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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:02,102 --> 00:00:05,138 [arrows whooshing] 2 00:00:12,045 --> 00:00:14,682 [sombre music] 3 00:00:50,050 --> 00:00:52,386 [indistinct hospital PA announcement] 4 00:01:02,429 --> 00:01:05,265 [indistinct hospital PA announcement] 5 00:01:20,048 --> 00:01:22,650 [phone vibrates] 6 00:01:32,927 --> 00:01:34,194 Yeah? 7 00:01:38,165 --> 00:01:39,366 On my way. 8 00:01:44,906 --> 00:01:46,440 [sighs] 9 00:01:55,349 --> 00:01:58,586 [Richard] She's tachycardic, up from an hour ago, on Fibral. 10 00:01:58,620 --> 00:02:00,655 Respiration 22 and pressure is down. 11 00:02:00,688 --> 00:02:02,122 That's why we called. 12 00:02:02,155 --> 00:02:03,891 [Elizabeth] Hello, Lisa. Hello. 13 00:02:05,225 --> 00:02:06,961 My name is Elizabeth Taylor. 14 00:02:06,995 --> 00:02:08,362 I'm the consultant surgeon. 15 00:02:08,395 --> 00:02:11,198 This is my registrar, Richard Whitehead. 16 00:02:11,231 --> 00:02:13,266 Lisa, do you know where you are? 17 00:02:13,300 --> 00:02:14,736 Can you hear us all right? 18 00:02:15,803 --> 00:02:17,572 Does it hurt when you breathe? 19 00:02:17,605 --> 00:02:19,974 She's had no increase of pain at McBurney's, 20 00:02:20,008 --> 00:02:21,576 so it doesn't look like appendix. 21 00:02:21,609 --> 00:02:24,378 But she has had ten milligrams of morphine since 9:30 22 00:02:24,411 --> 00:02:26,981 and ten megs of Maxolon. 23 00:02:27,015 --> 00:02:28,448 The history? 24 00:02:28,482 --> 00:02:31,586 [Richard] Um, it was one day of cramping abdominal pain. 25 00:02:31,619 --> 00:02:34,254 Tender abdomen with guarding at the left iliac. 26 00:02:34,287 --> 00:02:37,125 Was given trimethoprim, diclofenac and paracetamol, 27 00:02:37,157 --> 00:02:38,860 and then sent away. 28 00:02:38,893 --> 00:02:40,293 Fuck. They sent her home. 29 00:02:40,327 --> 00:02:43,731 [Richard] She came back three days later in a lot of pain, 30 00:02:43,765 --> 00:02:44,799 elevated pulse. 31 00:02:44,832 --> 00:02:47,935 She was put on IV fluids and then transferred here. 32 00:02:47,969 --> 00:02:49,637 Decreased urine output for two days. 33 00:02:49,671 --> 00:02:52,573 Imaging suggests there's possible bowel involvement, 34 00:02:52,607 --> 00:02:55,743 and notes there is also an IUCD in the situ. 35 00:02:55,777 --> 00:02:57,177 [screaming] 36 00:02:58,813 --> 00:03:01,214 Okay. Sorry, Lisa. 37 00:03:01,248 --> 00:03:02,517 Sorry, Lisa. 38 00:03:04,484 --> 00:03:07,021 [gasping] 39 00:03:07,055 --> 00:03:08,690 Well? 40 00:03:08,723 --> 00:03:11,059 Uh, clearly intra-abdominal catastrophe, 41 00:03:11,092 --> 00:03:12,593 so immediate surgery to assess 42 00:03:12,627 --> 00:03:14,729 for perforated bowel or appendix. 43 00:03:14,762 --> 00:03:15,730 Extensive fluids, 44 00:03:15,763 --> 00:03:18,166 transfer to theatre for laparoscopy, right? 45 00:03:18,198 --> 00:03:20,802 I agree with immediate urgent laparoscopy. 46 00:03:20,835 --> 00:03:23,671 Radiology suggests necrosis of the bowel 47 00:03:23,705 --> 00:03:27,008 and abscess not amenable to percutaneous drainage. 48 00:03:27,041 --> 00:03:29,010 She needs an operation. 49 00:03:29,043 --> 00:03:31,311 Three units packed red blood cells, 50 00:03:31,344 --> 00:03:32,613 cross-matched. 51 00:03:32,647 --> 00:03:33,581 Prep for theatre. 52 00:03:33,614 --> 00:03:36,249 Call Dr. Colton to consent her. 53 00:03:36,283 --> 00:03:37,752 Lisa, we'll see you soon. 54 00:03:38,318 --> 00:03:39,754 [ECG monitor beeps] 55 00:03:39,787 --> 00:03:40,822 All right! 56 00:03:40,855 --> 00:03:44,625 We will go in today using the Hasson technique. 57 00:03:46,961 --> 00:03:48,062 Alex. 58 00:03:48,096 --> 00:03:50,865 [Alex] We are... good to go. 59 00:03:50,898 --> 00:03:52,332 [Elizabeth] Knife. 60 00:03:52,365 --> 00:03:53,901 [Robin] Knife. 61 00:03:53,935 --> 00:03:56,838 [Elizabeth] All right, we make a ten mil incision 62 00:03:56,871 --> 00:03:58,706 just above the umbilicus, 63 00:03:58,740 --> 00:04:03,511 right through the subcutaneous tissue into the fascia. 64 00:04:03,544 --> 00:04:04,612 Kocher. 65 00:04:08,015 --> 00:04:09,282 S-Bends. 66 00:04:09,316 --> 00:04:10,752 [Robin] S-Bends. 67 00:04:10,785 --> 00:04:12,820 [Richard] Thank you, Robin. Holding. 68 00:04:12,854 --> 00:04:13,955 [Elizabeth] Thank you. 69 00:04:16,624 --> 00:04:17,658 Knife. 70 00:04:17,692 --> 00:04:19,761 Now, just a few... 71 00:04:20,795 --> 00:04:22,429 fibres at a time. 72 00:04:24,431 --> 00:04:26,501 And there's the peritoneum. 73 00:04:28,069 --> 00:04:29,436 [Robin] Stitch. 74 00:04:32,240 --> 00:04:33,273 Here you go. 75 00:04:33,306 --> 00:04:34,509 [Elizabeth] Okay. 76 00:04:43,050 --> 00:04:44,819 [Robin] Clip. 77 00:04:44,852 --> 00:04:46,654 -[Elizabeth] Ready? -[Robin] Cut. 78 00:04:48,022 --> 00:04:49,891 [Richard] This one's out. 79 00:04:49,924 --> 00:04:50,925 Thank you, Robin. 80 00:04:50,958 --> 00:04:54,629 [Elizabeth] Thank you. Now, we use traction. 81 00:04:54,662 --> 00:04:55,763 Why? 82 00:04:55,797 --> 00:04:58,533 [Richard] To avoid damaging the underlying structures 83 00:04:58,566 --> 00:05:00,935 when we penetrate the peritoneal sheath into the abdomen. 84 00:05:00,968 --> 00:05:02,603 [Elizabeth] Good, Richard. 85 00:05:04,939 --> 00:05:07,575 -All right. Port, please, Robin. -[Robin] Port. 86 00:05:07,608 --> 00:05:09,677 [Elizabeth] All right, we'll be inserting 87 00:05:09,710 --> 00:05:11,344 three trocars into Lisa today. 88 00:05:11,378 --> 00:05:12,580 Here we go. 89 00:05:16,316 --> 00:05:18,385 [Richard] Uh, reducer. Please, Robin. 90 00:05:21,488 --> 00:05:23,356 [Elizabeth] Give her the gas port there, Richard. 91 00:05:23,390 --> 00:05:25,293 Thank you. 92 00:05:25,325 --> 00:05:27,427 [ECG monitor beeping continues] 93 00:05:27,460 --> 00:05:28,863 [Richard] That's set up. 94 00:05:28,896 --> 00:05:31,098 -[Robin] Gas on. -[Richard] Thank you. 95 00:05:31,132 --> 00:05:32,432 [Elizabeth] All right, maestro. 96 00:05:32,465 --> 00:05:33,568 [Mei-Lynn] Yes? 97 00:05:33,601 --> 00:05:35,069 [Elizabeth] Gas, please. 98 00:05:35,102 --> 00:05:36,270 [Mei-Lynn] Gas is on. 99 00:05:36,304 --> 00:05:37,505 Light is on. 100 00:05:37,538 --> 00:05:39,040 [Elizabeth] There it comes. 101 00:05:40,308 --> 00:05:41,676 [air blowing] 102 00:05:44,645 --> 00:05:46,814 There we are, Richard. You guide it. 103 00:05:48,883 --> 00:05:50,585 There we go. 104 00:05:50,618 --> 00:05:51,953 Marsh? 105 00:05:53,420 --> 00:05:55,656 [foreboding music plays] 106 00:05:55,690 --> 00:05:56,757 Hmm. 107 00:05:56,791 --> 00:05:58,826 [Richard] Well... uh, it's extensive pus. 108 00:05:58,860 --> 00:06:01,996 [Elizabeth] Indeed. Sepsis it is. 109 00:06:02,029 --> 00:06:05,132 All right, I'm inserting the second trocar now. 110 00:06:08,603 --> 00:06:10,037 Yeah, that's good. Thank you, Richard. 111 00:06:10,071 --> 00:06:13,406 Hold it right there, I need direct visualization, please. 112 00:06:15,076 --> 00:06:16,210 Put it back in a little bit. 113 00:06:16,244 --> 00:06:17,945 There... 114 00:06:17,979 --> 00:06:18,980 Okay. 115 00:06:24,719 --> 00:06:26,287 Thank you. 116 00:06:26,320 --> 00:06:28,356 All right, what's going on with the gas? 117 00:06:28,388 --> 00:06:29,957 [Mei-Lynn] How much pressure? 118 00:06:29,991 --> 00:06:31,125 [Elizabeth] I need ten. 119 00:06:31,158 --> 00:06:32,660 We need more flow, 120 00:06:32,693 --> 00:06:34,328 more separation of the organs. 121 00:06:34,362 --> 00:06:35,997 [Mei-Lynn] Flow rate is at six. 122 00:06:36,030 --> 00:06:37,198 But we're not at ten yet. 123 00:06:37,231 --> 00:06:38,599 [Robin] The tank was full. 124 00:06:38,633 --> 00:06:41,302 [Elizabeth] Mei-Lynn, can you increase the flow, please? 125 00:06:41,335 --> 00:06:42,703 [Mei-Lynn] Copy that. 126 00:06:42,737 --> 00:06:45,472 [Elizabeth] Richard, do you want to put in the last trocar? 127 00:06:45,506 --> 00:06:47,074 [Richard] Yeah. 128 00:06:47,108 --> 00:06:48,142 Thank you, Robin. 129 00:06:48,175 --> 00:06:49,944 [Elizabeth] Let's find you a spot. 130 00:06:51,512 --> 00:06:52,580 Here we are. 131 00:06:52,613 --> 00:06:53,814 [Richard] Thank you. 132 00:07:02,857 --> 00:07:05,026 [Elizabeth] Honey, you've got plenty of room Richard, 133 00:07:05,059 --> 00:07:06,727 you've got plenty of room. 134 00:07:07,828 --> 00:07:08,829 You can see? 135 00:07:09,964 --> 00:07:10,965 [Richard] Yeah. 136 00:07:13,100 --> 00:07:16,203 [Elizabeth] All right, Richard. Time's ticking. Let's go. 137 00:07:16,237 --> 00:07:17,738 [ECG monitor beeping increases] 138 00:07:17,772 --> 00:07:20,207 [Elizabeth] Let's go. Give it some welly. 139 00:07:20,241 --> 00:07:21,509 [Richard] Sorry. 140 00:07:24,412 --> 00:07:26,280 [tense music] 141 00:07:26,314 --> 00:07:28,616 [Elizabeth] Fuck! Quick, we need to open. 142 00:07:28,649 --> 00:07:30,785 -We're converting. -[Robin] We're converting. 143 00:07:30,818 --> 00:07:32,452 [Elizabeth] I need the B tray 144 00:07:32,485 --> 00:07:33,554 and arterial instruments, please. 145 00:07:33,587 --> 00:07:34,655 [Robin] B tray, please. 146 00:07:34,689 --> 00:07:35,488 [Elizabeth] Pull the trocars out, Richard. 147 00:07:35,523 --> 00:07:36,791 [Richard] Sorry. 148 00:07:36,824 --> 00:07:38,359 [Elizabeth] Someone call Mei-Lynn back in right now. 149 00:07:38,392 --> 00:07:40,094 -[Robin] Someone call Mei-Lynn! -[Elizabeth] B tray, please! 150 00:07:40,127 --> 00:07:41,494 [Elizabeth] Alex, talk to me. 151 00:07:41,529 --> 00:07:43,564 [Alex] Systolic 90. Pressure is falling now. 152 00:07:43,597 --> 00:07:45,232 [Elizabeth] Of course it's fucking falling. 153 00:07:45,266 --> 00:07:47,668 [Elizabeth] I need the B tray! 154 00:07:47,702 --> 00:07:49,270 [Robin] B, B, quick, quick, quick! 155 00:07:49,303 --> 00:07:51,105 [Elizabeth] Calm, calm. 156 00:07:51,138 --> 00:07:52,173 Please, everybody, quiet. 157 00:07:52,206 --> 00:07:53,607 -[Mei-Lynn] Diathermy? 158 00:07:53,641 --> 00:07:56,544 -[Elizabeth] Uh, no. I don't have time. I'll do it myself. 159 00:07:56,577 --> 00:07:58,279 Richard, hold that. 160 00:07:58,312 --> 00:07:59,347 Alex? 161 00:07:59,380 --> 00:08:01,615 [Alex] Heart rate is 160. 162 00:08:01,649 --> 00:08:03,250 Pushing midribonol now. 163 00:08:03,284 --> 00:08:04,418 [Elizabeth] Hold that, Richard. 164 00:08:04,452 --> 00:08:06,554 Here we go. All right. I'm going in, Alex. 165 00:08:06,587 --> 00:08:08,622 [ECG monitor beeping rapidly] 166 00:08:10,490 --> 00:08:12,026 -Fuck! -Suction. 167 00:08:12,059 --> 00:08:12,994 [Robin] Suction. 168 00:08:13,027 --> 00:08:15,229 Retractors. I'll hold it. Retractors. 169 00:08:15,262 --> 00:08:17,531 -[Richard] Yeah, we need... -[Elizabeth] Nice, Robin. 170 00:08:17,565 --> 00:08:19,266 -[Elizabeth] Good. You got it? -[Robin] I got this. 171 00:08:19,300 --> 00:08:20,334 [Elizabeth] Get the big one. 172 00:08:20,368 --> 00:08:21,836 Pull it, Richard. Pull it. 173 00:08:22,603 --> 00:08:23,938 -[Richard] (indistinct) 174 00:08:23,971 --> 00:08:25,673 -[Robin] Yeah, Richard. -[Elizabeth] I got it. I got it. 175 00:08:25,706 --> 00:08:28,242 -[Elizabeth] Packs. -[Robin] Packs. 176 00:08:34,148 --> 00:08:35,282 [sighs wearily] 177 00:08:38,786 --> 00:08:40,554 -Careful with the ureter. -[Richard] Mm-hmm. 178 00:08:41,689 --> 00:08:43,924 [Elizabeth] Suction-- I can't find it. 179 00:08:43,958 --> 00:08:45,493 Find it. 180 00:08:45,526 --> 00:08:47,628 It's not the IVC, 181 00:08:47,661 --> 00:08:49,230 it's the lumbar artery. 