Eat Your Heart Out Holby City

Well, that's it, then.

The Tressler Foundation will support neurosurgery.

Look, I know what you're thinking.

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

-You're not going to shut me out, Jac.

-I don't know who you think you are coming in here...

-Your new boss.

You are never to perform CPR on my watch again

until I've personally retrained you.

I don't want to be a surgeon. I don't want to be anything like you.

I am getting Emma christened

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

-Don't you think I want that as well?

-I can fit you in next week.

-Fine.

Look at him. He's loving this.

-And you wouldn't?

-Fair play to the man.

He did write an award-winning paper on the future of resus medicine.

Yeah, but it doesn't mean he has to relish the attention

in such a narcissistic -

"Ooh, love me!" - kind of way, does it?

He'll be here all day,

sucking up the glory... You'll see.

Right. I think that's enough! I'm sure we've all got

more important things to be getting on with.

Oh, no... Hey... What about my team?

You've got to get a shot of the whole A team.

The man who makes it all possible.

Oh, no... The man who wrote the paper.

Mary-Claire... Come on! You've got to be in this.

Shut the front door! Move.

We need some glamour...

And Adele. Come on.

We can't have a shot of the whole AAU Resus Team

without our favourite HCA.

That's it. Big smiles.

DOOR HANDLE RATTLES

Who is it? Go away!

The name's Bond...James Bond... Why is this door locked?

What are you doing with...

Oh. My. Wow! You look lovely.

-Thank you.

-For what?

For making an effort. I was a wee bit worried,

cos I know I'd pushed for this christening, and you were a bit...

-Nonplussed.

-I'd say more...

just lacking in any kind of enthusiasm whatsoever.

I was worried you might turn up in bloody scrubs

with a crabbit look on your face.

It's my only daughter's christening. Her big day.

Her moment to be recognised

in the eyes of some cloud-dwelling fantasy figure with a flowing beard

and the first-ever God-complex.

Well, at least you're not cynical about it, right?

These are £300 four-inch shoes...

-There is nothing cynical about these.

-Oh, your theatre list.

-I've kept it particularly light today.

-Whoopdee-doo.

-So there's no chance of you running over...or being late?

-Never.

So, 2.30 at the chapel of the fantasy beard. Be there.

And bring my daughter...

-It's all about specialisms.

-Uh-huh.

-It's narrow-mindedness, really. The easy option.

-Here, open that for me.

You know, doctors like him, they specialise and specialise,

and in the end, there's only one thing they're any good at.

Oh, like becoming world-beaters in their chosen field.

Well, that's one way to look at it. If you ask me,

it's short-sighted elitism. You know, a good doctor...

-Pays attention to what he's doing.

-..has a broad palette.

Straddles a wide church.

Or are you just saying that

because you have no idea what your specialism is?

-Absolutely not.

-So?

-Specialism? What?

-What's your specialism?

If you could choose to be expert in any medical discipline. Right here.

-Right now. What would it be? Tell me.

-Later.

-You don't have a clue...

Dr Henry Tressler, clueless? Surely not.

What's the matter with you?

-Look like someone's run over your puppy...again.

-I, um...

It's too soon, isn't it? Too close to the bone? I'm sorry.

-Jac. I've done something terrible.

-Good.

-I couldn't help myself.

Not a defence I'd use in court.

I agreed to something which I shouldn't have agreed to, but...

-I just couldn't say no.

-Again,

-not going to stand up in front of a judge.

-Jac, I am so sorry.

I won't be able to attend Emma's christening today.

-I really, really want to, but...

-Is that all?

Look, some woman with a collar on back-to-front is going to mumble

some gibberish and splash some water...

I put a line through my diary.

A line through the middle of the day.

-Theatre list closed. But...

-What?

Unruptured congenital aneurysm of the left sinus of valsalva.

Left sinus?!

Left.

-No way!

-I know!

-Left?!

-I know.

-Have you ever seen that before?

-Once.

And you've been cutting up hearts for how long?

-Oh, about 100 years now.

-Today of all days.

I know. I'm so sorry.

-But...

-Right coronary sinus, that counts for what...75%?

-70.

-Non-coronary?

-29%.

-Which leaves?

-1% left coronary sinus.

-Wow.

So, in heart surgeon's terms,

this is...as rare as rocking-horse...

-No.

-No?

-No.

-No.

-Don't even think about it, Jac.

No, no, no, no, no. I am way ahead of you, Gandalf.

I'm out the other side.

I'm wearing the T-shirt. I'm writing the paper. We're getting the glory.

No, I am not going to let you do it.

-What if we get delayed?

-You have just said that you really, truly,

-absolutely want to be at my baby's christening.

-Yes. Of course, but...

But you have to stay and you have to operate

on the rarest heart condition Holby has seen

-since Roman times.

-No. No.

Look, it's going to take me at least five hours to...

Not if there's two of us.

Hi, Jonny.

Right, moving swiftly on. We have bed eight, Mrs Hillary Whithers,

who has an un ulcer on her leg.

-Hi, Hillary.

-Leg ulcer.

-Yeah, that's an awful lot of pus.

I'm not the only doctor Ric could give this to.

-Probably want to perform an incision and drainage.

-Nice.

Then bed seven...

we have Mr Ridout, who has a possible abdominoperineal excision.

