Sacha gives Zosia the opportunity to prove herself with a vulnerable patient, but events take a catastrophic turn. Meanwhile, Harry is frustrated when Annie returns.
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How bad was it?
Not, er...not bad at all, actually.
We're supposed to be co-parenting, right?
That's what we agreed and that means we both get an equal say.
I promise you are not alone.
If you ever fancy a stint in bariatrics,
I'd be happy to give you a glowing reference.
I don't blame him for her death.
-Are you sure?
-I blame him...
Ask me, you need to look at your own stuff.
Hold the doors!
De rien. Ca va?
Sorry, just practising.
I'm meeting some Belgian bureaucrats
from the European Hospital Federation.
Good luck with that.
Is that anything interesting?
I doubt you'd think so.
He's a psychiatrist specialising in PTSD, survivor guilt,
that sort of thing.
Hmm. You're right. Not exactly my sphere of interest.
-Where's Dr Tressler?
-I wish I knew.
Well, you're going to have to cope until he gets here.
Mr Self has press-ganged me into the diplomatic corps.
Don't worry about us. I'll keep an eye on things.
SHE CLEARS HER THROAT
Since when have you been a stickler for time-keeping?
I'm not, but Raf has been threatening to practise
suturing on your face.
-Quick, hide me under the desk(!)
Good of you to join us(!)
What was it this time? Did the Rolls Royce break down?
Sorry, it was an old lady in the car park having a heart attack.
Had to quickly save her life.
The terrifying thing about you, Dr Tressler, is I think you
sometimes believe the rubbish that comes out of your mouth.
I look at it on the bright side.
In a few weeks, I'll be off to start my bariatrics rotation.
I'll be out of your hair for good.
I'm glad you're so psyched about your new specialism...
It's the future. Fat patients and fat pay cheques.
Because your friend is back.
Please stop! I'm not being rude. Please will you...?
She's in acute abdominal pain. And she's only got eyes for you.
Sorry I'm late.
Oh, don't worry, you're just in time!
Mrs Jenkins has ascites and I want you to perform
the abdominal paracentesis to drain the fluid.
Right. Lucky me.
I give up.
I diagnose a chronic case of parrimorphophobia.
The crippling fear of turning into one's parents.
It's hardly surprising she doesn't want to be a surgeon
when she hates her father's guts.
She thinks she'd make a good psychiatrist?
She's got all the empathy of a bear-trap.
The more you tell someone they can't have something, the more they want it.
Good morning! And how is everybody this morning?
What have I told you about drinking too much coffee first thing?
Who needs artificial stimulants when I've got one of these?
If you've finished with the pathetic superdad routine, can we begin?
The Director of Nursing Services is coming to spend the day with us.
Now, the last thing I need is her swanning in here
and messing up my wards.
You can start with checking on Steffan Eldridge, bed eight.
The rest of you just get on with whatever it is you do
and try not to kill anyone.
Steffan Eldridge. Name rings a bell.
Actually, it plays a cello.
The Lucky Plucker!
I hear Colette's pretty militant about
standing up for downtrodden nurses.
Northchurch, two consultants got suspended cos of her.
-And I care because...?
-Well, unless you want her on your case,
you're going to have to play nice.
I'm always nice. Now, don't you have a corpse somewhere
waiting to be stripped for parts?
How are you doing? Jonny.
Er, Nurse Maconie?
I was there when you had your heart transplant? Never mind.
I understand you're having a bit of trouble with the old ticker.
Or should I say new ticker?
How's your pain now?
Yeah. It's a bit better, thanks.
Great. And how's life with the Philharmonic?
Did you ever get round to asking out
that oboist you had your cheeky eye on?
Why not, man?
Music is supposed to be the food of love.
So that makes you, like, the Jamie Oliver of love, or something.
Do you mind if I...?
No, not at all. It's fine.
-I was thinking...
-Why do I feel sick when you say that?
I just wondered if we could leave
the final decision about the nanny till later?
Didn't you get my email? It's already done.
I was saving time. We'd have ended up going with my choice anyway.
OK, I think we need to get you transferred over to bariatrics
so they can keep a closer eye on you.
Can't I stay here?
Not possible, I'm afraid.
Dr Tressler, where have you been?
Between me and you, I had a bit of a late night.
But fear not, I'm firing on all cylinders.
Nothing that a pain au chocolat and a double espresso can't sort out.
I meant all week.
You said you'd look after me.
I'm not sure that's quite what I...
You said that if I had the gastric band fitted, I wouldn't be alone.
The thing is we've been really short staffed this week
and I've been doing some double shifts.
Hence the late night.
I should've known there was a good reason.
I've been an idiot!
No, no, don't worry at all.
I have. It's just... When you didn't come...
