PEOPLE CHATTER AND LAUGH
Mr Lake? Yeah. I'm Susannah Marshall, specialty trainee.
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.
I hope the sky doesn't come crashing down.
Morning. Morning.
Start Enoxaparin. I can order the ultrasound, it's on my way.
You really are new here, aren't you?
Why d'you say that? You'll see.
You've got me curious now. Thanks, Mr Lake.
Dr Clacy?
Sorry to bother you. I'm Rob Lake, I wondered 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.
Now 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.
OK it's crowning. Good, here it
comes, here it comes, come on, push!
That's it. Come on...
Ingrid, I'm Mr Lake, I'm a consultant.
Come on. Really, really well.
That's it, that's it, now come on, you can push. That's it.
Right, now you're doing so well.
Push. I can see the head. You're doing so well.
Push. Go on, my love, push.
OK, Ingrid, let's take a look. You're doing really well.
Ingrid come on, a really big push now. OK, nice big push.
That's it, big push down. Not long now.
Good girl.
Push.
Baby's coming. Come on, Ingrid.
Come on, Ingrid, big push.
OK babe, baby's out. Let's go, push!
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 going to
help get the shoulder's out, OK?
OK. Big push, darling, big push.
Susannah, give suprapubic pressure.
Good girl.
Keep pushing, keep pushing. Come on, Ingrid, let's go!
Really good, really push, come on. 30 seconds.
Really push. Shit! I'm going to try and turn him.
Fuck it!
And 60 seconds.
All right, still got time.
I'm going to try and release the posterior shoulder... Come on, Ingrid, keep pushing.
Come on, Ingrid, push! Shoulders are jammed. I can't get him out. Fuck.
One minute 30. Can somebody call....
Ingrid, big push! One minute 45.
Come on! Come on, Ingrid!
Right, Ingrid, listen to me, listen to me.
This is very important. You're going to hear a crack now.
I 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?
All right, all right, all right.
Good girl. Push, keep pushing.
There we go, there's the baby.
It's a boy. It's a lovely boy.
Well done, Ingrid. Good girl. Scissors.
Where's the baby? It's OK. They're just checking the baby out.
Is he OK? Yeah, they're just checking.
We're just giving him some oxygen, OK, Ingrid?
Why can't I hear him? OK, gently push now, please.
I'm sure it's fine.
A gentle push, here we go.
Just the placenta, well done.
Is he OK? It's all right, Ingrid, don't worry.
What's wrong? They're checking him out.
The doctors are just checking him out. He'll be OK.
Suture kit.
Few more minutes. You did really well.
They're just checking him out. He'll be all right.
BABY CRIES
There you go.
Well, done Ingrid. Congratulations, Ingrid. Well done. Well done.
Fucking hell.
CAR RADIO PLAYS
MUSIC PLAYS IN THEATRE
You're all done.
Here's your baby. Thank you.
You're so beautiful.
Congratulations. Thank you. Thank you very much.
Busy day? Sorry I didn't make the scan.
Was everything all right?
Ah, 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 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, this whole thing is a stupid misunderstanding
that's, that's 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'd be short at first, but they'd go back to normal
as soon as the social worker's satisfied that the boys... What, aren't in any danger?
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. Shall we talk here, or would you rather we went to the clubhouse?
No, here. I've got 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're getting 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.
Kevin Keegan. Fucking hell.
Ah, 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 focussed 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.
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.
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.
Clearly this reference would 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.
Your pair of total cocky wankers.
Good, good.
I'll let Chrissy here iron out the details.
HE CLEARS HIS THROAT
Oh, Tony! Polly.
You been up to anything while I've been away?
The locum should be here by 8am. If he's not, don't leave it to the administrators,
call the agency yourself.
OK. I'll keep my 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. Will you be back for the Regional O&G Forum?
We're hosting and I'm counting on a full departmental presence.
I'll be back. But I'll miss the interviews for the new consultant post. Is that gonna be a problem?
No, we don't normally ask a recently-appointed consultant to sit on the panel.
OK.
Well, enjoy the break.
Thank you.
What are you doing?
There's loads to do, and a week's leave,
so I thought I'd get stuck 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 of 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.
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.
OK.
PHONE RINGS
Hello.
Hiya.
How did you get this number?
No, no, 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.
