Going the Distance Holby City

I am demoting you from head of CT effective immediately.

You're not serious?

Everything all right, Mr Rossini?

Of course.

You just look a little deflated,

not your usual swash and buckle, I thought.

Is leadership not suiting you?

I think the most important thing to me...

is to see you happy again,

and if that's with Raf, then so be it.

One step at a time.

Tell me what you know!

I'm putting you on compassionate leave as of this moment.

Is there anything you want to say?

Morven, mind if I join you?

Oh, please. Sorry,

it's not very ladylike, is it?

Oh, well, we all enjoy a little comfort food now and again.

Oh, it's not comfort food. I eat like this every breakfast time.

Very good.

So, I wanted to welcome you back firstly,

and also to update you on Nurse Reynolds. Thank you.

The CPS are deciding whether to prosecute or not.

OK. Um...

Is she OK?

She's getting all the help she needs.

Good.

If there is anything I can do, let me know, won't you?

And I hope that the events haven't affected your grieving in any way.

No. Me and grief, we're like that, best of friends.

Anyway.

I'll...

Enjoy. Thank you, Mr Hanssen.

Thank you.

Ms Naylor.

I received a letter of condolence. Oh. Good.

From Elliot Hope?

It's the stamp, you see.

Commissioned to celebrate the Golden Jubilee

of Pakistan's Ayub Bridge, I believe.

Is he well?

Busy.

Understaffed.

Happy.

He said to say hello.

Just the person. This is for you.

For me? Hm. Punchbag.

Er, you think?

It's a present.

You know, in case you want to let off a bit of steam.

Might avoid... Controversy.

Yeah, and I'm sorry for, you know.

So, actually, it's you who I should be punching?

You wouldn't even get close. Chance would be a fine thing.

So, go on, give it your best shot. Hard as you like.

What was that? Oh, come on, you can do better than that.

I'm so sorry I'm late. I've been up all night with Amber.

I've barely slept a wink.

Look, come on, I can take it.

Like Ali said, "Float like a butterfly, sting like..."

"And hit the deck like a tonne of bricks."

THEY LAUGH

It's Parker's summer holiday, isn't it?

Would've thought the prospect of all that freedom

would have cheered him up. That's what worries me.

I'm not home that much. What's he going to do?

Am I meant to be encouraging him to do things

like get a job or washing cars or something?

Not if you ever want to see him again. What about a hobby?

Kids don't have hobbies these days. They've got screens.

Well, that's the problem. He's on his own, not doing very much.

Which I think you'll find is

the definition of a perfect school summer holiday.

I used to spend days on end holed up in my room.

Doing what? Just lying there staring into space.

The male teenage spine can't sustain being upright for too long.

It's a biological thing.

You're not taking this seriously. It's my first summer with him.

I've got nothing to measure it against.

Yes, you do. You've got your own experience. What did you do?

This is Roma Portman and her son.

She has relapsing remitting MS, fell at home.

GP noted a slight chest infection and deterioration in movement.

Requested a proper assessment. I'm so sorry.

My GP is so overreacting.

This is a complete waste of your time.

I'm just very clumsy, missed my footing on the stairs.

Didn't I, Lewis?

OK, so, we'll see to your mum straight away. Hm.

It's me. I'm clearly a natural.

Che barba! Basta non me ne frega niente!

Why do I not think that means,

"Good morning! What a lovely day it is?"

Great, it's my F1 assessment today.

Oh. Good luck.

Morning. Reporting for duty. My assessment...

I forgot. I can't do it.

But we spoke about it.

Not today. I'm too busy.

But today's the deadline.

I'm in theatre with Zosia.

Someone else will have to do it for you. Who?

Your favourite person.

Jac, good morning to you.

I have something very special for you today.

Oh?

I want you to oversee a CABG.

A CABG! Something "special"!

No, no. It's not the procedure what's special about it.

It's who you will be performing it with.

Dr Ford.

And the fact that today is his F1 assessment.

What better procedure?

What better person to assess?

What do you say?

Bring it on. Me and you. Dream team.

Make it quick.

I knew you'd be pleased.

Any tiredness? Problems with vision or numbness?

Nothing to write home about.

Honestly, this has less to do with my having MS

and more to do with being a dizzy mare.

How can you be so sure?

That I'm a dizzy mare? Believe me. Years of practice.

What am I, Lewis? A dizzy mare.

I mean, about your illness. It's early stages.

Even though you've already been prescribed beta interferon? A DMT.

Well, who isn't with MS?

Do you have any muscle spasms or stiffness at all?

Right arm's a bit weird, but...

You're like a dog with a bone, aren't you?