-I tried. I tried really hard,
but I got so down, I didn't know what to do.
I've messed it up, haven't I?
There's no need to get upset. Just tell me exactly what you've done.
I had a few little...
You've been eating solids?
You were supposed to be on a liquid-only diet. We discussed this!
I'm sorry! I've let you down.
You should never have bothered lying to them about my weight.
We both know I wasn't under the cut-off point.
You know what?
You should stay here on AAU. That way, I can look after you myself.
But, erm, tell you what,
don't mention to anyone that I gave you a bit of help with the weigh-in.
You might get me into trouble.
I hear you're looking for neuro cases for your European friends?
Yeah, you got something for me?
Well, it's early days, but maybe.
Zosia, could you do the honours?
Yes, this is Beth Forbes, 24,
recurring headaches and suspected seizure.
She was in a car accident six months ago, no head injury sustained.
Suspected seizure? What happened?
Came round on my living room floor. I've no idea how I got there.
Well, takes me back to my student days.
No tequila involved, sadly. I think I was just light-headed.
I'd skipped breakfast.
OK, so you're not feeling sick, you're not hungry?
Why did you skip breakfast?
I've had quite a lot on my mind.
Matthew. He died in the accident.
Oh. More than a lot, I'd say. My sincere condolences.
Well, I'm sure Mr Levy here will find out what's going on.
He's a bit squidgy round the edges,
but actually he's a ruthlessly efficient medical machine.
And Dr March is one of Holby's bright young things.
So what's the plan of action?
Blood tests, hourly obs...
Let's do a CT scan. Better to be safe than sorry.
-Just what I was about to say.
-Good. We're agreed, then.
Listen, I've got to go and waffle with some Belgians,
so keep me informed.
Dr March, can I have a word, please?
-He didn't let me finish!
-I know, I know.
But that's not what I want to talk to you about.
I want you to do this with Beth.
A mental state exam? Why?
Just because I want to see how she's coping with her bereavement.
Of course, if you want Dr Digby to do it...
No, no, no, no! I'll do it.
Good. Because, you know, if we have a rising psychiatric star
in our midst, we want to make the most of you.
Well, if you're sure.
Just show me what you can do.
Shouldn't your girlfriend have been transferred to bariatrics by now?
Well, until we know exactly what the problem is, Annie should stay here.
If I need a review, my good friend and future colleague,
the fragrant Sally, is but a phone call away.
Annie wants to see you.
Of course she does. She's only human.
OK, Annie, your tests are clear, and there's no sign of infection.
But there is a blockage of food above your band.
Now, if it doesn't want to go down,
we will have to work out a way of trying to make it come back up.
How about a drink? I know you're busy...
That's a very good idea! Bear with me.
Whatever it is, it's going to cost you more than that.
I want you to get Annie a drink.
Surely that's an HCA's job?
It's strictly medical. Something fizzy. Go to the vending machine.
Are you having a laugh? She's supposed to be losing weight.
A carbonated drink could help dislodge any lumps of food
stuck at the top of her gastric band.
You might want to get a vomit bowl, though. It could get frothy!
Any problems with your sleeping?
And what about your network of support?
D'you have someone with you at home?
Yes. All the time.
Good. Who is that? Parent? Friend?
Would you come with me to the CT scan?
I can get claustrophobic.
Yes, sure, I'll come.
-Go on, then. What's the next question?
-Right, let's see...
Do you ever feel that you are a failure
or have let yourself or your family down?
I lost control of my car
and killed the person I love most in all the world.
Does that count?
I'm sorry, I don't know why I said that. Please, carry on.
Why don't we just have a chat instead?
Let's have a full set of bloods, an ECG, echo, chest X-ray.
I...I don't want another transplant.
Please. Whatever it is, you have got to fix this one.
I guess we'll have to wait for those tests.
We'll be right back.
I think he might be rejecting.
It's been less than two years since the transplant so...
Thank you, Jonny. I'm so glad I've got you to help me,
or I'd have to rely on all those years of medical training(!)
OK, sorry. You've got this. Oh, while I've got you here,
I was a little surprised by your choice of nanny.
What's wrong with him?
Whilst I'm sure his abseiling experience will no doubt
come in handy, I was thinking we could go for someone with
a gentler, more nurturing presence?
Priceless, the male nurse has a problem hiring the male nanny!
No, not at all.
I'm just interested in picking the right person for the job.
Well, he is. Emma needs a strong male role model in her life.
That's me! I'm her dad!
Look, it's my decision, I'll choose whoever I want to.
-What happened to co-parenting?!
-You can have an equal say on everything.
-When you can contribute equally.
Until then, my money, my choice.
Now get on with doing those bloods.
What, because I'm not on a consultant's salary,
I'm not allowed an opinion about my child?
