A Delicate Truth Holby City

-I'm sure everyone's going to be mighty pleased to have you back.

-Great.

-ELECTRONIC HEARTBEAT

-Are you OK?

CONSOLE BEEPS

-Can you turn that down to at least mildly deafening?

-It's practically on mute.

I'm surprised you can hear anything over that haircut.

I now suspect that you'll never learn bedside manner

until you're out in the trenches, dealing with patients on your own.

Art-house cinema?

What were you expecting? Judy Garland?

Er, I was hoping for Die Hard.

I thought you might go for the strong, silent type.

-I think you'll find I've got slightly more refined tastes.

-Yeah, well...

I haven't.

As well as the surgical aspects of the case,

it's also important to be aware of Mr Duffy's state of mind.

Right, so the man has an alien-style mutant sucking at his chest.

What state of mind are we expecting him to be in?

It's never too late to take you off this case, you know.

No, you need me.

No man could face Godzilla alone.

Oh, you've named the tumour. How very mature.

Just try and remember that the past few months can't have been easy for him.

Kid gloves would be a good idea.

Yes, so no "alien mutant" or "Godzilla" in front of the patient?

-Thank you.

-OK...

Mr Duffy, good morning. I'm Mr Valentine, this is Dr March.

What do you think?

About what?

No specs!

I've been afraid of contacts for years, you know the whole, um...

And then I thought to myself,

"You've got a ruddy great tumour growing on your chest,

"why not live a little?"

Why not, indeed?

Shall I, um... Shall I release the kraken?

Please do.

Actually, we've started getting used to each other.

I've been calling him...

..Howard.

Suction?

Quiet, please.

MACHINES BEEP

Yep.

Found the bleed.

What now? 3.0 Prolene?

OK, you just need to let us work right now, OK?

3.0 Prolene.

That's just what I said...

Cut.

And that looks like it's holding.

Good work, team.

Any sign of those biopsy results that have been giving me nightmares?

Not as of yet.

But we are chasing them.

Uh, in the meantime - drum roll, please...

Your obs are good,

and your bloods are getting better

so there's no real reason why we can't discharge you.

You can't do that to me. I can't go home yet.

How will I cope without the constant noise,

the bad food and your lame banter?

I know it's going to be a bind,

but you're just going to have to struggle on.

Um, look, I can try and have a word with Mr Levy

and perhaps see if we can rush through those results.

Maybe even have you out of here by this afternoon.

Fancy losing a couple of matchsticks before I go?

PHONE RINGS

I'm here, I'm smart, why aren't they using me properly?

You know what? You are so right.

It must be awful to be an intelligent, capable woman

and be treated like all you are good for is carrying urine samples.

Wait. Oh, no. That's me.

It's different.

NOT that you're not smart.

You are - all of you.

You're like one smart gang of nursing ninjas.

Don't lay it on too thick.

But I want to be a surgeon.

Sometimes you learn the most standing at the back

with your mouth shut.

At this stage, all you need to do

is make sure you keep getting invited back in the room.

Thank you. Good talk!

Well, at this point there is an argument to do the procedure using VATS,

but the consultant and I prefer the open approach.

I'll be taking the lead in theatre.

Can you say that for the camera, please?

Don't worry, I'm not trying to keep tabs on you.

It's just the, um...

Well, everyone else is trying to keep tabs on me.

Ever since the forum realised today's the big day,

-everyone wants a piece of me.

-Forum?

Yes. The Neurofibromatosis

Community Forum.

We... We're working on a better name.

It's mainly people with the condition,

plus a few interested parties.

People who are interested in...tumours?

Now you're making it sound weird.

No, not really, no. Sorry.

There are a few strange ones.

People were wanting to know how big it's going to get or,

"Can you send me some photos?" You know, that sort of thing.

Just when you think the dark recesses of the internet couldn't get any creepier...

Oh, no, mainly it's people with the condition just trying to reach out.

It started off as an information thing - me trying to understand what was happening to me.

And then the... Well, the tumour grew into this.

And the internet thing, it grew into something else.

Well, now everyone's coming to me for advice.

Right, well, we'll be back as soon as we've got your blood results. Excuse us.

Tumour forums. I know what I'm googling when I get home tonight.

We need FBC, U & Es, group and save, cross match of four units and clotting.

-We cut no corners on this, OK?

-Don't know what you had for breakfast, but it certainly worked.

-Never seen you so confident.

-Really?

Well, get used to it.

What you did in theatre, it was...

Can't WAIT till it's my turn!

Some nights I dream about having my hand

inside someone's lower intestine.

Is that weird?

It's a little bit, but, er, we've all been there.

Sort of...

So I've been thinking about my next surgery...

OK, you're putting the cart a bit before the horse, aren't you?

Usually like to see if the patients need surgery first.

You're right. I suppose what I meant was,

when do you think my next surgery will be?

Come on, you know how this works.

It's probably going to be somewhere between hard to say and who knows.

But in the meantime, how can I stretch myself?

I've got serious adrenaline pumping through me.

I feel like I can...heal the world!

OK, well, why don't we start with one patient at a time?

In the interests of not running before we can walk.

Beth Musgrove, 75, abdominal pain.

