What It Takes

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0:00:40 > 0:00:43You should have the surgery, Mills.

0:00:43 > 0:00:44Guy...

0:00:44 > 0:00:47You told me that the op would work.

0:00:47 > 0:00:50I think you need to step away.

0:00:50 > 0:00:52I think a leave of absence is in order.

0:00:56 > 0:00:57Arthur.

0:00:57 > 0:00:59I don't know what you think you saw,

0:00:59 > 0:01:01but you've got the wrong end of the stick.

0:01:01 > 0:01:03Stealing medication?

0:01:03 > 0:01:04..is unforgivable.

0:01:04 > 0:01:06You wouldn't accept help with your issues.

0:01:06 > 0:01:09I'm not going to stick around and see you kill somebody.

0:01:12 > 0:01:16SHIPPING FORECAST ON RADIO

0:01:25 > 0:01:29I looked up "counselling" in the dictionary. Oxford English.

0:01:29 > 0:01:31Obviously.

0:01:31 > 0:01:35"The giving of advice on personal, social and psychological problems."

0:01:40 > 0:01:43So far I seem to be doing all the talking.

0:01:47 > 0:01:52And if the point's to... to lead me towards some sort of

0:01:52 > 0:01:56self-awareness, believe me, I am well aware of my own shortcomings.

0:01:58 > 0:02:00Most days, I wish I could be someone else.

0:02:03 > 0:02:05I could retrain.

0:02:05 > 0:02:07I'm young enough.

0:02:07 > 0:02:13I could, erm, move to Australia and, I dunno, take up marine biology.

0:02:13 > 0:02:15But it wouldn't make any difference.

0:02:15 > 0:02:17I'd still be me.

0:02:18 > 0:02:22The truth is, if I'm not a doctor...

0:02:22 > 0:02:24I don't know who I am.

0:02:35 > 0:02:38This is Walter Dunn, 55.

0:02:38 > 0:02:41Car came off the road into a ditch and he was trapped for two days.

0:02:41 > 0:02:43Now, he's no obvious injuries, just cuts and bruises,

0:02:43 > 0:02:46but he's hypernatremic and clinically dehydrated

0:02:46 > 0:02:48so the ED have sent him through for fluid resuscitation.

0:02:48 > 0:02:50Nice contacts.

0:02:50 > 0:02:51Thank you.

0:02:51 > 0:02:53Hello there, I'm Dr Digby.

0:02:53 > 0:02:55You're not THE Walter Dunn, are you?

0:02:55 > 0:02:58As in Cambridge Professor of stem cell research?

0:02:58 > 0:02:59Er... Yes.

0:02:59 > 0:03:01Good grief. Um, it's an honour.

0:03:01 > 0:03:02I've read all your papers.

0:03:02 > 0:03:05- Walter, you never told me you were famous.- I didn't know.

0:03:05 > 0:03:08- He's going to cure Parkinson's. - Well, I don't know about that,

0:03:08 > 0:03:11but I appreciate the vote of confidence, Dr Digby.

0:03:11 > 0:03:12Arthur, please.

0:03:12 > 0:03:13Well, look, Arthur.

0:03:13 > 0:03:17It's been quite a couple of days and I really want to get home.

0:03:17 > 0:03:19Of course, of course, erm...

0:03:19 > 0:03:21Ah, Dr Digby! Welcome back.

0:03:21 > 0:03:24Um, Dr Shreve? Could you take over here, please?

0:03:24 > 0:03:26Oh, no, it's fine, we were just, er...I was...

0:03:26 > 0:03:29There's something different about you. Have you changed your hair?

0:03:29 > 0:03:34- Uh, no...- Contacts. - Oh, yes! Suits you.

0:03:34 > 0:03:36I think.

0:03:36 > 0:03:39Now then, I'm afraid we're a little short-staffed today.

0:03:39 > 0:03:41Mr Di Lucca's claimed all his unused annual leave.

0:03:41 > 0:03:43As he's about to lose his entitlement to it,

0:03:43 > 0:03:45I couldn't really say no.

0:03:45 > 0:03:48But it does mean I'm spinning rather a lot of plates this morning.

0:03:48 > 0:03:50So I just need to go and check on a patient for a minute.

0:03:50 > 0:03:52I'll be back with you as soon as I can.

0:03:52 > 0:03:55- Do you want to go and wait in my office?- Right, um...

0:03:58 > 0:04:01Morning, darling. You waiting for someone?

0:04:01 > 0:04:04Yes. You. Would you like a coffee before you go in?

0:04:04 > 0:04:06Oh, I'll be fine. It's just a formality.

0:04:06 > 0:04:10I know. I was here early anyway. I'm hoping to bag some theatre time.

0:04:10 > 0:04:12There's a bilateral lung transplant coming in.

0:04:14 > 0:04:19Can we get a soya latte, extra shot, extra foam, hazelnut syrup and a...?

0:04:19 > 0:04:21- A coffee. - I'll bring it over to you.

0:04:24 > 0:04:26So who's going to be there, do you know?

0:04:26 > 0:04:28The usual suspects.

0:04:28 > 0:04:31The root cause analysis has been done,

0:04:31 > 0:04:34the report's been written, I've had a psych review, which was fine,

0:04:34 > 0:04:37so this is just a box-ticking exercise, really.

0:04:37 > 0:04:40Good. There's nothing to worry about, then.

0:04:40 > 0:04:41No.

0:04:41 > 0:04:4318-year-old male.

0:04:43 > 0:04:47Found unconscious on a playing field with a GCS of three.

0:04:49 > 0:04:51Uh, intubated at the scene.

0:04:51 > 0:04:54BP 165 over 70,

0:04:54 > 0:04:57pulse 65, sats 98 and ventilation.

0:04:57 > 0:05:02No obvious injuries, query neurological event.

0:05:02 > 0:05:06Right, FBC, LFTs, U&Es, clotting, group and save, please,

0:05:06 > 0:05:08and an urgent head CT.

0:05:08 > 0:05:11Thanks, Jamie. Any name on the notes?

0:05:11 > 0:05:14Um...can't see anything.

0:05:14 > 0:05:16OK, can I have his ID, please? Thank you.

0:05:21 > 0:05:24Right, can you see if Mr Self is still in the building?

0:05:24 > 0:05:27And then can you call Mr Hanssen and say we've got a situation?

0:05:27 > 0:05:29OK.

0:05:32 > 0:05:34You're out already. How'd it go?

0:05:34 > 0:05:38There's no referral to the GMC and I can resume clinical duties

0:05:38 > 0:05:41- whenever I'm ready. - That's great.

0:05:41 > 0:05:43- Isn't it?- Yeah.

0:05:43 > 0:05:44Just a second.

0:05:44 > 0:05:47You know what the Clinical Governance Committee are like.

0:05:47 > 0:05:50- They choose their words carefully. - OK...?

0:05:50 > 0:05:53They said that there was no negligence but, in hindsight,

0:05:53 > 0:05:56said that the judgment call I made

0:05:56 > 0:05:58on the Renwick case was the wrong one.

0:05:58 > 0:06:00Wow, they actually said that?

0:06:00 > 0:06:02Yep. Not in so many words, but you know what they're like.

0:06:02 > 0:06:06- Well, we can always make the right decision in hindsight.- Exactly.

0:06:06 > 0:06:08- You're not letting this get to you, are you?- No. No, no, no.

0:06:08 > 0:06:11Darling, I probably shouldn't talk to you about this here.

0:06:11 > 0:06:13- I'll go.- No, no, no. Let's talk about this properly.

0:06:13 > 0:06:15Tell me exactly what they said.

0:06:17 > 0:06:20Everything all right there, Professor?

0:06:20 > 0:06:21Ah, good. I was just coming to find you.

0:06:21 > 0:06:24I'd rather we actually kept that in just for a minute.

0:06:24 > 0:06:26Honestly, I'm feeling so much better.

0:06:26 > 0:06:29Just tired.

0:06:29 > 0:06:32So if you don't mind discharging me, I'll get out of your hair.

0:06:32 > 0:06:36I just want to make sure that you're definitely OK first. OK?

0:06:36 > 0:06:40All I need is a hot shower and my own bed.

0:06:40 > 0:06:41Really. Thank you.

0:06:41 > 0:06:44Any headache? Dizziness?

0:06:44 > 0:06:46No.

0:06:46 > 0:06:49Your fluids haven't finished running through yet.

0:06:49 > 0:06:50I'll have a drink at home.

0:06:50 > 0:06:54- A glass of water won't cut it, I'm afraid.- I'll have two.

0:06:54 > 0:06:57Um, listen, just give me two hours.

0:06:57 > 0:06:59We'll finish running the rest of those fluids through.

0:06:59 > 0:07:02Check your bloods are back to normal, and then you can go.

0:07:02 > 0:07:03Right.

0:07:03 > 0:07:07I'll just go and grab another cannula and I'll be right back.

