No Matter Where You Go, There You Are - Part One Holby City


No Matter Where You Go, There You Are - Part One

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-You didn't kill her.

-I didn't save her either.

-You taught me this. Remember?

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You said it would make me a better surgeon.

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-What happened with Lola?

-She didn't want to go to hospital,

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so I called you and you called Mr Griffin, then he fixed everything.

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-So, you and Fletch! Anything going on there?

-No!

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I feel compelled to suspend this case, in consideration of criminal

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charges relating to gross negligence. Manslaughter.

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-VOICE-OVER:

-At 9am, on the 2nd of October 2017, Elaine Elisabeth Warren was admitted

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to the Acute Admissions Unit at Holby City Hospital.

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What's her BP?

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Ms Warren had been referred complaining of severe pain

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and numbness in her right leg.

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Symptoms consistent of Ms Warren's medical history of Type 2 diabetes.

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Hello. Thanks.

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Hiya, so... Elaine Warren.

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And while Ms Warren's condition was serious,

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it was in no way life-threatening.

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Ms Warren was in the best possible place

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to receive the best possible care.

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She did not receive it.

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Now, this trial is about a man, an expert in his field.

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who failed his duty of care.

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A Consultant Surgeon and Clinical Lead whose poor leadership,

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lack of communication and arrogance,

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contributed to a series of basic errors.

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A man who was distracted, angry, out of his depth.

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And whose absence from his ward

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was to have catastrophic consequences.

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On the 3rd of October at 2:15am

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Elaine Warren died as a result of complications from sepsis.

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Undiagnosed,

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untreated

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until too late.

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We will show that Elaine Warren's death

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was not only entirely avoidable,

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but that it was criminal.

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The result of a series of mistakes and missed opportunities,

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by the defendant, Mr Eric Griffin, that amount to gross negligence.

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That amount to manslaughter.

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Still doing that stupid trick?

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Master this and you can be a great surgeon. You taught me that.

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What's your secret - skipping into work, good as new?

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My injuries were less serious than yours, Ollie. That's all.

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-BEEPER

-No miracle. Just dumb luck.

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Serena. I have to go.

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SHE GRUNTS Not quite "good as new", then?

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Don't run before you can walk, Valentine.

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-What are you doing?

-Walking.

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-You're a stubborn fool.

-Takes one to know one.

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-What are you trying to prove?

-I'm ready.

-To do what?

-To go home.

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I want to be discharged.

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Today.

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Bold strategy, Valentine. Let's see if it pays off for you.

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Thought you were supposed to be at the trial?

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-Here.

-What's this?

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Month's holiday. Signed off.

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I didn't ask for any holiday.

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That's the problem. You've accrued too much.

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HR is insistent. Use it or lose it. I suggest the former.

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-Ah. Bon voyage.

-A month? What would I do with myself?

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Sit on a beach? Read a book?

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Plot the violent downfall of all your enemies, real and imagined?

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Pretend to have fun. You might actually have some by accident.

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-I have to go.

-How's he holding up?

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You know Ric...

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He's...angry.

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-About what?

-Everything.

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No-one knows what really happened that day...

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That's what the trial is for, isn't it? To find out what really happened.

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If it pleases M'Lady, the prosecution calls Donna Jackson...

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Ms Jackson.

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You were the ward nurse on duty.

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Can you tell the court what it was like that morning?

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Busy. By 8:30am occupancy was at 93%,

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with an unusually high quota of Hasselhoffs.

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It was like there was a full moon, right?

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Your mother-in-law will be so proud.

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Can we get some bolt-cutters, please?

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OK, everyone, listen up.

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45 minutes ago, St Francis declared Black Alert and closed its doors.

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25 minutes ago, there was a four-way pile-up on the motorway.

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MAJAX could be called any minute.

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Expect delays on labs, and Radiology. And all non-urgent cases to be sent home.

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OK, you know what to do.

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This is AAU. We're swamped down here.

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Any chance of someone getting me some agency bods? Thanks.

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Hello. Elaine Warren, is it?

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Listen, we are a little bit mad in here today, but don't worry.

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

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Have you got a minute? I've got a Type 2 diabetic with pain in her lower right leg.

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-You all right?

-Donna, I'm...

-PHONE RINGS

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Yes?

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Understood.

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The Trust have activated the Major Incident Plan.

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-Was expecting that...

-What the hell is Hanssen thinking?

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We cannot cope with this. Not here. Not today.

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Let's look at this diabetic of yours.

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'A major incident is declared when the number of admissions requires

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'implementation of a plan designed to ensure

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'that all the emergencies can be treated.'

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Non-urgent cases are sent home. Staff and resources are redeployed

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where needed, but there's never enough.

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It's like plugging holes in a dyke with your fingers.

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Mr Richardson to day care and Mrs Clarke to be sent home.

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Yes, yes. OK, thank you very much, bye-bye.

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Oh, sorry. Didn't see you there!

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-I was just on a training course and...

-She smells of alcohol.

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Your diabetic. Elaine Warren.

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-She's been drinking.

-I noticed.

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Doppler shows a very low pulse in the lower right leg.

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Could be ischemic. Need a CT angiogram to be sure...

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Ah! Thank goodness.

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The cavalry's arrived. I take it that Mr Di Lucca is on his way?

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Raf's not coming and I'm not staying, either I'm afraid.

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We've both being seconded to the ED.

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-On whose orders?

-Who do you think?

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Yes, I understand your concerns, but there is really nothing I can do.

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-We are the designated primary...

-We don't have the staff!

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We don't even have the proper equipment or the expertise!

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The hospital has had to make difficult choices recently.

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We don't have to be the primary designation for this MAJAX.

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We are stretched to breaking point.

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-I know. I'm sorry.

-'Is it unusual for the Clinical Lead to question

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'the CEO's decision so publicly?'

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Er... He was worried about patient safety.

