 > 0:04:55No, I've got too much to do.
0:04:55 > 0:04:59A conference call from Brussels coming in about the funding application.
0:04:59 > 0:05:01Look, she's sending me e-mails already.
0:05:01 > 0:05:04Maybe it's time for a break, you know, I mean,
0:05:04 > 0:05:07- you've been cooped up in here ever since Eddi... - Is this some kind of joke?
0:05:07 > 0:05:10"As fascinating as the research deems itself to be,
0:05:10 > 0:05:13"extensive efforts have yet to yield any results.
0:05:13 > 0:05:17"I'm sure you'll appreciate in the current economic climate
0:05:17 > 0:05:21"we have to tighten budgets... blah-blah-blah-blah.
0:05:21 > 0:05:25"current state of finances." Right, she wants to park it.
0:05:25 > 0:05:28And she tells me in an e-mail. Over my dead body.
0:05:28 > 0:05:30You've forgotten your...
0:05:30 > 0:05:33Mrs Endokuwe is fully prepped and all bloods are back.
0:05:33 > 0:05:35She had a mild heart murmur on examination
0:05:35 > 0:05:37but I've discussed this with the cardiologists who feel
0:05:37 > 0:05:40it's not of any significance, and are happy to go ahead.
0:05:40 > 0:05:43Excellent. Well, we'll see you in theatre.
0:05:44 > 0:05:46So, thank you, Dr Birdwood, what's next?
0:05:48 > 0:05:51Sorry, Mr Griffin, I know we're up to our ears.
0:05:51 > 0:05:53but the ED really think you should take a look at this.
0:05:53 > 0:05:56Gabriel Vaughan. 42. Collapsed at a train station.
0:05:56 > 0:05:59Mr Vaughan, you had a fall?
0:05:59 > 0:06:00Stumble, really.
0:06:00 > 0:06:03It looks like you've been unwell for some time. Abdominal pain,
0:06:03 > 0:06:07- weakness, fatigue, dizziness. - The GP said it's just a virus.
0:06:07 > 0:06:10If you're taking Mr Enright in right away, we've a spare bed.
0:06:10 > 0:06:15- Go.- Do you want me to take this?
0:06:18 > 0:06:20I'm quite awed.
0:06:20 > 0:06:22Well, I think you can see what we're up against.
0:06:22 > 0:06:24But, er, we have a great team.
0:06:24 > 0:06:26And now that we have Dr Birdwood with us.
0:06:26 > 0:06:29Er...yes. I was hoping to have a quick chat about that.
0:06:31 > 0:06:36- Square root of X plus PX plus Q. - I don't know, yesterday he suddenly got much worse.
0:06:36 > 0:06:38Billy, can you stop a minute, please?
0:06:38 > 0:06:40So, Leyton Orient fan, are we?
0:06:40 > 0:06:43When one wears a strip one is usually a fan, yes.
0:06:43 > 0:06:46Hey, be nice. Is Professor Gleeson coming?
0:06:46 > 0:06:48- Why would he be?- Well, he's the one we've always seen,
0:06:48 > 0:06:50he did the Baffle on Billy when he was a baby.
0:06:50 > 0:06:53This isn't Paediatrics. I'm afraid we'll have to do.
0:06:53 > 0:06:56Shhh! Can you be quiet?
0:06:56 > 0:07:00- Quadratic equations. Billy's a... - A maths prodigy.
0:07:00 > 0:07:03And I'll go to Oxford next year.
0:07:03 > 0:07:07If I can get this supporting materials in on time.
0:07:07 > 0:07:10Well, good for you. I'll just have a little listen.
0:07:10 > 0:07:14Excuse me. Have I not been clear? Or are you hard of hearing?
0:07:14 > 0:07:15Billy !
0:07:15 > 0:07:19Right. Let's get some fresh bloods and book an echo and an MRI.
0:07:19 > 0:07:23When he's ready to co-operate talk to the nurse.
0:07:23 > 0:07:27Excuse me. Ms Naylor, did you say your name was?
0:07:27 > 0:07:30Could I just have a word with you two?
0:07:30 > 0:07:34I don't understand. Has someone complained?
0:07:34 > 0:07:36Look, I'm not quite sure how this move came about.
0:07:36 > 0:07:39No doubt it was done with the best of intentions
0:07:39 > 0:07:42but Dr Birdwood's placement was supposed to be on AAU.
0:07:42 > 0:07:43What does it matter?
0:07:43 > 0:07:46You can see, we're buckling under, she's obviously thriving.
0:07:46 > 0:07:48I'm not quite sure THEY see it that way.
0:07:48 > 0:07:52- Mr Malick, you're clinical skills tutor, you know what I mean, don't you?- Well, I um...
0:07:52 > 0:07:54So someone has complained. Ms Campbell.
0:07:54 > 0:07:57I really don't want to get into that. In all honesty,
0:07:57 > 0:07:59I do think there's a point to be made.
0:07:59 > 0:08:01There's a way of doing things and this isn't quite it.
0:08:01 > 0:08:05So what are you saying, that she has to go back?
0:08:05 > 0:08:06It's frustrating, I know.
0:08:06 > 0:08:08But let's just start as we mean to go on, eh?
0:08:08 > 0:08:11Ms Cousins? Sorry to interrupt. I'm Mr Hemingway. Can I have a word, please?
0:08:11 > 0:08:14Mr Hemingway! It's so good to finally meet you. Excuse me.
0:08:16 > 0:08:18Are you going to tell her?
0:08:24 > 0:08:28The thing is, he's been under a lot of pressure recently.
0:08:28 > 0:08:31- Self induced. - That's neither here nor there.
0:08:31 > 0:08:35Actually, it is. You're treating him so you should know.
0:08:35 > 0:08:36This Oxford thing.
0:08:36 > 0:08:42He's got it into his head he's going and it's gone way out of control.
0:08:42 > 0:08:44He keeps going on and on about it in a loop.
0:08:44 > 0:08:48Ever since he's done the aptitude tests, it's...
0:08:48 > 0:08:50it's making him so anxious,
0:08:50 > 0:08:53God knows the last time he had a full night's sleep.
0:08:53 > 0:08:56- Must be fun and games for you. - It's party central.
0:08:56 > 0:09:01When he gets anxious, you get the vile brat act
0:09:01 > 0:09:06but, really, he's a lovely boy. He couldn't do enough for you.
0:09:06 > 0:09:10Hey, you should meet some of the other people we have to deal with around here.
0:09:10 > 0:09:12Well, now we know. Thank you. Get the bloods going.
0:09:12 > 0:09:13Excuse me one second.
0:09:15 > 0:09:19So, is there any particular reason why you've just been so lovely to this woman(?)
0:09:19 > 0:09:20Excuse me?
0:09:20 > 0:09:25Or is it the whole CEO thing that's derailed you. I mean, come on. You expected an interview, didn't you?
0:09:25 > 0:09:30- Wow, Jonny that is some dazzling insight. You really read me like a book.- Whatever.
0:09:30 > 0:09:33Look, just because he's a genius, it doesn't mean he can behave like that.
0:09:33 > 0:09:36Pot, kettle - you join the dots.
0:09:36 > 0:09:39Tell you what, why don't you give your wit a rest
0:09:39 > 0:09:41and get on with what you SHOULD be good at?
0:09:41 > 0:09:45Hey, hey. Don't talk to me like that.
0:09:45 > 0:09:48Just to remind you. I don't sleep with you anymore,
0:09:48 > 0:09:51so I don't have to take any more of your crap.
0:09:51 > 0:09:53And nor should anyone else.
0:09:56 > 0:09:59But if we get the Brussels Foundation on board
0:09:59 > 0:10:01we could be looking at a £100,000 grant.
0:10:01 > 0:10:03Golly. That would be marvellous.
0:10:03 > 0:10:05Exactly. So that why it's a little ridiculous to suspend...
0:10:05 > 0:10:09It's frustrating, I know, but so far, correct me if I'm wrong,
0:10:09 > 0:10:11it seems there's no sign of, well, results.
0:10:11 > 0:10:14- Of course not. Research takes years. - And no volunteers.
0:10:14 > 0:10:17- We're a little short.- Which is crucial. No volunteers, no results.
0:10:17 > 0:10:19- But I think you're missing the point.- Maybe.
0:10:19 > 0:10:21But I'm afraid the board expects these boxes to be ticked.
0:10:21 > 0:10:24The board will have to be reminded that I'm a fellow
0:10:24 > 0:10:26and, as such, my contract clearly states that I must be allowed
0:10:26 > 0:10:30- to complete my research otherwise I am under no obligation... - I'm afraid the board will point out,
0:10:30 > 0:10:36not without reason, that your contract also states that you must work on the wards.
