Cardiac Arrest (1994–1996): Season 2, Episode 1 - Shallow End - full transcript
Bomb scare at the General,
everything's coming here.
— Who's next?
— Query PE, cubicle 7.
Raj, there's a chap on the trolley somewhere,
Mr Crosby. Needs assistance, please.
— Mr Crosby?
— (Man coughs and splutters)
Back in a moment, sir.
Mr Crosby, hello. I'm Dr Rajah.
Raj, there's a very poorly lady in cubicle 5,
— Zelda Campbell, 79, bronchopneumonia.
— I'll be right back, Mr Crosby.
Doctor's here, Mrs Campbell.
Will you excuse us for a moment, please?
— Watch that guy in number 7, all right?
— OK.
(Phone)
The General hope to be reopened by midday.
We should be able to muddle through till then.
We'll do our best, Mr Legg.
I'L be at the management conference
if there are any problems.
— Mrs Campbell will take the last medical bed.
— All right.
By the way, in all the excitement,
| forgot to say welcome back.
One of the grown-up doctors at last, eh?
Yeah...
Yeah, Dr Collin, RMO.
We'll have to shut down all medical admissions.
Excuse me, Doctor. Ward M?
Please. Down to the end, next floor up.
Left at ultrasound, across the footbridge,
right at occupational therapy,
round the back and by the scaffolding.
Ah.
— Morning, Dr Turner.
— | hear congratulations are in order.
Now you can call yourself
Member of the Royal College of Physicians.
Um... | wouldn't hesitate to support you
if you applied for that research registrar post
that happens to be coming up at the General.
Thank you, Dr Turner.
— Morning, Barry.
— Hands off, Graham. She's my SHO now.
(Chuckles)
| was hoping to catch our new houseman.
Did a locum for me last summer. Top notch.
Gave him the job after seeing him
play number eight for the medics’ first XV.
Safest pair of hands on the field.
| knew | could trust him on the end of a needle.
You do know there's a directorate meeting
this morning, Barry?
Oh...
— Andrew.
— Caroline.
Andrew.
Don't tell me you're Dr Turner's new SHO?
Is my new houseman about yet?
I've sent an urgent U and E on Mr Napier.
| think he's hypercolemic on the IV.
| don't think Mrs Clement
should have coproximol
because she's on carbamezipine
which interacts.
So I've given her codydramol instead.
— Could you er...
— Yeah?
— Could you admit a bronchopneumonia?
— Sure, OK.
— Be sure to check...
— Chest X-ray, gases, cultures. | know.
Mr Franklin's venflon's tissued.
Later. I've got a patient in casualty.
Off you go, then. Go to casualty.
I'LL look after the venflon.
Hi, Pam.
— Mr Franklin.
— (Claire) There's a new deal for junior doctors.
— I've read about it in all the papers.
— You work under me and Claire.
We all work under two consultants,
Dr Turner and Dr Yates.
— Who's the chap doing that venflon for me?
— Yates is my name.
But you can call me sir.
(ALL laugh)
No, no. Seriously. If you have any worries,
you can call on me any time day or night.
This is on 24 hours a day, all right?
Unfortunately, it's the likes of him
who take their bleeps to an early grave.
— We work on this floor here.
— Phil, you work in a pool of excrement.
Your job is to swim for the shallow end.
| take delivery of the Jag and | can't open her
up on account of a pile—up on the ring road.
Probably only some bloody joy rider
who'll cost the taxpayer thousands
with a free holiday and intensive care.
No doubt he'll pilfer a ventilator
when he's discharged.
— (Woman screams)
— (Man) Help!
When will they learn not to leave upstairs
windows open in the psychiatric unit?
Consultants’ car park, sir?
Well, what do you think?
Time was a consultant
got a salute off the likes of you.
— Do you have any pain anywhere?
— Yes. My chest.
Excuse me, Doctor. Could you tell me
where the nearest disabled toilet is, please?
— [| um...
— Second floor, next to maternity.
Thank you. Ground floor
would be asking too much, of course.
— Raj, X-rays for Mr Crosby.
— OK.
Back in a moment, sir.
Julie? Which butcher's on call today?
— I'm the surgical registrar.
— Hi. | think I've got a customer for you.
Butcher, moi? Pah!
Long history of duodenal ulcer.
Recently taking aspirin for backache.
Excruciating abdominal pains this morning.
X-ray shows feed gas under the diaphragm.
— Hello, sir.
— (Man groans)
— Can | borrow your tubes?
— Yeah.
Aaaahh!
| reckon maybe your guts has burst open, mate.
We need to get in there and bung it up. Raj?