Is he always like this?

He just wants to make sure.

Well, I'm a little concerned why the right side of your body

isn't moving as freely as the left.

That's the side I fell on.

I bounced all the way down the stairs on it. Didn't I, Lewis?

Yeah, I thought the roof had fallen in. Thanks for that.

I'd like to run a few checks and hopefully get you home as soon as.

And in the meantime, can we clean that burn up?

FBC, U, LSTs and a bone biochemistry profile, please.

Seems like a sweet kid.

You caught me off-guard, that's all.

There must have been something slippy on the floor.

The only thing on the floor was you and your reputation, mate.

It was a one-off. You got lucky.

Happy for a rematch, any time you like. Anyone? Problem?

No, not with me there isn't. Oh, Fletch, Morven OK?

If she's not, she's doing a good job of pretending.

Morning. Dr Digby, Nurse Jackson.

We've met.

Right. Pneumonia and COPD in one.

Acute coronary syndrome in two.

Three needs and echo and an ECG.

Four, pyelonephritis and acute urine retention.

That's got my name written all over it.

And, Morven.... ED need to send a trauma victim through.

Male, stab wound to the chest, unresponsive, low BP.

We'll take that. Morven, Zach Hagenbach, bay five.

Crohn's disease and upper GI bleed. Cool.

Um, Donna, keep an eye.

Me? I barely know the woman. Chance to rectify that, then.

There you go.

Got it, Mum.

Does that happen often?

No. I think it's the DMT drugs they give me.

Get me a drink, love? Done.

Ah, he's a nice young man. He'll do.

Is it just you guys? Dad around?

No, it's just us.

Do you get much medical support?

Yeah, loads.

I've got the social services and a MS specialist nurse

and a GP who's gorgeous, worth throwing myself down the stairs for.

And Lewis, he's great, he's my rock.

That is quite some responsibility.

I guess he's got some exams coming up too?

Yeah. And the report last year was great. Higher grades than ever.

Right, I'll be back in a minute.

PHONE BEEPS

Mr Hagenbach. Zach.

Zach. Hi. I'm Dr Digby.

This is Nurse Jackson. Hello.

So, I gather you have Crohn's and you've had a bit of a bleed. OK.

You've been vomiting blood,

your haemoglobin levels are low and you've had some abdominal pain.

That's about the size of it, yeah.

OK. Whereabouts is the pain exactly?

OK.

Right. It's possibly an ulcer,

it's usually the cause of upper GI bleeding.

We can perform a gastroscopy to find out for sure.

So, you're a photographer?

Oh, it's just a hobby, just catching moments.

Click. Gone. Like life.

This place is great for it. The pain.

The boredom.

The beauty.

Oh, aren't you the little charmer?

Stop. Not in here, thank you.

What can I do?

OK. Let's get him on I/V fluids and monitor his urine output. OK.

I'm just going to take a closer look at your notes. Be my guest.

So, coronary artery bypass graft.

Not a great fan of hospitals, if I'm honest.

Think it goes back to when I was little

and a nurse stuck a thermometer where the sun don't shine.

You're not going to do that, are you?

No, I'm not a nurse. I'm a cardiothoracic consultant.

Good. You'll be quick, then?

I've got a load on at work that I need to get back to.

Explain.

After your operation you're going to be in hospital

for at least a week

and then recovering for probably another ten to 12.

You do know that, I take it?

Yeah, but...really? Yes, really.

The thing is, my job, I don't think Jeff'll be able to cope without me.

What is it you do?

I'm PA for an international human rights lawyer, and his wife.

Sounds interesting.

They're partners at the same firm. I do absolutely everything for them.

They'll never cope without me. Well, for the time being,

you'll have to think about yourself first and foremost.

And perhaps you'll find that...

in your absence, people will cope better than you think.

Any history of cardiac issues in your family? No.

Any lifestyle issues to speak of? Smoking? Drinking?

Nope.

And you're...30?

Two weeks ago.

Jeff threw me a surprise party.

Well, I had to ring round and check numbers,

but it's the thought, isn't it?

OK. Enough of the chat.

If there are no more questions, I'll call theatre,

get you in as soon as humanly possible.

They're great together, aren't they?

I wish me and Parker were more like that.

Him feeding you sugary drinks while you lie in a hospital bed?

Easy banter and open communication.

I think. You think?

She was drooling earlier.

She blamed the DMT, but he came over in a flash with a tissue.

So?

Well, surely it must have happened a lot for him to come armed,

only she said it didn't.

Well, she's fallen down the stairs, maybe she's confused.

Ah, hi. To what do I owe the pleasure?

Do you know Lewis? Not really.