MUSIC: "Club Foot" by Kasabian
So...
So... How are you doing?
I'm good. You?
Good.
How come you're in town? You've not moved down here, have you?
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 of 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, and I still do it from time to time when I could use the money.
And you?
Consultant yet?
Yeah. A month into my first post. How's it going?
It's good. That's good.
Wife and kids next?
That'll be the day.
How about you?
Divorced now.
Did you have a nice time?
Sorry. I didn't mean to wake you.
I'm not awake.
How's Rich?
He's fine.
'University Hospital.' It's Mr Roger Hurley.
I might not be on your staff roll yet.
'Welcome to UH, Mr Hurley.'
Thank you.
Just a small token, Roger, to welcome you aboard.
It's a, 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 it a little while, just till I find my feet...
Well, that's for later. For now, I was going to prevail upon you to deliver a lecture.
We're hosting the next Regional O&G Forum.
I wouldn't want to tread on the other consultants' toes. God, no. Yes, but you see how it might seem.
You know, just arrived and already hogging the limelight.
Roger, there's no point 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?
Yes, 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 elephant ears.
PHONE RINGS
Hello.
Now you know why I'm in town.
You knew about Hurley?
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.
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 bag.
OK, let's go and see her.
Fine, good.
Thank you, sister.
Who's next, Farah? Tracey Clark.
She came in on last night's take.
Tracey, I'm Roger Hurley, I'm the consultant.
Dr Hamid is 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 OK, Tracey.
Um, Farah, can we get an ultrasound scan for Tracey, please?
Yes, Mr Hurley.
Thank you.
Shit.
Do you think we should have the baby in with us for the first few weeks?
You'll never guess who's 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 not you'll have to cover. Ah, Mr Whitman, I need to talk to.
Mr Whitman, do you have a minute?
For you, of course, Ms Grey. ..Thank you.
Was it just a coincidence Roger Hurley left around
the same time you arrived?
We're rumblefish. You didn't do anything to smooth the path, did you?
Like what? Well, for a start he'd need a reference.
Polly, I can absolutely assure you, on my mother's grave...
For Christ 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 vadges of endless Tory housewives.
Did you even consider where he'd go, who'd 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...
Tracey, 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 specialty trainee, Dr Hamid, speak to you about an abdominal ultrasound for a...
Tracey Clark?
We had a discussion.
It's just the patient says she hasn't had her scan.
You have to leave her notes at reception.
Sorry, Dr Clacy, do you think you might be able to fit her in today?
Hold on, Tracey. Has she still not had a scan?
No... I'm sorry, I tried.
Well, it's too late now. I have to open her up.
OK, Tracey. Right to the back, that's it.
All right, Tracey.
OK, let's stretch her.
It's a torted cyst.
The pedicle's twisted two or three times. I'll have to untwist it.
Oh, shit! Suction! Swab!
Can I have two units to crossmatch please. Fucking hell.
Another swab, please.
Can't see a bloody thing. Suction.
In here, in here!
MONITOR BEEPS
BP's dropping.
Suction, Farah, come on, I've got to be able to see what the fuck I'm doing!
MONITOR CONTINUES BEEPING
We can't get in yet. Mr Hurley's emergency is still in theatre.
For fuck sake, we're losing her.
Come on, Farah, suction now, here!
Suction now, Farah, come on!
I can't see a bloody thing. Farah, will you get the suction in there!
Ah, shit! I can't let her die.
Yeah, got it. Good.
MONITOR BEEPS REGULARLY
Well done, everyone.
Well done to you too, Mr Hurley. Can I have a tie, please?
Some music, please.
Scissors.
MUSIC: "Can't Get You
Out Of My Head" by Kylie
Thank you.
Hi. Hi.
I was going to ask if you fancied a coffee, but you've already got one.
Do you mind if I ask, is everything all right?
Yeah, fine.
Rob. Have you two been introduced?
Ah, 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. Oh, excuse me. Sure.
You knew I was working here?
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.
Thank you, Roger.
Of course.
For gynae, no mortalities.
I had one patient transfer to HDU following perioperative blood loss.
I'm happy to say that she's doing very well now.
Can you tell us more about the perioperative blood loss, Roger?
Yes, the patient was admitted with left iliac fossa pain.
