One Small Step Holby City

Ah. There's your baby. Congratulations.

My boss is committed to the Herzig.

He wants whoever is best placed to ensure its success to lead it.

He's very impressed with you.

Dr Tressler isn't ready for this fellowship.

It could be embarrassing for us.

-Zosia, it's over!

-I love you!

I'm afraid you won't be continuing your training on Neurosurgery.

Try not to look like a child who has lost his mother in the supermarket.

Look, Zosia,

fun as this is shaping up, I would quite like to get to the

canteen before they run out of tuna sandwiches.

OK, we're rolling. Be quiet. Interview 3.

Behavioural therapy, releasing your past, dealing with your present.

Now. Talk me through an event in your life.

One that significantly changed your outlook.

I don't know...erm...

Well...last week's a good example isn't it? The end of term?

That was...a lively day, wouldn't you say?

Urgh!

Spoiled milk can lead to Salmonella and E-coli.

And Listeria and Campylobacter if I'm not mistaken.

This place is a landfill. I mean, look at that.

"Advances in Neurology."

Well, you're not going to need that anymore, are you?

Some way to finish the year, huh?

-Last year of term, let's get it over with.

-What's that, Arthur?

You're making bacon sandwiches for everyone? How thoughtful.

Yeah, no. No, because I can't actually even make a cup of tea.

Ooh! Who's is this?

That's mine. Leave it.

I'm trying clock-up 50 hours of material for my psych portfolio.

Morning.

Morning.

-Hope you're not too tired?

-No.

-Wait, wait.

-See you later.

And he is...?

I want to say Jason. But I think it's James.

I'm surprised your bedpost has room for any more notches.

Oh, I've got a wall-chart now. I can keep a much more accurate tally.

Ooh. Nice stunners.

I didn't buy them for me.

Oh. It's his loss, Zosh.

-Look. Just you so you know...

-Harry's back today?

Oh. So, you're in the loop.

It's been nice not having him in our faces, hasn't it?

Yes.

-You ruined his career.

-Hardly.

Morning, Doc! You seen this?! I wore it special.

Patrick "The Grenade" Grenville wore this

when he KO'd Jimmy Rushent for the Super Welterweight Belt.

-Very nice. I'll be with you in a minute.

-Made a friend?

A carotid endarterectomy that I'm booked in for.

Look, I'll admit, that when they eventually write

my glowing obituary

they probably won't mention this particular blooper,

but I don't see why we can't just move on and get back to...

To what?

To how things are meant to be with us.

And re-routing Harry back to AAU would support that theory how?

I thought the whole point was to get rid of HIM to make our lives easier?

All YOU had to do was write him a reference.

So you think I've cut off my nose to spite my face, is that it?

Your words.

You need to show me you're capable of moving forward

and that you're committed to me and this baby.

Look, I get it. And I'm on it, I promise.

I'll show you.

Hi. Morning, guys.

Right. Big day today, so let's go out with a bang.

Yes? Give it some wallop. Arthur, can I have a word, please?

There is life after Neuro, you know.

No, no, I know. I do.

In fact I'm thinking that in the long wrong run -

a general surgery placement is going to be better for me.

Oh, wow. That's great. That's...that's great.

Now, your time on Neuro has meant you've lost some GS air miles, OK?

Which means you need to bolster your GS portfolio, OK?

-Right.

-So I just need to see exceptional ability in all areas.

-OK?

-OK.

-OK, good.

Can I help you?

Cut from the same cloth, you and I, Ms Naylor.

You exhibit a drive and single mindedness

that appeals to people at the top

because people at the top have it themselves.

Can you cut to the punch line, Mr Self, I have a ward to run.

How would you like to do that full-time?

Painful though it is to admit,

our dear Professor Hope is fast approaching his sell-by date.

And I have targets to meet, so it's hunting season, I'm afraid.

I would like you to lead Darwin and the Herzig campaign...

-The answer's no.

-Why?

Think of what would be at your disposal.

Because I refuse to impale a spear

between Professor Hope's shoulder blades

and frankly I resent...

Being flattered sideways, offered a promotion? More money, more power.

As I said, it's a no.

What I really want is a spare pair of hands.

I have a pulmonary endarterectomy this afternoon.

And as you know, Professor Hope is laid up.

OK. I'll see what I can rustle up.

Thank you.

Born in Boston, Massachusetts, in February '88 which would make him...

26.

Well done.

OK. Mr Farnum. I'm Dr Digby. Are you diabetic?

How we doing?

26-year-old male found collapsed on the street

with feverish symptoms and abdominal pains.

Good. Thoughts?

Er...possible gastroenteritis or other infection.

It's on the list, but it's not at the top. Dr March?

High core temperature, which could indicate an appendicitis.

Good. Arthur, how do you want to proceed?

Erm... Right, FBCs, ABGs, chest and abdo X-rays.

Oh, thank you.

Mr Levy. You're wanted on ED.

Thank you.

Just so you know... If someone were to try and ask me out again,

they might be surprised by the outcome.

Pleasantly surprised?

-Do you like seafood?

-Apropos of...?

