Square One Holby City


Square One

Gaskell battles to protect his trial and save his patient. Serena is determined to find a solution, as she begins to fear that Ric is losing hope.


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Transcript


LineFromTo

Fiona. Today, we harvest the peripheral nerve,

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which will act as an axonal conduit once we implant it into your spine.

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How long until we know if it worked?

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The stem cells need some time to make a home in your body.

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You weren't dealing with your family emergency, were you?

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You were dealing with mine.

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Mr Duval, meet Dr Nicky McKendrick. Dr McKendrick...

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It's all right, we met last night.

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Bet you hate this.

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Left on the scrap heap.

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Triamcinolone 40mg will knock that out for weeks.

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You can continue your work unhindered.

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No, I felt something.

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-No, that's not possible. It's too quick.

-No, I felt something.

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07:32, 6th March 2018.

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Stem cell trial update.

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Following the positive advance with Patient One, Fiona Fawcett,

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selection is now underway for Patient Two.

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Confidence is high.

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We are close to repeating the success of Patient Zero,

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Laszlo Furz.

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The trial goal remains to improve the mobility

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and the lives of those suffering incurable and debilitating

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neurodegenerative disease, with patient care to the fore.

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First potential candidate: Patient A, male, 37,

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no obvious comorbidities,

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primary neurodegenerative condition with rapid onset paraplegia,

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suitable for nerve graft and stem cell treatment...

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SIREN WAILS

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HEAVY BREATHING

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-Oh, for heaven's sake.

-Here. Let me.

-Thank you.

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-Glad I've caught you.

-Oh, yes?

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I was wondering what happened with the board. I haven't heard.

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The TMS? Have they signed it off?

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Roxanna, we discussed this last week.

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I told you, I'm really not the best person to put forward this proposal.

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But what about Professor Gaskell's statement?

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He didn't submit one.

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He promised faithfully he would.

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Well, you'll have to take that up with the messiah himself.

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Ms Campbell, Serena, you promised Ollie the hospital would

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put its full resources into ensuring his recovery.

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Things are starting to look hopeless.

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Believe me, I wish there was more we could do but my hands are tied.

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I'm sorry.

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She went into SVT around 40 minutes ago.

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BP 85 over 60, resps high at 30, pulse 126, sats 92%.

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-She's in a lot of pain...

-Let's get her settled.

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Sorry.

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I'm her mum. She hasn't been right for days.

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She wouldn't let me call.

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Try not to worry. We're gonna look after her from now on.

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It's Fiona. Professor Gaskell's patient from the trial.

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HEAVY BREATHING

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You'll be giving Mr Tickle a run for his money.

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Sorry, what?

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All that stuff? Stretching your arms down to the floor?

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Never mind.

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I'm going to see Ric later.

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Good.

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-I wouldn't want him missing out on a visit.

-No.

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Just hope he understands why I can't go.

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I'm sure his solicitor's filled him in.

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I feel totally sick whenever I think about it.

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You had no option but to tell the truth.

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You've got to stand up in court.

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I've had another letter.

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-The trial starts in two weeks.

-I know.

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Do you think his lawyers have done enough to get him off?

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Let's hope so.

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Give him a big squeeze from me, eh?

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Long arms come in handy for some things.

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-LIFT:

-Doors closing.

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She's on oxygen, I/V fluids and 5mg morphine for the pain.

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-Right.

-We've got her more comfortable but she's still pyrexial.

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-I think it's an infection.

-OK, thank you, you two.

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I'll take a look.

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Fiona, how are you feeling?

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Professor...

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Sorry, I should've come in a lot sooner...

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-It's OK, Fi. You're here now.

-The whole team is here.

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-This is Lesley, Fiona's mum.

-Hello, Lesley, I'm John.

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I assumed it was flu...

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The pain...fever...temperature of 103.

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-Have you taken any medication?

-Paracetamol and fluids...lots of fluids.

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That's good.

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The sensation in my foot... I haven't felt it since...

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I must have imagined it.

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Look, let's just focus on getting you better.

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So stupid...to get ill.

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-She's worried she's letting you down.

-That's impossible.

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But you chose me...

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You said you selected me...because I was strong.

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And you are. You are.

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We'll need to check the surgical wound.

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Can you sit forward for me, Fiona?

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Seems to be healing.

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What is it? What's wrong?

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You have an infection. Dr Chowdhury was absolutely right.

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We'll run some tests to find the source. YOU need to rest.

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Check inflammatory markers, the usual bloods.

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Let's start her on meropenem and aciclovir.

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We've got this. She'll be fine.

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What about the implant? Can it still work?

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This is a disappointing setback. Not least for Fiona.

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But we'll find the problem, we'll deal with it,

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we'll get back on track.

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SHE HUMS A TUNE

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-Good morning, Dave!

-Morning, Jac!

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-Morning, Michelle!

-Morning...

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Morning, everyone!

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Ah! Ms Petrenko, lovely day.

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-Mr Fletcher...that's a nice tie!

-Cheers.

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-Evie chose it.

-Well, it matches your eyes.

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SHE HUMS A TUNE

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-You're humming!

-Hmm?

-That is a definite hum.

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That's Jason Donovan, right?

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# Too many broken hearts in the world... #

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Well, I happen to have two right here.

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-Mitral valve repairs.

-Life in the fast lane.

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You sure you can cope?

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Why don't you scrub in and keep an eye on me?

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Oh, no, this tie - staying outside today.

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Primed, ready and waiting for a crisis.

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You'll be wearing your underpants over your trousers next.

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-Is there anything I can help with?

-Yes.

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Mitral valves. Too tame?

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-Not at all.

-Excellent.

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CTs, ECGs all round, please.

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SHE HUMS TUNE

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Have I stepped in to a parallel Darwin?

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Make sure you notify her GP that she's on her way home and remember

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she has early-stage dementia so she might be prone to walkabouts.

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-Better keep a close eye until she goes.

-Will do, Ms Campbell.

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OK, mate. You take it easy and I'll be back to check on you shortly.

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-Everything all right?

-Tip top.

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Good. I have an appointment that's going take me

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away from the hospital for a few hours. So you're in charge.

