Cardiac Arrest (1994–1996): Season 3, Episode 3 - The Practice of Privacy - full transcript
— Pulse?
— Absent.
— Rhythm?
— Monitor shows normal signs.
— Electromechanical dissociation.
— Causes?
Cardiac tamponade.
Hypovolemic shock. Pneumothorax.
Deranged electrolytes, drug overdose.
— Trachea?
— Shifted to the right.
Findings on percussion and auscultation?
Hyperresonance and absent breath sounds
on the left.
Left—sided tension pneumothorax.
Ventflon, please.
— Pulse?
— Now present.
That's it for this week.
Next time Mr Smedley will take you through
blunt abdominal trauma.
— Thank you, Mr DeVries.
— Well done, mates.
IF only you were so able
at making up chemotherapy.
Ward round at 2:15.
I'm particularly keen to get an ultrasound
on the chappie with right upper quadrant pain.
| just knew Miss Right
would come along eventually.
Severe abdo pain, cubicle four.
(Laboured breathing)
Doctor's here, Michelle.
Hi. I'm Mr Smedley.
That's it. Just take it easy.
— When did the pain start?
— Last night.
Pethidine, 75mg.
— Metoclopramide, 10mg, please.
— (Moaning)
I'm giving you something for the pain.
Exactly where does it hurt?
— All across the bottom of my stomach.
— OK.
— Dull or sharp?
— Sharp.
— Is it anywhere else?
— No.
— Does it come and go?
— No.
— Does anything make it better or worse?
— No.
Sorry. Chap you saw earlier,
you didn't write him up for a tetanus.
— OK if I give it and you sign later?
— Sure.
Sh. That's it. Take it easy.
OK.
Any nausea, vomiting?
Change in bowel motions,
change in appetite or weight?
— | feel sick, but | haven't vomited.
— When was your last period, Michelle?
— A few months ago. Since | came off the pill.
— Might you be pregnant?
| might.
Just try and take it easy
and I'll be back in a minute.
Could have some action in there, Julie.
Could you chaperone?
OK. Cot death inbound, CPR in progress.
Thank you.
Erm...| was thinking that maybe you and |
could go out for a drink later.
Oh.
Well, I'LL er, I'll have to check I've got
no other prior engagements in my diary.
Oh, Ernest, don't be
such an old stick—in—the—mud.
Don't you see it makes perfect sense for you
to move in with me?
| mean, erm...
my cottage is a lot cosier
than that Lonely old house of yours.
Yes.
It's just that Mary loved the place so much,
| never thought either of us would ever leave.
I'm so sorry. I'm sorry.
| didn't mean to be insensitive. I'm sorry.
— Not at all.
— (Knock on door)
Oh. I'm sorry.
| do hope I'm not interrupting, Mr Docherty.
| just wanted to let you know that my blood test
has come back immune hepatitis B.
Oh, that's excellent news, Sister.
Oh, you must be so relieved.
| am. Anyway, | just wanted to thank you
for all your support.
My pleasure.
Morning, Phil.
Hello, Jackie.
— Has being a celebrity changed your life, then?
— Hal
(Laughs)
Are you...OK doing that IV?
What, in case | kill another patient, you mean?
(Sighs)
Phil, I'm only trying to be helpful.
Well, I'm sorry. It's just people looking over
my shoulder the whole time, makes me...
Look, I'm sorry, Jackie.
| know you're only trying to help.
Quick, Jacks, it's on.
The people who say that there's no crisis are
the people who do not work in the real NHS.
I've been in nursing for 20 years.
These fat—cat hospital managers
haven't spent five minutes on the wards.
— (Applause)
— Sister Landers, Ward M.
(Jackie) | just said the truth, that's all.
— | told them what for.
— You were great. | could not believe it.
Yes, yes.
WiLL you come with me, please?
Your observations are a distortion.
They bring this hospital into disrepute.
You are suspended from duty,
effective immediately.
But...
what am | charged with?
Oh, we haven't decided yet.
Try and relax, Michelle, it will soon be finished.
Agh!
I'm sorry.
There we go.
I'm concerned that you may have
an ectopic pregnancy.
The egg implants in the Fallopian tubes
instead of the womb.
Yeah, | know. I've heard of that.
I'm getting a gynaecologist to look at you.
You may need an operation today.
No.
I'm sure everything will be all right.
IF you've got no proper business on
these premises, I'll have to ask you to leave.
Is there really such intimidation in this hospital?