Oh, sorry! Ric said that should be Mr Di Lucca.

No, that sounds interesting.

-No. That's Raf's.

-What...no... just because...

-So, bed one.

This is more like your remit, Dr Tressler. Ms Annie Hinkley.

-Hi, Annie.

-Annie had an accident this morning, with a fridge.

-Freezer compartment, actually.

-Sorry. Freezer compartment.

-Stood up too quick.

-Right... So you banged your head on the freezer door.

I left it open when I got the ice cream.

Occipital laceration, no loss of consciousness. What were you doing

-when you stood up and banged your head?

-Eating.

-So, when you banged your head, you were eating?

-On my knees.

-Why?

-I have a problem.

-What, with your freezer?

With...food.

You were in the peacock position? The Feathered Peacock Pose.

Javier was applying gentle pressure to my thighs.

-WOMAN GIGGLES

-Shut up!

-Sorry.

-And...

-And I felt a hand grip my heart.

-A hand?

-And I passed out.

-She has clammy extremities.

-Echo shows the ruptured sinus.

-Severely distended neck veins.

-Muffled heart sounds.

What you have is extremely rare.

-I am an indigo child.

-Oh, no, here we go.

-Envy.

-"Indigo child"?

-Are you aware of other people's auras, Professor Hope?

-Well...

When some children are born,

they have an indigo aura that radiates around them.

-The indigo child is a special child.

-I blame our mother.

She filled Tilly's head with this...

We come into this world with an innate sense of belonging.

Some believe we are a next step

on the mental and spiritual spectrum of human evolution.

You...you're an indigo?

So, you see, it really doesn't surprise me

that my condition is very, very rare.

-So, what's occurring?

-Oh, you know, same old story. Sick patients.

-Needy students.

-Happy days.

-Out-of-date yoghurt.

-I quite like it.

And I am Emma's godfather at the christening. So me...half shift.

-I'll be in charge without you?

-Think you can handle the pressure?

Got any more yoghurt? KNOCK ON DOOR

-Yep.

-ED just sent a patient.

Temperature is 38 degrees, severe constipation.

The throbbing pain in his rectum... is "unbearable".

Throbbing rectum...she's in charge.

Right... Jolly good.

-I wonder what Guy's up to today?

-Did I mention vomiting?

I think I'll pass on the second yoghurt.

-So, my first shift in the company of the chief's daughter.

-Dr Zosia March.

-Married?

-No.

-So... "March"?

-Mother's maiden name.

Why not "Self" like your father? Professional reasons?

With all due respect, Ms Campbell, is it any of your business?

Absolutely none. I was just, you know shooting the...

-Ah.

-We have a plaque.

Well, I wonder why I wasn't told this was going up.

Tressler, Harry Tressler's father...

Yes, I know who Mr Tressler Senior is.

Your father sequestered that generous donation

and has now apparently sidelined me.

Get used to it. This is Anthony Dransfield, 47,

-works as a stonemason.

-He's been in severe pain for a few days

-and feverish for about a week.

-Pains in your bottom, I believe?

What's an F1? Apart from a racing car. He says he's an F1.

-First year Hospital Foundation Training.

-First year! So...

get an F1 and it's like being treated by an apprentice?

I've studied medicine for seven years.

And I've been spotting trains for 30 years. Don't mean I could drive one.

-I'm not sure that's very helpful.

-I'm not being funny, lad,

but are you a pooftah?

Now, resus medicine

is one of the least explored frontiers in modern medicine.

Great advances have been made abroad, whilst in the UK,

they just seem to have trodden water for decades.

Look, I hope you don't mind, but I've got to get back to work.

I look forward to seeing it. Cheers.

Raf. I know there was a little bit of getting off on the wrong foot

between you and me.

-But I was wondering...

-It wouldn't be a good fit.

-What?

-You.

-Sorry?

-On my team. For resus and ECMO.

Oh, no, no, I wasn't, I didn't...

I'm sorry. Is that not what you were going to ask?

What, if I could join your team? Oh, no. No. Erm... Well, yes.

-Actually.

-OK.

-"OK"... OK, I can join?

-No.

-OK - that is what you were going to ask.

-It's a no-brainer, surely?

-Look, I don't think you'd be a good fit.

-You don't mean that. Come on.

-I would seriously dedicate...

-Why resus?

-Why?

-Why resus? Why now?

-Why you?

-Because...

Resus medicine is one of the least explored frontiers

of everyday medicine.

And great advances have been made abroad, whilst the UK...

-"Has just trodden water for decades..."

-Yeah.

You just listened to my interview and quoted back what I said.

Oh, no, no, no, no. That's... what I believe...

-You just summed up what...

-It's not happening.

I'm sure you could be a good doctor, Harry.

When you make an effort, you can charm the birds out of the trees.

I like to think I've got a warm bedside manner, yeah.

-But you have no passion.

-I do.

-No hunger.

-I...look...

-I need hungry, dedicated doctors,

with passion who want to change lives.

Who know what they want to specialise in.

-I want to specialise.

-In what?

-In...uh...

-You hesitated.

-What?

-You hesitated.

You're not speaking from the heart.

You're trying to second guess. That is not passion.

-You can't speak to people like that.

-Can't I? Why not?

It's rude and intrusive.

He had his hand down me shirt, squeezing me belly.

-What are you insinuating?

-I'm not insinuating nothing.