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And yet, he left his ward and his patients when he should have been

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carrying out a Major Incident Plan.

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It's all a bit chaotic, don't you think?

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I wouldn't describe it as that, no. It was just...

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..a difficult day.

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Any more or less difficult than similar major incidents

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that you've dealt with?

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-Not for me, no.

-Not for you.

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Now, you've worked with Mr Griffin on several major incidents.

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Has he ever left the ward to question the CEO's decision before?

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Not to my knowledge. No.

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-You seen Fletch?

-Yes.

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-Why?

-There are literally thousands of reasons I could be wanting to

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-know where Fletch is.

-Yes.

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But what is the actual reason?

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Why are you so interested?

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You have an...aura about you. Excitement...

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-Happiness, perhaps.

-He did Emma a favour and I wanted to say

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-thank you. Why am I having this conversation with you?

-Bantz...

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What's that?

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Nothing I'm interested in.

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-Where's Fletch?

-There.

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HE CHUCKLES

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-Jacky!

-Oh, no...

-So good to see you!

-Please make it stop.

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Same old Jacky!

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I'll organise a bed.

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Buns so tight you could eat marmalade off them.

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Er... What are you doing here?

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-Surgery's not for months.

-I've had a setback.

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After you diagnosed the HCM, I took some time off to chillax. Have some me time.

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All was fine until last week, when I had several fainting spells.

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So they booked me in here.

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What exactly did you do during this me time?

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Bit of this, bit of that.

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Your median blood pressure is running at 140/90.

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That's a 30% spike in six weeks.

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And your blood sugar levels are all over the place.

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-Are you pregnant?

-What?! No!

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What makes you say that?

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You've put on a stone. That's a lot of kale smoothies.

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I haven't been exercising as much as I used to.

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Any...type of exercise.

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OK. We'll run some tests.

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Can I get a chest CT?

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-How is Becky doing?

-Frisky. Surprised your ears weren't burning.

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You have buns to die for, apparently.

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Well, I have been working out. Nice that somebody noticed.

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Frieda says you want me?

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I don't want you.

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To talk.

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Oh, yeah. That. Erm...

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Kid Karate, Emma was accepted, so your letter was great.

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Fantastic! She must be over the moon.

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-She is. Thank you.

-Well, it was more Evie than it was me, so...

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Still, it was bizarrely important to her, so thank you again.

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Well, to celebrate, do you fancy a drink?

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-Yeah, OK.

-All right.

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-Great.

-I'll pick you up after shift.

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-What?

-I don't know what's more surprising -

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that Fletch asked you out on a date, or that you actually said yes.

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Date? I don't know what you're talking about.

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A trial period in which two people consider taking their relationship

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to a more permanent, sometimes intimate...

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That is not what just happened. It's not a date.

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I don't date. And definitely not Fletch.

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You keep telling yourself that.

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By 10:45am, Elaine Warren's condition had worsened.

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-Is that correct?

-She had complained of feeling unwell, yes.

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These are your notes from that day.

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"Patient clammy; temperature 38.2, heart rate 110. Appears drowsy."

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What treatment was given for these symptoms?

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Er... Fluids, oxygen,

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vitamins and glucose.

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Blood tests had come back showing Ms Warren's blood alcohol count

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-was 18.

-So it was assumed she was hungover?

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It was known that she was intoxicated.

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-And that explained those symptoms?

-Some. Not all.

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What else could explain those symptoms?

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Any number of things.

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Could sepsis explain them?

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Ms Jackson? Could sepsis explain those symptoms?

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Yes, but without a CT angiogram there was no way to know that it was

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that serious. And by then, things were delayed.

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Priority were given to MAJAX casualties.

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Radiology has had to bump all non-urgent scans.

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-They're completely backed up.

-No, no, no. They do not decide who is urgent and who is not.

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Um... Get on the phone and I'll speak to them myself.

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OK.

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Radiology, please.

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Hi, it's AAU. Mr Griffin would like to speak to Ms Randall.

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We're ALL busy. He's insisting.

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That lady - she's asking after her son?

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Next of kin details should be on the system.

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Ms Randall?

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One moment, please. Ric!

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He's just coming.

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INDISTINCT CHATTER

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Look, I'm going to have to pop out.

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-Is there a problem?

-No.

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It's...family stuff. Is there anything outstanding?

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Just Ms Warren's angiogram.

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-Hello, Jenny.

-It's Ric Griffin.

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I've got a 60-year-old,

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Type 2 diabetic with possible ischemia of the leg.

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Yes, I understand that, but the Doppler showed very weak pulse.

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I'm concerned that there might be a clot.

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All the blood thinners in the world aren't going to tell me what cause of the ischemia is!

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-Is it mad in there?

-Raf's just gone in with the last of the MAJAX

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casualties, so it should start to calm down now.

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-But we need more clotting factors and blood.

-I'll see what I can do. LOUD CRASH

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I'm going to have to go out.

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Can you keep an eye on Warren and page me if there's any change?

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-What about her angiogram?

-Like I say, Radiology will try and fit her in this afternoon.

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When was the next time you saw Mr Griffin?

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It was approximately three hours later.

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Did you know where he'd gone or why?

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No.

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And what was Elaine Warren's condition like at this time?

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By 1:30pm Ms Warren's blood pressure had dropped to 90/60.

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I paged Mr Griffin.

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Did you get any response?

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No. I later discovered later that his pager had been damaged and he

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hadn't received it. When he returned to the ward at 3pm, I immediately informed him.

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Elaine Warren's blood pressure is 90/60.

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But by then it was too late, wasn't it?

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A bit leading don't you think, M'Lady?

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I beg your pardon. I'll rephrase.

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Would it be fair to say that by the time you next saw Mr Griffin

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back on the ward, Elaine Warren was already dying?

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Yes.

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Saline. Push fluids. Colloid and Hartmann's, stat.

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The CT angiogram.

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She's septic. The limb looks completely dead.

