0:00:38 > 0:00:39Actually, Dr Copeland,
0:00:39 > 0:00:41I'm the most senior doctor on the ward at the moment
0:00:41 > 0:00:46so if you wouldn't mind stepping aside, please, thank you.
0:00:47 > 0:00:49He shouldn't be doing that, so why are we letting him?
0:00:49 > 0:00:50She's been through a lot
0:00:50 > 0:00:53and we're going to have to keep a close eye on her
0:00:53 > 0:00:54over the coming weeks,
0:00:54 > 0:00:57but there's absolutely no reason not to be optimistic.
0:00:57 > 0:00:59What are you doing here?
0:00:59 > 0:01:02We needed someone for the flat and...
0:01:02 > 0:01:05Ta-da! She twisted my arm.
0:01:53 > 0:01:55Do you feel a tingle down your spine?
0:01:55 > 0:01:58I've waited 20 years for this.
0:02:00 > 0:02:02I've got goose bumps.
0:02:02 > 0:02:06I've waited twenty years - he's waited 2,000!
0:02:09 > 0:02:12So boring!
0:02:12 > 0:02:13It's amazing.
0:02:13 > 0:02:15The mechanics of a Spiral Cone Tomography scanner?
0:02:15 > 0:02:18We're looking at something no-one's ever seen before.
0:02:18 > 0:02:21What? The insides of a shrivelled old man?
0:02:21 > 0:02:24I first read about Prince Karnak two decades ago.
0:02:24 > 0:02:27It's been like a long, unrequited love affair.
0:02:27 > 0:02:31First I wrote letters, to his curator.
0:02:31 > 0:02:33They sent me a photograph.
0:02:33 > 0:02:37- You must have been very persuasive. - I tried everything.
0:02:37 > 0:02:40Finally, the National Museum of Albania
0:02:40 > 0:02:43granted me four days with him.
0:02:44 > 0:02:46Twenty years, for just four days.
0:02:48 > 0:02:51Actually, I think it's very romantic.
0:02:54 > 0:02:56We can go in now.
0:02:59 > 0:03:02Except we're the poor plebs that have to be up at 6am
0:03:02 > 0:03:05in order to "enhance our Spiral Tomography skills".
0:03:06 > 0:03:08Ah, to think, I could still be sleeping.
0:03:08 > 0:03:11Looks like he's sleeping.
0:03:11 > 0:03:12I haven't slept for days.
0:03:12 > 0:03:15- Really?- Too excited.
0:03:15 > 0:03:17What do you hope to discover?
0:03:17 > 0:03:20What his life was like. How old he was.
0:03:20 > 0:03:25How he died. He's been so closely guarded, for so long,
0:03:25 > 0:03:28he's a complete mystery to Egyptologists.
0:03:30 > 0:03:33The real story here is not the mummy. It's her.
0:03:33 > 0:03:34Mummy-mad Mary?
0:03:36 > 0:03:38She was probably quite hot once...
0:03:38 > 0:03:40you know, like a hundred years ago.
0:03:40 > 0:03:44If you ask me, I think Sacha still feels her heat.
0:03:44 > 0:03:48Ee-yuk. Don't, I haven't even had breakfast yet.
0:03:48 > 0:03:51To devote your life's work to a dead man...
0:03:51 > 0:03:53I love it when you talk all psyche...
0:03:58 > 0:04:01MONITOR BEEPS
0:04:21 > 0:04:25Morning. Is Mummy having trouble?
0:04:27 > 0:04:30Not everyone finds it easy to connect.
0:04:33 > 0:04:35I always say - fake it to make it.
0:04:35 > 0:04:38Even if you don't know, or don't entirely believe...
0:04:38 > 0:04:41I'm not "Mummy". I'm "Ms Naylor".
0:04:47 > 0:04:51By comparing the Harris lines here between the diaphysis and epiphysis
0:04:51 > 0:04:55of the long bones, we should be able to identify dietary deficiencies...
0:04:55 > 0:04:57even childhood diseases.
0:04:57 > 0:05:00Now, I am all of a tingle.
0:05:00 > 0:05:04I know it's mad, to be so excited, but I've been preparing so long.
0:05:04 > 0:05:05I'm just happy we can be of service.
0:05:05 > 0:05:08Feels like my wedding day.
0:05:08 > 0:05:10Is there a Mr Tinsley?
0:05:11 > 0:05:13Married to my work.
0:05:13 > 0:05:15Yes, quite right.
0:05:15 > 0:05:18Neither of you two find this is a life-sucking waste of time?
0:05:18 > 0:05:20Learning to analyse the finer points of a CT scan
0:05:20 > 0:05:22is a great diagnostic tool.
0:05:22 > 0:05:24That's what radiologists are for.
0:05:24 > 0:05:26We clone a special breed of nerd for that.
0:05:26 > 0:05:30She intrigues me... "married to a mummy"?
0:05:30 > 0:05:33I mean, wouldn't you rather be elbows deep
0:05:33 > 0:05:35in some hot, wet surgery?
0:05:35 > 0:05:38And you, wouldn't you rather have your face-buried in a book
0:05:38 > 0:05:40or in some patient's head?
0:05:40 > 0:05:44Arthur's right. CT analysis skills are very useful.
0:05:44 > 0:05:47Can explain a whole range of neurological issues.
0:05:47 > 0:05:50You must think me quite mad.
0:05:50 > 0:05:54No, no. Not mad, just... passionate.
0:05:56 > 0:06:03Right, well. Is there anything else you'd like to ask, Mr Griffin?
0:06:03 > 0:06:05Erm, no. No.
0:06:07 > 0:06:10That's um, that's all clear. Thank you.
0:06:10 > 0:06:12Thank you.
0:06:15 > 0:06:18And your career ambition is...
0:06:20 > 0:06:26"the exemplary and expedient delivery of optimum quality care"?
0:06:30 > 0:06:34OK. Well, um... thank you very much. We'll be in touch.
0:06:49 > 0:06:51Um... Sorry, you are?
0:06:51 > 0:06:54Raffaello Di Lucca. Raf.
0:06:54 > 0:06:56What is that?
0:06:56 > 0:06:59It's my lunch. And these... are my clogs.
0:06:59 > 0:07:01I assume you guys provide scrubs.
0:07:01 > 0:07:03This is just a preliminary interview to find...
0:07:03 > 0:07:06Your new registrar. To work alongside Mr Griffin.
0:07:06 > 0:07:07In the Acute Admissions Unit.
0:07:07 > 0:07:08Yes.
0:07:08 > 0:07:10Well, that's me.
0:07:10 > 0:07:12And, as soon as this "interview" is finished,
0:07:12 > 0:07:15I'll be going straight down to AAU, to start my new job.
0:07:15 > 0:07:16Like I said, it really is just...
0:07:16 > 0:07:19What makes you think that we'd hire you?
0:07:19 > 0:07:20Well, because Mr Self here needs me...
0:07:20 > 0:07:23to help you make Holby City into the most cutting-edge
0:07:23 > 0:07:26Acute Admissions Unit in the country.
0:07:26 > 0:07:28What do you think you could...
0:07:28 > 0:07:31Long way to go to catch up with Newcastle, of course,
0:07:31 > 0:07:33or Leicester for that matter...
0:07:33 > 0:07:37But with the Pri Def initiatives that Mr Griffin studied in the US,
0:07:37 > 0:07:40and my two years' experience of new style resus
0:07:40 > 0:07:43and ECMO techniques around the Pacific Rim...
0:07:43 > 0:07:44It's a piece of cake.
0:07:45 > 0:07:47You're very sure of yourself, aren't you?
0:07:47 > 0:07:48Very.
0:07:48 > 0:07:52Six months in Japan with Nozomi Fugusaki...
0:07:53 > 0:07:55six months in the Philippines,
0:07:55 > 0:07:57six months in Hong Kong...
0:07:57 > 0:07:59And, the next year - in Holby City.
0:07:59 > 0:08:02Maybe two - if you're lucky.
0:08:02 > 0:08:04Why would you assume that...?
0:08:04 > 0:08:06Read the small print.
0:08:12 > 0:08:15He's been a locum for six months, plus a Fellowship
0:08:15 > 0:08:17and research-funding from the NHS.
0:08:17 > 0:08:21In other words, I'm already paid for. Except overtime.
0:08:21 > 0:08:22Why Holby?
0:08:23 > 0:08:27Because when it comes to AAU, Mr Griffin has a vision.
0:08:27 > 0:08:29And Henrik Hanssen had one.
0:08:29 > 0:08:30He's no longer here.