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I trust that's agreeable?

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Of course! Although yours are very big shoes to fill, obviously.

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You'll be fine.

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Nicky? Mr Thornley, here.

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Head injury. Under obs, four to six hours.

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-OK?

-Fine, but Ms Campbell...

-Just put me in charge.

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So, any problems, I'm all yours.

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Auntie Serena! Are you still visiting Ric today?

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-I am.

-Please give him this.

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How...thoughtful.

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The prison guards will probably want to vet it

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but I don't think it says anything contentious.

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I'm sure it'll be fine.

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The lady's family are upset that she died and that's understandable.

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But prison should be for bad, dangerous people, not good

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people like Ric, who was just doing his best and got things a bit wrong.

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Yes, well, this is really very sweet of you.

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Well, when I needed help and you were off finding yourself,

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Ric was there for me.

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He was, yes.

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Got to run.

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HE LAUGHS

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LAUGHING: You should see this!

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Norway's best bloopers.

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HE LAUGHS HEARTILY

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It's good to see you smiling.

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-Ollie, I just wanted to update you.

-On what?

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Remember I said we would start the TMS treatment next week?

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HE CONTINUES TO LAUGH

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I'm afraid we're gonna have to postpone.

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There's a delay on the finances.

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You know what the board can be like.

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How's it going?

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Lofty, have you seen this?

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Let's have a look.

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Oh, brilliant. Is that real?

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Yes!

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HE LAUGHS

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He's great with Ollie, isn't he?

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Who?

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Who? That nurse you've been mooning over all morning.

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-That's who.

-I never moon, thank you.

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Not until a third date, at least.

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So I take it the second date went very well?

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Yeah.

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And?

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You know me. I'm not one to gossip.

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Oi! No, we had a really nice time.

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We went to this amazing Japanese restaurant.

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Lovely food, lovely wine and then he walked me home.

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Well, you can spare me the details.

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He didn't stay over, thank you very much.

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No, I think he was in early this morning, so...

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Yeah, I think he was, actually.

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Anyway, I've sent him a text saying I had a very lovely time

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and that we should do it again some time.

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Not that he's replied yet.

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You know you could just walk over there, maybe speak to him,

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face to face, in person.

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Don't be ridiculous.

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No, I'll just wait until he replies. When he's not so busy.

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Careful! Jeez, if I wasn't feeling ropey before, I certainly am now.

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Good God, if it isn't Doctor Frost!

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Who saved your life.

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Sorry, is this where I'm meant to say, "Thank you"?

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Surprised you can remember. You were submerged in a bottle for most of the day.

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New man now.

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Not that it's doing me much good.

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Ken!

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The whole welcoming committee. What joy.

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Almost didn't recognise you out of season, mate.

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-All right, OK, take it easy.

-Suspected pericardial constriction.

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OK. Nice deep breath for me, please.

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HE GROANS Lean forwards.

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Try and relax.

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OK and back.

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How long have you been having these chest pains?

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I don't know. Since I tripped and fell over the other week.

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-Not drunk, though.

-Legs are a bit swollen.

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-Flatterer.

-Mrs Khan's test results.

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OK.

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Let her down gently and prepare for a pericardiectomy.

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Nice!

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OK, Ken. We're gonna be prepping you for theatre.

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What, straight away? No waiting about for hours?

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Not while I'm running the show.

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Ho-ho-ho! Efficiency.

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Seem to remember, you could learn a thing or two from...

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Although that big grin is making me feel vaguely uneasy.

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Hey. Thought you could do with this.

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That's kind, thanks.

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SHE SIGHS I don't know whether to stay or...

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Usually when she's in hospital I go and clean her flat,

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fill her fridge and...wait.

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-That's the hardest part.

-Fi always insists on going it alone.

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I can imagine. She's very independent.

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After her dad left, I worked all hours

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and she had to fend for herself.

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-Too much really.

-Stood her in good stead.

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It was me that saw the trial advertised.

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-Was it?

-I know Fi had got used to things as they were but...

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She's missed out on so much.

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We couldn't believe it when Professor Gaskell chose her.

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I know you'll look after her. The trial's so important.

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Right now, Fiona's health is our priority.

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We didn't think it would come to this.

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Speak for yourself...

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Hey, Fiona, how are you?

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The legs don't work...

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But there's nothing wrong with my ears.

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I read the Professor's papers...

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I knew...

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I knew what I was getting into...

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ALARM BEEPS, SHE HITS BUZZER

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-Oh, Fiona!

-OK...

-Fiona!

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KNOCK ON DOOR

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Sorry to interrupt.

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I heard the board hadn't received your statement

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-For what?

-The TMS.

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Oh, yeah...

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-John, time's running out.

-I know.

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MESSAGE ALERT

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Fiona.

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Four of a kind.

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Ha-ha, ha! That's another win, isn't it ?

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You sure you shuffled?

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My motor skills aren't what they used to be.

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-Sorry to interrupt.

-I know, I'm thrashing him anyway.

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Erm, Mrs King's ECG. Has it come back yet?

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-I got a bit distracted but I'll check.

-Aw!

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-Did you get home OK last night?

-Fine, yeah.

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Yeah? Did you get a cab?

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Er, I didn't have to cos the bus came straight away.

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Cool. Good.

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ECG is in.

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Looks normal.

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Brilliant.

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Thanks.

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Her white blood count is falling and inflammatory markers are up.

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The medication isn't working.

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ALT 105, alkaline phosphatase 276, gamma-GT 540.

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Liver function's deteriorating.

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U&Es show early AKI.

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-Her immune system's breaking down.

-Is her body rejecting the implant?

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This is awful.

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She had this procedure for the trial, not because she needed to.

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-None of us were expecting this.

-We need to act quickly.

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Let's get her into surgery, reopen the wound and find the source of the infection.

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-I'll check theatres.

-And page Ms MacMillan.

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I'd like her consultation given she assisted on the first surgery.

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ECG and CT as quick as you can.

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ALARM CONTINUES TO SOUND

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MUFFLED VOICES

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BUZZER SOUNDS

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KEYS JANGLE

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-We are preparing to operate.