Not saying he was copping a feel.

Sure he's got nicer bodies than mine to squeeze.

-Just wanted to establish a fact.

-Why?

Just like to know who I'm dealing with, is all.

-Will it make a difference?

-Probably not.

No, Dr Copeland's sexuality

has no bearing on his professional abilities whatsoever.

-Never said it did.

-So why ask?

-I work on a building site.

I don't meet a lot of pooft... homosexuals. Just checking.

Human nature.

-Right, a few questions, Mr Dransfield.

-Anthony's fine.

Or Tony. Whatever suits.

When was the last time you had a bowel movement?

-Don't know.

-Roughly.

-Long time.

-It's agony down there.

-How long?

-Ages.

-A week?

-Least a week. Maybe two.

After we've opened up the aorta, the aneurysm is pulled inside

and excised at the base, and then we patch the aortic wall.

You two have such contrasting auras. Couldn't be more different.

Pay attention, Tilly.

They are talking about cutting into your heart.

-Yours is very warm, golden, biscuity hues...

-Long story short.

Heart-lung machine. Stop heart. Open aorta. Patch it. Close up. Restart.

-Whereas yours is...

-Important note -

-at any time during this procedure, you could die.

-No.

-Will you stop with all the hippy stuff and just listen?

-No.

-I won't die.

-We appreciate your confidence.

-It's not my time.

-Glad to hear it. Hold that thought.

-Little observation...

never have children. Your aura is not a good maternal aura.

-How could you be so rude?!

-Miss Fawin, I've...

Hello. Um... What's going on here? Professor Hope?

Ms Naylor?

Aneurysm of the left sinus of valsalva.

Part of the Hobbit trilogy?

Ha-ha.

You know, I really don't think

that this was on your theatre list today, Ms Naylor.

In fact, as I recall, we kept your theatre list

-pretty simple today on account of...

-Yes, thank you, Nurse.

-May I have a wee word, Ms Naylor?

-No.

-Professor Hope?

-Well, look...um...

-No!

Right, my office. Now.

Excuse me.

OK, any idea how you got this?

-Had warts.

-Yep.

-Tried popping them with my fingernail.

But wouldn't pop.

-Yeah, warts don't usually pop.

-So I scrubbed them with bath cleaner.

-You scrubbed them?

-And wrapped them in clingfilm.

-Clingfilm?

-For a month.

-Why in heaven's name...

-I didn't have no bandage.

When took clingfilm off...

..smells like silage.

So here I am.

Right. OK. Very good.

-Thank you, carry on, Nurse.

-Is that supposed to be funny?

Doctor...

Doctor. I need to cancel my operation for this afternoon.

We didn't say anything about an operation. It's just a few staples.

-An X-ray.

-Gastric band fitting.

-I'm sorry?

I have a gastric band procedure booked with

Sally Downing on the bariatric ward this afternoon.

THE Ms Downing?

Well, as far as bariatric surgeons go, she is the best.

She is the best. Sally said she'd change my life.

-Totally transform me.

-Weight-loss surgery. Transformative medicine.

It's a big growth area now, humans get so fat.

-But I can't go.

-Why not?

-Because I didn't keep to my pre-op diet.

-Right. OK.

-So, can I ring her to cancel?

-Not just yet.

Elliot wouldn't be able to make the christening.

He'd be stuck in theatre all day.

Well, with all due respect to Professor Hope...

Look, if I assist,

the both of us, we could be done and dusted by lunchtime.

And I know that Mo's not coming, because she's in quarantine.

Well, your sympathy for her nephew's chickenpox is duly noted.

However, and I say this with all due respect,

as lovely as it'd be to have you there,

you're not quite such a principal player as the baby's mother.

-No. I completely understand.

-Who has to be there. On time. 2.30.

Because we've booked the vicar.

Because Emma's ICU treatment schedule has been planned.

Because we've sent out all the invitations to the guests...

We will be there.

On time. Both of us.

How on earth could you even risk this?

This is the rarest heart procedure

Darwin has seen in well over a decade.

It is rare.

It's so rare, they don't even have a name for the surgery

we're about to perform.

So, in other words, it's all about work.

And actually nothing to do with making sure

that Professor Hope can attend Emma's christening.

Are you saying you don't want Elliot there?

-No, Jac. That's not what I'm saying.

-That's what it sounds like.

Yeah, well, you're twisting my words.

Look, I promise, hand on heart, I will not be late.

-Bariatric surgery.

-What about it?

-As a specialism.

-Uh-huh.

-If I was to be asked,

hypothetically, what kind of surgery I'd most like to do,

what sort of case I'd most like to see

-wheeled in through those doors...

-Right. Good.

-Good?

-Yes.

-Bariatric weight-loss surgery.

-I mean, it is life-changing.

-Certainly is.

-Mrs Whithers' ulcer.

-La-la-la-lah.

-Not listening.

-I think you should take another look at it.

Dress it. IV antibiotics. Bump her or discharge her.

I have bigger fish to fry.

I just...I just don't like the way it's looking at the minute.

-You nurse. Me doctor. How many times?

-You're a clem. Do you know that?

I can't believe I'm asking this, but what is a "clem"?

Exactly what it sounds like.

Look, if you're so worried go and ask Dr Time Magazine.

See how he likes a leg ulcer.