0:07:07 > 0:07:09Cara, keep an eye on Professor Dunn, will you?

0:07:09 > 0:07:11Just do his obs or something?

0:07:11 > 0:07:12Sure.

0:07:14 > 0:07:18Walter? How about we see how your blood pressure's doing?

0:07:18 > 0:07:20If you insist.

0:07:26 > 0:07:28I think you're reading into this much more than you should.

0:07:28 > 0:07:30They're not neurosurgeons.

0:07:30 > 0:07:33It's not for them to say whether you made the right call or not.

0:07:33 > 0:07:35Well, yeah - I don't need them to tell me I got it wrong.

0:07:35 > 0:07:38I know. I feel bad enough as it is. I couldn't feel any worse.

0:07:38 > 0:07:41I mean, how do they expect me to go to theatre every day

0:07:41 > 0:07:43and make these decisions...

0:07:43 > 0:07:45I mean, the consequences can spiral out of control at any...

0:07:45 > 0:07:47Listen, this is what you do.

0:07:47 > 0:07:51Someone has to make these very difficult choices.

0:07:51 > 0:07:54And as long as, at that moment, when you're making that decision,

0:07:54 > 0:07:57you feel sure you're doing the right thing...

0:07:57 > 0:08:00I don't think anyone can ask any more of you than that.

0:08:00 > 0:08:04- But they do.- Well, they shouldn't. You're only human.

0:08:04 > 0:08:06Who? What? Me?

0:08:06 > 0:08:09Yes, I'm sorry to break it to you, but there it is.

0:08:09 > 0:08:12Listen, thanks, darling. I'm sorry to have off-loaded all this on you.

0:08:12 > 0:08:15No, no, I'm glad you did. Anyway, I'd better get on.

0:08:15 > 0:08:18- Yeah, yeah, of course. I'll head home.- Good idea.

0:08:18 > 0:08:20BEEPING

0:08:22 > 0:08:26- Excuse me, Dr March. - Ah yes, of course, thanks.

0:08:26 > 0:08:28So, a bilateral lung transplant, eh?

0:08:28 > 0:08:31I was thinking of asking Zosia to scrub in, if you can spare her?

0:08:31 > 0:08:33- HE CHUCKLES - What?

0:08:33 > 0:08:35- Oh, she said you'd ask. - Did she?

0:08:35 > 0:08:37She already got me to clear her schedule.

0:08:37 > 0:08:39Oh, did she now? Little Miss Presumptuous.

0:08:39 > 0:08:42She wouldn't have that much brass with Jac. Am I a soft touch?

0:08:42 > 0:08:44Come on. It would be good for her portfolio.

0:08:44 > 0:08:46All right, but I'm not going to wrap it up in a bow

0:08:46 > 0:08:49- and hand it to her on a silver platter.- Meaning?

0:08:49 > 0:08:52Meaning I've got more work than time to do it in and a very able

0:08:52 > 0:08:54and keen junior at my disposal.

0:08:54 > 0:08:56Quid pro quo, my funny Valentine. Quid pro quo.

0:08:56 > 0:08:58Ms Effanga...

0:08:58 > 0:09:01Selfie Junior! You've got a big day with me today.

0:09:01 > 0:09:02Ward round in five minutes.

0:09:06 > 0:09:08Do you know who's on duty?

0:09:08 > 0:09:10No, sorry, Sacha's ringing now.

0:09:10 > 0:09:15Good. OK, let's get a central line in. He'll need catheterising.

0:09:15 > 0:09:20- Let's get some more fluids up. Do we have an ABG?- Yes, sir.

0:09:20 > 0:09:22OK. Have our anaesthetic team seen this?

0:09:22 > 0:09:24- Yes, sir. - Good. Is his mother here?

0:09:24 > 0:09:26- Not yet.- But she's been informed?

0:09:26 > 0:09:28- As far as I know.- OK, good.

0:09:33 > 0:09:35Good morning, Mr Osborne, you're looking perkier.

0:09:35 > 0:09:38Let's chase his bloods and do a repeat ECG.

0:09:40 > 0:09:45FBC, U&Es, LFTs, and clotting. Run an ECG and organise an echo.

0:09:49 > 0:09:51Ah, Mr Iqbal. Nice to see you.

0:09:51 > 0:09:52Bay one, please.

0:09:52 > 0:09:54We're going to need IV access.

0:09:54 > 0:09:57Put a catheter in, run some fluids and do a spirometry test.

0:10:00 > 0:10:02Mrs McArdle.

0:10:02 > 0:10:05Doctor March here is going to remove your surgical drain,

0:10:05 > 0:10:10dress your wound and then we'll see about getting you discharged, OK?

0:10:10 > 0:10:12Ah, the lovely Mrs Monroe.

0:10:12 > 0:10:15OK, let's do an INR, adjust her warfarin dose,

0:10:15 > 0:10:18and then call H-COP and see if they've got a bed free.

0:10:20 > 0:10:23Good morning, Mrs Adejoke. Has the nausea subsided?

0:10:23 > 0:10:25SHE VOMITS

0:10:25 > 0:10:26Guess that's a no, then.

0:10:26 > 0:10:29Get a nurse to clean that up, put her on nil by mouth,

0:10:29 > 0:10:31increase fluids, give her an anti-emetic.

0:10:31 > 0:10:3520 milligrams of metoclopramide should do the trick.

0:10:37 > 0:10:41Sorry to have kept you. It's getting a bit hectic out there.

0:10:41 > 0:10:43Well, I'm here and ready to roll my sleeves up, so...

0:10:43 > 0:10:47Great! Though obviously you can't just pick up where you left off.

0:10:47 > 0:10:49Can't I? Why not?

0:10:49 > 0:10:51Um, my GP's prescribed me citalopram,

0:10:51 > 0:10:54which I've been taking, referred me to counselling,

0:10:54 > 0:10:55which I've been attending

0:10:55 > 0:10:58and I've been interviewed by HR and occupational health,

0:10:58 > 0:10:59and Mr Hanssen...

0:10:59 > 0:11:01I appreciate you've already jumped through a lot of hoops

0:11:01 > 0:11:04and that medically speaking you've been cleared to come back.

0:11:04 > 0:11:07- But that's not all there is to it. - What else is there?

0:11:07 > 0:11:10Well, you don't exist in a bubble, Arthur.

0:11:10 > 0:11:12This is a front-line department,

0:11:12 > 0:11:15which means we sometimes have to deal with difficult situations

0:11:15 > 0:11:17in a professional and diplomatic manner.

0:11:17 > 0:11:18No, I understand that...

0:11:18 > 0:11:21Hang on there, tiger, I haven't quite finished.

0:11:21 > 0:11:22We also have to work as a team.

0:11:22 > 0:11:26And as the consultant ultimately responsible for everything that

0:11:26 > 0:11:29happens here, I need to be convinced that you have the right attitude.

0:11:29 > 0:11:31Of course. Yep. I understand.

0:11:32 > 0:11:36And can I just say that I am really sorry for my previous behaviour.

0:11:36 > 0:11:38I'm sure you are.

0:11:38 > 0:11:41Um, obviously at the time I wasn't myself,

0:11:41 > 0:11:43but now I have my condition under control

0:11:43 > 0:11:46so I can assure you that nothing like that will ever happen again.

0:11:46 > 0:11:48No. It won't.

0:11:48 > 0:11:50You're going to be under my direct supervision

0:11:50 > 0:11:54until I'm satisfied that there is indeed a place for you on AAU.

0:11:54 > 0:11:56Is that really necessary?

0:11:56 > 0:11:57I think it is.

0:11:58 > 0:12:02You have some bridges to build, Arthur. Don't take that lightly.

0:12:08 > 0:12:10I've never really been a people person.

0:12:12 > 0:12:13How can I explain it?

0:12:15 > 0:12:20Um, I have this...aunt, who, well, she gets very nervous around dogs

0:12:20 > 0:12:24because she says she can never tell what they're thinking.

0:12:26 > 0:12:28That's how I feel about people.

0:12:29 > 0:12:32They change their mind from one moment to the next.

0:12:32 > 0:12:34They say one thing when they mean another.

0:12:36 > 0:12:39You never quite know where you are.

0:12:39 > 0:12:42And throughout school and university it didn't matter, you know.

0:12:42 > 0:12:44I didn't need to make friends.

0:12:44 > 0:12:48I absorbed myself in my work. In my books. In my exams.

0:12:48 > 0:12:52And everyone said "you'll go far" because I was doing so well.

0:12:55 > 0:13:01But it's not enough, is it? It's not enough.

0:13:01 > 0:13:03OK, thank you.

0:13:03 > 0:13:06McKenna is on call but he's been pulled into surgery.

0:13:06 > 0:13:10They said he's going to ring as soon as he gets out.

0:13:10 > 0:13:12- McKenna.- Yes.

