Cardiac Arrest (1994–1996): Season 3, Episode 8 - The Way of All Flesh - full transcript

Honestly, Andrew,
I'd just give her a shot of adenosine and see.

How do you tell if they should be
small, medium or large?

Try one of each and see which fits.

Thanks.

Schoolboys, the Lot of you.

— Sorry, Andrew.
— Raj is the man in pole position.

— Eh?
— Kirsty. The wet dream come true.

— She was asking me about him.
— Yeah, me too.

— "Does Dr Rajah have a girlfriend?”
— Yeah, sure.

— No joke, mate.
— She's got a major wide—on for the Raj.

— A what?
— A wide—on.



Look, mate. Where | come from,
when a girl gets the hots for a guy...

I'LL tell you, mate... Straight through, thanks.

Darling, I'm sorry.

Chest pain. This one’s medical.

— Mine.
— OK. Got no cubicles free.

Deborah!

— Airway clear, apart from a few stray teeth.
— Breathing spontaneously.

She's tachycardic as hell, but good volume.
Chateau colloid, please, waiter.

— Yes, sir.
— Let's get a second Line in.

— Right.
— Comatose. Pupils equal and reactive.

— Blood is down.
— She's taken a hit to the head.

— Mannitol?
— Yeah.

She's got a degloved hand.

RTA. Mr Broadbent was the driver.
His daughter is the girl in resus.



| took the wrong exit.

| asked Deborah
to get the map off the back seat.

— She took her seatbelt off.
— Right.

OK, we can move. There's a cubicle free.
Through there. Thanks.

Taking FBC, U and E and cross—matching 12.

— O neg on standby.
— Two bottles of the house claret, please.

— Yes, sir.
— Let's have the radiographer.

— I'll bleep him, gents.
— I'll take gases.

Let's get that mannitol running.

— Have you had chest pain tonight?
— It was my fault.

— I'll run off an ECG.
— Thanks.

— You had chest pain whilst you were driving?
— Yes.

— No breath sounds on the left.
— Reckon we're looking at a haemopneumo.

— Let's just drain her.
— You'll have to put the drain in.

— Oh, sorry, mate. | forgot.
— Gases going off.

| know you're distressed about your daughter
but you're my patient. | have to take a history.

— Have you ever had chest pain before?
— Yes.

Have you ever had angina
or a heart attack in the past?

— Angina.
— For how long?

Years. | don't know.

— But never a heart attack?
— No.

— The pain tonight, did it feel like angina?
— Yes.

— In the middle of your chest, like a weight.
— Yes.

— Going into your arm or neck or jaw?
— Yes.

— Which?
— My arm.

And did it come on suddenly or gradually?

| know you're concerned about your daughter
but | need to know. Suddenly or gradually?

It was there for a while
and suddenly it got worse.

ls it there now?

— Unclamping.
— There she blows.

— Still keeping good blood pressure.
— Just check the pulsus paradoxus.

Good thinking.

Belly's swelling up.
Something's awfully wrong inside.

I'd taken me eyes off the road,
just for a second.

Heart tracing suggests that this
is more likely to be angina than a heart attack.

We'll admit you
for observations and further tests.

— How's Deborah?
— They're doing everything they can.

I'll do the bloods and book a bed on Gen Med.

I'm very sorry about your daughter,
Mr Broadbent.

Take cover, lads,
or all your kids‘ll have seven heads.

No time for a CT scan.

I'LL bleep DeVries. Let's get this girl into theatre.

ALL clear.

Big heart shadow. We're in for a long night.

Claire, | know you've got a job to do,
but | think you're being a bit unsympathetic.

Just cos you've picked up one of my cast—offs,

doesn't mean you can give me
this sanctimonious crap.

Cyril. Have you got a moment
for the girl's father, please?

Uh-huh. And don't call me that.

Oh. Such a nice name.

Going up.

— What?
— I'm just not in the mood.

(Bleeping)

(Man) Mr DeVries, please contact theatre.

I've started so I'LL finish.

You'd better answer it.
They're taking a major trauma to theatre.