-Again?

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I think Fiona has some infected tissue which needs to be removed.

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What do you mean? From her last operation? The trial?

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-It's possible.

-But that was weeks ago.

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Well, some strains take time to show up.

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-WHISPERING:

-Sorry to interrupt. Excuse us.

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Please.

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-Theatre's booked out for the next couple of hours.

-With what?

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Ruptured AAA and a stoma revision.

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-We can't afford to delay.

-I know.

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What about Darwin? Have they got a slot?

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You haven't the authority to override a consultant on a different ward.

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-I'll call Ms Campbell.

-I've already tried her.

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She's out and can't be reached.

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Thanks for coming.

0:18:040:18:07

Donna would be here if she had any choice in the matter.

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I know.

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Oh, Ric...are you eating OK? I mean, can you sleep?

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Is the man who attacked you here?

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Transferred.

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Well, that must make things a little easier.

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Plenty of others to take his place.

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You haven't been attacked again, have you?

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I'm getting better at keeping my head down.

0:18:410:18:44

Well, at least it shouldn't be for too much longer.

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John Gaskell's come up trumps.

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Stuck his head out of his lab long enough to find you an expert witness.

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Far more eminent than the one your brief lined up.

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HE SIGHS

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Oh, come on now, that's meant to be good news.

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-An expert witness won't help.

-Why not?

0:19:050:19:08

One medical professional speaks out for another medical professional.

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-What does that look like?

-He'll testify that your actions that day were entirely appropriate.

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Except that they weren't.

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Not entirely.

0:19:210:19:22

Ric, you need to focus on the positives,

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on the things you did right.

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HE SIGHS

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Oh! Jason made you a card.

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They believe in you. We all do.

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Well... Tell Jason, thank you.

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If only I hadn't asked you to help.

0:19:560:19:59

I have no regrets on that front.

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Mr Davies' results are back.

0:20:130:20:15

Blood alcohol concentration is zero.

0:20:150:20:18

He had scotch on a drip feed the last time he was here.

0:20:180:20:20

Must have signed the pledge.

0:20:200:20:22

It's amazing what a near death experience can do.

0:20:220:20:24

Your, er, theatre nurse is here and ready to scrub in.

0:20:240:20:27

Great, thank you.

0:20:270:20:28

What, that's it? No third degree?

0:20:290:20:31

No, "Where did she go to school? What did she have for breakfast?"

0:20:310:20:34

I'm happy if you're happy.

0:20:340:20:35

It appears we're under surveillance, Ms Naylor.

0:20:350:20:39

-Just checking you're OK.

-Why wouldn't I be?

0:20:390:20:42

A pericardiectomy is more challenging than a mitral valve.

0:20:420:20:45

Thank you, Adrian. I am aware of the difference.

0:20:450:20:47

Fortunately for Ken.

0:20:470:20:49

-And, hello? I'm here?

-Yeah, of course.

0:20:490:20:52

Sorry, Ms Petrenko, could you let Ken know we're ready to go, please?

0:20:520:20:55

Go on then. Spill it.

0:21:020:21:04

What did you sprinkle on your muesli this morning? I'm not stupid.

0:21:040:21:09

What did you do? Change your meds?

0:21:090:21:11

Maybe the physio's just finally paying off.

0:21:110:21:14

And...

0:21:140:21:16

It's miraculous what a full five hours' kip can do for you.

0:21:160:21:20

Mm, well, long may it continue.

0:21:200:21:23

You've got an excellent legal team.

0:21:270:21:29

With barely a case to argue and only two weeks to go.

0:21:300:21:35

Get the jury on side and who knows what will happen?

0:21:350:21:38

Ric, now is not the time to give up.

0:21:390:21:42

I'm fighting a justice system that pits me against a colleague,

0:21:510:21:55

against a friend.

0:21:550:21:57

And to what end? I'm a surgeon.

0:21:570:22:00

What good does it serve keeping me locked up in here?

0:22:020:22:04

None. The whole thing is utter madness.

0:22:040:22:07

-Will you do something for me, please?

-Of course, anything.

0:22:130:22:16

If, when the worst happens...

0:22:170:22:20

..would you look out for Darla and Kofi, please?

0:22:220:22:27

The constriction in Ken's pericardium will have been

0:22:340:22:37

caused by the trauma when he fell.

0:22:370:22:38

It's led to the pericardium getting stuck. Can you see?

0:22:380:22:41

-PETRENKO:

-Fascinating.

0:22:410:22:43

Now to separate the pericardium from the heart. Scissors, please.

0:22:430:22:46

Thank you. What follows, Ms Petrenko?

0:22:460:22:48

Wire the breastbone together with the ribs and then close up.

0:22:480:22:52

Good.

0:22:520:22:54

ALARM BEEPS Damn it. There's a tear in the atrium.

0:22:540:22:56

It's bleeding out. No, it's too delicate. Glue, please.

0:22:560:22:59

-BP dropping.

-Suction, please.

0:23:010:23:04

-Still bleeding.

-Come on, Ken, Come on.

0:23:040:23:07

BP still dropping.

0:23:070:23:08

Ms Naylor, we have to get him on bypass now,

0:23:080:23:10

-to keep his BP safe.

-No, I'll plug the hole myself.

0:23:100:23:13

With what?

0:23:130:23:15

My finger will plug the tear while I suture around it.

0:23:150:23:18

See? Easy-peasy.

0:23:200:23:23

Incredible.

0:23:240:23:26

I really appreciate you clearing your schedule.

0:23:310:23:34

I don't suppose the world's eyes will be upon us this time.

0:23:340:23:37

Rox, I've got to turn this around.

0:23:370:23:39

You will. You always do.

0:23:390:23:41

Yeah?

0:23:430:23:44

-Theatre's gonna be at least another hour.

-This is ridiculous.

0:23:440:23:47

-By then, we're gonna be an anaesthetist down.

-We'll get a locum in.

0:23:470:23:49

That'll need authorisation.

0:23:490:23:51

Can I not do that?

0:23:510:23:52

According to Fletch, it has to be Ms Campbell.

0:23:520:23:54

-Who's God knows where.

