(PEOPLE CHATTERING)
(SIGHING)
(POLICE SIREN WAILS)
-Mr Lake. -Yeah.
-I'm Susannah Marshall, speciality training. -Pleased to meet you, Susannah. I got a call?
Yeah, the nurses are querying cellulitis.
So, how are you finding UH, Mr Lake?
Fine, thank you. You can call me Rob.
Calling a consultant by his first name? Hope the sky doesn't come crashing down.
-Morning. -Morning.
Start her on oxypan. I can order the ultrasound. It's on my way.
-You really are new here, aren't you? -why do you say that?
-You'll see. -Ooh, you got me curious now.
Thanks, Mr Lake.
Dr Clacy? Sorry to bother you, I'm Rob Lake.
I wonder If I could trouble you to do a ultrasound on a gynae patient with a suspected DVT?
I have to make sure this gets through your skull.
Go and get a form, fill it in, and get your consultant to sign It.
I am the consultant.
SUSANNAH: Come on, push, Ingrid. You're doing really well.
Push for me now. Come on, Ingrid.
Give It a real push. Go on, you can do It. You're doing really well.
Okay, It's crowning. Good.
-Here It comes. Come on, push. -Good girl, Ingrid.
-That's It. -Good girl
Ingrid, I'm the doc... I'm Mr Lake. I'm the consultant.
-Come on. -You're doing really, really well.
-That's it. Come on, you can do it. That's it. -Push!
There, right. Now, you're doing so well.
Push! I can see the head. You're doing so well.
Push, go on, my love. Push.
-Okay, Ingrid, let's take a look. -You're doing really well.
Come on, I want a really big push now.
Okay, nice big push.
That's It, push down. You're doing well. Not long now.
(GROANING)
-Good girL -Push.
-Baby's coming. Come on, Ingrid. -It's coming. It's coming. Good girL
-Come on, Ingrid, big push! -Good girL Head's coming.
-That's It. Good girL -Okay, babe. Baby's out. Let's go. Push.
Push, come on, Ingrid.
-Push harder. -just the shoulders. Come on.
That's It, girL Come on.
Right, someone keep an eye on the clock. McRoberts.
Ingrid, we're pushing your legs right back to open the pelvis up.
Your baby's shoulders are jammed at the moment.
This is gonna help get the shoulders out, okay? Okay.
Big push. darling. Big push.
-Push! -Come on. Come on, good girl!
Susannah, give suprapubic pressure.
Keep pushing.
-Come on, Ingrid, let's go. -Really good.
-Really push. Come on. -Thirty seconds.
Oh, shit.
-I'm gonna try and turn him. -That's It, you're doing so well.
-we're just gonna turn it round. -Fuck It.
And 60 seconds.
-All right. we've still got time. -okay.
I'm gonna try and release the posterior shoulder.
Come on, Ingrid, keep pushing.
Come on, Ingrid, push!
-Shoulder's jammed. can't get him out. Fuck! -One minute 30.
Has someone been called?
Ingrid, big push! Come on!
-One minute 40. -Come on, Ingrid!
Keep going. Come on.
Right, Ingrid, listen to me. Listen to me. This Is very Important.
You're gonna hear a crack now. I'm gonna have to crack your baby's collar bone.
It will heal, but I've got to do It to get your baby out. Do you understand?
SUSANNAH: All right, all right.
(BONE CRACKS)
-Good girl, push. Keep pushing. -You're doing really well.
There we go. There's the baby. There's the baby.
It's a boy. It's a lovely boy.
ROB: well done, Ingrid. Good girL scissors.
-You did so well. -Go.
Clamps, please.
-where's the baby? -It's all right. They're just checking the baby out.
Is he okay?
They're just checking. That's what the doctors are gonna do.
we're just giving him some oxygen, okay, Ingrid?
(INGRID PANTING)
-INGRID: why can't I hear him? -Okay, gentle push, now, please.
I'm sure he's fine.
Gentle push. Here we go.
(INGRID MOANS)
-okay. -just the placenta. well done.
-INGRID: Is he okay? -It's all right, Ingrid. Don't worry. Don't worry.
what's wrong?
They're just checking him out. The doctors are just checking him out.
He'll be all right.
Suture.
A few more minutes. A few more minutes. You dld really well.
They're just checking him out. He'll be all right.
(BABY WAILS)
Ah, there you go.
-That's it. -There you go.
(BABY CRYING)
well done, Ingrid. well done.
-Congratulations, Ingrid. well done. -well done.
Fucking hell.
POLLY: You're all done.
-Here's your baby. -Thank you.
MOTHER: So beautifuL
So beautifuL
-Congratulations. -FATHER: Thank you very much.
MOTHER: Thank you.
-Busy day? -ROB: Sorry I didn't make the scan.
Is everything all right?
we had a shoulder dystocia.
-Oh, God. How's the baby? -Yeah, doing fine.
-You ever managed one before? -Once, when I started my registrar rotation.
with Hurley?
what I realised today was back then, when I was a reg, I was a lot calmer.
There was always someone else to calL someone else to blame.
welL the previous generation had 30,000 hours of training before becoming consultants.
we've got 8,000.
You'll get through It. Everyone does.
-Not everyone. -You're not Hurley.
-where are the boys? -I've been phoning you.
I left my mobile at work. I was in a rush, I didn't want to be late.
-The boys aren't coming. -But I've planned the whole day.
-why not? -I don't think It's appropriate at the moment.
I'm not saying that you can't ever see them.
It wouldn't be fair on the boys. It wouldn't be fair on you.
Harriet, this whole thing Is a stupid misunderstanding.
