Mummy Dearest Holby City

You're not me!

Mum! Mum! It's all right!

WOMAN SOBS AND WAILS

It's OK, Adrienne. It's OK, I've got you.

'From what you're telling me,

'your mother is showing signs of delusion and paranoia.'

Her mental health is deteriorating rapidly.

-The Nuss procedure? What, you going ahead with it?

-I am.

What part of "no" do you not understand?

You were like a daughter to me. Perhaps I expected too much.

You've always been a huge inspiration.

Well, you're all grown-up now. No more of that, eh?

-TV:

-We're talking about treats. We're talking about pleasure.

Morning, everyone! Have I got a treat for you?!

Wakey-wakey, little moley.

Diggers?

Unbelievable.

Trying to do something nice...don't even have the decency to be here.

Whatever.

-TV:

-'Finally, two tablespoons of self-raising flour.

'Don't even think about the calories.'

'Now this is a treat with chocolates...'

Then there is a huge temptation for me to involve nuts.

'Hazelnuts and chocolate, for me, is just...

'Just the best of the lot.'

'I skin my hazelnuts.

'You can buy them already done,

'but I think they keep better with their skins on.'

'It's easy...'

Get a life!

HE SLAMS DOWN REMOTE

-CLASSICAL MUSIC ON RADIO

-# Dee-dee, dee-dee

# Eee-dee-dee, dee-dee... #

ADRIENNE CONTINUES TO SING

No!

ADRIENNE HUMS AGAIN

-MAN:

-'BACK OFF! BACK OFF!'

BACK OFF! BACK OFF!

Back off!

-Put the stand down!

-Back off!

-MAN SHRIEKS

-BACK OFF!

-Put the stand down. MAN GROWLS

I've got him! Just...grab his legs.

-Just look at me. That's it.

-All right, mate, calm down.

-Let's see that. You all right?

-Yeah.

-Morning!

-I sublet your room to a family of Syrian refugees,

I figured someone should get use of it.

-I was staying at Maria's.

-You stink of sin.

-She has a box set.

-I bet she does, little minx!

No, it's David Attenborough.

I don't know what's worse -

living with you or not living with you.

-Rag week...

-Oh, that's too much information.

Whoo-hoo! Rag week!

CROWD CHATTERS

I hate random acts of fun committed in the name of CHARITY!

St James's medical students - must be for their cardio unit.

Dig deep, boys. Give from the heart for the heart.

Here we go. Two fresh ones.

Yay... Whoo-hoo! Nice stripes!

The Nuss procedure Professor Hope performed

was the perfect opportunity to build some bridges with your former mentor.

-It was needless plastic surgery.

-That is a matter of opinion, Jac.

This transition was never going to be easy for Elliot,

there was always going to be a period of "bedding in", shall we say?

Don't you think you should be talking to him?

No, not when all I'm seeing is outright revolt

from every member of your team.

You get this under control, Jac, or you'll leave me no option but to...

What? Review the position you more or less bullied me into taking?

I suggest you use a bit of diplomacy and tact.

I'm sure you'll find a dictionary somewhere

if you're unsure of their meaning.

Have you... Have you seen the theatre lists?

-Our glorious leader...

-Put me on the subs bench again?

Yeah, something like that.

But I managed to pluck this from her hooded claw,

right before the all-seeing eye spotted it!

The incorrigible Bernie Reddy, our old friend.

Yeah. He's reported breathlessness and has tachycardia.

He's been asking for you.

Goode and Reddy... D'you remember them?

Err.. A bit before my time. Mum used to love 'em, though.

They were right up there with Cannon and Ball.

Gina and I went to see them in the Summer Pavilion, Torquay -

our first holiday together.

Torquay? And she still married you?

So you think Bernie's heart failure's progressing?

Oh, there's a possibility that the meds have failed.

There's nothing matching on the transplant list so far

if it is progression.

Uh, even if you did, there is the small matter of...

Dextrocardia in a situs inversus patient.

You've done your homework.

Have you ever seen a heart positioned on the wrong side before?

Twice, it's pretty rare.

I was kinda hoping that I might be able to work it with you.

I think we should keep Bernie our little secret, don't you?

-Mm-hm.

-Doughnut?

Mmm!

Team announcement...

I've been examining your e-portfolios

and you're all light on Clinical Evaluation Exercises.

Right, I think if you look at my back catalogue...

All for one, one for all, Dr Digby. That's our motto. Remember?

-What, when did we get a motto?

-There's always been a motto.

-Thank you.

Now, today, I've set aside some time

for you to discuss your diagnostic specifics.

OK, interesting cases, please. Extra credit for complexity.

Show me the diagnostic magic, yes?

The magic, people, remember? Show me the magic.

Diagnostic complexities.

Right, I think if we're all going to have a motto

we should probably have agreed on it together first, you know?

-Donation, please!

-Don't touch me.

Did you know about this motto?

CLASSICAL MUSIC ON RADIO

MUSIC STOPS

Mum.

Mum, come on.

Time to wake up...

-D'you know where you are?

-I know who you are!

It's Serena, your daughter.

-HIGH-PITCHED:

-"It's Serena! I'm Serena!"

Mum, please.

Where...? Where are we, dear?

-Haemorrhoids...

-Boring.

-Varicose veins.

-Tedious.

