Casualty 1909 (2009) - full transcript

Available records and diaries of nurses, doctors, and patients of the London hospital are put to life in this compelling series about the historic London Hospital. - stop by if you're interested in the nutritional composition of food
You didn't have to stay,
you know.

- I wanted to.
- Well, he'd better have
been no trouble.


Ada, it's half past six.




It's on the table.
If you want it,
you have to get up and get it.

Can't you bring it to me?

I know you.
You'll fall back to sleep.

Nurse Bennett, I order you
to bring me that cup of tea,
as your superior.

Not horizontal, you're not.

Wake up, ladies!
It's half past six.

The sick are on the march.

The London is calling.
The London is calling!

Your colleagues
will be pleased to see you.

You look well, brother.

Your eyes are clearer
than I've seen in months.

You seem focused and fit.

My dearest Edith,
God has answered our prayers.

You are my god, Henry.
I pray to you.

I'll fetch your jacket.

Nurse Bennett?

What are you doing lurking

Doctors don't lurk, Nurse
Bennett. We wait patiently

- then strike with surgical
- How exciting.

- How are you?
- All the better for seeing you.

Though you don't seem
quite as happy to see me.

It's not you. It's, er,
well, it's...this place.


No matter how many we cure
or patch up, more will always

Poor Dr Culpin.

Perhaps you should change
your Christian name from
"Millais" to "Mmalaise".

Why don't we see if I can't
cheer you up this evening?

Have you completed the work
I set on the lymphatic system?

- I stayed up half the night
with Gray's Anatomy.
- That's not what I asked.

I find lymphatics so tedious.

Before your brother died, you'd
have digested the subject in a

It's been three now.

I know.

Ethel, we, each of us, get
less from life than we expect,

but if you lower your
expectations, you will,

I guarantee,
receive even less than that,

and deservedly so.

In which case, I shall fully
expect to see you this

You see Mr Gray this evening.

- She doesn't seem to be ill or
- Inebriated?

She doesn't seem to be.

Well, if she's neither drunk,
hurt nor sick, then what the
bloody hell is she doing here?

- Nurse, get this man a sputum
mug, will you?
- Yes, Matron.

- Dr Culpin, where is Sister
- I have no idea.

Well, have you had any word from
nursing quarters that she's


Does she make a habit
of being late for work?

No, Matron. She doesn't.

- Now, if you'll excuse me, I've
a patient to attend to.
- Yes, of course.

Sister Russell!

Miss Luckes.

- May I have a word with you
in your office?
- Of course.

So, Maude, what is it today?

- My chest.
- What about it?

Pains, Doctor. All over.

I know that you are not prone
to laziness, so, I expect a

for you being late this morning.

I will not lie to you,
Miss Luckes. I overslept.

- You've never overslept before.
- No.

Very well.

I've been spending my evenings
helping a poor family
in lodgings at Wilkes Street,

teaching the mother how to
maintain hygiene in the home.
I've also showed her how to

feed her children as
nutritiously as she is able
on a pauper's budget.

And this has kept you up
until what hour?

It may vary, depending on what
time the mother returns home
from work.

I will often sit up with the
children until the early hours.

I can scarcely believe my ears.

The family needs me.

I need you to set an example
to your nurses and
probationers beneath you.

A constant and immaculate
example of self discipline.

Now, later today,
you will assist me

in interviewing
prospective probationers.

We will judge whether they are
suitable to join this hospital.

I now find myself questioning
whether you are fit
to sit in such judgement.

- The woman was a patient here.
- You followed her home.

I became aware of her wider
needs which I felt in my duty...

Your duties are limited to the
patients of the London Hospital,

within the four walls
of the London Hospital.

You have no duty to engage
in personal projects
of your own making.

Do I make myself clear?

Yes, Matron.

I'll see you later...

...assuming you can stay awake.

Straight down and left.

What in God's name are they?


- High voltage?
- Progress.

- Can I put it down?
- Not yet.

Perhaps a yucca
or, better still, an aspidistra.

Excellent, gentlemen.
Straight through.

- They are going to be wonderful.
- The crates or the delivery

The contents of the crates
carried by the delivery boys.

Princess Hatzfeld has given them
exclusively to us, Ernest.