Before we could make a firm diagnosis, the ovary haemorrhaged,
but oophorectomy was successful.
Any further questions for Mr Hurley?
Thank you. 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
and be hopefully home in the next few days.
Thank you.
Donna! Donna! Roger.
What a surprise! How are you? I'm fine, thank you.
Wha... What brings you here? Oh, agency work.
I thought you'd left all this behind you. How many of us have tried and failed? Quite.
Listen, I can't stop, but really, really nice to see you. Sure.
Sure you don't want a cuppa? Plenty of time for skiving
when I'm on maternity leave.
Hope you have a quiet night.
I definitely won't be back before midnight.
I might go and see Rich then. 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.
All right? A lager mate, please.
That'll do. Cheers.
All right. You been here long? No, just arrived.
I'll grab us a seat.
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?
A month history of insomnia.
A bit of short-term memory loss, anxiety,
a sense of fear, of feeling on edge and a nervous tremor.
Christ, you're describing 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.
OK.
How many neurological patients whose symptoms were originally put down to neurosis
actually turn out to have an organic illness?
Most.
Rich, I really don't think this is nothing.
OK.
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's yes, to both.
I've got to do the tests. It's not an easy diagnosis
to make at this early stage.
You're thinking the worst. We don't even have a diagnosis yet.
Of 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 got to get your life sorted.
I heard you come in. Sorry. I'll be up soon.
Is everything OK? Fine.
I just thought, with the baby. Nothing morbid.
I was thinking about the Surinder Kaur case.
Sorry? She was an emergency section.
Twins, praevia. We lost one of the twins.
Ah yes, that was very upsetting.
You cut my hand.
Did I?
During the section, with the scalpel.
I don't recall.
If I didn't do so at the time, then I, 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 a patient from coming to harm. OK?
PHONE RINGS
Gynae. 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.
OK. Bye.
Spicy.
I'm sorry if my invitation took you by surprise.
I've moved to another hospital, I 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.
That's not quite true, is it, Roger? Rob Lake?
Well, yes...
We're trying to make the best of it.
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 was such a surprise seeing you on the ward.
A very pleasant surprise.
One of the things I realise
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 I...should've tried to share the pressures more.
What pressures do you mean?
I felt vulnerable to criticism. What doctor or nurse doesn't?
A single accusation...
is the end of your career.
Occasionally procedures didn't go as well as they might've.
You continue as if these things have no effect, but they do.
For fuck's sake, Pol, don't you ever check the date on these packages?
We're having all this food delivered and it doesn't end up on our plates, or the freezer,
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 and it isn't the only thing.
You've got a wardrobe in there half full of clothes that you never wear.
Cos I got pregnant! How much money do you owe? What?
How much money do you owe on your credit card? I don't know.
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.
We're expecting a good turn-out, Roger. Very good.
I received this.
It 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 perioperative 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.
I see. 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.
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 and you
could use it as a swimming cap?"
Tony.
Rob. Rumours of my death and all that.
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...
Right I'll, er...
You're fucking kidding.
He's back at your place, you're working with him, and you never said anything. As 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 straight away.
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.
Now, you've got the lay of the land, you're back in your stride.
Thanks, Don.
Delivery Room one, please. Thank you.
Victoria, I'm Tania, your midwife.
Let's go through to the delivery room.
OK, you're all right. How many is there?
Two. That's it. That's it.
Take it easy, OK, slowly does it.
Slowly does it. That's it.
Victoria, I'm Roger, I'm a consultant.
Sorry. Tense, tender uterus.
I'm just going to put this over your face, OK?
It's oxygen for you and the baby.
You're in the right place, OK? We'll look after you.
There you go. Keep your arm straight. You're doing really well.
BP's 90 over 60. OK, there's the baby's heartbeat.
Can you hear it? You're doing really well.
Ultrasound now, please.
Farah, often an abruption is difficult to visualise,
so diagnosis has to be purely on clinical grounds.
Victoria, it's most likely the placenta has detached
from the lining of the womb, causing the severe blood loss.
At this point, the baby is not in distress, and we're replacing your blood loss.
Hopefully the placenta will stabilise, and the bleeding will stop, OK?
BP's still 90 over 60.
OK, let's give her two units of O neg while we wait for the crossmatch, please.
All right, you're doing very well.