-Inguinal hernia.

-Done it.

-Large bowel resection...

-Not again!

You're just keeping all the good things to yourself, Squirrel Face.

No, no, no, no, no! All for one, one for all!

-Right. Hernia, bowel, veins...

-Give me veins...

Done.

No-one is going to win any prizes for diagnostic ingenuity with this lot.

But it's credits, it's not prizes, is it? It's not a dog show!

HE LAUGHS MOCKINGLY Right, well then, I shall take haemorrhoids

cos my life sucks like a Hoover and I might as well make it worse.

So I hear you're quite the celebrity?

WAS my dear, was.

My star has waned somewhat of late,

but I had my moment in the spotlight.

-That is so amazing!

-Well, you know what they say -

behind every great man there's a devoted wife.

Behind her, a very surprised mother-in-law!

-ELLIOT CHUCKLES

-Les Dawson?

All me own work. I'm here all week.

Well, let's hope not. We need to find out what's going on in there.

So... Usual cardiac, bloods, ECG and echo, please.

Echo, echo, echo. Woman goes to see a gynaecologist...

Whoa! Let's keep it clean.

You can entertain Adele whilst we wait for your test results.

Good to see you again, Doc. Let's get this sorted, shall we?

Supposed to be playing golf at three. You can't get the staff!

Honestly, I've had plenty of horrible shifts on a Saturday night in the ED.

-Do you not want me to look you over?

-I'm fine.

It was Lou I was worried about. Thought he was going to kill her.

-Did you see his eyes?

-Ketamine and "meow meow". Put money on it.

It's like he wasn't there.

I bet he doesn't remember a thing. Do you know what?

Probably a very ordinary kid.

Right, well, we've got to do some photos.

Lou's injuries and any injuries that you sustained.

This is going to be a paperwork nightmare.

Someone care to tell me what on earth's been going on?

Been a definite deterioration since his last visit.

I think you should make him a priority on the transplant list.

Yeah, but even if I can find him a suitable heart, his physiology...

We had some difficulty the last time we did a transplant on a patient

with mirrored image organ layout...

The harvested pulmonary artery proved insufficient mid-op.

Well, if the test results confirm my fears, it'll be his only option.

Look, Mo, you've been here before.

I need to know exactly what I'm up against.

Congenital heart disease

and dextrocardia in a situs inversus patient?

-Yes, I was hoping...

-To keep this little gem to yourself?

Well, at least Mo should get involved,

she's treated a patient with this condition before.

Which she messed up, did she tell you that?

The pulmonary artery and the aortic arch were insufficient.

She didn't accommodate for the abnormal physiology.

It was simple maths and she got it badly wrong.

Then she needs to learn from her mistakes.

-Why take the chance?

-Look, don't you see?

Mo is our transplant specialist.

You'll undermine her confidence if you don't take her on board.

Fine. Don't you think you're jumping the gun a bit?

You haven't found a donor heart for him yet.

HE PANTS

Dominic!

Oh, for pity's sake, go away!

If you want to raise money for some cardio thing

then go and pester your own patients.

Dom, it's me, Kyle.

Listen, Tiger, I don't know

if you're doing some sort of... stunt for Comic Relief,

but if you are, go badger Darwin. OK?

-It's Kyle.

-Sorry?

-Kyle, remember?

-No.

-You probably don't recognise me.

-I think I'd remember a tiger.

-Hang on, remember this...?

-HE IMITATES DANCE BEATS

"Hey, you... You look a little hot...

-"If you like, I could blow on your..."

-Oh, my God.

That's right. That night.

-Kyle.

-Kyle.

Hey, you never said you were a doctor. Wow!

And you didn't say you were a tiger impersonator.

Actually, I'm a nurse. Agency.

Oh, goodie(!) And people wonder why I don't give my number out.

-What's the matter?

-I don't know. Probably the dancing.

Or maybe I ran up the stairs too fast.

Maybe you should go and slowly walk back down them.

Sorry, is this a work/play thing? Are you not, like, "out" at work?

Are you kidding? The coma patients know I'm gay.

So...what's...your problem?

You're wearing a tiger onesie, shaking a bucket of shrapnel.

And you're an agency nurse, and a seemingly desperate one at that.

COINS RATTLE

Crash trolley, we need help now!

Are you kidding me? One rejection and you faint?!

What a drama queen!

Professor, I've found a donor organ.

Oh, someone else's misfortune is our gain?

Yeah, just the way of the world, isn't it?

Bernie's ECG and echo.

The heart is further enlarged as you thought, hence the tachycardia.

-Right, and transplant is his best option?

-Yeah.

I've been doing some research on all the different approaches

to transplant situs inversus...

-Mm-hm.

-The biggest task seems to be the atrio-pericardial tunnel.

I'd have to create one, it's something I've never done before.

-I have every faith in you.

-Aw, thanks!

The donor heart is in Manchester.

We're in a fight to claim it, so I'm going to need your backing.

I don't think I'm the lead on this case any more.

She can't keep doing this to you.

Anyway, why are you standing here talking to the monkey

when the organ grinder's waiting?

(Go get that heart!)

Right, Manchester General's transplant co-ordinator's been on.

The donor heart's gone to someone else.

What, and you didn't even scrap for it?

This might be the only chance he gets.

