Original subtitles

(Siren wailing)

| just helped them scrape some schoolkid off the ring road. Looks touch and go.

I've saved a space, Mr DeVries.

— Morning, Jack. — Morning, Mr Docherty.

Hey, you know, since you done his prostrate,

the old fella, he can pee over a five—bar gate t'first time in years.

(Laughs) | fear | may not be doing that sort of thing for very much longer.

Don't let the bastards grind you down, Mr Docherty.

Can you hear us?

— (Horn blares) — Out the way!

Claire! Had your knuckles rapped by the teacher, eh?

There's more to this, isn't there?

You can talk to me.

No.

"The management writes to remind staff

"that their entitlement is no more than two cups of tea or coffee per day.

"Any member of staff exceeding his or her entitlement

"will be charged with theft.”

What the bloody hell's going on?

The Cas officer wants him in X-ray for C—spine, chest and pelvis.

— Back into Resus. — What?

Get him into Resus!

Tell Haematology to cross—match 12 units.

Get the radiologist to do portable films.

Bleep the anaesthetist on call and Scissors!

— Yes, Mr DeVries. — Raj, Resus!

But he's not my patient.

When faced with a seriously injured patient, what's the first thing to ascertain?

Whether you're on call or not?

Pulse 140, good blood pressure, 110 over 60.

— Estimate his blood loss, Raj. — Couple of units at most.

I'll do the gases, shall |, while you listen to Mr DeVries.

We should have his Hb by now. And can we see about some O-neg as well, please?

(Fast regular beeping)

A young person can lose half their blood volume and still maintain a decent blood pressure.

The only giveaway is their pulse increases.

— OK? — Yes, Mr DeVries.

Glad you could join us, Scissors.

Ten-year-—old pedestrian involved in an RTA.

Hb 5.2.

Six units, stat. Pass a catheter, Raj.

Right, colleagues... Bilateral femorals,

right tib and fib...

and a right parietal skull fracture.

Let's see if we can get a CT.

Neuro obs, James.

Come on, gentlemen, let's do what we're paid for!

Regarding untrained staff covering Ear, Nose and Throat out of hours,

Dr Turner and | are in agreement that last week's tragedy

has opened up a case for further discussion.

— An appalling tragedy. — It happened.

Next time it might be acute laryngeal obstruction

or epiglottitis or whatever

but it will happen.

We are satisfied that emergency cover

is adequate for all but the most improbable of circumstances.

We feel that the present arrangement should continue.

But this letter of yours, Dr Maitland.

You have threatened to circumvent proper channels

and express your concerns to the press.

Whistle—blowing.

Claire, if you were to stir trouble with the press,

you must know that your career in medicine could be jeopardised.

(Door opens)

| do hope she's not about to do anything foolish.

Junior doctors work inhuman hours for poor pay

with little respect from those above or below them.

They're used to being beaten.

(Phone rings)

— Oh, I'l. — Yes?

(Woman) About the conference. Blackwood Lodge.

— That's only a four star, isn't it? — Yes, is that a problem?

Look, this is the first conference I've hosted.

I'm sure there's enough money in the health authority coffers

to stump up for a venue that won't embarrass me in front of my managerial colleagues.

Thank you.

Er, some more trying business this morning, Graham.

(Coughs) The latest initiative from our £100,000—a-year image consultant.

Oh, God.

A film crew are coming to make a promotional documentary thing about the hospital

to raise our image in the region.

| knew | could count on you, Graham.

This is what we call the critical hour,

in which prompt diagnosis and resuscitation pay off.

Unfortunately in this country it's time likely spent faffing about by the roadside

or in Casualty.

— There's a fullness in the left upper quadrant. — His resps are dropping off.

— The scanner's ready. — Let's get him up there.

We'll give him peritoneal lavage as soon as we can but | want this CT right away.

Have you got a minute for the lad's parents?

Tell CT I'm gonna bring this boy round myself.

I'm Mr DeVries, the surgeon looking after your boy.

— We're taking him for a brain scan. — It is serious?

I'm afraid so. He's broken both legs and his right arm

and may have a ruptured spleen.

We're concerned about a blood clot in his brain.

There's brain damage?

As pressure builds in the skull, brain damage can occur. We need to remove that clot.

— We shouldn't keep you. — Thank you.

Extradural haematoma...

with signs of raised intercranial pressure.

| see,

What did General have to say?

I'm taking this boy to theatre now.