It's just a useful thing to know about someone.

Mmm.

Arthur, all of those things might lead you nowhere,

so thinking cap, get it on.

-OK.

-OK.

Morning, morning.

Pop quiz.

Transurethral prostatectomy remains the treatment of choice for...

Uh... Symptomatic benign prostatic hyperplasia,

unless the prostate is large enough to warrant the retropubic approach.

Excellent.

What's the most important rule of Advance Trauma Life Support?

I really should know this one.

Assess, reassess, and reassess again.

Argh, I KNEW that!

Procedure for a subtotal thyroidectomy?

Erm...

At ease. You did well.

And I know you must be disappointed about UCLA.

Well, you take the "Raf" with the smooth, right?

It's a joke.

You know, for a second I thought that you'd had a hand in it.

-But I'm just being paranoid, right?

-Yeah, that you are.

Anyway, it is what it is, so let's look to the future.

If you put the work in, there's no reason why you can't step up

and have another swing at the Fellowship.

There could be a bleed in his digestive system.

I'm thinking gastroscopy.

What do you say to a blow-out of epic proportions? A house party.

Can we focus, please, guys?

We'd have to actually clean the house if we did that.

-Not that house. (This house.)

-You're an evil genius!

Right, if they were handing out awards for terrible ideas,

this would be RIGHT up there, so...

OK, Mr Farnum, your notes say

you've recently had an MRI and an Ultrasound.

Yeah. That was to check that I don't have an arteriovenous malformation.

Sorry, a what?

AVM. An abnormality that doesn't show up on Earth,

but in space...

I'm starting a course at The Kennedy Center to

train as a prime contractor for NASA's Space Station Program.

-You're an astronaut?!

-No. Well, not yet anyway.

I mean, the odds of going to orbit are one in 42,000.

I'll be accountable for the day-to-day operation

of the space shuttle fleet. I'm a mechanic, at best.

Still. Nothing to be sniffed at.

So, what brings you to Holby?

Do you have any relatives or friends we can call?

Yeah, my mom, she's English.

We came over to visit my grandma.

OK, have you taken any anabolic steroids or narcotics?

No, sir. They have zero tolerance on all that.

-I don't drink. I don't smoke.

-Regular exercise?

I got 10K down in 40 minutes flat.

You certainly look like you look after yourself.

OK, right, so...blood test results and X-rays are normal,

but I want to order a gastroscopy.

Good. Excellent. Zosia, Dom, can you...?

Hello?

Yes, so, that is where we stick a camera down your throat

and then we take a look inside your digestive system.

-So I'll book a room in theatre.

-Sorry, excuse me a second.

-Arthur?

-Yes.

-Can I...?

I think we've been here before, haven't we?

It's not just diagnostic aptitude that I'm looking for.

You've got to stop treating your patients like an experiment.

So, he shrugs him off, buys himself a yard.

Then...BOOF! Kick's like an Ox.

Hits him so hard, blood sprayed all across the judges' clipboards.

Another charming story, Mr Matterson.

-You think that's bad...

-Full set of obs, please.

This guy doesn't come up for air.

How did you get on with Mr Bleetman?

Yes. Only took the three attempts.

Good. Now, I'm performing a carotid endarterectomy this afternoon,

perhaps you'd like to observe, Dr Tressler?

-Sure. But how about I assist?

-Erm...

Look, I know you think I'm a mediocre surgeon,

but if I'm going to improve then, surely I need some theatre time.

-I'll think about it, OK?

-Thank you.

I was going to ask. Your Fellowship. How hard was it?

I mean, are we talking blood, sweat and tears?

And the rest. They're extremely selective, as they should be.

They want high achievers with good backgrounds.

Well, I'd hardly consider myself as hoi polloi.

Good medical backgrounds. Class has got nothing to do with it.

25th July, 1990, me and a field full of highland bulls,

where were youse then, eh?

Shattered my kneecap, and lost three pints of blood.

-This? This is nothing.

-Giuseppe?!

There he is! And skinny as a racing snake...

Come here, you!

Thanks so much for coming in at such short notice.

It's a big procedure,

and Jac Naylor's going to need all the help she can get.

OK, there's the oesophagus. Down we go. You're doing excellently.

Now, let's take a look around your abdomen.

There's no sign of any ulcer on the stomach lining.

Yep, I can see the monitor, thank you.

HE CHOKES

Right, OK, Noah, OK, right, just stay calm.

-We just need to remove the endoscope! OK, Noah.

-Noah!

What's wrong with him?! I'm his mother!

Right, I need to remove the endoscope, so let go of my hand.

No, that's it. Step aside, step aside, that's it.

OK, look at me, look at me. OK, nice deep breaths.

There we go. There we go. Nice deep breaths.

Repeat bloods and CTs. Now, please. Thank you. That's it, that's it.

Will you stop your fussing, you?

Stop babbling and tell me what you're doing here?!

Look, where is the mum-to-be?

She's around here somewhere. Listen...

-Hang on. Are you two related?

-Can you not tell?!

I mean, admittedly, he got Dad's brains,

but I won the looks war hands down.

Giuseppe! Answer me.