There was a more urgent case in Liverpool.

-PHONE CLATTERS

-I was forced to concur.

It might be time to come up with a plan B.

There must be some other option for the heart.

Maybe we could give him Jac's - she's obviously not using it.

Voila.

So, Kyle... Any asthma or hay fever?

-A bit as a kid.

-Allergies?

I get wheezy in the summertime when the rapeseed's in flower, or...

when they cut for silage.

A country boy.

That was a deduction, Arthur. Razor sharp(!)

-Do you hear any crackling?

-You?

-Did you?

-I asked you first.

A little, I think, but nothing obvious.

Have you treated any patient with a lung infection

at St James's recently?

Nope.

OK. So?

-Full blood count.

-Chest X-ray.

-Lung function test.

-Just looking for an infection.

Huh...

So, do you know our...Dominic?

I'm not sure I do.

Mr Di Lucca's absolutely right, strict proper protocol.

Photographs of injuries and all property breakages.

Full statements by the end of the day?

Em, yes, and you'll need to read and sign each other's.

-Are we looking for a prosecution?

-Without question.

-I agree that we need to protect our staff from behaviour like that, but...

-But what?

-FLETCH SIGHS

-I can't help but feel for kids like him.

They get a head full of poison and then have a meltdown.

-We can't have staff being assaulted.

-I agree.

Zero tolerance. Protocol, protocol, protocol.

I want all the evidence correctly collated,

I's dotted, T's crossed.

-Will do.

-I do not want to give Mr Self

or Ric Griffin an opportunity to point the finger at AAU

and say we don't run a tight ship without them.

We've already got one doctor on suspension as it is.

Has anyone done the sats on my mother yet?

You know, by rights - professionally speaking -

she should either be in the ED, or up on Keller.

Well, I'm afraid that's not going to happen.

If transplant isn't an option, then the assist device can work

as a form of bridge therapy.

And in a few months' time, he'd be back to square one, if he lives that long.

I'm not losing a patient because we're dragging our heels.

Don't mind me, I just need a couple of my text books.

It would keep him alive until another organ becomes available.

Tosh, the chances of Bernie being offered a new heart are slim.

So you're just writing him off?

You want to save his life, then let's break out the big guns.

We'll be piggybacking a Herzig Five to his existing heart instead.

That's never been done before.

We are a centre of cardio excellence.

It's exactly the type of ground-breaking work that we should be doing.

-It sounds too experimental.

-That sounds like you're questioning my judgment.

And she's right to. Herzig Five was never designed for his kind of anatomy.

You'd better help me then.

A hypothetical for you, Mr Di Lucca...

Your mother is suffering from vascular dementia, so...

confusion, time slips, short-term memory loss.

She misses the odd word out, sometimes uses the wrong word

and has a habit of calling you Marjorie.

Now, these symptoms have worsened dramatically

over a short period of time.

So, what do you think might be going on?

I'd think TIAs.

Transient ischaemic attack, a mini stroke.

-You think she's had...?

-I do. That's exactly what I think.

But what I want to know is what would you do now

if she were your mother?

I would order an FBC, U&Es, clotting, lipid profile,

a head CT and a duplex ultrasound.

You are a very good and thorough doctor, Mr Di Lucca.

Thank you.

But would you send your mother up to another ward for these tests

and just wave goodbye at the lift?

-I might.

-I don't think so.

-If I was sure she'd be well looked after...

-Really?

I'd appreciate by my code of ethics that I wouldn't be permitted

to treat her myself.

Would you?

Or alternatively, I would entrust the treatment to a colleague

whose opinion I respected.

I do believe we're beginning to speak the same language.

I guess if they're talking heart transplants,

I better start taking things seriously.

Is there anyone you'd like me to contact for you?

-(No.)

-No?

-No-one, not even Bobby Goode?

-Especially not Bobby.

-So, is this not even up for discussion?

-It never was...

I designed the Herzig for the situs solitus anatomy.

-I'll find a way...

-Situs inversus is listed specifically

as one of the contradictions to fitting...

I believe that you wrote that particular manual

and I believe that I can rewrite it.

You're showboating, Jac, and you know it!

-I'll need you to assist.

-That won't be happening.

You don't care about your patient?

I do believe you've made it quite clear that he's your patient now.

I was always chasing skirt.

I'm paying alimony to three ex-wives just to prove it.

Serves you right, you dirty dog!

It was the ego, the fame!

Women were throwing themselves at me day and night

and it messes with your mind, you think you can have anyone.

I just didn't care.

Not even when I went after Bobby's wife, Stella.

Relentless, I was, and then one day she just cracked.

Then, of course, Bobby found out and the rest's history.

He walked away from everything - me, her, the show.

-How could you do that to your friend?

-BERNIE SIGHS

What can I say, I paid the price, didn't I?

I realised... I was just the straight man.

It was Bobby who had all the talent.

Mr Reddy, I'm Ms Naylor, I'm going to be your surgeon.

Stroke is about the heart, isn't it?

I know that, everybody knows that!

Yeah, well, your heart's a pump.

Why does she want pictures of my head?

-Well, the blood flows up...

-Oh, she just wants to embarrass me.

-How does she want to embarrass you?

-Pictures of my brain...

You all right there, love? You seem to be in a bit of pain.

-D'you want me to take a look at that?