0:13:12 > 0:13:15Well, we're going to have to tread very carefully, Mr Levy.

0:13:15 > 0:13:16With the mother's influence,

0:13:16 > 0:13:19things could spiral out of control very quickly.

0:13:19 > 0:13:21Yes, yes. I understand.

0:13:21 > 0:13:23We must ensure that we have the right man for the job.

0:13:23 > 0:13:26I can't tell you how grateful I am not to be a neurosurgeon right now.

0:13:26 > 0:13:28Indeed. You and me both.

0:13:28 > 0:13:30- Where is he? - Ms Brassvine.

0:13:30 > 0:13:34- Where's my son? - He's in ITU. Guy's with him.

0:13:34 > 0:13:35Oh, my God.

0:13:35 > 0:13:38Nurse Reynolds, would you escort Ms Brassvine to ITU, please.

0:13:38 > 0:13:40Yeah, of course. This way.

0:13:42 > 0:13:45Right, well, I'll go and make a few phone calls and you let me know

0:13:45 > 0:13:46as soon as McKenna's out of surgery, please.

0:13:46 > 0:13:48Yes. Of course.

0:14:02 > 0:14:04- Everything all right? - Yeah, fine, thank you.

0:14:04 > 0:14:08I just thought Professor Dunn had already been cannulated in the ED?

0:14:08 > 0:14:11That was my fault, I'm afraid. I...I jumped the gun.

0:14:11 > 0:14:14Does that happen often, Professor? The tremor?

0:14:14 > 0:14:16No, it's just come on. Sorry. I don't know why.

0:14:16 > 0:14:19Hey, it's to be expected after the shock you've had.

0:14:19 > 0:14:21It's bound to catch up with you.

0:14:21 > 0:14:24- May I?- Sorry.

0:14:24 > 0:14:25No, it's my fault. Silly.

0:14:29 > 0:14:31I see you've got a cut on your head there.

0:14:31 > 0:14:33Was that during the accident?

0:14:33 > 0:14:36Just on the air bag. It's fine.

0:14:36 > 0:14:38OK, and you didn't hit your head on anything else?

0:14:38 > 0:14:41- Miracle, isn't it? - Sounds like you had a lucky escape.

0:14:42 > 0:14:49Just humour me for a minute. Just bend your arms.

0:14:49 > 0:14:51And then back down again.

0:14:51 > 0:14:54OK, and pull me towards you... And push away...

0:14:56 > 0:14:57Just get rid of this.

0:14:57 > 0:15:00OK, touch your nose and then touch my finger.

0:15:05 > 0:15:07There we go. And then palms,

0:15:07 > 0:15:11OK, then pat your head and rub your tummy.

0:15:11 > 0:15:13Just kidding.

0:15:15 > 0:15:17Um, what's his temperature?

0:15:17 > 0:15:20Is all this really necessary? It's just a superficial head injury.

0:15:20 > 0:15:23No, I'm sure, I'm sure. It's just I wouldn't want to miss anything.

0:15:23 > 0:15:26- The Medical Research Council would never forgive me.- 37.6.

0:15:27 > 0:15:29OK, let's do a CRP then,

0:15:29 > 0:15:32and just to be on the safe side, can we order a head CT as well, please?

0:15:32 > 0:15:34I'd just as soon get home.

0:15:34 > 0:15:37- I don't want to cause any trouble. - Oh, no, it's no trouble at all!

0:15:37 > 0:15:40A head CT? Don't you think that's a bit over the top?

0:15:40 > 0:15:41No, I don't think so.

0:15:45 > 0:15:48He's very fit.

0:15:48 > 0:15:50I don't know how this has happened.

0:15:54 > 0:15:56What are you doing here, J?

0:15:56 > 0:15:59Just here to observe, help out where I can.

0:15:59 > 0:16:01Kai's head CT.

0:16:06 > 0:16:08Well?

0:16:10 > 0:16:12There's a bleed.

0:16:12 > 0:16:15In the brainstem, here.

0:16:15 > 0:16:17Caused by?

0:16:17 > 0:16:18An MRI should answer that.

0:16:18 > 0:16:20I'll call down now.

0:16:20 > 0:16:21Tell them it's urgent.

0:16:24 > 0:16:26Will he need surgery?

0:16:26 > 0:16:27One step at a time.

0:16:29 > 0:16:33I'm so glad you're here. I wasn't sure you would be after...

0:16:34 > 0:16:36everything that happened.

0:16:37 > 0:16:40Just so you know, Patsy, once the on-call neurosurgical

0:16:40 > 0:16:43consultant arrives, I'll be handing over.

0:16:44 > 0:16:46Why?

0:16:46 > 0:16:49You're well known to me, as is Kai.

0:16:49 > 0:16:51It would be much better to have a fresh pair of eyes,

0:16:51 > 0:16:54someone who can be truly objective.

0:16:54 > 0:16:58In case there are any... difficult decisions to make.

0:16:58 > 0:17:01What do you mean by difficult decisions?

0:17:01 > 0:17:03Kai's situation is very serious.

0:17:03 > 0:17:06We're not sure what damage there's been...

0:17:06 > 0:17:09or whether this is something that he will survive.

0:17:13 > 0:17:16Right, Mrs Choudry's back from X-ray when you're ready.

0:17:16 > 0:17:18Mr Goodwin's catheter's back in and his bloods have gone off.

0:17:18 > 0:17:21Miss Lyons asked for some more pain relief and I said you'd check.

0:17:21 > 0:17:23- All right?- Thanks. - Now, leave me to it.

0:17:23 > 0:17:26- I've got a mountain of paperwork to get through.- Sure.

0:17:26 > 0:17:29- Shout if you need me.- I will. Do you know when Mr Di Lucca's coming back?

0:17:29 > 0:17:33No idea. But that is the luxury of having a holiday with no end date...

0:17:33 > 0:17:36- Professor Dunn's blood results. - Ah, excellent.

0:17:36 > 0:17:38Ah, I thought he was Dr Shreve's patient?

0:17:38 > 0:17:39Oh, yes. OK.

0:17:39 > 0:17:41Thank you.

0:17:41 > 0:17:44OK, so CRP's up.

0:17:44 > 0:17:47- OK. Has he been for his head CT yet?- Still waiting for a slot.

0:17:47 > 0:17:51You think, because of his tremor, he's got Parkinson's.

0:17:51 > 0:17:52Well, not just cos of the tremors.

0:17:52 > 0:17:55He's also got signs of muscle wastage,

0:17:55 > 0:17:57and he's got poor co-ordination.

0:17:57 > 0:17:59He's a single man in his fifties who lives alone,

0:17:59 > 0:18:02and he's exhausted and dehydrated from spending two days in a ditch.

0:18:02 > 0:18:05Yes, but if they're pre-existing symptoms,

0:18:05 > 0:18:07that might be why his car ended up in the ditch in the first place.

0:18:07 > 0:18:11The CT won't tell us he's got Parkinson's.

0:18:11 > 0:18:15- No, but it will rule out some other things.- OK.

0:18:15 > 0:18:17He wouldn't be the first doctor who's dedicated himself

0:18:17 > 0:18:20- to curing his own disease.- Sure. But why would he keep it a secret?

0:18:20 > 0:18:24Well, to stay on his research. It'd be a conflict of interest, surely.

0:18:24 > 0:18:25But he retired. Last year.

0:18:25 > 0:18:30Listen, I think you might be looking for a mystery where there isn't one.

0:18:30 > 0:18:34Most cases aren't as complicated as that.

0:18:34 > 0:18:36Sometimes people just crash their car.

0:18:38 > 0:18:39Am I missing something?

0:18:41 > 0:18:43You are kind of stealing her thunder.

0:18:43 > 0:18:44What?

0:18:44 > 0:18:46She had everything under control,

0:18:46 > 0:18:49then you came in and sort of took over.

0:18:49 > 0:18:51No, I was trying to help.

0:18:51 > 0:18:53I know. but I think you might have...

0:18:53 > 0:18:55What?

0:18:55 > 0:18:59Embarrassed her. Maybe. Just saying.

0:19:03 > 0:19:07The worst part is, it's as if everyone else instinctively

0:19:07 > 0:19:09knows how to navigate these social minefields.

0:19:11 > 0:19:13And it's not as if I don't try. I do.

0:19:15 > 0:19:19I just always manage to get the wrong end of the stick or...

0:19:21 > 0:19:23say the exact wrong thing.

0:19:23 > 0:19:26- Dr Shreve. Morven? - Look, can it wait?

0:19:26 > 0:19:28I think we might have had a little misunderstanding.

0:19:28 > 0:19:30- I didn't mean to upset you. - You haven't.

0:19:30 > 0:19:34OK, look, I don't want to get off on the wrong foot here.

0:19:35 > 0:19:38And I owe you an apology. For before.

0:19:39 > 0:19:40OK.

0:19:44 > 0:19:47I apologise for what happened. I wasn't myself.