0:08:30 > 0:08:34Yeah, I know. But I'm kind of gambling on you having a vision too.
0:08:37 > 0:08:39Old dog, new tricks.
0:08:39 > 0:08:41- You're referring to...? - To you. Yes.
0:08:41 > 0:08:43- Charmed.- Come on, Ric.
0:08:43 > 0:08:45You've been Clinical Director,
0:08:45 > 0:08:47Head of Surgery, head of every ward in Holby.
0:08:47 > 0:08:50You are our most senior and respected consul...
0:08:50 > 0:08:51Now, you're just blowing smoke up.
0:08:51 > 0:08:54I'm not going to tell you who you can hire.
0:08:54 > 0:08:55But you're going to suggest.
0:08:55 > 0:08:57No buts. It's your registrar.
0:08:57 > 0:08:59Your ward. Your choice.
0:08:59 > 0:09:02- My neck?- Your words.
0:09:02 > 0:09:04Look, you've seen his experience.
0:09:04 > 0:09:06Yes. And I can read between the lines.
0:09:06 > 0:09:08Not exactly a "team player".
0:09:09 > 0:09:11Well, I like him.
0:09:13 > 0:09:16Do you think he meant what he said about starting today?
0:09:19 > 0:09:21Ah, there you are. Mr Griffin has just confirmed you.
0:09:21 > 0:09:23So how long have you been here?
0:09:23 > 0:09:25For ever. Think I started here when I was about eight.
0:09:25 > 0:09:28Well, new boy needs nurse-of-the-world insight.
0:09:28 > 0:09:33Holby City? Well it's like a cross between a secondary school
0:09:33 > 0:09:35and a safari park.
0:09:35 > 0:09:38- Tell me.- Ask me.
0:09:38 > 0:09:39Ric Griffin?
0:09:39 > 0:09:41Have you seen The Lion King?
0:09:41 > 0:09:42Guy Self?
0:09:42 > 0:09:44Too early to say.
0:09:44 > 0:09:47Could be in the gift shop on the cuddly toy shelf,
0:09:47 > 0:09:51- could be lurking in the reptile house.- Darwin Ward?
0:09:51 > 0:09:54Oh, they're like sixth formers - they all think they're so clever.
0:09:54 > 0:09:55Keller?
0:09:55 > 0:09:57The aquarium. Lots of pretty fish.
0:09:57 > 0:09:58No sharks.
0:09:58 > 0:10:00And AAU?
0:10:00 > 0:10:02Monkey World - no question.
0:10:02 > 0:10:04< Quickly!
0:10:07 > 0:10:09Come on, quickly!
0:10:15 > 0:10:17I'm going to call it.
0:10:17 > 0:10:19We've been going 21 minutes.
0:10:21 > 0:10:25Resus stopped. Time of death - 12.01. Thank you, guys.
0:10:25 > 0:10:27What do you call that?
0:10:28 > 0:10:31- Sorry, who are you? - What - do - you - call - that?
0:10:31 > 0:10:33CPR? What do you call it?
0:10:33 > 0:10:35- Ha! That, you call CPR? - What do you call it?
0:10:35 > 0:10:39A waste of time. Maybe even a waste of a life.
0:10:39 > 0:10:42I don't know who you think you are, coming in here telling me...
0:10:42 > 0:10:44- Your new boss.- Well, I know for a fact that that is cobblers,
0:10:44 > 0:10:46because the new guy who is coming in...
0:10:46 > 0:10:49This is Mr Raffaello Di Lucca, Mr Griffin's new registrar.
0:10:49 > 0:10:51This is Dr Harry Tressler.
0:10:51 > 0:10:53That is the single worst example
0:10:53 > 0:10:57of cardiopulmonary resuscitation I've ever seen.
0:10:57 > 0:11:00You are never to perform CPR on my watch again
0:11:00 > 0:11:02until I've personally retrained you.
0:11:02 > 0:11:03Seriously, you must be...
0:11:03 > 0:11:07OK. This is my one speech. CPR is my big, gnarly passion.
0:11:07 > 0:11:09So listen,
0:11:09 > 0:11:12in my opinion, CPR in this country is done badly.
0:11:12 > 0:11:15A junior doctor has a frenzied pump at a patient's chest.
0:11:15 > 0:11:18Stop at 20 minutes - ish. Game over.
0:11:18 > 0:11:20"Junior doctor"? I'm a...
0:11:20 > 0:11:23Other countries I've worked, Japan, Korea, America,
0:11:23 > 0:11:27you have a 33% chance of being resuscitated after cardiac arrest.
0:11:27 > 0:11:31Here - in Holby today - the percentage is somewhat less.
0:11:32 > 0:11:35Things around here are about to change.
0:11:46 > 0:11:48It's fascinating.
0:11:48 > 0:11:52The skull alone gives us a whole catalogue of information.
0:11:52 > 0:11:53Tell me everything.
0:11:53 > 0:11:56Well, there's an unusually enlarged nasal cavity.
0:11:56 > 0:11:58That'll be his embalmers, making room to fit a funnel.
0:11:58 > 0:12:00PAGER BEEPS
0:12:02 > 0:12:07Sorry. Excuse me. I'm going to have to call the ward.
0:12:18 > 0:12:21- Your prince was an adult. Probably over 45.- Really?!
0:12:21 > 0:12:25Most Egyptologists believe he died when he was a teenager.
0:12:25 > 0:12:26No. Not the skull of a teenager.
0:12:26 > 0:12:29- The fontanels... - Babies have big fontanels.
0:12:29 > 0:12:30Big gaps between the bones in the skull.
0:12:30 > 0:12:33At a certain age, those gaps begin to close.
0:12:33 > 0:12:34People shrink as they get older.
0:12:34 > 0:12:37Mary, I'm so sorry. I'm going to have to go back upstairs.
0:12:37 > 0:12:40We have an emergency appendisectomy and only me to whip it out.
0:12:40 > 0:12:42- Can I assist?- Me too?
0:12:42 > 0:12:44Well, you all need this on your rotation list.
0:12:44 > 0:12:45So yes, you can all observe.
0:12:45 > 0:12:48- But what about...?- I can stay and help Mary analyse the CT scans.
0:12:48 > 0:12:50Zosia, you of all people need to spend time in theatre.
0:12:50 > 0:12:54It would be great, if Dr March could possibly stay.
0:12:55 > 0:12:57OK, make it up next week. OK.
0:12:57 > 0:13:00Double-bubble in theatre. Come on, guys.
0:13:10 > 0:13:12And, this is Adele Effanga, HCA.
0:13:12 > 0:13:13- Are you texting?- Are you asking?
0:13:13 > 0:13:15- Yes.- Guilty.
0:13:15 > 0:13:17Who are you?
0:13:17 > 0:13:19- New registrar.- Ah! Adele.
0:13:19 > 0:13:21Your new registrar.
0:13:22 > 0:13:24- Ri-ight.- Your phone.
0:13:24 > 0:13:26Er, what? Nah...
0:13:26 > 0:13:28You'll get it back at the end of the day.
0:13:28 > 0:13:30I ever see you using it on the ward again,
0:13:30 > 0:13:32I'll make sure you're disciplined.
0:13:32 > 0:13:33Are you serious?
0:13:33 > 0:13:35And I'll microwave it.
0:13:37 > 0:13:39He a strippogram?
0:13:39 > 0:13:40No.
0:13:40 > 0:13:42Who's your patient?
0:13:42 > 0:13:43OK, ED have called it in.
0:13:43 > 0:13:45With palpitations and shortness of breath.
0:13:45 > 0:13:47This is Tay. Tay Simons.
0:13:47 > 0:13:49He said he was named after the river.
0:13:49 > 0:13:50But, like, what river?
0:13:50 > 0:13:53OK, notes also say he was treated before at Queen's Hospital.
0:13:53 > 0:13:56I think he's in some play or something. Are you in a play?
0:13:57 > 0:13:59It's my school uniform.
0:13:59 > 0:14:02Tay, what treatment were you in hospital for before?
0:14:02 > 0:14:04Fashion bypass?
0:14:05 > 0:14:07Kidney transplant.
0:14:13 > 0:14:14Hi.
0:14:16 > 0:14:18Ah, bless.
0:14:18 > 0:14:20How's she doing?
0:14:20 > 0:14:23Blood pressure is 60 over 40. Oxygen sats are good.
0:14:23 > 0:14:25Up by 10%.
0:14:25 > 0:14:27She's still on the ventilator?
0:14:27 > 0:14:29Coming off it for a while, today.
0:14:29 > 0:14:31Good. Great. First step.