Hello, there. Yes, hello. Is that Ms Sally Downing? Hi, there.

It's Dr Harry Tressler here. Hello. Sorry to bother you.

Yeah, it's just a quick thing, actually,

about one of your patients...

I wasn't the dad I could have been.

OK.

-Great surgeon, though... back in your day.

-This is my day.

-When you've got me to help you.

-Jac, I just...

-I don't want you...

-To make the same mistakes that you did?

-Yes.

Everything you do, or don't do, affects who you are to her.

-And who were you?

-To my Martha...

-..I was a set of headlights on her bedroom ceiling.

-Car headlights.

Sounds very deep.

I asked her once what she remembered of me, when she was little.

She never saw me weekday nights.

She'd be in bed whenever I eventually got home.

Weekends, I was on call...

And she'd see your headlights on the ceiling as she fell asleep.

-That's all.

-She had a dad. With a car.

That's way more than I had.

-"Tug"?

-Like tug boat. "Chubs". "Porky". "Pork chop". "Blimpy".

But "Tug"?

-Every pretty girl needs a tugboat for a friend.

-I don't get it.

To clear the way. Tow her into a party. And make her look good.

-That's cruel.

-The fatter your mate, the thinner it makes you look.

-Ouch!

-Girls are vicious.

-You don't think boys call me names too?

Look, what if I was to tell you there still might be a chance

that you could have your gastric band op today?

No. I couldn't. It'd be wrong.

I need to give you a rectal examination.

-What's that?

-I need to feel up inside your anus.

-Jog on!

You have lower abdominal pain and chronic constipation.

The chances are, the problem will be rectal.

-Inside?

-I very much doubt the cause will be evident externally.

I'm not sure about all this...

What are you not sure about? The pain?

No, I'm bloody sure about that.

-You want the pain to go away?

-What? I'm not here for the scenery.

No disrespect intended.

Well, you can either let us see what the problem is or you can go home.

-Simple. And take the pain with you.

-You from up north?

-No.

-Should be.

-You calls a shovel when you sees it.

-So..?

-Who's doing the looking?

-We are.

-What, it takes both of you?

-I'd like Dr March to observe.

She was very clear...

I had to stick to my diet. 950 calories a day.

-So you bent the rules.

-No sweets. No buns. No doughnuts.

No ice cream.

Hey. Hey, hey, hey, hey, hey. Come on. Don't beat yourself up.

-We all make mistakes.

-Sally was offering me a way out. I blew it.

-Typical.

-No sugar - that is pretty strict, actually.

-I threw it back in her face.

-You ate some ice cream.

-Two litres.

-OK.

Well, you know, that's...

Annie...

Do you want to know how I see it?

How I read what's happening here? I see...

I see a beautiful woman who is trapped in a vicious cycle

of depression and disappointment.

-Beautiful?

-A beautiful woman.

Who can't see the beauty in herself any more.

Who's lost sight of who she really is.

Now, I am a doctor,

who is passionate about helping to change people's lives...

and with you, I feel I need to save you from yourself.

Now, look. I've got to go and get some blood results,

but I want you to really think about what I've said.

Will you do that for me?

I hate moaners.

I see them all the time on telly, whining about what they haven't got.

Everyone's entitled to their opinion, Hillary.

Reckon Government owes them a living and a flat-screen TV.

Don't start me. You haven't seen moaning till you've been sucking

tequila slammers with a bunch of nurses.

Ooh!

I hate moaners.

-But I'm going to have to moan.

-Go on.

-It hurts.

Like it's got stuck in a flail-mower.

Right. I'm not happy with the colour.

Particularly these purple bits here. I'm going to get you a doctor.

Ah, Mr Di Lucca, sorry to bother you,

but could you take a look at this ulcer?

She's Dr Tressler's patient, but...

-He's gone walkabout?

-Well, I'm sure it's something important.

-No worries. Just give me five.

-Thank you.

The only way I see this working

-is that you look while she stands guard.

-Guard?!

I don't want anyone walking in while she's shining her torch

at me starfish.

What exactly are you scared of?

Have you ever had a beam shone up your jacksie?

I have had gynaecological examinations.

-I've no idea what that is. But I haven't.

-Oh, come on, Anthony.

I don't want someone walking in in the middle of it,

asking for directions to the canteen.

Go on. Right,

I am going to insert

a gloved and lubricated finger into your anus.

Talking about it doesn't make it better.

I'll swivel my finger through 180 degrees,

feeling the inner walls of the rectum

for abnormalities.

Breathe out.

HE BREATHES OUT

-It's on the ground floor.

-What is?

-The canteen, should anyone ask.

-For the love of Mike...

it feels like you've just stuck a stingray up me hole.

Potassium infusion running.

OK. Stopping the heart in five...

..four...

..three...two...

..one.

MONITOR BEEPS

Good.

Suction.

-Wonder what that does to your aura.

-Stopping your heart?

Well, it's got to mess with your inner chi vibrations a tad.

-Do I detect cynicism?

-Moi? No.

Opening the aorta obliquely.

So this is what the inside of an indigo child looks like.

Red.

Pretty much like the inside of every other human being

I've ever seen.

Imagine believing you're the next stage of mankind's evolution...

I know every mother thinks their child is special, but...

-Wow. Look at that aneurysm.

-You beauty.