0:19:47 > 0:19:50I was suffering from a condition which obviously

0:19:50 > 0:19:51affected my behaviour.

0:19:54 > 0:19:57So it won't happen again. OK?

0:20:05 > 0:20:09Excuse me, Professor. I'm sorry to wake you, I know you're tired.

0:20:09 > 0:20:12I've had your blood results back.

0:20:12 > 0:20:14I was just thinking about you.

0:20:14 > 0:20:17Do you remember when we went to Margate?

0:20:17 > 0:20:20- Margate? - Yes, with Peter and Claire.

0:20:23 > 0:20:25You won the roller derby, you remember?

0:20:25 > 0:20:29- Yeah. That wasn't me. - Yes! Silly girl. Ha!

0:20:29 > 0:20:32Are you all right, Professor? Do you know where you are?

0:20:32 > 0:20:34Of course I do, I'm in the hospital.

0:20:34 > 0:20:37What time is my meeting with the board?

0:20:37 > 0:20:40Oh. I've lost the stethoscope.

0:20:40 > 0:20:42I've lost my stethoscope.

0:20:44 > 0:20:45Can I borrow yours?

0:20:45 > 0:20:47Not just at the minute.

0:20:47 > 0:20:50- I can't lie around here all day, I've got work...- OK, Professor.

0:20:50 > 0:20:52It's OK, Professor, you don't have to work today.

0:20:52 > 0:20:55- Everything OK?- Yes. He's got some confusion. It's just come on.

0:20:55 > 0:20:59He's tachycardic and pyrexic. Bloods showed raised CRP.

0:20:59 > 0:21:00I think he's septic.

0:21:00 > 0:21:01So?

0:21:08 > 0:21:10Breathe in for me.

0:21:10 > 0:21:12And out again.

0:21:13 > 0:21:15And again.

0:21:17 > 0:21:20Bilateral basal crackles. Maybe pneumonia?

0:21:20 > 0:21:22Suggest we start him on IV tazocin.

0:21:23 > 0:21:25Yes, good.

0:21:25 > 0:21:28Radiology just called. They're ready for Walter's head CT now.

0:21:28 > 0:21:30- What head CT?- Uh, well, I was concerned

0:21:30 > 0:21:33that there was an underlying cause. Possibly Parkinson's.

0:21:33 > 0:21:37- And how would a head CT help? - Well, no, I wanted to rule out...

0:21:37 > 0:21:39Cancel it. Get the antibiotics started - let's see

0:21:39 > 0:21:42if we can get on top of this infection.

0:21:42 > 0:21:44Quick word please, Dr Digby?

0:21:48 > 0:21:50It's Guy Self. Is McKenna coming?

0:21:51 > 0:21:54Well, can somebody please call and find out what is going on?

0:21:54 > 0:21:56Thank you.

0:21:57 > 0:21:59What have you found?

0:21:59 > 0:22:01Patsy, you really shouldn't be in here.

0:22:01 > 0:22:04Someone will come and talk you through everything in a moment.

0:22:04 > 0:22:05Don't patronise me, Guy.

0:22:05 > 0:22:07If it wasn't for the money I brought in,

0:22:07 > 0:22:09this hospital wouldn't even have that scanner.

0:22:09 > 0:22:11I want answers.

0:22:14 > 0:22:17OK, there's a cavernous malformation in the brainstem.

0:22:17 > 0:22:19A cavernoma.

0:22:19 > 0:22:22It's a cluster of abnormal blood vessels.

0:22:22 > 0:22:24The cells that line them are thinner than they should be

0:22:24 > 0:22:29so they're prone to leak blood into the surrounding brain tissue.

0:22:29 > 0:22:30Can you fix it?

0:22:30 > 0:22:34Well, it is possible for someone to remove a cavernoma with surgery

0:22:34 > 0:22:37but it's extremely risky, especially in the brainstem.

0:22:37 > 0:22:40And if you don't remove it? Will it keep bleeding?

0:22:40 > 0:22:43Or bleed again further down the line?

0:22:43 > 0:22:46Well, yes, if he survives this one then it could happen again.

0:22:46 > 0:22:47Causing more damage?

0:22:47 > 0:22:49Yes.

0:22:49 > 0:22:52And potentially...kill him.

0:22:54 > 0:22:55Yes.

0:22:55 > 0:22:58Better to act then, surely?

0:23:01 > 0:23:06What's going on? You've never shied away from a surgery before.

0:23:06 > 0:23:09We can't just do nothing and hope for the best.

0:23:09 > 0:23:12Look, Patsy, they're taking Kai back to ITU.

0:23:12 > 0:23:14Why don't you go and be with him

0:23:14 > 0:23:16and I will come and join you as soon as I can.

0:23:27 > 0:23:30We're short-staffed and the department's almost at capacity.

0:23:30 > 0:23:33Don't you think we've got enough to do without ordering

0:23:33 > 0:23:34unjustified investigations?

0:23:34 > 0:23:37Not to mention exposing a patient to unnecessary radiation.

0:23:37 > 0:23:38Well, I didn't want to miss anything.

0:23:38 > 0:23:41I told you to build bridges and be part of a team.

0:23:41 > 0:23:43Not start a one-man crusade to diagnose one of the most

0:23:43 > 0:23:46notoriously difficult conditions to identify.

0:23:46 > 0:23:48Well, he does have...

0:23:48 > 0:23:51Please, Dr Digby. Don't argue with me.

0:23:51 > 0:23:53I really need everyone pulling together here.

0:23:53 > 0:23:55Now, for the rest of the day,

0:23:55 > 0:23:58I want you to run all clinical decisions past me first.

0:23:58 > 0:23:59Surely that's not practical?

0:23:59 > 0:24:01No, it isn't really, but I'd like you to do it anyway.

0:24:01 > 0:24:05And I have to say, Arthur, I had expected a little more

0:24:05 > 0:24:07humility from you today.

0:24:08 > 0:24:10Excuse me? I had a call from someone in A & E.

0:24:10 > 0:24:13Apparently my brother's been brought in. Walter Dunn.

0:24:13 > 0:24:18Oh, yes. Um...I'll take you to him.

0:24:18 > 0:24:19Is he ready to leave?

0:24:19 > 0:24:21Oh, I'm afraid not.

0:24:21 > 0:24:25- Did A & E explain he'd been in a car accident?- Yes.

0:24:25 > 0:24:28And that he was trapped for some days before he was found?

0:24:30 > 0:24:33- This is Professor Dunn's sister. - Hello. Mary.

0:24:33 > 0:24:35Hello, Dr Shreve.

0:24:35 > 0:24:37- Professor?- Walter?

0:24:37 > 0:24:38OK, so this isn't from the sepsis.

0:24:38 > 0:24:40Go and fetch Ms Campbell, please,

0:24:40 > 0:24:42and can I get me five milligrams of diazepam?

0:24:42 > 0:24:44- What's happening?- I'm not sure...

0:24:44 > 0:24:47Is there any other medical condition that we might not be aware of?

0:24:47 > 0:24:49- Anything neurological? - Not that I know of.

0:24:49 > 0:24:51And it's self-terminating.

0:24:52 > 0:24:53What?

0:24:57 > 0:24:59I'd move the rest of them if I were you,

0:24:59 > 0:25:01before he comes round.

0:25:03 > 0:25:05Why don't you take a break?

0:25:05 > 0:25:08Go and get some fresh air, then come back and we'll start again.

0:25:08 > 0:25:10We need a little help out here, please.

0:25:10 > 0:25:14Can you make sure these other bottles are out of reach as well, please?

0:25:14 > 0:25:15Torch, please.

0:25:15 > 0:25:20It was alcohol withdrawal. Explains the seizure and his earlier tremors.

0:25:20 > 0:25:21He's just helped himself to

0:25:21 > 0:25:26three-quarters of a bottle of hand gel, which is 85% ethanol.

0:25:26 > 0:25:29I've given him 50 milligrams of chlordiazepoxide.

0:25:29 > 0:25:32- Good.- His blood alcohol test did come back negative,

0:25:32 > 0:25:35but um, he's been at least two days without a drink.

0:25:35 > 0:25:38Hence the reason why he was so keen to leave.

0:25:38 > 0:25:42I am worried, though, that his confusion is

0:25:42 > 0:25:44the start of Wernicke-Korsakoff's.

0:25:44 > 0:25:46I've starting IV pabrinex.

0:25:46 > 0:25:48Well, looks like you didn't need me after all, Dr Shreve.

0:25:48 > 0:25:50Well done.

0:25:53 > 0:25:56When you've sobered him up, tell him to take a taxi home.

0:25:56 > 0:25:58I've got to get back to work.

0:26:08 > 0:26:10- Well done.- Thanks.

0:26:11 > 0:26:13I really thought that he was...

0:26:13 > 0:26:15Yeah. I know you did. Sorry.