Just being seen talking to you
can cause us trouble. Now please leave, miss.
Straight through to resus.
— Where's paeds?
— Not here yet.
Julie. Can you phone obs and gobs for me,
please?
OK.
Sister...
Julie Novac.
| was wondering would anyone like to comment
on the suspension of Sister Jackie Landers?
| think the people that run this hospital
have no more idea about what really goes on
than the generals had of life in the trenches
during the First World War.
The baby's just gone through to resus.
Officially, they can't discipline us
for speaking out.
This is a significant pneumothorax, Andrew.
| can't see why you elected
for conservative management.
— Carry on, would you, please, Claire?
— Yes, Dr Turner.
Phil.
Nothing serious, | hope.
That's right, the pneumothorax.
— You wouldn't mind doing that, would you?
— Why?
Personal reasons.
What, are you having an affair with the patient?
HIV or hepatitis?
A doctor refuses to do a procedure involving
a sharp instrument inside a body cavity.
The doctor must fear passing on
a blood-borne virus.
I've had HIV contact.
I'm awaiting the result.
Claire, I'm not joking.
It's not that. It's just that, erm...
You got to admit, Andrew, God seems to be
missing the toilet and hitting you instead.
One bit of nookie and you end up a passenger
on the fatal retrovirus express.
Don't take up smoking.
One drag and you'd be riddled with cancer.
Constant whispers, gibes about killing patients.
It gets me down.
This must be a terrible ordeal for you, Phil.
You haven't...
told anyone...
anything other than the official version
of events, have you?
I've lost count of the number of times
I've wanted to.
— You haven't, though, have you?
— Dr Turner.
| thought we agreed that
this was between us alone.
Yes, of course, Phil. I'm sorry.
| just wish they'd hurry up
and make up their minds one way or another.
Yes.
Now, this may sound silly, but you know
this cricket match we've been talking about,
| wouldn't be surprised if getting together
a team of juniors to take on the consultants
didn't take your mind off medico—legal matters.
Give us old duffers a good thrashing, eh?
Now, if there's anything | can do for you, Phil...
A dozen red roses, please.
No, no. No message, thank you.
Oh, I'm sorry, Ernest, is the telephone
keeping you from your bladder?
Er, no. No, not at all.
Well, was it anything important?
No, no, no. Just an addition
to my, er...outpatients clinic.
Isobel.
Would you contact Mr Tennant's secretary and
arrange an appointment as soon as possible?
Regarding the suspension of Sister Landers.
Oh. | wouldn't advise you to do that, Ernest.
| can't simply rest on my laurels.
No, of course not.
But decency and principle
aren't the way to fight these people.
You've got to learn to compete on their terms.
(Laughs) Become a political animal.
No ectopic. No nothing.
Diagnostic puzzle.
Makes a welcome change
from the usual bumps and Lumps.
Try phoning them again.
Stop winding me up. It’s bad enough as it is.
I'm doing this for us, Caroline.
All the lies and covering up.
All so that we can get away with this.
So | can make a clean break with Alison.
That's what this is about.
Don't you see?
I'LL phone them as soon as | get a chance.
Claire.
Is your answer machine on the blink
or something?
It's got a quality control device.
Any messages from oily old tossers
get automatically wiped.
— What have you got against me suddenly?
— Only two things.
Your looks and your personality.
If | happen to appear to care for you,
it's only because you made me believe
that's what you wanted.
Give me another chance.
Please.
It's all too late, Adrian.
I've been asked to see the hospital manager.
Now, would that be the clinical director,
the business manager,
the administrator, the administrative assistant,
the unit manager,
the assistant general manager,
the unit general manager,
the executive, or the chief executive,
do you think?
Michelle.
How are you?
I'm OK. It still hurts.
I'LL make sure you get some stronger painkillers.
Thank you.
| want to go on and do some more tests.
OK.
We'll get it right next time.
Ultrasound?
I'm afraid they can't fit us in today, Mr DeVries.
| believe | was quite specific
we should get that scan.
I'm sorry, Mr DeVries.
(Sighs)
My apologies, sir. It appears we're to have
the pleasure of your company for one more day,
at your inconvenience
and great expense to the taxpayer,
until we're able to reach a diagnosis.
— Can we have this lot done too, please?
— Yes.
| suppose | should be grateful.
You haven't killed him.
| mean, why, Julie?
To undermine my position?
To stand up and be counted!
