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1
00:00:03,800 --> 00:00:07,160
Clive's all right. Be careful,
you don't know what he's like.
2
00:00:08,560 --> 00:00:12,360
I can see you're upset, but... Then
some of us need to raise their game.
3
00:00:14,560 --> 00:00:17,640
Where's Lorraine?
I've told you, I don't know.
4
00:00:19,080 --> 00:00:21,840
Did you come straight to us
from active service?
5
00:00:21,960 --> 00:00:23,720
Sorry, dying man waiting for me.
6
00:00:25,560 --> 00:00:27,560
I'm actually heading back
to my digs.
7
00:00:36,840 --> 00:00:38,560
I saw you do it!
8
00:00:38,720 --> 00:00:41,680
TANNOY: 'Major trauma Foxtrot Hotel
received.
9
00:00:41,840 --> 00:00:43,840
'Major trauma Foxtrot Hotel
received.'
10
00:00:44,000 --> 00:00:46,720
If you go into the cubicle.
Take him in there, will you, please?
11
00:00:46,880 --> 00:00:49,560
Calm down! We can't treat you
if you're shouting.
12
00:00:49,680 --> 00:00:51,680
Sister Nerys, Staff Nurse Costello!
13
00:00:53,000 --> 00:00:54,320
Nice party?
14
00:00:54,480 --> 00:00:57,000
Right, we have this invention
called a Tannoy.
15
00:00:57,160 --> 00:00:59,080
We need more security.
It's mental in there.
16
00:00:59,240 --> 00:01:02,160
Oh, dear. Major trauma
Foxtrot Hotel. Gunshot wound.
17
00:01:02,320 --> 00:01:04,840
Started to unload two minutes ago.
Right. Oh, funny! Hi, Bob.
18
00:01:13,680 --> 00:01:16,680
Major Trauma Foxtrot Hotel for you,
love. Gunshot wound.
19
00:01:16,800 --> 00:01:18,440
Bay A, please, Nerys.
20
00:01:21,960 --> 00:01:24,720
Nerys, you don't mind
if I scribe on this one do you?
21
00:01:24,840 --> 00:01:26,840
Scribe away, love. Thank you.
22
00:01:28,520 --> 00:01:30,920
Where's this bullet hole then?
Left lumbar region.
23
00:01:32,080 --> 00:01:34,240
No exit wound?
Probably still in there.
24
00:01:34,400 --> 00:01:37,240
We'll try and find you
something more exciting next time.
25
00:01:38,560 --> 00:01:40,440
Cl...
26
00:01:40,560 --> 00:01:42,440
Clover. Clover. Mmm.
27
00:01:42,600 --> 00:01:45,120
I thought they had you chained
to a desk. I broke loose.
28
00:01:45,280 --> 00:01:48,120
Are we ready to transfer?
One, two, three.
29
00:01:49,600 --> 00:01:51,640
Unclipping top and bottom.
30
00:01:51,760 --> 00:01:53,840
One, two, three.
31
00:01:54,000 --> 00:01:57,480
My name is Fiona Lomas.
We're at City General Hospital.
32
00:01:57,640 --> 00:02:00,920
Can you hear me?
Onto taxpayers' oxygen. Yep.
33
00:02:01,040 --> 00:02:03,040
Immediate needs? Sats were 82.
34
00:02:03,200 --> 00:02:05,920
We bagged with 100% oxygen,
but her numbers didn't improved.
35
00:02:06,040 --> 00:02:08,840
BP? 110 over 95, and stable.
36
00:02:09,000 --> 00:02:11,920
I'll just check if there's anything
obvious obstructing the airway.
37
00:02:13,920 --> 00:02:15,560
There's nothing to see.
38
00:02:15,680 --> 00:02:17,400
What are the sats now?
39
00:02:17,560 --> 00:02:21,160
Er, 81. Let's get a tube in.
Yeah. I'll do a GCS.
40
00:02:21,320 --> 00:02:23,400
Any other points
before we start primary?
41
00:02:23,520 --> 00:02:25,440
Who do I put as Team Leader?
42
00:02:25,600 --> 00:02:28,400
Glen will be here shortly.
Has anyone seen him?
43
00:02:28,560 --> 00:02:32,760
Sorry I'm late. I got puked on.
Can you believe it? Nice.
44
00:02:32,920 --> 00:02:35,960
Harry, I need IV access,
right side.
45
00:02:36,120 --> 00:02:39,120
All the usual bloods through
the Venflon plus Beta HCG. OK.
46
00:02:39,280 --> 00:02:42,120
And, Nerys, would you put up another
bag of O neg for me, please?
47
00:02:42,240 --> 00:02:45,040
Yes, of course. C spine is protected.
48
00:02:45,160 --> 00:02:47,720
The trachea is central.
49
00:02:47,840 --> 00:02:51,840
Pupils are equal and reactive.
50
00:02:52,000 --> 00:02:55,960
O pos, dated and checked.
Breathing laboured. Lips cyanosed.
51
00:02:56,120 --> 00:02:58,040
My name is Dr Chandramohan.
Can you hear me?
52
00:02:58,160 --> 00:03:00,000
QUIET GROANING
53
00:03:00,160 --> 00:03:02,560
Patient doesn't open eyes
in response to verbal stimulus.
54
00:03:02,680 --> 00:03:04,440
That's E1.
55
00:03:04,560 --> 00:03:06,640
Making incomprehensible sounds. V2.
56
00:03:06,760 --> 00:03:08,040
Strong pulses.
57
00:03:09,800 --> 00:03:13,920
Withdraws from trap pinch.
That's M4. GCS, 7.
58
00:03:15,560 --> 00:03:18,680
Round of my usual, please, Billy.
Coming right up, boss.
59
00:03:18,840 --> 00:03:22,320
Can we have a bit of speed there,
please, Justin? Yeah.
60
00:03:22,440 --> 00:03:24,640
Forensic bag, Justin. OK.
61
00:03:24,800 --> 00:03:29,200
Why isn't she already exposed?
There were loads of people about.
62
00:03:29,360 --> 00:03:31,920
For God's sake, Bob.
Patient dignity.
63
00:03:33,120 --> 00:03:34,400
Yeah, good call.
64
00:03:36,040 --> 00:03:37,720
Not that dignified if she died.
65
00:03:40,640 --> 00:03:43,360
OK. Let's do a log roll
and get this coat out.
66
00:03:45,000 --> 00:03:48,240
One, two, three. Thank you, Bob.
67
00:03:50,120 --> 00:03:51,560
Let me have a look.
68
00:03:57,440 --> 00:04:00,640
OK. Let's have a look
at the other side. Harry?
69
00:04:00,760 --> 00:04:02,200
Scooch down, Bob.
