Things We Lost in the Fire Holby City

Herzig is a particularly delicate piece of...

I know, I know. No smoking, no drinking, no getting pregnant.

You are officially the fun police.

If you can finally let go of the resentment that you didn't get CEO,

maybe we can work together.

Only if you're prepared to give me a voice.

Tomorrow morning. 8am. I want you all in the wet lab.

If any of you fails this test, then you will all fail the rotation.

That's not fair.

No, it's not fair. But that's how it's going to be.

-You can't just...

-I will accept nothing less than 100%.

And if that is a problem, then there is the door.

Use it.

So... Here we are. "Back to Basics - Day 5

Surgical Incisions."

Now... You have in front of you

a water-filled balloon within a balloon to practise on, OK?

Now, what I want you to do is take your scalpel...

like so...and very, very gently just cut out a circle,

being very careful not to perforate the second balloon within.

Et voila!

Easy peasy.

Sorry, am I boring you, Dr Copeland?

Not at all. Fascinated.

Good. Because cutting with absolute precision is essential.

Particularly when making incisions close to vital organs.

ie the spleen.

Exactly, Dr Digby. I'm glad SOMEONE'S paying attention.

PAGER BEEPS

I'll be back in a minute.

How much longer is he going to make us

come in at the crack of dawn to perform these moronic tasks?

As long as we're stupid enough to go along with it.

If one of us fails, we all fail. That's what he said.

I know, and I was SO scared! Weren't you?

-HE IMITATES SACHA:

-I will accept nothing less than 100%.

And if that's a problem, there's the door!

Use it!

And I was being deadly serious, Dr Copeland.

So if you can't take this seriously, please leave.

Now.

Sorry, Mr Levy.

Dr Digby has far more experience than you,

and I don't see HIM complaining.

So if you don't want to fail this year -

again - then I suggest you take a leaf out of his book and just...

..get on with it.

What?!

What do you mean, you gave it to St James's?

I didn't even know they were in the running.

Well, thanks for your support!

Good morning.

No, it isn't. And you won't be needing the lift.

-You're covering AAU.

-Excuse me? I'm in strategy meetings all day.

Not anymore.

Ah. Did you finish the balloon exercise?

I made a perfect incision, Mr Levy. Very satisfying.

Good. Keep it up and you too will excel. Like Dr Digby.

Ah! Thank you!

I just wanted to get it framed for you.

It was looking a bit dog-eared on the wall of the staff room.

It's an example, really, to all the other students, to see

what can be achieved by determination and hard work.

To which end,

this is a list of the 20 most-common conditions

that we're likely to see, and their symptoms, OK?

And I'm going to set you a quiz

on the ABCs of each of those conditions.

It's a refresher course, really, on the fundamentals.

Complete familiarity enables us

to diagnose patients with more efficiency and accuracy.

Good luck!

-Mr Levy...?

-Yeah?

I really don't think I need to take the quiz.

Not with my level of experience.

Oh, I see.

The thing is... My previous training was a tad more, er...

sophisticated than this.

You're saying that

the fundamentals of medicine aren't sophisticated enough for you?

No, it's just that I think I've already grasped them,

as this would surely demonstrate.

It's part of the programme, OK? For all of you. Yeah.

He's wasting your time, he really is.

Hmm, I'm starting to agree.

Well, I mean, we have no choice. You - you're an F2.

Doctor Of The Year, no less.

You shouldn't have to put up with it,

especially from some loser who's been in the profession

for over 20 years and still hasn't made Consultant.

I was brought onto this team because of my experience

in business strategy, and that expertise has always been respected.

Look, I really don't need this hassle, especially not today.

Are you seriously asking me

to give up a whole day of meetings just because you're short on cover?

No, Serena, I'm not asking you - I am telling you.

I see.

Well, I'm sure the board will be delighted to know

you're using senior staff as nothing more than floating dogsbodies.

The board will be more interested to know why a substantial

amount of funding promised to us has been diverted to St James's.

Ah...

So unless your incredible business acumen

gives you a direct line to Bill Gates,

I suggest you take off those ridiculous shoes

and get yourself to AAU.

Daddy Mac?

Makes me sound a wee bit like a flasher.

Mac Daddy.

Sounds a wee bit too hip-hop for me.

-I like it.

-Well, maybe I could do hip-hop.

Nurse Maconie, I don't suppose you know where Jac is?

She's not due till nine o'clock.

Exactly. She's never normally this late.

Well, maybe she's been up all night building furniture for the nursery.

Or knitting a blanket.

Or reading up on baby massage or baby yoga or whatever.

Well, that's a good thing, isn't it - getting into the spirit?

I see it more as displacement activity bordering on OCD.

-Ah, Jac.

-Get me my theatre list. I'll be in my office.

"Good morning, Jonny. And how are you this morning?"

You're getting a nanny? So soon?

What?

Well, this is the first I'VE heard of it.

There's no way "Ludmilla" is getting anywhere near my wee girl!

Well, I suppose it makes sense.

Emma will be home soon and Jac is planning to work full-time.