He's at school, but we're not mates or anything.

What's he doing here?

Do I get a "hello"?

Fletch, bay three needs to be transferred for his CT.

Right you are.

I'll take him for his scan.

So, what happened to him?

Domestic.

And? How bad is it?

BP's stable, but the stab wound's deep.

It's not likely to be without complications. How's our Crohn's?

Oh, yeah, I'm still going through his notes.

I'm here if you need.

No, no, it's fine. He's not my patient.

Whereas...

Excuse me, excuse me,

can you stop that, please, or I'll have to confiscate it?

It's an invasion of people's privacy, it's not on. So is Crohn's.

I mean, you know,

I have quite a record of a life lived with the condition.

Owning it.

Hey, you got me figured yet?

No, not yet,

although have you thought of immunotherapy?

Or a small bowel MRI?

Yeah, been there, done that, got the T-shirt.

Had the tests done, but they didn't go ahead

cos of concerns about the state of my bowel.

Well, an MRI can assess specifically how bad the bowel is.

I know how bad my bowel is, I've had nine operations.

Well, that's just greedy. Yeah. It gets in the way of work as well.

Hey, do you know how long the average small bowel is?

Four metres? Yeah. I have 1.2 metres left. That's more than enough.

I was told last time that any more operations

and I might be fed through a tube for the rest of my life.

So, what do you do for work? You didn't say.

Oh, I run a smallholding. Yeah, only bought it recently.

How many acres?

It's more like a vegetable garden, with some animals attached.

32 in total. I got chickens, a sheep, goat

and about 3,000 bees. A couple of pigs soon.

Sounds idyllic.

It is, yeah. I used to work in tech and hated it.

But this, I just love it.

Just me, my animals and no-one else to answer to.

Nice.

Immunomodulators! What about them? Has anyone spoken to you about them?

They didn't just speak to me. They tried one out.

See? Lost cause.

Well, look, there are advances the whole time,

and I'm sure there's lots of other options.

Want to bet?

Sure. What've you got?

A camera. Or a pig?

I think a pig might be a bit of a commitment.

All right, camera it is, then.

Fix me and it's yours.

All right.

So, the guys are going to the game shop... Are they now?

..and I was wondering if I could...

Fleece some money out of the Royal Bank of Essie.

No, no, I was just checking that me going was OK with you. Parker.

You did say we could introduce some kind of allowance system.

How do I know it's for computer games?

Oh, because we got all the drink and drugs we needed yesterday.

Well, in that case, seeing as you put it so openly.

But there are conditions.

I want you to meet me after my shift

and then we're going to go home together

and we're going to have pizza, OK?

Games, yes? Yes!

Can I go now?

Don't be late. Or else!

Hey, mate, how's it going?

Something I said?

Nope, that would be me it seems.

Can't seem to say or do the right thing,

unless I'm handing out money.

Are you sure you don't want me to talk to him?

I'm happy to. I mean, he's cool about us, right?

Yeah, yeah, he's fine.

Just a pity he doesn't come with a manual, though.

KNOCK ON DOOR

Got a mo? No.

It's about Helena Cork.

Don't you think she's a bit young for a CABG?

Young people get heart issues.

Just because of the assessment...

..how best do I convey that she needs a change of lifestyle?

Give her the facts and move on. She's the nanny, not you.

You're still here.

That's the Hertzig, isn't it?

You developed it with Professor Elliot Hope. Your mentor, right?

Are you stalking me? No.

Then you need to get out more.

Her job is not the issue. Her heart is. Hence the CABG.

No. Her heart. She's in love with her boss.

She's endlessly hoping he'll ring

even though he either doesn't care or he's too scared of wifey,

whose name she can't bring herself to utter, to bother.

Wow! Liking the holistic approach.

Don't ever, ever use the word "holistic" in my presence again.

I don't care that she's in love with him,

but it adds to the picture of stress -

the wanting, the guilt, the relentless obsessive giving.

It's a relevant clinical concern.

So, how do I make her see that?

Tell it like it is.

Come on. No time like the present.

Oh, I hate surprises. Cheers, love, I'll have that.

Bay four, little Miss Prom Queen one minute, the next, bam...

no warning, nothing, just sick everywhere.

You all right?

OK, I'll be going.

Actually, Nurse Jackson, there is something.

Right, er. Do you want to talk about it?

Do you mind?

No. Hit me. Not literally, obviously.

Well, this Zach Hagenbach.

Right, what about him?

Right, he's got this condition yeah, chronic Crohn's.

He's had more operations than you can shake a stick at.

He's got about a metre of bowel left... Hardly worth having it.

He's had more treatments than he's had operations

and none of them are working.

