Mummy Dearest

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0:00:38 > 0:00:41You're not me!

0:00:41 > 0:00:42Mum! Mum! It's all right!

0:00:42 > 0:00:45WOMAN SOBS AND WAILS

0:00:48 > 0:00:49It's OK, Adrienne. It's OK, I've got you.

0:00:49 > 0:00:51'From what you're telling me,

0:00:51 > 0:00:54'your mother is showing signs of delusion and paranoia.'

0:00:54 > 0:00:58Her mental health is deteriorating rapidly.

0:00:58 > 0:01:01- The Nuss procedure? What, you going ahead with it?- I am.

0:01:01 > 0:01:04What part of "no" do you not understand?

0:01:04 > 0:01:07You were like a daughter to me. Perhaps I expected too much.

0:01:07 > 0:01:09You've always been a huge inspiration.

0:01:09 > 0:01:12Well, you're all grown-up now. No more of that, eh?

0:01:14 > 0:01:17- TV:- We're talking about treats. We're talking about pleasure.

0:01:17 > 0:01:21Morning, everyone! Have I got a treat for you?!

0:01:22 > 0:01:25Wakey-wakey, little moley.

0:01:25 > 0:01:26Diggers?

0:01:38 > 0:01:40Unbelievable.

0:01:40 > 0:01:44Trying to do something nice...don't even have the decency to be here.

0:01:45 > 0:01:47Whatever.

0:01:47 > 0:01:50- TV:- 'Finally, two tablespoons of self-raising flour.

0:01:50 > 0:01:52'Don't even think about the calories.'

0:01:53 > 0:01:55'Now this is a treat with chocolates...'

0:01:55 > 0:01:59Then there is a huge temptation for me to involve nuts.

0:02:00 > 0:02:03'Hazelnuts and chocolate, for me, is just...

0:02:03 > 0:02:04'Just the best of the lot.'

0:02:06 > 0:02:07'I skin my hazelnuts.

0:02:07 > 0:02:09'You can buy them already done,

0:02:09 > 0:02:12'but I think they keep better with their skins on.'

0:02:13 > 0:02:14'It's easy...'

0:02:14 > 0:02:16Get a life!

0:02:16 > 0:02:18HE SLAMS DOWN REMOTE

0:02:18 > 0:02:20- CLASSICAL MUSIC ON RADIO - # Dee-dee, dee-dee

0:02:20 > 0:02:23# Eee-dee-dee, dee-dee... #

0:02:23 > 0:02:25ADRIENNE CONTINUES TO SING

0:02:25 > 0:02:27No!

0:02:28 > 0:02:31ADRIENNE HUMS AGAIN

0:02:38 > 0:02:42- MAN:- 'BACK OFF! BACK OFF!'

0:02:42 > 0:02:44BACK OFF! BACK OFF!

0:02:45 > 0:02:46Back off!

0:02:46 > 0:02:49- Put the stand down!- Back off! - MAN SHRIEKS

0:02:49 > 0:02:52- BACK OFF!- Put the stand down. MAN GROWLS

0:02:58 > 0:03:00I've got him! Just...grab his legs.

0:03:00 > 0:03:03- Just look at me. That's it. - All right, mate, calm down.

0:03:03 > 0:03:07- Let's see that. You all right?- Yeah.

0:03:07 > 0:03:11- Morning!- I sublet your room to a family of Syrian refugees,

0:03:11 > 0:03:13I figured someone should get use of it.

0:03:13 > 0:03:16- I was staying at Maria's. - You stink of sin.

0:03:16 > 0:03:18- She has a box set. - I bet she does, little minx!

0:03:18 > 0:03:19No, it's David Attenborough.

0:03:19 > 0:03:21I don't know what's worse -

0:03:21 > 0:03:23living with you or not living with you.

0:03:23 > 0:03:25- Rag week... - Oh, that's too much information.

0:03:25 > 0:03:26Whoo-hoo! Rag week!

0:03:26 > 0:03:29CROWD CHATTERS

0:03:29 > 0:03:32I hate random acts of fun committed in the name of CHARITY!

0:03:32 > 0:03:35St James's medical students - must be for their cardio unit.

0:03:37 > 0:03:40Dig deep, boys. Give from the heart for the heart.

0:03:40 > 0:03:42Here we go. Two fresh ones.

0:03:44 > 0:03:47Yay... Whoo-hoo! Nice stripes!

0:03:51 > 0:03:53The Nuss procedure Professor Hope performed

0:03:53 > 0:03:57was the perfect opportunity to build some bridges with your former mentor.

0:03:57 > 0:04:01- It was needless plastic surgery. - That is a matter of opinion, Jac.

0:04:01 > 0:04:03This transition was never going to be easy for Elliot,

0:04:03 > 0:04:06there was always going to be a period of "bedding in", shall we say?

0:04:06 > 0:04:08Don't you think you should be talking to him?

0:04:08 > 0:04:11No, not when all I'm seeing is outright revolt

0:04:11 > 0:04:12from every member of your team.

0:04:12 > 0:04:15You get this under control, Jac, or you'll leave me no option but to...

0:04:15 > 0:04:20What? Review the position you more or less bullied me into taking?

0:04:20 > 0:04:23I suggest you use a bit of diplomacy and tact.

0:04:23 > 0:04:25I'm sure you'll find a dictionary somewhere

0:04:25 > 0:04:27if you're unsure of their meaning.

0:04:29 > 0:04:31Have you... Have you seen the theatre lists?

0:04:31 > 0:04:35- Our glorious leader... - Put me on the subs bench again?

0:04:35 > 0:04:36Yeah, something like that.

0:04:36 > 0:04:40But I managed to pluck this from her hooded claw,

0:04:40 > 0:04:43right before the all-seeing eye spotted it!

0:04:44 > 0:04:47The incorrigible Bernie Reddy, our old friend.

0:04:47 > 0:04:50Yeah. He's reported breathlessness and has tachycardia.

0:04:50 > 0:04:52He's been asking for you.

0:04:52 > 0:04:54Goode and Reddy... D'you remember them?

0:04:54 > 0:04:57Err.. A bit before my time. Mum used to love 'em, though.

0:04:57 > 0:04:59They were right up there with Cannon and Ball.

0:04:59 > 0:05:02Gina and I went to see them in the Summer Pavilion, Torquay -

0:05:02 > 0:05:04our first holiday together.

0:05:04 > 0:05:06Torquay? And she still married you?

0:05:06 > 0:05:08So you think Bernie's heart failure's progressing?

0:05:08 > 0:05:11Oh, there's a possibility that the meds have failed.

0:05:11 > 0:05:13There's nothing matching on the transplant list so far

0:05:13 > 0:05:15if it is progression.

0:05:15 > 0:05:17Uh, even if you did, there is the small matter of...

0:05:17 > 0:05:20Dextrocardia in a situs inversus patient.

0:05:20 > 0:05:21You've done your homework.

0:05:21 > 0:05:25Have you ever seen a heart positioned on the wrong side before?

0:05:25 > 0:05:27Twice, it's pretty rare.

0:05:27 > 0:05:31I was kinda hoping that I might be able to work it with you.

0:05:32 > 0:05:36I think we should keep Bernie our little secret, don't you?

0:05:36 > 0:05:38- Mm-hm.- Doughnut?

0:05:38 > 0:05:39Mmm!

0:05:42 > 0:05:43Team announcement...

0:05:43 > 0:05:46I've been examining your e-portfolios

0:05:46 > 0:05:48and you're all light on Clinical Evaluation Exercises.

0:05:48 > 0:05:50Right, I think if you look at my back catalogue...

0:05:50 > 0:05:53All for one, one for all, Dr Digby. That's our motto. Remember?

0:05:53 > 0:05:56- What, when did we get a motto? - There's always been a motto. - Thank you.

0:05:56 > 0:05:58Now, today, I've set aside some time

0:05:58 > 0:06:00for you to discuss your diagnostic specifics.

0:06:00 > 0:06:03OK, interesting cases, please. Extra credit for complexity.

0:06:03 > 0:06:05Show me the diagnostic magic, yes?

0:06:05 > 0:06:08The magic, people, remember? Show me the magic.

0:06:10 > 0:06:11Diagnostic complexities.

0:06:11 > 0:06:13Right, I think if we're all going to have a motto

0:06:13 > 0:06:16we should probably have agreed on it together first, you know?

0:06:17 > 0:06:19- Donation, please!- Don't touch me.

0:06:21 > 0:06:22Did you know about this motto?

0:06:24 > 0:06:27CLASSICAL MUSIC ON RADIO

0:06:29 > 0:06:31MUSIC STOPS

0:06:32 > 0:06:34Mum.

0:06:34 > 0:06:35Mum, come on.

0:06:35 > 0:06:37Time to wake up...

0:06:38 > 0:06:41- D'you know where you are? - I know who you are!

0:06:41 > 0:06:44It's Serena, your daughter.

0:06:44 > 0:06:47- HIGH-PITCHED: - "It's Serena! I'm Serena!"

0:06:47 > 0:06:49Mum, please.

0:06:52 > 0:06:55Where...? Where are we, dear?

0:06:57 > 0:06:59- Haemorrhoids...- Boring.

0:06:59 > 0:07:01- Varicose veins.- Tedious.

0:07:01 > 0:07:03- Inguinal hernia.- Done it.

0:07:03 > 0:07:06- Large bowel resection...- Not again!

