Casualty S40E04
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😹
FunTranscript
00:00I was just thinking, if you need a bit of company...
00:02Company?
00:03Yeah, like a housemate, you know, just to keep an eye.
00:05My place or the room, something.
00:07Natalia thinks that she's got some sort of feelings for me.
00:12What kind of feelings?
00:13She made a pass at me a while ago.
00:17Girls, I want it, Des, yeah? Make sure you tell him!
00:20I think I just want a quiet one tonight.
00:22We'll go somewhere else then.
00:23Another time, maybe.
00:24I know you're not a people person, but he needs guidance, support.
00:27He needs a mentor.
00:28That works with interest.
00:30An MRI might rule out any other possible complications.
00:33You'd be suggesting a patient to another invasive procedure?
00:37Probably unnecessary.
00:38You did say to trust my instincts.
00:40Not if they're divorced from reality.
00:43We are trying.
00:44OK, he's in the F.
00:46Dad?
00:47I don't understand this.
00:48Can somebody help him, please?
00:50He came in for a couple of stitches, now he's dead.
00:52What happened? What the hell did you do?
00:58With Nicole?
01:00Still a valuable resource.
01:02Just because it hasn't worked out with Roush
01:03doesn't mean you can't mentor someone else.
01:06Do I not get the opportunity to talk to her?
01:08Roush, I'll ask that you don't supervise him any more.
01:12That's something you just move over, not argue with.
01:16Good man, thanks.
01:20Right, OK, so we've had an influx of patients
01:24from a wedding reception since about midnight.
01:27Olly, can you buffer here?
01:29Yeah, because he's already texted me.
01:31Don't wear your good shoes.
01:32OK, well the process really is just a cycle.
01:35Billy, Billy, just been dumped on the doorstep.
01:39OK, so this one's not food poisoning.
01:45Hello, can you hear me?
01:46His pad's secure.
01:48How is the pulse check, Faith?
01:50He's in P.E.A., no pulse.
01:53He doesn't have an I.A.D., would you let me start compression?
01:54Yeah, let's do that and let's get the crash trolley, please.
01:58So we need to concentrate here on hot principles,
02:00so large-bore access and bloods and fluids.
02:05Let's make sure that the BVM there is up to 15 litres.
02:10OK, and with a traumatic arrest such as this,
02:14we need to concentrate on the causes that we can treat,
02:17so particularly blood loss.
02:18Let's have a size eight, please, and suction.
02:22OK, that's the first cannula in.
02:25All right, I need to get the pelvic binder on.
02:26Can I have someone to tie his feet, please?
02:28Right, OK, who needs what?
02:29Let's stop the CPR, because there's no point, I think,
02:32until we've addressed the hyperbulimia.
02:34Major hemorrhage protocol?
02:36Yeah.
02:37OK, I will prime the rapid-engaging saline.
02:39OK, need someone to put in a second line.
02:41Yeah, I can do that.
02:43OK, so rash, if you're...
02:45Sorry, Nicole.
02:48If you're happy with end tidal CAT fluid,
02:50then we need to consider the likelihood of attention pneumothorax
02:56here, so let's set the ventilator to CPR mode.
03:00I think we should loosen off this pelvic binder
03:02so that we can get the fast scanner in, I think.
03:04No, no, no, no, no, no.
03:05I would say, looking at the belly,
03:07that looks like catastrophic bleed,
03:08so I would say we need to keep it on for now.
03:12Yeah.
03:13Yeah?
03:13Yeah.
03:15OK, yeah, that's two minutes of faith.
03:18Can you go do another pulse check, please?
03:21OK, I can feel a thready pulse.
03:23Any respiratory effort?
03:25Two seconds.
03:34We have Rask.
03:35OK.
03:36OK, good.
03:36Right, let's get him sedated and paralysed,
03:39and we'll start a post-Rask care bundle.
03:42We'll go top to bottom, please, Faith.
03:44Nicole, are you OK to stay on airway?
03:46Cam, can you get the bloods up for transfusion?
03:47Thanks.
03:48And let's get full monitoring on him,
03:49get him stable before we move him to CT.
03:52I thought he was dead, May.
03:54No, he's good.
03:54Good work.
04:23I mean, social things come up for the job.
04:51Never proved me as a guardian.
04:53I'm not sure.
04:54I like thinking about you as a grandfather.
04:57Makes me feel blooming ancient.
05:01Yeah, if he was mad for me, too.
05:03I mean, he can't have his family, but I'm a stranger to him, you know?
05:07That's all going to change pretty quickly.
05:10Yeah.
05:12Yeah.
05:22Why do we never get called out to the seaside on a nice day, then?
05:35E-006 to Control.
05:37We're arriving at Conliver Bay.
05:39Any more details on their location?
05:40Negative.
05:41Caller just had the beach.
05:42Sorry.
05:43Copy that.
05:45I'll follow the path.
05:47You can go herring around in the rock pools if you want.
05:50No crab fishing, though.
05:52I can get us a net from the shop, then.
05:56Right.
05:58Needle in haystack.
06:10Hi.
06:11Hi.
06:12Can you just give me a sec?
06:13If it's about time, we can reschedule.
06:16No, no, it's fine.
06:17Okay, so the thing about my being your counsellor is
06:22you do not have to say you are fine if you are not.