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We're going to have to amputate.

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-Let's get her to theatre now.

-Amputate?

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It's everywhere. It's spread so quickly.

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Ric?

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Ms Jackson, one last question.

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Are you familiar with the medication heparin?

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It's a blood thinning agent.

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In his statement to police, Mr Griffin claims he instructed you

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to have a registrar write up a heparin prescription for Ms Warren.

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Do you have any recollection of that?

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The thing is, I now believe there was a mix-up...

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Unfortunately, the court can't hear what you believe, Ms Jackson.

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Mr Griffin repeatedly insisted

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that he had instructed you to get a registrar to prescribe Ms Warren

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the heparin that could have saved her life.

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Do you have any recollection of that?

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-No.

-Thank you, Ms Jackson.

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No further questions.

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-You disapprove.

-I think it's precipitous.

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I'm getting stronger every day.

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-I can look after myself.

-Prove it.

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You make your way to the toilet and back, unaided,

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no Zimmer frame, and I will personally sign your discharge form.

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Easy peasy.

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-Where are you going?

-The loo.

-You have stairs in your flat, right?

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Yes.

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Do you see any stairs between here and the Keller toilet?

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No.

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What toilets were you thinking of?

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Darwin.

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-Bad news?

-There are fatty changes in the liver.

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Whatever is causing this is new. It's not related to your HCM.

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-So now I have two serious conditions?

-We don't know that yet.

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-We're going to do a TOE and work out exactly what's wrong with you.

-It's a date!

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-Date?

-The TOE thingy.

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Ms Naylor doesn't do dates.

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Bit young to have taken yourself off the market aren't you, Jacky?

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I'm a single mother with a great career, not a prize cow.

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Speaking of prize beef... Oof!

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You couldn't put a word for me, could you?

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With Fletch. Be my wingman.

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I've tried, but he just can't take a hint.

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Unless you're interested?

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-Don't be ridiculous.

-Cos you're off the market, right?

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-That's right.

-Well, then?

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Yeah, I'd be happy too, Becky.

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-Amazeballs!

-Except he is spoken for.

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-He is?

-He is?

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Who is the lucky cow?

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Yeah. Who is this "cow"?

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Er...

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He's met someone at the...martial arts class that Evie attends.

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-Kid Karate!

-Oh. you know it?

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My Bella got a place there last term.

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That's great...

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I'm needed on Keller but let's talk more about this lucky cow, yeah?

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I'm going to arrange that TOE.

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Jacky?

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Are you in pain?

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You're favouring your left side.

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This usually indicates pain in the T10/T11 region.

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Physiotherapist, remember?

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It's just a twinge. I'll be fine.

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Urgh!

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Sit.

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I can't. It's cheating. Something old Oliver would do.

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Oliver 1.0.

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You're not the old Oliver any more. Sit.

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-How did you know?

-I've got my spies.

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Come on, press the button.

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-Did you ask me on a date?!

-Blimey, Jac! You scared the living...

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I'm sorry. Did you ask me on a date?

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-What?

-Earlier when you suggested a drink.

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-Did you mean...?

-It was a date? No!

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Ah... Right.

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Just a drink.

0:21:150:21:17

OK. Great.

0:21:170:21:19

Between mates.

0:21:190:21:20

Yeah. Good. I'm glad we cleared that up.

0:21:200:21:24

Not unless you wanted a...?

0:21:240:21:26

-No! That would just be...

-Ridiculous.

0:21:260:21:29

-Hideous.

-Right...

0:21:290:21:31

-I'm really sorry about your coffee.

-Don't worry about the coffee...

0:21:330:21:36

PAGER BEEPS

0:21:360:21:39

HE CHUCKLES

0:21:390:21:42

It's Serena.

0:21:420:21:43

Donna's evidence hasn't gone down too well.

0:21:470:21:50

Well, she is a witness for the prosecution.

0:21:500:21:53

I should call Donna and see if she's OK.

0:21:530:21:55

-You all right?

-Yeah, fine.

0:21:580:22:00

-You don't look fine.

-Just leave it, Fletch.

0:22:000:22:02

OK.

0:22:040:22:05

Yeah, I'm just going back in now.

0:22:090:22:11

Thanks, Fletch. OK. Bye.

0:22:110:22:14

Amira?

0:22:160:22:19

You're a bit early, aren't you?

0:22:190:22:20

Defence's case isn't until this afternoon.

0:22:200:22:23

I'm not here for the Defence.

0:22:230:22:25

The prosecution calls Amira Zafar.

0:22:250:22:27

What's this, my locker?

0:22:380:22:41

Yeah, as far as I know, it hasn't been touched since the...

0:22:410:22:45

-I remembered.

-Or could be muscle memory.

0:23:040:23:06

Theatre tickets?! I don't remember liking theatre.

0:23:110:23:14

It's two tickets.

0:23:140:23:16

Maybe you were trying to impress a girl.

0:23:160:23:19

I don't remember a girl either.

0:23:190:23:21

Why have you brought me here?

0:23:240:23:25

You are discharging yourself, against Ms MacMillan's advice.

0:23:260:23:31

You want to start new life.

0:23:310:23:34

You've got to leave your old life behind.

0:23:340:23:37

This is your old life.

0:23:370:23:38

-I'll be back. Believe me.

-PAGER BEEPS

0:23:420:23:45

It's Jac. I have to go.

0:23:460:23:48

-Can you get yourself back to Keller?

-I'll manage.

0:23:480:23:51

I'll take you to the elevator.

0:23:510:23:54

Thank you.

0:23:540:23:55

Ms Zafar, can you tell us how you came to be on AAU that day?

0:23:550:24:00

I wasn't even supposed to be working that day.

0:24:000:24:02

I was supposed to be finishing a MIMS training module.

0:24:020:24:06

But then it all kicked off and I was sent to help out on AAU.

0:24:060:24:11

And what were your impressions when you arrived on the ward?