0:07:06 > 0:07:08You're just keeping all the good things to yourself, Squirrel Face.

0:07:08 > 0:07:11No, no, no, no, no! All for one, one for all!

0:07:11 > 0:07:15- Right. Hernia, bowel, veins... - Give me veins...

0:07:15 > 0:07:16Done.

0:07:16 > 0:07:19No-one is going to win any prizes for diagnostic ingenuity with this lot.

0:07:19 > 0:07:22But it's credits, it's not prizes, is it? It's not a dog show!

0:07:22 > 0:07:25HE LAUGHS MOCKINGLY Right, well then, I shall take haemorrhoids

0:07:25 > 0:07:29cos my life sucks like a Hoover and I might as well make it worse.

0:07:30 > 0:07:32So I hear you're quite the celebrity?

0:07:32 > 0:07:34WAS my dear, was.

0:07:34 > 0:07:37My star has waned somewhat of late,

0:07:37 > 0:07:39but I had my moment in the spotlight.

0:07:39 > 0:07:42- That is so amazing! - Well, you know what they say -

0:07:42 > 0:07:44behind every great man there's a devoted wife.

0:07:44 > 0:07:47Behind her, a very surprised mother-in-law!

0:07:47 > 0:07:49- ELLIOT CHUCKLES - Les Dawson?

0:07:49 > 0:07:51All me own work. I'm here all week.

0:07:51 > 0:07:54Well, let's hope not. We need to find out what's going on in there.

0:07:54 > 0:07:58So... Usual cardiac, bloods, ECG and echo, please.

0:07:58 > 0:08:02Echo, echo, echo. Woman goes to see a gynaecologist...

0:08:02 > 0:08:03Whoa! Let's keep it clean.

0:08:03 > 0:08:06You can entertain Adele whilst we wait for your test results.

0:08:06 > 0:08:10Good to see you again, Doc. Let's get this sorted, shall we?

0:08:10 > 0:08:13Supposed to be playing golf at three. You can't get the staff!

0:08:17 > 0:08:20Honestly, I've had plenty of horrible shifts on a Saturday night in the ED.

0:08:20 > 0:08:22- Do you not want me to look you over?- I'm fine.

0:08:22 > 0:08:25It was Lou I was worried about. Thought he was going to kill her.

0:08:25 > 0:08:29- Did you see his eyes?- Ketamine and "meow meow". Put money on it.

0:08:29 > 0:08:30It's like he wasn't there.

0:08:30 > 0:08:33I bet he doesn't remember a thing. Do you know what?

0:08:33 > 0:08:35Probably a very ordinary kid.

0:08:35 > 0:08:36Right, well, we've got to do some photos.

0:08:36 > 0:08:39Lou's injuries and any injuries that you sustained.

0:08:39 > 0:08:41This is going to be a paperwork nightmare.

0:08:44 > 0:08:47Someone care to tell me what on earth's been going on?

0:08:47 > 0:08:50Been a definite deterioration since his last visit.

0:08:50 > 0:08:53I think you should make him a priority on the transplant list.

0:08:53 > 0:08:56Yeah, but even if I can find him a suitable heart, his physiology...

0:08:56 > 0:09:00We had some difficulty the last time we did a transplant on a patient

0:09:00 > 0:09:02with mirrored image organ layout...

0:09:02 > 0:09:06The harvested pulmonary artery proved insufficient mid-op.

0:09:06 > 0:09:09Well, if the test results confirm my fears, it'll be his only option.

0:09:09 > 0:09:11Look, Mo, you've been here before.

0:09:11 > 0:09:13I need to know exactly what I'm up against.

0:09:13 > 0:09:14Congenital heart disease

0:09:14 > 0:09:18and dextrocardia in a situs inversus patient?

0:09:18 > 0:09:21- Yes, I was hoping... - To keep this little gem to yourself?

0:09:21 > 0:09:24Well, at least Mo should get involved,

0:09:24 > 0:09:26she's treated a patient with this condition before.

0:09:26 > 0:09:29Which she messed up, did she tell you that?

0:09:29 > 0:09:31The pulmonary artery and the aortic arch were insufficient.

0:09:31 > 0:09:33She didn't accommodate for the abnormal physiology.

0:09:33 > 0:09:35It was simple maths and she got it badly wrong.

0:09:35 > 0:09:37Then she needs to learn from her mistakes.

0:09:37 > 0:09:42- Why take the chance? - Look, don't you see?

0:09:42 > 0:09:44Mo is our transplant specialist.

0:09:44 > 0:09:47You'll undermine her confidence if you don't take her on board.

0:09:47 > 0:09:50Fine. Don't you think you're jumping the gun a bit?

0:09:50 > 0:09:52You haven't found a donor heart for him yet.

0:10:02 > 0:10:05HE PANTS

0:10:10 > 0:10:11Dominic!

0:10:11 > 0:10:13Oh, for pity's sake, go away!

0:10:13 > 0:10:15If you want to raise money for some cardio thing

0:10:15 > 0:10:17then go and pester your own patients.

0:10:17 > 0:10:18Dom, it's me, Kyle.

0:10:18 > 0:10:20Listen, Tiger, I don't know

0:10:20 > 0:10:23if you're doing some sort of... stunt for Comic Relief,

0:10:23 > 0:10:25but if you are, go badger Darwin. OK?

0:10:25 > 0:10:28- It's Kyle.- Sorry?

0:10:29 > 0:10:32- Kyle, remember?- No.

0:10:32 > 0:10:35- You probably don't recognise me. - I think I'd remember a tiger.

0:10:35 > 0:10:39- Hang on, remember this...? - HE IMITATES DANCE BEATS

0:10:44 > 0:10:47"Hey, you... You look a little hot...

0:10:47 > 0:10:50- "If you like, I could blow on your..."- Oh, my God.

0:10:50 > 0:10:52That's right. That night.

0:10:53 > 0:10:55- Kyle.- Kyle.

0:10:56 > 0:10:59Hey, you never said you were a doctor. Wow!

0:10:59 > 0:11:02And you didn't say you were a tiger impersonator.

0:11:02 > 0:11:05Actually, I'm a nurse. Agency.

0:11:05 > 0:11:08Oh, goodie(!) And people wonder why I don't give my number out.

0:11:09 > 0:11:14- What's the matter?- I don't know. Probably the dancing.

0:11:14 > 0:11:16Or maybe I ran up the stairs too fast.

0:11:16 > 0:11:19Maybe you should go and slowly walk back down them.

0:11:19 > 0:11:24Sorry, is this a work/play thing? Are you not, like, "out" at work?

0:11:24 > 0:11:26Are you kidding? The coma patients know I'm gay.

0:11:26 > 0:11:29So...what's...your problem?

0:11:30 > 0:11:34You're wearing a tiger onesie, shaking a bucket of shrapnel.

0:11:34 > 0:11:39And you're an agency nurse, and a seemingly desperate one at that.

0:11:39 > 0:11:41COINS RATTLE

0:11:41 > 0:11:43Crash trolley, we need help now!

0:11:43 > 0:11:47Are you kidding me? One rejection and you faint?!

0:11:47 > 0:11:48What a drama queen!

0:11:49 > 0:11:51Professor, I've found a donor organ.

0:11:51 > 0:11:54Oh, someone else's misfortune is our gain?

0:11:54 > 0:11:57Yeah, just the way of the world, isn't it?

0:11:58 > 0:12:00Bernie's ECG and echo.

0:12:00 > 0:12:04The heart is further enlarged as you thought, hence the tachycardia.

0:12:04 > 0:12:07- Right, and transplant is his best option?- Yeah.

0:12:07 > 0:12:09I've been doing some research on all the different approaches

0:12:09 > 0:12:11to transplant situs inversus...

0:12:11 > 0:12:14- Mm-hm.- The biggest task seems to be the atrio-pericardial tunnel.

0:12:14 > 0:12:17I'd have to create one, it's something I've never done before.

0:12:17 > 0:12:20- I have every faith in you. - Aw, thanks!

0:12:20 > 0:12:22The donor heart is in Manchester.

0:12:22 > 0:12:25We're in a fight to claim it, so I'm going to need your backing.

0:12:25 > 0:12:28I don't think I'm the lead on this case any more.

0:12:29 > 0:12:31She can't keep doing this to you.

0:12:31 > 0:12:34Anyway, why are you standing here talking to the monkey

0:12:34 > 0:12:37when the organ grinder's waiting?

0:12:37 > 0:12:38(Go get that heart!)

0:12:39 > 0:12:42Right, Manchester General's transplant co-ordinator's been on.

0:12:42 > 0:12:45The donor heart's gone to someone else.

0:12:45 > 0:12:47What, and you didn't even scrap for it?

0:12:47 > 0:12:49This might be the only chance he gets.

0:12:49 > 0:12:51There was a more urgent case in Liverpool.

0:12:51 > 0:12:53- PHONE CLATTERS - I was forced to concur.

0:12:53 > 0:12:55It might be time to come up with a plan B.

0:12:59 > 0:13:02There must be some other option for the heart.

0:13:02 > 0:13:05Maybe we could give him Jac's - she's obviously not using it.

0:13:07 > 0:13:08Voila.

0:13:09 > 0:13:12So, Kyle... Any asthma or hay fever?

0:13:12 > 0:13:15- A bit as a kid.- Allergies?

