Cardiac Arrest (1994–1996): Season 1, Episode 5 - Turning out the Light - full transcript
(Shrieking)
(Shouting)
(Boy) I’m doing biology and that for O Level
/ don't lke it
My mum says | need it for being a doctor.
Don't want te be 2a doctor.
/ want to be 2 soldier.
(Siren)
Bloods, drugs charts,
first dose IVs, Venflon.
— Mr Edwards is back to temperature again.
— Hoo-—bloody—ray.
Two quid an hour | get for this.
Compared to me, the geezer teasing body bits
out of the drain under the morgue is pampered.
| can think of no more miserable way to spend
a Saturday afternoon than to be second on...
house officer for crap like this,
stuck in this festering cackhole of a hospital
without one single thing to endear it but the...
Breathe in.
Peekaboo.
And out.
| can't find anything to explain
your temperature,
but | think we should do more tests of
your blood and urine just to be on the safe side.
I'd never forgive myself if | overlooked
a simple problem we could treat.
(Laughs)
You don't want to be doing yourself
a mischief, Arthur.
But my name's not Arthur,
(Laughs)
This one's for me. Something to stop vomiting.
| have an urgent bleep message.
Babe alert, Lecter Ward.
Babe alert, Lecter Ward.
(Pager bleeps)
(Woman on pager) Babe alert, Lecter Ward.
Hi there. Er...
Claire's still up to her neck in that DKA,
so maybe you could see this next one
we've had in.
59-year-old man, recently widowed,
dothiepin overdose during the night.
— Will you be washing him out?
— Not if the OD was Last night.
Well, Claire might insist on
washing him out anyway,
make him think twice
before taking another one.
The last thing this man needs is
to be punished for what he's done.
Thank you.
Er, | thought you'd be busy down here,
so | picked you some sandwiches up
before the canteen shut.
Thanks very much.
Would you lavage someone who OD'd last night?
No. But you can't rely on uncorroborated history
from someone who's just tried to top himself.
Well, you can make any excuse
if you resent ODs enough.
Even contempt counts as emotional involvement,
not my style.
Dr Maitland, can | ask you not to eat
in the department, please?
Unlike you, Charge Nurse Sutton,
| don't get protected breaks and meal times.
In an environment in which | can work
a couple of days without even a sit-down,
I'LL eat where and when | please.
Oh, yeah. That LVF we were expecting
died in the ambulance.
So that's one less admission to clerk.
— So what about this overdose, then?
— No wash-out.
Present the case, Dr Rajah.
Clinical inspection revealed little
apart from her chronic pulchritude.
| called upon the most searching instrument
of investigation known to medical science.
— | asked Ward Sister to check her out.
— Excellent.
She is Miss Judith Edwards, age 23,
legal secretary, self-referral to the ward,
visiting her father Mr Ronald Edwards.
Whatever her dad's got, he'll get better.
Nothing guarantees round-the-clock medical
attention like having a gorgeous daughter.
Oh, yes.
(Murmurs of approval)
(TV) The FA Carling Premiership.
Arsenal — nit, Manchester City — nil
Chelsea — one, Norwich City — two.
— Coventry City — one...
— Oh, United went down again.
| don't really follow football, Mr Blewitt.
No, | don't suppose you would.
Oi.
Cardiac arrest!
Caroline.
Mr Blewitt, cardiac arrest.
(Breathing heavily)
— (Pager)
— Oh, can you...
Yeah, fine.
What the bloody hell are you gawping at?
(Sighs)
Mr Blewitt has these funny turns sometimes.
Petit mal epilepsy.
Well, come on, sunshine.
Patients to see, lives to save.
Bye for now.
That's the first we've seen of them two all day.
No doubt they've been in the doctor's mess
drinking rivers of tea.
At least that false alarm
brought a bit of glamour to the ward.
| really don't know
what men see in Claire Maitland.
No. Andrew.
He's not exactly a pump—action, six—gun lover.
Do tell.
He's normally too tired to be decent company.
If he worked all the time he claims to,
he'd be doing 100 hours a week.
He does, doesn't he?
(Scottish accent) Hello there,
this is Staff Nurse MacDougall on Lecter Ward.
The RSO's accepted a patient of ours
for transfer to you,
a Mr Hector Gonzalez,
age 107.
He's alcoholic, senile,
incontinent in both urine and faeces,
and his bedsores are infested with maggots.
If you do manage to catch any of his diarrhoea,
it needs sending off for culture.