0:24:110:24:14

Chaos.

0:24:140:24:16

What are you doing, just standing there?!

0:24:160:24:18

Sorry. I was on a training course but they said...

0:24:180:24:20

-Just stand out of the way until someone can show you what to do.

-She stinks of alcohol.

0:24:200:24:24

Elaine Warren. Your diabetic.

0:24:240:24:27

They never learn. Doppler shows a very weak pulse, lower right leg.

0:24:270:24:31

Might be ischemic. Need to do a CT angiogram just to be sure.

0:24:310:24:35

-Well, about time! Where's Di Lucca?

-Raf's not coming and I'm not staying.

0:24:350:24:38

-We've both been seconded to ED.

-On whose orders?

-Whose do you think?

0:24:380:24:42

Hanssen!

0:24:420:24:44

And what were your impressions of Mr Griffin?

0:24:440:24:47

Formidable.

0:24:500:24:51

Angry. Frustrated.

0:24:520:24:55

Cold.

0:24:550:24:56

-Distracted?

-Distracted?

0:24:570:25:00

-In what way?

-Like he had the weight of the world on his shoulders.

0:25:000:25:04

Excuse me, um...

0:25:100:25:12

Can we take a break?

0:25:130:25:14

-A break?

-I took some heart burn tablets for my nerves earlier

0:25:140:25:19

and they've gone through me like a dose of salts.

0:25:190:25:22

M'Lady?

0:25:230:25:24

All rise.

0:25:260:25:27

OK. You win.

0:25:530:25:55

You summoned me, O Dark Mistress.

0:26:020:26:04

Close the door before anyone sees.

0:26:040:26:06

Are you OK?

0:26:130:26:15

Do I look OK? I need another shot.

0:26:150:26:18

-Don't act dumb. The triamcinolone.

-No.

0:26:190:26:23

-What?!

-The last shot should have lasted you over a month.

0:26:230:26:27

The fact you're back where you started means you really need to

0:26:270:26:31

address the source of your pain and not the symptoms.

0:26:310:26:33

-Stop talking like a therapist.

-If you stop talking like a junkie.

0:26:330:26:36

Jac, it's time to talk to somebody...

0:26:360:26:39

-Just get out!

-It's time to talk to somebody about what you've been

0:26:390:26:44

going through. Fletch?

0:26:440:26:45

-You breathe one word of this to him and I'll ruin you.

-Oh, wow! You're being ridiculous.

0:26:450:26:50

With your petty threats and your fear of being vulnerable.

0:26:500:26:53

-What are you talking about?!

-You have to address your feelings

0:26:530:26:56

for Fletch or is going to get very messy.

0:26:560:26:58

All right, then, Freuda! How's this any different to you pining after Oliver?

0:26:580:27:02

You think I haven't noticed you hovering around him like some pathetic guardian angel?

0:27:020:27:07

He never loved you before. He's not going to start now.

0:27:070:27:10

It doesn't matter how much brain damage he suffers.

0:27:100:27:13

Oh... All right. You're on your own.

0:27:130:27:18

Good. That's just how I like it.

0:27:180:27:19

-I can explain.

-We're not supposed to talk.

0:27:270:27:30

How could you do this? You're supposed to be on our side.

0:27:320:27:35

-I am on your side.

-"Cold, frustrated and "distracted".

0:27:350:27:38

You're making us sound awful. It wasn't like that.

0:27:380:27:41

It was like that. For me.

0:27:410:27:42

I'm sorry.

0:27:440:27:45

Will all parties in the case of Griffin please return to Court One?

0:27:450:27:50

Aw! Good luck!

0:27:530:27:56

Look after yourself.

0:27:570:27:59

Right. Well, I guess this is it.

0:28:060:28:08

It's not like it's over between us.

0:28:100:28:12

I think you still have some stuff in your locker on Darwin? Would you like me to forward it on?

0:28:120:28:16

No, I'll be back to pick it up. As a surgeon. Sooner than you think. You'll see.

0:28:160:28:21

Going home?

0:28:310:28:33

-Yeah.

-You're either very brave, or very stupid.

0:28:330:28:36

Good luck.

0:28:360:28:37

You've described a ward in chaos.

0:28:480:28:51

What happened the next time you saw Mr Griffin?

0:28:510:28:55

By 11, things had calmed down.

0:28:550:28:59

I was mucking in as best I could.

0:28:590:29:02

OK, my love, I'll see what I can do.

0:29:020:29:04

-And there was this woman.

-We're all busy.

0:29:040:29:08

She was asking after her son.

0:29:080:29:10

That lady's asking if her son's been told she's here?

0:29:100:29:14

Warren? Well, check the patient history.

0:29:140:29:17

Ms Randall? One moment, please. Ric!

0:29:190:29:22

I might have to go. Family stuff.

0:29:230:29:25

-Is there anything outstanding?

-Only the diabetic's angiogram.

0:29:250:29:29

Hello. It's Ric Griffin here.

0:29:320:29:33

Look, I've got a 65-year-old,

0:29:330:29:35

Type 2 diabetic with possible ischemia of the leg.

0:29:350:29:39

I need a log in.

0:29:400:29:42

All the blood thinners in the world aren't going to tell me what's actually causing the ischemia!

0:29:420:29:47

Got it!

0:29:480:29:50

Radiology can't fit her in until this afternoon at the earliest.

0:29:500:29:56

So, we'll have to buy time. Get Raf to write up a script

0:29:560:29:59

for therapeutic heparin and administer it.

0:29:590:30:03

30-minute obs until I get back. OK?

0:30:030:30:05

Um... Are you...?

0:30:050:30:08

HUGE CRASH

0:30:080:30:11

I wondered if I should ask if he was speaking to me.

0:30:110:30:16

Clarify. But when I saw him with the ward nurse, I assumed that his

0:30:160:30:19

instructions had been passed on.