Maybe | can pull a few strings,
keep this out of the press.
(Sighs)
You don't listen, do you, Paul?
I'm not allowed to.
(Whimpers)
She's got excruciating abdominal pain.
Central, but radiating to back and arms.
— Did you do the X-rays?
— Yes.
(Sighs)
Same pain as before, Michelle?
— Oh.
— Sharp or dull?
Like I'm being squeezed.
It goes into your back?
And my arms.
— (Whimpers)
— Do you feel sick?
Sweaty?
There's nothing on these.
Julie Novac is our senior casualty sister.
Her comments may have been...ill-advised,
but her record at this hospital is exemplary.
I'd like to give her the opportunity
to make some sort of retraction.
Are you sure, Paul?
I'd stake my position on this.
Leave it to me.
Her pain's settled for the time being,
but | wanted your opinion.
Ah.
The films are unremarkable.
| think we should seek a physician's opinion.
Ah. I'm sure we can get to the bottom of this
ourselves, Mr D.
Well, | hope professional vanity
isn't being put before our patient's welfare.
I'LL ask the physicians to see her, Mr Docherty.
— Ah, Scissors.
— Yes, Mr Docherty?
Your opinion now,
Flowers.
Are they a good idea?
Research indicates that flowers
outperform chocolates in that particular field.
Although the data may be skewed by
relative underreporting of negative results.
Thanks for doing it so quickly.
Nothing to write home about here.
But | suppose one of us
should have a look at her.
At least that way the patient gets to be seen
by one proper doctor during her admission.
It wasn't my idea to run to teacher.
We'll get the diagnosis soon enough.
So far the evidence appears to be
to the contrary.
— See you later, Andrew.
— OK.
— Michelle.
— Hi.
I'm Dr Collin. I'm gonna ask you
a couple of questions, OK?
OK.
Have you ever had any chest pain
or unexpected shortness of breath?
— Maybe the occasional twinge, yeah.
— Do you get pain if you overdo things?
— Don't we all?
— Where?
In the pit of my stomach.
— And it goes if you rest?
— Yeah.
Do you smoke, Michelle?
SOIry.
Any diabetes, high blood pressure,
family history of any heart trouble?
My uncle died of a heart attack.
And my father takes heart tablets,
and my mother gets palpitations
from time to time, but they're not serious.
Mm.
You see I'm wondering, er, whether the pain's
actually coming from your heart.
Occasionally it can feel like
it's coming from somewhere else.
| know we've been round the houses with you,
— but we'll get there in the end, OK?
— OK.
I'LL arrange to transfer her to L Ward.
There's no need.
Well, if we don't sort her out, she's just
going to bounce back to you, isn't she?
Caroline.
Sorry, | got called away.
You know, don't you?
You... You were leaving without telling me.
Caroline.
| meant every word | said.
(Sighs) The test result was negative.
I'm so glad.
I'LL..telL Alison.
Sure you will.
This intimidation of hospital staff
must come to an end, you know, Graham.
| think you'd agree this is now a matter
for the committee to act upon.
With respect, Ernest, | disagree.
| would strongly discourage any challenge
to a manager's right to manage.
Then once more | put it to you,
you should stand down.
| have no intention of so doing.
To my regret, Graham,
you and | have now become adversaries.
Those of us who stand by
and let these things happen...
we're just as guilty.
I'm trying to contact the duty social worker
in reference to a patient
who the doctors want to send home,
but, er...she needs domiciliary support.
OK. Yeah, Sister Novac. Thank you.
So...how about this drink, then?
WelL..
(Clatter}
Mr Hammond, really!
I'm sorry.
| don't know what came over me.
Looks the other way around to me.
Mr Hammond.
I've received a report that you gave
a tetanus injection this morning
without it being prescribed by a doctor.
Report from whom?
One of your nurses. People actually
report each other, it's amazing.
The doctor was busy. | gave the Tet—Tox
and got him to sign afterwards.
It's getting so a nurse can't wipe
a patient's bum without a doctor's consent.
Julie, what if the patient had had a reaction
to the injection?
Then he'd have had it
whether the doctor had signed or not.
— You were in clear contravention of policy.
— (Sighs)
Your interview has gone to press.
Maybe we can find a way of making
your comments a little less mordant.
Retraction.
And then you'll overlook
the tetanus crime of the century?
— Yes.
— Oh, don't bully me, Paul.
— I'm trying to save you.
— Why?
Why do you think?
Oh, Paul.
