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Casualty Season 40 Episode 01
Show moreShow lessCasualty is a weekly television show broadcast on BBC One, and the longest running emergency medical drama television series in the world. Created by Jeremy Brock and Paul Unwin, it was first broadcast on 6 September 1986 and transmitted in the UK on BBC One. The producer was Geraint Morris. The programme is based around the fictional Holby City Hospital and focuses on the staff and patients of the hospital's Accident and Emergency Department.Year started: 1986
Country: UK
Creators: Jeremy Brock Paul Unwin
IMDB rating: 6.1
Categories: Drama
Show moreShow lessStars: Derek Thompson Suzanne Packer Ian Bleasdale Jane Hazlegrove Tony Marshall Charles Dale Sunetra
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Transcript
00:00Dad, come on, open up.
00:02He was comparing me to my cousin earlier, Tarek,
00:05about how I'll never be a consultant, that I'm useless.
00:10Bash, I'm so sorry.
00:12Your dad was hit by a bus.
00:16Sorry. I can't.
00:19You know, the last few months have been, um, they've been hard.
00:23Rush, I'd do anything to speak to him now.
00:27I should have been there at the end.
00:30Me, me, no one else.
00:31No, no, no, come on, man, it's all right.
00:36This is another thing that's broken.
00:40That's what I have to do.
00:41Why doesn't anyone care?
00:42It's broken.
00:44Why hasn't anyone seen it's broken?
00:46You need to see this.
00:48It's broken.
00:48It's not safe.
00:50Why hasn't anyone noticed it's broken?
00:52Why hasn't anyone seen it's broken?
01:00You know why you're here?
01:08I did nothing wrong.
01:10People weren't safe.
01:11I had to do something.
01:12Okay.
01:14In that moment, tensions were high.
01:17You felt what you did was justified.
01:19What about now?
01:21What do you mean, now?
01:22I need to know.
01:24Do you think you're safe to practice as a doctor?
01:26What do you mean, now?
02:11Rash, it's good to have you back.
02:34Um, if you want to talk about it...
02:36Dylan, I need you.
02:39Patrick, hang on.
02:40Yeah, we'll catch up later.
02:42Okay.
02:46Cos!
02:48Hey, how you doing?
02:49Hey, sorry.
02:50I didn't think you were on the road here today.
02:51Yeah, I picked up an extra shift.
02:52I wanted to be here on your first day back, man.
02:55Right, how are you setting it in?
02:57Oh, it's great.
02:58You were dead right about this place.
02:59It's only been a week, but...
03:00Feels like rubber.
03:02I need your cubicles.
03:02You know how it is.
03:06Always in demand.
03:12Can we get four bloods with a VBG for its potassium and a 12-lead ECG?
03:16Your heart rate is still a lot faster than we'd expect.
03:18Has this happened before?
03:19Oh, no.
03:21I can't breathe.
03:23I...
03:23Right, right, I'll take that.
03:25The Valsalva maneuver hasn't worked.
03:26Can I get six milligrams of adenosine?
03:28Yeah?
03:29Okay.
03:30Can you see that?
03:32Yeah.
03:32Yeah, it's a...
03:33Don't worry, it's a faulty bulb.
03:34That light was flickering before I went on leave.
03:36Oh, no.
03:36Okay, um, Jack.
03:39Jack, you have something we call superventricular tachycardia, okay?
03:41Your heart's beating very fast.
03:42Now, this drug I'm going to give you will make you feel a bit unwell,
03:45but it should bring your heart rate down, okay?
03:50Am I dying?
03:52What's happening?
03:54Help me.
03:56Tell me I'm not dying.
03:59No, no.
04:00Help.
04:01Someone help, please.
04:02Help.
04:03It's killing me.
04:05It's killing...
04:06Help.
04:06Uh, right, uh, his, uh, his heart rate's not coming down.
04:10Can I get 12 milligrams?
04:10Is that 12?
04:11Help.
04:12Help.
04:13Okay, okay, okay.
04:14Someone help.
04:14Listen to me, listen to me.
04:15You're going to be fine.
04:17Yeah, you're going to be fine.
04:18I think we should step outside.
04:21I'll see you in my office.
04:23Okay, now this is going to make you feel terrible, really terrible,
04:27but we needed to bring your heart rate down.
04:30Okay, here we go.
04:32There we go.
04:34Okay.
04:35Let's get another 12 milligrams ready.
04:36And if that doesn't work, we'll prep the DC cardioversion.
04:39There we go.
04:41Don't worry.
04:42We've got you.
04:49Come in.
04:50Okay, I can explain...
04:51Dr. Masson, isn't it?
04:53Sit down.
04:54Yeah.
04:55Yeah, it's...
04:55It's Rash.
04:57When patients come in here, Rash,
04:59they want us to work miracles.
05:01Now, you know as well as I do that we can't always do that.
05:04But one thing we can do is make people feel as if they're in safe hands.