Sally! How lovely to see you again.
A little bird tells me you've kidnapped one my patients?
I wouldn't say "yours". "Ours", surely?
She's a bariatric patient. Why didn't you call me?
Well, I didn't have your number.
Now, I know how busy you get down there. Why clog up a bed?
Her symptoms are very mild -
probably just a bit of post-op soreness to be honest.
Blood tests are clear, X-ray on its way. Everything's in hand.
Consider this a "thank you"
for letting me assist in surgery last week.
OK. It sounds as though you're doing us a favour.
-But any complications...
-I will be straight on the Bat-phone.
Everything's under control, trust me.
I'm glad to hear it.
You did a good job the other day. You'd be welcome back.
It's a date.
In a purely medical sense, obviously.
Where's she going?
Recognising my vast talent when it comes to patient care,
she has returned back from whence she came.
Careful, Nurse, or Dr Tressler will need his smelling salts.
Nothing but liquids, I'm afraid.
Well, we are going to have to find a way to make her throw up.
Why don't you tell her one of your chat-up lines?
You'll have plenty of opportunity on your date.
You going on a date with Annie?
What? No, of course not!
That's not what she thinks.
NHS regulations require you to dispose of that immediately
to prevent the spread of contagious diseases.
So she may have got the wrong idea.
With no encouragement from you?
No! It's not my fault if women get their hopes up.
Look, could you have a word with her?
Let her down gently or something?
No way! This is your mess. You tell her if you're not interested.
I can't turn her down, it will break her heart.
You should have thought about that
before you started flirting with her.
You can't let her go on thinking that she's got a chance.
Maybe you should tell her that you're gay or something.
Oh, yeah, she's going to believe that(!)
A pint says she doesn't bat an eyelid.
Fine. You're on.
I hate it when I feel like people are keeping things from me.
Mr Levy just wants a second opinion on the CT scan.
I'm sure it'll all be OK.
That's what they said after the accident.
"Everything's going to be OK."
I was trapped in the car for an hour next to Matthew's body
and no-one would even admit he was dead!
You must miss him very much.
No. I don't.
But you were very happy?
We are happy. I don't miss him because he's still with me.
Right, as in looking down on you from heaven?
Mm-hm. Something like that.
So have you got a boyfriend?
-Not at the moment, no.
-I suppose it's hard,
with you being so busy here.
Don't worry, I'm sure Mr Right's just around the corner.
What are you doing?
I'm going to let a little bit of the fluid out of your band.
Hopefully that will help any food that's got stuck to slip down
and you'll feel a lot better.
Why didn't you tell me? About you being gay.
Well, it's difficult. You never know how people are going to react.
I'm absolutely fine with it.
In fact, I've always kind of wanted a gay friend.
Someone to hang out with, take shopping, that sort of thing.
Really? That's great! I'll start thinking of some things we can do.
Sorry, let me try that again.
It's probably best that you don't say anything about this either.
One of the nurses said she saw you talking to yourself.
Were you talking to Matthew?
-I don't want to talk about it.
I'm not judging.
No offence, but you won't get it.
Have you ever had someone you love die?
I'm not meant to talk about my private life...
So I have to bare my soul and you get to say nothing?
My mum died.
I'm sorry, I shouldn't have put you on the spot like that.
Were you close?
Yes. Very. And I still speak to her all the time.
Sounds a bit childish, now I say it out loud.
No, I don't think so.
So, were you? Talking to him?
Seriously, are they trying to kill us with these bleach fumes!
It's fine. I can't smell it.
-You can't smell that?
Slightly burnt toast. And strong, sweet coffee.
No, I'm not getting that.
I think the smells are just for me.
What do you mean?
Have you got my results?
Beth, we think you might have an aneurysm in your brain.
That's when the walls of the blood vessel weaken and balloon out.
I'm afraid it could be very serious.
You worried they're talking about you?
Just debating whether to save Colette from Scotland Lacks Talent.
They seem to be getting on OK, making nursey jokes,
complaining about doctors.
Well, you seem very popular here.
-Careful of that one. I think she's after your phone number.
-That's an occupational hazard.
Tell me about it.
Well, Jonny, I'm impressed.
You've got good systems in place
and the other nurses clearly look up to you.
Well, in that case, is there any way
-that I could get a little extra... responsibility?
-You mean money?
Well, the next step for you would be a Clinical Nurse Manager,
but to be honest I don't see the need for one on Darwin.
What if I told you there was a consultant on this ward who
views the nurses as little more than walking bandage dispensers?
All I'm asking for, all I want is the opportunity
and the seniority to make things better.
You know how it is - money is getting tighter every day.
I would have to be 100% sure
that the problem on the ward was serious enough to justify the cost.