This has got completely out of control People are turning it into something it isn't.
They're turning me Into something you know I'm not.
The way It would work would be for the visits to be supervised by a social worker.
They'll be short at first, but then they'll go back to normal
as soon as the social worker's satlsfied that the boys...
what, aren't in any danger?
Look, what's... what's gone on between us is one thing,
but please don't let this stupid misunderstanding drive a wedge between me and our children.
welL well.
-Hello, Tony. -Chrissy.
Should we talk here or would you rather we went to the clubhouse?
No, here. I have a very tight schedule.
Of course.
This is the reason you're far too busy to come to the hospital,
or, indeed, return any of my calls.
Your tight schedule.
we want to make a deal, Sir Paul and I.
Who with? The devil?
worse. with you, Mr whitman.
we'll rescind your suspension and drop all charges against you.
well as you can see, I'm rather enjoying my suspension.
You have a dwindling private practice.
without your NHS employment, you'll get no more referrals.
simply not true at all.
If you think life is good, then that's fine, Tony.
But I think this could be like Kevin's epiphany.
Keegan, on the golf course at La Manga,
finally realising he was pissing away his knowledge of the game.
(SNORTS)
Kevin Keegan? Fucking hell.
Here's my golf partner.
Excuse me. Lovely talking to you, Chrissy.
I wouldn't call it a pain, or even a discomfort.
I'd call It more a sense of unease.
or as if something wasn't quite right,
as it should be.
The feeling seems focused on my lower tummy,
but then radiates outwards sometimes as well.
what do you think, Mr whitman?
A situation has arisen with Roger Hurley.
And Sir Paul and I feel It would be in everyone's best interest
If he were to take up a position at another hospital
At last, you've cottoned on to Hurley's incompetence.
well I see why they gave you a gong.
The matter in question does not relate to Roger Hurley's clinical practice.
He received a caution for exposing himself.
(SNORTS)
Roger!
Roger Hurley will require a hagiographic reference
from the senior consultant in the O&G department
In order to move him on quickly and quietly.
Now, clearly, this reference will be best served
If the senior consultant in question Is not currently on suspension.
I took a coffee refill from the hospital canteen and you charged me with theft.
I was suspended for three years, my career put on hold.
You bastards. You pair of total cocking wankers.
Hmm.
Good. Good.
I'll let Chrissy here iron out the details.
(CLEARS THROAT)
(EXCLAIMS)
-Tony- —Polly-
You been up to anything while I've been away?
Locum should be here by 8:00 am. If he's not, don't leave it to the administrators.
-Call the agency yourself. -okay.
I'll keep the mobile on till midday, so If you need me for anything, I'm available.
Thanks, Rob.
Hiya.
-Hey, Mary, how are you? -Good.
-Emptying the In-tray before your holiday? -Not really a holiday, more a pre-paternal leave.
Oh, will you be back for the regional O&G forum?
we're hosting, and I'm counting on a full departmental presence.
Yeah, I will be back,
but I am gonna miss the interviews for the new consultant post.
That's not going to be a problem, Is It?
No, we don't normally ask a recently appointed consultant to sit on the paneL
Okay
-well, enjoy the break. -Thank you.
(RUSTLING)
what are you doing?
There's loads to do. I've only got a week's leave, so I just thought I'd get stuck right into It.
we said yellow for the walls. we changed our minds about the pink.
Sorry. Bloody hell, what a twat.
I want to assure you, Mr Hurley, we've listened to all sides in this matter.
well If you've listened to me, you'll know I'm the victim of a deep misunderstanding.
But you do see how this allegation does great damage to the hospital's Image?
Yes, I categorically deny the allegation. I'm sure Paul will support me.
He decided not to attend this meeting.
I have a proposal for you.
A position has become vacant at University Hospital
Okay
(MOBILE RINGING)
Hello?
Hiya.
How did you get this number?
No, no. It's just I'm surprised to hear from you, that's all.
I can't really give you an answer now. Can I call you back on this number?
All right. Bye.
(FUNK MUSIC PLAYING)
-How are you doing? -I'm good. And you?
Good.
How come you're in town? You've not moved down here, have you?
Mmm-mmm. No, I've still got my flat In Edinburgh.
-You did your degree? -2:1 In English Lit.
-Congratulations. -Thanks.
And now?
journalism. I did a post-grad diploma.
I've done pieces for the Nursing Times and for the health pages at some of the dailies.
-Mainly In Scotland. -Excellent. You got out and you stayed out.
Not entirely. I did agency work when I was a student.
I still do from time to time when I could use the money.
And you? Consultant yet?
-Yeah. A month in to my first post. -How's it going?
-well, It's good. -That's good.
well wife and kids next.
That'll be the day.
How about you?
Divorced now.
You have a nice time?
-Sorry, I didn't mean to wake you. -I'm not awake.
How's Rich?
He's fine.
-WOMAN: University Hospital. -It's Mr Roger Hurley.
I might not be on your staff roll yet.
-Welcome in UH Mr Hurley. -Thank you.
just a small token, Roger, to welcome you aboard.
It's a very kind thought. Thank you, Mary.
we're very excited to have you join our team.
we should set aside some time as soon as possible to discuss your research programme.
Oh, I thought I'd give that a Little while, just till I find my feet.
well that's for later.
For now, I was gonna prevail upon you to deliver a lecture.
we're hosting the next regional O&G forum.
Oh, well, I wouldn't want to tread on the other consultant's toes.
Oh... No.
Yes, but you see how It might seem, you know, just arrived and already hogging the limelight.
Roger, there's no point In having one of the country's leading ovarian experts on staff
without exploiting him shamelessly.