0:14:34 > 0:14:37- To?- Taking her home. You must be so excited.
0:14:40 > 0:14:43- What have you lost?- My lupes.
0:14:46 > 0:14:48Marvellous.
0:14:48 > 0:14:49Busy?
0:14:49 > 0:14:51List is chock-a-block.
0:14:51 > 0:14:54In the middle, I've got a lung decortication.
0:14:55 > 0:14:58Three hours peeling off fibrous membrane. Bummer.
0:14:58 > 0:15:02- You?- No. They're keeping my list light and easy.
0:15:02 > 0:15:04Just in case the act of giving birth
0:15:04 > 0:15:06has turned my brain to butternut squash.
0:15:06 > 0:15:08Right.
0:15:08 > 0:15:11I could help with your peel? Leapfrog it. Take turns.
0:15:11 > 0:15:13- Free you up? - I'm not sure I...
0:15:13 > 0:15:17I'm being paid £110,000 a year to download my baby pictures!
0:15:17 > 0:15:18Tag me later.
0:15:20 > 0:15:22Right.
0:15:29 > 0:15:31And you had the transplant...?
0:15:31 > 0:15:33Nearly two years ago.
0:15:33 > 0:15:38Do you mind? Pains around the lower quadrant, around your back?
0:15:38 > 0:15:39No.
0:15:39 > 0:15:41But I didn't want to come.
0:15:43 > 0:15:46House Master insisted because I had a cough
0:15:46 > 0:15:49- and so, Matron took my temperature and...- She was right.
0:15:59 > 0:16:0135,000 thousand squids a year!
0:16:01 > 0:16:03- What?- His school.
0:16:03 > 0:16:05That's like a Mazda convertible,
0:16:05 > 0:16:07a boob job and a week in the Maldives
0:16:07 > 0:16:09every single year for, like, ten years.
0:16:09 > 0:16:12You're not serious?
0:16:15 > 0:16:16Dr Tressler. Thoughts?
0:16:16 > 0:16:18TAY COUGHS
0:16:18 > 0:16:23Well, X-ray. CT scan. Get hold of his previous medical notes...
0:16:23 > 0:16:25Better still, send him up to Keller, general ward,
0:16:25 > 0:16:28where they can do a full assessment of FBCs, LFTs, U&Es.
0:16:28 > 0:16:31Rule out problems with renal system, rule out infection.
0:16:31 > 0:16:34Problems with his lungs, then send him up to Darwin.
0:16:34 > 0:16:36In other words, ship him out?
0:16:36 > 0:16:38We're AAU. That's kind of what we do.
0:16:40 > 0:16:44When you cough, do you sometimes see blood flecks in the mucus?
0:16:45 > 0:16:47Get me those notes.
0:17:01 > 0:17:05Mr Levy, could I bend your ear a minute?
0:17:06 > 0:17:08- We need a chest X-ray.- Right.
0:17:08 > 0:17:10If there's a queue - bump him.
0:17:10 > 0:17:11OK.
0:17:11 > 0:17:15"Matron" e-mailed over his list of his medications.
0:17:15 > 0:17:19Have you been taking your medication regularly, as prescribed?
0:17:19 > 0:17:23Always. Matron is very strict.
0:17:23 > 0:17:25- Like the sound of that.- Really?
0:17:26 > 0:17:30You'd want to be treated like a six-year-old all the time?
0:17:30 > 0:17:31Any side-effects?
0:17:32 > 0:17:35Dry mouth, hot flushes.
0:17:35 > 0:17:37Bit of a Nazi, is she?
0:17:37 > 0:17:40Whole school's like a prison camp.
0:17:40 > 0:17:43Mostly, it's because everyone's scared my dad'll sue them.
0:17:43 > 0:17:45Your dad?
0:17:46 > 0:17:48Know what litigious means?
0:17:48 > 0:17:49Not really.
0:17:49 > 0:17:51He likes to sue people.
0:17:51 > 0:17:52Is he a lawyer?
0:17:52 > 0:17:53Was...
0:17:53 > 0:17:56"School for Boys" - does that mean, there's no...?
0:17:56 > 0:17:57Distractions?
0:17:57 > 0:17:59Girls?
0:17:59 > 0:18:00Bummer.
0:18:00 > 0:18:02Major.
0:18:02 > 0:18:05Got the Queen's Hospital notes. OK.
0:18:05 > 0:18:07Details of transplant.
0:18:07 > 0:18:11List of treatments and medics. And on the list is a name...
0:18:11 > 0:18:13One we know really quite well.
0:18:14 > 0:18:18- Hi, Ms Effanga, pleased to meet you.- Mr Di Lucca.
0:18:18 > 0:18:20I just caught up with his ED file.
0:18:20 > 0:18:22Vomiting blood or coughing blood? Makes a big difference.
0:18:22 > 0:18:25I do know that. He was coughing. Which is why we sent for...
0:18:25 > 0:18:28A cardiothoracic surgeon. Yeah. Sorry, I didn't mean to sound...
0:18:28 > 0:18:31- Patronising? - Tay's father's just arrived.
0:18:31 > 0:18:34- You prescribed Zoptholex.- Yes. - Anti-rejection drug.
0:18:34 > 0:18:37Well, not me, not personally. It was my consultant.
0:18:37 > 0:18:40His chest pains are getting more severe. He's tachycardic at 110.
0:18:40 > 0:18:41And he's going the wrong way.
0:18:41 > 0:18:43His films are just up.
0:18:45 > 0:18:48- This here...- Could be...- ..a lesion.
0:18:48 > 0:18:50- Which could indicate... - ..an infection.
0:18:50 > 0:18:53Which may have been exacerbated by anti-rejection medications.
0:18:53 > 0:18:54Let's not jump to conclusions.
0:18:54 > 0:18:57Let me do an echo, listen to his lungs, then I can get a better idea.
0:18:57 > 0:18:59This is your fault. You made him sick.
0:18:59 > 0:19:02- This is Mr Simons.- I don't want this woman anywhere near my son.
0:19:04 > 0:19:07You know what I love about your style of teaching, Sacha?
0:19:07 > 0:19:09The warmth.
0:19:09 > 0:19:11Oh. Thank you. I try.
0:19:11 > 0:19:13The warmth and the care.
0:19:13 > 0:19:16You care about the patients and you care about your pupils.
0:19:16 > 0:19:18Well, I like to create an environment of...
0:19:18 > 0:19:21The first consultant I ever reported to was an absolute monster.
0:19:21 > 0:19:23Well, there are a few.
0:19:23 > 0:19:26Most horrible human being who ever drew breath.
0:19:26 > 0:19:30But, you know, I can honestly say to this day - hand on heart
0:19:30 > 0:19:33he's also the best surgeon that I have ever worked with.
0:19:33 > 0:19:37- Wow, that's...- I mean, he taught us like we were scum.
0:19:37 > 0:19:39But he taught us. Again and again.
0:19:41 > 0:19:42I take it this is about...?
0:19:42 > 0:19:44Zosia.
0:19:44 > 0:19:46Right.
0:19:46 > 0:19:48I mean, you know and I know,
0:19:48 > 0:19:50that she's not exactly enamoured with hands-on,
0:19:50 > 0:19:52knife and fork surgery.
0:19:52 > 0:19:54She asked to be let out of this.
0:19:54 > 0:19:56"One step up from plumbing".
0:19:57 > 0:19:59She can be quite dismissive.
0:19:59 > 0:20:02If she fails this surgical rotation, then she fails her F1 year.
0:20:02 > 0:20:06That's 12 months wasted. Her medical career potentially over...
0:20:06 > 0:20:08There is only so much cajoling I can do.
0:20:10 > 0:20:16Maybe teaching isn't where your real talents lie after all?
0:20:22 > 0:20:23What was that about?
0:20:23 > 0:20:25I have no idea.
0:20:25 > 0:20:27This is doctor-to-doctor.
0:20:27 > 0:20:29Nothing. On my life.
0:20:29 > 0:20:30So, why's Tay in hospital again?
0:20:30 > 0:20:32A hundred different reasons.
0:20:32 > 0:20:35The boy's just had someone else's kidney fitted in his belly!
0:20:35 > 0:20:36That doesn't come without consequences.
0:20:36 > 0:20:40But complications due to surgery two years down the line is unlikely.
0:20:40 > 0:20:42Last chance. What went wrong?
0:20:42 > 0:20:44Nothing.
0:20:44 > 0:20:47So why request you keep away?
0:20:47 > 0:20:48He's a control freak?
0:20:48 > 0:20:52A surgeon calling a civilian a control freak!