0:13:15 > 0:13:18I get wheezy in the summertime when the rapeseed's in flower, or...

0:13:18 > 0:13:20when they cut for silage.

0:13:20 > 0:13:21A country boy.

0:13:21 > 0:13:24That was a deduction, Arthur. Razor sharp(!)

0:13:24 > 0:13:26- Do you hear any crackling?- You?

0:13:26 > 0:13:29- Did you?- I asked you first.

0:13:29 > 0:13:31A little, I think, but nothing obvious.

0:13:31 > 0:13:33Have you treated any patient with a lung infection

0:13:33 > 0:13:35at St James's recently?

0:13:35 > 0:13:36Nope.

0:13:36 > 0:13:38OK. So?

0:13:38 > 0:13:40- Full blood count.- Chest X-ray.

0:13:40 > 0:13:43- Lung function test. - Just looking for an infection.

0:13:44 > 0:13:46Huh...

0:13:53 > 0:13:56So, do you know our...Dominic?

0:13:57 > 0:13:59I'm not sure I do.

0:14:01 > 0:14:04Mr Di Lucca's absolutely right, strict proper protocol.

0:14:04 > 0:14:07Photographs of injuries and all property breakages.

0:14:07 > 0:14:08Full statements by the end of the day?

0:14:08 > 0:14:11Em, yes, and you'll need to read and sign each other's.

0:14:11 > 0:14:13- Are we looking for a prosecution? - Without question.

0:14:13 > 0:14:17- I agree that we need to protect our staff from behaviour like that, but...- But what?

0:14:17 > 0:14:19- FLETCH SIGHS - I can't help but feel for kids like him.

0:14:19 > 0:14:21They get a head full of poison and then have a meltdown.

0:14:21 > 0:14:24- We can't have staff being assaulted. - I agree.

0:14:24 > 0:14:27Zero tolerance. Protocol, protocol, protocol.

0:14:27 > 0:14:30I want all the evidence correctly collated,

0:14:30 > 0:14:32I's dotted, T's crossed.

0:14:32 > 0:14:34- Will do. - I do not want to give Mr Self

0:14:34 > 0:14:37or Ric Griffin an opportunity to point the finger at AAU

0:14:37 > 0:14:39and say we don't run a tight ship without them.

0:14:39 > 0:14:42We've already got one doctor on suspension as it is.

0:14:42 > 0:14:45Has anyone done the sats on my mother yet?

0:14:45 > 0:14:48You know, by rights - professionally speaking -

0:14:48 > 0:14:51she should either be in the ED, or up on Keller.

0:14:51 > 0:14:53Well, I'm afraid that's not going to happen.

0:14:58 > 0:15:01If transplant isn't an option, then the assist device can work

0:15:01 > 0:15:03as a form of bridge therapy.

0:15:03 > 0:15:06And in a few months' time, he'd be back to square one, if he lives that long.

0:15:06 > 0:15:09I'm not losing a patient because we're dragging our heels.

0:15:09 > 0:15:12Don't mind me, I just need a couple of my text books.

0:15:12 > 0:15:16It would keep him alive until another organ becomes available.

0:15:16 > 0:15:19Tosh, the chances of Bernie being offered a new heart are slim.

0:15:19 > 0:15:20So you're just writing him off?

0:15:20 > 0:15:23You want to save his life, then let's break out the big guns.

0:15:23 > 0:15:27We'll be piggybacking a Herzig Five to his existing heart instead.

0:15:29 > 0:15:30That's never been done before.

0:15:30 > 0:15:32We are a centre of cardio excellence.

0:15:32 > 0:15:35It's exactly the type of ground-breaking work that we should be doing.

0:15:35 > 0:15:39- It sounds too experimental. - That sounds like you're questioning my judgment.

0:15:39 > 0:15:42And she's right to. Herzig Five was never designed for his kind of anatomy.

0:15:42 > 0:15:45You'd better help me then.

0:15:47 > 0:15:49A hypothetical for you, Mr Di Lucca...

0:15:49 > 0:15:52Your mother is suffering from vascular dementia, so...

0:15:52 > 0:15:55confusion, time slips, short-term memory loss.

0:15:55 > 0:15:58She misses the odd word out, sometimes uses the wrong word

0:15:58 > 0:16:00and has a habit of calling you Marjorie.

0:16:00 > 0:16:03Now, these symptoms have worsened dramatically

0:16:03 > 0:16:05over a short period of time.

0:16:05 > 0:16:07So, what do you think might be going on?

0:16:07 > 0:16:09I'd think TIAs.

0:16:09 > 0:16:11Transient ischaemic attack, a mini stroke.

0:16:11 > 0:16:14- You think she's had...? - I do. That's exactly what I think.

0:16:14 > 0:16:18But what I want to know is what would you do now

0:16:18 > 0:16:20if she were your mother?

0:16:20 > 0:16:24I would order an FBC, U&Es, clotting, lipid profile,

0:16:24 > 0:16:26a head CT and a duplex ultrasound.

0:16:26 > 0:16:29You are a very good and thorough doctor, Mr Di Lucca.

0:16:29 > 0:16:30Thank you.

0:16:30 > 0:16:34But would you send your mother up to another ward for these tests

0:16:34 > 0:16:36and just wave goodbye at the lift?

0:16:36 > 0:16:38- I might.- I don't think so.

0:16:38 > 0:16:41- If I was sure she'd be well looked after...- Really?

0:16:41 > 0:16:44I'd appreciate by my code of ethics that I wouldn't be permitted

0:16:44 > 0:16:45to treat her myself.

0:16:47 > 0:16:48Would you?

0:16:50 > 0:16:55Or alternatively, I would entrust the treatment to a colleague

0:16:55 > 0:16:56whose opinion I respected.

0:16:58 > 0:17:01I do believe we're beginning to speak the same language.

0:17:04 > 0:17:06I guess if they're talking heart transplants,

0:17:06 > 0:17:09I better start taking things seriously.

0:17:09 > 0:17:11Is there anyone you'd like me to contact for you?

0:17:12 > 0:17:14- (No.)- No?

0:17:14 > 0:17:17- No-one, not even Bobby Goode? - Especially not Bobby.

0:17:18 > 0:17:21- So, is this not even up for discussion?- It never was...

0:17:21 > 0:17:24I designed the Herzig for the situs solitus anatomy.

0:17:24 > 0:17:28- I'll find a way...- Situs inversus is listed specifically

0:17:28 > 0:17:30as one of the contradictions to fitting...

0:17:30 > 0:17:32I believe that you wrote that particular manual

0:17:32 > 0:17:34and I believe that I can rewrite it.

0:17:34 > 0:17:36You're showboating, Jac, and you know it!

0:17:36 > 0:17:38- I'll need you to assist. - That won't be happening.

0:17:38 > 0:17:39You don't care about your patient?

0:17:39 > 0:17:43I do believe you've made it quite clear that he's your patient now.

0:17:48 > 0:17:49I was always chasing skirt.

0:17:49 > 0:17:52I'm paying alimony to three ex-wives just to prove it.

0:17:52 > 0:17:55Serves you right, you dirty dog!

0:17:55 > 0:17:57It was the ego, the fame!

0:17:57 > 0:17:59Women were throwing themselves at me day and night

0:17:59 > 0:18:02and it messes with your mind, you think you can have anyone.

0:18:02 > 0:18:04I just didn't care.

0:18:04 > 0:18:07Not even when I went after Bobby's wife, Stella.

0:18:07 > 0:18:11Relentless, I was, and then one day she just cracked.

0:18:11 > 0:18:14Then, of course, Bobby found out and the rest's history.

0:18:14 > 0:18:18He walked away from everything - me, her, the show.

0:18:18 > 0:18:20- How could you do that to your friend? - BERNIE SIGHS

0:18:20 > 0:18:24What can I say, I paid the price, didn't I?

0:18:24 > 0:18:27I realised... I was just the straight man.

0:18:27 > 0:18:29It was Bobby who had all the talent.

0:18:29 > 0:18:33Mr Reddy, I'm Ms Naylor, I'm going to be your surgeon.

0:18:35 > 0:18:37Stroke is about the heart, isn't it?

0:18:37 > 0:18:40I know that, everybody knows that!

0:18:40 > 0:18:42Yeah, well, your heart's a pump.

0:18:42 > 0:18:44Why does she want pictures of my head?

0:18:44 > 0:18:48- Well, the blood flows up... - Oh, she just wants to embarrass me.

0:18:48 > 0:18:52- How does she want to embarrass you? - Pictures of my brain...

0:18:52 > 0:18:54You all right there, love? You seem to be in a bit of pain.

0:18:54 > 0:18:57- D'you want me to take a look at that?- "Love"?

0:18:57 > 0:19:00Are you a doctor? What's your name?

0:19:00 > 0:19:04Fletch. Well, Adrian Fletcher, but everyone just calls me Fletch.

0:19:04 > 0:19:06It's more like a boxer, not a doctor.

0:19:06 > 0:19:14- Well, I'm not a doctor. I'm a nurse. - A nurse?! Why are you a nurse?

0:19:14 > 0:19:18- Well, we need nurses, don't we? - I had a nurse, my own.

0:19:18 > 0:19:21- He was a very good nurse.- OK.

0:19:21 > 0:19:23He came to my house.

0:19:23 > 0:19:27We played backgammon and he'd read to me from the Telegraph.