0:30:190:30:21

Like I say, Radiology will try and fit her in this afternoon.

0:30:210:30:24

And then, he was gone.

0:30:240:30:26

Is there a Dr Raf here?

0:30:260:30:28

Yeah, he's busy elsewhere. Why?

0:30:280:30:30

Nothing. I thought that I might have been asked to do something.

0:30:300:30:33

But I must have heard wrong.

0:30:330:30:35

But I didn't hear wrong. I realise that now.

0:30:350:30:38

Mr Griffin may have thought he was speaking to someone else.

0:30:390:30:44

Someone who...might have understood what he needed.

0:30:440:30:49

But I was the only one listening. And I didn't understand.

0:30:490:30:53

Maybe I should have asked.

0:30:530:30:55

But that day I kept my head down and my mouth shut.

0:30:550:31:01

And...that poor old woman died.

0:31:030:31:07

And I'm so sorry.

0:31:080:31:10

I'm sorry.

0:31:150:31:16

He thought he ordered those blood thinners.

0:31:180:31:20

He thought I understood...

0:31:200:31:22

Ms Zafar, is an agency nurse accountable for diagnosing

0:31:220:31:26

and setting up treatment plans for patients?

0:31:260:31:30

No, the consultant is, but...

0:31:300:31:32

And did you "understand" that Mr Griffin, the consultant in charge,

0:31:320:31:37

was ordering you to arrange a course of heparin for Ms Warren?

0:31:370:31:41

-Not at the time. No.

-Thank you, Ms Zafar.

0:31:430:31:46

No further questions.

0:31:460:31:47

If it pleases the court, I have an agreed statement from Jeremy Warren.

0:31:520:31:56

He is unable to attend due to ill health.

0:31:560:31:58

On the 2nd October 2017,

0:32:030:32:04

I received a message from a nurse at Holby City Hospital

0:32:040:32:08

telling me my mother, Elaine Warren, had been admitted with a sore leg.

0:32:080:32:14

It was not considered serious.

0:32:140:32:17

I never saw or spoke to my mother alive again.

0:32:170:32:21

I spent the next few weeks trying to make sense of what had happened.

0:32:220:32:26

Why there was a delay on recording a cause of death,

0:32:260:32:30

why a 65-year-old woman could die from "a sore leg".

0:32:300:32:36

But there was no explanation.

0:32:360:32:39

When I finally met the consultant in whose care my mother had been left,

0:32:390:32:43

he could not remember her name correctly.

0:32:430:32:46

Jeremy Warren.

0:32:460:32:48

M'Lady, that is the case for the prosecution.

0:32:480:32:51

All right?

0:33:010:33:03

Yeah, just looking for some prolene.

0:33:030:33:06

Up here I think.

0:33:060:33:08

Just had a really odd conversation with Becky.

0:33:080:33:11

She seemed to think I was seeing someone. Didn't say why.

0:33:110:33:15

Must be because I washed under my pits this morning!

0:33:150:33:17

Or maybe it's because you're fit and healthy and generous and honest.

0:33:170:33:24

OK... Who are you and what have you done with Jac Naylor's corpse?

0:33:240:33:27

I could say all the same things about you, you know?

0:33:300:33:33

Are you all right? Talk to me.

0:33:380:33:41

Serena's given me four weeks off. Apparently, I'm owed it.

0:33:430:33:46

Wow. Um...

0:33:480:33:50

What are you going to do?

0:33:500:33:52

Do you want to come away with me?

0:33:520:33:54

-What?

-Just get out of here. Go anywhere.

0:33:550:34:00

Throw a dart at a departure board and see where we end up.

0:34:000:34:03

It has its appeal.

0:34:050:34:06

-But...

-But?

0:34:080:34:11

There's things to consider.

0:34:110:34:13

-Cover. Money. The kids...

-PAGER BEEPS

0:34:150:34:18

I've... I've got to go.

0:34:230:34:24

So, when's the next contestant enter the stage?

0:34:310:34:33

-What?

-Gaskell's trial.

0:34:330:34:35

Firstly, it's Professor Gaskell to us.

0:34:350:34:38

And secondly, they're not contestants.

0:34:380:34:40

They're very ill people helping a great scientific endeavour.

0:34:400:34:43

-And thirdly?

-Thirdly?

0:34:450:34:47

The way you were speaking implied there was a third, definitive point.

0:34:470:34:50

Nope. No third point.

0:34:530:34:55

Hey... I've had a bit of an accident,

0:34:550:34:58

but I'd appreciate if you didn't tell Roxanna.

0:34:580:35:01

SOBBING

0:35:120:35:16

Hello?

0:35:170:35:19

Don't mind me.

0:35:190:35:20

Becky?

0:35:270:35:28

I think we've found the cause of the hypertension then.

0:35:320:35:35

I don't know what's wrong with me.

0:35:350:35:37

The defence calls Eric Griffin.

0:35:380:35:41

Do you remember the events of 2nd October, 2017?

0:35:410:35:46

I beg your pardon?

0:35:500:35:52

I asked if you remember the events of 2nd October, 2017?

0:35:520:35:56

I am unlikely ever to forget them.

0:35:560:35:57

Was there anything in particular that was different about that day?

0:35:570:36:02

Other than the death of one of my patients?

0:36:020:36:04

That was how it ended. Could you tell us about how it began?

0:36:040:36:08

I had had some troubling news from my daughter in Australia.

0:36:130:36:18

She'd written to say that she was reconciling with her ex-husband.

0:36:190:36:24

Are you crazy? He will kill you!

0:36:320:36:34

I forbid it, Jess! I absolutely forbid you to see this man again!

0:36:340:36:37

I will not allow it!

0:36:370:36:39

Please, Jess. Can we just talk about this?

0:36:390:36:42

Calmly, rationally.

0:36:420:36:45

Think of Jacob. Jess...

0:36:450:36:47

Please. Just call me.