We should have had a neurosurgery unit here.

Only the health authority claimed they couldn't afford the 100 grand.

We often have a lot of problems shooting in some hospitals.

Erm, staff not given advance notice, that sort of thing.

They've all been thoroughly briefed to suspend normal practice

and behave in the nauseatingly caring fashion expected by the public.

Only kidding.

If that lot at Jimmy's can do it week in, week out,

I'm sure we can manage it for one blasted day.

He's one of our top consultants. You're lucky to have him.

— Is my hair all right? — I've told him everything. He's briefed.

— Sure. Pete. — You're not filming this bit?

No, it's just tests. OK, ready to go, Alan?

OK, great.

OK, North Central, take one.

(Clears throat protractedly)

I'm just going to, er, call in on one or two of my regular patients,

as | do every day without fail.

Now, my dear, | just want you to get well.

Leave all the worrying to me.

And how are we today?

Do we know where we are?

— Hello. — Hello.

— Have you hurt your little handy? — Yes.

Ah, bless him.

Let me have a look at it so | can make it all better.

(Sucks in breath, tuts)

He'll be all right.

Stupid little twat. Needs a damn good slapping.

It's a long shift.

But we'd keep you company.

Well, I'LL certainly bear that in mind, ladies.

Er...

Right, are we ready to go?

Er, OK, Alan?

Raj, OK.

Erm, why don't you tell us some things about what you enjoy about the work here?

| think that's enough of that, thank you.

It's more interesting down there, and we'll be sticking to our schedule. Back.

(Nurse Reece whoops)

Cut! Don't... Get... Stop!

Ernest, sorry to drag you away from clinic.

— Think nothing of it. — Are you all right to do the head for us?

— Certainly. — I'd do it myself, only, er...

All in a day's work, Adrian, all in a day's work.

(Water running)

(Steady beeping)

(DeVries) Bugger!

Suction. More suction.

How's it going at the head end, Ernest?

Everything under control, Adrian.

— There she goes. — (Beeping speeds up)

That's the, er, pressure relieved.

Nearly done.

Swimming in it down here.

This boy's going to end the day with one less spleen than he started.

Any idea what hit him, Mr DeV?

J-reg BMW, 3'8is.

— Blimey. — | know.

Ruining the paint job on a classy beast like that.

| think we're winning. At last.

Do you mind if | go and have a butcher's at what's going on up top?

(Docherty) Good idea, my boy. Come have a look—see.

No, no problem.

There's a rupture of the frontal branch of the middle meningeal.

Normally one wouldn't be exposed to this technique in a hospital like ours.

Modern surgeons are becoming more and more specialised.

In my day, we were trained to turn our hands to anything.

That's what I'm here to learn, Mr Docherty.

Yes.

(Clears throat)

Good afternoon, Adrian. Busy day?

Oh, nothing special.

How's your motor running, Mr DeVries?

Oh, my God, the Jag!

(Talking quietly)

James.

— Hi. — | think that's all we've got time for.

Mr Docherty, would you have time to pop into my office this afternoon?

I'm already late for clinic. Can we talk on the way?

As you wish.

Good news! Mr Smedley will explain!

see ya!

Oj!

Oj!

You've seen our advertisement? Another consultant means new blood for the department.

There's not enough theatre or clinic time to support a new consultant's workload.

Sorry, Mr Docherty. I'm doing the best job | can.

| had imagined | was a surgeon whose experience was still of some value.

Obviously | must now conclude that | have become one of those old duffers

who so amused me when | was a youngster.

Hmph. Seems a lifetime ago now.

| get no pleasure from this, Mr Docherty.

| am charged in a small way of shaping an efficient health service

and that means letting go of some of the old values.

A consultant will soon no longer have a job for life.

Doctors will be paid commensurate with their performance.

Those who don't perform will be replaced.

And that is no different from the terms under which the rest of the world has to work.

| shall make plans for early retirement, Mr Tennant.

| can only hope I've been of service to my patients, a guide to my juniors

and not been a burden to my colleagues.

I'LL catch you up, guys. James!

You're acting as though | hadn't told you | was gonna be here.

— Sorry. — You are still on for tonight, OK?

Er, | dunno.

Look, if you don't want us to see each other any more, just come out with it.

| don't feel like going out tonight. Maybe I'm coming down with something.

— You should know. — Yeah, | suppose | should.

Look, erm...

— I'll call you sometime, OK? — OK.