I came to surprise you, didn't I?

Wet the baby's head and all that!

And look, from here on out, it's Uncle Giuseppe,

unless of course Amy had a whoopsie with the milkman.

Can you just pipe down for a second and tell me what happened?

I got jumped this morning outside my B&B. Four of them.

On those little ped things. They took my wallet and my phone.

Left me face down in the gravel.

-You should call the police.

-He's right.

Ah, there's no point, I didn't really get a good look at them,

plus I've got a couple of unpaid parking tickets

I'd rather keep on the DL.

Right, well, this cheek needs stitching.

Actually, it's my ribs that are doing me in.

I bet that Amy and Raf

are like Holby City's very own Kanye and Kim, am I right?

Minus the banks accounts, maybe.

Right well, it looks as though you've busted a few ribs.

Hello, there, I'm Ms Campbell. How are we faring here?

Are you the big boss lady?

Actually, I prefer Deputy Chief Executive Officer, it's less formal.

I like her already.

OK, fast scan shows trace amounts free fluid in the abdominal cavity.

Could order a chest and abdo CT?

Oh and I could take the wheel from here, if you like,

given that it's against protocol for staff to treat family members.

-Family members?

-Yeah, he's...my little brother.

-There are two of you?! What a treat.

-I'm sure we can make an exception.

-No, we can't.

-Rules is rules, Raf.

Darcy and Nurse Ratched here can take care of me.

Make sure you do full bloods, LFTs, Us and Es.

Thank you, Mr Di Lucca. We will take excellent care of him.

Hey, I hope you realise how momentous all of this is.

The pack is growing, pal, and you are going to make one heck of a dad.

Why's it taking so long?

It's not a race against the Russians, Arthur.

So, do you think Buzz Nice Rear

dances on my side of the ballroom then?

-You wish! Jane, Albie's tonight. You in?

-I'm in.

Sorry, what are you planning?

We're entitled to let our hair down, aren't we?

Look. OK, right, I know you've got me pegged as the fun police.

But I actually agree, I think it's really important that you wind down.

You know, you deserve it. You've had a really rough year.

We all have.

But dishing out corporal punishment to our livers

the day before we start our new roles - that is not exactly a...

Thank you. What?!

Awww, look at him.

Chocolate in his beard. And his wee belly full of fizzy pop.

His nose was doing that whistling thing when he was dozing earlier.

You do know that lemonade doesn't count as one of his five-a-day.

He's hardly a beetroot smoothie kind of guy though.

Do you know how many grams of sugar there are in one of those things?

-15?

-Try 25.

Actually, they use fructose not glucose, but I do like your point.

Connie.

Jac!

-This IS a surprise.

-Mmm!

-Whoa. So, you're Mrs Beauchamp!

-And you are?

-Humbled to meet you. Nurse Maconie.

-Oh.

Mo Effanga. CT Registrar.

I've seen you in the lift a couple of times.

So you and the Professor go way back. Do you want to pop in and see him...?

No, I wouldn't like to rouse him from his slumber,

I'll speak to him later.

I hope you're all giving him the five-star treatment.

He's an extraordinary man.

Ah! We're at his every beck and call.

-He may as well be at The Savoy.

-Well, I'd hardly go that far.

It's more like roadside B&B here at the moment. No offence.

-BOTH: None taken.

-So, run out of bedpans on ED?

Actually, Guy asked me to help you with your pulmonary endarterectomy.

-Really?

-I gather you've only done a few?

Where as you've performed...

14, yeah. Well, 15 if you count Jo-burg.

But, really, who's counting?

Well, you've been around longer. A LOT longer.

Right, this is a very complex operation,

we're going to have to work together throughout.

It's like The Avengers!

-Have you done a heart catheterization?

-Yes.

I can see the CT, V/Q,

Pulmonary Function test, but no TTE.

Shall we order one in?

As you'd expect, I'm across all the detail.

I'll let you know if anything relevant crops up.

You've been out of CT for a while. You sure you're up to this?

I think I'll manage. That was that THE Nurse Maconie?

I mean, he seemed like a nice guy.

-He's an idiot.

-Hmm. And the father of your child.

-Aw, it's good to have you back.

-Isn't it?! Shall we? Oh.

It's an anatomical abnormality of the intestine.

Present in around 2% of the population.

It can cause bleeding and blockages in the bowel.

So, I'm afraid that you're going to need a laparascopic operation.

Have you done all the tests?

I mean, are you positive that you know that that's what it is?

-The technical term is...

-Meckels Diverticulum.

Have you run repeat bloods, and angio CT?

Yes, yes, we have. That's how we found the blockage.

What does it mean in the long run? I mean will he still...

It's OK. You can lay it on the line.

We'll do everything we can to make sure the procedure goes smoothly.

Yeah, obviously.

OK, so in theory, the beauty of it being an anatomical issue

rather than an underlying condition is that it shouldn't affect

your chances of certifying with NASA.

Physically, you are in excellent shape.

So, erm...yeah, all that work is going to pay off.

We should ring Dad?

There's not a lot he can do from Boston, darling.