Fast IVI, routine bloods, group and save.
— (Andrew) No. The General is still shut.
— James? James?
— Bomb scare.
— Looks like a perf'd duo is our first punter.
No worries, mate.
OK, well, you'll have to send him up to us. Yes.
Damn...
Um, I've had to accept a DVT.
Can we start an IVI on Mr Crosby, please, Julie?
— Um... Yes. Uh...
— Crosby.
Call for Dr Rajah.
Hello, Dr Rajah. Mum.
Wasn't she little Sinua’s arranged—to—marry?
I'm sure she's very nice but | don't fancy a girl
who's been hawked round like a special offer.
Bye, Mum.
Asthma attack.
Well, check his gases
and I'LL see him with the results myself.
Dr Collin. Alison, how are you?
Yeah, it's busy, but...
You know | do.
Now, Mrs Trimble. There are a few
odds and ends which | like to go over
every time | have a new secretary appointed.
Er... Firstly, | am very particular about...er...er...
A GP is addressed by name.
Drugs are...er...er...
have an initial capital letter,
whereas generic names, of course,
initially, are—are—are...
According to the... I'm a very fussy old man.
Mr Docherty. A gentleman who attends
to details is a gentleman you can trust.
Would Mrs Docherty agree?
Oh...Mary passed away.
Five years ago this Christmas.
Oh, Mr Docherty, I'm sorry. I'm very sorry.
Thank you.
(Phone rings)
Hello, Um... Mr Docherty's secretary.
Oh, yes, thank you. Mmm.
Yes, I'll let him know.
Sister Landers wishes to inform you that your
ward round should have begun half an hour ago.
Oh. Thank you, Mrs Trimble.
— So...
— Scissors.
| hear you recently passed your fellowship.
That's right.
| remember | was pleased as punch
when | passed both parts.
First time?
Of course,
the real benefits come with consultancy.
I've just taken on a brand—spanking—new Jag.
Well, you put a decent bloke behind the wheel
of one of those monsters and...
The car park chappie was telling me that some
tit asked him for a salute this morning.
(Phone)
Well, | have given her the first dose of antibiotic
for the chest infection.
And I'm also gonna see
if | can get her an urgent brain scan.
— What are you looking for?
— Well, there are a number of conditions
that might be taken for a stroke when in fact
they're something quite different.
— Something curable, you mean?
— Possibly.
— We're very grateful, Doctor.
— OK.
Ah. I'm afraid that bed's not come up.
The gentleman who was supposed to be
discharged has developed a wound infection.
We'll just put you over here for a moment,
Mr Crosby.
You should have a bed fairly soon.
Mr Crosby.
Good news, mate. We've managed
to tuck you back in and stitch you up.
You see, what had happened was
your ulcer had burst through your stomach wall.
But we've sealed it for you.
So you can just take it easy.
Enjoy the scenery.
Mr Docherty's started the ward round.
Better get your skates on.
This is the gentleman who had a foreign body
removed yesterday, Mr Docherty.
Oh, you remember, Mr Docherty.
The gentleman who had a thing in his bowel.
A thing he'd put up there himself.
Ah.
— All's well, | trust.
— Obs are satisfactory, Mr Docherty.
You appear to be on the road to recovery,
young man.
| only wish the same could be said
for your hamster.
(Sniggers)
Sister, who is that young fellow
who keeps following us about?
Oh. He's your new registrar, Mr Docherty.
Ah...
In the mornings, the registrar
is expected to attend my colonoscopy List.
I'm no expert, Mr Docherty, but | reckon to be
able to tell a patient's arse from his elbow.
— So to speak.
— Ah, yes.
You can tell a great deal about a chap
from looking up his ah—ah—ah...
Of course, when he first arrived,
Defries expected to take my list.
Then it was pointed out
that there was no great value
in having an arsehole
at both ends of the colonoscope.
Mr Crosby's not looking very well.
His BP's 90 over 60.
— Are you in pain, sir?
— My chest is...
Morphine, please, Sister. We should do
a cardiogram. | suspect coronary thrombosis.
Connect up the defib, please.
(Continuous tone)
— Thank you, Staff Nurse Dalton. One to five?
— Yeah.
One, two, three, four, five.
One, two, three...
Clear!
(Regular beeping)
Who's in charge here?
(James) Well, technically you are, Mr D.
This chap's had major surgery and suffered
a VF arrest. Sounds like an MI to me.
Perhaps we should start with a 12—lead ECG.
Yes. Thank you, Staff.
He's got bugger all breath sounds on the right.
Give him a pneumo by CPR.
Let's have a chest drain in here.
— Trachea's shifted.