Go and put that adrenaline to good use.

That neurofibroma of yours is a bit of a doozy.

Haven't seen one that unusual for a long time.

-It is and I don't.

-What?

-Need any help.

-No, no, you've got me all wrong.

See, this isn't competitive, give me a shot of the case

and I'll whip you ten ways to Sunday, Mo. No.

-I'm just really happy for a colleague.

-Of course you are.

But if you do run into any problems and you need a bigger,

badder registrar to lend a hand...

Er, what's the phrase...?

"Don't call us, we'll call you."

Excuse me.

-DOMINIC:

-I never been much of a plumber,

but if this is what you do all day...

Tea times and lunch breaks only.

The rest of the time it's one hand down the u-bend,

while the other holds our trousers up.

Or not, as the case probably is.

You know, for a decent bloke, you don't half stereotype people.

So you've never been caught with your jeans slung down low

whilst drinking some poor unsuspecting customer out of tea bags?

Maybe once or twice.

Once or twice a day.

HE MOANS

Are you OK?

Ooh...

Do we need alarms on our equipment to stop other departments nicking our stuff?

He's not taking out, he's bringing in.

Adele. What's the word on the street?

OK, first of all, never say that again.

Secondly, what makes everyone that think I'm the source of all gossip around here?

Cos you've got a big mouth and we've got ears.

Now spill.

Right, well, according to the ward sister up on neuro,

Mr Self will be taking over a bay down here...as of today.

Orders from Mr Hanssen.

He can't just come in here and start chopping off bits of our ward.

Can't he? That looks like that's exactly what he's doing...

I see you've been laid low by a dubious pork pie.

Homemade?

Not guilty, doctor.

Bought at the corner shop, so if you want to file charges,

you can see them.

May I?

It's the only thing she had that I haven't.

Ah, lucky escape. I can't stand pork pies, either.

The jelly in them makes me feel a bit strange.

I've always loved them since I was a kid.

And the jelly, well, that... That's the best bit.

It's no fun getting older.

Lucky I've got him to keep me smiling.

Is this the first time you've had stomach pain after eating?

Oh! You've got to be joking!

Once upon a time she was like a horse.

-Now she eats like a rabbit.

-Ah!

Oh! It gets me right here sometimes.

She'll be right as rain.

Won't you, love?

How are we getting on?

I'm thinking possible ischemic gut.

I'm just about to order a CT angiogram to confirm.

OK, sorry about all that. Let's, um,

let's try and sniff you out something a bit more interesting.

-I can take over here if you like?

-Actually...

I think I'll stick with Mrs Musgrove.

OK.

Shall we talk about the procedure?

No questions? Worries...?

I haven't slept well since I was diagnosed.

Do you know why?

Well, anyone in your position would feel apprehensive.

I couldn't sleep because I was so worried if this tumour doesn't kill me,

I might die of boredom sat at my desk one random Tuesday.

So I quit.

I walked into my boss' office and I said,

"You can stuff your job...

"I've got a life to lead!"

So...

you might think the way I spend my time now is a little bit sad...

..but I can assure you, it's nothing compared to how it was before.

I didn't mean that...

Good.

Well, it all looks good to me. In a few hours I don't see any...

Care to introduce me to your friends, Oliver?

I'm not a professional, but stuff that comes out the body shouldn't be green, should it?

I've seen a few baby's nappies that would beg to differ.

So it's not one of those superbugs?

Looks like the common or garden type to me.

Nasty bacteria, but you'll live.

Just as well.

We've got a poker game to finish.

I'm beating him hands down.

-DOM CLEARS HIS THROAT

-So the next step is to clean and dress the wound

and then we'll get you sorted with some antibiotics.

More needles.

Did I mention this is the worst hotel ever?

We'll be back shortly.

Well, don't you two make a cute couple?

You do realise people can just be friends?

Oh, chill out.

I think it's sweet.

Neurotic, uptight doctor meets handsome, young plumber...

I am neither neurotic nor uptight, thank you.

Oh, come on, you're in classic romcom territory.

A tenner says he wants to meet you on the roof of Holby

at New Year's Eve.

You've really got something wrong with you, haven't you?

Sleepless in Holby!

Do you get it?!

NF1 neurofibromatosis,

the plexiform neurofibroma already advanced when presented.

-Family history?

-None. Took him completely by surprise,

which I think is why it took him so long to deal with the growth.

Something the size of Jupiter starts growing out of your chest

-and most people still think it'll go away on its own?

-He's afraid. Alone, I think.

Oh, well, now he has Ollie Valentine riding to the rescue.

I know you think this is a step up for me...

Out of interest, have you found a Yellow Pages to stand on in theatre,

-or do you still need to borrow one?

-I am ready for this.

Jac. What a lovely surprise.

Bored of mummy time already?

I, er, thought I'd better show face

when I heard Hanssen had given Lucifer the keys to half of my ward.

-Index finger broken, is it?

-What?

So you have the physicality to operate a telephone,

just not the brainpower.

You two are cut from the same tainted cloth.

Careful. It upsets the kiddies to see Mummy and Daddy fighting.

You have four beds.