Yeah, but he's going to want to know, right?

If he can tear himself away from work.

OK, team. Follow me.

-SHE COUGHS VIOLENTLY

-Did you finish your antibiotics?

You got to complete the whole course, every last pill, Mom.

What are you now, a doctor?

You need to get some rest, before they take you in.

Now, actually,

this procedure is a very good training case

for you all to step up.

So, Arthur, you can lead in theatre.

Will and Grace, you can observe.

OK, guys, guys, guys.

Just so both of you know, there's to be absolutely no merrymaking

until we've seen Noah's case through to the end, OK.

I'm actually going to pull rank on this particular...

Don't tell him I told you so, but those two have only ever been

with each other, if you catch my drift?

University sweethearts.

There's tiny bits of glass in here.

Aye, yeah, one of them walloped me with a cola bottle.

-So what do you do for a living?

-I'm an offshore driller.

I work on a platform in the North Sea.

-How's it going over here?

-Yeah, fine.

So, you, what's the score?

Did you break your dial finger, or something?

Haven't heard a word from you or Amy since the news.

-Am I the only one rejoicing here?

-No. Of course not.

Just give us a sec here, Darcy, pal, eh?

I need to look Raf in the eyes,

I can see when he's at sixes and sevens.

I'm not. It's just, working here, mate, it's been...

Darcy, have you taken him out to celebrate yet?

Not yet. Nose to the grindstone.

Trying to stay ahead of the competition.

-Amy!

-Giuseppe! Are you all right?

Look at you! All aglow. And bearing new Di Lucca blood... Argh!

Giuseppe, are you all right?

-I'm all right, I'm all right.

-Pulse is a little high.

Yes, thank you, Mr Di Lucca.

Harry, let's get him on his feet, please.

It's all right, calm your jets, team, I'm fine.

Let's get an ECG. And repeat chest and abdominal X-ray.

Mr Di Lucca, take a break, I won't ask again.

Raf, Come on. You know you can't treat him.

Let them get on with their jobs. It'll be OK.

Raf, look at me. It'll be OK.

OK. HE SIGHS HEAVILY

We'll go for a partial circulatory arrest.

A full arrest would be the best option.

-It'll give us more time to operate.

-Yes, but with reduced visibility.

There's no chain of command here, I'm not your registrar anymore.

No, of course not.

Oh, I like what you've done with the place.

Organised chaos.

Must be a bit of a come-down for you, slogging it out on the ED?

Oh, trust me, that's where the action is.

Plus I can always pop up and help you.

Tell me, how's Sam?

Fine. He's living in the Big Apple.

I hear Joseph's got a LOVELY new wife.

Right. Let's do this your way.

We'll put her under in a few hours, we'll go for an all night procedure.

-We'll do it together and in shifts.

-Fine.

-Good.

Connie! Thanks again. Talk about a star substitution eh?

Remind me to remember never to let you leave.

So nice to be wanted, isn't it?

There it is...

But I just want to, I just want to keep looking

just to be EXTRA sure.

Arthur, we've seen the CT scan, we know where the affected area is.

We don't want to delay things unnecessarily by...

No. We because we want to see if there's any more haemorrhaging.

OK?

Right, and there's the appendix.

Appears normal, and there's the diverticulum,

OK, so let's use the staple gun to resect before we close up.

That's very good, very thorough, Dr Digby. Well done.

Thank you. I don't really like taking short cuts.

I wasn't suggesting we take short cuts, I was MERELY suggest...!

I need to concentrate, please!

Giuseppe doesn't want to call the police. He's rather stubborn.

Must run in the family. Thank you.

What's up? Is everything OK?

There's a bleed in Giuseppe's kidney, a grade II haematoma.

We'll keep on top of his obs and order another CT scan in an hour.

I'm just keeping you in the fold.

-If that gets any worse, then...

-Potentially, yes.

Are you sure you considered every option before you operated?

Absolutely. He's going to be fine.

Famous last words. Never know with you doctors.

-SHE COUGHS AND WHEEZES

-Are you all right?

Would you like me to take a look at your...?

It's fine. It's a chest infection, I get one every year.

You could set your watch to it.

Mr Farnum?

Noah? How are you feeling?

Good, I think.

Oh, thank God for that!

B/P's stable.

OK, pulse is nice and steady too. That's good. Really good.

So, I'm just going to have a little feel of your abdomen.

Some cold hands coming.

That's not a good face.

You'll need foam-edge protectors, guard-rails, baby monitors.

Amy's only 12 weeks, you know?

We probably should start clearing a room out for the cot though.

You haven't even cleared out a room yet?

Man! What planet are you on?

All right, well I've got the weekend off.

So I'll get the overalls on

and I'll and take the paint roller to the spare room.

Well, you better get on it.

You need to get in a family state of mind.

Speaking of which, how's Shona and the kids?

Ah, yeah, they're fine. They send their love.

Now, listen. I'm not stupid. Something's going on.

You two look as miserable as sin.

And when are youse going to go and visit Mama Di Lucca?

Another grandchild on the way

and she's got nothing to tell the ladies down at the salon.

