Cardiac Arrest (1994–1996): Season 3, Episode 7 - The Glass Ceiling - full transcript
— Liz. Edith Channing. Stroke.
— |'m not in the mood.
Hey. I've been waiting here three hours, pal.
Patients are seen in order of importance.
Clearly, you can't be very important.
Edith Channing. CBA.
— Where's Liz?
— Gone.
Great. I've got to go to ITU.
(Tuts)
— What happened?
— He's been stabbed.
— One for the surgeons, abdominal wound.
— I'LL call them.
Could you slow down, please?
What happened to you?
— | got bitten.
— Someone bit your ear?
No, Einstein, | reached round and bit it myself!
| would strongly advise you not to do this.
Do it, mate. It's a bit parky in here, anyway.
Be quiet and lie down.
No Paki tells me to be quiet.
Just put the lighter down, OK?
It's OK, mate. Just take it easy, all right?
It's all right, it's all right.
He's here to see another patient.
I'm Julie. I'm the sister here.
Why don't you put that cigarette lighter away,
and then we can talk?
I'm sure you've got a very, very good reason
for wanting to do this,
but I'd like to hear it first.
WiLL you give me the lighter?
Do it. Do it!
Please.
Just give me the lighter.
Thanks.
We'll go through to this cubicle here, shall we?
— (Smedley clears throat)
— Stab wound.
Thanks.
Useless little yard dog.
(Sighs)
It's not hard to see why he got stabbed.
What's all the noise?
The neighbours are at it again, Eric.
| just found her like this.
She could have been on the floor for days.
— My wife and |, we live two hours away.
— Your mother's very poorly.
Looks like she had a stroke.
Whether that's why she fell, | don't know.
She's not been herself for weeks.
Losing her way just going to the corner shop.
She keeps calling me Eric.
Eric was my late father.
— Well, she's elderly.
— And senile.
Look, I'm going to admit her and do some tests.
We'll see where we stand in the morning, OK?
It's always worth exploring an abdominal wound,
though, Phil A lot of clot work in here.
Terry "The Animal" Binns. Real tasty geezer.
Blacks, shooters, the full monty.
So what did he do?
Grievous bodily harm.
Actual bodily harm.
— What's the difference?
— Do | look like a copper?
Well, there ain't much evidence
of any bodily harm in here.
Deep penetration.
(Panting)
Exploring the cavity.
This X-ray shows that your father has fluid in
the lungs which is making him short of breath.
I've started treatment to remove that fluid
and I'm sure we'll see a quick improvement.
I'LL be back to see your father shortly.
These gases are heaps better.
Continue present treatment, I'll review Later.
Liz.
Mr Risley's sugar still hasn't come down.
(Sighs) Right. We should up the insulin
to ten units per hour.
— Are you sure?
— | think so.
Don't you want to ask Claire?
It seems | can't do anything
without having to ask Claire first.
Yep.
— That's it, isn't it?
— Yeah.
OK. Thanks.
Edith Channing. Uraemic as anything
with only moderately raised creatinine.
Start slow IVI normal saline, one in 12.
— Have | missed an arrest call?
— No. Why?
Just look like you might have had
a sprint down the corridor.
Can we have her on a monitor, please, Pam?
Just until tomorrow, if her enzymes are OK.
| wanted to ask you about the diabetic patient
you saw earlier.
His BMs are still high,
so | increased the insulin...
I'd have left it as it was.
No. | want to know when to put him onto a GIK.
You've heard what | think.
Please yourself what you do.
(Sighs)
(Pager beeps)
Please call Crippen Ward, 2650.
— I've gotta go, Caroline.
— Why don't you talk to me?
What about?
What do you think? About leaving Alison.
It's not going to happen straightaway.
Alison and |, we've got a lot to sort out.
| need time.
Look.
I've got to go to the ward.
— She's ripped another Venflon out.
— (Sighs)
I'm sorry, Andrew,
I've been trying for 20 minutes.
Your eyes are red,
give the contact lenses a rest.
I'd rather have eyes like ripe tomatoes
than go back to being a four—eyes.
— Edith. It's Dr Collin.
— Yeah.
We have to put a needle in your arm
so we can give you fluids.
You're dehydrated and the fluids
will make you comfortable, so come on.
— You bloody bastard, get off me.
— Come on, Edith. Edith.
— No.
— (Sighs) Give me the chlorpromazine.
— Chlorpromazine, 75mg.
— Yes, yes, yes.
— Hold her still, Liz.
— Get off me, get off me!
You bloody bastards. Agh!
Oh.
He's hurting me.
— And if that doesn't do it, give her another.