Take one step towards a fifth and I'll gut you like a fish

and enjoy doing it.

Is this a permanent return or just a quick visit to boost morale?

-So your maternity leave...

-Is over.

As fascinating as finger painting is,

-it doesn't quite compare to holding a man's heart in your hands.

-No.

So you'll be keen to get straight back into theatre on your first day and a neurofibroma...

Unclench, Oliver. I have no interest in your case.

Really?

I'm here to make sure the hoards of evil don't get overexcited

and decide to invade Poland.

The rest of you have done fine so far,

so keep it up and don't bother me.

The CT angiogram on Mrs Musgrove

confirmed it's acute on chronic mesenteric ischemia.

OK, we need to do a laparotomy straight away

to assess the extent of that damage.

Shall I book a theatre?

Ah.

Um, sorry, when I said "we", I meant Mr Di Lucca and me.

They're my patients and I've got a bond with them.

Right, well, I'll check with Mr Di Lucca

and if he's happy for you to scrub in, that's fine with me.

(Yes!)

Impeccably handled, Dr Shreve.

Ollie? Mr Duffy's blood results.

Normal, but his BP's a little high for my liking.

OK, thank you.

I haven't told you about HER yet, have I?

Maybe we should close the curtains.

Her name's Sarah.

I haven't known her for very long, but, er,

I've bought a ring and everything.

-Sounds romantic.

-Dr March?

Why are we hiding our patient like he's some dirty little secret?

The last thing that Mr Duffy needs is people staring at him

like he's an animal at the zoo.

I don't mind.

Whoever wants to look at me is more than welcome.

I've never been a CURIOSITY before.

Well, we're a bit concerned about your blood pressure.

Try and get some rest and we'll test again.

Hopefully it's just a glitch.

Are you afraid somebody's going to catch us saving lives

and remind us we're here to do the plumbing?

What he needs is peace and quiet. That means privacy.

You are the best man for this job - whether she's back or not.

Just keep the curtains closed.

Right, you, brace yourself.

This is going to probably sting.

That'll test a bloke's mettle.

Yeah, well, it's the only thing that works.

It would hurt a lot more if the infection spread.

Right little ray of sunshine, aren't you?

Well, when you've seen a man's leg turn black

and fall off within a matter of hours,

-it does tend to stick with you.

-What...?

It's a joke.

Anyway, if it did spread,

I'd catch it way before anything had the chance to fall off.

Cos I'm just that good.

Just when I thought I've got you figured out, Dr Copeland.

Ah. I'm a mystery wrapped in an enigma,

and head to toe in berry scrubs.

Whatever you are,

you're my kind of bloke.

Um, Jane?

Would you mind finishing up for me?

Try not to sneeze in the wound before it's been dressed...

Jac.

This must be what recurrent herpes feels like.

I know you must think this is the first step

in some sort of bid for world domination...

Actually, I had it more as a petty attempt to irritate me.

Oh, really? Why would I want to do that?

Talking of which, how is the flying Scotsman?

The magical world of cohabiting going well, is it?

It's called co-parenting and it remains none of your business.

Ah, so the romance didn't last.

Now, I wonder what the common denominator

in all these failed relationships is.

Speaking of failure, I see that Selfie Junior works for me now.

Is this your doing

or did she just pick a speciality out of a hat like usual?

Actually, she's quite committed.

She should be.

As well as being talented, which I'm sure you'll find out soon enough.

In fact, if I had my way, I'd have her work for me.

Well, not everybody falls into line when you snap your claws, do they?

No, not quite.

You know my agenda for the move to Darwin is entirely transparent.

Better resources for the patient,

more money and prestige for the hospital.

Going to give me the benefit of the doubt?

Oh, come on, Jac.

Prove to us you're not the paranoid narcissist we all think you are.

Stay on your territory. Keep well away from mine.

Can you see that Mo Effanga gets these notes?

Patient of hers was transferred down from Keller this morning.

No problemo.

-Is that Jac Naylor?

-Mm-hm.

Unless she's figured out a way to clone herself, which...

ooh...

The thought of it gives me heebies...

OK, so, I'm afraid this is as far as you can go, Mr Musgrove.

She's in good hands, I promise you.

Yeah, but I just...

You heard her, you daft thing.

I'll be fine.

Why don't...

you go on ahead

and I'll stay here with you.

Uh, but I thought you wanted to...

No. I'll stay.

So, finally you can tell me the full story of that marriage proposal...

JAC GROANS

My neurofibroma case, Will Duffy...

he has an elevated BP. I'm slightly concerned it might present some complications.

Why is this my problem?

Look, if this is some sort of a test where you intend to snatch the case off me last minute...

Try to remember that we're on a world-class surgical ward

and not in a sandpit.

I just meant that I'd rather discuss MY case together now,

than be ambushed later.

Are you or are you not capable of handling this case?

I am. 100%.

Then man up and stop bothering me.

Otherwise I'm sure Ms Effanga will be more than happy to take over.

How long have you two been married?

59 years next October.

A child-bride, you see.

I was 17 years old.

We got married on the Saturday

and then I was shipped to the forces on the Sunday.

Well, we never really got to know each other.

Not properly...

..till I was discharged.