The band is attached around the top portion of your stomach...

and tightened, like a belt, to form a pouch,

which acts like a much smaller stomach.

But today, all I want you to do is to take away the literature. Read.

-Discuss. And come back with any questions.

-Thank you very much.

Thank you very much. Bye-bye.

Thanks so much for letting me sit in.

-Well, I appreciate your help with Annie.

-What you do is amazing.

-We try.

-You change lives.

-I've always been fascinated by the surgical aspects.

-Really?

Yeah, I've heard quite a lot about it

from my godfather, Christian Ovendon...

-He's a consultant in London.

-"Wandering hands" Christian?

-Might want to keep that connection quiet.

-Ah.

Given that I've lost my theatre slot for Annie,

do you think there's a chance I could operate in AAU?

Well, I know for a fact that Guy Self would be more than amenable

to a cross-disciplined procedure

using frankly under-employed facilities.

You're quite a mover and shaker, Dr Tressler.

I would be so excited if there was even the tiniest possibility

that I might be able to assist?

It's the way he talks to me. Most men talk down to me.

If they speak to me at all. Most don't.

I wouldn't pay any attention to what most...

But with him, it's so...different.

-Sorry, who are we talking about?

-Dr Tressler.

-That's what I thought.

It's like he knows me. Sees me. The real me. Inside.

Well, the thing is, with our Dr Tressler...

Look, I'm not saying the man hasn't got twinkle.

He's got plenty of twinkle.

But between us girls, I wouldn't take much notice.

Do you think he can make me happy?

-Well, it kind of depends...

-He says he can make me happy.

-Yeah, the man says a lot.

-I think he can.

We have a growing overweight population whose weight issues

create all manner of serious health problems.

-That is a fact. Not an opinion.

-Another fact.

There are not enough bariatric surgeons in this country.

It's a rare specialism.

Well, one of the best specialists, Ms Sally Downing,

has a monthly consultancy here in Holby.

Yeah, yeah. I hear very good things.

But she often has to operate elsewhere,

meaning Holby loses out on revenue.

So what do you want now - a job in management consultancy?

-No, I want to assist her on a gastric band fitting.

-OK, knock yourself out.

-As long as it's in your own time.

-In AAU.

-Mr Griffin might have something to say about that.

-Look...

This afternoon. Empty. Nothing booked, right?

She has a patient here today with a minor skull laceration.

They can't make their appointed slot in bariatrics.

-Meanwhile, we have a theatre sitting empty.

-OK, I'll talk to Ric.

-He's out. All day.

-You know, you can be really intense sometimes.

-I have a passion for bariatrics.

-A passion?

-Yeah. For a long time now.

Look, one of the best surgeons is here today.

Holby is a teaching hospital.

And there is a consultant here who can teach me things

-no other consultant...

-Yeah, yeah. OK.

-I hear you.

-I mean, it broadens my surgical skills.

It brings revenue to Holby. And I guess, you know,

if an opportunity presents itself in life, then you should...

Yes. Yes. The answer is yes. But only if the list is clear.

Sorry to drag you away. I just didn't like the look of the ulcer.

-It's getting bigger.

-You did the right thing...

Sometimes you just get a feeling.

HE SNIFFS

It doesn't smell like an ulcer.

Ulcers have a sweet, deep, cloying tang.

This is more...ripe.

-Mrs Whithers, do you recognise your leg?

-Yep. It's mine.

-No, was that this big this morning?

-The red bit's got bigger.

-Did Dr Tressler check for crepitates?

-I don't think he did.

Oh!

Oh!

I feel this is crackling like Rice Krispies.

-Let me see the blood-test results.

-They're not back from the lab yet.

I want them in my hands in five minutes, even if you have to kick

-down the lab door and hold them at gunpoint.

-Sure.

-And put intensive care on stand-by.

-Why, what do you think it is?

-Necrotising fasciitis.

-Flesh-eating bacteria?

-My God. If I'm right,

every minute we waste she could be losing tissue. Go.

I'm so glad Sally's letting you assist.

Between you and me, I think

she needs a strong pair of hands to fall back on.

-What if I'm over my target weight?

-That's why we're weighing you.

-I didn't keep to my diet. I know I'm going to be over.

-Don't panic.

Let's just see what the scales say before we go into meltdown.

CAMERA CLICKS

I don't know about you and Jac, but I'm excited.

Tinny's banging like a drum.

-You're not having palpitations, are you?

-No.

-Banging in a good way, Jon.

-Hello, hello, hello, hello.

-Aw, Sacha.

-You are just the BEST, man!

-Hello!

Right, I made the very big mistake of telling Ma Levy

we needed a few scones for a christening.

So we have fruit scones, cheese scones, plain scones, wholemeal.

Bath buns, Chelsea buns and Eccles cakes.

This is just so generous, Sacha.

She's catered for all denominations here. Lemon sponge, macaroon,

rugelach, babka and bagel.

We were thinking about just laying-up in Albie's.

Well, I'll just drop them down there.

So where's my little fairy cake?

-Mother and daughter are yet to arrive.

-Ah. I see.

-Emma's only allowed out the ward for 30 minutes.

-And Jac is...?

-Late.

-OK.

-Right, I'll take these down. Come straight back.

-Sacha, thank you.

-Thank you so much.

-Pleasure. Pleasure.

Do you think I should get Emma?

I don't know if that's such a great idea.