— Why is he hurting me? (Sobs)
— He did this to help you sleep.
— Come and take me home, Eric.
Incarcerated hernia.
Acute renal failure.
This, mate, is my ticket to fame and fortune.
Oh, no. Not another game show.
This one's a sure-fire winner. It's called...
It Could Be...
Cancer.
The contestants have to go through
a disease process
and you win a prize
based on your final diagnosis.
— Naturally cancer wins you the jackpot.
— Naturally.
Contestants choose symptoms
from a symptoms box.
For example, a choice of sore throat
would be greeted with sighs of disappointment
from the audience,
whilst coughing up blood
would be greeted with cheers.
Next...
they move onto the disease ladder
which leads to the diagnosis door.
The contestants choose additional symptoms
hidden behind the panels.
— This is the good bit.
— Well, | was waiting for that.
The contestant with the sore throat might
choose hoarse voice and shortness of breath.
Behind the diagnosis door is a tumour
and thus the jackpot prize.
Meanwhile, the one coughing up blood
might choose fever and pleurisy,
and thus lead to the disappointing diagnosis
of pneumonia.
— So, what do you think?
— | think it's crap.
Go on. Pick a symptom.
— I've got itchy feet.
— Lymphoma.
— I've got a rash.
— Tumour of the pancreas.
Runny nose.
A tumour's eaten through
your meningeal membrane,
causing cerebrospinal fluid
to drip out through your nose.
— This is stupid.
— What about a mystery celebrity round?
A famous person hides behind the screen,
and tells the contestant their symptoms.
The contestants have to guess both the celebrity
and the tumour to win the holiday.
Just to remind you about
the five—a—side tonight.
We're meeting in the social club after Star Trek.
You'll be needing me upfront.
| could have played for the Baggies, me.
— The porters told me you were good in the air.
— Useful is the term.
They used to call me Hanging Garden
on account of my uncanny ability
to dangle in the air for a cross.
— Raj?
— Not me, mate.
Nasreen's got tickets for a play.
— Plays are crap.
— Culture? Pah!
— You've never been to the theatre.
— School trip to Shakespeare.
You're blowing out your mates
so you can get bored silly with Nasreen?
Maybe | should get you
into the operating theatre
so as | can surgically remove her thumb
from your head.
— Yeah.
— Major.
— Loser.
— Any other time, lads, and | would have...
No.9 for the Baggies.
— Could have been me.
— Hi.
Erm... We're the new set of students.
Oh, right, girls, erm...
I'LL show you round.
Remember...
Mrs Garden and the twins.
(Laughs)
| wouldn't make a habit of that if | were you,
Mr Binns.
I'm sorry, Sister.
| didn't mean to frighten the girl
— Just trying to make her laugh.
— Apology accepted.
Good morning, Mr Binns. How do you feel?
Not too bad.
If this wound is satisfactory...
Oh.
— Something wrong, Doctor?
— | was hoping to send you back to...
to discharge you.
The only discharge here is from the wound.
We're worried that the wound's infected,
Mr Binns.
— Oh, you're not keeping me in, are you, Doc?
— Just another day, | hope, Mr Binns.
— Can you do a swab and start fluclox, please?
— Sure.
— Leave me be.
— Stroke appears to have resolved.
(Caroline) She kept the ward up
for most of the night. She's a handful.
You're telling me.
Do we have an ECG, Liz?
This is from this morning.
She's flipped her T waves anteriorly.
| reckon this lady's had a non—Q wave infarct.
It would have been nice to know she'd had a
heart attack before | started a wrestling match.
What am | listening for?
Murmurs.
She's had a heart attack and a stroke.
She may well have endocarditis
and a blood clot to the brain.
No murmurs.
Keep listening to her heart.
If a murmur develops, you treat for endocarditis
first and ask questions Later.
Treat the pneumonia and rehydrate her slowly.
Since we can presume a TIA,
cancel the CT if one's been requested,
and aspirin if there are no contraindications.
Only CT if there's any lingering doubt
about the diagnosis.
Caroline, can you see if there are any beds
on Geriatrics coming up, please?
OK.
If you do an ECG, look at it.
There'll be no shortage of people to look at it
when you're in court.
Andrew, you know the protocol
for patients of this age.
She should have been sent to Geriatrics this
morning. Get this old crumbly off our ward.
Thank you, Claire. I've been doing an urgent
echocardiogram. So where have we got to?
Mr Risley.
Diabetic ketoacidosis.
— Good morning, sir.
— Morning.
— I'm Sarah Hudson, Consultant Physician.
— How do you do?
Right.
This patient's sugar is climbing.
| thought we were supposed to keep it normal,
not have it go up and down like a yo-yo.
