Cardiac Arrest (1994–1996): Season 3, Episode 2 - Open and Shut - full transcript

Shock at 200.

Clear.

— Andrew.
— He's in VF.

— Shock 200.
— No pulse.

Clear.

— Get a milligram of adrenaline ready, please.
— (Andrew) Still VF. 360.

— No pulse.
— (Andrew) Clear.

P waves bearing no relation
to ventricular complexes.

— Pacemaker?
— Third—degree block.

— You OK while | call the boss?
— Safe as houses.

OK.



Successful cardioversion following VF arrest,

now stuck in third-degree block
with severe haemodynamic compromise.

He needs a temporary pacemaker.

Dr Turner, I'm afraid
I've only ever seen that done once.

Then you've seen one,

But Claire's not on call tonight and, er...

I'd feel more confident
if | was supervised in this procedure.

Have a go, you'll be fine.

Yes, Dr Turner.

Forgive me.

Clearly, a three—month waiting list is intolerable,

but privately,
this is something we can do next week.

There's been a distinct lack
of a mess party recently.

CCU had a night out last week.



— Good?
— Hardly anyone went.

Isn't it time for the docs to put on a do?

Yeah.

Erm, heparinised flush. Is that OK?

— Yep.
— And a feeder cath?

I'm fine with everything
the way you're used to it.

If there's, er, something you're not happy with,
please do say.

No, everything's fine, thank you.

Mr Gibson, the first thing | need to do
is to clean this area with antiseptic, OK?

— You'll be putting the drapes on, won't you?
— Mm-—hm. Yeah.

Just, er, getting ahead of myself.

— Two per cent OK for you?
— Hm?

Oh, lignocaine. Yeah, fine. Like | said,
everything, erm, the way you're used to it.

OK, Mr Gibson, I'm going to give you
an injection of local anaesthetic.

I'm, er, looking for one of the big veins

that, er...run towards your heart.

Ah.

There.

OK. Mr Gibson, the next step is to run a wire
down the tube into your heart,

so we can then pass an electric current down
that wire and, er...control your heartbeat.

|, er...

| need the, erm...

The wire?

Yeah.

The wire.

OK. (Clears throat)

Screen, please.

Doc, we've pumped a lot of rays into this chap.

Mr Gibson, I'm having trouble getting the wire

in exactly the right place
to create a good heartbeat.

Please bear with us.

Er, Andrew.

Isn't it time to get some help?

(Sighs)

See if you can get Claire.

She used to go out with that surgical registrar,
Smedley.

If he's on call tonight,
he might be able to give us her phone number.

His rate's dropping. 25.

(Monitor beep slows)

20.

OK, let's connect the box up
and see if | can get capture.

Five at 80?

Whatever.

No capture. Let's go to external pacemaker.

Get me 10mg of diazemuls, please.
Could you give me a hand?

Thanks. Roll him on his side on three.

One, two, three.

OK. Mr Gibson, we're gonna control
your heartbeat from the outside.

We'll give you a sedative
so you're not too uncomfortable, OK?

(Monitor beep quickens)

Let me see.

Picture, please.

| reckon that's about as close to the RV apex
as this wire's been tonight.

OK. Let's have a go.

Set two millisecond pulse rate of 80
starting at two volts.

Discontinue external pacemaker.

Pace, please,

Pacing at 1.5,

Pacing at 1.0.

Threshold at 0.8.

Set .9.

Thanks, Claire. I'll see to the wire for you.

Thanks.

Dr Maitland.

Do | smell alcohol on your breath?

Could you do a blood alcohol level for me,
please?

— Who for?
— Me, actually.

| might have to prove that
I've had no more than a sip of wine tonight.

— Send it down.
— Thank you.

Something's got to be said, Claire.

What? Challenge the consultant's right to do
private practice when he should be here?

There's a hurricane in Florida,
why don't you go there for a piss instead?

| tried calling you last night.

— Your wife otherwise engaged, | presume.
— Yes. Charlotte was at her mother's.

| got to thinking...

"Claire and | haven't seen each other for a bit.”

Get used to it.

— What are you saying?
— I'm saying...

How can | break this to you gently?

You're chucked. Dumped. Jilted. You've become
a letter of the alphabet between W and Y.

What brought this on?

That kind of answers the question, really,
doesn't it?

Oh, come on, Claire.

Don't tell me you've got a man.

Adrian, there's a first time for everything.

I'LL see the patient at lunch time.

In the meanwhile, an ECG and a chest X-ray
would be greatly appreciated.

Dr Mortimer, can | have a quick word?

Celerity.

| wanted to get a comment
for the evening edition.

One of the hospital governors has described
your condition as "an immoral disease",

and described the decision to keep you on
as madness.

Well, as you know, the hospital
is back—testing all your patients.

What's your reaction to the widespread panic
that this has generated among the public?

