I think you've got an issue with food, Kim.
Help me understand what's going on.
Part of being a doctor is doing the medicine. So do the medicine!
I'm done with this rotation.
Maybe it gets better from here.
It does.
I know the treatment has been successful,
but, uh, I'd advise more time to rest.
I keep getting this, um... like, stabbing stomach pains.
I don't think I love you.
I think I am only with you to fix you.
I'm pregnant. What do we do?
Whatever you need, I'm here.
CHURCH ORGAN PLAYS
Congregation, please stand.
ORGAN MUSIC STOPS
HORN BLARES
TYRES SCREECH
HORNS HONK
So what you're saying is you don't trust me.
No, don't put words in my mouth.
I'm not putting words in your mouth! You're the one that went
and got a lawyer! Look, I just want to make sure we both know
where we stand.
Detailing where your shared child will live?
Have you lost your mind?!
TYRES SCREECH
HORNS BLARE
It's OK. It's going to be OK.
Do you know what?
I can't talk to you when you're like this.
Oh, right, shall I go and find myself a lawyer
and send you a letter?
Mum? Mum!
Is she going to die?
Get her on her side. Quick!
Try and tilt her chin up.
Iain! Look!
Get your seat belt back on, now!
HORN BLARES, TYRES SCREECH
I wonder if Kim leaving means Matty will stay on,
Hm! Bet you do.
Look... Right!
RIDA YELPS
PHONE BUZZES
Hey.
Stevie. Faith's waters have broke. She's bleeding.
Stevie? Right, OK. Uh, just get her here, we'll be ready.
Right. Hold tight.
HORNS BLARE
SIREN WHOOPS
Hey, Matty. I spoke to the Resident Education Lead.
At this point it's just a formality.
If you want it, the job is yours.
Oh.
Right, OK.
I thought it was what you wanted.
Uh, no, it is.
Thank you.
OK. Uh... And just so I know...
..if Kim hadn't have left,
would you be having this conversation with her instead of me?
Look, I wouldn't back you if I didn't want you in my department.
Can I have a think about it?
It's just I've been on a night shift, and my head's fried.
Yeah, sure. Think about it.
Um, just don't take too long, OK?
Dr Nash? Yeah. Wei Chang.
Kim Chang's father. Oh, right, er, she's not here today.
She tells me she no longer wishes to be a doctor.
Not just in the emergency department. At all.
Well, I'm really sorry to hear that, because she's talented.
I do not wish for her to throw away her education.
Hey, look, Mr Chang,
this sounds like a conversation you need to be having with her, not me.
Sorry. I still need to speak to you. I'll wait.
Er, excuse me, sorry.
I'm Matty. I'm one of Kim's friends.
Did you say she's quitting completely?
OK, she's 30 weeks? Er, yeah.
What was she doing when her waters broke? She was, um...
We were arguing. Luka?
I'm here, Mum. Luka.
I'm sorry, baby. Are you OK?
Are you OK? Right, Luka, stay out here. I'm sorry. Luka is absolutely fine. Let's get you sorted, OK?
Take her into bay 3, please. Thank you.
Stevie, if you have to save one, save her.
It doesn't work like that, OK?
Just need you and Luka to hang tight.
Come here, mate. Come here.
No, no, no, don't worry, don't worry.
I'll see if I can ask Teddy.
Look, just let me know if you hear anything, OK? Thanks, Jan.
Whoa! Sorry.
I'm so late. Town was absolutely gridlocked, it's mad out there.
Faith's gone into labour.
What, now? But hasn't she got, like, two months left?
Yeah.
OK, let's get some oxytocin up, and we'll do 1g of TXA,
and let's do 800 milligrams of misoprostol.
Can we prep two units of o-neg, please?
Right, line's in.
FAITH MOANS
Yeah, that's really tender round there. Or really firm.
OK, we could be looking at an abruption.
Um, Rida, are you OK to do...?
Let's do FBCs, U&Es, clotting and crossmatch, please. OK, she's still
losing a lot of blood. Can we get some inco pads, please?
I'll get O-neg in. OK, thank you.
Just get here as quickly as you can, please.
Hey, Stevie, emergency obstetrics are in theatre with a crash section.