70
00:04:02,320 --> 00:04:05,680
OK, one, two, three. Thank you, Bob.
71
00:04:07,680 --> 00:04:09,240
Let's have a look.
72
00:04:09,400 --> 00:04:13,480
There's a small penetrating wound
consistent with a gunshot.
73
00:04:13,600 --> 00:04:15,200
One, two, three.
74
00:04:16,280 --> 00:04:18,000
Justin, collar? Yeah.
75
00:04:20,160 --> 00:04:21,600
Come on, mate, grab on.
76
00:04:24,520 --> 00:04:26,640
I thought she was still off sick.
77
00:04:33,360 --> 00:04:35,040
Billy, cricoid.
78
00:04:37,280 --> 00:04:40,640
250 of thio going in.
79
00:04:49,280 --> 00:04:52,440
And 100...of sux.
80
00:04:53,600 --> 00:04:55,080
Flush.
81
00:04:55,240 --> 00:04:58,520
Diminished breath sounds and
a hyperresonance on the right side.
82
00:04:58,680 --> 00:05:02,760
Clinically, there's a pneumo.
Chest drain kit, please, Nerys. Yes.
83
00:05:05,320 --> 00:05:06,720
Three minutes gone.
84
00:05:06,880 --> 00:05:09,680
I'm going to put in a chest drain
to relieve the pneumothorax.
85
00:05:09,800 --> 00:05:11,200
Scope, please.
86
00:05:19,200 --> 00:05:22,160
OK, scope in, chords visualised.
Tube?
87
00:05:24,080 --> 00:05:25,400
And...
88
00:05:28,800 --> 00:05:31,600
..bull's-eye.
Mmm-hmm. Nice one, Rama.
89
00:05:34,240 --> 00:05:35,400
Cuff up.
90
00:05:37,880 --> 00:05:40,680
Justin, can you do bloods, please?
Yep.
91
00:05:50,240 --> 00:05:53,040
Patient is on vent.
92
00:05:55,360 --> 00:05:57,120
Let's do the hand over. Yep.
93
00:05:57,280 --> 00:06:01,880
Patient is female. No ID.
Appears to be late 20s.
94
00:06:02,040 --> 00:06:06,400
We arrived at 00.37.
Time of the injury was 00.15.
95
00:06:06,560 --> 00:06:08,520
According to police,
a witness saw her being shot
96
00:06:08,680 --> 00:06:10,600
and falling down
three concrete steps.
97
00:06:10,760 --> 00:06:13,320
Small penetrating injury
to the left lumbar region,
98
00:06:13,480 --> 00:06:15,400
three centimetres
from the lumbar spine.
99
00:06:15,560 --> 00:06:17,680
Police on scene believed that
to be a gunshot wound.
100
00:06:17,800 --> 00:06:19,320
Suspect bullet still inside.
101
00:06:19,480 --> 00:06:24,480
Stats at scene - GCS 9, sats 82%.
Resps spontaneous but laboured.
102
00:06:24,600 --> 00:06:28,080
BP 118 over 74. Pulse 119.
103
00:06:28,200 --> 00:06:30,440
We gave her 100% oxygen via mask.
104
00:06:30,560 --> 00:06:32,760
IV established on the left arm.
105
00:06:32,880 --> 00:06:35,480
One 250ml bolus of saline given.
106
00:06:35,600 --> 00:06:37,080
OK, guys, thank you.
107
00:06:37,200 --> 00:06:38,480
VBGs.
108
00:06:41,120 --> 00:06:43,360
Ramakrishna. Do you want me
to finish the primary?
109
00:06:43,480 --> 00:06:45,000
Yes, thank you, Harry.
110
00:06:46,880 --> 00:06:49,520
Nice seeing you again, Rama.
Yeah. You too.
111
00:06:49,640 --> 00:06:50,760
Call me.
112
00:06:53,360 --> 00:06:55,440
"Why don't you give me
a call sometime?"
113
00:06:55,560 --> 00:06:57,160
"I am SO calling you, babes."
114
00:06:57,280 --> 00:07:00,240
THEY LAUGH
115
00:07:04,120 --> 00:07:07,240
Don't forget the muscle relaxant
masks abdominal signs.
116
00:07:07,360 --> 00:07:10,080
Really? Cos I'm stupid, me, "Rama".
117
00:07:11,320 --> 00:07:13,640
OK, let's prep for CT.
118
00:07:13,800 --> 00:07:16,400
Justin, will you call Brian,
tell him we're on our way? Yep.
119
00:07:17,520 --> 00:07:18,480
Hi.
120
00:07:21,080 --> 00:07:24,080
Lorraine. It's good to see you.
121
00:07:24,200 --> 00:07:26,440
Yeah, it's good to see you too.
122
00:07:26,560 --> 00:07:29,480
I'm glad you're well again. Yep.
123
00:07:33,760 --> 00:07:37,080
So, what have we got?
Gunshot wound, but she's stable.
124
00:07:37,240 --> 00:07:40,000
That's you for the night.
Hallelujah for that.
125
00:07:41,480 --> 00:07:43,400
Lorraine, good to have you back.
126
00:07:43,520 --> 00:07:45,200
It's good to be back. Good.
127
00:07:45,360 --> 00:07:49,400
Nerys, would you do the sitrep for
Lorraine, please? Yes, be glad to.
128
00:07:50,520 --> 00:07:52,560
Hiya, yes, this is Staff Nurse
Costello in resus.
129
00:07:52,720 --> 00:07:55,200
We've got a major trauma
Foxtrot Hotel here.
130
00:07:55,360 --> 00:07:58,160
CT available? Lorraine, sweetie,
do I put you down as Team Leader?
131
00:07:58,320 --> 00:08:01,920
Yeah, of course. Do you mind
if I nip out for a second?
132
00:08:02,040 --> 00:08:04,160
Is everything OK? Yeah.
133
00:08:06,120 --> 00:08:07,880
I'm not interested in your rota.
134
00:08:08,040 --> 00:08:10,440
I'm not interested
in who you're giving time off.
135
00:08:10,600 --> 00:08:13,640
It's not my problem. Giles? Listen,
I've had three fights in ED already.
136
00:08:13,800 --> 00:08:16,080
I need some backup. Giles...
We've got the police...
137
00:08:16,240 --> 00:08:18,480
Can you tell me who the on call
consultant is tonight?
138
00:08:18,640 --> 00:08:20,520
I'll get back to you.
I've had the police...
139
00:08:20,680 --> 00:08:23,280
What's going on?
I just got cornered by Clive.
140
00:08:23,400 --> 00:08:26,360
I mean with the rota. Nothing.
141
00:08:31,240 --> 00:08:34,080
What have we got?
