Cardiac Arrest (1994–1996): Season 3, Episode 6 - Suffer Little Children - full transcript
Andrew?
Andrew, the bog'LL be free now, Andrew.
— | told you not to have that curry last night.
— Thank you, but I'm feeling a whole Lot better.
— | might even try some lunch now.
— There is a bloke who's been waiting a while.
— Edwin Corbett.
— Old boy. Off legs.
But there again,
it is Caribbean Day at the canteen.
| suppose it won't take long, eh? Thanks.
— Edwin Corbett?
— Ted.
Morning. I'm Dr Collin.
Your doctor mentioned you'd had a fall.
Oh, | just went over. No damage, touch wood.
Before you fell, any chest pain,
palpitations, shortness of breath?
No. I've just been
a bit unsteady on me feet lately.
— Your legs have felt weak?
— Yes, that's right.
— Have you seen anyone about it?
— Doctor got me an outpatients appointment.
— When was that for?
— Year 2000, | think.
Sounds about right. We're chock—a—block.
Mind if | look here?
Oh, no. Go straight ahead.
Had any nausea, drowsiness,
fixed faints, blurred vision?
— No.
— I'm just gonna see how stiff your legs are.
OK. Keep your knee bent.
Don't let me straighten your leg.
OK. Now, keep it straight. Keep it straight.
OK. Same again. Don't let me straighten it.
Keep it straight.
Right. Just gonna do some reflexes, Ted, OK?
All righty.
Feel a little scratch on the bottom of your foot?
Have you, erm...
had any problems with your waterworks?
Sorry to have to ask. It's important.
Have you lost control of your water?
Just this last couple of days. | thought perhaps
it was an infection or something.
Any serious illness in the past?
— No. Appendix when | was a kid.
— Mm-—hm.
— And pneumonia in the army.
— | think we've got an MI. Taking him through.
You just relax there, Ted.
I'll be with you shortly.
Could you bleep Liz Reid to see Ted Corbett
and do some bloods? Thanks.
| think we've got a cord compression there, Pat.
Are you in any pain now, sir?
— It's Mr O'Neill
— It's getting easier.
Is it in the middle of your chest?
— It's like someone's sitting on me.
— You've read the textbooks.
— Want some more oxygen?
— 35 per cent, please, and aspirin too.
So your heart rate would suggest
that you have had a heart attack
sO we're gonna arrange
a transfer to Coronary Care
where we can start treatment
to dissolve the blood clot that's caused it.
— We'll be back with you very soon, Mr O'Neill.
— 35 per cent oxygen, OK?
Let's get hold of CCU,
see if they can make a bed for him.
— He should be strepped as soon as possible.
— I'll do my best.
— How are you doing, Liz?
— Fine.
I'm gonna do some blood tests and X-rays.
I'm worried that your legs are weak
because there's pressure
on your spinal cord.
— Is that serious?
— We need to release it to avoid damage.
— What sort?
— Bit early to say.
Andrew?
Won't be a minute, OK?
FBCs. U&Es. LFTs. Calcium profile.
Electrophoresis, B12, folate and ESR.
Chest and spinal films too.
Staff nurse wants to talk to his referring doctor.
I'm only the wazzock in charge of
the busiest department in the hospital.
Dr Collin. Hi, yeah. Can we get him up there
as soon as possible, please?
I'd rather not keep him waiting.
The sooner we treat, the better his chances.
here Full
Fine. Thank you.
Damn it.
— Any chance of him being strepped here?
— | don't like it. It's not policy.
— What's the issue?
— Complications of thrombolysis.
The guidelines say it must be done in Coronary.
Where there are no beds. Those bloods
are urgent, yeah? Can you get ‘em done?
Ted, the operation you need
to relieve the pressure on your spinal cord
requires specialised surgery
so I'm gonna refer you to another hospital.
— What, today?
— Straightaway.
Patrick, can you see which neurosurgical unit's
got a bed for Mr Corbett?
I'm gonna go to the, erm...
(Bleeping)
(Woman) Outside cail.
Won't be long, Ted, all right?
We'll transfer you soon.
— I'm holding.
— Dr Collin?
— it's me.
— Alison.
— This could not be a worse time, honestly.
— Andrew, you know I'm worried sick.
I'LL call you later, OK? Bye.
Sorry, Andrew.
Dr Collin. Oh, right, yeah. Can you transfer me
to the switchboard at the general?
Can you do some urgent bloods for me, please?
— Switchboard.
— This is Dr Collin, Medical SHO at Fort Apache.
— Could you bleep the neurological surgeon?
— just a moment.
(Man) Biochemistry.
Could you do some urgent urea electrolytes,
liver function and calcium?
— And electrophoresis.
— Our machines are offline.
— Shit. Biochemistry's machines are down.
— That's all we need.
Sorry, people. This patient's one of yours.
Could you see her, please?
Dr Turner will go spare
not having me on the wards.
Well, Dr Turner
will just have to have you somewhere else.
— Go on, Andrew. Be a sweetie.
— Mr Ray, yeah. This is Dr Collin.
I've a 71-year—old with spastic paraparesis,
highly suspicious of cord decompression.
— I'm sorry. We have no beds for him.
— Really? Do you know anywhere who does?
— Take your pick,
— OK. Right. Thanks for your time.
No room at the inn, Ted. But don't worry, we'll
have you away from here as soon as possible.
— Don't you worry, Doctor.
— (Patrick) Andrew?
What?
His heart's going ten to the dozen.
Yeah, your heart's just got a little bit
enthusiastic, so that's bog—standard SVT.
— Can | have...
— Adenosine, 3mg per mL.
— | wanted verapamil.
— What?
Kidding. This may feel a little bit funny, sir.
Like you.
Can you contact the bed manager, Pat?
See if you can get him in on CCU right away.
— Sure.
— And the on-call administrator.
— There's gotta be a neurosurgical bed.
— You'll be Lucky.
— | know.
— (Patient groans)
— Is that better, sir?
— Yeah. Thank you.
— Yeah.
— Erm, excuse me a minute, Mr O'Neill.
— Oh, Andrew. | just want to...
— | just went round on a visit.
— How she let herself get so bad, I've no idea.
— Ivy. She's one of my regulars. Thanks.