06:25Um, okay, can I have five minutes?
06:29Yeah.
06:29I'll call you back, then.
06:32Thanks.
06:32Hello, can you hear me?
06:52It's okay, it's okay.
06:53My name's Jacob.
06:54What's your name?
06:56Can you tell me what happened?
06:58Mother, I pulled 999.
07:01Yes, you did.
07:02You did, Samantha.
07:03You did really good.
07:05Can you please tell me what happened?
07:06I fell.
07:12Open fracture, right wrist.
07:13Any pain anywhere else?
07:15No, just the wrist.
07:18Samantha?
07:20Have you been drinking?
07:22Have you taken anything?
07:26Let's get a tent and some warm blankets, please.
07:28My boy went in the water.
07:36Sorry, love, can you say that again?
07:40He went in the water.
07:45I don't know where he is.
07:48How long's the time been going on?
07:53How long ago was this?
07:54Can you tell me?
07:553006, it's a control.
07:57Can you watch the dispatch coast guard?
07:59Reports of a missing child in the sea.
08:02Oh, God, I'm sorry.
08:06Stop him.
08:07No, stop.
08:09Jacob, hold on.
08:11It's not now.
08:14It was 19 years ago.
08:18It was only seven.
08:21Right, let me just get this right.
08:24He's not in the water today.
08:26He's not out there now.
08:28Is that what you're saying?
08:29I don't know where he is.
08:353006, it's a control.
08:37Stand down on my last.
08:39False alarm.
08:40OK, great.
08:40Thanks for the update, 3006.
08:41All right, my darling.
08:42We're just going to sort out your wrist, get you to the ambulance.
08:51You know, we can talk about anything you want.
08:53Like?
08:57Anything.
08:58Your day.
09:00What was it that I interrupted earlier?
09:02Oh, the dishes.
09:04Nothing interesting.
09:05Do you often leave them to the last minute?
09:07No, they weren't mine.
09:08So why were you doing them?
09:13What's funny?
09:14Being a doctor, I know tactics.
09:19You get me to talk about the dishes, so I open up about something else.
09:23What's wrong with seeing the direction I'm going in?
09:26This whole thing, it's about finding solutions that I haven't thought of.
09:33To outsmart me, I guess.
09:37You don't think I'm smart enough for you?
09:39No, no, no.
09:40Sorry, that's not what I meant.
09:42It's OK, Rash.
09:44It is my job to get you to be truthful.
09:47OK, the dishes.
09:50Um, my cousin left them.
09:53And he always says, don't worry, I'll just sort it all out when I get back.
09:56But he gets back late and there's fruit and yogurt that's been left out.
10:02Stuff you can't leave out.
10:03And I end up clearing it up.
10:06And that frustrates you?
10:07Yeah, it does.
10:08Selfish.
10:09He makes everything about him.
10:12Does he?
10:15Maybe you're personalising events.
10:18Your father's decline, his death, your cousin's personality.
10:24Are these natural, normal things that are happening around you?
10:28Or terrible things that are happening to you?
10:34It makes me sound self-centred.
10:36And let me put it another way.
10:38What's the bigger issue for you?
10:40How your cousin behaves, or how you react?
10:44And which of the two things do you think we can solve?
10:48Can you stop?
11:08Can you stop, please?
11:15I'm a doctor, it's all right, it's fine.
11:17Oh god, oh god.
11:19My baby.
11:21Pull over and stop the bus now!
11:26What's your name?
11:27Riley, help me.
11:30Here, Riley, don't lose these, okay?
11:35Okay, it's okay, it's okay, it's okay.
11:44Uh, Dylan.
11:45So, um, your man has gone from CT straight to theatre.
11:50And there's six more from the vomit buffet.
11:54Lovely.
11:54I really hope all the guests haven't had salmon in this.
11:58Um, you all right?
12:05That's Sam Williams' notes.
12:07Sam Williams who dined.
12:10Dead person's notes.
12:11Dylan.
12:12I need them for the morbidity and mortality meeting.
12:16Is that today?
12:16Because they haven't had a post-mortem yet, have they?
12:19Well, I wanted to get you through it when it's fresh in my mind and see what we can learn.
12:24You want to see what lessons we can learn from a case that
12:27you and I are not likely to see again in our lifetime?
12:30Well, yeah.
12:32Just park it.
12:33Leave it, there's nothing you can do.
12:35Okay, just focus on today's stuff.
12:37New student, new start.
12:38Stevie, three more from the wedding have just turned up.
12:41Great, okay, that should really help with the smell and reception.
12:51Okay, uh, you ready for the next one?
12:53Sure.
12:56Find out now.
12:58Make way, please.
13:00Rush, I need a vet quickly.
13:02Riley Camilleri, 29, PV bleeding, nausea, 16 weeks pregnant.
13:0616 weeks pregnant.
13:07I was coming in for my scan.
13:08Okay, do you two know each other?
13:09No, literally just met.
13:11He made the bus to the hospital.
13:13Only to avoid the ambulance queues.
13:14Okay, I'm Dr Masson.
13:16We're going to get you into a bed and get you checked out, okay?
13:17This is my cousin.
13:19Skills like mine run in the family.
13:21Trust me, I'll make sure he takes good care of you.