59 years...

Can you get us to 60, doctor?

BP's still too high.

We've had conversations about this, Will. Avoiding stress

and controlling your diet.

Sorry.

This is high-risk surgery, Mr Duffy.

If there's a possibility of a bleed, blood pressure control is essential.

Oh, oh, look! I've got two more followers.

I'll be getting requests for interviews shortly if I'm not careful.

The only thing that I'm concerned about is you making it through this surgery alive.

There are risks.

If you don't understand those risks,

you can't consent to the surgery. Do you understand?

You want to save my life, you need to focus.

I understand.

Would you like to be interviewed, Dr March?

You need to rest, Mr Duffy!

How many times do I need to say it?

Rest...

Got it.

Aye, aye, sir.

He's a lonely guy, not some bloke in the bushes with a long lens.

If he wants to turn himself into a sideshow, that's fine with me.

I need to keep him alive.

I'm sorry, did I miss something?

Because the last time I checked you were pretty much on top of things.

I am...pretty much on top of things. I'm fine.

Nothing's changed.

MOBILE BEEPS

I talked to Will about his camera.

-He's agreed to dial down his media commitments until after theatre.

-Fine.

Good.

I know you planned to do this without...

certain people looking over your shoulder, but nobody wants you to fail.

I've known Jac a long time.

And, uh, she's been gone a long time.

You've got nothing to prove.

I'm surprised Morven agreed to stay with the old boy.

She seemed keen as mustard before.

Well, she knows how smart she is, and how capable.

She just hasn't got the message that it's a marathon, not a sprint.

Assessing the damaged tissue...

It's been a while since I've seen one this bad.

Indeed.

This is too far gone.

She's no small bowel left.

Loop PDS, please?

Mr Duffy.

Relax! I'm not going to make you delete your followers.

That is the right term, isn't it?

Some people call themselves fans.

-Their term - not mine.

-OK.

You're sure that I can't go over anything for you?

Point me in the right direction and do your worst.

I'm in your capable hands.

OK, it's just that at the beginning of this process you seemed a lot more,

well, how do I put it...?

Uptight? Riddled with anxiety?

No-one would blame you for being worried.

You don't need to put a brave face on for me.

I got a chemistry set for my eighth birthday.

Right...?

I never used it cos I was terrified I'd burn the house down

or die of ingesting poisonous fumes or something.

I've always been a worst-case-scenario man.

Then you get a tumour on your chest and you think...

..the only way is up.

Well, I suppose it's not uncommon for patients to find

a new lease of life after this sort of thing.

And it's all thanks to Howard, here.

OK, well, uh, as I understand it,

Howard has dominated your life for quite some time

and I'm going to change that, get you back to the man you used to be.

-The man I used to be?

-A normal person.

Someone that can do all the things you used to do.

Anything less than that is a bad outcome for both of us,

do you understand?

Anyway, I'm sure that one picture

isn't going to affect your blood pressure too much,

so let's go for it.

After the, um...

After the surgery, I won't have much in common

-with the guys on the forum, will I?

-Well, that's the plan.

CAMERA CLICKS

Right, back in a bit.

Do you come to the roof for every bloke that sends you a mystery text?

I was intrigued.

What is all this?

I haven't seen you stop for lunch yet, so I thought...

Me and the blokes at work do this sometimes.

Raid the nearest shop for pasties and pop,

out comes the trusty picnic basket and here we are.

So you've prepared me a plumber's picnic in winter?

Not exactly the couscous and greens you doctors are used to, I take it?

Couscous is very last year. It's all about quinoa.

Rematch?

OK.

But I feel it is my medical duty to say

that you should not be out of bed.

I'll forget how to walk and talk if I don't get off that ward for a bit.

Anyway, with a doc like you treating me, I'm in safe hands,

aren't I?

Well, these are trans-fat-tastic.

Where the flavour is, mate.

Look, I know it's not much,

I just wanted to do something to say thank you.

Well, Mr Levy did have something to do with it.

I'm not talking about the surgery. I mean...

The sitting with me, chewing the fat.

I know we didn't exactly, um, gel at first...

I think oil and water had a more immediate connection.

You've been a good mate.

Having you about's made this all a bit easier.

Sorry to interrupt, but, um, I promised Mr Musgrove an update.

Not much to say, I'm afraid.

What? So you're closing up already?

You didn't find any dead bowel?

What's wrong?

Oxygen at 100%, please. Thank you.

Mr Duffy?

Mr Duffy, look at me, please. Thank you.

Pull up his latest CT, please. OK, now breathe. Breathe for me, Mr Duffy.

In and out. That's it. In. And out.

Yeah, tumour's very close to the aorta. The upper lobe's collapsed.

Could be pressing on the lung? Should we hold off on theatre until...

He's only going to get worse. We need to get him to theatre now.

-Keep him stable.

-Where are you going?

-Stable!

Mrs Harrison almost missed her slot in surgery because we hadn't chased up her CT results.

I'm really sorry.

It's on my to-do list, I've just been really swamped.

Swamped or busy with one patient in particular?

Look, I know Lee must be anxious about these biopsy results,

but there are other patients on the ward.

I'm more than aware of that.