0:19:27 > 0:19:33- Backgammon, eh?- He was a man too! And a very good listener.

0:19:33 > 0:19:35Well, sounds to me like you two got on very well.

0:19:35 > 0:19:39- Until SHE said he couldn't come any more.- Who did?

0:19:39 > 0:19:44- My nurse! Aren't you even listening? - No, sorry, I just meant...

0:19:44 > 0:19:46Who said that he couldn't come and see you any more?

0:19:46 > 0:19:48Well, who do you think?

0:19:48 > 0:19:51BUZZER

0:19:53 > 0:19:54- Thanks.- Oh...

0:19:54 > 0:19:57Exposing an organ is always so exciting during surgery!

0:19:57 > 0:19:59I know, I know. I mean, seeing a heart takes some beating,

0:19:59 > 0:20:01but looks so complicated!

0:20:01 > 0:20:03No, but the brain, the brain is the complete opposite.

0:20:03 > 0:20:05To expose a section of the brain...

0:20:05 > 0:20:08It's just boring grey matter, but actually, what it controls...

0:20:08 > 0:20:10- Please!- What is wrong with you?

0:20:10 > 0:20:12Since when have you been a neurology groupie?

0:20:12 > 0:20:14Whatever happened to, "Oh, Daddy does it, so I don't like it"?

0:20:14 > 0:20:16Maybe I grew up.

0:20:16 > 0:20:19- Got our St James's nurse's test results.- Aha! OK...

0:20:19 > 0:20:20Go on, amaze us.

0:20:20 > 0:20:23Bloods show... Oh, mild neutrophilia.

0:20:23 > 0:20:26- High-ish white cell count...- X-ray?

0:20:26 > 0:20:28Em... Couple of fine nodular shadows...

0:20:28 > 0:20:30- Nothing very interesting then. - Diagnosis?

0:20:30 > 0:20:34- Mild lung infection. - "Right side - partial swelling..."

0:20:34 > 0:20:36- Reaction to a chest cold, maybe. - Treatment?

0:20:36 > 0:20:39Some antibiotics and we probably could discharge...

0:20:39 > 0:20:41maybe with some meds and a letter to follow up with the GP.

0:20:41 > 0:20:44- Nothing going on but the rent, then? - Chase those meds and discharge please.

0:20:44 > 0:20:45- Who?- You.

0:20:45 > 0:20:47- You!- You!

0:20:47 > 0:20:49- You... I always... - I don't want to do it!

0:20:49 > 0:20:51For goodness' sake, I'll do it. Sooner we get rid, the better.

0:20:56 > 0:21:01- Sorry, do you know this guy or not? I can't quite work it out.- Not.

0:21:01 > 0:21:03Well, at least not to talk to.

0:21:07 > 0:21:09Jac wouldn't listen to me, even when Elliot chipped in.

0:21:09 > 0:21:11Er, probably BECAUSE Elliot chipped in!

0:21:11 > 0:21:13That woman. She's a law unto herself.

0:21:13 > 0:21:16Yeah, but she always has been, that's just Jac.

0:21:16 > 0:21:18But if the Dream Team aren't together then...

0:21:18 > 0:21:21Do you expect Elliot to toe the line after he's been hung out to dry

0:21:21 > 0:21:23by the Wicked Witch of the West Country?

0:21:23 > 0:21:25Doesn't all this cold war worry you?

0:21:29 > 0:21:33Hey, I got to the bottom of why Goode and Reddy split if you're interested?

0:21:33 > 0:21:36- Yeah, dish! - Goode could never forgive Reddy for sleeping with his wife.

0:21:36 > 0:21:38- You knew?- Bernie's a bit of an early discloser.

0:21:38 > 0:21:42He told me on his first admission... That and then some.

0:21:42 > 0:21:45- There's more?- For Bernie to know and you to find out.

0:21:45 > 0:21:49Oh, come on, Prof, dish the dirt! Don't leave us in suspense like this!

0:21:49 > 0:21:52I'm not one for tittle-tattle, Adele, so don't even ask.

0:21:54 > 0:21:56Do you really think this...

0:21:56 > 0:21:59cold war, as you call it, is affecting morale?

0:21:59 > 0:22:01- Nah...- Yeah...

0:22:01 > 0:22:05- How couldn't it...? - I think what my gobby little sister is trying to say is...

0:22:05 > 0:22:08Look, Jonny's even taken some time off to get out of the firing line.

0:22:08 > 0:22:11And to be honest, I don't blame him. I would too.

0:22:11 > 0:22:14Look, we used to do the job and have fun doing it.

0:22:14 > 0:22:17What happened to our little dysfunctional family?

0:22:19 > 0:22:21Then something needs to be done.

0:22:23 > 0:22:25Oh, don't look at me like that.

0:22:25 > 0:22:28- Don't tell me it didn't need saying! - Prof...

0:22:28 > 0:22:30So are you going to do Bernie's op?

0:22:30 > 0:22:32Don't tell me you turned it down for my sake.

0:22:32 > 0:22:34I had my reasons.

0:22:34 > 0:22:39Right, well, Bernie's a bit confused about the Herzig. It might be a good idea if you had a word with him.

0:22:39 > 0:22:41- Didn't Ms Naylor explain the procedure?- Yeah,

0:22:41 > 0:22:44in her own unique way, a bit bish, bash, bosh, if you know what I mean.

0:22:44 > 0:22:48I've tried to smooth things over, but he wants to speak to you.

0:22:48 > 0:22:49Right.

0:22:50 > 0:22:52'And in...'

0:22:53 > 0:22:54And out...

0:22:56 > 0:22:59Antibiotics and you're good to go.

0:22:59 > 0:23:01Anything look familiar?

0:23:01 > 0:23:05Like I said, it seems you have a mild chest infection.

0:23:06 > 0:23:08Is it really because I'm a nurse?

0:23:08 > 0:23:10I don't do repeats.

0:23:10 > 0:23:12What, never?

0:23:12 > 0:23:14Strictly a one-time guy.

0:23:14 > 0:23:15Sounds sad.

0:23:15 > 0:23:17- Hey-ho.- Sounds lonely.

0:23:19 > 0:23:21I did have one very serious relationship, thank you very much.

0:23:21 > 0:23:24Ah-hah! Not so ice-man.

0:23:24 > 0:23:25One significant one.

0:23:25 > 0:23:28So...so, I don't get why you're all...

0:23:28 > 0:23:30He was a consultant.

0:23:30 > 0:23:31So it IS the nurse thing.

0:23:31 > 0:23:34Look, the sooner you get your meds and go, the better.

0:23:34 > 0:23:36HE COUGHS

0:23:36 > 0:23:38You're such a snob. HE COUGHS

0:23:38 > 0:23:40A...partner snob.

0:23:40 > 0:23:43Well, some of us need to have standards.

0:23:43 > 0:23:44Because I'm a nurse?

0:23:44 > 0:23:47Because you're wearing a tiger onesie and you grew up on a farm.

0:23:47 > 0:23:50See? You did listen to SOMETHING that night.

0:23:50 > 0:23:53I only remember some weird Silence Of The Lambs thing you had going on.

0:23:53 > 0:23:55You are so mean.

0:24:00 > 0:24:02Sit down.

0:24:03 > 0:24:05You're like a limpet.

0:24:05 > 0:24:06Nurse!

0:24:06 > 0:24:08Stay here while I get Mr Levy.

0:24:10 > 0:24:12It's your carotid artery that I want to have a look at.

0:24:12 > 0:24:14If you feel at each side of your neck,

0:24:14 > 0:24:16you can feel it just there.

0:24:16 > 0:24:18Are you a doctor?

0:24:18 > 0:24:20I am a doctor.

0:24:20 > 0:24:21He's a nurse.

0:24:21 > 0:24:24I am. Can you remember my name?

0:24:24 > 0:24:27Are you a consultant? My daughter's a consultant.

0:24:27 > 0:24:30No. I'm a registrar. A senior registrar.

0:24:30 > 0:24:33If she worked here, she would be your superior.

0:24:33 > 0:24:35She does work here.

0:24:35 > 0:24:36Does she?

0:24:36 > 0:24:40It was her that brought you in. Can you remember?

0:24:40 > 0:24:41I know that!

0:24:41 > 0:24:43Let's have a look at your artery.

0:24:43 > 0:24:46Make sure your blood's flowing as it should.

0:24:46 > 0:24:48Does it have music?

0:24:48 > 0:24:52No, I'm afraid not. What kind of music do you like?

0:24:52 > 0:24:54I...don't know.

0:24:56 > 0:24:58- Oh, that hurts! - I'm barely touching your skin.

0:24:58 > 0:25:01You're strangling me! It hurts everywhere.

0:25:01 > 0:25:03OK, let's just relax. Let's...let's calm down.

0:25:03 > 0:25:05We'll take a break.

0:25:05 > 0:25:06Just relax.

0:25:10 > 0:25:11They look sore.

0:25:16 > 0:25:19The bruises on your arms, Adrienne...how did you get them?

0:25:20 > 0:25:21How do you think?

0:25:25 > 0:25:27So, a robotic heart in me chest?

0:25:27 > 0:25:31I'm going to be like Robocomic. Zzztt! Zzztt!

0:25:31 > 0:25:33Just think of it as a glorified pacemaker.

0:25:33 > 0:25:34You designed this?

0:25:34 > 0:25:36My claim to fame, apparently.