-She's gone to visit Ric Griffin.

0:23:540:23:57

-Unbelievable.

-Fletch has left her a message. But I can call her again now.

0:23:570:24:02

Is there some sort of hold up?

0:24:020:24:03

Nothing that can't be fixed.

0:24:030:24:05

I thought maybe you'd changed your mind, maybe Fi was improving.

0:24:060:24:11

She's looking better, don't you think?

0:24:120:24:14

There's been no improvement, alas.

0:24:140:24:16

But once we get her into theatre...

0:24:160:24:19

She's had so many operations and each one seems to make her worse.

0:24:190:24:22

She has had a pretty challenging time of it.

0:24:220:24:25

We appreciate that.

0:24:250:24:28

What if this one goes wrong too?

0:24:280:24:30

Well, there's an element of risk with any procedure.

0:24:300:24:33

Can't you wait a bit longer?

0:24:330:24:34

So the medication has time to work?

0:24:340:24:36

Theatre is our only option now.

0:24:360:24:38

MONITOR BEEPS STEADILY

0:24:380:24:41

Is there anything else you'd like to ask?

0:24:430:24:46

Do I have your support?

0:24:500:24:51

What do you think Fiona would want?

0:24:590:25:02

She'd want me to trust you.

0:25:030:25:06

A hundred per cent.

0:25:060:25:09

Yes. No, that's fine - go ahead. Thank you.

0:25:110:25:14

Auntie Serena! I have a very big bone to pick with you!

0:25:140:25:18

I've been speaking to Lou in AAU.

0:25:180:25:21

She told me Ric left the ward at 11.30am on the day his patient

0:25:210:25:25

died - Monday, 2nd October, 2017.

0:25:250:25:27

That was precisely the time and date he came to help me and Lola.

0:25:290:25:32

It was, yes.

0:25:320:25:34

So the lady died when Ric was helping us?

0:25:340:25:36

No, she died later that night.

0:25:360:25:38

-Oh, no, no!

-It's all right!

0:25:380:25:40

I'd better go to the police and explain.

0:25:400:25:42

-No, you mustn't do that.

-Why not? I'm going to be a dad.

0:25:420:25:45

-I have to be responsible.

-Because it wouldn't help Ric.

0:25:450:25:49

But if the police knew why he left the lady, they might let him go.

0:25:490:25:52

They wouldn't. There are other factors.

0:25:520:25:54

She died because Ric was helping me instead of her.

0:25:540:25:56

-No, she didn't.

-She did. She must have.

0:25:560:25:59

He was her doctor and he wasn't there.

0:25:590:26:01

Why else would he be in prison?

0:26:010:26:03

Jason, listen to me.

0:26:030:26:05

The main reason Elaine Warren died is

0:26:050:26:08

because she didn't get the medication that Ric had prescribed.

0:26:080:26:11

-Are you sure?

-Quite sure.

0:26:110:26:13

So there's absolutely nothing for you to worry about.

0:26:130:26:17

I'm so glad you found yourself and came home.

0:26:170:26:20

We need to get a move on now. Ms Campbell's given us the go-ahead.

0:26:230:26:27

Fiona?

0:26:270:26:29

What's happening? Where am I?

0:26:290:26:32

-You're still in hospital.

-We're taking you to theatre.

0:26:320:26:34

Mum!

0:26:340:26:37

You'll be OK. It'll be OK.

0:26:370:26:41

-WHISPERING:

-I'm scared.

-I know...

0:26:410:26:43

I know.

0:26:430:26:44

I'll see you later, darling. You'll be OK.

0:26:440:26:46

We're going to take very good care of her. OK?

0:26:490:26:52

-Nicky? You done the bloods for bed six yet?

-Yeah.

0:27:010:27:04

Good, come and observe while I do the chest drain.

0:27:040:27:06

See the master at work.

0:27:060:27:08

OK, thanks. It's just...

0:27:080:27:11

What?

0:27:110:27:13

Mr Thornley's laceration, it needs suturing...

0:27:130:27:15

I think.

0:27:150:27:17

You think?

0:27:170:27:18

Well, it was glued in the ED but it's dehiscing.

0:27:180:27:22

Dr McKendrick, you need to breeze the bread and butter stuff.

0:27:220:27:24

It's just with the glue, I don't want to make things worse and cause scarring.

0:27:240:27:27

-Suturing should be second nature to you by now.

-It is.

0:27:270:27:29

But you want me to take a look?

0:27:290:27:31

Or hold your handbag while you stitch?

0:27:310:27:33

No! Not at all.

0:27:350:27:38

I'm just telling you that's what I'll be doing.

0:27:380:27:40

Then I'll assist with the chest drain.

0:27:400:27:42

OK, great. Problem solved!

0:27:420:27:44

Dura exposed.

0:27:520:27:54

Implant looks to be intact

0:27:550:27:58

and is pulsating along with the adjacent cord.

0:27:580:28:01

Signs of inflamed tissue along the right lateral recess.

0:28:010:28:04

Got it.

0:28:040:28:06

Sample?

0:28:060:28:08

I propose leaving the implant in-situ.

0:28:160:28:19

But the infection might have infiltrated.

0:28:190:28:21

It's situated to the right of the implant,

0:28:210:28:24

around the intercostal artery.

0:28:240:28:26

There was a bleed at the intercostal during the last procedure.

0:28:260:28:30

Well remembered, Dr Chowdhury.

0:28:300:28:31

I would err on the side of caution.

0:28:310:28:34

You always do.

0:28:350:28:38

Just an opinion.

0:28:380:28:39

If I remove the implant, that ends the trial for Fiona.

0:28:390:28:43

Your patient. Your decision.

0:28:430:28:45

Then let's remove what looks abnormal and take it from there.

0:28:490:28:54

MONITOR BEEPS STEADILY

0:28:540:28:57

Damn it...

0:29:110:29:12

..still alive.

0:29:140:29:16

Well, I did what I could

0:29:170:29:18

but despite my very best efforts, you made it through.

0:29:180:29:23

Super surgeon.

0:29:230:29:25

Just my luck.

0:29:250:29:27

Anyone we can call for you?