05:08I knew what I was doing.
05:09I'm sure you did.
05:10But he was hysterical.
05:12He needed you to take control.
05:19Is it too soon?
05:21Recess.
05:23We're a bit thin on the ground, but I can try and...
05:25No, no.
05:26I'm ready.
05:28In fact, I wanted to speak to you about becoming a consultant through the Caesar route.
05:33Do you know how intense that is?
05:35It's something I've been considering for a while, but with my dad being unwell, it wasn't
05:39an option.
05:39But now, I...
05:41I'm ready.
05:44I'm ready to step up.
05:48Well, give it some thought.
05:50I'd like you to stick with cubicles for now.
05:52That's not necessary.
05:53When I took over this department, it was like halting a runaway train.
05:57Month in, getting a measure of the place.
06:00So, cubicles.
06:02Please.
06:09Patrick asked me to see you as a favour.
06:18He wants my opinion on your mental state and your ability to practice.
06:23He said.
06:25Your father died recently, and you took some time off.
06:31I tried to return straight away, but I wasn't ready, so I took more time.
06:35So, how did it feel coming back this week?
06:38Fine.
06:39I'm going to need a little bit more than that, Rash.
06:47There were a lot of changes.
06:49Some people have left, like Charlie, he'd been there forever, and there are new people.
06:54How did you feel about that?
06:56Okay.
07:01I decided it would be best if I started in cubicles.
07:04Not to push myself.
07:06Rash, it's going to be an awful lot harder if you don't tell me the truth.
07:12First day back.
07:21Always a tough one.
07:23Yeah, I've already messed up with Patrick.
07:25Billy Big Balls.
07:26Don't worry about him.
07:28That nickname stays between us.
07:29I want a doctor.
07:32I want to speak to a doctor.
07:35Get off me!
07:36Oh, hello.
07:37Um, Fern.
07:39Is it okay if I call you that, love?
07:41My name's Siobhan.
07:42I'm the clinical nurse manager.
07:43I don't want a nurse.
07:44I need to speak to a doctor.
07:45Okay, well, this is Dr Massome, and we would like to help you calm down.
07:50Thanks.
07:50Uh, Fern, can you tell me what's wrong?
07:55I did something bad.
08:00Okay, um, you've taken these.
08:02Okay, do you know how many tablets you took?
08:05Oh, I just, I couldn't stop.
08:07Sorry.
08:07Okay, uh, do you remember what time you took them?
08:11Like, ten o'clock?
08:13Uh, just over an hour.
08:15Right.
08:15Okay, okay, did you take them with anything else, any alcohol?
08:18Nope, the fobs are stable.
08:20Right.
08:20Okay, let's try, let's try activated charcoal.
08:22We'll need FBCs, use in ease, salicin at levels, and a clotting screen in four hours.
08:26I'm sorry.
08:27No need to apologise.
08:29Let's get you comfy, shall we?
08:31Right down.
08:32Fern, your sister is down as your next of kin, Sally Cross.
08:35Is it okay to give her a call?
08:36Tell her I didn't mean it.
08:39I can't keep doing this to her.
08:42It's okay, love.
08:45Old DSH scar and two wrists and arms, not a first attempt.
08:50Right, and her notes say she's been diagnosed with BPD, several admissions to a psychiatric unit.
08:58Uh, Fern?
08:59Fern, okay, now this isn't going to taste brilliant, but it will do the job.
09:03Okay.
09:04Once she's cleared medically, we'll organise a mental health assessment.
09:07Um, Rash, sorry, we need you.
09:10Okay.
09:12Once her sister's arrived, can you let me know?
09:15Okay.
09:16It's all right.
09:17It's all right.
09:18Hey, uh, what are you doing?
09:23Oh, shoulder dislocation.
09:24I'm going to do a scapula manoeuvre.
09:26Just stick around and see your master at work.
09:27Just put it away, not in front of the patient.
09:29No, I don't need you to...
09:30I'll show you what to do.
09:31Um, this might be a bit uncomfortable, but I'll try and be as quick as I can.
09:34All right, just keep sucking on that inhaler, okay?
09:36All right, just, uh, just try and relax.
09:38Get the patient to relax.
09:39Yeah, yeah, yeah.
09:39And then get over the muscle spasor.
09:41Right, yeah, I've got it now.
09:43No, I've got it, I've got it.
09:43Okay, here we go.
09:49Three, two, one, go on.
09:52I can't hear you.
09:54Oh, I'm sorry.
09:55Oh, no, it's done now.
09:58That was a piece of cake.
09:59Well, that was mostly rash.
10:03FYI, no one likes to show off here.
10:07No, Per.
10:09I don't believe this.
10:11You knew I was going out tonight.
10:13I told you I'm sorry.
10:14You're always sorry.
10:16Excuse me, can we try and keep it down, please?
10:18I am sorry.
10:19I just wanted the pain to stop for a little bit.
10:21What, my pain?
