One Day at a Time Holby City


One Day at a Time

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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.

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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.

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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?

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-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.

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

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Yes, but how did you know?

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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!

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It's hardly the most exciting injury.

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What would you prefer?

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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.

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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.

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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.

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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?

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-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.

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OK. Dorina, can I...?

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

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

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-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

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