1
00:00:02,414 --> 00:00:05,200
[arrows whooshing]

2
00:00:12,337 --> 00:00:14,905
[sombre music]

3
00:00:50,332 --> 00:00:52,508
[indistinct hospital
PA announcement]

4
00:01:02,822 --> 00:01:05,347
[indistinct hospital
PA announcement]

5
00:01:20,318 --> 00:01:22,842
[phone vibrates]

6
00:01:33,201 --> 00:01:34,245
Yeah?

7
00:01:38,467 --> 00:01:39,468
On my way.

8
00:01:45,169 --> 00:01:46,562
[sighs]

9
00:01:55,701 --> 00:01:59,008
[Richard] She'’s tachycardic,
up from an hour ago, on Fibral.

10
00:01:59,009 --> 00:02:00,836
Respiration 22 and
pressure is down.

11
00:02:00,837 --> 00:02:01,968
That's why we called.

12
00:02:02,447 --> 00:02:04,145
[Elizabeth] Hello, Lisa. Hello.

13
00:02:05,537 --> 00:02:07,190
My name is Elizabeth Taylor.

14
00:02:07,191 --> 00:02:08,713
I'm the consultant surgeon.

15
00:02:08,714 --> 00:02:11,499
This is my registrar,
Richard Whitehead.

16
00:02:11,500 --> 00:02:13,588
Lisa, do you know where you are?

17
00:02:13,589 --> 00:02:14,938
Can you hear us all right?

18
00:02:16,026 --> 00:02:17,549
Does it hurt when you breathe?

19
00:02:18,028 --> 00:02:20,203
She's had no increase
of pain at McBurney's,

20
00:02:20,204 --> 00:02:21,987
so it doesn't look
like appendix.

21
00:02:21,988 --> 00:02:24,729
But she has had ten milligrams
of morphine since 9:30

22
00:02:24,730 --> 00:02:27,210
and ten megs of Maxolon.

23
00:02:27,211 --> 00:02:28,820
The history?

24
00:02:28,821 --> 00:02:31,954
[Richard] Um, it was one day
of cramping abdominal pain.

25
00:02:31,955 --> 00:02:34,305
Tender abdomen
with guarding at the left iliac.

26
00:02:34,610 --> 00:02:37,394
Was given trimethoprim,
diclofenac and paracetamol,

27
00:02:37,395 --> 00:02:39,091
and then sent away.

28
00:02:39,092 --> 00:02:40,702
Fuck. They sent her home.

29
00:02:40,703 --> 00:02:43,922
[Richard] She came back three
days later in a lot of pain,

30
00:02:43,923 --> 00:02:45,315
elevated pulse.

31
00:02:45,316 --> 00:02:47,840
She was put on IV fluids
and then transferred here.

32
00:02:48,232 --> 00:02:50,059
Decreased urine
output for two days.

33
00:02:50,060 --> 00:02:52,975
Imaging suggests there's
possible bowel involvement,

34
00:02:52,976 --> 00:02:55,934
and notes there is also
an IUCD in the situ.

35
00:02:55,935 --> 00:02:57,198
[screaming]

36
00:02:59,025 --> 00:03:01,505
Okay. Sorry, Lisa.

37
00:03:01,506 --> 00:03:02,638
Sorry, Lisa.

38
00:03:04,596 --> 00:03:07,250
[gasping]

39
00:03:07,251 --> 00:03:08,557
Well?

40
00:03:09,166 --> 00:03:11,298
Uh, clearly
intra-abdominal catastrophe,

41
00:03:11,299 --> 00:03:12,995
so immediate surgery to assess

42
00:03:12,996 --> 00:03:14,910
for perforated
bowel or appendix.

43
00:03:14,911 --> 00:03:16,216
Extensive fluids,

44
00:03:16,217 --> 00:03:18,435
transfer to theatre
for laparoscopy, right?

45
00:03:18,436 --> 00:03:21,264
I agree with immediate
urgent laparoscopy.

46
00:03:21,265 --> 00:03:24,093
Radiology suggests
necrosis of the bowel

47
00:03:24,094 --> 00:03:27,270
and abscess not amenable
to percutaneous drainage.

48
00:03:27,271 --> 00:03:29,272
She needs an operation.

49
00:03:29,273 --> 00:03:31,622
Three units
packed red blood cells,

50
00:03:31,623 --> 00:03:32,754
cross-matched.

51
00:03:32,755 --> 00:03:33,972
Prep for theatre.

52
00:03:33,973 --> 00:03:36,540
Call Dr. Colton to consent her.

53
00:03:36,541 --> 00:03:37,934
Lisa, we'll see you soon.

54
00:03:38,630 --> 00:03:39,935
[ECG monitor beeps]

55
00:03:39,936 --> 00:03:41,284
All right!

56
00:03:41,285 --> 00:03:44,767
We will go in today using
the Hasson technique.

57
00:03:47,204 --> 00:03:48,291
Alex.

58
00:03:48,292 --> 00:03:51,076
[Alex] We are... good to go.

59
00:03:51,077 --> 00:03:52,643
[Elizabeth] Knife.

60
00:03:52,644 --> 00:03:54,341
[Robin] Knife.

61
00:03:54,342 --> 00:03:57,039
[Elizabeth] All right,
we make a ten mil incision

62
00:03:57,040 --> 00:03:59,128
just above the umbilicus,

63
00:03:59,129 --> 00:04:03,611
right through the subcutaneous
tissue into the fascia.

64
00:04:03,612 --> 00:04:04,743
Kocher.

65
00:04:08,269 --> 00:04:09,573
S-Bends.

66
00:04:09,574 --> 00:04:11,183
[Robin] S-Bends.

67
00:04:11,184 --> 00:04:13,011
[Richard] Thank you, Robin.
Holding.

68
00:04:13,012 --> 00:04:14,187
[Elizabeth] Thank you.

69
00:04:16,755 --> 00:04:17,799
Knife.

70
00:04:17,800 --> 00:04:19,932
Now, just a few...

71
00:04:20,977 --> 00:04:22,500
fibres at a time.

72
00:04:24,763 --> 00:04:26,591
And there's the peritoneum.

73
00:04:28,332 --> 00:04:29,507
[Robin] Stitch.

74
00:04:32,510 --> 00:04:33,554
Here you go.

75
00:04:33,555 --> 00:04:34,599
[Elizabeth] Okay.

76
00:04:43,304 --> 00:04:45,217
[Robin] Clip.

77
00:04:45,218 --> 00:04:46,785
- [Elizabeth] Ready?
- [Robin] Cut.

78
00:04:48,265 --> 00:04:50,092
[Richard] This one's out.

79
00:04:50,093 --> 00:04:51,354
Thank you, Robin.

80
00:04:51,355 --> 00:04:54,749
[Elizabeth] Thank you.
Now, we use traction.

81
00:04:54,750 --> 00:04:56,228
Why?

82
00:04:56,229 --> 00:04:58,883
[Richard] To avoid damaging
the underlying structures

83
00:04:58,884 --> 00:05:01,146
when we penetrate the peritoneal
sheath into the abdomen.

84
00:05:01,147 --> 00:05:02,714
[Elizabeth] Good, Richard.

85
00:05:05,413 --> 00:05:07,936
- All right. Port, please, Robin.
- [Robin] Port.

86
00:05:07,937 --> 00:05:10,068
[Elizabeth] All right,
we'll be inserting

87
00:05:10,069 --> 00:05:11,635
three trocars into Lisa today.

88
00:05:11,636 --> 00:05:12,681
Here we go.

89
00:05:16,598 --> 00:05:18,426
[Richard] Uh, reducer.
Please, Robin.

90
00:05:21,820 --> 00:05:23,647
[Elizabeth] Give her
the gas port there, Richard.

91
00:05:23,648 --> 00:05:24,954
Thank you.

92
00:05:25,607 --> 00:05:27,738
[ECG monitor beeping continues]

93
00:05:27,739 --> 00:05:29,001
[Richard] That's set up.

94
00:05:29,350 --> 00:05:31,351
- [Robin] Gas on.
- [Richard] Thank you.

95
00:05:31,352 --> 00:05:32,743
[Elizabeth] All right, maestro.

96
00:05:32,744 --> 00:05:33,918
[Mei-Lynn] Yes?

97
00:05:33,919 --> 00:05:35,311
[Elizabeth] Gas, please.

98
00:05:35,312 --> 00:05:36,530
[Mei-Lynn] Gas is on.

99
00:05:36,531 --> 00:05:37,835
Light is on.

100
00:05:37,836 --> 00:05:39,272
[Elizabeth] There it comes.

101
00:05:40,578 --> 00:05:41,797
[air blowing]

102
00:05:45,017 --> 00:05:46,976
There we are, Richard.
You guide it.

103
00:05:49,065 --> 00:05:50,674
There we go.

104
00:05:50,675 --> 00:05:52,155
Marsh?

105
00:05:53,722 --> 00:05:55,766
[foreboding music plays]

106
00:05:55,767 --> 00:05:57,159
Hmm.

107
00:05:57,160 --> 00:05:59,248
[Richard] Well...
uh, it's extensive pus.

108
00:05:59,249 --> 00:06:01,512
[Elizabeth] Indeed.
Sepsis it is.

109
00:06:02,470 --> 00:06:05,386
All right, I'm inserting
the second trocar now.

110
00:06:08,954 --> 00:06:10,477
Yeah, that's good.
Thank you, Richard.

111
00:06:10,478 --> 00:06:13,437
Hold it right there, I need
direct visualization, please.

112
00:06:15,308 --> 00:06:16,439
Put it back in a little bit.

113
00:06:16,440 --> 00:06:18,136
There...

114
00:06:18,137 --> 00:06:19,182
Okay.

115
00:06:24,840 --> 00:06:26,536
Thank you.

116
00:06:26,537 --> 00:06:28,625
All right, what's going
on with the gas?

117
00:06:28,626 --> 00:06:30,148
[Mei-Lynn]
How much pressure?

118
00:06:30,149 --> 00:06:31,367
[Elizabeth]
I need ten.

119
00:06:31,368 --> 00:06:32,587
We need more flow,

120
00:06:33,065 --> 00:06:34,588
more separation of the organs.

121
00:06:34,589 --> 00:06:36,198
[Mei-Lynn]
Flow rate is at six.

122
00:06:36,199 --> 00:06:37,460
But we're not at ten yet.

123
00:06:37,461 --> 00:06:39,027
[Robin]
The tank was full.

124
00:06:39,028 --> 00:06:41,551
[Elizabeth] Mei-Lynn, can you
increase the flow, please?

125
00:06:41,552 --> 00:06:43,118
[Mei-Lynn] Copy that.

126
00:06:43,119 --> 00:06:45,773
[Elizabeth] Richard, do you want
to put in the last trocar?

127
00:06:45,774 --> 00:06:47,296
[Richard] Yeah.

128
00:06:47,297 --> 00:06:48,384
Thank you, Robin.

129
00:06:48,385 --> 00:06:50,126
[Elizabeth]
Let's find you a spot.

130
00:06:51,823 --> 00:06:52,910
Here we are.

131
00:06:52,911 --> 00:06:53,956
[Richard]
Thank you.

132
00:07:03,269 --> 00:07:05,227
[Elizabeth] Honey, you've got
plenty of room Richard,

133
00:07:05,228 --> 00:07:06,838
you've got plenty of room.

134
00:07:07,970 --> 00:07:08,971
You can see?

135
00:07:10,146 --> 00:07:11,147
[Richard]
Yeah.

136
00:07:13,541 --> 00:07:16,456
[Elizabeth] All right, Richard.
Time's ticking. Let's go.

137
00:07:16,457 --> 00:07:18,109
[ECG monitor beeping increases]

138
00:07:18,110 --> 00:07:20,199
[Elizabeth] Let's go.
Give it some welly.

139
00:07:20,504 --> 00:07:21,549
[Richard]
Sorry.

140
00:07:24,682 --> 00:07:26,509
[tense music]

141
00:07:26,510 --> 00:07:28,946
[Elizabeth] Fuck!
Quick, we need to open.

142
00:07:28,947 --> 00:07:31,166
- We're converting.
- [Robin] We're converting.

143
00:07:31,167 --> 00:07:32,733
[Elizabeth]
I need the B tray

144
00:07:32,734 --> 00:07:33,864
and arterial
instruments, please.

145
00:07:33,865 --> 00:07:35,039
[Robin]
B tray, please.

146
00:07:35,040 --> 00:07:35,779
[Elizabeth] Pull
the trocars out, Richard.

147
00:07:35,780 --> 00:07:37,215
[Richard]
Sorry.

148
00:07:37,216 --> 00:07:38,869
[Elizabeth] Someone call
Mei-Lynn back in right now.

149
00:07:38,870 --> 00:07:40,305
- [Robin] Someone call Mei-Lynn!
- [Elizabeth] B tray, please!

150
00:07:40,306 --> 00:07:41,785
[Elizabeth]
Alex, talk to me.

151
00:07:41,786 --> 00:07:43,874
[Alex] Systolic 90.
Pressure is falling now.

152
00:07:43,875 --> 00:07:45,485
[Elizabeth] Of course
it's fucking falling.

153
00:07:45,486 --> 00:07:48,009
[Elizabeth] I need the B tray!

154
00:07:48,010 --> 00:07:49,532
[Robin]
B, B, quick, quick, quick!

155
00:07:49,533 --> 00:07:51,316
[Elizabeth]
Calm, calm.

156
00:07:51,317 --> 00:07:52,404
Please, everybody, quiet.

157
00:07:52,405 --> 00:07:54,015
- [Mei-Lynn]
Diathermy?

158
00:07:54,016 --> 00:07:56,844
- [Elizabeth] Uh, no. I don't
have time. I'll do it myself.

159
00:07:56,845 --> 00:07:58,541
Richard, hold that.

160
00:07:58,542 --> 00:07:59,586
Alex?

161
00:07:59,587 --> 00:08:01,936
[Alex]
Heart rate is 160.

162
00:08:01,937 --> 00:08:03,503
Pushing midribonol now.

163
00:08:03,504 --> 00:08:04,765
[Elizabeth]
Hold that, Richard.

164
00:08:04,766 --> 00:08:06,854
Here we go. All right.
I'm going in, Alex.

165
00:08:06,855 --> 00:08:08,683
[ECG monitor beeping rapidly]

166
00:08:10,772 --> 00:08:12,207
- Fuck!
- Suction.

167
00:08:12,208 --> 00:08:13,425
[Robin]
Suction.

168
00:08:13,426 --> 00:08:15,689
Retractors.
I'll hold it. Retractors.

169
00:08:15,690 --> 00:08:17,821
- [Richard] Yeah, we need...
- [Elizabeth] Nice, Robin.

170
00:08:17,822 --> 00:08:19,519
- [Elizabeth] Good. You got it?
- [Robin] I got this.

171
00:08:19,520 --> 00:08:20,563
[Elizabeth] Get the big one.