The on-call consultant's on her way in, but she's coming from home,
so it's going to be half an hour at least. Right, OK.
Well, baby's breeched, so... What about Neo-natal?
They've got a septic 28-weeker, peri-arrest,
but they're sending down an ANNP down with CPAP.
Right, OK.
Er, so, yeah, let's... let's do the delivery here.
All right, OK, you guys are with the baby, I'm over with Faith, yeah?
Hey, hey.
FAITH SOBS
Look at me, look at me, OK?
So, baby wants to come early,
wants to meet her Auntie Stevie, all right? No, Stevie, not yet.
Stevie, no! Yeah, look, she's coming out
bum first, OK? No, no, no, I know you feel that way,
but we're going to do this together, OK? Me and you. Here? Mm-hm.
Yeah, here. How? Here, now.
How? Well, it's me and you, so...brilliantly.
OK. OK? OK.
It's your fault.
If she dies...
..it's because of you.
No-one's going to die.
OK, good, that's one leg free.
OK. Ah! I'm going to try the second. OK, ready for a push, OK?
Come on, Faith. Come on, Faith. One big push for me. Nice big push.
Here we go. Big push. OK. One push, here we go. Big push. Big push.
Yes! There we go! Good, good, good, good, good.
There we go, there we go. That's it, that's it. Yep.
There we go, that second leg is free.
We've got two legs and we've got ten toes.
Well done, Cadogan. Or Dean, or Fernandez, whatever your name is!
RIDA CHUCKLES
This is taking too long, Jodie.
She's ready to come, OK?
Yeah? So let's finish it with this one, OK?
Last big push.
FAITH MURMURS
Right, I'm going to take that as a yes, OK? Here we go.
One big push for me. Here we go, you can do it.
FAITH GROANS
One big push! Yes, yes!
LUKA: What's happening?
I don't know.
FAITH MOANS There you go. Well done, keep going.
That's it, that's it, that's it. That's it! Well done. Come on!
Like that! That's it, that's it, that's it. Yes! Well done.
Bear down, that's it.
There we go! Well done, well done, she's out, she's out. Well done!
Well done, you. Yes!
You did it.
You can rest now.
Where is she?
Oh, look at her, she's beautiful. Hi, baby.
Oh, well done. Hi, baby?
Oh, she's beautiful.
Hi, baby.
You can rest now, OK?
I... I can't hear anything, Stevie.
OK, it's OK. It's OK.
Right, OK, um, can we get TXA maintenance up, please?
And let's prep two more units, thank you. OK.
He's got flu-like symptoms, like shortness of breath
and a temperature of 39.4.
His heart rate is 78. His BP's 180/90.
Sats 97, and GCS 15 throughout.
OK, thanks. We'll take him straight through, please.
Do you know how Faith is?
No, sorry, I've been in cubicles all morning.
I'll see what I can find out.
FAITH BREATHES DEEPLY
I can't hear her.
She'll be OK. She'll be OK.
Right, OK, let's have 800 misoprostol, PR.
And we'll do oxytocin, ten units IV bolus,
and 40 in a 500ml bag over four hours, please.
Thank you.
Increase the Fi02 to 100%.
We'll do 30 seconds ventilation breaths.
Come on, baby girl.
Stevie...
Is she breathing?
They're working on her, OK?
So let's just focus on getting you sorted, all right?
Stay with Jacob.
It's OK.
Stevie? Iain! What's happening? No, no. Don't! Don't!
Rida, Rida, Rida, it's OK, it's OK. He can stay, he can stay.
Faith? Faith, I'm here, darling. It's me, can you hear me?
Yeah, you're all right. You're going to be OK.
Faith?
Faith?! OK, Rida, hit that alarm, please.
OK, Iain, if you're going to be in here, I need you to stand well back,
thank you. Faith, it's Iain. Faith, I'm sorry, don't do this!
Come on, come on. Come on! Get off! Get off me!
Let go! No, no, no, Faith! Wake up Faith. Stevie, do something, now!
Faith!
Kim, come on, open up, it's me.
Listen, I...
Listen, I know you're in there cos I just spoke to your dad.
He's only gone down to the ED to
convince Nash to talk you into staying.
What a legend, eh?
Kim!
Kim?
Ki...!