0:20:52 > 0:20:53You don't smell the irony?
0:20:53 > 0:20:55Bleeding's worse.
0:20:58 > 0:21:01- Do something!- Sit him up. Let's get him to theatre.
0:21:01 > 0:21:03OK, Tay, just sit up for me.
0:21:03 > 0:21:05HACKING COUGH
0:21:05 > 0:21:06What have you done to him?
0:21:06 > 0:21:09I need to know exactly what you people have done to my son!
0:21:09 > 0:21:11Quickly, please.
0:21:11 > 0:21:13COUGHING CONTINUES
0:21:18 > 0:21:21So you opted to do a decortation rather than be with Emma?
0:21:21 > 0:21:24Our baby is in the NICU with three monitors and five full-time staff.
0:21:24 > 0:21:25What am I supposed to do?
0:21:25 > 0:21:27- Just be with her. - I've been with her!
0:21:27 > 0:21:31- I've no choice, right...- Look, we've bonded. OK? It was awesome.
0:21:31 > 0:21:34- I have to be here. - And we'll bond again later.
0:21:34 > 0:21:36But you - you could be getting her room ready.
0:21:36 > 0:21:37Nest building?
0:21:37 > 0:21:38Preparation for...
0:21:38 > 0:21:41- Pandas or giraffes?- What?
0:21:41 > 0:21:44You want me to go home, stencil a jungle scene over her cot,
0:21:44 > 0:21:46so tell me, pandas or giraffes?
0:21:46 > 0:21:48Do we even have a cot?
0:21:49 > 0:21:53What I want is for you not to be at work...
0:21:53 > 0:21:54Or, at least not as much.
0:21:54 > 0:21:58And for you to stop acting like nothing has changed in your life.
0:21:58 > 0:21:59Well, it has.
0:21:59 > 0:22:01How, exactly?
0:22:01 > 0:22:04I'm online shopping on sites I've never used before.
0:22:08 > 0:22:10Wait a minute, what is this?
0:22:10 > 0:22:13He obviously had a hard life.
0:22:13 > 0:22:16The compression of the upper spine and arthritic nodules
0:22:16 > 0:22:19suggest he carried heavy weights in his youth.
0:22:19 > 0:22:21Maybe he wasn't always of high bearing.
0:22:21 > 0:22:25Maybe he worked his way up. Some sloves did become free men.
0:22:25 > 0:22:27"Sloves?"
0:22:27 > 0:22:30Did I say, "sloves"? I mean...
0:22:30 > 0:22:31Slaves?
0:22:31 > 0:22:34Yes.
0:22:34 > 0:22:35You mentioned parasites.
0:22:35 > 0:22:37Yes. Intestinal worms.
0:22:37 > 0:22:39Probably Guinea worm or some kind of tapeworm.
0:22:39 > 0:22:43So he'd have suffered diarrhoea, dehydration, anaem... Oh!
0:22:43 > 0:22:46Ohh!
0:22:48 > 0:22:50Mary?
0:22:55 > 0:22:59So you just went and bought everything?!
0:22:59 > 0:23:02Days-of-the-week bibs, steriliser, car seat.
0:23:02 > 0:23:05And a baby monitor, so sensitive I'll be able to hear her hair grow.
0:23:05 > 0:23:07And you didn't think... It just never occurred to you...
0:23:07 > 0:23:11that this might be something nice for us to do together?
0:23:12 > 0:23:15I thought you wanted me to bond?
0:23:15 > 0:23:16I do. But...
0:23:16 > 0:23:18I got you a present...
0:23:18 > 0:23:20in bland, to match your girlfriend.
0:23:27 > 0:23:29Has this happened before?
0:23:29 > 0:23:31I just fainted.
0:23:31 > 0:23:33- Has it? - I don't know when I last ate.
0:23:33 > 0:23:35Has it happened before?
0:23:35 > 0:23:37- Never.- That is a lie.
0:23:38 > 0:23:40Once.
0:23:40 > 0:23:42Have you got tingling feelings down your left arm?
0:23:42 > 0:23:44Bad circulation.
0:23:44 > 0:23:45Eyesight comes and goes?
0:23:45 > 0:23:47I spend far too much time in front of a computer screen.
0:23:47 > 0:23:49Words. You get some words wrong?
0:23:49 > 0:23:50I... I...
0:23:50 > 0:23:52I will give you three words.
0:23:52 > 0:23:53I'm fine.
0:23:53 > 0:23:55Transient Ischemic Attacks.
0:23:55 > 0:23:59Really... I'm just so very happy that the prince remained unhurt.
0:23:59 > 0:24:01TIAs, do you know what they are?
0:24:01 > 0:24:04Please, I just want to get back to the CT scan.
0:24:04 > 0:24:06Mini strokes.
0:24:08 > 0:24:11- So what've we got?- Bay three - cholecystitis.- Good, let's go.
0:24:11 > 0:24:13Four - ileostomy reversal.
0:24:13 > 0:24:14Possible.
0:24:14 > 0:24:16Leg ulcers.
0:24:16 > 0:24:17Varicose veins.
0:24:17 > 0:24:19Ah, varicose veins.
0:24:19 > 0:24:21- Really?- Really.
0:24:21 > 0:24:24Mr Tindal, good morning. Today is your lucky day.
0:24:24 > 0:24:26Right, let's get you prepped and ready for theatre.
0:24:26 > 0:24:27And I'm going to get Zosia.
0:24:27 > 0:24:29No-one dodges surgical training on my team.
0:24:32 > 0:24:34Zosia agreeing to do a varicose "nip and rip".
0:24:34 > 0:24:38You really see that happening?
0:24:38 > 0:24:39Did you see the look on her dad's face
0:24:39 > 0:24:42when she wasn't in the appendisectomy? Not a happy bunny.
0:24:45 > 0:24:46You have to let me take you upstairs.
0:24:46 > 0:24:48No!
0:24:48 > 0:24:51- And the mummy can't come. - Then definitely no.
0:24:51 > 0:24:55Mini strokes are a warning. They lead to bigger strokes.
0:24:55 > 0:24:58I only have him for four days.
0:24:58 > 0:24:59You might not have four days.
0:24:59 > 0:25:02All the stress and excitement could blow...
0:25:02 > 0:25:05I don't want any fuss!
0:25:05 > 0:25:07So you'd rather be paralysed?
0:25:07 > 0:25:09I know something is wrong. I've felt it for weeks. My arm...
0:25:09 > 0:25:11PAGER BEEPS
0:25:11 > 0:25:16But while I've got him here I am not being ill.
0:25:16 > 0:25:18That is my choice.
0:25:18 > 0:25:20A blood clot could choose for you.
0:25:20 > 0:25:22You could be upstairs removing an appendix. That was your choice.
0:25:22 > 0:25:25That doesn't float my boat. That's not the point.
0:25:25 > 0:25:27No, no, but this floats mine.
0:25:27 > 0:25:31This...unravelling the mystery,
0:25:31 > 0:25:36this makes me feel more alive than anything else.
0:25:36 > 0:25:39Until a clot lodges in your brain and pow!
0:25:39 > 0:25:41- So, you don't answer your pager any more?- Mary just...
0:25:41 > 0:25:45Choose your own curriculum. Decide what modules you think relevant...
0:25:45 > 0:25:46- ..collapsed!- What?
0:25:46 > 0:25:49Weakness in left arm. Slurring words. Elevated pulse...
0:25:50 > 0:25:52I'm fine.
0:25:52 > 0:25:54She won't let me examine her.
0:25:54 > 0:25:57Nonsense. You'll let me.
0:25:57 > 0:26:00Come on. Sit down. That's it.
0:26:02 > 0:26:04Let's have a look.
0:26:06 > 0:26:09Right. You're going to come up to the ward.
0:26:09 > 0:26:12OK? So we can take a proper look at you.
0:26:14 > 0:26:16I'm not going anywhere without my prince.
0:26:48 > 0:26:51OK, that's it.
0:26:56 > 0:26:57Mr Solis wants us. Now!
0:27:07 > 0:27:09Oh, I'm so sorry. I didn't mean you to rush.
0:27:09 > 0:27:13The pager message should have said not urgent. It's good news...
0:27:14 > 0:27:18But as always here, it comes with a side-order of caution.
0:27:18 > 0:27:20We have had a movement.
0:27:20 > 0:27:21Of?
0:27:21 > 0:27:24A bowel movement. Baby's first nappy!
0:27:25 > 0:27:28You called us here - we ran all the way here for that!
0:27:28 > 0:27:31This is massive. Not the bowel movement - that's tiny.