172
00:08:20,564 --> 00:08:21,957
Pull it, Richard. Pull it.

173
00:08:22,914 --> 00:08:24,393
- [Richard]
[indistinct]

174
00:08:24,394 --> 00:08:26,003
- [Robin] Yeah, Richard.
- [Elizabeth] I got it. I got it.

175
00:08:26,004 --> 00:08:28,485
- [Elizabeth] Packs.
- [Robin] Packs.

176
00:08:34,360 --> 00:08:35,536
[sighs wearily]

177
00:08:39,104 --> 00:08:40,584
- Careful with the ureter.
- [Richard] Mm-hmm.

178
00:08:42,020 --> 00:08:44,065
[Elizabeth] Suction--
I can't find it.

179
00:08:44,066 --> 00:08:45,762
Find it.

180
00:08:45,763 --> 00:08:47,938
It's not the IVC,

181
00:08:47,939 --> 00:08:49,461
it's the lumbar artery.

182
00:08:49,462 --> 00:08:51,247
Put your finger on it.

183
00:08:51,639 --> 00:08:52,769
Pressure.

184
00:08:52,770 --> 00:08:54,292
- [Richard] Sorry.
- [Elizabeth] Feel it?

185
00:08:54,293 --> 00:08:55,511
[Elizabeth] Right there.
It's pumping.

186
00:08:55,512 --> 00:08:56,904
- Feel it?
- [Richard] Mm.

187
00:08:56,905 --> 00:08:59,080
[Elizabeth] Keep your
finger on it. Clamp.

188
00:08:59,081 --> 00:09:00,386
[Alex] Thank you.

189
00:09:05,566 --> 00:09:07,088
[Elizabeth]
Got it? Okay.

190
00:09:07,089 --> 00:09:08,743
One more here.
One more here.

191
00:09:10,396 --> 00:09:11,397
Stitches.

192
00:09:12,485 --> 00:09:13,790
Five-0, please.

193
00:09:13,791 --> 00:09:15,140
[Robin] Stitch.

194
00:09:37,685 --> 00:09:39,687
[cutting]

195
00:09:40,949 --> 00:09:41,950
[Elizabeth]
Okay.

196
00:09:43,168 --> 00:09:45,126
The torrential bleeding
from the vena cava

197
00:09:45,127 --> 00:09:46,607
is controlled with clamps...

198
00:09:47,651 --> 00:09:50,131
[sighs] ...and we move
in order of urgency.

199
00:09:50,132 --> 00:09:52,089
Richard has control

200
00:09:52,090 --> 00:09:54,353
of the posterior
tear with his finger.

201
00:09:55,267 --> 00:09:58,705
The most urgent
is the lumbar vessel

202
00:09:58,706 --> 00:10:00,489
due to the volume of bleeding,

203
00:10:00,490 --> 00:10:03,536
and I am focused
on that right now.

204
00:10:07,628 --> 00:10:09,325
There's a rent in the IVC...

205
00:10:12,110 --> 00:10:13,416
which is clamped,

206
00:10:14,591 --> 00:10:17,463
and severe lumbar
bleeding in the psoas,

207
00:10:18,726 --> 00:10:21,684
which is posterior...

208
00:10:21,685 --> 00:10:23,992
and deep.

209
00:10:25,080 --> 00:10:27,125
Currently sewing
five-0 prolene.

210
00:10:33,610 --> 00:10:34,958
[Alex]
Looking much better now.

211
00:10:34,959 --> 00:10:37,222
- [Elizabeth] Okay.
- [Alex] Pressure is coming up.

212
00:10:38,528 --> 00:10:40,703
[Elizabeth] Now
for the original operation.

213
00:10:40,704 --> 00:10:43,575
Let's wash out this pelvis,
pop in a drain,

214
00:10:43,576 --> 00:10:45,491
take out the appendix
for good measure.

215
00:10:46,579 --> 00:10:47,841
[Richard]
Yeah. Okay.

216
00:10:47,842 --> 00:10:49,799
Uh, I'm-- Elizabeth, I'm sorry.

217
00:10:49,800 --> 00:10:52,324
[Elizabeth]
Hey, just close.

218
00:10:57,155 --> 00:10:59,331
- [Robin] Josie.
- I need you on this retractor.

219
00:10:59,984 --> 00:11:00,985
[Robin]
Yeah.

220
00:11:03,596 --> 00:11:04,597
[Richard]
Okay, uh...

221
00:11:05,729 --> 00:11:06,687
Okay, splash me.

222
00:11:08,123 --> 00:11:10,125
- [Robin] Thank you.
- I'll take suction. Thank you.

223
00:11:13,171 --> 00:11:14,694
Fuck.

224
00:11:14,695 --> 00:11:16,609
- [Richard] Yeah, well--
- [Robin] Suction.

225
00:11:20,962 --> 00:11:22,137
[Richard]
Uh, yes, let me.

226
00:11:22,877 --> 00:11:24,399
Thank you, that's it.

227
00:11:24,400 --> 00:11:25,748
[Robin]
Suction.

228
00:11:25,749 --> 00:11:29,797
[sombre music]

229
00:11:39,850 --> 00:11:41,590
[door opening]

230
00:11:41,591 --> 00:11:43,505
[Elizabeth] Unfortunately,
I've got to reschedule

231
00:11:43,506 --> 00:11:44,942
my next surgery.

232
00:11:49,381 --> 00:11:51,295
Go tell Lisa's
parents it went well.

233
00:11:51,296 --> 00:11:52,688
Uh, don't you want--

234
00:11:52,689 --> 00:11:53,776
[Elizabeth]
She's out of the woods.

235
00:11:53,777 --> 00:11:55,212
But surely you could explain--

236
00:11:55,213 --> 00:11:57,649
[Elizabeth] Richard,
it went well.

237
00:11:57,650 --> 00:11:59,347
She's in recovery.

238
00:11:59,348 --> 00:12:01,089
They can talk to her in ICU.

239
00:12:03,265 --> 00:12:04,614
You're good with families.

240
00:12:05,484 --> 00:12:06,703
Thank you, Richard.

241
00:12:13,101 --> 00:12:14,145
[breathes shakily]

242
00:12:19,107 --> 00:12:20,890
[Richard] Um,
Mr. and Mrs. Williams,

243
00:12:20,891 --> 00:12:23,588
I am Richard Whitehead,
the registrar.

244
00:12:23,589 --> 00:12:25,460
I'm with Mrs. Taylor.

245
00:12:25,461 --> 00:12:27,592
Lisa's doing well.
She's in recovery now.

246
00:12:27,593 --> 00:12:29,726
I just want to apologize
about the delay.

247
00:12:31,032 --> 00:12:33,730
[distant sirens blaring]

248
00:12:38,300 --> 00:12:39,344
[sighs]

249
00:12:58,537 --> 00:13:01,279
[strained breathing]

250
00:13:04,456 --> 00:13:06,196
[machine beeps]

251
00:13:06,197 --> 00:13:07,981
[Jan] Just nice,
deep breaths, Lisa.

252
00:13:07,982 --> 00:13:10,158
Just easy breaths.
Yeah.

253
00:13:11,202 --> 00:13:12,247
That's it.

254
00:13:17,948 --> 00:13:19,036
How's she doing?

255
00:13:19,689 --> 00:13:20,950
Uh, she's stable.

256
00:13:20,951 --> 00:13:23,171
A bit agitated about the mask.

257
00:13:33,616 --> 00:13:34,878
[Elizabeth]
Hi, Lisa.

258
00:13:51,634 --> 00:13:52,853
It went well.

259
00:13:53,941 --> 00:13:56,030
[foreboding music]

260
00:13:59,033 --> 00:14:00,338
[breathing raggedly]

261
00:14:17,965 --> 00:14:20,924
[foreboding music continues]

262
00:14:24,188 --> 00:14:25,668
[register beeps]

263
00:14:43,991 --> 00:14:46,167
[sombre music]

264
00:14:49,170 --> 00:14:50,519
[door creaks shut]

265
00:14:52,042 --> 00:14:54,566
[Elizabeth] Robin,
did you get a taxi?

266
00:14:56,438 --> 00:14:57,830
Uh, yeah.

267
00:14:58,875 --> 00:15:00,354
Clear night.

268
00:15:00,355 --> 00:15:01,877
[Robin]
Um, yeah. It is.

269
00:15:01,878 --> 00:15:03,313
It's beautiful.

270
00:15:03,314 --> 00:15:05,273
- Want some chicken?
- [scoffs]

271
00:15:08,493 --> 00:15:10,407
Got a double shift tomorrow.

272
00:15:10,408 --> 00:15:11,670
- That's shit.
- [Robin] Mm.

273
00:15:13,020 --> 00:15:14,499
- I'll talk to Alastair--
- [Robin] Mm-mm.

274
00:15:15,457 --> 00:15:16,979
Please don't.

275
00:15:16,980 --> 00:15:18,981
You can't do things like that.

276
00:15:18,982 --> 00:15:20,201
It might ruin things.

277
00:15:25,293 --> 00:15:26,294
You good?

278
00:15:30,211 --> 00:15:31,994
Yeah.

279
00:15:31,995 --> 00:15:32,996
Yup.

280
00:15:37,261 --> 00:15:39,568
[both giggling]

281
00:15:52,059 --> 00:15:54,278
[seagulls squawking]

282
00:16:05,420 --> 00:16:08,292
[water rushing]

283
00:16:16,997 --> 00:16:18,694
[phone vibrates]

284
00:16:23,090 --> 00:16:24,526
[muted gasp]

285
00:16:26,310 --> 00:16:27,746
Fuck!

286
00:16:53,946 --> 00:16:54,990
[Elizabeth]
All good?

287
00:16:54,991 --> 00:16:57,036
Yeah, of course.
Uh, five by three.

288
00:16:57,037 --> 00:16:58,299
Walk beside me, Richard.

289
00:17:01,606 --> 00:17:03,216
How are you doing?

290
00:17:03,217 --> 00:17:04,826
[Richard]
I'm all right.

291
00:17:04,827 --> 00:17:07,611
Good. How did you hear?

292
00:17:07,612 --> 00:17:08,657
[Richard]
Hear what?

293
00:17:09,832 --> 00:17:11,007
[sighs]

294
00:17:13,749 --> 00:17:16,185
Richard, we lost
the sepsis this morning.

295
00:17:16,186 --> 00:17:18,145
I was texted on the way in.

296
00:17:19,885 --> 00:17:22,061
She-- What?
So she was what, in the ICU?

297
00:17:22,062 --> 00:17:23,411
[Elizabeth]
Yes, in ICU.

298
00:17:24,455 --> 00:17:25,890
[Richard]
Ah, I didn't know.

299
00:17:25,891 --> 00:17:27,153
Yes, it's a bad outcome.

300
00:17:27,154 --> 00:17:28,503
It's very disappointing.

301
00:17:29,939 --> 00:17:30,939
Okay?

302
00:17:30,940 --> 00:17:32,115
Yeah, of course. Yeah.

303
00:17:34,161 --> 00:17:35,770
The sepsis was too advanced,

304
00:17:35,771 --> 00:17:38,469
and she was likely
never going to make it.

305
00:17:42,517 --> 00:17:44,561
The trocar... did that--
Was that--

306
00:17:44,562 --> 00:17:46,434
This was advanced sepsis,
wasn't it?

307
00:17:46,956 --> 00:17:48,174
You saw that yourself.

308
00:17:48,175 --> 00:17:51,786
So we'll never know
to what degree if any,

309
00:17:51,787 --> 00:17:53,918
the extra time
in surgery contributed.

310
00:17:53,919 --> 00:17:55,529
Yeah... I suppose
the complication--

311
00:17:55,530 --> 00:17:56,878
The complication
may have contributed,

312
00:17:56,879 --> 00:17:58,140
but we'll never know how much.

313
00:17:58,141 --> 00:17:59,185
Right?

314
00:17:59,186 --> 00:18:01,101
So certainly didn't help.

315
00:18:01,884 --> 00:18:03,973
Look, all we can do
now is move on.

316
00:18:05,148 --> 00:18:06,627
Get past it. Get better.

317
00:18:06,628 --> 00:18:07,672
Learn.

318
00:18:10,110 --> 00:18:11,285
Morning, Liz.

319
00:18:13,200 --> 00:18:14,504
Good morning, Alastair.

320
00:18:14,505 --> 00:18:16,941
Have you seen the staff
photo on the website?

321
00:18:16,942 --> 00:18:19,422
Yes. It looked like
a group of prisoners

322
00:18:19,423 --> 00:18:21,120
about to be taken out and shot.

323
00:18:21,121 --> 00:18:22,165
[Alastair] Ah.

324
00:18:23,384 --> 00:18:24,515
Well, maybe
it was the black and white.

325
00:18:24,820 --> 00:18:26,387
What can I do for you, Alastair?

326
00:18:27,214 --> 00:18:29,040
Can we have a quick word?

327
00:18:29,041 --> 00:18:30,694
Of course.

328
00:18:30,695 --> 00:18:32,000
I'll catch up.

329
00:18:32,001 --> 00:18:34,133
- Yeah, okay.
- [Alastair] Thanks, Richard.

330
00:18:34,134 --> 00:18:35,135
[Richard]
No worries.

331
00:18:36,310 --> 00:18:37,353
I'm sorry.

332
00:18:37,354 --> 00:18:39,008
Um, hi, David isn't it?

333
00:18:39,226 --> 00:18:41,141
- [David] Yes.
- [Richard] Great, I've got--

334
00:18:42,185 --> 00:18:43,446
Anyway, Alastair?

335
00:18:43,447 --> 00:18:45,622
[Alastair] Liz,
the family of Lisa Williams,

336
00:18:45,623 --> 00:18:47,929
who died this morning,
are asking to see you.

337
00:18:47,930 --> 00:18:49,148
They're here now.

338
00:18:49,149 --> 00:18:50,366
Oh.

339
00:18:50,367 --> 00:18:53,239
I should warn you,
they're very distraught.

340
00:18:53,240 --> 00:18:56,242
They were under the impression
that when she was admitted,

341
00:18:56,243 --> 00:18:57,591
yes, it was an emergency,

342
00:18:57,592 --> 00:19:00,811
but an appendix
or something like that.

343
00:19:00,812 --> 00:19:02,857
They feel very caught off guard,

344
00:19:02,858 --> 00:19:04,772
and they say
they're very unsatisfied

345
00:19:04,773 --> 00:19:06,948
with the explanation from ICU.

346
00:19:06,949 --> 00:19:08,558
Who spoke to them from ICU?

347
00:19:08,559 --> 00:19:09,733
Ben Matthews.

348
00:19:09,734 --> 00:19:11,258
Ben was the intensivist.

349
00:19:13,085 --> 00:19:14,521
[sighs]
Andrew.

350
00:19:14,522 --> 00:19:16,263
Elizabeth, how are you?

351
00:19:17,394 --> 00:19:19,396
Well, I'm happy
to speak with them.