Some patients say you're putting them at risk.

They say all doctors should be tested for HIV,
and ones like you should be kicked out.

I"lL go with that as soon as
they start testing every bastard

who comes through that door
asking for our help!

(Beeps horn)

— (Rapid thuds)
— Shit.

Yes. Mr DeVries regards his car
as an extension of his penis.

| doubt you can begin to contemplate
the seriousness of your crime.

— What shall | do, Mr Docherty?
— Exercise the better part of valour, my boy.

Eh?

He who squirms and runs away

lives to squirm another day.

Piss off.

Just look at it.

| fear you've suffered
a frightful misfortune, Adrian.

You didn't see anything, did you, Ernest?

| fear the old peepers
aren't what they used to be.

I'm pleased that the patient is faring well.

| must pass on my thanks to Claire.

Good experience for you too, Andrew.

| recall the Prof — in a waggish moment —

defining experience as the quality one gains

just after one has most needed it.

Well, Dr Turner, with all due respect,

| do feel that there is some cause for concern.

Oh?

Regarding me, do you mean?

Andrew, do you have an observation to make?

You have a complaint
regarding my availability on call.

— Yes?
— Yes.

Then you've already made it.

Your designated channel of complaint
is through your consultant.

Your consultant is informed,
your consultant will act accordingly.

Your involvement in this matter ends herewith.

Thank you for bringing your concern
to my attention.

Hello.

Oh.

Andrew.

I've spoken to Luke. (Sighs)

Luke? Oh, yeah.

He and | slept together last year.

Well, | did kind of realise.

He's HIV positive.

| have to have a test.

And I'm telling you
that you need to have one too.

— Do you want to get some brekkie?
— | don't know.

Go on. All right, | promise
| won't dip my soldiers in my egg this time.

Is something wrong between you and Nasreen?

— Worse.
— Worse than woman trouble?

A motor, then?

Conference.

Breakfast.

You know the difference between you and Elvis?

You are definitely dead.

— As if he'll ever find out.
— Yeah.

Rajesh.

Can't pay, won't pay.

What a perfect example
of the welfare state you are.

| can't afford to lose my no claims, but | can't
lay my hands on the cash either, Mr DeVries.

Please don't make me beg, Mr DeVries.

| think I'd rather like it if you were to beg.

Student overdraft.

Rent.

Bills.

Nasreen, my girlfriend, she’s in the police.
She'll kill me.

Oh, please. Come on.

You're not even very good at begging, are you?

You have two days’ leave coming.

We're short of a locum in the private wing.

Your earnings will pay for the Jag and...

— calm my jangled nerves.
— | was hoping to use the...

Ill be there bright and early tomorrow morning,
Mr DeVries.

Good day, madam.

We're waiting for today's PT, are we not?

— The houseman's just sent it off, Mr Docherty.
— Thank you, Sister.

Your drip's through. I'LL take it down for you.

Agh!

Are you all right, Sister?

| think so.

One of the doctors
must have forgotten the needle.

That's right, get it to bleed.
That hepatitis is still communicable.

I'm sure it's nothing to fret about.

I'LL get someone to take your drip down.

Come on.

— No, I'm gonna be late back, I'm afraid.
— There's something wrong.

Alison, nothing's wrong.
I'm just on a late ward round, OK?

— OK,
— OK.

— Still here, Andrew?
— Yeah. Dr Turner's been called to see a patient.

Of the paying kind, | assume.
Yes, Claire told me about that.

| deplore Graham Turner's action.

Of the record, it is a practice
that has not gone unnoticed by management.

Watch this space.

This, erm, tinnitus of mine,

| didn't catch a word.

Tumour, I'll be bound.

What am | gonna tell Alison?

Hm? "We can't have sex for six weeks
and then you've got to have a blood test.

"Why? Oh, no particular reason."

Well, maybe this was what was needed
to bring it out into the open.

We've got a problem.

We have to support each other.

Yes?

— Claire.
— You'll never leave your wife

and maybe it's time | gave up
all these shallow...

— No, Claire.
— Adrian, never argue with the referee.

See your red card, take an early bath.

Claire, | am not interested in trivia
at a time like this.

| was hoping | could have a Lift.

(Laughs)

Oh, Adrian, I'm sorry.

Yeah, of course.

Oh, er, deliveries out the back.

Sorry, Andrew, Liz hasn't answered her bleep.
Pulse rate 30 to 4O.

— Blood pressure 110 over...
— He's gone back into complete heart block.

(Monitor beep quickens)

There you go, Mr Gibson.

If it happens again,
just try clicking up the voltage.

| don’t think any of us would be happy
doing that, Andrew. This isn't Coronary Care.

While you're here
can you have a look at Mrs Pandit?

Her urine output's been under 30
for the past two hours.

OK. Quickly, then.

