One Day at a Time Holby City


One Day at a Time

The clinical trial is heating up and it's time for Gaskell to live up to his reputation. Nicky tests Sacha's patience in a bid to prove her abilities.


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Transcript


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I'm a religious man. Can you imagine meeting someone

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who tells you he can make you walk again?

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The professor did this. Come...

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HE SOBS

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Mr Gaskell.

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Close.

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Raf's inheritance,

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I'm going to donate it to Professor Gaskell's stem cell research.

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When can we discuss how you're going to save my life, sexy man?

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Jac?

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-It's none of your business.

-I need you to stay in your job.

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I want to learn from the best

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and if you get fired I'll be stuck with your replacement.

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I've spent a lifetime being passed from one specialist

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to another without a sniff of a diagnosis.

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You're suffering with something known as Wegener's Granulomatosis,

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which has now been more conveniently renamed GPA.

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-You ready?

-Ready!

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HE EXHALES

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DISTANT SIRENS WAIL

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Tyger, Tyger, burning bright

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In the forests of the night

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What immortal hand or eye

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Could frame thy fearful symmetry?

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In what distant deeps or skies

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Burnt the fire of thine eyes?

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On what wings dare he aspire?

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What the hand, dare seize the fire?

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And what shoulder, and what art

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Could twist the sinews of thy heart?

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And when thy heart began to beat

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What dread hand? And what dread feet?

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WHIRRING

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Why exactly are you in an out-of-order toilet?

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Saw the sign, needed five minutes.

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Already?

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Essie had me in at five, obsessing over every detail.

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You should be chuffed you're involved.

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Not after a string of nights followed by three 12-hour days.

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Can you see these bags?!

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You know, it's pretty rare an F1 gets to assist

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on stem cell procedure.

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Nerve extraction actually today.

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The stem cell bit isn't until...

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I'm not sure when.

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Do you think Hanssen will be back?

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It's a big day - you'd think he'd want to be here for it.

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Oh... Are they going to attach the stem cells

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to the end of the nerve or throughout the whole substrate?

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Because I've been doing some research

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and a peripheral nerve graft is pretty big

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but to attempt a spinal stem graft, that's just insane...

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Seriously, do you ever stop?

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I sneaked into Gaskell's wet lab yesterday.

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It's incredible. Have you seen his stuff?!

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Yeah, and I don't know what any of it does.

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Even the thought of going down there makes me...

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I wish my day was going to be as exciting as yours.

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BEEPING She can't be here yet!

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-Who?

-The patient's in reception.

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And they're sending you?

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Does it look like I've slept for more than three hours?

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Almost.

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The whole hospital's talking about it.

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Probably won't surprise you - you know what this place is like.

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I really need it to go well.

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I just wish Hanssen was here.

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Anyway, the patient's due in so...

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..I just wanted to say hi.

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What is this?

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Self-defence classes. The information is very clear.

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I just thought people might feel safer after a class.

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-You know, just the basics.

-When did you have time to do these?

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Mikey showed me on the computer last night. Impressive, eh?

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-You're not keen?

-No.

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Is there a reason you're not ready to for your shift?

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I have five minutes.

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Three minutes, if we're going by my watch, which we are.

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And I prefer those I'm teaching to be on the ward 15 minutes early,

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looking willing. So, you are late.

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Well, the ninja classes, they weren't my idea.

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No word on Hanssen?

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With such a public case, he should be here.

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Do we know where we're putting the patient? She's due any minute.

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-Everything's ready for her.

-BEEPING

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Are you sure you don't want me to...?

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I've done this before, promise.

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You didn't need to get a taxi. We had the ambulance booked.

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A taxi fare for me

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is a fraction of the cost of an ambulance for the NHS.

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And much more incognito.

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You need to get used to the star treatment, you're the VIP today.

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-Oh...

-Let me help. Oh!

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-I'm so sorry! That must have hurt.

-Not one bit.

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One of the few perks of having no feeling in my legs.

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I didn't mean that.

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It's OK, Meena. I can take it from here.

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These wheels have a life of their own sometimes. No harm done.

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Well, let's just check anyway. We can't be too sure today.

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SHE MOUTHS SILENTLY

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Nurse Fletcher wants us to nominate a safety officer.

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OK, all the information's in here.

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So, any takers?

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Great. Well, that's it.

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Thank you.

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That must have taken Fletch hours.

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It's cathartic, I think.

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You don't fancy being Dr Safety then?

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HE SCOFFS As exciting as that sounds...

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SHE LAUGHS

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I've got so much paperwork

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and also I've somehow agreed to hold the fort when Hanssen's away.

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-Still no word from him?

-No.

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-Well, we're all here to support each other.

-Yeah. Absolutely.

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Mr Levy, hi. Just wanted to let you know I'm here to pitch in wherever

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you need me. Just point me in the right direction.

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That's great, thank you. There is something, actually.

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This is patient information that needs to be collated for everyone

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admitted overnight. The night shift were completely snowed under.

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-Right.

-Great.

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Also...do you fancy being a safety officer as well?

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-Oh, I'm not...

-That would be really, really great.

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Thank you. Thank you.

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Yeah, there's a little bit of redness there,

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so I'm going to do an X-ray just to be sure.

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There's really no need.

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I don't want to take the risk. This trial is far too important.

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-A lot of time and money.

-I know. Precisely.

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And we can't have our trailblazer anything less than 100%.

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Professor Gaskell's the trailblazer, not me.

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It's normally 113 over 65, or thereabouts.

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Spot-on.

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One thing about my body I CAN rely on.

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OK, so Professor Gaskell will be down to talk to you shortly.

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-Is there anything I can get you in the meantime?

-I'm fine.

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-How is she?

-She's fine. Very positive, actually.

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Did you page Professor Gaskell?

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I found it on his desk. He must have popped out.

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Oh, right. He must be in the wet lab.

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Could you go down and tell him that she's here?

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Sure, I'll do that right now.

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This is the third text from Darla this morning, asking to see Ric.

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What, he's still not seeing visitors?

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OK. Ring the prison, tell Ric how much Darla misses him.

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-That'll sway him.

-Good idea.

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Right. What have we got?

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It's Adina, isn't it?

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You remembered!

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How could I forget?

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My mother, her stomach is not good.