I'd be delighted to help, Mary.
-well, thank you, Roger. Have a good day. -You, too.
would you like to come through?
-Ready? -Yes, sorry.
Sorry, boss. Have you seen these hormone assays?
-Yeah, she's very attractive, Isn't she? -Not my type.
God, did you see the size of her labs? They're like a pair of elephants ears.
(MOBILE RINGING)
Hello?
Now you know why I'm In town.
-You knew about Hurley? -No, that was a coincidence.
I came to write the story and discovered he'd moved.
-what story? -A dangerous doctor.
How whistle-blowers are silenced and ostracised so that Hurley can continue to practice.
whistle-blowers are silenced and ostracised for more complex reasons than that.
Yeah, that's exactly the perspective I want to put in my piece.
-No. -You'd be off the record.
All the things you've ever wanted to say about Hurley and couldn't,
they'd be out in the open.
Roger Hurley is a danger to patients.
I've looked at all the arguments back and forth.
They're meaningless. He's a monster.
Doctors like him should be struck off and never allowed to practise again.
I've moved on.
Thank you, Sister.
Actually, I'll just check her.
Okay. Let's go and see her.
Looks fine. Good.
Thank you, Sister.
who's next, Farah?
Tracy Clarke. She came in on last night's take.
Thank you. Tracy, hi, I'm Roger Hurley. I'm the consultant.
Dr Hamid's just telling me about your admission.
Initially seen by the surgeons with acute abdomen.
They're happy to exclude anything surgically acute.
Referred to Gynae with LIF pain, which seems to have subsided overnight.
I'd like to examine you now, If that's okay, Tracy.
Um, Farah, can you get an ultrasound scan for Tracy, please?
-Yes, Mr Hurley. -Thank you.
(SIGHS) Shit.
Do you think we should have the baby in with us for the first few weeks?
You'll never guess who started at work today.
-Who? -Hurley
My God. You're kidding?
Keep out of It, Rob.
-I will. -Keep out of It.
He nearly ruined your career. He did ruin Tony's.
Roger Hurley isn't your boss any more. He's not got a hold over you.
He's a consultant. You're a consultant.
You're separate. Don't give him the time of day.
You're preaching to the converted. I really don't give a toss where Hurley works.
...If they're free. If not, you'll have to cover.
Oh, Mr Whitman, I need to talk to you.
Mr Whitman, do you have a minute?
For you? of course, Miss Grey. Thank you.
was it just a coincidence Roger Hurley left around the same time that you arrived?
we're rumble fish.
You didn't do anything to smooth the path, did you?
-Like what? -well for start, he'd need a reference.
Polly, I can absolutely assure you, on my mother's grave...
For Christ's sake, I knew It.
It was testify that Roger Hurley was this hospital's answer to Jim Kildare,
or spend the rest of my life being stupefied
by the vages of endless Tory housewives.
Did you even consider where he'd go? who's gonna end up being his colleague?
-Polly. -And why did they need to get rid of him anyway?
None of the malpractice allegations stuck.
-He'd received a police caution. -what for?
Exposure.
Fucking hell, Tony.
Polly.
-Tracy, morning. Did you get a scan yesterday? -No.
Right, I'll come back to you. Thank you.
Ah, Dr Clacy. Sorry to trouble you, I'm Roger Hurley.
Did my speciality trainee, Dr Hamid,
speak to you about an abdominal ultrasound for Tracy Clarke?
we had a discussion.
It's just that the patient said she hasn't had her scan.
You have to leave her notes at reception.
(CLEARS THROAT)
Sorry, Dr Clacy, do you think you might be able to fit her in today?
ROGER: Hold on, Tracy.
-She's still not had a scan? -No, I'm sorry, I tried.
It's too bloody late now. we have to open her up. All right, Tracy. watch the back. That's It.
Hold on, Tracy.
Okay, stretch now.
It's a torted cyst.
The pedicle's twisted two or three times. we're gonna untwist It.
Oh, shit. Suction. Swab.
-Katya, use crossmatch, please. -Fucking hell.
And a swab, please.
Curved Kocher.
I can't see a bloody thing. Suction.
In here, In here.
(HEART MONITOR BEEPING)
FARAH: BP's dropping.
Oh, suction, Farah. Come on, I gotta be able to see what the fuck I'm doing.
Sorry, Rob, we can't get in yet. Mr Hurley's gynae emergency's still in theatre.
ROGER: For fuck's sake, we're losing her. Come on, Farah, suction now, here.
Suction now, Farah. Come on.
can't see a bloody thlng. Farah, will you get the suction In there?
ROGER: Oh, shit.
I can't do It now.
Yeah, got it. Good. Another curved Kocher, please.
-well done, everyone. -well done to you too, Mr Hurley.
Can I have a tie, please?
Some music, please.
(DANCE MUSIC PLAYING)
Scissors.
Thank you.
-HI. -Hiya.
was gonna ask If you fancied a coffee, but you've already got one.
-Do you mind If I ask, Is everything all right? -Yeah, fine.
(CHATTERING)
Rob.
-Have you two been introduced? -The opportunity hasn't come up, actually.
Oh, well, I suppose this is it, then.
Rob was my SpR when we still called them SpRs. I trained him.
-Oh. -MAN: Mary?
-Oh, excuse me. Sorry. -Sure.
You knew I was working here?
well It's not a situation I would've chosen. It's the way things turned out for me.
But we could try and make the best of things. we're not Ahab and the whale.
Congratulations on your appointment, by the way.
-Thanks. Congratulations on yours, Roger. -Thank you.
-MARY: Thank you, Roger. -Of course.
For Gynae, no mortalities.
