0:00:39 > 0:00:42Arthur said I'd never make it as a doctor.
0:00:42 > 0:00:44Why should Arthur's opinion account for anything?
0:00:44 > 0:00:46You want me to say you're better than Zosia?
0:00:46 > 0:00:49She can be off her game, because she can play the dead mum card.
0:00:49 > 0:00:53My mum had this thing about the pond in the field behind our house.
0:00:53 > 0:00:55She told me never to go near it.
0:00:55 > 0:00:57We had a huge pond behind our house.
0:00:57 > 0:01:00My mum always said I wasn't allowed to go anywhere near it.
0:01:00 > 0:01:04IVF. Of course. The nausea, the needle phobia.
0:01:06 > 0:01:08Is this your third round?
0:01:08 > 0:01:09When are you going to come and see Emma?
0:01:09 > 0:01:11I've been seeing her with the nanny, when you're here.
0:01:14 > 0:01:18I'm not going to let you poison me. Or Emma.
0:01:18 > 0:01:20I'm taking her away from you.
0:01:24 > 0:01:26Ooh!
0:01:30 > 0:01:33Tell me it's the hormone injections that are making you want to kill!
0:01:33 > 0:01:35Not the sight of my face!
0:01:35 > 0:01:38- But I love your face, hun! - Thank you.
0:01:38 > 0:01:41I want to see your face in the face of my babies!
0:01:41 > 0:01:43- Yeah, I know!- So...
0:01:43 > 0:01:45Let's...get...pregnant!
0:01:45 > 0:01:47SHE LAUGHS
0:01:47 > 0:01:48Come on.
0:01:54 > 0:01:56It's like a tragic ballet on ice.
0:01:57 > 0:01:59Cut the atmosphere with a knife.
0:01:59 > 0:02:01Carve it into blocks. Make us an igloo!
0:02:01 > 0:02:04You don't think Jonny will really launch
0:02:04 > 0:02:06- a legal battle for Emma, do you? - I'm way past knowing
0:02:06 > 0:02:09what grief these two are going to dish up to each other.
0:02:09 > 0:02:11Do I say something? Involve HR?
0:02:11 > 0:02:14HR? What, Sophia from HR? She sticks her nose into Jac's business,
0:02:14 > 0:02:17she'll be hanging from a hook in the morgue.
0:02:17 > 0:02:19Morning, campers! How ya diddlin'?
0:02:19 > 0:02:22Just when you thought it was safe to go back in the water.
0:02:22 > 0:02:25- Alan Herring! - Herring by name! Herring by nature!
0:02:25 > 0:02:28- What's that even mean?- No idea, Mo. It all just tumbles out of me
0:02:28 > 0:02:31north and south. Half of it don't make sense.
0:02:31 > 0:02:34- Lovely to see you, Alan. - And you, Mo.- But why are you here?
0:02:34 > 0:02:38Wallpaper samples, Mo. I loved the Darwin decor so much last time,
0:02:38 > 0:02:42I decided to recreate some of the ambience at home.
0:02:42 > 0:02:45- That's not what it says here. - Ah, Mr Hope!
0:02:45 > 0:02:48Still getting extras work on the Hobbit movies, eh?
0:02:48 > 0:02:51I thought I told you, we didn't want to see you back here again.
0:02:51 > 0:02:53Shouldn't have done a cowboy job on me ticker, then,
0:02:53 > 0:02:54should you, Pro-fess-or?
0:02:54 > 0:02:57- SOFT LAUGHTER - It says here he collapsed.
0:02:57 > 0:03:00Ah! There they are - the Darwin lovebirds!
0:03:00 > 0:03:02Last time I saw yous...
0:03:02 > 0:03:05Ooh! ..waft of pheromones made me eyes water.
0:03:05 > 0:03:07- Alan, how are you? - Hi, how are you doing?
0:03:09 > 0:03:12Jac Sprat, keeper of my heart.
0:03:12 > 0:03:14By the way, I want it back some time.
0:03:14 > 0:03:15HE LAUGHS
0:03:15 > 0:03:18- What've you done now?- I think you must've left one of your earrings
0:03:18 > 0:03:21in here last knockings, cos something's not right.
0:03:21 > 0:03:23High temperature, fatigue, night sweats, and chest pain.
0:03:23 > 0:03:25Yeah. No biggie.
0:03:25 > 0:03:27Only hurts when I breathe(!)
0:03:27 > 0:03:30- We did an aortic valve replacement? - Ten months ago.
0:03:30 > 0:03:34So, Spratters... Word is, Jock slipped you his little scotch egg
0:03:34 > 0:03:36and you two was off to play "happy families".
0:03:36 > 0:03:40- Right, Alan, let's see if we can find you a bed, shall we?- Uh-oh!
0:03:40 > 0:03:44I know that look. Someone's not getting no sugar on his porridge.
0:03:45 > 0:03:48- We're late!- Sacha looks grumpy. Golden boy was early.
0:03:48 > 0:03:52- No. We're late. Today, no mistakes. Agreed?- I've got your back.
0:03:54 > 0:03:55Afternoon.
0:03:55 > 0:03:57We have a rush on hernias.
0:03:57 > 0:04:01Er, Zosia, umbilical hernia in bed five, please.
0:04:01 > 0:04:02Right, we have a hiatus hernia pre-op
0:04:02 > 0:04:04and an inguinal hernia post-op.
0:04:04 > 0:04:07Mr Carling - ready to go. Mr Cart's already been.
0:04:07 > 0:04:10- Well, do we get to scrub in on the hiatus?- Yes, you do.
0:04:10 > 0:04:12- Yep, I'll take that.- OK.
0:04:13 > 0:04:16Ah, you caught the easy one. All done and dusted.
0:04:16 > 0:04:19- Discharge. Think you can handle it? - ALARM BUZZES
0:04:19 > 0:04:20BUZZING CONTINUES
0:04:22 > 0:04:24Seems like Mr Cart needs our help, again.
0:04:24 > 0:04:27Bit of a buzzer-bug, I fear. Third time. Bed one.
0:04:30 > 0:04:32- Did you know about this?- No!
0:04:32 > 0:04:35You better not have saddled me with a trouble-maker, Spreckles.
0:04:35 > 0:04:37BUZZING CONTINUES
0:04:37 > 0:04:39Don't wear your thumb out!
0:04:39 > 0:04:42GRUNTING
0:04:42 > 0:04:44- Oh, I'm going to be sick. - It happens.
0:04:44 > 0:04:46- HE RETCHES AND COUGHS - That is why we stock
0:04:46 > 0:04:49a lovely selection of paper bowler hats,
0:04:49 > 0:04:52for your delectation...and vomit.
0:04:52 > 0:04:56- Ooh.- Sorry, I didn't mean to... - That's fine. Like I said...
0:04:56 > 0:04:58Kevin, it happens...
0:05:00 > 0:05:01Kevin Cart?
0:05:01 > 0:05:03As in Scurvy Giblet Wet-Fart Cart?
0:05:06 > 0:05:08Serves you right, you fat little munter!
0:05:08 > 0:05:09GASPING
0:05:09 > 0:05:11Do I know you?
0:05:12 > 0:05:16- Dr Tina's at 4:30.- Do you think I'm going to forget that?
0:05:16 > 0:05:18- Meet here or outside her office? - Office.
0:05:18 > 0:05:20And you, remember what she always says.
0:05:20 > 0:05:24- Yes. So don't say it. - Don't do a home pregnancy test.
0:05:24 > 0:05:26You said it. Not at "home". So I can't.
0:05:26 > 0:05:28- Hey!- Search me, Officer.
0:05:28 > 0:05:32- Look, no pregnancy test kits.- Good!
0:05:32 > 0:05:34- THEY LAUGH - Don't be late.
0:05:34 > 0:05:37- Mwah! I'm going to grab a coffee. Do you want...?- Caffeine?
0:05:37 > 0:05:40- You really think your sperm need caffeine.- Come on!
0:05:40 > 0:05:44I eat Brazil nuts, pumpkin seeds, broccoli, oysters.
0:05:44 > 0:05:48- Just a big ol' lovin' machine! - I've done selenium and vitamin B.
0:05:48 > 0:05:51A little cappuccino's not going to hurt.
0:05:51 > 0:05:54Yuck! Nothing in the world is worth chugging that for!
0:05:54 > 0:05:55You promised - "whatever it takes".
0:05:55 > 0:05:59- Well, I draw the line at wheatgrass snot.- Mean it. Don't be late.
0:05:59 > 0:06:01Nothing could possibly make me late.
0:06:01 > 0:06:04Listen to Dr Tina. Wait for the official results!
0:06:07 > 0:06:09SHE SIGHS
0:06:21 > 0:06:24Ah, Raf. I was just about to page you. Glad I caught you.
0:06:24 > 0:06:28- Where are we going?- Freight handlers had an emergency call from the airport.
0:06:28 > 0:06:31They just unloaded a cargo box under an hour ago.
0:06:31 > 0:06:32It's a short flight from Rotterdam.
0:06:32 > 0:06:35- All the way in the hold. Unpressurised.- Sub-zero temperature.