Ah, yeah. Yeah, it makes sense all right. It makes sense to Jac.

Who am I to argue, right? Oh, yeah, that's right -

I'm her dad!

HE WOLFWHISTLES Looking sharp, Ms Campbell. Dior or Chanel?

Neither. But thank you.

Um, continue on broad-spectrum antibiotics and we'll take a view.

-Transfer from ED.

-Thanks.

Ms Effanga.

Not my fault, OK? Major bus-related stress.

I'm not that late anyway.

That may be, but you're also not suitably dressed.

Get into your uniform, wash your face

and take off those absurd nails

before you perforate somebody's bowel.

-I'll call you back in an hour. ..Sorry about that.

-Serena Campbell.

-I'll be looking after you today, Mr...

-Call me Billy.

Harry!

Well, don't look so pleased to see me.

What are you doing here?

It's a sad day

when you have to get admitted into hospital to see your only son!

At last.

Some eye candy to make this never-ending day go

-a little bit faster.

-He's a patient.

Yes. But he's not OUR patient.

Guys?

Maybe I spoke too soon.

Stop the press. Doctors may actually get to TREAT patients today.

Now you've focused on the theory, let's see you apply it in practice.

This is Danny Lewis. He is a fireman. He's 26 years old.

He was referred to us

from the ED after being involved in an incident at a plastics factory.

Bradycardic, abdominal pain, headache and nausea.

I'm fine, really...

Sorry, Danny. Danny, sorry, you need to keep that on.

Good.

I'm going to leave the diagnosis and the treatment up to you.

Now, I want you to treat this with absolute urgency, OK?

Chemicals from plastics can be highly toxic. Right, first thoughts?

Firstly we need to work out what toxins are causing his symptoms.

So WBCs, FBCs, U&Es...

Plus serum lactate levels, ABGs, and I'd recommend an ECG.

So far, so good. Right, keep me posted.

Like father, like son.

The flirtation gene's clearly dominant!

I'm nothing like him.

I agree. He's very charming!

He can be, absolutely, when it's in his own best interests.

There's no love lost, I take it.

Look, suffice to say, I'd be grateful

if I could have as little to do with him as possible.

-And I suggest you do the same.

-Do you?

We've found your notes, Mr Tressler.

It's Billy. I told you, I hate formality.

Yes, sorry.

So apart from the pain caused by the hernia, have you been

experiencing any other symptoms?

Any change in bowel movements, fatigue?

I've never felt better.

Do you smoke, drink?

In moderation, of course.

Well, you appear to be in very good shape for a man of your age.

Well, you're not looking so bad yourself.

So what's the deal?

Well, I need to examine you,

but your notes do suggest that surgery's going to be necessary.

Nurse, would you mind just...

Thank you. If you could just pop your feet up.

What do you do for a living,

if you don't mind my asking?

I'm in the hotel business - health clubs, spas.

I started as a kitchen porter.

And now your son's a doctor.

Well, he'd do anything not to follow in his father's footsteps.

Well, as Huxley said... "Sons have always a rebellious wish to

"be disillusioned by that which charmed their fathers."

Whoever he is, he was spot on.

When Harry finished med school, I said, "Why not take a year off,

"do an MBA, keep your options open?"

But he wouldn't have any of it.

Shame. I did a Business MBA at Harvard.

Did you?

You smart girl.

Were any of your colleagues admitted to the ED?

It would be useful for us to cross-reference results.

I was alone. We got separated.

Do you want me to call the station? They must be worried.

It's OK. I spoke to the chief.

OK. You're just going to help yourself if you stay calm, OK?

We're just going to ask you a few more questions.

It's difficult to stay calm when your oxygen levels are that low.

I am aware of that, Dr Copeland, but this information is important.

Keep the mask on when you're not speaking, Mr Lewis.

Er, thank you, Dr Copeland. Why don't you chase up those results?

I was about to do the ECG.

No, it's fine, I'll be doing that.

No. WE will. Mr Levy wants us to work together.

HE CLEARS HIS THROAT

Unlucky to be the only casualty.

I know. Wasn't even supposed to be working.

But it was a serious call and they were short of experienced men, so...

Sounds like a Hollywood movie.

What was that one with the big fire?

I wouldn't know. Can we please just focus on the job in hand?

Anyway, how did you end up on your own?

I thought in these movies there was always a partner

watching your back, who ends up getting killed halfway through.

Bomber Lewis always gets sent in first to do the recce.

Bomber Lewis! Cool name.

-Yeah, the lads gave it to me.

-Dr Copeland?

Go on.

We went on this shout once.

The roof wasn't secure so we were told to back off.

But there was this woman shouting,

"Lucy's still in there, you've got to find Lucy!"

And there was no way I was going to let this woman's kid die,

so I just bombed in there. Didn't even think about it.

Jamie Foxx would play you in the movie.

Anyway, there was no sign of any kid,

so I came back out, gutted, desperate,

and then I saw the woman...

hugging this dog.

Lucy was a dog?

Couldn't believe it.

Anyway, after that, all the lads started calling me Bomber Lewis

and it just stuck.