— Well, | tried asking Claire...
— Dr Hudson, I...
Yes, we will discuss this at a later time.
So, erm, stop the GIK, restart a driver,
six units an hour,
hourly BMs,
— sliding scale.
— OK.
It's just a little hiccup, sir.
We'll get you right in no time.
| have to find Eric.
Edith. Come on, Edith, back to bed now.
Come on.
— Come on, Edith.
— Where am |? Where am |?
— I'm the nurse. Let's get you back into bed.
— Come on now. Come on.
— You'll only hurt yourself, Edith.
— No, no!
— What's going on now?
— Mr Channing.
Last night two of you held her down
and stuck a needle in her.
Mr Channing, | gave her a sedative because she
was a danger to herself and to other patients.
— It's no way to treat a frightened old lady.
— | know. I'm sorry.
(Sighs)
| just want to know how she is.
It looks like she's had
a transient ischaemic attack.
It's a kind of mini stroke that goes away again.
There's also evidence of a heart attack
and her kidney function is impaired.
All these things together may be the reason
why she's not been herself.
You see, illnesses in the elderly
may mimic senile dementia.
| don't want her suffering for no reason.
— No needles or drips.
— Only what's necessary.
If you don't know, don't be afraid to ask.
— Thanks, Patrick.
— No, it's my job.
Kirsty, could you start by helping Enrolled Nurse
Reece in the plaster room, please?
Kirsty.
Of course | want to. I'm a devotee of
contemporary theatre, but...
— (Woman) But what?
— But I've got a tummyache.
— Of, yes?
— | might be better by tonight, though.
We'll see, shall we? Bye, love.
You pillock.
Patrick.
I've got these tickets and, well, no use for them,
for tomorrow.
| thought they might make a nice treat for you
and Mrs Garden for the opera.
Oh, well, it's difficult getting baby—sitters
for the twins, you know.
Kirk and Dirk.
Opera's even more boring than plays.
Fat birds singing in foreign. The sort of crap
Nasreen would make Raj go and see.
| don't like Beethoven and all that.
Beethoven didn't write any operas, stupid.
In fact, he did write one entitled Fidelio.
Oh. Well, you're welcome to them, Cyril.
Ooh.
Children, please.
— Got to be joking.
— It's Judas we came to see.
Mate, do you think I'd rather see a poxy play
than join the lads for footie?
Then tell your girlfriend
it's a question of priorities.
You're right. Priorities. Count me in.
My team.
Good decision.
Raj.
If James and Scissors asked you
to jump in a lake,
— would you do it?
— No.
You would, wouldn't you?
No.
Are you chewing?
No.
Give it to me, please.
Thank you.
| accept there's no love lost
between you and Liz,
what | cannot accept
is when it affects patient care.
— That's not my fault.
— It is your fault
that Liz is scared to ask your advice
in case you bite her head off.
It is your fault that when | asked you to accept
responsibility for teaching her,
you do so in a needlessly adversarial manner.
— | believe in education through humiliation.
— Don't be flippant.
Do you not realise
we work under a glass ceiling?
A female consultant, a female registrar,
a female house officer.
Graham Turner and his old—boy cronies
would cream their pinstriped suits
if they knew what was going on.
Stop being such a bitch.
I'm sorry if I've let you down, Dr Hudson.
Claire, if you want to get where | have,
there is that ceiling to break through.
There are plenty of people waiting to find fault,
stop making it so bloody easy for them.
He's not coming, is he?
Just give him five more minutes.
He's away to the theatre, isn't he?
Ah.
Claire.
We were going to pick Raj.
Turns out he's a girl after all.
(Toilet flushes)
You were ages. What do you get up to in there?
(Bleeping)
(Continuous bleep)
Ow!
Edith.
Edith. Come on, back to bed. This way.
I'm so sorry. She'll be going
to the geriatric ward tomorrow.
You kept that a secret pretty well.
— Kept what a secret?
— You know.
No.
You and, er...Scissors Smedley.
What about me and Scissors?
Was that a clanger | heard dropping?
Better go and pick it up.
How's that wound infection today, Mr Binns?
Another day?
I'm afraid so.
Well, your chest is clearing, Edith.
| think you're getting better.
Better.
Antibiotics to oral.
Continue oral rehydration.
Can we start mobilising her
on the cardiac rehab protocol, please?
Can't it wait till she goes to Geriatrics?
They've fewer acutely ill patients
to be busy with.
I'd rather give her a chance here first.
But you know what happened last night.
Look, she's a danger to other patients.
| don't want this to become something personal
between you and me.
— (Pager beeps)
— Dr Collin, outside call.
