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1
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[arrows whooshing]
2
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[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
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[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 withthe 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 ZealandJournal 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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