Well, it suits you. Very heroic.

OK, we really need to chase those blood results now, Dr Copeland, yep?

-Oh, for heaven's sake!

-Wait!

There's always a way.

I never give up - on anything.

I've heard. You've already made quite an impression.

Some people feel threatened by forward thinking.

But I'm not interested in innovation for its own sake.

Only ideas that improve efficiency, reduce time wasted...

In manufacturing, it's called lean processing.

You can start by tackling my mountain of filing.

I'd be happy to.

I think Mr Griffin might argue his project takes priority

-over alphabetising my files.

-Quite possibly.

But thank you for the offer. And for enabling my sugar rush.

You'll have to excuse me, I've got a patient I need to see.

-Do you mind if I join you?

-Oh! Be my guest.

Billy, this is my colleague, Mr Di Lucca.

TWO doctors? I hope I'm not getting preferential treatment.

All part of the service.

Now, we've decided to treat your hernia with what's known

as an open repair, which will involve making a small incision

and using mesh to repair the weakness in your abdominal wall.

Mesh? Not sure I like the sound of that.

It'll mean you won't need a general anaesthetic

and you should be able to go home shortly afterwards.

When I was out in Hong Kong, I was part of a team that developed

a self-fixing mesh that uses glue rather than sutures.

Oh, you're a globe-trotting innovator?

It was extraordinary. Patients spent less time in surgery,

faster recovery,

and a significantly decreased risk of infection.

I'd like to introduce it here.

-Pitch a trial to Mr Self.

-Given that I've already committed him

to several thousand pounds of new equipment, he may not be so keen.

Yes. Actually, I'd leave it a while.

What's not to like?

Being the first to introduce cutting-edge procedures

encourages further investment.

True. But all these things cost money.

Money we sadly do not have.

If you're not busy, would you like to scrub in?

-Love to.

-Good.

Just been chatting to your dad.

-Really?

-Great guy. Quite the mover and shaker.

Would never have put YOU two together, though.

-Ah, Lexy!

-Hello.

I heard you were gracing us with your presence today.

Having a check-up with Dr Frankenstein.

-Sorry, may I?

-And how's Tinny been behaving for you?

Well, I'm still here, aren't I? That's SOME sort of miracle.

I assume you're still not smoking?

No. And I'm staying off the communion wine, as you suggested.

Good. So how has your health been in general?

Fine. We tough old boots have strong constitutions.

I will never call you that again, I promise.

BP and heart rate are normal. Temperature's slightly raised at 38.

So, how are you getting on with your warfarin now?

I learnt my lesson. Taking one a day.

Religiously, as they say.

Good.

Right, Ms Naylor and I will be checking the Herzig's output.

And, Nurse Maconie, can we have full blood count and an INR test, please?

Thank you.

Mr Lewis's results. Looks like cyanide poisoning to me.

Thank you.

Danny's results are back.

His O2 saturation levels are low,

but his serum lactate levels have elevated to 11mm.

That could just be due to smoke inhalation

-and prolonged carbon monoxide exposures.

-Anything else?

A narrowing of the venous-arterial PO2 gradient

and metabolic acidosis has started to occur.

Kidney failure?

That's unlikely.

Now, look, I'm just thinking on my feet here,

but considering ALL the results,

it could be cyanide poisoning.

What's the goss, Jonny? Mad Mo not working today?

No, day off.

She'll be parked on the couch with a large tub of ice cream

watching back-to-back episodes of Banged Up Abroad.

Wouldn't we all be, given half the chance?! And how's little Emma?

Oh, she is just delicious.

Oh, I'm so pleased to hear that.

And I'm really glad you're looking so happy.

Last time I saw you...

I know. And, you know what, thank you for that -

for being there.

I really appreciate it.

It was my pleasure.

Perhaps...you could sneak me up later for a little Emma cuddle?

I'd have to get you past the guard dog first.

Cyanide poisoning is very rare.

But having reviewed the results, I think your diagnosis is spot on.

-Thank you.

-Which means we need to act quickly.

OK, have you seen a case before?

-Only once.

-And?

-He didn't make it, unfortunately.

OK. We could start him on sodium thiosulfate. 25ml at 50%.

I was thinking mononitrate, 20mg.

Sodium thiosulfate is the preferred treatment for cyanide poisoning.

Yes, but mononitrate has a more rapid onset of action,

and is safe to use on patients who have experienced smoke inhalation,

such as Danny.

Let's go with the mononitrate.

Theatre's booked. I just need you to sign this.

-They seem well into each other.

-What?

Your dad and Ms C. She's giving him the come-on. Look.

It's dead obvious.

Cyanide? That's poison, right?

You just need to try and relax

and let the antidote do its job.

But I don't understand. How did that happen?

Um, burning plastics can emit cyanide fumes.

But I'll be OK, yeah?

There's a variety of additional symptoms you may begin to exhibit -

dilated pupils, low levels of consciousness.

Can result in coma, cardiac arrest...

-Heart attack?!

-Dr Digby...

Cyanide has profound effects on the cardiovascular system.

But not in the levels that you've experienced.