Your wife, no doubt.
— Mr Channing.
— What are these from?
— It's, er...where the drips have been.
— | know she's been held down.
I'm afraid sometimes your mother
does become confused, but she's getting better.
I've been looking at nursing homes near us.
So my wife and | can visit more.
| want my mother to be somewhere
where people can look after her properly,
instead of tormented with tests and injections.
Mr Channing, we're still doing
all we can for your mother.
How about that, Mother?
You'd like that, wouldn't you?
(Knocks on door)
— Hi. Hope I'm not disturbing you.
— No, no, no. Not at all.
| was wondering if those opera tickets
were still available for tonight.
— Sorry.
— Oh.
That's a pity.
| thought maybe you and | could have gone.
Oh.
Together, you know.
We could always do something else.
(Sighs)
Erm...
Was, er... Was that you asking me out just then?
That bit just then?
Yes.
This bit just now is me saying yes.
— Yes.
— (Laughs)
Look, James, I'm really sorry about last night.
| can hear this strange whining noise.
Maybe my bleep's on the blink.
— Not speaking?
— Not speaking.
Ever get the feeling you can't do anything right?
Tell me about it.
Here we are, Scis.
Wound infection due to Strep. faecalis.
Phil.
The knife wound never perforated the bowel,
remember?
I'd like to have a word with Mr Binns in private,
please.
We've discovered the germ
which has infected your stab wound.
It normally lives inside the bowel,
but I'm sure your bowel hasn't been punctured.
So?
So | wonder if you've been doing something
which might have caused the wound
to become infected by this particular germ.
Such as?
Ooh, er...| don't know, perhaps...
Let's just say, for a figure of speech...
— smearing your own faeces into the wound.
— What do you take me for?
— Someone else's faeces, then.
— Don't you come up with me, sunshine!
We're going to clean the wound,
continue the antibiotics,
and I'd better see an improvement by tomorrow.
What a hygienic gentleman.
Maybe that's why they call him The Animal.
She looks much more with it all of a sudden.
She's less toxic from the infection.
Now, Edith. Are you going to speak to me
this afternoon? Hm?
What's that you're writing?
Your handwriting's got worse recently, has it?
| won prizes in school.
Now I'm so...
untidy.
Edith.
Can you do that button for me?
It's all right. It's all right. I'll do it.
So, you won prizes, did you? When was that?
Could you keep your arm right up there?
When was that, Edith?
Before the war.
What else do you remember?
The King had a Silver Jubilee.
Who was prime minister, hm?
lit was Mr Chamberlain.
That's right.
I'm just going to tap your forehead, OK?
Who's prime minister now, Edith?
I'm sorry, you must be tired. It's OK. Sorry.
— Parkinson's disease.
— Yeah.
The physio said she’s had no joy with her.
She'll be able to do more with her
on a geriatric ward.
We'll start L-Dopa immediately.
Thank you.
— How is she, doctor?
— | think she's improving.
I'm suspicious that she's an undiagnosed case
of Parkinson's disease.
I've started a tablet which should help her.
Like hell is she going anywhere
until we're finished with her.
Mr Major.
That's the answer.
(Sighs)
— Fancy another one before we go?
— Yeah. OK.
Same again, thanks, mate.
Oh, Andrew.
| know there's a couple more patients to see,
but you don't mind if | get off, do you?
— I'm dead beat.
— OK.
— (Pager beeps)
— Thanks, Andrew.
(Pager) Outside call.
— Dr Collin.
— /t’s me.
Hi, Alison.
Dr Hudson wants a bed
for one of her cardiology patients tomorrow,
so let's get Mrs Channing over to Geriatrics.
— OK.
— Just hang on one sec.
Caroline. You keep Edith where she is,
I'LL transfer one of the others.
— Look, I'll be there.
— You know how important this is.
Alison, | want to sort things out between us
just as much as you do.
| won't be a bit on the side any more.
You say you'll tell her, nothing happens.
Leave Alison.
Or we stop seeing each other.
Well, you said it, not me.
You'll have your own room.
See?
They're nice, aren't they?
Look at the garden.
Look at the apple trees.
Won't they look lovely in summer?
Some more of the new tablets, Edith.
— (Car horn)
— Cab's here.
You...don't have to go, you know,
if you...if you don't want to.
Not taking things for granted, are you?
You wouldn't do that, would you?
Assume something before you'd made sure?
(Laughing)
Healing nicely.
That's you out of here, Mr Binns.
(Prison officer Laughs)
We think we've found a nursing home.
Well, actually, your mother today...
Excuse me, Mr Channing.
I'd like to make arrangements for my mother
to see the home for herself.
