Fran escalates her campaign against Jac, with disastrous consequences. The AAU team lack festive cheer, but Serena restores some Christmas goodwill.
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The man you dismissed as an oddball has been managing undiagnosed
autism and you discharged him when he needed a critical operation.
All I wanted to be able to do was provide for my kids, and I failed.
-You're not staying another night in a B&B.
I don't want you to leave. This hospital needs you.
You're my kind of bloke.
The last time somebody looked at me the way he has just looked at you,
I ended up moving in with him.
There is a complaint of negligence against you.
You have been here all of five minutes.
What the hell do you know about me?
The complaint stands.
If I ever need a reason to get out of bed in the morning
and come to work...
-Mm, it is beautiful.
-The perfect storm.
Large distal arch and proximal descending aortic aneurysm.
How can something so deadly...
Just look so beautiful?
It's kind of a beauty-in-the-eye-of-the-beholder
situation, I think.
You don't think this is beautiful?
It could explode at any moment and kill your patient.
Just makes it more beautiful.
In your opinion.
This is exactly what I've been waiting for.
For months. Years.
Since Seoul, Korea, 2014.
An aneurysm so perfectly deadly.
You got something special up your sleeve?
Total arch replacement and descending aortic repair
with a brand-new frozen elephant trunk.
It's very noisy.
It's, erm, disturbingly noisy.
The sort of noises that I'd really rather not, erm...
I can't eat. I can't concentrate.
I'm definitely not getting enough sleep.
-It's just so...
Would you keep it down, please?
He's still sleeping. The poor thing's exhausted.
Right, can we just get to work? Come on.
You know, for years I've been so cynical,
just thinking that love was something to sell
Valentine's Day cards or stupid heart-shaped jewellery.
Can't you stay at his place occasionally?
He's very picky about who he invites to his own private environs.
Meanwhile he's all over our "environs" like a fungal rash.
But I am definitely due a visit soon.
Not soon enough.
Oh, you know, what is it?
You just can't see me happy, can you?
Is that just too hard to swallow?
Quiet happy, good.
All night long, noisy happy, not good!
You could suck the ho-ho-ho out of Christmas.
We're just not used to seeing you so... Whoa!
What? Happy? Content? In love? You know what?
You'd just prefer it if I was just "Sad-Sack" Dom.
Desperate, depressed, lonely Dominic.
Well, you know what? You can kiss my figgy pudding.
Well, you have collated a series of figures outlining Ms Naylor's
mortality rates relating to operating schedules over...
..eight years of cardiac procedures.
Just because people are in a position of power
doesn't mean they're good people. Or should be trusted.
Well, I understand you may be a little disappointed by this result
but Mr Orson's case notes have been carefully reviewed
and Ms Naylor's clinical care was entirely appropriate.
And I would trust her and her ability in the operating theatre
over any cardiac surgeon in the country.
Well, look at the figures. Maybe you wouldn't
if you looked into how many patients die at her hand.
Yes, but she operates on diseased and damaged hearts every day.
Many of the patients in most parlous condition.
-And they die!
-Yes. Sometimes they do.
Now, if you'll excuse me, I need to get to a departmental meeting.
318 operations in 2013 with a mortality rate of 4.85%.
Many patients who are so near to death
have only a one in ten chance of survival, don't they?
The figures speak for themselves!
No, these don't.
By the Society for Cardiothoracic Surgery data,
she falls well within the two standard deviations of risk.
Why are you doing this?
Someone has to stand up.
Expose the lies.
Silence and secrets. That's how abusers of power stay in power.
Hogmanay was always a bigger thing than Christmas Day in our house.
It was Giuseppe's big night. He was in demand all up the street.
-Gigolo, was he?
First man through the door after midnight.
Usually carrying a lump of coal.
Coal? Do you know what? Stuff independence.
We should have just done a massive refurb on Hadrian's Wall.
It meant good luck to the household for the rest of the year.
The darker the first-footer's hair, the better the luck.
Now, that - I could do with a house full of good luck for a change.
You have had a bit of a rough year.
Yeah, and I told the kids that we'd be in our own house by Christmas.
I'm a bit disappointed.
Oh, I get it. You lot can't wait to be away from me, is that it?
No, not at all. You're a top man.
I just feel like I'm letting them down.
I can't wait to see the back of 2015.
Good luck was definitely out of fashion.
-Is this him...?
-A bit like that fur coat.
A & E didn't get a surname. They think his name is Aubrey.
-Not making a lot of sense, is he?
-Seems very confused.
Also complained of severe headaches, and he's quite dehydrated as well.
Had a bit of a tumble, did you, Aubrey?
Turns out he was knocked over by a bike. Hit and run.
A bike? Here's me thinking I had bad luck.
I saw it.
The light, my dear boy!
I saw the light.
"Frozen Elephant Trunk" is the name given to this procedure
because the graft device we fit looks like...
An elephant's trunk!
Only it's frozen.