The deserving poor will
derive great relief from them.

While the undeserving rich
will pay for the cachet
of availing themselves of the

very latest trend from the
continent. It's the perfect

for the London. It's like, um...

It's like tossing a coin that
lands both simultaneously
"heads" and "tails".

Well, a dry bath
sounds pretty rum to me.

A hot, dry bath for the
treatment of rheumatic gout

by electrically heated air
is anything but rum, Ernest.

I think her jaw might be broken.

Um, I am just going to look
at your jaw.

I am not going to hurt you.

I am a doctor, it's fine.

Jesus Christ!

No man touch!

Stop her, will you?

- Dr Ingrams?
- The creature just bit me!

Why was she here?

I saw her face, I suspected a
broken jaw, went to examine her
and the stupid bitch bit me!

Let me take a look at your hand.

- It's deep.
- Yes, I know!

On the bright side,

I think we can safely say
her jaw is not broken.

How do you find it, Ernest?

Comfortable enough.

According to the specifications,

a hot air temperature
of 170 to 200 degrees

can be achieved in five minutes,

rising to 300 in 10!



an ordinary treatment is going
to cost us tuppence in

If we charged the poor nothing
and those who can pay,
one florin,

we could potentially net
hundreds of pounds a year.

At the cost of turning
The London into a spa!

Nonsense. Everyone who uses the
baths will be The London's

Heads and tails, Ernest.

Heads and tails.

Just thought I'd pop my head
round the door to say, well,

- Hello.
- What time are you in theatre?


Well, old man, break a leg.

That won't be necessary.
I'm performing a hysterectomy.


Excellent. Er, better get a clip
on. Good to see you back, Henry.

And you.

And how long have you been
coughing up blood?

Three months, four.

- A lot of the walkers suffer the
- Walkers?

When you lack a home
for want of good health,

you must take to the streets.

Or should you happen to find a
bench somewhere and close your

you can depend upon a policeman
to rouse you and order you to
move along.

Or should you find a darkened
alley some...

- Am I boring you?
- Of course not.

- An axe embedded in my forehead
would be more entertaining?
- I'm so sorry.

And this will do what?

Enable us to see whether or not
you have contracted


Well, over the next 72 hours,
your body will respond to

the contents of the injection,
and the severity of the response

will tell us what we need
to know.

And if I have tuberculosis,
is there a cure?

There's a treatment.

Come back in three days,
Mr Prescott.

We'll talk again.

In anticipation of the worst
when the cough first appeared,
I left my wife...

...and my children
for fear of infecting them.

But walking the streets
is breaking me.

I need you to make me well,
doctor. Please.

Come back in three days.

Gentlemen, you are about to
observe a
total hysterectomy

with bilateral or unilateral
and the removal of the cervix.

If the cancer is advanced, we
may well remove the
surrounding lymph nodes as well.

This technique,
known as a radical hysterectomy,

was pioneered only recently,
it was four years ago.

By a Viennese professor
of gynaecology
by the name of...



Quickly. Before the patient

Ernst Wertheim.

Creator of the Wertheim
hysterectomy. Very good.

Have you assisted
on such an operation before?

I have read about it.

Well, then, either you should
read what Nurse Bennett is

or she should take your place
and you, hers.

I don't recall saying anything
even remotely amusing.

Are we ready, Dr Bennett?

Yes, we are.

Then let us commence
with the Pfannenstiel incision.

Yes. Come in.

Sister Russell.

Are you quite prepared?


Their futures do, after all,
rest in our hands.

Their application forms.

They're getting younger.
Or am I getting older?

Their age remains constant.

Ours, alas, does not.

We are now through
the abdominal wall...

...and the fallopian tubes and
the ovaries are clearly visible.

The uterus sits
just behind the bladder.

If I gently move the bladder
forward, you can see...


The next stage is...

to... to, um...

Mr Dean?

...the next stage is to remove
the main body of the uterus,
the cervix

and the upper part
of the vagina.
More swabs, please.


I cannot deny my ambition,
but in my heart is...

...a great conviction
that I can help the sick.

In your references, it says

you are quick to learn
and you relish hard work.


Would you describe nursing
as hard work, Miss Lawson?