It is serious. Trust me.
Excuse me, Ms Naylor, I'm sorry, I know you asked me
to chase up those results for Mr Eldridge, I just haven't had time.
Don't worry, Nurse Maconie.
The workload can get on top of all of us sometimes. I'll do it for you.
I was talking to Beth just now about her husband and she mentioned...
Are you sure it's an aneurysm?
Mr Self and I both think so, yes,
but until we do an angiogram we can't be sure.
Is it on the frontal lobe?
It looks like an anterior circulation aneurysm.
Oh, no reason.
Um, I wonder if I could write up my findings
and present them to you later?
What, like a case study?
ANNIE SPLUTTERS AND RETCHES
OK, OK, OK.
There we go. There we go.
Well, looks like you've got some of that food up at last.
You feeling any better?
Where's Dr Tressler?
I think he's on a break.
He's avoiding me, isn't he?
Why would he do that?
I made a fool of myself. I didn't realise, you see?
About him being...
You know...liking men.
-Didn't you know?
-Ah, there's nothing to know.
Ah, you can take it from me, Dr Tressler is most definitely not gay.
You and him...?
Honestly, the only man Harry fancies is himself.
Can I use the loo, please?
Sure. I'll get someone to take you.
So what do you smell now?
Him. He's here. Looking after me.
Describe it to me.
His skin. His aftershave.
That silk jacket he thought made him look like Ryan Gosling.
You just bear with me for just one moment.
Do you know anything about olfactory hallucinations?
Phantom smells? Ooh, a bit.
Beth can smell her dead husband.
-I mean, as if he's still alive.
Isn't that amazing?!
-Wow, OK. Well, what did Mr Levy say?
-I haven't told him.
-He told me to show him what I can do.
-I'm putting together a case study.
-Doesn't he still need to know about the symptom?
No, it won't make any difference. He's identified the problem. It's an aneurysm.
Aren't aneurysms asymptomatic? Surely it's a tumour, or...
Yes, that's why it's so interesting! The aneurysm must be in contact
-with a specific point in the frontal lobe.
-I still think you need a second opinion.
I did see a leading neurosurgeon around here. Guy something...
Arthur, promise me you won't say anything.
If her condition changes, I will tell Mr Levy, I swear.
So what did the patient say? When you told her that her dead husband smells aren't her dead husband.
She's happy as she is, I'll tell her when I'm done.
It's just you're even worse at this stuff than I am.
Seriously, I don't blame you.
A quick op, lose a few pounds, what's not to like?
Sure I had some in here.
I need some, er...you know...
That's not a crisis. I'll get you some. I'll be right back.
ANNIE SPLUTTERS AND COUGHS
So tell me, how do you all get along here?
-In what way?
-Well, does the team work well together?
Yeah, I think so. I don't know about you,
but I can't stand this old-fashioned notion of hierarchy.
I fully value the advice of our experienced nursing staff.
So it's just one big, happy family?
You could say that.
Nurse Maconie and I even have a child together.
Sadly, he's now moved on to young Nurse Wallis,
but I think it's all amicable.
I certainly respect him.
Hi. What's going on with Steffan?
Well, his pain has abated
but his echocardiogram shows signs of constrictive pericarditis.
So I've booked him in for surgery later.
Right, and have you done an MRI?
No. I didn't see the need. He's due for review soon.
Well, protocol dictates...
Ms Naylor is a consultant. I'm sure she's aware of the protocol.
I haven't told him about his operation yet. Could you?
I've always respected your communication skills.
Isn't that something you should do?
Yes, if that's what you'd prefer.
You don't understand. She's not always this...normal.
-I need some help!
-Sorry, do you mind if I call you back? Thanks.
ANNIE SPLUTTERS AND GASPS
Annie? We need to get this open.
-I only left her for a few minutes.
-Forget it. Go and get a trolley.
Right, let's get her out.
Something's blocked her oesophagus.
We need to help you clear the blockage. This might hurt a bit.
OK, the catheter is in place and the dye is going in now.
Now you may feel a slight warmth or tingling sensation around your face.
But that's quite normal, OK?
It'll be OK, Beth. Just relax.
Right, here we go.
Won't be long now.
Can you see if Mr Self has finished his meeting, please?
It's OK, Annie, won't be long now.
-Who is this?
-It's Annie Hinkley. Post-op bariatric patient.
Looks like she might have perforated her oesophagus.
Let's get her consultant down here, now.
No, she's busy. Doing a sleeve gastrectomy on a human whale.
You might show a little bit more respect for our patients,
especially considering your chosen career path.
Do you want me to take her into theatre, have a look?
I can do it. I know the patient.
That's not a bad idea. Are you happy to supervise?
-It will be good experience for him.