And you're adamant you can't remember a thing?

| can't even remember my own name.

OK. All right. Well, we'll get a doctor to see you shortly.

You're gonna like this one. Complete amnesia.

I'm checking the details now.

| don't believe it! It is you, isn't it?

— I've got all your albums. — | can't remember a single thing about myself.

What about the groupies? Ten a night, they say.

Do they?

Is it true what the page three girl says about the size of your, er...

It is! It is! | knew it.

Look, can | have your autograph?

Oh. Sorry. When you remember.

(Chuckles)

OK, so your name is Desmond Frimp,

you're a chartered accountant

and, erm, you live with your parents.

OK?

Hello, Steven. Where's your mum?

— Fancy a kickabout? — Yeah.

| used to be a bit of a rugger man myself. They always say control is the thing.

Stop the ball, find your man,

get in, side of the foot.

Yeah. Ha, ha! Whoop!

— Do you really cut people open? — Well...

Sometimes it's the only way to make people better.

Why? Too gory for you, eh?

No way. | think it's great.

| hope | can do that when I'm older.

Home time. Final whistle.

— Do you want to open the car for me? — Oh, Mum!

Steven, just do as | say, please.

Oj!

He's mine, isn't he?

No.

| don't believe you.

Just believe it, and leave it at that.

Don't worry. The doctor will be with you in a minute.

Hello, I'm Dr Rajah.

— What happened to you? — | fell off a roof.

— How does your foot feel? — Dead.

He's had 75 of pethidine.

We're gonna put this fracture back in place, I'm afraid.

If you'd like to apply counter—traction.

— Doctor? — Yes?

| think you ought to know I'm HIV positive.

Is there a problem, Charge Nurse Garden?

Let's do our job, shall we?

(Crunch)

— How does your foot feel? — Better.

Good. Put it in a back—slab and I'LL do a form for an X-ray.

Railwaymen and French air traffic controllers strike.

— Junior doctors don't. — (Pager beeps)

Any idea where Dr Yates might be?

Yeah, he'll be starting his outpatients in about 15 minutes.

Dr Maitland, RMO.

You go through all the proper channels. Are you off? See you Later.

It won't make a difference, unless you've got the support of your consultant.

If word gets out, no decent hospital would touch you.

I'm just having a few minutes for Lunch.

| don't think that's asking too much after 32 hours without a break.

What kind of people are we, that we just stand by and let it be done to us?

Bullied, beaten...

scared people.

You know I've got the beginnings of a career in a profession to which I'm dedicated.

I've also got a wife and a mortgage

and a consultant who's already threatened to blacklist me on the old boy network

if | don't toe the line.

Not so long ago it was you who advised me not to start a fight you can't win.

Yeah, well...

the stakes have changed.

Your precious Dr Maitland certainly hasn't pulled any punches, Graham.

Management repeatedly warned...

Intimidation of junior doctors who spoke out...

31-year-old man with wife and seven-year-old daughter

dies in A&E owing to lack of trained staff.

She hasn't named him, has she?

No.

At least she had the sense not to breach confidentiality.

Graham, focus.

The repercussions are gonna affect more careers than hers,

impinge on more resources than we normally command

and interfere with patient care in fields wider than just out—of—hours ENT.

She must know that going this far over the line means there's nothing | can do to help her.

What a waste.

| never thought she'd be so foolish as to throw away such a promising career.

Well, like as not, it's missed the vital organs.

Should be OK.

Bit of a nasty splinter.

— Sorry to bleep you over such an iffy one. — No probs.

Some old Doris coughed up about a teaspoonful of blood.

Normal gases and chest X-ray, cubicle three.

— Admit her for investigation. — Aren't you gonna see her?

— (Pager beeping) — Can't be arsed.

I'LL tell her we're keeping her in.

Dr Maitland RMO.

Thank you for seeing me, Dr Yates.

Right. Er, what can | do for you, James?

I've noticed a Kaposi's sarcoma on the roof of my mouth.

— Well, let's, erm...have a look, then, shall we? — OK.

Mm!

Have you ever had your HIV status checked?

Not for five years or more.

— It was negative. — I'd like to do the test again, please.

— OK. — And, er...

we may as well do your CD4 count while we're at it.

Since oral Kaposi's would be an AlDS—defining diagnosis.

Any, er, risk factors?

I'm...bisexual.

Right. A prick in your arm.

Makes a change for you.

Keep still.

Off legs? No, no, no, send them up immediately.