Look, it's just, we've... been buried alive here, haven't we?

So, spill. Is everything all right?

-It's fine.

-Yeah.

Well, I hope you two never need to lie under oath.

Look. Seppy. It's just...

It's taking me a while to get my head around all of this.

And I'm still trying to balance things out.

Well, get balancing, pal, because in six months' time,

your world's going to be turned downside-up.

You're suppose to be enjoying this part, you know?

Hey, I imagine you do quite well round here, Darcy,

with those pin-up boy good looks?

Actually, I'm having a bit of a dry spell at the moment.

Aye, right! I imagine someone like you

has had a fair bit of squeaky mattress

with half the female workforce in this place, am I right?

-Look at him, he's blushing.

-Yeah, he's a regular heart-breaker.

-Seconds out, Doc. You ready?

-Ah! My carotid endarterectomy.

Raf, am I in?

Yeah, fine.

Excellent! Nice one.

-MONITOR BLEEPS

-Raf!

-Giuseppe?!

-Pulse 120.

-He's going into shock!

-Fluids!

OK, B/P 119/90. Pulse steady.

Let's have the pump at the ready, people, please.

Must be nice keeping Elliot's seat warm.

I must say, the crown sits nicely on your head.

Actually, I've been made an offer elsewhere.

-Knife.

-Oh. Canula, please.

Right, headhunters are out already are they?

Something like that.

OK, ready on bypass, cardioplegia as standard.

And I'm sure I don't need to remind everyone

to keep an eye on her temperature.

So, are you going to take them up on their offer?

It means selling someone down the river.

-Ooh. Juicy. Is it someone I know?

-No.

Well, there are few enough opportunities for us women

at this level, don't get sentimental.

But, as my father used to say, if you can't fish, cut bait.

All right, ladies and gentlemen, I will need vitals and temps, please.

I did it blow-by-blow.

Speak to Sacha before you get yourself all worked up.

-I'm not getting worked up.

-Yes, you are.

I am NOT getting worked up, I am trying to work it out.

-Dr Digby...

-SHE COUGHS

Are you all right?

Sorry, do you mind? What stage are you?

Three. It's spread to my bones.

I've had every test under the sun

but it just wasn't detected early enough.

Why do you think my medical glossary is so red-hot?

I'm so sorry. If there's anything we can do?

Don't tell Noah. He's moved mountains to get where he is.

-I can imagine.

-You have to tell him.

I don't want him worrying when he's so close to certifying.

-Promise me, won't you.

-Yeah, of course.

-You don't think he deserves know?

-Zosia!

Look, don't worry. Of course we'll respect your wishes.

-It's fine.

-Thank you.

-OK.

Right, you can't say a word, Zosia.

It's a very slippery slope, so just, PLEASE, do not interfere.

-You've gone quiet on me.

-Time of my life, Doc.

Here, look. I wanted to give you this.

This is Henry Armstrong Jr's gumshield. You know who he was?

How did you get that in here?

He was the only boxer to hold three world titles at the same time.

Homicide Hank they used to call him. My uncle gave me it.

Here.

Haven't you... got some kids you give it to?

No. Two boys.

They're all grown-up now,

don't think they can be bothered with their old man,

I think they're scared I'll bore 'em silly with tales of the ring.

-It's just me.

-You might be able to sell it one day.

Treat yourself to a Vegas holiday. Fight night at the MGM or something?

-Yeah, that'd be nice.

-Now, how about a bit of hush?

Could you clean the blood around the incision for me?

I've told doctor Tressler to stay with your brother.

He's stable.

However, the bleed IS present, so we will have to remove the kidney.

-OK.

-Good. He's booked in for this evening. Dr Tressler will assist.

-Absolutely not! He isn't good enough.

-Excuse me?!

I'm sorry but could we... discuss this afterwards, please?

-All right.

-OK, first things first, clamps.

I'm going to root out this blocked carotid artery.

There you go. And the other.

-You OK, Walt?

-Yeah, fine. Fine.

We'll have you back in the ring in no time my friend. Scalpel.

Making light work of it.

Right, we're going to peel the plaque deposit

by removing the lining

of the diseased section

-of the artery containing the plaque.

-You clearly don't need MY hands.

Zosia and Dom, can you finish up as normal?

Arthur, I need you on call, but get plenty of rest, OK?

Everyone in, 7:30am, raring to go. Good.

So, are you coming for a drink, Penfold, or not.

No, you heard Sacha, we've all got to be alert

and I've got to go and explain this to Noah.

You need to talk to your mother, there's something...

Dr March, can I just, can I just have a quick word?

-Why should I talk to my mom?

-Have you lost your mind?

-He has a right to know!

-It's none of our business.

He has to spend more time with her. Make preparations, say goodbye.

OK. Look, look! I completely get it,

it is so difficult for you, but you just have to...separate.

You have to compartmentalise.

No. He has a right to know! He has a right to know!

Stop, stop, stop! It's amazing how you find a way to make it about you.

You cannot play God in other people's lives. So self-absorbed.

And you wonder why Jesse ran for the hills.

SHE GASPS

I need a drink, right now.