Because his bowel is so compromised, right? Exactly.

So, why not take it out?

OK. That's radical.

They're pretty handy things to have, aren't they?

Bowels... Unless you're talking about...giving him a new one.

Exactly. A bowel transplant.

SHE COUGHS

You OK? Yes.

Fizz is right up my nose, I think.

Down the wrong way.

Are you sure? Mm-hm. Yes.

Have you been having any difficulties?

No. Ask the boss.

It's a new one on me.

OK, so this DMT that you're on.

Is injected, right, so who does the injections?

Me. How often?

Every other day. Nurse showed me how.

Why? Do you want some tips?

Look, I get that you're on top of this, OK,

but if you do need any extra advice or help, then Holby has a carer

support worker and they can maybe introduce you to a wider support...

Thanks, but we're cool.

Is the patient prepped?

What I'm trying to say is when you go back to your job,

you might want to think about ways you can help yourself,

put yourself first and foremost.

I could work out a bit, I suppose. Is that what you mean?

Not exactly, no. Ostrich.

Exactly, ostrich, meant to be good for you.

As in you are being one.

What's he called - Jeff?

Stop waiting for him to do something he might never do.

Stop giving. Start taking.

Make the world work for you, not the other way round.

What she means is... Exactly what I'm saying.

In case you hadn't noticed, goodness doesn't get rewarded.

See you in theatre.

Ah! Ms Wolfe. Zach Hagenbach.

I think we should apply for a bowel transplant.

All things considered, it seems to be the best way forward.

Right, well, two minor glitches -

one, it's a highly specialised procedure.

Well, we do highly specialised procedures the whole time.

Yeah, two, it's a highly specialised procedure

that Holby doesn't happen to offer.

Yeah, there is that.

But I've looked into it

and there are four centres in the UK that carry it out.

I could contact them and then I could take it from there.

I do, Morven, I admire your optimism enormously.

Great. Thank you.

But what makes you think that one of those centres will just jump

when an F2 from Holby makes contact?

Well, obviously they're not,

so I was thinking maybe you could make the call.

CAMERA CLICKS

All right, all right.

Come back when you have the results of his gastroscopy.

If it shows a bleed, then you have your answer.

If not, he needs a CT angiogram.

If both are clear and his symptoms subside then we can talk.

Great. Thanks, Ms Wolfe.

Could you take another look at Roma Portman for me?

Sure, what's the problem?

Possible dysphagia. She had a coughing episode a few minutes ago.

I don't think it's the first time. What does she say?

Otherwise. Both of them did.

But Sixth Sense Harrison senses otherwise.

Nurse Harrison tells me you've been having some problem swallowing.

Do you mind if I just take a look?

No. It's worse when I'm tired.

Throat issues aren't just about discomfort.

Problems swallowing can affect the intake of nutrients into your body.

But I'm OK. Look.

It's OK! Take a mo.

Excuse me. Right, take a breath.

Let's raise her up.

She'll be OK in a mo. It's fine. I don't think this is fine.

How many times has this happened, really?

This is important, Lewis.

It started a few weeks ago. I've logged every occasion.

So, this is what you've been doing on your computer.

I've got files on the muscle spasms, the vision glitches,

the numbness. He's on top of it.

Want to do a good job. Well, this indicates that

the swallowing issue's been happening quite a lot.

What about the falls? Have you got a file on them?

Third time this week.

Right. Well, I want a full formal speech and language assessment

and we're going to have to do some extra tests.

It will be OK, though, won't it?

Yeah, we're on top of this, OK?

It's really important that you tell us what's happened,

so thank you for being straight with us.

A bowel transplant? You can do that?

Yeah, of course we can. I mean, I can't.

In fact, we can't, but someone else can at a different hospital.

We can contact them.

You'd have to be assessed, which can take a few weeks.

And then if you're successful, you'd then go on to a waiting list.

Do you know how long I'd need to be in hospital for?

About four to six weeks and then recovery time on top of that.

That's quite a long time.

It is, but just think it'd be worth it.

If it was successful, you'd have no more of this.

Um, what about risks? Are there...?

OK, so, with a bowel transplant there are risks of heart

and breathing problems.

Right. And with any major operation there is of course risk of infection

and or the body rejecting the donor organ,

which can, in extreme cases, lead to organ failure.

Well, you're not exactly selling it. I'm not trying to.

I'm just saying exactly how it is

because I think it's the best option for you.

I just...

I don't know if I can take that kind of time out, you know?

I'm sure your animals won't mind.

I don't know. This lot can be pretty demanding.

They need round-the-clock care.

Well, is there anyone else that can help? No, it's just me.