I haven't just been treating him for anxiety all day.

The wound infection. Yeah, yeah, Fran mentioned.

Well, on first inspection, it didn't look like much,

but he will need more antibiotics.

Right, then hook him up and move on.

Come on, you know I hate to crack the whip, but...

needs must.

I've been trying to move on, but it's difficult. He's...

needy.

You know what patients are like when they don't have family.

Is this something that I should be worried about?

Uh, well, it's just difficult to disengage with someone

when they're clearly in need of attention.

So he's become attached?

No, no, that's... That's not what I mean, not exactly.

So what are you talking about?

Harmless crush or...

..a stalker?

I hardly think I need to take out an injunction against the guy,

if that's what you're implying.

Well, you can joke about it, but I've seen it happen before.

Watch your back.

It became clear almost as soon as we got into theatre

that the damage to the bowel was much more extensive than we thought.

So I'm afraid to say I don't feel further surgery is your best option.

Um, all right, so...

So what is?

I think it might be time to think about

letting nature take its course.

Oh, so she's well enough to go home?

No, unfortunately not. Your wife is much sicker than we thought.

So, erm, does she need to stay here?

Listen to what the doctor's saying, Hugh.

I am listening.

She's got a problem with her bowels, is that right?

Dr Digby doesn't think we should do any more surgery, Hugh.

So you can give her medicine to sort it out?

Hugh, listen.

He's saying

it's my time, love.

We knew it had to happen sometime, didn't we?

What are you talking about?

There has...has to be some mistake.

She came in here with just a spot of tummy trouble.

That's all.

Well, you'll just have to run your tests again.

Oh, Hugh.

I said,

"Rerun the tests!"

Why don't we step out for a while

and then we can leave you two to talk?

'Dr Shreve?'

Are you sure you've looked into everything?

There must be something else we can do.

Not everyone can be saved.

It's one of the toughest parts of the job.

I'm surprised you let Oliver get his hands on that neurofibroma patient without a fight.

Or maybe he's been tied up with that for so long,

I've managed to do three better surgeries already?

Glad to see some things haven't changed since I've been gone.

Right back at you.

-Excuse the interruption, Ms Naylor...

-Speak.

My neurofibroma patient.

His BP was elevated, now his oxygen levels have crashed through the floor.

I think the tumour's pushing against his lung.

He can't wait much longer for theatre.

So you want me to abandon this patient

and step in at the last second?

Take Mrs Dawson back to Darwin and reschedule for tomorrow.

Mm-hm.

I gave you a chance to eat at the grown-ups' table and you bottled it.

Just like you thought I would, right?

Look, Mr Duffy is my patient.

This is my chance to prove what I can do.

Oh, mission accomplished.

Make sure there's a theatre available and prep Mr Duffy for a thoracoscopic procedure.

There's a plain between the aorta and the tumour with a narrow pedicle.

A thoracotomy would be the best shot.

What?

Well, open procedure is much better for risk management.

Well, you'll have to increase the size of the incision...

Fine. Thoracoscopic it is.

-ZOSIA:

-Charging. Stand clear.

Shocking.

Charge again.

Stand clear.

Shocking.

A team in the US have done extensive research

-into advanced mesenteric ischemia in older patients.

-Morven...

Another team in Sweden back up the study

and both agree that a small bowel transplant can all but cure the condition.

I don't see any reason why Mrs Musgrove can't be a candidate.

OK, forget the transplant.

-There's nothing more we can do.

-What...?

Look, she'd have only had a 10% chance of survival

even if she hadn't been so acutely ill.

And I wouldn't have wished those extra years on anyone.

If we remove the dead bowel, she can no longer eat or drink.

She'd have had to be fed through a tube through her neck,

which would have been invasive and downright miserable.

Which is why we do the transplant.

Look, just because we can do more, doesn't mean that we should.

I'm sorry, I really am.

You're my superior and I respect your decision making.

You happy?

-WILL:

-'Here.

'Here we go.'

Impressive, isn't it?

A lot of doctors say they haven't seen one like this before.

Now, I know you don't agree with him

because I could see it in your face.

Look you have to understand, Mr Musgrove,

I'm still very junior here.

Yeah, but you're our doctor.

You're looking after Beth.

You get to a certain age, you know,

when people stop looking at you properly.

They think we've got one foot in the grave and you don't matter.

Well, you matter to me.

Well, please, just...just help us.

Come on. Just tell me what I should do.

Anything.

I really have done my best.

I even suggested Mrs Musgrove be put forward for a transplant,

but I'm not senior enough for anyone to listen to me.

I'm sorry.

You think I should go to somebody higher up?

I'm not saying anything.

Really.

Please tell me you didn't have a chance to down any coffee or croissants

before I got down here.

I got an instant message from some guy in the hospital

and I thought to myself... Well, this might be the last time.

The last time that people crowd around you like an oddity?

I hope so.

The last chance that anyone might pay attention to me.

Before this, I was a no-one who wouldn't say boo to a goose.

I used to go to work,

refuse people's loans,

go home, watch TV.

No interaction, no hope.

No chance of anything changing.

And then the tumour happened.

It gave me confidence.

I've got friends.