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All right. Er, Mrs Salu. Sorry, do you mind if I call you Dorina?

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ADINA TRANSLATES TO ROMANIAN

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Da. Imi place camasa ta.

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Yes. She says yes. Her English is not great.

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She also says she likes your shirt.

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Thank you very much. Very kind of you.

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Does she understand any English?

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When she wants to.

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OK, well, thank God we've got you.

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Right, let's get you settled into a bay.

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-One? He's ready to be discharged.

-Great.

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What can I do?

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Paperwork to discharge bay one would be great.

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And as quick as you can, OK?

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Is this the best bed you've got?

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It's as good as any other.

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Where does all the action happen?

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Mr Sparkes...

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Thomas. Tommy to mates.

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I see you have a history of heart problems,

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including a heart attack a few weeks ago.

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-"Nine lives Tommy" they call me.

-And this morning you had a fall.

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You sure you can't move me?

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Yes. Absolutely sure.

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What are these?

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-Ah, self portraits, they're, uh...

-Nude.

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I've always wanted to try a bit of life modelling.

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But I'm not sure that I've got the proportions quite right.

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FRIEDA SNIGGERS

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Well, seeing as you're finding this so funny, Ms Petrenko...

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Ms Petrenko, this is Mr Sparkes.

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She looks fun.

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We can hear you.

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Let's have FBC, U&Es, LFTs, clotting.

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But before all that, please take these and put them somewhere

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no-one's accidentally going to get an eyeful. For all our sakes.

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The time is 08:59.

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Connecting the irrigant, growth factor and catalyser tubules.

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Once the solutions are added, these will provide an optimum balance

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between nutrient supply and metabolite removal...

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..or so I sincerely hope.

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LOUD CLATTERING

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-I'm sorry, I didn't even see it! I'll get it...

-Leave it.

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Where's my knight in shining armour? My Stefan.

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Dominic?

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He's taking a well-earned week off. Visiting his mum, I think he said.

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He never text to invite me. Maybe it's too soon to meet the parents.

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Right, Dorina - does she have abdominal pain and nausea?

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ADINA TRANSLATES TO ROMANIAN

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-DORINA SPEAKS IN ROMANIAN

-She says, "A little".

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May I examine her?

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I hope your hands are warm when you touch my mother, Mr Levy.

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Optimum mother-touching temperature. Right.

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DORINA GROANS

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LFT, U&Es, and FBC to start.

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She never complains, always smiles but I don't want her to be unwell.

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My daughter, she adores her bunica, her grandmother.

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I told her the hospital will make her better.

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We'll do our best.

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SHE SPEAKS IN ROMANIAN

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Looks like you've got a fan.

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Could be a duodenal ulcer, maybe?

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I've read up on them but I've never seen one.

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Let's not jump the gun, let's just do some tests first, OK?

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Right, I'm going to nip upstairs, don my lederhosen

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and I'm going to do my best

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all-singing, all-dancing Hanssen impression.

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Lederhosen? Sweden? No?

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Don't they wear lederhosen in Bavaria?

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Of course they do.

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Hello.

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Fiona, good to see you again.

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Likewise.

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I imagine you're keen to get going?

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Any new demyelinating events?

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I've probably had about a 20% degradation

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in my spinothalamic function.

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Er, Fiona's pre-op assessment...

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What are these?

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Oh, I was just being over-cautious.

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Both ankles are absolutely fine.

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Thorough, good.

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Today we harvest the peripheral nerve, which will act as

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an axonal conduit once we implant it into your spine in a couple of days.

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Now, which ankle would you prefer the nerve to come from?

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It's absolutely up to you.

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I'm left-footed, so let's go with the right.

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There we are.

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We'll look after you in theatre. I shall see you in recovery.

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Is there anything to add to the checklist before we go into theatre?

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I think you have it all covered.

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-She seems very at ease.

-She's remarkable,

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able to handle the pressure of an operation this significant.

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As are you.

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I'm satisfied our trial is at the best place

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-that it could be at this stage.

-Me too.

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How's our resident Michelangelo?

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His heart rate has normalised, BP 120 over 80.

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Bloods are clear and he says his pain has subsided.

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OK, let's have an ECG and a chest X-ray - see where we are.

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-I can't, my elective has arrived.

-You can't multi-task?

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Yes. Well, er, Thomas has asked particularly for you.

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Something about the sunshine on a cloudy day.

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Couldn't possibly imagine what he meant.

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Thomas!

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Everyone OK in here?

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Much better. I can see all the comings and goings from here.

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You were in a little while ago, weren't you? It's Tommy.

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You've smartened up a bit.

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Tell me about it. Your wife - Reenie?

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Carked it about a month back.

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Oh. Sorry about that.

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Well, we had 50 beautiful years together

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but we made a pact - I'm not going to wallow.

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Hard not to, though.

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She made me write out one of those bucket lists.

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All the things that we'd have liked to have done.

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Get you, eh?

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Now all we need is for that firecracker over there

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to make my ticker all right.

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And I'm just standing there, stuff all over the floor,

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wondering whether he wants me to leave, or stay.

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-Complete silence.

-At least you're doing stuff.

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I'll be lucky if I get my hands on a patient by the end of this rotation,

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and then clinically I'm going to be way behind everyone else.

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As if you'd ever be behind any of us.

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I swear Mr Levy doesn't trust me.

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It's like he doesn't think I'm capable or something.

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-We all have to do admin.

-Not for a whole shift!

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It's like 2013 all over again, except I don't even have

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cadaver dissection classes to look forward to.

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You looked forward to those? You're so weird.

0:16:530:16:56

I'd lap up a day of admin right now!

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Seriously, I'm the queen of sulking, not you!

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So don't even try to steal my crown.

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Come here...

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You just need to prove to Mr Levy

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that you're more than an admin monkey...

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..and he'll have you assisting before you know it.

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OK. Come on.

0:17:170:17:19

Er, I was... When nature calls and all that.

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Is everything all right, Dr Chowdhury?

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Can I just say? Your work so far has been commendable.

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Channel any nerves you might feel today into energy.

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Theatre is a great calmer.

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I will.

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And remember, you're part of a team.

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At no point will you be on your own.

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Oh, yeah, yeah, he totally hates you.

