Group Animal, Part One Holby City

Holby Trust remains. St Francis will merge with us.

Don't forget - the new Neuro consultant starts today.

They like to mark their territory.

If you're willing, I'd like us to start again.

Let me be your case study.

But isn't it designed for people with dementia?

I'm sorry, I had no idea.

Roxanna's dementia project - choose hers.

Why are you hiding in here?

I don't know.

You and me - we've got to stick together more than ever.

What would you say if I told you I was leaving?

Leaving this place for good, leaving Holby.

I'd say I didn't know what you're talking about.

Exactly what I just said.

That I don't believe you?

And then?

You mean it?

Never been more uncertain about anything.

I'm close.

O aviao esta pronto para partir.

And those papers?

Thank you.

-Could you please let the others know?

-OK.

-Any updates, you know where to find me.

-OK.

The miracle man.

Because, for some reason, he found me to be his vessel.

I have nothing.

I'm nobody.

Just Laszlo.

I'm alone and...

DOG BARKS

OK, not alone - I had Rolo.

But motor neuron disease.

I was running out of days.

Breathing, swallowing...

always weaker, every day.

Then this man finds me

and he tells me that he can make me feel better.

That I will walk again.

I'm a religious man.

Can you imagine meeting someone

who tells you that he can make you walk again?

Now look at me.

INDISTINCT

The professor did this.

Mr Gaskell gave me a second life.

Is it just me or did Rolo seem a little staged?

Olly! He reversed motor neuron disease using stem-cell therapy!

It's incredible!

He almost had me until he compared the guy to Christ.

Did you guys just watch what I've just watched?

Cos what I saw was amazing.

Is he really coming here?

-Something else, isn't it?

-It really is.

Who knew you could change the future of medicine with

a face that symmetrical?

Well, I've heard about it before, but seeing it is...

Going to be some ride, I promise you that.

Blimey. I had less stuff when I moved an entire life

and four kids across town.

An embarrassment.

Whole hospital in meltdown about a few expensive toys

and a flashy title.

Director of Surgical Innovation.

Hanssen dancing around Oompa Loompas like a child who's just found

out Willy Wonka's coming to stay.

Genius confectioner though he was,

I'm pretty sure Willy Wonka never made a man walk again though,

-did he?

-I'll take your word for it.

It's hard not to get excited that he chose here.

Though I can see you're giving it your best shot.

And I suppose you stopped to ask yourself why he's chosen here?

What are you waiting for, a formal invitation?

Our paths haven't crossed much this week

and I just wanted to see if you're OK, all right?

-Cos the last time...

-Save it for your bedside diary.

I meant, what have you got for me?

Some of us have surgical innovations to be getting on with.

That is the blanket term now, I presume?

I have a preliminary report on Mrs Khan that needs your signature.

OK?

I need to read it through.

Course. And Professor Gaskell's team called ahead.

They're bringing a patient with them.

Spindle cell tumour with an intrathoracic vascular supply.

Obviously he needs you in theatre with him.

Asked for you specifically.

Well, here's an idea - why not open with that?!

Whatever. Just get them to send me the details.

You knew.

-I did not.

-I think you did.

And judging by Donna's hot flush at his imminent arrival, I think

you tied me down to your bourgeois dream in case I got any ideas.

You got all this without even watching

this morning's propaganda message?

Might just be the way you're delivering it,

but am I sensing some jealousy here?

Am I the only one who remembers all the cutting-edge science

we do here on a daily basis?

What, by patching up the levee and praying the rains don't come?

I'm not suggesting the professor

is bringing a broom to this system - thank you -

but it is an opportunity to impress an impressive person.

Is this all before or after you've fallen at his feet

-and proposed your affair?

-SHE SCOFFS

He reversed motor neuron disease using stem-cell treatment!

Allegedly.

That is the medical equivalent of landing on the moon!

All I'm saying is, once you've been to space,

the chances are you're going to want to go back.

And you think I should go with him?

Someone's going to.

Three Cabgs, one AVR and a Vats lobe in one day?

I thought you began every morning begging for a new challenge.

Tests of skill, not of will power.

Well, prove you have the latter and the rest will follow.

All these years later and I'm still at the "prove it" stage with you.

What other stage is there?

Yet, if I'm going to take the entire list,

what exactly does that leave you with?

Intrathoracic vascular isolation and resection of spindle cell tumour

with implantation of spinal progenitor matrix. Huh!