Me and my wife, we split a couple of years ago.

I'm really sorry to hear that.

Yeah, and I've deliberately kept myself to myself since.

Look, I admire your independence but, I mean,

surely some friends could cover for you.

Where there's a will, there's a way.

And you're taking time out anyway.

A few days here and there, yeah, I can manage that, but...

Look, if it's successful,

the transplant can massively improve your quality of life.

And even if your ulcer heals you'll still have Crohn's

and all the problems associated with the operations. Exactly.

You win.

Yeah. Why not? Great.

Right, let's get you to your gastroscopy

and if you're lucky I'll let you take a few pics.

Oh, I'll do one now if you want.

Donna. Hop in. Oh.

And snap. Aw.

He's arresting.

Right, page CT. We need to get him straight into theatre.

And I need someone to help with a clamshell incision. I'm in.

And someone to manually massage his heart.

I can deal with this. You go.

You needn't worry because I've been giving her softer foods

to help with the swallowing.

Liquids, soups, mashed-up vegetables.

My concern is the risk of further chest infections.

How many of those have you had? This is my first proper one.

"Proper one"?

She had a mild one last month, lasted about three days,

but we saw that off with antibiotics. We're coping.

But Lewis is having to do more, presumably?

I'm fine. I enjoy it.

Look, apart from all the statistics,

what else are you doing on that thing?

Reading up on stuff.

You might have to take a look at your overall care package.

We don't want to. We don't want to do that.

We're fine, OK?

What are you worried about?

We want to stay at home.

We want to stay together.

We understand that.

But you do understand that your MS could develop from...

Relapsing, remitting... To progressive, we all know that.

And we know that ultimately things will change for us,

but ultimately is a long way off, OK?

Massive haemorrhage caused by the wound. Cardiac massage now.

Yeah, I've got it.

You OK? Yep.

I can see where the wound is penetrating the lung.

What's his name? Pete. Pete Kingston.

Come on, Pete. Stop mucking about now.

More adrenaline?

Yes, and Amiodarone to stabilise the dysrhythmia, please.

What can you feel?

Nothing. OK. Shock paddles.

Charge to 30.

Stand back.

Go again.

What?

You can't knock his conscientiousness, can you? No.

But keeping a detailed record of everything doesn't mean

his mum's necessarily getting the medical care that she needs.

Lewis obviously knows his stuff.

Let's just wait for the assessors' report.

Lewis could do with some of what Parker's got.

A carefree summer holiday?

No, someone like you.

To worry about him.

Now you're just trying to get around me.

MACHINE BEEPS

Nothing.

Pacing wires?

More compressions.

Do you want to swap? I can take over.

Nope. Pete's just about to resurface. Aren't you, Pete?

Any time now. Today would be good.

Perhaps we should call it.

No. He's still here.

Come on, come on.

Don't let me down, don't let me down...

MACHINE BEEPS

Gotcha.

Regular function. BP rising.

Speech and language assessment, neurology assessment and MRI scan.

Bad news, I'm afraid. Shall we?

I'm back, like you insisted.

I'm still a bit tied up at the minute.

Your swallowing, speech and general mobility

have been gradually worsening for some time.

I'm sorry to say, but your condition has deteriorated

from relapsing remitting to progressive MS.

Are you sure?

The speech and language therapist and the neurologist were both

very clear, you're going to have to have a thing called a PEG.

It's a feeding tube that will take food and fluids

and medicines into your stomach.

Yeah, we know what it is. A percutaneous endoscopic gastrostomy.

She doesn't need that. I'm afraid that you do.

Apart from the chest infection, you're aspirating,

you're not swallowing properly.

You should have this procedure as a matter of urgency.

Well, thanks for your opinion. We'll look into it.

We're a bit past the point of looking into things.

I can do this procedure today, here, but I do need your consent.

What about aftercare? Can Lewis do that?

You won't need aftercare cos you won't need the procedure.

Not on his own, no. You'll have to have visits from physio,

and an occupational therapist.

Mrs Portman, perhaps now is the time

to start handing over some responsibility.

It's in your best interests.

Well, we don't want it.

I'm sorry, Lew.

I think we should listen to them.

I'll have it.

What is wrong with everyone? We can manage.

I'll be back with some forms to sign. You OK?

I'm sorry. Can you wait in the cafe?

I'll try and make it as quick as I can.

You go, I've got this.

Go on.

I mean, I bought it for Morven, really,

but I do think every ward should have one.

Whoa! OK! Whoa!

See, no-one's getting up from that.

Quick hands and a granite chin. I could have been a contender.

Lightweight?