352
00:19:22,269 --> 00:19:24,574
And what are you going to say?

353
00:19:24,575 --> 00:19:27,055
I'm going to tell them
what happened in surgery.

354
00:19:27,056 --> 00:19:28,665
I wasn't there in ICU.

355
00:19:28,666 --> 00:19:30,015
Okay.

356
00:19:31,191 --> 00:19:33,193
What really happened, Liz?

357
00:19:34,672 --> 00:19:36,544
Well, you've obviously
read the notes.

358
00:19:38,981 --> 00:19:41,330
Uncontrolled
insertion of a trocar

359
00:19:41,331 --> 00:19:43,289
leading to internal damage--

360
00:19:43,290 --> 00:19:46,248
...Which was unrelated
to the galloping infection

361
00:19:46,249 --> 00:19:49,078
that led to her fatal
deterioration in ICU.

362
00:19:50,471 --> 00:19:51,558
"Unrelated"?

363
00:19:51,559 --> 00:19:53,255
Yes, that's what I said.

364
00:19:53,256 --> 00:19:54,778
Okay...

365
00:19:54,779 --> 00:19:56,084
But you know what
you're going to say.

366
00:19:56,085 --> 00:19:57,216
You've got it in hand.

367
00:19:57,217 --> 00:19:58,260
[Elizabeth] I think
well in hand.

368
00:19:58,261 --> 00:20:00,610
- Okay.
- Thank you, Andrew.

369
00:20:00,611 --> 00:20:01,916
Actually, I just
wanted to ask you

370
00:20:01,917 --> 00:20:03,265
if you're coming
to the conference,

371
00:20:03,266 --> 00:20:05,920
the Surgical Safety
and Measurements Jamboree?

372
00:20:05,921 --> 00:20:08,836
Yes, Andrew. I will take
that one for the team.

373
00:20:08,837 --> 00:20:11,317
Actually, I want the whole team
to be there. Richard, Robin.

374
00:20:11,318 --> 00:20:12,492
I think it's important.

375
00:20:12,493 --> 00:20:14,842
It's... It's quite interesting.

376
00:20:14,843 --> 00:20:16,060
[Elizabeth]
Interesting?

377
00:20:16,061 --> 00:20:17,497
Well... it is about
publishing results.

378
00:20:17,498 --> 00:20:19,542
That's our new reality.

379
00:20:19,543 --> 00:20:23,242
Our surgical results are going
to be published in the paper.

380
00:20:23,243 --> 00:20:25,984
Mortality, complications.

381
00:20:26,724 --> 00:20:28,465
<i>My</i> results, you mean.

382
00:20:30,511 --> 00:20:32,208
True, your results.

383
00:20:33,209 --> 00:20:35,079
Everything under your watch.

384
00:20:35,080 --> 00:20:37,299
But I don't think it's, uh...

385
00:20:37,300 --> 00:20:39,301
I don't think
it's necessarily a bad idea.

386
00:20:39,302 --> 00:20:42,173
It will incentivize us to
avoid very sick patients

387
00:20:42,174 --> 00:20:43,611
and it will affect training.

388
00:20:44,481 --> 00:20:46,875
Liz, the family are waiting
in the Whanau room.

389
00:20:47,919 --> 00:20:49,442
Thank you.

390
00:20:49,443 --> 00:20:50,704
Andrew.

391
00:20:50,705 --> 00:20:51,749
Elizabeth.

392
00:20:54,361 --> 00:20:57,189
[tense music]

393
00:21:18,602 --> 00:21:22,214
[sad music]

394
00:21:48,197 --> 00:21:50,112
I'm so sorry for your loss.

395
00:21:53,420 --> 00:21:54,464
Well...

396
00:21:55,596 --> 00:21:58,381
This is what happened to Lisa.

397
00:21:59,861 --> 00:22:02,646
Lisa was very sick
when she came to hospital.

398
00:22:05,083 --> 00:22:08,826
Some of her reproductive
organs had become infected.

399
00:22:10,045 --> 00:22:12,960
We believe this was
because of her IUCD.

400
00:22:12,961 --> 00:22:15,920
That stands for "Intrauterine
Contraceptive Device."

401
00:22:18,575 --> 00:22:20,184
Uh...

402
00:22:20,185 --> 00:22:24,580
We needed to do what
is called a "laparoscopy."

403
00:22:24,581 --> 00:22:27,017
That's a kind of keyhole surgery

404
00:22:27,018 --> 00:22:29,106
where we make a small hole

405
00:22:29,107 --> 00:22:32,066
and... and use a small
camera to look inside Lisa

406
00:22:32,067 --> 00:22:36,157
and see... um...
what's wrong with her.

407
00:22:36,158 --> 00:22:39,073
And we could see
that she was very sick,

408
00:22:39,074 --> 00:22:41,641
that many of her abdominal
organs had become infected,

409
00:22:41,642 --> 00:22:45,688
and that she needed a...

410
00:22:45,689 --> 00:22:48,735
a proper operation to
help her get better.

411
00:22:48,736 --> 00:22:51,652
And I can give you the details
of that if you'd like.

412
00:23:00,182 --> 00:23:02,402
I mean, we just don't
know what happened.

413
00:23:04,708 --> 00:23:07,318
We... We want to know more.

414
00:23:07,319 --> 00:23:09,017
[sobbing]

415
00:23:17,112 --> 00:23:18,809
Uh...

416
00:23:20,376 --> 00:23:22,986
There was a complication
during the surgery.

417
00:23:22,987 --> 00:23:27,557
We had to make a larger
incision than initially planned.

418
00:23:28,558 --> 00:23:29,951
What complication?

419
00:23:31,082 --> 00:23:34,042
[Elizabeth] As I said,
her IUCD had become infected.

420
00:23:34,695 --> 00:23:37,610
And, um, we don't
know why at this point.

421
00:23:37,611 --> 00:23:40,439
But there are many
reasons it could have happened.

422
00:23:40,440 --> 00:23:44,355
Lisa was moved to intensive
care after the surgery,

423
00:23:44,356 --> 00:23:46,967
and I was not directly
involved in that.

424
00:23:46,968 --> 00:23:49,100
We just thought,
"Oh, it's her..."

425
00:23:50,754 --> 00:23:53,408
We just thought
her appendix had burst,

426
00:23:53,409 --> 00:23:56,019
which is why it was so bad.

427
00:23:56,020 --> 00:23:57,369
[Elizabeth]
I'm sorry.

428
00:23:58,762 --> 00:24:00,763
I know this must be very hard,

429
00:24:00,764 --> 00:24:03,331
but it was not to do
with her appendix.

430
00:24:03,332 --> 00:24:06,160
Lisa had trouble
breathing in ICU.

431
00:24:06,161 --> 00:24:08,989
The infection was
too much for her body,

432
00:24:08,990 --> 00:24:12,167
and this led to
her cardiac arrest.

433
00:24:16,780 --> 00:24:18,390
She's in the morgue.

434
00:24:20,088 --> 00:24:23,744
[angrily] Our daughter
is in the morgue.

435
00:24:33,014 --> 00:24:34,494
Wh... What's your name?

436
00:24:38,759 --> 00:24:41,762
Elizabeth Taylor is my name.

437
00:24:54,296 --> 00:24:55,384
[camera clicks]

438
00:25:00,258 --> 00:25:01,651
[sighs wearily]

439
00:25:04,436 --> 00:25:06,961
[sombre music]

440
00:25:50,657 --> 00:25:52,746
[siren blaring in distance]

441
00:25:56,837 --> 00:25:58,315
[Andrew]
<i>Welcome, everybody,</i>

442
00:25:58,316 --> 00:26:02,363
<i>to this week's M&M.</i>

443
00:26:02,364 --> 00:26:06,107
<i>So we'll start with
the Lisa Williams case.</i>

444
00:26:06,890 --> 00:26:12,852
Anaesthesia, nursing,
as well as surgery.

445
00:26:12,853 --> 00:26:14,332
Glad to see you.

446
00:26:15,856 --> 00:26:17,726
Uh, excuse me.
Where's Dr. Matthews?

447
00:26:17,727 --> 00:26:19,728
Well, Dr. Matthews
is an apology.

448
00:26:19,729 --> 00:26:21,425
Dr. Matthews
was the intensivist

449
00:26:21,426 --> 00:26:22,862
on Lisa Williams,

450
00:26:22,863 --> 00:26:24,646
- the main case today.
- Well...

451
00:26:24,647 --> 00:26:27,997
I'd like to call for this
meeting to be adjourned.

452
00:26:27,998 --> 00:26:29,825
[Andrew]
Oh... Why, Liz?

453
00:26:29,826 --> 00:26:32,654
Without Dr. Matthews,
what's the point?

454
00:26:32,655 --> 00:26:33,873
Well, the point is that

455
00:26:33,874 --> 00:26:36,440
this is a morbidity
and mortality meeting,

456
00:26:36,441 --> 00:26:39,618
and in it, we're going to
be discussing in particular

457
00:26:39,619 --> 00:26:41,228
surgery and mortality.

458
00:26:41,229 --> 00:26:44,231
The mortality in this case is
not related to the surgery.

459
00:26:44,232 --> 00:26:46,537
It's related to her
advanced sepsis,

460
00:26:46,538 --> 00:26:49,279
and the nearly 12 hours
of intensive care

461
00:26:49,280 --> 00:26:51,412
that failed to save
her afterwards.

462
00:26:51,413 --> 00:26:52,979
No, this is just an M&M.

463
00:26:52,980 --> 00:26:54,808
We're not apportioning blame.

464
00:26:55,460 --> 00:26:56,504
Um... Blame?

465
00:26:56,505 --> 00:26:57,810
No--

466
00:26:57,811 --> 00:26:59,812
I want to know what happened.

467
00:26:59,813 --> 00:27:01,727
Family want more information.

468
00:27:01,728 --> 00:27:02,989
What information?

469
00:27:02,990 --> 00:27:04,686
I've spoken to them already.

470
00:27:04,687 --> 00:27:06,862
Well, let's just say
their acceptance

471
00:27:06,863 --> 00:27:09,386
of their daughter's death
is not yet settled.

472
00:27:09,387 --> 00:27:11,651
Okay, this is so fucking stupid.

473
00:27:13,130 --> 00:27:16,002
Why would that be stupid, Liz?

474
00:27:16,003 --> 00:27:18,658
[Elizabeth] It's stupid,
Andrew, because...

475
00:27:20,747 --> 00:27:22,225
We can go through our notes,

476
00:27:22,226 --> 00:27:24,445
you can talk to my team
till you're blue in the face.

477
00:27:24,446 --> 00:27:28,492
But we can't possibly know
what happened with this girl

478
00:27:28,493 --> 00:27:30,364
without ICU
and their nurses here,

479
00:27:30,365 --> 00:27:31,931
because they took over her care

480
00:27:31,932 --> 00:27:34,542
and she <i>died</i> on their watch.

481
00:27:34,543 --> 00:27:37,110
[Andrew] Lisa Williams' parents
have questions about errors

482
00:27:37,111 --> 00:27:40,156
made by the surgical staff,
not ICU.

483
00:27:40,157 --> 00:27:43,682
They want to know about
complications in the surgery,

484
00:27:43,683 --> 00:27:47,424
your surgery,
because you told them

485
00:27:47,425 --> 00:27:51,212
there were complications
for Liz... apparently.

486
00:27:52,430 --> 00:27:54,476
[chuckles]
I mean, for Lisa.

487
00:27:56,130 --> 00:27:57,784
Am I right?

488
00:27:58,610 --> 00:27:59,959
[inhales sharply]

489
00:27:59,960 --> 00:28:02,135
Or...

490
00:28:02,136 --> 00:28:03,615
am I being stupid?

491
00:28:05,792 --> 00:28:08,707
Right.
Let me just summarize.

492
00:28:08,708 --> 00:28:12,319
- Anaesthesia started at 1:40.
- Yes, it did.

493
00:28:12,320 --> 00:28:14,974
- And the surgery at 1:50.
- Correct.

494
00:28:14,975 --> 00:28:16,758
And the gas port was inserted

495
00:28:16,759 --> 00:28:21,068
into the abdomen and,
uh, insufflation commenced.

496
00:28:21,677 --> 00:28:22,678
Robin?

497
00:28:24,332 --> 00:28:26,159
Yes. Yes, that is correct.

498
00:28:26,160 --> 00:28:28,291
And you say here in your notes

499
00:28:28,292 --> 00:28:32,121
that Mrs. Taylor verbalized
that there was no gas.

500
00:28:32,122 --> 00:28:33,557
Insufficient gas.

501
00:28:33,558 --> 00:28:35,081
I-I said in my notes

502
00:28:35,082 --> 00:28:39,607
that, um, Mrs. Taylor said
there was insufficient gas flow.

503
00:28:39,608 --> 00:28:41,044
What did she mean?

504
00:28:43,307 --> 00:28:44,917
What...

505
00:28:44,918 --> 00:28:47,789
She meant there's insufficient
pressure of gas in the abdomen

506
00:28:47,790 --> 00:28:49,748
that lifts the peritoneal sac

507
00:28:49,749 --> 00:28:51,706
away from internal structures

508
00:28:51,707 --> 00:28:54,927
that could be damaged
by insertion of instruments.

509
00:28:54,928 --> 00:28:57,451
And what was the pressure
at that point?

510
00:28:57,452 --> 00:28:59,279
How much gas was in her abdomen?

511
00:28:59,280 --> 00:29:01,107
I mean, frankly speaking,

512
00:29:01,108 --> 00:29:03,066
was it safe to go
sticking things in her?

513
00:29:03,980 --> 00:29:05,546
Well, I don't know, Doctor.

514
00:29:05,547 --> 00:29:07,069
Ah! You don't know?

515
00:29:07,070 --> 00:29:08,767
[Alex]
She can't know!

516
00:29:08,768 --> 00:29:11,813
The indicator on the insufflator
reads "enough" or "not enough."

517
00:29:11,814 --> 00:29:13,989
When the belly is inflated,
the gas slows down

518
00:29:13,990 --> 00:29:15,904
as the pressure
doesn't let it in there.

519
00:29:15,905 --> 00:29:18,994
The theoretical pressure needed
inside the cavity is ten, sure,

520
00:29:18,995 --> 00:29:22,171
but there's no actual
gauge that measures that.

521
00:29:22,172 --> 00:29:25,653
It just says the flow rate
is or is not high enough

522
00:29:25,654 --> 00:29:27,089
to inflate at that level.

523
00:29:27,090 --> 00:29:28,656
- [Andrew] Okay.
- Okay or not.

524
00:29:28,657 --> 00:29:31,485
We had direct visualization
of the organ space.

525
00:29:31,486 --> 00:29:32,703
[Andrew] Okay.

526
00:29:32,704 --> 00:29:34,836
And at whatever
actual pressure it was,

527
00:29:34,837 --> 00:29:36,838
in my clinical judgment,

528
00:29:36,839 --> 00:29:38,187
there was sufficient pressure--

529
00:29:38,188 --> 00:29:40,146
To insert the last trocar?