It's only been two weeks since we saw you, lvy.
Can we get her into a cubicle?
— They're all blocked.
— I'll move this gentleman.
Don't worry, Ivy. It'll be all right.
— Let's get some oxygen going, please.
— 2 litres per minute.
Yeah, and some gases off straight away.
5mls of salbutamol nebulised over air,
200mg of hydrocortisone.
Ivy, are you allergic to penicillin?
And 500mg of amoxicillin.
Straightaway, please.
Ivy, this is one of our new doctors, Dr Reid.
— She is very...
— Usual story. Wheezing, coughing up.
OK. Have you any chest pain?
— I'll get this to the lab.
— Machines are down. Run it up to ITU.
Go on.
The bed manager's not answering the bleep.
Doesn't make much odds.
Couldn't find a bed in a bed shop.
— The on-call admin?
— Said she was coming down.
Believe it when | see it.
We should go for aminophylline.
— (Bleeping)
— All right.
(Woman) Outside cail.
They can wait, can't they, Ivy? Listen, Ivy, you
know me. I'm not gonna beat about the bush.
You're looking very ilL
If your heart stops, do you want us to...
I'm sorry. Was that a loading dose you wanted?
— I'll put out the arrest call.
— No. No, no.
— Anybody with her?
— Daughter.
OK. Can you, er...
— Any joy yet, Doctor?
— With you in a minute, Ted.
You're Ivy's daughter. Remember me, Dr Collin?
As you know, your mother had
a serious long-standing chest disease
and I'm afraid this time
it was just too much for her.
She er... She passed away a few moments ago.
Sorry, love, not that...
| thought Liz was looking after this one.
So did I.
I'm really very sorry. Could you? Thanks.
— (Bleeping)
— Dr Collin, contact Surgery at once.
— Dr Collin.
— Oh, at last! Dr Curry.
— Sorry, Dr Curry.
— Young lady, swollen leg. | think it’s a DVT.
— What makes you think it's a DVT?
— I've been a GP for 30 years.
(Patrick) Andrew!
Look, just send her up.
| can't be bothered arguing with you.
Er...diazemuls, please.
— Do you have a patient for Lecter Ward?
— Not this one, mate. Can | have a pillow?
— VO2, 4.5.
— Where's Liz?
She had some stuff to do
so she asked me to go to ITU for her.
— PCO2, 9.1.
— She's dead, Rob. Ivy's dead.
Sorry. Gasping for a cuppa.
Such a queue at the canteen.
— That'd be on account of Caribbean Day.
— Can you get oxygen, please?
Have you got those diazemuls? Thanks.
You know that old Ted Corbett?
His GP booked him an outpatient appointment
instead of sending him as an emergency.
Now that stuffed shirt Curry's on at me
about a DVT of all things.
— Can you keep her still?
— Can | make myself useful?
— It's no good.
— Watch yourselves.
Hang on. Go for it!
Good. OK.
There you go. That'll do it.
Well done.
You can get up now. What's your name?
— Mustafa.
— Thanks, Mustafa.
| can't get up, Doc.
| think I've put me back out again.
— Eh?
— Come on, help him up.
— One, two, three...
— Whoa! Whoa! Hang on! Hang on!
Look, Mustafa, take your time, will you?
| won't be rushing.
— Ted?
— | think I've had a bit of an accident.
Don't worry about it, Ted.
It could happen to anybody, honest. All right?
Erm... I'll get someone to clean you up.
Ted, don't worry. OK?
Patrick? Sorry, Ted Corbett's wet himself.
— Didn't he have a bottle?
— | dunno.
You knew he was incontinent.
— | forgot.
— I'LL sort it.
— No joy on getting Mr O'Neill to CCU, is there?
— Correct.
(Woman on floor) Get him off!
— Rob, could you...if you don't mind?
— Fine. No, of course | don't.
Liz?
There's an ulcerative colitis in three
and this is a TIA.
Tell you what. Instead of spending all day
on the phone, I'm gonna see a punter.
"NHS Shock. Doctor Sees Patient.”
Take the UC. I've got to go to the loo.
— Dr Collin?
— What?
— I'm the on-call administrator.
— Oh, hi. Sorry. Thanks for coming down.
I've got one chap with a cord compression.
That's an emergency — he could end up
with paralysis and incontinence.
I've not been able to get him
on any neurosurgical unit anywhere.
The other guy's had a heart attack.
| can't get him a place on CCU
so that means | can't give him streptokinase
which would improve his chances of survival.
— Excuse me. I've got to go to the loo.
— I'll see what | can do.
— Oh, thanks a lot.
— So, where's the bed manager, then?
She's on a course.
What, they're showing her mattresses and
pillows and stuff so she'll know what a bed is?
— (Administrator laughs)
— (Pager bleeping)
— Oh...
— Cardiac arrest...
— Who do you think it'll be?
— Bloke in the end bed.
— | thought he was getting better.
— Exactly.
The thing is, Andrew,
| was hoping to pop out later.
Just for an hour.
I've only just noticed my car tax has run out.
| was gonna get somebody to hold my bleep.
Hopefully I'll be back before Long.
Dad bought it for me when | graduated.
| wanted red but he bought blue.
Do you know who | feel like? The Red Queen.
You know, in The Wizard Of Oz?
No matter how fast we run,
everything just seems to stand stilL
— So, is it OK if | pop out, then?
— No.
What did | say?
Excuse me.
Sorry, it's not an arrest.
A student nurse found her comatose.
Let's have 50ml of 50 per cent glucose, please.
Caroline, forget the airway. She'll need a dentist
if you carry on. Do a BM instead, will you?
Liz, go back to Casualty.
You'll be more help there.
Oh, and The Red Queen? Alice In Wonderland.
Don't worry about it. I'd rather you put out a call
and felt a bit silly than didn't
and ended up feeling a whole lot worse.
She's been having problems
controlling her diabetes.
We admitted her
so we could regulate her insulin injections.
— Looks like we overdid it a bit.
— One to two millimoles.
Thank you. The overdosage of insulin
has pushed her blood sugar right down
causing her to faint.
So we replace that sugar...
and...
Hello, Kimberley.
Right. Let's start a bag of 5 per cent dex
and check BM's half—hourly.