In the sense that
all real accomplishment

can only be achieved by
hard work,

then, yes.

Miss Lawson, what do you think
should bring a nurse

the greatest sense
of accomplishment,

strictly adhering to
established codes of
practice or

following her own instincts
about the care a patient
may need?

Mr Dean.

I've cut the ureter.

Shall I prepare a suture?

Yes. Get me a suture.

The dedication you spoke of
when caring for your mother,

could you show that
to a complete stranger?

- I should like to think so.
- An inebriate,

who stinks of urine and faeces,
uttering one disgusting
profanity after another?

Well, yes.

I would feel sorry, of course,
for anyone who found

in such condition, but I
would set aside such

to attend to the ailing
patient beneath.

- What about the hours,
Miss Riley?
- The hours?

A nurse must be up
at 5.30 in the morning

and does not finish
until 10.00 at night.

If those are the hours I must
commit to, then I'd do so

- In bed, lights out, by 10.30.
- Yes, of course.

You will have to become expert
at lifting patients, fitting

changing bedpans.

Much of which I was required to
do for my mother.

And in ten years' time, Miss

as you will be aware, nurses
are not permitted to marry.

How do you think
you will cope with spinsterhood,

all your time spent in the
company of patients and
hospital staff,

because the life of a nurse,
Miss Riley, is not one that
allows romance,

- a husband...
- Sister Russell.

...or children.

Mr Dean?

- Mr Dean?
- I can't.

You have to, the ureter needs...

I know what needs to be done!

Get help.

- And thank you, Miss Luckes.
It was a pleasure to meet you.
- The pleasure was mutual.

Nice girl.


The woman you've been visiting
in Wilkes Street.

What is her name?

Anna. Anna Baker.

Did you say how many children
she had?

I did not.

She has five.

What ages?

From ten months to eight years.

The reason I asked Miss Riley

if she could transfer
what she did for her mother
to a complete stranger,

was because I wanted to make
a distinction between love
and care.

We do not love our patients,
we care for them.

And if we fraternise with them
outside the hospital,

the line between love and care
may become blurred.

I am always in uniform.

Nevertheless, you were in her
home, looking after her

And even if you can maintain
the necessary distance,

how can you expect Anna
and the children to do the same?

This is our vocation,
Sister Russell.

We cannot risk becoming
emotionally involved
with our patients.

When we do, it can cost us
more than we can afford to give.

When they need us,
truly need us

they will find a way to us, and
we will be here to care
for them.

And that is how it has to be.

Thank you, Matron.

Feast your eyes, gentlemen,
on the human heart.

Down the ages, philosophers
and scientists have considered
this remarkable muscle

to be the seat of thought,
reason, emotion,

while the Stoics believed it
to be the seat of the soul

Feast your eyes, gentlemen.

You even wash your hands
like a doctor.

Aren't you going to invite me?

I thought we agreed
you'd be studying this evening.

I've been thinking about that.

Thinking is generally considered
to be a good thing.

I think I want to stop.

Every day, I assist surgeons,

knowing that my sex
precludes me from being one.

It precludes me from even taking
my place among their students.

I look at you.

I can never be what you are.

- Other hospitals train women
to be doctors.
- What kind? Shilling doctors?

The kind who can be trusted
to treat verrucas and coughs?

The female kind?

Is that truly worth the risk
we both run in training me?

Ethel, you haven't been yourself
since you buried your brother.

Freddy had his life stolen from
him and I don't want to throw
mine away.

Is there something else you want
to do?

You want to be a doctor so much,
so...become one!

Press on from there.

There are other possibilities,

- A doctor's wife?
- Why not?

Because it would be
a criminal waste
of your exceptional abilities!

Talent is one thing.

Opportunity, unfortunately,
is quite another.

Good night, Millais.


Madam, we're closed for the day.
You're going to have to go
home now.

If you saw where I lived,
you wouldn't call it a home.

- Dr Ingrams. You couldn't give
us a hand here?
- I'm due at my club.

She's been sat in the same spot
all day and she refuses to move.

Dr Culpin?

Maude! I told you there's
nothing wrong with you!

Then why am I getting
pains in my chest?

Mrs Anderson.

Where's Mr Anderson?


Working up at Swan Hunter
the past three months.