182 00:08:49,263 --> 00:08:51,065 Put your finger on it. 183 00:08:51,399 --> 00:08:52,466 Pressure. 184 00:08:52,500 --> 00:08:53,901 -[Richard] Sorry. -[Elizabeth] Feel it? 185 00:08:53,934 --> 00:08:55,269 [Elizabeth] Right there. It's pumping. 186 00:08:55,302 --> 00:08:56,604 -Feel it? -[Richard] Mm. 187 00:08:56,637 --> 00:08:58,939 [Elizabeth] Keep your finger on it. Clamp. 188 00:08:58,973 --> 00:09:00,174 [Alex] Thank you. 189 00:09:05,312 --> 00:09:06,747 [Elizabeth] Got it? Okay. 190 00:09:06,781 --> 00:09:08,682 One more here. One more here. 191 00:09:10,184 --> 00:09:11,185 Stitches. 192 00:09:12,253 --> 00:09:13,522 Five-0, please. 193 00:09:13,554 --> 00:09:14,989 [Robin] Stitch. 194 00:09:37,445 --> 00:09:39,647 [cutting] 195 00:09:40,648 --> 00:09:41,849 [Elizabeth] Okay. 196 00:09:42,783 --> 00:09:44,819 The torrential bleeding from the vena cava 197 00:09:44,852 --> 00:09:47,154 is controlled with clamps... 198 00:09:47,188 --> 00:09:49,790 [sighs] ...and we move in order of urgency. 199 00:09:49,824 --> 00:09:51,759 Richard has control 200 00:09:51,792 --> 00:09:54,862 of the posterior tear with his finger. 201 00:09:54,895 --> 00:09:58,466 The most urgent is the lumbar vessel 202 00:09:58,499 --> 00:10:00,067 due to the volume of bleeding, 203 00:10:00,101 --> 00:10:03,304 and I am focused on that right now. 204 00:10:07,374 --> 00:10:09,143 There's a rent in the IVC... 205 00:10:11,779 --> 00:10:13,214 which is clamped, 206 00:10:14,148 --> 00:10:17,251 and severe lumbar bleeding in the psoas, 207 00:10:18,486 --> 00:10:21,422 which is posterior... 208 00:10:21,455 --> 00:10:23,891 and deep. 209 00:10:24,758 --> 00:10:26,994 Currently sewing five-0 prolene. 210 00:10:33,367 --> 00:10:34,603 [Alex] Looking much better now. 211 00:10:34,635 --> 00:10:37,071 -[Elizabeth] Okay. -[Alex] Pressure is coming up. 212 00:10:38,105 --> 00:10:40,274 [Elizabeth] Now for the original operation. 213 00:10:40,307 --> 00:10:43,144 Let's wash out this pelvis, pop in a drain, 214 00:10:43,177 --> 00:10:45,279 take out the appendix for good measure. 215 00:10:46,347 --> 00:10:47,582 [Richard] Yeah. Okay. 216 00:10:47,616 --> 00:10:49,551 Uh, I'm-- Elizabeth, I'm sorry. 217 00:10:49,584 --> 00:10:52,153 [Elizabeth] Hey, just close. 218 00:10:56,824 --> 00:10:59,160 -[Robin] Josie. -I need you on this retractor. 219 00:10:59,693 --> 00:11:00,895 [Robin] Yeah. 220 00:11:03,364 --> 00:11:04,365 [Richard] Okay, uh... 221 00:11:05,466 --> 00:11:06,667 Okay, splash me. 222 00:11:07,768 --> 00:11:10,004 -[Robin] Thank you. -I'll take suction. Thank you. 223 00:11:13,040 --> 00:11:14,241 Fuck. 224 00:11:14,275 --> 00:11:16,377 -[Richard] Yeah, well-- -[Robin] Suction. 225 00:11:20,681 --> 00:11:22,016 [Richard] Uh, yes, let me. 226 00:11:22,617 --> 00:11:24,218 Thank you, that's it. 227 00:11:24,251 --> 00:11:25,520 [Robin] Suction. 228 00:11:25,554 --> 00:11:29,757 [sombre music] 229 00:11:39,601 --> 00:11:41,168 [door opening] 230 00:11:41,202 --> 00:11:43,304 [Elizabeth] Unfortunately, I've got to reschedule 231 00:11:43,337 --> 00:11:44,872 my next surgery. 232 00:11:49,009 --> 00:11:51,145 Go tell Lisa's parents it went well. 233 00:11:51,178 --> 00:11:52,246 Uh, don't you want-- 234 00:11:52,279 --> 00:11:53,515 [Elizabeth] She's out of the woods. 235 00:11:53,548 --> 00:11:54,882 But surely you could explain-- 236 00:11:54,915 --> 00:11:57,418 [Elizabeth] Richard, it went well. 237 00:11:57,451 --> 00:11:59,019 She's in recovery. 238 00:11:59,053 --> 00:12:00,988 They can talk to her in ICU. 239 00:12:02,923 --> 00:12:04,391 You're good with families. 240 00:12:05,292 --> 00:12:06,460 Thank you, Richard. 241 00:12:12,800 --> 00:12:14,034 [breathes shakily] 242 00:12:18,806 --> 00:12:20,642 [Richard] Um, Mr. and Mrs. Williams, 243 00:12:20,675 --> 00:12:23,377 I am Richard Whitehead, the registrar. 244 00:12:23,410 --> 00:12:25,079 I'm with Mrs. Taylor. 245 00:12:25,112 --> 00:12:27,181 Lisa's doing well. She's in recovery now. 246 00:12:27,214 --> 00:12:29,483 I just want to apologize about the delay. 247 00:12:30,751 --> 00:12:33,487 [distant sirens blaring] 248 00:12:38,158 --> 00:12:39,193 [sighs] 249 00:12:58,345 --> 00:13:01,148 [strained breathing] 250 00:13:04,285 --> 00:13:05,919 [machine beeps] 251 00:13:05,953 --> 00:13:07,722 [Jan] Just nice, deep breaths, Lisa. 252 00:13:07,756 --> 00:13:10,057 Just easy breaths. Yeah. 253 00:13:11,091 --> 00:13:12,126 That's it. 254 00:13:17,699 --> 00:13:18,966 How's she doing? 255 00:13:19,466 --> 00:13:20,702 Uh, she's stable. 256 00:13:20,735 --> 00:13:23,070 A bit agitated about the mask. 257 00:13:33,414 --> 00:13:34,848 [Elizabeth] Hi, Lisa. 258 00:13:51,432 --> 00:13:52,600 It went well. 259 00:13:53,668 --> 00:13:55,969 [foreboding music] 260 00:13:58,773 --> 00:14:00,207 [breathing raggedly] 261 00:14:17,726 --> 00:14:20,894 [foreboding music continues] 262 00:14:23,897 --> 00:14:25,466 [register beeps] 263 00:14:43,752 --> 00:14:46,086 [sombre music] 264 00:14:48,889 --> 00:14:50,357 [door creaks shut] 265 00:14:51,793 --> 00:14:54,395 [Elizabeth] Robin, did you get a taxi? 266 00:14:56,296 --> 00:14:57,599 Uh, yeah. 267 00:14:58,633 --> 00:15:00,033 Clear night. 268 00:15:00,067 --> 00:15:01,636 [Robin] Um, yeah. It is. 269 00:15:01,669 --> 00:15:03,003 It's beautiful. 270 00:15:03,036 --> 00:15:05,172 -Want some chicken? -[scoffs] 271 00:15:08,142 --> 00:15:10,077 Got a double shift tomorrow. 272 00:15:10,110 --> 00:15:11,478 -That's shit. -[Robin] Mm. 273 00:15:12,747 --> 00:15:14,348 -I'll talk to Alastair-- -[Robin] Mm-mm. 274 00:15:15,315 --> 00:15:16,751 Please don't. 275 00:15:16,785 --> 00:15:18,753 You can't do things like that. 276 00:15:18,787 --> 00:15:20,120 It might ruin things. 277 00:15:25,192 --> 00:15:26,193 You good? 278 00:15:29,930 --> 00:15:31,733 Yeah. 279 00:15:31,766 --> 00:15:32,966 Yup. 280 00:15:36,970 --> 00:15:39,406 [both giggling] 281 00:15:51,820 --> 00:15:54,188 [seagulls squawking] 282 00:16:05,098 --> 00:16:08,202 [water rushing] 283 00:16:16,744 --> 00:16:18,513 [phone vibrates] 284 00:16:22,817 --> 00:16:24,384 [muted gasp] 285 00:16:26,220 --> 00:16:27,555 Fuck! 286 00:16:53,715 --> 00:16:54,749 [Elizabeth] All good? 287 00:16:54,782 --> 00:16:56,784 Yeah, of course. Uh, five by three. 288 00:16:56,818 --> 00:16:58,218 Walk beside me, Richard. 289 00:17:01,455 --> 00:17:02,957 How are you doing? 290 00:17:02,991 --> 00:17:04,626 [Richard] I'm all right. 291 00:17:04,659 --> 00:17:07,261 Good. How did you hear? 292 00:17:07,294 --> 00:17:08,495 [Richard] Hear what? 293 00:17:09,631 --> 00:17:10,765 [sighs] 294 00:17:13,367 --> 00:17:15,937 Richard, we lost the sepsis this morning. 295 00:17:15,970 --> 00:17:18,105 I was texted on the way in. 296 00:17:19,473 --> 00:17:21,809 She-- What? So she was what, in the ICU? 297 00:17:21,843 --> 00:17:23,310 [Elizabeth] Yes, in ICU. 298 00:17:24,144 --> 00:17:25,680 [Richard] Ah, I didn't know. 299 00:17:25,713 --> 00:17:26,915 Yes, it's a bad outcome. 300 00:17:26,948 --> 00:17:28,382 It's very disappointing. 301 00:17:29,717 --> 00:17:30,718 Okay? 302 00:17:30,752 --> 00:17:32,085 Yeah, of course. Yeah. 303 00:17:33,922 --> 00:17:35,389 The sepsis was too advanced, 304 00:17:35,422 --> 00:17:38,358 and she was likely never going to make it. 305 00:17:42,195 --> 00:17:44,231 The trocar... did that-- Was that-- 306 00:17:44,264 --> 00:17:46,701 This was advanced sepsis, wasn't it? 307 00:17:46,734 --> 00:17:47,669 You saw that yourself. 308 00:17:47,702 --> 00:17:51,405 So we'll never know to what degree if any, 309 00:17:51,438 --> 00:17:53,508 the extra time in surgery contributed. 310 00:17:53,541 --> 00:17:55,208 Yeah... I suppose the complication-- 311 00:17:55,242 --> 00:17:56,678 The complication may have contributed, 312 00:17:56,711 --> 00:17:57,879 but we'll never know how much. 313 00:17:57,912 --> 00:17:58,947 Right? 314 00:17:58,980 --> 00:18:01,448 So certainly didn't help. 315 00:18:01,481 --> 00:18:03,751 Look, all we can do now is move on. 316 00:18:04,886 --> 00:18:06,486 Get past it. Get better. 317 00:18:06,521 --> 00:18:07,522 Learn. 318 00:18:09,857 --> 00:18:11,224 Morning, Liz. 319 00:18:12,927 --> 00:18:14,127 Good morning, Alastair. 320 00:18:14,161 --> 00:18:16,531 Have you seen the staff photo on the website? 321 00:18:16,564 --> 00:18:19,132 Yes. It looked like a group of prisoners 322 00:18:19,166 --> 00:18:20,868 about to be taken out and shot. 323 00:18:20,902 --> 00:18:22,135 [Alastair] Ah. 324 00:18:23,071 --> 00:18:24,404 Well, maybe it was the black and white. 325 00:18:24,438 --> 00:18:26,306 What can I do for you, Alastair? 326 00:18:26,941 --> 00:18:28,810 Can we have a quick word? 327 00:18:28,843 --> 00:18:30,545 Of course. 328 00:18:30,578 --> 00:18:31,579 I'll catch up. 329 00:18:31,613 --> 00:18:33,881 -Yeah, okay. -[Alastair] Thanks, Richard. 330 00:18:33,915 --> 00:18:35,115 [Richard] No worries. 331 00:18:36,050 --> 00:18:37,085 I'm sorry. 332 00:18:37,117 --> 00:18:38,753 Um, hi, David isn't it? 333 00:18:38,786 --> 00:18:41,121 -[David] Yes. -[Richard] Great, I've got-- 334 00:18:41,923 --> 00:18:43,091 Anyway, Alastair? 335 00:18:43,123 --> 00:18:45,292 [Alastair] Liz, the family of Lisa Williams, 336 00:18:45,325 --> 00:18:47,729 who died this morning, are asking to see you. 337 00:18:47,762 --> 00:18:48,896 They're here now. 338 00:18:48,930 --> 00:18:50,031 Oh. 339 00:18:50,064 --> 00:18:52,800 I should warn you, they're very distraught. 340 00:18:52,834 --> 00:18:56,004 They were under the impression that when she was admitted, 341 00:18:56,037 --> 00:18:57,270 yes, it was an emergency, 342 00:18:57,304 --> 00:19:00,440 but an appendix or something like that. 343 00:19:00,474 --> 00:19:02,476 They feel very caught off guard, 344 00:19:02,510 --> 00:19:04,411 and they say they're very unsatisfied 345 00:19:04,444 --> 00:19:06,748 with the explanation from ICU. 346 00:19:06,781 --> 00:19:08,248 Who spoke to them from ICU? 347 00:19:08,281 --> 00:19:09,383 Ben Matthews. 348 00:19:09,416 --> 00:19:11,218 Ben was the intensivist. 349 00:19:12,854 --> 00:19:14,221 [sighs] Andrew. 350 00:19:14,254 --> 00:19:16,223 Elizabeth, how are you? 351 00:19:17,125 --> 00:19:19,326 Well, I'm happy to speak with them. 352 00:19:21,996 --> 00:19:24,264 And what are you going to say? 353 00:19:24,297 --> 00:19:26,834 I'm going to tell them what happened in surgery. 354 00:19:26,868 --> 00:19:28,536 I wasn't there in ICU. 355 00:19:28,569 --> 00:19:29,804 Okay. 356 00:19:30,938 --> 00:19:33,173 What really happened, Liz? 357 00:19:34,341 --> 00:19:36,443 Well, you've obviously read the notes. 358 00:19:38,579 --> 00:19:41,082 Uncontrolled insertion of a trocar 359 00:19:41,115 --> 00:19:42,850 leading to internal damage-- 360 00:19:42,884 --> 00:19:45,820 ...Which was unrelated to the galloping infection 361 00:19:45,853 --> 00:19:48,856 that led to her fatal deterioration in ICU. 362 00:19:50,190 --> 00:19:51,258 "Unrelated"? 363 00:19:51,291 --> 00:19:52,994 Yes, that's what I said. 364 00:19:53,027 --> 00:19:54,428 Okay... 365 00:19:54,461 --> 00:19:55,863 But you know what you're going to say. 366 00:19:55,897 --> 00:19:56,964 You've got it in hand. 367 00:19:56,998 --> 00:19:58,032 [Elizabeth] I think well in hand. 368 00:19:58,066 --> 00:20:00,300 -Okay. -Thank you, Andrew. 