0:26:29 > 0:26:32Sorry. Force of habit.

0:26:36 > 0:26:37I'm heading down to Keller now.

0:26:37 > 0:26:39Is there anything I can get you?

0:26:39 > 0:26:45No. Thank you. How are you finding your new surgical role?

0:26:45 > 0:26:48Yeah, it's great. It's different.

0:26:50 > 0:26:54Why are you really observing today, Mr Law? Is Guy OK?

0:26:54 > 0:26:57He doesn't seem to be himself.

0:26:57 > 0:27:01I know he's been through quite an ordeal but...

0:27:01 > 0:27:04is there anything else I should know?

0:27:06 > 0:27:09My son's life is at stake here.

0:27:10 > 0:27:13Well, McKenna's surgery has run into complications.

0:27:13 > 0:27:16He's going to be tied up for the rest of the day.

0:27:16 > 0:27:18So who's coming?

0:27:18 > 0:27:20Mr Levy is ringing around.

0:27:20 > 0:27:22You're not looking at me for this, are you?

0:27:22 > 0:27:24Because I'm simply not ready.

0:27:24 > 0:27:26Don't worry, your reluctance is patently obvious.

0:27:26 > 0:27:29I'd like you to talk me through the options, though, please.

0:27:29 > 0:27:32OK well, the bleed does come to the surface of the brainstem,

0:27:32 > 0:27:34so surgery is a possibility.

0:27:34 > 0:27:37Given his age and general good health, a successful operation

0:27:37 > 0:27:41could prevent any further damage and remove the risk of a re-bleed.

0:27:41 > 0:27:43- But?- It's not run of the mill.

0:27:43 > 0:27:46There's only a handful of surgeons in the country who would

0:27:46 > 0:27:47attempt such a high-risk operation

0:27:47 > 0:27:50in such a difficult-to-access part of the brain.

0:27:50 > 0:27:52The potential for catastrophic damage is extremely high.

0:27:52 > 0:27:55You've done it before, though, I recall.

0:27:55 > 0:27:57Yes, and the patient had multiple issues.

0:27:57 > 0:28:01Issues which were caused by the initial bleed, though, not the surgery.

0:28:01 > 0:28:03I'm not asking you to perform the surgery, Mr Self.

0:28:03 > 0:28:06I'm just asking whether or not, in your professional opinion,

0:28:06 > 0:28:08you think it should be performed.

0:28:08 > 0:28:10That is up to the surgeon who is going to be

0:28:10 > 0:28:12responsible for the outcome.

0:28:13 > 0:28:15Patsy knows you. She trusts you.

0:28:15 > 0:28:17She would value your opinion.

0:28:17 > 0:28:18Well, I'm not going to give it.

0:28:18 > 0:28:22I'm sorry, I'm not going to responsibility for this. Not right now.

0:28:22 > 0:28:24I will tell Patsy I've done everything I can

0:28:24 > 0:28:28to make him stable, and that another surgeon will be taking over.

0:28:31 > 0:28:34Send them immediately.

0:28:35 > 0:28:39- I don't want you treating my son. - I have no intention of...

0:28:39 > 0:28:41You lied to me.

0:28:41 > 0:28:43I asked you why you wanted to hand over this case

0:28:43 > 0:28:46and you said it was about objectivity.

0:28:46 > 0:28:48You never told me you had a nervous breakdown!

0:28:48 > 0:28:51- What? - He told me everything.

0:28:51 > 0:28:52Hang on a minute - that's not what I said.

0:28:52 > 0:28:55As good as. I've sent his scans to Greg Cawley.

0:28:56 > 0:28:59Fine. If you want to go private, that's your prerogative.

0:28:59 > 0:29:00I'll leave you to it.

0:29:00 > 0:29:03Guy. She's misrepresenting what I said.

0:29:03 > 0:29:06It's fine. She's getting Greg Cawley - problem solved.

0:29:10 > 0:29:12'Doors closing. Lift going down.'

0:29:12 > 0:29:13PHONE BEEPS

0:29:19 > 0:29:22- Ms Effanga.- Selfie Junior!

0:29:22 > 0:29:24- Mr Osborne's ECG. Perfectly normal. - OK.

0:29:24 > 0:29:25As were his bloods.

0:29:25 > 0:29:28- Get his TTOs done, then get him discharged.- OK.

0:29:28 > 0:29:31Mrs McArdle's drain came out fine,

0:29:31 > 0:29:33although the site's still a little unfinished.

0:29:33 > 0:29:35Do a CRP and check her inflammatory markers.

0:29:35 > 0:29:39If they're all right, then send her home with a course of amoxicillin

0:29:39 > 0:29:42and that's two beds cleared. I am on fire. Next!

0:29:42 > 0:29:44- Mrs Monroe. - Please tell me H-COP are taking her?

0:29:44 > 0:29:46They're waiting for a hospice transfer.

0:29:46 > 0:29:49- There should be a bed this afternoon, though.- Yes! Hat-trick!

0:29:49 > 0:29:52Selfie, with these cleared beds you're really spoiling me!

0:29:52 > 0:29:55What about Mrs Adejoke? She still hurling up?

0:29:55 > 0:29:59No, actually - she just asked for a jacket potato.

0:29:59 > 0:30:02- Excellent! Give the woman a potato! - Really?- No.

0:30:02 > 0:30:06Start her off on a small amount of fluids and then we'll see how we go.

0:30:06 > 0:30:08Right. OK. Sorry.

0:30:08 > 0:30:10Anything else? I've got a transplant coming soon...

0:30:10 > 0:30:14Yes. Mr Iqbal. I got the catheter in, and his fluids up.

0:30:14 > 0:30:17Urine output is normal and that's all fine.

0:30:17 > 0:30:21But I did his spirometry test and his FVC is 61%.

0:30:21 > 0:30:24He's also complaining of right-sided chest pain

0:30:24 > 0:30:26and there are pleural rubs on auscultation.

0:30:26 > 0:30:29- Am I all right to send him for a chest X-ray?- Absolutely.

0:30:29 > 0:30:31Ah, there he is! My favourite patient.

0:30:31 > 0:30:33Ms Effanga, I wondered if I...

0:30:33 > 0:30:37Hey, Charlie. Looking forward to a breath of fresh air? HDU, please.

0:30:37 > 0:30:39Hop to it, Selfie Junior.

0:30:39 > 0:30:41Mr Iqbal's X-ray's not going to order itself.

0:30:53 > 0:30:55- Arthur?- Mr Self!

0:30:56 > 0:30:59I nearly didn't recognise you without your, erm...

0:31:01 > 0:31:02Dare I ask...?

0:31:02 > 0:31:03Popping candy.

0:31:05 > 0:31:06OK...?

0:31:06 > 0:31:08It's a mindfulness exercise.

0:31:09 > 0:31:13Focusing on a unique sound and sensation blocks out...

0:31:13 > 0:31:15unwelcome thoughts. It clears the mind.

0:31:17 > 0:31:18Sound good to me.

0:31:22 > 0:31:24Would you like some?

0:31:24 > 0:31:25Yeah, why not?

0:31:41 > 0:31:44- How do they make this stuff? - I've no idea.

0:31:48 > 0:31:51Listen, I hear you've been having a pretty hard time recently so...

0:31:51 > 0:31:53Well, if this helps then, eh...

0:31:53 > 0:31:55No, it's fine. I'm on top of it.

0:31:57 > 0:32:00Actually, that's not true. But I'm trying.

0:32:00 > 0:32:02Well, there's nothing to be ashamed of.

0:32:02 > 0:32:03I mean, look at Zosia.

0:32:03 > 0:32:06If she can overcome, then...

0:32:06 > 0:32:08Actually, she uses similar techniques -

0:32:08 > 0:32:10mindfulness and so on.

0:32:10 > 0:32:13- She was the one who taught me. - Did she?

0:32:14 > 0:32:17As soon as you can would be great, thank you.

0:32:19 > 0:32:20All right?

0:32:20 > 0:32:21Yes, fine.

0:32:21 > 0:32:25Fine. Yes, you seem fine. It's that cheery air that you have(!)

0:32:25 > 0:32:28Have you seen this list of jobs Ms Effanga has given me?

0:32:28 > 0:32:30How am I supposed to impress if all she ever gives me

0:32:30 > 0:32:32- is this menial grunt work? - Impress her?

0:32:32 > 0:32:33You know what I mean.

0:32:33 > 0:32:37I'm sure you'll get your moment in the transplant.

0:32:37 > 0:32:38I'm not on the transplant.

0:32:38 > 0:32:40I haven't even had time to ask her about it!

0:32:40 > 0:32:42OK. Breathe.

0:32:44 > 0:32:47Right. I'm going to go and get a cup of coffee.

0:32:47 > 0:32:50- Good.- Is this yours? - Yes.

0:32:50 > 0:32:52He's good to go as soon as the lungs arrive.