Let me assist with Giuseppe.

-Forget about the red flags for a minute.

-I don't think so.

Then as next of kin, I don't give consent for Tressler to operate.

-Really?!

-My brother's life is at stake. He's not experienced enough.

-He won't be leading, I will. Am

-I

-experienced enough for you?

Yes, of course!

Mr Di Lucca, despite your brilliant skills in theatre just now,

I sense today isn't your day. We all have them.

And need I remind you that you were not happy endorsing

Dr Tressler's UCLA application and as a consequence,

he is still on AAU, and yet you don't seem happy about that either!

-I mean, what's going on?

-Nothing. It's just...

Look, he has a way of... involving himself too much.

Well, that clarifies very little.

You DO realise you're virtually handing Doctor Tressler

leeway to file for workplace harassment?

And indeed, from where I'm standing

your unethical and CONTRADICTORY behaviour

is bordering on the unacceptable.

In fact should it continue I won't hesitate to suspend you,

pending further enquiries.

I'll let you know how the operation goes.

HE SIGHS

OK. The area in question, it needs monitoring,

before Noah can board a plane or even get on a treadmill.

But fear not.

We're going to watch it and hopefully it should resolve itself.

-"Hopefully"?!

-Mom.

Can you get me some magazines, please?

I know what she's hiding from me.

Her and Dad haven't got on for years.

I guess being from a broken home will be good for my street cred.

Just, get me into orbit as soon as possible, man!

I think your mum is... very proud of you, Noah.

I know.

And don't get me wrong, she's the reason I've made it this far.

College fees, driving me to my circuit training,

pushing me, but not forcing me.

-I'm going to be OK, right?

-Yeah, I'll make sure of it.

And, remember what I said about your mum.

BOTH: Three, two, one...

-Again.

-Urgh!

They're going to name a hurricane after you at this rate.

MOBILE BLEEPS

You meeting someone?

You know, just an old friend.

Right, this is to Annus Horribilis.

I feel a bit bad for Arthur.

-Speak for yourself.

-I know he was out of order,

but you DO have to stop taking things so personally.

Look, the poor boy is still getting over not getting into to Neuro,

and he had a massive man-crush on Jesse!

-Argh!

-Sorry, sorry.

It's OK. You CAN say his name. Shall we have another one?

Slow down. I don't fancy hugging the toilet again tonight.

Ever feel like booze isn't quiet scratching your itch?

Are you OK, Zosh?

Yeah. Ignore me. I'm, er... you know, a broken heart.

I'm just going to powder my nose, you get us some drinks in.

Why have you really crashed this party?

I'm still one of the most experienced CT surgeons in the hospital.

Why? Where would you have me ply my trade?

I think there's an opening in the canteen.

Cooking's the one thing I CAN'T do. How's Emma?

She's with her father now.

-I'm sorry.

-And Grace?

Yeah, she's gorgeous. And loud and perfect.

I'm sorry, I can't imagine what that must be like for you,

I'm sure the sacrifice will be worth it professionally.

You're an excellent surgeon.

Of course my experience puts me way out ahead, but...

Right, let's get her out the fridge.

One hour to dissect, let's make it count.

We may not get another opportunity.

LAUGHTER

Diggers!

You two are wasted! What are you doing here?

We wanted to see Buzz Nice Rear!

No, no, no. OK. He's asleep!

Seriously!

You guys are drunk in your place of work, which is a hospital.

If Sacha sees you...

He's not going to see us, we're special ninjas!

What have we got here?!

They're bowel resection papers. Just give them back...

Right, time to give Noah some home truths about deceitful parents.

Dom! Just get her off the ward.

OK, let's...let's go and leave Arthur to his homework.

And we'll go have some fun, elsewhere.

There's haemorrhaging around the renal pedicle.

OK. Gently clamp the ureter and vein.

Careful.

That's it. Now put an incision in both.

Eyes on the prize, Dr Tressler.

Careful of the adrenal gland.

Focus. That's it.

And now remove the kidney.

Pulse is stable. B/P normal.

-Good. I think we're done.

-Hold on.

I think there's a tear in the renal vein.

I need a clip to tie of the bleed before suturing.

Quite the spot.

Yes, more often than not it's the small things that are important.

Assess, reassess, and reassess again.

Exactly.

-How's Giuseppe doing?

-So far so good.

He dropped his phone on the ward.

-What?

-He said it got stolen.

It's funny you say that - I was in ED earlier

and two males were admitted, steaming drunk and beaten to a pulp.

One of them kept going on about

"A Scotsman with a mouth like a Tommy gun."

I'll have a word with him when he comes around.

I heard you didn't want him to operate?

You can understand that, right?

I'm doing my best here, Amy.

Let's play Snog, Marry, Kill.

I'll go first. Dr Tressler.

Hey! Don't be daft! Zosh? Wake up!

Zosh?! Wake up! Zosh?

SHALLOW BREATHS

What? What happened?!

I don't even know, she just collapsed.

Zosia! Zosia!

OK, we have to get her to the ED.

No! Wait! She's taken something.

Pulse is barely registering. We have to get her to ED!