I'm talking worst-case scenario. What can happen -

not what WILL happen.

You're unnecessarily scaring my patient.

YOUR patient? Since when?

I've established a relationship with him. I diagnosed him.

Yes. But I have the necessary experience to run the case.

Yes. But who do you think's impressed Levy so far?

Anything good on?

-Oh, we only seem to be able to get this one channel.

-Shame.

Herzig seems to be functioning normally.

Well, that makes a change.

You can stop looking so worried now, Prof.

I'm sorry. I know I'm being overprotective.

But Tinny's success is extremely important to me.

And I am just the human vessel

for your dastardly scientific experiments!

No. You are an extraordinary woman whose bravery

and good humour never ceases to amaze me.

I'm sorry to interrupt this little love-fest

but we do still have the problem of the raised temperature.

Is now the right moment to mention

the electric blanket I've been carrying around with me all day?

Um, Ms Naylor doesn't do jokes.

You told Professor Hope that your general health has been OK.

-Is that right?

-Yep.

A few aches and pains but that's just getting old, isn't it?

Anything else?

I've had a bit of bleeding from my gums...

But I've probably been brushing too hard.

That could be an indication there's an underlying infection.

Right, let's chase up the bloods, please, see if they tell us anything.

Thank you, Lexy.

Ms Naylor. Phone call for you.

I'm busy.

It's Elmswood Academy for Girls,

something about putting Emma on a waiting list?

What? She's four weeks old, Jac.

I'll take it.

Nurse Maconie, I assume that you can manage to finish off without me?

You seem perfectly capable of doing without ME, so...

What do you think they're talking about?

Ms Campbell will be talking him through his procedure.

She's practically sitting in his lap!

Look at them... He's like...

"You're all right for a posh bird."

-IN HIGH VOICE:

-"I'm quite partial to a bit of rough."

"I can be as rough as you like."

"Oh, Billy, take me now!"

Adele... Go and empty a bed pan or something, please.

-Quite fit for her age, I suppose.

-Adele...

Are you telling me you wouldn't?

I've seen the way you look at her.

She's old enough to be my mother!

Be careful what you wish for!

SHE LAUGHS

I cannot believe that she's put Emma's name down for a school

without even consulting me!

She's just being practical. Planning ahead.

Surely this is the time to celebrate Emma's recovery.

Not fight over it.

Tell that to Jac, you know...?

It'll be all right, Jonny.

You just have to have faith.

You know I used to go to Church - I told you that, right?

I'm a lapsed Catholic. I never really got it.

It was just something our mum used to drag us to...

As soon as I was a teenager, I was out of there,

blaspheming to my heart's content.

But when Emma was born,

I just felt this...

..something.

But the "something" comforts you.

Whatever it is.

Exactly.

And I want Emma to feel that too.

His oxygen levels are improving.

Seems I made the right call, then, with the mononitrate.

Well, I bet you'll think twice before you go bombing in again.

You can't think like that. Not in my job.

If people need your help, you can't say no.

You're like a real-life superhero.

I used to listen out for the sirens when I was a kid,

follow the engine on my bike.

Just always wanted to be part of it.

You know, that team spirit.

Camaraderie.

That's exactly what it's like here, isn't it, Dr Digby?

If you say so.

Luckily Dr Digby and I live together,

so we get to see each other at home as well.

Oh, I didn't realise.

No, no, it's a house share.

It's nothing like that.

How's he doing?

I just administered a second dose of mononitrate, 20mg,

-and he seems to have stabilised.

-Excellent. Excellent.

-Hi Danny.

-Hi.

I've been asked to sit in on a complex case meeting,

and it's going to take up most of the day.

So I would like it if you would run the ward, Dr Digby.

Me?

Yes, you said before, you've got the experience, the expertise...

-It's time to show us what you can do.

-OK.

PHONE RINGS

Anyway theatre should be ready for you in an hour or so. Excuse me.

Guy.

Oh, it's all right.

In fact, I'm getting used to your little outbursts.

I'm sorry, I'm really rather busy.

-Boyfriend?

-Boss. Just had some funding withdrawn this morning.

-He was not a happy bunny.

-And you were the nearest whipping boy.

-Got the scars to prove it.

-Maybe I can help?

I've been looking for a philanthropic investment opportunity

for some time now. Obviously medicine's not my strong suit,

-so I'd need a steer on this.

-Which is where I'd come in?

Precisely. If I was to invest -

and I mean seriously invest -

it would be on the basis that the Holby brand

would become synonymous with...cutting edge.

Well, that's exactly what I've been working towards.

Actually, I've already got something that might interest you.

Why don't I pull some information together for you to take a look at?

-Can you get it to me today?

-Absolutely.

Yep.

Oh, yeah. Thank you.

Yes, we're still waiting on the test results for bed three,

so can you call the lab and tell them I'm not happy?

Thanks.

Ah, right, we need an update on Mrs Acourt.

Er, we're waiting for the results of her chest X-ray.

Then I suggest you chase them, hm?

Yes, sir...!

-Oh, did you hear?

-What?