0:29:290:29:31

Why don't you have a guess?

0:29:320:29:34

You seemed to suss out my whole life last time.

0:29:340:29:37

I'm glad to see you've stopped drinking.

0:29:380:29:41

How's your wee girl doing?

0:29:450:29:47

She's good, thanks.

0:29:480:29:49

It pains me to say it but your Santa routine really made her Christmas.

0:29:490:29:54

She must be so pleased to have you back home,

0:29:540:29:57

running round after her...

0:29:570:29:59

..so soon.

0:30:000:30:03

Whatever you're on, darling. It's working a treat.

0:30:050:30:09

I don't have a clue what you're talking about.

0:30:130:30:15

-How is she doing?

-BP 60/30, Sats 90.

0:30:150:30:18

Nearly there. The area's clear.

0:30:190:30:21

Ms MacMillan?

0:30:230:30:25

It would be safer to remove everything.

0:30:350:30:36

Including the implanted nerve.

0:30:360:30:38

ALARM SOUNDS BP's dropping.

0:30:380:30:41

There's no time. I'll take a sample for analysis.

0:30:410:30:43

Meena, this is from the implant.

0:30:520:30:54

Label the dishes separately and get them to the wet lab. Quick as you can.

0:30:540:30:57

-SECOND ALARM SOUNDS

-Organs are failing.

0:30:570:31:00

Vasopressors, please!

0:31:000:31:03

Everything OK?

0:31:080:31:10

Yep.

0:31:100:31:12

Taking a while.

0:31:120:31:14

I'm finished now.

0:31:150:31:18

Did you want to look at it?

0:31:210:31:24

You delivered a baby the other week.

0:31:240:31:26

Are you really telling me you don't have the belief to tie a knot?

0:31:260:31:30

Sorry, I thought your job was to supervise.

0:31:300:31:33

Supervise, yeah, not spoon feed.

0:31:370:31:39

You are so patronising - I only asked if you wanted to check it.

0:31:410:31:44

-Nicky, what if this was an emergency?

-It isn't!

0:31:440:31:46

-What if you had seconds to make a life-or-death decision?

-I don't!

0:31:460:31:49

This is the real world, love. It's time to grow a pair!

0:31:490:31:52

Problem?

0:31:520:31:54

No. All good.

0:31:540:31:56

Sounded overly heated to me.

0:31:560:31:58

Dr McKendrick?

0:31:580:32:00

I've sutured a scalp laceration and it was a bit tricky

0:32:030:32:06

because it was glued in the ED and was dehiscing...

0:32:060:32:08

And I was just about to check it.

0:32:080:32:10

Which bed?

0:32:100:32:12

Four.

0:32:120:32:14

Wait in my office. I'll check it myself.

0:32:140:32:17

MONITOR BEEPS STEADILY

0:32:250:32:27

-BP rising.

-She's stable.

0:32:290:32:31

Well done, everyone, thank you.

0:32:310:32:34

If you wouldn't mind closing, Ms MacMillan.

0:32:340:32:36

5-0 prolene, please.

0:32:360:32:38

When we're done, take her to ITU, then GCSF and Vasopressors.

0:32:380:32:42

-Yep.

-And let me know if anything changes.

-Will do.

0:32:420:32:46

HEAVY BREATHING

0:32:480:32:51

The suturing is fine.

0:33:010:33:03

A bit belt and braces but not bad at all.

0:33:040:33:07

I knew it would be.

0:33:070:33:09

Yeah. If Dr McKendrick had concerns, she was right to consult you.

0:33:090:33:13

Ms Campbell, with respect, Nicky needs more faith in herself,

0:33:160:33:20

-more backbone.

-I don't disagree.

0:33:200:33:23

I've got backbone. It's him.

0:33:230:33:25

-He treats me like I'm an idiot!

-That's more like it.

0:33:250:33:28

About time. She's been dithering all day.

0:33:280:33:31

You need to model yourself on Ms Campbell.

0:33:310:33:33

Smart and decisive.

0:33:330:33:34

How flattering.

0:33:360:33:37

You're a good doctor, Mr Duval.

0:33:390:33:41

-Thank you.

-But it was premature to leave you running my ward.

0:33:410:33:46

Why? I run half the hospital on the night shift.

0:33:460:33:49

Managing a ward, inspiring hearts and minds,

0:33:490:33:52

is a COMPLETELY different ball game!

0:33:520:33:55

Your F1 needed support and encouragement,

0:33:550:33:58

which I too readily assumed you could provide.

0:33:580:34:00

I made a mistake.

0:34:000:34:02

People do.

0:34:040:34:05

SHE GROANS

0:34:180:34:20

-DEVICE BEEPS ON

-17:27, 6th of March, 2018.

0:35:360:35:41

Stem cell trial update.

0:35:410:35:42

Samples taken from Patient One show catastrophic cellular

0:35:440:35:48

fragmentation.

0:35:480:35:50

Reason for apoptosis - unidentified.

0:35:500:35:52

Hypothesis - one, abnormal immune response in patient.

0:35:540:35:58

Two, presence of as yet unknown factors in peripheral nerve conduit.

0:35:580:36:03

Three, infection.

0:36:030:36:05

In short, the implanted stem cells are dead

0:36:070:36:11

and are the most likely cause of the infection which has caused

0:36:110:36:15

multi-organ failure in patient.

0:36:150:36:17

This stage of the trial has failed.

0:36:190:36:23

HE SIGHS

0:36:250:36:26

KNOCK ON DOOR

0:36:290:36:31

-Essie...

-Sorry to interrupt.

0:36:310:36:34

Is there a problem?

0:36:340:36:36

Er, I just needed to know,

0:36:360:36:37

any clues as to what's caused the infection?

0:36:370:36:39

Not yet.

0:36:390:36:41

-Could it be the implant?

-That's unlikely.

0:36:420:36:46

Most probably it's something post-op.

0:36:470:36:50

Obviously we'll know more when we identify the strain of bacteria.

0:36:500:36:54

Poor Fiona. She wasn't expecting this.

0:36:540:36:57

Well, none of us were.

0:36:570:36:58

So, er, what does this mean for the trial?