530
00:29:40,147 --> 00:29:41,451
Yes, Jason.

531
00:29:41,452 --> 00:29:44,193
Jesus, Jason.
There's no definitive timing.

532
00:29:44,194 --> 00:29:46,152
That's what you do.

533
00:29:46,153 --> 00:29:47,981
You use your clinical judgment.

534
00:29:49,112 --> 00:29:52,027
So, who inserted
the last trocar, Liz?

535
00:29:52,028 --> 00:29:54,335
Who put it... the trocar in?

536
00:29:58,252 --> 00:29:59,253
Uh...

537
00:30:01,429 --> 00:30:02,864
I did.

538
00:30:02,865 --> 00:30:05,736
[Andrew] You inserted
the last trocar

539
00:30:05,737 --> 00:30:08,174
that caused
the damage to this girl,

540
00:30:08,175 --> 00:30:11,264
which was a rent in
the inferior vena cava,

541
00:30:11,265 --> 00:30:13,527
cut in the posterior
abdominal wall,

542
00:30:13,528 --> 00:30:14,876
a tear in the lumbar artery--

543
00:30:14,877 --> 00:30:18,793
Yes, yes, which we repaired,
of course.

544
00:30:18,794 --> 00:30:19,968
[Andrew]
Okay, good.

545
00:30:19,969 --> 00:30:21,666
Good. Yes.

546
00:30:24,365 --> 00:30:25,366
Okay.

547
00:30:27,542 --> 00:30:30,892
[sighs] Look, it was more
complicated than that.

548
00:30:30,893 --> 00:30:35,288
I instructed my registrar,
Richard Whitehead,

549
00:30:35,289 --> 00:30:38,900
to make the incision
and insert the last trocar,

550
00:30:38,901 --> 00:30:40,293
and he did.

551
00:30:40,294 --> 00:30:43,209
Oh, so <i>Richard</i> inserted
the last trocar.

552
00:30:43,210 --> 00:30:44,688
I'm the team leader.

553
00:30:44,689 --> 00:30:45,952
I'm the lead surgeon.

554
00:30:46,648 --> 00:30:48,344
It's my theatre.

555
00:30:48,345 --> 00:30:49,824
Under my instruction,

556
00:30:49,825 --> 00:30:52,219
Richard inserted
the last trocar,

557
00:30:53,742 --> 00:30:55,396
which failed to penetrate.

558
00:30:56,701 --> 00:30:59,007
I told him to push harder.

559
00:30:59,008 --> 00:31:00,748
[Andrew]
Told Richard...

560
00:31:00,749 --> 00:31:03,143
I said to give it some welly.

561
00:31:05,058 --> 00:31:06,102
"Welly."

562
00:31:12,674 --> 00:31:13,675
That's right.

563
00:31:19,855 --> 00:31:22,989
[sombre music]

564
00:31:27,950 --> 00:31:31,953
Would you look at
this gorgeous creature?

565
00:31:31,954 --> 00:31:33,347
[Elizabeth]
You're a dog mother.

566
00:31:34,826 --> 00:31:37,393
[Jessica] Have you ever seen
anything so photogenic?

567
00:31:37,394 --> 00:31:39,874
- He's like your child.
- [Jessica] Mmm.

568
00:31:39,875 --> 00:31:41,311
He's great company.

569
00:31:42,965 --> 00:31:44,357
What's new?

570
00:31:44,358 --> 00:31:45,967
[Jessica clears throat]

571
00:31:45,968 --> 00:31:47,838
You know, it's...

572
00:31:47,839 --> 00:31:49,754
It's complicated.

573
00:31:50,538 --> 00:31:52,408
I met a really smart guy.

574
00:31:52,409 --> 00:31:54,716
[sighs] And your marriage?

575
00:31:55,717 --> 00:31:56,979
[Jessica] It's over.

576
00:31:59,764 --> 00:32:01,461
- Yeah.
- [Elizabeth] I'm sorry.

577
00:32:01,462 --> 00:32:03,029
Yeah, I know.
It's shit, really.

578
00:32:08,295 --> 00:32:10,906
[sighs] I had a shit week too.

579
00:32:12,473 --> 00:32:13,560
Yeah.

580
00:32:13,561 --> 00:32:14,909
[Elizabeth]
Complicated, as you say.

581
00:32:14,910 --> 00:32:15,955
Mm.

582
00:32:20,568 --> 00:32:22,177
Um...

583
00:32:22,178 --> 00:32:25,006
So I really hate to ask, Liz,

584
00:32:25,007 --> 00:32:27,008
but is there any
way that Atticus

585
00:32:27,009 --> 00:32:28,750
could stay with you
for a little while?

586
00:32:30,404 --> 00:32:32,057
- The dog?
- [Jessica] Yeah.

587
00:32:32,058 --> 00:32:33,580
[Jessica] It's just
because I'm...

588
00:32:33,581 --> 00:32:35,408
I'm moving into his apartment,

589
00:32:35,409 --> 00:32:38,802
and-and you know,
it's no good for a big dog.

590
00:32:38,803 --> 00:32:40,804
There's elevators and stuff.

591
00:32:40,805 --> 00:32:45,505
And Stephen won't take him
because he's punishing me, so...

592
00:32:45,506 --> 00:32:47,290
But it would just
be for a short term.

593
00:32:48,117 --> 00:32:50,031
Jess, no. I really don't--

594
00:32:50,032 --> 00:32:51,554
I really don't think I can.

595
00:32:51,555 --> 00:32:53,556
Atticus is so old, Liz.

596
00:32:53,557 --> 00:32:55,210
He's totally house trained.

597
00:32:55,211 --> 00:32:58,126
All he does is just lie around
in the sun all day and sleep,

598
00:32:58,127 --> 00:32:59,214
and he'll be your best buddy.

599
00:32:59,215 --> 00:33:00,346
I am never home.

600
00:33:00,347 --> 00:33:01,695
Oh, God. Fuck.
Don't worry about it.

601
00:33:01,696 --> 00:33:04,003
We're never home either.
He's totally used to it.

602
00:33:14,839 --> 00:33:16,537
Robin, where are you?

603
00:33:17,668 --> 00:33:19,148
I want you to come over.

604
00:33:20,497 --> 00:33:21,890
Do you want to?

605
00:33:23,326 --> 00:33:24,458
Um.

606
00:33:25,894 --> 00:33:28,722
Hey, I'm sorry I've been
so distracted by everything,

607
00:33:28,723 --> 00:33:31,030
you know,
all the shitty fucking shit.

608
00:33:32,901 --> 00:33:36,773
Jessica is making
me take her dog.

609
00:33:36,774 --> 00:33:38,471
[laughs]

610
00:33:38,472 --> 00:33:39,777
<i>It's such...</i>

611
00:33:40,604 --> 00:33:42,041
Uh... Okay.

612
00:33:44,739 --> 00:33:46,261
Bye for now.

613
00:33:46,262 --> 00:33:47,350
Call me.

614
00:34:40,099 --> 00:34:44,059
[uneasy music]

615
00:35:01,685 --> 00:35:03,687
[distant crackling]

616
00:35:27,885 --> 00:35:29,452
[sombre music]

617
00:35:39,549 --> 00:35:40,811
[Atticus barks]

618
00:36:08,622 --> 00:36:10,362
[Te] You have been
invisible to your patients

619
00:36:10,363 --> 00:36:13,278
and your performance levels
have been equally invisible

620
00:36:13,279 --> 00:36:14,714
until now,

621
00:36:14,715 --> 00:36:16,498
because we are
going to be publishing

622
00:36:16,499 --> 00:36:18,761
surgical outcomes publicly.

623
00:36:18,762 --> 00:36:20,677
This, of course, raises
profound questions,

624
00:36:21,374 --> 00:36:23,984
because once publication starts,

625
00:36:23,985 --> 00:36:27,030
patients and potential patients

626
00:36:27,031 --> 00:36:29,556
will assess your track records
and compare you to others.

627
00:36:30,252 --> 00:36:32,732
Of course, they won't know
that the surgeon down the road,

628
00:36:32,733 --> 00:36:34,864
who has much better statistics,

629
00:36:34,865 --> 00:36:36,605
only qualified six months ago,

630
00:36:36,606 --> 00:36:40,261
and has operated on
a grand total of seven young,

631
00:36:40,262 --> 00:36:42,002
non-smoking white patients,

632
00:36:42,003 --> 00:36:44,961
whilst you have
been in the trenches,

633
00:36:44,962 --> 00:36:48,661
operating on the morbidly obese,
the diabetic,

634
00:36:48,662 --> 00:36:51,098
elderly brown folk
with histories of falls

635
00:36:51,099 --> 00:36:53,143
and gout
and respiratory disease.

636
00:36:53,144 --> 00:36:55,711
You will be compared
surgeon to surgeon,

637
00:36:55,712 --> 00:36:58,279
and every case of everyone
who has ever died

638
00:36:58,280 --> 00:36:59,585
underneath your scalpel

639
00:36:59,586 --> 00:37:01,674
will be on full public display.

640
00:37:01,675 --> 00:37:05,244
Every surgical site,
infection, every nicked aorta.

641
00:37:06,419 --> 00:37:08,637
Will some surgeons
be forced to retire?

642
00:37:08,638 --> 00:37:10,160
Maybe.

643
00:37:10,161 --> 00:37:11,553
Probably.

644
00:37:11,554 --> 00:37:13,729
Will some surgeons
be treated unfairly?

645
00:37:13,730 --> 00:37:15,296
Yes, most likely.

646
00:37:15,297 --> 00:37:16,819
Why, then,
should we allow this,

647
00:37:16,820 --> 00:37:17,995
even encourage it?

648
00:37:18,909 --> 00:37:21,607
Transparency
and informed consent.

649
00:37:21,608 --> 00:37:23,565
And I'm talking about
real consent,

650
00:37:23,566 --> 00:37:26,438
not just a scribble
on a piece of paper

651
00:37:26,439 --> 00:37:27,961
moments before operating.

652
00:37:27,962 --> 00:37:29,484
In the broader context,
a surgeon--

653
00:37:29,485 --> 00:37:31,181
Sorry. I'm sorry.

654
00:37:31,182 --> 00:37:32,270
Yes?

655
00:37:32,271 --> 00:37:33,836
Liz Taylor.

656
00:37:33,837 --> 00:37:36,230
Yes, Mrs. Taylor?

657
00:37:36,231 --> 00:37:38,277
This will turn
surgery upside down.

658
00:37:38,973 --> 00:37:40,190
It is inevitable

659
00:37:40,191 --> 00:37:42,932
that good surgeons
will be treated unfairly.

660
00:37:42,933 --> 00:37:44,413
You just said so yourself.

661
00:37:45,458 --> 00:37:47,415
And it sounds like
you accept this.

662
00:37:47,416 --> 00:37:49,896
Well, isn't being
transparent about your results

663
00:37:49,897 --> 00:37:52,159
what a good surgeon does,

664
00:37:52,160 --> 00:37:54,466
so that your patients are
able to give informed consent?

665
00:37:54,467 --> 00:37:56,468
Okay, look,
sorry if I'm-- [chuckles]

666
00:37:56,469 --> 00:37:58,252
Maybe I'm coming off
like a tendentious bitch...

667
00:37:58,253 --> 00:38:00,299
- [chuckles]
- but this is important to us.

668
00:38:00,995 --> 00:38:03,823
Publishing results
is a bad idea.

669
00:38:03,824 --> 00:38:06,174
We will avoid
very sick patients.

670
00:38:07,262 --> 00:38:10,133
Why risk adding someone who
will likely die to my numbers?

671
00:38:10,134 --> 00:38:11,701
Why should I take that risk?

672
00:38:12,398 --> 00:38:14,312
Changes everything.

673
00:38:14,313 --> 00:38:16,836
Which surgeon will
give their registrar a go,

674
00:38:16,837 --> 00:38:18,403
if when it all
turns to shambles,

675
00:38:18,404 --> 00:38:20,013
it goes on their record?

676
00:38:20,014 --> 00:38:21,320
[Andrew] Liz.

677
00:38:22,582 --> 00:38:25,627
That's... That's a good point.

678
00:38:25,628 --> 00:38:26,933
Lots of good points.

679
00:38:26,934 --> 00:38:29,892
But what we're talking
about here is resources.

680
00:38:29,893 --> 00:38:31,329
No! We're talking about numbers.

681
00:38:31,330 --> 00:38:33,461
- Well--
- I'm talking about numbers.

682
00:38:33,462 --> 00:38:36,464
We're talking about
ranking people

683
00:38:36,465 --> 00:38:39,293
best to worst in league tables

684
00:38:39,294 --> 00:38:43,211
using data that is
insufficient and partial.

685
00:38:43,907 --> 00:38:46,388
And surgeons will
be hung out to dry.

686
00:38:50,218 --> 00:38:51,261
[Te] Whoa!

687
00:38:51,262 --> 00:38:53,002
It appears we have entered

688
00:38:53,003 --> 00:38:55,831
the Q&A portion of our session

689
00:38:55,832 --> 00:38:57,485
- slightly ahead of time.
- [chuckles]

690
00:38:57,486 --> 00:38:59,661
I just don't think
we can be idiots about this,

691
00:38:59,662 --> 00:39:02,098
and do it just because
other countries do.

692
00:39:02,099 --> 00:39:05,015
How many cardiac surgeons
can we afford to lose?

693
00:39:06,277 --> 00:39:07,322
Do you know how many we've got?

694
00:39:08,018 --> 00:39:10,020
- Twenty-nine! It's not enough.
- Liz.

695
00:39:11,239 --> 00:39:12,240
Thank you.

696
00:39:13,676 --> 00:39:15,416
Twenty-nine.

697
00:39:15,417 --> 00:39:17,026
And according to him,

698
00:39:17,027 --> 00:39:18,419
half are going to
have to retire soon.

699
00:39:18,420 --> 00:39:21,030
[Andrew] Yeah, okay.
That's a good point.

700
00:39:21,031 --> 00:39:22,292
But let's...

701
00:39:22,293 --> 00:39:23,338
Doctor.

702
00:39:24,295 --> 00:39:27,168
[sombre music]

703
00:40:09,253 --> 00:40:13,475
[sombre music continues]

704
00:40:43,157 --> 00:40:45,375
Very gripping stuff.

705
00:40:45,376 --> 00:40:46,464
[Elizabeth] Wasn't it.

706
00:40:46,465 --> 00:40:48,641
Interesting, provocative.

707
00:40:49,206 --> 00:40:50,468
People will be crucified.

708
00:40:50,469 --> 00:40:53,166
[Andrew] Yeah, some surgeons
need to reassess.

709
00:40:53,167 --> 00:40:54,646
You're not worried
about your data.

710
00:40:54,647 --> 00:40:56,518
The other specialties
are nervous.