So, the boss hooked the big one, eh? The great Professor Gaskell.

I'm sorry, who are you?

This is Ms MacMillan's husband, the eminent David Hopkins.

David's here for Ms MacMillan's project...

David, this is...

You know Gaskell?

Know him? Man introduced me to this one many moons ago.

She has him to blame.

Hope you don't mind -

Roxanna let me have a sneak preview of the case.

He's nothing if not persistent.

Going to need ice in those veins.

Trust me, if anyone's cold enough...

Don't you have an AVR to attend to?

And a very steady hand.

Which theatres are free?

-None of them. We're back-to-back. Why?

-Every ward?

All squeezed to make room for the King and Queen.

Page me the second he gets here.

But I'll be in...

theatre.

I heard he walks everywhere.

Pretty sure Hanssen said he's arriving by car.

Why would you, though, if you had a plane?

Apparently he likes those long night-time city strolls.

He's not Jack the Ripper, Lofty.

I'd go by helicopter. I think it makes a statement.

He's flying from Europe, I'm not sure a helicopter can...

Actually, how far can a helicopter fly?

Am I standing too straight? I feel like I'm standing too straight.

-Honestly, would you lot chill yourselves?

-I think he's here.

-What's this?

-Does my hair look all right?

-Yeah.

-OK, great.

-Is this him?

SIREN WAILS

Ugh, you are kidding!

Where is he?

Never one for surprises.

How long are you going to leave it before you tell them

that he's slipped right by?

Fresh air will do them good.

Would you care to join me in greeting our esteemed new colleague?

Oh, he'll find us when he's ready.

He's coming here because of you, Henrik,

and this team.

Because of what you fostered.

That's what this buzz is about.

Mr Di Lucca, need you here, please!

Bloke hauled her out of a frozen lake.

-We've given her around ten shocks. She's still in VF.

-Core temperature?

-25.

-That's too low.

If we can't get a regular rhythm, we'll have to get her on Ecmo.

Can we get a warming blanket and I'll get the Ecmo kit?

-Do not stop massaging that heart!

-How did it happen?

No idea. ED are chasing the police, I'm chasing the medical notes.

She's not shivering. That's not good.

Yeah, well, this one cost me a front-row seat at the meet-and-greet

with Professor Marvellous, so she needs to pull through.

-Full recovery, please.

-He's here?

-No idea.

Doors opening.

Doors closing.

METALLIC RATTLING

Something so visceral about this place, isn't there?

Cage-lined walk to an illicit chamber.

I suppose they only told you about the cardiac element this morning,

but, if you're anything like me, less time to worry about the

outcomes is probably the best way, don't you find?

I really need to trust these student doctors more.

Letting go of control.

Impossible in our game, isn't it?

Well, look forward to dancing together.

Femoral artery's in.

Femoral vein...and we are good.

Shall we give her bicarb?

No need. Acidic PH protects at a low temperature.

Get the Bair Hugger started.

Essie?

She's pregnant.

Right, let's give her some heparin.

It's a go on the Ecmo, let's start warming her up fast.

Raf, she's pregnant!

-The chances of a major bleed on Ecmo are high.

-Less than 50%.

-We can't take her off now.

-She might go into premature labour.

-The mother has to be our concern.

-Retroplacental bleed!

The mother is our concern! It's the best that we can do!

Rosie Cranham's notes! She's pregnant!

-We know!

-We know!

With twins.

You were supposed to page me when he arrived.

Can I help you?

What stage are you at?

This is the AVR that you asked me to do for you.

Again, not what I asked. I said, what stage? Just move.

I'm just about to make the first cut. I'm sorry, what?

-I'm taking over.

-What do you think you're doing?

I don't have time for your brain to catch up with your feet. Move.

Do you remember the part where I signed up to today's entire list

so that you could focus on the glitz and glamour of...

I signed you up to the entire list and I'm letting you go!

OK, just to be clear, are you going

to do this with every procedure today?

You know, there's a reason you haven't progressed the way

you should have done, Valentine, because you don't have the mettle,

the drive, the ability. None of it.

But most of all, it's because you constantly fail

to remember that you work for me!

I decide where you go and what you do.

I own you.

And until you get that, you will never, ever, have even

the slightest chance of saving,

let alone enhancing, your pathetic excuse for a career.

Status is something you earn.

6/0 prolene, please. Let's start grafting.

Oi! I just took the stairs!

I thought you said he was on the stairwell.