0:27:31 > 0:27:35It's like a sparrow. But it's massive in terms of her progress.
0:27:35 > 0:27:36Because of the hernia?
0:27:36 > 0:27:38A percentage of babies with CDH
0:27:38 > 0:27:41are readmitted with bowel obstruction as a result of surgery.
0:27:41 > 0:27:43But Emma's...
0:27:43 > 0:27:45The poop speaks volumes.
0:27:45 > 0:27:47She pooped!
0:27:47 > 0:27:48Isn't that great?
0:27:48 > 0:27:52Us neonatal doctors, we get obsessed with bowel movements.
0:27:52 > 0:27:55Nothing makes us happier than a soiled nappy!
0:27:55 > 0:27:57- So can we...?- You can!
0:27:57 > 0:27:58Hold her?
0:27:58 > 0:28:01It started with a poop. Ended with a cuddle.
0:28:08 > 0:28:10- Where's the father now? - Gone to phone the mother.
0:28:10 > 0:28:13- She's where? - On a yoga retreat - hard to reach.
0:28:16 > 0:28:17Anything from the drains.
0:28:17 > 0:28:19Pumping blood.
0:28:19 > 0:28:21The lungs are filling up.
0:28:21 > 0:28:24A kidney transplant presenting with bleeding lungs?
0:28:24 > 0:28:25It's not necessarily connected.
0:28:25 > 0:28:29- No.- If I was married to him, I think I'd be at a yoga retreat too.
0:28:29 > 0:28:33Actually, we're divorced. The stress caused by Tay's condition.
0:28:33 > 0:28:35Which it appears was entirely your fault.
0:28:35 > 0:28:37You and your incompetent team.
0:28:38 > 0:28:41Look, I'm really sorry for any stress that Tay's been under.
0:28:41 > 0:28:44Ms Effanga. How many heart/lung transplants
0:28:44 > 0:28:46have you been involved in?
0:28:46 > 0:28:47I don't know exactly.
0:28:47 > 0:28:48Ball park?
0:28:48 > 0:28:50More than fifty. Less than a hundred.
0:28:50 > 0:28:52OK. I want you in here, now.
0:28:52 > 0:28:54No. She's not putting a hand on my son.
0:28:54 > 0:28:57Now, Ms Effanga, means now.
0:28:57 > 0:28:59I don't want her operating on my son!
0:29:01 > 0:29:03And I don't want him to die.
0:29:05 > 0:29:07I'm going to complain to your superior.
0:29:07 > 0:29:10Do what you have to do. We'll do our job.
0:29:16 > 0:29:18It's far too warm in here. Where's my meter?
0:29:18 > 0:29:21Never mind your meter. We need to get you an angiogram
0:29:21 > 0:29:23and an ultrasound to check your blood flow.
0:29:23 > 0:29:27I can't stay here.
0:29:27 > 0:29:29Look, just to run some tests.
0:29:29 > 0:29:31What if she's right, and I have had a mini stroke?
0:29:31 > 0:29:33Then you're going to want to shove me into some bed.
0:29:33 > 0:29:36No, no. We can cross that bridge when we come to it.
0:29:36 > 0:29:38I can't stay. He can't stay.
0:29:38 > 0:29:40Statistics show that within three to seven days of a TIA
0:29:40 > 0:29:43there is a vastly increased risk of a full stroke.
0:29:43 > 0:29:44I don't care.
0:29:44 > 0:29:47I've only got Prince Karnak for three more days, and nothing is...
0:29:47 > 0:29:50A bed. A chair.
0:29:50 > 0:29:51- A box.- Zosia, please.
0:29:51 > 0:29:54Those are the three options after a full stroke. A bed.
0:29:54 > 0:29:56A chair. Or a box.
0:29:56 > 0:29:59Do you really want to risk your life over a shrivelled relic?
0:29:59 > 0:30:02All right, I'll get you another doctor to run those tests.
0:30:02 > 0:30:04Zosia.
0:30:06 > 0:30:09I'll do the angiogram and ultrasound.
0:30:09 > 0:30:11You are in theatre as of ten minutes ago. Varicose veins.
0:30:11 > 0:30:14"Nip and rip"? Thanks, but I think I'll pass.
0:30:14 > 0:30:16You're in theatre now. Or you're off my team.
0:30:16 > 0:30:18- Come on.- I mean it.
0:30:24 > 0:30:26OK, so I may have oversold it slightly.
0:30:26 > 0:30:28It's not so much a cuddle. More of a cradle.
0:30:28 > 0:30:30I've wanted to hold her so much.
0:30:30 > 0:30:31It's frustrating, I know.
0:30:31 > 0:30:35- But she looks so fragile. - Now's your chance.
0:30:36 > 0:30:38Will you do the honours?
0:30:38 > 0:30:40Sit down, and I'll pass her to you.
0:30:43 > 0:30:45Keep everything very slow.
0:30:45 > 0:30:48It's a bit like reversing a strange car for the first time.
0:30:48 > 0:30:50Got to watch out for all the corners.
0:30:50 > 0:30:52BABY WHIMPERS
0:30:52 > 0:30:53That's it.
0:30:53 > 0:30:56Gently support the head.
0:30:56 > 0:30:59I have had guinea pigs bigger than she is.
0:30:59 > 0:31:01Sit down. I'll pass her to you.
0:31:04 > 0:31:06- Jac?- You go first.
0:31:06 > 0:31:09No, she's your wee girl, you gave birth to her...
0:31:09 > 0:31:10You hold her.
0:31:15 > 0:31:16I'm sorry, she's not...
0:31:16 > 0:31:18There's only one thing that matters.
0:31:21 > 0:31:23Do you think I should go and get her?
0:31:23 > 0:31:27I think you should hold your daughter.
0:31:33 > 0:31:35- There we go! You got her?- Yeah.
0:31:35 > 0:31:37Oh, hello!
0:31:37 > 0:31:40I know, I know.
0:31:44 > 0:31:46BABY SQUAWKS
0:31:50 > 0:31:52Why did you do that?
0:31:52 > 0:31:54Perform a thoracotomy?
0:31:54 > 0:31:57Ignore the wishes of a young patient's parent.
0:31:57 > 0:31:58You like being told what to do
0:31:58 > 0:32:01by people who aren't qualified to make the call?
0:32:01 > 0:32:03- Obviously not.- Me neither. So?
0:32:10 > 0:32:15There's an awful lot of pus. More suction, please.
0:32:15 > 0:32:16The poison he ingested
0:32:16 > 0:32:18that messed up his kidney in the first place - what was it?
0:32:18 > 0:32:21Said he accidentally ate a death cap mushroom.
0:32:21 > 0:32:23How did he "accidentally" eat a death cap?
0:32:23 > 0:32:27Teenage experimentation, I guess. Picking magic mushrooms...
0:32:27 > 0:32:28Big mistake.
0:32:30 > 0:32:31Why did you ask me in here? I mean,
0:32:31 > 0:32:34you could have just sent me upstairs. Let the boss sort it out.
0:32:34 > 0:32:35I wanted to see how good you are.
0:32:35 > 0:32:37You never really know a surgeon
0:32:37 > 0:32:39until you've seen them with a knife in their hand.
0:32:47 > 0:32:50Oh. Graced us with your presence in theatre, at last.
0:32:50 > 0:32:51Shouldn't we be honoured(!)
0:32:51 > 0:32:52Shut up, Dom. I had no choice.
0:32:52 > 0:32:53Sacha got all on my case.
0:32:53 > 0:32:56- Maybe because someone rattled his cage.- Who?
0:32:59 > 0:33:03It's a train wreck... Blood vessels around both lobes are haemorrhaging.
0:33:03 > 0:33:05Tissue's mushy.
0:33:05 > 0:33:06- So?- So, this is a 17-year-old boy
0:33:06 > 0:33:09with the lungs of a 70-year-old asbestos worker.
0:33:09 > 0:33:10Well, can we save them?
0:33:10 > 0:33:14I really don't know. Honest answer - probably not.
0:33:14 > 0:33:17- Way forward? - The only option is pneumonectomy.
0:33:17 > 0:33:19Why did this happen?
0:33:19 > 0:33:21- Infection. - Linked to the kidney transplant?
0:33:21 > 0:33:24No, the mushroom toxin wouldn't affect his lungs,
0:33:24 > 0:33:25not this long after.
0:33:25 > 0:33:28No, but the anti rejection meds would compromise his immune system.
0:33:28 > 0:33:30Yeah. That's what they're meant to do.
0:33:30 > 0:33:32After transplant, we have to shut down the body's responses,
0:33:32 > 0:33:34otherwise it'll attack that big old lump of meat
0:33:34 > 0:33:36that we've grafted into him.