-"Love"?

Are you a doctor? What's your name?

Fletch. Well, Adrian Fletcher, but everyone just calls me Fletch.

It's more like a boxer, not a doctor.

-Well, I'm not a doctor. I'm a nurse.

-A nurse?! Why are you a nurse?

-Well, we need nurses, don't we?

-I had a nurse, my own.

-He was a very good nurse.

-OK.

He came to my house.

We played backgammon and he'd read to me from the Telegraph.

-Backgammon, eh?

-He was a man too! And a very good listener.

Well, sounds to me like you two got on very well.

-Until SHE said he couldn't come any more.

-Who did?

-My nurse! Aren't you even listening?

-No, sorry, I just meant...

Who said that he couldn't come and see you any more?

Well, who do you think?

BUZZER

-Thanks.

-Oh...

Exposing an organ is always so exciting during surgery!

I know, I know. I mean, seeing a heart takes some beating,

but looks so complicated!

No, but the brain, the brain is the complete opposite.

To expose a section of the brain...

It's just boring grey matter, but actually, what it controls...

-Please!

-What is wrong with you?

Since when have you been a neurology groupie?

Whatever happened to, "Oh, Daddy does it, so I don't like it"?

Maybe I grew up.

-Got our St James's nurse's test results.

-Aha! OK...

Go on, amaze us.

Bloods show... Oh, mild neutrophilia.

-High-ish white cell count...

-X-ray?

Em... Couple of fine nodular shadows...

-Nothing very interesting then.

-Diagnosis?

-Mild lung infection.

-"Right side - partial swelling..."

-Reaction to a chest cold, maybe.

-Treatment?

Some antibiotics and we probably could discharge...

maybe with some meds and a letter to follow up with the GP.

-Nothing going on but the rent, then?

-Chase those meds and discharge please.

-Who?

-You.

-You!

-You!

-You... I always...

-I don't want to do it!

For goodness' sake, I'll do it. Sooner we get rid, the better.

-Sorry, do you know this guy or not? I can't quite work it out.

-Not.

Well, at least not to talk to.

Jac wouldn't listen to me, even when Elliot chipped in.

Er, probably BECAUSE Elliot chipped in!

That woman. She's a law unto herself.

Yeah, but she always has been, that's just Jac.

But if the Dream Team aren't together then...

Do you expect Elliot to toe the line after he's been hung out to dry

by the Wicked Witch of the West Country?

Doesn't all this cold war worry you?

Hey, I got to the bottom of why Goode and Reddy split if you're interested?

-Yeah, dish!

-Goode could never forgive Reddy for sleeping with his wife.

-You knew?

-Bernie's a bit of an early discloser.

He told me on his first admission... That and then some.

-There's more?

-For Bernie to know and you to find out.

Oh, come on, Prof, dish the dirt! Don't leave us in suspense like this!

I'm not one for tittle-tattle, Adele, so don't even ask.

Do you really think this...

cold war, as you call it, is affecting morale?

-Nah...

-Yeah...

-How couldn't it...?

-I think what my gobby little sister is trying to say is...

Look, Jonny's even taken some time off to get out of the firing line.

And to be honest, I don't blame him. I would too.

Look, we used to do the job and have fun doing it.

What happened to our little dysfunctional family?

Then something needs to be done.

Oh, don't look at me like that.

-Don't tell me it didn't need saying!

-Prof...

So are you going to do Bernie's op?

Don't tell me you turned it down for my sake.

I had my reasons.

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

-Didn't Ms Naylor explain the procedure?

-Yeah,

in her own unique way, a bit bish, bash, bosh, if you know what I mean.

I've tried to smooth things over, but he wants to speak to you.

Right.

'And in...'

And out...

Antibiotics and you're good to go.

Anything look familiar?

Like I said, it seems you have a mild chest infection.

Is it really because I'm a nurse?

I don't do repeats.

What, never?

Strictly a one-time guy.

Sounds sad.

-Hey-ho.

-Sounds lonely.

I did have one very serious relationship, thank you very much.

Ah-hah! Not so ice-man.

One significant one.

So...so, I don't get why you're all...

He was a consultant.

So it IS the nurse thing.

Look, the sooner you get your meds and go, the better.

HE COUGHS

You're such a snob. HE COUGHS

A...partner snob.

Well, some of us need to have standards.

Because I'm a nurse?

Because you're wearing a tiger onesie and you grew up on a farm.

See? You did listen to SOMETHING that night.

I only remember some weird Silence Of The Lambs thing you had going on.

You are so mean.

Sit down.

You're like a limpet.

Nurse!

Stay here while I get Mr Levy.

It's your carotid artery that I want to have a look at.

If you feel at each side of your neck,

you can feel it just there.

Are you a doctor?

I am a doctor.

He's a nurse.

I am. Can you remember my name?

Are you a consultant? My daughter's a consultant.

No. I'm a registrar. A senior registrar.

If she worked here, she would be your superior.

She does work here.

Does she?

It was her that brought you in. Can you remember?

I know that!

Let's have a look at your artery.

Make sure your blood's flowing as it should.

Does it have music?

No, I'm afraid not. What kind of music do you like?

I...don't know.

-Oh, that hurts!

-I'm barely touching your skin.

You're strangling me! It hurts everywhere.