10:23You could have died.
10:24I can't do this anymore.
10:28Claire, could you...
10:29I'm sorry, I know this is a difficult time, but it would help us to have some background on Fern's emotional state.
10:48She's just taken an overdose, so...
10:50Sorry.
10:52I sound like a heartless bitch.
10:55No.
10:56No, you don't.
10:59It's unbearable, this.
11:01I never know what I'm going to come home to.
11:03It's making me ill.
11:04Caring for someone who's volatile, it takes its toll.
11:12I want to be there for her.
11:15But I feel so alone with all of this.
11:19Fern's in the right place now.
11:21Okay, we're going to get the help she needs.
11:23I've heard it all before.
11:25Yeah, not from me, you haven't.
11:26Sally, you're not on your own in this, okay?
11:34I'm going to help.
11:46They're very mad.
11:47We've got three patients breaching and three on the verge.
11:49Yeah, I know.
11:51You okay?
11:52Yeah, I was just dealing with a relative.
11:54If you need some support.
11:57I can manage.
11:58Okay.
12:04Yes, I'll hold.
12:06Is that firm cross?
12:08I still need the mental health liaison team to assess her
12:11before we can transfer her to a specialist unit,
12:13but apparently no one's available.
12:15All I can do is keep trying.
12:23Surely you've got better places to be.
12:24It's fine.
12:31Sally will be glad of the rest.
12:33She'll be snoring her head off by now.
12:37She always did it when we were kids.
12:39Because I hate sharing a room with her.
12:40Do you snore?
12:47No.
12:48No, I don't.
12:49Well, people that snore don't know how hard it is for those of us that don't.
12:54She's not done it since I've moved back in.
12:59She doesn't sleep now, not really.
13:04Maybe that's why she's so gnarly.
13:07You should try and get some rest.
13:10You bored of talking to me already?
13:12No.
13:12I'm messing.
13:16Do you ever crack a smile?
13:17It's like Blackpool Illumination's in here.
13:30How's anyone getting a cape?
13:33Hopefully it won't be for too much longer.
13:36We'll get you admitted somewhere more suitable.
13:38Are you all right, you?
13:42For a doctor.
13:52Thanks.
13:56Some of your colleagues have expressed concerns to Patrick about how emotionally involved you've become with your patients.
14:03Why?
14:03Because I was trying to help a woman who's been let down by the system.
14:06That's ridiculous.
14:08Do you think you are able to distance yourself?
14:10Yes.
14:11Yes, I offered to check in so her sister could go home.
14:15Which meant you couldn't.
14:17Are you saying I did it because I didn't want to go home?
14:20What do you think?
14:22Is that the reason?
14:33Sorry.
14:33Do you look lost?
14:41Yeah, Fern Cross, she was in here.
14:43Ah, yeah.
14:44She's been moved to the corridor.
14:46What?
14:46Not my decision.
14:48Blame our esteemed leader, apparently.
14:51She had a good night and he said we needed the bay.
14:59Fern, please.
15:00I need you to spit it out, okay?
15:02Fern, please.
15:03Just let me...
15:04Hey, hey, hey, what happened?
15:06She's chewed down on a light bulb.
15:07How did you get a hold of a light bulb?
15:09Someone left a new bulb with a slit lamp on the nurse's desk.
15:11Fern?
15:12Fern?
15:13I'm sorry.
15:14Okay, I'm sorry.
15:15I didn't know you'd be moved out here.
15:17It's so loud in here and I can't...
15:19Can I get the spitball?
15:21Let me help.
15:21Can you spit anything out?
15:25Did you swallow any glass?
15:27She's just...
15:28That's it.
15:32Is there anything else?
15:34No?
15:35Karen, can I get some suction?
15:39Can you open your mouth?
15:41Can you open your mouth?
15:43As wide as you can.
15:48Can you use some suction?
15:51Sit on.
15:56It doesn't work.
15:57Please, can I get one that works?
15:58What's happened here?
16:00There was a bulb just lying around.
16:03But the bleed doesn't seem to be too bad.
16:05And we need to stop it, get it to x-ray,
16:07make sure there's no glass further down.
16:08Okay, I'll fetch some gauze for that bleed.
16:11And then I will take it to x-ray myself.
16:13I don't want to find anything else on the way.
16:16And please, can you chase up the mental health team?
16:18Yep, I'm trying.
16:20I'm sorry that I did it.
16:22I just...
16:23I needed to feel something.
16:28I'm going to get you moved back to cubicles.
16:30Away from all of this.
16:31And I promise you, Funt,
16:33the next place you go
16:34is somewhere you can get specialist help.
16:35I need you.
16:36I have a patient.
16:38Bill, 60s.
16:39Um...
16:40I'm so sorry.
16:43Sorry.
16:43He was found asleep on a park bench.
16:45Police brought him in.
16:46He's possibly hypothalic, confused,
16:48and a bit aggressive.