0:10:36 > 0:10:39And, if truth were told, you are currently in breach of this.
0:10:39 > 0:10:44- I don't think...- So unless you can produce evidence of a significant step forward,
0:10:44 > 0:10:47you'll just have to muck in like everyone else.
0:10:51 > 0:10:55This won't take long. We've got our daughter's birthday tomorrow
0:10:55 > 0:10:57and she's waiting for us at my sister's.
0:10:57 > 0:10:59Naomi. Her name's Naomi.
0:10:59 > 0:11:02- Oh? How old is she?- She's, er... - She's ten.
0:11:05 > 0:11:09That's tender, right?
0:11:09 > 0:11:10I'd like to run some more tests.
0:11:10 > 0:11:15- What tests? - Bloods, ECG, chest and abdo x-ray... - Hang on. Why so many?
0:11:15 > 0:11:20I suspect the reason that you've been unwell for a while
0:11:20 > 0:11:23is that you may have a blockage to one of your arteries.
0:11:23 > 0:11:25- I need the toilet. - Just, in a minute, darling...
0:11:25 > 0:11:27- I need the toilet now.- OK.
0:11:27 > 0:11:29It's just through the double doors and...
0:11:29 > 0:11:31OK, how about I get a nurse to take you?
0:11:31 > 0:11:35Nurse Lane? Could you take, Mrs Vaughan to the toilets? And back?
0:11:35 > 0:11:38- I'm... I'm OK, I can... - Of course, just this way.
0:11:41 > 0:11:45I don't mean to pry but... your wife. Is she...?
0:11:45 > 0:11:47She's got early dementia.
0:11:49 > 0:11:54- BREATHING HEAVILY:- Simultaneous movement as centre back moves forward
0:11:54 > 0:11:56and reaches position in a 4-4-2 permutation.
0:11:56 > 0:12:00Hi breathing's laboured. Er, Ms Naylor?
0:12:00 > 0:12:02Billy? I'm sorry.
0:12:02 > 0:12:04This is the only thing that helps him wind down.
0:12:04 > 0:12:07Billy, don't make me take it off you. Cue World War III.
0:12:07 > 0:12:11- His legs are swelling up. - I am going to complete this half,
0:12:11 > 0:12:13so you're going to have to wait until half-time.
0:12:13 > 0:12:18- I really need to examine him, so... - Yes, I know that. I am trying.
0:12:18 > 0:12:21Right. Sorry about this.
0:12:21 > 0:12:23You want this back?
0:12:25 > 0:12:28You need to understand this - you are not well.
0:12:28 > 0:12:33Forget Oxford. You won't make it round the corner if you don't let us do our jobs.
0:12:33 > 0:12:34Thank you.
0:12:40 > 0:12:43Yeah. There's a strong crackle. I think he's developed an SVT.
0:12:43 > 0:12:46Let's have a loading dose of Amiodarone.
0:12:46 > 0:12:50Skip the echo, let's go straight for an MRI. Can you call them, please?
0:12:50 > 0:12:51Sure.
0:12:55 > 0:12:57They took five years to diagnose her?
0:12:57 > 0:12:59I had to make myself a total pain.
0:12:59 > 0:13:01She was shunted from one consultant to another.
0:13:01 > 0:13:05They mooted a nervous breakdown because of marital difficulties.
0:13:05 > 0:13:07Ludicrous.
0:13:07 > 0:13:09A pianist doesn't forget how to play the piano
0:13:09 > 0:13:11because of marital difficulties.
0:13:11 > 0:13:15- She's a pianist...? Is that...? - Muscle memory.
0:13:15 > 0:13:18I kept saying to them. I know her. We spend all our time together,
0:13:18 > 0:13:21we play together, we perform together.
0:13:23 > 0:13:26Must be hard... With a little girl.
0:13:26 > 0:13:29No, she keeps us going. We can't miss tomorrow.
0:13:30 > 0:13:33I understand. But if we don't deal with this now,
0:13:33 > 0:13:37your daughter will remember this birthday for all the wrong reasons.
0:13:38 > 0:13:39I...
0:13:39 > 0:13:43Look. No offence but you're not going to disappear
0:13:43 > 0:13:47- and leave your junior doctor here to chase after you.- Absolutely not.
0:13:47 > 0:13:51Mr Griffin is only a corridor away and I'll keep him in the loop at all times.
0:13:58 > 0:13:59Got that MRI slot.
0:13:59 > 0:14:01Great.
0:14:01 > 0:14:04That was good back there. The way you handled him.
0:14:04 > 0:14:09Wow! Good, thank you, please. Careful, you almost sound nice.
0:14:09 > 0:14:11Oh yeah, I better watch it.
0:14:11 > 0:14:13Don't worry I won't tell anyone.
0:14:16 > 0:14:18Anyway, don't want to miss that slot.
0:14:18 > 0:14:20Hold on. I'm, er, going to come with you.
0:14:20 > 0:14:23Really? Don't have to.
0:14:23 > 0:14:25And wait for them to e-mail the result?
0:14:25 > 0:14:29We'll be here all year. Could just analyse on the spot.
0:14:29 > 0:14:30Sure.
0:14:34 > 0:14:35Mr Griffin?
0:14:36 > 0:14:39See, I was thinking we could go for an immediate blood gas,
0:14:39 > 0:14:42check the pulses in his legs, that would give us a clearer picture sooner.
0:14:42 > 0:14:45- Great. Go for it. - Er, really?
0:14:47 > 0:14:49- Is there a problem? - No. There's no problem.
0:14:49 > 0:14:53I've ruffled some feathers when I moved you up here, that's all.
0:14:53 > 0:14:56Nothing for you to worry about. Or you for that matter.
0:14:56 > 0:15:00I run this ward and I know what I'm doing. Putting patients first.
0:15:00 > 0:15:01So carry on with what you're doing.
0:15:01 > 0:15:03Think of it as an executive decision.
0:15:05 > 0:15:06Any problems, you know where I am.
0:15:09 > 0:15:12Come on, come on. Some of us are on a tight schedule.
0:15:12 > 0:15:15If she got a move on, I could still make this call.
0:15:15 > 0:15:19Ah. Count Luc. Daylight hasn't extinguished you yet.
0:15:19 > 0:15:22Maybe a nurse is exactly what this place needs.
0:15:22 > 0:15:23Absolutely.
0:15:28 > 0:15:30Yeah, all right, let's get this over with.
0:15:30 > 0:15:34Evalyn Slate. Transferred from radiology outpatients.
0:15:34 > 0:15:37Hello, right, so you're suffering from recurring ulcers.
0:15:37 > 0:15:41Oh, they're troublesome things. I don't drink, I don't smoke,
0:15:41 > 0:15:43I never have coffee, I'm a strict vegan.
0:15:43 > 0:15:46Fresh set of bloods, cross match and save and set up some fluids.
0:15:46 > 0:15:50- And we'll get on with the gastroscopy.- Well, how long will I be here?- Er, well...
0:15:50 > 0:15:52It's just, the... The cats will need to be fed.
0:15:52 > 0:15:58Right. Elsie's away, Mary's got the grand-kids.
0:15:58 > 0:16:03- I'll leave you with that, shall I? - Oh, it's not that simple, you see there are 21 of them.
0:16:03 > 0:16:06- 21?- Well, they can feed on each other then, can't they?
0:16:10 > 0:16:14No, Claire, don't. Don't tell her anything yet.
0:16:14 > 0:16:19Invent something. Look, I've got to go. Yes, yes, as soon as I know.
0:16:21 > 0:16:25No point...until we know.
0:16:25 > 0:16:27'Course.
0:16:27 > 0:16:29Is that for Naomi?
0:16:29 > 0:16:33Yes, a new one. She takes after me.
0:16:33 > 0:16:34I give her lessons when I can.
0:16:34 > 0:16:36You still perform?
0:16:36 > 0:16:37Oh, no. I give that up ages ago.
0:16:39 > 0:16:43It wouldn't really work with anyone else. Us two click.
0:16:45 > 0:16:47Not enough hours in the day anyway.
0:16:48 > 0:16:51- You sole carer then? - Of course. I want to be.
0:16:51 > 0:16:53And it is cheaper.
0:16:53 > 0:16:59OK. Sharp scratch coming.
0:16:59 > 0:17:03Sorry, sorry. Sorry, that radial artery can be a slippery little bugger.
0:17:03 > 0:17:06OK, let's have a look. Nah, you haven't got it.
0:17:06 > 0:17:09Let me see.
0:17:13 > 0:17:15And here we go.