We diagnosed a patient with cyanide poisoning.

-No.

-I

-did, and then I told Dominic.

-Did you?

Arthur, it's not a competition!

We are supposed to share information with colleagues

for the good of our patients.

Yes, but he always wants to take the credit!

Give him a break! You are a year his senior.

Doctor of the 21st century.

Why do you always give him such a hard time?

Because I don't trust him.

Well, I like him. He's smart and funny.

And excellent company.

And I'm not, I suppose.

I think you have more important things to think about.

MACHINE BEEPS RHYTHMICALLY

-Please, where is it?

-What's going on? What's happening?

Where'd you get that posh voice from,

when your dad speaks like Lord Sugar?

Harrods. £25.99. I'll get you one for Christmas.

Oh, come on, I hate it when you go all mysterious on me.

-Maybe I don't want to talk about it.

-Where is he anyway?

In theatre, I believe.

You really couldn't give a monkey's, could you?

I'd be in a right state if my dad was going under the knife.

-But he seems to make you proper aggy.

-Aggy?

Yeah. Tense, irritable, like you want to punch someone.

Look, I'm not aggy, all right?

Um, yes, you are. I've seen the way you look at Raf.

He seems to really pull your chain.

And then there's the beef with your dad...

You know, maybe I'm a tiny bit aggy

because I'm being stalked by an incredibly annoying HCA.

I'm going to let that slide because you're in a bad place.

But the rest of it - you can't tell me I'm wrong, can you?

My father - he never quite worked out

the difference between an employee and a son.

And so when he finally realised that I wasn't going to follow him

into the family business, he terminated my contract.

Oh. I'd be WELL made up if my kid was a doctor.

I'm dying... Help me.

OK, you need to stay calm, Danny, yeah?

The antidote's not working. He's hypertensive.

Oh, God, I don't understand...

-I want my brother.

-We'll call him for you.

But what I need you to do at the moment is to stay calm.

Can you do that for me?

Danny, how long were you in the fire for?

I can't remember.

Try to think, it'll help us find the right treatment for you.

What I don't understand is how he inhaled any gas or chemicals.

His breathing apparatus should protect him.

It's a self-contained unit. OK, OK.

Tell me about your equipment. Is it tested? What type do you use?

That's it. It's cool, OK.

Your questions are stressing him out.

We need answers. Now.

-I stepped outside for a second, took my mask off...

-Yeah?

-There was an explosion.

-Explosion?!

OK, so he must have had a higher exposure than we thought.

So we could give him 20ml of 1.5% dicobalt edetate solution.

Followed by 50ml of 50% dextrose.

Are you sure you want to proceed with such an aggressive treatment?

Maybe we should just call Mr Levy.

I'm perfectly capable of making this decision on my own, OK?

Hi. The procedure went extremely well. We'll keep you here

until you've passed urine and then you're free to go.

I don't want to go! The company's too good.

Don't worry. I expect we'll be seeing a lot more

of each other in the Holby boardroom.

You're a fast mover.

I don't mean to, er, rush you.

That was a compliment, not a criticism.

OK, there you go.

-Thanks.

-I'll be back to check on you later.

What's that?

It's a little business proposal that Ms Campbell and I are working on.

Do not ruin it for me, I warn you.

You're the only one likely to do that.

And why's that, Dad? Go on, tell me.

You've always been weak. Always taken the easy course.

Never pushed yourself to the limit...

Do you know what, Dad?

Most people would be proud to have a doctor as a son.

Yeah, but you've had it all on a plate, Harry.

Anyone can do that. In my world you have to earn respect.

If you'd had a childhood like mine, instead of being spoiled rotten

by your mother, you might've learned that lesson by now.

I tried his brother, but it must be the wrong number because it's dead.

OK, I'll ask him again. He's still confused at the moment.

-He also has new symptoms - severe abdominal pain and diarrhoea.

-What?

OK, we must have missed something. I mean, why would he take off his mask?

-He must have known how dangerous it would be.

-Look, we need to move on.

The new symptoms are inconsistent with chemical poisoning.

No, some chemicals can cause gastrointestinal disturbance.

-Turpentine, mercury, lead.

-But the fire was in a plastics factory,

-not an artist's studio.

-So he must have been exposed

-to any number of things.

-All of which we've tested for.

OK, well, what does the iron sulphate test show?

Prussian blue. It's definitely cyanide.

OK, I want you to get hold of Fire Control, and find out if they have

any further information on identified hazardous chemicals at that incident.

Shall I ask for the unidentified ones, while I'm at it?

-If you think that might be useful.

-No, it won't be useful

because contacting them is as useful as a chocolate teapot.

Just do as I ask, Dr Copeland, OK?!

HE GRUNTS

What have you got him on?

Ah, those the results for Robo Vicar?

What?

I want to have Emma christened.

What are you going on about?

I want to celebrate the fact that she's made it through,

That she's coming home soon and that she's safe.

And Lexy's agreed to do that for us.

-You're Catholic.

-And?

-Lexy's C of E.

-She's cool with that. And so am I.

-Well, I'm not.