0:32:52 > 0:32:59Good. Um... Is, er, Zosia assisting today?

0:32:59 > 0:33:02I don't know, she's pretty busy. We'll have to see if she's got time.

0:33:04 > 0:33:09He's a drunk. Of long standing, and he's got early signs of Korsakoff's.

0:33:09 > 0:33:14I just can't help seeing wasted potential.

0:33:14 > 0:33:17You know, he was top of his class at UCL.

0:33:17 > 0:33:19He was a Cambridge fellow. Countless prizes.

0:33:19 > 0:33:21Probably would have won a Nobel if he'd have carried on.

0:33:21 > 0:33:25And then... pfft. You know, it all just went away.

0:33:25 > 0:33:28Hmm. Well, maybe he'd given all he had to give.

0:33:30 > 0:33:34You know, sometimes people's expectations are overinflated.

0:33:34 > 0:33:39So you think, subconscious self-sabotage rather than

0:33:39 > 0:33:41admit that he'd peaked?

0:33:41 > 0:33:44It's a bit vain, isn't it?

0:33:44 > 0:33:47No, it's fear.

0:33:47 > 0:33:51Who wants to admit they're not as capable as everyone thinks?

0:33:51 > 0:33:53But how is that not vanity?

0:33:55 > 0:33:58Well, what about his sense of identity, of self-worth?

0:34:00 > 0:34:04I mean, if he's not this genius curing an incurable disease,

0:34:04 > 0:34:06then who is he?

0:34:06 > 0:34:09Yeah, maybe I'm being a bit unfair. I just can't help thinking...

0:34:09 > 0:34:11it's not a good way to go out.

0:34:15 > 0:34:18- I should get back.- Oh, here.

0:34:18 > 0:34:19Oh, no, you keep it. You keep it.

0:34:19 > 0:34:21We've got a whole box at home so...

0:34:24 > 0:34:26Mr Self? Are you OK?

0:34:26 > 0:34:29Yes, I'm fine.

0:34:29 > 0:34:32Really? It's just that this was a bit unusual.

0:34:32 > 0:34:34You get back to work, Dr Digby.

0:34:47 > 0:34:48Hi.

0:34:50 > 0:34:51Hi.

0:34:53 > 0:34:58I should have listened to you. But, hey, we were both wrong.

0:34:58 > 0:35:00You know, there was something more to it.

0:35:02 > 0:35:04Look, I know that you're still angry with me

0:35:04 > 0:35:08but we do have to work together.

0:35:08 > 0:35:11And I really need the rest of this shift to go smoothly.

0:35:12 > 0:35:16Uh, I'm not trying to be funny, but... Where's Walter?

0:35:38 > 0:35:40Ah, you all right?

0:35:40 > 0:35:42Yeah. Can you see a confused man anywhere?

0:35:42 > 0:35:43Yes.

0:35:45 > 0:35:46SIREN SOUNDS

0:35:48 > 0:35:49He could be anywhere.

0:35:49 > 0:35:52This is bad. We've got to tell Ms Campbell.

0:35:59 > 0:36:02Well, I appreciate the courtesy, Mr Cawley. Thank you.

0:36:02 > 0:36:04- Goodbye.- Is Cawley is on his way?

0:36:04 > 0:36:07No. He's not going to take the case.

0:36:07 > 0:36:10That was just a heads-up before he breaks the news.

0:36:10 > 0:36:13Yes, Mr Cawley?

0:36:13 > 0:36:15Well, if Cawley isn't doing it, who is?

0:36:15 > 0:36:18Patsy Brassvine is a very powerful woman.

0:36:18 > 0:36:22I'm afraid in this case, her influence is working against her.

0:36:22 > 0:36:26Nobody wants her son dying on them. It's career suicide, isn't it?

0:36:26 > 0:36:27SHE SOBS

0:36:29 > 0:36:32When did we all become such bloody politicians?

0:36:32 > 0:36:33Excuse me.

0:36:40 > 0:36:45Patsy, if you want Kai to have this operation, I will do it.

0:36:49 > 0:36:51Look me in the eyes.

0:36:51 > 0:36:53Tell me you're up to this.

0:36:55 > 0:36:57Yes. I am.

0:36:58 > 0:37:02And it's the right decision? To go ahead?

0:37:03 > 0:37:07If it was Zosia, would you do it?

0:37:11 > 0:37:13Yes, I'd do it.

0:37:13 > 0:37:16Don't make me regret this.

0:37:18 > 0:37:21Let's prep him for theatre.

0:37:21 > 0:37:22I'm sorry.

0:37:37 > 0:37:40- Any sign?- No. - Where's Ms Campbell?

0:37:40 > 0:37:42- OK, just wait, wait, wait, wait. - What?- I don't know, just...

0:37:42 > 0:37:45- There she is.- Oi. You lot.

0:37:45 > 0:37:46Isn't that your Professor?

0:37:52 > 0:37:55- Professor! - Professor! Whoa! Professor, wait!

0:37:57 > 0:37:59Help me! Help me!

0:37:59 > 0:38:01Help me! Security! I am a doctor!

0:38:01 > 0:38:03Help me!

0:38:10 > 0:38:12OK, he's fine. He's not a doctor.

0:38:12 > 0:38:14I am a doctor!

0:38:14 > 0:38:16Well, yeah, technically he is a doctor, but he's also a patient.

0:38:16 > 0:38:18These people are chasing me!

0:38:18 > 0:38:21OK, Professor, we just need to get you back to the ward.

0:38:21 > 0:38:23Why? What do you want?

0:38:25 > 0:38:29- I just want to make you better. - Liar! I don't know who you are!

0:38:32 > 0:38:36- OK.- No! Don't come near me.

0:38:39 > 0:38:42Morven. I don't...

0:38:44 > 0:38:45Can you help me, please?

0:38:48 > 0:38:51Professor Dunn, we've been trying to bleep you.

0:38:51 > 0:38:54A patient has presented with bradykinesia, muscle rigidity

0:38:54 > 0:38:58and dystonia. Query Parkinson's.

0:39:03 > 0:39:07Book an MRI. And let's do a lumbar puncture.

0:39:09 > 0:39:11Right. Um... She's this way.

0:39:20 > 0:39:23- You found him, then? - Yes. Thank you.

0:39:25 > 0:39:27Mary?

0:39:34 > 0:39:38Mr Hanssen. You're sure about this, yeah?

0:39:38 > 0:39:41Because if... if something goes wrong in there,

0:39:41 > 0:39:44Guy's not going to get over it. He'll be done.

0:39:48 > 0:39:50Mary, wait.

0:39:52 > 0:39:54I'm really sorry you had to see that.

0:39:57 > 0:40:00Oh, believe me, I've seen all sorts from my brother.

0:40:00 > 0:40:02Um, do you wanna...

0:40:02 > 0:40:03Are you OK?

0:40:03 > 0:40:07You're probably wondering how he could be missing for two days

0:40:07 > 0:40:08without me noticing...

0:40:10 > 0:40:12but he isolated himself.

0:40:12 > 0:40:15You don't have to explain. I'm sure you care about him.

0:40:15 > 0:40:19I adored him. I looked up to him.

0:40:19 > 0:40:21He always took care of me.

0:40:21 > 0:40:27And then suddenly... I was the one taking care of him.

0:40:27 > 0:40:29Picking him up when he'd been arrested,

0:40:29 > 0:40:31or when he was drunk at work.

0:40:31 > 0:40:33I cleaned his house. I cooked his meals.

0:40:33 > 0:40:35I tried to help him to stop.

0:40:37 > 0:40:41Time and again I kept coming back and he kept pushing me away.

0:40:43 > 0:40:44You can only take so much.

0:40:44 > 0:40:45Of course.

0:40:47 > 0:40:51Is there any family or anyone else that can support you?

0:40:51 > 0:40:55No. There's just the two of us.

0:40:57 > 0:41:02- Would you like to come back inside? - No. I don't think so.

0:41:02 > 0:41:04OK.

0:41:12 > 0:41:15- Is that his chest X-ray?- Yes.

0:41:15 > 0:41:16Thank you.

0:41:18 > 0:41:20Mr Iqbal? How are you feeling?

0:41:20 > 0:41:22You OK?

0:41:22 > 0:41:25Right, mind if I have a listen to your chest for a moment?

0:41:27 > 0:41:30OK, there is some air trapped between your lung

0:41:30 > 0:41:33and your chest wall which is making it difficult for you to breathe.

0:41:33 > 0:41:36Rachelle? Can I get a drain set and trolley, please?

0:41:36 > 0:41:38And can you pass me that oxygen?

0:41:38 > 0:41:41Thank you.

0:41:41 > 0:41:44Rachelle, if you can keep him in position, please.

0:41:48 > 0:41:51OK. Now, short, sharp scratch.

0:41:54 > 0:41:56You're doing brilliantly.