— Let's do something about that.
(Continuous tone)
Chest compression can sometimes
cause the Lung to collapse.
The pressure change in the chest cavity
could push the windpipe to one side.
The real danger
is if the heart gets pushed over there.
That's what's happened
so shut up and give us a hand.
(James)
OK. Roll him over. Stop thinking. Get on with it.
— Get him over.
— Ready, one, two, three...
— OK.
— Hold him steady.
Stabilising now.
OK. Carving now.
(Continuous tone)
— That's it.
— Sister.
Thank you.
I'm in. Clamp, please.
Thank you, Mr Docherty.
Right. Connected and clear.
Thank you.
Output recovered.
(Steady beeping)
Department of Emergency Medicine,
Johannesburg, ‘91...
'9?.
So you appear to have had a slight heart attack,
precipitated by the strain of major surgery.
No beds on CCU. I'll have to put him on Crippen
for the time being.
Nobody expects a new senior house officer
to know all the answers, you know.
Except that new houseman of yours.
It's pretty unusual
for a house officer to look at the scans.
It's clear what's behind her problems, right?
Right.
So I'll take these for reporting?
Yup.
— Has anyone seen the old boy yet?
— Tony said he'll see him next.
Trisha, can you take over...
What are you two doing?
We've had an alert, major chest injuries,
ETA 15 minutes.
— More to the point, what are you doing here?
— | thought I'd help out.
Translation — this is Raj's pitiful method of
worming his way into Sister Novak's good books
and hopefully into her knickers.
Dislocated finger, cubicle 2.
— You done A&E before?
— No.
You poor bloody lamb to the slaughter.
It's like being a houseman all over again,
except people's expectations of you
are even higher.
Look and learn, boy.
Hello, sir.
This is the gentleman that Dr Yates
wanted admitting from outpatients, yes?
| changed some of the treatment you wrote up
for him. It seemed a bit complicated.
Nothing to find on the examination.
May | take a look at your hands, please, sir?
Fingers are clubbed, the index and middle finger
are stained with nicotine and what's this?
It's a coal—dust tattoo.
I'LL see you later, sir.
You might have thought that coal was a mineral
found naturally
in the sheds of the working class.
In fact,
people have to go underground and dig it out.
If they get a cut and coal dust gets inside,
it discolours the wound permanently,
like a tattoo.
This is a man who's smoked,
who's worked down the mines.
| don't think it's that complicated to work out
why he's short of breath, do you?
Our patient is a male in his 30s
who didn't fasten his seatbelt.
He has severe chest wall injuries.
James will manage the airway for us.
Scissors, would you cannulate the patient
then commence fluid replacement
while | perform primary and secondary surveys?
Julie, would you ensure bloods are sent
and X-rays requested?
Nurse, if you would do an initial blood pressure
measurement, please?
Raj.
— Just do as you're told.
— (Chuckles)
You show him, Raj.
(Cart crashing)
(Urgent chatter)
Raj, get that smoothly.
One, two, three, Lift.
Good.
Airway secure. Breathing spontaneously.
Rapid pulse. Fast fluids, please, Scissors.
Make way.
Chest exposed,
— Pupils reacting equally.
— Multiple rib fractures.
— Let's get his neck fixed and X-ray.
— |'min.
— Still no bed, Mr Crosby?
— Sister said there could be one soon.
The CT report is a brain tumour.
— Did you see this scan yourself?
— Yeah.
And it was a tumour?
Yeah.
They've sent us the wrong patient's report, Phil.
This is a massive infarct, a stroke.
Look. We all want to impress when we start,
| know.
But if you don't tell me when you need help,
| won't be able to help you, will 1? Hmm?
Yeah.
— Have you spoken to the family?
— Yeah.
Well, | mean, no, not really.
Looking after her haven't been easy,
but it's what we wanted to do.
You see, Doctor,
when she became so much sicker,
our doctor thought it best
she come into hospital.
She is very sick, isn't she?
Mr Campbell, none of the tests
have uncovered anything treatable.
| think your mother is dying.
— There's nothing you can do for her?
— Only make her more comfortable.
— Would you like her to come home?
— Yes, Doctor. We would.
Front—type temporal skull fracture.
Cervical spine.
No bone injury.
(Rapid beeping)
Multiple rib fractures.
Plus a fractured skull.
(Beeping slows)
BP's still only 50 over unrecordable.
(Continuous tone)
— We're losing him.
— CPR and adrenalin.
Now.
(Crunch)
Whoops.
You just lost your no—claims bonus insurance
on your medical insurance.
Would have died anyway, mate.
It wasn't your operation.