This is a state-of-the-art, fifth generation, complex graft design.
In my business, "redesign" means there was something wrong
with the last go round.
This just gets better and better. It's a piece of genius.
Does in one operation what is usually a two-stage procedure.
No, hang on a minute.
How many of these have you done?
Using the previous device, lots.
Using the new device, she will be the first.
At Holby, yes, but we have governance approval
and I've performed the surgery in South Korea under supervision.
-I am positively thrilled to be the first.
Alice, you don't know what...
Bring it on!
Consent to her is just a piece of paper that needs to be signed.
Now, that simply isn't true.
Tell that to your past patients.
Are you refusing to consider seriously
my submission of evidence, which I believe exposes
unsafe practice in your Cardiothoracic Department?
-No, of course that is not what I'm doing.
However, I think that while you're making these accusations,
you might be happier working on another ward.
No. Absolutely not.
Move me and it'll look like you're trying to gag a whistle-blower.
Is that what you're trying to do?
The ED couldn't find any ID on him.
What, no bag?
Did you have a bag, Aubrey?
Did someone steal your bag?
Hit and run and mugged. See, that IS cruel.
It was beautiful.
-What, your bag?
Yeah, I forgot about the light(!)
-What sort of fur do you reckon that is?
Bear? Maybe like a brown bear or Prussian black? I don't...
Well, the label says Savile Row.
So whatever animal it was, it cost an arm and a leg.
Push plenty of fluids.
30 minute obs and can you clean up that head wound, please?
Are you from London, Aubrey?
Or are you an international playboy, just stopping off in Holby
-on his way to Monte Carlo?
I wanted to go towards the light.
But...behind the light was a face.
Listen, try and think back to before the light.
So this morning, when you woke up.
Where were you?
Peering down at me.
Was it the cyclist?
Probably the paramedic.
It was an angel.
Let me guess.
The angel said to you, "Don't go towards the light, Aubrey?"
She said she'd call down her father.
..that I shouldn't wear fur.
HE COUGHS VIOLENTLY
# There is just one thing I need, I don't care... #
Oh! Silly me.
Must've taken a wrong turning after the ladies' room.
-Fletch, there's a call for you at the desk.
It's school. About Evie. And they say it's urgent.
So, let's talk through Ms Naylor's plan.
The frozen elephant's trunk is a hybrid vascular prosthesis
consisting of a tube graft, here,
but also an extra endovascular stent graft here,
which can be inserted into your descending aorta.
Are you going to stick all of that inside of me?
Said the actress to the bishop!
Yes, well, not this exact one, of course,
but one that looks a little like it.
We will cut the great vena cava...
Kat, it's just so weird they're going to, like,
stick all of that inside of my chest.
Are you sure this is a good procedure?
Um, I'm just worried you're not taking this seriously.
This is major surgery. You do realise that...
Zosia? I think Alice understands perfectly.
Right, we're going to cut you open. Spread your chest bones...
Yes, thank you!
-If I worry, is it going to help?
No, well, always look for the positive. That's my motto.
So a friend saw her arrive, but she didn't make it to registration?
I don't get it. That's not truancy.
There will be a perfectly reasonable...
I just think that you're over-reacting.
No! Bloody stupid is what I call...
What are you doing with your back to the ward? For heaven's sake!
It's all right, it's all right. OK. Can you help me here, please?
Sorry. On three. One, two, three.
There we are.
Well, you definitely don't look like you need to shoplift.
I don't look like I need to shoplift, because I shoplift!
No-one normal can afford these labels, unless they steal them,
or pay someone like me to steal for them.
So that's...that's what you do?
Hmmm. "Liberate" to order.
Yes, I am like a personal shopper.
I do dressing, styling, fashion advice, colour consultancy...
So more like a personal shoplifter...?
Customised purchases to suit the client.
Just, I don't do the... purchasing bit.
I'm a professional thief. Yes, I am.
Robin Hood of retail.
Taking haute couture from the rich designer brands and...
Giving them to the poor?
Mmm, not exactly "giving". No.
That bit I don't really do either.
Could you chase Alice's bloods?
Check in with Anaesthetics, see what time they're coming down?
Yeah. Your patient, Alice Thorne.
She seems surprisingly upbeat for someone about to have
a major procedure.
Yes. She has a very positive outlook on life.
Hmm. Which can sometimes be a mask for hidden fears.
I guess everyone has their own coping mechanisms.
Ms Naylor doesn't seem too concerned, does she?
Ms Naylor would prefer all her patients to be unconscious.
OK, I'll be there in a minute. Cheers.
I didn't mean to snap.
I get it. You know what? I'd be narked with me, too, if I was you.
I'm just sick of personal matters interfering with the running of the ward.
But of course, you've got to go find out where Evie's gone.
She'll be at school. She's not one for bunking off.
Anyway, I've got to get Aubrey's chest X-rays.
-I do appreciate your children only have you.
but I can't just keep dropping everything - including
my patients - every time there's a Fletcher family crisis, can I?