-Well, let's get on with it.
And for heaven's sake - get yourself cleaned up.
Why have you got a face like a colostomy bag?
This is terrible.
Some people are never happy.
I thought you wanted Jac to be less...Jac.
Yeah, but not today!
Today I wanted Colette to see what Jac was really like,
-so I could get a promotion and...
-Pay for Mary Poppins rather than Bruce Willis?
Exactly. But what I didn't realise
when I came up with this ingenious plan,
is that Jac has been kidnapped by aliens
and replaced with Mother Teresa!
Right, yeah, that might be my fault.
But, hey, if anyone knows how to bring out the worst in Jac,
it's definitely you.
BP's down to 110 over 75.
Here it is.
Actually, it doesn't look too bad.
I think the blockage around the band
may have made the build up of blood look worse than it was, to be honest.
What are you doing with my patient?
-Why wasn't I informed immediately?
-There wasn't really time.
I was under the impression that you were otherwise engaged?
I don't know what gave you that idea.
Her colour's good.
I don't think this is going to need surgical intervention.
It should seal itself off. Stabilise her with fluids.
She said she was sticking to the diet?
She gave me her word.
This job would be a hell of a lot easier
if people told the truth once in a while.
If I don't have the operation, would I definitely die?
No. Some people can live with aneurysms for a long time.
But the size of yours makes rupture a more likely outcome.
This all makes sense now. The aneurysm, everything.
This is Matthew's way of telling me he's waiting for me.
So why not just let nature run its course?
-No, you don't understand, if it ruptures...
-We'll be together again.
I had planned to spend my whole life with him,
but that's not how it worked out.
All I'm doing is leaving the rest up to fate.
Don't look so scared. I'm not.
-I'm worried about Steffan. His pain's got worse.
-Have you told Jac?
I asked her to do an MRI,
but she's so determined to prove how insignificant I am today.
-I'm going to speak to Steffan myself.
-Is that a good idea?
He's in pain.
She might not listen to me, she might to him.
Steffan, listen, I think you need an MRI.
The only problem is, you're going to have to ask for it yourself.
-From Ms Naylor?
-I... I couldn't do that.
You have to. I've tried and she said no.
-But coming from you...
I'm not very good with women at the best of times, let alone her.
Steffan, this is important.
She's the consultant, right?
Wouldn't she know if there was...?
She's a brilliant doctor, but I don't think you've been
entirely honest with her about the level of pain you're experiencing.
I didn't want to be a bother.
Steffan, you don't want to risk losing that heart, right?
I can't help you with that unless you speak up for yourself.
Zosia, where are the forms?
On their way.
You mean she hasn't signed yet?
-Er, I was just getting a pen. Mine ran out.
-Could you hurry up, please?
-She really needs to be prepped for theatre.
-I'm on it.
Following our chat earlier, I've been reading about aneurysms...
I don't have time for this. Beth is refusing the operation.
-She thinks her husband is waiting for her on the other side.
-I know, it's my fault.
I spent too long humouring her, getting too close.
But it's time for her to face the truth.
OK, listen to me. It is not Matthew.
-The smells. He is not causing them.
-Are you calling me a liar?
Your recent trauma has clouded your judgment.
You're wrong. It's Matthew.
He is dead, Beth.
I know that.
The smells are not some sort of ghost!
He is not haunting you.
You can let yourself die, but you'll be doing it for the wrong reasons.
Why are you doing this to me?
Are you jealous? Because Matthew is still here looking after me,
while your mum just left you!
-you've got to trust me.
-I won't consent.
Please, Beth. Please do not refuse treatment.
If you're telling the truth, if he's gone, what do I have to live for?
Matthew wouldn't want this. He'd want you to fight, to live.
Please let us operate.
What did he say?
He said he needed time to think about it.
If Jac finds out you've gone behind her back,
she's going to go ballistic.
Oh, yeah. I hadn't really thought about that.
I'm sorry, Jonny, but I have seen no evidence whatsoever to
back up your assertions about Ms Naylor.
What did you say to Mr Eldridge?
I merely suggested to him
-that an MRI might actually be in his best interests.
Well, because I had serious concerns about his condition
which I didn't feel were being properly addressed.
Protocol for a transplant patient dictates...
I don't care what your protocol dictates.
I care that a seriously ill patient is now missing.
-Is it true?
You lied to me.
You're not gay, are you?
..we're not allowed to get involved with our patients.
It was stupid of me, but I thought it might make it
easier for both of us if you thought that I was unavailable.
Remove the temptation.
So you were tempted?
Nobody here needs to know. It could be one of our secrets.
We'll go for a bite to eat.
Yeah, I'm not sure that's such a good idea.
Or the cinema? I kept quiet.