No, we can't! Her career will be ruined!

-WE have to do this! Me and you!

-But you're...

-We HAVE to!

OK, lift her head up.

It's not like I told her to take the bloody stuff?

Oh, God. OK, right.

We need to get to her oxygen, so let's just, er...

-Let's get her into to theatre. Move, move.

-OK. OK.

We've got another 30 seconds, maximum,

-before he we have to bring her core up.

-Then we have to stop,

because I can't access the emboli on the left artery.

20 seconds. There are two left. Come on.

Got one. Right, I can't see a thing here.

Suction! Really we're going to have to cool her down again.

No, 12 seconds. There's one left. I can see it.

-COUNTDOWN BLEEPS

-My hand's gone, my hand's gone.

Five seconds.

Come on.

I've got it!

Oof! No arguing with that. Well done!

She said they were called, erm, Misties, MSTs.

OK. That's an opiate!

So... OK, respiration drops, cause unconsciousness...

..can be fatal when combined with alcohol.

OK, OK, I think she needs... Naloxone.

It's on the arrest trolley.

OK, well stop staring and go get it.

SACHA: They do the best seafood platter I've ever had.

They've got all the props, lobster forks, you know,

the crab mallets. We could go if you want?

I wouldn't have to pick out my lobster though, would I?

I'm not sure I can look my supper in the eye

before it's dropped into boiling water.

Well, maybe Thai food, instead?

She's slipping into respiratory depression.

We're running out of time.

Dr Digby, what are you up to?

Shona turfed me out few weeks ago. Served me with papers.

-It's finished.

-What did you do?

It's what I didn't do.

Away for weeks on end.

Come home, eat, sleep, drink, ship out again.

She got bored, who can blame her?

-Have you talked to her?

-She turned a corner.

It's what people do if you give them enough reason to.

I was just too caught up in my own world,

too stubborn to realise how much of a good thing I had going.

You know - medical reps, big expense accounts.

Zero sense of humour.

Sounds kinda painful. So, what you doing?

So what you doing just checking the barracks, or...?

I rather like it here at night. Place has a different pulse to it.

Yeah, I know what you mean. It's like the erm...

the outback, isn't it? Or the open country.

Except instead of crickets chirping,

it's ECG machines and it's ventilators.

I better go, so...

-Arthur?

-Yep.

Is everything OK with you three at the flat?

The flat. Yeah, yeah, it's great.

-Where have you been?!

-OK, I've got it.

Her respiratory rate is only eight, so come on!

Yeah, OK, I'm trying to get the blasted...! Come on, come on!

We're way out of our depth here,

I think maybe I should go and get Sacha...

No! We're not U-turning now, OK? We've come this far.

Arthur. You're a good doctor, OK?

Don't let me or anyone else tell you otherwise.

Now, come on! Do this!

SHE GASPS FOR BREATH AND COUGHS

Zosia! Zosia! Can you hear me?

Are you all right? Are you OK?

-SHE COUGHS

-Oh, thank God.

-OK, what's the capital of Romania?

-What? Even I don't know that!

-Look, what day is it?

-Tuesday. Bucharest.

We had a good night then, I take it?

Guess who?

Connie! Oh! To what do we owe the pleasure?

Oh, you know, you can take the girl out of Darwin.

Actually Jac and I were doing a pulmonary endarterectomy.

-How are your hands?

-D'you know what? Sore. I got cramp.

Pulmonary endarterectomys should come

with a complimentary bucket of ice.

-Ah, that's lovely. You all right? You feeling better?

-I am.

Though Mr Self has stressed that he wants me to take as long as I need.

Jac seems to be doing an excellent job as my stand-in.

He's a very big fan of hers.

Ah, of course. Well, Emma's with her father.

Yes?

Jac's always been a go-getter, Elliot.

Right, come on. You need to get some sleep.

So do I.

-Thank you so much. Thank you.

-Look after yourself.

-See you soon.

-Yeah.

-Jac. Always a pleasure, never a chore.

-Absolutely.

We should do it again sometime.

Remember, Autumn tones.

I know something's going on with you and Amy.

It worries me, so Lord knows how it makes you feel.

Whatever it is, I want you to know that there's a...

there's an ear and a shoulder here, all right?

Giuseppe. Listen...

Remember, Raf, a man is nothing without his family.

You, me, Mama, Amy, the bump, that's the pack now.

So whatever it is that's bothering you and the missus, make it work.

Sort it out.

Life is too cruel and too short for petty grievances,

really, it is.

Remember, big picture.

It's not too late for you.

Amy, what are you doing here?

Hi. Sorry. I couldn't sleep and...

I just wanted to check my brother-in-law was OK.

Principessa! What a woman!

One Fiorentina and one Quattro Stagioni.

Fantastico!

I'm sorry. What was it you were going to say?

I keep banging on.

It doesn't matter, bro.

Jac, I'm glad you're here. I wonder if I might bend your ear.

I've been... Some thoughts have been fermenting as to how I can,

-well, you know, shake the snow-globe up a bit!

-OK.

I think the power-broker's upstairs need to see that

I mean business, so first up, a new secretary to help with dictating.