You haven't, have you?
You can't have.
Even | know a shag when I've had one.
Nowadays, death is institutionalised.
People die in hospital beds as if their lives
were the property of the state.
I'd like to let this lady home, please, Debbie.
Do you agree?
You know your wish is my command, Dr Yates.
Mm. That will be the day.
As you'll soon learn,
we have a love/hate relationship.
Yeah. He loves me and | hate him.
Yeah. Yeah. Yeah, thanks. Bye.
I'm very sorry, Dr Yates,
but the support services
can't make arrangements until the morning.
I've discussed the matter
with the on-call nursing manager
and she's not happy
to go ahead with the discharge.
| remember the time, long ago, when the most
important people were the patients.
And the second most important
the doctors and nurses who looked after them.
(Phone)
(Struggling)
— Is anyone seeing you, sir?
— Where am |?
In a hospital. Have you any pain anywhere?
— In my chest.
— In your chest. OK. Let me check it for you.
Right, can you take him to 6, please? Thank you.
— I'm sorry. Raj?
— What?
— What?
— Raj, come here!
I'LL be right back, sir, | promise.
We've got a star in. The hospital manager
collapsed at the conference.
Look, that old man's been here all day and his
oxygen is now empty so could you change it?
— Yes, sir.
— First time I've been in this place after 5.
You know | had a heart attack only a year ago.
I'm sure you'll be all right, Mr Legg.
(Continuous tone)
Don't worry about it.
After the day you've had, this is the Vanessa
Paradis—dipped—in—chocolate scenario.
IF you save him, he'll love you.
If you don't, what's he gonna do?
— Shock, please, Raj.
— Clear.
Back in now. Thanks, everybody.
— He'll be dead, then.
— Wasn't much more active when he was alive.
She became distressed
so | increased the diamorph.
— As you can see, that settled her.
— Doctor?
Please, don't tell me there's a problem.
All we want is for our mother
to end her time with her loved ones
— and not be a burden to you good people.
— Look, look, Mr Campbell.
Why don't you go home, get some sleep
and we'll get your mother home
first thing in the morning.
A patient on a trolley
because we haven't got a bed for him
and another patient who we can't send home
when common sense and decency
say she ought to go home.
Andrew,
Mrs Campbell is going to be among her family
even if | have to take her out
in the boot of my car.
Paralysis, my arse. He's fubar bundy.
(Continuous tone)
Your patient's just gone into heart block, Doctor.
(Continuous tone)
Can you give me a picture, please?
There's an AA van round the back.
We'll get them to rev up the engine
and connect the jump leads.
OK. (Sighs) His bowel burst open.
He had a heart attack, a collapsed lung
and he stopped breathing twice.
| think he's now qualified for a hospital bed.
All right, Mr Crosby?
— Morning, sir.
— Diabetic. Visiting friends locally.
Usually under regular review
at St Bartholomew's. Glucose...
Can't be bad. | was at Bart's.
Glucose 439.3.
So was my father. He almost disinherited me
when | accepted an offer from St Thomas's.
Yes. (Chuckles)
— Human actraphane, 36 units in the morning.
— Wait a minute.
There was a Kirkby two years my senior.
Pardon me, Dr Turner. Andrew,
there's a problem with Mrs Campbell.
Bullish fellow. Army type.
(Turner) | don't believe it!
Close the curtains, Carol.
Now, Sharon, as long as there's nothing nasty in
those tests, you should be free to go tomorrow.
All right? Good.
Dr Turner. Can | see you, please?
If you see your general practitioner,
he will refer you to my outpatient clinic.
Dr Turner, my name is Paul Tennant.
Until yesterday,
| was the new assistant hospital manager.
After last night,
you can drop the word “assistant”.
Do forgive me. | had no idea.
Are you aware that the facilities here
for the disabled are appalling?
You did everything you could.
Please...
Don't be kind to me.
I've failed you, terribly.
(Paul) | hope we can meet this afternoon.
Among other things,
| plan we attain our audit targets.
That we satisfy the conditions
of the patients’ charter
and that we meet the requirements
of the junior doctors’ new deal.
| may be in a caretaker position
at the moment, Dr Turner,
but | intend to convince our masters
it should be permanent.
This afternoon, then, Mr Tennant.
Dr Yates. | hope this isn't a bad time.
But | noticed you've yet to give us a satisfactory
account of your outpatients’ waiting times.
Please fill in the audit forms as requested.
Thank you for your cooperation.
— Doctor...
— Maitland.
Maitland.
They bury you under a mountain of paperwork
and then they have the gall
to wonder why you can't see enough cases.