I didn't tell anyone about you breaking the rules.
A drink, then. I won't tell anyone.
Sure. OK. Why not?
Please tell me that you have these consent forms. Beth is due in surgery any minute.
Consent forms and the preliminary notes of my case study.
-What case study?
On Beth. I wanted to explore the extent of
-the psychological implications.
-Implications of what?
Well, it turns out that the aneurysm is causing phantom smells.
Because of these olfactory hallucinations, Beth is under the impression...
Er, no! Back up a minute. What smells?
Compared to her post-op X-ray this band looks...deflated.
Maybe it sprung a leak?
I doubt it. Maybe it's just the angle that this one's taken from.
That would probably be it. So what now?
Get her back into surgery and have a look at the anterior slippage.
The stomach is clearly herniated.
Will you check her obs? Make sure that bleed is completely stopped.
Yeah. I'll do that now.
-Hi. If you could just open up,
I've just got to see if there's any signs of any blood.
OK, that looks lovely.
Do you really think I'll be beautiful?
I said so, didn't I?
-D'you really mean that?
-Yeah, of course.
When you're finished here, Lord Fauntleroy,
you do have other patients to see.
Sick of being judged for things I have absolutely no control over.
I know exactly what it's like.
Yeah, well, I didn't have a choice about the family I was born into.
You think I'm like this out of choice?
Well, no-one forced you to eat this much, did they?
Is that what you think of me?
Sorry, I didn't mean that.
Just sat at home eating junk food and watching telly?
All I meant is that with a better diet...
-Do you realise how hard it's been for me?
-Oh, come on.
At some point you've got to take responsibility for your own actions!
You're going to get me in a whole heap of trouble, mate, you know that?
What are you listening to?
I'm not going anywhere until you start talking to me, so...
It's the, erm,
Elgar Cello Concerto in E minor.
Oh, aye? Any good?
-One of the greatest pieces of classical music ever written.
D'you mind if I have a wee...?
Who's playing this?
Is this you?
You played this?
I can't lose this heart.
Steffan, we don't even know
if there's anything for you to be scared of.
That's just it. I've always been scared of everything.
But since I've had this heart...
..when I play...
Yeah, but that's not the heart doing that, is it?
That's you. That's the part of you that wants to be heard.
And I'm sorry, OK?
Because my head has been in entirely the wrong place today
and I really shouldn't have scared you like that.
..if you want to save that heart,
the best thing you can do
is come back onto the ward with me. Let us take care of you.
-You should have told me what was going on.
-I didn't think it would
make a difference. It's not like it changes the diagnosis.
But that's just it, it does.
The smells cannot be a symptom of the aneurysm.
You don't honestly think her husband is trying to
contact her from beyond the grave, do you?!
No, but if you'd studied the condition properly,
you'd know that it couldn't possibly be the aneurysm either.
I don't understand.
Beth is probably experiencing some sort of hallucination
as a result of post-traumatic stress.
OK, now, you did the crib sheet.
It specifically mentions hallucinations as a warning sign.
I might not have entirely finished it.
-It's a box-ticking exercise.
It doesn't tell you anything.
It tells you when a patient is in need of
urgent psychiatric referral.
I thought this is what you wanted to do for a living?
It made perfect sense.
I'm trying to support you, Zosia, but this is your problem.
Well, I'm sorry if I let you down.
I feel I should take responsibility.
It was my idea for Zosia to do the mental state exam,
and she clearly isn't ready.
Clearly. Let's concentrate on Beth for now, shall we?
I want you to phone Psych and ask for an immediate assessment.
When you've done that, come and see me.
-What have you done now?
Well, that "nothing" is in pieces out there.
Look, I didn't do anything! She over-reacted to something I said.
What was that?
"Be serious, Annie! I play Polo!
"Why would I be interested in a common slob like you?"
What is your problem? You know nothing about me.
I know you're a lazy, arrogant posh boy who'd rather be sucking
the money out of rich housewives than helping people with real problems.
When things get tough, you come and hide in here.
What do you expect me to do?
Tell Annie it's not her fault she crammed chocolate down her throat?
It's a bit late for that.
She's out here pouring her heart out...to Ric Griffin.
He kept telling me everything would be all right,
and I trusted him.
I don't want him anywhere near me.
Go to my office. Now, please.
The psychiatrist is with her now.
You do realise that by telling her the smells are caused by the
aneurysm, that you gained consent through incorrect medical advice.
If we'd operated, my reputation
and that of the whole hospital would have been put into serious doubt.
I'm sorry. I honestly thought I could help her.
Why are you so keen to help her?
I'm a doctor. That's what we do.
There have been a dozen surgical cases recently that you've
shown little or no interest in. Why her?
She's been through a lot.