If Jac is expecting to pick her up from NICU

-and then WE do instead... she might...

-Throw a fit?

-We have to be respectful.

-Respectful?! Lexy's already here.

We've catered, decorated...

Now we're all stood round twiddling our thumbs, while she's...

-I'll hurry her up.

-Look, if she's running late,

get Emma's christening outfit from her

-and I'll get the wee scrap dressed. It takes time.

-Thank you.

OK, so...

5ft 10 with a body mass index of 37.2.

Sally said if I was one ounce over 17 stone,

she'd cancel my operation.

She was probably trying to motivate you.

-I tried, Dr Tressler. Really, I tried.

-Come on. Step on.

OK. Step off.

-How bad was it?

-Not... not bad at all, actually. Not bad.

You know, little... little margin for correction.

-But we're all good, actually. All good.

-Really?

-Hmm. Like I say,

your future awaits.

God, I wish I had your nimble little fingers.

If that wasn't coming from a surgeon, it could sound creepy.

Your parachute stitching is nothing short of exquisite.

-Who thought that needlepoint could be so exhilarating?

-But...

-you're going to be late.

-I'm already late.

-So go...

-when you've finished the aortic patch.

-We're in this together.

Jac, people will be waiting.

So let them wait. We're making history here.

This is your daughter.

You're right. Let's finish off the plumbing,

and then we'll wake her up together. I can then...

You are late!

You promised you would not be late. People are arriving.

-Emma is still in NICU.

-I need ten minutes.

-No.

-Five?

-You promised.

I can get from the table to the font in 30 seconds, guaranteed.

-Elliot?

-Jonny, I'm sorry it's not a good time to swap over.

-Three more stitches.

-Fine, fine. I'll go and get Emma. And I'll...

-I'll meet you there.

-Deal.

-Ten minutes or we start without you.

-Not going to happen.

-Where's her outfit?

-Whose?

Emma's christening outfit. Where is it? Is it in your office? Or...

So you managed to find time to get YOURSELF a dress,

to get new shoes, to have your...

Go on, say it. I just took selfish to a whole new level.

You forgot to buy a christening outfit for your own daughter!

And there it is. It's official - I am a cow.

Get yourself out of here and to that chapel - NOW.

What? I've never been at a wedding where I was the bride,

and I've never been to a christening where I supplied the baby.

-Jac...

-This is new to me. Don't start judging me.

Like you didn't neglect your family in favour of this stuff.

We're off pump. Ready to start the heart?

Clamp off.

MONITOR ALARM BEEPS

-She's fibrillating.

-Paddles.

-Charge to 20.

-Charging.

MONITOR ALARM BEEPS

-Still nothing.

-Come on. Don't do this!

-Do not let her do this!

-Still not here?

-I know.

Emma's your daughter too. Is this the way it's always going to be?

-MONITOR ALARM BEEPS

-This is not the way it's going to be.

Patch is good. Reconnect is perfect.

We could put atrial wires in.

-Lignocaine IV.

-I just don't know what's wrong...

Maybe something's wrong.

If Jac's not here or not in the right place,

-there's no point forcing a christening.

-Just one more minute.

-Just one more.

-Maybe we should let the heart rest for a while.

One more try.

-Charge to 20.

-Charged.

Shocking.

SHOCK THUDS

REGULAR MONITOR BEEPING RESUMES

-And we have rhythm.

-Oh, sweet joy! At last.

At last!

Erm...

My brothers and sisters.

Can I begin by welcoming you all here to this

very special service, where Emma is welcomed into the family of faith?

This is a day of celebration. Sadly, Mo couldn't be here.

But she sent me a couple of lines, which she wanted me to read out.

BABY CRIES

"Baby Emma. I know your mum and dad will love you to bits,

"but if you ever need anything, come to your Auntie Mo,

"cos I do supersized love."

BABY FUSSES

-Oh, dear. She's not happy, is she?

-Just give her a wee sec.

SHE CRIES

-No way.

-You don't have to feel ashamed for not being able to walk.

I'm not. I just don't want to sit down.

Haven't been able to sit down for over a fortnight.

-He insists on walking.

-Ah, right.

Anthony, I wanted to show you something.

This is a diagram of an anal passage. Here's the lower colon.

And about here you have an infected anal abscess

about the size of a Scotch egg.

-No wonder I can't poo.

-Yes, quite.

We need to lance it, drain it, biopsy and test it,

then pack the excised wound with surgical gauze.

-And who'll be ferreting around up there?

-I will.

-And Dr March will assist.

-No. No, no, no. That's not right.

-Excuse me?

I want a man present.

My not being a man is of no bearing...

I'll be lying unconscious with me bum stuck up in the air,

and you two will be laughing at me tackle.

I assure you, we will not be laughing.

All the same, I want a man there to...defend me honour.

Not the...

Not the first-year.

-Sacha?

-Clocked off for the day.

-Anyone else?

I'm afraid there's no male surgeon available. Only me.

-And I have to say, I think you're being unreasonable.

-Hang on, love.

If I were a lady and you were two bloke doctors, and I weren't

comfortable with that, would you be telling me I had no choice?

-He has got a point.

-I mean, if I was nervous and shy,

would you still tell me I couldn't have a female doctor present?

-Yes, but there's no male surgeon available.

-Ric Griffin?