13:30What is it?
13:31Part of a handlebar.
13:33One of our clients left a kid's scooter in the long grass.
13:36A colleague emailed over it, crushed it to bits.
13:38I was in the beds, locked up in whack.
13:43Okay, well, I'm just going to have a quick listen to your chip.
13:45No, I'm sorry, of course I'm not, uh, Nicole.
13:49I'm going to have a listen to your chip.
13:53Just breathe normally for me.
13:56And the dangers are...
13:59Sorry.
14:00Okay.
14:03I thought it'd hurt more if it was serious, though, right?
14:07Good to get back.
14:08You're not there, but really good fun.
14:10Okay, well, that fragment has dug in quite a bit.
14:16I don't think this is as superficial as you'd like it to be.
14:19I'm sorry.
14:20We're going to need to do some scans before we can think about removal.
14:24Sure.
14:25I figured you'd say that.
14:28Can you pass me my phone?
14:30Yes.
14:32I'm going to see if I can do topiary with a facetime.
14:35Well, good luck with that.
14:38Any thoughts?
14:40Our resource is full, but I think we should move her to a more high-dependency area.
14:45Just to keep an eye on her as a precaution.
14:47Yeah, very good.
14:47We'll be happy with the chest exam.
14:49Then, uh, should we book her for CT?
14:51Yeah.
14:52I just need to know the baby's okay.
14:54We have a midwife coming to do an ultrasound,
14:57and in the meantime, we need to make sure you are okay as well as people.
15:00Hey.
15:01How are you feeling now?
15:03Less painful.
15:04Maybe a bit more scared.
15:06Is there anything I can do to help?
15:07Tarik, can you liaise with Faith?
15:09See what triage we can do with the ambulance queue.
15:11Uh, yeah.
15:13Yeah, sure.
15:13Okay.
15:14I'm going to use something called a Doppler to see the baby's heartbeat.
15:17Can you get that for me, please?
15:18It's not a specialist obstetric scanner.
15:20The pregnancy scanner will lead to the midwife.
15:23Well, anything that shows a heartbeat, please.
15:25Yeah, I understand.
15:26Just try and relax.
15:30Thanks.
15:32This is going to be a little cold.
15:38So you were on your way in?
15:40Uh, yeah.
15:41Well, I missed my 12-week, um, because I had the rona.
15:44I'm 16 weeks now.
15:53Is it on?
15:54The volume, can I hear it?
15:56Just, um, just bear with me, please.
16:00Uh, I can't hear a heartbeat.
16:03Why isn't there a heartbeat?
16:05Can you, well, can you just tell me what's going on?
16:07Um, Gossie, can you chase, uh, Gynae, please?
16:09Can you get them to come down here?
16:11What's happening?
16:11Okay, I think it's best that you get seen by the right people.
16:15Just tell me, is my baby alive?
16:20I'm going to do everything I can to get you that answer as soon as possible.
16:29Hi.
16:38Hi.
16:39Hi.
16:45Hold up, don't, don't even start.
16:47What's wrong with you?
16:49You're losing your touch.
16:51What are you doing?
16:52Baby.
16:52Hey, no, mate, mate, mate, mate, mate.
16:54No, no, no, we need that.
16:55We need that toilet open.
16:57What do you mean, sir?
16:58I said we need that toilet.
17:00No, I didn't want to work somewhere with bad lighting and uncomfortable seats.
17:04I don't know if that's skill.
17:06So I got a job gardening and, uh, did some things for the council.
17:11And then I did this gig.
17:13There's much demand for it.
17:15Yeah, all the big houses down by the seafront.
17:18It's an arms race.
17:20Yeah, no one wants to do their own.
17:23You're joking.
17:25Whoa, careful, careful.
17:26Lie back down slowly.
17:28Oh, she gets.
17:30Can you describe the pain?
17:33Okay, pop that on for me.
17:35Open your nose and mouth, right.
17:37Have we got the CT there?
17:39Uh, we're doing a biopsy.
17:41She's next in line.
17:42And the HDU is full as well.
17:44Okay, for future reference, penetrating, uh, chest trauma like this is, um,
17:48it's a massive injury, so it takes priority.
17:51Yeah, we've got reduced breath sounds there.
17:53So, uh, forget the CT.
17:55Let's get some local, please.
17:57And we need to do a...
17:58Finger thoracostomy.
17:59Exactly that, yeah.
18:00Jessie, I'm gonna perform a procedure called a finger thoracostomy.
18:04Just do it, whatever it is, just do it.
18:11Thanks.
18:17Can I get you anything?
18:18Uh, no, uh, no.
18:22I'm, uh...
18:29I'm... I'm gonna be...
18:34I was just supposed to get a scan.
18:37I was supposed to come home with a scan.
18:41I have to tell my boyfriend.
18:44What do people say?
18:45What did they say when this happens?
18:48I was never pregnant.
18:50A clump of cells, how does that make any sense?
18:55I'm... I'm sorry.
18:56I'm sorry.
18:58A molar pregnancy, it produces the same hormones,
19:02very similar physical effects to a viable fetus.
19:05There's... there's really no way you would have known before the scan.
19:08I've... I've lost a baby I never had, so...
19:13Why does it feel the same?
19:20It doesn't hurt, does it?