711
00:40:57,171 --> 00:40:58,476
We're years behind
the world on this,

712
00:40:58,477 --> 00:40:59,913
and it's not thought through.

713
00:41:01,044 --> 00:41:02,567
You're not nervous, eh?

714
00:41:02,568 --> 00:41:04,178
'Cause you're brilliant.

715
00:41:05,571 --> 00:41:07,267
You're absolutely brilliant.

716
00:41:07,268 --> 00:41:08,922
But, um...

717
00:41:10,010 --> 00:41:12,838
Elizabeth, unfortunately,
it falls to my lot

718
00:41:12,839 --> 00:41:14,970
to tell you that
there's been a...

719
00:41:14,971 --> 00:41:16,625
formal complaint.

720
00:41:18,322 --> 00:41:19,366
[Elizabeth]
A complaint?

721
00:41:19,367 --> 00:41:21,500
Formal complaint.
Lisa's parents.

722
00:41:24,590 --> 00:41:26,592
When were you going
to tell me about this?

723
00:41:28,028 --> 00:41:29,943
Well, I'm telling you now.

724
00:41:37,080 --> 00:41:38,081
Piece of shit.

725
00:41:39,735 --> 00:41:42,869
[dramatic music]

726
00:41:47,090 --> 00:41:48,091
Hey.

727
00:41:49,266 --> 00:41:50,267
Hi.

728
00:41:51,312 --> 00:41:52,313
Leave you to it.

729
00:41:54,663 --> 00:41:56,491
I called you last night.

730
00:41:58,101 --> 00:41:59,102
Yeah.

731
00:42:00,843 --> 00:42:02,975
I can feel you disappearing.

732
00:42:02,976 --> 00:42:05,544
Yeah, I just want to
get the fuck out of here.

733
00:42:08,068 --> 00:42:11,026
So, what did Andrew want?

734
00:42:11,027 --> 00:42:12,811
Saw he cornered you.

735
00:42:12,812 --> 00:42:15,901
[Elizabeth] Apparently,
there's been a complaint

736
00:42:15,902 --> 00:42:17,207
about the surgery.

737
00:42:18,208 --> 00:42:20,601
Like a...
Like a formal complaint?

738
00:42:20,602 --> 00:42:22,517
I haven't read it.

739
00:42:23,649 --> 00:42:25,693
Haven't seen it
in writing, but yes.

740
00:42:25,694 --> 00:42:28,391
And, um, he wanted
to rub it in my face.

741
00:42:28,392 --> 00:42:29,524
Well, that's shit.

742
00:42:30,438 --> 00:42:31,656
Well.

743
00:42:31,657 --> 00:42:32,701
Yeah.

744
00:42:33,484 --> 00:42:34,834
Can't handle you.

745
00:42:35,704 --> 00:42:39,229
[club music playing]

746
00:42:48,935 --> 00:42:50,023
Did you...

747
00:42:51,546 --> 00:42:54,114
Did you know Richard left
when you were speaking?

748
00:42:55,463 --> 00:42:56,594
Richard?

749
00:42:56,595 --> 00:42:57,596
Yeah.

750
00:42:58,509 --> 00:42:59,510
No.

751
00:43:01,643 --> 00:43:03,644
He was pretty upset.

752
00:43:03,645 --> 00:43:06,865
Richard is a sensitive type.

753
00:43:06,866 --> 00:43:09,302
He needs to learn
to love the hook.

754
00:43:09,303 --> 00:43:10,651
Well, uh...

755
00:43:10,652 --> 00:43:12,044
I don't blame him, Liz.

756
00:43:12,045 --> 00:43:13,263
It was... It was pretty public.

757
00:43:14,613 --> 00:43:15,656
What's public?

758
00:43:15,657 --> 00:43:17,790
The things you say out loud...

759
00:43:19,835 --> 00:43:21,837
Registrars in shambles.

760
00:43:22,359 --> 00:43:23,883
[chuckles]

761
00:43:25,536 --> 00:43:27,060
Oh, Jesus Christ.

762
00:43:28,191 --> 00:43:29,845
What's wrong with people?

763
00:43:48,211 --> 00:43:50,779
[dark music]

764
00:44:01,834 --> 00:44:04,488
[sombre music]

765
00:44:47,836 --> 00:44:48,837
[sighs]

766
00:44:50,883 --> 00:44:52,754
[indistinct conversation]

767
00:45:00,762 --> 00:45:01,893
Andrew.

768
00:45:01,894 --> 00:45:02,938
Seen this?

769
00:45:13,427 --> 00:45:14,907
[gasps]

770
00:45:21,087 --> 00:45:22,088
Fuck!

771
00:45:23,742 --> 00:45:26,135
[bird chirping]

772
00:45:35,101 --> 00:45:36,537
[sharp breath] Unbelievable.

773
00:45:43,152 --> 00:45:44,326
[sighing]

774
00:45:44,327 --> 00:45:45,589
[phone vibrates]

775
00:46:03,520 --> 00:46:04,520
[Richard] Hey.

776
00:46:04,521 --> 00:46:06,609
Uh, sorry to interrupt.

777
00:46:06,610 --> 00:46:08,961
[Elizabeth] Oh, no,
you're not interrupting.

778
00:46:13,095 --> 00:46:14,922
What can I do for you, Richard?

779
00:46:14,923 --> 00:46:17,751
[Richard] I, uh...
I think it's ridiculous.

780
00:46:17,752 --> 00:46:20,102
That's ridiculous and wrong.

781
00:46:20,842 --> 00:46:22,060
You'll be all right.

782
00:46:22,061 --> 00:46:24,453
Just keep your head
down and work.

783
00:46:24,454 --> 00:46:26,282
Don't start looking unlucky.

784
00:46:27,893 --> 00:46:29,590
What does your father
say about it?

785
00:46:30,156 --> 00:46:33,549
I haven't told him anything yet.

786
00:46:33,550 --> 00:46:35,769
Isn't that something
you'd talk to him about?

787
00:46:35,770 --> 00:46:37,423
You talk about work, don't you?

788
00:46:37,424 --> 00:46:39,991
But the thing is, like,
he's just been appointed

789
00:46:39,992 --> 00:46:41,820
to the head of surgery
in Dunedin.

790
00:46:43,212 --> 00:46:44,169
Yeah.

791
00:46:44,170 --> 00:46:45,518
I'm just not sure

792
00:46:45,519 --> 00:46:47,607
what position it would
put him in if I told him.

793
00:46:47,608 --> 00:46:49,218
- You know?
- [Elizabeth] Oh?

794
00:46:51,177 --> 00:46:52,178
Yeah.

795
00:46:54,963 --> 00:46:56,791
Not actually sure
what he would say.

796
00:47:01,840 --> 00:47:04,059
He'd probably say
you're better than this.

797
00:47:05,408 --> 00:47:06,974
Probably, but...

798
00:47:06,975 --> 00:47:09,237
What if I'm not, though?

799
00:47:09,238 --> 00:47:11,152
[Elizabeth]
Come on, Richard.

800
00:47:11,153 --> 00:47:12,327
You don't understand.

801
00:47:12,328 --> 00:47:14,808
Look, I have been
having dreams about her.

802
00:47:14,809 --> 00:47:15,854
[Elizabeth]
Richard...

803
00:47:17,768 --> 00:47:20,379
We did everything in our power,

804
00:47:20,380 --> 00:47:22,208
inside and outside theatre.

805
00:47:24,340 --> 00:47:26,168
Mistakes may always happen.

806
00:47:28,736 --> 00:47:30,651
They're scary dreams, Liz.

807
00:47:36,222 --> 00:47:38,310
They're just dreams.

808
00:47:38,311 --> 00:47:41,009
Just dreams.

809
00:47:43,969 --> 00:47:44,970
Yeah.

810
00:47:51,541 --> 00:47:54,152
Maybe you'd be interested in
some confidential counselling

811
00:47:54,153 --> 00:47:55,545
or something like that.

812
00:47:56,807 --> 00:47:58,505
Can I set that up for you?

813
00:48:00,376 --> 00:48:01,725
I...

814
00:48:04,076 --> 00:48:05,337
I want you to know that,

815
00:48:05,338 --> 00:48:08,644
I know what you've done for me.

816
00:48:08,645 --> 00:48:09,951
I did nothing, Richard.

817
00:48:11,387 --> 00:48:13,649
It was my mistake.

818
00:48:13,650 --> 00:48:15,782
I trusted your judgment,
I was wrong.

819
00:48:15,783 --> 00:48:16,957
It's called training.

820
00:48:16,958 --> 00:48:18,220
It has risks.

821
00:48:20,092 --> 00:48:22,180
I took the decision to do it.

822
00:48:22,181 --> 00:48:23,268
[Richard] That was me--

823
00:48:23,269 --> 00:48:24,400
No, I did.

824
00:48:25,836 --> 00:48:26,925
I did.

825
00:48:27,926 --> 00:48:28,927
Me.

826
00:48:31,973 --> 00:48:33,366
Leave it with me.

827
00:48:35,455 --> 00:48:38,370
You can. You can just
leave it with me.

828
00:48:38,371 --> 00:48:40,373
Really, I can take it.

829
00:48:41,504 --> 00:48:42,505
[muted groan]

830
00:48:46,292 --> 00:48:47,945
Why don't you get
something, hmm?

831
00:48:47,946 --> 00:48:49,381
Get something to eat.

832
00:48:49,382 --> 00:48:50,470
Uh...

833
00:48:51,166 --> 00:48:52,863
Uh, no, no.

834
00:48:55,344 --> 00:48:57,998
Okay, well... [clears throat]

835
00:48:57,999 --> 00:48:59,086
[phone vibrates]

836
00:48:59,087 --> 00:49:00,741
I've got to get going.

837
00:49:01,263 --> 00:49:03,134
So...

838
00:49:03,135 --> 00:49:05,919
To be continued? Yeah.

839
00:49:05,920 --> 00:49:07,269
Well, when are we--

840
00:49:09,054 --> 00:49:10,142
When what?

841
00:49:11,882 --> 00:49:13,406
When will it be continued?

842
00:49:15,930 --> 00:49:16,975
Tomorrow sometime.

843
00:49:19,325 --> 00:49:21,805
I told her parents
that she was okay,

844
00:49:22,850 --> 00:49:23,893
that it went well.

845
00:49:23,894 --> 00:49:24,983
You said that.

846
00:49:27,463 --> 00:49:28,725
Yes, I did.

847
00:49:30,075 --> 00:49:31,598
Yes, she was.

848
00:49:34,993 --> 00:49:36,951
Stop telling yourself
a different story.

849
00:49:41,608 --> 00:49:43,436
Jesus!
Fuck, Richard.

850
00:49:46,395 --> 00:49:49,703
[sombre music]

851
00:50:36,532 --> 00:50:37,880
[Alex] Gonna go fishing
this weekend.

852
00:50:37,881 --> 00:50:39,099
You want to come?

853
00:50:39,100 --> 00:50:40,405
- [Elizabeth] Me?
- You'd enjoy it.

854
00:50:40,406 --> 00:50:42,059
I don't fish.

855
00:50:42,060 --> 00:50:43,451
[Alex] Well, you could try.

856
00:50:43,452 --> 00:50:45,540
- [phone rings]
- You could learn.

857
00:50:45,541 --> 00:50:46,889
Everything is always there.

858
00:50:46,890 --> 00:50:49,588
You go away, take a rest,
come back.

859
00:50:49,589 --> 00:50:51,459
Is the patient consented?

860
00:50:51,460 --> 00:50:52,766
Yes.

861
00:50:53,462 --> 00:50:55,507
- It's cancelled.
- What, really?

862
00:50:55,508 --> 00:50:57,162
I don't know, they just told
me it's cancelled.

863
00:50:59,512 --> 00:51:00,948
[sighs]

864
00:51:02,080 --> 00:51:03,081
Fuck!

865
00:51:04,386 --> 00:51:06,910
[indistinct hospital
PA announcement]

866
00:51:07,650 --> 00:51:08,650
[knocking]

867
00:51:08,651 --> 00:51:09,825
Oh...

868
00:51:09,826 --> 00:51:11,305
What happened?

869
00:51:11,306 --> 00:51:12,915
Oh, I'm sorry about that.

870
00:51:12,916 --> 00:51:14,265
He, he ate something in
the middle of the night,

871
00:51:14,266 --> 00:51:15,744
forgot about it,

872
00:51:15,745 --> 00:51:17,747
and then remembered
all of a sudden during consent.

873
00:51:18,270 --> 00:51:19,488
Oh.

874
00:51:20,054 --> 00:51:21,533
[soft chuckle] You're going
through a bit

875
00:51:21,534 --> 00:51:23,057
over there, I gather.

876
00:51:24,624 --> 00:51:26,146
It'll blow over.

877
00:51:26,147 --> 00:51:28,062
[Mary] It's a cracked
system, Liz.

878
00:51:32,632 --> 00:51:35,113
Look, how well known
is my complaint?

879
00:51:36,766 --> 00:51:38,942
Well, it's about, can't lie.

880
00:51:41,031 --> 00:51:42,815
But as you say,
it'll blow over.

881
00:51:42,816 --> 00:51:44,034
[sighs]

882
00:51:47,473 --> 00:51:48,996
Did he really eat something?

883
00:51:51,477 --> 00:51:52,652
So I'm told.

884
00:51:54,436 --> 00:51:57,265
Some spag bowl from the fridge
in the middle of the night.

885
00:51:58,353 --> 00:52:00,702
And there's really
nothing else...

886
00:52:00,703 --> 00:52:02,965
Nothing else that I
can use you for today.

887
00:52:02,966 --> 00:52:05,665
So, um,
I'm sorry to waste your time.

888
00:52:10,278 --> 00:52:12,715
[sombre music]

889
00:53:03,418 --> 00:53:06,204
[seagulls squawking]

890
00:53:15,474 --> 00:53:16,475
Excuse me?

891
00:53:17,519 --> 00:53:18,606
Are you Mrs. Taylor?

892
00:53:18,607 --> 00:53:19,738
I am.

893
00:53:19,739 --> 00:53:21,261
I have a registered
letter for you.

894
00:53:21,262 --> 00:53:22,307
Oh?

895
00:53:24,831 --> 00:53:28,095
[dramatic music]

896
00:53:29,139 --> 00:53:30,576
What the fuck?

897
00:53:30,706 --> 00:53:31,837
Fuck is this?

898
00:53:31,838 --> 00:53:34,101
[tense music]

899
00:53:38,148 --> 00:53:40,063
[tires screeching]

900
00:53:43,545 --> 00:53:46,199
[voicemail]
<i>Hi, this is Robin's phone...</i>

901
00:53:46,200 --> 00:53:47,461
[message beeps]

902
00:53:47,462 --> 00:53:49,158
Robin.

903
00:53:49,159 --> 00:53:50,769
So they've, uh,

904
00:53:50,770 --> 00:53:52,336
"temporarily restricted

905
00:53:52,337 --> 00:53:55,426
my practice of laparoscopy
and laparotomy."