This is nothing to do with Mama, if this is what you're getting at.
Zosia, you know, you pour so much energy into learning
how to help people find peace, and yet you're so angry yourself.
-I'm not angry, I'm...
-Yes. You are.
You are angry with me. You don't even try to hide it.
How do you expect me to feel?
If I had been anyone else out there today, you'd have asked advice.
Are we done here?
I thought I'd have a go at this after all.
I've only managed to skim through the first chapter, but, er...
Well, apparently, dying can be sometimes
less frightening than living, but then I knew that.
-Is that what Mama thought?
-You said this wasn't about her.
Is it what she thought?
I should have been there for her.
Why didn't you tell me sooner?
She asked me not to.
She asked you not to?
I had a right to know.
Yes. Yes, you did.
You should have helped her.
-It's not what she wanted.
Why refuse treatment? She could have had time.
I loved your mother so much.
I would have given anything to have had more time.
That's not what I asked. Why?!
Because she thought it was the right thing to do.
Mostly for herself.
Your mother was a very proud, very brave lady.
And I think she thought...
in the face of certain defeat,
that there was more dignity in surrender.
If our psychiatrist gives the thumbs up,
let's get Beth into theatre and try save her life.
That OK with you?
Please accept my apologies, once again, on behalf of this department.
No need. We all know it only takes one weak link.
Dr Tressler, the patient says that you pressured her
into having an operation. Is that true?
No. That is not true at all.
Then why would she say it?
Miss Hinkley expressed a few doubts. That's not unusual.
We talked them through and she was happy to proceed.
At the time, I thought that the department was pleased
with my handling of the situation.
So there were never any signs that she wasn't in complete control?
Well, I think if she was in complete control she wouldn't
have needed bariatric surgery in the first place, to be honest.
Don't get smart with me, Dr Tressler.
Look, with hindsight, my inexperience in this particular
field may have led to a regrettable decision.
I'm sure she's told you what happened at the weigh-in.
No. What was that?
That she burst into tears.
She begged me to do everything that I could to help her.
And, seeing how desperate she was,
I believed that the operation was in her best interest.
Tell me, having witnessed your patient vomiting up blood,
do you still think that's true?
No. But the complications were caused by her actions, not mine.
I've heard enough. Annie should be our priority from now on.
I'm going to scrub in. Dr Tressler, you can join me.
-I'm not sure that's a good idea.
I want him to see the damage he's caused.
Psych believe that Beth has the capacity to consent
and is happy to go ahead, so we can proceed.
Why do I get the feeling that Zosia's foray into psychiatry
hasn't been entirely successful for her?
Don't even go there.
It's definitely slipped. It's not in the right place.
I'm going to have to take it out.
Bariatric patients are vulnerable.
They pin their hopes and dreams on surgery like it's a magic wand
that's going to cure all life's problems.
You took advantage of her frailty,
and this is the result.
Pass me a liver dish.
If you could just give me another chance...
I don't think this is the specialism for you.
I'm not convinced that you possess the necessary emotional maturity.
Oh, and by the way, gastric bands
don't just "spring a leak", Dr Tressler.
Unlike your intellect, it seems.
If I could prove that someone had tampered with this,
their career would be over.
There's your oxygen for you.
Have you got this? I'll be right back.
Sorry. Sorry, crisis averted.
Now, about our other wee problem...
Jonny, the only problem I can see in this ward is you.
I know it must be difficult working with an ex,
but you've just undermined a patient's trust in their consultant -
a consultant who, I might add,
has been nothing but professional all day.
You don't understand. She's not normally...
Jonny, we've all been there.
Workplace romances often end like this.
In the meantime, maybe you should follow Ms Naylor's example
and put the past behind you.
Congratulations, ladies and gentlemen,
I can see the vascular feeders.
Now for the difficult bit.
Yes, that bayonet clip, please.
You know, Zosia, neurosurgery and psychiatry can be pretty similar.
It's just a question of digging around in the brain,
trying to find that flaw that causes pain.
I'd not thought of it like that before.
Maybe we're not so different after all.
The aneurysm's burst.
Drop the blood pressure.
I can't see a thing.
Heart rate's 112.
Heart rate's stabilising.
No sign of any further bleed.
Right, that was...interesting.
Zosia, let's close up.
We'll do an angiogram. Check everything's flowing properly.
-Yes, that's it for now.
We'll keep her in a coma, keep her ICP down, but...
so far, so good.
Fun, isn't it?
'Yeah, he just wanted to let you know'
that he won't be able to make it to rehearsals tomorrow.
Oh, wait, while I've got you on the phone,
can you pass on a message from Steffan to your oboist?
Yeah, can you let her know that Steffan would love
to go out for a drink when he's feeling better, is that OK?
You're a star. Thank you.