OK? I'll leave you to it.
— Have you, erm...
— Have you told your wife?
(Sighs) | couldn't.
| told her | had a needle—stick injury
from an HIV patient.
— You were supposed to tell her about us.
— | know.
Look. Let's just get
through the first problem, eh?
And then we'll deal with the future.
The answer's no. | haven't been tested.
If | had, why should | tell you the result?
Certainly not to make things cosy
between you and Alison.
(Sighs)
I'm very sorry, Dr Collin. Mr Tennant said
| shouldn't be doing doctors’ jobs for them.
Great.
He's got me projecting the hospital's
car park requirements for the year.
It's not your fault, | suppose. Thanks anyway.
Andrew, Casualty's chock—a—block.
We'll have to move ‘em out.
— OK.
— We've got ten minutes if you want Lunch.
No. Shouldn't risk it anyway
with this stomach of mine.
— Gorgeous stuff, this is.
— Is it?
You know, Mrs Garden
should have a go at cooking stuff like this.
But she loses her sense of ambition every time
she steps in the kitchen, that woman.
Mind you, it can't help having Kirk and Dirk,
that's the twins,
snapping round her ankles all day.
Still, you've got all that to come
with your missus, eh, Andrew?
She's had her scan, Mrs Garden. We've got
another pair on the way. Great, isn't it?
Runs in her family, not mine.
Her sisters, Maureen and Doreen,
are supposed to be identical twins.
Well, one of ‘em is, anyway. | dunno.
Take my advice, Andrew. Don't get married,
don't have children and don't get caught.
What do you mean, don't get caught?
It's a joke.
Take it easy! Slowly, slowly.
Steady as she goes. You'll have to throw water
over him, lads, till he’s returned to sea.
| see Ted Corbett's been transferred at last.
— Yes, to cubicle three.
— What about the MI in Resus, Mr O'Neill?
Still ‘ere.
Get CCU to send down
1.5 million units of streptokinase.
— But Andrew...
— What?
— Ted, how are you feeling?
— Not good, sir.
— Oh, you need a fresh bottle.
— Oh, | didn't realise.
I'm just gonna pinch one of your legs, OK?
Tell me which one.
Ready when you are, Doctor.
Right. I'm gonna give you a catheter.
That's a tube to go inside your bladder.
Save you worrying about your waterworks.
| had a lunchtime session
at the Old Varsity Tavern...
Pack it in, the pair of you!
Can | have the general, please?
This is a casualty department, not a boxing ring!
Get back in your cubicles. Behave and the
doctors see you. Otherwise, out on your botties.
— Get in!
— Pat, are you covered to do male catheters?
— No, sorry.
— Get me a size 12 Foley cat for Ted, please.
It's Dr Collin. | spoke to you this morning
about a cord compression.
— Has one of our administrators talked to you?
— No.
Surprise. I'm getting worried
about this guy. | don't suppose...
— fm sorry.
— Please?
— Sorry.
— OK.
— Andrew, about the streptokinase.
— What about it?
Mr O'Neill, I'm considering treating you here
rather than at coronary care.
Have a think about consenting.
IL be back in a couple of minutes.
Right, right.
Ah, your TIA. Forgot all about it. Erm...
— Right. Um...
— Liz? Liz?
Liz, | need your moniker.
Not that your name is moniker.
— You dork.
— Why don't you have a word with her for me?
| don't work with her. Ask Andrew...
— Ah, just the person.
— The UC's fine.
Good, Can you do Ted's catheter? Thank you.
— Andrew, may | have a word, please?
— Dr Turner, yeah.
I'm afraid I've received a complaint from
Dr Curry regarding your telephone manner.
General practitioners rightly take exception
to discourtesy from junior doctors.
Dr Turner, I'm sorry to be a pest but there's
so much work to catch up with on the wards.
You should have said, my dear.
I'LL walk with you.
Canteen pulled out all the stops today,
didn't they?
I'LL be with you in a moment.
— Here's your strep.
— Thank you.
Mr O'Neill? What's your verdict?
Well, | don't suppose I've any choice.
I'll just have to take my chances.
Good man.
Doctor, | wanted to ask you something personal.
— Uh~huh?
— With me having had this heart attack, er...
Well, it's my wife. She's still a young woman.
Oh, right.
— Well, how long?
— Six weeks.
— Oh.
— OK?
(Rob) Kids of a generation,
International Rescue...
(Patrick) Forget your Thunderbirds
and Captain Scarlet.
The only true stars of the puppet firmament
were The Pipkins.
— The what?
— "My name is Pig and | like chips."
I've started the strep on Mr O'Neill, OK?
Andrew, if you've got a minute,
could | have a word?
— What, about Mr Harris?
— No, no. About Liz.
— You want me to...
— Pyt a word in for him.
Yeah, you know. Only if you get the chance.
— Yeah, sure. I'll pass her a note at playtime.
— Eh?
— Dr Collin?
— And what about Hartley Hare?
Hartley Hare wasn't...
I've had to reassign my colleague
to her appropriate administrative duties.
Do we have a CCU bed?
No. | was alarmed to find out that you were
considering treating the patient regardless.
What about a neurosurgical bed
for my other patient?
Before | answer that,
| should remind you that this hospital...
Yes or no?
— After a patient's death...
— Yes or no?
— No!
— (Patrick) Andrew!
Stopped the strep. Blood pressure's 130 over 90.
OK. Can we nebulise 5mg of salbutamol
and have 200mg of hydrocortisone IV.
— Do you get asthma, Mr O'Neill?
— No.
You've had a reaction to the streptokinase. It's
not unusual Is that the new ECG over there?
We're gonna give you something
to damp it down.
You've had a mild allergic reaction
to a very important treatment.
| recommend we continue the streptokinase
along with anti—allergy treatment.
We're gonna keep a very close eye on you.
Feel free to disagree.
(Breathless) | don't know.
Mr O'Neill, | would like to continue
this treatment. We can stop it at any time.
— All right.
— Good.
Would you look after Mr O'Neill for us, please?
OK. BPs, pulse, respiratory rate,
quarter—hourly. Thank you.
Andrew?
| don't mean to be funny,
but do you think it's wise to press on?