16:49And he's definitely had a drink.
16:50Is there no one else?
16:52I'm sorry.
16:53I'll come over.
16:54Okay.
16:56Terry, can you take over?
16:57Yeah.
16:58Look, I'll be back.
16:59Okay?
17:00Hey, finally.
17:01There we go.
17:03Okay.
17:03Is it nice and easy?
17:05Okay.
17:05You open wide for me?
17:06Hi.
17:14Hi.
17:14I'm Dr. Masson.
17:16Can you tell me your name?
17:18Everyone knows my name.
17:20Look, if you want a photo,
17:21it's ten pounds for a single.
17:22Or...
17:23Sorry.
17:25You were found asleep on a park bench.
17:28Can you tell me how you got there?
17:31Do you have any injury?
17:32Maybe you fell?
17:33You hit your head?
17:34No.
17:36No, I didn't.
17:38Okay, it's just, um,
17:39the police who brought you in
17:40said you were very confused, right?
17:42No.
17:44It's just a...
17:47Sleep.
17:50I'm tired.
17:56Do you have anywhere to live at the moment?
17:58Yes, do you?
18:01I was at a gig.
18:02The crowds are going wild for me.
18:06I'm a star, so...
18:08Yes, of course.
18:10Okay, uh, all right.
18:14Okay, let's wait until he warms up,
18:16but, uh, let's go for some blood,
18:18some FBCs using these LFT and a CK,
18:20and any details you can find out.
18:22I'll do my best.
18:23Well, you don't think it's a coat?
18:25It's cold, it's cold out.
18:30Sir, I think that's your coat.
18:33Huh?
18:36Yeah.
18:38Yeah, yeah.
18:39I just don't, you know,
18:42I don't wear it
18:43a lot, so...
18:47When he's a bit more alert,
18:52I'll come down to do a 480 assessment
18:54for delirium,
18:55booking for a head CT.
18:56I'm obviously concerned about the confusion.
19:08This has got nothing to do
19:09with my dad's death.
19:10I had grief therapy.
19:11Did Patrick tell you that?
19:12Yes.
19:13How was that?
19:14It was good.
19:16Yeah.
19:16I dealt with a lot.
19:19It must have been a pretty traumatic time.
19:21Your dad died in the same hospital you work in.
19:24I can't save everyone.
19:30But this is your father.
19:32How did that feel?
19:33How do you think it feels?
19:39This isn't relevant.
19:44Yeah, I know there's a way.
19:47She tried to eat a light bulb.
19:49Is that not urgent?
19:52Yeah, yeah, great.
19:53Just not urgent enough.
20:05Oh, CT results were clear,
20:07so I thought I'd do a repeat ECQ.
20:09Okay, thanks.
20:10Oh, and we have a name.
20:11Gareth.
20:12Can man.
20:12Uh, thanks.
20:14How are you feeling, Gareth?
20:15Only my mum calls me Gareth.
20:18It's Gaz.
20:20Do you mind pulling the blind?
20:22I don't want my picture in the papers.
20:30I'm famous.
20:32But don't tell anyone, though.
20:33Okay?
20:39Ah!
20:39Are you okay?
20:42Yeah.
20:42Yeah.
20:43Sorry.
20:47I'll find another one.
20:50Sorry.
20:52You okay?
20:56Sorry, you were saying you're famous?
20:59Yeah, yeah.
20:59I'm a singer, you see.
21:01Because, you see, I had this number one.
21:03You say you look after my sister,
21:05and you dump her in a corridor.
21:07No, no, it wasn't like that.
21:09I thought we could trust you.
21:10Yeah, you can.
21:11I'm doing everything I can to get her a mental health assessment,
21:15and as soon as they come down,
21:16they'll see that she needs specialist treatment.
21:21Don't let the busters break you down, eh?
21:25I think you're doing a cracking job.
21:28Yeah.
21:30You're the best manager I've ever had.
21:32Dr. Onley, I need to ask,
21:49why did you move Fern Cross?
21:51Vulnerable patients came in with an overdose,
21:53and you put her in the corridor.
21:54The one with the HCA?
21:55Yes.
21:55Well, there's your answer.
21:57She had support.
21:58I had patients waiting.
21:59You didn't.
21:59She's hurt herself again
22:01because she was so distressed by being left in the corridor.
22:03Well, she needs to move back to a bay.
22:05I've arranged it.
22:06Good work.
22:09No, it's not good work.
22:12We've let her down.
22:14She shouldn't have been moved into the corridor.
22:15She shouldn't still be waiting for an assessment.
22:18This place, it's not working.
22:20I'm trying to treat people with broken equipment.
22:22Rash.
22:23We're on the same side.
22:25If you're serious about Caesar training,
22:28you need to start looking at the bigger picture.
22:31Any issues, contact your GP or call 1-9.
22:41Sir, sir, you should come and go to the keepers.
22:44Sir, you haven't been discharged.