I've written up Mr Martin's treatment
for his Peyronie's Disease.
Sister Jackie took the call from the GP.
Trevor, I've told Nurse White Coat
that the old sewer,
Mr Martin, has Peyronie's Disease.
And at this very moment,
she's applying ointment
to the affected part of his anatomy.
Doesn't that affect your...?
Willy. Yes. (Laughs)
Er, the medical officer's given steroids,
but the patient's still very wheezy.
Right. No chance of you being on steroids
after your slug—like approach to that crash call.
The only thing to which an on-call doctor
should respond instantly
is the opportunity to sleep.
The caring doctor learns as much
from listening to their patient's troubles
as from listening to their heart.
Didn't Dr Hilary Jones say that last week?
My mum says | look like him.
| think he's disgusting.
Girl's name too.
Were there these little marks on your fingernails
yesterday?
I'm...not sure.
| completely forgot to ask you,
how did you do in your exam?
| failed.
Let's hear about Mr Edwards.
He has a prosthetic heart valve,
and he's had low-grade pyrexia and malaise
on and off for a week.
Now he has splinter haemorrhages
and | think his murmur its louder.
Two blood cultures this week
have shown no growth.
(Sighs)
If you're worried, repeat them.
Do you think there's still a fair chance
he's got endocarditis?
Dying for a shower.
Could you take the RSO bleep for half an hour,
please?
(Pager)
Hello, Dr Rajah.
Oh.
Hello, Mum.
— Are you busy?
— | am actually.
— You're eating properly, | hope?
— Course I'm eating properly.
— | know hospital food...
— | can bring you something in at lunch time.
— No, don't bring me anything in at Lunch time.
— Am | embarrassing you?
Course you don't embarrass me.
— When are you coming home?
— Next weekend.
— Oh. | look forward to it.
— OK.
— Then you can meet Meera,
— No, | don't want to meet her.
— But why not?
— Because her dad's a gangster, that's why.
| know you're busy and | know
you don't like me coming into your work,
but I'm afraid | care about you.
| can't just stand back
and watch you falling apart.
Peter, | failed.
For the past four months,
I've spent every spare minute studying.
Working 90 hours a week,
running a home and raising two children.
| just can't face having to
pick up the pieces again.
— Monica, | can understand...
— Nol
You can't even understand
the tiniest part of what it's like.
Cut.
Cut.
Oh, Monica...
Monica, what is wrong with you this morning?
sorry, Mr Betancourt.
Cut.
Ah.
| think we're finally in business with this graft.
— Sorry, Mr Betancourt.
— Raj. Swap places with Monica.
It's time the little lady stood in the back
and left the brain work to the men.
(Monica laughs)
A fine demonstration of your gender-specific
aptitude for surgery, Raj.
You've just wiped out the graft
we've been working on for two hours!
This gentleman took an overdose of dothiepin
on Friday night
and was brought into casualty
Saturday afternoon.
He was given activated charcoal
with no complications.
| should think he can come off the monitor now.
Psychiatrists to see, please.
Oh.
So far, they've been unable to find a locum
to cover Dr Mardu's leave.
I'm sorry, but I've been asked
if you'd do tonight.
We've just worked an unbroken 50 hours,
Dr Turner.
Surely Andrew can't be expected
to go another 24 without sleep.
| fully agree, but this situation
has rather been thrust upon us.
Dr Turner, with respect,
| honestly feel | couldn't take another night.
In that case, | shall do everything in my power
to ensure that alternative cover is found.
— Thank you very much, Dr Turner.
— That's what I'm here for.
But if there isn't any alternative, you're not
going to let us down, are you, Andrew?
This is the second fluid balance chart
which hasn't been completed, Sister.
I'LL make it known to the ward, Mr Betancourt.
Mr Betancourt, | wondered if you'd mind
quickly seeing Mr Edwards this morning.
Post—take rounds, | have to take patients.
Raj thinks he has
subacute bacterial endocarditis.
(Sighs) Make it quick.
There are some splinters, yes.
But there's plenty of evidence of trauma.
— What's your job, sir?
— Er, cabinet—maker.
Dr Broome?
Three sets of cultures all negative.
Well, I'm sure there's nothing to worry about.
He's not ill enough for SBE.
Monitor temperatures and repeat culture
if he becomes pyrexial.
Mr Betancourt, in view of the patient's history
of heart valve replacement...
You're not exactly a houseman
who dazzles me with his clinical acumen.