This is your on-call room.

You've got your own television
with satellite channels.

If there's nothing on, you can use the video.
We've got loads of tapes.

— Have you seen Jurassic Park?
— | work in it.

Oh, we don't mind you using the phone
for one or two personal calls, but keep it local.

So where do | pick up my bleep?

Bleep? It's rare there's anything to do.
We'll just come and knock you up.

Oh, do you prefer tea or coffee
when you're called out?

— | don't know how bad the infection is.
— (Beeping)

It's more of a medical matter
and | haven't got the result back yet.

— Claire, | got tied up, | won't be long.
— The doctor might know.

If her output doesn't pick up,
can she have a shot?

OK.

Andrew.

Can you have a word
with Mr Reynolds's son, please?

If you'd just like to take a seat in Sister's office,
please, Mr Reynolds.

It's like ward problems. See what happens
when we don't help each other?

Naturally I'd like to extend my sympathy,
Sister. This must be a worrying time.

— How are your family taking it?
— They're concerned, of course, Mr Tennant.

It's not knowing whether I'm going to get
the infection or not.

Quite.

What a business.

Erm...

Yes, I'm afraid I've had to decline
your request for sick leave.

This is in line with hospital policy.

You have been directed to observe safe practice
until you receive a clean bill of health.

And the, er, question of compensation?

Well, it is deemed your responsibility
to safeguard your health in the workplace.

Read this.

Why not try and claim against your colleague
whose negligence caused this injury?

The operative word is "colleague", Mr Tennant.

— Mr Tennant.
— Mr Docherty.

| was happy to accede to
Sister Landers's request for you to be here.

But may | remind you that you have no mandate

to interfere in my day-to—day management
of this hospital's affairs.

| insist on all comments being made through
the chairman of the Consultants Committee.

Graham Turner?

Indeed.

And please don't forget
to raise the head of your bed at night.

And lose some frigging weight.

(Sighs) Sorry, Claire.

It looks like someone's gonna get
their comeuppance.

They're auditing which doctors
actually attend clinic sessions.

Gotcha.

Ah. Good morning. Sorry I'm a few minutes Late.

Traffic doesn't get any better, does it?

Well, Claire, looks as if you'll be spared
covering my clinic after all.

— Good morning, Graham.
— Morning, Paul.

Just thought I'd ensure the audit
got underway smoothly.

Mr Tennant, may | ask
who knew about this audit in advance?

Only my staff. And, of course,
the Consultants Committee.

Which reminds me, Graham,
the committee Luncheon will be at 12:30 today.

I'm sure the caterers
will do us proud as usual, Paul.

Excuse me.

Thank you.

Well, | can't do my list
if our anaesthetist's off sick, can I?

Let's see if we can find someone who won't
go whingeing to the newspapers, shall we?

Dr Mortimer, | am annoyed to say the least.

Stuck on the crossword again, Mr Tennant?

(Laughing)

| am sickened and appalled by Graham Turner's
refusal to accept consultant responsibilities.

The very person the audit was designed
to catch out.

Mm.

Sarah, wouldn't you agree...

if Graham remains chairman,
it does us all a disservice?

— Mutiny, Ernest?
— Oh.

Yes.

— Alison, can we not talk about this at work?
— | don't speak to you otherwise.

Well, I'm sorry. I'm sorry about the way
I've been recently, I'm sorry about last night.

/ want us to get heip.

What are you talking about? You...

— Are you saying marriage counselling?
— Yes,

Well, this is definitely something
| can't talk about now.

Ill, er, see you tonight.

OK.

Oh, God.

Steak au poivre,

French fries,

onion rings, button mushrooms,
carrots and green beans.

Black Forest gateau for dessert
and a selection of cheese and biscuits.

| do a mean Irish coffee if you fancy.

Yeah.

— Anything on the telly tonight, Doc?
— Oh, the usual crap.

Then might you be interested
in one of my special videos?

I"lL ask Dr Hudson to put him on
a pacemaker list for tomorrow afternoon.

Er, Mr Gibson, we need you to sign a form.

Dr Maitland, may | have a word
with you, please?

| have just received a very serious complaint.

Oh, you're the fellow who saw me
over the other side when | had my heart attack.

That's right, Mr Crichton.

Brigadier, old chap.

I'm pleased the misunderstanding with
my private health insurance has been overcome.

There's no danger of, er...

slumming it this time.

No, Brigadier.

My daughter...

she's due to arrive any minute.

| wonder, would you mind
putting her in the picture?

She's never satisfied with my answers.

Tends to fuss, you know.

That really should be left to the consultant.

— Ah.
— Hello, Daddy.

Hello, dear. Mm. There we are.

All right.

Julia Crichton. How do you do? Doctor?

Hello. Er... Perhaps | should explain
what's going on, just to put your mind at rest.