Are you feeling better?
— Yeah.
— How long since you took the tablet?
— About ten minutes?
— About that, yeah.
It was actually only a couple of minutes,
Michelle.
Sorry. Yeah.
Well, we'll put you on a drip,
keep the pain away overnight.
Thank you.
We got there in the end, eh?
This is very brave of you, Cyril,
being seen with NHS public enemy number one.
I'm here for a bet.
Me too. Only mine's a lot bigger,
as you can imagine.
Seriously, if you want someone
to support your stand...
Not a good idea
to jeopardise your career as well.
Some things are worth it.
Look, | should go.
— Well, I'm sorry, Julie, | thought...
— There's a complication.
But you thought right.
— Adrian?
— Hello?
It's Claire.
— Do you have a headache?
— No.
— Any sickness or drowsiness?
— Nol
— Is it one eye or both eyes?
— Both.
— Follow my fingers.
— (Andrew) Pam.
The doctor will see you now.
Andrew, she's complaining of sudden blindness.
Blindness?
— Michelle.
— Yeah.
— Has it come and gone?
— Yeah.
— Just in one eye.
— Yeah.
— (Pam) Didn't you say both, Michelle?
— It's my right eye!
OK. Just get me an ophthalmoscope,
please, Pam.
— Your pupils are OK. Is it back to normal now?
— | think so, yeah.
So you were blind in one eye for a few minutes?
— Yeah.
— Look straight ahead.
— Has it ever happened to you before?
— No.
— You've not had migraine in the past?
— No.
It looks fine.
Good.
| think we need to do some tests fairly urgently.
This could be vasculitis
affecting both the heart and eye.
We'll start steroids. I'll phone Claire.
You're a fickle one, Maitland.
| despair of ever...
understanding you.
— Mm-mm-mm.
— What?
Can't you at least pay me some lip service
for winning my affections?
How?
| know. We could go to the social club
for a drink.
| thought you didn't like going there any more.
What's the hurry?
No hurry.
— Your wife's expecting you.
— (Pager beeps)
Shit.
— it’s Andrew. Contact me on Crippen.
— Ignore it.
| won't be long. Wait for me.
(Man speaking on phone, indistinct)
The die is cast.
This is someone who will not surrender
their principles, nor give in to intimidation.
I've started steroids and requested angiography.
| wonder if this could be
something like Takayasu's arteritis.
Her coronary artery ostial stenosis
would account for her angina.
Amblyopia's well recognised. It might even
be something like mesenteric angina.
You might get a presentation out of this.
Let's hope she doesn't pop her clogs
before you get your Brownie points.
(Pam) Quick. It's Michelle.
— Let's get her into recovery position.
— Diazemuls straight away, Pam.
Come on, Michelle.
— Hello?
— Hello.
Yeah. Do you have an ESR for a patient
called Michelle Elliott, please?
Pack your bags and go home.
| don't care how important this makes you feel.
You're still a nobody.
There are some people
who fake medical conditions
so they can go through tests and procedures.
Is that you?
You do have an illness, Michelle.
It's called Munchausen's syndrome.
— We can help you.
— (Sobs)
(Pager beeps)
Go to Casualty.
No, Charlotte, er...
(Clears throat) Something important’s come up.
| know, I...
— Off home? Good night, Phil.
— Dr Turner.
— Hm?
— Erm...
You know you said this morning
if there's anything you can do to help?
Anything at all, my pleasure.
| thought perhaps, er...
you might tell people which one of us
really ought to be up for manslaughter.
(Sighs)
Whoops.
Red roses, Ernest. Aren't they lovely?
And, erm...
No card.
| must have a secret admirer.
How romantic.
There's a very good-looking man
down at the bridge club.
Mm. Wonder if he...
I'm only kidding.
They're lovely. Thank you.
Isobel, regarding your suggestion this morning...
Oh, | was thoughtless and I'm sorry.
Er, no, no,
It's time to look forward.
I've spent five lonely years in that old house.
It's time | realised how fortunate | am
to find a second person
who means as much to me.
— Let's go home.
— Yeah.
Ooh. My roses.
| thought you and your girlfriend would be off
tripping the light fantastic by now.
Yeah, well. Life's a bitch.
And so are you.
I'm sorry about the way | ended things
between you and me.
| never said it and | should have done.
We could have one drink.
Why not?
Ah. I'm sorry.
| told Charlotte there's an aneurysm coming in.
Just in time to save you
from the wonder from down under.