As a result of your incompetence,
the health authority is having to pay a gang
of Irish navvies to rebuild a crematorium.
Wind your neck back in and do as you're told.
You've already wasted enough of my time.
(Trumpeting Casualty theme tune)
— Dr Rajah, | believe.
— Yeah.
I'm Mary Powell,
the assistant hospital manager.
| wonder if we could have a chat
in Sister's office.
Sure.
A number of incidents
have been brought to my attention,
both from your time here and also previously
on Ward C. These pranks of yours.
Mrs Powell, these pranks were part of
a fair exchange of practical jokes
— between the nurses and junior doctors.
— There is such a thing as going too far.
Following discussion with Mr Betancourt
and Mr Docherty,
it has been proposed
that we terminate your contract,
with the statutory one month's notice
under Whitley Council regulations,
owing to unprofessional conduct.
Naturally this will mean that you shan't qualify
for full registration with
the General Medical Council,
unless you repeat
your pre-registration house job.
What?
This is my career we're talking about.
Less tactful people might be tempted
to comment, "What career, Dr Rajah?"
— You have got to be kidding.
— Yes, | am.
— S-sorry?
— |'m no assistant hospital manager.
But you, Doctor, have been had.
(Laughter)
Whoo!
Still 38.2.
— Right. What I'LL need to do is start...
— (Jackie) Dr Rajah.
A moment, please.
Monica is not answering her bleep.
I've tried Mr Betancourt's secretary.
He's left for a meeting in the district.
We'll just start antibiotics anyway.
I'd prefer if we wait till it's been discussed
with either Monica or Mr Betancourt.
lf Edwards has SBE, he needs antibiotics now.
| don't quite know how to put this, but...
What you mean is,
you have no confidence in my ability.
Look, you're a great bloke,
so don't get me wrong, you're a good laugh...
I'LL draw them up myself.
(Phone rings)
Sister Lockley.
Andrew, it's for you. Dr Turner's secretary.
Hello.
No!
(Sighs) Is Dr Turner there?
(Sighs)
"Dr Turner regrets that
you will be expected to cover tonight."
British Rail regret to announce that the light
at the end of the tunnel has been turned out.
Please, take a seat.
Which one?
Now, how can | help?
Well, | know you don't usually see
junior medical staff, but...
| really feel at my wit's end.
| know Dr Turner's already made an appeal
on my behalf, but...
| think there's been some misunderstanding. Dr
Turner hasn't raised the matter with me at all
However, | am aware of the situation.
| feel | should remind you
that your contract does bind you to accept
additional duties in an emergency.
| really don't see how this is an emergency
when you've had six weeks' notice of
Dr Mardu's leave.
It is the nature of the National Health Service
that we all have to take the strain
at some time or other.
Well, in that case, Mr Legg, perhaps
you'd like to volunteer to come in tonight
and take on some of the clerical duties
that contribute to my workload.
Management and consultants are accustomed
to the disaffection of junior doctors.
You don't have to help us, of course.
That is, if you can't bring yourself to show
any concern for your patients’ welfare.
Right, your peak flows
are coming up nicely now,
so you can go home tomorrow if you're well.
Change nebs to inhalers, stop IV steroids,
and continue prednisolone, 30mg already.
— What was that about steroids again?
— Hello.
I'LL do it.
Hi.
We should talk, don't you agree?
Maybe you could drop by tonight.
| don't know.
Please.
(Sighs) Tonight... OK.
I'm pretty sure she'd been drinking
when she was on last night.
— She told me she never touched the stuff.
— You work for days without sleep,
then they've got the nerve to say
that having a drink jeopardises patient care.
Anyway, about this Herbert with the query SBE.
Start broad-spectrum IV antibiotics,
urgent echocardiogram.
— No one will buy it.
— Because it's you?
You do the dog work,
I'LL beep the cardiology reg.
Claire. Do you think I'm a crap doctor?
Yes.
Does that upset you?
Yeah.
Whatever he's got, it's not endocarditis.
— (Sighs)
— Thanks, Mark.
That's a bit of bad Luck,
him not having a life-threatening disease.
Wrong diagnosis, OK,
but you made all the right moves.
Buy her a drink, take her to the pictures.
No. You decided to woo her
by doing an echocardiogram on her father.
You're an idiot, boy!
— Hello, Judith.
— Hi.
Listen. | was wondering, maybe you and |
could go out for a drink sometime.
(Laughs)
You're just a bit too nice.
I'm one of those mad people
who always seem to fall for the bastards.
But | am a bastard.