Erm! Middleweight, thank you very much.

Adrian "The Force" Fletcher, pleased to meet you. What about yourself?

Me? Oliver "Handbags" Valentine.

Wasn't really my thing, I was a chess club man.

You're just putting yourself down. You just need a few pointers, son.

So, come on, get your hands up.

Come on, then. Come on, big boy.

Harder. Go on. Harder!

Oh, yeah, go on, that's the way.

No, no, no. Slow down, slow down. Watch me. Breathe, breathe, breathe.

Now come in big over the top.

Hi. Bernie. Hi.

I hope you don't mind me asking, but what are you doing in here?

Us?

Yes, you.

Nothing.

Didn't sound like nothing.

Oh, was just blowing off some steam.

Yeah, won't take long.

Don't suppose it will. Well, quick as you can then, boys.

Not talking any more now, are you?

Do you always just make the world do your bidding?

When I know what I want. Which is?

Right, let's try and take her off bypass again.

Stop the pump.

MACHINE BEEPS

Nope, still not working and this is the third time we've tried.

Her heart's distending.

Yeah, and the BP's dropping. Great. Let's get her back on bypass.

Going to have to insert an aortic balloon pump.

Come on, ten thumbs. A four-year-old could do that.

I'm struggling to push the balloon upwards on to the artery.

I think it's just nerves. It can't be.

You wouldn't have got this far if you had a problem with nerves.

It's never happened to me before.

Why do men who can't perform always say that? It must be you.

They say that too.

The uniqueness of this situation is there is someone else in the room

on the operating table,

and I'd rather they didn't die on my watch.

I can't be in two places at once.

You need to do that and you need to do it now.

I can't do it!

You can and you will.

Thank you for looking out for Dr Digby.

Oh. Oh, and, fellas, what you get up to in the privacy of the Locker Room

is your own business, but try and keep

the noise down next time, please?

Boys have been playing again, have they? Well... What?

Fletch is just working on his technique

before having another pop at me. Ready when you are.

Yeah? Come on, then. Let's do it.

Dr Digby! I thought you'd like to know.

Mr Kingston is stable.

Great. What about longer term?

Well, we've done the best we could under the circumstances,

but he's a fighter.

You performed brilliantly today.

I was just doing my job.

And doing it quite well. Nice work.

Any time you're ready will be fine by me.

I'm trying. Try harder.

Look at me. Forget everything else.

This is about you.

Your skill. Your talent.

Clear your head, take a breath and go again.

Make it happen. Connect the balloon pump.

You in?

Good. Inflate.

Your mum does need this operation and you will need help.

Yeah, and what if she gets taken away as a result?

No-one's going to take her away.

Why don't you think I can look after her?

I do think you can look after her.

I just don't think you can do it on your own.

But I know what's best for her, what's best for us.

When was the last time you had a holiday?

I'm on holiday now.

You should be with your mates.

Did you go on that school trip that Parker did last week?

No.

Because you were looking after your mum, presumably.

And what about the studies?

Your mum said you're doing really well.

That your grades are the best they've ever been.

Has she actually seen the report?

The last month or so has just been tough, that's all.

And that's why you need the support.

And that's why she needs the procedure.

The PEG will actually make things easier.

She'll get nutrients from the tube.

That'll take the pressure off you feeding her, and free you up.

Asking for help is not a weakness, you know.

It's a sign of strength.

Parker and I need help. Everyone needs help sometimes.

It's not that I don't want help.

It's more, it's just always been me and Mum.

And I don't want anyone taking over.

I want us to have the final say.

You can and you will.

So, we're just waiting to speak to the specialist.

Cheers, Doc.

Please, call me Morven.

If he accepts you, there'll be a six-month waiting list,

then hopefully we can wave goodbye to your small bowel issues.

How weird would that be?

I owe it, really. Owe it?

If it wasn't for Crohn's, I'd probably still be in tech.

How so?

Well, a smallholding was my long-term dream,

but as the operations mounted up, and then my marriage went south,

I decided to just get on with it.

So, you carped that diem. Nice one.

It was you that did that, though, not your condition.

Thank you. Good for you.

Right, you might want to put something down to cushion the fall.

I told you, lightning doesn't strike twice. Mm-hm.

Beginner's luck, it was a one-off.

So, Morven, she's... I mean, she's a bit kooky, right?

Yeah, I know. Exactly the way we like 'em.

Right, come on, then. Seconds out.

Round two, come on.

Right. Go on, then! That's it.

See? Yeah? Yeah?

Knees of steel. Knees of steel.

Yeah, is that what you reckon is it?

Excuse me? Hello?

SHE CHUCKLES

What game did you get? Is it all explosions and guns and...