I am truly sorry.
To be honest, I'm not angry at you, I'm disappointed...
Me too. I'm not achieving...
..at my own situation.
OK. In what way?
Well, it's just that...
What is she...?
Fletch, sorry I lost my temper.
You know what? Don't worry about it.
Anyway, I'm about to lose mine.
What are you doing here?
You are in so much trouble, young lady.
We've spoken about this before. You do not leave school.
Not for any reason whatsoever.
My angel! It's her!
Told you my dad'd fix you up, didn't I?
Look! No fur!
Still in date until 2017.
OK. Who's this for now?
Helen. I thought the earrings were for Helen.
No, no. Chrissie. Chrissie. Earrings for Chrissie to keep her sweet,
for Daniel's sake. Chrissie's easy.
Buy anything gold, doesn't matter what it is.
-Yeah, but the pashminas, though? Really?
-FBC Us and Es?
They've been taken and sent off. Just waiting for results.
Pashminas always go down really well, don't they?
A woman of a certain age.
You can't have too many expensive scarves, can you?
Anyway, this site's great because, you know, if there's a problem,
instant credit gift voucher. So, it's easy.
Nothing in the history, apart from an allergy to penicillin.
Although her hands were a little bit shaky.
But that could just be the anxiety from being arrested.
Right, let's run a urine test and check
if there's any problems with her kidneys or dehydration.
Why don't you just get a gift voucher in the first place?
Do you know nothing about middle-aged ex-wives?
Do you know me?
Now, Essie. She's the wild card.
History's short and gift success rate is quite mixed.
But of all the women I'm buying Christmas presents for,
she's the one I most want to really, really want to impress.
What scent does she wear?
Citrus, floral or musk?
-Start from basics.
-OK, does she prefer red wine or white?
-Last record she bought?
-Carly Simon's Greatest Hits.
And how does she feel about chick lit?
Loves it openly, loves it secretly? Would never read chick lit?
And nobody else saw him get hit by the bike?
Charmayne and Honey Mae. I told them to tell Miss Atkinson.
Well, obviously they didn't.
Probably forgot. Attention span of a gnat.
The school thought that you'd done a bunk, love.
Cyclist done a bunk. I saw him.
Just left Aubrey lying there on the ground.
Well why didn't you go and tell a teacher then?
Recovery position. Clear the airway.
Don't move any more than necessary. Dial 999.
Stay put until paramedics arrive. It's what you've always taught me.
Position. Airway. Ambulance.
I just wish you'd gone back to school after.
Paramedic said I done brilliant.
Yeah, I mean... You did do brilliant...
Wouldn't let me ride in the ambo, though. So I walked.
-What do you mean, you walked?
-I wanted to see how Aubrey was doing.
Lovely. Right - school.
Aubrey had a pulse of 100 at the scoop.
Medic said BP was 100 over 60.
How's he doing now?
I do know he'd be a lot worse off if it wasn't for you, so...
let's go and see.
Milk, dark or white chocolate?
Milk. Tonnes of it. Big chunks.
None of that sort of wafer-thin stuff.
Last time you took her somewhere and she loved it -
really loved it?
I mean, when you cuddled up in bed that night,
she whispered, "You're a wonderful man,"
and stuck her tongue in your ear?
-I took her to the theatre. Just once.
-OK, OK, OK.
Here's what you do.
You buy an evening clutch bag
in Italian kid leather.
Thistle. Hang on, sorry.
-I will, I will.
And in it you put two tickets to The Nutcracker at the Coliseum
and a tiny pair of white gold diamond stud earrings.
You're a genius. Thank you so much.
Right, whatever's the matter with you, we're going to mend you.
OK, you're going to go out of here like new.
Oh, that is quite some gift.
Yes, it'll work.
No, I meant what you just did for Mr Levy.
Reading his girlfriend like that and working out what she'd want.
I wasn't always a thief. I worked in Beauty and Accessories
-at a London department store through my
Hm. Learn a lot about people in retail.
Well, your blood test results are back.
You do have an elevated white blood cell count at the moment,
and your haemoglobin levels are low.
Now, that, coupled with the lethargy and the aching,
leads me to believe that this could be anaemia.
-You want to know what I think it is?
I think I've got a brain tumour.
'Forgive me if I'm speaking out of turn.'
-I just thought you should know.
I didn't want to say anything in front of your sister
-because it's her decision.
-Yeah, guinea pig?
Of course, the hybrid graft goes through rigorous testing.
It's just, a complex graft like that, it only works
if it's fitted properly.
She did say she'd...
Well, that they'd never done one before, at Holby.
And she outlined the huge risks the procedure carries?
She mentioned pros and cons.
OK. Well, there's this website. It's American.
Lots of theorists and patients.
The blog is full of case histories. I can give you the link.
The other doctors though did seem to think Jac Naylor is the best
consultant to be doing this.
-She's their boss.
-Yeah, I get that, but...