(Laughs)
| don't know, it always amuses me
to see a doctor
who would stop resuscitating
a critically ill patient at the drop of a hat,
attempting to resuscitate a chat—up line
long after it's dead.
The only reason | helped that fella
was to pull his daughter.
Turns out he doesn't even have bloody SBE.
|, on the other hand, have a raging case
of FBE, full—bollock encephalopathy.
It's the same old story, a boy meets girl,
father has echocardiogram, boy loses girl.
Their muscles were glistening with oil
while they did their dancing.
Are you nearly done yet, Andrew?
You've another one still to see.
Nearly.
(Whispers)
No. No!
— (Laughs)
— That chap's ready for the ward now, isn't he?
— Have you called a porter for the bloods?
— No. Sorry.
(She tuts)
Cheer up. It may never happen.
| find it hard to be cheery
when I've seen 12 shifts of nurses come and go.
When is someone gonna see my mother?
I'm not the doctor looking after your mother.
I've seen you, sitting on your arse,
pen pushing. You doctors don't do bugger all!
If | hadn't ended up like this,
| would have turned into something worse.
Please.
Please.
17-year-old who's been accepted by the RMO,
She took a paracetamol overdose
about ten hours ago.
The GP was phoned and advised them
to come straight up.
— How many did you take?
— A few.
Dunno.
We think she took about 20.
She's been drinking.
Thanks. Why did you take them?
To teach me boyfriend a lesson.
— | only did it for a laugh.
— And you took about 20?
Just leave me alone, fishface.
Let me sleep.
Nurse.
Wash her out.
— But her friend says she took the tablets...
— Wash her out.
(Pager)
(Woman on pager) Please contact
coronary care urgently.
(Sighs)
(Sobs)
Why couldn't you have...
died in the ambulance?
Doctors are highly trained professionals,
yet we let our hospitals be run by...
spods with a 2:2 in geography
from the University of Ulan Bator.
| can't believe the management's so
incompetent that they can't even find a locum.
They're not.
We decided to not even look
for a locum tonight.
Much cheaper to persuade a houseman to cover.
Mmm.
(Laughs)
We force him to work tonight,
but we shan't pay him
because it's illegal to work the extra hours.
An exquisite catch—22, don't you agree?
See, junior doctors, they're like cattle.
House them in crumbling flats,
pay them a pittance,
and they daren't bite the hand...
that writes their reference.
(Zip)
Agh!
| want Andrew paid.
You're crazy.
Would you put me through
to Mr Betancourt's home number, please?
Good evening, Mrs Betancourt.
(Mouths)
And, er, Simon, stick to
working on the anaesthetised.
Your technique does nothing
for the conscious body.
Why this when you've had nothing
but contempt for him before?
Because he bought me a sandwich.
I've no speech. It's just wrong, that's all.
— Sorry to get you up, Andrew.
— That's OK.
A 35-year-old man, no history of heart trouble,
but central crushing chest pain tonight.
Er, ECG looks like an anteroseptal,
and there's one other thing.
| need to get... (Sighs)
«a needle in your arm,
so | can do something about the pain.
Have |... Have | had a heart attack?
Oh, it looks like it.
I've been working like this now
for three days
and three nights.
So...
how safe do you feel?
(Sighs) I'm so glad we got it together at last.
— You're so butch.
— (Laughs)
— Ah, Andrew.
— Dr Turner.
A quick word. I've a pile of letters to dictate
before outpatients.
Look, | want to remind you it's highly irregular
for junior doctors to complain to management.
Any repetition is likely to lead to a suspension
on the grounds of insubordination.
Hm?
So | do hope we can now put
this misunderstanding behind us.
Um, could you sign this form
for this sputum sample, please?
Thanks.
Caroline.
— Look.
— (Sighs)
I'm sorry about the last couple of days,
it's work and stuff and...
Maybe we can go out tomorrow night.
Look, I'm really busy this week,
I'LL phone you, OK?
Just popped in to do some bits
before | go over to the General,
do me ACLS course today.
— I'm sure you'll manage without me.
— Sure. Only nine more hours to go.
How was last night?
| would have been grateful
if a few of them had died in the ambulance.
A well-adjusted houseman
would rather sell his granny
— than have to get out of bed to admit her.
— | just wonder what monster I've become.
Listen, you work twice the hours of anyone else,
cope with testing circumstances
when you're too tired to write your own name,
and you still manage to help people.
That's no monster.
(Pager bleeps)
Claire, it’s Andrew.