I had one patient transferred to HDU following perioperatlve blood loss.
I'm happy to say that she's doing very well now.
Can you tell us more about the perioperatlve blood loss, please, Roger?
Yes, the patient was admitted with left illac fossa pain.
Before we could make a firm diagnosis, the ovary haemorrhaged,
but oophorectomy was successful
Any further questions for Mr Hurley?
-Thank you. -MARY: Rob.
Obstetrics. we had no maternal or foetal mortality.
we experienced a shoulder dystocia, which resulted in a clavicular fracture.
However, I'm pleased to say that mother and baby are now doing extremely well.
we performed 12 caesarean sections, giving a rate of 24%.
As you know, Rob, that's in excess of the target set us by the Department of Health.
would anyone like to comment?
Moving on to Gynaecology
You'll feel weak for about 24 hours and then we'll assess your progress.
-But hopefully home in the next few days. -Thank you.
-Donna? Donna. -Roger.
-what a surprise. How are you? -I'm fine, thank you.
-what brings you here? -Oh, agency work.
-I thought you'd left all this behind you. -No, how many of us have tried and failed?
Quite. Listen, I can't stop, but really, really nice to see you.
-Sure. -See you around.
Sure you don't want a cuppa?
Plenty of time for skiving when I'm on maternity leave.
I hope you have a quiet night.
I definitely won't be back before midnight.
-I might go and see Rich, then. -what, again?
Yeah, he said something about getting together to watch the game.
You don't mind, do you?
The amount you two are seeing of each other, you should be having an affair.
TV ANNOUNCER: Well, Group E remains delicately balanced...
All right?
Pint of lager, mate, please. That one will do. Cheers.
All right?
-Been here long? -No, no, just arrived.
I'll grab us a seat.
just to remind you, then, the country finishing top of the group…
-There you go, mate. -Thank you.
-Rich, I need a bit of advice. -what, you and Polly?
Fuck off, no.
I've been feeling kind of weird.
what are your symptoms?
Month history of insomnia.
Bit of short term memory loss. Anxiety.
Sense of fear, feeling on edge and nervous tremor.
Christ, you describe what it's like to be a first year consultant.
Trust me, mate, I've been there.
Come and see me as a PP.
Thanks.
-So, what are you thinking? -I'm thinking...
this Is probably nothing, mate.
Except for you being totally stressed out about your job,
your relationship and impending fatherhood.
okay.
How many neurological patients whose symptoms are originally put down to neurosis,
-actually turn out to have an organic Illness? -Most.
Rich, I really don't think this Is nothing.
okay.
what would be your differential?
Do you eat beef or beef products?
Have you ever received an Injury from a surgical Instrument?
It's a possibility, nothing more.
The answer is yes, to both.
I'll go do the tests. It's not an easy diagnosis to make at this early stage.
You're thinking the worst, mate. we don't even have a diagnosis yet.
Course I'm thinking the fucking worst.
Variant CjD progresses to dementia. Death occurs between 12 and 24 months.
If I've got It, there's absolutely fuck all you can do for me.
I can destroy my notes.
Give you time to buy critical Illness and life Insurance,
though that might be premature.
I'm a doctor. I know what I've got.
You've got a baby due.
whatever the diagnosis, you gotta get your life sorted.
-I heard you come In. -I'm sorry, I'll be up soon.
-Is everything okay? -Fine.
I just thought with the baby... Nothing morbid.
-I was thinking about the Surinda Carr case. -Sorry?
She was an emergency section, twins. Lost one of her twins.
Ah. yes, It was very upsetting.
You cut my hand.
-Dld I? -During the section, with a scalpel
I... I don't recall.
If I didn't do so at the time, then I apologise now.
I just wanted you to remember.
That was three years ago.
I assumed we wouldn't be revisiting old cases. This is a new start, for both of us.
Listen, we haven't really established operating protocols.
I had a boss once that could be a danger to patients.
Shit.
You ever see me doing anything like that, you step In and stop It happening.
Rob, you're totally on the ball.
I know. I'm just saying, you save the patient from coming to harm.
Okay.
(PHONE RINGING)
Gvnae. Speaking.
HI.
No, It's just your call took me by surprise, that's all.
Let me think about It, and I'll see how It fits in with my plans.
Yeah.
akay. Bye
spit!!-
well I'm sorry If my invitation took you by surprise.
I've moved to another hospital, haven't really made any bonds yet.
-So, have you seen anyone from the old days? -I've lost touch.
Yeah. I suppose I'm the same.
No, that's not quite true, is It, Roger? Rob Lake?
well. YES-
-we're trying to make the best of It, though. -Does he want to make the best of It, though?
As I recall you got him suspended,
and then you refused to provide him with a job reference.
I look back on that adversarial relationship with some measure of regret.
I was a fairly new consultant, only a couple of years into my post.
I was inexperienced.
There were things that I didn't deal with as well as I could have. And Rob was one of those.
You never struck me as someone who suffered from self-doubt.
why did you move jobs, Roger?
I was ready for a change and the post at UH came up.
But you were in your element. Clinical Director.
Harriet and I are no longer together. It felt like a fresh start.
-I'm sorry. -It's such a surprise, seeing you on the ward.
A very pleasant surprise.
One of the things I realised about my last post
was that I didn't confide enough in my colleagues.
As a new consultant, I should've been open to advice more often
and should've tried to share the pressures more.
what pressures do you mean?
well I felt vulnerable to criticism. what doctor or nurse doesn't?
A single accusation could be the end of your career.
Occasionally, procedures didn't go as well as they might have,
and you continue as If these things have no effect.
But they do.