A GSW in the lumbar region.
142
00:08:34,200 --> 00:08:35,720
The patient is stable
143
00:08:35,880 --> 00:08:37,960
and we're imaging
the bullet track in CT. Good.
144
00:08:38,120 --> 00:08:42,160
Oh, hi. I'm Lorraine Rappaport.
Trauma Consultant.
145
00:08:42,320 --> 00:08:45,600
Glen Boyle. Same.
Oh, why's that happened?
146
00:08:47,760 --> 00:08:51,160
Look, as we're both here, I suggest
we get on with it together
147
00:08:51,320 --> 00:08:53,840
and sort it out later,
if that's OK with you?
148
00:08:53,960 --> 00:08:55,720
Yep, sounds very sensible.
149
00:08:59,800 --> 00:09:01,720
Can I assume all lines
and tubes are safe?
150
00:09:01,840 --> 00:09:03,320
All safe and secure, Brian.
151
00:09:04,840 --> 00:09:06,640
Everybody in position, please.
152
00:09:14,600 --> 00:09:16,760
Starting control scan.
153
00:09:19,960 --> 00:09:21,520
She was just being friendly.
154
00:09:22,720 --> 00:09:26,040
And what were YOU doing?
Just being friendly as well.
155
00:09:27,840 --> 00:09:29,000
OK.
156
00:09:34,200 --> 00:09:37,600
Control scan complete.
Running head scan.
157
00:09:40,920 --> 00:09:42,360
No abnormalities.
158
00:09:45,720 --> 00:09:47,520
Nobody touch any buttons.
159
00:09:51,080 --> 00:09:52,640
How did the flat hunting go?
160
00:09:52,800 --> 00:09:56,160
There's not much out there
on short-term leases.
161
00:09:56,320 --> 00:09:58,800
Well, you can't stay
in that hospital room.
162
00:09:58,920 --> 00:10:01,560
Why? It's not that bad.
163
00:10:01,680 --> 00:10:04,520
It's terrific...if you're a student.
164
00:10:06,320 --> 00:10:08,120
Well, like I said,
there's not much choice.
165
00:10:09,560 --> 00:10:11,360
Contrast connected.
166
00:10:13,200 --> 00:10:14,680
Go long-term and cancel.
167
00:10:16,960 --> 00:10:18,600
Starting contrast run.
168
00:10:29,880 --> 00:10:31,440
What is that?
169
00:10:33,360 --> 00:10:35,640
Can we see that again,
please, Brian?
170
00:10:41,920 --> 00:10:43,800
Could it be a cyst?
171
00:10:47,640 --> 00:10:49,800
That's a scull.
172
00:10:49,920 --> 00:10:51,680
She's pregnant.
173
00:10:51,800 --> 00:10:54,200
How the hell did we miss that?
174
00:11:04,014 --> 00:11:05,814
It's Fiona Lomas, Trauma Fellow.
175
00:11:05,974 --> 00:11:07,734
We need an O&G consultant
immediately.
176
00:11:09,334 --> 00:11:11,494
Can you tell me
who's on call today, please?
177
00:11:11,654 --> 00:11:14,814
Tom Farrow.
Oh, right, OK. Thank you.
178
00:11:16,334 --> 00:11:20,334
Brian, can we get the images
with the reduced artefacts, please?
179
00:11:25,454 --> 00:11:29,494
How did we miss this pregnancy?
I was responsible for the primary.
180
00:11:29,654 --> 00:11:32,014
We skipped FAST
and went straight to CT.
181
00:11:32,134 --> 00:11:34,854
I palpated the abdomen. Images up.
182
00:11:34,974 --> 00:11:37,854
OK, so we have a piece of metal,
183
00:11:38,014 --> 00:11:40,854
possibly a bullet...
Or a bullet fragment.
184
00:11:41,014 --> 00:11:44,574
..about 12mm long, against
the left common iliac artery,
185
00:11:44,734 --> 00:11:46,934
about four centimetres
below the bifurcation.
186
00:11:47,054 --> 00:11:48,854
3D, please, Brian.
187
00:11:49,014 --> 00:11:52,454
We also have a rupture
of the left common iliac artery,
188
00:11:52,614 --> 00:11:56,334
which looks like a pseudoaneurysm
of about six centimetres.
189
00:11:56,494 --> 00:11:59,134
There's no active extravasation
of contrast,
190
00:11:59,294 --> 00:12:01,734
but there is some retroperitoneal
fluid.
191
00:12:01,894 --> 00:12:04,174
Fast bleep the trauma theatre staff,
please.
192
00:12:04,294 --> 00:12:06,214
Justin, pack A from resus, please.
193
00:12:06,374 --> 00:12:09,094
Nerys, we need a trauma line kit
and rapid infuser, please.
194
00:12:09,254 --> 00:12:12,974
Harry, you may as well return to ED.
No, Harry, you come with me.
195
00:12:13,134 --> 00:12:16,134
Fiona Lomas, Trauma Reg.
We need trauma theatre immediately
196
00:12:16,294 --> 00:12:18,174
and can you fast bleep
trauma theatre staff?
197
00:12:18,334 --> 00:12:21,214
And we need the radiographer
and a vascular C-arm, thank you.
198
00:12:21,374 --> 00:12:24,054
Lines and tubes secure.
Prep for transfer.
199
00:12:24,214 --> 00:12:26,374
We're not moving her
until we've got a trauma line in.
200
00:12:26,494 --> 00:12:27,934
You can't do that there.
201
00:12:28,094 --> 00:12:30,374
One knock and her iliac artery
could haemorrhage.
202
00:12:30,534 --> 00:12:33,854
Mother and foetus will die.
We're doing it.
203
00:12:34,014 --> 00:12:36,774
I think her weight's made it
almost impossible to pick up.
204
00:12:36,894 --> 00:12:40,054
These things happen, yes? Yeah.
205
00:12:45,854 --> 00:12:47,374
SHE MOUTHS
206
00:12:47,534 --> 00:12:50,814
Got blood, got products, got Bruce.
Oh, that's an improvement.
207
00:12:50,974 --> 00:12:54,734
We'll prime the rapid infuser in
theatre, thank you. Good decision.
208
00:12:54,854 --> 00:12:56,614
OK, yes, thank you.
209
00:12:56,774 --> 00:12:59,574
Trauma theatre's prepped and ready.
Trauma line's in place.
210
00:12:59,734 --> 00:13:01,894
Let's get some blood running
through it then, please.
211
00:13:02,014 --> 00:13:03,294
O pos, dated and checked.
212
00:13:07,934 --> 00:13:10,694
Sliding across on three.
Everyone ready? One...