Have a nice day.
See you tomorrow.
(Shouting)
(Boy) I’m doing biology and that for O Level
/ don't lke it
My mum says | need it for being a doctor.
Don't want te be 2a doctor.
/ want to be 2 soldier.
(Siren)
Bloods, drugs charts,
first dose IVs, Venflon.
— Mr Edwards is back to temperature again.
— Hoo-—bloody—ray.
Two quid an hour | get for this.
Compared to me, the geezer teasing body bits
out of the drain under the morgue is pampered.
| can think of no more miserable way to spend
a Saturday afternoon than to be second on...
house officer for crap like this,
stuck in this festering cackhole of a hospital
without one single thing to endear it but the...
Breathe in.
Peekaboo.
And out.
| can't find anything to explain
your temperature,
but | think we should do more tests of
your blood and urine just to be on the safe side.
I'd never forgive myself if | overlooked
a simple problem we could treat.
(Laughs)
You don't want to be doing yourself
a mischief, Arthur.
But my name's not Arthur,
(Laughs)
This one's for me. Something to stop vomiting.
| have an urgent bleep message.
Babe alert, Lecter Ward.
Babe alert, Lecter Ward.
(Pager bleeps)
(Woman on pager) Babe alert, Lecter Ward.
Hi there. Er...
Claire's still up to her neck in that DKA,
so maybe you could see this next one
we've had in.
59-year-old man, recently widowed,
dothiepin overdose during the night.
— Will you be washing him out?
— Not if the OD was Last night.
Well, Claire might insist on
washing him out anyway,
make him think twice
before taking another one.
The last thing this man needs is
to be punished for what he's done.
Thank you.
Er, | thought you'd be busy down here,
so | picked you some sandwiches up
before the canteen shut.
Thanks very much.
Would you lavage someone who OD'd last night?
No. But you can't rely on uncorroborated history
from someone who's just tried to top himself.
Well, you can make any excuse
if you resent ODs enough.
Even contempt counts as emotional involvement,
not my style.
Dr Maitland, can | ask you not to eat
in the department, please?
Unlike you, Charge Nurse Sutton,
| don't get protected breaks and meal times.
In an environment in which | can work
a couple of days without even a sit-down,
I'LL eat where and when | please.
Oh, yeah. That LVF we were expecting
died in the ambulance.
So that's one less admission to clerk.
— So what about this overdose, then?
— No wash-out.
Present the case, Dr Rajah.
Clinical inspection revealed little
apart from her chronic pulchritude.
| called upon the most searching instrument
of investigation known to medical science.
— | asked Ward Sister to check her out.
— Excellent.
She is Miss Judith Edwards, age 23,
legal secretary, self-referral to the ward,
visiting her father Mr Ronald Edwards.
Whatever her dad's got, he'll get better.
Nothing guarantees round-the-clock medical
attention like having a gorgeous daughter.
Oh, yes.
(Murmurs of approval)
(TV) The FA Carling Premiership.
Arsenal — nit, Manchester City — nil
Chelsea — one, Norwich City — two.
— Coventry City — one...
— Oh, United went down again.
| don't really follow football, Mr Blewitt.
No, | don't suppose you would.
Oi.
Cardiac arrest!
Caroline.
Mr Blewitt, cardiac arrest.
(Breathing heavily)
— (Pager)
— Oh, can you...
Yeah, fine.
What the bloody hell are you gawping at?
(Sighs)
Mr Blewitt has these funny turns sometimes.
Petit mal epilepsy.
Well, come on, sunshine.
Patients to see, lives to save.
Bye for now.
That's the first we've seen of them two all day.
No doubt they've been in the doctor's mess
drinking rivers of tea.
At least that false alarm
brought a bit of glamour to the ward.
| really don't know
what men see in Claire Maitland.
No. Andrew.
He's not exactly a pump—action, six—gun lover.
Do tell.
He's normally too tired to be decent company.
If he worked all the time he claims to,
he'd be doing 100 hours a week.
He does, doesn't he?
(Scottish accent) Hello there,
this is Staff Nurse MacDougall on Lecter Ward.
The RSO's accepted a patient of ours
for transfer to you,
a Mr Hector Gonzalez,
age 107.
He's alcoholic, senile,
incontinent in both urine and faeces,
and his bedsores are infested with maggots.
If you do manage to catch any of his diarrhoea,
it needs sending off for culture.
I've written up Mr Martin's treatment
for his Peyronie's Disease.