369 00:20:00,333 --> 00:20:01,536 Actually, I just wanted to ask you 370 00:20:01,569 --> 00:20:02,770 if you're coming to the conference, 371 00:20:02,804 --> 00:20:05,540 the Surgical Safety and Measurements Jamboree? 372 00:20:05,573 --> 00:20:08,475 Yes, Andrew. I will take that one for the team. 373 00:20:08,509 --> 00:20:11,079 Actually, I want the whole team to be there. Richard, Robin. 374 00:20:11,112 --> 00:20:12,212 I think it's important. 375 00:20:12,245 --> 00:20:14,481 It's... It's quite interesting. 376 00:20:14,515 --> 00:20:15,616 [Elizabeth] Interesting? 377 00:20:15,650 --> 00:20:17,217 Well... it is about publishing results. 378 00:20:17,250 --> 00:20:19,053 That's our new reality. 379 00:20:19,087 --> 00:20:22,990 Our surgical results are going to be published in the paper. 380 00:20:23,024 --> 00:20:25,793 Mortality, complications. 381 00:20:26,393 --> 00:20:28,395 My results, you mean. 382 00:20:30,230 --> 00:20:31,966 True, your results. 383 00:20:32,967 --> 00:20:34,869 Everything under your watch. 384 00:20:34,902 --> 00:20:36,838 But I don't think it's, uh.... 385 00:20:36,871 --> 00:20:38,840 I don't think it's necessarily a bad idea. 386 00:20:38,873 --> 00:20:41,943 It will incentivize us to avoid very sick patients 387 00:20:41,976 --> 00:20:43,978 and it will affect training. 388 00:20:44,011 --> 00:20:46,714 Liz, the family are waiting in the Whanau room. 389 00:20:47,749 --> 00:20:49,183 Thank you. 390 00:20:49,217 --> 00:20:50,585 Andrew. 391 00:20:50,618 --> 00:20:51,619 Elizabeth. 392 00:20:54,122 --> 00:20:56,958 [tense music] 393 00:21:18,311 --> 00:21:21,983 [sad music] 394 00:21:47,975 --> 00:21:49,911 I'm so sorry for your loss. 395 00:21:53,147 --> 00:21:54,414 Well... 396 00:21:55,315 --> 00:21:58,351 This is what happened to Lisa. 397 00:21:59,554 --> 00:22:02,557 Lisa was very sick when she came to hospital. 398 00:22:04,692 --> 00:22:08,696 Some of her reproductive organs had become infected. 399 00:22:09,664 --> 00:22:12,600 We believe this was because of her IUCD. 400 00:22:12,633 --> 00:22:15,770 That stands for "Intrauterine Contraceptive Device." 401 00:22:18,306 --> 00:22:19,774 Uh... 402 00:22:19,807 --> 00:22:24,312 We needed to do what is called a "laparoscopy." 403 00:22:24,344 --> 00:22:26,647 That's a kind of keyhole surgery 404 00:22:26,681 --> 00:22:28,716 where we make a small hole 405 00:22:28,749 --> 00:22:31,886 and... and use a small camera to look inside Lisa 406 00:22:31,919 --> 00:22:33,154 and see... 407 00:22:33,187 --> 00:22:35,756 and see... um... what's wrong with her. 408 00:22:35,790 --> 00:22:38,693 And we could see that she was very sick, 409 00:22:38,726 --> 00:22:41,361 that many of her abdominal organs had become infected, 410 00:22:41,394 --> 00:22:45,398 and that she needed a... 411 00:22:45,432 --> 00:22:48,435 a proper operation to help her get better. 412 00:22:48,468 --> 00:22:51,572 And I can give you the details of that if you'd like. 413 00:22:59,780 --> 00:23:02,149 I mean, we just don't know what happened. 414 00:23:04,417 --> 00:23:07,088 We... We want to know more. 415 00:23:07,121 --> 00:23:08,856 [sobbing] 416 00:23:16,931 --> 00:23:18,699 Uh... 417 00:23:19,934 --> 00:23:22,637 There was a complication during the surgery. 418 00:23:22,670 --> 00:23:27,508 We had to make a larger incision than initially planned. 419 00:23:28,309 --> 00:23:30,678 What complication? 420 00:23:30,711 --> 00:23:34,382 [Elizabeth] As I said, her IUCD had become infected. 421 00:23:34,414 --> 00:23:37,151 And, um, we don't know why at this point. 422 00:23:37,184 --> 00:23:39,987 But there are many reasons it could have happened. 423 00:23:40,021 --> 00:23:43,925 Lisa was moved to intensive care after the surgery, 424 00:23:43,958 --> 00:23:46,627 and I was not directly involved in that. 425 00:23:46,661 --> 00:23:48,930 We just thought, "Oh, it's her..." 426 00:23:50,463 --> 00:23:53,167 We just thought her appendix had burst, 427 00:23:53,200 --> 00:23:55,670 which is why it was so bad. 428 00:23:55,703 --> 00:23:57,138 [Elizabeth] I'm sorry. 429 00:23:58,471 --> 00:24:00,473 I know this must be very hard, 430 00:24:00,508 --> 00:24:03,110 but it was not to do with her appendix. 431 00:24:03,144 --> 00:24:05,780 Lisa had trouble breathing in ICU. 432 00:24:05,813 --> 00:24:08,649 The infection was too much for her body, 433 00:24:08,683 --> 00:24:11,986 and this led to her cardiac arrest. 434 00:24:16,489 --> 00:24:18,159 She's in the morgue. 435 00:24:19,727 --> 00:24:23,664 [angrily] Our daughter is in the morgue. 436 00:24:32,673 --> 00:24:34,241 Wh... What's your name? 437 00:24:38,478 --> 00:24:41,682 Elizabeth Taylor is my name. 438 00:24:54,095 --> 00:24:55,162 [camera clicks] 439 00:25:00,067 --> 00:25:01,602 [sighs wearily] 440 00:25:04,205 --> 00:25:06,841 [sombre music] 441 00:25:50,418 --> 00:25:52,686 [siren blaring in distance] 442 00:25:56,557 --> 00:25:58,125 [Andrew] Welcome, everybody, 443 00:25:58,159 --> 00:26:01,962 to this week's M&M. 444 00:26:01,996 --> 00:26:06,567 So we'll start with the Lisa Williams case. 445 00:26:06,600 --> 00:26:12,573 Anaesthesia, nursing, as well as surgery. 446 00:26:12,606 --> 00:26:14,141 Glad to see you. 447 00:26:15,576 --> 00:26:17,478 Uh, excuse me. Where's Dr. Matthews? 448 00:26:17,512 --> 00:26:19,480 Well, Dr. Matthews is an apology. 449 00:26:19,514 --> 00:26:21,215 Dr. Matthews was the intensivist 450 00:26:21,248 --> 00:26:22,583 on Lisa Williams, 451 00:26:22,616 --> 00:26:24,218 -the main case today. -Well... 452 00:26:24,251 --> 00:26:27,688 I'd like to call for this meeting to be adjourned. 453 00:26:27,721 --> 00:26:29,558 [Andrew] Oh... Why, Liz? 454 00:26:29,590 --> 00:26:32,393 Without Dr. Matthews, what's the point? 455 00:26:32,426 --> 00:26:33,594 Well, the point is that 456 00:26:33,627 --> 00:26:36,030 this is a morbidity and mortality meeting, 457 00:26:36,063 --> 00:26:39,366 and in it, we're going to be discussing in particular 458 00:26:39,400 --> 00:26:40,801 surgery and mortality. 459 00:26:40,835 --> 00:26:43,871 The mortality in this case is not related to the surgery. 460 00:26:43,904 --> 00:26:46,107 It's related to her advanced sepsis, 461 00:26:46,140 --> 00:26:48,909 and the nearly 12 hours of intensive care 462 00:26:48,943 --> 00:26:51,212 that failed to save her afterwards. 463 00:26:51,245 --> 00:26:52,680 No, this is just an M&M. 464 00:26:52,713 --> 00:26:54,748 We're not apportioning blame. 465 00:26:55,249 --> 00:26:56,283 Um... Blame? 466 00:26:56,317 --> 00:26:57,552 No-- 467 00:26:57,586 --> 00:26:59,554 I want to know what happened. 468 00:26:59,588 --> 00:27:01,489 Family want more information. 469 00:27:01,523 --> 00:27:02,690 What information? 470 00:27:02,723 --> 00:27:04,458 I've spoken to them already. 471 00:27:04,492 --> 00:27:06,595 Well, let's just say their acceptance 472 00:27:06,627 --> 00:27:08,996 of their daughter's death is not yet settled. 473 00:27:09,029 --> 00:27:11,398 Okay, this is so fucking stupid. 474 00:27:12,800 --> 00:27:15,703 Why would that be stupid, Liz? 475 00:27:15,736 --> 00:27:18,405 [Elizabeth] It's stupid, Andrew, because.... 476 00:27:20,509 --> 00:27:21,842 We can go through our notes, 477 00:27:21,876 --> 00:27:24,044 you can talk to my team till you're blue in the face. 478 00:27:24,078 --> 00:27:28,082 But we can't possibly know what happened with this girl 479 00:27:28,115 --> 00:27:29,984 without ICU and their nurses here, 480 00:27:30,017 --> 00:27:31,652 because they took over her care 481 00:27:31,685 --> 00:27:34,155 and she died on their watch. 482 00:27:34,188 --> 00:27:36,790 [Andrew] Lisa Williams' parents have questions about errors 483 00:27:36,824 --> 00:27:39,827 made by the surgical staff, not ICU. 484 00:27:39,860 --> 00:27:43,430 They want to know about complications in the surgery, 485 00:27:43,464 --> 00:27:47,034 your surgery, because you told them 486 00:27:47,067 --> 00:27:51,071 there were complications for Liz... apparently. 487 00:27:52,039 --> 00:27:54,275 [chuckles] I mean, for Lisa. 488 00:27:56,010 --> 00:27:57,745 Am I right? 489 00:27:58,379 --> 00:27:59,880 [inhales sharply] 490 00:27:59,914 --> 00:28:01,815 Or... 491 00:28:01,849 --> 00:28:03,384 am I being stupid? 492 00:28:05,520 --> 00:28:08,289 Right. Let me just summarize. 493 00:28:08,322 --> 00:28:11,959 -Anaesthesia started at 1:40. -Yes, it did. 494 00:28:11,992 --> 00:28:14,695 -And the surgery at 1:50. -Correct. 495 00:28:14,728 --> 00:28:16,297 And the gas port was inserted 496 00:28:16,330 --> 00:28:20,968 into the abdomen and, uh, insufflation commenced. 497 00:28:21,435 --> 00:28:22,436 Robin? 498 00:28:23,971 --> 00:28:25,839 Yes. Yes, that is correct. 499 00:28:25,873 --> 00:28:27,942 And you say here in your notes 500 00:28:27,975 --> 00:28:31,812 that Mrs. Taylor verbalized that there was no gas. 501 00:28:31,845 --> 00:28:33,347 Insufficient gas. 502 00:28:33,380 --> 00:28:34,583 I-I said in my notes 503 00:28:34,616 --> 00:28:39,386 that, um, Mrs. Taylor said there was insufficient gas flow. 504 00:28:39,420 --> 00:28:40,955 What did she mean? 505 00:28:43,157 --> 00:28:44,391 What... 506 00:28:44,425 --> 00:28:47,562 She meant there's insufficient pressure of gas in the abdomen 507 00:28:47,596 --> 00:28:49,496 that lifts the peritoneal sac 508 00:28:49,531 --> 00:28:51,265 away from internal structures 509 00:28:51,298 --> 00:28:54,669 that could be damaged by insertion of instruments. 510 00:28:54,703 --> 00:28:57,071 And what was the pressure at that point? 511 00:28:57,104 --> 00:28:58,939 How much gas was in her abdomen? 512 00:28:58,973 --> 00:29:00,808 I mean, frankly speaking, 513 00:29:00,841 --> 00:29:02,977 was it safe to go sticking things in her? 514 00:29:03,712 --> 00:29:05,346 Well, I don't know, Doctor. 515 00:29:05,379 --> 00:29:06,780 Ah! You don't know? 516 00:29:06,814 --> 00:29:08,282 [Alex] She can't know! 517 00:29:08,315 --> 00:29:11,385 The indicator on the insufflator reads "enough" or "not enough." 518 00:29:11,418 --> 00:29:13,722 When the belly is inflated, the gas slows down 519 00:29:13,787 --> 00:29:15,456 as the pressure doesn't let it in there. 520 00:29:15,489 --> 00:29:18,727 The theoretical pressure needed inside the cavity is ten, sure, 521 00:29:18,759 --> 00:29:21,862 but there's no actual gauge that measures that. 522 00:29:21,895 --> 00:29:25,432 It just says the flow rate is or is not high enough 523 00:29:25,466 --> 00:29:26,800 to inflate at that level. 524 00:29:26,834 --> 00:29:28,235 -[Andrew] Okay. -Okay or not. 525 00:29:28,269 --> 00:29:31,305 We had direct visualization of the organ space. 526 00:29:31,338 --> 00:29:32,239 [Andrew] Okay. 527 00:29:32,273 --> 00:29:34,609 And at whatever actual pressure it was, 528 00:29:34,643 --> 00:29:36,578 in my clinical judgment, 529 00:29:36,611 --> 00:29:37,878 there was sufficient pressure-- 530 00:29:37,911 --> 00:29:39,847 To insert the last trocar? 531 00:29:39,880 --> 00:29:41,048 Yes, Jason. 532 00:29:41,081 --> 00:29:43,884 Jesus, Jason. There's no definitive timing. 533 00:29:43,917 --> 00:29:45,853 That's what you do. 534 00:29:45,886 --> 00:29:47,921 You use your clinical judgment. 