0:36:580:37:02

Well, naturally, we need to find the source of the trouble

0:37:020:37:05

so we can ensure it doesn't happen again.

0:37:050:37:08

-So we carry on?

-Yes. Absolutely.

0:37:080:37:10

Patient care to the fore, as usual.

0:37:100:37:13

What about Fiona? Surely this is over for her?

0:37:130:37:15

Well, if we can just get her through recovery,

0:37:150:37:18

I'm confident the implant will still work.

0:37:180:37:21

-That's a relief.

-Yeah.

0:37:210:37:23

Look, would you mind popping back to ITU, keep an eye on Dr Chowdhury?

0:37:250:37:28

Yeah. Yeah, of course.

0:37:280:37:30

It's been a rough day for her... For all of us.

0:37:300:37:33

So, did he guess?

0:37:520:37:54

Who, Ken?

0:37:540:37:55

Ken? I mean Fletch.

0:37:550:37:58

No. Fletch thinks I'm OD-ing on physio and sleep.

0:37:580:38:02

He seemed overly curious to me.

0:38:020:38:04

Are you thinking of telling him?

0:38:060:38:08

Don't be ridiculous.

0:38:080:38:10

He'd get his knickers in a right twist.

0:38:100:38:12

Jac, I gave you that shot off the books and I won't do it again.

0:38:120:38:15

-It was a risk.

-I know.

0:38:150:38:17

So you need to deal with the pain properly

0:38:170:38:19

and find a long-term solution.

0:38:190:38:21

MONITOR BEEPS STEADILY

0:38:250:38:28

Is it all right to hold her hand?

0:38:310:38:33

Course.

0:38:330:38:34

Reminds me of when she was a baby.

0:38:360:38:38

I didn't dare turn my back in case she stopped breathing.

0:38:390:38:44

HIGHER-PITCHED BEEP

0:38:440:38:46

-WHISPERS:

-Page Professor Gaskell.

0:38:470:38:50

Never had you down as a five-a-day kind of guy.

0:38:540:38:57

-Looks can be deceiving.

-In your case, I think not.

0:38:580:39:02

I'm only doing it for me old Ma.

0:39:020:39:04

To stop the nagging.

0:39:040:39:05

Well, a few vitamins certainly won't hurt your recovery.

0:39:050:39:09

Can't be something we're not though, can we? Not forever.

0:39:090:39:14

Uh-oh, paranoia's kicking in.

0:39:160:39:20

ALARM SOUNDS

0:39:220:39:24

-She's in VF.

-OK, Lesley, let's move you out of the way

0:39:240:39:27

-so that Professor Gaskell can do his job, please.

-No, no...

0:39:270:39:30

-I can't feel a pulse!

-Defibrillate.

-Charging to 150.

0:39:300:39:32

Come on, Fiona.

0:39:330:39:36

Stand clear. Shocking...

0:39:360:39:39

-No output.

-Again!

-Charging to 150.

0:39:390:39:41

-WHISPERS:

-Stay with us!

0:39:410:39:43

Stand clear. Shocking...

0:39:430:39:46

-No output.

-Again!

0:39:460:39:48

Charging to 200.

0:39:480:39:50

Stand clear. Shocking...

0:39:510:39:55

No output.

0:39:550:39:57

CONTINUOUS BEEP SOUNDS

0:39:570:39:59

HE CONTINUES CHEST COMPRESSIONS

0:40:040:40:06

SOUND DISTORTS

0:40:150:40:18

CONTINUOUS BEEP SOUNDS

0:40:290:40:31

Professor...

0:40:310:40:32

I think we should stop.

0:40:380:40:41

John. Stop.

0:40:440:40:48

Dr Chowdhury, do you agree?

0:40:550:40:56

Yes.

0:40:570:40:59

Time of death, 1813 hours.

0:41:050:41:06

BEEP CONTINUES

0:41:080:41:11

BEEP FADES TO SILENCE

0:41:230:41:26

What were you and Frieda talking about?

0:41:410:41:45

Er... Just how well you did in theatre.

0:41:450:41:47

You know, so, chill. Take it as a compliment.

0:41:470:41:49

-Oh. Right.

-You made me feel bad.

0:41:490:41:52

-Why?

-I've been taking the mick all day.

0:41:520:41:55

I know how hard you've worked in physio.

0:41:550:41:58

And if you feel like you're back on form then THAT -

0:41:580:42:01

-is brilliant.

-Well, it's not just...me.

0:42:010:42:04

And modesty too? Blimey, I've seen it all today.

0:42:040:42:06

I'm really proud of you.

0:42:070:42:09

I get it.

0:42:170:42:19

You really don't.

0:42:190:42:21

Lesley... I am so sorry.

0:42:450:42:48

We did all we could.

0:42:490:42:52

Her organs were just too badly damaged by the infection.

0:42:520:42:55

You know, when I read about your trial,

0:42:580:43:01

all I could think about was seeing her walk.

0:43:010:43:04

Seeing her back how she was.

0:43:050:43:08

Before...

0:43:080:43:10

I went...on and on at her.

0:43:120:43:16

"Fi, give it a go.

0:43:190:43:21

"You've got nothing to lose."

0:43:220:43:25

I never thought...

0:43:280:43:31

I didn't think of the risks.

0:43:310:43:34

Is there someone we can call?

0:43:410:43:43

Look, If there's ever anything I can do...

0:43:450:43:48

I wish that I was religious.

0:43:510:43:54

So that I could believe that this wasn't the end.

0:43:540:43:57

Me too.

0:44:010:44:03

It's as if a light's gone out.

0:44:070:44:09

Like he's given up.

0:44:090:44:11

Poor Ric.

0:44:120:44:14

I dread to think what will happen if he has to stay there longer.

0:44:140:44:17

You don't seriously think he's gonna go down for this?

0:44:170:44:19

He does.

0:44:190:44:21

I haven't helped, have I?

0:44:210:44:23

Let's focus on what action we CAN take.

0:44:230:44:26

There's only two weeks till the trial.

0:44:260:44:28

Yeah, we need to find concrete proof that Ric only left the ward

0:44:280:44:31

-once everything was under control.