Come on, Claire. We've got patients to see.
Don't say it. It's like | never left.
everything's coming here.
— Who's next?
— Query PE, cubicle 7.
Raj, there's a chap on the trolley somewhere,
Mr Crosby. Needs assistance, please.
— Mr Crosby?
— (Man coughs and splutters)
Back in a moment, sir.
Mr Crosby, hello. I'm Dr Rajah.
Raj, there's a very poorly lady in cubicle 5,
— Zelda Campbell, 79, bronchopneumonia.
— I'll be right back, Mr Crosby.
Doctor's here, Mrs Campbell.
Will you excuse us for a moment, please?
— Watch that guy in number 7, all right?
— OK.
(Phone)
The General hope to be reopened by midday.
We should be able to muddle through till then.
We'll do our best, Mr Legg.
I'L be at the management conference
if there are any problems.
— Mrs Campbell will take the last medical bed.
— All right.
By the way, in all the excitement,
| forgot to say welcome back.
One of the grown-up doctors at last, eh?
Yeah...
Yeah, Dr Collin, RMO.
We'll have to shut down all medical admissions.
Excuse me, Doctor. Ward M?
Please. Down to the end, next floor up.
Left at ultrasound, across the footbridge,
right at occupational therapy,
round the back and by the scaffolding.
Ah.
— Morning, Dr Turner.
— | hear congratulations are in order.
Now you can call yourself
Member of the Royal College of Physicians.
Um... | wouldn't hesitate to support you
if you applied for that research registrar post
that happens to be coming up at the General.
Thank you, Dr Turner.
— Morning, Barry.
— Hands off, Graham. She's my SHO now.
(Chuckles)
| was hoping to catch our new houseman.
Did a locum for me last summer. Top notch.
Gave him the job after seeing him
play number eight for the medics’ first XV.
Safest pair of hands on the field.
| knew | could trust him on the end of a needle.
You do know there's a directorate meeting
this morning, Barry?
Oh...
— Andrew.
— Caroline.
Andrew.
Don't tell me you're Dr Turner's new SHO?
Is my new houseman about yet?
I've sent an urgent U and E on Mr Napier.
| think he's hypercolemic on the IV.
| don't think Mrs Clement
should have coproximol
because she's on carbamezipine
which interacts.
So I've given her codydramol instead.
— Could you er...
— Yeah?
— Could you admit a bronchopneumonia?
— Sure, OK.
— Be sure to check...
— Chest X-ray, gases, cultures. | know.
Mr Franklin's venflon's tissued.
Later. I've got a patient in casualty.
Off you go, then. Go to casualty.
I'LL look after the venflon.
Hi, Pam.
— Mr Franklin.
— (Claire) There's a new deal for junior doctors.
— I've read about it in all the papers.
— You work under me and Claire.
We all work under two consultants,
Dr Turner and Dr Yates.
— Who's the chap doing that venflon for me?
— Yates is my name.
But you can call me sir.
(ALL laugh)
No, no. Seriously. If you have any worries,
you can call on me any time day or night.
This is on 24 hours a day, all right?
Unfortunately, it's the likes of him
who take their bleeps to an early grave.
— We work on this floor here.
— Phil, you work in a pool of excrement.
Your job is to swim for the shallow end.
| take delivery of the Jag and | can't open her
up on account of a pile—up on the ring road.
Probably only some bloody joy rider
who'll cost the taxpayer thousands
with a free holiday and intensive care.
No doubt he'll pilfer a ventilator
when he's discharged.
— (Woman screams)
— (Man) Help!
When will they learn not to leave upstairs
windows open in the psychiatric unit?
Consultants’ car park, sir?
Well, what do you think?
Time was a consultant
got a salute off the likes of you.
— Do you have any pain anywhere?
— Yes. My chest.
Excuse me, Doctor. Could you tell me
where the nearest disabled toilet is, please?
— [| um...
— Second floor, next to maternity.
Thank you. Ground floor
would be asking too much, of course.
— Raj, X-rays for Mr Crosby.
— OK.
Back in a moment, sir.
Julie? Which butcher's on call today?
— I'm the surgical registrar.
— Hi. | think I've got a customer for you.
Butcher, moi? Pah!
Long history of duodenal ulcer.
Recently taking aspirin for backache.
Excruciating abdominal pains this morning.
X-ray shows feed gas under the diaphragm.
— Hello, sir.
— (Man groans)
— Can | borrow your tubes?
— Yeah.
Aaaahh!
| reckon maybe your guts has burst open, mate.
We need to get in there and bung it up. Raj?
Fast IVI, routine bloods, group and save.