535 00:29:48,822 --> 00:29:51,760 So, who inserted the last trocar, Liz? 536 00:29:51,792 --> 00:29:54,194 Who put it... the trocar in? 537 00:29:58,132 --> 00:29:59,133 Uh... 538 00:30:01,268 --> 00:30:02,604 I did. 539 00:30:02,637 --> 00:30:05,306 [Andrew] You inserted the last trocar 540 00:30:05,339 --> 00:30:07,875 that caused the damage to this girl, 541 00:30:07,908 --> 00:30:10,944 which was a rent in the inferior vena cava, 542 00:30:10,978 --> 00:30:13,147 cut in the posterior abdominal wall, 543 00:30:13,180 --> 00:30:14,649 a tear in the lumbar artery-- 544 00:30:14,683 --> 00:30:18,553 Yes, yes, which we repaired, of course. 545 00:30:18,586 --> 00:30:19,721 [Andrew] Okay, good. 546 00:30:19,754 --> 00:30:21,455 Good. Yes. 547 00:30:24,224 --> 00:30:25,225 Okay. 548 00:30:27,161 --> 00:30:30,464 [sighs] Look, it was more complicated than that. 549 00:30:30,497 --> 00:30:34,968 I instructed my registrar, Richard Whitehead, 550 00:30:35,002 --> 00:30:38,673 to make the incision and insert the last trocar, 551 00:30:38,707 --> 00:30:39,940 and he did. 552 00:30:39,973 --> 00:30:42,910 Oh, so Richard inserted the last trocar. 553 00:30:42,943 --> 00:30:44,478 I'm the team leader. 554 00:30:44,512 --> 00:30:45,913 I'm the lead surgeon. 555 00:30:46,447 --> 00:30:48,015 It's my theatre. 556 00:30:48,048 --> 00:30:49,584 Under my instruction, 557 00:30:49,617 --> 00:30:52,119 Richard inserted the last trocar, 558 00:30:53,521 --> 00:30:55,255 which failed to penetrate. 559 00:30:56,490 --> 00:30:58,760 I told him to push harder. 560 00:30:58,793 --> 00:31:00,528 [Andrew] Told Richard... 561 00:31:00,562 --> 00:31:03,063 I said to give it some welly. 562 00:31:04,799 --> 00:31:06,033 "Welly." 563 00:31:12,473 --> 00:31:13,474 That's right. 564 00:31:19,614 --> 00:31:22,950 [sombre music] 565 00:31:27,488 --> 00:31:31,693 Would you look at this gorgeous creature? 566 00:31:31,726 --> 00:31:33,227 [Elizabeth] You're a dog mother. 567 00:31:34,395 --> 00:31:37,064 [Jessica] Have you ever seen anything so photogenic? 568 00:31:37,097 --> 00:31:39,634 -He's like your child. -[Jessica] Mmm. 569 00:31:39,667 --> 00:31:41,201 He's great company. 570 00:31:42,704 --> 00:31:44,037 What's new? 571 00:31:44,071 --> 00:31:45,740 [Jessica clears throat] 572 00:31:45,774 --> 00:31:47,609 You know, it's... 573 00:31:47,642 --> 00:31:49,544 It's complicated. 574 00:31:50,177 --> 00:31:52,079 I met a really smart guy. 575 00:31:52,112 --> 00:31:54,516 [sighs] And your marriage? 576 00:31:55,517 --> 00:31:56,950 [Jessica] It's over. 577 00:31:59,353 --> 00:32:01,155 -Yeah. -[Elizabeth] I'm sorry. 578 00:32:01,188 --> 00:32:02,990 Yeah, I know. It's shit, really. 579 00:32:07,995 --> 00:32:10,665 [sighs] I had a shit week too. 580 00:32:12,332 --> 00:32:13,200 Yeah. 581 00:32:13,233 --> 00:32:14,669 [Elizabeth] Complicated, as you say. 582 00:32:14,702 --> 00:32:15,703 Mm. 583 00:32:20,407 --> 00:32:21,910 Um... 584 00:32:21,942 --> 00:32:24,779 So I really hate to ask, Liz, 585 00:32:24,813 --> 00:32:26,548 but is there any way that Atticus 586 00:32:26,581 --> 00:32:28,550 could stay with you for a little while? 587 00:32:30,083 --> 00:32:31,820 -The dog? -[Jessica] Yeah. 588 00:32:31,853 --> 00:32:33,220 [Jessica] It's just because I'm... 589 00:32:33,253 --> 00:32:35,088 I'm moving into his apartment, 590 00:32:35,122 --> 00:32:38,593 and-and you know, it's no good for a big dog. 591 00:32:38,626 --> 00:32:40,394 There's elevators and stuff. 592 00:32:40,427 --> 00:32:45,165 And Stephen won't take him because he's punishing me, so... 593 00:32:45,199 --> 00:32:47,201 But it would just be for a short term. 594 00:32:47,869 --> 00:32:49,804 Jess, no. I really don't-- 595 00:32:49,838 --> 00:32:51,205 I really don't think I can. 596 00:32:51,238 --> 00:32:53,207 Atticus is so old, Liz. 597 00:32:53,240 --> 00:32:54,676 He's totally house trained. 598 00:32:54,709 --> 00:32:57,879 All he does is just lie around in the sun all day and sleep, 599 00:32:57,912 --> 00:32:58,947 and he'll be your best buddy. 600 00:32:58,979 --> 00:33:00,047 I am never home. 601 00:33:00,080 --> 00:33:01,315 Oh, God. Fuck. Don't worry about it. 602 00:33:01,348 --> 00:33:03,984 We're never home either. He's totally used to it. 603 00:33:14,629 --> 00:33:16,396 Robin, where are you? 604 00:33:17,498 --> 00:33:19,099 I want you to come over. 605 00:33:20,367 --> 00:33:21,669 Do you want to? 606 00:33:23,237 --> 00:33:24,338 Um. 607 00:33:25,439 --> 00:33:28,342 Hey, I'm sorry I've been so distracted by everything, 608 00:33:28,375 --> 00:33:30,778 you know, all the shitty fucking shit. 609 00:33:32,479 --> 00:33:36,584 Jessica is making me take her dog. 610 00:33:36,618 --> 00:33:38,352 [laughs] 611 00:33:38,385 --> 00:33:39,587 It's such... 612 00:33:40,454 --> 00:33:41,789 Uh... Okay. 613 00:33:44,559 --> 00:33:45,994 Bye for now. 614 00:33:46,026 --> 00:33:47,261 Call me. 615 00:34:39,847 --> 00:34:43,818 [uneasy music] 616 00:35:01,335 --> 00:35:03,538 [distant crackling] 617 00:35:27,695 --> 00:35:29,363 [sombre music] 618 00:35:39,239 --> 00:35:40,642 [Atticus barks] 619 00:36:08,301 --> 00:36:09,904 [Te] You have been invisible to your patients 620 00:36:09,937 --> 00:36:13,041 and your performance levels have been equally invisible 621 00:36:13,074 --> 00:36:14,374 until now, 622 00:36:14,408 --> 00:36:16,209 because we are going to be publishing 623 00:36:16,243 --> 00:36:18,412 surgical outcomes publicly. 624 00:36:18,445 --> 00:36:21,082 This, of course, raises profound questions, 625 00:36:21,115 --> 00:36:23,584 because once publication starts, 626 00:36:23,618 --> 00:36:26,621 patients and potential patients 627 00:36:26,654 --> 00:36:29,757 will assess your track records and compare you to others. 628 00:36:29,791 --> 00:36:32,392 Of course, they won't know that the surgeon down the road, 629 00:36:32,426 --> 00:36:34,494 who has much better statistics, 630 00:36:34,529 --> 00:36:36,296 only qualified six months ago, 631 00:36:36,329 --> 00:36:40,001 and has operated on a grand total of seven young, 632 00:36:40,034 --> 00:36:41,602 non-smoking white patients, 633 00:36:41,636 --> 00:36:44,572 whilst you have been in the trenches, 634 00:36:44,605 --> 00:36:48,341 operating on the morbidly obese, the diabetic, 635 00:36:48,375 --> 00:36:50,878 elderly brown folk with histories of falls 636 00:36:50,912 --> 00:36:52,714 and gout and respiratory disease. 637 00:36:52,747 --> 00:36:55,382 You will be compared surgeon to surgeon, 638 00:36:55,415 --> 00:36:58,019 and every case of everyone who has ever died 639 00:36:58,052 --> 00:36:59,286 underneath your scalpel 640 00:36:59,319 --> 00:37:01,388 will be on full public display. 641 00:37:01,421 --> 00:37:04,992 Every surgical site, infection, every nicked aorta. 642 00:37:06,160 --> 00:37:08,529 Will some surgeons be forced to retire? 643 00:37:08,563 --> 00:37:09,931 Maybe. 644 00:37:09,964 --> 00:37:11,264 Probably. 645 00:37:11,298 --> 00:37:13,601 Will some surgeons be treated unfairly? 646 00:37:13,634 --> 00:37:15,069 Yes, most likely. 647 00:37:15,103 --> 00:37:16,671 Why, then, should we allow this, 648 00:37:16,704 --> 00:37:18,506 even encourage it? 649 00:37:18,539 --> 00:37:21,308 Transparency and informed consent. 650 00:37:21,341 --> 00:37:23,276 And I'm talking about real consent, 651 00:37:23,310 --> 00:37:26,180 not just a scribble on a piece of paper 652 00:37:26,214 --> 00:37:27,582 moments before operating. 653 00:37:27,615 --> 00:37:29,217 In the broader context, a surgeon-- 654 00:37:29,249 --> 00:37:30,952 Sorry. I'm sorry. 655 00:37:30,985 --> 00:37:32,019 Yes? 656 00:37:32,053 --> 00:37:33,688 Liz Taylor. 657 00:37:33,721 --> 00:37:35,990 Yes, Mrs. Taylor? 658 00:37:36,023 --> 00:37:38,258 This will turn surgery upside down. 659 00:37:38,793 --> 00:37:39,727 It is inevitable 660 00:37:39,761 --> 00:37:42,563 that good surgeons will be treated unfairly. 661 00:37:42,597 --> 00:37:44,364 You just said so yourself. 662 00:37:45,199 --> 00:37:46,968 And it sounds like you accept this. 663 00:37:47,001 --> 00:37:49,537 Well, isn't being transparent about your results 664 00:37:49,570 --> 00:37:51,739 what a good surgeon does, 665 00:37:51,773 --> 00:37:54,208 so that your patients are able to give informed consent? 666 00:37:54,242 --> 00:37:56,010 Okay, look, sorry if I'm-- [chuckles] 667 00:37:56,043 --> 00:37:57,812 Maybe I'm coming off like a tendentious bitch... 668 00:37:57,845 --> 00:38:00,581 -[chuckles] -but this is important to us. 669 00:38:00,615 --> 00:38:03,483 Publishing results is a bad idea. 670 00:38:03,518 --> 00:38:06,788 We will avoid very sick patients. 671 00:38:06,821 --> 00:38:09,924 Why risk adding someone who will likely die to my numbers? 672 00:38:09,957 --> 00:38:11,592 Why should I take that risk? 673 00:38:12,160 --> 00:38:13,861 Changes everything. 674 00:38:13,895 --> 00:38:16,496 Which surgeon will give their registrar a go, 675 00:38:16,531 --> 00:38:18,166 if when it all turns to shambles, 676 00:38:18,199 --> 00:38:19,834 it goes on their record? 677 00:38:19,867 --> 00:38:21,068 [Andrew] Liz. 678 00:38:22,302 --> 00:38:25,338 That's... That's a good point. 679 00:38:25,372 --> 00:38:26,541 Lots of good points. 680 00:38:26,574 --> 00:38:29,544 But what we're talking about here is resources. 681 00:38:29,577 --> 00:38:31,078 No! We're talking about numbers. 682 00:38:31,112 --> 00:38:33,214 -Well-- -I'm talking about numbers. 683 00:38:33,247 --> 00:38:36,217 We're talking about ranking people 684 00:38:36,250 --> 00:38:38,853 best to worst in league tables 685 00:38:38,886 --> 00:38:43,524 using data that is insufficient and partial. 686 00:38:43,558 --> 00:38:46,359 And surgeons will be hung out to dry. 687 00:38:49,997 --> 00:38:51,032 [Te] Whoa! 688 00:38:51,065 --> 00:38:52,633 It appears we have entered 689 00:38:52,667 --> 00:38:55,503 the Q&A portion of our session 690 00:38:55,536 --> 00:38:57,038 -slightly ahead of time. -[chuckles] 691 00:38:57,071 --> 00:38:59,372 I just don't think we can be idiots about this, 692 00:38:59,406 --> 00:39:01,709 and do it just because other countries do. 693 00:39:01,742 --> 00:39:04,846 How many cardiac surgeons can we afford to lose? 694 00:39:06,047 --> 00:39:07,615 Do you know how many we've got? 695 00:39:07,648 --> 00:39:09,851 -Twenty-nine! It's not enough. -Liz. 696 00:39:11,018 --> 00:39:12,019 Thank you. 697 00:39:13,386 --> 00:39:15,189 Twenty-nine. 698 00:39:15,223 --> 00:39:16,657 And according to him, 699 00:39:16,691 --> 00:39:18,192 half are going to have to retire soon. 700 00:39:18,226 --> 00:39:20,862 [Andrew] Yeah, okay. That's a good point. 701 00:39:20,895 --> 00:39:22,063 But let's... 702 00:39:22,096 --> 00:39:23,097 Doctor. 703 00:39:24,065 --> 00:39:26,968 [sombre music] 704 00:40:09,043 --> 00:40:13,446 [sombre music continues] 705 00:40:42,977 --> 00:40:45,146 Very gripping stuff. 706 00:40:45,179 --> 00:40:46,213 [Elizabeth] Wasn't it. 707 00:40:46,247 --> 00:40:48,983 Interesting, provocative. 708 00:40:49,016 --> 00:40:49,984 People will be crucified. 709 00:40:50,017 --> 00:40:52,787 [Andrew] Yeah, some surgeons need to reassess. 710 00:40:52,820 --> 00:40:54,388 You're not worried about your data. 711 00:40:54,422 --> 00:40:56,757 The other specialties are nervous. 