Pericardial effusion, haemopneumothorax

and probable GI rupture with haemorrhage.

— Blood pressure?
— Steady as a rock. She's a strong girl.

Right, then. Let's get into that abdomen.

Her mesentery's torn through.
Ruptured vessels everywhere.

There's also a traumatic perforation
of the small bowel.

— Let's clamp.
— Kef and met?

1.5 of kef, 500 of metronidazole, please.

Clamping.

Any more accumulation of fluid in the pericardial
sac and there would have been tamponade.

Ibsen's first name.

Mel

Minor contusion of the ventricular wall

| think she's through the worst. Scissors?

| think we've been Lucky to contain
her thoracic and abdominal trauma.

(Bleeping)

Phil here. Please call Casualty 3080.

I'LL get it. Well, let's just hope
there's still a light on upstairs.

Yeah, this is James for Scissors.

— Thank you.
— I'd like her to have a CT scan tonight, please.

Yes, certainly, Mr DeVries.

— OK. Phil reckons there's an appendix for us.
— I'lk do it next.

I'm gonna see if | can make sure we're not
on call again with our shirt—lifting friend.

James is as good a gasman as they come.

You work with him, then.

OK.

Just what is your problem, Mr Smedley?

None, Mr DeVries.

On the contrary.
| think you have a very real problem,

the fact that a certain medical registrar
keeps my bed warm nowadays.

See what a pickle you get into
when you go stirring your consultant's porridge?

— Mr Broadbent?
— Here.

Hi. I'm not disturbing you, | hope.

How's my daughter?

Her condition is very serious.

— I'd like to see her, please.
— | don't think that's wise in your condition.

Maybe tomorrow if your own doctors
give you the OK. I'm sorry.

As soon as the angina came on,
| knew | should have pulled over.

Bob, you have heart disease. It's not your fault.

OK? Try to get some sleep. Good night.

(Bleeping)

Bob Broadbent's your patient, isn't he?

How's the daughter?

What's put you in the mood all of a sudden?

(Claire and DeVries laugh)

(Scissors groans)

(DeVries Laughs)

(Bleeping)

(Woman) Appendix has arrived.

(Bleeps)

(Man) Outside call waiting.

Dr Maitland, Medical Registrar.

(Line goes dead)

— Who was it?
— Dunno.

It's mine!

Charlotte...

Is there a bruit? Sorry.

When you're in and out of hospital this much,
you tend to pick up the Lingo.

Yes, there is.

— In time to save the fistula?
— Don't know. They'll say on the renal unit.

Claire Maitland's
usually the one that deals with me.

— Then I'll let her know you're here.
— Thanks.

OK.

Casualty. Charge Nurse Garden.

— Can | speak to Raj, please?
— Yes, Nasreen. I'll hand him over.

Thanks. Can you bleep Claire Maitland about the
renal patient and get a heparin infusion, please?

— OK.
— Ta.

— Hi.
— Hi. Have you decided about Saturday?

Yes, | have.

sorry, Nasreen.
| think it would be really good for us to...

For us to go to the museum
that afternoon and, er...

And then to visit your grandparents
in the evening after all.

Are you all right, Raj?

Yeah. Sorry. One of the nurses
was just showing me something.

Haemodynamic but she's holding her own.

Morning, Mr DeV.

She's being maintained on SIMV.

Er... Looks pretty grim, I'm afraid.

She's been well oxygenated
and blood pressure's good throughout

so there shouldn't be any organ damage.

| didn't operate half the night
for this girl to become butcher's offcuts.

James is quite properly just pointing out
this patient's suitability for organ donation.

Thank you, Scissors. That hadn't escaped me.

Continue present management.
| want to be informed of any changes.

— Sometimes...
— Yeah.

Doctor?

Dr Turner
said it wasn't a heart attack, didn't he?

He said that that was the probability, yes.

I'd like to go and see my daughter, then,
please, Doctor.

I'm afraid we'll be doing heart tracings
and blood tests on you for another two days.

| can't sit here.