Paul
So I'm suspended?
No. | am.
— Absent.
— Rhythm?
— Monitor shows normal signs.
— Electromechanical dissociation.
— Causes?
Cardiac tamponade.
Hypovolemic shock. Pneumothorax.
Deranged electrolytes, drug overdose.
— Trachea?
— Shifted to the right.
Findings on percussion and auscultation?
Hyperresonance and absent breath sounds
on the left.
Left—sided tension pneumothorax.
Ventflon, please.
— Pulse?
— Now present.
That's it for this week.
Next time Mr Smedley will take you through
blunt abdominal trauma.
— Thank you, Mr DeVries.
— Well done, mates.
IF only you were so able
at making up chemotherapy.
Ward round at 2:15.
I'm particularly keen to get an ultrasound
on the chappie with right upper quadrant pain.
| just knew Miss Right
would come along eventually.
Severe abdo pain, cubicle four.
(Laboured breathing)
Doctor's here, Michelle.
Hi. I'm Mr Smedley.
That's it. Just take it easy.
— When did the pain start?
— Last night.
Pethidine, 75mg.
— Metoclopramide, 10mg, please.
— (Moaning)
I'm giving you something for the pain.
Exactly where does it hurt?
— All across the bottom of my stomach.
— OK.
— Dull or sharp?
— Sharp.
— Is it anywhere else?
— No.
— Does it come and go?
— No.
— Does anything make it better or worse?
— No.
Sorry. Chap you saw earlier,
you didn't write him up for a tetanus.
— OK if I give it and you sign later?
— Sure.
Sh. That's it. Take it easy.
OK.
Any nausea, vomiting?
Change in bowel motions,
change in appetite or weight?
— | feel sick, but | haven't vomited.
— When was your last period, Michelle?
— A few months ago. Since | came off the pill.
— Might you be pregnant?
| might.
Just try and take it easy
and I'll be back in a minute.
Could have some action in there, Julie.
Could you chaperone?
OK. Cot death inbound, CPR in progress.
Thank you.
Erm...| was thinking that maybe you and |
could go out for a drink later.
Oh.
Well, I'LL er, I'll have to check I've got
no other prior engagements in my diary.
Oh, Ernest, don't be
such an old stick—in—the—mud.
Don't you see it makes perfect sense for you
to move in with me?
| mean, erm...
my cottage is a lot cosier
than that Lonely old house of yours.
Yes.
It's just that Mary loved the place so much,
| never thought either of us would ever leave.
I'm so sorry. I'm sorry.
| didn't mean to be insensitive. I'm sorry.
— Not at all.
— (Knock on door)
Oh. I'm sorry.
| do hope I'm not interrupting, Mr Docherty.
| just wanted to let you know that my blood test
has come back immune hepatitis B.
Oh, that's excellent news, Sister.
Oh, you must be so relieved.
| am. Anyway, | just wanted to thank you
for all your support.
My pleasure.
Morning, Phil.
Hello, Jackie.
— Has being a celebrity changed your life, then?
— Hal
(Laughs)
Are you...OK doing that IV?
What, in case | kill another patient, you mean?
(Sighs)
Phil, I'm only trying to be helpful.
Well, I'm sorry. It's just people looking over
my shoulder the whole time, makes me...
Look, I'm sorry, Jackie.
| know you're only trying to help.
Quick, Jacks, it's on.
The people who say that there's no crisis are
the people who do not work in the real NHS.
I've been in nursing for 20 years.
These fat—cat hospital managers
haven't spent five minutes on the wards.
— (Applause)
— Sister Landers, Ward M.
(Jackie) | just said the truth, that's all.
— | told them what for.
— You were great. | could not believe it.
Yes, yes.
WiLL you come with me, please?
Your observations are a distortion.
They bring this hospital into disrepute.
You are suspended from duty,
effective immediately.
But...
what am | charged with?
Oh, we haven't decided yet.
Try and relax, Michelle, it will soon be finished.
Agh!
I'm sorry.
There we go.
I'm concerned that you may have
an ectopic pregnancy.
The egg implants in the Fallopian tubes
instead of the womb.
Yeah, | know. I've heard of that.
I'm getting a gynaecologist to look at you.
You may need an operation today.
No.
I'm sure everything will be all right.
IF you've got no proper business on
these premises, I'll have to ask you to leave.
Is there really such intimidation in this hospital?
Just being seen talking to you
can cause us trouble. Now please leave, miss.