19:43Right.
19:45I'm gonna insert your hand if that's okay with you.
19:50What do you think of those lovely big houses by the sea?
20:01Is that all right?
20:02Feel okay?
20:03Good.
20:06Great luck.
20:09Yeah.
20:09Yeah, that's good work.
20:11No notes.
20:13I'll, uh, get around to our CT and we'll get an X-ray as well.
20:16Okay, well done.
20:18Should we get that sutured in?
20:20Nice one.
20:22Feels better, doesn't it?
20:27Hi there, this is Samantha Hardy.
20:29She's 64 years old.
20:31She fell about a metre onto rock about two hours ago.
20:34Open distal radius and ulnar fracture.
20:37No other obvious injuries.
20:39Her obs are within normal range.
20:41Apart from initial hypothermia of 33.
20:44She's now up to 35.9.
20:46She's had one gram of IV paracetamol, five milligrams of morphine,
20:49and she's allergic to penicillin.
20:52Hey, okay.
20:52Thank you very much indeed.
20:53Any questions?
20:54No, none.
20:54That's great.
20:56Sorry.
20:57So, uh, for the allergy.
21:00Hiya, Samantha.
21:00I'm gonna pop this red band on you.
21:03Penicillin allergy, but we'll pop it on the good wrist, yeah?
21:06Sam.
21:07Say again?
21:09Sam Hardy.
21:11I'm sorry about this.
21:13It's fine, don't worry.
21:15I'm gonna get you an iodine soak for that wrist,
21:18some IV antibiotics,
21:19and do we know the tetanus status?
21:23Uh...
21:26No.
21:30Is there anyone we can call for you, Sam?
21:32Oh, my son Ben.
21:35I think the paramedics tried to get a hold of him,
21:37but I don't want to bother him.
21:39Well, we should probably know how you're doing, though.
21:41No.
21:44Dr. Kew, she's bradycardic,
21:47slow AF, and pulse rate's 38.
21:51Okay, so she's at risk of dysrhythmia.
21:54Um, we should keep ECG and monitoring on.
21:56Let's warm slowly,
21:58and, uh, keep an eye on potassium levels,
22:01and electrolytes.
22:04Oh, look, yeah, there you go.
22:05That's exactly it, yeah.
22:06When I get you warmed up,
22:07uh, we'll order an x-ray?
22:11Yeah, that sounds like a good idea.
22:13Yeah, that sounds about right, yeah.
22:17Can we get a sign saying
22:19where they can find other facilities
22:20before you have to resort to buckets?
22:21Yes, I've already spoken to maintenance.
22:23Mr. Clark!
22:26Ah, uh, Adam Clark.
22:29Dylan, um, just a minute.
22:31Uh, you just saw the Sam Williams thing.
22:34It was the table for this afternoon's M&M's.
22:36I'm with a patient at the moment called Sam Hardy.
22:38You know that I spoke to Sam Williams about Lord Nelson,
22:41and now I'm with a patient called Hardy,
22:42as in Kiss Me Harder.
22:43You don't think that's strange?
22:46Uh, yeah, both seem like pretty common names to me.
22:49Um, look, I think it's too early
22:51to address the Williams case.
22:52M&M's always put too much focus
22:54on our department's losses anyway,
22:55so push it back, will you?
22:57Dylan?
22:57Yeah?
22:58Sorry, um, the ambulance queue?
23:01Uh, yeah, you'll have to show me who's most urgent.
23:03I don't even know where to start.
23:04Um, right, there it is.
23:07Hiya!
23:08So, the CT scan shows quite a bit more tissue damage
23:13than we were anticipating.
23:15And with the way the metal's got this sort of barb
23:18against your ribs,
23:20that's not going to be an easy extraction.
23:24It's going to have to come out of the air.
23:26But that way they can look for any more damage
23:28and give it a proper clean out.
23:30So that means I've got to stay in here.
23:32Because those people that I work for
23:33aren't claiming this is a workplace accident.
23:36And I can't see them until how long?
23:38I cannot see.
23:40Well, that means that I'm off work for the foreseeable.
23:43I've got no cover either.
23:46Do you know what I said about them being
23:48a good firm to work for?
23:50Hey, forget it.
23:53I'm going to sue the fillings out of their teeth.
23:57Oh, do try and be careful.
24:00Your teeth always have been, that's mine as well.
24:04X-ray's sorted.
24:06OK, well done.
24:09Do you want a coffee?
24:09I was about to go and...
24:10No, thanks, you're all right.
24:12I didn't mind.
24:13I am not drinking coffee at the moment.
24:16OK, tea then.
24:17I did it.
24:17How would you take it?
24:18No, well, it's caffeine.
24:20So no caffeine.
24:21Big no.
24:24If it helps, you could get me a fruit tea.
24:27Don't get a fruit tea, I don't like them.
24:30And not a hot chocolate because I will fall asleep.
24:32I'm trying very hard not to turn you down.
24:34I can't have them at the moment because I'm pregnant.
24:42Oh, OK, congratulations.
24:44Thanks.
24:46It's not mine, I'm surrogating.
24:48So yes, it shouldn't interfere too much with progress here.
24:51And I can work quite far into it, can't I?
24:54And then I won't need time off after because there's a handover.
24:57Not my problem.