0:06:35 > 0:06:37- Practically frozen.- What is?
0:06:37 > 0:06:39- They found a body.- A stowaway.
0:06:39 > 0:06:42I want to see it. But I don't! But I do!
0:06:42 > 0:06:43- HORN BLARES - Wow!
0:06:46 > 0:06:47HORN BLARES AGAIN
0:06:53 > 0:06:57As far as anyone could see, the body was a dead body.
0:06:57 > 0:06:58It was rigid, apparently.
0:06:58 > 0:07:01Airport first aider thought she could feel a faint pulse.
0:07:01 > 0:07:04Ambulance crew knew we had an ECMO machine at AAU, so...
0:07:04 > 0:07:08- Looks like it's already news. - Pulse described as very, very weak.
0:07:08 > 0:07:10We found him like this in the hold, but we couldn't move him
0:07:10 > 0:07:13because some metal's pierced his leg. I was sure I felt a pulse.
0:07:13 > 0:07:14Show me.
0:07:19 > 0:07:21Don't cover him. Keep him cold.
0:07:26 > 0:07:27Excuse me.
0:07:54 > 0:07:55You did good.
0:07:58 > 0:07:59Darren Copeland?
0:08:00 > 0:08:02- "Dar" Copeland?- Dominic.
0:08:02 > 0:08:06It's Dominic now. Deed poll. Dar?
0:08:06 > 0:08:08I always hated "Dar". I mean, really, is that as inventive
0:08:08 > 0:08:11as a schoolboy's imagination could possibly get?
0:08:11 > 0:08:13Abbreviating Darren to "Dar"?
0:08:13 > 0:08:16- You're a nurse now? - Doctor, Wet-Fart! I'm a doctor!
0:08:16 > 0:08:19You're a doctor? That's amazing!
0:08:19 > 0:08:23- We all thought you'd go out... - Poof-Dar! Gay-Dar! Bend-Dar!
0:08:23 > 0:08:25- HE SNORTS - You lot were so creative(!)
0:08:25 > 0:08:29- You said you were going to be an actor!- Well, I'm a doctor.
0:08:29 > 0:08:30And I'm YOUR doctor.
0:08:30 > 0:08:34And the big wheel of karma is turning round and round and round
0:08:34 > 0:08:35and guess what?
0:08:35 > 0:08:39You...Kevin... You're it!
0:08:39 > 0:08:42- What's that mean? - An inguinal hernia? Really?
0:08:42 > 0:08:45You do realise that's THE most common type of hernia.
0:08:45 > 0:08:48- One in every eight men. - Mine was really painful.- Ooh!
0:08:48 > 0:08:51Body Mass Index of 40?!
0:08:51 > 0:08:53Kevin, have you never heard of a treadmill?
0:08:53 > 0:08:56Too many pastries. Not enough pilates.
0:08:56 > 0:09:00- Mr Fart. - Should I be seen by another doctor?
0:09:00 > 0:09:02And what do you do for a living, Kevin?
0:09:02 > 0:09:05- Warehouseman.- Warehouseman? Oh, noble profession.
0:09:05 > 0:09:09- There's a lot of heavy lifting. The hernia was caused...- Kevin Cart MBE
0:09:09 > 0:09:13for services to..."warehousing". I don't think so.
0:09:13 > 0:09:16- I'm covered in sick.- So you are. I'll have a nurse clear that up.
0:09:16 > 0:09:19- All in good time. - Do you know what...
0:09:19 > 0:09:21Touch that buzzer once more...
0:09:21 > 0:09:24- I stink of puke!- Yes. You do.
0:09:24 > 0:09:26- HE SIGHS - You will stay there
0:09:26 > 0:09:30and you will be quiet. But most importantly of all,
0:09:30 > 0:09:34you will not tell anyone on this ward that you know me.
0:09:34 > 0:09:39- I've got a really bad pain in my... - And if you do, Kevin Cart,
0:09:39 > 0:09:41I will tell my boss
0:09:41 > 0:09:46exactly what you and your ugly ignorant friends did to me.
0:09:46 > 0:09:47Did what to you?
0:09:49 > 0:09:52It goes... # Boom-diddy-boom Diddy-boom-diddy-boom
0:09:52 > 0:09:55# Diddy-boom-diddy-boom Diddy-boom-boom-boom... #
0:09:55 > 0:09:58Shut up, Alan, or, so help me, I'll punch you!
0:09:58 > 0:10:01There you go! Bit of the old Sprat back.
0:10:01 > 0:10:03You love me really. Don't she?
0:10:04 > 0:10:08Yeah, Nurse Maconie's the expert on human emotion.
0:10:08 > 0:10:09Hang on, go back.
0:10:09 > 0:10:13- Left again.- Can you roll on to your right side, please?
0:10:13 > 0:10:16- And they all rolled over and the little...- Shut it!
0:10:16 > 0:10:19Sorry, Alan, it's just we have to concentrate.
0:10:21 > 0:10:22There.
0:10:22 > 0:10:25- That look thickened to you? - Maybe slightly.
0:10:25 > 0:10:27What are you thinking? Infection or age-related wear and tear?
0:10:27 > 0:10:29Oi! Enough with the "age" stuff!
0:10:29 > 0:10:32- Let's wait until we see the bloods.- Mmm.
0:10:37 > 0:10:39You not discharged your inguinal?
0:10:39 > 0:10:40Nope.
0:10:40 > 0:10:43Right, well, I'm off to do a Nissen fundoplication repair.
0:10:43 > 0:10:44Riveting(!)
0:10:44 > 0:10:48- I think Sacha wanted that bed clear as soon as possible.- That's the plan.
0:10:50 > 0:10:52Pull the short hernia straw?
0:10:53 > 0:10:54Yes and no.
0:10:58 > 0:11:00I shouldn't tell you this...
0:11:00 > 0:11:02- But...- You want me to stop checking discharge meds forms
0:11:02 > 0:11:05in order to look you in the face and say, "What shouldn't you tell me?"
0:11:06 > 0:11:09Look, I can't. Patient confidentiality.
0:11:09 > 0:11:12Dominic, we're not doing melodrama today. Sacha was gunning for...
0:11:12 > 0:11:14You know I told you that I was bullied at school?
0:11:19 > 0:11:21We need to get him out.
0:11:21 > 0:11:23Do you want me to take over?
0:11:25 > 0:11:27- No.- We should intubate him. Get me a kit.
0:11:27 > 0:11:29No. No intubation! I'm sorry.
0:11:29 > 0:11:33The state he's in, oxygenation is the least of our problems.
0:11:33 > 0:11:34We'll intubate him inside.
0:11:34 > 0:11:37Do you think he's going to die?
0:11:37 > 0:11:38Not if I can help it.
0:11:38 > 0:11:41- Did we get that?- Give me a job, Raf, please? Tell me what you need.
0:11:41 > 0:11:43OK. Yes, good.
0:11:43 > 0:11:45Look, er, we're going to move very quickly.
0:11:45 > 0:11:47As his temperature rises, oxygenation will become crucial.
0:11:47 > 0:11:50- Could lead to diffuse cerebral hypoxia?- Precisely.
0:11:50 > 0:11:53Now what I want is for you to go and get Ms Effanga.
0:11:53 > 0:11:56Tell her to prep for cannulation, possible sternotomy.
0:11:56 > 0:11:59- You want me to run an errand? - Yes, that's it. Get Mo.
0:11:59 > 0:12:00Well, go!
0:12:05 > 0:12:08No. Stay with the boss guy. That one - he knows what he's doing.
0:12:08 > 0:12:10Where's those cutters?
0:12:19 > 0:12:21CUTTERS WHINE
0:12:23 > 0:12:26LOUD GRINDING BAR SNAPS AND RATTLES
0:12:30 > 0:12:34- You can't leave him like that! - I know. I just had to tell someone.
0:12:34 > 0:12:36- SHE SIGHS - You're the only one I can trust.
0:12:36 > 0:12:38I'll clean him and discharge him.
0:12:38 > 0:12:39No, you shouldn't have to deal with it.
0:12:39 > 0:12:42Look, Sacha told me to discharge him. So...
0:12:42 > 0:12:43WE'LL discharge him.
0:12:43 > 0:12:47Or we'll go and tell Sacha. There has to be some protocol about this.
0:12:47 > 0:12:49No, it's fine, really. I'll clean him up.
0:12:49 > 0:12:51Let's not make this official.
0:12:51 > 0:12:53We discharge him together or I tell Sacha.
0:12:53 > 0:12:56We know the vomiting isn't clinically significant
0:12:56 > 0:12:58and there are no other problems.
0:12:58 > 0:13:00No cock-ups. Noses clean. Remember?
0:13:00 > 0:13:03OK. OK. Fine. We'll discharge him together.
0:13:03 > 0:13:05But please don't tell Sacha.
0:13:05 > 0:13:08I don't want to be the problem doctor today.
0:13:08 > 0:13:12And I don't need everyone knowing my personal business. Only you.
0:13:17 > 0:13:20You have no idea how happy I was to get your call.