0:17:18 > 0:17:20Easy peasey.
0:17:21 > 0:17:23Cheers.
0:17:23 > 0:17:27Stickybeak. I'll get the lab to fast track these.
0:17:32 > 0:17:35An MRI machine is known as the doughnut of death.
0:17:35 > 0:17:38I had 40 of these in the last 16 years.
0:17:38 > 0:17:41I don't mind them one bit apart from the fact I detest the noise.
0:17:41 > 0:17:44Right, I'll go through.
0:17:44 > 0:17:45I've got you.
0:17:45 > 0:17:47Well done. Well done.
0:17:48 > 0:17:50That's it.
0:17:59 > 0:18:02And the ball goes to Carrol...
0:18:04 > 0:18:06And the ball goes to Carrol...
0:18:06 > 0:18:07Jonathan Tehoue.
0:18:07 > 0:18:11Hmmm...heart's dilated. A lot of fluid on his chest.
0:18:11 > 0:18:14I think this is becoming acute heart failure.
0:18:14 > 0:18:17And it's Jonathan Tehoue! And the equaliser for Leyton Orient!
0:18:17 > 0:18:21Not looking too bad. Should be able to just keep the fluids going.
0:18:23 > 0:18:26Brussels rescheduled the call so I should be fine.
0:18:26 > 0:18:28Oh, good.
0:18:28 > 0:18:30Wait a minute. What have we got here?
0:18:30 > 0:18:32What is that? A lesion?
0:18:33 > 0:18:36Angiodysplasia.
0:18:36 > 0:18:41That, my friend, is what we call a breakthrough moment.
0:18:45 > 0:18:47I might just e-mail Imelda Marcos right now.
0:18:47 > 0:18:51- What's the jubilation for? - Angiodysplasia of the greater curve.
0:18:51 > 0:18:54The stomach does not stop bleeding, because of the thin blood vessels.
0:18:54 > 0:18:57So she's a perfect candidate for his trial.
0:18:57 > 0:18:59Exactly. The Belgians will wet themselves with excitement.
0:18:59 > 0:19:03- You might show her more interest then.- What? - A little of charm wouldn't go amiss
0:19:03 > 0:19:07cos right now she's more likely to run a mile than have anything to do with you.
0:19:11 > 0:19:13So she struggled with the arterial bloods.
0:19:13 > 0:19:15- That can happen to the best of us. - Absolutely.
0:19:15 > 0:19:19But I'm just concerned she doesn't put herself under pressure to run before she can walk.
0:19:19 > 0:19:22Mr Griffin, I was just about to call you.
0:19:24 > 0:19:25What we got?
0:19:25 > 0:19:27An absence of femoral pulses.
0:19:28 > 0:19:32Together with the atrial fibrillations, the sats and BP,
0:19:32 > 0:19:34I'd say Aortic saddle embolus.
0:19:36 > 0:19:38Just tell me.
0:19:40 > 0:19:43I'm afraid that we're going to have to take you into theatre.
0:19:43 > 0:19:46- An operation?- Yes.
0:19:46 > 0:19:47- When?- Well...
0:19:47 > 0:19:51I can't fit you in now right but hopefully later today.
0:19:51 > 0:19:54- I... I can't get this round. - I'll help you in a minute, darling.
0:19:54 > 0:19:58Isn't there anything else you can do?
0:19:58 > 0:20:01I really think that we need to put your welfare first.
0:20:01 > 0:20:02We could try for an angioplasty.
0:20:02 > 0:20:06Blast the clot with a guide wire. Now.
0:20:06 > 0:20:08I can do it. I've done it before.
0:20:08 > 0:20:11Would you just excuse us for a moment, please?
0:20:11 > 0:20:15Look, I appreciate you trying to push the boat out for them.
0:20:15 > 0:20:19I'm sorry if I got carried away but we could at least give it a go.
0:20:19 > 0:20:22- Theatre is groaning. This would work for everyone. - PAGER BEEPS
0:20:22 > 0:20:25All right, check his clotting, speak to Radiology.
0:20:25 > 0:20:27And, erm, keep an eye on the wife.
0:20:27 > 0:20:32- I know he's keen to play it down but...- Yeah, absolutely.
0:20:32 > 0:20:35Mr Griffin? You trust her with all this?
0:20:35 > 0:20:39She's put up a very good argument. Plus you need to give people room to grow.
0:20:39 > 0:20:43- You should know that better than anyone.- Exactly. I know what it's like trying to impress a consultant.
0:20:43 > 0:20:46I think I'm old enough and ugly enough to see past that.
0:20:46 > 0:20:49With all due respect, are you sure this has nothing to do
0:20:49 > 0:20:51with trying to prove a point to the new CEO?
0:20:53 > 0:20:56So... fancy your chances of relegation?
0:20:56 > 0:20:59We were outstanding mid season.
0:20:59 > 0:21:01Three points in the first ten games stuck us bottom
0:21:01 > 0:21:06and the play-offs became a mere fantasy when we came crashing with 12 points in the last 17 games.
0:21:06 > 0:21:09And then if it weren't for Wycombe running out of steam,
0:21:09 > 0:21:11- we'd have been relegated immediately.- Wowza.
0:21:11 > 0:21:16- You really know your stuff. - I do. Shame I can't play.
0:21:16 > 0:21:19Well, at least you can always get off to see a game.
0:21:19 > 0:21:20I've never been.
0:21:20 > 0:21:24But that will all change when I'm going to Oxford.
0:21:24 > 0:21:27I'm going to get a student loan and live on my own
0:21:27 > 0:21:28and buy my own tickets
0:21:28 > 0:21:31and study all night if I want to and Mum can't stop me.
0:21:33 > 0:21:35- But don't tell her. - Mum's the word.
0:21:35 > 0:21:38She thinks I can't make it on my own.
0:21:38 > 0:21:40I know I have the social skills of a potato
0:21:40 > 0:21:44but I'm very clever and I want to be someone.
0:21:44 > 0:21:46Of course you do.
0:21:46 > 0:21:47Here he is.
0:21:47 > 0:21:50Billy! Look who's here.
0:21:50 > 0:21:52- Hey, you. - Professor Gleeson.
0:21:52 > 0:21:54Eamonn Gleeson. Good to meet you.
0:21:54 > 0:21:57Could I have all latest stats, bloods, echo and get them
0:21:57 > 0:22:00- to e-mail the MRI images as soon as possible.- Sure.
0:22:01 > 0:22:04Let's have a proper look at you.
0:22:04 > 0:22:07Before you say anything. I called him.
0:22:11 > 0:22:13I figured something like this might happen.
0:22:13 > 0:22:16You two haven't exactly been getting on.
0:22:16 > 0:22:17Thanks for your support, Jonny.
0:22:21 > 0:22:25- Angiodysplasia?- Mmm-hmm. Could have gone unnoticed for a long time.
0:22:25 > 0:22:28And that's why I've been getting ulcers?
0:22:28 > 0:22:31It's also why you're anaemic. It's a form of chronic bleeding.
0:22:31 > 0:22:34I see. So, what can you do?
0:22:34 > 0:22:36Well, most physicians would say not very much.
0:22:36 > 0:22:39They'd pack you off home with some medication.
0:22:39 > 0:22:41But, if you stick around, there's an innovative new technique
0:22:41 > 0:22:43called endoscopic coagulation therapy...
0:22:43 > 0:22:46Oh, let me stop you right there. I don't want any of this.
0:22:46 > 0:22:50I want to talk to Rosie first. My healer.
0:22:50 > 0:22:53- Your healer? - Reiki healer. She's wonderful.
0:22:53 > 0:22:56- When Petite Fleur had her tumour. - Petite Fleur?- My eldest.
0:22:56 > 0:22:59- Daughter?- No. Cat.- Right.
0:22:59 > 0:23:02Well, you can of course talk to your healer, see your healer
0:23:02 > 0:23:04- and we'll carry on with the... - I don't think so, no.
0:23:04 > 0:23:07You see treatments might interfere with each other.
0:23:07 > 0:23:13They don't always flow together. And you said yourself, doctors think there's not much you can do.
0:23:13 > 0:23:16- Well, that's not exactly what I said...- I know that you're a young man in a hurry
0:23:16 > 0:23:18but I like to think these things through
0:23:18 > 0:23:22so maybe you could get me some literature to take home.
0:23:22 > 0:23:24I'll be in touch.
0:23:28 > 0:23:31It's a classic bilateral pleural effusion.
0:23:31 > 0:23:35- BREATHING HEAVILY:- Young... adults...who have gone through the Baffle
0:23:35 > 0:23:37- Ms Naylor.- Thank you.