Beautiful new ship for Cunard's.

And when was the last time
you saw him?

The day he left.

- How much money do you have?
- What?

Come on. How much money
do you have?
I have 12 shillings.

- You're not giving her money!
- You're right. I'm not. We are,
to pay for a trip up north

to see her old man.

Now, put your hand
in your pocket, rich boy.

-20 shillings. She'll spend it
on drink.
- And you weren't going to?

Still, champagne's so different
to beer.

- I think she's telling the
- What makes you such a good

- judge of character?
- Had you pegged from day one,
didn't I?


take the train to Newcastle.
Go and see your husband.




I am clear of cocaine.

I swear to you.

Even if that is the case,
the residual damage to your
nerves appears to have

rendered you
unsafe to operate.

"Even if that is the case"?
Meaning that you don't believe
that I'm clear!

Unfortunately, this has moved
beyond what we may or may
not wish to believe.

If my brother says he is clear
of cocaine, you must believe

My dear woman, Henry's word
is no longer sufficient.

- I am one of the finest
surgeons in London!
- Then let that be your legacy.

And not the needless death
of a patient under your knife.

I was fetched in time to save
the woman this afternoon,
but it was far too close.

Next time, or the time after
that, you mightn't be so

If the London will no longer
allow me to practise, then
nowhere will.

Henry, let me spell this out.

You are not safe to practise as
a surgeon anywhere ever again!

This is what you have wanted
all along, isn't it?

This is the revenge that
mediocrity exacts upon
superior talent.

For God's sake, man, you
nearly killed a woman today!

Please, Sydney. One more chance.

- Henry, you've contributed
brilliantly to your...
- Sydney...

I am begging you,

in the name of
my beloved wife and daughter,

do not do this to me,
I beg of you.
I beg of both of you.

We've no intention
of losing a man
of your outstanding gift.

The management council
would like to offer you a
permanent teaching position.

Teaching others what I am
no longer allowed to do myself?

Henry, that's not how it is.

Sydney! That is now precisely
how it is. You may take it or
leave it, Dean.

But you have left us with no

Souls for bread, is that it?

- The bread is not contingent
on the prayer.
- But prayer comes first.

Is it wrong to be reminded
that all bounty derives
from God, and give thanks?

- How long have you been coming
- Two weeks.

- And before that, I worked the
slums in Princely Street, New...
- Spreading the word...

We each do what we can
according to our calling,

Nobody pays you to come here.
Nobody pays me.

I must go.


Thank you.

If there's anything you need,
you have my card.

Good night, gentlemen.

Terrible, terrible business.

We've done the right thing.

I don't doubt it for a

'The odds will always be
against you, Ethel,

'studying to be a doctor.'

'Do you think I should
give up my ambition?'

- 'Do you?'
- 'Never.'

Take him to bed, and
you're off in a minute.

Late shift tonight.

You've been a little bit quiet
since Elizabeth went.

Have I?

You don't have to admit
everyone who comes knocking,

If you need more food or coal,
ask me and I'll see what I
can do.

I have to take what I'm offered.

I can bring everything you need.

And when you get bored
of bringing it, then what?

When you get yourself a chap,
you know,

yeah, and you got better things
to do?

- Who helps us then?
- That won't happen.

You're a good woman, Ada

But I know what this is,
even if you don't.

What do you mean?

- You cradle my baby like a
pet cat.
- I do no such thing!

Like I said, you're kind
and you're good to my children.

But you knock on my door
for your reasons and I
let you in for mine.

That goes for anyone else
offering help.

That's just the way it is.

The stone steps of the old
Nurses' Home are in a very
bad way.

Several nurses have fallen
as a consequence.

- Cost to repair?
-30 pounds.

Fallen, you say?
Not merely stumbled?

Several have actually fallen.

Well, we can't have
actually falling nurses, can we?

A request to cover
the hot-water pipes
in the outpatients' department.

- Cost, 110 pounds.
- No.

A request to put heating
in the post mortem department.
Cost 60 pounds.

Surely heat is the last thing
one would want in the
post mortem department.

- The request comes from the
chief pathologist.
Granted, and move swiftly.

Once again, a request for an
extra telephone in the theatre

- From?
- Mr Dean.