24:58So if I get a bit baby brained, you'll now know why.
25:02Yeah, you're a baby brained.
25:05At the minute, that is just screaming constantly,
25:07chicken nuggets, chicken nuggets, all the time.
25:09But not on their own.
25:10No, that would be easy.
25:11Dipped into banana milkshake.
25:13You've got no idea what sort of compulsion that is.
25:18I could have just asked for a decaf, couldn't I?
25:19That would have been simpler.
25:20I am sorry.
25:21I think you probably should let your line manager know, though.
25:26Dylan, excuse me, sorry.
25:27I believe that you're looking after this lad's mum?
25:30Sam, Sam Hardy, is she here?
25:32Yes, she is.
25:33Yeah.
25:35OK, follow me.
25:41I called the house, your mobile.
25:43It wasn't worth any trouble.
25:45It's just a fall.
25:46Are you beginning to feel a bit warmer?
25:48I was concerned about hypothermia.
25:50Hypothermia, from what?
25:52Well, your mum was found on the beach.
25:55Beach?
25:57I thought this happened at home.
25:58Not as far as I know.
25:59Conliffe Bay.
26:02You said you were coming to the zoo with us, Mum.
26:04I've left Simon there with Carly.
26:06I just wanted to be close to Eddie.
26:09It's Simon's birthday.
26:11For God's sake, you said you would be there.
26:12I should be there.
26:13I've left them for this.
26:14It's not going to help if you're winding each other up.
26:15Why don't you go and grab something to eat?
26:19And if there's any change, we'll come and find you.
26:21OK?
26:22Fine.
26:28I only go there to remember my boy.
26:31There's nothing wrong with that, is there?
26:36Right, we're going to have to wait in the queue, I'm afraid.
26:38We'll look after you out here for now.
26:40Your fault.
26:42She says it's my fault.
26:44Always watching Tic Tac.
26:47Because I'm always watching Tic Tac videos.
26:50They draw on your nose.
26:53The makeup tutorials I watch.
26:54She doesn't like when they contour noses for foundation.
26:58Pretty good at interpreting.
27:00It's because she always says the same thing.
27:02Not good at anything.
27:06Well, once we get her inside, you can have a bit of a rest, eh?
27:10Tilly, can you speak to Faith?
27:12Tilly!
27:12What?
27:15You all right?
27:15Hey, yeah, so, uh, there's no spare bed, sorry.
27:19Any update on the CT booking?
27:21Uh, I'll chase it up for you, OK?
27:24She's a head injury.
27:25I'm at coagulants.
27:26She's doing no good being out here.
27:27She needs an overnight admission.
27:29I just told you, there is literally no space.
27:31There's none in the corridor or the linen closet.
27:34OK, well, I'm just letting you know.
27:36Yeah, same.
27:43Well, she needs a bed away from the ED.
27:45That's paramount.
27:46The whole consultation just needs to happen away from here, please.
27:48Whatever you can do.
27:50Thanks.
27:53I don't think there's anything else you could have done.
27:55It was always going to be heartbreaking for her.
27:57Yeah, I know.
27:58I know, but I still think she deserves a proper consultation.
28:02Can't happen all piecemeal down here.
28:04She...
28:05She needs care.
28:07Focus.
28:09What happened with Riley Cavalieri?
28:11I was told she was screaming.
28:12What's going on?
28:18She lost a baby?
28:20Sorry, there isn't a baby.
28:22A suspected molar pregnancy.
28:24Oh, you're so worried, man.
28:28I know, and a likely hysterectomy as well.
28:32Rush?
28:33Sorry, um, sorry, Dr. Nash needs me.
28:35Oh, Cam, I'm a little busy.
28:37She said she'd stab me if I didn't fetch you.
28:38So, thank you.
28:40OK.
28:54I'm sorry I didn't realise you.
28:56It's all right.
28:59How are you?
29:04That's a stupid question.
29:05I know.
29:06It's just...
29:09I feel like...
29:12I'm trying to work out the thing I did wrong.
29:15What?
29:15You didn't do anything.
29:16This class, I mean.
29:18I didn't do anything.
29:19I'm sorry.
29:19I'm sorry.
29:20I'm sorry.
29:21I'm sorry.
29:21I'm sorry.
29:22I'm sorry.
29:22I'm sorry.
29:23I'm sorry.
29:23This can't be it.
29:27It really might not be.
29:29That hysterectomy is only a possible outcome to a molar pregnancy.
29:34A hysterectomy?
29:39Uh...
29:41Um...
29:43What did your consultant say?
29:45That I've got an abnormal cluster of cells in me, not a baby.
29:49So, why would I need a hysterectomy?
29:53Okay, so look, it's probably best your gynecologist explain...
29:56How is it you know more about my womb than I do?
29:59Can someone just tell me what's going on?
30:02Oh, come in.
30:03I'm sure we can fit more men in here.
30:04The bloody cervix committee.
30:05I'm sorry, what's going on?
30:08I was just, uh...
30:10Do I need a hysterectomy?
30:15Um, I think we should get the gynecologist...
30:17Fine, I'll look it up.
30:18No, no, please, don't look anything up.
30:23A hysterectomy is a possibility, yes.
30:26Depending on how the cells have developed and where,
30:30it may require a hysterectomy.