213
00:13:10,814 --> 00:13:13,694
Like she is an IED, please.
214
00:13:13,854 --> 00:13:17,614
Gently across on three.
One, two, three.
215
00:13:25,934 --> 00:13:27,414
Excuse me.
216
00:13:27,534 --> 00:13:29,774
SHOUTING
217
00:13:35,134 --> 00:13:36,494
Sorry, sorry!
218
00:13:36,614 --> 00:13:38,934
It's OK, BP's stable.
219
00:13:39,094 --> 00:13:41,294
They're in the corridor.
Yeah, they've got out of ED.
220
00:13:41,414 --> 00:13:42,774
Be back in a second.
221
00:13:42,934 --> 00:13:45,134
I've got one nurse
and one security guard
222
00:13:45,294 --> 00:13:48,614
trying to keep about 50 people out.
They're all over the place.
223
00:13:48,774 --> 00:13:50,974
Why can't you just send
someone down?
224
00:13:51,094 --> 00:13:53,134
How about a bit of basic security?
225
00:13:53,294 --> 00:13:55,654
Giles, the on call
trauma consultant?
226
00:13:55,774 --> 00:13:57,774
Er, it's Glen Boyle.
227
00:13:57,934 --> 00:14:00,894
What if one of these nutters gets
out of here and into theatre?
228
00:14:01,054 --> 00:14:02,974
Well, of course it could happen.
229
00:14:03,134 --> 00:14:04,934
There's no-one here,
no-one to stop them.
230
00:14:05,054 --> 00:14:06,214
Harry.
231
00:14:11,174 --> 00:14:13,774
Hello, darling. You rang?
232
00:14:15,254 --> 00:14:16,574
Tom...
233
00:14:18,534 --> 00:14:20,134
Are you OK?
234
00:14:21,294 --> 00:14:22,934
Glen Boyle's in there.
235
00:14:25,374 --> 00:14:28,814
He's the locum consultant.
How long has he been working here?
236
00:14:28,974 --> 00:14:31,454
They brought him in to cover
for Lorraine's suspension.
237
00:14:31,614 --> 00:14:34,574
A couple of months?
I was wrong not to tell you.
238
00:14:35,854 --> 00:14:37,934
But let's not argue about it now.
239
00:14:44,054 --> 00:14:45,774
So, what's happened here?
240
00:14:45,934 --> 00:14:47,694
The police think
she was shot in the back,
241
00:14:47,854 --> 00:14:50,174
then fell down some concrete steps.
Right.
242
00:15:00,054 --> 00:15:01,614
Is it alive?
243
00:15:06,774 --> 00:15:09,014
Yes. What's the gestation?
244
00:15:15,534 --> 00:15:17,294
22 to 24 weeks.
245
00:15:18,694 --> 00:15:21,574
Given there's a question mark
over viability, I suggest...
246
00:15:21,734 --> 00:15:23,974
We'll put the neonatal team
on standby.
247
00:15:24,134 --> 00:15:27,814
I want to keep the foetus where
it is, if that's at all possible.
248
00:15:27,974 --> 00:15:30,694
Billy, she needs to be
on the table now. Yep.
249
00:15:41,374 --> 00:15:43,054
Thank you.
250
00:15:43,214 --> 00:15:46,174
Hi, it's Tom Farrow,
O&G Consultant.
251
00:15:46,334 --> 00:15:48,694
Can I have a neonatology team
on standby, please?
252
00:15:48,814 --> 00:15:50,214
I'm in the trauma theatre.
253
00:15:50,334 --> 00:15:52,294
Yeah, thank you. Bye.
254
00:15:58,014 --> 00:16:00,974
Have you dealt with a foetus
in a trauma situation before?
255
00:16:01,094 --> 00:16:04,174
It can get intense. Bastion.
256
00:16:05,414 --> 00:16:07,894
Medecins Sans Frontieres,
Helmand Province.
257
00:16:09,654 --> 00:16:12,094
Tom Farrow. Glen Boyle.
258
00:16:12,214 --> 00:16:14,894
Yeah...I know.
259
00:16:26,414 --> 00:16:29,334
Could we tilt the table
to the left, please?
260
00:16:29,454 --> 00:16:31,814
Yep. Say when.
261
00:16:34,254 --> 00:16:35,534
Yep. Yeah.
262
00:16:37,174 --> 00:16:38,974
Mind your backs.
263
00:16:49,294 --> 00:16:50,854
23 minutes gone.
264
00:16:51,014 --> 00:16:54,334
I intend to stent the tear
in the left common iliac artery
265
00:16:54,454 --> 00:16:56,454
via the right femoral artery.
266
00:16:57,654 --> 00:17:00,494
You're going to lead...
I AM the vascular.
267
00:17:00,614 --> 00:17:03,774
Excuse me. Can I have a word, please?
268
00:17:05,174 --> 00:17:06,374
Er...
269
00:17:08,614 --> 00:17:10,094
Fiona.
270
00:17:15,934 --> 00:17:18,494
Lorraine, you'll be under
Glen's supervision tonight.
271
00:17:21,574 --> 00:17:25,374
But what does that mean?
I'm sorry. It came from Clive.
272
00:17:30,294 --> 00:17:31,934
We should just get started.
273
00:17:43,534 --> 00:17:45,494
Could I have the jelly, please?
274
00:17:46,814 --> 00:17:49,334
I'm sorry, Mrs Rappaport,
but we haven't done a WHO.
275
00:17:49,454 --> 00:17:53,294
Oh... I suppose that's over to you.
276
00:17:53,454 --> 00:17:55,654
I'm Glen Boyle,
I'm the Trauma Consultant.
277
00:17:55,774 --> 00:17:57,494
Fiona Lomas, Trauma Fellow.
278
00:17:57,654 --> 00:17:59,854
Ramakrishna Chandramohan.
Anaesthetics Registrar.
279
00:17:59,974 --> 00:18:01,974
Billy Finlay, Anaesthetic ODP.
280
00:18:02,094 --> 00:18:04,174
Bruce Corby, Rapid Infuser Operator.
281
00:18:04,294 --> 00:18:05,854
Dalisay Guinto, Scrub nurse.
282
00:18:05,974 --> 00:18:07,654
Tom Farrow, O&G Consultant.
283
00:18:07,774 --> 00:18:09,294
Shelley Imms, Radiographer.
284
00:18:09,414 --> 00:18:10,974
Jason Marshall, Staff Nurse.
285
00:18:11,094 --> 00:18:13,174
Jo Hallam, Documentation Nurse.
286
00:18:13,334 --> 00:18:16,854
Lorraine Rappaport.
Consultant Vascular Surgeon.
287
00:18:17,014 --> 00:18:21,014
Our patient is major trauma
Foxtrot Hotel.