OK, let's just relax. Let's...let's calm down.

We'll take a break.

Just relax.

They look sore.

The bruises on your arms, Adrienne...how did you get them?

How do you think?

So, a robotic heart in me chest?

I'm going to be like Robocomic. Zzztt! Zzztt!

Just think of it as a glorified pacemaker.

You designed this?

My claim to fame, apparently.

So why aren't you doing me op?

Bernie, I assure you, you're in perfectly good hands.

-Ms Naylor is head of the department...

-Oh, don't give me that claptrap.

Till recently, she was your understudy.

Did you...get in touch with your son?

Now might be a good time. This procedure isn't without risk.

Stella died three months ago.

It's too little too late for that kind of thing, don't you think?

Well, if my mother had just died, I think I would...

Stella never told the boy that I was his dad.

Took the secret to her grave.

Ashamed of what we'd done.

Why bother tracking him down after all these years if you didn't want to make amends?

Ach...I don't know.

He's married now with kids of his own,

he's got his own life to live.

It's hardly fair on him, or the grandkids, or you.

Theatre's ready for you to go down now, Bernie.

'Ey, I'm good and ready, sweet cheeks. Let's get this thing done.

I might even make that tee-off time!

Thank you.

-So, we have a bit of a situation.

-You think(?)

The mother of the head of this department,

the deputy CEO of this hospital...

-Our boss.

-..is in effect accusing her daughter of abusing her.

-Are you sure that that's what she's saying?

-We're not in any way SURE.

Because she is sometimes very confused.

Very. And often.

Shouldn't she just be on another ward, I mean, away from Serena?

-In many ways, that would be preferable.

-So how do we manage that?

Go over her head?

To who?

-To Guy Self?

-Oh...

-No, that just wouldn't be...

Listen. My last job didn't exactly end well with those upstairs.

Yeah, but if, and I stress the "if",

an innocent old lady is suffering because...

All I'm saying is that we just need to

be 100% certain before we start throwing hand grenades.

"Nine bean rows shall I have there, a hive for the honey bee..."

What's that?

WB Yeats.

Do you know it all the way through?

Yes, of course. It's only three verses long.

Can we look at your arms again, please?

-You may.

-Thank you.

"I will arise and go now..."

It could be defensive.

Can you lean forward for me?

"And a small cabin build there, of clay and wattles made,"

"Nine beans rows shall I have there, and a hive for the honey bee..."

You have a lovely voice.

Oh, we were taught to project.

"Aim for the back of the hall, girls."

"..and live alone in the bee loud glade."

You have some nasty bruising on your back, Adrienne.

-Can you tell me how you got it?

-How can I recite if you keep interrupting?

Duplex scan?

Oh, er...we have to do it again. The results were inconclusive.

She became agitated.

Well, do it again now.

If she's trouble, call me and I'll help.

-No, you were right to keep him in.

-I put him on IV antibiotics.

Yep, hourly obs too. So, what, are you...

taking over this patient now?

I suppose.

-I can always ask Arthur or Zosia...

-No.

OK, honestly, I'd really like to do a full immunoglobulin analysis

and chest CT scan.

Really? Why, if it's just a lung infection?

Because I don't know if it is just that. It's a hunch,

it's a diagnostic hunch.

-Ah, you've got your eye on some e-portfolio credits, haven't you?

-Something like that.

You don't want to just keep tabs on him because you think that Kyle might be...an OK guy?

He's a nurse.

I was married to a...nurse.

And how did that work out for you?

'And what's the distal degree of stenosis?'

According to this, 80%.

-Very high.

-Yes.

-Blood flow's restricted.

Quite dramatically. I'd recommend a carotid endarterectomy.

Too invasive.

It is a more invasive procedure, I grant you,

but with more potential for a longer life, and more quality of life.

And peace of mind, freed from the worry of further strokes.

If it was your mother, that's really what you'd recommend,

-rather than the much simpler option of fitting a stent?

-I would.

I don't believe you. She's an 80-year-old woman.

A stent would be fitted with much less risk of post-op infection

and it could be done today.

In my opinion, I think your judgment is understandably clouded.

Do you?

Because she's your mother, you're erring on the side of surgical caution, rather than long-term gain.

All I want is for her to have the most effective procedure.

And I don't think you're the best person to make that decision.

You might be the best surgeon to perform a complicated

vascular operation, but you might not be the best person

to decide which operation your mother has.

Cut.

More 2-0 prolene, please, and keep the glue coming.

-Fascinating, isn't it?

-Yeah.

Every organ working perfectly but in mirror image.

Evolution worked it out for a reason,

but sometimes it still throws out a freak of nature.

It's not his fault he was born this way. MACHINE PINGS

Damn it. The cuff's rotating. Pulmonary artery's torn.

PINGS CONTINUE

As I said to your colleague and the one before that and the one before that,

Adrian Fletcher, AAU Ward, Holby City.

Great. Right, OK.

Um, yeah. Your agency looked after an Adrienne McKinnie...

and we've got some concerns about her care.

We'd really like to see her notes.

That's lovely. Thank you, but I've really got to go. Bye.

-Step back, madam, please.

-How rude!

-I need you to step back, please.

-How very, very rude!

-I thought I told you to stay put.

Look, I am personal friends with your chief inspector...

and I will see to it that you are properly reprimanded.