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How did he know I was in there?

0:17:570:17:59

-Can't we go back to your ward?

-They need the bed.

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Until there's space on HCOP you'll have to stay here.

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-It's hardly a thrill a minute is it?

-Slight detour.

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Ooh, except for this young lady. She's hot property.

0:18:110:18:16

Hello. You must be Professor Gaskell's trial patient?

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Yes, but how did you know?

0:18:180:18:21

I'm a nurse here. My day off, when I visit clumsy gardeners.

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I wish you'd stop telling people that!

0:18:240:18:27

It's hardly the most exciting injury.

0:18:270:18:29

What would you prefer?

0:18:290:18:31

Ooh, I don't know.

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Something involving being experimental with a younger man?

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THEY LAUGH

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Anyway. The whole hospital is behind you,

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wishing you the best of luck with the operation.

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See you.

0:18:440:18:46

All right. Let's get this hot property off to theatre.

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Seems everyone in the hospital knows about this trial.

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It's a big day for Holby but, as Lofty said, we're all behind you.

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Everything OK?

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All as it should be.

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Except Henrik isn't here...

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He signed the operation off before he left.

0:19:190:19:21

That's not what I meant.

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Well, I'm here for you, whatever you need.

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It has to go to plan.

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With you leading, I have no doubt it will.

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Thank you, all, for your work so far.

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As you know, this is the second phase of a three-phase process,

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no less crucial than the first.

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Without the successful harvesting of the nerve,

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there won't be a phase three.

0:19:510:19:53

I have chosen you all for your skill, your expertise,

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your determination.

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I believe in every one of you

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and I know you have the capacity to do extraordinary things.

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So now, together, we prove it. Everybody ready?

0:20:040:20:08

-Good news?

-Certainly is. Ric's agreed.

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My mother, she is in pain. Mr Levy?

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Oh, OK. He's just had to pop out.

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She is not talking, and when she's quiet, I know there is a problem.

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-OK.

-All right. Page Mr Levy. I'll take a look at her.

0:20:290:20:33

OK. Dorina, can I...?

0:20:390:20:41

Sacha's signed off on Omeprazole. So, 20mg?

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Dorina has myasthenia gravis. She can't have Omeprazole.

0:20:520:20:55

-What is this?

-MG - it was noted when she was admitted.

0:20:550:20:58

How do I not know about this?

0:20:580:21:00

Omeprazole is contraindicated in this case, she needs Ranitidine.

0:21:000:21:03

You're certain?

0:21:030:21:04

I did a myasthenia gravis case study in my final year,

0:21:040:21:06

-I know exactly the drugs you can and can't use.

-OK.

0:21:060:21:09

-An expert, that's what I like.

-Don't worry, Dorina.

0:21:090:21:13

We're going to have you feeling more comfortable, OK?

0:21:130:21:15

-THEY SPEAK IN ROMANIAN

-She says, "Thank you".

0:21:150:21:19

MONITOR BEEPS STEADILY

0:21:190:21:21

The nerve is exposed. Retract.

0:21:210:21:23

Scalpel, please?

0:21:270:21:28

It's caught.

0:21:440:21:46

Can anybody see where?

0:21:460:21:48

Dr Chowdhury?

0:21:500:21:51

Er... Lower right side, underneath...

0:21:560:21:59

Left a bit... No, no.

0:21:590:22:01

Whose left, Dr Chowdhury? Yours or mine?

0:22:010:22:03

My left. My left.

0:22:030:22:05

Got it.

0:22:110:22:13

Could you close?

0:22:260:22:28

I have to get this back to the lab immediately.

0:22:300:22:32

Good work, everybody, thank you.

0:22:320:22:34

All I need is the name of your rep from Darwin.

0:22:380:22:40

What kind of safety procedures?

0:22:400:22:41

All in there.

0:22:410:22:43

When did you have time to do this?

0:22:430:22:46

Between you and me, I'm not actually sleeping.

0:22:460:22:48

I'd rather be doing stuff than just staring at the ceiling.

0:22:480:22:51

Thomas's test results.

0:22:510:22:53

-Oh...

-Take it it's not good news?

0:22:550:22:57

No, it's not ideal.

0:22:570:22:58

Poor fella. Been through a lot lately.

0:22:580:23:01

-Jac. Your rep?

-Petrenko will do it.

-Ah.

0:23:010:23:04

Argh! Don't tell me, I'm dying?

0:23:050:23:09

Not quite.

0:23:090:23:10

But given your recent heart attack I do want to keep you in.

0:23:100:23:13

-Oh! Getting fond of me already?

-Something like that.

0:23:130:23:17

We'd like to get you on stabilising medication and run some more tests.

0:23:170:23:20

I'll take my chances if it's all the same with you.

0:23:200:23:22

It isn't. We're doing our best for you,

0:23:220:23:24

so the least you can do is let us.

0:23:240:23:27

Sounds like you're stuck with me.

0:23:270:23:28

Nice.

0:23:300:23:32

-Was that a compliment?

-No.

0:23:320:23:35

Ms Petrenko?

0:23:350:23:36

Incredible.

0:23:440:23:45

The human body IS incredible.

0:23:460:23:49

Is there anything else I can do?

0:23:490:23:51

You've been a great help already.

0:23:510:23:53

I want to check in with Oliver.

0:23:530:23:54

He's with physio having his hydrotherapy session today.

0:23:540:23:57

Any improvement?

0:23:570:23:59

Slow progress.

0:23:590:24:01

Take as much time as you need.

0:24:010:24:03

All that remains here is for the stem cells to bed in...

0:24:040:24:07

..and then we await phase three.

0:24:080:24:10

-So I told Nurse Jackson to give...

-Ranitidine, yes.

0:24:200:24:23

But Omeprazole would have been much more suitable.

0:24:230:24:25

Good job I saw MG in her notes then.

0:24:250:24:27

What is this "MG"? We knew nothing about this.

0:24:270:24:30

Dorina doesn't have myasthenia gravis...

0:24:300:24:32

What?

0:24:320:24:33

MG are the initials of the doctor who clerked her notes

0:24:340:24:37

when she was in A&E.

0:24:370:24:39

-I can't believe I did that.

-No, it's fine.