Operating at St James's.

Actually, there IS someone we could ask.

So...what seems to be the problem?

-What it's not, is a magic wand.

-Sure. No.

-Of course.

-I tell that to all my students. And my patients.

Weight-loss surgery, though - it's pretty radical.

We can shrink a stomach. We can bypass a stomach, even.

That's a game-changer for unhappy people, isn't it?

What we can't do with surgery

is change what's going on inside their heads.

-No. Of course.

-There are all sorts of psychological issues

that go along with chronic obesity.

I read that bariatric surgery is the fastest-growing,

most rapidly-evolving discipline today.

And yet there are many professionals think

we shouldn't be practising it at all.

I'm just going to go and check Annie in.

I've changed my mind.

-I can't go through with this.

-What's happened?

-I feel such a fraud.

-Why?

-I'm such a liar. I'm not worth it.

-Don't say that.

-All the money.

-All the facilities.

-Do you mind if you give us a moment? Thanks.

Look, Annie.

This "I'm fat, I'm not worth it" thing - that is your illness talking.

-Your poor self-image attacking you, OK?

-I know you're trying to help.

-I know I'm not really under 17 stone.

-Shh.

Do you really want Ms Downing to hear you rubbishing what she does?

-I'm not.

-Well, that's what it sounds like to me.

-I don't mean it to.

-She can release you from this trap of self-loathing.

I don't know.

-I'm scared.

-I promise, you're not alone.

-I don't NOT trust anyone.

-No.

-It's just not right.

-Yes...

-But I am a brain surgeon.

-Blimey! You paid attention at school, then.

Which means I'm not best qualified to perform this procedure.

So you operate on brains, but you can't do bums?

-There are specialisms.

-About time you learned, then.

This one'll show you what to do, won't you?

And make sure no-one snips off me knackers by mistake.

-So now the band is fully inserted.

-Nice.

Will you retract the stomach so that I can line it up? No problem.

-We should see it on the screen any moment now.

-As if by magic.

-Not just good with your hands.

-Sorry?

Got a little bit of bedside charm going on there, Dr Tressler.

-Oh, you mean...

-Just now, in anaesthetics -

-do you think I didn't see she was in a flap?

-Having some doubts.

It happens all the time with obese patients. A mass of contradictions.

Just a bit of a wobble.

When you've had such an intense relationship with food -

bingeing, comfort-eating -

the prospect of giving up is a complicated one.

She just needed some reassurance, to be honest.

-I wanted see how you handled it. You did well.

-Thank you.

Now I'm attaching the band to the top portion of the stomach.

Lots of vessels round the back, so we take it slow.

-You have amazing hand-eye co-ordination.

-I know.

Thanks all the same.

As a rule of thumb,

-I go a quarter of the way down the stomach. And there we go.

-Brilliant.

MONITOR BEEPS

-BP's falling.

-It's a bleed in the short gastrics, if I'm not mistaken.

-Endo clip?

-Yes, please. Go for it.

Clip on.

Bleed sealed. Very good.

Dr Tressler. Would you like to do the honours and inflate the band?

I'd love to, thank you.

Into theatre now. Page the anaesthetist.

Mrs Whithers. You know when I said worst-case scenario?

The flesh-eater?

The sooner we operate, the sooner we can arrest the spread.

This bacteria can't be stopped. It's like wildfire.

We need to cut-in a break. ..What? This wasn't on the schedule.

We need this theatre.

Still busy doing a bariatric band procedure, I'm afraid.

-Necrotising fasciitis.

-Flesh-eating bacteria?

-Your patient.

-Leg ulcer?

Not an ulcer - if you'd bothered to properly examine her. Grab the team.

-We'll have do this on Darwin.

-"Grab the team."

She was always the special one.

She was sick as an infant, got a lot of attention.

-And she managed to keep the attention?

-And then some!

-And you?

-I just got on with life.

Mum was happy to have Tilly as the special one. She could do no wrong.

Even bad behaviour was seen as "a rejection of conventional authority".

Meanwhile you toed the line. Who's doing better now?

I earn a couple of hundred grand a year running my own business...

And she had a strategic divorce. Depends which way you call it.

Do you believe all that indigo child stuff?

Auras and evolutionary superiority? It's total garbage.

The more she and Mum believed it, the more I rejected it.

-Well, I'm surprised you don't hate her.

-I do. Well, I did. Sometimes...

But that's family.

You love, you hate. You make up.

Respecting the wishes of the patient is...

I think it clearly says in the Holby City Surgical Mission Statement

that the choices and wishes of the patient are paramount.

So you should incise the abscess.

-Really?

-I would be inclined to make a large incision

over the most fluctuant area.

-Would you?

-Mm-hm.

HE CLEARS HIS THROAT

Thank you.

SQUELCHING

Very good, Mr Self.

Now we need to pack the abscess with gauze,

just to soak up any more infectious material.

-We can do that for you, if you like.

-No, no.

I've started, so I'll finish. Forceps, please.

Thank you.

Here we go.

-Thank you, Sacha. Cheers, cheers.

-Cheers.

-Emma did really well, didn't she?

-Once she put a sock in it, yeah!

-Bonnie had a very calming influence.

-It was a fluke, right?

If anyone else tells me I'm a "natural mother", I'm going

to knock their teeth out with my maternal fist.

-You're a natural mother.