Bye-bye.

I'm not here to wag my finger, Claire.

You did what you thought was right.

But you know | can't let this go.

| know.

Six more admissions and we're full

— What happens then? — We shut.

— Referrals go to the General. — We never shut.

Claire, I'm not sure about this chap with chest pain.

No past history of ischaemic heart disease,

pain only lasted five minutes.

— Admit him. — | thought we might send him home.

Admit. Serial ECGs, serial enzymes.

| wish you'd stop calling me Cyril.

Claire, this lady's for the Cas officer. She's only got a headache.

Chronic subdural haemorrhage is difficult to exclude in patients of her age group.

I'm admitting her for neuro obs. Phil?

We can't be full, surely?

Julie, can you tell the Cas officer to refer all patients to the General from now on?

I"lL get on to bed bureau and ask them to redirect GP calls.

— So what do we do now? — | don't know about you, I'm going to bed.

Me and Mick are at it hammer and tongs at the minute.

He wants to have kids as soon as we're married.

| wanna give it a couple of year.

Are you and Alison planning a family?

— It's not a safe topic of conversation. — Oh...

We haven't, erm...

— Four months. — Oh.

You know Alison's handicapped sister lives with us now.

Yeah.

Well, er, she comes into our room at all times.

Alison doesn't want her to...

you know...

catch us at it.

— (Laughter) — Oh, sorry.

(Giggling)

450,000 patients per year.

100,000 medical emergencies.

6,000 emergency operations, 20,000 elective operations.

Comfort, caring, needing. Treating you as a person,

not just as a patient,

24 hours a day,

365 days 2 year.

Looking after you and your loved ones.

(Laughs)

(Pager beeping)

(Woman's voice)

I'm tired. Leave me alone.

(Woman's voice)

No one else on the planet has to work all day, all night and all the next day. Why should I?

Claire?

Claire, tell me what's wrong.

Scissors!

You've got the smallest dick I've ever seen.

(Door closes)

(Pager beeps)

(# Motorhead: Ace Of Spades)

# You win some, lose some, jt’s all the same to me

# The pleasure is to play, makes no... #

(Pager beeps)

(Woman's voice, cuts out)

# ,.difference what you say

# | don’t share your greed, the only card | need

# Is the ace of spades

# The ace of spades #

(Siren wailing)

You go round the other side.

Are you all right in there, mate?

Get a line through me.

Look, I'm a surgeon. Just get some fluids into me now.

— We're gonna have to get him out of here. — There's no time! Just clear the glass...

— and get through to me. — All right, keep calm. Just relax.

I'm in shock. I'm close to decompensating.

If | decompensate, I'LL die.

Brown venflon, crystalloid, colloid, whatever.

— Please! — OK, just relax.

Come on, you bastards.

— Just relax. — I'm shutting down!

Just relax.

Aargh! Give me the venflon.

Give me the bloody venflon! Come on!

Argh!

Aagh!

I'm in. I'm in.

(Approaching sirens)

(Distorted voices over radio)

Dr Yates.

| didn't know you wanted to start the post—take round so early.

Tennant called me in last night. I've been taking your bleeps right through.

— | think | want you to take some sick leave. — (Pager)

(Man's voice on pager)

| don't take sick leave. I'm still a doctor, for the moment at least.

Claire, what's the matter?

| just want to be me again.

I've made no errors of clinical judgment.

NHS guidelines permit me to bring matters of concern to public attention.

Officially, no disciplinary action can be brought against you for anything relating to this case.

However, despite numerous demands,

you have failed to settle your account with hotel services

regarding a pint of milk which you took on behalf of the doctors’ mess

which exceeded the entitlement.

The princely sum of 36 pence...

is grounds for your suspension on a charge of theft,

effective immediately.

You've won.

Mr Cullen's widow recognised the case you've brought to everyone's attention.

| have the unenviable task of speaking to her shortly.

The health authority legal advisers expect us to settle out of court

for a considerable sum.

| see no winners among us.

Mrs Cullen! Mrs Cullen?

Do you remember me?

You're the doctor that told me my husband was dead.

Are you the one that said the things in the paper?

Yes.

(Sniffs)

It must have been awful for you.

Being a doctor and not knowing what to do.

(Sobs and sniffs) You of all people... I'm so sorry...

(Sobs) I'm really sorry...

— Oh... — (Howls) I'm so sorry...

— Don't! — I'm really sorry.