0:25:36 > 0:25:38So why aren't you doing me op?

0:25:39 > 0:25:42Bernie, I assure you, you're in perfectly good hands.

0:25:42 > 0:25:46- Ms Naylor is head of the department... - Oh, don't give me that claptrap.

0:25:46 > 0:25:49Till recently, she was your understudy.

0:25:51 > 0:25:55Did you...get in touch with your son?

0:25:55 > 0:25:59Now might be a good time. This procedure isn't without risk.

0:25:59 > 0:26:01Stella died three months ago.

0:26:01 > 0:26:04It's too little too late for that kind of thing, don't you think?

0:26:04 > 0:26:09Well, if my mother had just died, I think I would...

0:26:09 > 0:26:12Stella never told the boy that I was his dad.

0:26:12 > 0:26:14Took the secret to her grave.

0:26:14 > 0:26:15Ashamed of what we'd done.

0:26:15 > 0:26:20Why bother tracking him down after all these years if you didn't want to make amends?

0:26:20 > 0:26:22Ach...I don't know.

0:26:22 > 0:26:24He's married now with kids of his own,

0:26:24 > 0:26:26he's got his own life to live.

0:26:26 > 0:26:29It's hardly fair on him, or the grandkids, or you.

0:26:32 > 0:26:35Theatre's ready for you to go down now, Bernie.

0:26:35 > 0:26:39'Ey, I'm good and ready, sweet cheeks. Let's get this thing done.

0:26:39 > 0:26:42I might even make that tee-off time!

0:26:42 > 0:26:43Thank you.

0:26:46 > 0:26:49- So, we have a bit of a situation. - You think(?)

0:26:49 > 0:26:52The mother of the head of this department,

0:26:52 > 0:26:53the deputy CEO of this hospital...

0:26:53 > 0:26:57- Our boss.- ..is in effect accusing her daughter of abusing her.

0:26:57 > 0:27:00- Are you sure that that's what she's saying? - We're not in any way SURE.

0:27:00 > 0:27:02Because she is sometimes very confused.

0:27:02 > 0:27:04Very. And often.

0:27:05 > 0:27:08Shouldn't she just be on another ward, I mean, away from Serena?

0:27:08 > 0:27:12- In many ways, that would be preferable. - So how do we manage that?

0:27:12 > 0:27:13Go over her head?

0:27:13 > 0:27:15To who?

0:27:15 > 0:27:18- To Guy Self?- Oh... - No, that just wouldn't be...

0:27:18 > 0:27:22Listen. My last job didn't exactly end well with those upstairs.

0:27:22 > 0:27:24Yeah, but if, and I stress the "if",

0:27:24 > 0:27:26an innocent old lady is suffering because...

0:27:26 > 0:27:28All I'm saying is that we just need to

0:27:28 > 0:27:31be 100% certain before we start throwing hand grenades.

0:27:31 > 0:27:36"Nine bean rows shall I have there, a hive for the honey bee..."

0:27:36 > 0:27:38What's that?

0:27:38 > 0:27:39WB Yeats.

0:27:39 > 0:27:41Do you know it all the way through?

0:27:41 > 0:27:44Yes, of course. It's only three verses long.

0:27:44 > 0:27:47Can we look at your arms again, please?

0:27:47 > 0:27:49- You may.- Thank you.

0:27:49 > 0:27:52"I will arise and go now..."

0:27:52 > 0:27:54It could be defensive.

0:27:54 > 0:27:55Can you lean forward for me?

0:27:55 > 0:28:01"And a small cabin build there, of clay and wattles made,"

0:28:01 > 0:28:06"Nine beans rows shall I have there, and a hive for the honey bee..."

0:28:06 > 0:28:08You have a lovely voice.

0:28:08 > 0:28:10Oh, we were taught to project.

0:28:10 > 0:28:13"Aim for the back of the hall, girls."

0:28:13 > 0:28:16"..and live alone in the bee loud glade."

0:28:16 > 0:28:19You have some nasty bruising on your back, Adrienne.

0:28:19 > 0:28:22- Can you tell me how you got it? - How can I recite if you keep interrupting?

0:28:27 > 0:28:28Duplex scan?

0:28:29 > 0:28:33Oh, er...we have to do it again. The results were inconclusive.

0:28:33 > 0:28:35She became agitated.

0:28:35 > 0:28:36Well, do it again now.

0:28:36 > 0:28:38If she's trouble, call me and I'll help.

0:28:45 > 0:28:48- No, you were right to keep him in. - I put him on IV antibiotics.

0:28:48 > 0:28:51Yep, hourly obs too. So, what, are you...

0:28:51 > 0:28:53taking over this patient now?

0:28:53 > 0:28:54I suppose.

0:28:54 > 0:28:57- I can always ask Arthur or Zosia... - No.

0:28:58 > 0:29:01OK, honestly, I'd really like to do a full immunoglobulin analysis

0:29:01 > 0:29:02and chest CT scan.

0:29:02 > 0:29:06Really? Why, if it's just a lung infection?

0:29:06 > 0:29:08Because I don't know if it is just that. It's a hunch,

0:29:08 > 0:29:09it's a diagnostic hunch.

0:29:09 > 0:29:13- Ah, you've got your eye on some e-portfolio credits, haven't you? - Something like that.

0:29:13 > 0:29:19You don't want to just keep tabs on him because you think that Kyle might be...an OK guy?

0:29:19 > 0:29:21He's a nurse.

0:29:21 > 0:29:23I was married to a...nurse.

0:29:23 > 0:29:25And how did that work out for you?

0:29:41 > 0:29:43'And what's the distal degree of stenosis?'

0:29:43 > 0:29:46According to this, 80%.

0:29:46 > 0:29:48- Very high.- Yes. - Blood flow's restricted.

0:29:48 > 0:29:52Quite dramatically. I'd recommend a carotid endarterectomy.

0:29:52 > 0:29:53Too invasive.

0:29:53 > 0:29:55It is a more invasive procedure, I grant you,

0:29:55 > 0:29:58but with more potential for a longer life, and more quality of life.

0:29:58 > 0:30:01And peace of mind, freed from the worry of further strokes.

0:30:01 > 0:30:04If it was your mother, that's really what you'd recommend,

0:30:04 > 0:30:06- rather than the much simpler option of fitting a stent?- I would.

0:30:06 > 0:30:09I don't believe you. She's an 80-year-old woman.

0:30:09 > 0:30:12A stent would be fitted with much less risk of post-op infection

0:30:12 > 0:30:14and it could be done today.

0:30:14 > 0:30:17In my opinion, I think your judgment is understandably clouded.

0:30:17 > 0:30:18Do you?

0:30:18 > 0:30:23Because she's your mother, you're erring on the side of surgical caution, rather than long-term gain.

0:30:23 > 0:30:26All I want is for her to have the most effective procedure.

0:30:26 > 0:30:29And I don't think you're the best person to make that decision.

0:30:31 > 0:30:34You might be the best surgeon to perform a complicated

0:30:34 > 0:30:36vascular operation, but you might not be the best person

0:30:36 > 0:30:39to decide which operation your mother has.

0:30:42 > 0:30:44Cut.

0:30:45 > 0:30:48More 2-0 prolene, please, and keep the glue coming.

0:30:52 > 0:30:54- Fascinating, isn't it?- Yeah.

0:30:54 > 0:30:57Every organ working perfectly but in mirror image.

0:30:57 > 0:30:59Evolution worked it out for a reason,

0:30:59 > 0:31:02but sometimes it still throws out a freak of nature.

0:31:02 > 0:31:05It's not his fault he was born this way. MACHINE PINGS

0:31:05 > 0:31:09Damn it. The cuff's rotating. Pulmonary artery's torn.

0:31:09 > 0:31:10PINGS CONTINUE

0:31:13 > 0:31:16As I said to your colleague and the one before that and the one before that,

0:31:16 > 0:31:18Adrian Fletcher, AAU Ward, Holby City.

0:31:19 > 0:31:20Great. Right, OK.

0:31:20 > 0:31:24Um, yeah. Your agency looked after an Adrienne McKinnie...

0:31:24 > 0:31:26and we've got some concerns about her care.

0:31:26 > 0:31:28We'd really like to see her notes.

0:31:28 > 0:31:31That's lovely. Thank you, but I've really got to go. Bye.

0:31:31 > 0:31:34- Step back, madam, please.- How rude! - I need you to step back, please.

0:31:34 > 0:31:37- How very, very rude! - I thought I told you to stay put.

0:31:37 > 0:31:39Look, I am personal friends with your chief inspector...

0:31:39 > 0:31:42and I will see to it that you are properly reprimanded.

0:31:42 > 0:31:45- Let's get you back into bed. - Oh, the impertinence!

0:31:46 > 0:31:49I simply wanted to report a crime.

0:31:49 > 0:31:52And he kept telling me to step back.

0:31:52 > 0:31:53What crime?

0:31:53 > 0:31:55A crime against me.

0:31:55 > 0:31:57OK, what sort of crime is that?

0:31:57 > 0:32:00A horrible one. One I need to talk to the police about.

0:32:00 > 0:32:04OK, well... do you want to talk to me about it?

0:32:04 > 0:32:06It's confidential.

0:32:06 > 0:32:08OK, er...

0:32:08 > 0:32:11does that mean that you DO want to talk to me about it?

0:32:11 > 0:32:13Have you got a cigarette?