I mean, she's been to international conferences, and...
Where medical reps encourage them to try out their new products.
So, this graft, it's...
Well, it's new.
So they're keen to try it out on guinea pig patients.
Also, and I hope you don't mind me saying, Alice seems very upbeat.
Like maybe she's in some sort of denial?
-She lives in a state of denial.
And you feel that Jac Naylor
has taken this into serious consideration?
Oh, I don't know.
Even her colleagues think she's trigger happy
when it comes to experimental procedures.
-It's... It's not what?
It's not the first time Jac Naylor's done something like this.
Right, OK, so did you bang your head today at all?
I fell down a flight of stairs and an escalator.
Not much of me I didn't get banged.
Right, well, what I can do is
when Neuro come down, I will strongly recommend a scan.
Oh, would you? I'd be so grateful.
It'll put my mind at rest.
And, in return, I'll tell you what to buy your boyfriend for Christmas.
I'm sorry, I don't remember mentioning that.
Don't be silly, a boy like you.
Um, but I did think about it. I just...
I don't know, I didn't want to go over the top
and end up coming across as clingy and weird.
SHE PATS HER BED
His name is Lee.
The Rothschilds, Barclays, Sopwiths.
They'd all come up from London in their Rolls-Royces and Bentleys.
Shoot grouse, of course, you dolt.
Terribly exclusive. Creme de la creme.
Topmost of the top drawer.
Did you shoot grouse?
Hardly. I was a little further down the drawers, in those days.
When was this exactly?
Before my "indiscretion" with Lady Cholmondeley's daughter, of course.
The lovely Araminta.
She didn't need to hunt for grouse.
Her smile could tempt birds from the trees.
What happened with Araminta?
Let's just say...
to the rubber plantations of southern Sri Lanka
was not entirely voluntary.
Aubrey's GCS's at 14, but he's complaining of headaches.
OK, Well, I think it'd be wise to get him a head CT.
Will do. And if it's all right with you, I was thinking
in my lunch break I'd take Evie back to school,
-explain what happened.
But I do promise it won't take more than an hour.
It's fine. Look, the reason I bit your head off earlier...
You were absolutely right to.
Elinor had just bailed on our long-planned Christmas together.
By text. Apparently, her boyfriend's parents have taken
a mountain-view chalet in Val-d'Isere
with VIP platinum service.
Well, I'd love to pretend that I knew what any of that means.
Well, it means that Mum and her turkey and her stuffing
and her cranberry sauce and her Christmas pudding
and her mince pies and her honey-glazed ham...
-have been given the elbow.
-Wow. Someone's been online shopping.
No. I'm going to make it myself... Well, I was going to make it myself.
-You're joking, right?
-There were so many years when I didn't.
You know, working. This year, I thought - ta-da!
'We need to reduce carbon dioxide emissions now.
'It's absolutely critical.'
It says all sorts of different things.
'The ice caps are melting because of ozone depletion.'
I can see that.
It's to encourage more girls to become scientists.
-I get the picture.
-Evie's bright as a button.
I wanted to encourage any aspirations.
Yeah, I don't think you could actually be any more of a nerd.
Bless. So, wait, you're asking me if I think Fletch is going to mind?
Yeah, you don't think that I'm stepping on his toes
-with all this, do you?
-Raf, come on!
I'm not even going to be there over Crimbo to give them.
You can pop them under the tree.
Ah, don't have one.
Like I said, I'm not actually going to be there over Christmas.
Are you going home to your dad's?
We're meeting at a hotel. Me, Giuseppe, Dad.
Sounds better than mine.
Couldn't face being at the family home at Christmas, without Mum.
It's a good alternative.
I am kind of dreading it, to be honest.
She's now starting to have doubts. She's been given some file.
Ollie's talking to them both. The sister is now trying to
-persuade her to refuse...
-Hang on. What file?
'I don't care.'
How can you not care?
I have a good feeling about it.
-Then care for your kid.
-Kat. Come on.
You know I do nothing but care for my baby.
Then don't take this massive risk.
Don't let her do this elephant thing to you. It's not safe.
I don't know what you've heard.
But the honest truth is, no heart surgery is safe.
Well, what I've read suggests my sister isn't safe in your hands.
I can assure you that this procedure, in my opinion,
is the best possible choice for you and your family.
That's fine. I'm sold.
No, hang on, how many of these aneurysms do you see in a year?
And how many suitable for this graft?
-One or two.
-You see? Guinea pig!
Exactly as Nurse Reynolds said.
She's desperate to get her hands on one.
Can I trust you?
-Oh, great. That's it!
-Look, I'm happy to sign,
because I'm happy for Ms Naylor to do what she thinks is best.
Read the file.
I don't want to. I don't need to.
I've got my faith.
Don't come at me with your higher power, positive energy gibberish,
-Alice, just read the file.
-Can I read it?
Look, I, erm... I don't know why you've been given this.
But if you don't want to go ahead with the procedure, then that's fine.