-We've tried.

0:44:310:44:33

Yes, I know but if he didn't give the anti-coagulant order to Donna,

0:44:330:44:36

-then he must have given it to someone else.

-Who? Nobody's owned up.

0:44:360:44:39

I've already checked with every single person that was

0:44:390:44:42

-working that shift on AAU.

-What about other departments?

0:44:420:44:45

-Hospital staff pass through AAU all of the time.

-No. The police cross-checked every rota.

0:44:450:44:49

So anyone that went through AAU on that day has been interviewed.

0:44:490:44:52

It could be any one of us in that prison.

0:44:520:44:55

We have to put this right.

0:44:550:44:56

We've only got staffing rotas and timesheets to go on.

0:44:560:44:59

How about members of staff who were technically on duty?

0:44:590:45:02

What would they have been doing on the ward?

0:45:020:45:04

-Overtime?

-No. Checked it.

-Visiting?

0:45:040:45:07

Nope. There's no records.

0:45:070:45:09

Training? Has anyone checked the training logs?

0:45:120:45:17

We lost Fiona.

0:45:330:45:35

I'm sorry.

0:45:350:45:36

So, where does this leave the trial?

0:45:410:45:43

The trial continues as planned.

0:45:480:45:51

With lessons learnt, of course.

0:45:540:45:56

I doubt removing the implant would've changed the outcome.

0:45:590:46:03

I've been doing some thinking.

0:46:080:46:11

About this TMS of yours.

0:46:110:46:14

If I could authorise the purchase of that machine myself, I would.

0:46:140:46:17

Seems the only power in this hospital is

0:46:170:46:19

a seat at the round table.

0:46:190:46:22

You wouldn't be interested in the board, would you?

0:46:220:46:24

No way.

0:46:240:46:26

You'd be much better suited to that kind of thing.

0:46:260:46:30

You think that's a good idea?

0:46:300:46:32

Why, would you want to?

0:46:330:46:35

If it meant you and me could access theatres and equipment

0:46:350:46:38

when we wanted, why not?

0:46:380:46:41

The Director of Medicine post is available.

0:46:420:46:45

You could discuss it with Serena.

0:46:460:46:48

She's overloaded as it is.

0:46:480:46:50

And quite rightly,

0:46:500:46:52

she's postponing key decisions out of deference to Henrik.

0:46:520:46:54

-So call him first.

-No...

0:46:540:46:57

He's on compassionate leave.

0:46:590:47:01

I could call him, if you like.

0:47:090:47:11

Well, I suppose it would seem less formal.

0:47:110:47:14

If the post is absolutely what you want?

0:47:150:47:18

I just want what's best for my patients.

0:47:200:47:22

See you tomorrow, then. And no grapes, mind.

0:47:340:47:37

Chocolate, yes. Grapes, no. Chocolate - very good for the heart.

0:47:370:47:40

The doctor's here and she agrees.

0:47:400:47:43

All right, see you tomorrow. Bye-bye

0:47:430:47:46

-Visitors?

-Mother.

0:47:460:47:49

On her way down on the train.

0:47:490:47:50

-Well, take care, then.

-Yes.

0:47:520:47:54

You too, Ms Naylor.

0:47:540:47:57

-Night.

-Night.

0:48:010:48:04

SIREN APPROACHES

0:48:100:48:13

-Henrik, thank you for coming.

-That's quite all right.

0:48:230:48:26

How can I help?

0:48:270:48:30

Right, John and I were thinking.

0:48:300:48:33

The way things are, it might be helpful for him

0:48:330:48:36

to have a seat on the board.

0:48:360:48:38

In what capacity?

0:48:380:48:40

Director of Medicine.

0:48:400:48:42

Meetings, paperwork.

0:48:420:48:44

Hardly John's field of expertise, is it?

0:48:440:48:46

No, but he'd have more influence.

0:48:460:48:48

-At the expense of his research?

-In order to help his research.

0:48:480:48:52

More autonomy. More access to resources.

0:48:520:48:54

Without you at the helm,

0:48:540:48:56

he could assist Ms Campbell with the workload.

0:48:560:48:59

Unless of course you were thinking of coming back...

0:48:590:49:01

Fine.

0:49:010:49:02

Ms Campbell would have to agree, though.

0:49:020:49:05

Are you sure?

0:49:050:49:06

If you think it's in the best interests of the hospital,

0:49:060:49:09

then I trust your judgement completely.

0:49:090:49:12

Perhaps you should take some time to think it through.

0:49:120:49:15

Roxanna, if you're happy to fight John's corner,

0:49:150:49:18

that's enough for me.

0:49:180:49:20

Things may not be quite the same by the time you get back.

0:49:220:49:26

So be it.

0:49:260:49:28

Well, it's...unexpected.

0:49:330:49:36

I knew you wouldn't want to make such a such a key decision

0:49:360:49:38

without Henrik's approval.

0:49:380:49:40

So Roxanna took the liberty of talking to him in advance.

0:49:400:49:43

He's happy if you're happy.

0:49:430:49:45

Did Henrik give any indication when he might be coming back?

0:49:450:49:49

No. Unfortunately.

0:49:490:49:51

In his absence, the board needs medics like us, Serena.

0:49:510:49:56

Do-ers who know the coalface.

0:49:560:49:58

I don't get my hands grubby nearly enough these days.

0:49:580:50:00

This is where I can help, you see?

0:50:000:50:02

What would it mean for your research?

0:50:020:50:04

I don't see why the two roles can't run alongside.

0:50:040:50:08

I was very sorry to hear about your patient, by the way.

0:50:090:50:12

That must have been a blow for you. Personally as well as for the trial.

0:50:120:50:15

-The trial continues as planned.

-Without a review?

0:50:150:50:18

There'll be a post-mortem, naturally,

0:50:180:50:20

but the signs are that the patient, sadly, succumbed to an infection.

0:50:200:50:25

Is there a link to the implant?

0:50:250:50:27

Too soon to say.

0:50:270:50:29

The admin delays, getting to theatre, didn't exactly help us

0:50:290:50:33

turn it around. But if I have the power to approve, it would be less

0:50:330:50:37

weight on your shoulders.