For fuck's sake, Pol, don't you ever check the dates on these packages?
we're having all this food delivered
and It doesn't end up on our plates, It doesn't end up In the freer,
It ends up In the fucking bin.
How much money are we pissing away on this lot?
-Christ, Rob, It's only a few quid. -It's not only a few quid, Is It?
And It isn't the only thing.
You've got a wardrobe in there half full of clothes that you never wear.
-Because I got pregnant. -How much money do you owe?
-what? -How much money do you owe on the credit card?
-Don't know. -well, roughly, to the nearest thousand?
what are you talking about?
we're having a baby, Polly. Don't you understand that?
we have to provide.
HI, Rob.
Thanks.
-Is this her? -who?
The right patient.
Dawn Blair, vaginal hysterectomy.
-Is everything all right? -I just don't want any fuck-ups, that's all.
Mary, hi.
-we're expecting a good turnout, Roger. -Oh, very good.
I received this.
Came via the internal mail, addressed to me as Clinical Director.
I decided to look over the notes relating to your patient
who had the severe perioperatlve haemorrhage.
She was admitted as an acute abdomen,
but you didn't make the diagnosis till nearly 36 hours later,
by which time her condition was life-threatening.
well there were problems securing an ultrasound scan.
So you're aware of Dr Clacy's personal style?
It's a matter for the radiology department, we just have to make the best of it.
I'm sorry, Roger, consider the matter closed.
Thank you, Mary.
sorry.
So, I've decided the only thing to do Is to open her up.
Are you sure It's this way? Bloody UH. Their signs don't make any sense.
Anyway, the thing is shaped like a football,
so I said, "why not turn it inside out? She can use It as a swimming pool"
TONY-
Rob. Rumours of my death and all that, hmm?
You don't have to go everywhere handcuffed to a security guard, then?
No, It's the post-suspension equivalent of care In the community.
who's the unlucky hospital?
Um...
TONY: Rlght, I'll...
You're fucking kidding.
He's back at your place, you're working with him and you never said anything?
Because you'd react like this.
I'm reacting like this because you never said anything.
That'll be the reason.
welcome, everyone.
It's particularly pleasing to see those colleagues
who've made the journey from our neighbouring hospitals.
I'm convinced that it's Rob.
And now you're worried that you might have done something to bring It about?
well you could argue that I should've followed up on the ultrasound straightaway.
It's my responsibility to ensure that my juniors carry out the orders they've been given.
Then we'd have had the diagnosis
and I could've operated well before she nearly bled to death.
well you weren't to know about the problems with getting scans.
well now you've got the lay of the land, you're back In your stride.
Thanks, Donna.
Delivery room 1, please. Thank you.
Victoria, I'm Tania, your midwife. Let's get through to the delivery room.
Okay, you're all right.
-How many is that? Two? -Take It easy. It's okay.
-Okay, slowly does It, slowly does It. That's It. -Okay.
That's It. It's all right.
-That's It. -I'm Roger Hurley, the consultant.
(GROANS)
All right, sorry. Tense, tender uterus.
Put this over your face, okay? Some oxygen for you and the baby.
You're at the right place, okay? we'll look after you.
Here we go. Keep your arms straight. You're doing really well.
Okay, fine. Thank you.
BP's 90/60.
Okay, there's the baby's heartbeat.
Can you hear It? You're doing really well.
Okay, ultrasound now, please. Thank you, Farah.
Thank you.
Okay, Farah, often an abruptlon is difficult to visualise,
so diagnosis has to be purely on clinical grounds.
Victoria, It's most likely that the placenta has detached from the lining of the womb,
causing the severe blood loss.
At this point, the baby's not in distress and we're replacing your blood loss.
Hopefully, the placenta will stabilise and the bleeding will stop, okay?
BP's still 90/60.
let's give her two units of O-neg while we wait for the crossmatch, please.
(VICTORIA GASPING)
well done. You're doing very well.
All right, Victoria.
Farah, can you make sure there's an anaesthetist standing by, please?
It's okay.
DONNA: Right, okay, If...
Let me know If It drops below 14 mils, okay? Thank you.
was It you? The anonymous note?
This conversation sounds familiar somehow.
I thought you said you'd moved on. what changed your mind?
The question is, has Hurley changed? Has he moved on from killing mothers and babies?
Deceleratlon?
Victoria, I was hoping the bleeding would stop, but It hasn't.
I'm afraid I'm now concerned for the wellbelng of your baby If we delay any longer.
I would like your consent for a Caesarean section, please
-Yeah. -Good, I think It's the safest course.
Transfer her to theatre, please.
Forceps and scissors, please.
we're doing a vertical incision because the uterus is small for date.
Oh, shit. Suction. Swabs.
I can't get in. Oh, shit.
Extending the Incision.
Fuck.
(HEAR'T MONITOR BEEPING RAPIDLY)
BP, 90140.
-Pressure's dropping. -I can hear, for fuck's sake.
Doyens out.
Fundal pressure.
clamp.
Okay. 40 of synto please.
More crossmatch FFP.
Clearlng placenta.
-Doyens In. -Cold gases on that, please.
Carboprost 250 micrograms, for lntramyometrlal injection.
Come on.
Okay, let's try and save the uterus. Give me a big stitch, please.
Come on, I can't see a bloody thlng. Suction. Come on!
(HEART MONITOR FLATLINING)
She's In VF arrest. Charge the deflb to 200.
-Clear. -Clear.
Shocking.
She's asystolic. Start chest compressions.
Adrenaline.
I can compress the uterus...
-Good mobility? -Yeah.
Okay, continue current management. Excellent.