712 00:40:56,791 --> 00:40:58,225 We're years behind the world on this, 713 00:40:58,259 --> 00:40:59,794 and it's not thought through. 714 00:41:00,695 --> 00:41:02,330 You're not nervous, eh? 715 00:41:02,363 --> 00:41:03,998 'Cause you're brilliant. 716 00:41:05,299 --> 00:41:07,068 You're absolutely brilliant. 717 00:41:07,101 --> 00:41:09,637 But, um... 718 00:41:09,670 --> 00:41:12,540 Elizabeth, unfortunately, it falls to my lot 719 00:41:12,573 --> 00:41:14,842 to tell you that there's been a... 720 00:41:14,875 --> 00:41:16,577 formal complaint. 721 00:41:18,112 --> 00:41:18,946 [Elizabeth] A complaint? 722 00:41:18,980 --> 00:41:21,481 Formal complaint. Lisa's parents. 723 00:41:24,118 --> 00:41:26,554 When were you going to tell me about this? 724 00:41:27,688 --> 00:41:29,824 Well, I'm telling you now. 725 00:41:36,931 --> 00:41:37,932 Piece of shit. 726 00:41:39,467 --> 00:41:42,770 [dramatic music] 727 00:41:46,941 --> 00:41:47,942 Hey. 728 00:41:49,076 --> 00:41:50,077 Hi. 729 00:41:51,112 --> 00:41:52,113 Leave you to it. 730 00:41:54,415 --> 00:41:56,250 I called you last night. 731 00:41:57,952 --> 00:41:58,953 Yeah. 732 00:42:00,554 --> 00:42:02,690 I can feel you disappearing. 733 00:42:02,723 --> 00:42:05,292 Yeah, I just want to get the fuck out of here. 734 00:42:07,728 --> 00:42:10,698 So, what did Andrew want? 735 00:42:10,731 --> 00:42:12,533 Saw he cornered you. 736 00:42:12,566 --> 00:42:15,603 [Elizabeth] Apparently, there's been a complaint 737 00:42:15,636 --> 00:42:17,038 about the surgery. 738 00:42:17,838 --> 00:42:20,374 Like a... Like a formal complaint? 739 00:42:20,408 --> 00:42:22,276 I haven't read it. 740 00:42:23,377 --> 00:42:25,446 Haven't seen it in writing, but yes. 741 00:42:25,479 --> 00:42:28,182 And, um, he wanted to rub it in my face. 742 00:42:28,215 --> 00:42:29,283 Well, that's shit. 743 00:42:30,217 --> 00:42:31,419 Well. 744 00:42:31,452 --> 00:42:32,653 Yeah. 745 00:42:33,254 --> 00:42:34,755 Can't handle you. 746 00:42:35,456 --> 00:42:39,060 [club music playing] 747 00:42:48,636 --> 00:42:49,904 Did you... 748 00:42:51,105 --> 00:42:53,974 Did you know Richard left when you were speaking? 749 00:42:55,242 --> 00:42:56,343 Richard? 750 00:42:56,377 --> 00:42:57,578 Yeah. 751 00:42:58,279 --> 00:42:59,280 No. 752 00:43:01,382 --> 00:43:03,417 He was pretty upset. 753 00:43:03,451 --> 00:43:06,587 Richard is a sensitive type. 754 00:43:06,620 --> 00:43:09,123 He needs to learn to love the hook. 755 00:43:09,156 --> 00:43:10,391 Well, uh... 756 00:43:10,424 --> 00:43:11,725 I don't blame him, Liz. 757 00:43:11,759 --> 00:43:13,094 It was... It was pretty public. 758 00:43:14,361 --> 00:43:15,396 What's public? 759 00:43:15,429 --> 00:43:17,731 The things you say out loud... 760 00:43:19,568 --> 00:43:21,769 Registrars in shambles. 761 00:43:22,169 --> 00:43:23,804 [chuckles] 762 00:43:25,306 --> 00:43:26,941 Oh, Jesus Christ. 763 00:43:27,842 --> 00:43:29,777 What's wrong with people? 764 00:43:48,062 --> 00:43:50,731 [dark music] 765 00:44:01,576 --> 00:44:04,278 [sombre music] 766 00:44:47,589 --> 00:44:48,789 [sighs] 767 00:44:50,625 --> 00:44:52,726 [indistinct conversation] 768 00:45:00,501 --> 00:45:01,636 Andrew. 769 00:45:01,670 --> 00:45:02,870 Seen this? 770 00:45:13,247 --> 00:45:14,848 [gasps] 771 00:45:20,988 --> 00:45:21,989 Fuck! 772 00:45:23,490 --> 00:45:26,026 [bird chirping] 773 00:45:34,802 --> 00:45:36,337 [sharp breath] Unbelievable. 774 00:45:43,043 --> 00:45:44,178 [sighing] 775 00:45:44,211 --> 00:45:45,379 [phone vibrates] 776 00:46:03,330 --> 00:46:04,331 [Richard] Hey. 777 00:46:04,365 --> 00:46:06,200 Uh, sorry to interrupt. 778 00:46:06,233 --> 00:46:08,902 [Elizabeth] Oh, no, you're not interrupting. 779 00:46:12,806 --> 00:46:14,676 What can I do for you, Richard? 780 00:46:14,709 --> 00:46:17,512 [Richard] I, uh... I think it's ridiculous. 781 00:46:17,545 --> 00:46:20,014 That's ridiculous and wrong. 782 00:46:20,582 --> 00:46:21,782 You'll be all right. 783 00:46:21,815 --> 00:46:24,084 Just keep your head down and work. 784 00:46:24,118 --> 00:46:26,153 Don't start looking unlucky. 785 00:46:27,622 --> 00:46:29,857 What does your father say about it? 786 00:46:29,890 --> 00:46:33,160 I haven't told him anything yet. 787 00:46:33,193 --> 00:46:35,530 Isn't that something you'd talk to him about? 788 00:46:35,563 --> 00:46:37,064 You talk about work, don't you? 789 00:46:37,097 --> 00:46:39,734 But the thing is, like, he's just been appointed 790 00:46:39,768 --> 00:46:41,802 to the head of surgery in Dunedin. 791 00:46:43,103 --> 00:46:43,871 Yeah. 792 00:46:43,904 --> 00:46:45,105 I'm just not sure 793 00:46:45,139 --> 00:46:47,408 what position it would put him in if I told him. 794 00:46:47,441 --> 00:46:49,109 -You know? -[Elizabeth] Oh? 795 00:46:51,078 --> 00:46:52,079 Yeah. 796 00:46:54,716 --> 00:46:56,551 Not actually sure what he would say. 797 00:47:01,388 --> 00:47:03,991 He'd probably say you're better than this. 798 00:47:05,259 --> 00:47:06,728 Probably, but... 799 00:47:06,761 --> 00:47:08,929 What if I'm not, though? 800 00:47:08,962 --> 00:47:10,864 [Elizabeth] Come on, Richard. 801 00:47:10,898 --> 00:47:11,999 You don't understand. 802 00:47:12,032 --> 00:47:14,569 Look, I have been having dreams about her. 803 00:47:14,602 --> 00:47:15,603 [Elizabeth] Richard... 804 00:47:17,539 --> 00:47:20,040 We did everything in our power, 805 00:47:20,074 --> 00:47:22,109 inside and outside theatre. 806 00:47:24,011 --> 00:47:26,080 Mistakes may always happen. 807 00:47:28,516 --> 00:47:30,451 They're scary dreams, Liz. 808 00:47:35,956 --> 00:47:38,192 They're just dreams. 809 00:47:38,225 --> 00:47:40,961 Just dreams. 810 00:47:43,732 --> 00:47:44,932 Yeah. 811 00:47:51,171 --> 00:47:53,874 Maybe you'd be interested in some confidential counselling 812 00:47:53,907 --> 00:47:55,376 or something like that. 813 00:47:56,578 --> 00:47:58,345 Can I set that up for you? 814 00:48:00,247 --> 00:48:01,516 I... 815 00:48:03,818 --> 00:48:05,018 I want you to know that, 816 00:48:05,052 --> 00:48:08,455 I know what you've done for me. 817 00:48:08,489 --> 00:48:09,923 I did nothing, Richard. 818 00:48:11,058 --> 00:48:13,260 It was my mistake. 819 00:48:13,293 --> 00:48:15,563 I trusted your judgment, I was wrong. 820 00:48:15,597 --> 00:48:16,731 It's called training. 821 00:48:16,765 --> 00:48:18,132 It has risks. 822 00:48:19,834 --> 00:48:21,902 I took the decision to do it. 823 00:48:21,935 --> 00:48:23,170 [Richard] That was me-- 824 00:48:23,203 --> 00:48:24,271 No, I did. 825 00:48:25,607 --> 00:48:26,674 I did. 826 00:48:27,675 --> 00:48:28,676 Me. 827 00:48:31,713 --> 00:48:33,247 Leave it with me. 828 00:48:35,115 --> 00:48:38,051 You can. You can just leave it with me. 829 00:48:38,085 --> 00:48:40,254 Really, I can take it. 830 00:48:41,355 --> 00:48:42,356 [muted groan] 831 00:48:45,993 --> 00:48:47,695 Why don't you get something, hmm? 832 00:48:47,729 --> 00:48:49,263 Get something to eat. 833 00:48:49,296 --> 00:48:50,330 Uh... 834 00:48:50,899 --> 00:48:52,634 Uh, no, no. 835 00:48:55,035 --> 00:48:57,739 Okay, well... [clears throat] 836 00:48:57,772 --> 00:48:58,840 [phone vibrates] 837 00:48:58,873 --> 00:49:00,542 I've got to get going. 838 00:49:01,175 --> 00:49:02,877 So... 839 00:49:02,911 --> 00:49:05,680 To be continued? Yeah. 840 00:49:05,713 --> 00:49:07,181 Well, when are we-- 841 00:49:08,817 --> 00:49:10,083 When what? 842 00:49:11,653 --> 00:49:13,287 When will it be continued? 843 00:49:15,690 --> 00:49:16,957 Tomorrow sometime. 844 00:49:19,026 --> 00:49:21,596 I told her parents that she was okay, 845 00:49:22,630 --> 00:49:23,665 that it went well. 846 00:49:23,698 --> 00:49:24,732 You said that. 847 00:49:27,334 --> 00:49:28,536 Yes, I did. 848 00:49:29,804 --> 00:49:31,438 Yes, she was. 849 00:49:34,542 --> 00:49:36,711 Stop telling yourself a different story. 850 00:49:41,248 --> 00:49:43,317 Jesus! Fuck, Richard. 851 00:49:46,086 --> 00:49:49,524 [sombre music] 852 00:50:36,203 --> 00:50:37,672 [Alex] Gonna go fishing this weekend. 853 00:50:37,705 --> 00:50:38,840 You want to come? 854 00:50:38,873 --> 00:50:40,107 -[Elizabeth] Me? -You'd enjoy it. 855 00:50:40,140 --> 00:50:41,809 I don't fish. 856 00:50:41,843 --> 00:50:43,143 [Alex] Well, you could try. 857 00:50:43,176 --> 00:50:45,212 -[phone rings] -You could learn. 858 00:50:45,245 --> 00:50:46,480 Everything is always there. 859 00:50:46,514 --> 00:50:49,249 You go away, take a rest, come back. 860 00:50:49,283 --> 00:50:51,351 Is the patient consented? 861 00:50:51,385 --> 00:50:53,120 Yes. 862 00:50:53,153 --> 00:50:55,188 -It's cancelled. -What, really? 863 00:50:55,222 --> 00:50:57,124 I don't know, they just told me it's cancelled. 864 00:50:59,393 --> 00:51:00,728 [sighs] 865 00:51:01,829 --> 00:51:02,830 Fuck! 866 00:51:04,097 --> 00:51:06,701 [indistinct hospital PA announcement] 867 00:51:07,501 --> 00:51:08,502 [knocking] 868 00:51:08,536 --> 00:51:09,637 Oh... 869 00:51:09,671 --> 00:51:11,039 What happened? 870 00:51:11,071 --> 00:51:12,507 Oh, I'm sorry about that. 871 00:51:12,540 --> 00:51:14,008 He, he ate something in the middle of the night, 872 00:51:14,042 --> 00:51:15,342 forgot about it, 873 00:51:15,375 --> 00:51:17,579 and then remembered all of a sudden during consent. 874 00:51:18,012 --> 00:51:19,581 Oh. 875 00:51:19,614 --> 00:51:21,214 [soft chuckle] You're going through a bit 876 00:51:21,248 --> 00:51:22,817 over there, I gather. 877 00:51:24,484 --> 00:51:25,887 It'll blow over. 878 00:51:25,920 --> 00:51:27,822 [Mary] It's a cracked system, Liz. 879 00:51:32,292 --> 00:51:35,095 Look, how well known is my complaint? 880 00:51:36,396 --> 00:51:38,733 Well, it's about, can't lie. 881 00:51:40,802 --> 00:51:42,637 But as you say, it'll blow over. 882 00:51:42,670 --> 00:51:43,805 [sighs] 883 00:51:47,174 --> 00:51:48,776 Did he really eat something? 884 00:51:51,178 --> 00:51:52,513 So I'm told. 885 00:51:53,948 --> 00:51:57,217 Some spag bowl from the fridge in the middle of the night. 886 00:51:58,086 --> 00:52:00,354 And there's really nothing else... 887 00:52:00,387 --> 00:52:02,557 Nothing else that I can use you for today. 888 00:52:02,590 --> 00:52:05,526 So, um, I'm sorry to waste your time. 889 00:52:10,031 --> 00:52:12,567 [sombre music] 890 00:53:03,151 --> 00:53:06,186 [seagulls squawking] 891 00:53:15,195 --> 00:53:16,396 Excuse me? 892 00:53:17,230 --> 00:53:18,498 Are you Mrs. Taylor? 893 00:53:18,533 --> 00:53:19,366 I am. 894 00:53:19,399 --> 00:53:21,035 I have a registered letter for you. 895 00:53:21,069 --> 00:53:22,269 Oh? 896 00:53:24,672 --> 00:53:27,875 [dramatic music] 897 00:53:28,910 --> 00:53:30,545 What the fuck? 898 00:53:30,578 --> 00:53:31,679 Fuck is this? 899 00:53:31,713 --> 00:53:33,881 [tense music] 900 00:53:37,919 --> 00:53:39,854 [tires screeching] 901 00:53:43,290 --> 00:53:45,960 [voicemail] Hi, this is Robin's phone... 902 00:53:45,993 --> 00:53:47,195 [message beeps] 903 00:53:47,227 --> 00:53:48,930 Robin. 904 00:53:48,963 --> 00:53:50,430 So they've, uh, 905 00:53:50,464 --> 00:53:52,100 "temporarily restricted 906 00:53:52,133 --> 00:53:55,169 my practice of laparoscopy and laparotomy." 907 00:53:55,203 --> 00:53:56,838 Suspended me. 908 00:53:57,404 --> 00:53:59,040 It's fucking... 