— (Andrew) No. The General is still shut.
— James? James?
— Bomb scare.
— Looks like a perf'd duo is our first punter.
No worries, mate.
OK, well, you'll have to send him up to us. Yes.
Damn...
Um, I've had to accept a DVT.
Can we start an IVI on Mr Crosby, please, Julie?
— Um... Yes. Uh...
— Crosby.
Call for Dr Rajah.
Hello, Dr Rajah. Mum.
Wasn't she little Sinua’s arranged—to—marry?
I'm sure she's very nice but | don't fancy a girl
who's been hawked round like a special offer.
Bye, Mum.
Asthma attack.
Well, check his gases
and I'LL see him with the results myself.
Dr Collin. Alison, how are you?
Yeah, it's busy, but...
You know | do.
Now, Mrs Trimble. There are a few
odds and ends which | like to go over
every time | have a new secretary appointed.
Er... Firstly, | am very particular about...er...er...
A GP is addressed by name.
Drugs are...er...er...
have an initial capital letter,
whereas generic names, of course,
initially, are—are—are...
According to the... I'm a very fussy old man.
Mr Docherty. A gentleman who attends
to details is a gentleman you can trust.
Would Mrs Docherty agree?
Oh...Mary passed away.
Five years ago this Christmas.
Oh, Mr Docherty, I'm sorry. I'm very sorry.
Thank you.
(Phone rings)
Hello, Um... Mr Docherty's secretary.
Oh, yes, thank you. Mmm.
Yes, I'll let him know.
Sister Landers wishes to inform you that your
ward round should have begun half an hour ago.
Oh. Thank you, Mrs Trimble.
— So...
— Scissors.
| hear you recently passed your fellowship.
That's right.
| remember | was pleased as punch
when | passed both parts.
First time?
Of course,
the real benefits come with consultancy.
I've just taken on a brand—spanking—new Jag.
Well, you put a decent bloke behind the wheel
of one of those monsters and...
The car park chappie was telling me that some
tit asked him for a salute this morning.
(Phone)
Well, | have given her the first dose of antibiotic
for the chest infection.
And I'm also gonna see
if | can get her an urgent brain scan.
— What are you looking for?
— Well, there are a number of conditions
that might be taken for a stroke when in fact
they're something quite different.
— Something curable, you mean?
— Possibly.
— We're very grateful, Doctor.
— OK.
Ah. I'm afraid that bed's not come up.
The gentleman who was supposed to be
discharged has developed a wound infection.
We'll just put you over here for a moment,
Mr Crosby.
You should have a bed fairly soon.
Mr Crosby.
Good news, mate. We've managed
to tuck you back in and stitch you up.
You see, what had happened was
your ulcer had burst through your stomach wall.
But we've sealed it for you.
So you can just take it easy.
Enjoy the scenery.
Mr Docherty's started the ward round.
Better get your skates on.
This is the gentleman who had a foreign body
removed yesterday, Mr Docherty.
Oh, you remember, Mr Docherty.
The gentleman who had a thing in his bowel.
A thing he'd put up there himself.
Ah.
— All's well, | trust.
— Obs are satisfactory, Mr Docherty.
You appear to be on the road to recovery,
young man.
| only wish the same could be said
for your hamster.
(Sniggers)
Sister, who is that young fellow
who keeps following us about?
Oh. He's your new registrar, Mr Docherty.
Ah...
In the mornings, the registrar
is expected to attend my colonoscopy List.
I'm no expert, Mr Docherty, but | reckon to be
able to tell a patient's arse from his elbow.
— So to speak.
— Ah, yes.
You can tell a great deal about a chap
from looking up his ah—ah—ah...
Of course, when he first arrived,
Defries expected to take my list.
Then it was pointed out
that there was no great value
in having an arsehole
at both ends of the colonoscope.
Mr Crosby's not looking very well.
His BP's 90 over 60.
— Are you in pain, sir?
— My chest is...
Morphine, please, Sister. We should do
a cardiogram. | suspect coronary thrombosis.
Connect up the defib, please.
(Continuous tone)
— Thank you, Staff Nurse Dalton. One to five?
— Yeah.
One, two, three, four, five.
One, two, three...
Clear!
(Regular beeping)
Who's in charge here?
(James) Well, technically you are, Mr D.
This chap's had major surgery and suffered
a VF arrest. Sounds like an MI to me.
Perhaps we should start with a 12—lead ECG.
Yes. Thank you, Staff.
He's got bugger all breath sounds on the right.
Give him a pneumo by CPR.
Let's have a chest drain in here.
— Trachea's shifted.
— Let's do something about that.