0:50:370:50:39

Think about poor Mr Griffin, this is outrageous.

0:50:410:50:44

Quite.

0:50:440:50:46

These kinds of accusations will only increase.

0:50:460:50:49

Budget restrictions, staff cuts.

0:50:490:50:52

Mistakes are going to be made. We need to be ready.

0:50:520:50:54

Well, I certainly can't say no to another firefighter.

0:50:540:50:57

My first priority would be to ensure that Ms MacMillan can proceed

0:50:570:51:01

with her TMS project.

0:51:010:51:03

I hear the board are difficult to persuade.

0:51:050:51:08

Why don't we discuss the details later over a drink?

0:51:090:51:14

Hm! Reading my mind already.

0:51:140:51:16

I'll sign his discharge papers.

0:51:170:51:19

I'll get transport sorted to get him home.

0:51:190:51:21

Great, thank you.

0:51:210:51:23

Let me guess.

0:51:300:51:32

No reply?

0:51:320:51:34

Sacha, I don't play games.

0:51:350:51:37

I'm done.

0:51:390:51:41

Enough.

0:51:410:51:43

I reckon we can put a smile back on that face.

0:51:490:51:51

Taken up miracle-working?

0:51:510:51:53

No. We've been through all of the training logs.

0:51:530:51:55

Monday, the 2nd of October, 2017. The day Elaine Warren died -

0:51:550:51:58

there was a trauma course for nurses.

0:51:580:52:01

-Right?

-The list of participants here.

0:52:010:52:03

And one nurse does stand out. Amira Zafar.

0:52:030:52:06

Why? What's her connection?

0:52:060:52:08

Well, soon as I saw her name, it clicked.

0:52:080:52:09

I remember her telling me that she was working on AAU

0:52:090:52:12

when it was manic. The consultant was run ragged

0:52:120:52:14

and then some poor woman ended up dying.

0:52:140:52:16

I've double-checked and Elaine Warren's was the only death in AAU that day.

0:52:160:52:19

-Did the police speak to her?

-I doubt it because they haven't got the training logs.

0:52:190:52:23

-Does she still work here?

-Agency.

0:52:230:52:25

But don't worry, we're going to track her down.

0:52:250:52:27

Good work.

0:52:270:52:29

SIREN WAILS

0:52:290:52:32

I had a brilliant time last night.

0:52:380:52:40

Do you fancy doing something at the weekend?

0:52:400:52:42

Well, you've ignored my message and pretty much blanked me all day.

0:52:440:52:48

Dom, what's wrong?

0:52:510:52:53

Why didn't you wanna come and stay last night?

0:52:560:52:59

Because last time was so amazing but it all fell apart.

0:52:590:53:02

So I thought it'd be nice to take it slow.

0:53:020:53:04

I'm sorry. We should've talked about it.

0:53:040:53:07

And I didn't reply to your message because we had a great night

0:53:070:53:10

and I thought that was obvious?

0:53:100:53:12

It was.

0:53:140:53:16

I'm sorry... Old wounds.

0:53:190:53:23

I'm not him.

0:53:250:53:27

I know.

0:53:290:53:31

Come on.

0:53:410:53:43

All right?

0:54:060:54:08

Yeah.

0:54:090:54:11

-Nicky...

-Please...

0:54:140:54:17

Please can we just forget today?

0:54:180:54:22

Look, I know you think I'm a...

0:54:220:54:25

I just wanted to say, I do know what it's like to feel...

0:54:280:54:32

..not up to scratch.

0:54:360:54:38

OK?

0:54:390:54:41

So, if I have been too tough on you, then...

0:54:410:54:46

..I'll ease off.

0:54:480:54:51

Cheers.

0:54:520:54:55

So, we're all good, yeah?

0:54:580:55:00

Yeah.

0:55:040:55:06

Same again, please.

0:55:160:55:18

Not for me, John. I'm about to go.

0:55:180:55:20

-Will you call Henrik and tell him that Serena agreed?

-Yeah.

0:55:200:55:24

And how much we miss him.

0:55:240:55:26

I don't want him thinking there isn't a place for him here.

0:55:260:55:28

He'll be back soon enough calling the shots.

0:55:280:55:31

He's like the rest of us. Lost without a stethoscope.

0:55:310:55:34

Ah, lovely - look forward to that!

0:55:360:55:40

-Here.

-Oh, thank you.

0:55:420:55:44

-I can't stay.

-Pity. I was just warming up.

0:55:450:55:49

Why don't we meet tomorrow, first thing?

0:55:510:55:53

-In your office.

-I look forward to it.

0:55:530:55:57

Our Director of Medicine. My new partner in crime.

0:55:590:56:03

Does Bernie know?

0:56:030:56:05

I wish she was here.

0:56:050:56:07

I know you do.

0:56:070:56:09

Between you and me, I'd cheerfully hand Gaskell the whole show.

0:56:090:56:13

You don't mean that.

0:56:130:56:14

Oh, I'm fed up with the boardroom, believe me.

0:56:140:56:17

Well, Hanssen needs you there. And to be honest, we all do.

0:56:170:56:20

More importantly, how did you get on tracking down that nurse?

0:56:220:56:26

Ah... Well, seems like she's left nursing.

0:56:260:56:29

-I mean, she was never really cut out...

-Where is she now?

0:56:290:56:32

Not exactly sure.

0:56:320:56:33

It's going to be a bit more of a challenge than I thought

0:56:330:56:36

but we'll get there.

0:56:360:56:38

To Ric.

0:56:390:56:41

To Ric.

0:56:420:56:44

Subtitles by Red Bee Media

0:58:000:58:03

Gaskell and Essie are shaken when Fiona returns to the hospital with complications. As Gaskell fights to save Fiona, he becomes frustrated with the limitations of the hospital systems and takes drastic action to ensure the future of his trial.

Serena is dismayed to discover that Ric seems to be losing hope in prison. Her determination to find a way to help Ric distracts her from a fight for power within the hospital.

Jac is back on the ward and back on form, but her cheery attitude is drawing suspicion from others. Will Jac be able to keep her secret safe?


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