And I'm not happy you've been making decisions without my say so.

But it's all right the other way round, though, yeah?

-I don't want to talk about this now.

-Well, that's tough. Because I do.

We're supposed to be co-parenting. Right? That's what we agreed.

And that means we both get an equal say.

Not if you're going to find God every time Mother Mary

-comes in for a check-up.

-You're twisting it, as usual.

Look, I know what you're thinking.

If only Jac had a big, fat maternal streak like Bovine Bonnie.

You are not going to shut me out, Jac.

I'm just not going to let that happen.

So you need to get that thought out of your head right now!

I'm going to do exactly what I want.

And there's nothing you can do about it.

Do you still not get it? This is not just about you anymore!

-How long has he been like this?

-Mr Levy.

About an hour.

You should have paged me sooner.

Erm, well... He was responding well to treatment.

But then his symptoms changed.

So therefore we're looking at an underlying problem. Still no notes?

No. What? Erm, no.

And...can't seem to get hold of any family either.

OK. Call the station, find out what you can from his colleagues.

And order an emergency CT. Page me as soon as the results come back.

Yes. Of course.

Hey. You called him...behind my back.

I didn't feel I had any choice.

Right, is that because you didn't trust me

or because you saw an opportunity to land me in it?

You're becoming incredibly paranoid, Dr Digby.

I was merely prioritising our patient.

Maybe you're right. Maybe, maybe I'm in over my head.

Shall I call Levy back?

No. No, no, wait...

His kidneys!

What?

Kidneys.

Right, he's already had metabolic acidosis

so the dicobalt edetate could have had an adverse effect on them.

So if we send him for a CT, the contrast will only make things worse.

Shouldn't we check that with Levy?

No! Let's order an abdominal ultrasound instead of the CT.

It'll show what's going on with the kidneys

without damaging them further. Yes.

-If you're sure?

-Positive.

While he's not exactly Bill Gates,

I think you'll be suitably impressed.

Serena, you are a miracle worker.

Never, ever underestimate me.

Hello, I'm Guy Self, CEO of this hospital.

Billy Tressler. Pleased to meet you.

Here's to the new Foundation For Innovative General Surgery.

The Tressler Foundation. What do you think?

It's got a nice ring to it, hasn't it?

Yes. We'll have to put it before the Board,

-but I don't see why not.

-Don't worry, it's nonalcoholic.

We'll save the strong stuff for the unveiling of the plaque.

Tressler... You're not, um...

-Harry's my son, for my sins.

-Right...

I know what you're thinking, but you don't have to worry.

I don't believe in buying privilege.

-No, I just want to put something back.

-Time for a toast.

-Here you go.

-Thanks.

To the Tressler Foundation.

The Tressler Foundation!

Oh, don't worry. We'll get someone to clear that up for you. ..Nurse.

Sorry... I can be a bit clumsy.

Billy, can you see this?

-What is this - a test for new investors?

-Just humour me.

So, Lexy...good news!

Your test results show that your warfarin levels are too high.

-Which is an easy fix.

-Right.

Due to the issues when you were last here, your dosage wasn't right.

Herzig treatment is still so new, we're learning as we go.

This is frontier medicine. You are the pioneer.

Boldly going where no-one's gone before?

Precisely! We need to be vigilant

and make adjustments according to your needs.

So we'll reduce your dosage

and things should be back to normal pretty quickly.

So I don't need to stay in?

-Much as we like having you, no.

-Thank you.

That's me told, then.

I wouldn't take it to heart. It's me she's angry with.

And you, a little bit.

I take it you mentioned the christening to her.

-And she said no?

-Correct.

-But you still want to go ahead with it?

-Of course I do.

The Jonny Mac I know would never take no for an answer.

So what's changed?

Yes. Danny Lewis.

Yeah, are you sure? Right.

Thank you very much.

Danny's ultrasound results. Doesn't look like it's his kidneys.

-Bad luck.

-You probably should've ordered Levy's CT.

-Yeah, yeah, I'll do it now.

-He's not going to be happy.

Well, he's unlikely to find out, isn't he?

-Unless you tell him, of course.

-Me? I'm the soul of discretion.

Dr Digby!

His temperature is through the roof.

OK, page Mr Levy! We need to get him into theatre now.

It's nothing. I've always been a bit clumsy.

And has it been getting worse recently?

You know, bumping into things, knocking things over?

My assistant's always telling me to slow down.

-And what about headaches?

-Nothing I can't handle.

Ms Campbell, there's a referral from the ED. Acute appendicitis.

Page the on-call surgeon, I'm tied up here.

-No, it's fine. I've got this. You go.

-Billy's MY patient.

It'll have to wait.

Mr Tressler is in urgent need of an MRI scan.

Update, please.

Temperature 38.5, severe localised abdominal pain and vomiting.

Where are the CT results?

Digby?

I...um... I didn't order it.

-What?

-Yeah, right.

OK, so I was concerned that his kidneys were compromised

so I... Obviously the contrast for the CT would make that worse.

So I sent him for an ultrasound.

A scan that tells us absolutely nothing!