-I can't make you.
-I do want to proceed.
There are alternatives and you can always request another surgeon.
No I...I want to keep going.
Paralysed from the neck down!
Ah, just one of the risks of this frozen elephant thing.
Who told you that?
I saw it on the website that the nurse showed me.
Something goes wrong, it affects the blood supply to your spine.
-Is that true?
But it's more or less the same risk as any other procedure.
Do you want to discuss this with somebody else? Your mother?
Your GP? Your husband?
Mum had familial TAAD, too.
My GP's a lovable idiot.
And James died in a climbing accident 20 months ago.
-Don't be. We were married six years.
And I couldn't have been happier.
Like I said,
-I'm the luckiest woman I know.
-Oh, yeah, with an aneurysm
the size of a tennis ball and connective tissues as soft
-as boiled spaghetti.
-Which is why I'm happy to let them operate.
I just know it will be fine.
And what if it isn't?
If it isn't... Well, that will be fine, too.
Kathryn, it is what it is. Accept it.
Where do I sign?
I know I come across like I'm tough as Teflon.
But I'm worried. Really worried.
I'm losing little tufts of hair.
I'm scared it's some kind of payback for all my dishonesty.
-I mean, stealing isn't very Zen.
-Angela, do you have any idea
how relatively rare brain tumours actually are?
I'm going to have to take this. You go on ahead. I'll catch you up.
Yes. No, thank you very much for calling me back.
Um, yeah, as I was saying to your colleague, I was trying to
make a purchase online and for some reason my credit card was declined.
Er, yeah, no, absolutely.
Well, it was a gift, a Christmas present for my partner, erm..
Yeah, I know, that's what I thought. Erm, but...
Sorry, what do you mean I've reached the end of my limit?
But that's impossible. I haven't...
No, but I...
OK, yeah, no. Of course I'm going to speak to my bank. Absolutely.
OK, thank you.
OK, Aubrey, all you've got to do is lie still.
They're not venomous, you know.
Try not to move.
The snakes. Native snakes.
Look frightful, I agree. But lack any venom.
Except the yellow ones. They are devilish blighters.
I'm afraid to ask, but I'm going to. Aubrey, where are we now?
Kenya, dear boy. Kenya, of course.
He's got a ventriculoperitoneal shunt in situ.
Is that going to be a problem?
Ventricles are very enlarged. Looks like gross hydrocephalus.
How can he have hydrocephalus if he's got a shunt?
Cos it's not working properly.
It's either blocked or it's been disconnected.
Things would be much easier if we had his medical history.
Yeah, I am trying, but it's really hard to get information out of him.
Any concrete information, he keeps wandering off into the '50s.
You know, off playing polo with the Shah of Persia, dear boy.
The increased pressure certainly could cause
the headaches and confusion.
Call Neurosurgery. He needs a shunt revision quickly.
HE LAUGHS TO HIMSELF
Lemon and ginger?
Make me one.
There's no more hot water.
So, boil it again.
Very interesting read.
Mr Hanssen seemed to think so.
Well, he needs to look like he's taking it seriously.
But he knows what really matters in surgery.
And what matters to you is you get to show off.
Use new toys.
A simple pulmonary valve replacement like Seymour Orson needed
is so dull, you're happy to send him home.
Whether he needs the operation or not.
You're making a study of all my patients, now?
The ones you want,
you bully into letting you do experimental procedures that...
-That save their lives.
-That promote Jac Naylor.
Make you look so special.
I'm a leading heart surgeon. I AM special.
It's what you've always done.
Excuse me? You know precisely nothing about me.
Don't be too sure.
Why not just ask to be transferred to another ward?
Why? Am I supposed to be scared of you?
No. Not in the slightest. How's my herbal getting on?
-Got to wait for it to boil.
-Do you think you're the first?
-To do what?
-Make accusations? The NHS is rabidly litigious.
Surgeons get accused of all sorts, all the time.
And they get off because of insufficient evidence.
Cos no-one on the inside is keeping a close enough watch.
And that'll be you, will it?
You think because I'm a nurse, no-one's going to listen to me.
I think people will see that you have trouble working with
-strong women and prefer male bosses.
-That's a lie.
Because then you can flutter your eyelids and flash some cleavage.
I am a professional.
Who's sleeping with a senior male colleague.
And you didn't when he was CEO?
I think we both know exactly how you got promoted
to director of the Cardiothoracic Department,
and it wasn't to do with your performance in the theatre, was it?
Where did you get that?
Aubrey gave it to me.
-You do know you can't keep it, right?
-I know, I told him.
But he just went off on one.
Said it belonged to his great aunt, Lady Painswick.
-Now, I can't get it off.
-Here, let me have a go.
Oh, it's moving.
-There you go.
Fletch. His GCS has dropped to 12 post scan.
Do 15 minute neuro obs and keep a close eye on him, please,
until Neuro get here.
Aubrey, I've got your brooch.
Not now, love. I don't think he's doing too well.