0:13:20 > 0:13:21"Come treat a frozen, lifeless body
0:13:21 > 0:13:24"found in an air cargo container with practically no pulse."
0:13:24 > 0:13:28- It's way more appealing than being on Darwin today.- With Jac and Jonny?
0:13:28 > 0:13:30Mm-hm. I hear urinary infections are more fun.
0:13:30 > 0:13:31Thanks.
0:13:34 > 0:13:36HEART MONITOR BEEPS
0:13:43 > 0:13:46Er, the paramedics couldn't get any decent venous access.
0:13:46 > 0:13:49His core temperature means his veins are in spasm.
0:13:49 > 0:13:51- If you do get in, we pump Hartman's. - Definitely. If we get in.
0:13:51 > 0:13:54- Hartman's?- It's a solution.
0:13:54 > 0:13:56IV crystalloid solution?
0:13:56 > 0:13:58- MO:- What's his sats?
0:13:58 > 0:14:01Er, no reading on the pulse oximeter. Suture.
0:14:01 > 0:14:04- Heartbeat?- Very deep. Very weak.
0:14:04 > 0:14:07Right, so are we saying he's as good as dead before we even start?
0:14:07 > 0:14:10His core temp is 22 degrees. You know as well as I do,
0:14:10 > 0:14:13you're not dead until you're warm and dead. This guy's freezing.
0:14:13 > 0:14:15So why are we not warming him up?
0:14:15 > 0:14:18When everything's frozen, it's in shut down.
0:14:18 > 0:14:22- Body tissue's in suspension. - When it warms, the damage gets done.
0:14:22 > 0:14:25Lack of blood, lack of oxygen - that's what'll kill him.
0:14:25 > 0:14:29- What about bicarb? I read you should inject bicarb...- Yeah, definitely(!)
0:14:29 > 0:14:32That would kill him quicker than just about anything.
0:14:32 > 0:14:35Overheat the blood before the heart can pump. End of story.
0:14:35 > 0:14:37Look, you want to do something useful? Get rid of them!
0:14:39 > 0:14:42Look, I'm going to need both of your help to get him on the pump.
0:14:42 > 0:14:43- Sure. - CHATTER OUTSIDE
0:14:43 > 0:14:46Raf, we have to be very sure we're doing the right thing here.
0:14:46 > 0:14:48What's the alternative?
0:14:48 > 0:14:51That pump is here on probation.
0:14:51 > 0:14:53We can't afford to make mistakes.
0:14:53 > 0:14:55So, we helicopter him out to a specialist centre?
0:14:56 > 0:15:00- Really?- There is a news crew in the building.
0:15:00 > 0:15:04Precisely! Look, this goes well, which it will, it's down to you.
0:15:04 > 0:15:07You turning Holby into something dynamic.
0:15:08 > 0:15:11Why do I get the feeling you're trying to butter me up?
0:15:11 > 0:15:14Look, I'm just the monkey who works the machine.
0:15:14 > 0:15:16You got us the machine in the first place.
0:15:16 > 0:15:19If this is a baby, we're having it together.
0:15:25 > 0:15:26OK.
0:15:28 > 0:15:30177.
0:15:30 > 0:15:32178!
0:15:32 > 0:15:34179.
0:15:35 > 0:15:38- SHE SIGHS - I'm not looking.
0:15:40 > 0:15:43Oh, my good God. I am looking!
0:15:43 > 0:15:46Thank you! Thank you! Thank you! Yes! Yes! Yes! Yes! Yes!
0:15:46 > 0:15:49Can I ask you something, Darren? As a doctor.
0:15:49 > 0:15:52- You can shut your mouth.- It hurts.
0:15:52 > 0:15:54My chest.
0:15:54 > 0:15:55My nipple really hurts.
0:15:55 > 0:15:57Go and see your GP.
0:15:58 > 0:16:01Or better still, don't.
0:16:01 > 0:16:05- It's crazy. My nipple's so sore. I'm worried about it.- Good.
0:16:05 > 0:16:07- I'm embarrassed.- You should be.
0:16:09 > 0:16:13I don't think I remember school the same way you do, Dar... Dominic!
0:16:13 > 0:16:15I'll never forget it.
0:16:16 > 0:16:22- I don't know what it is...you think I'VE done.- All of you.- No, me!
0:16:22 > 0:16:26- Me? What am I supposed to have done to...?- Bullied me! Humiliated me!
0:16:26 > 0:16:29- Hurt me!- Bullied you?!
0:16:29 > 0:16:32Dar, I'm Scurvy Giblet Wet-Fart Cart, remember?!
0:16:32 > 0:16:35Man-boobs at 14! A ginger afro, freckles
0:16:35 > 0:16:38and a mum that looked like a Princess Fergie blimp!
0:16:41 > 0:16:45- Well, you ruined my adolescence. - You think I wasn't get bullied?!
0:16:45 > 0:16:47I mean, fair enough, you were a little poof...
0:16:47 > 0:16:48What's going on?
0:16:49 > 0:16:51Nothing.
0:16:53 > 0:16:55It's about time we discharged you
0:16:55 > 0:16:57and got you out of our hospital, Mr Cart.
0:16:59 > 0:17:02- Are you a doctor?- Yes. - Could you have a look at my chest?
0:17:02 > 0:17:04I told him to go and see his GP.
0:17:04 > 0:17:07We were supposed to be discharging him, remember?
0:17:07 > 0:17:10- What seems to be the matter with your chest?- His nipple hurts.
0:17:13 > 0:17:15My nipple's flipping leaking blood!
0:17:16 > 0:17:19- Please leave the building. - Dr Tressler, is it?
0:17:19 > 0:17:21These ECMO machines, there are only - what -
0:17:21 > 0:17:24five or six of them in the country? This is a fantastic...
0:17:24 > 0:17:27- Listen!- ..news story.- It is not acceptable for you to be here.
0:17:27 > 0:17:29- It's not appropriate, I'm sorry.- But...
0:17:34 > 0:17:37- You look happy.- You don't! Can I see him?- He's in theatre.
0:17:37 > 0:17:39I'll only be a minute.
0:17:40 > 0:17:43- You look, erm...- What?
0:17:43 > 0:17:46- Flushed.- Thanks(!) - No, no. In a good way.
0:17:48 > 0:17:49Good news?
0:17:49 > 0:17:51What's he doing?
0:17:51 > 0:17:52He's putting a patient on ECMO.
0:17:52 > 0:17:55Frozen refugee found in the hold of a plane.
0:17:55 > 0:17:58- Not a good moment, then. - To see you?
0:17:58 > 0:18:00Surely there's no such thing?
0:18:00 > 0:18:03Smooth, Harry Tressler. Very smooth.
0:18:03 > 0:18:06You like that? The way I flipped it over, turned it into a compliment?
0:18:06 > 0:18:08Kind of weird.
0:18:08 > 0:18:09Me? Weird?
0:18:09 > 0:18:10You're saying you didn't see me
0:18:10 > 0:18:13with a pregnancy test stick in my hand just now?
0:18:13 > 0:18:15- I did.- And this grin?
0:18:15 > 0:18:17Well, you're either pregnant or you're not.
0:18:17 > 0:18:20And thrilled one way or the other. Had to bet...
0:18:20 > 0:18:22I'd go with pregnant.
0:18:22 > 0:18:25A positive pregnancy test and still you're flirting with me?
0:18:25 > 0:18:27There would be something wrong with me if I wasn't
0:18:27 > 0:18:29and I know how much our dinner date meant to you.
0:18:29 > 0:18:30Dinner date?
0:18:30 > 0:18:33We went to a drugs launch buffet, because my husband couldn't.
0:18:33 > 0:18:35Tom-ate-oes, tomatoes.
0:18:35 > 0:18:37Incorrigible!
0:18:37 > 0:18:38- What?- Look it up!
0:18:42 > 0:18:44- We don't need to tell Sacha. - We absolutely do!
0:18:44 > 0:18:47He has an oozing nipple and painful lumps in his underarm.
0:18:47 > 0:18:50Sacha told me to discharge him. I'm just doing what I was told.
0:18:50 > 0:18:51He might have a tumour, Dom!
0:18:51 > 0:18:54I just... I don't want him here! The sight of him reminds me...
0:18:54 > 0:18:58- You don't have to have anything to do with him... - What if he says something?
0:18:58 > 0:19:01- You really want to let him have power over you again, do you?- Who?
0:19:01 > 0:19:02Dom's inguinal hernia.
0:19:02 > 0:19:04- Mr Cart?- I thought he was just a simple discharge?
0:19:04 > 0:19:06Well, actually, he's got a discharge.
0:19:06 > 0:19:09- What, operation wound? - Oozing nipple and lumps.
0:19:09 > 0:19:11Let's go and take a look.
0:19:11 > 0:19:13- I don't need everyone crashing in on my case!- There is another issue.
0:19:13 > 0:19:16- No!- Apparently...- Don't! - Apparently...- Don't!
0:19:16 > 0:19:18Right, Arthur, go and examine Mr Cart, please.
0:19:19 > 0:19:21Thank you.