Yes, as long as we keep a close watch on him.
The reaction could get worse, his blood pressure
could crash, and his ticker's already dodgy.
— Nurse Garden, is this patient in danger?
— I'm just saying there's a risk, that's all.
Dr Collin, since your management of this patient
is already against guidelines,
| consider it bloody worrying
that you're being so cavalier.
I'm doing what | believe is best for the patient.
| accept your reservations but we'll do as | say.
If you have a problem with my judgment,
take it up with my consultant.
— (Bleeping)
— Outside cali
Patrick, can you get someone
to do Ted's catheter, please?
Thank you.
— Dr Collin.
— ft’s me.
Alison.
— Yeah, I'm sorry | didn't call you.
— I'm really, really worried.
There's not much | can do at the moment.
The patient | cut myself on, we don't know
whether she's...whether he's HIV or not.
— We're trying to get his consent for a test.
— When will you know?
| don't know.
Look.
I'll call you later on, OK?
Let's hope it's good news.
Yeah, Bye.
Could you help find me a patient
who's fit to move off the unit, please?
We're on a break, but now you're here,
can you...
Later on.
Afternoon, Mrs Chumley.
Oh, yeah. You've got your heart scan
this afternoon, haven't you? Yeah.
Yep. We'll transfer Mr Mason, please.
— He's only two days post—MI.
— Move him off.
I've a patient in Casualty
with streptokinase already up and running.
Very pleased with your progress, Mr Mason.
Change of scenery for you.
Thank you.
Andrew. | called
but they said you were a bit snowed under.
Almost as though | was pinned to the floor
by a morbidly obese porter.
— Eh?
— I'm rambling.
The diabetic girl, can you write her up
for some dextrose and can you do her insulin?
— | thought Liz was on the ward.
— Sorting out her car tax or something.
Look, | just don't wanna hurt Alison's feelings
any more than | have to.
Caroline, please take the test. Then it'll be me
and you who deal with the result, whatever it is.
Me and you.
My marriage, my career, you.
It's just got all tied in a knot.
I'm sorry that you're seeing this side of me.
But, erm...it's all just getting too much.
Yes, I'll take the test.
Thank you.
Ah. Mr O'Neill. ALL right?
Oh, yes, thank you. Yes.
Thanks for everything, Doctor.
— You're gonna be fine, sir.
— Thank you.
Ah. Any news on Ted Corbett?
— No, sorry.
— I'll give them another call.
— Are you gonna finish that apple?
— | think | am.
I'm only thinking of your tummy, Andrew.
Dr Collin. | resent your tone with me earlier.
— | shall lodge a complaint with your consultant.
— Put me through to the general, please.
There are procedures and protocols
we all have to follow.
— Could you bleep the neurosurgical registrar?
— | see my role as smoothing a path
between those procedures and protocols.
— Hi, it's Dr Collin.
— Oh, not you again.
— Yes, me again.
— Doctors have been disorganised far too Long.
— | don't suppose a bed's come up, has it?
— One's just come up.
It has? Brilliant. That's great.
— I'll transfer him straightaway. Thank you.
- OK
— (Whispers) Yes!
— (Pager beeps)
— Thank you, Mr Tennant.
— (Patrick) Andrew?
Your DVT's turned up.
— Well, I've got another job to do.
— | wouldn't keep her waiting.
— The GP's already lodged a complaint.
— Bleep Liz.
— | have. She didn't answer.
— Call her on the ward, then.
— | have. She weren't there.
— Get switchboard to put a call out.
I've done everything
except conjure up a hologram of her.
The patient must be seen. Please,
Right. OK. Where is she?
— Cubicle one.
— Thank you.
Hello. I'm Dr Collin.
Your own doctor's told me about your problems.
Please speak up
if you disagree with any of the following.
Your calf has become hot, red,
swollen and painful.
You've not had an infection,
you've not injured it
and you've no lump at the back of your knee.
— You're taking the oral contraceptive pill.
— Yes.
You smoke. You're otherwise well
and this has never happened to you before.
You've never had any chest pain, you've no
shortness of breath and you've no cough.
This is probably a blood clot
in the vein of your calf.
We need to perform an ultrasound scan
to confirm the diagnosis.
If it's a clot, we'll admit you,
dissolve it and send you home.
Ultrasound scan, please.
Goodbye.
Dr Collin, erm, | understand
that you're working under the pressure of time,
but your manner has become undesirably brutal.
Well, send me a memo.
Young man found unconscious in deep coma.
No injuries.
OK.
Pin—point pupils.
And needle marks. Looks like a heroin
overdose. Can someone give me a hand, please?
Just get in and help me.
We need to get him in the recovery position.
Roll him onto his side after three.
One, two, three.
Well done.
Er...locks on, please. Airways secure.
Can we have some suction, please?
Breathing very shallow.
Pulse is weak. Suction!
Can | have an airway, please?
Chest NAD.
Abdomen NAD.
Pulse is very weak. Breathing very shallow.
— Is it serious?
— He's shutting down. Patrick!
He's knackered all his veins.
— Shouldn't you wear gloves?
— Like I've got time to worry about that.
— Venflon, Andrew.
— No time. Mind out.
OK, let's get him into a cubicle.
Thank you.
— Oh, Pat?
— What?
— There's something jamming this door.
— Try pushing it harder.
There's somebody collapsed in there.
| don't believe it.
Oh, no. We'll have to call works department,
get them to take it off the hinges.
No time.
We need to establish the patient's condition.
Oi. Get me something to get this door off,
will you?
— Thank you, Mr Tennant.
— Thank you very much, Mr Tennant.
Ah, Ted. We've arranged an ambulance
to transfer you up to the general.
— Sorry it took so long.
— It's OK, Doc.
— Good luck.
— Thanks, Doctor.
Ah, Andrew. | understand that you proceeded
with a patient's streptokinase
even though
it was complicated by an allergic reaction?
Not everyone would have had
the courage of their convictions.
Well done.
Well, well, Paul. (Chuckles)
She's unconscious but breathing.
Yeah, she's only fainted.
Let's get her on some oxygen
and onto a trolley.
I've got a phone call to make.
But first I've er...
(Andrew sighs)
| don't know what he's so pleased about. He's
only managed to admit two patients all day.