22:45I said get off me!
22:48I've got to go.
22:48Sir, please, because you haven't been discharged,
22:50you can't leave.
22:51I'm going to go!
22:52I've gone again!
22:54I am gone again!
22:55I'm late!
22:56Gaz, Gaz, you can't do that!
22:59Gaz, you can't do that!
23:01Hey, are you okay?
23:02Yeah.
23:03Yeah?
23:04Hey, what are you doing out here?
23:07Well, I...
23:08I...
23:11I don't know.
23:15A drink?
23:19Why are you looking at me like that?
23:21It's okay.
23:22It's okay.
23:22We don't want to stay out here.
23:24All right?
23:24Your fans might recognize you.
23:28That's a good idea.
23:29We need to go somewhere.
23:34We'll go out.
23:35All right?
23:35Yeah.
23:35Okay, sugar, buts, keep going.
23:36We'll go out.
23:40We'll go out.
23:41We'll go out.
23:42We'll talk so far.
23:43We'll go out.
23:44We'll go out.
23:45We'll go out.
23:45We'll go out.
23:46Yeah.
23:48I'm so, so, so sorry.
23:51I...
23:51I just...
23:53I mean, about that...
23:55I...
23:56I'm just very tough.
24:00It's okay, really.
24:02You know, I looked you up.
24:04You've, um...
24:05You've had some big hits.
24:09Gaz had a number one single in, what was it, 92?
24:1393, actually.
24:16Love Like a Sheel.
24:17Hey, impressive.
24:21Do you ever get a fluttering feeling in your chest?
24:24Any lightheadedness?
24:25Fainting?
24:27Sometimes.
24:28I don't know.
24:30Why?
24:31Well, your...
24:32Your ECG is showing some irregularities in your heartbeat.
24:36Now, it could be something called second-degree heart block.
24:39But I'll get the cardiology team to come and see you.
24:41So, it's my heart.
24:44You know, all the getting mixed up.
24:45It's my heart that's causing the...
24:47Do you get that a lot?
24:51The confusion?
24:54It's just...
24:54I mean, sometimes I, you know, feel out of it.
25:00You know...
25:01Forgetting stuff.
25:05That's just normal anyway.
25:06Look, forget I said anything.
25:07Look, I don't mean...
25:08Don't worry. Don't worry.
25:09Don't worry.
25:09Can you get me an iPad and some headphones?
25:12I think there's something at the nurse's station.
25:13Please.
25:14Thanks.
25:19Look, Gaz, I...
25:20I'd like to speak to some colleagues.
25:23Decide if you need to see a neurologist about the confusion.
25:27You think I'm...
25:29Do you see my marbles?
25:30I think you need more tests.
25:38You know, I've...
25:41I've traveled the world.
25:47Now, some days, I...
25:51I'm too scared to go outside with my own front door.
26:00Oh, thanks.
26:01Um, look, why don't we find one of your albums?
26:05Oh, uh...
26:06We can have a listen while you're waiting.
26:07Okay.
26:10Oh, thank you.
26:19You're in the right place to get help.
26:22I'm sorry?
26:23What did you say?
26:24You thought your patient had early-onset dementia?
26:27That's the thing with working in an ED.
26:30You can spot things that might have gone unnoticed.
26:33Were you alert to that because of your father?
26:36Will you stop doing that?
26:38Doing what?
26:38Bringing up my dad.
26:41I know what you're doing.
26:42You're trying to get me to say I was so desperate to help my patient
26:44because I couldn't help my dad.
26:45It's pop psychology.
26:49I would like to hear about your dad, though.
26:52He must have been very proud of you, becoming a doctor.
26:57Uh, yeah.
27:00It's proud not the word you'd use.
27:03No, I...
27:04He wanted the best for me.
27:14Pushed me to...
27:16be better, to...
27:18do more.
27:20How did that feel?
27:21Like I wish I could have...
27:25Like I wish I could have done more before he died.
27:33That he could have seen me...
27:36make something of myself.
27:40Is that what drives you?
27:44Being a good doctor.
27:47That's what drives me.
27:48And are you?
27:52I try.
27:59I really, really try.
28:00No, I...
28:12I think we need to call this.
28:14Not yet.
28:15Rash.
28:15It's five minutes.
28:16But it's been 20 minutes already.
28:18He was asystolic from the start.
28:20Yeah, I know.
28:20I know.
28:21And he was in heart block.
28:22I think we've addressed all of the reversible calls.
28:25Yeah, no, no.
28:26We need to call it.
28:27Rash.
28:27Okay.
28:29No, no, I'm calling it.
28:35Oh.
28:37Time of death...
28:38erm...
28:391454.
28:42Thank you, everyone.
28:43You'll be okay.
28:44Do you need a couple of minutes to gather yourself?
28:46I'm fine.
28:47I'm fine.