0:19:24 > 0:19:25I have warned you both!
0:19:25 > 0:19:28Zero tolerance for medical student dramas, right?
0:19:30 > 0:19:33Now, you - every ward patient file updated and ready for my rounds.
0:19:33 > 0:19:36You - my office. File all past-patient cases.
0:19:36 > 0:19:38And both, back in an hour to explain yourselves.
0:19:58 > 0:20:00You were asked to stay in or around your bed, Alan.
0:20:02 > 0:20:04Pump head syndrome.
0:20:04 > 0:20:07- What?- Google it.
0:20:07 > 0:20:11- Why?- I Googled it.- Good for you. - I Bing'd it. Yahoo'd it. The lot.
0:20:11 > 0:20:13- So...- I think I've got it.
0:20:13 > 0:20:16- Post perfusion syndrome? - Yeah. Ask the Prof.
0:20:16 > 0:20:18Oi! Prof!
0:20:18 > 0:20:22Could I have pump head syndrome?
0:20:22 > 0:20:24Well, it's not actually a proper recognised...
0:20:24 > 0:20:26They say Bill Clinton's got it.
0:20:26 > 0:20:29That's why he's done some really stupid things.
0:20:29 > 0:20:33- What does he think he's got? - Post perfusion syndrome.
0:20:33 > 0:20:35Like Monica Lewinsky.
0:20:35 > 0:20:37I think I got it from here.
0:20:38 > 0:20:39I do.
0:20:46 > 0:20:49Thanks for letting me stay. I'll keep out the way.
0:20:49 > 0:20:53Without you, he wouldn't be alive. We wouldn't be about to do this.
0:20:53 > 0:20:55Good to go, guys. Chop-chop.
0:20:55 > 0:20:57I'd love you to get as hands-on as you want here.
0:20:57 > 0:21:00The more you know about ECMO, the more you'll love it.
0:21:00 > 0:21:02- The more you'll fight for it. - OK. Tell me what you want.
0:21:02 > 0:21:04Opening the right femoral artery.
0:21:04 > 0:21:07We injected 5ml of lidocaine around the site.
0:21:07 > 0:21:10- Only local anaesthetic? - What if the pain wakes him up?
0:21:10 > 0:21:12In his state, waking up in any way, shape or form
0:21:12 > 0:21:14is a good thing for him.
0:21:14 > 0:21:16Yeah, if he's able to feel pain, then things are looking up.
0:21:16 > 0:21:18Need the cannula, please.
0:21:18 > 0:21:21We open and cannulate one vein and one artery.
0:21:21 > 0:21:22Guy, you do the vein.
0:21:23 > 0:21:26Suck the blood out of the vein using the pump,
0:21:26 > 0:21:30through the extractor and back up the artery.
0:21:30 > 0:21:31Raf?
0:21:31 > 0:21:36Inserting the large bore cannula into the outflow.
0:21:52 > 0:21:53Vein is cannulated.
0:21:58 > 0:22:01- Clamps on and connected? - On.- Mm-hm.
0:22:01 > 0:22:03MACHINE WHIRS
0:22:03 > 0:22:05OK...
0:22:05 > 0:22:06Slowly draining.
0:22:09 > 0:22:11What flow rate would you expect?
0:22:11 > 0:22:14Blood this cold. You know, start slow. Two litres.
0:22:14 > 0:22:17Honestly, this...blows my mind.
0:22:17 > 0:22:20The exchanger takes the carbon dioxide out of the blood
0:22:20 > 0:22:22- and puts oxygen in. - Warms it up too.
0:22:24 > 0:22:25Clamps off?
0:22:26 > 0:22:27- Off.- Off.
0:22:30 > 0:22:32BEEPING
0:22:35 > 0:22:38Once it's warmed and oxygenated...
0:22:38 > 0:22:41That's the good stuff. That's what'll bring him back.
0:22:43 > 0:22:44Good job.
0:22:46 > 0:22:50There is a study in America - only one, mind you -
0:22:50 > 0:22:54that posits that people who have been put on a bypass machine
0:22:54 > 0:22:57during heart surgery suffer cognitive impairment.
0:22:57 > 0:23:01I was on one when I had my valves done. Turned stupid as a turnip.
0:23:01 > 0:23:05As a result of being put on a bypass pump.
0:23:05 > 0:23:08Pump head, see? Makes you do stupid things.
0:23:08 > 0:23:12You don't need a bypass to make you do stupid things, Alan.
0:23:12 > 0:23:17- No. But maybe it made me do extra stupid things.- Like?
0:23:18 > 0:23:21Frankly, I've always thought the whole idea was ridiculous.
0:23:21 > 0:23:24- I entirely disagree. - Why does that not surprise me?
0:23:24 > 0:23:27- I'm sorry!- The study at Duke University Medical Centre
0:23:27 > 0:23:30suggests that during bypass, while on a pump,
0:23:30 > 0:23:33the brain is showered with tiny fragments and bubbles of oxygen...
0:23:33 > 0:23:36- Microemboli. - My, you have been Googling.
0:23:37 > 0:23:39..which can cause minor brain damage
0:23:39 > 0:23:42and possibly some cognitive impairment.
0:23:42 > 0:23:45Including "poor recall, social difficulties
0:23:45 > 0:23:48"and personality changes".
0:23:48 > 0:23:51We have done a thousand bypass procedures.
0:23:51 > 0:23:53They're the meat and potatoes of our trade.
0:23:53 > 0:23:55That doesn't mean they can't cause damage.
0:23:55 > 0:23:58Really, you're going to go with this one small...?
0:23:58 > 0:24:00As theories go, it carries some weight.
0:24:00 > 0:24:03- In horse dung.- Oh, and you'd know because?- Because, up until today,
0:24:03 > 0:24:05I'd never heard of it, because Professor Hope...
0:24:05 > 0:24:07No, because if I think it's true, then it must be wrong?
0:24:07 > 0:24:11Oh, yeah, Jac. That's right. Because anything you believe in
0:24:11 > 0:24:14is bound to turn out to be some kind of poisonous cack!
0:24:14 > 0:24:15I'm with you, Spratters.
0:24:15 > 0:24:18Heart op pump made me soft in the noodle.
0:24:22 > 0:24:23It's official.
0:24:34 > 0:24:37Mr Cart? I've been looking for you. Er, where are you going?
0:24:37 > 0:24:39Out of here. To another hospital.
0:24:39 > 0:24:43- Why?- Because I'm not staying here...with him.
0:24:43 > 0:24:45LIFT BEEPS 'Doors closing.'
0:24:45 > 0:24:47CROCKERY RATTLES HE CRIES IN PAIN
0:24:47 > 0:24:49Wheelchair, please.
0:24:49 > 0:24:51HE WINCES AND GROANS Stay still, stay still.
0:24:51 > 0:24:52Try not to move.
0:24:52 > 0:24:54KNOCK ON DOOR
0:25:03 > 0:25:07- I know that grin. You did a test.- No!- You lie.
0:25:07 > 0:25:09- I do.- What?
0:25:09 > 0:25:12- What do I always say? - "Don't do a home test."
0:25:12 > 0:25:14- What did you do?- A home test.
0:25:14 > 0:25:16You're mad! What did I say?
0:25:16 > 0:25:20- I said it too!- And by the looks on your face, it read positive.
0:25:20 > 0:25:22- Yes.- Is she?
0:25:22 > 0:25:25- Are you?- Why do I always say not to do tests?
0:25:25 > 0:25:27Not to get your hopes up.
0:25:27 > 0:25:30Not to drive yourself and your partner crazy with unreliable data.
0:25:30 > 0:25:31Not always unreliable.
0:25:31 > 0:25:35- No. But a home test... - Isn't as accurate! I know.
0:25:35 > 0:25:38- So...?- Home tests can give false positives,
0:25:38 > 0:25:41- because you have HCG in your blood.- I know!
0:25:41 > 0:25:44I injected it myself. Remember?
0:25:44 > 0:25:46Makes your body think it's pregnant.
0:25:46 > 0:25:48Just for a while. Then...
0:25:48 > 0:25:50- Is she?- My breasts tingle.
0:25:50 > 0:25:53I feel like I'm about to start my period the whole time.
0:25:53 > 0:25:55It would explain the violent mood swings.
0:25:55 > 0:25:58And I've got that weird metallic taste in my mouth.
0:25:58 > 0:26:03- Is she pregnant?- I am pregnant! I know it. I can feel it.
0:26:03 > 0:26:06No.
0:26:06 > 0:26:08No?!
0:26:08 > 0:26:11No, you are not pregnant.
0:26:16 > 0:26:19- You're joking. - Sweetheart, I wish I was.
0:26:27 > 0:26:29OK...
0:26:30 > 0:26:32You've popped some sutures.
0:26:34 > 0:26:35What's this?
0:26:36 > 0:26:39- OK, is that hurting? - Ow! Yeah, yeah! Ow, ow, ow!
0:26:39 > 0:26:40- Yeah.- Oh!
0:26:40 > 0:26:43OK. I'll redo your sutures, and then we'll find out what this is.
0:26:43 > 0:26:45Just...