30:33Removing my womb?
30:37No babies ever?
30:39It's just a...
30:39It's just one possibility.
30:41We should get a gynecologist to come down...
30:43Get out!
30:45Get out!
30:47Get out!
30:54Rush, staff room, now.
30:56I'm gonna go to Obstacone myself.
30:58Can you keep an eye on Miss Camilleri?
30:59Of course.
31:11Hiya.
31:12So, um, Dylan has told me to tell you
31:15that I am pregnant.
31:20Right.
31:22It's a surrogacy sort.
31:26Right.
31:28Okay, um, fine.
31:30Uh, put it in writing,
31:33include the relevant dates,
31:34and let us know how you want us to work
31:35around your foundation requirements, okay?
31:37Okay.
31:39Okay?
31:40And best of luck with it and the child.
31:43Patrick, um, I've got another cat one coming in,
31:46so can I get somebody to cover my bed list?
31:49And there's a play therapist arriving
31:51for the lady with the baby.
31:52No problem, I'll knock in.
31:54Bro, I...
32:13What were you thinking?
32:15I'm sorry.
32:16Sorry?
32:17You're not her doctor,
32:17why are you telling her anything?
32:19Look, I wasn't trying to tell her anything new.
32:22I just wanted to comfort her.
32:24That's it.
32:25Comfort? Oh, well done.
32:26That worked out well.
32:29How is she?
32:30I brought the gynecologist down to talk her through it all.
32:32Getting a bus to stop doesn't make you a hero.
32:35But it was more than just...
32:36It's unacceptable, okay?
32:37What you did is unacceptable.
32:39It's not about being popular, you're selfish.
32:42All this posturing and swagger,
32:44have you earned any of it?
32:45In fact, it's made all the more ridiculous
32:46by how mediocre you are as a doctor.
32:53Are you going to be sick?
33:01I think you are, aren't you?
33:01You're going to be sick.
33:02Hold on a second.
33:07For Pete's sake.
33:08How much did you drink?
33:10What does it matter?
33:11Because I'm not letting you do this to my boy.
33:14You can punish me, that I can live with.
33:17But you can't break his heart as well.
33:19Sorry, can I just have a quick look at this on your neck?
33:21What?
33:23Is that uncomfortable or is it painful when I press like that?
33:25No.
33:26No?
33:28I'll punish you.
33:30What are you talking about?
33:32You've never been there.
33:33Ever since Eddie.
33:35I don't know if you understood what that did to me.
33:39Maybe that was the point.
33:40Um, okay, I'm going to be right back.
33:43Dr. Piper.
33:46Nicole, um, has Mrs. Hardy been given anything at all
33:50since she came in?
33:51Uh, IV morphine.
33:54It was about an hour ago.
33:55Okay, do you want to come with me?
33:56Yeah.
33:59Vaping stents, you've heard them before.
34:01Okay, Sam.
34:02I need to have a look in your mouth.
34:03Could open up.
34:04Can you wait to?
34:06I'm sorry.
34:08I didn't want to hurt you.
34:11Tell Simon I'll be over for some care.
34:16Okay, now I really need to have a look in there.
34:18That's it.
34:19Mum.
34:20Okay, do you want to step outside with me?
34:22Jodie.
34:23Jodie, I need you.
34:24We've got a severe allergic reaction here.
34:26So we need adrenaline, NEVs and IMs.
34:29Let's have steroids, saline and antihistamines as well.
34:33I don't understand this.
34:34She collapsed on the beach, is that right?
34:36So why is she having a response like this?
34:39Uh, could it be a latex allergy?
34:42Well, it's an allergy to something, isn't it?
34:44You know, I mean, she's going to need close monitoring now.
34:47So we need to find a bed for that, please.
34:49Jodie, can we get those NEVs on as quickly as possible, please?
34:51I mean, are we sure that we didn't give her penicillin?
34:53Because, you know, I mean, you did say you were a bit baby-brained.
34:58I put the wristband on her.
34:59You saw me, okay?
35:01Okay, well, somebody's given her something, haven't they?
35:02Let's get those NEVs on, please.
35:05If it walks like a duck and it talks like a duck,
35:07it's a penicillin allergy.
35:09She said she didn't give her anything.
35:10Well, I know I didn't.
35:16Can you pass me the iPad, Ted?
35:18Sorry, what?
35:19Come on, mate, you're useless today.
35:20What's up?
35:24He's going to gunk up the track here with Flo.
35:26Right, let's get the suction going.
35:27No suction.
35:28She hates it.
35:30Synth, I'm going to swap them out and I'm going to clean them, okay?
35:33I'm just going to put this over your mouth.
35:35There we go.
35:37Right, Ted.
35:38I think we need her in ED.
35:48Fuck.
35:49Does she normally get this bad?
35:53Hey.
35:54I'm worried about her, we're struggling here.
35:57Okay, I'll speak to Patrick, yeah?
36:00This is why I wanted to be a beautician.
36:05I don't follow.
36:07Is she...
36:08Can she wake up?
36:10We're going to transfer her to a more high-dependency setting
36:13and there they'll be able to monitor our vitals much more closely.
36:16Okay, but allergic to what?
36:18We don't know.
36:20People can develop allergies all throughout their life.