0:33:39 > 0:33:40It's Mr Self.
0:33:40 > 0:33:42Tell him I'm in theatre.
0:33:42 > 0:33:44I think he knows. He's called you on the theatre phone.
0:33:45 > 0:33:49Mr Self, can we update you later? Thank you.
0:33:50 > 0:33:53You some kind of rebel against authority?
0:33:53 > 0:33:54Do you like your job?
0:33:54 > 0:33:56- Transplant?- Yeah.- I love it.
0:33:56 > 0:33:58Except on days like these.
0:33:58 > 0:34:00You don't like it when things go wrong?
0:34:00 > 0:34:01Do you?
0:34:02 > 0:34:04I love it.
0:34:05 > 0:34:06Oooh!
0:34:28 > 0:34:30Oh, Jac, she's so beautiful.
0:34:30 > 0:34:31Do you want to hold her?
0:34:31 > 0:34:34I think that's enough. We don't want to tire Emma out.
0:34:39 > 0:34:41Jac, she's so light. Jonny's right,
0:34:41 > 0:34:43like a little guinea pig.
0:34:43 > 0:34:45I wouldn't know.
0:34:45 > 0:34:47You've never had a guinea pig?
0:34:50 > 0:34:53B/P's dropping. Push more fluids and FFPs.
0:34:53 > 0:34:55- Adrenaline's going in. - Volume's still dropping.
0:34:55 > 0:34:57Lungs like a sieve.
0:34:57 > 0:34:58Saturations falling down to 82.
0:34:58 > 0:35:00We can't wait for the antibiotics to kick in,
0:35:00 > 0:35:01just in case they might work.
0:35:01 > 0:35:04We need to get more oxygen into his bloodstream, or he'll die.
0:35:04 > 0:35:07Rack the PIP up to 45 and the PEEP to 15.
0:35:07 > 0:35:08We need to get him on ECMO.
0:35:08 > 0:35:11VV would be ideal, but as he's so unstable, VA's the only option.
0:35:11 > 0:35:15Yeah. That'd be great but we don't have one. The nearest one's probably...
0:35:15 > 0:35:17Leicester. There's two in Newcastle.
0:35:17 > 0:35:19In Japan, ECMO is standard.
0:35:19 > 0:35:20Yeah, well, not here.
0:35:24 > 0:35:26If it was me and my son had to have a transplant,
0:35:26 > 0:35:29I'd be climbing the walls too. Fingernails in the plasterboard.
0:35:29 > 0:35:32It's not your son. And you have no idea what it's like.
0:35:32 > 0:35:34OK. Well, I understand your...
0:35:34 > 0:35:37I did not give permission for her to operate on him.
0:35:37 > 0:35:39And I want to make an official complaint.
0:35:39 > 0:35:41It was an emergency procedure.
0:35:41 > 0:35:44Your son's welfare was seriously compromised.
0:35:44 > 0:35:45He's a very sick young man.
0:35:45 > 0:35:47Because of the kidney they gave him.
0:35:47 > 0:35:49No, we don't know there's anything wrong...
0:35:49 > 0:35:53- Or the drugs they put him on.- ..with the donor kidney or the schedule of medications that he was put on.
0:35:53 > 0:35:56Someone has to shoulder the blame!
0:35:56 > 0:35:57I'm sorry, what blame?
0:36:03 > 0:36:06Look, I'm just trying to get up to speed here.
0:36:06 > 0:36:09Why did he have the kidney transplant in the first place?
0:36:09 > 0:36:11What was it that caused the damage?
0:36:11 > 0:36:13There was an incident with... wild fungi.
0:36:13 > 0:36:15- Right.- The mushrooms were... PHONE RINGS
0:36:15 > 0:36:19- ..that he ate, they...ah... - Excuse me one minute.
0:36:19 > 0:36:22Yes. I'll be right there.
0:36:22 > 0:36:25You're not going anywhere until you've answered my questions.
0:36:25 > 0:36:27I'm afraid your son has stopped breathing.
0:36:27 > 0:36:30How dare you let her hold my baby before I've had a chance to!
0:36:30 > 0:36:32I offered. You didn't want to.
0:36:32 > 0:36:37- I wasn't... - Ready? Yep. Jonny was. Bonnie was.
0:36:37 > 0:36:39Most important of all, Emma certainly was.
0:36:39 > 0:36:40I'm her mother.
0:36:40 > 0:36:44Who chose to be the busy consultant rather than hold her own baby.
0:36:44 > 0:36:48Has it ever occurred to you that I might find the first time...
0:36:48 > 0:36:53- Difficult?- Difficult? Yup. That's not my concern.
0:36:53 > 0:36:57What goes on inside your head it's not my remit.
0:36:57 > 0:36:58I can't let it make any difference.
0:36:58 > 0:37:00I have to put Emma first.
0:37:04 > 0:37:06I have been in Neonatal ITU for 16 years.
0:37:06 > 0:37:12It's the most singularly depressing and uplifting unit in any hospital.
0:37:12 > 0:37:14Do you know how many babies I've watched die?
0:37:14 > 0:37:16What's this - mine's-bigger-than-yours?
0:37:16 > 0:37:191,334.
0:37:23 > 0:37:24You count?
0:37:24 > 0:37:27I count. Every. Single. One.
0:37:28 > 0:37:31In here, we measure lives in minutes.
0:37:31 > 0:37:35Every single one of those mothers would rip her own heart out
0:37:35 > 0:37:38for a chance to hold her baby.
0:37:40 > 0:37:43So this is Holby City's fault? Is that what you're saying?
0:37:43 > 0:37:46You're telling me this hospital doesn't have the right equipment?
0:37:46 > 0:37:47No, he really is not saying that.
0:37:47 > 0:37:50- He's like this because you don't have an...?- ECMO.
0:37:50 > 0:37:51Oh, for God's sake, what is...?
0:37:51 > 0:37:54Extracorporeal Membrane Oxygenator. It's a special pump.
0:37:54 > 0:37:56It takes the blood out of the heart,
0:37:56 > 0:37:59fills it full of oxygen and puts it back into the body,
0:37:59 > 0:38:01but without the lungs having to do any work.
0:38:01 > 0:38:03His lungs have been badly damaged, due to infection.
0:38:03 > 0:38:06ECMO is rare in emergency departments in the UK.
0:38:06 > 0:38:08Then get him to a hospital that has one.
0:38:08 > 0:38:12I'm afraid he won't survive being moved.
0:38:16 > 0:38:17He's going to die?
0:38:17 > 0:38:20At this stage, it's impossible to predict the outcome.
0:38:24 > 0:38:27- This was me. - Sorry?- I did this.
0:38:27 > 0:38:29Mr Simons, fault is not something we...
0:38:29 > 0:38:30Wild food foraging.
0:38:30 > 0:38:33You picked the death cap?
0:38:33 > 0:38:35Woodland mushroom risotto.
0:38:35 > 0:38:37I thought any idiot can identify a mushroom.
0:38:37 > 0:38:41I mean people have been living off the land for thousands of years.
0:38:44 > 0:38:47Could we get an ECMO team helicoptered in with their kit?
0:38:47 > 0:38:49Unlikely. It would still take too long.
0:38:49 > 0:38:52His lungs are so shot. Like soggy tissue paper.
0:38:52 > 0:38:55OK, so how do we rest his lungs without ECMO?
0:38:56 > 0:38:58We build it!
0:38:58 > 0:38:59Surgical stores. Show me.
0:39:10 > 0:39:13There. Ligation and stripping of the varicose vein.
0:39:13 > 0:39:14Nip and strip.
0:39:14 > 0:39:16Oh, sweet joy.
0:39:16 > 0:39:17Listen, don't knock it.
0:39:17 > 0:39:19This may not be the pinnacle of surgical glamour,
0:39:19 > 0:39:22but the skills you hone during varicose vein removal
0:39:22 > 0:39:24will translate directly to many more exciting operations,
0:39:24 > 0:39:27- such as, Arthur? - Ooh, aortic aneurysm.
0:39:27 > 0:39:29- Yep.- Ileostomy, pancreatic duct deviation.
0:39:29 > 0:39:32Good. Excellent, excellent. All the same basic techniques.
0:39:32 > 0:39:34Joining pipes. Or removing pipes?
0:39:34 > 0:39:36- No.- Plumbing, in other words.
0:39:37 > 0:39:40Right. This is how it's going to go. Show one, do one, OK?
0:39:40 > 0:39:42I've shown you three - now you do.