0:26:47 > 0:26:49Just don't let him touch me.
0:26:49 > 0:26:51Who, Mr Cart? Who mustn't touch you?
0:27:05 > 0:27:08- Hi.- Why did you want to see me here?
0:27:08 > 0:27:10I just thought we could take some time away from work,
0:27:10 > 0:27:13from the ward, to discuss what's...
0:27:13 > 0:27:14What's going on?
0:27:15 > 0:27:19- Professor Hope's personal mediation service.- Please.
0:27:29 > 0:27:31I don't want to run a professional department
0:27:31 > 0:27:34with a personal turmoil raging at its core.
0:27:34 > 0:27:36Who's raging? I'm not raging?
0:27:36 > 0:27:40- I'm as calm as a mill pond. - Yeah, right(!)
0:27:41 > 0:27:44- I have been made aware, through Ms Effanga...- Huh?!
0:27:44 > 0:27:47- Why does that not surprise me? - Motormouth Mo.
0:27:47 > 0:27:50..that you intend to challenge Jac for custody of Emma.
0:27:50 > 0:27:53No disrespect, but, um...
0:27:53 > 0:27:56this really isn't within your remit.
0:27:56 > 0:27:58Within my department.
0:27:59 > 0:28:01Between...my friends
0:28:05 > 0:28:11Look, I appreciate that, in the shock and aftermath of Bonnie's death,
0:28:11 > 0:28:15- you might not exactly be thinking straight and so...- Don't...
0:28:18 > 0:28:20And so, in understanding of this...
0:28:20 > 0:28:23I'm prepared to absolutely forget what you said to me...
0:28:23 > 0:28:26- Don't you dare!- ..when you threatened to challenge me.
0:28:28 > 0:28:33Don't you DARE use Bonnie's death as an excuse for MY behaviour!
0:28:34 > 0:28:37I am fighting you...
0:28:37 > 0:28:41because I believe that you will do my daughter harm.
0:28:44 > 0:28:47- I tried. One-time offer. - And for your information....
0:28:49 > 0:28:54..I have a lawyer already instructed and quite ready to prove
0:28:54 > 0:28:58that you're not fit to have sole custody of Emma.
0:29:04 > 0:29:06What's going on?
0:29:06 > 0:29:10Hmm? You said yourself, you caught an easy one.
0:29:10 > 0:29:12You know, hernia discharge. You can't do that without a fight?
0:29:12 > 0:29:16- We weren't fighting.- Well, that's not what it looked like.
0:29:16 > 0:29:19It's personal. I didn't want to have to say.
0:29:20 > 0:29:23He has a history with the patient.
0:29:23 > 0:29:24A history?
0:29:24 > 0:29:28- We went to school together. - Well, that's fine. It's no big deal.
0:29:28 > 0:29:31Arthur and Zosia can take over, OK. Just keep out of his way. OK?
0:29:31 > 0:29:33SHE SIGHS
0:29:33 > 0:29:36- Am I missing something? - Tell him!- No!
0:29:36 > 0:29:38Tell me what?
0:29:38 > 0:29:40He...bullied me.
0:29:42 > 0:29:46- At school or...?- Zosia wanted me to come and report it to you.
0:29:46 > 0:29:49I didn't want to say anything. I just wanted to get on with my job.
0:29:53 > 0:29:55Unfit mother, Elliot. You heard him.
0:29:55 > 0:29:58I don't mean to sound petty but he started it.
0:29:58 > 0:30:01Jac, if you get legal representation, it gets official.
0:30:01 > 0:30:03Messy. Impersonal. Bureaucratic.
0:30:03 > 0:30:06He's questioning my ability to be a mother!
0:30:06 > 0:30:09Of your daughter. Your baby. A tiny little package of life
0:30:09 > 0:30:12- which you both went through so much to bring into this world.- Yes!
0:30:12 > 0:30:17- MY daughter! She came from MY body. - A child that you're both
0:30:17 > 0:30:20going to stand in front of a judge and squabble over?
0:30:20 > 0:30:22- Unfit mother.- I know.
0:30:22 > 0:30:26- Do you have any idea what it feels like...?- Please, please!
0:30:26 > 0:30:27Just let me talk to him.
0:30:27 > 0:30:31Before you to go war, let me try and make him back down.
0:30:31 > 0:30:34Ah, lovely-jubbly! Just the guys I was looking for.
0:30:34 > 0:30:37The Yin and Yang of the "pump head" debate.
0:30:37 > 0:30:40You know the sort of clients I hate treating most.
0:30:40 > 0:30:42Ones who've got nothing wrong. You told us.
0:30:42 > 0:30:45Clients who've got no physical reason not to get pregnant
0:30:45 > 0:30:48are worst, because I've got no answers.
0:30:48 > 0:30:50Got an answer for me?
0:30:50 > 0:30:53- For us? - Other sort of clients I hate
0:30:53 > 0:30:55are anyone in the medical profession.
0:30:55 > 0:30:58Doctors are worse because they don't believe you.
0:30:58 > 0:31:00They think another doctor will give them another answer,
0:31:00 > 0:31:01because they know doctors.
0:31:01 > 0:31:05- Not infallible.- Are you saying we should get another opinion?
0:31:05 > 0:31:09Sure. Go private. Go abroad. Do whatever gives you hope.
0:31:09 > 0:31:13- Because?- Because I'm not going to give you much.- Come on!
0:31:13 > 0:31:16We've only had three sessions of IVF. Some people have ten.
0:31:16 > 0:31:19- It's not a question of money. - I know.
0:31:19 > 0:31:22You can throw money at IVF and get results sometimes.
0:31:22 > 0:31:25But only if you've got a sound basis to work on.
0:31:25 > 0:31:28- We haven't? - I just feel, in your case,
0:31:28 > 0:31:32there are issues in compatibility that we need to address.
0:31:33 > 0:31:35This last set of IVF, as you know,
0:31:35 > 0:31:38we did ICS - intracytoplasmic sperm injection.
0:31:38 > 0:31:41One sperm directly injected into one egg. Best bet all round.
0:31:41 > 0:31:45- But Amy didn't get pregnant?- No. - Doesn't mean we have to stop.
0:31:45 > 0:31:48Long ago, I learned never to say never in this job.
0:31:48 > 0:31:49It's the same in my world.
0:31:49 > 0:31:53The human body is an amazing and a surprising thing.
0:31:53 > 0:31:54We just have to keep trying.
0:32:12 > 0:32:17Oi! You look at me, you think "Lager Man". Am I right?
0:32:17 > 0:32:21Dyed in the wool amber nectar necker.
0:32:21 > 0:32:24- A liking for a particular...- Rose!
0:32:24 > 0:32:29Rose vino! Wine! I'm buying it by the box!
0:32:29 > 0:32:33- Again...- Strictly Ballroom! Sudoku! Steaming showers!
0:32:33 > 0:32:37- I mean, I'm a bath man! - None of these minor developments
0:32:37 > 0:32:40change my mind about pump head syndrome.
0:32:40 > 0:32:43- Excuse me, I have to go. - Then there's the affair.
0:32:45 > 0:32:5024 years a loyal, faithful, loving husband. Suddenly,..
0:32:52 > 0:32:54..I'm bonking me book-keeper.
0:32:55 > 0:32:58How do you explain that, Professor?
0:32:59 > 0:33:00Hmm?
0:33:00 > 0:33:02What was that in there?
0:33:02 > 0:33:05- The S word. We don't mention the S word now?- Please!
0:33:05 > 0:33:08- I've got a patient about to go into...- Sperm, Raf.
0:33:08 > 0:33:10- Sperm. Sperm. Sperm. Sperm. - HE SIGHS
0:33:14 > 0:33:18Blood exchange is a long, slow process.
0:33:18 > 0:33:21We have to keep constant monitoring. And fit a Bair Hugger.
0:33:23 > 0:33:25I'm also keeping a close eye on heparin levels,
0:33:25 > 0:33:28which controls the viscosity of the blood.
0:33:28 > 0:33:32Don't get me wrong. ECMO. Resus. Very compelling medicine.
0:33:32 > 0:33:36But it's kind of passive. Do you know what I mean? It's, um...
0:33:36 > 0:33:38reactive, not pro-active.
0:33:38 > 0:33:41- Oh...OK.- Personally, I'm more of a sort of, er...
0:33:41 > 0:33:44knife-and-fork, up-to-the-elbows kind of surgeon.
0:33:49 > 0:33:50Is that blood?
0:33:53 > 0:33:54Mr Self, there's a bleed!
0:33:58 > 0:34:01Yeah, blood pouring out at the cannulation site.
0:34:01 > 0:34:02OK, get Raf.
0:34:02 > 0:34:05- Er, he's got a consultation. - He needs to be here now. Go get him.
0:34:05 > 0:34:06- Yeah, no...- I said go!
0:34:07 > 0:34:09Now give me a swab!
0:34:11 > 0:34:14- One sperm was injected into one egg. One "Class A" egg.- Ah!
0:34:14 > 0:34:16- So it's my fault?- No, Raf!