-who's next? -Miss Hall.
-Ready? -Yes.
Simon, I'm afraid I've got some bad news.
ROGER: But the bleeding was very severe. we weren't able to stop It.
(SIMON SOBBING)
SIMON: My baby?
ROGER: The baby was premature and very weak,
and the bleeding was too severe for the baby to survive.
I'm really sorry, Simon. I understand this Is a difficult time for you,
and If there's anything we can do, please don't hesitate to ask.
I'm really very sorru-
I did everything I could do for them,
but the degree of foetal anoxla and the volume of blood loss was...
The bleeding was torrential
Perhaps I could have got the baby out a bit sooner
or made an earlier decision to carry out the hysterectomy.
would that have made any difference, do you think?
I don't know. It's impossible to say.
-But It might have saved her life? -Yes, It might have.
You know, all these decisions lie In a grey area of clinical judgement,
and I thought that once I'd been a consultant for long enough,
that the grey areas would become black or white, but they haven't.
I'm not sure If they do for anyone.
Is it something like this that made you move, Roger?
No, that was a separate matter.
A silly misunderstanding.
Police got involved.
They didn't press any charges, but it was yet another thing
to come between Harriet and me.
It's okay, Roger. It's okay.
-Do you still see your husband? -Ex
-You're single now? -No, separated.
That's single.
So what happened with you and the police?
-I was drunk. -Hmm.
Things were bad between Harriet and me and... well they hadn't been good for a while.
Things weren't great at work, either.
I don't remember much about It, but...
well I couldn't find a toilet and I used an alleyway or something.
-I was convinced no one could see me. -You were having a piss?
Yeah, course. why, what did you think I meant?
No, just...
-what are you playing at with Roger? -I'm researching my story.
That's it?
ROGER: Perhaps I could have got the baby out a bit sooner
or made an earlier decision to carry out the hysterectomy.
DONNA: would that have made any difference, do you think’
ROGER: I don't know. It's impossible to say.
DONNA: But It might have saved her life.’ ROGER: Yes, it might have.
And you're filing your story?
I thought I understood him.
I understand him.
I understand that a dangerous doctor should not be protected by the system,
he should be punished by It.
He got In trouble with the police.
I'm with someone.
Yeah, well, I'm back on the hospital grapevine. I heard about Polly and the baby.
I should have told you earlier,
but I didn't want to sound like one of those guys who says, "My wife doesn't understand me."
Our relationship just kind of happened.
Pregnancy just kind of happened.
I don't know If any of this Is really what I want.
Or even what she wants.
we've been here before.
I had to put my life in order. Now It's your turn.
First Tony, now Hurley.
what are you talking about?
Did you know he had a police caution and not tell me?
we agreed you and Roger Hurley would keep away from each other.
I didn't want to inflame the situation.
Someone had to write a reference for him. who could that have been?
-It was Tony. -Exactly. Tony Fucking Whitman.
He's written that reference to get his job back. You're working with him again.
This guy committed professional suicide over some dippy little thing that he had for you.
Is he working today? Is he?
Rob. Rob!
Cabln isn't pressurised. I've gotta keep her below 10,000 feet...
Hello, Rob. What are you doing here?
Excuse us. Thank you.
-Polly's having a scan. -Ah, the young lake in the making.
-Let's hope he's not all surly and northern. -You've sold out, haven't you, Tony?
Giving Hurley a reference so that you can grease your way back In.
And to cap It all his first post is at my place.
Yes, that was hilarious, I admit, but unintentional
Yeah, It's fucking hilarious.
Your reference counted because you're a senior consultant.
I want you to rescind it.
And I want you to testify to all of Hurley's fuck-ups that he's committed over the years.
As a senior consultant, you'll be believed.
Why go looking for trouble, Rob, hmm?
We've been through all that Hurley shit. We were lucky to survive It.
I'm boss of my department again, you're a consultant on your own patch.
It's time to look to the future, son.
Still breech. Shit.
(DOOR OPENING)
-Hope you don't mind. -Where Is he?
Don't know.
I thought you might need a little, you know, moral support.
WHY are you doing this?
-Someone has to. -No one has to.
-I do. -why?
Tell me.
All that we've worked for, what we've got now, that's what's at stake.
-I know. -Why now?
Now that we've got a future.
You think that we have a future?
I've done nothing for too long. It's time I finish Hurley.
Drive me home.
Pulse and respiration were absent in the baby,
a boy weighing 1.94 kilograms.
He did not respond to resuscitation and was pronounced dead at 16:11.
The mother was severely haemodynamlcally compromised by the abruptlon.
Urgent efforts were made to close the uterus,
but the patient experienced a VF arrest.
She received six cycles of CPR,
but did not recover from asystole.
She was pronounced dead at 18:30.
I've arranged counsellIng for the patient's husband,
and the same opportunity has been afforded to all the staff involved.
What uterine incision did you employ?
Well, given the state of the pregnancy, I adopted a vertical incision of the uterus.
It's unorthodox to use a vertical Incision after 28 weeks. Why would you do that?
The uterus appeared small for the dates, and I judged it to be the appropriate technique.
How long did it take you to deliver the baby from the time after you opened the uterus?
-I'll have to consult my notes. I don't know. -That's okay.
I've got them here.
Working backwards from the time of the baby's death, about five minutes,
I'd argue that this delay contributed to the baby's death,
and that a orthodox transverse incision would have resulted In a prompt delivery.
Mr Lake, we appreciate the MEM meeting as a forum for robust debate, but...
Did you avoid an orthodox transverse incision
because you were concerned about extension into the venous plexus of the broad ligament?
Well, we're all aware that that is the rationale behind the vertical approach.