Straight through to resus.
— Where's paeds?
— Not here yet.
Julie. Can you phone obs and gobs for me,
please?
OK.
Sister...
Julie Novac.
| was wondering would anyone like to comment
on the suspension of Sister Jackie Landers?
| think the people that run this hospital
have no more idea about what really goes on
than the generals had of life in the trenches
during the First World War.
The baby's just gone through to resus.
Officially, they can't discipline us
for speaking out.
This is a significant pneumothorax, Andrew.
| can't see why you elected
for conservative management.
— Carry on, would you, please, Claire?
— Yes, Dr Turner.
Phil.
Nothing serious, | hope.
That's right, the pneumothorax.
— You wouldn't mind doing that, would you?
— Why?
Personal reasons.
What, are you having an affair with the patient?
HIV or hepatitis?
A doctor refuses to do a procedure involving
a sharp instrument inside a body cavity.
The doctor must fear passing on
a blood-borne virus.
I've had HIV contact.
I'm awaiting the result.
Claire, I'm not joking.
It's not that. It's just that, erm...
You got to admit, Andrew, God seems to be
missing the toilet and hitting you instead.
One bit of nookie and you end up a passenger
on the fatal retrovirus express.
Don't take up smoking.
One drag and you'd be riddled with cancer.
Constant whispers, gibes about killing patients.
It gets me down.
This must be a terrible ordeal for you, Phil.
You haven't...
told anyone...
anything other than the official version
of events, have you?
I've lost count of the number of times
I've wanted to.
— You haven't, though, have you?
— Dr Turner.
| thought we agreed that
this was between us alone.
Yes, of course, Phil. I'm sorry.
| just wish they'd hurry up
and make up their minds one way or another.
Yes.
Now, this may sound silly, but you know
this cricket match we've been talking about,
| wouldn't be surprised if getting together
a team of juniors to take on the consultants
didn't take your mind off medico—legal matters.
Give us old duffers a good thrashing, eh?
Now, if there's anything | can do for you, Phil...
A dozen red roses, please.
No, no. No message, thank you.
Oh, I'm sorry, Ernest, is the telephone
keeping you from your bladder?
Er, no. No, not at all.
Well, was it anything important?
No, no, no. Just an addition
to my, er...outpatients clinic.
Isobel.
Would you contact Mr Tennant's secretary and
arrange an appointment as soon as possible?
Regarding the suspension of Sister Landers.
Oh. | wouldn't advise you to do that, Ernest.
| can't simply rest on my laurels.
No, of course not.
But decency and principle
aren't the way to fight these people.
You've got to learn to compete on their terms.
(Laughs) Become a political animal.
No ectopic. No nothing.
Diagnostic puzzle.
Makes a welcome change
from the usual bumps and Lumps.
Try phoning them again.
Stop winding me up. It’s bad enough as it is.
I'm doing this for us, Caroline.
All the lies and covering up.
All so that we can get away with this.
So | can make a clean break with Alison.
That's what this is about.
Don't you see?
I'LL phone them as soon as | get a chance.
Claire.
Is your answer machine on the blink
or something?
It's got a quality control device.
Any messages from oily old tossers
get automatically wiped.
— What have you got against me suddenly?
— Only two things.
Your looks and your personality.
If | happen to appear to care for you,
it's only because you made me believe
that's what you wanted.
Give me another chance.
Please.
It's all too late, Adrian.
I've been asked to see the hospital manager.
Now, would that be the clinical director,
the business manager,
the administrator, the administrative assistant,
the unit manager,
the assistant general manager,
the unit general manager,
the executive, or the chief executive,
do you think?
Michelle.
How are you?
I'm OK. It still hurts.
I'LL make sure you get some stronger painkillers.
Thank you.
| want to go on and do some more tests.
OK.
We'll get it right next time.
Ultrasound?
I'm afraid they can't fit us in today, Mr DeVries.
| believe | was quite specific
we should get that scan.
I'm sorry, Mr DeVries.
(Sighs)
My apologies, sir. It appears we're to have
the pleasure of your company for one more day,
at your inconvenience
and great expense to the taxpayer,
until we're able to reach a diagnosis.
— Can we have this lot done too, please?
— Yes.
| suppose | should be grateful.
You haven't killed him.
| mean, why, Julie?
To undermine my position?
To stand up and be counted!
Maybe | can pull a few strings,
keep this out of the press.
(Sighs)
You don't listen, do you, Paul?