Sister Jackie took the call from the GP.
Trevor, I've told Nurse White Coat
that the old sewer,
Mr Martin, has Peyronie's Disease.
And at this very moment,
she's applying ointment
to the affected part of his anatomy.
Doesn't that affect your...?
Willy. Yes. (Laughs)
Er, the medical officer's given steroids,
but the patient's still very wheezy.
Right. No chance of you being on steroids
after your slug—like approach to that crash call.
The only thing to which an on-call doctor
should respond instantly
is the opportunity to sleep.
The caring doctor learns as much
from listening to their patient's troubles
as from listening to their heart.
Didn't Dr Hilary Jones say that last week?
My mum says | look like him.
| think he's disgusting.
Girl's name too.
Were there these little marks on your fingernails
yesterday?
I'm...not sure.
| completely forgot to ask you,
how did you do in your exam?
| failed.
Let's hear about Mr Edwards.
He has a prosthetic heart valve,
and he's had low-grade pyrexia and malaise
on and off for a week.
Now he has splinter haemorrhages
and | think his murmur its louder.
Two blood cultures this week
have shown no growth.
(Sighs)
If you're worried, repeat them.
Do you think there's still a fair chance
he's got endocarditis?
Dying for a shower.
Could you take the RSO bleep for half an hour,
please?
(Pager)
Hello, Dr Rajah.
Oh.
Hello, Mum.
— Are you busy?
— | am actually.
— You're eating properly, | hope?
— Course I'm eating properly.
— | know hospital food...
— | can bring you something in at lunch time.
— No, don't bring me anything in at Lunch time.
— Am | embarrassing you?
Course you don't embarrass me.
— When are you coming home?
— Next weekend.
— Oh. | look forward to it.
— OK.
— Then you can meet Meera,
— No, | don't want to meet her.
— But why not?
— Because her dad's a gangster, that's why.
| know you're busy and | know
you don't like me coming into your work,
but I'm afraid | care about you.
| can't just stand back
and watch you falling apart.
Peter, | failed.
For the past four months,
I've spent every spare minute studying.
Working 90 hours a week,
running a home and raising two children.
| just can't face having to
pick up the pieces again.
— Monica, | can understand...
— Nol
You can't even understand
the tiniest part of what it's like.
Cut.
Cut.
Oh, Monica...
Monica, what is wrong with you this morning?
sorry, Mr Betancourt.
Cut.
Ah.
| think we're finally in business with this graft.
— Sorry, Mr Betancourt.
— Raj. Swap places with Monica.
It's time the little lady stood in the back
and left the brain work to the men.
(Monica laughs)
A fine demonstration of your gender-specific
aptitude for surgery, Raj.
You've just wiped out the graft
we've been working on for two hours!
This gentleman took an overdose of dothiepin
on Friday night
and was brought into casualty
Saturday afternoon.
He was given activated charcoal
with no complications.
| should think he can come off the monitor now.
Psychiatrists to see, please.
Oh.
So far, they've been unable to find a locum
to cover Dr Mardu's leave.
I'm sorry, but I've been asked
if you'd do tonight.
We've just worked an unbroken 50 hours,
Dr Turner.
Surely Andrew can't be expected
to go another 24 without sleep.
| fully agree, but this situation
has rather been thrust upon us.
Dr Turner, with respect,
| honestly feel | couldn't take another night.
In that case, | shall do everything in my power
to ensure that alternative cover is found.
— Thank you very much, Dr Turner.
— That's what I'm here for.
But if there isn't any alternative, you're not
going to let us down, are you, Andrew?
This is the second fluid balance chart
which hasn't been completed, Sister.
I'LL make it known to the ward, Mr Betancourt.
Mr Betancourt, | wondered if you'd mind
quickly seeing Mr Edwards this morning.
Post—take rounds, | have to take patients.
Raj thinks he has
subacute bacterial endocarditis.
(Sighs) Make it quick.
There are some splinters, yes.
But there's plenty of evidence of trauma.
— What's your job, sir?
— Er, cabinet—maker.
Dr Broome?
Three sets of cultures all negative.
Well, I'm sure there's nothing to worry about.
He's not ill enough for SBE.
Monitor temperatures and repeat culture
if he becomes pyrexial.
Mr Betancourt, in view of the patient's history
of heart valve replacement...
You're not exactly a houseman
who dazzles me with his clinical acumen.
As a result of your incompetence,
the health authority is having to pay a gang
of Irish navvies to rebuild a crematorium.