He must have come up the back lift.

So he's here, then?

Right, so what? They're all friends?

All four of them apparently. Rigden University.

Imagine that, these four young prodigies together in America

and all these years later, here they are, together again.

Just trying to imagine Hanssen as a student,

eating cheese burgers and chain-smoking.

Anyway, how do you know this?

And what are you doing up here on Keller stalking them?

David had a copy of the notes and offered to let me have a look.

Oh, David is it now? Well, haven't you done well.

Apparently the professor left this with us.

He's wondering if we could get some Blu Tack to stick it up

-outside his lab.

-All right. Well, I can do that.

-It's very precious apparently, so...

-All right, chill out.

-Just saying!

It's half-finished.

All the best art is.

It's probably a worth a fortune. I can look after it, if you like.

No. You need to chill out as well.

I think I can find some Blu Tack, thank you.

I've missed you, my old friend.

All of you.

Well, we've been aware of you.

Yes, rather a splendid achievement, if I may say so.

Luck. Hard work and luck.

Nothing to do with it. Either of them.

Well, if it hadn't have been me, it would have been one of you.

Oh, no, it was always going to be you, John.

You finally did it.

Full motor neuron reversal.

So, come on - tell us what we're all burning to know, Professor Gaskell.

Can it be done again?

I'm close.

I'm sorry to interrupt. Professor, your patient has arrived.

He collapsed en route.

Excuse me.

Professor Gaskell, I'm Mr Valentine.

I'm afraid Ms Naylor is tied up in theatre.

-You're her number two.

-I wouldn't say that.

Patient's autonomic system has shut down due to

compression of the spinal cord.

He's profoundly shocked, hypotensive.

Will that affect his treatment?

Only if we let it.

Give him two litres of plasma expander

and a starting infusion of norad.

0.2 micrograms per kilo, per minute.

I took a glance at the notes.

You're using a tissue scaffold laced with stem cells?

Progenitor cells, to grow back the part we're taking from him.

How on earth do you go about getting approval for something like that?

Well, first, you have to make a man walk again.

Doors opening.

Sorry, I-I-I just meant,

if those cells have been treated with growth factor...

Let's talk some other time.

I hear you have ideas to pitch. My door is open.

Thank you.

David?

Surprised you're not getting in on this too, Mr Valentine.

A chance for us all to witness the future first hand.

-You're here for the project, though?

-Sorry?

Ms MacMillan's project, the VR simulator.

Oh, she gave up on that.

Turns out I'm not such a viable candidate after all.

Though, to be honest, how can she be expected to focus

when her old friend comes jetting in with this kind of challenge?

Trust me, she'd be the first to say it.

There's only one team to be on now.

As soon as they are done, can you run an EEG on the mother?

If there's no brain activity,

then we have to make a decision about the foetuses.

-Fine.

-You OK?

I don't know. I'm sorry.

Hey, hey, hey. Come on, in here.

What's going on?

I don't know, I just feel strange.

It's like, the professor arrives and I suggest that you do something to

-impress him and then suddenly we need Ecmo.

-And?

Well, you introduced Ecmo to the hospital.

Don't you think that's weird?

I never made the link.

And then there are twins. Kim had twins.

Essie, what are you saying?

I'm just really worried!

I can't explain it.

It's like someone's trying to tell me something.

Right, well, maybe just trust the science, not superstition.

I know what I'm doing.

She will be OK, so will the babies.

KNOCK ON DOOR

Hi, I'm so sorry to disturb you,

but I think there's something you should come and see.

Having quite the time of it today, David, isn't he?

-It's like he's never been away.

-Yes, he's been looking forward to...

Wasn't quite sure what to make of it when he told me.

-Told you?

-You're not going to deny it, are you?

You know what I'm talking about. Your little video game solution!

Your project! The project I gave you!

The project your husband tells me you abandoned

-because he isn't even a viable candidate.

-I...

Yes, I abandoned it, but...

You said nothing when I mentioned it earlier.

I'm sorry, I'm not sure I understand what you want.

OK, well, here's a thought out of left field -

how about the tiniest sliver of respect for who I am and what I do?!

-Mr Valentine, can I speak to you?

-Not now.

It's Professor Hopkins.

Do you think he's OK?

Only I tried to ask for the notes earlier on and he stumbled.

There was nobody around him.

He just brushed it off.

Yes, well, turns out he may be a lot more lucid than

you may have been led to believe by Ms MacMillan.