0:36:470:36:49

I'm sorry for getting angry. Just call me...

0:36:490:36:53

MESSAGE ALERT

0:36:590:37:02

KNOCK AT DOOR

0:37:090:37:12

Have you got a minute?

0:37:120:37:13

I've got a Type 2 diabetic with pain in her lower right leg.

0:37:130:37:17

You all right?

0:37:170:37:19

I had tried to call her several times and I was expecting her to call back.

0:37:190:37:26

Well, I was hoping desperately that she would.

0:37:260:37:31

She's been drinking.

0:37:310:37:32

Yes, I was frustrated. I may have been angry.

0:37:320:37:37

Short-tempered with colleagues...

0:37:370:37:40

-On whose orders?

-Whose do you think?!

0:37:400:37:42

..and management.

0:37:420:37:44

Was I cold?

0:37:440:37:46

Was I distracted?

0:37:460:37:48

Family traumas happen. We all have them.

0:37:480:37:51

The professional pushes them to the back of the mind and gets on with

0:37:520:37:58

his job regardless of how he feels.

0:37:580:38:02

My phone did ring. But it wasn't Jess, my daughter.

0:38:050:38:10

It was a friend.

0:38:100:38:13

A good friend of mine who needed my help.

0:38:130:38:17

So I gave it, as friends do.

0:38:180:38:22

I tied up all my loose ends I thought I had and I left the ward.

0:38:220:38:28

If you like, yes, I took my eye off the ball.

0:38:300:38:33

And that's all there is to say about that.

0:38:350:38:38

You left the ward to help a friend?

0:38:380:38:40

-Yes.

-What did you do?

0:38:400:38:42

-Did you hurt her, Jason?

-This is my blood. She bit me.

0:38:430:38:47

I pushed her. She fell. Hurt her head.

0:38:480:38:51

I called Auntie Serena and she said you would help.

0:38:520:38:56

But now it's her tummy that hurts.

0:38:560:38:58

-Why didn't you take her straight to the ED?

-Lola will go to jail.

0:38:580:39:02

She can't go to jail.

0:39:020:39:04

I'll take a look. You stay here.

0:39:090:39:10

-Lola?

-Are you the doctor friend?

0:39:120:39:14

Yes. Jason said you hurt your head.

0:39:140:39:17

It's just a scratch. I tried to tell him that but he kept banging on about Elinor.

0:39:170:39:20

Things have escalated since then... Argh!

0:39:200:39:23

I can see...

0:39:250:39:27

Lola, is Jason aware that you're about to give birth?

0:39:270:39:32

He's autistic, he's not stupid.

0:39:320:39:34

-What are you doing?

-Doing what you and Jason should have done an hour ago.

0:39:360:39:39

-I'm going to call for assistance.

-You can't...

-Don't be ridiculous.

0:39:390:39:44

If you make that call, then I'll say it was Jason who did this.

0:39:440:39:47

Those bruises are days old. Who did do this to you?

0:39:470:39:51

Doesn't matter. What matters is no hospitals.

0:39:510:39:53

No authorities. Or Jason's prime suspect...

0:39:530:39:57

What is wrong with you?!

0:39:570:39:59

Everything.

0:39:590:40:00

Argh!

0:40:000:40:03

As I said, that's all there is to say about that.

0:40:060:40:08

-You've nothing to be afraid of.

-The wrong side of 30.

0:40:100:40:13

Single mum. A career built on the ability to sustain

0:40:130:40:18

peak physical fitness. I've got everything to be afraid of.

0:40:180:40:22

But I try and hide it.

0:40:230:40:25

Pretend.

0:40:250:40:27

And where better to hide but in that.

0:40:270:40:30

You wouldn't understand.

0:40:300:40:32

Maybe I do.

0:40:320:40:34

Maybe I just self-medicate differently.

0:40:360:40:38

I have a friend, Milos,

0:40:420:40:44

he specialises in scar tissue neuropathy.

0:40:440:40:47

Do you want me to call him?

0:40:470:40:48

You should have stayed in Physio.

0:40:500:40:52

You didn't finish. You went back to work too soon.

0:40:520:40:55

And it shows. You're in pain.

0:40:550:40:58

You must have been in pain for months.

0:40:580:41:00

Why?

0:41:030:41:05

I had to work.

0:41:060:41:07

I had to have purpose and pain was the price.

0:41:090:41:12

It was also a useful reminder never to let your guard down

0:41:140:41:18

because when that happens people get hurt.

0:41:180:41:21

And maybe it's your fault, so what's a little pain compared to that?

0:41:240:41:27

You can't tell anyone...

0:41:300:41:33

Becky?

0:41:330:41:34

Becky! Wake up!

0:41:350:41:37

Becky!

0:41:390:41:41

Come on. Wake up, please. I need some help here!

0:41:410:41:44

And some adenosine!

0:41:440:41:46

Becky?

0:41:460:41:48

-What's going on?

-She's in SVT.

0:41:490:41:52

Stay with me. Stay with me, come on!

0:41:520:41:55

Come on. Good, good. You scared us there for a minute.

0:41:550:41:59

-You're going to be fine. Get that TOE ASAP.

-Yeah.

0:42:000:42:04

Someone forgot to remind me about the hidden step between the bedroom and the en suite...

0:42:060:42:12

-Feel free to say "I told you so".

-Is there any point?

-Might make you feel good.

0:42:120:42:15

-Won't make you less obstinate.

-I've always been hard-headed.

0:42:150:42:18

-That, I'm aware of, it's the mushy bits inside I'm worried about.

-I slipped. It happens all the time.

0:42:180:42:22

-I just need to be more careful.

-You need to be more realistic!

0:42:220:42:26

You keep setting yourself impossible goals and then cheating when you can't meet them.

0:42:260:42:31

Yes, I know Ms Petrenko helped with your little promenade earlier.

0:42:310:42:34

Thank you, Dr Chowdhury. Nice work.