Wind your neck back in and do as you're told.
You've already wasted enough of my time.
(Trumpeting Casualty theme tune)
— Dr Rajah, | believe.
— Yeah.
I'm Mary Powell,
the assistant hospital manager.
| wonder if we could have a chat
in Sister's office.
Sure.
A number of incidents
have been brought to my attention,
both from your time here and also previously
on Ward C. These pranks of yours.
Mrs Powell, these pranks were part of
a fair exchange of practical jokes
— between the nurses and junior doctors.
— There is such a thing as going too far.
Following discussion with Mr Betancourt
and Mr Docherty,
it has been proposed
that we terminate your contract,
with the statutory one month's notice
under Whitley Council regulations,
owing to unprofessional conduct.
Naturally this will mean that you shan't qualify
for full registration with
the General Medical Council,
unless you repeat
your pre-registration house job.
What?
This is my career we're talking about.
Less tactful people might be tempted
to comment, "What career, Dr Rajah?"
— You have got to be kidding.
— Yes, | am.
— S-sorry?
— |'m no assistant hospital manager.
But you, Doctor, have been had.
(Laughter)
Whoo!
Still 38.2.
— Right. What I'LL need to do is start...
— (Jackie) Dr Rajah.
A moment, please.
Monica is not answering her bleep.
I've tried Mr Betancourt's secretary.
He's left for a meeting in the district.
We'll just start antibiotics anyway.
I'd prefer if we wait till it's been discussed
with either Monica or Mr Betancourt.
lf Edwards has SBE, he needs antibiotics now.
| don't quite know how to put this, but...
What you mean is,
you have no confidence in my ability.
Look, you're a great bloke,
so don't get me wrong, you're a good laugh...
I'LL draw them up myself.
(Phone rings)
Sister Lockley.
Andrew, it's for you. Dr Turner's secretary.
Hello.
No!
(Sighs) Is Dr Turner there?
(Sighs)
"Dr Turner regrets that
you will be expected to cover tonight."
British Rail regret to announce that the light
at the end of the tunnel has been turned out.
Please, take a seat.
Which one?
Now, how can | help?
Well, | know you don't usually see
junior medical staff, but...
| really feel at my wit's end.
| know Dr Turner's already made an appeal
on my behalf, but...
| think there's been some misunderstanding. Dr
Turner hasn't raised the matter with me at all
However, | am aware of the situation.
| feel | should remind you
that your contract does bind you to accept
additional duties in an emergency.
| really don't see how this is an emergency
when you've had six weeks' notice of
Dr Mardu's leave.
It is the nature of the National Health Service
that we all have to take the strain
at some time or other.
Well, in that case, Mr Legg, perhaps
you'd like to volunteer to come in tonight
and take on some of the clerical duties
that contribute to my workload.
Management and consultants are accustomed
to the disaffection of junior doctors.
You don't have to help us, of course.
That is, if you can't bring yourself to show
any concern for your patients’ welfare.
Right, your peak flows
are coming up nicely now,
so you can go home tomorrow if you're well.
Change nebs to inhalers, stop IV steroids,
and continue prednisolone, 30mg already.
— What was that about steroids again?
— Hello.
I'LL do it.
Hi.
We should talk, don't you agree?
Maybe you could drop by tonight.
| don't know.
Please.
(Sighs) Tonight... OK.
I'm pretty sure she'd been drinking
when she was on last night.
— She told me she never touched the stuff.
— You work for days without sleep,
then they've got the nerve to say
that having a drink jeopardises patient care.
Anyway, about this Herbert with the query SBE.
Start broad-spectrum IV antibiotics,
urgent echocardiogram.
— No one will buy it.
— Because it's you?
You do the dog work,
I'LL beep the cardiology reg.
Claire. Do you think I'm a crap doctor?
Yes.
Does that upset you?
Yeah.
Whatever he's got, it's not endocarditis.
— (Sighs)
— Thanks, Mark.
That's a bit of bad Luck,
him not having a life-threatening disease.
Wrong diagnosis, OK,
but you made all the right moves.
Buy her a drink, take her to the pictures.
No. You decided to woo her
by doing an echocardiogram on her father.
You're an idiot, boy!
— Hello, Judith.
— Hi.
Listen. | was wondering, maybe you and |
could go out for a drink sometime.
(Laughs)
You're just a bit too nice.
I'm one of those mad people
who always seem to fall for the bastards.
But | am a bastard.