All right, Victoria.
Farah, can you make sure there's an anaesthetist standing by please?
Let me know if it drops below 40 mils, OK.
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?
Decelerations.
Victoria, I was hoping the bleeding would stop, but it hasn't.
I'm afraid I'm now concerned for the wellbeing 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. Shit.
Extending the incision.
BP 90 over 40. Pressure's dropping.
Yes, I can hear, for fuck's sake!
Doyen's out.
Under pressure.
Clamp.
40 of Synto, please.
More crossmatch. FFP.
Delivering the placenta.
Carboprost 250 micrograms for intramyometrial injection. Come on!
Thank you.
OK, let's try and save the uterus. Give me a big stitch, please.
Come on, I can't see a bloody thing! Suction. Come on!
She's in VF arrest, charge the defib to 200.
Clear. Clear. Shocking.
Start chest compressions.
Adrenaline.
If I can compress the uterus...
You got mobility?
Yeah.
OK. OK, continue current management.
Excellent, who's next?
Ah, Ms Hall.
Ready? Yes.
Simon, I'm afraid, I've got some bad news...
We did everything we could,
unfortunately the bleeding was very severe
and we weren't able to stop it.
My baby? The baby was premature and
very weak and the bleeding was too severe for him to survive.
I'm really sorry, Simon. I understand how difficult a time this is for you.
If there's anything we can do, don't
hesitate to ask.
I really am very sorry.
I did everything I could for them,
but with the degree of foetal anoxia and the volume of blood loss was...
The bleeding was torrential.
Perhaps I, I could've got the baby out a bit sooner.
Or made an earlier decision to carry out the hysterectomy. Would that have made any difference?
I don't know. It's impossible to say.
But it might've saved her life?
Yes, it might've.
All these decisions lie in a grey area of clinical judgement.
I thought that once I've 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.
Was it something like this that made you move, Roger?
No it was a separate matter,
a silly misunderstanding.
The police got involved. They didn't press any charges.
But it was yet another thing to come between Harriet and me and...
It's OK, Roger.
It's OK.
Do you still see your husband? Ex.
You're single now.
Well, separated. That's single.
So, what happened with you and the police?
I was drunk.
Things were bad between Harriet and me.
They hadn't been good for a while.
Things weren't great at work either.
I don't remember much about it.
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? Of course. Why, what did you think I meant?
What are you playing at with Roger? I'm researching my story. That's it?
Perhaps I, I could've got the baby out a bit sooner,
or made an earlier decision to carry out a hysterectomy.
Would that have made any difference? I don't know, impossible to say.
But it might've saved her life?
Yes, it might've.
When you filing your story?
I thought I understood him, but...
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've 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 it's 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 who committed professional
suicide over some dippy little "thing" that he had for you?
Is he working today?
Is he?
Rob. Rob!
The cabin isn't pressurised, so I've got to 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 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?
We've been through all that Hurley shit, and 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.
I hope you don't mind. Where is he?
Don't know.
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?
D'you think that we have a future?
I've done nothing for too long.
It's time to finish Hurley.
Drive me home.
Pulse and respiration were absent in the baby, a boy weighing 1.94kg.
He did not respond to resuscitation and was pronounced dead at 1611.
The mother was severely haemodynamically compromised
by the abruption. 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 1830.
I've arranged counselling for the patient's husband
and the same has been afforded to all the staff involved.
What uterine incision did you employ?
Well, given the stage 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'd have to consult my notes. I don't know. That's OK.
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 an orthodox transverse incision would have resulted in a prompt delivery.
Mr Lake, we appreciate the M&M meeting is a forum for
robust debate, but I...
Did you avoid an orthodox transverse incision because you were concerned
about extension into the venous plexus of the broad ligament?
We're all aware that is the rationale behind the vertical approach.
Did you consider hysterectomy in the mother? Yes, of course.
At once?
Well, obviously, it was an option.
At once? Mr Lake, I really think...
You delayed a hysterectomy because you wanted to give
the patient, a primigravida,
the chance of having another baby, and in delaying the hysterectomy you allowed her to exsanguinate.
Mr Lake, I'm going to have to ask
you to leave this... 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 you were unaware of.
Roger Hurley managed a placental abruption four years ago
in 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 learned from, Roger,
and is the cardinal error responsible for Victoria Newby's death.