-Oi!

-I've got to say, I did feel for Jac...

I know what it's like -

-your baby won't quieten down for you, no matter what you do.

-It's true.

Then someone else - total stranger, even - takes over,

and suddenly "shtoom"! Silence.

-Where is Jac?

-I don't know.

CHILDREN SING

Hi.

-Our indigo child's woken up.

-We didn't manage to kill her, then.

-Stats are encouraging.

-Well, it's another notch on the bedpost.

Left sinus of valsalva.

-She saw angels.

-What?

-When she was under and her heart stopped.

-She would.

-Led her around their habitat.

-"Habitat"?

-They sound like hedgehogs.

-Said they had a message for her.

-Which was?

-That she was chosen.

-For what?

-They didn't say. Just she was chosen.

I, erm...I got you a little present.

-I was going to give it to you at the party.

-Yeah, I couldn't hack it.

The chain is my mother's, the locket is my grandmother's, and...

the little wisp of hair inside

is your daughter's.

-Emma's hair?

-Yes.

Not that she's got that much. Jonny got it for me.

You don't like it?

I hate it.

If I give permission for a theatre to be used

for a bariatrics procedure, that is my prerogative.

Sure. Why don't you book it out for liposuction and botox sessions

-while you're at it?!

-You're really going to adopt that tone with me?

Are you really going to put patients at risk in favour of tummy tucks?

-Bariatric surgery is not just about...

-Yeah, I know what it is.

I know that Holby wants a slice of the obesity pie,

the same as every other NHS Trust.

I just thought that when I applied here that you and Mr Griffin

had a bit more integrity.

You really think a lot of yourself, don't you?

Only because I worked my nuts off to get to where I am.

-Oh, is that right?

-And suddenly, where I am, it doesn't look so rosy.

I'm sorry we disappoint you, Mr Di Lucca.

But I will always and only run this hospital in the way that I see fit.

Come on.

There we are. That's it. There we go.

Your daughter is beautiful.

You are beautiful.

-And you are going to be a wonderful mother.

-You don't know that.

-I do know that.

-How, Sacha? Tell me how do you know that?

Because I know that when Jac Naylor

-puts her mind to doing something well, it always...

-I...

I did pregnancy really badly -

she had CDH.

I did giving birth badly - she had to be cut out of me.

I didn't breastfeed. I couldn't even cuddle her properly. And now...

..now I so much as touch her, and she screams her lungs out!

So tell me, Sacha, what exactly have I done

to make you think I'm going to be such a great mother?

So this is Keller ward.

Now, this is where the majority of the funding has gone.

Now, I am actually a neurosurgeon as well as CEO of the hospital...

-You must hate him.

-Yes, I suppose I must.

-But life's too short for hate, and it eats you up.

-I

-hate him.

-He's your father.

-Doesn't act like it.

What did he do that was so wrong?

My mother had terminal cancer.

He kept the severity of her condition secret from me.

Ah, yes, fathers do that - protect their children.

It meant I didn't get to see her before she died.

I was busy taking my final medical exams.

-And I suppose he wanted you to pass?

-Of course.

-To be fair, your mother probably did too.

-But I missed saying goodbye.

-And you've been punishing him for it ever since?

-I hate him for it.

How did he react to your mother's death?

Drunk himself stupid for the next eight months.

-A meltdown?

-It's pathetic!

You want to major in Psych, I hear.

So?

Empathising with and understanding other people's mental

and emotional issues?

-Yes, that's some of it.

-Ever tried to understand his?

Issues of bullying and self-control?

Or issues of losing his soulmate

and having his daughter blame him for her death.

-I don't blame him for her death.

-Are you sure?

-I blame him for not...

-Ask me - and I'm just a general abscess

kind of a surgeon - but you need to look at your own stuff.

You can't do everything, Jac. Can't do it all.

Something's got to give.

Why don't you go home and have a glass of wine and just veg out?

Me and Bonnie'll stay with Emma. We'd like to, honestly.

It's OK to admit you need a wee bit of help now and then.

-How do you feel?

-Awful.

And you are doing very well. Can I have a quick word?

I'd like you to keep an eye on her if that's OK.

-Yeah, absolutely, yeah.

-You did well today.

-Thank you.

Put all of this in your clinical log.

If you ever fancy a stint in bariatrics,

I'd be happy to give you a glowing reference.

I definitely will, thank you very much. Oh, Sally.

I hope you don't mind me asking this, but...

I was just wondering if you fancy going for a quick drink later.

-To help me celebrate finding my specialis...

-Steady now, Doctor.

This morning you barely knew where bariatrics was.

-Now you're chatting up a consultant.

-I did know where it was.

Keep me in the loop.

-She's not all that.

-Sorry..?

-Remember The Very Hungry Caterpillar?

-Hmm?

-Children's story

-about a caterpillar who...

-Oh, who ate everything? Yeah.

-The sausage, the muffin, the gherkin, the...

-Ice-cream.

I'm like the Very Hungry Caterpillar.

In the end, the Very Hungry Caterpillar finally

turns into a beautiful butterfly.

I'm going to turn into a very beautiful butterfly.

With your help.

It's a lovely story.

DOOR SHUTS

BABY STIRS

BABY CRIES SOFTLY

BABY CRIES SOFTLY

BABY CRIES

BABY CRIES SOFTLY