906
00:53:55,427 --> 00:53:57,037
Suspended me.

907
00:53:57,733 --> 00:53:59,299
It's fucking...

908
00:53:59,300 --> 00:54:03,303
It's just
ass-covering cowardice.

909
00:54:03,304 --> 00:54:05,131
It's unbelievable.

910
00:54:05,132 --> 00:54:06,786
Unbelievable! Anyway.

911
00:54:09,005 --> 00:54:10,006
Call me.

912
00:54:16,361 --> 00:54:17,971
[startled gasp]

913
00:54:20,974 --> 00:54:24,412
[tense music]

914
00:54:46,478 --> 00:54:47,740
[grunts]

915
00:54:54,442 --> 00:54:55,355
[scoffs]

916
00:54:55,356 --> 00:54:56,487
[grunting]

917
00:54:56,488 --> 00:54:59,142
[thudding]

918
00:55:02,624 --> 00:55:04,539
[Atticus grunts]

919
00:55:11,938 --> 00:55:13,809
[Atticus whining]

920
00:55:30,391 --> 00:55:33,220
[thudding continues]

921
00:55:34,743 --> 00:55:37,267
[seagulls squawking]

922
00:55:39,444 --> 00:55:41,184
[phone ringing]

923
00:55:47,756 --> 00:55:49,322
[Elizabeth] Hello again.

924
00:55:49,323 --> 00:55:51,455
Mrs. Taylor...

925
00:55:51,456 --> 00:55:53,457
from the conference.

926
00:55:53,458 --> 00:55:54,807
Please sit down.

927
00:55:57,157 --> 00:56:00,203
You're here to talk about
the publishing of data?

928
00:56:01,466 --> 00:56:02,510
I am, yes.

929
00:56:03,555 --> 00:56:04,643
Look... [clears throat]

930
00:56:05,644 --> 00:56:07,819
there's no easy
way to say this,

931
00:56:07,820 --> 00:56:11,213
but our priority
isn't to shelter

932
00:56:11,214 --> 00:56:13,433
surgeons from criticism.

933
00:56:13,434 --> 00:56:15,957
Our priority is deciding
what's good for everybody,

934
00:56:15,958 --> 00:56:17,742
most importantly, the public,

935
00:56:17,743 --> 00:56:19,439
our patients.

936
00:56:19,440 --> 00:56:21,223
I understand that
the methodology

937
00:56:21,224 --> 00:56:22,877
may not yet be perfect,

938
00:56:22,878 --> 00:56:25,271
but I believe transparency
is a good thing.

939
00:56:25,272 --> 00:56:27,491
And we can improve
the methodology over time.

940
00:56:27,492 --> 00:56:29,057
[Elizabeth] The decisions
that we have to make

941
00:56:29,058 --> 00:56:31,320
in theatre in
fractions of seconds

942
00:56:31,321 --> 00:56:34,976
are boiled down to
"they lived" or "they died."

943
00:56:34,977 --> 00:56:38,937
No context, no case histories,

944
00:56:38,938 --> 00:56:40,199
just "they lived"
or "they died."

945
00:56:40,200 --> 00:56:41,984
That's not transparency.

946
00:56:43,246 --> 00:56:45,161
It's looking for
someone to blame.

947
00:56:48,426 --> 00:56:50,775
I understand what you're saying.

948
00:56:50,776 --> 00:56:52,124
- [Elizabeth] Do you?
- Yes.

949
00:56:52,125 --> 00:56:56,476
But once we pass
this first storm,

950
00:56:56,477 --> 00:56:59,958
hopefully then we can
focus on worthy things,

951
00:56:59,959 --> 00:57:01,612
such as risk adjustment.

952
00:57:01,613 --> 00:57:03,223
Risk adjustment?

953
00:57:04,659 --> 00:57:07,008
[Te] Have you heard of Z51.5?

954
00:57:07,009 --> 00:57:09,924
That's a code for palliative
care in the UK system.

955
00:57:09,925 --> 00:57:13,450
A Z51.5 doesn't go on
anyone's stats because it says

956
00:57:13,451 --> 00:57:15,408
that the patient was already
dying when they came in.

957
00:57:15,409 --> 00:57:17,497
Patients died quietly.

958
00:57:17,498 --> 00:57:19,412
No chemo, no scalpels,

959
00:57:19,413 --> 00:57:22,067
just morphine and flowers.

960
00:57:22,068 --> 00:57:24,809
Would my sepsis have qualified?

961
00:57:24,810 --> 00:57:25,940
Do you understand?

962
00:57:25,941 --> 00:57:27,595
Should I have not intervened?

963
00:57:29,379 --> 00:57:33,340
Maybe, it's better for
the patients that way.

964
00:57:34,515 --> 00:57:38,779
Maybe, because at times
it's best not to operate.

965
00:57:38,780 --> 00:57:40,999
Let them die with dignity.

966
00:57:41,000 --> 00:57:42,696
And maybe the publishing of data

967
00:57:42,697 --> 00:57:46,484
will mean that more people
die with less intervention.

968
00:57:47,702 --> 00:57:50,182
You know what's best
for patients, do you?

969
00:57:50,183 --> 00:57:52,011
Sitting here at your keyboard?

970
00:57:54,230 --> 00:57:57,015
I know your reputation,
Mrs. Taylor.

971
00:57:57,016 --> 00:57:58,538
You're the best at what you do.

972
00:57:58,539 --> 00:58:00,018
[Elizabeth]
One of.

973
00:58:00,019 --> 00:58:02,935
But is what you do always
best for the patients?

974
00:58:05,067 --> 00:58:07,329
I'm sorry that sounds tough.
I know.

975
00:58:07,330 --> 00:58:10,289
But hospitals hide
these things, don't they?

976
00:58:10,290 --> 00:58:12,683
Staff learn to hide things,

977
00:58:12,684 --> 00:58:14,423
and patients never know
anything went wrong.

978
00:58:14,424 --> 00:58:16,905
And the ones hurt the most
are the families left behind.

979
00:58:18,211 --> 00:58:20,474
We must hold ourselves
to a higher standard.

980
00:58:22,781 --> 00:58:24,085
I have a standard.

981
00:58:24,086 --> 00:58:26,044
It's the Hippocratic Oath.

982
00:58:26,045 --> 00:58:27,786
And I'm not trying
to hide anything.

983
00:58:33,139 --> 00:58:35,750
[birds chirping]

984
00:58:44,150 --> 00:58:45,543
[door opens]

985
00:58:48,415 --> 00:58:50,635
- [Elizabeth] Hey!
- Well, hi.

986
00:58:51,244 --> 00:58:52,940
How are you?

987
00:58:52,941 --> 00:58:54,072
You good?

988
00:58:54,073 --> 00:58:55,900
[chuckles in disbelief]

989
00:58:55,901 --> 00:58:57,380
Did you forget
some of your stuff?

990
00:58:58,599 --> 00:59:00,121
No, I, um...

991
00:59:00,122 --> 00:59:02,995
I just... I came to get it.

992
00:59:07,652 --> 00:59:08,914
Well...

993
00:59:09,958 --> 00:59:10,959
Why?

994
00:59:15,616 --> 00:59:17,704
I can't be inside this, Liz.

995
00:59:17,705 --> 00:59:19,227
You'll be Dr A,

996
00:59:19,228 --> 00:59:20,577
Richard will be Dr B,

997
00:59:20,578 --> 00:59:22,709
and the nurses
will be there by name,

998
00:59:22,710 --> 00:59:23,884
and one of us will go down.

999
00:59:23,885 --> 00:59:25,016
That's just noise.

1000
00:59:25,017 --> 00:59:26,932
[Robin] No, it's not noise.

1001
00:59:27,323 --> 00:59:29,020
I need my job, Liz.

1002
00:59:29,021 --> 00:59:30,588
[Elizabeth] Robin.

1003
00:59:31,545 --> 00:59:33,024
Robin, I can protect you.

1004
00:59:33,025 --> 00:59:34,156
[Robin] You can't.

1005
00:59:38,378 --> 00:59:39,466
I'm done.

1006
00:59:42,643 --> 00:59:43,601
There it is.

1007
00:59:51,870 --> 00:59:53,740
- [Elizabeth] I'm sorry.
- No, I'm sorry.

1008
00:59:53,741 --> 00:59:54,786
Just go.

1009
00:59:56,918 --> 01:00:01,401
[melancholic music]

1010
01:00:16,851 --> 01:00:17,983
[sighs]

1011
01:00:19,288 --> 01:00:20,289
Fuck.

1012
01:00:37,219 --> 01:00:39,178
[sad music]

1013
01:00:52,365 --> 01:00:53,453
[sighs]

1014
01:01:01,069 --> 01:01:02,418
[sighs wearily]

1015
01:01:15,823 --> 01:01:16,824
[breathes sharply]

1016
01:01:19,784 --> 01:01:22,482
[foreboding music]

1017
01:01:29,837 --> 01:01:30,838
[grunting]

1018
01:01:35,060 --> 01:01:37,976
[thumping]

1019
01:01:44,243 --> 01:01:48,464
- [screaming]
- [insects buzzing]

1020
01:02:10,312 --> 01:02:11,705
[groans]

1021
01:02:47,697 --> 01:02:50,657
[foreboding music continues]

1022
01:03:15,421 --> 01:03:16,988
[lock beeps]

1023
01:03:34,179 --> 01:03:36,616
[phone vibrates]

1024
01:03:48,933 --> 01:03:50,716
[phone notification]

1025
01:03:50,717 --> 01:03:52,675
Oh, fuck off, Richard.

1026
01:04:06,080 --> 01:04:07,865
[bottles clanking]

1027
01:04:23,141 --> 01:04:25,708
[sombre music]

1028
01:04:30,061 --> 01:04:31,889
[dog barking on street]

1029
01:04:40,636 --> 01:04:41,899
[Elizabeth gasps]

1030
01:04:43,335 --> 01:04:46,120
Oh, fuck! Oh, fuck!

1031
01:04:46,947 --> 01:04:49,210
[tense music]

1032
01:04:51,038 --> 01:04:53,823
Atticus!

1033
01:04:55,173 --> 01:04:57,044
Oh fuck! Atticus, here boy!

1034
01:05:09,013 --> 01:05:11,536
He's quiet. I didn't see him.

1035
01:05:11,537 --> 01:05:14,321
I forgot. I forgot the dog.

1036
01:05:14,322 --> 01:05:16,194
- [vet] Right.
- I forgot him.

1037
01:05:18,239 --> 01:05:20,197
- I forgot he was there.
- Okay.

1038
01:05:20,198 --> 01:05:22,200
I'm just going to
check his heart, okay?

1039
01:05:24,158 --> 01:05:26,464
Shhh.

1040
01:05:26,465 --> 01:05:28,119
[Atticus whimpers softly]

1041
01:05:44,874 --> 01:05:46,092
Yeah.

1042
01:05:46,093 --> 01:05:48,182
He's not doing so good.

1043
01:05:49,531 --> 01:05:50,619
Um...

1044
01:05:52,099 --> 01:05:54,145
I think it's time
to say goodbye.

1045
01:05:56,321 --> 01:05:57,713
[sighs]

1046
01:05:59,063 --> 01:06:00,411
Right now?

1047
01:06:00,412 --> 01:06:01,761
- Right now?
- [vet] Yeah.

1048
01:06:02,370 --> 01:06:03,805
[vet] Okay.

1049
01:06:03,806 --> 01:06:06,418
- [Elizabeth] Right. Right.
- [Atticus whimpers softly]

1050
01:06:08,246 --> 01:06:09,899
- You ready?
- [Elizabeth] Mm-mm.

1051
01:06:14,687 --> 01:06:17,037
[panting]

1052
01:06:30,137 --> 01:06:31,920
You can...
You can put your hand on him.

1053
01:06:31,921 --> 01:06:33,445
You can help him out.

1054
01:06:39,755 --> 01:06:41,409
[Atticus groans softly]

1055
01:06:42,410 --> 01:06:44,150
Good dog.

1056
01:06:44,151 --> 01:06:45,413
[stifled cries]

1057
01:06:47,720 --> 01:06:49,025
Yeah.

1058
01:06:49,026 --> 01:06:51,070
I'm going to put
the needle in now, okay?

1059
01:06:51,071 --> 01:06:53,072
[Elizabeth] Mm.

1060
01:06:53,073 --> 01:06:54,727
All right. Here we go.

1061
01:07:03,997 --> 01:07:05,520
[stifled sobs]

1062
01:07:15,661 --> 01:07:17,010
Check his heart.

1063
01:07:25,627 --> 01:07:26,846
He's gone now.

1064
01:07:29,675 --> 01:07:32,243
[Elizabeth cries]

1065
01:07:34,723 --> 01:07:36,377
Would you like him cremated?

1066
01:07:40,686 --> 01:07:42,340
[breathes deeply]

1067
01:07:43,341 --> 01:07:44,907
He's not mine.

1068
01:07:46,039 --> 01:07:48,607
He's not... my dog.

1069
01:07:51,914 --> 01:07:53,916
He's not my dog.

1070
01:07:57,833 --> 01:07:59,139
[sobbing]

1071
01:08:02,490 --> 01:08:06,102
You killed my dog.

1072
01:08:06,103 --> 01:08:07,625
I'm sorry.

1073
01:08:07,626 --> 01:08:09,670
[Jessica] What is wrong with
you?
[sad cello music]

1074
01:08:09,671 --> 01:08:11,498
He's gone.

1075
01:08:11,499 --> 01:08:13,283
I'm sorry.

1076
01:08:13,284 --> 01:08:14,936
I'm so fucking sorry.

1077
01:08:14,937 --> 01:08:16,634
[Jessica mumbles]

1078
01:08:16,635 --> 01:08:18,419
I'm so fucking sorry.

1079
01:08:23,120 --> 01:08:24,773
[crying]

1080
01:08:26,471 --> 01:08:30,649
[sad cello music continues]

1081
01:08:34,609 --> 01:08:36,916
[Jessica sobs]

1082
01:08:39,048 --> 01:08:41,660
[Elizabeth] I'm so,
I'm so sorry.

1083
01:08:46,708 --> 01:08:49,842
[sad cello music continues]

1084
01:09:09,992 --> 01:09:13,170
[birds squawking]

1085
01:09:20,264 --> 01:09:21,394
Jesus.

1086
01:09:21,395 --> 01:09:22,962
[sighs wearily]

1087
01:09:25,443 --> 01:09:27,271
[ringtone rings]

1088
01:09:35,670 --> 01:09:37,671
Hello, this is
Mrs. Elizabeth Taylor.

1089
01:09:37,672 --> 01:09:39,543
I'm trying to
reach my registrar,

1090
01:09:39,544 --> 01:09:40,936
Richard Whitehead.

1091
01:09:41,589 --> 01:09:43,287
<i>Could I get his address, please?</i>

1092
01:09:44,679 --> 01:09:47,204
[sombre music]

1093
01:10:05,309 --> 01:10:07,136
[knocking at door]

1094
01:10:17,321 --> 01:10:18,278
Richard?