0:32:13 > 0:32:15No.

0:32:15 > 0:32:16A cigarillo?

0:32:16 > 0:32:17No.

0:32:17 > 0:32:18A cigar.

0:32:18 > 0:32:20No. Look, I don't smoke.

0:32:20 > 0:32:22Oh, pity.

0:32:22 > 0:32:26I do so love the smell of good tobacco on a man's jacket.

0:32:28 > 0:32:31OK...right. Shall we go and have a little chin-wag in there?

0:32:31 > 0:32:35- Have a cup of tea?- A cup of tea? That would be lovely!- OK.- Thank you.

0:32:35 > 0:32:37You're a very nice young man.

0:32:37 > 0:32:38I'm glad you think so.

0:32:38 > 0:32:40Moment of truth.

0:32:40 > 0:32:42Let's take him off bypass.

0:32:44 > 0:32:46MACHINE PINGS

0:32:46 > 0:32:47Blood flow's poor.

0:32:47 > 0:32:50PINGS CONTINUE

0:32:54 > 0:32:56OK, let's get him back on bypass.

0:32:59 > 0:33:01A lot of kinks in the cuffs?

0:33:01 > 0:33:04This was always going to be tricky given his anatomy.

0:33:04 > 0:33:06No more difficult than if we were using a normal heart.

0:33:06 > 0:33:09We'll just have to start again, won't we? Scissors.

0:33:09 > 0:33:13- You've only just come back! - That's irrelevant. I want to resign.

0:33:13 > 0:33:16I'm afraid I can't allow that. This hospital needs you.

0:33:16 > 0:33:17No, it doesn't.

0:33:18 > 0:33:22I feel like I may have inadvertently become a liability.

0:33:22 > 0:33:24And I am not rebellious by nature,

0:33:24 > 0:33:27but I'm finding Ms Naylor's tenure unbearable.

0:33:29 > 0:33:31Pulmonary artery keeps tearing.

0:33:36 > 0:33:39You do understand why I've had to do this?

0:33:39 > 0:33:42Undergone brain surgery, a hair's breadth from retirement.

0:33:42 > 0:33:44That's a factor, but not a deciding one.

0:33:44 > 0:33:48No, the Americans who are trialling the Herzig like them young and hard,

0:33:48 > 0:33:50not soft and furry.

0:33:53 > 0:33:55SHE EXHALES

0:34:00 > 0:34:01SHE EXHALES

0:34:04 > 0:34:05I need Elliot here now.

0:34:06 > 0:34:08Page Professor Hope, please.

0:34:11 > 0:34:14I need to know the future of the Herzig is secure.

0:34:14 > 0:34:15PAGER BEEPS

0:34:15 > 0:34:18I feel I'm compromising the department if I stay.

0:34:18 > 0:34:21The Herzig is your lasting legacy, Elliot.

0:34:21 > 0:34:24I need to know it's in safe hands.

0:34:24 > 0:34:28Once that's done, you can hit the golf course with my blessing.

0:34:33 > 0:34:35Robbing machine!

0:34:35 > 0:34:38Oh, it's nice that it plays fair with the overpaid doctors,

0:34:38 > 0:34:40- but then robs the underpaid nurses! - Life is not fair.

0:34:40 > 0:34:43Yeah, why does this feel so flippin' familiar? Cheers.

0:34:43 > 0:34:46Did you see how quiet she went?

0:34:46 > 0:34:47- As soon as Serena came over?- Yeah.

0:34:47 > 0:34:50It was like she was suddenly a different person.

0:34:50 > 0:34:52- I know. Like a puppy... - A scared puppy.

0:34:54 > 0:34:55So now what do we do?

0:34:56 > 0:35:00We need to document her injuries. Examine her thoroughly.

0:35:00 > 0:35:02- Talk to her. - Well, I've spoken to the agency

0:35:02 > 0:35:04and they're being surprisingly helpful.

0:35:04 > 0:35:05They're going to send over all of her notes

0:35:05 > 0:35:08- and put us in touch with a Tito Mullins.- Who?

0:35:08 > 0:35:09He was her old carer.

0:35:09 > 0:35:12- Apparently he got given his marching-orders.- Who by?

0:35:12 > 0:35:13Who do you think?

0:35:17 > 0:35:19There's a resistance to in-flow and out-flow.

0:35:19 > 0:35:22I've tried to connect the unit twice, but the positioning is...

0:35:22 > 0:35:24I did warn you.

0:35:24 > 0:35:25So what are you going to do?

0:35:26 > 0:35:29I think Ms Effanga was onto something

0:35:29 > 0:35:31with her assist device idea.

0:35:31 > 0:35:34Accommodating Bernie's unique anatomy rather than trying to

0:35:34 > 0:35:37force a square peg into a round hole.

0:35:37 > 0:35:41I suggest we think along the same lines for the Herzig device.

0:35:41 > 0:35:44- Give it enough room to attach the cuffs properly.- How?

0:35:45 > 0:35:46Miss Effanga?

0:35:46 > 0:35:49All we could really do is open up the diaphragm

0:35:49 > 0:35:51and reposition the Herzig, but...

0:35:53 > 0:35:56- Have faith in your convictions. - It's just theory.

0:35:56 > 0:35:58Well, time to turn it into practice.

0:35:58 > 0:36:00We're re-writing the manual, remember.

0:36:03 > 0:36:06OK. I'll seal the diaphragm, you attach the cuffs.

0:36:13 > 0:36:16Right, looks like I'm going to need a hand.

0:36:17 > 0:36:18Scalpel, please.

0:36:20 > 0:36:21Last one?

0:36:21 > 0:36:24Right, OK, can you hold your arms like that for me?

0:36:24 > 0:36:26That's it. Close your eyes again.

0:36:26 > 0:36:29All right? Lovely. You can relax.

0:36:31 > 0:36:33This is what I'm talking about.

0:36:34 > 0:36:38- What? The crime?- Exactly.

0:36:38 > 0:36:40Do you want to explain it to me?

0:36:40 > 0:36:43Explain it? What is there to explain?

0:36:43 > 0:36:45Just look at my fingers.

0:36:50 > 0:36:51I don't see anything.

0:36:53 > 0:36:55Exactly, that's my whole point.

0:36:56 > 0:36:57What's the point? I'm sorry.

0:36:57 > 0:37:00You're going to, you're going to have to explain it to me again.

0:37:00 > 0:37:03Oh, you stupid man. They've gone, haven't they?

0:37:03 > 0:37:05What? Your fingers?

0:37:05 > 0:37:07My rings, idiot. My rings.

0:37:07 > 0:37:12- You haven't got any rings. - No. She stole them.

0:37:12 > 0:37:17Here I should have my solitaire diamond engagement ring...

0:37:17 > 0:37:19which was my husband's dear mother's.

0:37:19 > 0:37:25My eternity ring. My turquoise and gold Edwardian dress ring.

0:37:25 > 0:37:27OK, so who stole them?

0:37:27 > 0:37:32My daughter. She stole them. And I want to tell the police.

0:37:32 > 0:37:35She should go to prison.

0:37:35 > 0:37:38So the skinny is, you and Nurse Tiger-Onesie bumped

0:37:38 > 0:37:40and squealed in the past.

0:37:40 > 0:37:41Now, you're too cool for him,

0:37:41 > 0:37:45yet for some reason you don't want to send him home.

0:37:45 > 0:37:47- They're called "test results". - For what?

0:37:47 > 0:37:50- He has a mild or not-so-mild lung infection. That is all.- Or...

0:37:50 > 0:37:52Or you fancy him much more than you're prepared to admit,

0:37:52 > 0:37:53and you are trying to find...

0:37:53 > 0:37:56Did you order a full immunoglobulin analysis on Kyle?

0:37:56 > 0:37:59- Is that it?- And a chest CT? - Can I see it, please?- Why?

0:37:59 > 0:38:01Does the fact the NHS is crumbling under the weight of massive

0:38:01 > 0:38:03overspend mean nothing to you?

0:38:06 > 0:38:08HE CHUCKLES

0:38:08 > 0:38:10Farmer's lung.

0:38:10 > 0:38:11Farmer's lung?

0:38:11 > 0:38:15- His lung.- Farmer's lung! - Kyle?- Yep.

0:38:17 > 0:38:20Mm. Farmer's lung, eh? Nice.

0:38:20 > 0:38:23Now, has that been diagnosed on Keller before?

0:38:23 > 0:38:26No. To my knowledge, that's a first.

0:38:26 > 0:38:29Ooh! Well, then that's all for one and one for me, then!

0:38:29 > 0:38:31Isn't it? Show me the magic!

0:38:34 > 0:38:35That's not the motto.

0:38:39 > 0:38:41- This is a mess. - What about her procedure?

0:38:41 > 0:38:44Serena's not in a rational position to make a good call.

0:38:45 > 0:38:48Adrienne's saying that Serena stole her rings.

0:38:48 > 0:38:50Do you think she's mistaken?

0:38:50 > 0:38:52Well, you don't see many women her age

0:38:52 > 0:38:53without a ring on her finger, do you?

0:38:53 > 0:38:55There's plenty of marks to show where they were.

0:38:55 > 0:38:57And then there's the marks on her back.

0:38:59 > 0:39:01Do you know what?

0:39:02 > 0:39:05I think we're going to have to go upstairs and report this to Guy Self.