0:24:390:24:41

Er, nothing to worry about, both drugs are very similar

0:24:410:24:44

and they will both provide the pain relief she needs.

0:24:440:24:47

But another case and this would be...

0:24:470:24:49

-Yeah. I know.

-I know I can be a pain,

0:24:490:24:52

but I didn't imagine you'd try and kill my mother.

0:24:520:24:54

Ranitidine will cause her no harm at all. I promise you.

0:24:540:24:57

Well, it worked. The pain has gone apparently.

0:24:570:24:59

-She's saying now she wants to go home.

-Home?

0:24:590:25:02

-Dorina, are you sure?

-Da. I am fine.

0:25:020:25:05

Ideally I'd like to keep you in to do some more tests, if that's OK?

0:25:070:25:11

ADINA TRANSLATES TO ROMANIAN

0:25:110:25:13

No, no need. No need. OK.

0:25:130:25:16

It's your decision.

0:25:170:25:19

She wants to see her grandchild.

0:25:190:25:21

All right. Well, let me the discharge form.

0:25:210:25:24

It's my fault she wants to be discharged. I'm sorry.

0:25:270:25:29

It's fine. You've just got to make sure that you make patient

0:25:290:25:33

-safety the centre of every single decision you make. OK?

-Yeah.

0:25:330:25:38

It was a mistake. Just don't worry about it, all right?

0:25:390:25:42

Just next time you take an interest,

0:25:420:25:44

make sure you come and find me and ask me to observe, OK?

0:25:440:25:48

-Yeah.

-OK. All right.

0:25:480:25:50

All right.

0:25:540:25:56

My heart aches and a drowsy numbness pains

0:25:580:26:02

My sense as though of hemlock I'd drunk

0:26:020:26:07

Or emptied some dull opiate to the drains

0:26:070:26:10

One minute past and Lethe-wards had sunk.

0:26:100:26:15

Keates.

0:26:160:26:18

Of course!

0:26:180:26:19

You've certainly made an impression in your new job,

0:26:210:26:25

I've never seen a doctor whose team is quite so...

0:26:250:26:28

..smitten.

0:26:290:26:31

They're a pretty accepting bunch.

0:26:310:26:33

When will you know if the nerve will allow us to progress?

0:26:350:26:38

Two days, maybe three.

0:26:410:26:43

It's all looking favourable.

0:26:430:26:44

-You just need to focus on rest and recovery.

-Thank you.

0:26:460:26:50

You've done all the hard work.

0:26:500:26:51

'Tis not through envy of thy happy lot

0:26:590:27:02

But being too happy in thine happiness

0:27:020:27:05

That thou, light-winged Dryad of the trees

0:27:050:27:08

In some melodious plot.

0:27:080:27:09

I bet you thought this day would never come.

0:27:110:27:15

I hadn't considered if it would or it wouldn't.

0:27:150:27:18

It's a trial, that's all.

0:27:180:27:20

Well, Professor Gaskell's worked miracles before.

0:27:200:27:23

I've no doubt he can do it again.

0:27:230:27:25

-You OK?

-Of course.

0:27:270:27:29

What are you doing?

0:27:450:27:47

They've fixed them, haven't they? Out of order sign's gone.

0:27:480:27:51

So you're blocking the loo in case you need a hiding place?

0:27:510:27:55

Some of us haven't had a day off.

0:27:550:27:57

I'm in the double-vision stage of tiredness.

0:27:570:28:00

Oh, yeah. Must be tough assisting on a medical first.

0:28:000:28:04

At least you haven't let down the nicest consultant in the hospital

0:28:040:28:07

and had a patient's family who think you're completely incompetent.

0:28:070:28:10

Well, there's no way they're going to let me back into theatre,

0:28:100:28:13

not after direction-gate.

0:28:130:28:16

"Whose left Dr Chowdhury? Yours or mine?"

0:28:160:28:18

Ha-ha. Not that it'd be a bad thing.

0:28:180:28:21

Did I mention there's a global live link? As in on camera.

0:28:210:28:25

Only about six times.

0:28:250:28:28

I can see Gaskell's beady eyes now, waiting for me to mess up again.

0:28:280:28:31

The time is 07:59.

0:28:320:28:34

the NMR-S system is signalling there is sufficient

0:28:350:28:37

neuroepilethelial mass.

0:28:370:28:40

I'm satisfied the seeding process is complete.

0:28:400:28:44

The graft is ready.

0:28:440:28:45

Someone's a keen bean this morning.

0:28:550:28:58

Got some ground to make up with Sacha.

0:28:580:29:00

Honestly, he's really not like that.

0:29:000:29:03

Look, why don't you ask him to get a little bit more involved?

0:29:040:29:07

You know, show him what a great doctor you are.

0:29:070:29:09

Honestly, I'll take that. Go.

0:29:090:29:12

-Mr Levy?

-Yes?

-I just wanted to apologise again about the other day.

0:29:130:29:18

I haven't given it another thought and neither should you.

0:29:180:29:21

Well, I'd still like to make it up to you, erm, maybe take you up

0:29:220:29:25

on your offer to observe a patient?

0:29:250:29:27

I don't see why not. Erm...

0:29:270:29:31

An obvious candidate.

0:29:310:29:32

We meet again.

0:29:420:29:43

How is Fiona doing?

0:29:480:29:49

She seems well.

0:29:490:29:51

You looking forward to another day in theatre?

0:29:510:29:53

-Yeah?

-Good.

0:29:530:29:55

All the obs are done and she's prepped and ready to go.

0:29:550:29:57

Perfect.

0:29:570:29:59

I'm really sorry. I can't go through with the operation.

0:30:060:30:10

He arrested overnight. They had to shock him.

0:30:140:30:17

His STs are up, he's still ischemic.

0:30:170:30:19

I don't think medication alone is working. He needs surgery.

0:30:190:30:22

He's not going to like it.

0:30:220:30:24

-BIRDS TWEET

-What's that noise?

0:30:240:30:26

Sh!

0:30:260:30:29

Chaffinches, blackbirds and wrens.

0:30:290:30:32

Three days I've been stuck in here.

0:30:330:30:35

Three days of listening to that.

0:30:350:30:39

HE SNORES

0:30:390:30:40

Still, nice to see you two so chirpy.

0:30:440:30:50

Like two robin red breasts.