0:23:37 > 0:23:40Complications...such as...
0:23:40 > 0:23:45- coronary artery problems...- A mathematician and a cardiologist.
0:23:45 > 0:23:49Look at all the fluid here. I think the Baffle is potentially causing an obstruction. We need to take him in.
0:23:49 > 0:23:51Another operation?
0:23:51 > 0:23:55I think we should try and hold on. Let's just put him on a combo
0:23:55 > 0:23:58of dopamine, dextrose infusion and frusemide, see how we go.
0:23:58 > 0:24:00BILLY COUGHS AND SPLUTTERS Excuse me.
0:24:04 > 0:24:06We need to drain the fluid now.
0:24:10 > 0:24:12So I've put in a call to Angioplasty
0:24:12 > 0:24:15but I think the heparin might just do the job.
0:24:15 > 0:24:18I don't know how to thank you.
0:24:18 > 0:24:20Where's Ellie?
0:24:20 > 0:24:23That nice nurse took her to the shop to get a card.
0:24:23 > 0:24:25Best to do is keep her busy.
0:24:25 > 0:24:26It's just that this is a very busy ward.
0:24:26 > 0:24:30- You may want to call someone to... - Someone?
0:24:30 > 0:24:32There is no-one. Only me.
0:24:32 > 0:24:34- Let go.- It's mine!
0:24:34 > 0:24:35No, it's not.
0:24:35 > 0:24:37Mrs Vaughan, this is Mrs Mallow's, let go.
0:24:37 > 0:24:39No, I.
0:24:40 > 0:24:45- SOBBING:- I...thought it was mine I... I was hungry.
0:24:45 > 0:24:48It's OK. It's OK. It's nearly lunchtime.
0:24:48 > 0:24:51She's just a bit tired, that's all.
0:24:51 > 0:24:53I could see what I could rustle up.
0:24:53 > 0:24:56The nurse found one with a fairy on it.
0:24:56 > 0:24:59- I'm going to write it. Right now.- OK.
0:25:02 > 0:25:03To...
0:25:03 > 0:25:05Dr Birdwood?
0:25:07 > 0:25:08N...
0:25:08 > 0:25:10Is this a heparin infusion?
0:25:10 > 0:25:13- Yes, of course. - Have you seen these latest stats?
0:25:17 > 0:25:21I mean, Petite Fleur. What kind a name is that for a cat anyway?!
0:25:21 > 0:25:24I really am beginning to think there's something wrong with you.
0:25:24 > 0:25:31I mean, why didn't you go on about your Shamanic experiences eating lava worms in Thailand?
0:25:31 > 0:25:35I mean, she'd be eating out of your hands by now. Softly softly catchy monkey.
0:25:35 > 0:25:37While we're treading softly softly,
0:25:37 > 0:25:39the monkey might die of internal bleeding.
0:25:39 > 0:25:43- ALERT BEEPS - That's my conference call from Brussels.
0:25:43 > 0:25:47- This could make or break my funding. I can't miss it. Can you talk to her, please?- What?
0:25:47 > 0:25:51Just get her to stick around, agree to the endoscopic coagulation therapy. I'll do the rest.
0:25:51 > 0:25:54- I must have doormat tattooed on my...- Bonjour.
0:25:54 > 0:25:55..forehead.
0:25:55 > 0:25:57It's OK, sweetheart.
0:25:58 > 0:26:00You're going to feel much better in a minute.
0:26:00 > 0:26:04- You're being very brave here. - Heart beat fast and irregular.
0:26:07 > 0:26:10- I don't think we can wait. - Siobhan?
0:26:12 > 0:26:15- Can you finish up, please? - Sure.
0:26:15 > 0:26:17We can go for a straightforward procedure.
0:26:17 > 0:26:20Just widen the Baffle, and remove the obstruction.
0:26:20 > 0:26:23- Er, to be fair, we'll only know that when we open him up.- And afterwards?
0:26:23 > 0:26:26Carry on as you are.
0:26:26 > 0:26:29Keep the medication going, continual checkups, close observation.
0:26:29 > 0:26:32But who'll be operating? Can you be there?
0:26:34 > 0:26:36If Ms Naylor would have me.
0:26:36 > 0:26:37I'd really like that.
0:26:38 > 0:26:41Right. Shall we go tell Billy?
0:26:41 > 0:26:43No, it's OK. I'll do that.
0:26:44 > 0:26:47I need to make some calls. Juggle my timetable.
0:26:47 > 0:26:51Why are we not talking to him? Directly? He is 16.
0:26:51 > 0:26:53In here maybe. But not in here.
0:26:53 > 0:26:54But still, we should be honest with him.
0:26:54 > 0:26:56He thinks he's going to Oxford.
0:26:56 > 0:26:59It's typical of his condition, repeating things in a loop.
0:26:59 > 0:27:01That doesn't mean he's not serious about it.
0:27:01 > 0:27:04The Asperger's is bad enough without a heart condition.
0:27:04 > 0:27:07He needs constant care. It's never going to happen.
0:27:12 > 0:27:14Heparin? You aware of the risk?
0:27:14 > 0:27:17- In case he does have to go into theatre.- But why would he?
0:27:17 > 0:27:19This is an aortic saddle embolus,
0:27:19 > 0:27:21the heparin might well dissolve it on its own.
0:27:21 > 0:27:22Look at these.
0:27:22 > 0:27:25It may have started as an embolus but it's an occlusion by now.
0:27:25 > 0:27:28And if you need to take him in, he could bleed out on you because of the heparin.
0:27:28 > 0:27:30If. OK, let's just wait and see.
0:27:31 > 0:27:36And exactly how much experience have you had dealing with this condition?
0:27:36 > 0:27:38- Well...- Right, take him off the heparin immediately
0:27:38 > 0:27:42and we'll try to delay radiology while it gets out of his system.
0:27:42 > 0:27:45I want to know when they call you back.
0:27:45 > 0:27:49No, Alex, just your latest data.
0:27:49 > 0:27:52Yup. Yeah, I got it. Cheers.
0:27:58 > 0:28:00Secret stash.
0:28:00 > 0:28:05Mmm. Nectar. Do you want to...
0:28:06 > 0:28:09Arterial Switch. That's a tricky one.
0:28:11 > 0:28:13Pull it off and your patient gets a new lease of life.
0:28:13 > 0:28:18- However... This for your boy?- Mmm.
0:28:18 > 0:28:20You must be feeling brave today.
0:28:20 > 0:28:21Today?
0:28:21 > 0:28:23Brand new world.
0:28:23 > 0:28:26KNOCK ON DOOR
0:28:26 > 0:28:30Now, what are the chances of finding two fantastic heart surgeons
0:28:30 > 0:28:34in one room at the same time?
0:28:34 > 0:28:36Can you spare five minutes for a chinwag?
0:28:41 > 0:28:46- That's Petite Fleur.- Oh, that's Petite Fleur. Oh, my gosh,
0:28:46 > 0:28:47Oh, I love them.
0:28:49 > 0:28:54Just to say again, this endoscopic, you know,
0:28:54 > 0:28:57coagulation therapy is actually quite ingenious.
0:28:57 > 0:29:01I mean, it may not be 100% fool proof but it is less invasive
0:29:01 > 0:29:04and I know that's what Mr Hemingway thought you might prefer.
0:29:05 > 0:29:08And it might get rid you of those pesky ulcers, you know.
0:29:12 > 0:29:15Do you know what? He's not quite the ogre he appears to be.
0:29:15 > 0:29:20He does appear quite thorny. Bound flow, you see.
0:29:20 > 0:29:21Oh. I know, I know.
0:29:21 > 0:29:27But actually that's to cover up the fact that he's quite soft in the middle.
0:29:31 > 0:29:33Right.
0:29:33 > 0:29:37Anyway, I must say it's very nice to put names to the faces.
0:29:37 > 0:29:39Maybe we can make a time to chat some more?
0:29:40 > 0:29:42Absolutely. I'm due in theatre.
0:29:42 > 0:29:43Yes, me too.
0:29:43 > 0:29:49Indeed. But I just wanted to dispel any, well, fears
0:29:49 > 0:29:52and assure you that I believe in letting people get on with what they're good at.
0:29:52 > 0:29:56I'm not a clinician, I wouldn't dream of telling the medics how to do their job.
0:29:56 > 0:29:59Darwin has been doing sterling work.
0:29:59 > 0:30:03I'd hate to think my arrival would derail you in any way.
0:30:03 > 0:30:05Absolutely, thank you.
0:30:05 > 0:30:07Don't worry. It won't.