(Continuous tone)
Chest compression can sometimes
cause the Lung to collapse.
The pressure change in the chest cavity
could push the windpipe to one side.
The real danger
is if the heart gets pushed over there.
That's what's happened
so shut up and give us a hand.
(James)
OK. Roll him over. Stop thinking. Get on with it.
— Get him over.
— Ready, one, two, three...
— OK.
— Hold him steady.
Stabilising now.
OK. Carving now.
(Continuous tone)
— That's it.
— Sister.
Thank you.
I'm in. Clamp, please.
Thank you, Mr Docherty.
Right. Connected and clear.
Thank you.
Output recovered.
(Steady beeping)
Department of Emergency Medicine,
Johannesburg, ‘91...
'9?.
So you appear to have had a slight heart attack,
precipitated by the strain of major surgery.
No beds on CCU. I'll have to put him on Crippen
for the time being.
Nobody expects a new senior house officer
to know all the answers, you know.
Except that new houseman of yours.
It's pretty unusual
for a house officer to look at the scans.
It's clear what's behind her problems, right?
Right.
So I'll take these for reporting?
Yup.
— Has anyone seen the old boy yet?
— Tony said he'll see him next.
Trisha, can you take over...
What are you two doing?
We've had an alert, major chest injuries,
ETA 15 minutes.
— More to the point, what are you doing here?
— | thought I'd help out.
Translation — this is Raj's pitiful method of
worming his way into Sister Novak's good books
and hopefully into her knickers.
Dislocated finger, cubicle 2.
— You done A&E before?
— No.
You poor bloody lamb to the slaughter.
It's like being a houseman all over again,
except people's expectations of you
are even higher.
Look and learn, boy.
Hello, sir.
This is the gentleman that Dr Yates
wanted admitting from outpatients, yes?
| changed some of the treatment you wrote up
for him. It seemed a bit complicated.
Nothing to find on the examination.
May | take a look at your hands, please, sir?
Fingers are clubbed, the index and middle finger
are stained with nicotine and what's this?
It's a coal—dust tattoo.
I'LL see you later, sir.
You might have thought that coal was a mineral
found naturally
in the sheds of the working class.
In fact,
people have to go underground and dig it out.
If they get a cut and coal dust gets inside,
it discolours the wound permanently,
like a tattoo.
This is a man who's smoked,
who's worked down the mines.
| don't think it's that complicated to work out
why he's short of breath, do you?
Our patient is a male in his 30s
who didn't fasten his seatbelt.
He has severe chest wall injuries.
James will manage the airway for us.
Scissors, would you cannulate the patient
then commence fluid replacement
while | perform primary and secondary surveys?
Julie, would you ensure bloods are sent
and X-rays requested?
Nurse, if you would do an initial blood pressure
measurement, please?
Raj.
— Just do as you're told.
— (Chuckles)
You show him, Raj.
(Cart crashing)
(Urgent chatter)
Raj, get that smoothly.
One, two, three, Lift.
Good.
Airway secure. Breathing spontaneously.
Rapid pulse. Fast fluids, please, Scissors.
Make way.
Chest exposed,
— Pupils reacting equally.
— Multiple rib fractures.
— Let's get his neck fixed and X-ray.
— |'min.
— Still no bed, Mr Crosby?
— Sister said there could be one soon.
The CT report is a brain tumour.
— Did you see this scan yourself?
— Yeah.
And it was a tumour?
Yeah.
They've sent us the wrong patient's report, Phil.
This is a massive infarct, a stroke.
Look. We all want to impress when we start,
| know.
But if you don't tell me when you need help,
| won't be able to help you, will 1? Hmm?
Yeah.
— Have you spoken to the family?
— Yeah.
Well, | mean, no, not really.
Looking after her haven't been easy,
but it's what we wanted to do.
You see, Doctor,
when she became so much sicker,
our doctor thought it best
she come into hospital.
She is very sick, isn't she?
Mr Campbell, none of the tests
have uncovered anything treatable.
| think your mother is dying.
— There's nothing you can do for her?
— Only make her more comfortable.
— Would you like her to come home?
— Yes, Doctor. We would.
Front—type temporal skull fracture.
Cervical spine.
No bone injury.
(Rapid beeping)
Multiple rib fractures.
Plus a fractured skull.
(Beeping slows)
BP's still only 50 over unrecordable.
(Continuous tone)
— We're losing him.
— CPR and adrenalin.
Now.
(Crunch)
Whoops.
You just lost your no—claims bonus insurance
on your medical insurance.
Would have died anyway, mate.
It wasn't your operation.
You haven't, have you?
You can't have.
Even | know a shag when I've had one.