(Laughs)
| don't know, it always amuses me
to see a doctor
who would stop resuscitating
a critically ill patient at the drop of a hat,
attempting to resuscitate a chat—up line
long after it's dead.
The only reason | helped that fella
was to pull his daughter.
Turns out he doesn't even have bloody SBE.
|, on the other hand, have a raging case
of FBE, full—bollock encephalopathy.
It's the same old story, a boy meets girl,
father has echocardiogram, boy loses girl.
Their muscles were glistening with oil
while they did their dancing.
Are you nearly done yet, Andrew?
You've another one still to see.
Nearly.
(Whispers)
No. No!
— (Laughs)
— That chap's ready for the ward now, isn't he?
— Have you called a porter for the bloods?
— No. Sorry.
(She tuts)
Cheer up. It may never happen.
| find it hard to be cheery
when I've seen 12 shifts of nurses come and go.
When is someone gonna see my mother?
I'm not the doctor looking after your mother.
I've seen you, sitting on your arse,
pen pushing. You doctors don't do bugger all!
If | hadn't ended up like this,
| would have turned into something worse.
Please.
Please.
17-year-old who's been accepted by the RMO,
She took a paracetamol overdose
about ten hours ago.
The GP was phoned and advised them
to come straight up.
— How many did you take?
— A few.
Dunno.
We think she took about 20.
She's been drinking.
Thanks. Why did you take them?
To teach me boyfriend a lesson.
— | only did it for a laugh.
— And you took about 20?
Just leave me alone, fishface.
Let me sleep.
Nurse.
Wash her out.
— But her friend says she took the tablets...
— Wash her out.
(Pager)
(Woman on pager) Please contact
coronary care urgently.
(Sighs)
(Sobs)
Why couldn't you have...
died in the ambulance?
Doctors are highly trained professionals,
yet we let our hospitals be run by...
spods with a 2:2 in geography
from the University of Ulan Bator.
| can't believe the management's so
incompetent that they can't even find a locum.
They're not.
We decided to not even look
for a locum tonight.
Much cheaper to persuade a houseman to cover.
Mmm.
(Laughs)
We force him to work tonight,
but we shan't pay him
because it's illegal to work the extra hours.
An exquisite catch—22, don't you agree?
See, junior doctors, they're like cattle.
House them in crumbling flats,
pay them a pittance,
and they daren't bite the hand...
that writes their reference.
(Zip)
Agh!
| want Andrew paid.
You're crazy.
Would you put me through
to Mr Betancourt's home number, please?
Good evening, Mrs Betancourt.
(Mouths)
And, er, Simon, stick to
working on the anaesthetised.
Your technique does nothing
for the conscious body.
Why this when you've had nothing
but contempt for him before?
Because he bought me a sandwich.
I've no speech. It's just wrong, that's all.
— Sorry to get you up, Andrew.
— That's OK.
A 35-year-old man, no history of heart trouble,
but central crushing chest pain tonight.
Er, ECG looks like an anteroseptal,
and there's one other thing.
| need to get... (Sighs)
«a needle in your arm,
so | can do something about the pain.
Have |... Have | had a heart attack?
Oh, it looks like it.
I've been working like this now
for three days
and three nights.
So...
how safe do you feel?
(Sighs) I'm so glad we got it together at last.
— You're so butch.
— (Laughs)
— Ah, Andrew.
— Dr Turner.
A quick word. I've a pile of letters to dictate
before outpatients.
Look, | want to remind you it's highly irregular
for junior doctors to complain to management.
Any repetition is likely to lead to a suspension
on the grounds of insubordination.
Hm?
So | do hope we can now put
this misunderstanding behind us.
Um, could you sign this form
for this sputum sample, please?
Thanks.
Caroline.
— Look.
— (Sighs)
I'm sorry about the last couple of days,
it's work and stuff and...
Maybe we can go out tomorrow night.
Look, I'm really busy this week,
I'LL phone you, OK?
Just popped in to do some bits
before | go over to the General,
do me ACLS course today.
— I'm sure you'll manage without me.
— Sure. Only nine more hours to go.
How was last night?
| would have been grateful
if a few of them had died in the ambulance.
A well-adjusted houseman
would rather sell his granny
— than have to get out of bed to admit her.
— | just wonder what monster I've become.
Listen, you work twice the hours of anyone else,
cope with testing circumstances
when you're too tired to write your own name,
and you still manage to help people.
That's no monster.
(Pager bleeps)
Claire, it’s Andrew.
Have a nice day.
See you tomorrow.