0:30:500:30:53

It seems your condition isn't improving,

0:30:560:30:59

so we need to consider surgery.

0:30:590:31:01

Isn't there anything else? She says you're the best in the business.

0:31:010:31:03

It's true.

0:31:030:31:06

I've got a bucket list. I promised Reenie.

0:31:060:31:10

Any operation on your heart will means a significant recovery time.

0:31:100:31:13

Who's going to climb Scafell Pike?

0:31:130:31:15

And you might have to reconsider some of your challenges.

0:31:150:31:18

-HE SCOFFS

-May as well order my coffin now.

0:31:180:31:21

Yeah, this is exactly what we're trying to avoid.

0:31:210:31:23

Are you...

0:31:230:31:25

Are you sure there isn't another option?

0:31:250:31:28

All right, let's run a contrast CMR and I'll make a final decision.

0:31:300:31:33

But no promises.

0:31:330:31:35

I'm not here to judge you, Fiona.

0:31:380:31:41

I'm here to listen.

0:31:410:31:42

This has always been a trial.

0:31:490:31:52

Research to help develop

0:31:520:31:55

the possibility of a successful procedure in the future.

0:31:550:31:58

That's what I signed up for.

0:31:580:32:00

Fundamentally, that's what it is.

0:32:000:32:02

No, it isn't.

0:32:020:32:04

Your team are convinced this will work.

0:32:040:32:06

Well, they're optimistic, but they know the limitations.

0:32:060:32:09

And they don't expect any. We all know the doctor you are.

0:32:090:32:14

You understand MS as well as I do. I've lived with it for half my life.

0:32:140:32:18

You've helped me understand.

0:32:180:32:20

Through it, I've met some incredible people,

0:32:210:32:24

people I'm proud to call my friends.

0:32:240:32:27

I don't deserve this any more than any one of them.

0:32:270:32:30

It's not about...who deserves what.

0:32:300:32:34

Fine, I don't NEED it any more than any one of them.

0:32:340:32:38

I am who I am.

0:32:390:32:40

I live a full and decent life.

0:32:400:32:43

There are other people for whom this would change so much,

0:32:440:32:47

given the chance.

0:32:470:32:49

You may know who you are with MS but that's not your fear, is it?

0:32:490:32:53

You're scared this might work.

0:32:560:33:00

You hadn't planned for this eventuality.

0:33:000:33:02

It's OK if you get better.

0:33:060:33:07

How did you know?

0:33:110:33:12

I will do my very best for you, IF you let me.

0:33:140:33:18

How does he do it?

0:33:220:33:23

I have no idea.

0:33:230:33:26

-Ready?

-As I'll ever be.

0:33:280:33:31

Right, LFT, U&Es, FBC and X-ray.

0:33:390:33:44

SHE SPEAKS IN ROMANIAN

0:33:440:33:46

Dr McKendrick is going to take your bloods now.

0:33:460:33:49

And you're staying in, all right? My rules.

0:33:500:33:54

You are as kind as you are handsome...

0:33:540:33:57

..for the older lady, of course.

0:33:570:34:00

Of course.

0:34:000:34:01

I realise we didn't get off to a great start before.

0:34:040:34:07

-All I care about is my mother.

-Same.

0:34:070:34:11

Dorina, can I take your arm?

0:34:110:34:13

-Erm... "Brat"?

-Vorbiti limba romana?

0:34:130:34:17

Oh. A little.

0:34:170:34:20

I went to med school with a girl who was from Romania.

0:34:200:34:22

She, erm, she was wild.

0:34:220:34:26

All the best ones are.

0:34:260:34:27

SHE SPEAKS IN ROMANIAN

0:34:290:34:32

-Erm... Cap?

-Mm-hm.

0:34:320:34:34

-Gura.

-Gura.

-Gura.

0:34:360:34:39

DORINA CHUCKLES

0:34:390:34:40

Mm?

0:34:410:34:43

Er... Ochi?

0:34:430:34:45

-Yes!

-THEY LAUGH

0:34:450:34:47

SHE SPEAKS IN ROMANIAN

0:34:470:34:49

Erm, you're clammy, erm...

0:34:500:34:52

SHE SPEAKS IN ROMANIAN

0:34:520:34:54

Hot. Cold. Sometimes.

0:34:550:34:58

-Ah...

-OK.

0:35:000:35:02

MONITOR BEEPS STEADILY

0:35:080:35:10

Global experts watching your every move.

0:35:120:35:16

You must have nerves of steel.

0:35:160:35:18

I'll just scrub in.

0:35:180:35:20

I focus merely on what's in front of me.

0:35:200:35:22

-LOUDSPEAKER:

-Just checking the new microscope meets your expectations?

0:35:230:35:26

It's ideal Mr Fletcher, thank you.

0:35:260:35:28

This op's going to be the main talking point

0:35:280:35:30

in the board meeting later. Best of luck.

0:35:300:35:34

Is our nerve standing by?

0:35:340:35:35

Scalpel, please.

0:35:360:35:38

Hardly ground-breaking so far.

0:35:530:35:56

It is no comparison to heart surgery.

0:35:560:35:58

There is just nothing like

0:36:010:36:02

the feeling of a beating heart in your hand,

0:36:020:36:05

knowing that without it, there would be just nothing else.

0:36:050:36:09

But then, you know, it takes a certain type to be a heart surgeon.

0:36:100:36:14

Debriding the scar tissue to create a fresh plane of neural tissue.

0:36:230:36:28

The area is fragile. Precision is key...

0:36:300:36:35

I've caught an intercostal artery. Suction, please.

0:36:360:36:39

Let's get some haemostatic activator to stop the bleed.

0:36:390:36:44

DEVICE SUCTIONS LIQUID

0:36:440:36:46

There's more scar material than I anticipated.

0:36:490:36:51

If I cut, will you remove?

0:36:510:36:53

SUCTIONING CONTINUES

0:36:570:36:59

There.

0:37:020:37:03

I can see the fresh tissue. One more piece...

0:37:050:37:08

..and the ends of the damaged section are clear.

0:37:110:37:13

Good.

0:37:130:37:14

Dr Chowdhury, the graft.

0:37:200:37:22

Quickly, please.