(Andrew groans with relief)
Andrew, the bog'LL be free now, Andrew.
— | told you not to have that curry last night.
— Thank you, but I'm feeling a whole Lot better.
— | might even try some lunch now.
— There is a bloke who's been waiting a while.
— Edwin Corbett.
— Old boy. Off legs.
But there again,
it is Caribbean Day at the canteen.
| suppose it won't take long, eh? Thanks.
— Edwin Corbett?
— Ted.
Morning. I'm Dr Collin.
Your doctor mentioned you'd had a fall.
Oh, | just went over. No damage, touch wood.
Before you fell, any chest pain,
palpitations, shortness of breath?
No. I've just been
a bit unsteady on me feet lately.
— Your legs have felt weak?
— Yes, that's right.
— Have you seen anyone about it?
— Doctor got me an outpatients appointment.
— When was that for?
— Year 2000, | think.
Sounds about right. We're chock—a—block.
Mind if | look here?
Oh, no. Go straight ahead.
Had any nausea, drowsiness,
fixed faints, blurred vision?
— No.
— I'm just gonna see how stiff your legs are.
OK. Keep your knee bent.
Don't let me straighten your leg.
OK. Now, keep it straight. Keep it straight.
OK. Same again. Don't let me straighten it.
Keep it straight.
Right. Just gonna do some reflexes, Ted, OK?
All righty.
Feel a little scratch on the bottom of your foot?
Have you, erm...
had any problems with your waterworks?
Sorry to have to ask. It's important.
Have you lost control of your water?
Just this last couple of days. | thought perhaps
it was an infection or something.
Any serious illness in the past?
— No. Appendix when | was a kid.
— Mm-—hm.
— And pneumonia in the army.
— | think we've got an MI. Taking him through.
You just relax there, Ted.
I'll be with you shortly.
Could you bleep Liz Reid to see Ted Corbett
and do some bloods? Thanks.
| think we've got a cord compression there, Pat.
Are you in any pain now, sir?
— It's Mr O'Neill
— It's getting easier.
Is it in the middle of your chest?
— It's like someone's sitting on me.
— You've read the textbooks.
— Want some more oxygen?
— 35 per cent, please, and aspirin too.
So your heart rate would suggest
that you have had a heart attack
sO we're gonna arrange
a transfer to Coronary Care
where we can start treatment
to dissolve the blood clot that's caused it.
— We'll be back with you very soon, Mr O'Neill.
— 35 per cent oxygen, OK?
Let's get hold of CCU,
see if they can make a bed for him.
— He should be strepped as soon as possible.
— I'll do my best.
— How are you doing, Liz?
— Fine.
I'm gonna do some blood tests and X-rays.
I'm worried that your legs are weak
because there's pressure
on your spinal cord.
— Is that serious?
— We need to release it to avoid damage.
— What sort?
— Bit early to say.
Andrew?
Won't be a minute, OK?
FBCs. U&Es. LFTs. Calcium profile.
Electrophoresis, B12, folate and ESR.
Chest and spinal films too.
Staff nurse wants to talk to his referring doctor.
I'm only the wazzock in charge of
the busiest department in the hospital.
Dr Collin. Hi, yeah. Can we get him up there
as soon as possible, please?
I'd rather not keep him waiting.
The sooner we treat, the better his chances.
here Full
Fine. Thank you.
Damn it.
— Any chance of him being strepped here?
— | don't like it. It's not policy.
— What's the issue?
— Complications of thrombolysis.
The guidelines say it must be done in Coronary.
Where there are no beds. Those bloods
are urgent, yeah? Can you get ‘em done?
Ted, the operation you need
to relieve the pressure on your spinal cord
requires specialised surgery
so I'm gonna refer you to another hospital.
— What, today?
— Straightaway.
Patrick, can you see which neurosurgical unit's
got a bed for Mr Corbett?
I'm gonna go to the, erm...
(Bleeping)
(Woman) Outside cail.
Won't be long, Ted, all right?
We'll transfer you soon.
— I'm holding.
— Dr Collin?
— it's me.
— Alison.
— This could not be a worse time, honestly.
— Andrew, you know I'm worried sick.
I'LL call you later, OK? Bye.
Sorry, Andrew.
Dr Collin. Oh, right, yeah. Can you transfer me
to the switchboard at the general?
Can you do some urgent bloods for me, please?
— Switchboard.
— This is Dr Collin, Medical SHO at Fort Apache.
— Could you bleep the neurological surgeon?
— just a moment.
(Man) Biochemistry.
Could you do some urgent urea electrolytes,
liver function and calcium?
— And electrophoresis.
— Our machines are offline.
— Shit. Biochemistry's machines are down.
— That's all we need.
Sorry, people. This patient's one of yours.
Could you see her, please?
Dr Turner will go spare
not having me on the wards.
Well, Dr Turner
will just have to have you somewhere else.
— Go on, Andrew. Be a sweetie.
— Mr Ray, yeah. This is Dr Collin.
I've a 71-year—old with spastic paraparesis,
highly suspicious of cord decompression.
— I'm sorry. We have no beds for him.
— Really? Do you know anywhere who does?
— Take your pick,
— OK. Right. Thanks for your time.
No room at the inn, Ted. But don't worry, we'll
have you away from here as soon as possible.
— Don't you worry, Doctor.
— (Patrick) Andrew?
What?
His heart's going ten to the dozen.
Yeah, your heart's just got a little bit
enthusiastic, so that's bog—standard SVT.
— Can | have...
— Adenosine, 3mg per mL.
— | wanted verapamil.
— What?
Kidding. This may feel a little bit funny, sir.
Like you.
Can you contact the bed manager, Pat?
See if you can get him in on CCU right away.
— Sure.
— And the on-call administrator.
— There's gotta be a neurosurgical bed.
— You'll be Lucky.
— | know.
— (Patient groans)
— Is that better, sir?
— Yeah. Thank you.
— Yeah.
— Erm, excuse me a minute, Mr O'Neill.
— Oh, Andrew. | just want to...
— | just went round on a visit.
— How she let herself get so bad, I've no idea.
— Ivy. She's one of my regulars. Thanks.
It's only been two weeks since we saw you, lvy.