-Let's get you back into bed.

-Oh, the impertinence!

I simply wanted to report a crime.

And he kept telling me to step back.

What crime?

A crime against me.

OK, what sort of crime is that?

A horrible one. One I need to talk to the police about.

OK, well... do you want to talk to me about it?

It's confidential.

OK, er...

does that mean that you DO want to talk to me about it?

Have you got a cigarette?

No.

A cigarillo?

No.

A cigar.

No. Look, I don't smoke.

Oh, pity.

I do so love the smell of good tobacco on a man's jacket.

OK...right. Shall we go and have a little chin-wag in there?

-Have a cup of tea?

-A cup of tea? That would be lovely!

-OK.

-Thank you.

You're a very nice young man.

I'm glad you think so.

Moment of truth.

Let's take him off bypass.

MACHINE PINGS

Blood flow's poor.

PINGS CONTINUE

OK, let's get him back on bypass.

A lot of kinks in the cuffs?

This was always going to be tricky given his anatomy.

No more difficult than if we were using a normal heart.

We'll just have to start again, won't we? Scissors.

-You've only just come back!

-That's irrelevant. I want to resign.

I'm afraid I can't allow that. This hospital needs you.

No, it doesn't.

I feel like I may have inadvertently become a liability.

And I am not rebellious by nature,

but I'm finding Ms Naylor's tenure unbearable.

Pulmonary artery keeps tearing.

You do understand why I've had to do this?

Undergone brain surgery, a hair's breadth from retirement.

That's a factor, but not a deciding one.

No, the Americans who are trialling the Herzig like them young and hard,

not soft and furry.

SHE EXHALES

SHE EXHALES

I need Elliot here now.

Page Professor Hope, please.

I need to know the future of the Herzig is secure.

PAGER BEEPS

I feel I'm compromising the department if I stay.

The Herzig is your lasting legacy, Elliot.

I need to know it's in safe hands.

Once that's done, you can hit the golf course with my blessing.

Robbing machine!

Oh, it's nice that it plays fair with the overpaid doctors,

-but then robs the underpaid nurses!

-Life is not fair.

Yeah, why does this feel so flippin' familiar? Cheers.

Did you see how quiet she went?

-As soon as Serena came over?

-Yeah.

It was like she was suddenly a different person.

-I know. Like a puppy...

-A scared puppy.

So now what do we do?

We need to document her injuries. Examine her thoroughly.

-Talk to her.

-Well, I've spoken to the agency

and they're being surprisingly helpful.

They're going to send over all of her notes

-and put us in touch with a Tito Mullins.

-Who?

He was her old carer.

-Apparently he got given his marching-orders.

-Who by?

Who do you think?

There's a resistance to in-flow and out-flow.

I've tried to connect the unit twice, but the positioning is...

I did warn you.

So what are you going to do?

I think Ms Effanga was onto something

with her assist device idea.

Accommodating Bernie's unique anatomy rather than trying to

force a square peg into a round hole.

I suggest we think along the same lines for the Herzig device.

-Give it enough room to attach the cuffs properly.

-How?

Miss Effanga?

All we could really do is open up the diaphragm

and reposition the Herzig, but...

-Have faith in your convictions.

-It's just theory.

Well, time to turn it into practice.

We're re-writing the manual, remember.

OK. I'll seal the diaphragm, you attach the cuffs.

Right, looks like I'm going to need a hand.

Scalpel, please.

Last one?

Right, OK, can you hold your arms like that for me?

That's it. Close your eyes again.

All right? Lovely. You can relax.

This is what I'm talking about.

-What? The crime?

-Exactly.

Do you want to explain it to me?

Explain it? What is there to explain?

Just look at my fingers.

I don't see anything.

Exactly, that's my whole point.

What's the point? I'm sorry.

You're going to, you're going to have to explain it to me again.

Oh, you stupid man. They've gone, haven't they?

What? Your fingers?

My rings, idiot. My rings.

-You haven't got any rings.

-No. She stole them.

Here I should have my solitaire diamond engagement ring...

which was my husband's dear mother's.

My eternity ring. My turquoise and gold Edwardian dress ring.

OK, so who stole them?

My daughter. She stole them. And I want to tell the police.

She should go to prison.

So the skinny is, you and Nurse Tiger-Onesie bumped

and squealed in the past.

Now, you're too cool for him,

yet for some reason you don't want to send him home.

-They're called "test results".

-For what?

-He has a mild or not-so-mild lung infection. That is all.

-Or...

Or you fancy him much more than you're prepared to admit,

and you are trying to find...

Did you order a full immunoglobulin analysis on Kyle?

-Is that it?

-And a chest CT?

-Can I see it, please?

-Why?

Does the fact the NHS is crumbling under the weight of massive

overspend mean nothing to you?

HE CHUCKLES

Farmer's lung.

Farmer's lung?

-His lung.

-Farmer's lung!

-Kyle?

-Yep.

Mm. Farmer's lung, eh? Nice.

Now, has that been diagnosed on Keller before?

No. To my knowledge, that's a first.

Ooh! Well, then that's all for one and one for me, then!

Isn't it? Show me the magic!

That's not the motto.

-This is a mess.

-What about her procedure?

Serena's not in a rational position to make a good call.