Oh, OK. Uh, BP's stabilising.
Yeah, pulse is strengthening.
Still tachy.
Faith?
Faith? Hey.
Hey, do you know where you are? Mm...
I think we've got the haemorrhaging under control.
STRAINED YELP, MOANING
It's OK, it's OK. It's just the placenta.
Rida, can you...? Yep. Thank you.
There we go.
Stevie, that...
That doesn't look complete to me.
No. No, it's not.
OK, so the rest must be attached to the uterus,
which explains the bleeding.
Yeah, I'll call Obstetrics. Thank you.
Cheers, Kaz.
Thank you. OK. Um, yeah, they're going to want to take her to theatre
because part of the placenta is still...still attached.
OK?
It's OK. Go, hold her hand.
Hey, darling.
It's me.
FAITH MOANS WEAKLY
Well done.
RELIEVED GASPS
OK. She's breathing.
Go on. See your daughter.
No, we'll do it together. No. Iain.
It'll help Faith if you go and be with your daughter.
So, go. I've got her.
Come on.
Congratulations, Dad. Thanks.
She's perfect.
FAITH CHUCKLES
I'm a dad.
Kim?
Kim, can you hear me?
No, no. No, no.
RINGING
Ambulance Service, is the patient breathing?
Hi, yeah. My name's Dr Matthew Linlaker,
I work in Holby ED. I need an ambulance to 72 Linley Way.
Matty? It's Indie. What's happened? Hi, Indie.
Yeah, I'm with Kim, she's unresponsive.
Signs of significant haematemesis.
OK, the nearest crew are about 25 to 30 minutes away
with the roads... No, Indie! Now, OK?
She's pale, her pulse is weak.
I'm worried she's going to bleed out!
Here we are.
Like a little oven-ready chicken. FAITH CHUCKLES
Just needs to finish roasting in the bag first, don't you, eh?
Hiya, baby!
I'm your mummy.
And I'm your hot aunt.
Erm, right, names.
Or name.
Not yet. I thought we had more time.
OK, that's fine.
I will just put her in the system as Baby Dean for now,
and, yeah, there's someone here who's desperate to meet his sister.
Oh, there he is. There's my boy.
Come here, come on.
Look at your wee sister! Oh, my goodness, look at her.
She looks so small. Are you OK?
Yeah, yeah, darling, I'm fine.
I'm sorry, did I scare you in the car?
You were amazing, though. Wasn't he amazing? You were.
Looking after your mum. You...
Flynn, I can't see her breathing. Why can't I see her breathing?
OK. All right, Faith.
Uh, Luka, let's get some fresh air, OK?
Luka. Come on, mate.
Yeah, she's apnoeic. She needs bagging again. OK.
Is she going to die?
The baby.
You know, babies' lungs don't fully develop until 36 weeks.
That's why your sister needs a bit of help.
But trust me, we can give her that help, OK?
Hey, it's OK.
I know it's a lot.
Sit down.
Now, listen.
We're going to put your sister on an incubator,
in a nice controlled environment.
Then they're going to take her up to neo-natal intensive care.
And those guys... Whew!
They're amazing.
Trust me, they know their stuff.
She'll be in good hands, all right?
LUKA WHEEZES
You OK?
You need your inhaler?
You've got asthma, right? No.
No?
WHEEZING CONTINUES
Mm-hm.
HELICOPTER ROTOR WHIRS
OK, so, obs-wise, I've checked her chest.
Chest sounds crackly.
She's tachypnoeic and tachycardic at about 20. OK.
Sats are sitting at around 92, but it's a home pulse-ox.
So it's up and down, but it's been about ten since I got here.
OK, well done. Let's put out a Code Red, please.
Alpha Sierra Helimed 8-6, Code Red.
And shall we turn her when we can?
OK, on roll. Ready, set, roll.
OK, let's get a large-bore cannula in, then, please.
Can we get bloods off, and two units of O-neg?
I'll stand by with ondansetron and TXA.
Yeah, OK. So her airway's patent.
Kim, I'm Josh, one of the helicopter paramedics.
I'm just going to pop this mask on your face.
Can you open your eyes for me?
OK, she's got shallow chest rise,
poor respiratory effort.
Can you pass me the end tidal?