0:39:42 > 0:39:43Yes, yes.
0:39:43 > 0:39:45Things to remember?
0:39:45 > 0:39:46- Tie the junction. - Insert guide wire.
0:39:46 > 0:39:48Double tie the junction.
0:39:48 > 0:39:51Sorry, double tie the junction.
0:39:51 > 0:39:54I've done the ultrasound on Museum Mary's carotid.
0:39:54 > 0:39:56- And?- You should take a look.
0:39:58 > 0:40:00OK. You two. Continue, right?
0:40:00 > 0:40:02Take out these other three short tributaries.
0:40:02 > 0:40:06Remember, take it slow and keep it neat.
0:40:15 > 0:40:20So you nip and I'll rip. And then we'll change over.
0:40:20 > 0:40:21I'll nip. You rip.
0:40:21 > 0:40:22You make it sound so inviting.
0:40:29 > 0:40:30OK, we tied off?
0:40:30 > 0:40:32- Yes.- Double tie?
0:40:32 > 0:40:34Yes!
0:40:34 > 0:40:35Nearly ready to rip.
0:40:40 > 0:40:44You do know the real reason Sacha arm-twisted you into here, now?
0:40:44 > 0:40:46Illuminate me.
0:40:46 > 0:40:48Your father.
0:40:48 > 0:40:53Had a massive go at Sacha about not pushing you into theatre.
0:40:54 > 0:40:56My father spoke to Sacha about me?
0:40:59 > 0:41:01OK. Ripping on three.
0:41:01 > 0:41:03One. Two. Three.
0:41:03 > 0:41:06- You said you tied it!- I did!
0:41:06 > 0:41:08Yes, quickly, hurry. We need to stem the bleed.
0:41:11 > 0:41:14OK, we've got access to the median sternotomy.
0:41:14 > 0:41:16So we just need to bodge up a simple circuit.
0:41:16 > 0:41:19One tube through his vena cav. One through his aorta.
0:41:19 > 0:41:22One cav. One aorta. Check.
0:41:22 > 0:41:25You are not seriously going to build this?
0:41:25 > 0:41:28I'm open to alternative suggestion? But it's this, or we lose him.
0:41:28 > 0:41:31We could use a normal CPB cannula
0:41:31 > 0:41:35- and a big two-stage for the right atrium.- Nice.
0:41:39 > 0:41:41An 18-French for the aorta.
0:41:41 > 0:41:44Do you actually know how to build it?
0:41:44 > 0:41:45Not exactly.
0:41:45 > 0:41:46If this doesn't work...
0:41:46 > 0:41:49On my own head? Deal?
0:41:49 > 0:41:51OK. Well, you're going to need a VAD pump.
0:41:54 > 0:41:56Three-eighth pump head?
0:41:56 > 0:41:59Check.
0:41:59 > 0:42:02Three-eighths tubing and half inch for the venous line.
0:42:02 > 0:42:04Pigtail connectors.
0:42:04 > 0:42:08We need an oxygenator and a heat exchanger.
0:42:08 > 0:42:10Defunct.
0:42:10 > 0:42:13OK. So if we don't have a heat exchanger...
0:42:13 > 0:42:15Maybe we could just use...
0:42:15 > 0:42:16- A bucket.- A bucket!
0:42:16 > 0:42:19- Right, push more units. - More blood!
0:42:19 > 0:42:22Push more blood. Hold it fast, tightening the stitches.
0:42:22 > 0:42:24Folding it over.
0:42:27 > 0:42:30OK. OK, yeah, I can get through there.
0:42:30 > 0:42:31- Yeah?- Yeah.- OK?
0:42:31 > 0:42:33- Yeah. Just...- Oh, sorry.
0:42:35 > 0:42:40We need more suction and I want two bulldog clips and some sloops.
0:42:43 > 0:42:46OK. I told you to tie off the vein.
0:42:46 > 0:42:49I did, I double tied it.
0:42:49 > 0:42:50Yeah, but you tied the wrong vein.
0:43:03 > 0:43:04Right, sats are 40%.
0:43:04 > 0:43:07Bradycardic. He's going to arrest any minute if we don't do this.
0:43:07 > 0:43:08Heparin in.
0:43:10 > 0:43:11Dividing lines.
0:43:16 > 0:43:19- Circuits ready.- What about the venous line in the right atrium?
0:43:19 > 0:43:23It's in. Clamps are off.
0:43:27 > 0:43:30Pumps at 2,000 revs.
0:43:30 > 0:43:32Got flow.
0:43:32 > 0:43:34OK, increase revs to one third flow.
0:43:37 > 0:43:39Looking good.
0:43:39 > 0:43:45OK, let's go to half. Sats to 71.
0:43:47 > 0:43:50All right, let's go up to two thirds flow.
0:44:02 > 0:44:03Sats are 98!
0:44:03 > 0:44:06Houston, we have lift-off!
0:44:08 > 0:44:11Slick, guys. Very, very slick.
0:44:13 > 0:44:17Are you hungry? Surgery always makes me hungry.
0:44:17 > 0:44:19Starving!
0:44:21 > 0:44:23Jac.
0:44:25 > 0:44:27I'm sorry.
0:44:27 > 0:44:31I feel terrible about...
0:44:33 > 0:44:34Can we talk?
0:44:34 > 0:44:38I would rather have my eyes pecked out by seagulls.
0:44:38 > 0:44:41I didn't know you hadn't held her. Jonny never said.
0:44:41 > 0:44:43I went with him to see Emma
0:44:43 > 0:44:45and before I knew it she was in my hands.
0:44:47 > 0:44:51Look, I can coo and cluck and sound like I love babies
0:44:51 > 0:44:55but the truth is, I know nothing about them.
0:44:55 > 0:44:56I'm 29!
0:44:56 > 0:44:59What I want most in my life is a car that actually works
0:44:59 > 0:45:01and a snowboarding holiday.
0:45:01 > 0:45:03Lots of necks get broken snowboarding.
0:45:05 > 0:45:10You gave birth to that beautiful little girl. To Emma.
0:45:10 > 0:45:14Don't! I hate it when I hear you say her name.
0:45:15 > 0:45:17Good. You should.
0:45:17 > 0:45:18When I saw you holding her...
0:45:18 > 0:45:22I wanted to reach across that cot and rip your throat out.
0:45:24 > 0:45:25So why didn't you hold her?
0:45:34 > 0:45:37So you still just bully anyone who doesn't do exactly what you want?
0:45:37 > 0:45:41Directly interfering in my training? Telling my tutor...
0:45:41 > 0:45:42That's my job.
0:45:42 > 0:45:45Just because you chose to come and work in the same hospital where I...
0:45:45 > 0:45:47Work? Darling, I run this hospital.
0:45:48 > 0:45:51You forced Sacha Levy to put me in theatre.
0:45:51 > 0:45:53Keller is a surgical rotation.
0:45:53 > 0:45:54I don't want to be a surgeon.
0:45:54 > 0:45:57I don't want to be anything like you.
0:45:57 > 0:45:59No, you don't even want to use my name. "Dr March?"
0:45:59 > 0:46:02What is that all about?
0:46:19 > 0:46:21You can talk to her, you know.
0:46:21 > 0:46:23Yeah. She's going to hang on my every word?
0:46:24 > 0:46:27She knows your voice better than anyone.
0:46:27 > 0:46:29She's heard it every day.
0:46:32 > 0:46:35Don't you think that might be comforting now?
0:46:39 > 0:46:41Hello.
0:46:44 > 0:46:46Hello, Emma. I'm your...
0:46:54 > 0:46:58- I want to hold her. - Sorry?- I want to hold her.
0:46:58 > 0:47:00Now's not a good time.
0:47:00 > 0:47:03She's just come off an O2 top-up and a small feed.
0:47:03 > 0:47:05If you come back in, I don't know, um...
0:47:05 > 0:47:07No. I want to hold her now.
0:47:07 > 0:47:10I'm so sorry, Jac. In terms of her care cycle,
0:47:10 > 0:47:13this wouldn't be an appropriate time.
0:47:14 > 0:47:16Let me hold my baby.
0:47:54 > 0:47:57- Cronut?- Yep. Cross between a croissant and a donut.
0:47:57 > 0:47:59All the rage in New York.
0:47:59 > 0:48:00Your wife makes these from scratch?
0:48:00 > 0:48:02No recipe. Nothing.
0:48:02 > 0:48:05My wife can do just about anything she sets her mind to.
0:48:05 > 0:48:08- Nearly anything.- She wouldn't be interested in leaving you
0:48:08 > 0:48:09and marrying me, would she?