288
00:18:21,134 --> 00:18:23,534
Date of birth, 01/01/1900.
289
00:18:23,654 --> 00:18:25,694
I have signed consent form four,
290
00:18:25,854 --> 00:18:28,094
to stent the tear
in the common iliac artery
291
00:18:28,214 --> 00:18:29,974
via the right femoral artery.
292
00:18:30,134 --> 00:18:33,214
The patient is between
22 and 24 weeks pregnant.
293
00:18:34,894 --> 00:18:36,694
Ultrasound, please.
294
00:18:42,774 --> 00:18:44,414
Needle.
295
00:18:54,054 --> 00:18:55,854
Femoral artery located.
296
00:18:58,174 --> 00:18:59,614
Swab.
297
00:19:03,654 --> 00:19:05,014
Wire, please.
298
00:19:09,934 --> 00:19:11,654
Wire going in.
299
00:19:11,774 --> 00:19:12,934
C-arm, please.
300
00:19:18,614 --> 00:19:20,014
Needle out.
301
00:19:21,334 --> 00:19:22,574
Blade.
302
00:19:24,134 --> 00:19:25,814
Screening.
303
00:19:28,854 --> 00:19:31,374
OK. Cutting.
304
00:19:35,254 --> 00:19:36,774
Terumo sheath, please.
305
00:19:46,974 --> 00:19:48,774
Pigtail catheter, please.
306
00:20:10,374 --> 00:20:14,254
Position's good.
Thank you. Contrast, please.
307
00:20:15,934 --> 00:20:19,174
Let's have a run of 10 at 10. Sure.
308
00:20:23,254 --> 00:20:25,014
Breathing off. Breathing off.
309
00:20:27,494 --> 00:20:28,894
Screening.
310
00:20:33,614 --> 00:20:35,174
Breathing on.
311
00:20:36,294 --> 00:20:37,694
Breathing on.
312
00:20:39,334 --> 00:20:40,614
Roadmap, please.
313
00:20:44,014 --> 00:20:45,454
Terumo wire, please.
314
00:21:10,134 --> 00:21:11,814
Cobra catheter, please.
315
00:21:43,174 --> 00:21:45,614
You're on the roadmap. I can see.
316
00:21:59,654 --> 00:22:01,294
Oh, damn. You're off the roadmap.
317
00:22:01,454 --> 00:22:05,414
I'm going to have a second attempt
at getting the wire across the tear.
318
00:22:14,574 --> 00:22:17,974
Lorraine! No. Shit.
I've gone through the tear.
319
00:22:18,094 --> 00:22:19,974
BP dropping, 100 over 78.
320
00:22:20,134 --> 00:22:22,214
Sats dropping, 87.
Heart rate rising.
321
00:22:22,374 --> 00:22:27,294
Let's get the BP up, shall we?
Contrast, please. Run of 5 at 10.
322
00:22:27,414 --> 00:22:30,094
OK. Breathing off. Breathing off.
323
00:22:30,214 --> 00:22:31,694
Screening.
324
00:22:34,254 --> 00:22:36,694
Shit.
The pseudoaneurysm is expanding.
325
00:22:36,814 --> 00:22:38,334
To about eight centimetres.
326
00:22:38,494 --> 00:22:41,414
Breathing on. Breathing on.
Another run of 5 at 10, please.
327
00:22:41,614 --> 00:22:44,174
Breathing off. Breathing off.
Screening.
328
00:22:46,814 --> 00:22:49,254
Nine centimetres. It could burst.
329
00:22:49,414 --> 00:22:52,614
Another run of 5 at 10, please.
Screening.
330
00:22:56,654 --> 00:22:59,814
No further expansion.
No extravasation of contrast.
331
00:23:02,654 --> 00:23:05,334
Breathing on. Breathing on.
BP is holding.
332
00:23:05,494 --> 00:23:08,494
There's a large defect
in the artery I can't get around.
333
00:23:08,654 --> 00:23:11,734
I want to put an occlusion balloon
across the tear.
334
00:23:27,614 --> 00:23:29,654
Can I have a moment, please?
335
00:23:29,774 --> 00:23:31,534
Now? Please.
336
00:23:31,654 --> 00:23:33,254
Fiona, please. Yes.
337
00:23:38,374 --> 00:23:41,334
Listen, you don't have to do this.
That could have happened to anyone.
338
00:23:41,494 --> 00:23:44,574
Oh, I agree,
that's not what I meant. It's Clive.
339
00:23:44,734 --> 00:23:47,734
He's gunning for you and this
could turn into a shitstorm...
340
00:23:49,134 --> 00:23:52,614
..so let's not give him
the ammunition. Yes?
341
00:23:57,654 --> 00:24:00,974
Fiona, are you OK to take over?
342
00:24:02,414 --> 00:24:05,854
Of course.
If that's all right with you?
343
00:24:06,014 --> 00:24:08,174
In which case,
I shall leave you to it.
344
00:24:21,334 --> 00:24:23,134
Let's go, please.
345
00:24:30,879 --> 00:24:32,359
Cobra catheter coming out.
346
00:24:39,119 --> 00:24:40,759
Berenstein balloon, please.
347
00:24:42,239 --> 00:24:43,719
Check the balloon.
348
00:24:48,399 --> 00:24:49,599
Yeah.
349
00:24:53,479 --> 00:24:56,079
Hey... You're fine.
350
00:25:24,199 --> 00:25:25,959
Inflating the balloon.
351
00:25:31,359 --> 00:25:34,879
No, deflate it.
It's not conforming to the artery.
352
00:25:34,999 --> 00:25:37,319
BP dropping. It's 105 over 84.
353
00:25:37,479 --> 00:25:39,999
Let's increase the blood, please.
90 over 76.
354
00:25:40,159 --> 00:25:42,159
The tear extends
higher than I thought.
355
00:25:42,319 --> 00:25:44,559
I'm going to occlude it
more proximally.
356
00:25:44,719 --> 00:25:47,159
OK. But that's not going
to take care of the back-bleed.
357
00:25:47,279 --> 00:25:48,719
I can't risk enlarging the tear.
358
00:25:56,039 --> 00:25:57,639
BP still dropping.
359
00:26:01,399 --> 00:26:04,519
The left common iliac artery
is occluded above the tear.
360
00:26:06,079 --> 00:26:07,839
Stop screening, please.
361
00:26:07,999 --> 00:26:10,759
The uterus is becoming
tense and woody. Can you relax it?
362
00:26:10,919 --> 00:26:12,999
250 micrograms of terbutaline,
please.
363
00:26:13,159 --> 00:26:15,599
Yeah, Billy, have we got that?
It's in there.