0:37:220:37:25

MONITOR CONTINUES TO BEEP

0:37:280:37:31

-I can come back, if you're busy?

-No, no, it's fine.

0:38:050:38:07

Dorina's blood results.

0:38:090:38:11

OK.

0:38:150:38:16

Erm... Well, that's not much to go on, is it?

0:38:180:38:21

She's clammy, and she's complained of hot and cold sweats.

0:38:210:38:25

Could be gastroenteritis.

0:38:250:38:26

-Hi.

-Hi.

-I like your hair.

0:38:290:38:31

Mama. Bobby Ewing.

0:38:310:38:34

In Dallas.

0:38:340:38:35

Bobby Ewing from Dallas?

0:38:360:38:38

-Yes.

-OK! Erm...

0:38:380:38:41

Thank you very much. Very kind.

0:38:410:38:44

Right. So, the bloods have come back inconclusive.

0:38:440:38:48

ADINA TRANSLATES TO ROMANIAN

0:38:480:38:50

Er...I would like to ask about your...stools.

0:38:520:38:56

Unconventional, after a compliment.

0:38:560:38:58

Erm... Yes, so... Is it painful passing stools?

0:39:010:39:05

THE SPEAK IN ROMANIAN

0:39:050:39:07

She says the pain comes and goes.

0:39:090:39:12

Putin sau mult?

0:39:120:39:13

Just a little thing I learned. I asked if it hurts a little or a lot?

0:39:150:39:19

Mult.

0:39:190:39:20

-A lot.

-A lot?

0:39:210:39:23

Right. Let's get a CT and an MRI. OK? Also...

0:39:250:39:30

..I'm going to need an amended ward list, OK?

0:39:310:39:34

In print and on my desk, as soon as possible.

0:39:340:39:37

Sure.

0:39:370:39:38

Lists are boring.

0:39:430:39:45

It's fine. But my flatmate and I were at the same level

0:39:450:39:48

and she's on a really complex case today, so...

0:39:480:39:52

And you're dealing with my mother's stools.

0:39:520:39:54

I want to help Dorina, honestly.

0:39:540:39:56

You know what I do? I'm a dental hygienist.

0:39:560:39:59

I look into people's mouths who say they floss, even though they don't,

0:39:590:40:02

and I say the same thing - brush your teeth and no problems.

0:40:020:40:06

And you'd rather be a dentist?

0:40:060:40:08

Not at all! I love my job.

0:40:080:40:10

When a mouth is clean, a smile is special.

0:40:100:40:13

Sometimes it's OK to do the small things.

0:40:140:40:17

The nerve is in place.

0:40:250:40:27

Now to stitch the incubated sections

0:40:280:40:32

of the nerve to bridge the gap...

0:40:320:40:34

The correct placing of every stitch is paramount.

0:40:360:40:40

Everybody ready?

0:40:420:40:43

Lost it.

0:40:480:40:50

Slow...and steady.

0:40:570:41:01

And...the knot.

0:41:060:41:09

Irrigation, please, Ms MacMillan.

0:41:160:41:18

HE EXHALES

0:41:290:41:31

Doctor.

0:41:330:41:35

Everything OK, Dorina?

0:41:390:41:42

-Cap.

-DORINA GROANS

0:41:420:41:44

And here? The Ochi?

0:41:440:41:47

Sometimes black.

0:41:470:41:49

I'll talk to Mr Levy, about getting you some pain relief, yeah?

0:41:490:41:54

Adina, she has...

0:41:540:41:57

-GPA.

-I no want her worry.

0:41:570:42:01

Of course, but I don't want you to worry either.

0:42:010:42:04

-Mr Levy?

-Yep?

-Dorina been complaining of...

0:42:110:42:15

-Her results?

-No, they're not back yet,

0:42:150:42:18

but she's complaining of headaches

0:42:180:42:20

and I don't think she's telling Adina everything...

0:42:200:42:23

OK. Go on.

0:42:230:42:25

Well, she says the headaches are so bad she loses vision sometimes,

0:42:250:42:28

and with the nausea, the stomach pain, the pain while passing stools

0:42:280:42:32

and the night sweats,

0:42:320:42:34

it sounds more hormonal than gastroenteritis.

0:42:340:42:37

Such as?

0:42:380:42:40

An underlying tumour, it has to be.

0:42:400:42:43

You knew?

0:42:520:42:53

Only because of this.

0:42:530:42:55

You found out by gaining the patient's trust. Well done.

0:42:550:42:59

She does have a tumour.

0:42:590:43:01

Yeah, but now we know what it is,

0:43:010:43:04

then we know that we can deal with it.

0:43:040:43:07

-Jac? Updated ward plan.

-What's wrong with the one we've got?

0:43:270:43:30

This one's colour-coded, it's got marked routes to emergency exits.

0:43:300:43:33

I've done one for every member of staff.

0:43:330:43:35

-You need to stop this.

-Er, Lisa?

0:43:350:43:37

Thomas's CMR results, you were right.

0:43:370:43:39

Well, I'm never wrong.

0:43:390:43:41

He'll have to go into surgery today, there is no other option.

0:43:410:43:43

He'll take some convincing.

0:43:430:43:45

Well, then we need to be clever about it.

0:43:450:43:47

It's not what we tell him but how we tell him.

0:43:470:43:49

It's distal sigmoid tumour,

0:43:520:43:54

which is almost completely obstructing your colon.

0:43:540:43:57

ADINA TRANSLATES

0:43:570:43:59

It's a perfectly routine operation

0:43:590:44:02

but we need to get you into theatre as soon as possible.

0:44:020:44:05

-Theatre? You'll be sick of us in there.

-Never.

0:44:050:44:08

SHE TRANSLATES

0:44:080:44:11

You must have been in a severe amount of discomfort, Dorina.

0:44:110:44:14

Why didn't she tell me? De ce nu mi-ai spus?

0:44:140:44:17

THEY SPEAK IN ROMANIAN

0:44:170:44:21

Can we get her prepped for the next available slot, please?

0:44:210:44:24

She wants to know how long she will be kept in to recover?

0:44:240:44:27

I'd say a few days in hospital

0:44:270:44:30

and probably just a couple of weeks at home with your feet up.

0:44:300:44:34

SHE TRANSLATES

0:44:340:44:35

-Weeks?