0:42:340:42:37

I'd have given anything to have seen you walk up those stairs to Darwin,

0:42:400:42:43

back to your old life, but I'm not John Gaskell.

0:42:430:42:47

I can't perform miracles. I'll get you out of here.

0:42:470:42:49

Get you home. Get you..."back".

0:42:490:42:53

But it takes time.

0:42:540:42:56

What happened to "you're on your own"?

0:42:590:43:01

-Appears we're inextricably linked.

-Like symbionts?

0:43:030:43:08

Like parasites.

0:43:100:43:12

You say potato. You see that?

0:43:120:43:15

Ventricular hypertrophy.

0:43:160:43:18

-Certainly is.

-What caused it?

0:43:180:43:21

Fried chicken. Becky's diet changed somewhat in the last six weeks.

0:43:210:43:25

Somewhat? Her aortic wall has thickened and she's exhibiting signs of atherosclerosis.

0:43:250:43:31

None of which will stop me from performing a myectomy.

0:43:330:43:35

We've had a cancellation, so I'll do it today.

0:43:350:43:39

I don't think that's a good idea.

0:43:390:43:40

Atherosclerosis doesn't affect risk factors of a myectomy.

0:43:410:43:46

I agree she needs surgery. I don't think you will be doing it.

0:43:460:43:49

You dropped this.

0:43:490:43:50

You need help. Go see Fletch.

0:43:560:43:58

Shove it, Petrenko!

0:43:580:44:00

I promised Becky I'd fix her and I mean to do so.

0:44:000:44:03

If you won't go see Fletch, I will.

0:44:050:44:07

Do that and you can kiss your training goodbye.

0:44:090:44:12

I fall - you fall.

0:44:120:44:14

We amputated Mrs Warren's leg, but the sepsis was too widespread.

0:44:180:44:24

There was nothing that we could have done to save her.

0:44:240:44:28

So we moved her to ITU.

0:44:300:44:32

The Intensive Treatment Unit,

0:44:330:44:36

where she later died.

0:44:370:44:40

Where were you when that happened?

0:44:400:44:41

I was with Mrs Warren.

0:44:430:44:44

Do you usually sit with dying patients?

0:44:470:44:51

No.

0:44:510:44:52

I want to go back to the three hours you were gone from the ward.

0:44:550:44:59

SCREAMS

0:44:590:45:03

-That's it, Lola. That's it. Not long now.

-You said that half an hour ago!

0:45:030:45:06

I don't think you're in any position to criticise my bedside manner.

0:45:060:45:13

Who hurt you, Lola?

0:45:190:45:21

Boyfriend.

0:45:220:45:24

Ex-boyfriend.

0:45:240:45:26

-Your father?

-Yeah.

0:45:260:45:28

We can go to the police, you know. Even if you're in trouble with them.

0:45:300:45:34

He is the police.

0:45:340:45:36

BEEPING

0:45:360:45:39

I said no authorities!

0:45:390:45:42

It's coming. It's coming.

0:45:450:45:48

Breathe.

0:45:480:45:49

-Push!

-Urgh!

0:45:490:45:51

Yes.

0:45:530:45:54

-Well done.

-BABY CRIES

0:45:540:45:57

It's a girl.

0:45:590:46:00

What for? I was gone. What I was doing is irrelevant.

0:46:100:46:14

It goes to character.

0:46:140:46:16

I wasn't aware it was my character on trial?

0:46:160:46:19

Mr Griffin, your character as a person and a surgeon goes to...

0:46:190:46:23

No matter where you go, there you are.

0:46:230:46:26

I'm sorry?

0:46:260:46:28

No matter where you go, there you are.

0:46:280:46:31

It's a piece of graffiti on the wall of my cell in prison.

0:46:310:46:36

-What is this place?

-It's a refuge. For women. They will provide medical attention.

0:46:360:46:41

Somewhere to stay. Some support. No authorities.

0:46:410:46:45

-Not unless you ask for them.

-How did you know about all this?

0:46:450:46:48

My daughter...

0:46:500:46:52

Let's just say I've had reason to know about this place.

0:46:530:46:57

All right. Now...

0:46:570:47:00

This should keep you going for a little while.

0:47:000:47:05

Jason will see you in.

0:47:060:47:07

-I've got to come back.

-But he'll come looking for me.

0:47:070:47:11

He can try. Look, what happened today stays between us.

0:47:110:47:17

-OK?

-I don't know how to thank you.

0:47:170:47:20

Never go back.

0:47:240:47:25

Never.

0:47:270:47:28

He will never change.

0:47:290:47:31

No matter where you go, there you are.

0:47:400:47:43

What does it mean?

0:47:430:47:45

It means it doesn't matter where I was for those three hours.

0:47:450:47:49

It doesn't matter what I did or why. Elaine Warren is dead.

0:47:500:47:55

She was my patient, my responsibility.

0:47:560:48:00

The responsibility that we assume as consultants.

0:48:000:48:04

The oath that we swear as doctors.

0:48:040:48:07

Every death hurts as it should,

0:48:090:48:12

but you're taught to move on because you have to.

0:48:140:48:19

Because you can't save everyone.

0:48:200:48:23

A distinguished professor from Johns Hopkins has testified that there was

0:48:250:48:29

nothing that could have saved Elaine Warren.

0:48:290:48:32

He may be right,

0:48:330:48:35

but regardless of the outcome of this trial,

0:48:360:48:39

Elaine Warren's death will haunt me

0:48:410:48:43

because I accept that I failed in my duty of care.

0:48:450:48:51

I did not kill Elaine Warren,

0:48:530:48:55

but I believe that I did not do enough to save her.

0:48:580:49:02

No matter where you go,

0:49:050:49:08

there you are.

0:49:080:49:09

Well, if it isn't Tweedle-dumb and Tweedle-dumber.

0:49:220:49:24

Step out, Jac. We need to talk.