Aubrey, can you open your eyes for me, please?
Why won't he open his eyes?
Raf? Open your eyes for me.
Why isn't he talking? Your brooch, Aubrey.
Open your eyes.
Aubrey? You OK? Aubrey!
No pulse! He's in VF. get the crash trolley, please.
Right, you need to disappear now, darling.
Evie, can you go, please?
Evie - go!
-I thought you weren't operating today.
-So, I'm looking at the theatre list.
And you know it's the same old, same old. Stents, stents and more stents.
And then I see, "Ms Naylor.
"Latest design frozen elephant trunk graft," and I'm like, "Wait, What?"
-And you don't think I'm not thinking,
"When, oh, when is she going to fit one of those?
"Because when she does, I'm all over that like bears on a picnic."
And it's a good thing I'm here cos you're going to need
more dexterous digits than these two clowns have got. No offence.
-Come on, then.
While we're cooling, you can complete the proximal anastomosis.
-Connect the arteries with 2.0 Prolene.
The aortic arch is very dilated so we need to replace it.
And a retrograde perfusion?
That'd be fantastic. If we want to kill our patient.
But we'd like to keep her brain alive so we'll go for
-cerebral perfusion anyway.
-Yeah. Fair enough.
-I'm all for keeping her alive.
-The joy of this thing is,
once we go to circulatory arrest, we open the aorta,
insert the trunk into the distal end of the aneurysm.
With the new insertion device then we can basically place
the trunk wherever we want it,
attach it to the landing zone and then retract the applicator.
Seriously. You had me at "trunk".
Well, this is obviously some mistake
so can you please just... Yes, please.
Neuro came back with a CT, and it's all-clear.
OK, well... Yes. I... Yes, I can hold.
And I agree with you about the blood work, by the way.
Anaemia's too severe to cause double vision and muscle weakness.
And it wouldn't explain the sweating and shaky hands.
It's obviously not right. So just check again.
I don't care! Just check again!
It's...it's all gone.
Right, OK, what's all gone?
My bank account has been emptied.
-You're kidding me.
Online this morning, apparently. Passwords, dongle, everything.
It could be an error, have you checked that?
Well, that's what I've said to them, no-one else has access to...
Oh, God, no. Please. Please, no, please, no.
-The neurosurgeons are all in theatre.
-Right, he's in cardiac arrest.
We're never going to get him back unless we relieve the pressure
-in his brain ourselves.
-No, no time.
-What, in here?
We've got no choice. Glove-up!
-OK, what do you need? Er, Lou!
-Large syringe. Full bore needle.
Swabs. And a lot of luck.
Well, don't look at me for that, mate.
So, shunt's supposed to be draining the excess cerebrospinal fluid
away from the brain ventricles and into his abdominal cavity.
Hydrocephalus is occurring cos the shunt's not working.
Give me your hand.
-Fluid. Feel it?
OK, that's a burr hole that was cut when the VP shunt was first fitted.
If I could just ask you to hold the hair out of the way,
I will attempt to go through the burr hole
and hopefully into the ventricle.
Right. Now, all I have to do is get his heart started again.
Charge to 100, please.
Charge to 150.
Hey, why don't we go outside?
No, I want to stay.
I promised him my dad would make him better.
Well, they'll do everything possible.
And my dad promised us we'd be in our own house by Christmas.
-Right, look, why don't we just go and sit down?
-But I want to stay.
Right, I'm going back in.
That's all I'm going to get, I'm meeting resistance.
Come on, mate, you can do it.
MACHINE BEEPS WITH HEARTBEAT And, we have rhythm.
-Did...did that remind you of your...?
Aubrey told me this brooch was given to his half-brother, Matthew.
Who was a solicitor from Manchester
who inherited this massive mansion.
From his cousin. Lord something.
Who hated Matthew because he wasn't posh.
But he fell in love with the posh lord's daughter.
Lord Grantham! That's it.
You heard of him?
"Made In China"?
My grandfather's medals.
He stole my grandfather's medals.
He's trashed Zosia's room as well.
He's taken my passport and my birth certificate.
Do you have any idea what Grandad Clarence had to go through
to win the Companion of the Distinguished Service Order?
Italy Star? The Croix de Guerre?
I'm sorry. OK? I am sorry.
I feel so violated...
He was parachuted behind enemy lines.
Recruited resistance fighters. Was hunted down.
-I'm sorry, OK? I'm sorry!
Ice bags on head. Lower theatre temperature.
Patient is at 17 degrees.
Start the stop clock.
OK, that gives us between 30 and 45 minutes.
Taking off the clamp.
With the old two stage procedure, we'd still have to
stitch the graft in place for the descending aorta.
But with this...
it should just slide...
There we go.
OK. Trunk is in place, removing the outer sheath.
Holding the inner sheath steady.
What about the Staff, Friends and Family Test?
It's an important survey.
Into whether patients would actually recommend the services
we provide to their friends and family.
No, it's stuck.