All right. I'll take you.

Can | have a wheelchair for Mr Broadbent,
please?

Don't worry. I'm driving.

No problem. Your daughter's in no danger now.

She's not my daughter, I'm the baby—sitter.
But thank you so much.

Her parents would have killed us
if anything had happened to her.

You've saved my life.

— What did you do to her?
— The usual. Saved the kid's life.

You wanna be careful, mate. The power
that you have over women.

— Huh.
— Seriously, pal.

Your problem is that you don't realise that
you're a sex god to all the women around here.

Only flesh and blood, mate.
Mere mortals after all. Isn't that right, Julie?

I'd like a word, please, Mr Smedley.

Certainly, Sister.

| don't like being on the receiving end
of bitchy comments from your ex.

| haven't told anyone about us
so | can only assume you have.

It was an accident. I'm sorry.

OK. But my name stays out of puerile banter
with your sad loser mates, right?

Deborah is wholly dependant
on the support equipment.

Her brain is swelling because of the injury.

And it's too severe
to be relieved by drugs or surgery.

What happens if the brain goes on swelling?

Tell me.

Please.

The skull is a closed vault

apart from a small hole
through which the spinal cord passes.

The swelling is forcing Deborah's brain down
through that small hole.

The brain tissue gets crushed
as it's squeezed through.

When that part which governs breathing
and circulation is destroyed...

Deborah will die.

I'm...very Sorry.

Patrick, is it OK if | go now
cos I've got to be in school this afternoon?

— No, | said it was, Kirsty.
— Didn't want to leave anyone in the Lurch.

Go on, then.

Oh, | envy you, Raj.

lf it wasn't for Mrs Garden and Kirk and Dirk...

What it is to be young, footloose and free, eh?

— But he's not. Are you?
— Nasreen and l...

— Nasreen and | what?
— Nasreen and | have a steady relationship.

No. Like me and Mrs Garden.

And the twins. And the ones on the way.

— Steady. Lovely.
— | could go my own way if | wanted.

No, you couldn't. You've been going out
with a bird so long, you've turned into one.

No, no, no. Raj can’t do no wrong with the birds.

Kirsty was asking me about him this morning.

You couldn't pull a bird like that.
Not so long ago, your mum had to fix you up.

— | could pull her.
— No, you couldn't.

— Yes, | could.
— Go on, then.

— Right.
— Right.

OK.

So what do you think, slapper?
Am | gonna lose this fistula?

— Doesn't look good.
— Only had this one a few months.

| know. You're crap at having kidney failure.
Couldn't you pick something else?

Cystic fibrosis?

Even less chance of getting a transplant.

| don't want one.

Freedom from all these complications.
No dialysis, normal Life.

It would cramp my style.

Sometimes, | just can't take it any more.

| know.

Check.

(Bob)
| know why you've come. Deborah's mother.

When she was dying, she asked the doctors if
they wanted to use her organs afterwards.

And they said no.

Because she had cancer.

Deborah's never had a day's illness in her life.

| refuse.

Phone Nasreen. Tell her
you don't wanna go to the museum.

Tell her you hate her wrinkly grandparents.

Nasreen or the single life, mate.
You can't have both.

You can talk, Mr Novac.

I'm a few years older than you.
I'm grateful for any bird who'll go out with me.

— But when | was your age...
— Who are you gonna trust, Nasreen or us?

That Kirsty, she's so wide for you, Raj.

— I'm crap at asking girls out.
— Aww.

Say you've won some money on a horse
and you want to celebrate.

Phone Nasreen.

Would we tell you wrong?

| will not have you interfering
in my patient's affairs.

| don't approach relatives
until all options are exhausted.

Adrian, she's deader than Elvis.

It's our responsibility to seek consent
for organ donation, not yours.

I'LL go as far as to call it unethical

for a doctor who has several patients
desperately requiring transplants

to get involved.

| forbid you
to talk to Mr Broadbent on this matter.

— Clear?
— Crystal.

Masterful, aren't |?

Go ahead. Look me in the eye
and tell me you don't love it.

| don't love it.