909 00:53:59,073 --> 00:54:03,044 It's just ass-covering cowardice. 910 00:54:03,077 --> 00:54:04,912 It's unbelievable. 911 00:54:04,946 --> 00:54:06,647 Unbelievable! Anyway. 912 00:54:08,816 --> 00:54:09,817 Call me. 913 00:54:16,124 --> 00:54:17,792 [startled gasp] 914 00:54:20,795 --> 00:54:24,364 [tense music] 915 00:54:46,220 --> 00:54:47,622 [grunts] 916 00:54:54,195 --> 00:54:55,129 [scoffs] 917 00:54:55,163 --> 00:54:56,230 [grunting] 918 00:54:56,264 --> 00:54:58,933 [thudding] 919 00:55:02,335 --> 00:55:04,471 [Atticus grunts] 920 00:55:11,779 --> 00:55:13,681 [Atticus whining] 921 00:55:30,131 --> 00:55:33,000 [thudding continues] 922 00:55:34,434 --> 00:55:37,038 [seagulls squawking] 923 00:55:39,173 --> 00:55:40,975 [phone ringing] 924 00:55:47,447 --> 00:55:49,083 [Elizabeth] Hello again. 925 00:55:49,116 --> 00:55:51,219 Mrs. Taylor... 926 00:55:51,252 --> 00:55:53,221 from the conference. 927 00:55:53,254 --> 00:55:54,689 Please sit down. 928 00:55:56,757 --> 00:55:59,994 You're here to talk about the publishing of data? 929 00:56:01,229 --> 00:56:02,462 I am, yes. 930 00:56:03,297 --> 00:56:04,565 Look... [clears throat] 931 00:56:05,365 --> 00:56:07,500 there's no easy way to say this, 932 00:56:07,535 --> 00:56:11,005 but our priority isn't to shelter 933 00:56:11,038 --> 00:56:12,974 surgeons from criticism. 934 00:56:13,007 --> 00:56:15,610 Our priority is deciding what's good for everybody, 935 00:56:15,643 --> 00:56:17,444 most importantly, the public, 936 00:56:17,477 --> 00:56:19,213 our patients. 937 00:56:19,247 --> 00:56:21,015 I understand that the methodology 938 00:56:21,048 --> 00:56:22,550 may not yet be perfect, 939 00:56:22,583 --> 00:56:24,852 but I believe transparency is a good thing. 940 00:56:24,886 --> 00:56:27,054 And we can improve the methodology over time. 941 00:56:27,088 --> 00:56:28,689 [Elizabeth] The decisions that we have to make 942 00:56:28,723 --> 00:56:30,925 in theatre in fractions of seconds 943 00:56:30,958 --> 00:56:34,629 are boiled down to "they lived" or "they died." 944 00:56:34,662 --> 00:56:38,599 No context, no case histories, 945 00:56:38,633 --> 00:56:40,001 just "they lived" or "they died." 946 00:56:40,034 --> 00:56:41,836 That's not transparency. 947 00:56:42,837 --> 00:56:44,972 It's looking for someone to blame. 948 00:56:48,175 --> 00:56:50,477 I understand what you're saying. 949 00:56:50,511 --> 00:56:51,746 -[Elizabeth] Do you? -Yes. 950 00:56:51,779 --> 00:56:56,050 But once we pass this first storm, 951 00:56:56,083 --> 00:56:59,620 hopefully then we can focus on worthy things, 952 00:56:59,654 --> 00:57:01,355 such as risk adjustment. 953 00:57:01,389 --> 00:57:03,024 Risk adjustment? 954 00:57:04,392 --> 00:57:06,661 [Te] Have you heard of Z51.5? 955 00:57:06,694 --> 00:57:09,597 That's a code for palliative care in the UK system. 956 00:57:09,630 --> 00:57:13,000 A Z51.5 doesn't go on anyone's stats because it says 957 00:57:13,034 --> 00:57:15,169 that the patient was already dying when they came in. 958 00:57:15,202 --> 00:57:17,271 Patients died quietly. 959 00:57:17,305 --> 00:57:19,173 No chemo, no scalpels, 960 00:57:19,206 --> 00:57:21,709 just morphine and flowers. 961 00:57:21,742 --> 00:57:24,512 Would my sepsis have qualified? 962 00:57:24,545 --> 00:57:25,613 Do you understand? 963 00:57:25,646 --> 00:57:27,548 Should I have not intervened? 964 00:57:28,950 --> 00:57:34,021 Maybe, it's better for the patients that way. 965 00:57:34,055 --> 00:57:38,491 Maybe, because at times it's best not to operate. 966 00:57:38,526 --> 00:57:40,661 Let them die with dignity. 967 00:57:40,695 --> 00:57:42,229 And maybe the publishing of data 968 00:57:42,263 --> 00:57:46,233 will mean that more people die with less intervention. 969 00:57:47,435 --> 00:57:49,804 You know what's best for patients, do you? 970 00:57:49,837 --> 00:57:51,872 Sitting here at your keyboard? 971 00:57:53,841 --> 00:57:56,677 I know your reputation, Mrs. Taylor. 972 00:57:56,711 --> 00:57:58,312 You're the best at what you do. 973 00:57:58,346 --> 00:57:59,680 [Elizabeth] One of. 974 00:57:59,714 --> 00:58:02,817 But is what you do always best for the patients? 975 00:58:04,719 --> 00:58:06,921 I'm sorry that sounds tough. I know. 976 00:58:06,954 --> 00:58:10,091 But hospitals hide these things, don't they? 977 00:58:10,124 --> 00:58:12,426 Staff learn to hide things, 978 00:58:12,460 --> 00:58:13,995 and patients never know anything went wrong. 979 00:58:14,028 --> 00:58:16,797 And the ones hurt the most are the families left behind. 980 00:58:17,832 --> 00:58:20,234 We must hold ourselves to a higher standard. 981 00:58:22,502 --> 00:58:23,738 I have a standard. 982 00:58:23,771 --> 00:58:25,706 It's the Hippocratic Oath. 983 00:58:25,740 --> 00:58:27,708 And I'm not trying to hide anything. 984 00:58:32,980 --> 00:58:35,683 [birds chirping] 985 00:58:43,991 --> 00:58:45,292 [door opens] 986 00:58:48,195 --> 00:58:50,598 -[Elizabeth] Hey! -Well, hi. 987 00:58:51,065 --> 00:58:52,833 How are you? 988 00:58:52,867 --> 00:58:53,734 You good? 989 00:58:53,768 --> 00:58:55,603 [chuckles in disbelief] 990 00:58:55,636 --> 00:58:57,171 Did you forget some of your stuff? 991 00:58:58,339 --> 00:58:59,774 No, I, um... 992 00:58:59,807 --> 00:59:02,877 I just... I came to get it. 993 00:59:07,415 --> 00:59:08,816 Well... 994 00:59:09,850 --> 00:59:10,851 Why? 995 00:59:15,356 --> 00:59:17,458 I can't be inside this, Liz. 996 00:59:17,491 --> 00:59:19,060 You'll be Dr A, 997 00:59:19,093 --> 00:59:20,327 Richard will be Dr B, 998 00:59:20,361 --> 00:59:22,463 and the nurses will be there by name, 999 00:59:22,496 --> 00:59:23,597 and one of us will go down. 1000 00:59:23,631 --> 00:59:24,698 That's just noise. 1001 00:59:24,732 --> 00:59:27,101 [Robin] No, it's not noise. 1002 00:59:27,134 --> 00:59:28,702 I need my job, Liz. 1003 00:59:28,736 --> 00:59:30,571 [Elizabeth] Robin. 1004 00:59:31,305 --> 00:59:32,706 Robin, I can protect you. 1005 00:59:32,740 --> 00:59:34,008 [Robin] You can't. 1006 00:59:38,179 --> 00:59:39,246 I'm done. 1007 00:59:42,383 --> 00:59:43,584 There it is. 1008 00:59:51,592 --> 00:59:53,494 -[Elizabeth] I'm sorry. -No, I'm sorry. 1009 00:59:53,528 --> 00:59:54,728 Just go. 1010 00:59:56,630 --> 01:00:01,202 [melancholic music] 1011 01:00:16,585 --> 01:00:17,885 [sighs] 1012 01:00:19,120 --> 01:00:20,121 Fuck. 1013 01:00:37,071 --> 01:00:39,039 [sad music] 1014 01:00:52,186 --> 01:00:53,254 [sighs] 1015 01:01:00,761 --> 01:01:02,229 [sighs wearily] 1016 01:01:15,577 --> 01:01:16,777 [breathes sharply] 1017 01:01:19,514 --> 01:01:22,283 [foreboding music] 1018 01:01:29,591 --> 01:01:30,791 [grunting] 1019 01:01:34,762 --> 01:01:37,898 [thumping] 1020 01:01:43,904 --> 01:01:48,275 -[screaming] -[insects buzzing] 1021 01:02:10,164 --> 01:02:11,465 [groans] 1022 01:02:47,468 --> 01:02:50,437 [foreboding music continues] 1023 01:03:15,262 --> 01:03:16,930 [lock beeps] 1024 01:03:33,881 --> 01:03:36,417 [phone vibrates] 1025 01:03:48,697 --> 01:03:50,497 [phone notification] 1026 01:03:50,532 --> 01:03:52,466 Oh, fuck off, Richard. 1027 01:04:05,814 --> 01:04:07,848 [bottles clanking] 1028 01:04:22,863 --> 01:04:25,499 [sombre music] 1029 01:04:29,804 --> 01:04:31,639 [dog barking on street] 1030 01:04:40,447 --> 01:04:41,649 [Elizabeth gasps] 1031 01:04:43,016 --> 01:04:46,053 Oh, fuck! Oh, fuck! 1032 01:04:46,688 --> 01:04:49,123 [tense music] 1033 01:04:50,792 --> 01:04:52,359 Atticus! 1034 01:04:52,393 --> 01:04:53,595 Atticus! 1035 01:04:54,895 --> 01:04:56,997 Oh fuck! Atticus, here boy! 1036 01:05:08,743 --> 01:05:11,178 He's quiet. I didn't see him. 1037 01:05:11,211 --> 01:05:14,014 I forgot. I forgot the dog. 1038 01:05:14,047 --> 01:05:16,116 -[vet] Right. -I forgot him. 1039 01:05:17,951 --> 01:05:19,920 -I forgot he was there. -Okay. 1040 01:05:19,953 --> 01:05:22,122 I'm just going to check his heart, okay? 1041 01:05:23,892 --> 01:05:26,126 Shhh. 1042 01:05:26,160 --> 01:05:28,061 [Atticus whimpers softly] 1043 01:05:44,646 --> 01:05:45,847 Yeah. 1044 01:05:45,880 --> 01:05:48,115 He's not doing so good. 1045 01:05:49,383 --> 01:05:50,451 Um... 1046 01:05:51,853 --> 01:05:54,087 I think it's time to say goodbye. 1047 01:05:56,223 --> 01:05:57,525 [sighs] 1048 01:05:58,827 --> 01:06:00,093 Right now? 1049 01:06:00,127 --> 01:06:01,563 -Right now? -[vet] Yeah. 1050 01:06:02,062 --> 01:06:03,363 [vet] Okay. 1051 01:06:03,397 --> 01:06:06,300 -[Elizabeth] Right. Right. -[Atticus whimpers softly] 1052 01:06:07,968 --> 01:06:09,671 -You ready? -[Elizabeth] Mm-mm. 1053 01:06:14,509 --> 01:06:17,010 [panting] 1054 01:06:29,891 --> 01:06:31,693 You can... You can put your hand on him. 1055 01:06:31,726 --> 01:06:33,327 You can help him out. 1056 01:06:39,567 --> 01:06:41,301 [Atticus groans softly] 1057 01:06:42,302 --> 01:06:43,905 Good dog. 1058 01:06:43,938 --> 01:06:45,305 [stifled cries] 1059 01:06:47,542 --> 01:06:48,776 Yeah. 1060 01:06:48,810 --> 01:06:50,845 I'm going to put the needle in now, okay? 1061 01:06:50,879 --> 01:06:52,847 [Elizabeth] Mm. 1062 01:06:52,881 --> 01:06:54,549 All right. Here we go. 1063 01:07:03,758 --> 01:07:05,392 [stifled sobs] 1064 01:07:15,502 --> 01:07:16,771 Check his heart. 1065 01:07:25,479 --> 01:07:26,648 He's gone now. 1066 01:07:29,517 --> 01:07:32,185 [Elizabeth cries] 1067 01:07:34,354 --> 01:07:36,290 Would you like him cremated? 1068 01:07:40,528 --> 01:07:42,262 [breathes deeply] 1069 01:07:43,063 --> 01:07:44,699 He's not mine. 1070 01:07:45,800 --> 01:07:48,468 He's not... my dog. 1071 01:07:51,706 --> 01:07:53,708 He's not my dog. 1072 01:07:57,645 --> 01:07:59,112 [sobbing] 1073 01:08:02,182 --> 01:08:04,084 You killed my dog. 1074 01:08:04,117 --> 01:08:05,853 You killed my dog. 1075 01:08:05,887 --> 01:08:07,287 I'm sorry. 1076 01:08:07,321 --> 01:08:09,524 [Jessica] What is wrong with you? [sad cello music] 1077 01:08:09,557 --> 01:08:11,391 He's gone. 1078 01:08:11,425 --> 01:08:13,027 I'm sorry. 1079 01:08:13,061 --> 01:08:14,729 I'm so fucking sorry. 1080 01:08:14,762 --> 01:08:16,296 [Jessica mumbles] 1081 01:08:16,330 --> 01:08:18,332 I'm so fucking sorry. 1082 01:08:22,870 --> 01:08:24,606 [crying] 1083 01:08:26,173 --> 01:08:30,511 [sad cello music continues] 1084 01:08:34,481 --> 01:08:36,718 [Jessica sobs] 1085 01:08:38,620 --> 01:08:41,522 [Elizabeth] I'm so, I'm so sorry. 1086 01:08:46,360 --> 01:08:49,664 [sad cello music continues] 1087 01:09:09,784 --> 01:09:12,920 [birds squawking] 1088 01:09:19,994 --> 01:09:21,129 Jesus. 1089 01:09:21,161 --> 01:09:22,764 [sighs wearily] 1090 01:09:25,165 --> 01:09:27,234 [ringtone rings] 1091 01:09:35,342 --> 01:09:37,344 Hello, this is Mrs. Elizabeth Taylor. 1092 01:09:37,377 --> 01:09:39,246 I'm trying to reach my registrar, 1093 01:09:39,279 --> 01:09:41,248 Richard Whitehead. 1094 01:09:41,281 --> 01:09:43,250 Could I get his address, please? 1095 01:09:44,552 --> 01:09:46,954 [sombre music] 1096 01:10:05,073 --> 01:10:06,908 [knocking at door] 1097 01:10:17,051 --> 01:10:18,251 Richard? 1098 01:10:21,022 --> 01:10:22,590 Richard, pick up. 1099 01:10:33,201 --> 01:10:36,503 [phone ringing close-by] 1100 01:10:48,182 --> 01:10:50,484 [gasps] Richard! 1101 01:10:50,518 --> 01:10:51,552 Richard! 1102 01:10:53,855 --> 01:10:55,156 Richard! 