28:47Don't you take my soul
28:57If you've got nothing to say
29:01Well, everyone just wanna be someone
29:04And I've been no exception
29:07You better listen high
29:10Cause I've got something to say
29:13Know yourself
29:17Do you know where you're going?
29:31Right, research straight through the cubicle to the left.
29:34Ian.
29:35What's going on?
29:36It's 5.8 St. James'
29:37So everyone's been diverted here.
29:38It's going to be a busy one.
29:39Can you hear me?
29:45We're just taking you through now.
29:47Okay, look.
29:47It's space for one more in here
29:50And then I think
29:50We can put one in there
29:52So any more of that I need to reassess
29:54Are you good?
29:58Rash
29:58Just take this
29:59Yeah
30:00I've done a full examination
30:02Some burns on his chest
30:04This is the reporter who raised the alarm
30:05I gave everyone time to get out
30:06Right, okay
30:07Can you chase up the senior anaesthetist
30:09And the ENT surgeon
30:10We need to RSM
30:11Can you drop the RSI drugs?
30:13Tony, were you injured anywhere
30:14When you tried to put out the fire
30:16Apart from the burns?
30:17This is Doctor
30:18Right, your chest
30:18Okay, can we get the vomit bowl?
30:20Okay
30:21Right, can I get some suction?
30:23Okay
30:24They're dealing with a complex patient
30:28This is a complex patient
30:30If we don't do something
30:31He loses airway
30:31Sats are dropping
30:34Okay, um
30:35This patient needs intubating
30:37We've got everything ready
30:38Crack on
30:40Me
30:41You started
30:43Now you're finished
30:44Yeah, okay
30:46Okay
30:46Tony, I'm just going to lie you back
30:48We're going to put you to sleep
30:49To help with your breathing
30:50Okay
30:51Can you administer the RSI drugs?
31:03Okay
31:03Okay, lorangoscope
31:04Okay
31:04Okay
31:10ET tube
31:10Okay
31:27Let's inflate the cough
31:29Get this connected to the BVM
31:32Sats are still dropping
31:36I think it's a blast lung
31:43He was in the stores
31:45When it happened
31:45It could have been an oxygen tank
31:47So, what do you want to do?
31:51We need to, um
31:52We need to adjust the settings
31:53On the ventilator
31:54To increase peep
31:55And improve oxygen delivery
31:57He needs an ultrasound of his chest
31:59To ensure we have plural slidings
32:00And no signs of anemic thorax
32:02If his sats drop
32:03Or CO2 goes up
32:04We may need to do a decompression
32:05Irrespective of the ultrasound findings
32:07That was seriously impressive
32:11Okay
32:13I can finish up here
32:15I need you in cubicles
32:16But I've been
32:17I need someone I can trust
32:18In there
32:19We've no idea
32:30Who's been waiting the longest over there
32:32So basically we're starting from scratch
32:34Have we got any notes from St. James's?
32:37Not yet
32:38Nor x-rays
32:39Which is causing ruckus
32:40Because radiology are quite rightly
32:41Refusing to re-expose anyone
32:43They don't need to
32:45Can't we email anything over?
32:46Well, you think
32:48Sending tourists into space
32:49Can't send a few x-rays electronically
32:51Go figure
32:52Onwards
32:54Oh, brush
32:55Brush
32:56Have you got a minute?
32:57I need a second opinion on the patient
32:59No one else is free
33:00Okay, yeah
33:01Okay, cool
33:01So look, she's 19
33:02Came off her mountain bike
33:03No obvious injuries
33:04But there were some bruises on her abdomen
33:06And her BP and heartbreak
33:07And her little cry
33:07I'm thinking
33:08Possible internal bleed
33:09Hey, you okay?
33:16So what did I tell you?
33:19Am I the better looking cousin or what?
33:24Is it your stomach?
33:26Okay, is it okay if I check your abdomen?
33:27Yeah
33:28Look, if you're gonna do stunts on your bike
33:30I went too fast on the hill
33:32Did you land on the handlebars?
33:35I think so
33:36Her spine was cleared at the scene
33:40Okay
33:41Yeah, I think you're right about the internal bleed
33:55Is there a chance you could be pregnant?
33:59We need to do a CT scan
34:01No?
34:02Okay, we'll speak to CT
34:03See if we can take you straight up
34:04I haven't broken anything though
34:07Have I?
34:08No, we don't think so
34:10Good
34:10Good
34:11Because I've got a flight book next week
34:13I'm going to Australia
34:14On your own?
34:16Yeah
34:17Yeah, they let women do that now, you know
34:18Alright, okay
34:20I meant
34:21That's brave
34:23Let's wait and see what the CT scan says first
34:26Whatever it says
34:28I'm going
34:29That's the spirit
34:31Look, shall we do something for that pain?
34:35Okay
34:35Hey
34:39You know it looks pretty serious for her
34:41Everyone needs a bit of hope
34:43Yeah
34:44I've got this
34:45Come on
34:46Someone will be down to take you to a ward very soon
34:54Thank you
34:54Another one on her way?