Did you consider hysterectomying the mother?
-Yes, of course. -At once?
-Obviously, It was an option... -At once?
-Mr Lake, I really think... -You delayed a hysterectomy
because you wanted to give the patient, prlma gravida, the chance of having another baby.
And in delaying the hysterectomy, you allowed her to exsanguinate.
Mr Lake, I'm gonna have to ask you to leave.
Ask him about Karen Taylor and her baby.
Mr Lake, If you have a problem...
Let's talk about Karen Taylor, Mary, this Is a case that you're unaware of.
Roger Hurley managed a placental abruption four years ago
on which the mother, Karen Taylor, was left brain damaged,
and her 28-week-gestation baby was stillborn.
Karen Taylor's brain damage occurred as a result of Mr Hurley extending the uterine incision
into the broad ligament,
which is why he was desperate not to make the same mistake this time.
But in doing so, he caused an adverse delay In delivering the baby.
As in the case with Karen Taylor, he also delayed performing a hysterectomy,
which is a mistake you haven't learnt from, Roger,
and Is the cardinal error responsible for Victoria Newby's death.
-...submucosal flbrolds. -Mr Lake.
-Miss Dodd…. -Come with me at once, Mr Lake.
I would like an explanation for your outrageous conduct.
-I want to protect the patients from Hurley. -We look into every maternal death.
We've looked Into this one and there's no evidence that Roger Hurley was negligent.
He fucked up the caesarean and he fucked up the hysterectomy.
-You're wrong about him, Rob. -1 was his SpR
No, you're wrong about him. He's a decent, hard-working consultant.
Then why Is his reference fake?
Would you have given him a job here knowing that he had a police caution
for a sexual offence?
-Clearly, I need to look into this allegation. -Yeah, I'd say so.
-You'll stop him seeing patients in the meantime? -You do your job and I'll do mine.
-Who've you been talking to? -No one.
Well, you must have talked to someone, Tony, because UH are querying Roger Hurley's reference.
I resent the assumption that I'm the one with loose lips here.
-I can assure you, Sir Paul.. -Oh, just stop It.
This isn't The Apprentice. You do understand what this means?
-Well, yes, that we've been caught. -We?
Oh, here we go again.
Can I help you, Rob?
You seem pretty friendly with Roger, given that he's under investigation.
Well, I've looked into this matter and I find your accusations against Roger baseless
for two reasons.
Firstly, that although his profession is exempt under the Rehabilitation of offenders Act,
Roger was under no obligation to declare a caution.
It was his hospital who sought to conceal it from his new employers.
If it should've been in his reference, he should have declared It...
But more importantly, that the nature of the misdemeanour, as described to me,
has no bearing on Roger's fitness to practise as a consultant obstetrician and gynaecologist.
Our management here is butting heads with their management over there, so let's leave them to It.
I don't take kindly to one doctor in my department seeking to denounce another.
Doctors stick together.
DONNA: What pressures do you mean.’
ROGER: I felt vulnerable to criticism.
What doctor or nurse doesn't.’
A single accusation could be the end of your career.
Occasionally, procedures didn't go as well as they might have,
and you continue as if these things have no effect
But they do.
So, filed the story yet or what?
You tried your best, but...
Well, maybe It's too complicated.
People want simple answers to who's a good doctor, who's a bad doctor,
and there Isn't one.
I'm relying on you, Donna.
You always said doctors should deal with doctors.
You're not going to the medical authorities, are you?
This exposé on Hurley was just to get your new career going.
And now you don't want to burn any bridges just In case this crappy journalism goes tits up
and you have to go back to wiping arses for a living.
-Fuck you! -Am I the only one
who sees this in black and white?
-Roger Hurley, he's gotta be stopped. -You didn't see it before I arrived.
Maybe my crappy journalism is the kick up the arse you needed.
The excuse to do what you should've done a long time ago, but didn't have the balls for.
You may have sweet-talked Mary, Roger, but you and I know the truth.
I thought we had an understanding. Why won't you let this drop, Rob?
-You destroy people's lives. -If you attack me, then I have to defend myself.
You destroy people's lives, then you just walk away.
I do neither. I've just spoken at length with Victoria Newby's husband.
Widower.
I've just spoken to him at length
and he, like everyone else involved, agrees that this was a tragic accident.
-Then I'll make the complaint. -You weren't there.
Your testimony would be speculation, nothing more.
Who's gonna take a complaint like that seriously?
(POLLY GROANING)
Oh, shit.
Contractions are four minutes apart.
Well, she's breech. She was due for an elective. She needs an emergency section.
-Oh, fuck It. -What's happening, Rob?
-They're full -Oh, shit!
It's okay. I'll sort It.
It's Mr Lake. Who's covering obstetrics today?
What's happening?
We're gonna have to go to my place.
I'll go and get scrubs on.
NURSE: The consultant's waiting for you, Mrs Lake.
Hello, It's Polly, Isn't It?
Okay, I'm Sarah. I'm your anaesthetist. That's It. Let's pop you up.
Okay, we need to pop you up on the table as soon as possible.
I'm just gonna go and get you a robe.
-No, no, no, I'm having a contraction. -All right.
Hello, Polly.
Everything Is perfectly In tune.
We'll get you a spinal and by then Rob should be back here with you.
We should crack on, yeah.
(POLLY GROANING)
SARAH: All right.
ROGER: Okay, Polly. As soon as the anaesthetist is done, we'll get started.
Bit of pushing and pulling now, Polly. Of course, you know all this.
-You're doing really well, Mrs Lake. -I'm not Mrs.
Doyens. please.