-PAGER BEEPS

-No, it was more the way he reacted, like he was embarrassed.

That's because he fell.

One of the nurses said she saw the same thing happen earlier.

He was getting angrier.

Nurse Chiltern, please, just get on with whatever it is you need to do.

Today is...

-A third heartbeat.

-I don't understand how it could have happened.

-It's much smaller...

They must have missed it on her 20-week scan.

The little thing must have been hiding behind one of the others.

-So this is...

-Triplets.

-Looks like superfoetation.

-Super-come-what-now?

Superfoetation. It means she got pregnant whilst already pregnant.

It's rare. Like, so rare.

-Like, one in a million rare.

-So this is a miracle baby?

Sacha, have you seen Jac? She's supposed to be with Gaskell, but...

All right, all right.

Before you start going on about me wasting NHS resources,

I did it on my break.

I swapped the frame with some disgusting painting

I found on Paeds. I'll get them another one.

Anyway, it's starting to grow on me.

Think I'm starting to see what it represents.

That fact that it's unfinished is...

I'm sure he'll love it.

Cool.

What do you mean, she's supposed to be with Gaskell?

Oliver, with me.

Actually, I wanted to talk to you first and now seems

like as good a time as any to inform you that I think you're right.

You've done absolutely nothing for me, clearly never plan to,

and while usually that feeds me with sufficient ammunition for a

Friday night spent alone cleaning my bathroom and guzzling gin,

I feel empty.

Here. I'm not having any fun.

Haven't we been here before?

An apology from you is the last thing I expect.

Or care about. But you have to acknowledge my resignation.

-Is it in writing?

-It will be.

What is this?

A test of skill over willpower or whatever you coined.

-Have a seat.

-I'm serious.

Not serious enough. That's part of the problem.

Which artery comes off the aorta to supply the spinal cord with blood,

and why focus on it?

Jac, my plan is to finish the day here and then...

Just sit down!

The artery of Adamkiewicz.

You have to make sure that the graft doesn't occlude

the outflow from that vessel.

So you'd just go ahead with this kind of experimental implant?

I'd want to see the entire clinical trial timeline.

I'd want certification from approved boards.

I'd want to know who I was dealing with.

See where the tissue came from.

And with the stakes this high, I'd want re-assurances...

It's not about him.

I'd want more re-assurances than just one man's word!

You're missing the point.

You think it should be delayed.

Is that what you think?

I think you owe me an apology.

OK, have it your way.

You're afraid.

And I'd go as far as to say, for some reason, you're terrified,

but I won't be your escape clause.

I give you one chance and you blow it.

Your arrogance astounds me, but your stupidity is breathtaking.

Tumour is in the spinal canal

and circling the aorta, causing paralysis and extreme weakness.

Been suffering excruciating back pain

and no sensation at all in this leg.

-Correct, Michael?

-Yeah.

The scaffold will be 3D printed, laced with stem cells, trimmed

to size and once the tumour has been removed safely, inserted...

Sorry, and this will then grow back the part that you've

removed from the patient?

If I'm not mistaken, you're suggesting the spine will

also have enhanced regenerative properties after injury?

Correct.

-Can I ask about the make-up of the cells? I mean...

-Ms Naylor.

Gaskell has just been filling us in on the future of medicine.

Ms Naylor, of course, will be...

Ms Naylor will be performing the only role that matters.

Unless the real surgery gets done,

nobody gets to play with any new toys.

I'll need to see the aortogram and a contrast CT.

I want to see the feeding vessels to this tumour

if I have to isolate it. And as lead surgeon on this,

I'll need access to my own team and equipment.

The operation will take place in my theatre on Darwin Ward.

I suggest you get him prepped.

Sorry about that.

It's been a very tricky time with the merger.

Everyone is very tense. She's not normally like that.

With what she's been through, I'm surprised she's even functioning.

I'm not sure I'd be.

Sorry, I don't know what you mean.

She lost her sister.

We all did.

Her core temperature is increasing lactates

-and she's cardiovascularly stable.

-That's great.

Urine output is much better, so she's well perfused.

Told you it was all under control.

Ess?

My ring. I don't know where it is.

OK, well, maybe you just left it somewhere.

I've checked everywhere.

And there was me thinking marriage was just a bourgeois conceit.

Raf! I told you today was... Just forget it.

Look, the patient is getting better. The babies are going to be fine.

You've just lost a ring. I can help you look for it.

We can retrace your steps.