Then nominated nurses for each individual patient

and then I was thinking of assigning junior doctors

to specific consultants,

thus bringing back the age of the protege!

What do you think?

-That's just for starters.

-Mmm.

They're not done with me yet, I tell you.

SHE SIGHS

Zosia! Zosia! No, stay awake. Stay awake. You're dribbling on me.

Ah, Danny, how are you? Good to see you.

-How are you? Good?

-Yeah!

Ah, there you are! Listen, I think you dropped this before.

No, I didn't.

-I'm sure you did.

-Glasgow?

Yeah, Mama Di Lucca needs to feed you both up on pasta

and play Sinatra records to the bump!

-Is that all right?

-When?

-Weekend after next.

This weekend, I'm a bit tied up, painting the spare room.

OK!

And this morning, I thought we might start a new Di Lucca tradition

of coffee and Cannolis.

Sounds nice. Sure you're not too tired?

-I'm shattered.

-So am I!

Give me 20 minutes to finish up here and triple shots are on me.

Thank you...both.

I assume nobody has any interest

in letting this particular cat out the bag

for a whole host of patently obvious reasons?

I'm sorry, guys, but this isn't a cub camp, OK?

Right, Zosia, do you actually REALISE that you nearly died last night?!

You took narcotics and you overdosed!

-All right, Arthur...

-SHUT UP! It is NOT all right! OK.

What if I'd given you the wrong meds? What then?

What happened last night is monumentally serious,

it was the stuff of nightmares. And I don't EVER want to have to...

I was in a car crash! And this was...

I'm sorry for putting you through such an ordeal!

I am acutely aware that I have issues I need to work through...

..but if it is any consolation

there's nobody I'd rather OD around than you, Arthur Digby.

Right. OK. We have to draw a line in the sand.

What has happened, it's happened, OK?

But there is the future.

And the past is not going to define us,

but we have got to entrust ourselves to our work and to our patients.

You agreed? So...

Morning.

Look, Raf, this whole train wreck,

I'm glad it hasn't affected our work.

And, as you know, I'm going to be here for another year,

so I hope we can let sleeping dogs lie.

What do you say?

HE SIGHS Look, I'm not a monster, Harry.

I can, and I WILL move on.

But I can't forgive you.

I'm glad we're all singing from the same hymn sheet on this one.

Well, we don't have much choice.

Illicitly treating a colleague with stolen meds

is at least a GMC hearing, if not a spell in prison.

-Are you going to get it right this time?

-Mom?

Absolutely. And it wasn't that we got it wrong, just...

-SHE COUGHS

-Hey. You OK?

Yep. I'll see you afterwards. Be brave.

OK, hang on in there. You're going to be absolutely fine, OK?

Thanks, man. You're a good guy.

DOOR OPENS

Oh, Ms Naylor, I hear the endarterectomy was a success.

We got through it.

Good. So...

I'm in. But I have terms.

Excellent. They'll all be addressed.

In the meantime pack your things,

you're going to Pittsburgh on the campaign trail for three weeks.

You have to tell him, OK?

Yeah, consider it done.

You know that feeling you get when know you've made the right decision?

There was never a decision to make.

Thank you, Cathy.

All clear. No rips, no tears, full MOT of the abdomen.

Obviously, we'll keep him in under obs for a few days then,

but then he's good to go.

Thanks, Jane.

CT1. Sounds a bit like a robot, doesn't it?

Well done, Arthur.

-How did it go?

-Yeah, it couldn't have gone any better.

We need to keep you in for a few days, plenty of rest, but...

-So, you reckon I'll be able to start my course?

-Yes.

-Houston, we don't have a problem!

-Good job, man.

-Yes!

I'll leave you to it.

Hey! Come on, this great news.

-I know.

-Come here, give me a hug.

No, I can't. I'm sorry.

I know about you and Dad splitting up.

Noah, I didn't leave the US because of your father.

Well, not really.

I left, because the divorce means

my US insurer won't pay for my chemotherapy.

Chemotherapy?

I've been getting treatment on the NHS from an oncologist.

Noah, I have lung cancer.

I'm sorry.

Oh, I'm sorry. I'm sorry.

I'm sorry! I'm sorry! I'm sorry!

BOTH SOB

He'll get to say goodbye.

That's something, isn't it?

Bet you wished you hadn't asked now.

I mean you spoke of a single event,

but it's more a series of little insights

into people around you that form a much bigger, messier picture.

I'll call my report officer. Cancel my enrolment.

No, you won't!

But I can't just leave you here.

I'll come with you.

You don't start until September,

we can go to Louisiana, hear some bluegrass.

OK! San Francisco and Yosemite...

And I still haven't been to the Grand Canyon.

I want to see the Grand Canyon.

You could do some rafting.

'So, you see, Zosia, "The web of our life is of a mingled yarn.

'"Good and ill together."

'It's a quote. Shakespeare. Oh, are we done?'

Great, so, missed all the tuna sandwiches,

and I'm definitely not one of your case studies now, Zosia, so...

Actually you really can't show anyone that,

because I did just confess to the whole thing, so...