I'm not allowed to.
(Whimpers)
She's got excruciating abdominal pain.
Central, but radiating to back and arms.
— Did you do the X-rays?
— Yes.
(Sighs)
Same pain as before, Michelle?
— Oh.
— Sharp or dull?
Like I'm being squeezed.
It goes into your back?
And my arms.
— (Whimpers)
— Do you feel sick?
Sweaty?
There's nothing on these.
Julie Novac is our senior casualty sister.
Her comments may have been...ill-advised,
but her record at this hospital is exemplary.
I'd like to give her the opportunity
to make some sort of retraction.
Are you sure, Paul?
I'd stake my position on this.
Leave it to me.
Her pain's settled for the time being,
but | wanted your opinion.
Ah.
The films are unremarkable.
| think we should seek a physician's opinion.
Ah. I'm sure we can get to the bottom of this
ourselves, Mr D.
Well, | hope professional vanity
isn't being put before our patient's welfare.
I'LL ask the physicians to see her, Mr Docherty.
— Ah, Scissors.
— Yes, Mr Docherty?
Your opinion now,
Flowers.
Are they a good idea?
Research indicates that flowers
outperform chocolates in that particular field.
Although the data may be skewed by
relative underreporting of negative results.
Thanks for doing it so quickly.
Nothing to write home about here.
But | suppose one of us
should have a look at her.
At least that way the patient gets to be seen
by one proper doctor during her admission.
It wasn't my idea to run to teacher.
We'll get the diagnosis soon enough.
So far the evidence appears to be
to the contrary.
— See you later, Andrew.
— OK.
— Michelle.
— Hi.
I'm Dr Collin. I'm gonna ask you
a couple of questions, OK?
OK.
Have you ever had any chest pain
or unexpected shortness of breath?
— Maybe the occasional twinge, yeah.
— Do you get pain if you overdo things?
— Don't we all?
— Where?
In the pit of my stomach.
— And it goes if you rest?
— Yeah.
Do you smoke, Michelle?
SOIry.
Any diabetes, high blood pressure,
family history of any heart trouble?
My uncle died of a heart attack.
And my father takes heart tablets,
and my mother gets palpitations
from time to time, but they're not serious.
Mm.
You see I'm wondering, er, whether the pain's
actually coming from your heart.
Occasionally it can feel like
it's coming from somewhere else.
| know we've been round the houses with you,
— but we'll get there in the end, OK?
— OK.
I'LL arrange to transfer her to L Ward.
There's no need.
Well, if we don't sort her out, she's just
going to bounce back to you, isn't she?
Caroline.
Sorry, | got called away.
You know, don't you?
You... You were leaving without telling me.
Caroline.
| meant every word | said.
(Sighs) The test result was negative.
I'm so glad.
I'LL..telL Alison.
Sure you will.
This intimidation of hospital staff
must come to an end, you know, Graham.
| think you'd agree this is now a matter
for the committee to act upon.
With respect, Ernest, | disagree.
| would strongly discourage any challenge
to a manager's right to manage.
Then once more | put it to you,
you should stand down.
| have no intention of so doing.
To my regret, Graham,
you and | have now become adversaries.
Those of us who stand by
and let these things happen...
we're just as guilty.
I'm trying to contact the duty social worker
in reference to a patient
who the doctors want to send home,
but, er...she needs domiciliary support.
OK. Yeah, Sister Novac. Thank you.
So...how about this drink, then?
WelL..
(Clatter}
Mr Hammond, really!
I'm sorry.
| don't know what came over me.
Looks the other way around to me.
Mr Hammond.
I've received a report that you gave
a tetanus injection this morning
without it being prescribed by a doctor.
Report from whom?
One of your nurses. People actually
report each other, it's amazing.
The doctor was busy. | gave the Tet—Tox
and got him to sign afterwards.
It's getting so a nurse can't wipe
a patient's bum without a doctor's consent.
Julie, what if the patient had had a reaction
to the injection?
Then he'd have had it
whether the doctor had signed or not.
— You were in clear contravention of policy.
— (Sighs)
Your interview has gone to press.
Maybe we can find a way of making
your comments a little less mordant.
Retraction.
And then you'll overlook
the tetanus crime of the century?
— Yes.
— Oh, don't bully me, Paul.
— I'm trying to save you.
— Why?
Why do you think?
Oh, Paul.
Are you feeling better?
— Yeah.
— How long since you took the tablet?