I know we risk losing people every day, but superfoetation?

When do you hear of that?

I mean, you might have seen it,

but I haven't and this is not superstition.

-It's not me.

-I never said it was. I said to trust the science.

Trust Ecmo.

Well, you trust it, but... it's a risk.

Ecmo's there to reduce risk.

I'm not doing all this because I get some sort of a thrill from it.

Aren't you? You don't get a buzz?

I understand, you're bringing people back from the brink, but...

That's not what Ecmo is for me. It's not a thrill.

It's...it's control. It's something I can trust.

It's the way that where limitations stop most doctors,

I get to carry on,

operating outside the of the margins.

Ecmo is your friend.

Yeah, if you like.

Ecmo is your life-affirming friend.

Yes, exactly.

Professor would like to see the real heroes of this place.

And before you put your foot in it, Mr Di Lucca, that's us nurses.

Come on.

It'll turn up. Stop thinking it symbolises Armageddon.

Hey.

How are you doing?

I'm looking into this miracle.

Patient zero. Laszlo Furz of Hungary.

Do you know the professor himself has Hungarian roots?

He parades him around

to the public, to the media, but it's so controlled.

It's never to doctors nor trained medics.

Has anyone exactly examined the patient zero, you know?

Looked at the workings, had them verified?

I'm not denying he made a man walk again.

I mean, that's incredible, but...

why keep him hidden away?

Did I ever tell you that when I feel anxious about an operation,

I practise my bloods triads in my head?

This is Levy's triad of bleeding -

all blood comes from cut blood vessels.

All bleeding eventually stops.

MACHINE WHIRS

Come on in.

Well, this is more than I had expected.

Thank you.

Look, I'll keep this brief, I know how busy you are,

and this is exactly why it had to be you that saw this first.

I hear there's been talk of flashy titles -

Director of Surgical Innovation or something.

You can just call me John,

Professor Gaskell, whatever you normally use here.

If I'm lucky, they'll paint me as solipsistic.

Normally it hovers around the self-obsessed narcissist mark.

I'm neither.

I have no interest in myself, only the end goal.

And anyone that can help me to achieve that

or who functions with a similar obsessiveness, I admire deeply.

But, look, I'm new to school.

And every new kid needs a friend.

Now, I know so many of you must have questions,

so I thought it best just to show you first.

I know what I need to do,

and if you guys can continue to provide the environment that

you do so immaculately...

Professor, you do realise this hospital is falling apart

at the seams, right?

No, no, I'm not talking about what the Trust

or what successive governments may have done.

No, no, I'm talking about the fire behind your eyes,

the smiles on your faces...

Serious people that want to affect change,

but want to have a good time along the way.

THEY CHUCKLE

My end, test tubes, stem cells - yours, hearts and minds.

Don't think that I don't know about your concern for the numbers

of clinical nursing staff retiring, Nurse Jackson,

or your proposal to increase nurse staffing budgets, Nurse Harrison.

As if that'd stick.

This is simply my version of those.

You have a new message. New messages...

Henrik, I know what his arrival means to this place,

and I know the size of the operation,

but, I have to say, I'm concerned.

I'm concerned about Jac.

DISTANT SIREN WAILS

She's not herself.

I'm starting to wonder,

you know, all this time she's been supporting me in my depression,

I should have seen that she needed support too.

I think you're going to be all right here.

I like the feel of it already.

Do you have a family of your own, John?

There are people I care deeply about, yeah,

and others I consider family, absolutely.

Oh, is this yours?

Yeah, it comes everywhere with me.

First time it's ever been caged up in a frame, though.

Oh, don't worry. I'll get the porters to sort it.

No, no, I wouldn't want to insult whoever it was

who went to all this trouble,

but if it was to, say, break...

Well, consider its shattering a catharsis of some kind,

or a chaos, if you prefer.

Don't worry, I'll clear up any mess.

GLASS SMASHES

HANDS SCRUBBING

Nerves?

I'm never nervous.

Darwin Clinical Lead.

Instigator of Holby City's stent trial programme,

leader of cardiac trauma unit,

performed several hemicorporectomies,

an obscene amount of pulmonary endarterectomies...

You pushed for the Herzig 5 when no-one else believed in it,

and the first surgeon here to implement stem cell projects.

So this...

WATER SPLASHES

I know my predecessor, Mr Self, performed a similar procedure.

Successfully.

What happened to him must have been tough.

I'm not here to replace anyone.