1103 01:10:55,189 --> 01:10:57,390 [tense music] 1104 01:10:57,859 --> 01:10:58,860 Jesus. 1105 01:10:59,861 --> 01:11:01,062 Fuck! Fuck! 1106 01:11:01,095 --> 01:11:02,864 Fucking stupid, stupid. 1107 01:11:02,897 --> 01:11:04,932 Fuck. Fuck. 1108 01:11:04,966 --> 01:11:07,034 Fuck. Fuck. Fuck. 1109 01:11:07,068 --> 01:11:08,502 Richard? Richard! 1110 01:11:08,536 --> 01:11:10,738 Oh, Richard? Richard! 1111 01:11:10,772 --> 01:11:12,039 Richard. 1112 01:11:12,073 --> 01:11:13,641 Oh, no, no, no. 1113 01:11:13,674 --> 01:11:15,977 No, Richard! 1114 01:11:16,010 --> 01:11:18,311 [crying] 1115 01:11:18,345 --> 01:11:19,647 You didn't. 1116 01:11:19,680 --> 01:11:20,915 You didn't. 1117 01:11:20,948 --> 01:11:22,315 You didn't. 1118 01:11:23,651 --> 01:11:25,186 You didn't. 1119 01:11:25,219 --> 01:11:26,888 Please! 1120 01:11:28,623 --> 01:11:29,624 Fuck. 1121 01:11:31,993 --> 01:11:34,228 Why? 1122 01:11:34,262 --> 01:11:36,097 [crying] 1123 01:11:36,130 --> 01:11:39,466 [sad music] 1124 01:11:42,703 --> 01:11:45,438 [whimpers softly] 1125 01:12:00,288 --> 01:12:02,990 [water rushing] 1126 01:12:24,312 --> 01:12:25,847 [Andrew] Right. 1127 01:12:27,648 --> 01:12:31,052 You were there I'm told, first responder. 1128 01:12:31,085 --> 01:12:32,485 -I was, yes. -I'm sorry. 1129 01:12:32,520 --> 01:12:35,323 Thank you. Stupid, stupid bugger. 1130 01:12:35,355 --> 01:12:36,524 Yeah, sadly so. 1131 01:12:36,557 --> 01:12:38,726 But listen, the staff don't know at present, 1132 01:12:38,759 --> 01:12:40,962 so do you think you've got this in hand? 1133 01:12:40,995 --> 01:12:42,096 I-- Yes, of course. 1134 01:12:43,297 --> 01:12:45,199 -I will, of course. -[Andrew] What a business. 1135 01:12:45,233 --> 01:12:47,702 For the hospital, for the department, 1136 01:12:47,735 --> 01:12:49,436 for everybody. 1137 01:12:49,469 --> 01:12:51,772 So, I think you and I should keep a lid on the gossip 1138 01:12:51,806 --> 01:12:54,008 and speculation before it even starts. 1139 01:12:54,041 --> 01:12:57,178 And, yeah, we've got to keep control of the situation. 1140 01:12:57,211 --> 01:12:58,411 Right. 1141 01:12:59,881 --> 01:13:02,016 Well, what... What can I do, Andrew? 1142 01:13:02,049 --> 01:13:03,117 What can I do? 1143 01:13:07,855 --> 01:13:10,558 Well, I think you probably know what this is about. 1144 01:13:11,592 --> 01:13:12,827 [Elizabeth] Right. 1145 01:13:12,860 --> 01:13:16,097 Yeah, it's not an uncommon phenomenon, burnout. 1146 01:13:16,130 --> 01:13:18,431 But I think for the majority of the staff here, 1147 01:13:18,465 --> 01:13:19,600 this will be the first time. 1148 01:13:19,634 --> 01:13:21,936 So we need to show a united front. 1149 01:13:24,238 --> 01:13:25,506 Andrew... 1150 01:13:27,575 --> 01:13:29,844 Richard was not "burnt out." 1151 01:13:31,646 --> 01:13:35,349 Elizabeth, we need one version of the truth, 1152 01:13:35,383 --> 01:13:36,817 for everybody's sake. 1153 01:13:36,851 --> 01:13:38,953 How... How does that work, exactly? 1154 01:13:41,822 --> 01:13:45,393 Well, did you know my father was a surgeon in Korea? 1155 01:13:45,425 --> 01:13:46,894 He was a POW. 1156 01:13:46,928 --> 01:13:49,597 And when he dealt with limb trauma, 1157 01:13:49,630 --> 01:13:52,833 he would take them to latrines for their examinations, 1158 01:13:52,867 --> 01:13:54,969 where there were millions of flies. 1159 01:13:55,002 --> 01:13:56,070 You know what that means? 1160 01:13:56,103 --> 01:13:56,938 Maggots. 1161 01:13:56,971 --> 01:13:59,073 But maggots do their job very well. 1162 01:13:59,106 --> 01:14:00,541 They debris dead flesh, 1163 01:14:00,574 --> 01:14:02,475 they clean the wounds, 1164 01:14:02,510 --> 01:14:04,612 they never sleep, they never take a break. 1165 01:14:04,645 --> 01:14:08,448 They're vigilant, consistent, persistent, trustworthy... 1166 01:14:10,217 --> 01:14:11,719 Unlike some people. 1167 01:14:14,021 --> 01:14:15,990 What's the point? 1168 01:14:16,023 --> 01:14:17,591 What are you getting at? 1169 01:14:20,895 --> 01:14:23,297 Do you remember you called me "stupid" 1170 01:14:23,331 --> 01:14:27,635 at the Mortality and Morbidity meeting? 1171 01:14:27,668 --> 01:14:30,838 You really were incredibly rude. 1172 01:14:34,342 --> 01:14:35,876 That's what this is about? 1173 01:14:38,179 --> 01:14:39,613 No... 1174 01:14:39,647 --> 01:14:40,915 [Elizabeth] No? 1175 01:14:40,948 --> 01:14:44,452 No, this hospital has invested huge amount in you. 1176 01:14:44,484 --> 01:14:46,520 You're a very valuable commodity. 1177 01:14:46,554 --> 01:14:48,923 You are brilliant, but you are not easy. 1178 01:14:48,956 --> 01:14:50,257 You're emotional. 1179 01:14:51,325 --> 01:14:52,893 Yeah, emotional. 1180 01:14:52,927 --> 01:14:54,795 I know it's not fashionable to say it, 1181 01:14:54,829 --> 01:14:57,365 but I'm not sure women are suited 1182 01:14:57,398 --> 01:14:58,799 to a career in medicine, 1183 01:14:58,833 --> 01:15:00,835 particularly unmarried women. 1184 01:15:01,836 --> 01:15:04,205 But when I have a vested interest in someone, 1185 01:15:04,238 --> 01:15:08,109 I act irrespective of the risk. 1186 01:15:08,142 --> 01:15:09,910 So it is decided. 1187 01:15:10,911 --> 01:15:12,947 What has? What's been decided? 1188 01:15:14,915 --> 01:15:15,916 Honestly? 1189 01:15:16,951 --> 01:15:19,186 Sometimes, Elizabeth, I could just, you know... 1190 01:15:19,220 --> 01:15:21,055 take you or leave you. 1191 01:15:22,890 --> 01:15:23,858 I see. 1192 01:15:24,759 --> 01:15:26,560 [Andrew] No, I don't think you do see. 1193 01:15:27,461 --> 01:15:30,131 You've been given a second chance. 1194 01:15:30,164 --> 01:15:32,800 You're going to be back on call after a week's leave. 1195 01:15:32,833 --> 01:15:34,035 That's what we've decided. 1196 01:15:34,068 --> 01:15:35,536 Then we're going to publish an article 1197 01:15:35,569 --> 01:15:37,671 in the New Zealand Journal for Medicine 1198 01:15:37,705 --> 01:15:38,906 and you're going to sign up to it. 1199 01:15:38,939 --> 01:15:40,841 It'll be about suicide, burnout 1200 01:15:40,875 --> 01:15:45,514 and, uh, Richard's effect on your data. 1201 01:15:45,546 --> 01:15:47,681 Richard will be shown as what he was... 1202 01:15:47,715 --> 01:15:50,351 young, ineffective, out of his depths, 1203 01:15:50,384 --> 01:15:53,522 and that he skewed the data. 1204 01:15:53,554 --> 01:15:55,322 You know, we took too much care of him. 1205 01:15:55,356 --> 01:15:56,791 You took too much care of him. 1206 01:15:56,824 --> 01:15:58,626 And it's a tragedy for the hospital, 1207 01:15:58,659 --> 01:16:00,261 for the community, 1208 01:16:00,294 --> 01:16:02,930 and it led to his suicide. 1209 01:16:02,963 --> 01:16:04,799 So, uh... 1210 01:16:04,832 --> 01:16:06,400 you know, the staff will get counselling, 1211 01:16:06,434 --> 01:16:07,468 there'll be a vigil, 1212 01:16:07,501 --> 01:16:11,772 and then business as usual. 1213 01:16:17,445 --> 01:16:20,181 And I want you to sign up to it all. 1214 01:16:23,684 --> 01:16:28,255 It's called "cleaning the wound," Elizabeth. 1215 01:16:32,093 --> 01:16:33,360 Like a maggot. 1216 01:16:35,162 --> 01:16:37,731 Those wonderful maggots. 1217 01:16:38,666 --> 01:16:41,836 [sad music] 1218 01:16:44,772 --> 01:16:46,740 [breathes deeply] 1219 01:17:00,421 --> 01:17:02,022 [sniffles] 1220 01:17:03,324 --> 01:17:05,092 Liz? Liz. 1221 01:17:08,062 --> 01:17:09,096 [sobs] 1222 01:17:09,130 --> 01:17:10,164 I'm sorry. 1223 01:17:11,999 --> 01:17:13,000 I'm sorry. 1224 01:17:18,540 --> 01:17:20,841 -[Elizabeth cries] -It's okay. 1225 01:17:23,811 --> 01:17:25,746 It's all right. 1226 01:17:27,448 --> 01:17:30,784 [sad music continues] 1227 01:17:57,711 --> 01:18:00,147 [birds chirping] 1228 01:18:09,558 --> 01:18:11,192 What? 1229 01:18:14,195 --> 01:18:15,729 It's just unfair. 1230 01:18:18,732 --> 01:18:21,835 You are good, Liz. 1231 01:18:22,703 --> 01:18:24,004 I know that. 1232 01:18:27,374 --> 01:18:29,476 I missed his calls. 1233 01:18:29,511 --> 01:18:31,145 I could have taken them. 1234 01:18:31,178 --> 01:18:32,179 [Robin] Yeah. 1235 01:18:34,982 --> 01:18:36,817 And you'll have to live with that. 1236 01:18:37,818 --> 01:18:39,787 And I am so sorry. 1237 01:18:44,325 --> 01:18:45,826 [sighs] Me, too. 1238 01:18:47,161 --> 01:18:48,762 So fucking sorry. 1239 01:18:49,698 --> 01:18:50,998 What a mess. 1240 01:18:51,732 --> 01:18:53,000 [sighs] 1241 01:18:58,573 --> 01:19:01,275 [dramatic music] 1242 01:19:09,350 --> 01:19:10,685 [Ben] Jan, I was wondering-- 1243 01:19:10,719 --> 01:19:12,186 Dr. Matthews? 1244 01:19:12,219 --> 01:19:13,254 Yes. 1245 01:19:13,287 --> 01:19:14,556 Excuse us a minute. 1246 01:19:14,589 --> 01:19:15,856 [Ben] How can I help? 1247 01:19:15,889 --> 01:19:19,827 I wanted to speak with you about a patient of ours. 1248 01:19:19,860 --> 01:19:21,061 Lisa Williams. 1249 01:19:21,095 --> 01:19:22,096 Yes. 1250 01:19:23,230 --> 01:19:26,635 Um, if it's okay, I'd like to bring Jan in on this. 1251 01:19:26,668 --> 01:19:28,603 She was running the ward. 1252 01:19:28,637 --> 01:19:30,204 Jan. 1253 01:19:30,237 --> 01:19:31,238 Of course. 1254 01:19:32,172 --> 01:19:33,173 [Ben] Okay. 1255 01:19:33,207 --> 01:19:35,677 Jan, this is about Lisa Williams, 1256 01:19:35,710 --> 01:19:37,044 the sepsis patient from a while ago. 1257 01:19:37,077 --> 01:19:37,911 Oh. 1258 01:19:37,945 --> 01:19:39,046 Mrs. Taylor was her surgeon 1259 01:19:39,079 --> 01:19:40,749 and wants to know about her admission. 1260 01:19:40,781 --> 01:19:41,915 -Okay. -Please. 1261 01:19:41,949 --> 01:19:46,320 Okay. Well, we had her on the usual lines, 1262 01:19:46,353 --> 01:19:49,890 inspected the surgery sites, and they were clean. 1263 01:19:49,923 --> 01:19:51,959 There was minimal output in the drains. 1264 01:19:51,992 --> 01:19:53,394 Her abdomen was soft. 1265 01:19:54,395 --> 01:19:56,230 Well, you tell her, Jan. 1266 01:19:56,263 --> 01:19:58,932 I sat with Lisa from about midnight. 1267 01:19:58,966 --> 01:20:00,968 She was pretty high maintenance at this point, 1268 01:20:01,001 --> 01:20:03,470 and she began to go into decline. 1269 01:20:03,504 --> 01:20:07,141 She was deteriorating. The sepsis was advanced. 1270 01:20:07,174 --> 01:20:10,144 [Jan] She called out. She was anxious and agitated. 1271 01:20:10,177 --> 01:20:12,313 [Ben] She was dropping her stats, 1272 01:20:12,346 --> 01:20:13,914 and cyanosis of the lips, 1273 01:20:13,947 --> 01:20:15,349 about one breath every second. 1274 01:20:15,382 --> 01:20:18,553 [Jan] She was complaining of being cold and tired, 1275 01:20:18,586 --> 01:20:19,920 and the catheter was bothering her, 1276 01:20:19,953 --> 01:20:22,823 and her breathing was very rapid. 1277 01:20:22,856 --> 01:20:26,293 We brought in the on-call anaesthetist to intubate. 1278 01:20:26,327 --> 01:20:28,896 Was Lisa able to speak with her parents? 1279 01:20:28,929 --> 01:20:31,065 Yeah, briefly. 1280 01:20:31,932 --> 01:20:33,601 But then they had to leave the room. 1281 01:20:33,635 --> 01:20:35,502 She arrested during induction, 1282 01:20:35,537 --> 01:20:37,806 and we began resuscitation. 1283 01:20:37,838 --> 01:20:41,509 We worked for... half an hour, I remember. 1284 01:20:41,543 --> 01:20:42,677 [Jan] She was 29. 1285 01:20:42,711 --> 01:20:44,978 A young, strong woman. 1286 01:20:45,012 --> 01:20:46,447 [Elizabeth] Right. 