-It shows there's free air above the liver.

-Caused by...? You don't know.

So why the hell didn't you call me?

Well, I just thought...

No, no, no, you didn't think -

otherwise this wouldn't have happened!

KNOCK AT DOOR

I just wanted to say...

Lexy and I will be heading up to NICU in the next hour or so.

-As if Mr Solis would allow that.

-Actually, he's fine about it.

I thought I made myself absolutely clear.

Giving thanks for Emma's life

is incredibly important to me, OK?

So you can say what you like.

I am not going to let you take this away from me.

And you know what, I would love you to be there.

But that's completely up to you.

What's the verdict, then?

It looks like you have a pituitary macroprolactinoma.

In English, please.

It's a tumour on your pituitary gland.

-Oh.

-Well, don't worry.

We can put you on a course of bromocriptine tablets

which should shrink it.

You might need surgery in the future, but certainly not just yet.

Just here. Some of the newer machines give an even sharper image.

And why don't you have any in here?

I'm working on it.

Good to see you back, Billy. May I?

What did you say it was again?

A pituitary macroprolactinoma.

And Guy managed to diagnose it from a spilt drink. That's incredible!

Neurosurgery is his specialism.

It wasn't just the spilt drink.

Yeah, I know. But it's still very impressive.

No points for guessing why you made CEO.

You said there were better scanners on the market?

Yes, there are.

Well, that's what we should do.

Bring the brain equipment up to scratch.

Yes, but neurosurgery doesn't fall under the banner of general surgery,

which is what the foundation would be funding.

The foundation will fund whatever I want it to fund.

Yes, of course.

What do you think, Mr Self?

Well, both areas of work are deserving. I'm biased, of course.

Well, that's it, then.

The Tressler Foundation will support neurosurgery.

See these lesions?

Is it ulcerative colitis?

No. Thank you.

-It's Crohn's disease.

-And by the looks of it,

he's been suffering - thank you - for quite some time.

Right, stapler, please. Thank you.

He must've been having symptoms. I mean, why didn't he say anything?

It's our job to ask the right questions.

A good doctor keeps thinking.

Questioning. Scissors, please.

When his symptoms changed...

..you should have recalculated,

not gone doggedly down the same path

-just to prove your initial theory right.

-I know. I'm sorry.

By the looks of it, there's not enough healthy bowel

to reconnect it. So...he's going to need a stoma.

Serena! Great work getting Billy Tressler's backing.

I've checked him out online, he's absolutely minted.

-Delighted to be of service.

-Given that you worked on the proposal,

I wondered if you'd be interested in fronting up the fund?

I'm surprised you don't want to take that role for yourself.

You seem to have taken everything else I've worked for.

-What's that supposed to mean?

-That money was mine.

Yours? The hospital's, surely.

I secured it for general surgery.

All you had to do was back my proposal,

but that was clearly too much to expect.

It's Billy's money so it's Billy's choice.

Which he'd already made till you came charging in.

You know, at New Year you said you'd give me my voice,

but every time I try to use it, you silence me.

-I feel totally unappreciated.

-What utter garbage.

You know, I've just congratulated you for getting that funding.

But you couldn't hear it because your pride has been hit.

I don't give a damn about your ego.

I need team players who want the best for this hospital,

and that means you closing this deal and fronting up the fund.

But if you'd rather stomp off

and have a temper tantrum because life is so unfair...

that's up to you.

Sacha wants to see you.

-Just me?

-I've already had the third degree.

He wants to know why we didn't call him sooner.

What did you say?

That I did suggest it, and you refused.

And as you were the one left in charge, I felt I had to respect

your greater experience, and leave the decision making up to you.

That really is just perfect. Thank you.

Come in.

Mr Levy, I know you're angry, and rightly so,

but I've got something I really need to show you.

There's no need. I'm fully aware of what happened today.

Yeah, I'm really sorry.

I gave you the opportunity to prove yourself.

And for some unknown reason you had the audacity to believe

that you were above the fundamentals,

and the moment my back was turned

you failed to perform even the simplest of tasks.

OK, that is not quite right.

This makes me wonder, do you think you know better than me, Dr Digby?

No.

Then why ignore my instructions?

-I just...

-Because cancelling that scan

nearly resulted in a patient dying today.

I find your arrogance absolutely astounding.

And how you managed to win that Doctor Of The Year award

defies belief.

So, I don't want to see, hear or speak to you for the rest of the day

until I've decided what to do about your behaviour.

Is that understood?

They've gone up.

Jac, I really think you should be there...

We, um, couldn't get hold of your brother, I'm afraid.

I did manage to speak to someone from your unit, though.

You don't really work for them, do you?

No... I do...

We know that you're not Danny Lewis.

OK, look. I'm not angry.

I just really, really want to help you, so...

Danny Lewis was a hero.

My brother was in that fire.

Danny Lewis tried to save him.

But the roof collapsed before he could get him out.

And they both died.

I thought maybe if... if I became a fireman...

I could make their deaths mean something.

Of course.

I've gone through the recruitment process,

like, eight, or nine times now.