Wow, a romcom?

For a mate.

You bought a romcom for one of your mates?

OK. It's for a girl that I like.

I was hoping to see her, but now I don't know.

Ah, right.

It's complicated.

Do you...? Do you want to talk about it? No.

She used to go out with a mate.

Now he's kicking off at her about seeing me

and she doesn't know if she should or not.

And I like her, I really like her.

I got her the DVD cos I thought... Now I don't know.

Why not?

What's the point?

OK. So, she's definitely finished with this mate of yours, right?

Now she's into you?

OK. When did she finish with your friend?

A couple weeks back.

That's a lifetime ago at your age. You are in the clear.

Do you want to know what I would do?

Keep clear lines of communication, talk to your mate.

Do you think? Yeah, text him now.

Talk to him while you're waiting for Essie.

Honesty is the best policy.

You can beat around the bush too long with these things.

Me and Essie were the same, took us ages before we...

She hasn't told you, has she?

So, Lewis has just gone back upstairs.

PHONE BEEPS OK.

I better get up there too.

Just checking that you're OK.

Why didn't you tell me you two were seeing each other?

We have Mr Hagenbach's angiogram.

Yep?

The bleed wasn't the result of an ulcer.

It was a herald bleed,

characteristic of an aortoenteric fistula.

He hasn't had any aortic surgery?

No, however he has developed a fistula between

the small bowel and the aorta and we're going to have to operate.

It's not going to be easy, is it?

No, it's going to be anything but.

SIREN BLARES

I just haven't had a chance to tell you.

Of course you have! We live in the same house.

You're the one always going on about being more open with each other.

I know, and I was going to. I just, I didn't get round to it.

I don't know what's wrong at the moment,

but I know there's something. Talk to me. Ask Raf.

Ask Raf what? Is it his fault? No. I told him.

Something you haven't told me? Why not tell me?

Annoying, isn't it?

There's something I have to do. I'll see you later.

So, what does this do to my chances of a transplant?

I'm afraid this is a life-threatening emergency.

You should know the operation is complex and potentially unsafe...

..and there is a chance of mortality if it's unsuccessful.

Look, why don't I just wait for the transplant?

You can't afford to.

The bleed won't stop without surgery.

So, you're telling me that I'm going to die if I don't have surgery.

But if I do, the surgery might kill me anyway.

Look, I know it's not an ideal situation,

but it is the only way forward.

OK.

Do I get some time to think about this? Yeah, of course.

We'll leave you to do that now.

Hey.

Looks like my camera's safe, then.

Dr Ford tells me everything went OK.

In the end.

Yeah, he did good.

Couple of months R and then back to you.

Plenty of time to put myself first.

Exactly. Dr Ford?

So, why cardiothoracics?

Subject close to my heart.

More paperwork for you.

I hear you knocked that cardiac massage right out the park.

You're going to do the same with Mr Hagenbach, right?

You reckon? I reckon.

If I don't?

Then you did everything you could.

Sometimes we lose.

We all do. Doesn't mean it's your fault.

I'm so sorry. Don't be, and thank you.

It was a good idea, and we can still do it.

As long as the surgery works, right? Then the transplant's still on.

Sure. Let's hope so.

Hope being a good thing, right? Which I'll be telling my kids.

I didn't know you had kids.

Yeah, two. They're with their mum. I'm about to phone them.

Encourage them to be positive, make sure they live their lives,

live their dreams and never give up.

Life is precious.

The procedure was a success.

Look, I'm sorry if I put my foot in it with Parker.

Why did you tell him about us? That was for me to do.

I thought you had. You told me you had!

Why didn't you? I don't know.

I guess I was just waiting for the right moment,

but there's never a right moment.

How did he take it? I'm not sure.

I should have just told him, shouldn't I?

Er, you should take a look at this.

Occupational Therapy?

Yeah, they paid a visit to Mrs Portman's house.

Does Lewis know about this?

Great!

The abdomen's hostile, to say the least.

There are too many adhesions.

I'm struggling to delineate the anatomy. You have to.

Oh! What is it?

It's a bleed.

OK, erm, shall we, erm, clamp the aorta?

Even if we do, I can't get to the fistula.

How many units has he had? 30.

MACHINE BEEPS

He's going into VF.

Hi, I am happy to say that the PEG procedure went well.

But we have feedback from our occupational therapist.

Occupational therapist, what do you mean?

They say that your home isn't suitable for your condition.

Hang on. What are you on about? When did they do that?

What right do you have sending people nosing about our home?!

They weren't nosing, they were just doing their job.

You said we'd decide. You promised me.