0:30:08 > 0:30:11Thing is, she rushed into offering him a procedure.
0:30:11 > 0:30:13She rushed into putting him on heparin.
0:30:13 > 0:30:15She is not as experienced as she likes to make out.
0:30:15 > 0:30:17It's an easy mistake to make. It did present as a clot.
0:30:17 > 0:30:21That's not the point. Plus I don't like people trying to tell me half truths.
0:30:21 > 0:30:25- Bit heavy, isn't it?- She's not just your responsibility.- OK, I get it.
0:30:26 > 0:30:29Erm, Dr Birdwood?
0:30:31 > 0:30:34It's about the heparin, right?
0:30:34 > 0:30:37See, I felt it was worth initially trying to heparise him
0:30:37 > 0:30:39as it could dissolve some of the blood clot
0:30:39 > 0:30:42before any radiological intervention.
0:30:42 > 0:30:45It may have even alleviated the need for a further action.
0:30:45 > 0:30:48True. Possible but unlikely.
0:30:48 > 0:30:50That really only works on a venous thrombosis,
0:30:50 > 0:30:52not in an arterial case.
0:30:52 > 0:30:55It was an understandable call and worth a try
0:30:55 > 0:30:57but probably irrelevant.
0:30:58 > 0:31:02I know that you may think that you have adequate experience.
0:31:02 > 0:31:05Oh, that was just a misunderstanding.
0:31:05 > 0:31:07I never said I had experience with the exact same cases.
0:31:07 > 0:31:10I mean, they do vary enormously.
0:31:10 > 0:31:11Precisely.
0:31:11 > 0:31:13Which is why you should have run it by me
0:31:13 > 0:31:17or another more experienced member of the team before proceeding.
0:31:17 > 0:31:18Of course.
0:31:18 > 0:31:21Obviously, I have taken Mr Malick's diagnosis
0:31:21 > 0:31:22and taken the patient off heparin.
0:31:22 > 0:31:25I'm still confident he won't need full surgery.
0:31:25 > 0:31:27IMELDA: Golly, that would be marvellous. >
0:31:27 > 0:31:31Look, I really appreciate everything that you've done. Especially today.
0:31:33 > 0:31:37I know what politics can be like and maybe I've been a bit insensitive.
0:31:37 > 0:31:39Insensitive?
0:31:39 > 0:31:42Maybe I might have ruffled a few feathers
0:31:42 > 0:31:45when I made no secret of how much I look up to you.
0:31:47 > 0:31:51- Look, why don't you take five. Page me when you take him in.- OK.
0:31:53 > 0:31:54It would certainly jolly up the place.
0:31:54 > 0:31:57Nurse Lane's just been telling me about her New Year charity ball.
0:31:57 > 0:31:58I think it's a super idea.
0:31:58 > 0:32:00I'll e-mail you.
0:32:00 > 0:32:03I was just coming to see how everyone's coping. Hope I'm not...
0:32:03 > 0:32:07Oh, no. Not at all, not at all. In fact, your timing is perfect.
0:32:07 > 0:32:09I was just coming to find you.
0:32:09 > 0:32:12An Arterial Switch? That's, er, a bit bonkers.
0:32:12 > 0:32:13Why?
0:32:13 > 0:32:16It's superseded the Baffle Billy had. Look at this data.
0:32:16 > 0:32:18The prognosis is miles better.
0:32:18 > 0:32:21But if we're looking at a simple patch obstruction,
0:32:21 > 0:32:23why take the risk?
0:32:23 > 0:32:27You're looking at hemodynamic issues, neoaortic regurgitation
0:32:27 > 0:32:30or even LV systolic dysfunction from myocardial infarction.
0:32:30 > 0:32:32It could transform his life.
0:32:32 > 0:32:35He could go to Oxford, he could play football, he could...
0:32:35 > 0:32:38End up on the transplant list. If we don't lose him on the table.
0:32:38 > 0:32:41- Should we at least give him the option?- No.
0:32:41 > 0:32:43No, I think it would be very unfair.
0:32:43 > 0:32:47You're talking someone whose cognitive abilities are impaired.
0:32:47 > 0:32:49He's not able to make that call.
0:32:49 > 0:32:53It might be right for some people but it's not right for him.
0:32:53 > 0:32:55Let me know when we're taking him in.
0:32:57 > 0:32:59Right.
0:32:59 > 0:33:01He might be right, you know.
0:33:01 > 0:33:04He has known him since he was a baby.
0:33:04 > 0:33:07Might want to try listening for once.
0:33:07 > 0:33:09For once?
0:33:09 > 0:33:12Look, if this is about you not liking being sidelined...
0:33:14 > 0:33:17- I didn't mean like that. - I really don't care what you mean.
0:33:21 > 0:33:23She's an exceptionally talented physician.
0:33:23 > 0:33:26She should be allowed to stay where she's most needed. Where's she's vital.
0:33:26 > 0:33:29Now, if that's putting someone's nose out of joint
0:33:29 > 0:33:30or not quite protocol, then so be it.
0:33:33 > 0:33:38- I'm sorry but I'm not here to win a popularity contest.- OK.
0:33:39 > 0:33:42You've put forward a very compelling case. I admire your passion.
0:33:45 > 0:33:51Right. Well that's... That's great.
0:33:51 > 0:33:55You don't know me yet but when you do you'll realise I'm no fan of the cloak and dagger routine.
0:33:55 > 0:33:58So I really appreciate your honesty. I mean it. It's rare.
0:34:00 > 0:34:02You and I may have more in common than you think.
0:34:03 > 0:34:06- Oh, sorry. - No, no. I think we're done here.
0:34:09 > 0:34:11So?
0:34:11 > 0:34:13Yeah, well, I think we can put that one down to
0:34:13 > 0:34:16a misunderstanding between you and Lilah.
0:34:16 > 0:34:17Is that what she said?
0:34:17 > 0:34:20Look, she's passionate, she's opinionated, she's committed.
0:34:20 > 0:34:22Kind of reminds me of someone.
0:34:22 > 0:34:25Hey. I busted my balls to earn people's respect round here.
0:34:25 > 0:34:29- She's no different.- Absolutely. I'm sure she's well aware of that.
0:34:29 > 0:34:31I hope so. Cos otherwise she's going to crash and burn in no time.
0:34:31 > 0:34:34Thanks. And we'll be the ones having to explain why.
0:34:35 > 0:34:38- She's reconsidering?- She's not as impenetrable as she looks.
0:34:38 > 0:34:40Do you know what, I could hug you.
0:34:40 > 0:34:43If I went in to the human contact stuff, I honestly could hug you.
0:34:43 > 0:34:47Do you know what, I might e-mail our charming CEO right now.
0:34:50 > 0:34:53If there's anyway I can repay this favour, Sacha...
0:34:53 > 0:34:57Well, actually. Um, Chrissie's been on at me, you know, for a while
0:34:57 > 0:35:01- to...further myself.- Oh, yeah?
0:35:01 > 0:35:05I was just thinking, if there was anything kind of low maintenance I can do on your research...
0:35:05 > 0:35:07Oh, there's nothing low maintenance involved really.
0:35:07 > 0:35:09You can't just dabble in it.
0:35:09 > 0:35:11I wasn't suggesting dabbling in it.
0:35:11 > 0:35:15They're a very serious business. Time consuming, too.
0:35:15 > 0:35:16OK.
0:35:19 > 0:35:22Just make sure you get your patient on board.
0:35:22 > 0:35:24Absolutely.
0:35:24 > 0:35:27I mean, we have been on a second date so maybe I should just ask him.
0:35:27 > 0:35:28Or do you think that's too soon?
0:35:28 > 0:35:30Although, New Year's is round the corner.
0:35:30 > 0:35:32I can't turn up to MY ball on my own.
0:35:32 > 0:35:36- Do you reckon he's going tonight? Maybe I should try and suss him then.- Poor Rhys.
0:35:36 > 0:35:37Joke. Joking.
0:35:37 > 0:35:40Chantelle, could you check on Mr Vaughan's stats for me please?
0:35:40 > 0:35:42- Sure.- And Mrs Vaughan?
0:35:44 > 0:35:48Mrs Vaughan. There's only so many times I can take her for a walk.
0:35:48 > 0:35:51Can you get her a magazine or something?
0:35:51 > 0:35:53Erm...'course.
0:35:53 > 0:35:56You know Nurse Lane will never say no to anything.
0:35:56 > 0:35:58Mrs Vaughan's care is not really her remit.
0:35:58 > 0:36:02- Well, they've got no-one else. - I understand but you need to be straight with him.
0:36:02 > 0:36:05We can't look after her here. That's what the Intermediary Care Team is there for so...