34:58Yep
34:58Yep, and once the antibiotics arrive for bay three
35:00They can be discharged too
35:02Cam
35:02Cam, can I get a litre of normal saline for Mr Stern?
35:05Yep, already on it
35:06The woman's had a double espresso
35:07Just trying to get through the backlog
35:09Hey, er, is that
35:12Yeah
35:12That's a Tilly Matthew scan
35:14Oh, it's really bad
35:16Her pancreas is shot to pieces
35:18I've called up to the theatre
35:19They're going to fit her in
35:20Have you told her yet?
35:23No
35:23She has no idea how serious this is
35:26She's not going to Australia any time soon
35:29I hate this bit
35:32Hey, um, Fern Cross, she's finally been moved
35:40Er, no, she got discharged
35:41What?
35:43She
35:43How, how was she discharged?
35:46Sorry, Brasher, it was Patrick
35:47I wasn't involved
35:48Chase up the CT and get the bus to me as quick as possible
35:53Dr Onley, you, you discharged Fern Cross
35:55We're a hair's breadth away from calling us a major incident
35:58I've discharged many patients today
35:59Well, you had no right to discharge her without speaking to me first
36:02Dr Masson, we're all stressed, but please watch your tone with me
36:06He was waiting for a psych assessment so we could transfer her to a specialist unit
36:10And you just let her go
36:12No, that's not what happened
36:13The mental health team came down and we decided with Fern
36:17That she would voluntarily admit herself for more psychiatric help
36:20Oh, come on, you really think she'll do that?
36:22Do I think the man that I told to give up smoking before it kills him will buy another packet on the way home?
36:26I don't know
36:27I can only hope she gets the support she needs
36:30So what, you just forget about it?
36:33I understand that some patients can get under your skin
36:36My advice?
36:38Focus on the people who need your help now
36:47I intend to take care of save her
36:48, father
36:48I understand that some people can get around
36:49Some of them can do it
36:50Befather
36:51Stop
36:52Stop
36:52Be Swami
37:24It was a difficult day.
37:50Losing a patient.
37:54I feel like I'd let another one down.
37:57Grief is so hard, isn't it?
38:01Hits us in ways we don't expect.
38:03Makes us do things we wouldn't even contemplate in normal times.
38:08Yeah.
38:08Is that why you did what you did yesterday?
38:20I don't know.
38:25Talk me through what happened.
38:26So, apparently St James's ED is closed for the foreseeable joy.
38:41You look how I feel.
38:43Yeah, I didn't sleep too well last night.
38:46Can you chase up the bloods in Bay 3, please?
38:48I've just chased.
38:50Well, well, well.
38:51Well, maybe he's trying a different socket.
38:54You all right?
38:55This place is a joke.
38:56I'll report it, but we just need to clear this backlog before I can let maintenance loose.
39:03Great.
39:04So, till then, we just keep patients at risk.
39:06From what I hear, that's what caused the fire at St James's.
39:10A phone charger?
39:12Dodgy electrics.
39:12Uh, I'm not sure the rumour mill is helpful.
39:17Hmm.
39:20Please help her.
39:25Okay, this is the pre-alert.
39:27Ferncross, 34.
39:28Suicide attempt.
39:29She cut her left wrist, losing about a litre of blood and is showing signs of hypervolemic shock.
39:33Uh, airway self-maintained.
39:35Arrests of 28.
39:37Tachyat, 132.
39:39BP, 70, over 45.
39:40And GCS is 12.
39:41Ready to transfer?
39:42Okay.
39:43Ready?
39:43All right.
39:44Yeah.
39:44On one, two, three.
39:47Okay, pressure dressings are holding.
39:49She's had one gram of TXA and, uh, 500 mils of fluid and high-flow O2.
39:53Okay, all right, thanks, Jacob.
39:54Okay, let's activate the major hemorrhage protocol.
39:56I need to get a second line and get some bloods off with the porter.
39:59What's happening?
40:00Um, okay, can you take Sally to the relative's room?
40:02Uh, get me the emergency one egg from the fridge, um, and let's steal the blood bank.
40:06I need four units cross-match and four units FFP to start with.
40:09Fern?
40:10Fern, it's okay.
40:11I hate you.
40:16All right, what have we got?
40:19This is Fern Cross.
40:20She slit her wrist.
40:21You might recognize her as the patient that you thought was safe to discharge.
40:24Dr. Masson, this is not the time or the place.
40:27All right, let's continue to transfuse with blood products.
40:31Okay, pauses 130.
40:33Let's get the vascular surgeons down to have a look.
40:35She should never have been discharged.
40:36That's enough.
40:38Dr. Masson, you're not needed here.
40:40What?
40:41No, she's my patient.
40:42Leave.
40:49Fern?
40:50I'm Dr. Onley.
40:51I'm just going to listen to your chest, if that's all right.
40:53This place is carnage.