36:22This could just be something new.
36:25We'll do more tests.
36:26But allergic to something here, right?
36:28Because she's been drinking,
36:29been on that beach dozens of times before this
36:31and never ended up suffocating from it.
36:33Hey.
36:33Thank you for coming down, Stevie.
36:35Yeah, that's okay.
36:35I thought she was a fractured wrist.
36:37She was.
36:37So what happened?
36:39She deteriorated.
36:40I'm afraid I'm going to have to leave you with Nicole to fill you in.
36:43I've got to go to the M&M meeting.
36:45Okay.
36:47Thanks.
36:49Keep the wait off of it for at least a week.
36:51We'll contact the GP and you can arrange a follow-up with them.
36:54Okay?
37:06We're ready to move you to Upps and Gynae if you are.
37:10I think so, yeah.
37:11Okay.
37:12If you have any questions, I can try my best to answer them.
37:16There was a baby crying.
37:20Are they all right?
37:22Uh, yeah.
37:24Yeah, it was the mother.
37:26She was in for treatment.
37:27The baby's fine, in good health.
37:29Just doesn't like hospitals.
37:31I get that.
37:34I'm glad she's okay.
37:39Once again, I am sorry about earlier.
37:42You were allowed to be angry.
37:44Yeah, and I am.
37:47Uh, here.
37:51Is it this?
37:57Tarek was the only one who showed any concern on the bus.
38:01I might not even have got here if it wasn't for him.
38:04So, if you see him, tell him I'm sorry.
38:09He helped.
38:10He did.
38:12So, the original hematoma sealed the initial bleed,
38:18and it was the pressure on the brain stem
38:22that led to a dysregulation of the cardiovascular system.
38:27So, it...
38:33Um, uh, in short,
38:36in short, the symptoms were hidden from us
38:42until the very last moments,
38:44and it pains me to say it,
38:47but I don't think there's anything
38:49any of us could have done differently.
38:54Yeah, very tragic.
38:56Very surprising case, Dr Keogh.
38:59Thank you for insight.
39:01Um, moving on to more recent events,
39:05I have a few questions about one of your patients today.
39:09Samantha Hardy?
39:13I haven't prepared her.
39:14Yeah, but she comes in with what appears to be
39:16a little bit of hypothermia and an open wrist fracture,
39:18and now she's on ITU, unresponsive.
39:24That's all right.
39:26This is the forum for it.
39:27We're all friends here.
39:30You were mentoring in both instances.
39:33Could that be a commonality here?
39:38Uh, the other doctors, no.
39:41I mean, they didn't do any...
39:43No, it's not their fault.
39:47So is it yours?
39:50See, from what I'm seeing,
39:51all we had to do was keep her comfortable
39:53until orthopaedics could take her.
39:55She's very comfortable now, isn't she?
39:59Just... just talk us through it.
40:04I'm... I'm sorry, it's a no.
40:07Well, he hasn't seen her.
40:09Yeah, but... yeah, her BP's OK, she's stable.
40:13Right.
40:14Well, she clearly needs admitting,
40:15and it's frustrating because there's not much more
40:16we can do for her.
40:17I know, Teddy.
40:18I'm sorry.
40:19I'm sorry.
40:22Wait.
40:23Hey, hey.
40:24Come on.
40:25Are you sure there's nobody going to look?
40:26Teddy's right, we're wasted here.
40:28Come on, it's me.
40:29I don't...
40:30I don't want to be here.
40:31I don't want to be here.
40:32It's me.
40:33Meaning?
40:34Meaning...
40:35in a favour I can pull in,
40:36cos I don't mean...
40:37I don't pull any for each other in the past.
40:38No, Ian, don't do that.
40:40What?
40:40Emotional blackmail's not getting you anywhere.
40:41It's not emotional blackmail, I'm just asking.
40:42Please don't, let's get out of my hands.
40:44OK?
40:52I told you not to do this.
40:55Is that why you ambushed me
40:57with questions about Samantha Hardy?
40:58No, but that's going to come out,
41:00and after your involvement with the Williams case,
41:02we need to get ahead of the story.
41:04If I don't acknowledge there's a problem,
41:05how am I expected to solve it?
41:07My problem?
41:08No, but I think you have one.
41:11So, I think we should attack it head on.
41:14How can I help?
41:15Have you considered a proper diagnosis?
41:17Putting a name on it?
41:18Sorry, you've lost me.
41:19A diagnosis for what?
41:20Autism.
41:22Aspergers.
41:23You're on the spectrum.
41:24That's been playing to everyone for some time.
41:27The obsessions you have,
41:28the hyperfixations,
41:30whatever you were on about earlier,
41:32with coincidences,
41:33communication difficulties,
41:34abrasive relationships...
41:35Sorry, I've got to stop you
41:36before you get any more offensive.
41:37I'm just saying.
41:39Firstly, the diagnosis of Aspergers
41:41was retired by the DSM-5 in 2013.
41:45Probably something to do with the fact
41:47that Asperger was a Nazi.
41:48You're right. Apologies.
41:50ASD, then.
41:51Secondly, and most importantly,
41:53how patronising.
41:55Even if I were autistic,
41:57it wouldn't stop me being a perfectly good doctor.
41:59Well, something's stopping you.