0:41:57 > 0:42:00Now, you're going to feel some pushing.

0:42:00 > 0:42:03One, two, three...

0:42:03 > 0:42:05AIR HISSES

0:42:06 > 0:42:08Well done.

0:42:08 > 0:42:10Now pain relief - five milligrams of oramorph, please.

0:42:10 > 0:42:13Sit back for me. You can relax.

0:42:14 > 0:42:16Uh, Ms Effanga, I'm sorry.

0:42:16 > 0:42:19I know I should have come and found you but um...

0:42:19 > 0:42:22Early tension pneumothorax. I panicked.

0:42:22 > 0:42:25Didn't look like you panicked to me. Good job, Dr March.

0:42:26 > 0:42:30OK, Little Miss Presumptuous. You can scrub in. You've earned it.

0:42:30 > 0:42:33But next time, just ask, eh?

0:42:33 > 0:42:34- Sorry, what?- Ollie.

0:42:34 > 0:42:37He told me that you asked him to clear your schedule

0:42:37 > 0:42:40- so you could assist on the transplant.- Uh, no...

0:42:40 > 0:42:43I asked him to clear my schedule because I was hoping

0:42:43 > 0:42:46you'd ask me and I wanted to be available just in case you did.

0:42:46 > 0:42:48OK, I think there's been a little misunderstanding.

0:42:48 > 0:42:50What exactly did Ollie say?

0:42:53 > 0:42:57BEEPING

0:42:57 > 0:42:59Can we get some help over here, please?

0:43:00 > 0:43:03- Where's Ms Campbell? - She stepped out.

0:43:03 > 0:43:05Arthur. I need your help.

0:43:05 > 0:43:07He's bleeding from somewhere.

0:43:07 > 0:43:09- I-I don't know, his throat or his stomach.- OK.

0:43:09 > 0:43:12Tachy at 130, BP 70 over 40.

0:43:12 > 0:43:14- He's peripherally shut down. - Where's Ms Campbell?

0:43:14 > 0:43:17- She's not on the ward.- OK, can you phone her? Get her back. Quickly, please.

0:43:17 > 0:43:20BP 70 over 35. He's going to arrest.

0:43:20 > 0:43:22We've got to do something, Arthur.

0:43:22 > 0:43:24- OK, I can't, not without Ms Campbell.- What??

0:43:24 > 0:43:26It's...it's literally more than my job's worth, OK?

0:43:26 > 0:43:28You did not just say that.

0:43:28 > 0:43:32No. OK. Suction. Let's get his airway clear.

0:43:32 > 0:43:35- She's on her way.- Right, we need to transfuse him so can you get O-neg?

0:43:35 > 0:43:38- As much as you can, fast as you can. - Look at this.

0:43:38 > 0:43:42- It looks like burns. Chemical burns. - He must've swallowed something.

0:43:42 > 0:43:44What's that?

0:43:47 > 0:43:50- It's pure ethanol. - For god's sake.

0:43:50 > 0:43:52Here you go.

0:43:52 > 0:43:54OK, well done. Let's get it rigged up.

0:43:58 > 0:43:59Thank you.

0:44:01 > 0:44:03- OK, look, I had no choice. - What happened?

0:44:03 > 0:44:06- He was peri-arrest. - It's from our pharmacy.

0:44:06 > 0:44:10He had a gastrointestinal bleed. He needs an urgent gastroscopy.

0:44:10 > 0:44:13OK, let's get him straight into theatre, quickly please.

0:44:13 > 0:44:15Well done, both of you. Good teamwork.

0:44:15 > 0:44:18- Scrub in, Dr Digby.- Um, I think Dr Shreve should scrub in.

0:44:18 > 0:44:20He's her patient.

0:44:21 > 0:44:25OK. You ready for some hands-on surgical experience, Dr Shreve?

0:44:30 > 0:44:33I still see him as a little boy.

0:44:33 > 0:44:35I've been away so much with work,

0:44:35 > 0:44:38I didn't notice he'd turned into a man.

0:44:50 > 0:44:56He's my son...and I don't know him.

0:44:58 > 0:45:01I wish that I could tell you it's going to be OK.

0:45:01 > 0:45:05I really, really do. What I can say is...

0:45:05 > 0:45:10I know what this means to Mr Self, personally and professionally.

0:45:10 > 0:45:12And if Kai was my son,

0:45:12 > 0:45:16there isn't a surgeon on the planet I'd rather have in there with him.

0:45:20 > 0:45:21We're bleeding. Diathermy.

0:45:26 > 0:45:30Still bleeding.

0:45:30 > 0:45:32I can't stop it.

0:45:32 > 0:45:34Surgicell. Quick!

0:45:36 > 0:45:37Come on, come on.

0:45:42 > 0:45:45Guy, you all right there, mate?

0:45:45 > 0:45:49Guy, it was just a small bleed. You're doing great.

0:45:52 > 0:45:58Come on, mate, you're nearly there. Let's finish this.

0:45:59 > 0:46:03Mr Self, just take a few moments, please, and then you'll be fine.

0:46:12 > 0:46:14Micro dissector.

0:46:53 > 0:46:56Just let me know, please. Thank you.

0:46:56 > 0:46:59Right, then. You ready for your first bilateral lung transplant, Selfie?

0:46:59 > 0:47:03- Hey, you're assisting. - Well, actually, I'm taking the lead.

0:47:03 > 0:47:06Yeah, it's true. She's got skills, this one.

0:47:06 > 0:47:08And she's impressed all day so I thought...

0:47:08 > 0:47:09why not give her have a go?

0:47:09 > 0:47:12Give her a go? At a bilateral lung transplant?

0:47:12 > 0:47:14Ah, it's a piece of cake.

0:47:14 > 0:47:16In fact, I don't even think I need to come in with you.

0:47:16 > 0:47:18I've got loads of paperwork to do.

0:47:18 > 0:47:21That's fine, I can always give you a shout if I get stuck.

0:47:21 > 0:47:24- You sure?- Yeah! No problem. - Great.- Is that such a great...

0:47:27 > 0:47:30Ah... Oh, you're joking.

0:47:30 > 0:47:32You're an idiot.

0:47:35 > 0:47:37What have I done?

0:47:37 > 0:47:39I never assumed she'd ask me to assist.

0:47:39 > 0:47:40How big-headed do you think I am?

0:47:40 > 0:47:43And I gave her hell today because of what you said.

0:47:43 > 0:47:44You owe this woman a drink.

0:47:44 > 0:47:48And you can buy me one and all. After work. Tonight.

0:47:48 > 0:47:51- Fine. - Good. Come on, Selfie.

0:48:02 > 0:48:05Patsy, both the haematoma

0:48:05 > 0:48:09and the cavernous angioma have been successfully removed.

0:48:09 > 0:48:12His vital signs are good. It couldn't have gone better.

0:48:15 > 0:48:17He's going to be OK?

0:48:17 > 0:48:20We can't say what damage was caused by the initial bleed, but...

0:48:20 > 0:48:21time will tell.

0:48:23 > 0:48:25Thank you.

0:48:25 > 0:48:26Thank you so much.

0:48:28 > 0:48:33- I'm so sorry...- No, no, please. Thank me when he's awake.

0:48:35 > 0:48:38- Where is Kai? Can I see him? - Yes, of course.

0:48:38 > 0:48:41Yeah, he's in recovery. I'll take you through.

0:48:48 > 0:48:49Congratulations.

0:48:49 > 0:48:52Thank you. For everything.

0:48:58 > 0:49:00Multiple necrotic patches.

0:49:00 > 0:49:02Here's the perforation.

0:49:02 > 0:49:04He's burnt right through his stomach.

0:49:04 > 0:49:07We can't repair this. Moving on to a partial gastrectomy.

0:49:07 > 0:49:09I should have kept a closer eye on him.

0:49:09 > 0:49:12If he hadn't left the ward, this would never have happened.

0:49:12 > 0:49:14This is the result of years of abuse.

0:49:14 > 0:49:16What happened this afternoon was just the final straw.

0:49:16 > 0:49:18You mustn't blame yourself.

0:49:18 > 0:49:19Stapler, please.

0:49:22 > 0:49:23You go ahead.

0:49:27 > 0:49:29That's it. And now the top.

0:49:30 > 0:49:34Excellent. Now remove the excised portion of the stomach.

0:49:41 > 0:49:45Very good, Dr Shreve. Nerves of steel.

0:49:45 > 0:49:46Right, let's close up, shall we?

0:49:51 > 0:49:53I suppose some people just have what it takes.

0:49:55 > 0:49:56And some people don't.

0:50:05 > 0:50:07He's just through here.

0:50:07 > 0:50:09Dr Digby?

0:50:09 > 0:50:12Please.

0:50:12 > 0:50:14He's still sedated, but, er...

0:50:16 > 0:50:19She said you took away his stomach?

0:50:19 > 0:50:20A good portion of it, yes.