-There's help available for both of you.

0:44:350:44:38

I'll get you the information.

0:44:380:44:40

SHE TRANSLATES

0:44:400:44:42

I know you're still waiting on that ward list

0:44:420:44:44

and I will have it on your desk ASAP.

0:44:440:44:45

OK, and when Dorina goes into theatre, I'd like you to scrub in.

0:44:450:44:49

Do you have any questions about the operation? Er... Operatie?

0:44:530:44:56

Theatre lighting is so harsh. This could have done with a filter.

0:44:560:45:01

Masterful though, wasn't he?

0:45:010:45:03

That's why I'm watching it back.

0:45:030:45:04

I don't really know what he did, I was shaking so much.

0:45:040:45:08

Do you think it'll work?

0:45:080:45:10

-MONITOR BEEPS STEADILY

-Something tells me it will.

0:45:100:45:14

ALARM TONE SOUNDS

0:45:200:45:22

Help, please! Page Professor Gaskell, now!

0:45:250:45:28

-MONITOR BEEPS CONTINUOUSLY

-Professor Gaskell to ITU now.

0:45:300:45:33

-Know what you're doing?

-I'm a fast learner.

0:45:410:45:44

Come to spoil the party?

0:45:510:45:54

Your CMR shows you have a left ventricular aneurysm with a clot.

0:45:540:45:58

-In layman's terms?

-We need to take you to theatre.

0:45:580:46:00

I have plans, places to be...

0:46:040:46:06

Postpone them, if you want any chance at all.

0:46:060:46:09

I disagree.

0:46:090:46:11

We solve it with medicine - Warfarin, Ramipril, Bisoprolol.

0:46:110:46:15

-For how long?

-For the rest of your life.

0:46:150:46:18

-Until the inevitable.

-Which is?

0:46:180:46:20

-Another heart attack.

-Not definitely.

0:46:200:46:22

A heart can only take so much stress.

0:46:220:46:24

Why do a major surgery if you can avoid it?

0:46:240:46:26

Medicine will give him months, enough for his bucket list.

0:46:260:46:29

-Only months?

-Maybe longer, it's tricky to tell.

0:46:290:46:34

-Surgery?

-Years.

-But with months of recovery.

0:46:340:46:37

-I say surgery.

-I think medicine.

0:46:380:46:41

HE LAUGHS

0:46:420:46:44

I never thought I'd see two such plucky young ladies

0:46:440:46:47

arguing over my heart.

0:46:470:46:50

This plucky, is that a good thing?

0:46:500:46:52

It's not up to either of us. It's your decision, Tommy.

0:46:530:46:56

Well...

0:46:590:47:00

..do your worst.

0:47:040:47:05

CONTINUOUS MONITOR TONE, ALARM SOUNDS

0:47:120:47:14

Her BP dropped, she's had inotropes and IV steroids.

0:47:140:47:17

Cardiac arrhythmia. Could be an immune response to the implant.

0:47:170:47:21

Stand by to shock.

0:47:210:47:22

Charging to 50. Stand clear. Shocking.

0:47:240:47:27

ALARM CONTINUES

0:47:300:47:31

Charging again.

0:47:330:47:34

Stand clear. Shocking.

0:47:370:47:40

-MONITOR BEEPS STEADILY

-BP has normalised.

0:47:490:47:51

Good work, Dr Chowdhury.

0:47:590:48:01

Credit to you.

0:48:010:48:02

Right, I'm now going to manipulate the anvil at the top

0:48:130:48:18

end of the bowel so it can fit in with the stapler at the bottom.

0:48:180:48:21

Slightly different to how it looks in a textbook.

0:48:230:48:25

Aha, yeah. All the best bowels are.

0:48:250:48:27

Actually, sorry, do you mind? Can Dr McKendrick take over, please?

0:48:300:48:33

-Of course.

-Really?

0:48:330:48:35

Yeah.

0:48:350:48:37

I mean it's not neurosurgery, you know, but...

0:48:370:48:40

-Right, ready?

-Yeah!

0:48:430:48:46

OK, that's it. OK, line it up.

0:48:460:48:49

Good. Right...

0:48:510:48:53

If you could fire the stapler gun...

0:48:550:48:58

..now.

0:48:580:48:59

Excellent. HE LAUGHS

0:49:040:49:08

Yes, you're a natural colorectal surgeon.

0:49:080:49:10

-I think we're there.

-Wow!

-Well done.

0:49:100:49:13

And she's waking up.

0:49:170:49:18

Page Professor Gaskell. He'll want to be here.

0:49:180:49:22

She should make a full recovery.

0:49:270:49:29

I could kiss you!

0:49:290:49:31

Here is that information I promised on aftercare assistance?

0:49:320:49:35

Your mum should also qualify for enhanced recovery too.

0:49:350:49:38

Thank you. You worked a little Romanian magic on my mother.

0:49:380:49:41

We're both suckers for that.

0:49:410:49:43

I'm sorry it wasn't the exciting operation of your friend...

0:49:430:49:46

No, it was better.

0:49:460:49:48

-Really?

-Really.

0:49:480:49:50

I think you might be challenging for the prize of our favourite doctor.

0:49:500:49:54

No, surely no-one can knock Dom off that perch?

0:49:540:49:56

And what about you, Mr Levy?

0:49:570:50:00

Are you single?

0:50:000:50:01

Me?

0:50:020:50:04

Erm...

0:50:040:50:06

Oh, well, that's a very interesting question with a very short answer.

0:50:060:50:10

You are Dominic's Daddy Bear?

0:50:100:50:12

His Daddy Bear? Er, no! No, no, no.

0:50:140:50:18

No, no, no...

0:50:180:50:20

THEY LAUGH

0:50:200:50:22

-She thought - me and Dom?

-Mm, yeah.

-Daddy Bear?!

0:50:280:50:33

God, you wait till I tell him that...

0:50:330:50:35

-I can see it, though.

-Really?

-Yeah.

0:50:350:50:37

-Oh, it's the hair.

-Strong hair.

-Strong hair!

0:50:380:50:42

FRIEDA: You have a very robust heart and now you are clot-free.

0:50:420:50:46

-Fit as a fiddle?