"The consequences of this will be severe,

"but you've brought this on yourselves...

Jeremy Warren. This is the second one today.

The first one said something about the red-haired doctor.

Jac? What's this got to do with Ja...?

ROSIE GROANS Raf.

Rosie? Rosie, can you hear me?

ROSIE MOANS Rosie, my love.

Can you tell me where it hurts?

Long hard contractions.

Right, these babies are coming, my love, OK?

Need to check but possibly.

The shock of the hypothermia must have triggered labour.

-Where's that CTG monitor?

-Erm, I don't know, I...

Oh, Terry, thank you.

-OK...

-I'll need to check the cervix.

Who's this?

This is Ezra. The police found him looking for his mum.

I don't believe this.

We'll come back.

Mummy's going to be fine,

but the doctors need to look at her and the babies,

so we're going to come back, OK?

OK.

Thoracotomy first, then identify the blood supply to the tumour.

Insert the graft to bypass that area,

and ligate the blood supply to the tumour.

Once that's done, remove the part of the vertebral body over the

tumour in order to access it,

remove the tumour and put the implant in.

The imperative to isolate the blood vessel properly

cannot be stressed enough.

Once the tumour has been excised from the aorta,

well, we all know the risks...

As ever, be decisive.

MACHINE BEEPS STEADILY

SHE TAKES A DEEP BREATH

Raf! Emergency C-section on the bradycardic baby?

-They're over 30 weeks.

-Only just!

If we do a C-section now,

we'll have a better chance of having three live babies.

We leave them in, the mother deteriorates and then what?

What happened to your faith in the Ecmo?

Keep the babies warm.

If you bring Rosie in now, there's a chance of a huge bleed

and potential hysterectomy!

She's young - I'll try to avoid that.

You might not have a choice!

You trust me, don't you?

Of course.

Mr Di Lucca, the ultrasound is showing a bleed

between the uterus and the placenta.

-Abruption?

-Mm-hmm.

Right, well, can we get an IV bolus of oxytocin

and 800 micrograms of misoprostol into her, please?

Sure, do you want me to scrub in?

You don't have to do the caesarean hysterectomy.

No. No, it's fine.

It can't be the only option!

How are they doing?

-Too early to say.

-Yeah.

How about you? Everything OK?

Fine. I just wish I was in there.

It must be strange watching the two of them operate together

after all this time, like being back at college...

But I have to admit, the more I read about what this is,

the more I'd like to be in there too.

Professor Hopkins?

It was at university that you met your...wife and Gaskell, right?

Who is this guy?

It's Mr Valentine.

Valentine, eh?

HE BREATHES HEAVILY

What...? What are we watching?

It's all right. I've got this.

Ms Macmillan. It's David.

Go. We'll be fine.

This bit's sticking.

-MACHINE CHIMES

-BP is dropping. Bleed! Huge bleed!

-Packs, please.

-Ms Macmillan, go, please!

I need some help here.

EQUIPMENT HISSING

OK, there's too much blood. Let's have an aortic clamp, please.

He didn't recognise me, then he didn't know where he was,

Nurse Chiltern saw him collapse and I dismissed it... I'm sorry.

-Don't apologise.

-I don't know what I was thinking.

My head... Well, there's no excuse for it.

I don't know why I doubted you or David's condition

and the severity of it...

-It's not your fault.

-Yes, it is.

I jumped to a false conclusion based on my own dented ego

and my need to...

I haven't been honest.

I haven't been honest with him.

I told him he wasn't eligible for the project,

that his decline wasn't as severe as we first thought,

and suggested he was getting better.

He can remember in great detail operations he's done before,

recall the most obscure medical dialect,

like the language of his workplace keeps him energised, young,

so I wanted him here,

where I could see him, of course,

but because it's where he's at his best.

The best David.

I abandoned the project for false hope.

Selfish, isn't it?

Roxanna, you know it's more complicated than that.

His speech has slurred. I think he's having a stroke.

MACHINE BEEPS

OK, as soon as the aortic graft is stitched

I can begin the hemivertebrectomy.

I'll need a 5mm diamond burr and some rongeurs.

Ms Naylor?

Send someone for the scaffold, please -

it needs to be here in the next ten minutes.

I need some Floseal, clotting activator, and a Caspar retractor.

Quickly, please.

Ms Naylor, let me know when you've stitched.

I...I can't do this. It's not going to work.

Take over.

It's not right. What you're doing is not right.