364
00:26:23,399 --> 00:26:25,279
250 mics going in now.
365
00:26:28,319 --> 00:26:31,039
Another 250, please. Come on.
366
00:26:32,439 --> 00:26:33,879
Another 250 going in.
367
00:26:35,359 --> 00:26:37,079
Can I see the BP, please?
Yep, sorry.
368
00:26:37,239 --> 00:26:40,239
It's not going to go up
until you get that baby out.
369
00:26:40,399 --> 00:26:43,479
It's relaxing a bit,
but it's unstable.
370
00:26:43,639 --> 00:26:45,359
I need to get the foetus out
immediately.
371
00:26:45,479 --> 00:26:47,079
What are its chances of survival?
372
00:26:47,239 --> 00:26:49,119
Depending on weight,
between 30 and 40%, max.
373
00:26:49,279 --> 00:26:51,159
And the long-term prognosis
if it does survive?
374
00:26:51,319 --> 00:26:53,839
There's about 60% risk
of some impairment -
375
00:26:53,999 --> 00:26:55,679
more if there's been
significant hypoxia.
376
00:26:55,839 --> 00:26:58,279
No, I want to control the back-bleed
with the foetus in place.
377
00:26:58,439 --> 00:27:00,239
The uterus is irritable.
It could contract
378
00:27:00,359 --> 00:27:01,639
or the placenta could abrupt.
379
00:27:01,799 --> 00:27:05,679
Caesarean now, or we could lose
mother and the foetus.
380
00:27:13,679 --> 00:27:15,719
OK. Right. Excuse me.
381
00:27:15,879 --> 00:27:20,079
12 units of O neg, 8 FFP,
4 platelets and 2 cryo, please.
382
00:27:20,199 --> 00:27:23,639
Yep. I need my team here now.
383
00:27:23,759 --> 00:27:26,359
We're doing an emergency C-section.
384
00:27:26,519 --> 00:27:28,879
Billy, we need neonatal here,
right now.
385
00:27:31,279 --> 00:27:34,159
Hello, yeah, it's Billy Finlay ODP,
in trauma theatre.
386
00:27:34,319 --> 00:27:37,839
We have a neonatal team on standby,
we need them here right away.
387
00:27:38,879 --> 00:27:41,319
Thanks. On their way.
388
00:27:43,599 --> 00:27:45,319
OK, we have to wait.
389
00:27:47,959 --> 00:27:49,759
So, what made you hang up your boots?
390
00:27:51,279 --> 00:27:53,039
Who said I have?
391
00:28:00,919 --> 00:28:05,839
12 units of O neg, 8 FFP,
4 platelets, 2 cryo. Bosh!
392
00:28:07,079 --> 00:28:09,359
There you go, Bruce. What about you?
393
00:28:11,079 --> 00:28:13,199
Oh, I just thought it was time
to settle down.
394
00:28:20,799 --> 00:28:24,119
All right, we are prepping
for a classical C-section.
395
00:28:24,239 --> 00:28:26,319
Sign in as you set up, please.
396
00:28:26,479 --> 00:28:28,199
Fay Ovenden,
Consultant Neonatologist.
397
00:28:28,319 --> 00:28:30,239
Stephen Canja, Midwife. Midwife!
398
00:28:30,359 --> 00:28:32,279
Hannah Simonson, Neonatal SHO.
399
00:28:32,399 --> 00:28:34,319
Zoltan Farkas, Neonatal Nurse.
400
00:28:34,479 --> 00:28:37,599
Ready, Fay? Ready.
Yeah, numbers stabilising.
401
00:28:37,759 --> 00:28:39,959
Right, let's get cracking then,
shall we? Excuse me.
402
00:28:42,799 --> 00:28:44,919
The uterus has relaxed.
403
00:28:46,359 --> 00:28:49,279
Means there's no immediate need
to do a C-section now, is there?
404
00:28:49,439 --> 00:28:52,719
Fiona, if I did a laparotomy,
can you clamp the artery?
405
00:28:56,039 --> 00:28:58,559
Maybe.
With the foetus still in place? Yes.
406
00:28:58,719 --> 00:29:01,199
But could you move the uterus?
Not much.
407
00:29:01,319 --> 00:29:03,879
It could trigger placental abruption.
408
00:29:03,999 --> 00:29:05,879
If she abrupts, she dies.
409
00:29:08,599 --> 00:29:10,599
Let's prep for a laparotomy,
everyone.
410
00:29:18,799 --> 00:29:20,719
This can't be easy for you.
411
00:29:22,239 --> 00:29:23,639
It's a tough case.
412
00:29:23,759 --> 00:29:26,159
Hmm... We'll talk about it at home.
413
00:29:38,439 --> 00:29:41,639
48 minutes.
I'll take a blade, please.
414
00:29:44,359 --> 00:29:46,399
Am I OK to cut? Yeah.
415
00:29:50,799 --> 00:29:52,079
Cutting.
416
00:30:22,559 --> 00:30:24,119
Mayo, please.
417
00:30:28,319 --> 00:30:29,999
RAMC finesse.
418
00:30:31,279 --> 00:30:34,559
You can join in any time you want.
Happy to watch and learn.
419
00:30:37,359 --> 00:30:39,199
Deaver retractor, please.
420
00:30:40,639 --> 00:30:42,359
Are you ready?
421
00:30:44,919 --> 00:30:47,279
Yeah. Over to you.
422
00:30:49,399 --> 00:30:50,599
Tom?
423
00:30:53,759 --> 00:30:56,079
Moving the uterus.
424
00:31:00,759 --> 00:31:02,479
That's as far as it will go.
425
00:31:02,599 --> 00:31:04,239
BP's holding.
426
00:31:06,759 --> 00:31:08,479
Dissecting scissors, please.
427
00:31:10,639 --> 00:31:13,039
I'm going to enter
the retroperitoneum.
428
00:31:21,399 --> 00:31:22,879
Suction.
429
00:31:26,119 --> 00:31:27,719
Dardik clamp, please.
430
00:31:29,919 --> 00:31:30,879
OK.
431
00:31:32,919 --> 00:31:34,599
A bit further.
432
00:31:36,239 --> 00:31:38,359
That's it. I need more room.
433
00:31:38,479 --> 00:31:40,399
BP dropping. 94 over 78.
434
00:31:40,559 --> 00:31:43,159
I'm in danger of stimulating
the uterus. I have to get in.
435
00:31:46,799 --> 00:31:50,279
73 over 61. Unstable.
Bruce, increase the blood, please.
436
00:31:50,439 --> 00:31:53,759
Tom, just give me 30 more seconds.
Please.
437
00:31:57,319 --> 00:31:58,959
30 seconds.