I didn't promise anything.

I said you needed to look into what was best for your mum.

Says who? You? Lewis...

But they're going behind our backs. You said you'd help.

You've just made things worse. Is this what you're like with Parker?

All anyone wants to do is help.

You need to have all the information and advice that you can

so that you can make a decision about your mum.

You said the PEG would free me up

so I'd have more time to look after Mum.

I didn't mean so that you could look after her,

I meant so you could go out with your friends

and go on the school trip that you missed.

What school trip, Lewis?

It's no big deal. I wanted to be with you.

Roma, Lewis is struggling and he's missing out.

What?

Have you seen his school report?

Report?

I can't believe you did that!

We have no rhythm.

We can't just abandon him now, we have a duty.

Morven, there's been too much damage.

There's nothing more we can do.

Zach, you come back to me right now, you hear?

Remember, you've got your dream to live for. Come on.

Come on!

Time of death - 18.30.

Mum, we don't have to listen to them. We do.

It was me who said they could send occupational therapist.

I gave permission. And look where that's got us.

Looking after someone can be tough, but you don't have to do it alone.

They're right.

They'll split us up. No.

Believe me, it is the exact opposite.

The occupational therapist said that your house can be modified.

Carers would come to your house four times a day.

And you can still help out, but they'll be there when you're not,

so you can rest, sleep, go and have fun,

knowing that your mum's being looked after.

Letting go will keep you together longer.

We have to do what's best for both of us.

It'll still be me and you. Always.

Nothing can come between us.

I promise.

Dr Ford seems most inspired.

He had a good teacher.

So, regarding...

Jac, I'm locked out of the system again. Can you...?

I want my job back.

I wasn't aware it was available.

Nor was I.

I'm better at it than him. Your heart's not in it.

He hates the paperwork, the planning, the proposals.

Who doesn't? Me.

I can bang that stuff out in minutes whilst running a team and

writing papers and attracting more money to Holby than he ever will.

Look, let's be honest.

He just wants to wallow elbow deep in a chest cavity

and come up smelling of roses with lots of people looking at him.

That's a little simplistic, isn't it?

Only a bit, and don't get me wrong, it is an absolute gift.

It is his talent, and it's a great one,

and I want him at the top of my team.

I'll give you as much glory as you can handle,

but I want to be back in control. Capiche?

Is "capiche" addressed to me or to him? Him, mainly.

I hate to say it, Ms Naylor, but maybe you know me too well.

So, we agreed?

The serious incidents that led to your demotion?

Won't happen again.

Good. Now, if you don't mind, I have a job to do.

Best get on. Shut the door.

Oh, hi. Everything OK?

Yeah, I spoke to my mate. We're cool.

Great. Cheers. Any time. Hey.

What's going on? Everything OK? Yeah.

Raf just gave me some advice and it turned out to be sound.

What kind of advice?

About a girl.

Yeah, you know girls, right? Arms, legs, tendency to worry too much.

She went out with a mate of mine.

I needed to make sure everything was over

before I did anything, you know.

Good for you.

Look, I'm sorry that I didn't tell you about me and Raf sooner.

Are you OK with it?

You could do worse.

Watch it.

Is Lewis OK?

He will be.

He knew the risks.

Why do we keep going?

Loss after loss after loss.

Because we're resilient.

And because the alternative is worse.

That being?

To stop caring.

Don't.

Hey. I gather you've been helping Parker behave in an honourable

and responsible manner.

Nothing to do with me. I'm being serious.

So am I. Parker is a good kid. He's thoughtful, he's caring,

and the main reason for that is because he's got you.

I'm sorry about overreacting earlier.

It just means so much for me to get it right with him.

You already are. You should get used to that

because I am not going through this every day.

Deal?

Maybe.

Are you OK? Yeah, I'm fine.

It's just stuff, I guess.

Well, I'm here if you need to talk.

Look, I know you've been looking out for me today.

I just want to say thanks.

You don't stop giving, do you?

Do you know, Zach said something.

He said our futures are still expanding.

We should make the most of that.

I will not be defined by grief.

He wanted me to give you this.

Oh, no, no! I didn't win the bet. You still need to look.

That's my favourite one. He's pretty good.

Right. So, home, pizza?

Actually, could we maybe leave it for another day? Only...

Oh, I see. Something better come up? No, no.

I just thought maybe you and Raf could use the time and space.

Don't use me as an excuse.

I'm off down the pub with some mates.

Although, I can always make time for some pizza.

Great. That's that, then. Not quite.

Before you go, I want to know everything about this girl

right from the start.

So, where did you meet her? And what does she look like?

We know we're the last thing

between something disastrous...