1095
01:10:21,281 --> 01:10:22,717
Richard, pick up.

1096
01:10:33,467 --> 01:10:36,601
[phone ringing close-by]

1097
01:10:48,439 --> 01:10:50,570
[gasps] Richard!

1098
01:10:50,571 --> 01:10:51,659
Richard!

1099
01:10:54,053 --> 01:10:55,184
Richard!

1100
01:10:55,446 --> 01:10:57,448
[tense music]

1101
01:10:58,057 --> 01:10:59,058
Jesus.

1102
01:11:00,059 --> 01:11:01,320
Fuck! Fuck!

1103
01:11:01,321 --> 01:11:03,061
Fucking stupid, stupid.

1104
01:11:03,062 --> 01:11:07,283
Fuck. Fuck. Fuck.

1105
01:11:07,284 --> 01:11:08,849
Richard? Richard!

1106
01:11:08,850 --> 01:11:10,895
Oh, Richard? Richard!

1107
01:11:10,896 --> 01:11:12,288
Richard.

1108
01:11:12,289 --> 01:11:13,767
Oh, no, no, no.

1109
01:11:13,768 --> 01:11:16,204
No, Richard!

1110
01:11:16,205 --> 01:11:18,598
[crying]

1111
01:11:18,599 --> 01:11:22,342
You didn't.

1112
01:11:23,778 --> 01:11:25,431
You didn't.

1113
01:11:25,432 --> 01:11:27,086
Please!

1114
01:11:28,740 --> 01:11:29,741
Fuck.

1115
01:11:32,221 --> 01:11:34,484
Why?

1116
01:11:34,485 --> 01:11:36,355
[crying]

1117
01:11:36,356 --> 01:11:39,533
[sad music]

1118
01:11:42,841 --> 01:11:45,496
[whimpers softly]

1119
01:12:00,554 --> 01:12:03,209
[water rushing]

1120
01:12:24,578 --> 01:12:26,014
[Andrew] Right.

1121
01:12:28,016 --> 01:12:31,279
You were there I'm told,
first responder.

1122
01:12:31,280 --> 01:12:32,803
- I was, yes.
- I'm sorry.

1123
01:12:32,804 --> 01:12:35,588
Thank you.
Stupid, stupid bugger.

1124
01:12:35,589 --> 01:12:36,894
Yeah, sadly so.

1125
01:12:36,895 --> 01:12:39,113
But listen, the staff
don't know at present,

1126
01:12:39,114 --> 01:12:41,159
so do you think
you've got this in hand?

1127
01:12:41,160 --> 01:12:42,335
I-- Yes, of course.

1128
01:12:43,641 --> 01:12:45,424
- I will, of course.
- [Andrew] What a business.

1129
01:12:45,425 --> 01:12:47,818
For the hospital,
for the department,

1130
01:12:47,819 --> 01:12:49,733
for everybody.

1131
01:12:49,734 --> 01:12:52,170
So, I think you and I should
keep a lid on the gossip

1132
01:12:52,171 --> 01:12:54,433
and speculation
before it even starts.

1133
01:12:54,434 --> 01:12:57,436
And, yeah, we've got to
keep control of the situation.

1134
01:12:57,437 --> 01:12:58,525
Right.

1135
01:13:00,309 --> 01:13:02,223
Well, what...
What can I do, Andrew?

1136
01:13:02,224 --> 01:13:03,356
What can I do?

1137
01:13:08,274 --> 01:13:10,624
Well, I think you probably
know what this is about.

1138
01:13:11,930 --> 01:13:13,234
[Elizabeth] Right.

1139
01:13:13,235 --> 01:13:16,542
Yeah, it's not an uncommon
phenomenon, burnout.

1140
01:13:16,543 --> 01:13:18,718
But I think for the majority
of the staff here,

1141
01:13:18,719 --> 01:13:19,937
this will be the first time.

1142
01:13:19,938 --> 01:13:22,114
So we need to
show a united front.

1143
01:13:24,508 --> 01:13:25,552
Andrew...

1144
01:13:27,902 --> 01:13:29,991
Richard was not "burnt out."

1145
01:13:31,993 --> 01:13:35,605
Elizabeth, we need
one version of the truth,

1146
01:13:35,606 --> 01:13:37,215
for everybody's sake.

1147
01:13:37,216 --> 01:13:39,131
How... How does
that work, exactly?

1148
01:13:42,221 --> 01:13:45,658
Well, did you know my father
was a surgeon in Korea?

1149
01:13:45,659 --> 01:13:47,268
He was a POW.

1150
01:13:47,269 --> 01:13:49,923
And when he dealt
with limb trauma,

1151
01:13:49,924 --> 01:13:53,231
he would take them to
latrines for their examinations,

1152
01:13:53,232 --> 01:13:55,146
where there were
millions of flies.

1153
01:13:55,147 --> 01:13:56,277
You know what that means?

1154
01:13:56,278 --> 01:13:57,365
Maggots.

1155
01:13:57,366 --> 01:13:59,280
But maggots do
their job very well.

1156
01:13:59,281 --> 01:14:00,847
They debris dead flesh,

1157
01:14:00,848 --> 01:14:02,762
they clean the wounds,

1158
01:14:02,763 --> 01:14:04,938
they never sleep,
they never take a break.

1159
01:14:04,939 --> 01:14:08,465
They're vigilant, consistent,
persistent, trustworthy...

1160
01:14:10,467 --> 01:14:11,816
Unlike some people.

1161
01:14:14,209 --> 01:14:16,167
What's the point?

1162
01:14:16,168 --> 01:14:17,648
What are you getting at?

1163
01:14:21,303 --> 01:14:23,522
Do you remember
you called me "stupid"

1164
01:14:23,523 --> 01:14:27,961
at the Mortality
and Morbidity meeting?

1165
01:14:27,962 --> 01:14:30,965
You really were incredibly rude.

1166
01:14:34,578 --> 01:14:36,014
That's what this is about?

1167
01:14:38,407 --> 01:14:39,930
No...

1168
01:14:39,931 --> 01:14:41,366
[Elizabeth] No?

1169
01:14:41,367 --> 01:14:44,717
No, this hospital has invested
huge amount in you.

1170
01:14:44,718 --> 01:14:46,806
You're a very
valuable commodity.

1171
01:14:46,807 --> 01:14:49,069
You are brilliant,
but you are not easy.

1172
01:14:49,070 --> 01:14:50,507
You're emotional.

1173
01:14:51,595 --> 01:14:53,247
Yeah, emotional.

1174
01:14:53,248 --> 01:14:55,162
I know it's not
fashionable to say it,

1175
01:14:55,163 --> 01:14:57,600
but I'm not sure
women are suited

1176
01:14:57,601 --> 01:14:59,166
to a career in medicine,

1177
01:14:59,167 --> 01:15:00,952
particularly unmarried women.

1178
01:15:02,214 --> 01:15:04,432
But when I have a vested
interest in someone,

1179
01:15:04,433 --> 01:15:08,306
I act irrespective of the risk.

1180
01:15:08,307 --> 01:15:10,048
So it is decided.

1181
01:15:11,310 --> 01:15:13,094
What has?
What's been decided?

1182
01:15:15,053 --> 01:15:16,054
Honestly?

1183
01:15:17,403 --> 01:15:19,404
Sometimes, Elizabeth,
I could just, you know...

1184
01:15:19,405 --> 01:15:21,233
take you or leave you.

1185
01:15:23,017 --> 01:15:23,975
I see.

1186
01:15:25,106 --> 01:15:26,586
[Andrew] No,
I don't think you do see.

1187
01:15:27,718 --> 01:15:29,458
You've been given
a second chance.

1188
01:15:30,634 --> 01:15:33,157
You're going to be back
on call after a week's leave.

1189
01:15:33,158 --> 01:15:34,462
That's what we've decided.

1190
01:15:34,463 --> 01:15:35,899
Then we're going
to publish an article

1191
01:15:35,900 --> 01:15:37,988
in the <i>New Zealand
Journal for Medicine</i>

1192
01:15:37,989 --> 01:15:39,293
and you're going
to sign up to it.

1193
01:15:39,294 --> 01:15:41,208
It'll be about suicide, burnout

1194
01:15:41,209 --> 01:15:45,778
and, uh, Richard's
effect on your data.

1195
01:15:45,779 --> 01:15:47,998
Richard will be shown
as what he was...

1196
01:15:47,999 --> 01:15:50,609
young, ineffective,
out of his depths,

1197
01:15:50,610 --> 01:15:53,786
and that he skewed the data.

1198
01:15:53,787 --> 01:15:55,571
You know, we took
too much care of him.

1199
01:15:55,572 --> 01:15:57,137
<i>You</i> took too much care of him.

1200
01:15:57,138 --> 01:15:58,922
And it's a tragedy
for the hospital,

1201
01:15:58,923 --> 01:16:00,488
for the community,

1202
01:16:00,489 --> 01:16:03,056
and it led to his suicide.

1203
01:16:03,057 --> 01:16:05,145
So, uh...

1204
01:16:05,146 --> 01:16:06,625
you know, the staff
will get counselling,

1205
01:16:06,626 --> 01:16:07,713
there'll be a vigil,

1206
01:16:07,714 --> 01:16:11,849
and then business as usual.

1207
01:16:17,681 --> 01:16:20,379
And I want you
to sign up to it all.

1208
01:16:23,991 --> 01:16:28,474
It's called
"cleaning the wound," Elizabeth.

1209
01:16:32,260 --> 01:16:33,610
Like a maggot.

1210
01:16:35,350 --> 01:16:37,788
Those wonderful maggots.

1211
01:16:38,963 --> 01:16:41,922
[sad music]

1212
01:16:45,099 --> 01:16:46,797
[breathes deeply]

1213
01:17:00,680 --> 01:17:02,160
[sniffles]

1214
01:17:03,552 --> 01:17:05,250
Liz? Liz.

1215
01:17:08,209 --> 01:17:09,253
[sobs]

1216
01:17:09,254 --> 01:17:10,342
I'm sorry.

1217
01:17:12,126 --> 01:17:13,127
I'm sorry.

1218
01:17:18,785 --> 01:17:20,918
- [Elizabeth cries]
- It's okay.

1219
01:17:24,138 --> 01:17:25,792
It's all right.

1220
01:17:27,707 --> 01:17:30,841
[sad music continues]

1221
01:17:57,998 --> 01:18:00,305
[birds chirping]

1222
01:18:09,793 --> 01:18:11,359
What?

1223
01:18:14,362 --> 01:18:15,755
It's just unfair.

1224
01:18:19,019 --> 01:18:21,892
You are good, Liz.

1225
01:18:22,980 --> 01:18:24,111
I know that.

1226
01:18:27,593 --> 01:18:29,725
I missed his calls.

1227
01:18:29,726 --> 01:18:31,291
I could have taken them.

1228
01:18:31,292 --> 01:18:32,337
[Robin] Yeah.

1229
01:18:35,340 --> 01:18:36,863
And you'll have
to live with that.

1230
01:18:38,125 --> 01:18:39,823
And I am so sorry.

1231
01:18:44,523 --> 01:18:45,872
[sighs] Me, too.

1232
01:18:47,308 --> 01:18:48,788
So fucking sorry.

1233
01:18:49,963 --> 01:18:51,095
What a mess.

1234
01:18:52,009 --> 01:18:53,097
[sighs]

1235
01:18:58,842 --> 01:19:01,453
[dramatic music]

1236
01:19:09,548 --> 01:19:10,940
[Ben] Jan, I was wondering--

1237
01:19:10,941 --> 01:19:12,332
Dr. Matthews?

1238
01:19:12,333 --> 01:19:13,420
Yes.

1239
01:19:13,421 --> 01:19:14,813
Excuse us a minute.

1240
01:19:14,814 --> 01:19:16,162
[Ben] How can I help?

1241
01:19:16,163 --> 01:19:20,079
I wanted to speak with you
about a patient of ours.

1242
01:19:20,080 --> 01:19:21,167
Lisa Williams.

1243
01:19:21,168 --> 01:19:22,213
Yes.

1244
01:19:23,692 --> 01:19:26,869
Um, if it's okay, I'd like to
bring Jan in on this.

1245
01:19:26,870 --> 01:19:28,827
She was running the ward.

1246
01:19:28,828 --> 01:19:30,350
Jan.

1247
01:19:30,351 --> 01:19:31,396
Of course.

1248
01:19:32,310 --> 01:19:33,571
[Ben] Okay.

1249
01:19:33,572 --> 01:19:35,921
Jan, this is about
Lisa Williams,

1250
01:19:35,922 --> 01:19:37,140
the sepsis patient
from a while ago.

1251
01:19:37,141 --> 01:19:38,228
Oh.

1252
01:19:38,229 --> 01:19:39,403
Mrs. Taylor was her surgeon

1253
01:19:39,404 --> 01:19:41,013
and wants to know
about her admission.

1254
01:19:41,014 --> 01:19:42,275
- Okay.
- Please.

1255
01:19:42,276 --> 01:19:46,758
Okay. Well, we had
her on the usual lines,

1256
01:19:46,759 --> 01:19:50,196
inspected the surgery sites,
and they were clean.

1257
01:19:50,197 --> 01:19:52,285
There was minimal
output in the drains.

1258
01:19:52,286 --> 01:19:53,592
Her abdomen was soft.

1259
01:19:54,593 --> 01:19:56,637
Well, you tell her, Jan.

1260
01:19:56,638 --> 01:19:59,249
I sat with Lisa from
about midnight.

1261
01:19:59,250 --> 01:20:01,294
She was pretty high
maintenance at this point,

1262
01:20:01,295 --> 01:20:03,906
and she began
to go into decline.

1263
01:20:03,907 --> 01:20:06,779
She was deteriorating.
The sepsis was advanced.

1264
01:20:07,562 --> 01:20:10,521
[Jan] She called out.
She was anxious and agitated.

1265
01:20:10,522 --> 01:20:12,479
[Ben] She was
dropping her stats,

1266
01:20:12,480 --> 01:20:14,220
and cyanosis of the lips,

1267
01:20:14,221 --> 01:20:15,787
about one breath every second.

1268
01:20:15,788 --> 01:20:18,790
[Jan] She was complaining
of being cold and tired,

1269
01:20:18,791 --> 01:20:20,226
and the catheter
was bothering her,

1270
01:20:20,227 --> 01:20:22,055
and her breathing
was very rapid.

1271
01:20:23,143 --> 01:20:26,711
We brought in the on-call
anaesthetist to intubate.

1272
01:20:26,712 --> 01:20:29,192
Was Lisa able to
speak with her parents?

1273
01:20:29,193 --> 01:20:31,151
Yeah, briefly.

1274
01:20:32,239 --> 01:20:33,849
But then they had
to leave the room.