Thank you, Doctor.

— What operation have you had done, Brigadier?
— (Chokes)

Oh, Doctor.

— What can | do for you?
— I'm very grateful for your speedy intervention.

| wondered if | could thank you
by taking you out to dinner tonight.

l—| would Love to.

No, | really would.

But I've, erm,
got to go out with my girlfriend tonight.

Oh.

| feel a real fool all of a sudden.

I'm not normally the one
to make the first move.

Oh. It's always drought or monsoon with me.

| go months making do
with watching Baywatch videos,

then | get a girlfriend and...

then | get asked out by a beautiful woman.

| know you don't mean it, but you're very kind.

Anyway, thank you very much.

— Goodbye.
— Bye.

— Excellent.
— | feel a bit mean, actually.

— He seemed really sweet.
— Oh, believe me, Julia,

at the moment | need any kind of laugh
that | can get. Thank you.

| have just received an anonymous letter
alleging that you were drunk on duty.

Now, usually these charges
would be impossible to substantiate.

Remarkably, however,

a blood sample taken at the time
shows an alcohol concentration in the blood

more than twice the legal limit for driving.

You are suspended pending further investigation.

I'd like to make a statement, Mr Tennant.

Go ahead.

You need a stronger deodorant.

15 quid | paid for this.

(James laughs)

You're onto a good thing here, though, mate.

What a downer on the consultants
who do private practice.

| can't believe you blew out
that brigadier's daughter. She was such a babe.

Nasreen says labels demean women.

She's a feminist, though, isn't she?

The sort who will suck your knob, but won't
iron your shirts because that's degrading.

Oh, right.

That's my sister.

It is.

(Laughs) Had you there, mate.

You're so gullible.

Never catch me being had so easily.

(Laughs)

Are you looking at
the pacemaker chest X-rays today?

| suppose I'll have to since Claire's been
suspended since someone reported her.

Maybe that someone should remember how the
patient might have died if it wasn't for Claire.

So have you...made arrangements
for the HIV test yet?

Not yet.

Scary, isn't it?

| know.

Anything | can do...

| mean, the sooner you have it,
the sooner, you know, the worrying's over.

Caroline, | was thinking that
maybe you could have your test and then...

| will

Soon.

Please.

Oh, | see.

| know. | know it must sound heartless,

but...

You see, I've still got to wait for my test

to allow time for seroconversion
after exposure to the virus.

Erm...if you've got it...

your test will already be positive.

You're my only potential source of infection.

So if...

your test is negative...

| don't need one.

Your wife neither.

| suppose it's asking too much for you to show
a scrap of concern for what this means to me.

Caroline.

Please.

You tell your wife about us,
I'll tell you my result.

(Speaks Hindi)

(Speaks Hindi)

Rajesh... England... (Speaks Hindi)

(Knock at door)

No, no. It's nothing, don't fuss.

He's had chest pain partially relieved by GTN.

Can we do an ECG, please?

It's Raj.

He reckons one of your PPs has had an MI.

What the bloody hell am | supposed to do?

Sew this one up half-finished?

Patient's had a heart attack
and his consultant's busy in theatre.

He needs proper emergency care.

I'm transferring him back to the NHS.

The black hole of Calcutta, here | come.

Our image in the community
is already rock bottom,

and we were this close
from another catastrophe.

If your private practice is so important, maybe
you should give it your sole consideration.

But Paul...

Of course, Graham,
if you gave up your NHS practice,

other clinicians might think you weren't keeping
up to date, and private referrals would dry up.

Now, this administration
appreciates our consultants’ hard work.

And respects your interest in the perquisites
of private practice.

But please...

do not stray from a happy medium.

| think we understand each other, Paul.

Good.

Of course, Dr Maitland's suspension
will be rescinded.

A doctor can't be drunk on duty
if she wasn't actually on duty.

Oh. (Laughs)

Odd, though, that she should go
to the trouble of giving a blood sample,

if she knew that it would prove her guilt rather
than her innocence.

Almost as if someone had wanted me
to delve into this incident.

(Laughs) No one's that clever, Paul.

You've had a scare, Brigadier,
but everything's under control now.

Yes, it looks, er...pretty steady.

Nice touch, | thought,
blaming the nurse for the Letter.

Turner's secretary said
he's facing the music now.

Word is Tennant's going to have him
filling out timesheets from now on.

(Laughs) Oh, poor Graham. My heart bleeds.

Come on, let's go and help Dr Hudson
with this pacemaker.

Yeah. Listen, I'll catch you up. Won't be long.

— Ernest.
— Ah, Graham.

Er...1 do hope this isn't a bad time.

| have decided to stand for the position
of chairman of the Consultants Committee.

Nothing personal.

(Ringing tone)

(Woman) Hello?

Alison.

There's, erm...something I've got to tell you.