Can we get her into a cubicle?
— They're all blocked.
— I'll move this gentleman.
Don't worry, Ivy. It'll be all right.
— Let's get some oxygen going, please.
— 2 litres per minute.
Yeah, and some gases off straight away.
5mls of salbutamol nebulised over air,
200mg of hydrocortisone.
Ivy, are you allergic to penicillin?
And 500mg of amoxicillin.
Straightaway, please.
Ivy, this is one of our new doctors, Dr Reid.
— She is very...
— Usual story. Wheezing, coughing up.
OK. Have you any chest pain?
— I'll get this to the lab.
— Machines are down. Run it up to ITU.
Go on.
The bed manager's not answering the bleep.
Doesn't make much odds.
Couldn't find a bed in a bed shop.
— The on-call admin?
— Said she was coming down.
Believe it when | see it.
We should go for aminophylline.
— (Bleeping)
— All right.
(Woman) Outside cail.
They can wait, can't they, Ivy? Listen, Ivy, you
know me. I'm not gonna beat about the bush.
You're looking very ilL
If your heart stops, do you want us to...
I'm sorry. Was that a loading dose you wanted?
— I'll put out the arrest call.
— No. No, no.
— Anybody with her?
— Daughter.
OK. Can you, er...
— Any joy yet, Doctor?
— With you in a minute, Ted.
You're Ivy's daughter. Remember me, Dr Collin?
As you know, your mother had
a serious long-standing chest disease
and I'm afraid this time
it was just too much for her.
She er... She passed away a few moments ago.
Sorry, love, not that...
| thought Liz was looking after this one.
So did I.
I'm really very sorry. Could you? Thanks.
— (Bleeping)
— Dr Collin, contact Surgery at once.
— Dr Collin.
— Oh, at last! Dr Curry.
— Sorry, Dr Curry.
— Young lady, swollen leg. | think it’s a DVT.
— What makes you think it's a DVT?
— I've been a GP for 30 years.
(Patrick) Andrew!
Look, just send her up.
| can't be bothered arguing with you.
Er...diazemuls, please.
— Do you have a patient for Lecter Ward?
— Not this one, mate. Can | have a pillow?
— VO2, 4.5.
— Where's Liz?
She had some stuff to do
so she asked me to go to ITU for her.
— PCO2, 9.1.
— She's dead, Rob. Ivy's dead.
Sorry. Gasping for a cuppa.
Such a queue at the canteen.
— That'd be on account of Caribbean Day.
— Can you get oxygen, please?
Have you got those diazemuls? Thanks.
You know that old Ted Corbett?
His GP booked him an outpatient appointment
instead of sending him as an emergency.
Now that stuffed shirt Curry's on at me
about a DVT of all things.
— Can you keep her still?
— Can | make myself useful?
— It's no good.
— Watch yourselves.
Hang on. Go for it!
Good. OK.
There you go. That'll do it.
Well done.
You can get up now. What's your name?
— Mustafa.
— Thanks, Mustafa.
| can't get up, Doc.
| think I've put me back out again.
— Eh?
— Come on, help him up.
— One, two, three...
— Whoa! Whoa! Hang on! Hang on!
Look, Mustafa, take your time, will you?
| won't be rushing.
— Ted?
— | think I've had a bit of an accident.
Don't worry about it, Ted.
It could happen to anybody, honest. All right?
Erm... I'll get someone to clean you up.
Ted, don't worry. OK?
Patrick? Sorry, Ted Corbett's wet himself.
— Didn't he have a bottle?
— | dunno.
You knew he was incontinent.
— | forgot.
— I'LL sort it.
— No joy on getting Mr O'Neill to CCU, is there?
— Correct.
(Woman on floor) Get him off!
— Rob, could you...if you don't mind?
— Fine. No, of course | don't.
Liz?
There's an ulcerative colitis in three
and this is a TIA.
Tell you what. Instead of spending all day
on the phone, I'm gonna see a punter.
"NHS Shock. Doctor Sees Patient.”
Take the UC. I've got to go to the loo.
— Dr Collin?
— What?
— I'm the on-call administrator.
— Oh, hi. Sorry. Thanks for coming down.
I've got one chap with a cord compression.
That's an emergency — he could end up
with paralysis and incontinence.
I've not been able to get him
on any neurosurgical unit anywhere.
The other guy's had a heart attack.
| can't get him a place on CCU
so that means | can't give him streptokinase
which would improve his chances of survival.
— Excuse me. I've got to go to the loo.
— I'll see what | can do.
— Oh, thanks a lot.
— So, where's the bed manager, then?
She's on a course.
What, they're showing her mattresses and
pillows and stuff so she'll know what a bed is?
— (Administrator laughs)
— (Pager bleeping)
— Oh...
— Cardiac arrest...
— Who do you think it'll be?
— Bloke in the end bed.
— | thought he was getting better.
— Exactly.
The thing is, Andrew,
| was hoping to pop out later.
Just for an hour.
I've only just noticed my car tax has run out.
| was gonna get somebody to hold my bleep.
Hopefully I'll be back before Long.
Dad bought it for me when | graduated.
| wanted red but he bought blue.
Do you know who | feel like? The Red Queen.
You know, in The Wizard Of Oz?
No matter how fast we run,
everything just seems to stand stilL
— So, is it OK if | pop out, then?
— No.
What did | say?
Excuse me.
Sorry, it's not an arrest.
A student nurse found her comatose.
Let's have 50ml of 50 per cent glucose, please.
Caroline, forget the airway. She'll need a dentist
if you carry on. Do a BM instead, will you?
Liz, go back to Casualty.
You'll be more help there.
Oh, and The Red Queen? Alice In Wonderland.
Don't worry about it. I'd rather you put out a call
and felt a bit silly than didn't
and ended up feeling a whole lot worse.
She's been having problems
controlling her diabetes.
We admitted her
so we could regulate her insulin injections.
— Looks like we overdid it a bit.
— One to two millimoles.
Thank you. The overdosage of insulin
has pushed her blood sugar right down
causing her to faint.
So we replace that sugar...
and...
Hello, Kimberley.
Right. Let's start a bag of 5 per cent dex
and check BM's half—hourly.
OK? I'll leave you to it.