— About ten minutes?
— About that, yeah.
It was actually only a couple of minutes,
Michelle.
Sorry. Yeah.
Well, we'll put you on a drip,
keep the pain away overnight.
Thank you.
We got there in the end, eh?
This is very brave of you, Cyril,
being seen with NHS public enemy number one.
I'm here for a bet.
Me too. Only mine's a lot bigger,
as you can imagine.
Seriously, if you want someone
to support your stand...
Not a good idea
to jeopardise your career as well.
Some things are worth it.
Look, | should go.
— Well, I'm sorry, Julie, | thought...
— There's a complication.
But you thought right.
— Adrian?
— Hello?
It's Claire.
— Do you have a headache?
— No.
— Any sickness or drowsiness?
— Nol
— Is it one eye or both eyes?
— Both.
— Follow my fingers.
— (Andrew) Pam.
The doctor will see you now.
Andrew, she's complaining of sudden blindness.
Blindness?
— Michelle.
— Yeah.
— Has it come and gone?
— Yeah.
— Just in one eye.
— Yeah.
— (Pam) Didn't you say both, Michelle?
— It's my right eye!
OK. Just get me an ophthalmoscope,
please, Pam.
— Your pupils are OK. Is it back to normal now?
— | think so, yeah.
So you were blind in one eye for a few minutes?
— Yeah.
— Look straight ahead.
— Has it ever happened to you before?
— No.
— You've not had migraine in the past?
— No.
It looks fine.
Good.
| think we need to do some tests fairly urgently.
This could be vasculitis
affecting both the heart and eye.
We'll start steroids. I'll phone Claire.
You're a fickle one, Maitland.
| despair of ever...
understanding you.
— Mm-mm-mm.
— What?
Can't you at least pay me some lip service
for winning my affections?
How?
| know. We could go to the social club
for a drink.
| thought you didn't like going there any more.
What's the hurry?
No hurry.
— Your wife's expecting you.
— (Pager beeps)
Shit.
— it’s Andrew. Contact me on Crippen.
— Ignore it.
| won't be long. Wait for me.
(Man speaking on phone, indistinct)
The die is cast.
This is someone who will not surrender
their principles, nor give in to intimidation.
I've started steroids and requested angiography.
| wonder if this could be
something like Takayasu's arteritis.
Her coronary artery ostial stenosis
would account for her angina.
Amblyopia's well recognised. It might even
be something like mesenteric angina.
You might get a presentation out of this.
Let's hope she doesn't pop her clogs
before you get your Brownie points.
(Pam) Quick. It's Michelle.
— Let's get her into recovery position.
— Diazemuls straight away, Pam.
Come on, Michelle.
— Hello?
— Hello.
Yeah. Do you have an ESR for a patient
called Michelle Elliott, please?
Pack your bags and go home.
| don't care how important this makes you feel.
You're still a nobody.
There are some people
who fake medical conditions
so they can go through tests and procedures.
Is that you?
You do have an illness, Michelle.
It's called Munchausen's syndrome.
— We can help you.
— (Sobs)
(Pager beeps)
Go to Casualty.
No, Charlotte, er...
(Clears throat) Something important’s come up.
| know, I...
— Off home? Good night, Phil.
— Dr Turner.
— Hm?
— Erm...
You know you said this morning
if there's anything you can do to help?
Anything at all, my pleasure.
| thought perhaps, er...
you might tell people which one of us
really ought to be up for manslaughter.
(Sighs)
Whoops.
Red roses, Ernest. Aren't they lovely?
And, erm...
No card.
| must have a secret admirer.
How romantic.
There's a very good-looking man
down at the bridge club.
Mm. Wonder if he...
I'm only kidding.
They're lovely. Thank you.
Isobel, regarding your suggestion this morning...
Oh, | was thoughtless and I'm sorry.
Er, no, no,
It's time to look forward.
I've spent five lonely years in that old house.
It's time | realised how fortunate | am
to find a second person
who means as much to me.
— Let's go home.
— Yeah.
Ooh. My roses.
| thought you and your girlfriend would be off
tripping the light fantastic by now.
Yeah, well. Life's a bitch.
And so are you.
I'm sorry about the way | ended things
between you and me.
| never said it and | should have done.
We could have one drink.
Why not?
Ah. I'm sorry.
| told Charlotte there's an aneurysm coming in.
Just in time to save you
from the wonder from down under.
Paul
So I'm suspended?
No. | am.