1275
01:20:33,850 --> 01:20:35,720
She arrested during induction,

1276
01:20:35,721 --> 01:20:37,244
and we began resuscitation.

1277
01:20:38,115 --> 01:20:41,726
We worked for...
half an hour, I remember.

1278
01:20:41,727 --> 01:20:42,901
[Jan] She was 29.

1279
01:20:42,902 --> 01:20:45,295
A young, strong woman.

1280
01:20:45,296 --> 01:20:46,644
[Elizabeth]
Right.

1281
01:20:46,645 --> 01:20:47,689
Yeah.

1282
01:20:49,082 --> 01:20:52,911
[Ben] Pronounced dead
about four... five--

1283
01:20:52,912 --> 01:20:55,654
- 4:48.
- [Ben] 4:48. Yes.

1284
01:20:56,307 --> 01:20:57,482
Wee small hours.

1285
01:20:59,832 --> 01:21:00,833
Yeah.

1286
01:21:03,053 --> 01:21:04,358
[sighs]

1287
01:21:05,838 --> 01:21:07,708
Thank you for
caring for my patient.

1288
01:21:07,709 --> 01:21:09,014
[Ben] Is that what you...

1289
01:21:09,015 --> 01:21:10,146
Is that what you needed?

1290
01:21:10,147 --> 01:21:11,582
It is, yes. Some of it.

1291
01:21:11,583 --> 01:21:13,410
[Ben] I can get some more notes.

1292
01:21:13,411 --> 01:21:15,020
- I can--
- No.

1293
01:21:15,021 --> 01:21:17,937
No, it's all right.

1294
01:21:19,983 --> 01:21:21,985
Was she lonely
at all at the end?

1295
01:21:23,290 --> 01:21:24,596
We were all here.

1296
01:21:25,684 --> 01:21:28,251
Her family, right up
until the intubation.

1297
01:21:28,252 --> 01:21:30,080
I was with her during the night.

1298
01:21:33,474 --> 01:21:34,518
Thank you both.

1299
01:21:34,519 --> 01:21:37,696
This very... was very helpful.

1300
01:21:38,784 --> 01:21:41,265
[dramatic music]

1301
01:22:06,768 --> 01:22:08,161
[microphone squelches]

1302
01:22:11,121 --> 01:22:12,122
[clears throat]

1303
01:22:13,732 --> 01:22:16,865
Tena koutou, tena koutou,
tena katou katoa.

1304
01:22:17,475 --> 01:22:19,912
Good afternoon,
ladies and gentlemen.

1305
01:22:21,087 --> 01:22:22,566
My name is Andrew McGrath.

1306
01:22:22,567 --> 01:22:26,309
As you know,
I am head of surgery.

1307
01:22:26,310 --> 01:22:27,919
Sad day.

1308
01:22:27,920 --> 01:22:31,227
And we are here, unfortunately,

1309
01:22:31,228 --> 01:22:32,837
to remember Richard Whitehead,

1310
01:22:32,838 --> 01:22:35,057
one of our brightest
young talents

1311
01:22:35,058 --> 01:22:38,148
whose future has been
so cruelly cut short.

1312
01:22:39,236 --> 01:22:40,366
And in a few moments,

1313
01:22:40,367 --> 01:22:43,761
I would like us to
hold a silence while

1314
01:22:43,762 --> 01:22:46,503
we remember Richard
and the brilliant work he did,

1315
01:22:46,504 --> 01:22:48,113
the part he played in the team

1316
01:22:48,114 --> 01:22:51,073
of one of our most gifted,
accomplished surgeons,

1317
01:22:51,074 --> 01:22:54,120
Mrs. Elizabeth Taylor.

1318
01:22:55,513 --> 01:22:58,167
But before we do,
I would like to say this.

1319
01:22:58,168 --> 01:23:01,735
What we now know is
that Richard's passing

1320
01:23:01,736 --> 01:23:07,177
is the result of the terrible
toll of burnout.

1321
01:23:08,874 --> 01:23:10,222
This is a tragedy,

1322
01:23:10,223 --> 01:23:12,572
but one from which
we will all learn,

1323
01:23:12,573 --> 01:23:14,271
<i>must</i> learn.

1324
01:23:15,141 --> 01:23:18,752
Richard's passing is
a timely reminder to us

1325
01:23:18,753 --> 01:23:22,408
that all our staff
are vulnerable

1326
01:23:22,409 --> 01:23:25,020
to these extreme pressures.

1327
01:23:25,021 --> 01:23:27,109
And unfortunately,

1328
01:23:27,110 --> 01:23:31,027
Richard was, um,
one of its victims.

1329
01:23:32,071 --> 01:23:33,289
It's not easy having to work

1330
01:23:33,290 --> 01:23:35,421
with the responsibility
of life and death.

1331
01:23:35,422 --> 01:23:38,816
We, the hospital,
the administration, the board,

1332
01:23:38,817 --> 01:23:42,689
we absolutely recognize this,

1333
01:23:42,690 --> 01:23:45,824
and, um, we are
responding immediately.

1334
01:23:46,912 --> 01:23:49,696
We are, from this moment,

1335
01:23:49,697 --> 01:23:53,048
putting in place measures
to enhance staff well being

1336
01:23:53,049 --> 01:23:56,747
and our collective
mental health,

1337
01:23:56,748 --> 01:23:58,749
soon as is practicable.

1338
01:23:58,750 --> 01:24:02,580
Because we are all in this
together,

1339
01:24:03,494 --> 01:24:04,842
a team

1340
01:24:04,843 --> 01:24:06,670
and a community.

1341
01:24:06,671 --> 01:24:07,975
[sighs]

1342
01:24:07,976 --> 01:24:11,458
It is indeed
a sad day for us all.

1343
01:24:13,417 --> 01:24:15,984
A minute's silence, please.

1344
01:24:20,728 --> 01:24:22,382
[sighs]

1345
01:24:35,482 --> 01:24:38,267
I'd like to say something.
I think I should. Don't you?

1346
01:24:38,268 --> 01:24:39,355
- [Andrew] Yeah.
- I think I should.

1347
01:24:39,356 --> 01:24:40,356
[Andrew] Yes.
Just a short.

1348
01:24:40,357 --> 01:24:41,574
Yeah, as his registrar,

1349
01:24:41,575 --> 01:24:43,141
don't you think
I should say something?

1350
01:24:43,142 --> 01:24:44,491
[clears throat] Sorry.

1351
01:24:46,450 --> 01:24:49,365
I'd like to say something,
if it's all right.

1352
01:24:49,366 --> 01:24:50,888
Thank you.

1353
01:24:50,889 --> 01:24:52,064
Hello.

1354
01:24:52,804 --> 01:24:53,848
[sighs]

1355
01:24:55,241 --> 01:24:59,071
The reason we're all here
today is, as Andrew says,

1356
01:25:00,072 --> 01:25:01,334
a tragedy.

1357
01:25:03,031 --> 01:25:06,078
Richard Whitehead
was my registrar.

1358
01:25:07,035 --> 01:25:09,733
Many of you knew Richard,
and those of you who didn't,

1359
01:25:09,734 --> 01:25:11,865
I'm sure you can
identify with him.

1360
01:25:11,866 --> 01:25:14,739
He was a young man, 26.

1361
01:25:15,653 --> 01:25:18,785
And as a registrar,
he was still learning,

1362
01:25:18,786 --> 01:25:20,092
still training.

1363
01:25:21,615 --> 01:25:22,659
He didn't die.

1364
01:25:22,660 --> 01:25:24,401
He committed suicide.

1365
01:25:27,317 --> 01:25:31,451
And, um, he's dead now
because he overdosed.

1366
01:25:32,409 --> 01:25:33,757
That's the truth of it.

1367
01:25:33,758 --> 01:25:37,631
He took his own life in
a filthy garage, alone.

1368
01:25:38,806 --> 01:25:40,981
Elizabeth, that's enough.

1369
01:25:40,982 --> 01:25:42,635
[Elizabeth] We talk
about teamwork.

1370
01:25:42,636 --> 01:25:44,247
- Liz--
- We talk about resilience.

1371
01:25:45,465 --> 01:25:47,423
Did Richard lack resilience?

1372
01:25:47,424 --> 01:25:49,512
This young man for whom
I am responsible?

1373
01:25:49,513 --> 01:25:51,862
Because if you're telling me
he lacks something,

1374
01:25:51,863 --> 01:25:52,907
I don't accept it.

1375
01:25:55,910 --> 01:26:01,307
I operated on a patient
that died after the surgery.

1376
01:26:02,352 --> 01:26:04,527
Richard was under
my supervision,

1377
01:26:04,528 --> 01:26:05,833
and he did as I asked.

1378
01:26:07,008 --> 01:26:09,314
I told him to push harder,

1379
01:26:09,315 --> 01:26:11,229
and I chose the timing,

1380
01:26:11,230 --> 01:26:12,752
and I chose the words I said,

1381
01:26:12,753 --> 01:26:15,233
and I chose the way I said them.

1382
01:26:15,234 --> 01:26:16,540
And he just...

1383
01:26:19,151 --> 01:26:20,457
It's my responsibility.

1384
01:26:22,023 --> 01:26:24,286
I am responsible
for the risks I take

1385
01:26:24,287 --> 01:26:25,897
every time I perform surgery.

1386
01:26:26,724 --> 01:26:31,249
And Richard is dead
because he blamed himself

1387
01:26:31,250 --> 01:26:33,209
for a mistake I made.

1388
01:26:36,690 --> 01:26:40,259
I didn't make my responsibility
clear enough to him.

1389
01:26:41,695 --> 01:26:43,654
He was a student doctor.

1390
01:26:47,484 --> 01:26:49,225
And...

1391
01:26:51,749 --> 01:26:53,489
And we're hanging

1392
01:26:53,490 --> 01:26:55,273
a target around his neck

1393
01:26:55,274 --> 01:26:56,406
with this vigil.

1394
01:26:58,625 --> 01:26:59,844
[speakers squelch]

1395
01:27:01,324 --> 01:27:04,195
And I'm not going
to let this boy

1396
01:27:04,196 --> 01:27:06,154
be scapegoated publicly

1397
01:27:07,547 --> 01:27:10,985
by middle managers
and doctors-turned-bureaucrats.

1398
01:27:13,379 --> 01:27:15,511
We are in service.

1399
01:27:15,512 --> 01:27:17,817
We have a covenant
with our patients.

1400
01:27:17,818 --> 01:27:19,559
"I will save you
with my skills."

1401
01:27:21,518 --> 01:27:23,520
But we have a covenant
to each other.

1402
01:27:24,651 --> 01:27:26,609
We're in service
to each other, too.

1403
01:27:26,610 --> 01:27:29,961
Both those covenants are
being broken here today,

1404
01:27:31,267 --> 01:27:32,703
and I will not stand by

1405
01:27:34,008 --> 01:27:37,316
and help pretend
that's not the case.

1406
01:27:40,145 --> 01:27:41,233
That's enough.

1407
01:27:45,716 --> 01:27:47,761
[crowd applauding]

1408
01:27:54,986 --> 01:27:57,292
Rest in peace, Richard.

1409
01:27:57,293 --> 01:27:58,642
Rest in peace.

1410
01:28:02,080 --> 01:28:04,909
[melancholic music]

1411
01:29:32,953 --> 01:29:35,913
[breathes deeply]

1412
01:29:48,578 --> 01:29:49,970
This is what happened.

1413
01:29:54,627 --> 01:29:56,237
Lisa was very sick.

1414
01:29:57,500 --> 01:29:59,066
She had septicemia.

1415
01:30:01,155 --> 01:30:05,595
Although the original operation
was marred by an error I made,

1416
01:30:07,945 --> 01:30:09,207
without that error,

1417
01:30:11,122 --> 01:30:14,647
it's highly likely
she would have still died.

1418
01:30:16,475 --> 01:30:18,738
The sepsis was advanced.

1419
01:30:24,048 --> 01:30:25,528
[sighs weakly]

1420
01:30:27,573 --> 01:30:29,095
Ev...

1421
01:30:29,096 --> 01:30:32,752
Even though
your operation went wrong...

1422
01:30:34,885 --> 01:30:36,626
she still could have died?

1423
01:30:42,806 --> 01:30:43,807
Yes.

1424
01:30:45,765 --> 01:30:46,766
Yes.

1425
01:30:51,336 --> 01:30:52,424
Yes.

1426
01:30:56,907 --> 01:30:58,343
[inhales sharply]

1427
01:31:00,345 --> 01:31:01,911
Is there anything

1428
01:31:01,912 --> 01:31:03,740
you would have
done differently?

1429
01:31:10,834 --> 01:31:12,313
That's the hard bit.

1430
01:31:13,358 --> 01:31:14,402
No.

1431
01:31:15,534 --> 01:31:16,666
I would not.

1432
01:31:18,450 --> 01:31:21,671
All the decisions I made
were to try to save Lisa.

1433
01:31:22,976 --> 01:31:24,803
If the operation
were to happen again,

1434
01:31:24,804 --> 01:31:27,328
I could make all
the same decisions.

1435
01:31:31,245 --> 01:31:33,508
But I would endeavour

1436
01:31:33,509 --> 01:31:36,163
to be better at explaining it,

1437
01:31:37,295 --> 01:31:41,125
be better at taking
responsibility.

1438
01:31:43,910 --> 01:31:45,651
I allowed doubt to creep in.

1439
01:31:58,316 --> 01:31:59,578
Lisa fought.

1440
01:32:00,753 --> 01:32:02,145
She fought really, really hard.

1441
01:32:02,146 --> 01:32:03,364
You need to know that.

1442
01:32:07,543 --> 01:32:09,109
In the end, her body gave up,

1443
01:32:11,068 --> 01:32:12,243
des...

1444
01:32:13,679 --> 01:32:16,552
despite all our
experience and care.

1445
01:32:17,944 --> 01:32:19,293
And please know

1446
01:32:20,512 --> 01:32:22,514
that your daughter
was cared for.

1447
01:32:38,574 --> 01:32:40,967
[breathes deeply]

1448
01:32:44,580 --> 01:32:46,669
I wanted a good
outcome for Lisa.

1449
01:32:48,845 --> 01:32:50,324
And I'm so sorry.

1450
01:33:31,627 --> 01:33:32,802
Thank you.

1451
01:33:38,503 --> 01:33:40,636
[sombre music]

1452
01:34:03,397 --> 01:34:05,835
[hopeful music]

1453
01:35:03,457 --> 01:35:06,373
[hopeful music continues]

1454
01:35:56,946 --> 01:35:59,862
[hopeful music continues]

1455
01:36:19,751 --> 01:36:22,667
[gentle music]

1456
01:36:50,173 --> 01:36:53,916
[gentle dramatic music]

1457
01:37:50,886 --> 01:37:54,498
[gentle dramatic
music continues]

1458
01:38:51,207 --> 01:38:55,211
[gentle dramatic
music continues]

1459
01:39:50,614 --> 01:39:54,748
[gentle dramatic
music continues]