438
00:32:09,719 --> 00:32:11,479
I've got it.
439
00:32:13,479 --> 00:32:16,719
A bit further, please. I can't.
I have to stop the back-bleed.
440
00:32:16,839 --> 00:32:18,719
BP dropping. 79 over 68.
441
00:32:21,399 --> 00:32:23,079
I can't get it.
442
00:32:28,959 --> 00:32:31,999
That's 30 seconds.
A few more seconds. 75 over 64.
443
00:32:33,239 --> 00:32:38,599
OK. Common iliac artery clamped,
distal to the metal fragment.
444
00:32:38,719 --> 00:32:41,119
Good. Keep going.
445
00:32:41,279 --> 00:32:44,319
You've controlled the back-bleed.
I need to put this back now.
446
00:32:44,479 --> 00:32:46,759
We need to clamp, proximal
to the metal. Dardik, please.
447
00:32:46,919 --> 00:32:49,079
It's controlled by the balloon.
It's not enough.
448
00:32:53,439 --> 00:32:54,759
Ten seconds. OK.
449
00:32:56,799 --> 00:33:00,479
The uterus is contracting.
Jesus, I think she's about to abrupt.
450
00:33:00,639 --> 00:33:03,559
I need a little more space and a
little more time. We're out of both!
451
00:33:03,679 --> 00:33:06,159
Get out now. OK! Still unstable.
452
00:33:07,999 --> 00:33:10,319
Right, why is this baby
still in there?
453
00:33:10,479 --> 00:33:13,999
We need to stabilise the iliac.
Let me make myself crystal clear.
454
00:33:14,159 --> 00:33:16,919
If that mother dies, it's going
to be all over national news.
455
00:33:17,079 --> 00:33:19,639
Foetal death doesn't make
local radio. Get it out.
456
00:33:28,840 --> 00:33:30,560
Ultrasound, please.
457
00:33:31,720 --> 00:33:33,960
Why didn't you tell me
he was working here?
458
00:33:34,080 --> 00:33:36,000
I was going to. Right.
459
00:33:44,000 --> 00:33:46,120
Placenta's position is normal.
460
00:33:50,800 --> 00:33:53,400
The foetus is in distress. Thank you.
461
00:33:53,560 --> 00:33:57,080
Let's get cracking. Ta. Doyens.
Thank you.
462
00:34:00,960 --> 00:34:02,520
Scalpel.
463
00:34:02,680 --> 00:34:05,840
We should try to shunt it,
give the baby a chance.
464
00:34:05,960 --> 00:34:07,680
You're kidding, right?
465
00:34:07,800 --> 00:34:09,400
The iliac's just on the balloon.
466
00:34:09,560 --> 00:34:11,600
A C-section could just as easily
dislodge it.
467
00:34:11,760 --> 00:34:14,240
You've had your chance. Step away.
I won't.
468
00:34:14,400 --> 00:34:17,120
Cos we should at least try,
we should give it a shot.
469
00:34:19,440 --> 00:34:20,560
Tom.
470
00:34:24,560 --> 00:34:25,920
For God's sake!
471
00:34:31,920 --> 00:34:35,280
Shunt kit, please. 55 minutes gone.
472
00:34:35,440 --> 00:34:38,480
I'm going to try and shunt
the left common iliac artery.
473
00:34:38,600 --> 00:34:40,160
Let's have the Lahey ready, please.
474
00:34:40,320 --> 00:34:42,640
I going to need you to retract.
Do you think you can do that?
475
00:34:42,760 --> 00:34:44,560
Yeah. Thank you. Tom.
476
00:34:47,280 --> 00:34:48,400
Please.
477
00:35:00,600 --> 00:35:02,240
That is as far as it will go.
478
00:35:03,560 --> 00:35:05,080
Numbers are stable, for now.
479
00:35:13,880 --> 00:35:16,360
OK, I've got it. Lahey.
480
00:35:23,880 --> 00:35:29,360
OK, I'm around the artery, distal
to the tear. Vicryl ties, please.
481
00:35:30,440 --> 00:35:31,680
Thank you.
482
00:35:38,240 --> 00:35:39,640
OK, clip.
483
00:35:42,600 --> 00:35:44,040
Let's do it again.
484
00:35:52,560 --> 00:35:55,280
Any more room you can give me?
I can't risk moving it.
485
00:35:58,040 --> 00:35:59,160
OK.
486
00:36:06,400 --> 00:36:07,800
Come on.
487
00:36:10,520 --> 00:36:11,800
Clip.
488
00:36:13,800 --> 00:36:18,960
The Vicryl ties are in position,
distal and proximal to the tear.
489
00:36:19,080 --> 00:36:20,760
Shunt, please.
490
00:36:22,240 --> 00:36:23,280
Thank you.
491
00:36:27,760 --> 00:36:29,600
The uterus is hardening a little.
492
00:36:30,840 --> 00:36:32,200
Let's remove the Dardik.
493
00:36:36,960 --> 00:36:38,920
OK, the shunt is in
494
00:36:39,080 --> 00:36:42,360
and I'm passing it down the left
common iliac, distal to the tear.
495
00:36:44,600 --> 00:36:46,200
I just need to ligate it.
496
00:36:50,480 --> 00:36:53,120
Scissors, please. It's unstable.
497
00:36:53,280 --> 00:36:57,480
Cut. The shunt is ligated,
distal to the tear.
498
00:36:57,600 --> 00:36:59,360
Can we get a clamp on this, please?
499
00:37:02,040 --> 00:37:04,800
I'm now going to try and shunt,
proximal to the tear.
500
00:37:07,120 --> 00:37:09,280
Give me as much space as you can,
please. I can't.
501
00:37:09,440 --> 00:37:12,960
I need to put it back. I just need
30 seconds. Oh, come on!
502
00:37:13,080 --> 00:37:14,640
BP crashing. 71 over 60.
503
00:37:14,800 --> 00:37:18,080
The balloon's failed. Fill her up,
please. Let's get the balloon out.
504
00:37:18,240 --> 00:37:21,040
Dardik. The uterus is hardening
again. 65 over 44.
505
00:37:24,080 --> 00:37:27,000
No, I can't get a hold of it.
It's too traumatised.
506
00:37:27,160 --> 00:37:30,080
Give me your hand. I need you
to compress with your fingers.
507
00:37:30,240 --> 00:37:32,480
She's going to abrupt.
Just a few more seconds.
508
00:37:32,640 --> 00:37:34,120
It's slipping.
I can't keep hold of it.
509
00:37:34,280 --> 00:37:37,200
She hasn't got a few more seconds.
I've lost it.
510
00:37:37,360 --> 00:37:40,160
55 over unreadable. As much blood
as you can get into her, please.