Er, the dads don't usually get this close, Rob.
I'm not a usual dad, though, am I, Roger?
Scissors and forceps, please.
A clean knife.
Stop the procedure. Mr Hurley, I'm relieving you. Everybody, wait while I scrub.
What are you doing, Rob? Rob? What's wrong?
Nothing's wrong, Polly. Rob, are you mad? I'm about to deliver the baby.
You're endangering the patient and the baby's lives. I'm taking over.
Rob, what's gone wrong?
Nothing's gone wrong, Polly. Everything's absolutely routine and under control.
Does anyone disagree?
Right, I'm gonna do the correct thing and continue with the delivery.
I'm the baby's father and you'll respect my wishes.
Somebody get me a gown. I'm withdrawing consent for you to continue, Roger.
-Rob? -Rob, this Is Insane.
You're making a mess of this operation, Roger.
-I'm taking over. -Rob, has he damaged my bladder or something?
What's going on?
No, the bladder's successfully been reflected. Everything's fine.
I'm intervening before he does do some damage, Polly.
Rob, you're totally out of order. You can't deliver your own baby.
There's no such rule. However, there Is one against negligent practice.
Well, I'm not negligent. I'm not being negligent.
-Christ, Rob, tell me what's happening! -Everything's perfectly fine.
Rob, this Is ridiculous.
Everything's gonna be fine, Polly.
-Step aside, Roger. -Rob.
-Step aside, Roger. -Please don't do this.
-Roger. -Please stop this.
Roger.
Please don't do this. Please don't. No.
(POLLY WHIMPERING)
-POLLY: No. -Clean knife.
Please stop this. Please.
Doyens out.
clamp.
Scissors.
(DRYING)
Where Is she?
(BABY WAILING)
Congratulations.
With the first one, there's possibly feelings of denial that you're not ready to be a father.
It's a... It's an emotionally difficult time.
We don't always know how we're gonna respond.
I suppose I'm saying, Rob, I don't want this to turn into something.
My girlfriend could have bled, my baby could have died.
Well, that's... That's clearly not the case.
I'll say that you were just about to put your scalpel into her bladder.
-You'll say? You mean you'll lie? -Truths, lies.
Little bit late for such unhelpful distinctions, don't you think?
But the theatre staff, they'll back me up.
I'm a consultant obstetrician. Whose word counts for more?
This is insane, Rob. Why are you doing this to me?
(DOOR OPENING)
She'll see you now.
Rob, I don't deserve this.
You were risking my life and our baby's life,
or you were using us both to further your personal vendetta against Roger Hurley.
Roger Hurley destroys people's lives, Polly. He kills people.
Was I In danger? Was our baby In danger?
He kills people.
You bastard, Rob. You never really wanted this baby.
You never really wanted me. If you were prepared to risk It all for...
You'll never see this baby grow up. Never! Never!
(BABY WAILING)
Hello, Mary, morning. Can I help?
I'm sorry. Sharon, can you give us 10 minutes, please?
Thank you.
I'm very sorry. Roger.
I've received formal notification from Rob Lake
that he's reporting you for alleged negligence during the delivery of his baby daughter.
He's also reporting Tony Whitman for providing a false reference.
Let me tell you, I did everything I could to deter him, but he's blowing the whistle.
No, no, It's denunciation. What, a word to the authorities,
and then suddenly a poor Innocent like me Is shipped off to the Gulag?
Look, there are... There are a dozen consultants and administrators,
surely together we can shut him up.
He's reported you to the General Medical Council
I don't... I don't deserve this, Mary. I don't deserve any of It.
I'm sorry, Roger.
I've had no choice but to advise management to suspend you from clinical practice.
They allow 15 minutes for you to clear your desk.
Take as long as you want.
Well, good. Good. They're right.
Think we'll probably have to keep our eye on this, but, you know.
-So? -So.
-I'm feeling okay. Better than I thought I would. -Good. Good.
-I'm really sorry, Tony. -No, come on.
GMC, you know what they'll do. They'll skirt around the real issues
and they'll probably ban me from writing references or something.
Relax, Polly, I'm fine. Absolutely fine.
Do you know...
I've had some experience looking after babies. Twenty years ago.
They still use nappies, or have they Invented something better?
I'm serious, Polly. You know, If you need anything, anything at all...
Thank you, Tony. You're a good friend.
Well, I was hoping that I'd be rather more.
I guess you're a pushover now, hmm? Hard-up single mum.
Seriously, Polly, I mean It.
Is there any chance that I could be more than a friend?
just a tiny chance?
No, Tony.
A teeny-weeny tiny chance?
Maybe.
Excellent.
I need a minute. Thank you.
You blew the whistle.
You always said you'd never do that.
I did.
-It's as likely to ruin your career as mine. -Maybe both.
-You made mistakes, too. -I did.
Medical mistakes that hurt people, that cost lives.
I did.
And I tried to make things right when I could.
-You didn't. -This system doesn't allow
for that level of understanding, only blame.
-You could have asked for help. -Really?
Did you ever?
For years, a dangerous doctor's been protected, quietly moved on.
Glowing references have been falsified.
I really don't believe that the GMC won't wanna know who knew what
and who covered what whilst babies and mothers were being harmed.
It could take years.
Like you said, It's something I should have done a long time ago.
All I needed was an excuse.
Are you gonna go back to nursing, then?
I missed it. Didn't think I would, but I did. I really missed helping people.
-Here? -Somewhere.
RICH: Premortem diagnosis can never be 100% certain.
That means that the news I give you at this early stage
can't be taken to be either a death sentence or a clean bill of heath.
I understand.
How do you feel?
Good.