How did he take the decision
this evening?

With great dignity,

We need to obtain a loan of
7,500 pounds from the bank to
pay the tradesmen's accounts.


An increase to the salary
of Dr Gilbert Scott
by five shillings.

Taking him to...?

Two pounds, six shillings a
week. Hardly a great sum.

You look at Gilbert Scott
and see a deserving young

I look at him and see the tip
of a potentially ruinous

What time is it?



- Details!
- Fire.

- We'll need boracic baths.
- On their way down.

Fire, sir.

Dr Culpin. I have no idea
what it might be, but whatever
assistance we can offer...

- Much appreciated. Right, let's,
er...let's clear a space here.
- Where is Sister Russell?

Sister, it's a fire. Mr Holland
and Mr Morris are at your

For fetching, carrying, lifting.

Mr Morris is somewhat squeamish
at the sight of bodily fluids,

but in all other respects,
use us as you see fit.

- Screens, please, gentlemen.
- Thank you.

Where is Nurse Bennett?

With all due respect, Matron,
this is no time for a roll call.

We need to prep for burns,
breaks and smoke inhalation.
- Which area was the fire up?

Two on the floor, side by side.

One against the wall.

Right away, Matron.

- Thank you, gentlemen.
We'll box it in.
- Yes, Matron.

Here they come, ladies and
gentlemen. You wouldn't give me
a hand, Mr Morris?

I'll make the initial assessment
as they're coming in.

She's dead.

Another kiddie,
no more than eight years old.

Also dead.

Sweatshop fire. All children.

Set up a makeshift morgue
in exam room two.

- I'll take care of that.
- Thank you, Matron.

- I shall need sheets and an
- Straight away.

He's alive! Morphia!

Prepare a boracic bath
to soak off his clothes.

This will help your burned
clothes float free from your

It might sting a little, but
only because it is working.

There's a good boy. Well...

Dr Culpin!


What's your name?

Florence, be brave.

Baths. Baths.

Nurse Bennett.

Sit him down.


- Mr Prescott.
- I was walking in the vicinity.
She's alive, Doctor,

but only just.

- Good to see you Ingrams
A sweatshop fire.
- I, er...

Do what you can...and sober up.

Thank you, Mr Prescott.

Sir, would you like to sit
for a moment?

I saw a glow
from behind the rooftops,
and then I smelled the smoke.

There were people running in
every direction and shouting.

A woman screaming,
there were children inside.
So I went in.

I could feel my eyeballs
starting to dry out.

But I managed to somehow drag
them out.

The building was an oven,
flaming timber, splitting wood,

We were inside a bonfire.

It could have been the devil

Take small sips.

If it were possible,
a glass of water.

- Matron...
- Yes?

I believe your skills
are more needed with the living.

As they come in...would you wrap
them as if they were your own... their parents
would wrap them?

I shall.

Very slowly.

The bath will help you,

Dr Culpin.

Have you inhaled a great deal
of smoke?

The heat and toxins you have
taken in may have damaged your

Take deep breaths.

Would you prefer to lie down?

Fetch a chair.

I used to box for my university.

I once saw a fellow come out
of the ring perfectly
compos mentis

only to collapse an hour later.

He died.

Is Mr Fenwick on his way in?

- He refuses to have a telephone
at home.
- Any other surgeons expected?

Messages have been left,
but none live local.

Where is the pain?

- In the side?
- Yeah.

Let's take a look at you.

Fetch me a stethoscope, please.

Take a deep, slow breath.


Just who I needed.

- Nurse Bennett requests the use
of a stethoscope.
- Give it to her.

Come straight back, please.

- Tracheotomy kit.
- Yes, doctor.

The ancients used to drill holes
in skulls to free evil spirits.

We do it to alleviate
the pressure from haemorrhage.

- Now, I saw this once
during training.
- I see.

I was, however, standing at the
back. We were a large group of
medical students.

Hold his head, please, and

We don't want it slipping off
the end of the drill.

Lean forward, please.

Don't move.

- Dr Culpin, I think we have
a tension pneumothorax.
- Why?

The patient is struggling for
breath. The respiration is
deteriorating. There is an

- absence of audible breath
- Which indicates?