Maybe you should come and see her first.
Bernard.
Mum!
(Laughter)
— |'m not in the mood.
Hey. I've been waiting here three hours, pal.
Patients are seen in order of importance.
Clearly, you can't be very important.
Edith Channing. CBA.
— Where's Liz?
— Gone.
Great. I've got to go to ITU.
(Tuts)
— What happened?
— He's been stabbed.
— One for the surgeons, abdominal wound.
— I'LL call them.
Could you slow down, please?
What happened to you?
— | got bitten.
— Someone bit your ear?
No, Einstein, | reached round and bit it myself!
| would strongly advise you not to do this.
Do it, mate. It's a bit parky in here, anyway.
Be quiet and lie down.
No Paki tells me to be quiet.
Just put the lighter down, OK?
It's OK, mate. Just take it easy, all right?
It's all right, it's all right.
He's here to see another patient.
I'm Julie. I'm the sister here.
Why don't you put that cigarette lighter away,
and then we can talk?
I'm sure you've got a very, very good reason
for wanting to do this,
but I'd like to hear it first.
WiLL you give me the lighter?
Do it. Do it!
Please.
Just give me the lighter.
Thanks.
We'll go through to this cubicle here, shall we?
— (Smedley clears throat)
— Stab wound.
Thanks.
Useless little yard dog.
(Sighs)
It's not hard to see why he got stabbed.
What's all the noise?
The neighbours are at it again, Eric.
| just found her like this.
She could have been on the floor for days.
— My wife and |, we live two hours away.
— Your mother's very poorly.
Looks like she had a stroke.
Whether that's why she fell, | don't know.
She's not been herself for weeks.
Losing her way just going to the corner shop.
She keeps calling me Eric.
Eric was my late father.
— Well, she's elderly.
— And senile.
Look, I'm going to admit her and do some tests.
We'll see where we stand in the morning, OK?
It's always worth exploring an abdominal wound,
though, Phil A lot of clot work in here.
Terry "The Animal" Binns. Real tasty geezer.
Blacks, shooters, the full monty.
So what did he do?
Grievous bodily harm.
Actual bodily harm.
— What's the difference?
— Do | look like a copper?
Well, there ain't much evidence
of any bodily harm in here.
Deep penetration.
(Panting)
Exploring the cavity.
This X-ray shows that your father has fluid in
the lungs which is making him short of breath.
I've started treatment to remove that fluid
and I'm sure we'll see a quick improvement.
I'LL be back to see your father shortly.
These gases are heaps better.
Continue present treatment, I'll review Later.
Liz.
Mr Risley's sugar still hasn't come down.
(Sighs) Right. We should up the insulin
to ten units per hour.
— Are you sure?
— | think so.
Don't you want to ask Claire?
It seems | can't do anything
without having to ask Claire first.
Yep.
— That's it, isn't it?
— Yeah.
OK. Thanks.
Edith Channing. Uraemic as anything
with only moderately raised creatinine.
Start slow IVI normal saline, one in 12.
— Have | missed an arrest call?
— No. Why?
Just look like you might have had
a sprint down the corridor.
Can we have her on a monitor, please, Pam?
Just until tomorrow, if her enzymes are OK.
| wanted to ask you about the diabetic patient
you saw earlier.
His BMs are still high,
so | increased the insulin...
I'd have left it as it was.
No. | want to know when to put him onto a GIK.
You've heard what | think.
Please yourself what you do.
(Sighs)
(Pager beeps)
Please call Crippen Ward, 2650.
— I've gotta go, Caroline.
— Why don't you talk to me?
What about?
What do you think? About leaving Alison.
It's not going to happen straightaway.
Alison and |, we've got a lot to sort out.
| need time.
Look.
I've got to go to the ward.
— She's ripped another Venflon out.
— (Sighs)
I'm sorry, Andrew,
I've been trying for 20 minutes.
Your eyes are red,
give the contact lenses a rest.
I'd rather have eyes like ripe tomatoes
than go back to being a four—eyes.
— Edith. It's Dr Collin.
— Yeah.
We have to put a needle in your arm
so we can give you fluids.
You're dehydrated and the fluids
will make you comfortable, so come on.
— You bloody bastard, get off me.
— Come on, Edith. Edith.
— No.
— (Sighs) Give me the chlorpromazine.
— Chlorpromazine, 75mg.
— Yes, yes, yes.
— Hold her still, Liz.
— Get off me, get off me!
You bloody bastards. Agh!
Oh.
He's hurting me.
— And if that doesn't do it, give her another.
— Why is he hurting me? (Sobs)
— He did this to help you sleep.
— Come and take me home, Eric.