0:39:05 > 0:39:08- Or...- Or what?

0:39:08 > 0:39:10Or we give Serena a chance to respond.

0:39:10 > 0:39:12That's easy for you to say with your fellowship

0:39:12 > 0:39:14and your senior registrar-ship.

0:39:14 > 0:39:17- I'm a staff nurse with a sketchy record.- I'll do it.

0:39:17 > 0:39:19You're going to ask her if she beat up her 80-year-old mum

0:39:19 > 0:39:22and then half-inched her jewellery?

0:39:28 > 0:39:33He complained a lot about allergies as a boy. Hay fever and such.

0:39:33 > 0:39:35I read Arthur's notes on his file.

0:39:35 > 0:39:36Yes, but that's historical...

0:39:36 > 0:39:39Yes, but he then spent all morning on the back of a rag week float

0:39:39 > 0:39:41covered in hay.

0:39:41 > 0:39:43He then starts complaining of wheeziness,

0:39:43 > 0:39:45shortness of breath and fever-like symptoms.

0:39:45 > 0:39:47OK. So you put two and two together.

0:39:47 > 0:39:50- His childhood "allergies" were misdiagnosed.- Yes?

0:39:50 > 0:39:54The straw bales on the back of the rag week float

0:39:54 > 0:39:57set off a reaction which had been lying dormant for years.

0:39:57 > 0:40:00And because you'd been living in an entirely urban environment...

0:40:00 > 0:40:02Soon as he came into contact with the spores from the hay...

0:40:02 > 0:40:04- Boom! Farmer's lung. - Excellent work.

0:40:04 > 0:40:07And he's now on a heavy batch of steroids and has been told under

0:40:07 > 0:40:10strict instructions to steer clear of anything that even resembles hay.

0:40:10 > 0:40:14Well, that's very impressive work, Dr Copeland. Well done.

0:40:14 > 0:40:16It's really, really lovely to have met you, Kyle.

0:40:16 > 0:40:18Thanks, Mr Levy.

0:40:19 > 0:40:20You're quite the doctor.

0:40:22 > 0:40:25- Thank you. - Very intuitive diagnosis.

0:40:25 > 0:40:28- I try.- Pity you are such a worm of a human being.

0:40:30 > 0:40:33- "Worm"?- Yeah. Worm.

0:40:36 > 0:40:38Whatever.

0:40:38 > 0:40:41We just want to clear up some confusion about her injuries.

0:40:41 > 0:40:44Did I ask you to do this? She is my mother.

0:40:44 > 0:40:45And she's our patient.

0:40:49 > 0:40:52It's her arms... her forearms and her back.

0:40:52 > 0:40:54Mum, what have you said?

0:40:55 > 0:40:58There's a lot of bruising on both sides of her spine.

0:40:58 > 0:41:00Lumbar and thorax.

0:41:00 > 0:41:02Mum, you fell. Do you remember?

0:41:02 > 0:41:05From the reclining chair in the conservatory.

0:41:05 > 0:41:07You landed on the stone planters.

0:41:07 > 0:41:10- Remember? The ones we'd put the seedlings in.- No.

0:41:10 > 0:41:14You fell because you were being... Because you were being silly.

0:41:14 > 0:41:16You told me off.

0:41:16 > 0:41:18- I told you off because... - She tells me off all the time.

0:41:18 > 0:41:20Mum, I don't.

0:41:20 > 0:41:24She can be difficult. It's the dementia.

0:41:24 > 0:41:28There are times when, when she can be hard to control.

0:41:28 > 0:41:30And what do you do then?

0:41:30 > 0:41:34Well, sometimes I, sometimes I have to...

0:41:39 > 0:41:41You think I did this?

0:41:41 > 0:41:45These wounds to me look like defensive wounds.

0:41:45 > 0:41:49Defensive? Are you...? You are seriously suggesting that...

0:41:49 > 0:41:51I'm sorry. But I'm sure you appreciate...

0:41:51 > 0:41:54..I have done this to her myself?

0:41:54 > 0:41:55Emergency. Bed eight.

0:42:02 > 0:42:06So, I live to see another day?

0:42:06 > 0:42:07Many more I hope.

0:42:08 > 0:42:13Sorry, Eric and Ernie, you'll have to wait for the party to get started.

0:42:13 > 0:42:14That would be some bash.

0:42:16 > 0:42:18How long does this buy me?

0:42:19 > 0:42:21The official line is five years plus.

0:42:21 > 0:42:24So, five minutes?

0:42:24 > 0:42:26It's not an exact science.

0:42:26 > 0:42:29Time to max out the credit card, eh?

0:42:29 > 0:42:30Or go and see your son.

0:42:32 > 0:42:35You know, I'd really like you to thank Ms Naylor

0:42:35 > 0:42:37for giving me this extra time.

0:42:40 > 0:42:42Yes. Yes, of course.

0:42:46 > 0:42:48I had to put a catheter in earlier.

0:42:48 > 0:42:50- The Ketamine paralysed his bladder.- Sedation?

0:42:50 > 0:42:53- He's had 10mg of diazepam. - Is he having a seizure?

0:42:53 > 0:42:55- Doesn't seem like it. - His heart rate's banging.

0:42:55 > 0:42:59His BPM's 120, but his blood pressure's really low. 100/50.

0:42:59 > 0:43:01I don't like this breathing.

0:43:01 > 0:43:03Very shallow. Very fast. His lung's collapsed.

0:43:03 > 0:43:05Tension pneumothorax.

0:43:05 > 0:43:09I need a 14 gauge angiocath needle. Catheter Tube. Large bore syringe.

0:43:09 > 0:43:11Air's getting trapped, not getting out.

0:43:11 > 0:43:13It's going to crush this good lung too.

0:43:13 > 0:43:15- Yeah. I'll do it. Fletch! - You sure?

0:43:15 > 0:43:18What? You think I might "abuse" him?

0:43:18 > 0:43:22Under the first rib in between the first and second rib.

0:43:22 > 0:43:24First intercostal space and we...

0:43:24 > 0:43:26What's he doing here?

0:43:26 > 0:43:28Why is he here?

0:43:28 > 0:43:30Did you do this?

0:43:38 > 0:43:40Tito! Oh, Tito.

0:43:40 > 0:43:44Adrienne. My word. How are you?

0:43:44 > 0:43:46Oh, better for seeing you.

0:43:49 > 0:43:51- Did you bring the board? - Backgammon?

0:43:51 > 0:43:54If I win, you're not going to pay me in confetti, I hope.

0:43:54 > 0:43:56Not today. No board.

0:43:56 > 0:44:00Oh, Tito. Oh, it's so good to see you.

0:44:00 > 0:44:04So, Adrienne, tell me, why are you here?

0:44:06 > 0:44:09It's her. It's always her.

0:44:10 > 0:44:11I don't want him here.

0:44:11 > 0:44:13Hello, Miss Campbell.

0:44:13 > 0:44:16Hi, yes, sorry, just, just, get out.

0:44:16 > 0:44:17He brought her care notes.

0:44:17 > 0:44:19- Out. Now. Please. - I'm not working for you.

0:44:19 > 0:44:22You can't tell me what to do, I'm afraid.

0:44:22 > 0:44:23This is my ward. My mother.

0:44:23 > 0:44:25And I would like you to leave, please.

0:44:25 > 0:44:27- Why is his being here a problem? - None of your business.

0:44:27 > 0:44:31- I'd like to speak to you in the office, in private, please.- No.

0:44:31 > 0:44:33Look, with all due respect,

0:44:33 > 0:44:36Ms Campbell, Adrienne is my patient and Mr Mullins may know

0:44:36 > 0:44:38useful medical history that could help with her treatment.

0:44:38 > 0:44:42- He doesn't.- Well, I'm afraid... - I don't want him to talk to you.

0:44:44 > 0:44:47Mr Mullins, please don't...

0:44:47 > 0:44:50Don't what, Ms Campbell? Don't tell the truth?

0:44:56 > 0:44:58Really nice guy.

0:44:58 > 0:44:59Hm?

0:44:59 > 0:45:01So, come on. Are you and him...?

0:45:01 > 0:45:02No. Good grief, no.

0:45:02 > 0:45:05Oh, I thought maybe, you know. You were...

0:45:05 > 0:45:08- No. I don't do relationships, Mr Levy. Not now.- No?

0:45:09 > 0:45:12Nope. Not since Malick.

0:45:12 > 0:45:15That kind of thing takes a little time to get over.

0:45:15 > 0:45:17Yes, but that wasn't a relationship.

0:45:17 > 0:45:19Excuse me?

0:45:19 > 0:45:22Well, Malick was in a relationship with someone else.

0:45:22 > 0:45:24What you two had was a mistake.

0:45:24 > 0:45:27- Biggest career mistake of his life. - What do you know?

0:45:27 > 0:45:30That, what you just let go out the door,

0:45:30 > 0:45:31that was an available man.

0:45:31 > 0:45:35That was something that had the potential of being a relationship.

0:45:51 > 0:45:53Ooh! Where are you going?

0:45:53 > 0:45:56- What? - I've never seen you run before.

0:45:56 > 0:45:57In fact, I didn't think you could run.

0:45:57 > 0:46:00Well, um...

0:46:00 > 0:46:01That wasn't running.

0:46:01 > 0:46:03Where you going?

0:46:03 > 0:46:05Are they giving away free tequila slammers in Pulses or...?