Adrienne's saying that Serena stole her rings.

Do you think she's mistaken?

Well, you don't see many women her age

without a ring on her finger, do you?

There's plenty of marks to show where they were.

And then there's the marks on her back.

Do you know what?

I think we're going to have to go upstairs and report this to Guy Self.

-Or...

-Or what?

Or we give Serena a chance to respond.

That's easy for you to say with your fellowship

and your senior registrar-ship.

-I'm a staff nurse with a sketchy record.

-I'll do it.

You're going to ask her if she beat up her 80-year-old mum

and then half-inched her jewellery?

He complained a lot about allergies as a boy. Hay fever and such.

I read Arthur's notes on his file.

Yes, but that's historical...

Yes, but he then spent all morning on the back of a rag week float

covered in hay.

He then starts complaining of wheeziness,

shortness of breath and fever-like symptoms.

OK. So you put two and two together.

-His childhood "allergies" were misdiagnosed.

-Yes?

The straw bales on the back of the rag week float

set off a reaction which had been lying dormant for years.

And because you'd been living in an entirely urban environment...

Soon as he came into contact with the spores from the hay...

-Boom! Farmer's lung.

-Excellent work.

And he's now on a heavy batch of steroids and has been told under

strict instructions to steer clear of anything that even resembles hay.

Well, that's very impressive work, Dr Copeland. Well done.

It's really, really lovely to have met you, Kyle.

Thanks, Mr Levy.

You're quite the doctor.

-Thank you.

-Very intuitive diagnosis.

-I try.

-Pity you are such a worm of a human being.

-"Worm"?

-Yeah. Worm.

Whatever.

We just want to clear up some confusion about her injuries.

Did I ask you to do this? She is my mother.

And she's our patient.

It's her arms... her forearms and her back.

Mum, what have you said?

There's a lot of bruising on both sides of her spine.

Lumbar and thorax.

Mum, you fell. Do you remember?

From the reclining chair in the conservatory.

You landed on the stone planters.

-Remember? The ones we'd put the seedlings in.

-No.

You fell because you were being... Because you were being silly.

You told me off.

-I told you off because...

-She tells me off all the time.

Mum, I don't.

She can be difficult. It's the dementia.

There are times when, when she can be hard to control.

And what do you do then?

Well, sometimes I, sometimes I have to...

You think I did this?

These wounds to me look like defensive wounds.

Defensive? Are you...? You are seriously suggesting that...

I'm sorry. But I'm sure you appreciate...

..I have done this to her myself?

Emergency. Bed eight.

So, I live to see another day?

Many more I hope.

Sorry, Eric and Ernie, you'll have to wait for the party to get started.

That would be some bash.

How long does this buy me?

The official line is five years plus.

So, five minutes?

It's not an exact science.

Time to max out the credit card, eh?

Or go and see your son.

You know, I'd really like you to thank Ms Naylor

for giving me this extra time.

Yes. Yes, of course.

I had to put a catheter in earlier.

-The Ketamine paralysed his bladder.

-Sedation?

-He's had 10mg of diazepam.

-Is he having a seizure?

-Doesn't seem like it.

-His heart rate's banging.

His BPM's 120, but his blood pressure's really low. 100/50.

I don't like this breathing.

Very shallow. Very fast. His lung's collapsed.

Tension pneumothorax.

I need a 14 gauge angiocath needle. Catheter Tube. Large bore syringe.

Air's getting trapped, not getting out.

It's going to crush this good lung too.

-Yeah. I'll do it. Fletch!

-You sure?

What? You think I might "abuse" him?

Under the first rib in between the first and second rib.

First intercostal space and we...

What's he doing here?

Why is he here?

Did you do this?

Tito! Oh, Tito.

Adrienne. My word. How are you?

Oh, better for seeing you.

-Did you bring the board?

-Backgammon?

If I win, you're not going to pay me in confetti, I hope.

Not today. No board.

Oh, Tito. Oh, it's so good to see you.

So, Adrienne, tell me, why are you here?

It's her. It's always her.

I don't want him here.

Hello, Miss Campbell.

Hi, yes, sorry, just, just, get out.

He brought her care notes.

-Out. Now. Please.

-I'm not working for you.

You can't tell me what to do, I'm afraid.

This is my ward. My mother.

And I would like you to leave, please.

-Why is his being here a problem?

-None of your business.

-I'd like to speak to you in the office, in private, please.

-No.

Look, with all due respect,

Ms Campbell, Adrienne is my patient and Mr Mullins may know

useful medical history that could help with her treatment.

-He doesn't.

-Well, I'm afraid...

-I don't want him to talk to you.

Mr Mullins, please don't...

Don't what, Ms Campbell? Don't tell the truth?

Really nice guy.

Hm?

So, come on. Are you and him...?

No. Good grief, no.

Oh, I thought maybe, you know. You were...

-No. I don't do relationships, Mr Levy. Not now.

-No?

Nope. Not since Malick.

That kind of thing takes a little time to get over.

Yes, but that wasn't a relationship.

Excuse me?

Well, Malick was in a relationship with someone else.

What you two had was a mistake.

-Biggest career mistake of his life.

-What do you know?

That, what you just let go out the door,

that was an available man.

That was something that had the potential of being a relationship.

Ooh! Where are you going?

-What?