Incarcerated hernia.
Acute renal failure.
This, mate, is my ticket to fame and fortune.
Oh, no. Not another game show.
This one's a sure-fire winner. It's called...
It Could Be...
Cancer.
The contestants have to go through
a disease process
and you win a prize
based on your final diagnosis.
— Naturally cancer wins you the jackpot.
— Naturally.
Contestants choose symptoms
from a symptoms box.
For example, a choice of sore throat
would be greeted with sighs of disappointment
from the audience,
whilst coughing up blood
would be greeted with cheers.
Next...
they move onto the disease ladder
which leads to the diagnosis door.
The contestants choose additional symptoms
hidden behind the panels.
— This is the good bit.
— Well, | was waiting for that.
The contestant with the sore throat might
choose hoarse voice and shortness of breath.
Behind the diagnosis door is a tumour
and thus the jackpot prize.
Meanwhile, the one coughing up blood
might choose fever and pleurisy,
and thus lead to the disappointing diagnosis
of pneumonia.
— So, what do you think?
— | think it's crap.
Go on. Pick a symptom.
— I've got itchy feet.
— Lymphoma.
— I've got a rash.
— Tumour of the pancreas.
Runny nose.
A tumour's eaten through
your meningeal membrane,
causing cerebrospinal fluid
to drip out through your nose.
— This is stupid.
— What about a mystery celebrity round?
A famous person hides behind the screen,
and tells the contestant their symptoms.
The contestants have to guess both the celebrity
and the tumour to win the holiday.
Just to remind you about
the five—a—side tonight.
We're meeting in the social club after Star Trek.
You'll be needing me upfront.
| could have played for the Baggies, me.
— The porters told me you were good in the air.
— Useful is the term.
They used to call me Hanging Garden
on account of my uncanny ability
to dangle in the air for a cross.
— Raj?
— Not me, mate.
Nasreen's got tickets for a play.
— Plays are crap.
— Culture? Pah!
— You've never been to the theatre.
— School trip to Shakespeare.
You're blowing out your mates
so you can get bored silly with Nasreen?
Maybe | should get you
into the operating theatre
so as | can surgically remove her thumb
from your head.
— Yeah.
— Major.
— Loser.
— Any other time, lads, and | would have...
No.9 for the Baggies.
— Could have been me.
— Hi.
Erm... We're the new set of students.
Oh, right, girls, erm...
I'LL show you round.
Remember...
Mrs Garden and the twins.
(Laughs)
| wouldn't make a habit of that if | were you,
Mr Binns.
I'm sorry, Sister.
| didn't mean to frighten the girl
— Just trying to make her laugh.
— Apology accepted.
Good morning, Mr Binns. How do you feel?
Not too bad.
If this wound is satisfactory...
Oh.
— Something wrong, Doctor?
— | was hoping to send you back to...
to discharge you.
The only discharge here is from the wound.
We're worried that the wound's infected,
Mr Binns.
— Oh, you're not keeping me in, are you, Doc?
— Just another day, | hope, Mr Binns.
— Can you do a swab and start fluclox, please?
— Sure.
— Leave me be.
— Stroke appears to have resolved.
(Caroline) She kept the ward up
for most of the night. She's a handful.
You're telling me.
Do we have an ECG, Liz?
This is from this morning.
She's flipped her T waves anteriorly.
| reckon this lady's had a non—Q wave infarct.
It would have been nice to know she'd had a
heart attack before | started a wrestling match.
What am | listening for?
Murmurs.
She's had a heart attack and a stroke.
She may well have endocarditis
and a blood clot to the brain.
No murmurs.
Keep listening to her heart.
If a murmur develops, you treat for endocarditis
first and ask questions Later.
Treat the pneumonia and rehydrate her slowly.
Since we can presume a TIA,
cancel the CT if one's been requested,
and aspirin if there are no contraindications.
Only CT if there's any lingering doubt
about the diagnosis.
Caroline, can you see if there are any beds
on Geriatrics coming up, please?
OK.
If you do an ECG, look at it.
There'll be no shortage of people to look at it
when you're in court.
Andrew, you know the protocol
for patients of this age.
She should have been sent to Geriatrics this
morning. Get this old crumbly off our ward.
Thank you, Claire. I've been doing an urgent
echocardiogram. So where have we got to?
Mr Risley.
Diabetic ketoacidosis.
— Good morning, sir.
— Morning.
— I'm Sarah Hudson, Consultant Physician.
— How do you do?
Right.
This patient's sugar is climbing.
| thought we were supposed to keep it normal,
not have it go up and down like a yo-yo.
— Well, | tried asking Claire...
— Dr Hudson, I...