0:50:20 > 0:50:23And something about... brain damage?

0:50:23 > 0:50:26It's called Korsakoff's Syndrome.

0:50:26 > 0:50:29It affects part of the brain that deals with memory.

0:50:29 > 0:50:31The symptoms are similar to dementia.

0:50:31 > 0:50:33And it's permanent.

0:50:33 > 0:50:36Well, it may improve over time with treatment,

0:50:36 > 0:50:40but, there is likely to be some permanent damage, yes.

0:50:44 > 0:50:46You stupid, stupid...

0:50:46 > 0:50:49Why can't you just die if you're going to...

0:50:50 > 0:50:52You foolish, selfish...

0:50:52 > 0:50:54OK, come on.

0:50:56 > 0:50:58SHE SOBS

0:51:00 > 0:51:01It's all right.

0:51:03 > 0:51:05- I'm sorry. - Don't worry. It's fine.

0:51:09 > 0:51:10I'm sorry.

0:51:19 > 0:51:22I've been given so many opportunities.

0:51:22 > 0:51:25I've been given so many second chances.

0:51:25 > 0:51:27I just keep letting everybody down.

0:51:30 > 0:51:33I don't know why I can't change...

0:51:33 > 0:51:37but there's no forcing myself to be something I'm not.

0:51:37 > 0:51:40OK, so if you just push your hands up against mine as hard as you can.

0:51:40 > 0:51:43Good. Now, shrug your shoulders.

0:51:45 > 0:51:48Excellent. Open your mouth and go "ahhh".

0:51:50 > 0:51:52Stick your tongue right out.

0:51:52 > 0:51:55Whoa. Excellent. Good lad.

0:51:55 > 0:51:58You get to sleep now and I'll see you first thing in the morning.

0:51:58 > 0:51:59Thanks, Guy.

0:52:00 > 0:52:02I'll be back in a minute, darling.

0:52:06 > 0:52:09Well, the signs are good. Very good.

0:52:09 > 0:52:11Obviously we'll keep monitoring him

0:52:11 > 0:52:13but there's every reason to be positive.

0:52:13 > 0:52:16Thank you. I spoke to my husband.

0:52:16 > 0:52:18- You remember Tristan?- Mm-hm.

0:52:18 > 0:52:22He told me to tell you whatever you wanted, it's yours.

0:52:22 > 0:52:25Oh, sorry - I don't quite understand.

0:52:25 > 0:52:28I hear you've shelved your plans for the Neuro Centre.

0:52:28 > 0:52:31Perhaps it's time they were resurrected.

0:52:32 > 0:52:36I should never have doubted you, Guy. You're something special.

0:52:37 > 0:52:40Don't waste that potential. Money's no object.

0:52:41 > 0:52:44I really don't know what to say.

0:52:44 > 0:52:46Say yes.

0:52:46 > 0:52:48Yes!

0:52:48 > 0:52:51Good. Because I've already told Mr Hanssen.

0:52:51 > 0:52:52Thank you.

0:52:52 > 0:52:55No, thank you.

0:53:02 > 0:53:04Hey.

0:53:04 > 0:53:05Hi.

0:53:05 > 0:53:07I heard you've had quite a day.

0:53:07 > 0:53:09Oh, you don't know the half of it.

0:53:09 > 0:53:12- Are you OK? - What time does your shift finish?

0:53:12 > 0:53:16I'll tell you all about it over a glass of something cold and bubbly.

0:53:16 > 0:53:19Actually, make that a bottle.

0:53:19 > 0:53:20OK.

0:53:23 > 0:53:25Seriously, well done for that back there.

0:53:25 > 0:53:28With Iqbal. That's a tough spot - you did really well.

0:53:28 > 0:53:31Thank you, Ms Effanga. That means a lot.

0:53:31 > 0:53:34All right, let's get a few things straight, yeah?

0:53:34 > 0:53:36Some ground rules for moving forwards.

0:53:36 > 0:53:39First of all, you don't have to call me "Ms Effanga" all the time.

0:53:39 > 0:53:41"Mo" is usually fine.

0:53:42 > 0:53:44Understood.

0:53:44 > 0:53:47Second, if you really want in on something, just ask.

0:53:47 > 0:53:49I won't bite.

0:53:50 > 0:53:55- OK.- And finally, if you do want to suck up...

0:53:55 > 0:53:57mine's a coffee with two sugars.

0:53:57 > 0:53:59Unless we're in the pub, then it's a pint.

0:54:02 > 0:54:06Right, let's make magic.

0:54:15 > 0:54:18Ah, Mr Self. I hear congratulations are in order.

0:54:18 > 0:54:21You succeeded in securing the funds for the Neuro Centre

0:54:21 > 0:54:22all by yourself, as I predicted.

0:54:22 > 0:54:25I look forward to working with you on the plans.

0:54:25 > 0:54:26Do you, now?

0:54:26 > 0:54:29Because as I recall, you didn't want anything to do with the project.

0:54:29 > 0:54:32This is my centre. If I need your help, I'll ask for it.

0:54:32 > 0:54:34Goodnight, Henrik.

0:54:35 > 0:54:36Goodnight, Mr Self.

0:54:48 > 0:54:51You look like you're off to a wedding or something.

0:54:53 > 0:54:55Tells you all you need to know about me, doesn't it?

0:54:57 > 0:54:59Weddings and funerals.

0:54:59 > 0:55:01That's the only time you'll see me

0:55:01 > 0:55:03in anything that's not scrubs or jeans.

0:55:03 > 0:55:07Yeah, my flatmate, Dom, thought a new look would make me

0:55:07 > 0:55:08feel more confident.

0:55:08 > 0:55:10Right. Well, that backfired.

0:55:15 > 0:55:18Thank you. For the theatre opportunity today.

0:55:18 > 0:55:21That was yours. You deserved it.

0:55:21 > 0:55:25Not really. You're the one that stopped him from arresting.

0:55:25 > 0:55:29Only temporarily. He still would have died without the surgery.

0:55:29 > 0:55:31You were amazing in there.

0:55:31 > 0:55:33It was pretty mad.

0:55:33 > 0:55:34Yeah.

0:55:37 > 0:55:42Look, um, I really am sorry.

0:55:44 > 0:55:46For everything.

0:55:46 > 0:55:49And I should have apologised properly before

0:55:49 > 0:55:55but I'm an idiot and I was embarrassed.

0:55:55 > 0:55:57I really, really am sorry.

0:55:59 > 0:56:03Thank you. Apology accepted.

0:56:04 > 0:56:08You're a great doctor, Morven. And a nice person.

0:56:08 > 0:56:11I wish you every success.

0:56:11 > 0:56:13And that's why I have to go.

0:56:14 > 0:56:17Jump before I'm pushed.

0:56:17 > 0:56:19Or worse, before I fall and take someone with me.

0:56:19 > 0:56:22I don't want that to happen.

0:56:22 > 0:56:25Well, I appreciate your candour, Dr Digby, but let me ask you -

0:56:25 > 0:56:27from what you know of me,

0:56:27 > 0:56:31do you think I would consider myself a "people person", as you put it?

0:56:31 > 0:56:34And yet here I sit.

0:56:34 > 0:56:38Consultant General Surgeon and CEO of this fine hospital.

0:56:38 > 0:56:43I prefer facts to emotions. Brevity to banter. Colleagues to friends.

0:56:43 > 0:56:46Do I also lack "what it takes"?

0:56:47 > 0:56:50I think it's different if you're the boss.

0:56:50 > 0:56:54True. But once upon a time I was an SHO.

0:56:54 > 0:56:58I haven't quite given up on you yet, Dr Digby.

0:57:00 > 0:57:01Don't give up on me.

0:57:06 > 0:57:09I put Dr Digby through the wringer a bit today.

0:57:09 > 0:57:12He'll be fine. He's more resilient than he gives himself credit for.

0:57:12 > 0:57:15I hope so.

0:57:16 > 0:57:19So The Guy Self Neuro Centre?

0:57:19 > 0:57:22You built him back up piece by piece,

0:57:22 > 0:57:25only to discover you'd created a monster.

0:57:25 > 0:57:28Well, it would have been an enormous waste of his talents,

0:57:28 > 0:57:29had he hung up his scrubs for good.

0:57:29 > 0:57:32However, I am but one man, Ms Campbell.

0:57:32 > 0:57:36In the face of Mr Self's renewed ego, I fear that may not be enough.

0:57:36 > 0:57:37I shouldn't worry about it too much.

0:57:37 > 0:57:41I understand we're looking forward to the imminent return of Ms Naylor.

0:57:41 > 0:57:43Mmm.

0:57:43 > 0:57:45I can't wait to give her the good news.

0:57:59 > 0:58:01HORN HOOTS

0:58:03 > 0:58:06Oh, Arthur. Listen, you take this back.

0:58:06 > 0:58:09I don't think I'm going to need them after all.