Kim, if you can hear me,
I'm just going to pop a little needle in your arm, OK?
It's going to be a sharp scratch coming up.
Dylan. Show me.
Does she have an eating disorder? Yeah.
That you knew about? Yeah, yeah, I knew.
Er...
But I didn't know it was this extreme.
She said she was getting help. Erm...
OK, OK.
So let's do an ABG with the portable machine and a 12-lead
when we can, please. Yeah, on it.
She is struggling to maintain breathing on her own but we've given
her some PEEP and her sats have come up,
so moving in the right direction.
I'm going to leave you to it, OK?
OK, guys. Thanks, pal.
You OK?
You don't have to do that, Iain.
Do what? I heard you.
"If you have to save one, save her."
Which is right - baby's your priority,
but you said it in front of Luka, and Luka's already lost his dad...
No, no, I meant you.
Save you.
Faith, I've never been as terrified in my entire life.
The thought of losing you with things like they are between us...
Mm. Well, of course you're going to say that, ain't you?
Because here I am, lying in a hospital bed, needing fixing.
And that seems to be the only time you want to be with me.
Come on, that's...
Hey, um, NICU want to see her now, OK?
Iain's going to go up with her, aren't you?
Hello, my wee baby.
I'm going to come up as soon as I can, OK?
OK? I love you very much.
You take good care of her, OK?
You go with her.
Come here.
Thank you.
Right. One more of these. Nice deep breath.
Lovely, that's it.
So, do I have asthma, then?
Not necessarily.
There's a nasty flu going round at the minute.
But it is probably a good idea to make an appointment
at the asthma clinic. I'll speak to your mam.
No, she's got enough on her plate.
Well, she'll still have time for you.
I'll...I'll just ask Gran.
I'll be with her for a bit, anyway.
You know, when I was growing up, I'd have given anything
for a big brother.
I had an imaginary one for a while.
Yeah, I know!
He taught me how to skateboard.
Not very well, because I broke two bones in that wrist.
But your new sister is the luckiest little girl, having you around.
Right, so, Rida, liaise with ITU. Yep. I'll go now.
And Jodie, ten-minute obs. Don't take your eyes off her. I won't.
Right, you,
get some rest, and I'll see you later.
I will. Thank you.
Hey, look, um, Mr Chang,
if you're not here to see a doctor, then...
I need to see you.
Five minutes.
There are things you don't know.
OK. Take a seat.
Um...
Sorry, what was it you wanted to talk to me about, specifically?
Kim has atypical anorexia nervosa.
Right. I-I didn't... I didn't know that.
She has managed it well for a few years.
But we know from therapy that it is triggered by feelings of failure,
of...inadequacy.
Which, of course, this place doesn't help with.
I suspect that's the conclusion she's come to.
So you think that she feels the job will lead to a relapse?
It doesn't have to.
With the right support, this is something she can manage.
She doesn't have to give up completely on her dream.
I'm not asking for Kim to continue in her job.
But she admires you enormously.
If you were to speak to her again...
..I think she would listen.
Right, OK, so here's what we're going to do.
KNOCKING
I will...
Hey, um, sorry to interrupt. I'm afraid this is important.
That's OK. This is Mr Chang, it's Kim's dad, and he's... Yeah.
I-I know. I was told that he was here.
I'm afraid it's actually you I need to speak to.
She's also had 10ml calcium chloride, she's had 50ml of
8.4% sodium bicarb, 5mg salbutamol,
and, um, a 10% bolus of dextrose.
OK, let's get bloods, ABG and a cross-match,
and let's get a portable X-ray in here and a bedside echo, please.
We'll continue with fluid resuscitation.
10% dextrose infusion and electrolyte replacement.
Right, I'll do your primary survey. Uh, no, not you.
Don't you think you've done enough? What do you think you're doing?
Yeah, read the journal. Oi! Who the hell do you think you're talking to?
"Today, Dr Nash finally said I wasn't a total waste of space."
Hey! Dr Linlaker! You are talking to a senior consultant.
Smarten up or get out.
Yeah, sorry.
Right, Nicole, you do primary survey, please. You OK?
I'm on it.
KIM MOANS
Guys. Guys, she's waking up.
Kim?