Yes, we will discuss this at a later time.
So, erm, stop the GIK, restart a driver,
six units an hour,
hourly BMs,
— sliding scale.
— OK.
It's just a little hiccup, sir.
We'll get you right in no time.
| have to find Eric.
Edith. Come on, Edith, back to bed now.
Come on.
— Come on, Edith.
— Where am |? Where am |?
— I'm the nurse. Let's get you back into bed.
— Come on now. Come on.
— You'll only hurt yourself, Edith.
— No, no!
— What's going on now?
— Mr Channing.
Last night two of you held her down
and stuck a needle in her.
Mr Channing, | gave her a sedative because she
was a danger to herself and to other patients.
— It's no way to treat a frightened old lady.
— | know. I'm sorry.
(Sighs)
| just want to know how she is.
It looks like she's had
a transient ischaemic attack.
It's a kind of mini stroke that goes away again.
There's also evidence of a heart attack
and her kidney function is impaired.
All these things together may be the reason
why she's not been herself.
You see, illnesses in the elderly
may mimic senile dementia.
| don't want her suffering for no reason.
— No needles or drips.
— Only what's necessary.
If you don't know, don't be afraid to ask.
— Thanks, Patrick.
— No, it's my job.
Kirsty, could you start by helping Enrolled Nurse
Reece in the plaster room, please?
Kirsty.
Of course | want to. I'm a devotee of
contemporary theatre, but...
— (Woman) But what?
— But I've got a tummyache.
— Of, yes?
— | might be better by tonight, though.
We'll see, shall we? Bye, love.
You pillock.
Patrick.
I've got these tickets and, well, no use for them,
for tomorrow.
| thought they might make a nice treat for you
and Mrs Garden for the opera.
Oh, well, it's difficult getting baby—sitters
for the twins, you know.
Kirk and Dirk.
Opera's even more boring than plays.
Fat birds singing in foreign. The sort of crap
Nasreen would make Raj go and see.
| don't like Beethoven and all that.
Beethoven didn't write any operas, stupid.
In fact, he did write one entitled Fidelio.
Oh. Well, you're welcome to them, Cyril.
Ooh.
Children, please.
— Got to be joking.
— It's Judas we came to see.
Mate, do you think I'd rather see a poxy play
than join the lads for footie?
Then tell your girlfriend
it's a question of priorities.
You're right. Priorities. Count me in.
My team.
Good decision.
Raj.
If James and Scissors asked you
to jump in a lake,
— would you do it?
— No.
You would, wouldn't you?
No.
Are you chewing?
No.
Give it to me, please.
Thank you.
| accept there's no love lost
between you and Liz,
what | cannot accept
is when it affects patient care.
— That's not my fault.
— It is your fault
that Liz is scared to ask your advice
in case you bite her head off.
It is your fault that when | asked you to accept
responsibility for teaching her,
you do so in a needlessly adversarial manner.
— | believe in education through humiliation.
— Don't be flippant.
Do you not realise
we work under a glass ceiling?
A female consultant, a female registrar,
a female house officer.
Graham Turner and his old—boy cronies
would cream their pinstriped suits
if they knew what was going on.
Stop being such a bitch.
I'm sorry if I've let you down, Dr Hudson.
Claire, if you want to get where | have,
there is that ceiling to break through.
There are plenty of people waiting to find fault,
stop making it so bloody easy for them.
He's not coming, is he?
Just give him five more minutes.
He's away to the theatre, isn't he?
Ah.
Claire.
We were going to pick Raj.
Turns out he's a girl after all.
(Toilet flushes)
You were ages. What do you get up to in there?
(Bleeping)
(Continuous bleep)
Ow!
Edith.
Edith. Come on, back to bed. This way.
I'm so sorry. She'll be going
to the geriatric ward tomorrow.
You kept that a secret pretty well.
— Kept what a secret?
— You know.
No.
You and, er...Scissors Smedley.
What about me and Scissors?
Was that a clanger | heard dropping?
Better go and pick it up.
How's that wound infection today, Mr Binns?
Another day?
I'm afraid so.
Well, your chest is clearing, Edith.
| think you're getting better.
Better.
Antibiotics to oral.
Continue oral rehydration.
Can we start mobilising her
on the cardiac rehab protocol, please?
Can't it wait till she goes to Geriatrics?
They've fewer acutely ill patients
to be busy with.
I'd rather give her a chance here first.
But you know what happened last night.
Look, she's a danger to other patients.
| don't want this to become something personal
between you and me.
— (Pager beeps)
— Dr Collin, outside call.
Your wife, no doubt.
— Mr Channing.
— What are these from?