Mr Lake. Ms Dodd, as you can see... 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 he was negligent. He fucked up the Caesarean and the hysterectomy.
You're wrong about him, Rob. I was
his SpR. You're wrong about him, he's a decent, hard-working consultant.
Then why's 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... 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've 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.
'What pressures do you mean?
'I felt vulnerable to criticism.
'What doctor or nurse doesn't?
'A single accusation
'can be the end your career.
'Occasionally procedures didn't go as well as they might've.
'You continue as if these things have no effect, but they do.'
So, have you filed this story yet or what?
You tried your best but...
maybe it's too complicated.
People want simple answers to who's a good doctor and who's a
bad doctor, and there isn't one.
I am relying on you, Donna. You always said doctors should deal with doctors.
You're not going to the medical authorities, are you?
This "expose" on Hurley was just to get your new career going.
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 has got to 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, who's going to take a complaint like that seriously?
GROANING
Oh, shit!
Contractions are four minutes apart.
But she's breech, she was due for an elective - she needs an emergency section.
Fuck it! What's happening, Rob?
They're full. Oh, shit!
It's OK, 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.
The consultant is waiting for you, Mrs Lake.
Hello, it's Polly, isn't it? OK.
I'm Sarah, I'm your anaesthetist. That's it, let's pop you up...
No, no, I'm having a contraction!
All right. Hello, Polly. Everything's perfectly routine.
We'll get you a spinal, and by then Rob should be back here with you.
We should crack on, yeah.
OK, Polly, this is the anaesthetist.
Let's go and get started.
A bit of pushing and pulling now, Polly. Of course you know all this.
You're doing really well, Mrs Lake.
I'm not "Mrs".
Doyen's please.
The dads don't usually get this close, Rob.
I'm not the usual dad though, am I, Roger?
Scissors and forceps, please.
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.
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 is absolutely routine and under control. Does anyone disagree?
Right, I'm going to 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.
Rob! Rob, this is insane.
You're making a mess of this operation, Roger,
and I'm taking over.
Rob, has he damaged my bladder or something? What's going on?
No, Polly, 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 going to be fine, Polly.
Step aside, Roger.
No. Step aside, Roger. Please don't do this!
Roger. Please stop this... Roger.
Please don't do this. Please don't.
No. Clean knife.
Please stop this. Please.
Doyens out. Under pressure.
Clamp.
Scissors.
BABY CRIES
Where is she?
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'll 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 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.
Truth. Lies.
A little bit late for such unhelpful distinctions, don't you think?
The theatre staff, they'll back me up.
I'm a consultant obstetrician.
Whose word counts for more?
This is insane, Rob. Why?
Why are you doing this to me?
She'll see you now.
Rob, I don't deserve this.
Either you were risking my life and our baby's life, or using us both
to further your own 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 wanted this baby, you never really wanted me!
If you were prepared to risk it all...
You'll never see this baby grow up... Never! Never!
Hello, Mary, can I help?
Sorry, Sharon, can you give us ten minutes, please?
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...I did everything I could to deter him,
but he's blown the whistle. No. No, it's denunciation...
a word to the authorities,
and suddenly a poor innocent like me is shipped off to the gulag.
Look, 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...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.
I think we'll probably have to keep an eye on this, but you know...
So... So... I'm feeling OK. Better than I thought I would.
Good. Good.
I'm really sorry, Tony.
The GMC? You know what they do, 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.
20 years ago.
Do 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 I'd be rather more.
You're a pushover now, being a hard-up single mum.
Seriously, Polly, I mean it.
Is there any chance that I could be more than a friend?
No.
Just a tiny chance? No, Tony.
(A teeny, weeny, tiny chance?)
Maybe.
(Excellent.)
I need a minute.
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. The system doesn't allow
for that level of understanding.
Only blame.
You could've asked for help. Really?
Did you ever?
For years, a dangerous doctor's been protected, quietly moved on.
A glowing reference has been falsified.
I really don't believe that the GMC won't want to 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've done a long time ago.
All I needed was an excuse.
Are you going to go back to nursing, then? I missed it.
I didn't think I would, but I did. I really missed helping people.
Here?
Somewhere.
Pre-mortem 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 health.
I understand. How d'you feel?
Good.
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