-Maybe you haven't used up all of your nine lives

0:50:460:50:50

but I would give yourself a chance to recover.

0:50:500:50:53

Where's your partner in crime?

0:50:540:50:56

She is taking a moment to rest. She had a very long day too.

0:50:560:51:00

You make a good team, you pair.

0:51:000:51:03

How did it go?

0:51:180:51:20

As well as it could.

0:51:210:51:23

How long until we know if it worked?

0:51:240:51:27

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

0:51:270:51:32

The next bit's as much of a mystery to me as it is to you.

0:51:320:51:36

-Everything crossed and hope for the best, you mean?

-Something like that.

0:51:370:51:41

I have no doubt Nurse Di Lucca and Dr Chowdhury will take

0:51:420:51:45

very good care of you over the next few days.

0:51:450:51:47

SHE GASPS

0:51:470:51:48

-Sorry.

-No, I felt something!

0:51:480:51:52

That's not possible. It's too quick.

0:51:520:51:55

Ten years without sensation, I know I felt something.

0:51:550:51:59

-Are you sure?

-Positive, absolutely positive.

0:51:590:52:03

Prison doesn't look like it looks on TV.

0:52:070:52:09

You shouldn't believe everything you watch.

0:52:090:52:12

You didn't have to visit.

0:52:150:52:16

I wanted to see you, Grandad.

0:52:160:52:18

How are you doing?

0:52:200:52:22

Well, they certainly know how to look after old guys in...this place.

0:52:220:52:25

I thought you might like a present. They said you were allowed books.

0:52:270:52:30

It's one of your favourites.

0:52:300:52:31

Crime fiction. That's very apt.

0:52:340:52:38

I didn't think about that.

0:52:380:52:40

I always enjoy Conan Doyle, wherever I am.

0:52:400:52:43

How is everybody at Holby? Oliver?

0:53:000:53:03

He's taking time, but he's fighting back stronger every day. So...

0:53:030:53:07

Ric? Is everything OK?

0:53:160:53:20

Erm... You know what? I'm going to need to get back.

0:53:260:53:31

But you just got here.

0:53:310:53:32

It's just that I'm really tired, that's all.

0:53:330:53:36

I'm really pleased to see you. Both of you.

0:53:380:53:42

But you need to go. Now.

0:53:420:53:45

Come on, come with me now.

0:53:470:53:49

So what does he do in the evenings? Gym?

0:53:540:53:57

Hmm...

0:53:570:53:59

-Poker?

-Maybe.

0:53:590:54:01

In my mind, he's a whisky and cigar man. Contemplative.

0:54:010:54:05

-Listening to sounds of the sea.

-Too far.

0:54:050:54:08

Drink?

0:54:090:54:11

Just because you've gone up in my estimations,

0:54:110:54:13

doesn't mean we're going to start socialising together.

0:54:130:54:15

It would take too many vodkas to let your hair down anyway.

0:54:150:54:19

Don't tell me, you are re-colour-coding the ward plan?

0:54:270:54:30

Baby-sitter's given me a free pass.

0:54:300:54:32

Said something about me needing to get out more.

0:54:320:54:35

And you took that to mean stay at work?

0:54:350:54:38

HE SIGHS Do you know what?

0:54:380:54:40

I'm not really in the mood for going to the pictures on my own.

0:54:400:54:43

I thought you were sorting Raf's record collection?

0:54:440:54:47

-I did have a look, but there's one missing.

-So...

0:54:470:54:51

It just made me realise there's just a lot of things that Raf's

0:54:560:55:00

never going to get a chance to finish.

0:55:000:55:03

Life's just not fair, is it?

0:55:040:55:07

I shouldn't be standing here.

0:55:070:55:09

-That's not what I meant.

-But I am. And so are you.

0:55:090:55:13

And if Raf decided to start up a pointless vinyl collection,

0:55:130:55:16

the least you can do is finish it for him.

0:55:160:55:19

Where do I start?

0:55:190:55:21

Online.

0:55:210:55:22

Night.

0:55:240:55:25

-About time!

-You'll never believe what happened.

0:55:350:55:38

You probably won't either. We're going to need a bottle of wine.

0:55:380:55:41

-At least one!

-THEY LAUGH

0:55:410:55:43

It's a good job Gaskell's buying. He left you this.

0:55:430:55:47

-Get yourselves to Albie's.

-Are you not coming?

-No, not tonight.

0:55:470:55:51

-LIFT:

-Lift going down. Doors closing.

0:55:510:55:55

Don't mind if I do!

0:55:550:55:57

THEY LAUGH

0:55:570:55:59

I only moved her blanket but she definitely felt something.

0:56:010:56:06

Looks like it's all going to be worthwhile.

0:56:060:56:09

Somebody's going to benefit from what happened.

0:56:090:56:12

Anyway I just wanted to let you know.

0:56:140:56:16

You would have loved it in theatre today...

0:56:170:56:19

..so I'm going to see it through, for both of us.

0:56:210:56:23

Bye, Raf. I love you.

0:56:240:56:27

And give us all the strength we need and the time to heal.

0:56:270:56:31

Amen.

0:56:320:56:34

Hm! Look at us. Both talking to spirits.

0:56:350:56:39

If you'd have told me that a year ago...

0:56:400:56:42

Who knows if they can even hear us?

0:56:480:56:50

We can't let it change us.

0:56:520:56:53

No?

0:56:560:56:58

No.

0:56:580:57:00

It can't take any more lives.

0:57:000:57:02

DISTANT SIRENS WAIL

0:57:020:57:05

WOMAN SPEAKS PORTUGUESE

0:57:110:57:14

Tyger, Tyger, burning bright

0:57:160:57:21

In the forests of the night

0:57:230:57:25

What immortal hand or eye

0:57:280:57:31

Dare frame thy fearful symmetry?

0:57:320:57:35

Gaskell's much-anticipated operation has arrived. With the press and the staff on tenterhooks, everything must go according to plan if Gaskell is to deliver his promised miracle.

In the shadow of Meena's involvement with Gaskell's groundbreaking trial, Nicky is desperate to get her hands dirty. But if she wants to impress Sacha, she'll have to walk before she can run.

Frieda and Jac form an unlikely partnership in order to deal with a lively patient, but has Frieda got what it takes to win Jac's trust?


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