41:07I need more from you than this.
41:09And if you ever speak to me like that in front of a patient again...
41:13How is she?
41:15Fern, how's she doing?
41:17Focus on the four patients about to breach.
41:20They are your concern.
41:33I don't want him in here.
41:34Fern?
41:35I don't want him treating me.
41:36I'm sorry, okay?
41:37I know you think...
41:38You can't do anything for me.
41:40I'm trying.
41:40The other doctor, he doesn't even pretend to care, but at least I know where I am with
41:46that.
41:47But with you, it messes with my head and I can't think.
41:51I just don't want him in here.
41:53You can go now.
41:55But I...
41:55We don't want you here.
41:58Ash, please.
42:01Please.
42:02It was like I could just...
42:09I could see it all.
42:13There was, um...
42:15There was broken equipment everywhere.
42:17There was...
42:18There was trolleys blocking fire exits.
42:23This shouldn't be here.
42:26This...
42:27This mess.
42:28This smoke alarm.
42:28Hey.
42:32Hey, you can't...
42:33You can't smoke in there.
42:35You can't...
42:35You can't smoke in there.
42:40Guys, the smoke alarm's not working.
42:42I had to do something.
42:45Smoke alarms aren't working.
42:47Smoke alarms aren't working.
42:50Nothing in this place...
42:52It doesn't work.
42:53Nothing works.
42:54Why hasn't anyone seen it's broken?
42:58It's all broken.
42:59It's all...
43:00It's all broken.
43:02It's all broken.
43:03I need to see that it's broken.
43:05This doesn't work.
43:06Nothing.
43:07You need to see this.
43:11It's all broken.
43:13It's not safe.
43:16What do I have to do?
43:18Why doesn't anyone care?
43:21Rash?
43:22Rash, what the hell?
43:23What are you doing?
43:26What's the hell with you?
43:37What the hell is going on?
43:41Rash, he smelt smoke and he found this on fire.
43:44I helped him put it out.
43:45It's just that the smoke alarm didn't even go off.
43:50Rash?
43:50It's just that the smoke alarm didn't even go off.
43:55Dr. Masson, I think it would be wise for you to go home.
44:08You know you could have put patients in real danger.
44:11They already were.
44:12That hospital is like a death trap.
44:15I didn't want to hurt anyone, but people aren't safe there.
44:19What about you?
44:21Do you feel safe?
44:23What do you mean?
44:25I started this session asking if you feel safe to practice, but...
44:30Maybe the real question is...
44:33Do you feel safe anywhere?
44:37I feel like everything's broken.
44:46I feel like everything's broken.
45:00And I don't know what I'm supposed to do to make it better.
45:10It can't carry on like this.
45:14Something has to change.
45:16But are you saying what you did, setting that fire, do you think that was the right way to change things?
45:27No.
45:28No.
45:29I shouldn't have done it.
45:31It was stupid, but...
45:33But in that moment, after...
45:36After everything that happened, I...
45:40I had to do something.
45:46Okay.
45:47Thank you, Rush.
45:49I think we can stop there.
45:54I'm going to tell Patrick that you engaged with this session.
45:59And...
46:03I think you will be safe to practice.
46:07But you need some time.
46:11And some additional support and some more counselling.
46:14Yeah, with you, that would be good.
46:16No, sorry, I should have said at the start, this was just a one-off for Patrick.
46:23But...
46:24But I think this is helping me.
46:26Yeah, you've done really well.
46:28And with another therapist, you'll make more progress.
46:33This was never going to be a quick fix, Rush.
46:38But you've got to keep talking.
46:40It's...
46:55It's... busy.
47:15I'm sorry. About yesterday.
47:20Maris made some recommendations.
47:22She said that you need some more time off and extra support when you do return.
47:32Rash, can I level with you?
47:35We're desperate for doctors, especially now St James's ED is out of action.
47:41So, I know what Maris is recommending.
47:44You want me to come back?
47:45I want you to do what's right for you.
47:47I know that, for me, if I have too much time on my own, home alone, I tend to dwell on things.
47:55Right.
47:56I get in my own way.
47:58You already took time off. Did that work?
48:02No. Not really.
48:03No, see, I think you're wired like me. Take your foot off the gas, you stall.
48:09What you need is a new challenge.
48:12I've been looking into the Caesar training.
48:15If you were to return now, I don't see any reason why we couldn't start setting things in motion.
48:20You would agree to the training?
48:22If we could make it work.
48:23But only if you're up to coming back.
48:28It's your decision.
48:32I'm up to it.
48:34I'm fine.
48:35Yeah.
48:36That's fair, Dad.
48:40It's your choice, Dad.
48:42I know who you is.
48:43Yeah.
48:44That's fair, Dad.
48:45That was just the better cause of Me.
48:46That's fair.
48:48That's really His only reason for us to get to the target of the force of the foreign services and housing is now...
48:49... backup.
48:52man Howard Howard II