0:34:18 > 0:34:22It's your sperm's fault. Over which I accept you have little control.
0:34:22 > 0:34:25- Is this an appropriate place...? - You know well as I do,
0:34:25 > 0:34:28tests showed the mumps you got in Malaysia damaged your testicles.
0:34:28 > 0:34:30- OK, so we might need more attempts...- The mumps
0:34:30 > 0:34:33and a possible gene abnormality mean your little guys are ruined.
0:34:34 > 0:34:35It only takes one.
0:34:35 > 0:34:39- You might not have one. A working one.- OK!
0:34:39 > 0:34:41- So it IS my fault. - Don't do this, Raf.
0:34:41 > 0:34:44I want to have our baby. Not watch you behave like one!
0:34:48 > 0:34:50You're a doctor.
0:34:50 > 0:34:53There are alternatives. Let's examine those alternatives.
0:34:53 > 0:34:57Let's just be clear about this. If there's a problem with my sperm,
0:34:57 > 0:34:59you are prepared to... KNOCK ON DOOR
0:34:59 > 0:35:01- Excuse me. Sorry. - I'm in a meeting!
0:35:01 > 0:35:04- It's Bakaray, big bleed. - Get out, Harry!
0:35:04 > 0:35:06Guy's scared he'll bleed out.
0:35:06 > 0:35:08I've got to go.
0:35:16 > 0:35:19A mass? What's a mass? Is it bad?
0:35:19 > 0:35:22Er, it just depends what kind of mass it is.
0:35:22 > 0:35:25Well, what kinds are there? I mean, I tried to show it to Darren...
0:35:25 > 0:35:27- Darren? - ..but he wouldn't even look at it.
0:35:27 > 0:35:29Now you're telling me I need to do this needle...what?
0:35:29 > 0:35:33Fine needle aspiration cytology. It's a further examination.
0:35:33 > 0:35:35I'm not saying we were best mates or anything,
0:35:35 > 0:35:38but, of the boys in our year, I'd say I was one of his few friends.
0:35:38 > 0:35:44Right. It's a histological biopsy of the mass. Sorry, OK, who is Darren?
0:35:44 > 0:35:46Dr Copeland. Dominic.
0:35:46 > 0:35:49- What, OUR Dominic? - I used to go round his house.
0:35:49 > 0:35:54His mum used to bake these home-made Cornish pasties. Proper crinkle top.
0:35:54 > 0:35:57- My mum couldn't bake a brick. - OK, well, um...
0:35:57 > 0:35:59Under the microscope, we'll be able...
0:35:59 > 0:36:01I still see her down at the supermarket.
0:36:01 > 0:36:03- She works Saturdays on the deli counter.- Yeah.
0:36:03 > 0:36:06..to identify the formation of cellular...
0:36:06 > 0:36:10- His mum?!- Yeah, well, not to talk to, exactly. But, you know, nod hello.
0:36:10 > 0:36:12- You mean his stepmother?- No, his mum.
0:36:12 > 0:36:15No, he doesn't have a step mum. His parents are just his parents.
0:36:15 > 0:36:17Right, erm...
0:36:19 > 0:36:21Dominic's mother is, er...
0:36:21 > 0:36:24- is dead.- Oh, my God! When?!
0:36:24 > 0:36:27I only saw her, like, two weeks ago!
0:36:27 > 0:36:31She died when he was 12. Um, the dog drowned.
0:36:31 > 0:36:32- The dog?- Yeah.
0:36:32 > 0:36:34Nah, he's Mr Allergic.
0:36:34 > 0:36:37He used to carry, um, tissues up his sleeve, like a granny.
0:36:37 > 0:36:41- That's one of the reasons he got stick.- Right, OK, so Darren...
0:36:42 > 0:36:46- ..is Dominic Copeland? - He told me not to say nothing.
0:36:46 > 0:36:48- But then you found a mass! - Right, OK.
0:36:48 > 0:36:50The cytology's just a precaution.
0:36:54 > 0:36:55Carole Copeland's dead.
0:36:56 > 0:36:58My mum will be gutted.
0:36:58 > 0:37:01The post perfusion study cites that cognitive decline
0:37:01 > 0:37:04is more about the slowing down of mental reactions.
0:37:04 > 0:37:06He don't look at you like he used to.
0:37:06 > 0:37:09Inability to perform mental arithmetic sums.
0:37:09 > 0:37:12- Are you having a barney? - Some vocabulary diminishment.
0:37:12 > 0:37:16- Or is it more serious? - Not having an extramarital affair!
0:37:16 > 0:37:18Who? You? Me? Or him?
0:37:18 > 0:37:19You!
0:37:21 > 0:37:24Personality changes. That's what it says.
0:37:24 > 0:37:28I mean, I never used to fancy Sylvia. Now I do, see?
0:37:28 > 0:37:31They refer more to depression, increased mood swings.
0:37:31 > 0:37:34Could have something to do with it!
0:37:34 > 0:37:38- I don't know, Alan. Maybe... - Maybe works for me!
0:37:38 > 0:37:40Tell that "maybe" to my lawyer.
0:37:42 > 0:37:45Hi. It's very nice to meet you.
0:37:49 > 0:37:51Suction. Come on.
0:37:51 > 0:37:53- What happened? - Haemorrhaging round the cannula.
0:37:53 > 0:37:55We need some more units of cross match.
0:37:55 > 0:37:58I'm trying to put an extra stitch in round the cannulation area.
0:37:58 > 0:38:01If you can't put in a purse string, you'll have to pack it.
0:38:01 > 0:38:03Trying to pull the string against the flow! I can't see a thing!
0:38:03 > 0:38:05- Suction!- What's the ACT?
0:38:05 > 0:38:08- 400.- Why's that so high? It should be 180.
0:38:08 > 0:38:12- I increased it. I gave him the usual dosage - 25K.- Did I tell you to?
0:38:12 > 0:38:15- No, but...- Well, that's why the bleed's out of control.
0:38:15 > 0:38:16Because the heparin's way too high.
0:38:18 > 0:38:21- Do you mind if I...? - No, please.
0:38:21 > 0:38:25- Give me some tape. Just below the cannulation site.- Way ahead of you.
0:38:27 > 0:38:29- Could you just...? - Put my finger on that artery?
0:38:29 > 0:38:32- Do you want me to...?- Get out of my theatre before you kill my patient?
0:38:32 > 0:38:34Yes, please!
0:38:34 > 0:38:37Can you give me some glue and some Fibrillar?
0:38:37 > 0:38:40We'll pack the site and slowly release the snares.
0:38:41 > 0:38:43What exactly is it you're doing?
0:38:43 > 0:38:45Basic stuff.
0:38:45 > 0:38:47Just a trick I picked up in Malaysia.
0:38:47 > 0:38:52Their vascular guys make me look like a troll tying crab pots.
0:38:53 > 0:38:56OK, pressure's coming back up.
0:38:56 > 0:38:57Good work.
0:38:57 > 0:39:00Listen, Raf, I'll, er... I'll leave you to it, OK?
0:39:03 > 0:39:04RAF SIGHS
0:39:06 > 0:39:08You should definitely look at this.
0:39:08 > 0:39:10We need to do a fine needle aspiration on the lumps.
0:39:21 > 0:39:24Why does it feel like you just made me the problem with Sacha?
0:39:24 > 0:39:27I don't like Arthur sniffing around.
0:39:50 > 0:39:51Blood's warming.
0:39:53 > 0:39:55- Pressure's dropping. - ALARM BEEPS
0:39:55 > 0:39:56Don't do this.
0:39:56 > 0:39:59- Right, he's beginning to fibrillate. - Maybe that's a good thing.
0:39:59 > 0:40:02- No, there could be a bleed in the pericardium.- No, no, no.
0:40:02 > 0:40:04- He's tamponading. - Right, what are the options?
0:40:04 > 0:40:06Saw his chest open. Drain the pericardium.
0:40:06 > 0:40:09We saw his chest open in this state and he'll die.
0:40:09 > 0:40:12- We've got to get to that leak. - What's the alternative?- He dies.
0:40:14 > 0:40:17All we'd require, Ms Naylor, is for you to appear in court
0:40:17 > 0:40:21and give a professional testimony on Mr Herring's behalf.
0:40:21 > 0:40:23You really need to go to all this trouble for a divorce hearing?
0:40:23 > 0:40:26Well, it's not exactly a divorce.
0:40:26 > 0:40:29I'm sorry, Ms Naylor, I'm not a family lawyer.
0:40:29 > 0:40:32- I'm a criminal lawyer. - Have you had a look at these?
0:40:32 > 0:40:35- Criminal?- Yeah. You see, Spratts...
0:40:35 > 0:40:39I embezzled three quarters of a million from the VAT man.
0:40:39 > 0:40:42- Staphylococcal endocarditis. - Totally out of character.
0:40:42 > 0:40:45- Not me at all. - Embezzlement?- Exactly!
0:40:45 > 0:40:48I mean, does that sound like me?
0:40:48 > 0:40:50- Endocarditis?- Vegetations.
0:40:50 > 0:40:52It wasn't a thickening of the valve walls.