Just hold it there.
OK. Well, look if you can't get it out, what you going to do?
-Have you got a backup plan?
-Do you want me to have a go?
-Maybe there's another way of releasing it?
Could you just shut up and let me concentrate
without the background hum of inane questions?
You think people who have been bullied and insulted
and ignored during her working day would actually recommend her
to their loved ones?
I'd be very surprised
if this patient's sister doesn't make a formal complaint.
The alternative is we backpedal
and do an old-fashioned fully open procedure.
After convincing her to go with the frozen elephant trunk?
Well, if you can't work the applicator properly...
-Just one more go.
-She's been on circulatory arrest for 20 minutes.
-We are running out of time.
-I said one more go!
There's another label in this coat, you know.
It's a retired aluminium welder from Weston.
-I guess being Aubrey was just a bit more fun.
Yes, well, sometimes I wish it was as easy as just
-slipping on a different coat.
-I know exactly what you mean.
Oh, come on, Fletch. You don't want to be anyone different.
I'm a widower with four kids, no money
and Christmas looming like Frankenstein's monster.
In fact, who'd want to be me?
Divorcee with an empty nest, too much time on her hands,
and no-one left in the world who actually needs her?
It's been nearly 30 minutes. We need to start circulation soon.
If it doesn't want to come out,
-then we should seriously...
Graft is in place.
Nice, Naylor. Nice.
If that doesn't get you out of bed and into work in the morning,
I don't know what does.
That is perfection.
It's a pay-as-you-go mobile.
Every time I phone through, it just says,
"The mobile number you have called is not available."
Oh, Dom. I'm really, really sorry.
I was just such a fool. I'm so trusting.
I gave him free run of my flat. All my stuff.
Hello, Angela. OK, you definitely do have an iron deficiency.
But your blood glucose levels are actually fine.
So we're just going to wait on the thyroid function test.
You're right. You were a fool.
Thank you. But I don't need you to tell me that. OK?
Er, so we just need to wait for the thyroid hormone levels.
You can't trust someone you don't really know like that.
You don't just open up your life to a total stranger.
Not everyone's a thief. Not everyone can't be trusted.
Not everyone thinks that stealing
is a perfectly acceptable way of making a living.
Well, clearly Lee does.
Right, well, when we've discharged you -
into police custody and then onwards to prison -
you'll need to take iron supplements.
I'm not criticising you. I'm just saying your lifestyle,
-the way you choose to...
-Whoa, I'm sorry, lifestyle?
You want to talk about lifestyle?
OK, erm... You worry.
You think you've got a brain tumour.
Now, when do these "symptoms" tend to occur, Angela?
Is it when you walk into a shop and decide to steal things?
Is it when you are hiding from CCTV, from shop security, from the police?
Is it when you're pretending to be a perfectly normal member of society
whereas, actually, you're just a little thief?
Dominic, I'm sorry.
I didn't mean to insult you.
It's stress. The wobbles, the hand shakes, the uncontrollable sweating.
My guess is it's stressed-induced anxiety
caused by your lifestyle choices.
I'm sorry what I said about, Lee.
in my handbag, hidden in the lining, I've got money.
-If you need cash, you...
-I don't want your dirty money.
Guy, it's Fran.
Please say you're free tonight for a large glass of red.
I need one. I need you.
Not quite as smooth as one might expect of you.
I couldn't work the new delivery device at first. My fault.
-Not the graft. It is fantastic.
And then there is this.
Your patient's sister is making noises
about pursuing a formal complaint,
so you need to talk to the patient and her sister
and perhaps apologise about not being more inclusive.
-I have a team to do that.
-And that is part of the sister's complaint.
I'm afraid being a brilliant surgeon isn't enough.
Well, I was busy planning it. Prepping for theatre.
And I reiterate,
being brilliant in theatre doesn't always satisfy the patient's needs.
She's alive. Her heart will now last decades.
That is enough.
What I can't believe is you're taking this seriously.
I have to.
If you hadn't been able to release the applicator,
-what would you have done?
-I did release it.
But that's what you do, isn't it?
You experiment on patients with such serious problems
and poor prognosis, that no-one's surprised if they die.
Nurse Reynolds, don't antagonise, please.
Mr Hanssen, why in heaven's name is she still here?
Can't you just get rid?
You'd like that, wouldn't you? No-one to keep a close eye.
Just everyone patting your back and kissing your feet.
Can't you just transfer her?
Let's not have this conversation here, please.
Put her down on AAU
amongst the verrucas and vomiters where she belongs.
Let's proceed to your office, shall we?
I've compiled a file that shows your mortality rate
is double the national average.
That you coerce vulnerable patients into experimental procedures.
If I'm forcibly transferred,
how would that look?
You're right. It wouldn't look good.
It would look like we were trying to cover something up.
It would look like we actually cared
what some chippy little doctor-bonking nurse thinks.
-Ms Naylor, please!
-I'm sorry. Consultant-bonking nurse.