There's a woman I barely know I'm thinking of asking to marry me.

I mean, how fantastic is that?

Look...

just because you don't like the way things used to be

doesn't mean you have to go back to that.

Things don't change. Not really.

Not deep down.

Well, I like to think I have.

What, you're telling me you were once a short, fat, ugly mortgage advisor?

-Well...

-To be honest, the problems of a tall, dark, handsome doctor

don't really seem that relevant to my life.

Everyone has problems.

Things they'd like to change.

I'd like to change everything.

You even smell nice.

Believe it or not, today's a pretty big day for me, too.

Now man up and prove yourself or for ever be overlooked sort of a deal.

If you don't have this procedure today,

the tumour will keep getting bigger.

You won't have a chance to visit all these new friends of yours.

You need to step up to the plate, Will.

Bet on yourself because no-one else will.

Is that what you're doing?

In it together?

Sorry.

Lee...

Um... You shouldn't be buying me gifts.

Technically, I gave one of the cleaners 20 quid to get it for me, so...

Relax. It was just a joke gift.

You don't have to wear it if it's not your sort of thing.

It's not that, it's just...

Just...what?

You just...you shouldn't be buying me gifts.

Yeah, you said that bit.

Look, I am a doctor.

I'm your doctor.

And we are not supposed to be friends with our patients.

(Do you always do what you're supposed to?)

I have other patients.

Thank you for the gift.

-HUGH:

-Now you're the one in charge of this place?

I am Henrik Hanssen, CEO, if that's the question.

My wife, Beth Musgrove...

She's down on AAU...

I'm afraid I'm going to have to stop you right there, Mr Musgrove.

I am unable to comment on specific cases.

At least not without an appointment.

She's dying down there.

Now, I'm sorry, we're not the sort to make complaints, but...

..it's my wife we're talking about.

Well, I do understand how upsetting it can be

when someone you love is unwell.

Unwell?

She's not unwell.

They've said they can do no more for her.

They won't help her any more.

There has to be something else.

There just has to be.

We can discuss it at length if you would kindly give me some time

to review your wife's case.

If I walk out of here, you'll palm me off like the rest of them.

I'm sorry, I'm staying.

I'm staying.

Right.

I think we should go back down to the ward together.

Don't you?

Thank you.

Dissecting the tumour away from the aorta.

There's a bleed.

Suction.

Plegit.

It's too intricate, we need to open him up.

Quiet.

LONG BEEPS

BP's falling.

OK.

All right, let's open him up.

Look, I want you to know that I didn't tell Hugh to do this.

I never even mentioned Mr Hanssen's name, he must've just...found out.

He's just trying to do what's best for his wife.

Don't let anybody say that my Beth doesn't deserve

all the help, well, that everybody else has had.

That's most understandable, Mr Musgrove.

Dr Digby, very glad you could join us.

Mr Musgrove has some concerns about his wife's case.

I see.

Well, there's a transplant she could have,

only he won't even think about it.

I will consult with Dr Digby and Dr Shreve.

Whatever decision is reached,

you may be sure that it will come with the backing of both myself

and Holby City Hospital.

-Thank you very much.

-You're welcome.

-Thank you.

Mr Hanssen, I don't know how he thought to go to you.

I never for one moment suggested it.

Right, so how did he get the idea of the transplant, then?

She's was badgering me earlier on the subject after we came out of theatre.

In private. Between us, that's all.

So you didn't mention the possibility of a transplant to Mr Musgrove?

I just wanted him to know that I cared.

That I'd done everything that I could.

A simple glance at this poor woman's chart would show

that Dr Digby's decision making has been beyond reproach.

And yet somehow you know better?

No. No, of course not.

-I just thought...

-Look, just give Mr Musgrove a chance

to process the situation

and then tell him quietly and calmly that, regrettably,

-there is nothing more we can do for his wife.

-Of course.

May I have a word, please?

-JAC:

-We may have to put him on bypass.

-Page the on-call perfusionist.

-Can I try something first?

30 seconds.

LONG BEEPS CONTINUE

Foley catheter, please.

Quickly.

Thank you.

If you could put your finger on the bleed, please, Ms Naylor?

OK.

REGULAR BEEPS

Well, it seems you have been paying attention while I've been away.

I was happy in blissful ignorance until now...

Now what?

Come on, you can tell me.

Sacha's Dr Intercom, I am a model of discretion.

Spill.

Well, there might have been something in what you said earlier.

-AMERICAN ACCENT:

-You are Sleepless in Holby!

-No, I'm not.

-Yes, you are!

-Look at your cheeks going all cute and red.

-Stop it!

Oh, chill out. He's here, he's hot.

Nothing wrong with a bit of harmless flirting.

Why are you taking this so seriously?

Well, BECAUSE it is serious, to me.

You and Lee the plumber.

-You could be soul-mates!

-Oh!

Oh, come on!

Scissors.

Actually...

you mind if I make the cut?

Thank you.

Ms Naylor?

The tumour has a tail going into the spinal cavity.

Shall I extract?

We don't know how far it extends.

The risk of paralysis is too high.

We could dissect through a vertebrae?

Go in through the back, picking the tumour from his spine as we go.