-Listen, before you say anything...
You told a patient that my clinical judgment was flawed.
-No, that is not exactly...
-You're a nurse. Just a nurse.
You're not paid to question my judgment,
you're paid to hand out pills and wipe people's backsides.
If you'd worked harder at school and weren't such a halfwit
you could be standing where I am now, but you're not.
And if you ever undermine me to a patient again, I will use
my considerable surgical expertise to remove your internal organs.
Here it is.
-Thanks, Mo. Totally forgotten about that.
Nurse Maconie, a word?
I think Mr Eldridge is still expecting
an MRI before his operation.
Better safe than sorry.
As Nurse Maconie wisely pointed out, it is protocol.
Don't you ever speak to one of my nurses like that again.
Sorry. My bad.
You're going to be referred back to bariatrics now.
When can I have another one put in?
Annie, it's very unlikely that you'll be approved
for another procedure on the NHS.
By failing to adhere to the post-op diet,
you've shown that you're an unsuitable candidate.
So, that's that?
There's always the option to go private?
Borrow some money, shall I?
All I wanted was to look at myself in the mirror without feeling sick.
Just for a while, I allowed myself to dream it was going to happen.
But it's not, is it?
So, I just had a look at Steffan's MRI.
Subendocardial fibrosis, right?
Did you just look that up in The Idiot's Guide To Heart Surgery?
Just to get this absolutely clear, am I right in thinking
that, if left undiagnosed, that would most probably
deteriorate to full rejection?
It would have been picked up when he had his biopsy done.
Do you really think I'd put a patient's life in danger
just to get one over on you?
There are so many easier ways I can do that.
Well, there might not be quite so many after today.
I'm Darwin's Acting Clinical Nurse Manager.
I guess Colette just wanted the ward to have a strong male role model.
Oh, and by the way, I've chosen a new nanny.
Her CV is on your desk.
You don't mind, do you?
Especially now there's all these horrible new things
that I can do to annoy you.
Like, er, rotas,
You wouldn't dare.
So we're agreed, then, yeah?
Well, a bet's a bet. Drinks are on you.
Oh, you buying? Count me in.
There's just something I need to do first.
Here. This is for you.
It should cover the cost of the procedure.
Or use it for whatever you want, but I just wanted to say I am sorry.
That's the thing, when you're as skint as I am,
you have to sit back and watch you lot swanning through
as if you're some sort of higher life form.
Well, trust me, you're not.
So I'll take your filthy money,
cos I'd rather I had it than you did.
Is this the Tressler MO - buying your way out of things?
Not all of us are blessed with your impeccable moral fortitude.
You want to take a good look at yourself,
because right now you're a disgrace to the profession.
Gentlemen, can I have a word, please?
I've already made it clear to Dr Tressler
that he needs to up his game.
Well, that applies to both of you.
-Both of us?
-This happened on your watch.
Dr Tressler was under your direct supervision.
You've both let me down,
and you're frankly lucky that I haven't suspended the pair of you.
Dr Tressler, I'd like you to write a full report for your e-portfolio.
Absolutely. And, Mr Griffin, can I just say I'm very sorry?
This will not happen again.
I'm glad we got that sorted.
Well, I think this calls for a celebratory drink.
I'm very proud of you.
And you're OK about being shacked up with the boss and all that?
They do say power is an aphrodisiac.
Maybe Jac will show me a wee bit of respect from now on.
Is that why you wanted a promotion? To impress Jac?
Of course not.
Look, I'm doing this so I can provide for my daughter.
And for us.
Surely that's a good thing, right?
Yeah, course it is.
Right. Now come on, there's a bottle of bubbly with our names on it.
So, I've decided on my new specialism.
-Go on, then, what is it now?
What? At least I'll end up with better-looking patients.
Embarrass me like that again, English boy, and I'll make sure
you're off my ward and out of the hospital for good.
Are we clear?
Why don't you come join us, Raf? Have a drink.
Might help you relax.
Have a nice evening, ladies.
I just wanted to thank you for being honest with me earlier.
And to say sorry for giving you such a hard time.
There's really no need to apologise.
It might take me a while to get used to it after all this time.
You calling me Dad in theatre.
Well, you are, aren't you?
Anyway, I've got to head home, so...
OK. Good night, then.
Zosia is excited when Sacha finally gives her the opportunity to prove herself with a psychiatrically vulnerable patient, but her own vulnerabilities are exposed as she struggles to grasp the severity of the case.
Harry is frustrated when adoring bariatric patient Annie returns and does his best - however shoddily - to deter her, but it does not prove as easy as he had hoped.
When Jac tells Jonny that her pay cheque dictates she has the right to make decisions about Emma, he resolves to get a promotion by exposing her as a bully.