-I've never seen you run before.

In fact, I didn't think you could run.

Well, um...

That wasn't running.

Where you going?

Are they giving away free tequila slammers in Pulses or...?

Er, no. I wasn't going anywhere.

So...?

What?

I know for a fact Arthur has a Battenberg stashed in his locker.

Kettle on?

Can you tell me why she should be so upset about us talking to you?

-She's very protective of her mother.

-Is she?

-Too protective, sometimes.

-In what way?

I have worked with the elderly and people with dementia for 30 years.

I've seen it all before.

-You work with the Hyde Agency still?

-Yes.

-But not with Adrienne?

-No.

I'll come to the point, Mr Mullins,

Adrienne has suffered injuries.

Her back is badly bruised and her arms show signs of defence wounds.

In your opinion, could Serena have caused these injuries to her mother?

Serena?! Assault Adrienne?

I know, it's unpleasant to think about, but it's our duty to ask.

No. I don't think it's possible. In any circumstances.

Why?

Because it's Adrienne who has a history of violence.

Of attacking her carers. She can be very quick.

And very vicious.

She stabbed me...

..with a grapefruit knife.

Serena and her mum have gone.

Please keep your hands in your lap. Don't touch the wheels!

Look at my hands. Look at them. Yes, look!

Naked. Where are my rings?

Not here, Mother. Not now.

My rings! You thief!

Listen to me, if you misbehave here. If you shout...

they will lock you up!

You hate me.

-I don't hate you.

-You hate me! You thief!

She cancelled our contract

because she didn't want anyone to know about the violence.

She wouldn't be able to get another agency to cover?

Getting home cover for a violent dementia patient is not easy.

I'm not going anywhere with you. You dirty thief!

Mother, don't start, please.

You thief! You stole my rings.

-You thief!

-Sit down!

-You bad, bad daughter!

Bad, bad daughter. You should be ashamed!

You bad, bad girl. I hate you.

I hate you. You bad, bad girl.

Mummy, Mummy, Mummy, Mummy... Ssh, it's OK.

It's all right. It's nothing.

I love you. I love you. There, there, there.

Come and sit down. There. It's all gone. It's all right, Mum.

Oh, my sweet. Oh, good girl.

Here, come and sit down. There's a good girl. There. There, there.

There, there. All right.

Are you OK?

I'm fine. I'm fine.

-Your back.

-Her rings.

-They're sharp.

She doesn't mean it. She doesn't know what she's doing.

Really, it's all OK. I can handle it.

Serena.

Mum.

What? What happened to you? Oh, your hair's a mess, dear.

Oh, well, III just got changed in a rush, that's all.

Your hair. Go back and do your hair properly.

You can't go out looking like that.

Tito, how lovely. Are we going to have a game of backgammon?

You don't want Mr Mullins to see you looking like that.

Not very lady-like, is it, Tito?

No. No. Serena is always the perfect lady, Adrienne.

-Takes after her mother.

-Oh.

See, this is what I mean by "roomie-harmony".

Yeah. Speaking of roomie-harmony, you ate my pate.

OK, well, you snooze, you lose.

You can't expect me to sit in an empty flat with duck liver

and cognac in the fridge.

Right, I was actually saving that for tonight, so...

OK. Well, I'll make it up to you.

With a caress to the taste buds in the form of a dark

full-bodied bottle of red.

Look. You do dinner, I'll provide dessert.

I've got pistachio nut and honey ice cream.

I am actually planning a picnic.

Call it what you want, big-boy, I'll still eat it.

Yes, it's for me and Maria, so, er...

You are kidding me.

No, we're going up Hook Hill with my telescope.

Spying on doggers?

What? No, no, no. It's a space station.

Yeah, closest orbit to Earth this month.

You're supposed to be able to track it all

the way across the eastern sky.

So, OK!

I hate you.

Thank you!

Got plans. Sorry.

Peace offering.

You once told me that death by chocolate was

the order of the day in times of dire need.

Jac...

I can't do this on my own. I can't fill your brogues.

The endless paperwork, and meetings, conferences.

Dealing with people's problems, what's that all about?

I find diplomacy and tact help.

I'll look them up in the dictionary, shall I?

I don't expect you to engage with me personally,

I realise I've burnt that particular bridge.

But for the good of the department and the Herzig programme...

You'd like to present a united front?

Something like that, yes.

Come on, move back to the office.

We can have some heated clinical debate.

It'll be just like old times.

Sadly, Jac, I fear those days are gone.

You're undermining me.

Show some respect, Ms Naylor. And maybe you'll get some in return.

MUSIC: Don't Know Why by Norah Jones

Dominic Copeland, you have so got to get a life.

Interesting day, Jac?

You know, losing Elliot to another Trust is not an option for you.

You look like you need a friendly face and a stiff drink.

You're buying.

You really don't have to take her home, you know.

I'm not. I'm taking her to a private hospital.

Well, we can keep her in. We'll look after her.

You don't have to do this alone.

I do. She's my mother.

And if she was my mother, I would need some help.

I'm not letting her out of my sight.

Then stay. Sleep in the on-call room.

And if you agree,

then tomorrow we can book her in for the endarterectomy.

We'll see if we can schedule Mr Self.

Is it time for Eggheads?

Come on. It'll be OK.

Let me take her.