0:48:09 > 0:48:12She comes with two neurotic Persian cats,
0:48:12 > 0:48:15and a mother like a pit-bull on crack.
0:48:21 > 0:48:24- Could just as easily have been Dad who ate it.- Yep.
0:48:24 > 0:48:27Could be him lying in there, fighting for his life.
0:48:27 > 0:48:29You don't think he wishes it was?
0:48:49 > 0:48:51Melted cheese!
0:48:51 > 0:48:54- Don't try and stop me. - Melted mozzarella cheese.
0:48:54 > 0:48:56- A couple more days is all I need. - Like on a pizza.
0:48:56 > 0:48:58If we did a CT scan on your brain right now,
0:48:58 > 0:48:59that's exactly what we'd find.
0:48:59 > 0:49:01Little tiny lesions that look like melted cheese.
0:49:01 > 0:49:04- I don't care. - The artery in your neck
0:49:04 > 0:49:06is starving your brain of blood, OK?
0:49:06 > 0:49:08Your vessels will rupture and fuse your synapses.
0:49:08 > 0:49:11Listen, I'm really grateful for everything you've done...
0:49:11 > 0:49:13Dr March... Dr March was right.
0:49:13 > 0:49:15A bed, a chair or a box. That's how this could end.
0:49:15 > 0:49:18In three days' time, you could be deader than that.
0:49:18 > 0:49:21I know this doesn't make sense to you...
0:49:21 > 0:49:22It does, I promise you, Mary. It does.
0:49:22 > 0:49:25I understand passion, obsession, compulsion.
0:49:25 > 0:49:27What I don't understand is how a beautiful,
0:49:27 > 0:49:30- intelligent woman would waste her life on a lie.- Lie?
0:49:30 > 0:49:34Lots of these mummies were switched around by Victorian collectors, yes?
0:49:34 > 0:49:38Some of the tombs that were grave-robbed lost their bodies.
0:49:38 > 0:49:42Yes, and some of the bodies ended up in empty sarcophagi,
0:49:42 > 0:49:44to make them more collectable.
0:49:44 > 0:49:46- That's great. Right. Look at this. - No, no, don't...
0:49:46 > 0:49:49We didn't get a chance to get into this before your short circuit.
0:49:49 > 0:49:50Look. Look at the prince's pelvis.
0:49:53 > 0:49:56See? See the way it's broad across there. And just look, look.
0:49:56 > 0:49:59There, there's a parting. OK. A split?
0:50:01 > 0:50:03Battle wound?
0:50:04 > 0:50:06Childbirth. The pelvis opens
0:50:06 > 0:50:10to allow the baby's head to be pushed through.
0:50:12 > 0:50:14You mean?
0:50:14 > 0:50:18Prince Karnak was a woman.
0:50:20 > 0:50:21I... I...
0:50:21 > 0:50:24So you see, you're going to need so much more time
0:50:24 > 0:50:26to unravel this particular mystery.
0:50:28 > 0:50:30But I...?
0:50:33 > 0:50:35Come on. Come on.
0:51:12 > 0:51:14Now. What do you think she smells of?
0:51:17 > 0:51:19- Toast.- Toast.
0:51:32 > 0:51:34This is just a temporary ECMO circuit.
0:51:34 > 0:51:38The mobile team is on its way with one to last him a few weeks.
0:51:38 > 0:51:41All we're really doing is giving his lungs a rest.
0:51:41 > 0:51:44Without the risk of damaging them with a mechanical ventilator.
0:51:44 > 0:51:46ECMO will do the work of the lungs.
0:51:46 > 0:51:50Giving the antibiotics a chance to fight the infection.
0:51:50 > 0:51:52And the tissue time to regenerate.
0:51:54 > 0:51:57I'm sorry. I...I behaved like a jerk.
0:51:58 > 0:52:00We see all sorts here.
0:52:00 > 0:52:04I just feel so guilty about...
0:52:04 > 0:52:06I lash out.
0:52:06 > 0:52:09I try to make it other people's fault.
0:52:09 > 0:52:11It's no biggie. Honest.
0:52:11 > 0:52:13We'll leave you to sit with him.
0:52:14 > 0:52:18I can't forgive myself - I poisoned my own son.
0:52:20 > 0:52:22It was an accident.
0:52:22 > 0:52:26I poisoned my only son.
0:52:28 > 0:52:31Can I ask you - does Tay blame you?
0:52:33 > 0:52:35He... I...
0:52:37 > 0:52:39He... Never.
0:52:40 > 0:52:44Not a word. Not a single recrimination.
0:52:45 > 0:52:47He's never said anything.
0:52:47 > 0:52:50So you beating yourself up about it, how does that help things?
0:52:52 > 0:52:56I think he blames me more for sending him to that school...
0:52:56 > 0:52:58He didn't sound too chuffed about it being all boys.
0:52:58 > 0:53:01It's the best education money can buy.
0:53:01 > 0:53:03- Maybe.- The best.
0:53:05 > 0:53:08He'd rather just live with me at home.
0:53:08 > 0:53:13Go to the local comp, hang out with girls at youth club.
0:53:13 > 0:53:17Sometimes "best" isn't always...best.
0:53:44 > 0:53:45Zosia.
0:53:45 > 0:53:48I am sure that one day, you are going to be a great psychiatrist.
0:53:48 > 0:53:53But today - today you are a very poor, very dangerous surgeon.
0:53:57 > 0:54:01This is a surgical rotation and if you're a rubbish surgeon,
0:54:01 > 0:54:03then that makes me a rubbish teacher.
0:54:03 > 0:54:05If the cap fits.
0:54:16 > 0:54:18I am the Clinical Skills Teacher.
0:54:18 > 0:54:21Me. This is the Sacha Levy School of Surgery...
0:54:21 > 0:54:24and I know that you have it in you to be a brilliant surgeon,
0:54:24 > 0:54:26- but if you don't want to be, you know what you can do?- What?
0:54:26 > 0:54:29Get. Out. Now!
0:54:42 > 0:54:43Tomorrow morning. 8am.
0:54:43 > 0:54:45I want you all in the wet lab,
0:54:45 > 0:54:48and you are going to perform a femoral venous stent,
0:54:48 > 0:54:49and to make it appropriate,
0:54:49 > 0:54:51an open artery fold suture.
0:54:51 > 0:54:53- Tomorrow? - Yes. Tomorrow. 8am sharp.
0:54:53 > 0:54:55And if any of you fails the test,
0:54:55 > 0:54:58then you will all fail this rotation.
0:54:58 > 0:55:01- That's not fair.- No, it's not fair. But that's how it's going to be.
0:55:01 > 0:55:02You can't just...
0:55:02 > 0:55:05I will accept nothing less than 100%.
0:55:05 > 0:55:09And if that is a problem, then there is the door.
0:55:10 > 0:55:12Use it!
0:55:38 > 0:55:41Jac, I've got a patient with a mitral valve replacement...
0:55:41 > 0:55:43No. Busy. Go away.
0:55:58 > 0:56:00Elliot!
0:56:05 > 0:56:08So you want me to commit my AAU department
0:56:08 > 0:56:12to buying a £90,000 extracorporeal membrane oxygenator pump?
0:56:12 > 0:56:15It would be the first in the southwest.
0:56:15 > 0:56:17Look, our patient today would have died
0:56:17 > 0:56:19without the one we cobbled together.
0:56:19 > 0:56:21- In the future...- You performed a procedure
0:56:21 > 0:56:24that's never been performed at Holby City before.
0:56:24 > 0:56:27Never in the UK, sir. I checked.
0:56:27 > 0:56:29Holby City made medical history.
0:56:29 > 0:56:33And you did all this without the guidance of the consultant who,
0:56:33 > 0:56:36I have to say, took a big risk in appointing you.
0:56:36 > 0:56:37If it'd been left up to me...
0:56:37 > 0:56:41Just imagine how much more I could do with Mr Griffin.
0:56:42 > 0:56:44So now, you want me to pat you on the back and say,
0:56:44 > 0:56:47"Good first day. Keep up the good work"?
0:56:47 > 0:56:50To be honest - I couldn't have done it without Mo Effanga.
0:56:50 > 0:56:54That is one registrar I'd fight to keep, if I was you.
0:56:54 > 0:56:57Oh, right, so now you're trying to tell me how to do my job as well?
0:56:57 > 0:57:00Sorry. I'd love to. But I can't... Not right now.
0:57:00 > 0:57:04Have to go pick up my wife. She doesn't do waiting.
0:57:04 > 0:57:07I could discuss it with you tomorrow if you like?