The lung is not properly
unfolded in the pleural

- Have you percussed the chest?
- I did and I got hyperresonance.

- You sure?
- I think so.

Do you think or do you know?

There's a sign of a broken rib,
possibly two. One of the
fractured ends

may have inverted into
the lung.

- Do you know the procedure?
- I know, but I'm not
qualified to do it.

- Do you know the procedure?
If you know it, do it.
- Dr Culpin...

Do it, Ethel.

If it is a tension pneumothorax,
you haven't much time.

- You've got it.
- Swab, please.

Thank you.

- Dr Ingrams...
- Not now.

Have the tracheotomy tube ready.



The boys are safe
but Peggy's missing.

- We heard that children
were being taken to the London.
- Yes.

To the morgue.

How many more are in there?


Excuse me, Matron.

The first rib
can't normally be felt.

The second rib can be felt
just below the collarbone.

The second intercostal space
is the area in between the
second and third rib.

Dr Culpin.

All right. Let's...
let's get her over here.

- Peggy!
- Anna, wait!

- Peggy!
- Wait.

You have to stay here, Anna.

She's Anna's.

What should I tell her?

I need glycerine and borax
to clear the airway.

Identify second rib and
the second intercostal space

and the mid clavicular line
in the centre of the collarbone.

Insert the needle
over the third rib,

through the intercostal space,
and into the chest cavity.

A small prayer might not go,
at this point, unanswered.

- Nurse Bennett, what are you
- A needle thoracentesis.

None of the doctors were

Nurse Bennett,
what do you think you're doing?

- Sorry, Matron. What was the
- Stethoscope.

Hold that there, please.

You did it. Good. Keep an eye
on him. You may need to repeat.

Nurse, your top button is

- Yes, Matron.
- Miss Luckes...

Drink this.

Miss Luckes, in the midst of all
this, does it honestly matter
that the button is undone?

Yes. I think it matters
very much, Doctor. It is a
matter of discipline.

Nurse Bennett, would you come
with me, please?

- Yes, Miss Luckes.
- Ethel, stay there.

- A doctor does not call a nurse
by her Christian name.
- Stay where you are!

And attend to your patient.

- A nurse does not have
a patient, doctor.
- You have my pity, Miss Luckes.

All round you the flames of
modernity are blazing as
fiercely as the fire

that tore through the slum,
yet there you stand, trying
to keep

everything right in its bloody
place. With buttons and all.

Dr Culpin, where did Nurse
Bennett learn to do a
needle thoracentesis?

It is not in any of the
nursing manuals.

- It is to her credit
if she reads widely.
- Dr Culpin!

Not if it interferes with her
true vocation.

In any other London hospital,
she could train as a doctor.

This hospital believes the
profession is not suitable
for women.

Meaning, you are not suited
to the profession.

- Dr Culpin!
- How dare you?

How dare you impose your
own limitations on the
aspirations of others?

I don't doubt you're a great
force for good, Miss Luckes,
but for progress, not at all!

Progress is not always for the

That rather depends upon how far
ahead one chooses to look.

Dr Culpin!

She's going.

Do something.

Do something.


I'm sorry.




If you'd find Dr Culpin and ask
him to join us. Form a line...

Form two lines over here,
wouldn't you?

Start to line up...

Shh, shh, shh.

I thought I'd find you
breathing the wards.

In all my years at this
hospital, Sydney, I have never
been spoken to like that.

It was very late, the end
of a long and gruelling night.

When you came to the London,
you were faced with a nursing
system that was

inefficient, inadequate and
unorganised. There was a blight
over everything.

One operating theatre with only
one table, for goodness' sake,

a wooden affair that, frankly,
wouldn't have been out of place
in a butcher's shop.

Nobody knew that you'd become
one of the ablest,

most remarkable women
of the age.

You transformed this hospital.

We've seen a few fiery young
doctors in our time,

all of them eager
to malign the status quo,

which is their right,
if not their duty. and I know
what came before.

You and I know how far the
London has come, because,

you and I dragged it
out of decrepitude,

inch by, forgive me,
bloody inch.

You don't regret me asking you
to come here, do you, Sydney?

My dear Eva, I refuse to dignify
that question with a response.

May I walk the wards with you?


Yes. I should like that
very much indeed.