— Have you, erm...
— Have you told your wife?
(Sighs) | couldn't.
| told her | had a needle—stick injury
from an HIV patient.
— You were supposed to tell her about us.
— | know.
Look. Let's just get
through the first problem, eh?
And then we'll deal with the future.
The answer's no. | haven't been tested.
If | had, why should | tell you the result?
Certainly not to make things cosy
between you and Alison.
(Sighs)
I'm very sorry, Dr Collin. Mr Tennant said
| shouldn't be doing doctors’ jobs for them.
Great.
He's got me projecting the hospital's
car park requirements for the year.
It's not your fault, | suppose. Thanks anyway.
Andrew, Casualty's chock—a—block.
We'll have to move ‘em out.
— OK.
— We've got ten minutes if you want Lunch.
No. Shouldn't risk it anyway
with this stomach of mine.
— Gorgeous stuff, this is.
— Is it?
You know, Mrs Garden
should have a go at cooking stuff like this.
But she loses her sense of ambition every time
she steps in the kitchen, that woman.
Mind you, it can't help having Kirk and Dirk,
that's the twins,
snapping round her ankles all day.
Still, you've got all that to come
with your missus, eh, Andrew?
She's had her scan, Mrs Garden. We've got
another pair on the way. Great, isn't it?
Runs in her family, not mine.
Her sisters, Maureen and Doreen,
are supposed to be identical twins.
Well, one of ‘em is, anyway. | dunno.
Take my advice, Andrew. Don't get married,
don't have children and don't get caught.
What do you mean, don't get caught?
It's a joke.
Take it easy! Slowly, slowly.
Steady as she goes. You'll have to throw water
over him, lads, till he’s returned to sea.
| see Ted Corbett's been transferred at last.
— Yes, to cubicle three.
— What about the MI in Resus, Mr O'Neill?
Still ‘ere.
Get CCU to send down
1.5 million units of streptokinase.
— But Andrew...
— What?
— Ted, how are you feeling?
— Not good, sir.
— Oh, you need a fresh bottle.
— Oh, | didn't realise.
I'm just gonna pinch one of your legs, OK?
Tell me which one.
Ready when you are, Doctor.
Right. I'm gonna give you a catheter.
That's a tube to go inside your bladder.
Save you worrying about your waterworks.
| had a lunchtime session
at the Old Varsity Tavern...
Pack it in, the pair of you!
Can | have the general, please?
This is a casualty department, not a boxing ring!
Get back in your cubicles. Behave and the
doctors see you. Otherwise, out on your botties.
— Get in!
— Pat, are you covered to do male catheters?
— No, sorry.
— Get me a size 12 Foley cat for Ted, please.
It's Dr Collin. | spoke to you this morning
about a cord compression.
— Has one of our administrators talked to you?
— No.
Surprise. I'm getting worried
about this guy. | don't suppose...
— fm sorry.
— Please?
— Sorry.
— OK.
— Andrew, about the streptokinase.
— What about it?
Mr O'Neill, I'm considering treating you here
rather than at coronary care.
Have a think about consenting.
IL be back in a couple of minutes.
Right, right.
Ah, your TIA. Forgot all about it. Erm...
— Right. Um...
— Liz? Liz?
Liz, | need your moniker.
Not that your name is moniker.
— You dork.
— Why don't you have a word with her for me?
| don't work with her. Ask Andrew...
— Ah, just the person.
— The UC's fine.
Good, Can you do Ted's catheter? Thank you.
— Andrew, may | have a word, please?
— Dr Turner, yeah.
I'm afraid I've received a complaint from
Dr Curry regarding your telephone manner.
General practitioners rightly take exception
to discourtesy from junior doctors.
Dr Turner, I'm sorry to be a pest but there's
so much work to catch up with on the wards.
You should have said, my dear.
I'LL walk with you.
Canteen pulled out all the stops today,
didn't they?
I'LL be with you in a moment.
— Here's your strep.
— Thank you.
Mr O'Neill? What's your verdict?
Well, | don't suppose I've any choice.
I'll just have to take my chances.
Good man.
Doctor, | wanted to ask you something personal.
— Uh~huh?
— With me having had this heart attack, er...
Well, it's my wife. She's still a young woman.
Oh, right.
— Well, how long?
— Six weeks.
— Oh.
— OK?
(Rob) Kids of a generation,
International Rescue...
(Patrick) Forget your Thunderbirds
and Captain Scarlet.
The only true stars of the puppet firmament
were The Pipkins.
— The what?
— "My name is Pig and | like chips."
I've started the strep on Mr O'Neill, OK?
Andrew, if you've got a minute,
could | have a word?
— What, about Mr Harris?
— No, no. About Liz.
— You want me to...
— Pyt a word in for him.
Yeah, you know. Only if you get the chance.
— Yeah, sure. I'll pass her a note at playtime.
— Eh?
— Dr Collin?
— And what about Hartley Hare?
Hartley Hare wasn't...
I've had to reassign my colleague
to her appropriate administrative duties.
Do we have a CCU bed?
No. | was alarmed to find out that you were
considering treating the patient regardless.
What about a neurosurgical bed
for my other patient?
Before | answer that,
| should remind you that this hospital...
Yes or no?
— After a patient's death...
— Yes or no?
— No!
— (Patrick) Andrew!
Stopped the strep. Blood pressure's 130 over 90.
OK. Can we nebulise 5mg of salbutamol
and have 200mg of hydrocortisone IV.
— Do you get asthma, Mr O'Neill?
— No.
You've had a reaction to the streptokinase. It's
not unusual Is that the new ECG over there?
We're gonna give you something
to damp it down.
You've had a mild allergic reaction
to a very important treatment.
| recommend we continue the streptokinase
along with anti—allergy treatment.
We're gonna keep a very close eye on you.
Feel free to disagree.
(Breathless) | don't know.
Mr O'Neill, | would like to continue
this treatment. We can stop it at any time.
— All right.
— Good.
Would you look after Mr O'Neill for us, please?
OK. BPs, pulse, respiratory rate,
quarter—hourly. Thank you.
Andrew?
| don't mean to be funny,
but do you think it's wise to press on?
Yes, as long as we keep a close watch on him.