0:40:52 > 0:40:56It's vegetations, bacterial formations around the valve.
0:40:56 > 0:40:59Infection spread quickly. We're past antibiotics, I'm afraid.
0:40:59 > 0:41:03- Vegetations?! - Growths around the valve.
0:41:03 > 0:41:05We're going to have to remove the valve and fit a new one.
0:41:05 > 0:41:08- I'm going to need another operation? - As soon as possible.
0:41:08 > 0:41:10You going to open me up, again?
0:41:10 > 0:41:14Open you up, pop you on bypass and cut the valve out.
0:41:14 > 0:41:17Unless, of course, you object to going on bypass again.
0:41:17 > 0:41:21- What?- You could just let the vegetations bloom around your valve
0:41:21 > 0:41:23- until it stops working.- And?
0:41:23 > 0:41:25And then, your heart would cease to beat.
0:41:33 > 0:41:35ALARM BEEPS
0:41:45 > 0:41:46Wait!
0:41:47 > 0:41:49- Do we want to do this? - It's your call.
0:41:49 > 0:41:51He's been through so much already.
0:41:51 > 0:41:54Yeah, but if it wasn't for you, he'd be long dead.
0:41:54 > 0:41:56Pressure's dropping like a stone.
0:41:58 > 0:41:59Now or never.
0:42:03 > 0:42:06SAW WHINES
0:42:13 > 0:42:15Salt and vinegar or cheese and onion?
0:42:17 > 0:42:20I would've said cheese and onion.
0:42:20 > 0:42:23Naturally, I can tell, snack-wise, you're no choccy comfort-eater.
0:42:23 > 0:42:25That's a fat girl's game. But, erm...
0:42:28 > 0:42:30Bad news?
0:42:30 > 0:42:33I couldn't help noticing earlier, when, er...
0:42:33 > 0:42:36- You barged into my office. - The boss told me to go get Raf.
0:42:36 > 0:42:38Yeah. But now, go away. Please!
0:42:40 > 0:42:43Raf's got a nightmare on his hands. Another emergency.
0:42:45 > 0:42:47Big surprise! My worst moment in living memory
0:42:47 > 0:42:50and he's spending it with an ECMO pump!
0:42:53 > 0:42:54Not pregnant, then?
0:42:54 > 0:42:58- Not your business! - I know, I know.- So go away!
0:43:00 > 0:43:02So what is it? Eggs or sperm?
0:43:03 > 0:43:05You really didn't just ask me that!
0:43:09 > 0:43:10Sperm, then.
0:43:10 > 0:43:14You ever been punched in the throat by a Chinese girl, Harry?
0:43:14 > 0:43:17No. I've been slapped in the face a few...
0:43:18 > 0:43:20..times.
0:43:20 > 0:43:23We should put some warm saline in the pericardium.
0:43:23 > 0:43:25Pericardium is cauterised.
0:43:25 > 0:43:26Excellent.
0:43:26 > 0:43:29Right, all I need to do now is... Paddles, please.
0:43:29 > 0:43:32..shock this patched-up heart back into some kind of normal rhythm.
0:43:32 > 0:43:35- Charge to 20.- Charging.
0:43:35 > 0:43:38You know what, I do love your ECMO machine.
0:43:38 > 0:43:40- It's a cracking bit of kit. - I knew you would.
0:43:40 > 0:43:44But it's got nothing on these things. Knives, saws, paddles.
0:43:44 > 0:43:45Charged.
0:43:45 > 0:43:46Shocking!
0:43:48 > 0:43:51This, Raf, this is surgery!
0:43:51 > 0:43:52Charge again!
0:43:55 > 0:43:59So, like I explained, um, we'll sit you down.
0:44:01 > 0:44:03There we go. Er...
0:44:03 > 0:44:06So we'll locate the mass and then we'll insert
0:44:06 > 0:44:09- a special hollow needle into it. - Several times.
0:44:09 > 0:44:12Yep, and then we'll remove some tissue samples
0:44:12 > 0:44:15from the centre of the mass.
0:44:15 > 0:44:18- Let's get that off. It'll be a little bit sore.- Ah!
0:44:19 > 0:44:20OK.
0:44:20 > 0:44:24Er, yes, sometimes a few punctures of the needle is necessary. It's just
0:44:24 > 0:44:27so the cytopathologists have enough tissue to run their tests.
0:44:27 > 0:44:30- Is this going to hurt? - Yes.- OK, erm...
0:44:30 > 0:44:34Maybe we could give Mr Cart a local anaesthetic, just to dull the pain?
0:44:34 > 0:44:36If absolutely necessary.
0:44:36 > 0:44:38- Don't want to suffer if I don't have to.- Yeah.
0:44:38 > 0:44:40Not a reasoning you applied to your own actions.
0:44:40 > 0:44:42Zosia! Just want to say that, as a result of
0:44:42 > 0:44:46a totally confidential conversation that I've had with our patient,
0:44:46 > 0:44:48it occurs to me that we may have grasped, or more to the point,
0:44:48 > 0:44:51been given the wrong end of the stick.
0:44:51 > 0:44:54- I'm sorry, what? - Some of what we think we may know
0:44:54 > 0:44:58regarding the history between our patient and a certain F1 doctor...
0:44:58 > 0:45:00(it may not be true.)
0:45:00 > 0:45:02So if we...
0:45:02 > 0:45:04And then I'll...
0:45:08 > 0:45:09OK.
0:45:10 > 0:45:12There we go.
0:45:16 > 0:45:19Can we just have one question at a time, please? ..Yes?
0:45:19 > 0:45:21Yes, Kim Keeble, HL1 TV.
0:45:21 > 0:45:24Can you tell us exactly what is an ECMO machine?
0:45:24 > 0:45:27I don't want to blind you with science,
0:45:27 > 0:45:30but what Mr Di Lucca and the Acute Admissions Unit team
0:45:30 > 0:45:34achieved here today is nothing short of a miracle.
0:45:34 > 0:45:39These machines, ECMO pumps, are used in intensive care situations
0:45:39 > 0:45:41to maintain pulmonary function.
0:45:41 > 0:45:44To keep heart and lung patients alive.
0:45:44 > 0:45:46But what we did here today
0:45:46 > 0:45:50was to adapt this machine for use in a different context -
0:45:50 > 0:45:52on an emergency patient.
0:45:52 > 0:45:55Now, we strongly feel that these machines
0:45:55 > 0:45:58should be available in every emergency department.
0:45:58 > 0:46:02- You brought him back from the dead? - That's probably an exaggeration.
0:46:02 > 0:46:05They're calling what you do the "Lazarus Technique".
0:46:05 > 0:46:08And what you did today was "nothing short of a miracle",
0:46:08 > 0:46:09according to a leading specialist.
0:46:09 > 0:46:12Er, well, let's not get too prosaic...
0:46:12 > 0:46:15It was a miracle! It made me totally want to become a doctor!
0:46:16 > 0:46:20Seriously, I was going to pack it in, but...seeing your team...
0:46:20 > 0:46:23I'm going back to medical school. Taking my exams.
0:46:23 > 0:46:26And judging from Lisa's performance today, she'd make a great doctor.
0:46:26 > 0:46:29REPORTERS SHOUT QUESTIONS
0:46:29 > 0:46:31- LAWYER:- 'This could work entirely in our favour.'
0:46:31 > 0:46:35They're about to zip open me ribs and lop off the top of me ticker!
0:46:35 > 0:46:39- On bypass!- On or off, I could still snuff it before dinner time.
0:46:39 > 0:46:43But if you survive, Mr Herring, another bout of bypass.
0:46:43 > 0:46:45Another dose of pump head syndrome!
0:46:45 > 0:46:48We've even more excuse for your financial misjudgement.
0:46:48 > 0:46:51- What, where we blame the doctors for what I done?- Er, now!
0:46:51 > 0:46:54- I'm your lawyer. I know nothing of this.- Oh, please.
0:46:54 > 0:46:58I robbed the books, cos I was trying to show Sylvia I was Jack Flash!
0:46:58 > 0:47:01Please, do not say such things in my presence. I have to defend you!
0:47:01 > 0:47:05- They're ready for us now, Alan. - This could be a landmark case.
0:47:05 > 0:47:07You know what?
0:47:07 > 0:47:10- I don't care. - I'll collect evidence and testimony.
0:47:10 > 0:47:12Are you absolutely sure you want to drag the people
0:47:12 > 0:47:15about to try and save your heart through the courts?
0:47:15 > 0:47:18Yeah, don't bother, Mannesh. I'm not going to lie and cheat.
0:47:18 > 0:47:21Court or not...I could die in there.
0:47:21 > 0:47:23So you're not going to fight the pump head angle?
0:47:23 > 0:47:24What about Bill Clinton?
0:47:25 > 0:47:28You know what, Jac, you're right.
0:47:29 > 0:47:32What will be will be.
0:47:32 > 0:47:34Sometimes, you've just got to take it on the chin.
0:48:01 > 0:48:02Is he going to live?
0:48:04 > 0:48:07- Yes.- This morning, he was a lump of frozen meat. Now...