It's possible.

We should page Mr Self.

Mr Duffy deserves the best possible chance.

Please.

We need to page Mr Self right now.

If you're so keen for Mr Self's assistance,

why don't you go and get him?

That's a runner's job, don't you think?

Well, we'll wait here.

Hurry back.

-I know you think I've made a mess of this whole thing...

-OK,

I think that you've given a dying woman and her husband false hope.

Which, in a situation like this,

I really can't think of anything much worse.

OK, fine. Fine.

I screwed up.

I accept now that Beth's reached the end of the line...

But, like it or not, they've bonded with me and...

I've bonded with them.

So maybe my being there can make this a tiny bit easier on them.

That's all I want.

Please.

-If you contradict me in any way...

-I won't.

I promise.

So, congratulations.

Excuse me.

There's been a complication in theatre.

A neurofibroma has infiltrated the spinal canal.

We were wondering if you'd scrub in, remove a vertebrae..

"We"?

Ms Naylor and I.

It's urgent.

OK, the last time I saw Jac Naylor, battle lines were drawn,

gauntlets were thrown.

I would have thought the last place she'd want to see me would be in her theatre.

Just because she doesn't want your help doesn't mean she doesn't need any.

Not a fully paid-up member to the cult of Jac Naylor, Dr Valentine?

OK, I'll scrub in, but I won't barge in on another consultant's procedure.

I won't set foot in theatre

unless I get an express invite from the lady herself.

Oh, what you doing here?

Cos unless you've come to apologise, we're not interested.

After discussing your situation with Mr Hanssen, I'm afraid

nothing has changed.

We all feel that it's in the best interests of Mrs Musgrove

if we concentrate on making her comfortable.

Let her die, you mean.

Stop her having the transplant that she needs?

Even if an organ were to become available,

the chances of any meaningful success are incredibly small.

Beth would be in pain.

She'd need constant care.

It doesn't matter. It doesn't matter.

I'd do it.

Whatever she needs.

Look, we know that you'd do whatever it took.

Well...

She's... She's everything.

Look, I thought holding on to Beth's life was the most important thing.

But maybe holding onto the life you had together is more important.

If we do the transplant,

you wouldn't have to grieve for Beth just yet...

..but you would have to watch her suffer.

I think that's a bit worse, don't you?

Oh, I... I don't know.

59 wonderful years.

Let's not spoil it now.

Listen...

I... I can't go home

without you.

Without YOU!

Mr Self has agreed to join us -

with one small condition.

He wants to hear it from you.

What is it about simple instructions you find so challenging?

Right, Jac, that's me ready to scrub in.

I'll just wait for your nod.

He said he couldn't in all good conscience

barge in on a peer's surgery without an express invitation.

I think maybe a simple "You're needed," would suffice.

Inform Mr Self that he's no longer required.

Don't.

I know you're the mighty Jac Naylor

and while you might be competent to do this procedure,

you are not the best person for the job. Not on this occasion.

So either you say whatever you need to Mr Self to get him in here...

or I go to Mr Hanssen.

It's your choice.

Get in here.

There, now.

That wasn't so hard, was it?

Hey.

It'll be better than home by the time you're done.

I think I'll just go and get a cup of tea.

He's used to barking orders and people falling into line.

Not being in control doesn't suit him.

My grandma always used to say that men find things like this harder.

Change, I mean.

I knew it.

Clever girls always spend time listening to their grandmas.

Well, um, my mum walked out when I was little,

so she practically brought me up.

We never had kids.

Just weren't blessed that way.

That's how it was back then.

You say you're over it, but...

..you never really are.

Oh!

Listen to me going all soft.

You don't have to dash off, do you?

-Ah.

-Hey.

I thought you'd be on the ward taking a lap of honour.

Turns out I wasn't required for the curtain call.

OK.

I took a risk in theatre, I spoke to Jac as a peer because I had no other choice...

I really thought that that was my moment to shine.

That Jac might actually be impressed by how much I'd grown as a surgeon.

But she still sees me as a timid little F1, not fit to lick her boots.

To hell with Jac.

If she thinks treating people badly is going to get the best out of them, then more fool her.

You don't get it. She doesn't think how to get the best out of us,

because she doesn't care about any of us.

In the world of Jac, there is only Jac.

OK.

You have a patient who's awake in recovery and he's asking after you.

I don't think he got the memo about how lowly and pointless you are.

DOOR CLOSES

There must be something else I could do.

Maybe if we transferred you to another hospital...

It's nature.

No stopping it.

I don't want to go angry.

But I can't go quietly unless I know Hugh's going to be all right.

I don't mean all right, cos who is?

But...

just...

at peace with it.

He keeps saying, "This is our time."

But the truth is, we've had it.

Our real time was when we were young

and we had all the time in the world to enjoy it.

Just...

went too quick

is the trouble.

I know he's been kicking up an awful fuss.

Will you help me with him?

I don't want him to be on his own...

..when I go.

Ooh, a vest-top!

Very early-'90s.

Actually, it was a present.

From Lee.

He's buying you presents now?

I know I've taken the mick a bit today,

but if I've pushed things too far, then I'm sorry.