1287 01:20:46,480 --> 01:20:47,481 Yeah. 1288 01:20:48,817 --> 01:20:52,687 [Ben] Pronounced dead about four... five-- 1289 01:20:52,721 --> 01:20:55,456 -4:48. -[Ben] 4:48. Yes. 1290 01:20:55,989 --> 01:20:57,324 Wee small hours. 1291 01:20:59,594 --> 01:21:00,595 Yeah. 1292 01:21:02,797 --> 01:21:04,231 [sighs] 1293 01:21:05,399 --> 01:21:07,501 Thank you for caring for my patient. 1294 01:21:07,535 --> 01:21:08,770 [Ben] Is that what you... 1295 01:21:08,803 --> 01:21:09,870 Is that what you needed? 1296 01:21:09,903 --> 01:21:11,205 It is, yes. Some of it. 1297 01:21:11,238 --> 01:21:13,273 [Ben] I can get some more notes. 1298 01:21:13,307 --> 01:21:14,776 -I can-- -No. 1299 01:21:14,809 --> 01:21:17,911 No, it's all right. 1300 01:21:19,714 --> 01:21:21,949 Was she lonely at all at the end? 1301 01:21:22,983 --> 01:21:25,252 We were all here. 1302 01:21:25,285 --> 01:21:27,955 Her family, right up until the intubation. 1303 01:21:27,988 --> 01:21:30,023 I was with her during the night. 1304 01:21:33,327 --> 01:21:34,194 Thank you both. 1305 01:21:34,228 --> 01:21:37,498 This very... was very helpful. 1306 01:21:38,566 --> 01:21:41,168 [dramatic music] 1307 01:22:06,561 --> 01:22:08,095 [microphone squelches] 1308 01:22:10,865 --> 01:22:12,065 [clears throat] 1309 01:22:13,333 --> 01:22:17,104 Tena koutou, tena koutou, tena katou katoa. 1310 01:22:17,137 --> 01:22:19,674 Good afternoon, ladies and gentlemen. 1311 01:22:20,842 --> 01:22:22,209 My name is Andrew McGrath. 1312 01:22:22,242 --> 01:22:26,213 As you know, I am head of surgery. 1313 01:22:26,246 --> 01:22:27,682 Sad day. 1314 01:22:27,715 --> 01:22:30,951 And we are here, unfortunately, 1315 01:22:30,984 --> 01:22:32,419 to remember Richard Whitehead, 1316 01:22:32,453 --> 01:22:34,622 one of our brightest young talents 1317 01:22:34,656 --> 01:22:38,091 whose future has been so cruelly cut short. 1318 01:22:38,959 --> 01:22:40,060 And in a few moments, 1319 01:22:40,093 --> 01:22:43,363 I would like us to hold a silence while 1320 01:22:43,397 --> 01:22:46,166 we remember Richard and the brilliant work he did, 1321 01:22:46,200 --> 01:22:47,669 the part he played in the team 1322 01:22:47,702 --> 01:22:50,839 of one of our most gifted, accomplished surgeons, 1323 01:22:50,872 --> 01:22:54,074 Mrs. Elizabeth Taylor. 1324 01:22:55,175 --> 01:22:57,912 But before we do, I would like to say this. 1325 01:22:57,946 --> 01:23:01,348 What we now know is that Richard's passing 1326 01:23:01,381 --> 01:23:07,120 is the result of the terrible toll of burnout. 1327 01:23:08,656 --> 01:23:09,958 This is a tragedy, 1328 01:23:09,990 --> 01:23:12,426 but one from which we will all learn, 1329 01:23:12,459 --> 01:23:14,696 must learn. 1330 01:23:14,729 --> 01:23:18,365 Richard's passing is a timely reminder to us 1331 01:23:18,398 --> 01:23:22,102 that all our staff are vulnerable 1332 01:23:22,135 --> 01:23:24,772 to these extreme pressures. 1333 01:23:24,806 --> 01:23:26,875 And unfortunately, 1334 01:23:26,908 --> 01:23:31,011 Richard was, um, one of its victims. 1335 01:23:31,813 --> 01:23:32,947 It's not easy having to work 1336 01:23:32,981 --> 01:23:35,115 with the responsibility of life and death. 1337 01:23:35,148 --> 01:23:38,620 We, the hospital, the administration, the board, 1338 01:23:38,653 --> 01:23:42,322 we absolutely recognize this, 1339 01:23:42,356 --> 01:23:45,627 and, um, we are responding immediately. 1340 01:23:46,694 --> 01:23:49,329 We are, from this moment, 1341 01:23:49,363 --> 01:23:52,800 putting in place measures to enhance staff well being 1342 01:23:52,834 --> 01:23:56,571 and our collective mental health, 1343 01:23:56,604 --> 01:23:58,372 soon as is practicable. 1344 01:23:58,405 --> 01:24:02,442 Because we are all in this together, 1345 01:24:03,377 --> 01:24:04,646 a team 1346 01:24:04,679 --> 01:24:06,514 and a community. 1347 01:24:06,548 --> 01:24:07,549 [sighs] 1348 01:24:07,582 --> 01:24:11,351 It is indeed a sad day for us all. 1349 01:24:13,120 --> 01:24:15,757 A minute's silence, please. 1350 01:24:20,562 --> 01:24:22,296 [sighs] 1351 01:24:35,175 --> 01:24:38,012 I'd like to say something. I think I should. Don't you? 1352 01:24:38,046 --> 01:24:39,079 -[Andrew] Yeah. -I think I should. 1353 01:24:39,112 --> 01:24:40,080 [Andrew] Yes. Just a short. 1354 01:24:40,113 --> 01:24:41,214 Yeah, as his registrar, 1355 01:24:41,248 --> 01:24:42,917 don't you think I should say something? 1356 01:24:42,951 --> 01:24:44,384 [clears throat] Sorry. 1357 01:24:46,153 --> 01:24:49,089 I'd like to say something, if it's all right. 1358 01:24:49,122 --> 01:24:50,692 Thank you. 1359 01:24:50,725 --> 01:24:51,826 Hello. 1360 01:24:52,627 --> 01:24:53,661 [sighs] 1361 01:24:54,762 --> 01:24:58,833 The reason we're all here today is, as Andrew says, 1362 01:24:59,834 --> 01:25:01,268 a tragedy. 1363 01:25:02,604 --> 01:25:06,574 Richard Whitehead was my registrar. 1364 01:25:06,608 --> 01:25:09,376 Many of you knew Richard, and those of you who didn't, 1365 01:25:09,409 --> 01:25:11,679 I'm sure you can identify with him. 1366 01:25:11,713 --> 01:25:15,282 He was a young man, 26. 1367 01:25:15,315 --> 01:25:18,620 And as a registrar, he was still learning, 1368 01:25:18,653 --> 01:25:19,854 still training. 1369 01:25:21,488 --> 01:25:22,322 He didn't die. 1370 01:25:22,356 --> 01:25:24,324 He committed suicide. 1371 01:25:27,061 --> 01:25:31,365 And, um, he's dead now because he overdosed. 1372 01:25:32,132 --> 01:25:33,367 That's the truth of it. 1373 01:25:33,400 --> 01:25:37,504 He took his own life in a filthy garage, alone. 1374 01:25:38,438 --> 01:25:40,575 Elizabeth, that's enough. 1375 01:25:40,608 --> 01:25:42,309 [Elizabeth] We talk about teamwork. 1376 01:25:42,342 --> 01:25:44,211 -Liz-- -We talk about resilience. 1377 01:25:45,178 --> 01:25:47,147 Did Richard lack resilience? 1378 01:25:47,180 --> 01:25:49,216 This young man for whom I am responsible? 1379 01:25:49,249 --> 01:25:51,686 Because if you're telling me he lacks something, 1380 01:25:51,719 --> 01:25:52,720 I don't accept it. 1381 01:25:55,523 --> 01:26:01,261 I operated on a patient that died after the surgery. 1382 01:26:02,096 --> 01:26:04,231 Richard was under my supervision, 1383 01:26:04,264 --> 01:26:05,667 and he did as I asked. 1384 01:26:06,801 --> 01:26:09,070 I told him to push harder, 1385 01:26:09,103 --> 01:26:10,972 and I chose the timing, 1386 01:26:11,005 --> 01:26:12,406 and I chose the words I said, 1387 01:26:12,439 --> 01:26:14,976 and I chose the way I said them. 1388 01:26:15,009 --> 01:26:16,443 And he just... 1389 01:26:18,913 --> 01:26:20,380 It's my responsibility. 1390 01:26:21,616 --> 01:26:24,052 I am responsible for the risks I take 1391 01:26:24,085 --> 01:26:26,353 every time I perform surgery. 1392 01:26:26,386 --> 01:26:31,025 And Richard is dead because he blamed himself 1393 01:26:31,059 --> 01:26:33,193 for a mistake I made. 1394 01:26:36,363 --> 01:26:40,233 I didn't make my responsibility clear enough to him. 1395 01:26:41,368 --> 01:26:43,538 He was a student doctor. 1396 01:26:47,207 --> 01:26:48,976 And... 1397 01:26:51,612 --> 01:26:53,213 And we're hanging 1398 01:26:53,246 --> 01:26:55,049 a target around his neck 1399 01:26:55,083 --> 01:26:56,349 with this vigil. 1400 01:26:58,318 --> 01:26:59,687 [speakers squelch] 1401 01:27:01,055 --> 01:27:03,958 And I'm not going to let this boy 1402 01:27:03,991 --> 01:27:05,927 be scapegoated publicly 1403 01:27:07,294 --> 01:27:10,798 by middle managers and doctors-turned-bureaucrats. 1404 01:27:13,134 --> 01:27:15,235 We are in service. 1405 01:27:15,268 --> 01:27:17,471 We have a covenant with our patients. 1406 01:27:17,504 --> 01:27:19,473 "I will save you with my skills." 1407 01:27:21,241 --> 01:27:23,443 But we have a covenant to each other. 1408 01:27:24,344 --> 01:27:26,313 We're in service to each other, too. 1409 01:27:26,346 --> 01:27:29,784 Both those covenants are being broken here today, 1410 01:27:31,018 --> 01:27:32,587 and I will not stand by 1411 01:27:33,621 --> 01:27:37,290 and help pretend that's not the case. 1412 01:27:39,927 --> 01:27:40,995 That's enough. 1413 01:27:45,398 --> 01:27:47,635 [crowd applauding] 1414 01:27:54,809 --> 01:27:57,044 Rest in peace, Richard. 1415 01:27:57,078 --> 01:27:58,546 Rest in peace. 1416 01:28:01,883 --> 01:28:04,752 [melancholic music] 1417 01:29:32,807 --> 01:29:35,776 [breathes deeply] 1418 01:29:48,322 --> 01:29:49,824 This is what happened. 1419 01:29:54,362 --> 01:29:56,030 Lisa was very sick. 1420 01:29:57,231 --> 01:29:58,900 She had septicemia. 1421 01:30:00,768 --> 01:30:05,539 Although the original operation was marred by an error I made, 1422 01:30:07,608 --> 01:30:09,010 without that error, 1423 01:30:10,745 --> 01:30:14,582 it's highly likely she would have still died. 1424 01:30:16,217 --> 01:30:18,653 The sepsis was advanced. 1425 01:30:23,891 --> 01:30:25,492 [sighs weakly] 1426 01:30:27,328 --> 01:30:28,763 Ev... 1427 01:30:28,796 --> 01:30:32,667 Even though your operation went wrong... 1428 01:30:34,568 --> 01:30:36,570 she still could have died? 1429 01:30:42,710 --> 01:30:43,711 Yes. 1430 01:30:45,680 --> 01:30:46,681 Yes. 1431 01:30:51,118 --> 01:30:52,186 Yes. 1432 01:30:56,590 --> 01:30:58,125 [inhales sharply] 1433 01:31:00,127 --> 01:31:01,629 Is there anything 1434 01:31:01,662 --> 01:31:03,664 you would have done differently? 1435 01:31:10,538 --> 01:31:12,106 That's the hard bit. 1436 01:31:13,140 --> 01:31:14,175 No. 1437 01:31:15,276 --> 01:31:16,610 I would not. 1438 01:31:18,012 --> 01:31:21,615 All the decisions I made were to try to save Lisa. 1439 01:31:22,650 --> 01:31:24,518 If the operation were to happen again, 1440 01:31:24,552 --> 01:31:27,121 I could make all the same decisions. 1441 01:31:31,058 --> 01:31:33,260 But I would endeavour 1442 01:31:33,294 --> 01:31:35,997 to be better at explaining it, 1443 01:31:36,897 --> 01:31:40,968 be better at taking responsibility. 1444 01:31:43,604 --> 01:31:45,606 I allowed doubt to creep in. 1445 01:31:58,119 --> 01:31:59,553 Lisa fought. 1446 01:32:00,488 --> 01:32:01,989 She fought really, really hard. 1447 01:32:02,023 --> 01:32:03,157 You need to know that. 1448 01:32:07,294 --> 01:32:08,963 In the end, her body gave up, 1449 01:32:10,931 --> 01:32:12,066 des... 1450 01:32:13,434 --> 01:32:16,537 despite all our experience and care. 1451 01:32:17,638 --> 01:32:19,106 And please know 1452 01:32:20,274 --> 01:32:22,276 that your daughter was cared for. 1453 01:32:38,325 --> 01:32:40,861 [breathes deeply] 1454 01:32:44,331 --> 01:32:46,634 I wanted a good outcome for Lisa. 1455 01:32:48,569 --> 01:32:50,137 And I'm so sorry. 1456 01:33:31,378 --> 01:33:32,746 Thank you. 1457 01:33:38,285 --> 01:33:40,387 [sombre music] 1458 01:34:03,210 --> 01:34:05,779 [hopeful music] 1459 01:35:03,270 --> 01:35:06,207 [hopeful music continues] 1460 01:35:56,691 --> 01:35:59,827 [hopeful music continues] 1461 01:36:19,514 --> 01:36:22,449 [gentle music] 1462 01:36:49,877 --> 01:36:53,881 [gentle dramatic music] 1463 01:37:50,638 --> 01:37:54,341 [gentle dramatic music continues] 1464 01:38:50,931 --> 01:38:55,135 [gentle dramatic music continues] 1465 01:39:50,257 --> 01:39:54,562 [gentle dramatic music continues] 98710

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