0:36:05 > 0:36:08I'd get on to them if I were you.
0:36:08 > 0:36:10Erm, Mr Vaughan. I think you should come have a look.
0:36:10 > 0:36:14BP 90 over 40, sats dropping.
0:36:14 > 0:36:18Legs are cold and clammy. The blood supply is getting more and more compromised.
0:36:18 > 0:36:22Get me five milligrams of morphine and call Angioplasty, tell them we're on our way.
0:36:22 > 0:36:23Where are you going?
0:36:23 > 0:36:27- Ellie, sit down, please. You'll have to wait here. - Ellie can't...- No, she'll be good.
0:36:27 > 0:36:31- She'll just sit here, won't you? - Look, if there's no-one you can...
0:36:31 > 0:36:35No, I don't want any of these people round her. ..Ellie, sit down.
0:36:38 > 0:36:41Now, listen. I promised her that she would never ever have to go
0:36:41 > 0:36:46to one of these places. I swore. Look I'm not going anywhere
0:36:46 > 0:36:49unless she can wait for me here. I mean it.
0:36:49 > 0:36:56Ellie, Ellie. Promise me you'll stay here and do everything you're told.
0:36:56 > 0:37:00Yes? There you are.
0:37:02 > 0:37:06Oh, come on, it'll only take a couple of hours.
0:37:06 > 0:37:09Page Mr Griffin. I'm taking him to Angioplasty.
0:37:11 > 0:37:14It'll make you better, sweetheart.
0:37:14 > 0:37:16Well enough to go to Oxford?
0:37:16 > 0:37:18We'll see.
0:37:18 > 0:37:24What? What will we see? Will this make me better?
0:37:24 > 0:37:27- Or will I stay the same? - Billy, please, don't upset yourself.
0:37:27 > 0:37:29I want the truth.
0:37:29 > 0:37:36- If I'm not going to get better then I don't want to go ahead.- Billy.
0:37:36 > 0:37:40Has anyone ever discussed an Arterial Switch with you?
0:37:40 > 0:37:44I don't want to get your hopes up, it's a big procedure
0:37:44 > 0:37:49and not without it's risks. The results can be life changing.
0:37:49 > 0:37:53Patients' quality of life... unrecognisable.
0:37:53 > 0:37:55They can be independent, they can exercise, they can...
0:37:55 > 0:37:59- Go to a football match?- If they're mad enough to like football, yes.
0:37:59 > 0:38:02I don't believe you.
0:38:04 > 0:38:07What the hell do you think you're doing?
0:38:07 > 0:38:11Why would you want to give him any false hope?
0:38:11 > 0:38:12Why false?
0:38:12 > 0:38:15You want him to give up the hope of being self-sufficient?
0:38:15 > 0:38:18Self-sufficient? Do you even know what that means?
0:38:18 > 0:38:22Billy can't boil an egg.
0:38:22 > 0:38:26He can't sort out his pills. He has to be lulled to sleep every night.
0:38:26 > 0:38:30But at some point, you're going to have to let him try.
0:38:30 > 0:38:32And maybe you could do with a break too.
0:38:32 > 0:38:34He's my son - I don't want a break.
0:38:34 > 0:38:36- Perhaps that's the problem. - Excuse me?
0:38:37 > 0:38:41Look, I know that caring for Billy means exhaustion and stress,
0:38:41 > 0:38:43but it's companionship too, isn't it?
0:38:43 > 0:38:46If Billy goes off to Oxford or wherever else, for that matter,
0:38:46 > 0:38:48that's you on your own.
0:38:48 > 0:38:50- SHE LAUGHS - Oxford, Oxford, Oxford.
0:38:50 > 0:38:53This is exactly what I mean. It's a fantasy,
0:38:53 > 0:38:56it's la-la-land. And you're encouraging it!
0:38:56 > 0:38:58What's going on?
0:39:01 > 0:39:04It's potentially ground-breaking. This drug can help clot bleeding
0:39:04 > 0:39:06- with patients who've suffered massive blood loss...- No.
0:39:06 > 0:39:08- You have bleeding issues so you're perfect.- No.
0:39:08 > 0:39:11- All we need is some blood samples which I can apply these tests to...- No!
0:39:11 > 0:39:13I don't want poked and prodded.
0:39:13 > 0:39:18And...and trials involve experimenting on animals, no?
0:39:18 > 0:39:19- No, not necessarily. - Yeah, but it might.
0:39:19 > 0:39:21I don't agree with that.
0:39:21 > 0:39:25There's a higher power at work. We must promote harmony with others.
0:39:25 > 0:39:28- Oh, for goodness sake. - Sorry, sorry, what's the problem?
0:39:28 > 0:39:33Oh, look at you two. Butter wouldn't melt!
0:39:33 > 0:39:35All that talk about coagulative thingy -
0:39:35 > 0:39:38that was just to get me to stay, wasn't it,
0:39:38 > 0:39:40because of his trial?
0:39:40 > 0:39:43- SHE SIGHS - I should have known better.
0:39:43 > 0:39:45I'm discharging myself. Now.
0:39:49 > 0:39:53- I don't understand you. I thought we agreed.- Agreed?
0:39:53 > 0:39:55You mean, you made a decision and walked off.
0:39:55 > 0:39:57Look, you know as well as I do
0:39:57 > 0:39:58there's another option on the table here
0:39:58 > 0:40:02- and he deserves to know what that is.- He is a vulnerable patient, and on balance...
0:40:02 > 0:40:06Exactly! He's vulnerable, so he needs someone to stand up for him
0:40:06 > 0:40:11and stop patronising him. Now, this is my ward and he is my patient.
0:40:11 > 0:40:12Jac...
0:40:13 > 0:40:15Absolutely. You want to deal with this on your own?
0:40:15 > 0:40:18Be my guest. Let me know when you do.
0:40:20 > 0:40:21When are you going to learn?
0:40:21 > 0:40:24This is not how you bring people round.
0:40:24 > 0:40:29- You've just painted yourself into a corner. - I'm doing what is right for him.
0:40:29 > 0:40:31You're not the only person who cares for him.
0:40:31 > 0:40:33Billy! Billy!
0:40:35 > 0:40:37Excuse me.
0:40:37 > 0:40:38LABOURED BREATHING
0:40:38 > 0:40:42All right, let's start him on dopamine, 50-50 dextrose,
0:40:42 > 0:40:44IV furosemide, one milligram per kilo.
0:40:44 > 0:40:48His heart's struggling to cope with this. BILLY MURMURS
0:40:48 > 0:40:50Billy, keep the oxygen on, please. Can we page theatre?
0:40:50 > 0:40:52- Billy, enough!- No! I want the...
0:40:52 > 0:40:55I want the arterial... I want what you talked about - the arterial switch.
0:40:55 > 0:40:59I want the arterial switch. Or I'm not going in.
0:40:59 > 0:41:01BILLY STRUGGLES FOR BREATH
0:41:04 > 0:41:07Are you sure there's nothing I can do make you stay?
0:41:07 > 0:41:09OK. Then you must take these. Take these with you.
0:41:13 > 0:41:16There really is no talking to her. She won't stay.
0:41:16 > 0:41:18Oh, well, you win some, you lose some.
0:41:18 > 0:41:20Or in your case you lose some and then you lose some more.
0:41:20 > 0:41:22Oh, come on. It was like talking to a brick wall.
0:41:22 > 0:41:26How would you know? You hardly even bothered to talk to her.
0:41:26 > 0:41:29Because you are so utterly, majestically, up yourself
0:41:29 > 0:41:30that you end up losing everything -
0:41:30 > 0:41:32Eddi, your research,
0:41:32 > 0:41:35and now you've got a patient thinking I've actually deceived them,
0:41:35 > 0:41:37and I'm your friend!
0:41:39 > 0:41:43Well, that was pretty comprehensive.
0:41:43 > 0:41:46I mean, if you don't get it now...
0:41:52 > 0:41:54- How do you mean?- We can't seem to get the guide wire in.
0:41:54 > 0:41:56How many tries?
0:41:56 > 0:41:59About three. It's just that...
0:41:59 > 0:42:03he's bleeding quite profusely and we can't seem to get on top of it.
0:42:03 > 0:42:05MONITOR BEEPS
0:42:05 > 0:42:07I need your back-up, Mr Griffin.
0:42:07 > 0:42:10I'm needed here. You're going to have to call Mr Malick.
0:42:10 > 0:42:11'Now.'
0:42:11 > 0:42:14BEEPING CONTINUES
0:42:19 > 0:42:22Ms Slate! Ms Slate, hang on.