I forgot you managed to hook your claws around the rungs
of the sleep-your-way-up ladder.
Ms Naylor, it ill behoves you to behave in this manner.
I couldn't care less about Guy Self.
I care about what you're doing here.
And you can't bear working with a successful female boss
because you can't use your charms, fading though they are.
And it just highlights what a loser you are.
Successful means putting your patients' lives at risk
so you can score points.
Instead of having a life that is pathetically pointless.
Living from shift to shift.
Shag to shag, with increasingly older doctors.
Jealous of anyone who wields more power than you.
You are such a vicious cow!
-Ladies, stop it now.
-And you are a bitter, frightened little nothing
who will always be nothing
because all you're good for is moaning and whining...
And there you have it!
Physical assault of a senior consultant in the workplace.
Did anyone miss that? No?
That should be more than enough to suspend her. Agreed?
Then she offered me money - from her secret going-to-prison stash.
That's rather sweet, actually.
She's a professional thief.
Oh, but apparently she only steals from the larger department stores.
Well, thief or not, she's been amazing for my Christmas list.
I got the lot done. Even Rachel.
Oh, well, good for you(!)
Well, I'm just saying.
Well, her life of crime has left her an anxious mess.
Shaking hands, sweating, loss of weight.
Mood swings? Muscle weakness?
She said she felt like a kitten with the flu.
She did fall over and crack her head.
Sounds a lot like thyroid to me.
But you did run a thyroid function test, didn't you?
Yeah. The results haven't been posted yet.
Oh, well, your shift's over. The night doctor will pick it up.
Really, she should be taking beta blockers
and being referred for thioamides treatment.
That'll happen all after her police custody, I suppose.
Well, it would happen a lot quicker if I just wrote up a treatment plan
and paid a visit to the prison doctor though, wouldn't it?
What else am I going to do at Christmas?
I'm penniless and heartbroken.
-Another, I think.
I went mad trying to compensate.
I've got a freezer groaning with food.
Not after my little swarm of locusts descend on you, you won't.
Good! I want it eaten. That's why I bought it.
Look, Giuseppe's not in exactly a good place at the moment.
Because your mother died. News flash - so did mine.
Look, think of it as the Dead Mothers Christmas Club
-We'll drive you mad.
-Mad? You want to see mad.
Come and see what I'll look like on Boxing Day night
after three long days on my own with the Downton Abbey boxset
and a crate of Shiraz!
So...actually we'd be, well, saving you from yourself, really?
-We'd be doing you a favour?
I suppose we've got nothing else planned.
I've got two trees.
Two. One in the kitchen and one in the sitting room.
-There's only me.
-You've got trees?
Yeah, it is Christmas.
And we'd be able to put our presents under the tree?
Yes, you can dance around it with nothing but a Santa hat
and a tinsel jockstrap, if you like.
Yeah, I actually haven't got round to getting a tree, yet.
So? Look, I'm asking Cara.
Apparently she's on her own this year.
Well, look, I could suggest it.
And we could consider it.
I won't take no for an answer.
Yeah, go on, then.
OK. Why not? Let's do it.
Is that all right with you, Evie?
Yeah. Sure. Sounds nice.
Go on. Tell me.
I thought we were staying at home in Raf's house. Just us.
Oh, you want to be just on your own as a family?
I kind of wanted to invite Aubrey to come to us as well.
-It's rubbish in their care home.
They make them dance the Hokey-Cokey
all sitting down in their wheelie chairs.
No question then. That's a clear infringement of his human rights.
If he's well enough, Aubrey's coming too.
Aww! How exciting.
Let's get her a referral to the endocrinologist.
They'll want her on a high dosage of Carbimazole.
But in the meantime, can we write her up for 40 mg of Propranolol
twice daily? That should hopefully keep the shakes under control.
Oh, and can we also put her down for oral iron supplements?
Might as well put a spring back in her step.
Oh, and Lawrence, would you let the prison doctor know
that I will be chasing it up?
These gentlemen are going to escort you off the hospital premises
and you are not to return until invited to for your HR hearing.
We operate a no tolerance of violence policy here
and this incident will be reported to the police.
Am I perfectly clear?
Thank you, gentlemen.
Oh, Guy. Guy, thank God you're here. Can you do something about this?
Erm, could you give us a moment, please?
I've been informed about today's events. So, you and me,
this...whatever it is - was -
we should end it.
Guy! Don't walk away from me.
DO NOT walk away from me!
Fran ramps up her manoeuvres against Jac, and when she raises the possibility of a formal complaint from a patient's sister, Hanssen has to take her concerns seriously. But has Fran underestimated Jac's ability to fight back?
Serena's disappointed when her daughter bails out of their planned Christmas together. Raf and Fletch are also dreading the festivities, but perhaps Serena has the perfect solution?
In the first flush of love, Dominic's keen to buy the perfect Christmas present for Lee with the help of a willing patient. However, a shocking revelation leaves him reeling.