Right, you're not actually...

So you were going out on your own?

Just for the practice. I never put anyone at risk.

Except yourself.

Don't report me. Please.

If the police get involved,

-I won't stand a chance.

-Danny, I'm not going to...

It's Ben.

Ben. OK...

OK, um...

When we operated...Ben,

we found something called Crohn's disease.

OK, it's an inflammatory condition,

it can affect the whole of the digestive system.

And, um, we had to remove a large section of your...bowel.

Because of that,

er, we had to fit a stoma....

-What?

-(It's a bag, it...)

HE SOBS

-What?!

-OK, OK. It's a lot to take on, let's just, um...

But I can still work, right?

Right, yes. OK, yeah.

Look, right, most people with Crohn's disease

live a perfectly normal life, just...

No...

I mean as a fireman.

It's, erm...

The severity of your condition, you can't...

you're not going to pass the medical.

No...

I am so sorry, Ben, OK?

You know...

I'm going to do everything I can to help you, yeah?

Thank you, thank you.

-Jac...

-I haven't changed my mind.

OK, right.

We were hoping you were coming to join us.

I'm not joining you because there's nothing to join.

Well, obviously I didn't make myself clear enough earlier.

This christening is going ahead, whether you like it or not.

If this is you asserting yourself, it's pretty pathetic.

Oh, I think it's quite encouraging, really.

And perhaps I wouldn't have to assert myself

if my Baby Mamma would just acknowledge the fact that

I have as much say over our daughter as she does.

Did you actually just use the term Baby Mamma?

Well, you're no Virgin Mary, Jac.

And Emma is OUR daughter.

-Not just yours.

-Oh, don't remind me.

The unfortunate reality of Emma's creation is something

-I have to live with for the rest of my life.

-As do I!

Is this going to carry on much longer?

If so, perhaps I could trouble you for some popcorn?

You know what, Jac, you know what?

You DO have to live with it for the rest of your life

because I'm not going anywhere.

Emma is my daughter. I'm her dad.

So you might as well just let me in. Let me help.

With choosing nannies and schools and putting up furniture.

So you're getting my daughter christened without my permission

-because I didn't ask you to put up some flat-pack furniture?

-No!

I am getting Emma christened

because I want to celebrate the fact that she's in our lives at all.

Don't you think I want that as well?

Then why are you trying to stop this?

Because if we're going to do this, let's do it properly.

Not in some two-bit, made-up, last-minute excuse for a ceremony.

I can fit you in next week.

Fine.

Fine.

It was really exciting being able to assist you in surgery earlier.

If the opportunity ever arises, I'd love to help out again.

Sorry, Dom, do you know where Dr Digby is?

-No.

-I really need to find him.

Yours, I believe.

I feel like such a fraud.

I didn't handle things very well today, did I?

No. No, you didn't.

I just want to...to prove that I can be worthy of that,

that I can be decisive, I can be a leader.

-Ignoring my instructions wasn't the best way of doing that.

-No. No.

It may feel like it sometimes, but what we do here,

it's not a competition.

Tell that to Dr Copeland. I don't...

He's young, he's ambitious. He'll settle down.

Mr Hanssen and Malick really believed in me.

I just feel like I've got to not let THEM down...

You won't.

I should never have dismissed your approach. I'm so sorry.

My approach might not speak to you the same way Malick's did,

but that doesn't necessarily mean it was any less valid.

-And I realise that now...

-We all have to be true to ourselves,

play to our different strengths.

I probably should've been a military historian, then.

Or a monk.

We all doubt ourselves sometimes, otherwise we wouldn't be human.

I suggest you go home, OK? Get some rest

-and then come back tomorrow raring to go.

-What about the quiz?

You're a year ahead - I can cut you some slack.

But just this once.

Dr Tressler, do we no longer knock before entering a room?

Sorry.

And I am sorry about my father.

-He's an idiot.

-Yeah.

Why do I always allow myself to get hooked by untrustworthy men?

-I did try to warn you.

-People always do.

You know, there's not much that being a Tressler has taught me,

-apart from an in-depth knowledge of the FTSE 100 index.

-Naturally.

But one thing the old man did drill into me was...

business is never personal.

There's no room for emotion.

You know, if things don't go your way,

you just pick yourself up and you start over.

Story of my life.

Tell me something. And I want you to be honest.

Would you say...I'm a team player?

Yes. Absolutely.

But I suppose... Well, if the team was a choir...

you would definitely be one of the soloists.

And I mean that as a compliment.

-Night.

-Good night, Harry.

OK. Let's start with gallstones.

DOOR OPENS

The first condition - gallstones.

Second condition - hernia, uncomplicated.

Third condition - hernia, complicated.

Fourth condition - acute pancreatitis.

Fifth condition - Crohn's disease.

KNOCK AT DOOR Come in.

Come for round two?

Not exactly.

The heels are back on. You must mean business.

Yeah, I'd just like to say, if you still want me

to front the Tressler Foundation, I'd be very happy to accept.

Deal.

And you can take those off now. I'm feeling vertically challenged.

My pleasure. They're killing me.