— It's, er...where the drips have been.
— | know she's been held down.
I'm afraid sometimes your mother
does become confused, but she's getting better.
I've been looking at nursing homes near us.
So my wife and | can visit more.
| want my mother to be somewhere
where people can look after her properly,
instead of tormented with tests and injections.
Mr Channing, we're still doing
all we can for your mother.
How about that, Mother?
You'd like that, wouldn't you?
(Knocks on door)
— Hi. Hope I'm not disturbing you.
— No, no, no. Not at all.
| was wondering if those opera tickets
were still available for tonight.
— Sorry.
— Oh.
That's a pity.
| thought maybe you and | could have gone.
Oh.
Together, you know.
We could always do something else.
(Sighs)
Erm...
Was, er... Was that you asking me out just then?
That bit just then?
Yes.
This bit just now is me saying yes.
— Yes.
— (Laughs)
Look, James, I'm really sorry about last night.
| can hear this strange whining noise.
Maybe my bleep's on the blink.
— Not speaking?
— Not speaking.
Ever get the feeling you can't do anything right?
Tell me about it.
Here we are, Scis.
Wound infection due to Strep. faecalis.
Phil.
The knife wound never perforated the bowel,
remember?
I'd like to have a word with Mr Binns in private,
please.
We've discovered the germ
which has infected your stab wound.
It normally lives inside the bowel,
but I'm sure your bowel hasn't been punctured.
So?
So | wonder if you've been doing something
which might have caused the wound
to become infected by this particular germ.
Such as?
Ooh, er...| don't know, perhaps...
Let's just say, for a figure of speech...
— smearing your own faeces into the wound.
— What do you take me for?
— Someone else's faeces, then.
— Don't you come up with me, sunshine!
We're going to clean the wound,
continue the antibiotics,
and I'd better see an improvement by tomorrow.
What a hygienic gentleman.
Maybe that's why they call him The Animal.
She looks much more with it all of a sudden.
She's less toxic from the infection.
Now, Edith. Are you going to speak to me
this afternoon? Hm?
What's that you're writing?
Your handwriting's got worse recently, has it?
| won prizes in school.
Now I'm so...
untidy.
Edith.
Can you do that button for me?
It's all right. It's all right. I'll do it.
So, you won prizes, did you? When was that?
Could you keep your arm right up there?
When was that, Edith?
Before the war.
What else do you remember?
The King had a Silver Jubilee.
Who was prime minister, hm?
lit was Mr Chamberlain.
That's right.
I'm just going to tap your forehead, OK?
Who's prime minister now, Edith?
I'm sorry, you must be tired. It's OK. Sorry.
— Parkinson's disease.
— Yeah.
The physio said she’s had no joy with her.
She'll be able to do more with her
on a geriatric ward.
We'll start L-Dopa immediately.
Thank you.
— How is she, doctor?
— | think she's improving.
I'm suspicious that she's an undiagnosed case
of Parkinson's disease.
I've started a tablet which should help her.
Like hell is she going anywhere
until we're finished with her.
Mr Major.
That's the answer.
(Sighs)
— Fancy another one before we go?
— Yeah. OK.
Same again, thanks, mate.
Oh, Andrew.
| know there's a couple more patients to see,
but you don't mind if | get off, do you?
— I'm dead beat.
— OK.
— (Pager beeps)
— Thanks, Andrew.
(Pager) Outside call.
— Dr Collin.
— /t’s me.
Hi, Alison.
Dr Hudson wants a bed
for one of her cardiology patients tomorrow,
so let's get Mrs Channing over to Geriatrics.
— OK.
— Just hang on one sec.
Caroline. You keep Edith where she is,
I'LL transfer one of the others.
— Look, I'll be there.
— You know how important this is.
Alison, | want to sort things out between us
just as much as you do.
| won't be a bit on the side any more.
You say you'll tell her, nothing happens.
Leave Alison.
Or we stop seeing each other.
Well, you said it, not me.
You'll have your own room.
See?
They're nice, aren't they?
Look at the garden.
Look at the apple trees.
Won't they look lovely in summer?
Some more of the new tablets, Edith.
— (Car horn)
— Cab's here.
You...don't have to go, you know,
if you...if you don't want to.
Not taking things for granted, are you?
You wouldn't do that, would you?
Assume something before you'd made sure?
(Laughing)
Healing nicely.
That's you out of here, Mr Binns.
(Prison officer Laughs)
We think we've found a nursing home.
Well, actually, your mother today...
Excuse me, Mr Channing.
I'd like to make arrangements for my mother
to see the home for herself.
Maybe you should come and see her first.
Bernard.
Mum!
(Laughter)