Nowadays, death is institutionalised.
People die in hospital beds as if their lives
were the property of the state.
I'd like to let this lady home, please, Debbie.
Do you agree?
You know your wish is my command, Dr Yates.
Mm. That will be the day.
As you'll soon learn,
we have a love/hate relationship.
Yeah. He loves me and | hate him.
Yeah. Yeah. Yeah, thanks. Bye.
I'm very sorry, Dr Yates,
but the support services
can't make arrangements until the morning.
I've discussed the matter
with the on-call nursing manager
and she's not happy
to go ahead with the discharge.
| remember the time, long ago, when the most
important people were the patients.
And the second most important
the doctors and nurses who looked after them.
(Phone)
(Struggling)
— Is anyone seeing you, sir?
— Where am |?
In a hospital. Have you any pain anywhere?
— In my chest.
— In your chest. OK. Let me check it for you.
Right, can you take him to 6, please? Thank you.
— I'm sorry. Raj?
— What?
— What?
— Raj, come here!
I'LL be right back, sir, | promise.
We've got a star in. The hospital manager
collapsed at the conference.
Look, that old man's been here all day and his
oxygen is now empty so could you change it?
— Yes, sir.
— First time I've been in this place after 5.
You know | had a heart attack only a year ago.
I'm sure you'll be all right, Mr Legg.
(Continuous tone)
Don't worry about it.
After the day you've had, this is the Vanessa
Paradis—dipped—in—chocolate scenario.
IF you save him, he'll love you.
If you don't, what's he gonna do?
— Shock, please, Raj.
— Clear.
Back in now. Thanks, everybody.
— He'll be dead, then.
— Wasn't much more active when he was alive.
She became distressed
so | increased the diamorph.
— As you can see, that settled her.
— Doctor?
Please, don't tell me there's a problem.
All we want is for our mother
to end her time with her loved ones
— and not be a burden to you good people.
— Look, look, Mr Campbell.
Why don't you go home, get some sleep
and we'll get your mother home
first thing in the morning.
A patient on a trolley
because we haven't got a bed for him
and another patient who we can't send home
when common sense and decency
say she ought to go home.
Andrew,
Mrs Campbell is going to be among her family
even if | have to take her out
in the boot of my car.
Paralysis, my arse. He's fubar bundy.
(Continuous tone)
Your patient's just gone into heart block, Doctor.
(Continuous tone)
Can you give me a picture, please?
There's an AA van round the back.
We'll get them to rev up the engine
and connect the jump leads.
OK. (Sighs) His bowel burst open.
He had a heart attack, a collapsed lung
and he stopped breathing twice.
| think he's now qualified for a hospital bed.
All right, Mr Crosby?
— Morning, sir.
— Diabetic. Visiting friends locally.
Usually under regular review
at St Bartholomew's. Glucose...
Can't be bad. | was at Bart's.
Glucose 439.3.
So was my father. He almost disinherited me
when | accepted an offer from St Thomas's.
Yes. (Chuckles)
— Human actraphane, 36 units in the morning.
— Wait a minute.
There was a Kirkby two years my senior.
Pardon me, Dr Turner. Andrew,
there's a problem with Mrs Campbell.
Bullish fellow. Army type.
(Turner) | don't believe it!
Close the curtains, Carol.
Now, Sharon, as long as there's nothing nasty in
those tests, you should be free to go tomorrow.
All right? Good.
Dr Turner. Can | see you, please?
If you see your general practitioner,
he will refer you to my outpatient clinic.
Dr Turner, my name is Paul Tennant.
Until yesterday,
| was the new assistant hospital manager.
After last night,
you can drop the word “assistant”.
Do forgive me. | had no idea.
Are you aware that the facilities here
for the disabled are appalling?
You did everything you could.
Please...
Don't be kind to me.
I've failed you, terribly.
(Paul) | hope we can meet this afternoon.
Among other things,
| plan we attain our audit targets.
That we satisfy the conditions
of the patients’ charter
and that we meet the requirements
of the junior doctors’ new deal.
| may be in a caretaker position
at the moment, Dr Turner,
but | intend to convince our masters
it should be permanent.
This afternoon, then, Mr Tennant.
Dr Yates. | hope this isn't a bad time.
But | noticed you've yet to give us a satisfactory
account of your outpatients’ waiting times.
Please fill in the audit forms as requested.
Thank you for your cooperation.
— Doctor...
— Maitland.
Maitland.
They bury you under a mountain of paperwork
and then they have the gall
to wonder why you can't see enough cases.
Come on, Claire. We've got patients to see.
Don't say it. It's like | never left.