No, you haven't.

It's...actually...

..kind of made me see what was under my nose all along.

A failed attempt at facial hair?

Why do you find this all so amusing?

Oh, I'm sorry.

I thought we were just having a laugh.

I had no idea you were being serious.

Dom, he's a patient.

You've only known him five minutes.

Yeah, but I feel like I've got more in common with him

than I have done with anyone for ages.

Don't worry, I'm not about to run off

and get married in matching vest tops.

But there's something there.

And he's not going to be a patient for ever.

Howard is exactly where he belongs.

Headed for the incinerator.

I think I was dreaming when I was under.

Mainly mortgage applications and tax returns.

Perhaps I should ring my boss.

Plead insanity, ask for my job back.

Don't you dare.

You're not the man you were.

Embrace the new you.

I think it was just the surgery talking.

You know, thinking I might die.

Trying to grab life by the danglies.

Yeah, well, that's probably got something to do with it.

Doesn't make it any less real.

I could always work for, you know, a different company.

A nicer one.

Everybody needs a number cruncher, don't they?

Fine. But don't lose those contacts.

They're a must.

Do you think so?

Here... I don't still have to propose to Sarah, do I?

We've... We've only been on two dates.

I might be rushing things a bit.

You've got the whole of the rest of your life ahead of you.

Why don't you try and strike a happy medium?

(Yeah.)

I haven't said thank you.

Without you pushing me,

I'd probably be a bloke attached to a tumour for the rest of my days.

All part of the service.

That, I doubt.

Anyway, look, we know how it turned out for me.

How was it for you?

Well, let's just say that my part of the bargain didn't exactly go

according to plan.

Ah, ha.

Um, time to try again.

Time to step up to the plate, Dr Valentine,

and bet on yourself.

No-one else will.

So...

..I have a confession to make.

That stunt I pulled in theatre might have been a tiny bit about irritating you.

Next on today's edition of Stating The Obvious...

But I have no intention of threatening your tenure on Darwin.

My tiny little fiefdom is more than enough.

Truce?

OK, so can I tell Hanssen we're one happy family?

You can tell him I've reconsidered killing you in your sleep.

-After that, we'll have to see how it goes.

-Fair enough.

You know, Jac, if today proved anything,

it's that it might not be a bad idea for us to have our two specialties side by side.

We did make quite a team in there.

I don't do teams.

Well, you might just have to learn.

# Why do birds suddenly appear

# Every time you're near?

# Just like me, they long to be close to you. #

CONTINUOUS BEEP

Locker room's that way.

What are you going to do for us?

Zosia, Mo and I.

The other registrars, the F1s, F2s, everyone who's here to learn.

What are you going to do for us?

I don't know if you'd noticed, but everyone's been falling over backwards

trying to impress you today.

It's hardly my fault if you have confidence issues.

Oh, this is your ward. I get that.

Running this place must feel colossal at times.

Because it is colossal.

But you have a whole team at your disposal

and you're trying to do everything yourself.

-What you said in theatre was gross insubordination.

-I know.

But it was something you needed to hear.

So you are all grown up, after all.

You're welcome.

What?

It is not my job to mollycoddle you or hold your hand.

This was a test?

Oh, you've been playing me.

All day.

It's come to my attention that I'll need a team around me.

Are you in?

100%.

Morven?

I didn't get into medicine so I could decide who lives and who dies.

I wanted to help people.

I sound about ten, don't I?

You sound like every decent doctor that I've ever met.

These decisions, they don't get any easier.

You sort of wouldn't want them to, really.

We have all this science at our disposal

and yet we still can't give two people who love each other

just one more year together.

It's... It's... It's never easy losing a patient.

This isn't about death, Dr Digby.

I've seen death.

How can you go through a day like today and not feel like

everything you've ever learned or achieved amounts to nothing?

Well, we helped Mrs Musgrove today.

Just because we didn't save her,

that doesn't lessen the good that we did.

You just think that I'm some naive little kid

-that'll get used to this sort of thing eventually, don't you?

-I don't think you're naive.

You will get used to it.

Look, I know I was wrong to suggest the transplant.

I know letting her go was the right thing to do.

But I will never get used to it.

And I will be a better doctor because of it.

I think, maybe, you and I see medicine differently and...

..I'm glad about that.

You're cold, Arthur.

You do realise this makes us superheroes, don't you?

How so?

Well, we defeated Godzilla with a minimal amount of casualties.

My sanity almost being one of them.

Mr Duffy can go back to his new life,

and we can say we helped remove one of the most unusual neurofibromas

the world has ever seen...

And everyone lived happily ever after.

-Yeah, that doesn't sound quite right, does it?

-Not at all.

I hear you stared down Medusa in theatre.

Keep it up.

That's not exactly how it went, but...

The lab have asked me to pass on an apology.

OK, they're overworked, they're underpaid,

so it's understandable, but it's hardly an excuse.

-But you've got the biopsy results through now, though?

-Yup.

It's good news. The cancer hasn't spread.

Now we'll need time to treat the infection,

but the signs are very good that you're responding well to the antibiotics.

So I'll soon be seeing the back of you, then?

In a few days, all being well.

Get in!