511
00:37:40,320 --> 00:37:44,160
The uterus needs to go back now.
Everybody, just be calm.
512
00:37:51,960 --> 00:37:53,000
OK.
513
00:37:54,200 --> 00:38:00,040
The shunt is in and is going up
the left common iliac artery,
514
00:38:00,160 --> 00:38:02,080
proximal to the tear.
515
00:38:06,080 --> 00:38:10,120
OK. Ligate it.
I need to put it back! Ten seconds.
516
00:38:12,840 --> 00:38:17,280
Ten, nine, eight,
517
00:38:17,400 --> 00:38:21,560
seven, six, five,
518
00:38:21,680 --> 00:38:23,880
four... Systolic dropping.
519
00:38:24,000 --> 00:38:26,960
Three... Cut it. ..two, one.
520
00:38:27,120 --> 00:38:30,280
Clamp off. Clamp off. We've done it.
Jesus Christ.
521
00:38:32,800 --> 00:38:37,040
I could have just worked
in my dad's chippy. So could I.
522
00:38:37,160 --> 00:38:38,280
Ultrasound, please.
523
00:38:39,600 --> 00:38:40,800
Thank you.
524
00:38:48,640 --> 00:38:50,840
The placenta appears to be intact.
525
00:38:56,520 --> 00:38:58,680
I can't find a heartbeat. Come on!
526
00:39:03,880 --> 00:39:06,120
HEARTBEAT
527
00:39:06,240 --> 00:39:07,920
Healthy heartbeat.
528
00:39:13,640 --> 00:39:15,520
I'll get the bullet.
529
00:39:26,800 --> 00:39:28,560
Metal one, please.
530
00:39:34,120 --> 00:39:36,520
CLINKING
531
00:39:36,680 --> 00:39:38,760
You can take the surgeon
out of the army...
532
00:39:42,600 --> 00:39:46,400
The patient needs to stay here for
a while and then go up to ICU, yes?
533
00:39:46,520 --> 00:39:47,440
Yeah.
534
00:39:48,640 --> 00:39:51,640
Fiona, are you OK? She's fine.
535
00:39:58,680 --> 00:40:01,600
That was good work, everyone.
Nice one.
536
00:40:08,160 --> 00:40:09,760
Pack up, guys.
537
00:40:21,920 --> 00:40:23,720
You didn't follow my guidance.
538
00:40:23,840 --> 00:40:25,120
No.
539
00:40:27,520 --> 00:40:29,240
Police still here?
540
00:40:37,360 --> 00:40:39,920
TANNOY: 'Duty hygiene assistant
to the staff canteen.
541
00:40:40,080 --> 00:40:43,040
'Duty hygiene assistant
to the staff canteen, please.'
542
00:40:43,160 --> 00:40:45,240
For the GSW? I am.
543
00:40:45,400 --> 00:40:47,280
It's ricocheted
off of a hard surface,
544
00:40:47,440 --> 00:40:50,120
but it's a piece of copper jacket
from a high velocity round.
545
00:40:50,280 --> 00:40:53,680
It's an SA80.
How did he get hold of that?
546
00:40:53,800 --> 00:40:56,240
Well, he's ex-army.
547
00:40:56,360 --> 00:40:57,880
He shot his wife.
548
00:40:58,040 --> 00:41:00,800
This should send him down.
Thank you.
549
00:41:02,320 --> 00:41:04,320
Dr Archerfield? Yes.
550
00:41:04,480 --> 00:41:07,840
We all thought
Lorraine was off sick. Yes.
551
00:41:08,000 --> 00:41:11,520
Well, someone told me that
she's now working under supervision.
552
00:41:11,680 --> 00:41:15,240
Lorraine's better than that!
Indeed she is.
553
00:41:15,400 --> 00:41:18,560
TANNOY: 'Staff and members
of the public are reminded
554
00:41:18,720 --> 00:41:22,880
'not to leave bags or personal items
unattended. Thank you.'
555
00:41:26,240 --> 00:41:28,560
Glen's CV said
he finished deployment
556
00:41:28,680 --> 00:41:30,360
immediately before starting here.
557
00:41:30,520 --> 00:41:32,960
But his last deployment
ended three months before.
558
00:41:33,120 --> 00:41:35,640
What did he do
for those three months?
559
00:41:35,800 --> 00:41:38,280
Lorraine. I'm in the middle
of a conversation. We need to talk.
560
00:41:38,440 --> 00:41:42,320
There's a blank he refuses
to account for. Thank you.
561
00:41:46,640 --> 00:41:48,840
You cancelled the competency hearing
562
00:41:49,000 --> 00:41:51,560
because the complaints against me
were unsubstantiated.
563
00:41:51,720 --> 00:41:54,640
Yes, but the accusations remain.
Remain? Well, how can they remain?
564
00:41:54,800 --> 00:41:57,560
They're unsubstantiated.
That means they're bullshit.
565
00:41:57,720 --> 00:41:59,400
Lorraine, please.
Where do they remain?
566
00:41:59,560 --> 00:42:01,960
Look, this hasn't been easy
for either of us.
567
00:42:03,680 --> 00:42:06,680
I'll keep the file closed.
In return, I want you back to work.
568
00:42:08,000 --> 00:42:09,240
I'm trying to help you.
569
00:42:21,080 --> 00:42:23,800
Excuse me, can you take this?
Sure.
570
00:42:23,960 --> 00:42:26,680
When Clive told me
that you were under my supervision,
571
00:42:26,800 --> 00:42:28,680
I assumed that he had told you too.
572
00:42:28,840 --> 00:42:30,600
I'm sorry it put you
in a difficult position.
573
00:42:30,760 --> 00:42:33,880
Both of us. Bastard wants us
to fight for the same job.
574
00:42:35,920 --> 00:42:37,120
See you later.
575
00:42:55,280 --> 00:42:57,120
Should we talk?
576
00:42:57,240 --> 00:42:59,520
Maybe we should leave it alone.
577
00:43:04,760 --> 00:43:06,440
Why didn't you tell me about Tom?
578
00:43:08,760 --> 00:43:10,960
I mean, why didn't you even
mention him?
579
00:43:12,640 --> 00:43:15,440
Fiona?
You'll fight for a stranger's baby.
580
00:43:21,360 --> 00:43:22,920
I was mad to call you.
581
00:43:25,160 --> 00:43:27,440
Lorraine's back.
582
00:43:27,560 --> 00:43:29,160
You should go.
583
00:43:31,320 --> 00:43:32,960
We don't need you.
584
00:43:42,440 --> 00:43:44,200
Oh, God!
585
00:44:20,200 --> 00:44:23,200
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586
00:44:23,320 --> 00:44:26,240
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