Kim? Hi.
Hi, you're in Resus.
Yeah. Kim, can you hear me?
Airway's patent. Sats 94.
Resp rate 20.
Heart sound is irregular, it sounds like AF.
All right, let's get the 12-lead on, then, please.
MACHINE CHIMES
Yeah, pulsed VT.
OK, charge to 120. Let's sedate her.
No, we don't have time, we need to sync-shock her now
before she arrests. OK.
Right, everyone clear? Sync.
Wait! At least give her some midazolam. She's still conscious.
Matty, stand clear!
Syncing. Matty.
Syncing.
Yeah, we're all clear.
Right, shocking.
KIM MOANS
SHE GASPS, PANTS
Come on.
STEADY BEEPING
OK, back in sinus.
Kim, I'm so sorry. We had to do that, OK?
All right, let's finish our primary survey, please,
and get a FAST scan in here. Yeah.
Hey.
PHONE BUZZES
OK.
It's clear.
Completely clear.
Just, last time I had a scan, you know,
since then, it feels like the pain's...
..moved further up.
I'm not going to teach you to suck eggs, Stevie.
What would you tell a patient who's saying what you're saying to me?
Uh...
I would...
I would say to them that you're panicking...
..because somewhere, not so deep down...
..you know that there's always a chance that it could come back.
Um, I would also say that, um,
scar tissue is prone to inflammation, and it conducts
signals differently, leading to referred pain. Blah, blah, blah.
I'll refer you to Pain Clinic.
It might take some time to find a solution,
but keep working with them.
It's normal to be afraid...
..to think that every twinge or stabbing sensation is
the cancer coming back.
That fear might never leave you,
but you will learn to live with it.
I'm sorry for what I said earlier.
That's all right.
You were scared.
People lash out when they're scared.
Do...? Do you hate me?
Don't be daft.
Families say stuff, it don't mean anything.
We're not family, though. Not any more.
Course we are.
Look, Luka, um...
..my daughter is now your sister.
So that makes us family forever. All right?
Mum still loves you.
I know she does. She told me.
And you love her, so why can't you just sort it out
and we can be a proper family again?
It's complicated. No, it's not!
It might be hard sometimes, but...
..it's not the same thing.
When did you get so smart?
MACHINE CHIMES
Faith? Faith?
Can I get some help, please?!
FRANTIC BEEPING
STEVIE: You want to see which one dies first with
a hole burned in its oesophagus? I don't have time to hold your hand.
She doesn't want your cookies, or your tears,
what she needs is your strength and your clarity.
I can't afford to carry any more dead weight.
We're saving lives on a knife-edge here,
and with the CQC coming back, they're not going to want
a resident running off every five minutes to cry, yeah?
Part of being a doctor is doing the medicine.
So do the medicine. Got it?!
She was practising.
Look.
Difficult cannulation spots.
Hey. How we looking?
Um, there's an absence of free fluid in the abdomen,
but her IVC is very flat.
So it looks like a perforated, either duodenal or gastric ulcer.
She'll need an endoscopy.
Well, her lab bloods came through.
DYLAN EXHALES
Are you sure these are hers?
Or the results of an 80-year-old.
She, erm, definitely has multi-organ failure.
I should have done more.
If it had been a different mental health problem, if she'd been
depressed or suicidal... I didn't appreciate how bad it was, you know?
I know it sounds naive, but...
You said it yourself, you know, you didn't know how extreme it was.
She's obviously been abusing over-the-counter meds
and injecting weight-loss drugs.
We're going to need to speak to her.
I'll do it.
Sure.
How long has she been out? Uh, five, ten minutes.
Faith? Faith?
Yeah, that's not right. OK.
Yeah, her uterus has inverted. OK. I've only ever read about this.
Right, I'm going to try a manual replacement.
Lynne, can you fast-bleep Obstetrics, please?
Tell them this girl's the closest thing I have left to a sister,
to have theatre ready in ten minutes, or God help them! Yeah, OK.
Hiya.
I'm in renal failure.
Hyperkalemic, and in metabolic acidosis.
I expect my bloods probably show
poor liver function, too.
My chest X-ray probably shows pulmonary oedema.
There were inverted T-waves
and tachycardia on the ECG.