0:48:07 > 0:48:10Not quite frozen. More like a ready meal.
0:48:10 > 0:48:15- Chilled.- What I mean is, you made him live again.
0:48:15 > 0:48:17Raf...
0:48:17 > 0:48:19you can work miracles.
0:48:19 > 0:48:21Don't you start with the miracle stuff.
0:48:21 > 0:48:22I want my miracle.
0:48:22 > 0:48:24Our miracle.
0:48:24 > 0:48:27- Do you think I don't? - Not as much as I do.
0:48:27 > 0:48:30Even that girl, the first aider.
0:48:30 > 0:48:33You changed her life but you won't change mine.
0:48:33 > 0:48:38- I've said I'll go on any drugs that you want me to.- Why haven't you?
0:48:38 > 0:48:43The side effects - water weight gain and painful man boobs.
0:48:43 > 0:48:46- What if they don't work? - Well, let's just try first.
0:48:46 > 0:48:48I need to know what we do if they don't.
0:48:57 > 0:49:00If ever we needed proof he's an inveterate liar,
0:49:00 > 0:49:03next to poor old Kevin and his TB, Darren's mum.
0:49:12 > 0:49:16- Don't walk away from me. - This is not the time or the place.
0:49:16 > 0:49:18- For me to hear you're committed? - To you?
0:49:18 > 0:49:21- You don't think I'm committed to...? - Having a baby. Starting our family.
0:49:21 > 0:49:24- Doing whatever it takes. - And that means what?
0:49:24 > 0:49:27- Sperm donor.- Let's not do this here.
0:49:27 > 0:49:31We can do it anywhere you like, Raf. So long as we do it now.
0:49:42 > 0:49:44You would really carry another man's baby?
0:49:44 > 0:49:47- My egg. Our baby.- But not mine?
0:49:47 > 0:49:50Don't pretend. Without my sperm, it's not mine.
0:49:50 > 0:49:53We bring it up. It's our baby.
0:49:53 > 0:49:56- No.- And if you don't have a single fertile sperm,
0:49:56 > 0:49:59- we don't have a baby?- I'm not bringing up another man's child.
0:49:59 > 0:50:01- My child! For God's sake! - But not mine.
0:50:03 > 0:50:07So, if YOU can't do it, WE don't do it?
0:50:07 > 0:50:08What about me?
0:50:10 > 0:50:13We have our work. We have each other.
0:50:13 > 0:50:18- You could take another degree. Do your PhD.- I want to have a baby!
0:50:18 > 0:50:22- Yeah, and if we can't, then we... - I've injected myself with hormones.
0:50:22 > 0:50:26Run the nightmare of tests, scares, almosts and chemical pregnancies!
0:50:26 > 0:50:30- I've done everything I can!- But I can't do what's required of me?
0:50:30 > 0:50:34You know, why not just print me a T-shirt - Firing Blanks?
0:50:34 > 0:50:36No-one cares what we do, Raf!
0:50:36 > 0:50:39Except us!
0:50:39 > 0:50:42- It's no-one else's business! - For me, another man's baby...
0:50:44 > 0:50:46It's worse than no baby at all.
0:50:58 > 0:51:00DOOR SLAMS
0:51:01 > 0:51:05- What?- Super Save's Employee of the Month!
0:51:05 > 0:51:07For January!
0:51:07 > 0:51:09- That chubby little snitch. - Delicatessen counter.
0:51:09 > 0:51:13Thought she drowned in a pond trying to save your dog Winston?
0:51:13 > 0:51:16- You told us your mother died! - For you. Because yours did die.
0:51:16 > 0:51:19- Oh...- I'm sorry?
0:51:19 > 0:51:22You lied about your mother dying so I would like you more?
0:51:22 > 0:51:26It makes me seem more interesting. Because the truth is...not at all!
0:51:26 > 0:51:29How are we supposed to believe that anything you say is truth or fantasy
0:51:29 > 0:51:32if you're going to lie about your own mother's death so elaborately?!
0:51:32 > 0:51:34What about the bullying? Kevin Cart?
0:51:34 > 0:51:38- I was bullied at school for being gay.- Yes, but by Kevin?- Yes!
0:51:38 > 0:51:39- I definitely think so! - SHE LAUGHS
0:51:39 > 0:51:43Why do you need to be so devious? You are so slippery!
0:51:43 > 0:51:44I believed all of this!
0:51:44 > 0:51:45Never again!
0:51:54 > 0:51:56DOOR SLAMS
0:52:07 > 0:52:08Hey.
0:52:09 > 0:52:12I've got a patient allergic to morphine. What do I give him?
0:52:12 > 0:52:14How long have you been a doctor?!
0:52:15 > 0:52:18OK, so maybe it was just an excuse.
0:52:18 > 0:52:21- To poke your nose in? - To see how you are.
0:52:23 > 0:52:28Look, I know you probably hate being asked you if you're OK, but...
0:52:28 > 0:52:30you look a bit ruffled and you did just have
0:52:30 > 0:52:34- a very public ding-dong with your husband, so...- No.
0:52:34 > 0:52:35Really relish the attention.
0:52:36 > 0:52:40- Yeah, thought so. - Just bursting to tell everyone -
0:52:40 > 0:52:44from complete strangers to sexually predatory doctors -
0:52:44 > 0:52:46all my personal secrets.
0:52:46 > 0:52:48Predatory?! Is that how you see me?
0:52:48 > 0:52:52That's how the entire female population of this hospital see you.
0:52:52 > 0:52:56In a bad way? Because I don't get a lot of knock-backs.
0:52:58 > 0:53:00- At least I make you smile.- Yeah.
0:53:02 > 0:53:04Things back there looked pretty intense.
0:53:04 > 0:53:06- You trying to cheer me up or depress me?- Sorry.
0:53:09 > 0:53:11According to your husband, I'm crap at my job,
0:53:11 > 0:53:13- so maybe I can't do anything right. - He on your case?
0:53:15 > 0:53:17All. The. Time.
0:53:19 > 0:53:23Frankly, it's hard competing with Mr Perfect.
0:53:23 > 0:53:25He's not perfect, believe me.
0:53:25 > 0:53:27Yeah? Well, erm...
0:53:28 > 0:53:31..that's good to know, because...
0:53:31 > 0:53:35- What?- Oh, nothing. - What?!- It's just, sometimes,
0:53:35 > 0:53:40he acts like he knows what's best for everybody and maybe he does...
0:53:40 > 0:53:41He doesn't.
0:53:41 > 0:53:43He's a very clever man.
0:53:43 > 0:53:46He doesn't always know what's best.
0:53:46 > 0:53:47- Trust me.- Yeah?
0:53:49 > 0:53:51So tell me.
0:53:55 > 0:53:56Give me a minute.
0:54:12 > 0:54:14Still experiencing conditions of permafrost?
0:54:14 > 0:54:17- There has been some thaw. - Oh, well, I'm not feeling it.
0:54:18 > 0:54:22- Did you miss me? - Like I'd miss herpes.
0:54:22 > 0:54:25- Is that the gold-digging Sylvia in there?- Er, No. Alan's wife Jill.
0:54:25 > 0:54:28She obviously forgave him his stray from the path of righteousness.
0:54:30 > 0:54:33Maybe she just thought he deserves a second chance.
0:54:33 > 0:54:35Some women only have themselves to blame.
0:54:39 > 0:54:41Not been easy, but I think I may have
0:54:41 > 0:54:44- poured a little balm over troubled waters.- Mmm.
0:54:44 > 0:54:47This is Jac Naylor. You're going to need a tanker-load of balm.
0:54:55 > 0:54:56- I'm off.- Right.
0:54:56 > 0:55:00- Look, Jac, I...- Listen, I, er, meant to give this to you earlier on.
0:55:00 > 0:55:04Vanessa Pryce - your typical rabid rottweiler in kitten heels,
0:55:04 > 0:55:07- but if you want a job done properly.- What?
0:55:08 > 0:55:09My lawyer.
0:55:14 > 0:55:16CARD CRUMPLES
0:55:16 > 0:55:18He lied about his mother dying to make you like him more?
0:55:18 > 0:55:21- It's almost flattering. - That's completely insane behaviour!
0:55:21 > 0:55:25I did it to make myself seem more interesting.
0:55:25 > 0:55:27- You saw my mum.- Yes.
0:55:27 > 0:55:30What, you've never lied to make someone like you, Spreckles?
0:55:30 > 0:55:33- Er, no. Never! - Well, aren't you lucky?
0:55:33 > 0:55:36I didn't think anyone would like me for being me.
0:55:36 > 0:55:38"Gay Darren".
0:55:38 > 0:55:41- Well, frankly...- Look, I'm sorry. Please don't hate me.
0:55:41 > 0:55:44- I won't lie to you again. - I don't hate you.
0:55:44 > 0:55:45You're fascinating.
0:55:45 > 0:55:48I've never met anyone with such a fluid concept of the truth.
0:55:48 > 0:55:50Albie's for a pint?
0:55:50 > 0:55:52Come on, Arthur.
0:55:55 > 0:55:56What?!