0:46:05 > 0:46:07Er, no. I wasn't going anywhere.

0:46:08 > 0:46:10So...?

0:46:11 > 0:46:13What?

0:46:13 > 0:46:16I know for a fact Arthur has a Battenberg stashed in his locker.

0:46:16 > 0:46:18Kettle on?

0:46:34 > 0:46:38Can you tell me why she should be so upset about us talking to you?

0:46:38 > 0:46:41- She's very protective of her mother. - Is she?

0:46:41 > 0:46:44- Too protective, sometimes. - In what way?

0:46:45 > 0:46:50I have worked with the elderly and people with dementia for 30 years.

0:46:50 > 0:46:52I've seen it all before.

0:46:52 > 0:46:56- You work with the Hyde Agency still? - Yes.

0:46:56 > 0:46:59- But not with Adrienne?- No.

0:47:03 > 0:47:06I'll come to the point, Mr Mullins,

0:47:06 > 0:47:09Adrienne has suffered injuries.

0:47:10 > 0:47:15Her back is badly bruised and her arms show signs of defence wounds.

0:47:16 > 0:47:22In your opinion, could Serena have caused these injuries to her mother?

0:47:22 > 0:47:25Serena?! Assault Adrienne?

0:47:25 > 0:47:29I know, it's unpleasant to think about, but it's our duty to ask.

0:47:30 > 0:47:35No. I don't think it's possible. In any circumstances.

0:47:35 > 0:47:36Why?

0:47:38 > 0:47:42Because it's Adrienne who has a history of violence.

0:47:42 > 0:47:47Of attacking her carers. She can be very quick.

0:47:47 > 0:47:48And very vicious.

0:47:51 > 0:47:52She stabbed me...

0:47:54 > 0:47:57..with a grapefruit knife.

0:47:57 > 0:47:59Serena and her mum have gone.

0:48:05 > 0:48:09Please keep your hands in your lap. Don't touch the wheels!

0:48:09 > 0:48:12Look at my hands. Look at them. Yes, look!

0:48:12 > 0:48:15Naked. Where are my rings?

0:48:15 > 0:48:17Not here, Mother. Not now.

0:48:17 > 0:48:18My rings! You thief!

0:48:18 > 0:48:22Listen to me, if you misbehave here. If you shout...

0:48:22 > 0:48:24they will lock you up!

0:48:24 > 0:48:27You hate me.

0:48:27 > 0:48:29- I don't hate you. - You hate me! You thief!

0:48:32 > 0:48:33She cancelled our contract

0:48:33 > 0:48:36because she didn't want anyone to know about the violence.

0:48:36 > 0:48:38She wouldn't be able to get another agency to cover?

0:48:38 > 0:48:42Getting home cover for a violent dementia patient is not easy.

0:48:45 > 0:48:50I'm not going anywhere with you. You dirty thief!

0:48:50 > 0:48:52Mother, don't start, please.

0:48:52 > 0:48:55You thief! You stole my rings.

0:48:55 > 0:48:59- You thief! - Sit down!- You bad, bad daughter!

0:48:59 > 0:49:02Bad, bad daughter. You should be ashamed!

0:49:02 > 0:49:04You bad, bad girl. I hate you.

0:49:04 > 0:49:06I hate you. You bad, bad girl.

0:49:06 > 0:49:09Mummy, Mummy, Mummy, Mummy... Ssh, it's OK.

0:49:09 > 0:49:11It's all right. It's nothing.

0:49:11 > 0:49:15I love you. I love you. There, there, there.

0:49:15 > 0:49:19Come and sit down. There. It's all gone. It's all right, Mum.

0:49:19 > 0:49:22Oh, my sweet. Oh, good girl.

0:49:22 > 0:49:28Here, come and sit down. There's a good girl. There. There, there.

0:49:28 > 0:49:31There, there. All right.

0:49:31 > 0:49:33Are you OK?

0:49:33 > 0:49:36I'm fine. I'm fine.

0:49:36 > 0:49:40- Your back.- Her rings. - They're sharp.

0:49:40 > 0:49:43She doesn't mean it. She doesn't know what she's doing.

0:49:43 > 0:49:45Really, it's all OK. I can handle it.

0:49:45 > 0:49:47Serena.

0:49:47 > 0:49:48Mum.

0:49:48 > 0:49:55What? What happened to you? Oh, your hair's a mess, dear.

0:49:55 > 0:49:59Oh, well, III just got changed in a rush, that's all.

0:49:59 > 0:50:03Your hair. Go back and do your hair properly.

0:50:03 > 0:50:06You can't go out looking like that.

0:50:06 > 0:50:11Tito, how lovely. Are we going to have a game of backgammon?

0:50:12 > 0:50:15You don't want Mr Mullins to see you looking like that.

0:50:16 > 0:50:19Not very lady-like, is it, Tito?

0:50:19 > 0:50:23No. No. Serena is always the perfect lady, Adrienne.

0:50:23 > 0:50:25- Takes after her mother.- Oh.

0:50:28 > 0:50:32See, this is what I mean by "roomie-harmony".

0:50:32 > 0:50:35Yeah. Speaking of roomie-harmony, you ate my pate.

0:50:35 > 0:50:36OK, well, you snooze, you lose.

0:50:36 > 0:50:39You can't expect me to sit in an empty flat with duck liver

0:50:39 > 0:50:40and cognac in the fridge.

0:50:40 > 0:50:43Right, I was actually saving that for tonight, so...

0:50:43 > 0:50:45OK. Well, I'll make it up to you.

0:50:45 > 0:50:50With a caress to the taste buds in the form of a dark

0:50:50 > 0:50:52full-bodied bottle of red.

0:50:52 > 0:50:54Look. You do dinner, I'll provide dessert.

0:50:54 > 0:50:57I've got pistachio nut and honey ice cream.

0:50:57 > 0:50:58I am actually planning a picnic.

0:50:58 > 0:51:00Call it what you want, big-boy, I'll still eat it.

0:51:00 > 0:51:03Yes, it's for me and Maria, so, er...

0:51:03 > 0:51:04You are kidding me.

0:51:04 > 0:51:07No, we're going up Hook Hill with my telescope.

0:51:07 > 0:51:08Spying on doggers?

0:51:08 > 0:51:11What? No, no, no. It's a space station.

0:51:11 > 0:51:13Yeah, closest orbit to Earth this month.

0:51:13 > 0:51:15You're supposed to be able to track it all

0:51:15 > 0:51:17the way across the eastern sky.

0:51:17 > 0:51:19So, OK!

0:51:19 > 0:51:21I hate you.

0:51:21 > 0:51:22Thank you!

0:51:25 > 0:51:27Got plans. Sorry.

0:51:39 > 0:51:41Peace offering.

0:51:41 > 0:51:45You once told me that death by chocolate was

0:51:45 > 0:51:47the order of the day in times of dire need.

0:51:48 > 0:51:50Jac...

0:51:50 > 0:51:53I can't do this on my own. I can't fill your brogues.

0:51:55 > 0:51:58The endless paperwork, and meetings, conferences.

0:51:58 > 0:52:01Dealing with people's problems, what's that all about?

0:52:01 > 0:52:03I find diplomacy and tact help.

0:52:05 > 0:52:08I'll look them up in the dictionary, shall I?

0:52:08 > 0:52:10I don't expect you to engage with me personally,

0:52:10 > 0:52:13I realise I've burnt that particular bridge.

0:52:13 > 0:52:17But for the good of the department and the Herzig programme...

0:52:17 > 0:52:20You'd like to present a united front?

0:52:20 > 0:52:22Something like that, yes.

0:52:24 > 0:52:26Come on, move back to the office.

0:52:26 > 0:52:28We can have some heated clinical debate.

0:52:28 > 0:52:30It'll be just like old times.

0:52:31 > 0:52:33Sadly, Jac, I fear those days are gone.

0:52:36 > 0:52:38You're undermining me.

0:52:39 > 0:52:43Show some respect, Ms Naylor. And maybe you'll get some in return.

0:52:54 > 0:52:57MUSIC: Don't Know Why by Norah Jones

0:53:15 > 0:53:18Dominic Copeland, you have so got to get a life.

0:53:27 > 0:53:29Interesting day, Jac?

0:53:30 > 0:53:34You know, losing Elliot to another Trust is not an option for you.

0:53:36 > 0:53:40You look like you need a friendly face and a stiff drink.

0:53:46 > 0:53:47You're buying.

0:53:57 > 0:53:59You really don't have to take her home, you know.

0:53:59 > 0:54:01I'm not. I'm taking her to a private hospital.

0:54:01 > 0:54:04Well, we can keep her in. We'll look after her.

0:54:04 > 0:54:06You don't have to do this alone.

0:54:06 > 0:54:09I do. She's my mother.

0:54:09 > 0:54:12And if she was my mother, I would need some help.

0:54:12 > 0:54:14I'm not letting her out of my sight.

0:54:14 > 0:54:16Then stay. Sleep in the on-call room.

0:54:16 > 0:54:17And if you agree,

0:54:17 > 0:54:20then tomorrow we can book her in for the endarterectomy.

0:54:20 > 0:54:23We'll see if we can schedule Mr Self.

0:54:23 > 0:54:24Is it time for Eggheads?

0:54:27 > 0:54:30Come on. It'll be OK.

0:54:32 > 0:54:33Let me take her.