-You are shaking...

-I am fine!

Why is everyone assuming there is something wrong with me today?

I am questioning your methods -

do not make this into something else.

I feel no need to advertise myself...

Which makes you truly ethical?

If you like, yeah.

You are feeding on their uncertainty.

See, I think you understand that we live the same paradox.

You want disorder, you need it -

because, like me, you see coherence that way.

-You need me!

-I need your skills, yeah.

You need me to trust you, and I'm sorry, but I don't know you...

No, wrong. I don't need you to trust me.

I need you to doubt everything I do, to criticise and interrogate

all of it, like clarity is an ending

and uncertainty is the purest thing we have!

But for the rest of them, yes, I need your endorsement!

I haven't got the time for them to catch up.

I need them to see it first-hand - witness what this can do!

You need them to witness what you can do.

You have everything to lose.

I know what you're going through.

-Don't...

-I've been to that place.

I said don't!

Then help me.

I need them to see you finish. We both do.

Professor Gaskell...

DOOR SLAMS

Where is she?

WATER SPLASHES

DOOR OPENS

We need more blood! Six units!

-MACHINE CHIMES

-There's a bleed.

Essie, I've been there -

fallen for a case because I needed to somehow know the world

still turned the way I was told.

MACHINE BEEPS

I've done two layers of suturing.

-We'll have to do the hysterectomy.

-No!

Look, we'll stop the heparin infusion and do an ACT.

I'll let it drop to 180.

You can't attach meaning to this.

It's not fair...on anyone.

Whether the babies survive, whether the mother does...

SHE TAKES A DEEP BREATH

..the outcome is just that, an outcome.

Yeah.

I know.

MACHINE CHIMES

Come on.

Inserting the stem cell scaffold into the space I've carved.

Careful to mind the clip from the earlier bleed.

BP is rising.

Systemic reaction to the growth medium.

He's having an immune response.

We need to lower the blood pressure.

Autonomic release of adrenaline. We need a GTN infusion, please.

Let's get that pressure down.

The clip's come off the artery.

Ms Naylor, I need you to stitch.

I'll cut the suture.

MACHINE CHIMES

He'll bleed out. Use your hand as a swab.

Pledget.

This is Naylor's triad of bleeding.

All blood comes from vessels.

All bleeding comes from cut vessels. All bleeding eventually stops.

SHE SNIFFS

WHEELS SQUEAK

It's stopped. The bleed's stopped...

Just hang on, hang on there a second...

All the babies are OK.

Rosie, did you manage to...? Is she OK?

Yeah.

So, mother and three babies.

HE EXHALES It all worked out.

-JAC:

-This is Naylor's triad of bleeding.

All blood comes from vessels.

All bleeding comes from cut vessels.

All bleeding eventually stops...

This is Naylor's triad of bleeding.

All blood comes from vessels. All bleeding comes from cut vessels.

All bleeding...eventually...

eventually stops.

MACHINE BEEPS STEADILY

She did it.

Of course she did.

Tisseel and Surgicel, please. Let's clean this up, shall we?

SHE PANTS

Jac?

Leave me alone.

Have a drink of water.

Leave me alone!

Right, breathe, OK?

You're stressed. You've been through a lot.

What would you know about it? You can't understand.

-SHE SOBS

-I know you.

You are not a surgeon! You don't know what it's like...

-This isn't about surgery!

-It's... Everything's about surgery!

If I don't have surgery, I don't have anything!

Look, you've got Emma, OK? You've got Emma.

-SHE HYPERVENTILATES

-No, don't!

-All right, listen.

You think this is about Gaskell? It's not, OK? It's not.

This is about you and what you've done to yourself.

It's everything you've put yourself through.

Jac! Come on. Look...

This is everything, Jac.

This is Guy, this is Zosia, this is Fran, this is Emma...

It's your sister!

-OK? You need to acknowledge it.

-SHE SOBS

It's Jasmine, OK? You haven't grieved for her.

Hey, just come on...

-No, no, no, no...

-It's all right.

-It's OK.

-No...

It's OK.

SHE SOBS

-A PFO?

-It's made the dementia worse.

I've booked the first available theatre slot.

Rox, a hole in the heart we can fix,

and this is the man we have to thank for spotting it.

-Oh, no, I wasn't the only one who...

-You spotted it.

You kept your eye on it even after I dismissed you.

Take the credit, Nurse Chiltern.

Professor, it's Michael.