The reaction could get worse, his blood pressure
could crash, and his ticker's already dodgy.
— Nurse Garden, is this patient in danger?
— I'm just saying there's a risk, that's all.
Dr Collin, since your management of this patient
is already against guidelines,
| consider it bloody worrying
that you're being so cavalier.
I'm doing what | believe is best for the patient.
| accept your reservations but we'll do as | say.
If you have a problem with my judgment,
take it up with my consultant.
— (Bleeping)
— Outside cali
Patrick, can you get someone
to do Ted's catheter, please?
Thank you.
— Dr Collin.
— ft’s me.
Alison.
— Yeah, I'm sorry | didn't call you.
— I'm really, really worried.
There's not much | can do at the moment.
The patient | cut myself on, we don't know
whether she's...whether he's HIV or not.
— We're trying to get his consent for a test.
— When will you know?
| don't know.
Look.
I'll call you later on, OK?
Let's hope it's good news.
Yeah, Bye.
Could you help find me a patient
who's fit to move off the unit, please?
We're on a break, but now you're here,
can you...
Later on.
Afternoon, Mrs Chumley.
Oh, yeah. You've got your heart scan
this afternoon, haven't you? Yeah.
Yep. We'll transfer Mr Mason, please.
— He's only two days post—MI.
— Move him off.
I've a patient in Casualty
with streptokinase already up and running.
Very pleased with your progress, Mr Mason.
Change of scenery for you.
Thank you.
Andrew. | called
but they said you were a bit snowed under.
Almost as though | was pinned to the floor
by a morbidly obese porter.
— Eh?
— I'm rambling.
The diabetic girl, can you write her up
for some dextrose and can you do her insulin?
— | thought Liz was on the ward.
— Sorting out her car tax or something.
Look, | just don't wanna hurt Alison's feelings
any more than | have to.
Caroline, please take the test. Then it'll be me
and you who deal with the result, whatever it is.
Me and you.
My marriage, my career, you.
It's just got all tied in a knot.
I'm sorry that you're seeing this side of me.
But, erm...it's all just getting too much.
Yes, I'll take the test.
Thank you.
Ah. Mr O'Neill. ALL right?
Oh, yes, thank you. Yes.
Thanks for everything, Doctor.
— You're gonna be fine, sir.
— Thank you.
Ah. Any news on Ted Corbett?
— No, sorry.
— I'll give them another call.
— Are you gonna finish that apple?
— | think | am.
I'm only thinking of your tummy, Andrew.
Dr Collin. | resent your tone with me earlier.
— | shall lodge a complaint with your consultant.
— Put me through to the general, please.
There are procedures and protocols
we all have to follow.
— Could you bleep the neurosurgical registrar?
— | see my role as smoothing a path
between those procedures and protocols.
— Hi, it's Dr Collin.
— Oh, not you again.
— Yes, me again.
— Doctors have been disorganised far too Long.
— | don't suppose a bed's come up, has it?
— One's just come up.
It has? Brilliant. That's great.
— I'll transfer him straightaway. Thank you.
- OK
— (Whispers) Yes!
— (Pager beeps)
— Thank you, Mr Tennant.
— (Patrick) Andrew?
Your DVT's turned up.
— Well, I've got another job to do.
— | wouldn't keep her waiting.
— The GP's already lodged a complaint.
— Bleep Liz.
— | have. She didn't answer.
— Call her on the ward, then.
— | have. She weren't there.
— Get switchboard to put a call out.
I've done everything
except conjure up a hologram of her.
The patient must be seen. Please,
Right. OK. Where is she?
— Cubicle one.
— Thank you.
Hello. I'm Dr Collin.
Your own doctor's told me about your problems.
Please speak up
if you disagree with any of the following.
Your calf has become hot, red,
swollen and painful.
You've not had an infection,
you've not injured it
and you've no lump at the back of your knee.
— You're taking the oral contraceptive pill.
— Yes.
You smoke. You're otherwise well
and this has never happened to you before.
You've never had any chest pain, you've no
shortness of breath and you've no cough.
This is probably a blood clot
in the vein of your calf.
We need to perform an ultrasound scan
to confirm the diagnosis.
If it's a clot, we'll admit you,
dissolve it and send you home.
Ultrasound scan, please.
Goodbye.
Dr Collin, erm, | understand
that you're working under the pressure of time,
but your manner has become undesirably brutal.
Well, send me a memo.
Young man found unconscious in deep coma.
No injuries.
OK.
Pin—point pupils.
And needle marks. Looks like a heroin
overdose. Can someone give me a hand, please?
Just get in and help me.
We need to get him in the recovery position.
Roll him onto his side after three.
One, two, three.
Well done.
Er...locks on, please. Airways secure.
Can we have some suction, please?
Breathing very shallow.
Pulse is weak. Suction!
Can | have an airway, please?
Chest NAD.
Abdomen NAD.
Pulse is very weak. Breathing very shallow.
— Is it serious?
— He's shutting down. Patrick!
He's knackered all his veins.
— Shouldn't you wear gloves?
— Like I've got time to worry about that.
— Venflon, Andrew.
— No time. Mind out.
OK, let's get him into a cubicle.
Thank you.
— Oh, Pat?
— What?
— There's something jamming this door.
— Try pushing it harder.
There's somebody collapsed in there.
| don't believe it.
Oh, no. We'll have to call works department,
get them to take it off the hinges.
No time.
We need to establish the patient's condition.
Oi. Get me something to get this door off,
will you?
— Thank you, Mr Tennant.
— Thank you very much, Mr Tennant.
Ah, Ted. We've arranged an ambulance
to transfer you up to the general.
— Sorry it took so long.
— It's OK, Doc.
— Good luck.
— Thanks, Doctor.
Ah, Andrew. | understand that you proceeded
with a patient's streptokinase
even though
it was complicated by an allergic reaction?
Not everyone would have had
the courage of their convictions.
Well done.
Well, well, Paul. (Chuckles)
She's unconscious but breathing.
Yeah, she's only fainted.
Let's get her on some oxygen
and onto a trolley.
I've got a phone call to make.
But first I've er...
(Andrew sighs)
| don't know what he's so pleased about. He's
only managed to admit two patients all day.
(Andrew groans with relief)