42:01Dylan, you're in a hole.
42:05I'm just trying to find a way out.
42:09I think you should be too.
42:17Can't we do something to get her in?
42:19Fake something, I don't know.
42:22Yeah, this is stupid.
42:23I'm not waiting around watching her deteriorate
42:25in the hope that he moves us up the queue.
42:28Hey, you're up.
42:31Let's get a CT scan right away.
42:35BP's still rising, her.
42:36She's becoming more hypertensive.
42:38It's a bleed, it has to be.
42:39All right, sweetheart,
42:40if you could just move out the way.
42:41We're going to transfer, okay?
42:43We need to stabilise her for a CT.
42:45Okay, I'm done.
42:47Send her across on slide, please.
42:49Ready?
42:49Grace, slide.
42:54Right, she hit her head on an open cupboard door.
42:56We were waiting for a CT.
42:58NAD, initially a bit of GCS has dropped
43:00and BP's rising.
43:01Suspected intracranial bleed.
43:03Okay, thanks.
43:06Excuse me, I think it's best if you wait outside.
43:07Can I stay, please?
43:10I think it'll be easier.
43:11Okay, okay, just try and keep clear.
43:21Hello, hello, hello.
43:23What are you doing tonight?
43:24You got plans for dinner?
43:25No, it's quite one for me.
43:27But thanks, though.
43:28Aw, it's boring.
43:33Hey, I was going to get some takeaway.
43:36Do you want in?
43:38I don't mind.
43:41I meant to say earlier,
43:43Riley Camilleri, she was grateful for your help.
43:46Oh, she didn't sound it.
43:47I know.
43:48All right, I didn't either.
43:51I should have coordinated with you.
43:53Made sure we were both on the same page.
43:56Okay.
43:58And my posturing?
44:01Like the swagger I haven't earned?
44:02What was that?
44:05It wasn't right.
44:07Sorry.
44:09I mean, you do swagger a lot.
44:12You're not mediocre.
44:15I know.
44:16Don't.
44:17Don't put yourself down to lift me up, man.
44:19That's not how this works.
44:27Who are you ordering from?
44:34Ian?
44:35Hey, just to let you know,
44:37Cynthia Poriecki has remained stable on ITU,
44:39and they're going to try waking her up tomorrow
44:41to see how she is.
44:42And is it Katie?
44:43Yeah.
44:44Well, she's staying at her side, okay?
44:46Okay, good.
44:48Listen, about outside,
44:50I shouldn't have been trying to pull a favor.
44:53Sorry.
44:54No, look, I'm as frustrated as you are
44:56with all this, and I took it out on you.
45:00No, that's what I'm here for.
45:02No, Ian, it's not.
45:07Anyway, we got there in the end, didn't we?
45:09Yeah.
45:10Look, while I've got you,
45:13all that stuff with Natalia-
45:15Ah, it's-
45:15No, no, hear me out, hear me out.
45:17That was parent territory,
45:19and I should have come straight to you with it, so...
45:22Yeah, I'm sorry.
45:24I am.
45:25Look, obviously, I've spoken to her about it, and...
45:31You know what?
45:32This is a lot more than I can unpack right now.
45:35Let's just say that she was understandably in a bad place,
45:39and you were just doing your best in a complete minefield.
45:44I, um...
45:46I messed up.
45:47My behavior.
45:48I shouldn't have cut you off.
45:50The way I did, that was cruel.
45:52It was, to all of us.
45:54The kids, they just-
45:55They missed you, and I-
45:57I missed-
45:59I missed your help.
46:02So, um, I'm apologizing.
46:08I want us-
46:10Sorry.
46:11No.
46:12No, no, you go.
46:15I, uh...
46:17I want us to be able to work together.
46:20You know, like workmates.
46:22Like before.
46:25Yeah.
46:26Yeah, me too.
46:27Yeah.
46:28Oh, good.
46:29Yeah.
46:30Sorry, um, Faith, can I borrow you?
46:33Yeah, sure.
46:33I'll be right there.
46:37I'll see you later.
46:54Did you tell Patrick that Samantha Hardy was my fault?
46:57What?
46:58Well, he seems unusually well briefed on the matter.
47:00Is that what you told him?
47:01I don't know what you're talking about.
47:03Well, you do, because I've just mentioned the patient's name,
47:05and I've told you what I'm talking about.
47:06It's a simple question.
47:07The answer's either yes or no.
47:08No.
47:09Yeah, because I've got to go and talk to the son now.
47:12While I do that, perhaps you can think about
47:13what exactly it is you're trying to do here.
47:15Whether you think you're doing any good.
47:16Yeah?
47:18Oh.
47:24Yeah.
47:45Hello, Bear.
47:49She's not waking up, is she?
47:50I'm afraid it doesn't look very much like that.
47:54Is that all you can say?
47:57Uh, uh, no, I...
48:00Kid out.
48:02Go!
48:16Meaning?
48:17I don't know if I can use that.
48:18Meaning?
48:19I don't know if I can do this anymore.
48:21I don't think I should try.
48:23No, no, hang on.
48:24We're dying on our feet here, Dylan.
48:25You can't just walk out.
48:26Well, I can't be here.
48:28So it's not enough to let your patients down.
48:29You have to let the entire department down, too.
48:32Dylan!