0:42:28 > 0:42:30Can we get some help here, please?
0:42:34 > 0:42:37- No. No, don't touch me. - Come on, come on.- Not you.
0:42:37 > 0:42:39Come on. I think you need a blood transfusion.
0:42:39 > 0:42:44That's it. All right, all right.
0:42:44 > 0:42:45Mr Malick!
0:42:46 > 0:42:48What's happening?
0:42:48 > 0:42:51Please, try to stay calm.
0:42:53 > 0:42:55This isn't going to work. The aorta is probably too occluded.
0:42:55 > 0:42:59- Get onto theatre and tell them we're coming over now.- He doesn't want to go in to theatre.
0:42:59 > 0:43:02- Call Mr Griffin and tell him to meet us.- He's in surgery...
0:43:02 > 0:43:07Dr Birdwood, focus and listen! This man has severe limb ischaemia.
0:43:07 > 0:43:11If we don't get him in now, he'll lose both legs or bleed out on us.
0:43:11 > 0:43:13OK?
0:43:15 > 0:43:19- You tell her that...- You mean you haven't called the intermediary? - It's OK, I'll sort it out
0:43:19 > 0:43:22Shall we go for a midline incision, do an aortobifem graft?
0:43:22 > 0:43:25No, it wouldn't work. Axillobifem graft is the only option.
0:43:25 > 0:43:28- Right, let's cancel the rest of the list for today.- What, all of it?
0:43:28 > 0:43:31- The state he's in, this will take at least six hours. - He's still bleeding?
0:43:31 > 0:43:35We've been trying to stem it. It's because of the Heparin, right?
0:43:35 > 0:43:38Now's not the time. Come on, let's get a move on.
0:43:40 > 0:43:42You have to understand, there's no guarantee.
0:43:42 > 0:43:44But if you try...
0:43:44 > 0:43:49- I could go next year. I could... - Stop it! Just stop it!
0:43:49 > 0:43:51There is no Oxford!
0:43:51 > 0:43:52You failed your last aptitude test.
0:43:52 > 0:43:54You haven't got an interview.
0:43:55 > 0:43:57No, no, no, no.
0:43:57 > 0:44:00- MONITOR BEEPS - Oh, Billy.
0:44:00 > 0:44:03Billy, I'm so sorry.
0:44:03 > 0:44:05Just help him! Do something, anything.
0:44:05 > 0:44:08- So I have your consent? - Yes, yes, whatever.
0:44:08 > 0:44:09Right, let's go.
0:44:09 > 0:44:12- Do you want me to page Gleeson?- No.
0:44:12 > 0:44:15What? Why not? Are you crazy?
0:44:15 > 0:44:18You heard me. Prep him. I'm taking him to theatre now.
0:44:18 > 0:44:20BILLY STRUGGLES TO BREATH
0:44:23 > 0:44:27Please, listen. You can't send her anywhere.
0:44:27 > 0:44:29You know what these places are like. She'll be scared.
0:44:29 > 0:44:33You promised me she could stay here and wait for me.
0:44:33 > 0:44:34I'm sorry.
0:44:36 > 0:44:39- Mr Griffin.- I'll deal with this.
0:44:39 > 0:44:41Well, I've been hoping for some advice on the theatre rota.
0:44:41 > 0:44:43As you can see, we've got an emergency here.
0:44:43 > 0:44:46- I want to go! I want to see Gabriel! - Ellie? Stop!
0:44:46 > 0:44:50- Gabriel's just having some treatment. We've been through this, remember?- Ellie. Ellie?
0:44:53 > 0:44:56It's OK.
0:44:56 > 0:44:57It's OK.
0:44:57 > 0:45:01Now, listen, I need to have an operation.
0:45:01 > 0:45:03Now, you do what these people say,
0:45:03 > 0:45:06and when I come out, we'll go and see Naomi, OK?
0:45:06 > 0:45:08We really need to make a move. Sort this out.
0:45:13 > 0:45:16Could I have a look at his notes, please?
0:45:16 > 0:45:19- Right, nice and easy... - Don't touch me!
0:45:19 > 0:45:23- OK, all right. All right, it's OK. - Where's Gabriel?
0:45:23 > 0:45:26- Where have you taken Gabriel?- He's gone for his operation, remember?
0:45:26 > 0:45:30- Naomi. Where's Naomi?- She's not here. She's with Gabriel's sister.
0:45:32 > 0:45:33Who are you?
0:45:33 > 0:45:35I'm Dr Birdwood.
0:45:37 > 0:45:39No, no, you can't...
0:45:41 > 0:45:43ELLIE WHIMPERS
0:45:44 > 0:45:45Come with me now.
0:45:45 > 0:45:47Where's Gabriel?
0:45:47 > 0:45:48How we doing?
0:45:48 > 0:45:50Scalpel.
0:45:54 > 0:45:56I'll be just a second.
0:45:58 > 0:45:59- What's this?- Nice work.
0:45:59 > 0:46:03- Did you actually think I would abandon my patient? - That is not the point
0:46:03 > 0:46:04- Don't bother.- Let's be clear.
0:46:04 > 0:46:07You so much as try and stop me going in there, I'm escalating this,
0:46:07 > 0:46:11all the way to the CEO. And you know as well as I do, you won't have a leg to stand on.
0:46:11 > 0:46:13Mask.
0:46:16 > 0:46:19He deserves the best chance. That means both of you
0:46:19 > 0:46:21I can't believe you would do this to me.
0:46:21 > 0:46:23I did this FOR you, Jac.
0:46:23 > 0:46:27- If this goes wrong, you're going to land yourself in a lot of trouble. - MONITOR BEEPS RAPIDLY
0:46:27 > 0:46:29You better get in here.
0:46:29 > 0:46:30Suction.
0:46:33 > 0:46:36OK, thank you. Must have been some scene.
0:46:36 > 0:46:39All in front of Cousins.
0:46:39 > 0:46:41Anyway, they finally called the intermediary care team.
0:46:41 > 0:46:43Right.
0:46:44 > 0:46:47Well, we've got this to get on with.
0:46:49 > 0:46:51Can we get the Dacron graft ready, please?
0:46:56 > 0:47:01Yes, yes. I'm well aware this is all my responsibility.
0:47:01 > 0:47:03Don't know about that.
0:47:03 > 0:47:05Like you said, there was logic to what she did.
0:47:05 > 0:47:06We were just unlucky.
0:47:06 > 0:47:08We're not fortune tellers.
0:47:11 > 0:47:13GRIFFIN SIGHS
0:47:13 > 0:47:16Long night ahead, ladies and gents.
0:47:22 > 0:47:24Where... What happened?
0:47:25 > 0:47:29You're bleeding. It got out of control. You collapsed.
0:47:29 > 0:47:32Mr Hemingway brought you back and we took you into theatre.
0:47:32 > 0:47:34Oh. Him.
0:47:34 > 0:47:38Don't worry, you've been reassigned to Mr Levy. I...um...
0:47:38 > 0:47:40I just wanted to say...um...
0:47:44 > 0:47:46I apologise for the way I behaved
0:47:46 > 0:47:48and I hope you feel better soon.
0:47:54 > 0:47:56It's the right atrium. He has severe right ventricular failure,
0:47:56 > 0:48:00it's not a patch obstruction, we can't widen the baffle, there's no point.
0:48:00 > 0:48:03But can you make the arterial switch?
0:48:03 > 0:48:06He has severe heart failure, it's not viable.
0:48:07 > 0:48:10This has gone far enough. Just do it, we'll put him on the transplant list.
0:48:10 > 0:48:12- It's the only way... - Are you a surgeon?
0:48:14 > 0:48:19- I know it's beyond you to ever admit that you're wrong, but...- Out.
0:48:19 > 0:48:23- What?- You heard me. Get out of my theatre now.
0:48:33 > 0:48:36- Right.- OK, so...
0:48:36 > 0:48:38- TCPC.- What?
0:48:38 > 0:48:42Total cavopulmonary procedure. We attach the vein draining the blood
0:48:42 > 0:48:46from the upper part of the body to the upper part of the lung.
0:48:46 > 0:48:48We don't have any other option, do we?
0:48:48 > 0:48:50- OK.- Clamps.
0:49:06 > 0:49:09We've sedated her. She's sleeping now.
0:49:09 > 0:49:11The intermediary care team are on their way
0:49:11 > 0:49:15and we might be able to find her a bed on a ward for a night, so she won't have to go to a home.
0:49:19 > 0:49:20I'm sorry.
0:49:25 > 0:49:30- BP dropping.- Suction. Must be a minor artery bleed.- Minor?