Differential diagnosis...
..left ventricular failure.
HE SCOFFS
You always were the better doctor.
I don't want to die.
Hey.
You listen to me, OK?
You won't.
OK?
We can fix this.
We can.
Are you going to intubate me now or when we go to ITU?
Now.
You should do it.
It's the last thing on your list.
DOOR OPENS
Dad!
I'm here.
I'm sorry. It's OK.
I'm so sorry!
Get yourself something from the vending machine
while I talk to your mum. Good luck. Get out of here, you!
Right, how we doing? Iain, step outside, please.
Stevie, what?! It's all right, we'll speak to you in a minute.
No, no, let me stay! Faith! Faith!
Bye.
I'll see you when you wake up.
OK. Ready to begin?
Yeah.
OK, bougie.
Here.
Thank you.
OK.
Cuff going on.
It's yours. Yeah.
OK, bougie out.
Inflate the cuff, please.
OK. We have end-tidal CO2.
Thank you.
It's fine.
Double-checking ventilator settings.
All correct.
RSI complete.
That was textbook, Matty. Well done. Thank you.
BEEPING
Guys! Guys!
Er, get suction on it. Yep! What have I done?
DYLAN: Nothing. What...? What have I...? Are you sure?
Yes, yes, I'm sure. Yeah, but how do you know?
The bleeding is coming through the mouth, isn't it?
It's not coming through the tube. That means it's a GI.
What if I've messed up? It's a GI bleed, that's not you.
She's PEA. Let's start compressions.
FRANTIC BEEPING
Faith? Uterine inversion, OK? We're taking her up to theatre now,
but I'll come back and talk you through it, OK?
Thank you.
FRANTIC BEEPING
OK.
Off the chest.
BEEPING CONTINUES
Back on the chest, then.
Let's, uh... Let's give another milligram adrenaline
and set up a prothrombin infusion, and 1,500 IU.
Hey.
Where's Luka?
Canteen, with Faith's mum.
Just tell me.
Let's give another milligram adrenaline and set up
a prothrombin infusion, with 1,500 IU over seven minutes.
Let's get more FFP.
More platelets. More cryo. We'll continue 8.4% sodium bicarb...
No, let's give her some calcium and vitamin K. Let's go. Come on.
How long's she been down?
FRANTIC BEEPING
Is there anything that we haven't tried? Anything?
I, uh...
I should have told you this sooner.
I'm sorry it's taken until now for me to figure it out, but...
The truth is, Faith, I...
..I did want to fix you.
But I wanted to fix you because I love you.
I love you so much.
HE SNIFFLES
And I don't know...
I don't know how I'm going to live
the rest of my life without you.
Letting you go was the biggest,
stupidest thing I ever did.
And I wish to God there was some way I could undo it.
FRANTIC BEEPING
Time of death is 14:45.
Come on. No! No! Get off me! Get off me, please! Matty.
Please! Stop. Stop. Stop! Please, Kim!
Matty, she's gone.
Kim... She' gone.
I'm really sorry.
I've been asked to give a reading today.
My name is Stevie...
..and I was Kim's mentor
during her rotation in A&E.
I know Kim would have made a brilliant doctor.
The bit I didn't know...
..was that she wouldn't get to be around to hear me say that.
Well done.
NICU team have been amazing.
I'm really glad to hear it.
Rash is about to do a rotation up there. Oh, yeah?
Yeah. Yeah, it's all part of my CESR pathway.
Have you made a decision about the fellowship yet?
I have, yeah.
I figured I should do it.
For the both of us.
So you're going to be around for a bit, then?
Looks that way.
I may have missed the first 24 years, but, you know,
as long as you're amenable to the idea, as long as you're here,
I think we should...we should have some sort of relationship,
no matter what it looks like.
Mum will want to see you, you know.
If we're spending more time together.
I hadn't thought of that.
IAIN: "Wherever you go
"and whatever you do,
"know that we'll always be right here for you.
"So, go out and get 'em,
"you brilliant girl."
FAITH CHUCKLES
"The world is your oyster,
"and you are its pearl."
Aw, Pearl.
I like that.
Yeah? Yeah!
Yeah, me too. Yeah.
Hi, Pearl!
We're your mum and dad.