-IN GRUFF AMERICAN ACCENT:

-Hey, if I cut loose, I'll revert to

the animal side of my nature so totally that I may never

regain my humanity.

And she's got no idea what we're talking about, does she, Ezra?

-Wolverine.

-Wolverine.

If he gets wounded, he can heal himself.

-Is that so?

-Mm-hmm.

I didn't know you were the comic book type.

Well, there's lots of stuff you don't know about me yet.

So, Ezra, when your mummy wakes up, we can go and meet your sisters.

And in the meantime, why don't you show Essie here

the X-Men game that you were telling me about?

It worked! Guys...

Gaskell and Naylor, the spinal implantation,

it worked.

He can move his toes.

I don't believe it.

It works.

Well, he's a long way from full recovery yet.

This is just the beginning.

if we can get the implant to stimulate axonal regrowth, then...

Well, it's something at least.

Oh, it's definitely something.

There's one more thing I need to show you.

Do you want my opinion?

I think you were scared.

You see so much grief in this place,

you worry that, if you let it in, there'll be no end.

Is there?

Maybe not, but it does get easier.

I lost control.

-Jac...

-No, no, it's a... It's a good thing.

I looked him in the eye in there and something happened to me.

I saw my reflection or something.

It's hard to explain,

but it surprised me.

It was a different me - a better me.

Now you're starting to worry me.

I have clarity,

but he's wrong that it means the end.

KNOCK AT DOOR

Hi, I'm sorry to interrupt you, Mr Fletcher.

Apparently they need you to sign the Trust Marketing Strategy

or something, and...

It's OK, what is it?

David Hopkins, he has a PFO.

They found him a quiet space on Keller,

but they need the Darwin Theatre.

Mr Valentine can do it, and you should observe.

It'll be good for your CT training.

Thank you.

I'll, erm...

DOOR CLOSES

DOOR OPENS AND CLOSES

A cure not just for motor neuron disease, for everything.

The body's ability to regenerate itself -

the Holy Grail.

When I found Lazlo, he'd progressed so rapidly,

he had weeks to live...

A year later, he's fully recovered from motor neuron disease -

fully recovered.

This is Lazlo.

Szia.

Szia.

..or, if you like, Patient Zero.

Valentine.

Before you chastise me for walking out on you in theatre, I didn't.

I went where I was most needed.

I know you did, because you always do.

It's what makes you the doctor you are.

Jac, I'm not interested in your games.

I owe you an apology.

Not because I doubted you - because I never have -

but because you were right.

I was afraid.

You're not going to change my mind. There's nothing you can do.

You have the ability in abundance, Valentine.

You have integrity and determination and, above all, you have courage.

Cuts are killing us.

Bureaucracy reigns and the truth is no-one's really in charge

when it matters,

and yet, amongst it all, you remain constant.

It's your duty to stay.

It's your duty to become the consultant you should be.

The future's here, Valentine, and it needs you.

Jac...

Thank you.

-What...?

-She's leaving.

I keep this on my wall as a reminder.

Spinal Diffusion Tensor Imaging.

Oh, I know all the lingo now.

Lazlo is here for you to study, to examine...

Treat me as your case study.

Please, it is my privilege to be here - my utopia.

Is this...?

It's Lazlo Furz.

Patient Zero.

So they weren't winding me up.

So that is your dog Rolo outside, barking like he wants to go home?

And therein lies the crucial fallacy of utopia -

assuming that everybody has the same vision of what it pertains to.

-LAUGHTER

-Go on. Your dog needs you!

Save four lives in one go and still humble enough to take the stairs.

Well, I hear you didn't do too badly yourself.

I was going to leave this with reception, but...

What would you say if I told you I was leaving?

Leaving this place for good - leaving Holby.

I'd say I don't know what you're talking about.

Exactly what I just said.

Or that I don't believe you.

And then?

You mean it?

I've never been more uncertain about anything.

I don't follow you.

Just give this to Hanssen.

I'm going to go say goodbye to Sacha,

and then I'm going home to my daughter.

I'll take her as far from all of this as possible.

So the system's broken and, what, you just abandon it?

Not broken, just found another future.

Ah, this is about self-interest.

You're not understanding me.

I'm a mother. That's all there is.

LIGHT SWITCH CLICKS

DISTANT SIREN WAILS

What are you...?

You shouldn't be down here. You can't come in this way.

LOUD BANG

What was that?

SHE GROANS

PANTING

SHE GROANS