0:49:240:49:27

I promised Becky I'd take care of her.

0:49:270:49:29

Becky will be taken care of. But not by you. Not today.

0:49:290:49:32

Guess I really am on my own.

0:49:390:49:41

Well, I have to hand it to Petrenko. That took guts...

0:49:450:49:49

Why didn't you tell me?

0:49:500:49:52

Why didn't you tell me what you've been going through?

0:49:550:49:58

What you ARE going though.

0:49:590:50:01

The pain...

0:50:010:50:03

I didn't know how.

0:50:050:50:07

Me and Petrenko are going to take care of Becky,

0:50:250:50:27

then you and me, we're going to talk.

0:50:290:50:31

About what?

0:50:320:50:34

About everything we haven't been.

0:50:350:50:37

You're nothing if not persistent.

0:50:550:50:57

Shouldn't you be off saving lives?

0:50:570:50:59

-Taking a break from all that stuff.

-Yeah. Me too. Sucks, right?

0:51:010:51:04

-Actually, I think it's time I focused on other things.

-Whatever.

0:51:050:51:09

-Ollie, stop doing that. It doesn't mean what you think it means.

-It's a motor skills test.

0:51:110:51:16

-Yes...

-If I can achieve this, I can achieve anything as a surgeon.

-It was a trick, OK?

0:51:160:51:21

-Just a stupid prank. That's all.

-I remember you telling me...

0:51:210:51:24

Yes, that mastering this would prove you were a great surgeon. But it was a prank.

0:51:240:51:29

A distraction.

0:51:310:51:32

Anything to get an annoying F2 to stop bugging me.

0:51:320:51:35

Why would you do something like that?

0:51:390:51:42

-I don't know. Because I...

-Because you're broken. Right?

0:51:420:51:47

Something inside you broke a long time ago.

0:51:470:51:52

And ever since you've become...

0:51:520:51:54

..more and more like a virus.

0:51:560:51:58

Parasite. Infecting and destroying everything you come across.

0:51:580:52:02

I don't even realise you do it. It's just in your nature.

0:52:020:52:05

-Like that scorpion that stings the frog...

-Yes. It is.

0:52:060:52:09

-I'm sorry.

-Are you? Will it stop you next time?

0:52:120:52:15

I don't know.

0:52:180:52:21

Goodbye, Valentine.

0:52:240:52:26

Goodbye, Jac.

0:52:280:52:29

The defence would like to call upon

0:52:350:52:37

someone to speak to Mr Griffin's character and standing.

0:52:370:52:40

The defence calls Mr Henrik Hanssen.

0:52:400:52:42

Eric Griffin has carried out thousands of operations.

0:52:450:52:49

His 90-day adjusted mortality rate

0:52:500:52:53

at 2.1% is rather below what one might expect,

0:52:530:52:56

for a surgeon who accepts high-risk patients.

0:52:560:53:00

He is a valued member of the Trust executive.

0:53:030:53:08

Gross negligence.

0:53:180:53:20

Not just negligence, but gross negligence.

0:53:210:53:25

Ric Griffin is the NHS.

0:53:300:53:33

Noble in intent, inflexible of conscience rational and objective

0:53:330:53:39

and yet full of a natural well of tremendous compassion.

0:53:390:53:45

I've never come across...

0:53:480:53:50

..a more principled...

0:53:510:53:53

..obstinate, yes, insubordinate, yes,

0:53:550:53:59

yet utterly loyal and brilliant surgeon.

0:53:590:54:04

I am privileged to call him a friend.

0:54:060:54:09

I say that Ric Griffin is like the NHS

0:54:110:54:14

because, like all human-made things, the NHS is flawed.

0:54:140:54:19

Like the people who make it work.

0:54:200:54:23

For we deal in empathy and yet we reserve

0:54:260:54:30

very little of it for ourselves.

0:54:300:54:32

Men and women of science, if you like.

0:54:340:54:37

Tilting at windmills.

0:54:370:54:39

Fighting battles we know can't be won.

0:54:400:54:42

And yet fighting them nonetheless.

0:54:440:54:47

Now, it is our nature to assign responsibility.

0:54:470:54:51

This is a necessary consequence of power.

0:54:510:54:54

Yet we must be very careful when we go on to apportion blame.

0:54:540:54:59

Elaine Warren was a Type 2 diabetic,

0:54:590:55:03

who ignored multiple care pathways

0:55:030:55:06

designed to help her deal with her condition.

0:55:060:55:09

Should we apportion blame to her?

0:55:090:55:12

Ric Griffin would not.

0:55:120:55:14

On the 2nd October 2017,

0:55:160:55:19

Holby City Hospital was primary receiver

0:55:190:55:22

for MAJAX victims of a motorway pile-up caused by a driver texting

0:55:220:55:29

while driving at 90mph. Should we apportion blame to him?

0:55:290:55:34

Ric Griffin would not. He did not.

0:55:340:55:36

Because all Ric Griffin sees are patients,

0:55:390:55:44

the treatment they require,

0:55:450:55:47

and his duty to provide it.

0:55:490:55:51

Ric Griffin always provides that treatment

0:55:530:55:56

to the very best of his ability.

0:55:560:55:59

Without fear, or favour, or prejudice.

0:55:590:56:02

It is human to be flawed.

0:56:050:56:09

Our grace is to take responsibility for those flaws.

0:56:090:56:14

Ric Griffin has always

0:56:190:56:22

taken that responsibility.

0:56:220:56:24

It is a very rare quality.

0:56:260:56:27

Ric Griffin is a rare man of character.

0:56:300:56:34

And if he is guilty

0:56:360:56:38

of gross negligence,

0:56:380:56:41

then so am I.

0:56:410:56:43

Aren't we all?

0:56:460:56:48

Yes, we have.

0:57:210:57:23

And do you find the defendant guilty or not guilty?

0:57:230:57:27

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