0:49:30 > 0:49:34Clamp. 40 Prolene. Let's start on adrenaline. 100% oxygen, please.
0:49:35 > 0:49:37Keep the pressure there.
0:49:38 > 0:49:41Just do it.
0:49:48 > 0:49:50OK. Release the clamp.
0:49:50 > 0:49:53Gently does it.
0:49:57 > 0:50:00Holding nicely.
0:50:00 > 0:50:02Right, where were we?
0:50:02 > 0:50:05Ready to make the incision in the right atrium.
0:50:05 > 0:50:08Stand by with the prosthetic for the lateral tunnel.
0:50:09 > 0:50:11Hey, Naylor...
0:50:11 > 0:50:13- Yeah?- Drink later?
0:50:14 > 0:50:17You're not out for my blood anymore, then?
0:50:17 > 0:50:20Ah, consultants always rip each other to bits - wouldn't be any fun otherwise.
0:50:20 > 0:50:21I don't mind a bit of Napalm.
0:50:21 > 0:50:25And I've got a thing for exceptionally talented heart surgeons with red hair.
0:50:25 > 0:50:28Irish heritage, you see. Swab.
0:50:31 > 0:50:34Clamping the subclavian.
0:50:34 > 0:50:3650 Prolene, please
0:50:49 > 0:50:51Suturing.
0:50:55 > 0:50:58Release the clamp, let's test the blood flow.
0:51:02 > 0:51:03Yes.
0:51:10 > 0:51:11Knock-knock.
0:51:13 > 0:51:16- Packing up?- No volunteers, no trial.
0:51:19 > 0:51:20I've talked her round.
0:51:22 > 0:51:23What?
0:51:23 > 0:51:26Well, as you said, the...
0:51:26 > 0:51:27the problem will be ongoing,
0:51:27 > 0:51:29so I explained to her that if she does the trial
0:51:29 > 0:51:31she'll get constant attention.
0:51:31 > 0:51:35And that, you know, we'll only use bloods we would have taken from her anyway,
0:51:35 > 0:51:38and that no animals will be harmed by your good self.
0:51:38 > 0:51:40What, and she went for that?
0:51:41 > 0:51:43LEVY SIGHS
0:51:43 > 0:51:47I've also sorted her out with Mama Levy's psychic healer, Linda,
0:51:47 > 0:51:51who lives in Southend and who has a two-year waiting list.
0:51:51 > 0:51:53Why would you do that for me?
0:51:54 > 0:51:57Well, I've always had a soft spot for the socially dysfunctional and the offensive.
0:51:57 > 0:51:59That's very kind, thank you.
0:51:59 > 0:52:00Well, that's perfectly all right.
0:52:06 > 0:52:08Sacha, um...the...
0:52:08 > 0:52:11With regard to the proposition you made earlier,
0:52:11 > 0:52:14I could probably use all the help I can get.
0:52:26 > 0:52:29Thank you, ladies and gentlemen. That was a heroic effort.
0:52:38 > 0:52:41Look, if you hadn't got him to stay this morning,
0:52:41 > 0:52:44he probably wouldn't even be alive now.
0:52:46 > 0:52:47But I should have known better.
0:52:48 > 0:52:51I should never have left you to it.
0:52:56 > 0:52:58I'll deal with this.
0:52:58 > 0:53:01Could this possibly wait? We've just come out of theatre.
0:53:01 > 0:53:05I know. Six hours! Lordy. Two minutes.
0:53:07 > 0:53:08Dr Birdwood, take a break.
0:53:08 > 0:53:11Actually, if you wouldn't mind sticking around.
0:53:12 > 0:53:14I've just been looking at his notes, you see.
0:53:14 > 0:53:19I suppose, considering you had to resort to a subcutaneous axillofemoral bypass,
0:53:19 > 0:53:20it could have been a lot worse.
0:53:20 > 0:53:23However, I'm just trying to ascertain - just for my records -
0:53:23 > 0:53:26was it really...inevitable?
0:53:26 > 0:53:28Inevitable?
0:53:28 > 0:53:32He was rushed to theatre after a catastrophic bleed
0:53:32 > 0:53:36which was a direct consequence of Dr Birdwood previously putting him
0:53:36 > 0:53:39- on a Heparin infusion, right? - Well...
0:53:39 > 0:53:40And it is the case, is it not,
0:53:40 > 0:53:45that if Mr Vaughan had been booked in for a conventional aortic bypass
0:53:45 > 0:53:48to start off with, we could have bypassed this massively risky,
0:53:48 > 0:53:51time-consuming and costly procedure we ended up with?
0:53:52 > 0:53:53Excuse the pun.
0:53:53 > 0:53:56Unless I've got this all back to front?
0:53:56 > 0:53:57No, you haven't.
0:53:57 > 0:54:01Not to mention the unfortunate incident with the patient's wife,
0:54:01 > 0:54:06- whom I believe you were aware was suffering from... - Can I just stop you there?
0:54:06 > 0:54:08Dr Birdwood kept me in the loop throughout.
0:54:08 > 0:54:10I take full responsibility.
0:54:10 > 0:54:13- I'm very relieved to hear you say that.- My point is...
0:54:13 > 0:54:16Granted, your circumstances are very challenging,
0:54:16 > 0:54:18as you pointed out to me this morning.
0:54:18 > 0:54:22Which is why I see no point in penalising one particular person.
0:54:22 > 0:54:26After all, I'm here to lend support.
0:54:26 > 0:54:28So I think, in everyone's interests,
0:54:28 > 0:54:30rather than your good self mentoring Dr Birdwood,
0:54:30 > 0:54:35I'd like to see her directly under Mr Malick's supervision.
0:54:35 > 0:54:38Relieve the pressure, as it were.
0:54:38 > 0:54:40Excellent. Onwards!
0:54:46 > 0:54:48Hi.
0:54:48 > 0:54:51See you've got your top back on. Got you a present.
0:55:00 > 0:55:02Don't look at me, I'm not going.
0:55:02 > 0:55:05But you will be fit to go.
0:55:05 > 0:55:07And just to be on the safe side, you'll be in a box
0:55:07 > 0:55:10and you'll have a cardiac nurse with you.
0:55:10 > 0:55:1326th of January.
0:55:13 > 0:55:15Kick-off 3pm.
0:55:16 > 0:55:20That's 66 days, 18 hours and nine minutes.
0:55:21 > 0:55:24I suppose it's got to happen sometime.
0:55:24 > 0:55:25Thank you.
0:55:25 > 0:55:26My pleasure.
0:55:28 > 0:55:30By the way, I never got into Oxford.
0:55:30 > 0:55:33St Barts is where it's at.
0:55:36 > 0:55:37Jac...
0:55:37 > 0:55:40Yeah, I know. You had to.
0:55:41 > 0:55:43But so did I.
0:55:44 > 0:55:47Um...look, you know, tonight -
0:55:47 > 0:55:48offer still stands.
0:55:48 > 0:55:50Like I said, I've got plans.
0:55:55 > 0:55:56Happy birthday.
0:56:10 > 0:56:12Thank you.
0:56:19 > 0:56:21I thought you might want this with you.
0:56:24 > 0:56:26She's never done anything like that before.
0:56:26 > 0:56:29She's not going to get any better, you know.
0:56:30 > 0:56:33You can't do this on your own anymore.
0:56:33 > 0:56:36Next time she hits someone, it could be you.
0:56:36 > 0:56:38Or Naomi.
0:56:40 > 0:56:44It's not like you're betraying her. You have to accept it -
0:56:44 > 0:56:47Ellie needs full-time care now.
0:56:58 > 0:57:00Come in.
0:57:01 > 0:57:04Mr Griffin. What are you still doing here?
0:57:04 > 0:57:06I'd have thought a well-earned drink was in order.
0:57:06 > 0:57:09Can we just dispense with the sympathetic tone?
0:57:11 > 0:57:13Was that really necessary?
0:57:13 > 0:57:15Talking to me in that way in front of my team?
0:57:15 > 0:57:19Putting Mr Malick in charge of Dr Birdwood?
0:57:19 > 0:57:21Bit of an overreaction, don't you think?
0:57:21 > 0:57:23But you did say you were responsible, didn't you?
0:57:23 > 0:57:28- Yes, but only in the sense... - And actions carry consequences for everyone.
0:57:28 > 0:57:30Even consultants.
0:57:30 > 0:57:32I have to seem to be fair. I'm sure you understand.
0:57:34 > 0:57:38Anyway, that was today, and tomorrow is another day.
0:57:38 > 0:57:39Onwards!
0:58:03 > 0:58:06Subtitles by Red Bee Media Ltd