(Phone)

— Adrian DeVries.
— ft’s me.

Charlotte, at Last.
I've been trying to call for ages.

— / want you out of the house.
— Look, this is a silly misunderstanding.

Switchboard are always putting calls through
to the wrong bleeps.

— Spend their time knitting as far as | can see.
— I'm not stupid.

| know you're not gonna be taken in
by some pathetic story. This is the truth.

| came in to operate on a case
of major trauma and when you called...

— (Line goes dead)
— Charlotte?

— Give us a minute.
— All right.

Claire, I'd like to talk to you about this morning.

What about it?

If there's anything unfinished between you,
that's none of my business.

Start a cat fight in my department, then it is.

OK?

Please. Nasreen, calm down.

| didn't mean it. Me and the lads went out
for a couple of drinks. | was only joking.

| don't think our relationship'’s boring.

(Line goes dead)

You've done it now, mate.

Plenty more fish in the sea.

If you've got the rod to reel them in with.

— What's the news?
— Well, your last ECG and blood test are normal.

— You can go home, Bob.
— | meant my daughter.

They're gonna test her for brain death.

I'm sorry.

We struggled to save your daughter.

But now her mind has been Lost.

However, through Deborah,
with your consent, Mr Broadbent,

we have the opportunity
to save the lives of others.

Um... Please, consider it carefully.

By chopping her up?

A surgeon will perform an operation
to remove the requisite organs

with as much care and respect
as he would give a living patient.

The decision is entirely of your own free will,
Mr Broadbent.

| want Deborah left the way she is.

Then that's exactly what'll happen.

I'm very sorry.

What happens now?

I'm afraid we have to turn the machine off now.

So let's talk about that patient you killed.

Her father's objections aren't religious,
aren't cultural.

He just doesn't think it's right.

— Then we have a duty to change his mind.
— We have a duty to respect his wishes.

— I'm gonna talk to him.
— Why risk it? You're already on thin ice.

Because maybe, for once in my life,
I'm gonna do something right.

— Hi.
— Hi.

He's in Frenulum Ward.

— Um... No. Er...
— A patient?

No. | had a bit of a flutter on the 3:30 at, er...

At, er...Chep...Chep—something,

and | won a few quid
and | thought | might splash out.

Um... Doctor, are you getting me mixed up
with someone else?

Like, | don’t even know who you are.

I'm angry, angry at all this emotional blackmail.

I'm angry, too.

I'm angry that people don't carry donor cards,
that there isn't an opt—out system,

that organs that could be used
to save people's lives are buried or burned.

I'm angry that because of all this,

heartless bitches like me have to bully
and berate relatives during their time of grief.

Your daughter's dead, Bob,
and you're not to blame.

Others are dying, and you and | are.

David?

Bob, this is David.

(David) Have a seat.

Thanks.

Claire said maybe we should have a chat.

| don't know what to say.

I'm sorry about your daughter.

Thank you.

— She said it was your kidneys.
— Yeah.

When | was about eight,
they became affected by a serious inflammation.

It damaged them so badly
that they don't work any more.

So | come here three times a week for dialysis.

That's the thing in your neck?

Yes. It cleans waste products from your blood.

My arm's swollen
because the vein on this side has been scarred

by all the lines they have to put into it.

They made a fistula here for dialysis,
but it broke down.

What will they do?

They'll operate on the other side
to make another fistula.

But...they had problems before.

I'm sorry about your daughter.

They were spring—cleaning those rooms.
Looks like we're getting new neighbours.

Great. Just what we need.

A couple of locums who don't speak English
and stay up all night studying.

Just don't say a word.

Looks like
someone'll be switching back to manual.

| don't expect you to understand.
It's what | believe to be right.

Why don't you expect me to understand?

| shouldn't have said that.

No, please. I'd like to know.

Maybe you've never loved anyone.

I'm really sorry about your daughter, Bob.

Are you ready?

I'm sorry.

We've...still a game to finish.

If you're not going anywhere special.

No. I'm not going anywhere special.