It's my husband, I think he's overdosed.
- OK. - I'm a doctor. He's got a weak pulse,
and I think he's going into respiratory arrest.
- Guy. - Pinpoint pupils.
Can we try naloxone?
He's coming round.
Guy?
Guy, can you hear me?
Guy. Guy, can you hear me?
- What've we got? - Overdose. Naloxone administered.
He'll be coming round and ready for you on the acute ward.
- Bad news for City last night. - Nah, it's a test of faith.
We'll pull through, you'll see. Just got to make the most of...
Forty-year-old male. Presumed opiate overdose.
One shot of naloxone. Still low-level consciousness,
and I'm concerned about his resp rate.
On my count. Three, two, one, slide.
Guedel airway, resps are low.
Saturation's 93%.
I'm not happy about this level of consciousness.
- Resp rate's dropping. - He needs another shot of naloxone. - Get me another shot of naloxone.
Guy?
Get a naloxone infusion set up. Go and get your consultant. Guy?
- What? - Get Marco.
'Promise Keeper' by Agnes Obel
Resp rate recovering.
Oxygen saturation's improving.
Catherine.
- Have I got my dates muddled, or...? - Er, yeah.
I came with a heart. Been in a transplant operation all night.
Oh, wow. How did...
And I was just filling Lars in on the new hierarchy.
Great.
Oh, well, elective backlog calls, so, erm...
Catherine, would you swing by my office?
- I've got the investigation panel today. - When you have a moment.
Sure
- I was going to tell you. - I'm sorry.
- Yeah. - Yeah.
It's not...
Actually, are you free for a minute?
- Yeah. - Thanks.
Hello, Sami's sister.
We met when you were born.
You probably don't remember.
I don't know what to do.
I'm scared of what will happen to you if...
..we don't take you.
I'm scared of what will happen to me if we do.
And none of this is your fault.
I can't keep this up, Lars.
It was supposed to be a tough few months
until I got the consultant job.
I'm paying as much as I earn in childcare,
and I'm barely seeing her.
Well, you know, there is another solution.
Get another consultant's job, yes, but that's gonna take some time.
Elis could come live with us.
I... Look... I'm not judging your parenting.
But this is pragmatic.
But you think she'd be best-off with you.
Well, you can't do General and Trauma
and raise a child on your own, you said so yourself.
I could retrain... and change specialties.
You'd be happy just throwing away a decade of education?
- There are ways I could build on it. - Do you wanna give it up?
Why should I have to?
I mean, you didn't have to give up your career.
Cos I have Brigitta.
It's a wonderful... amazing place to raise children.
And you'd still be part of her life.
Just a different balance. Right? And you're right,
why should you have to give up on the job that you love?
The job you're good at... ..so good at.
Just think about it.
Mae, I can't talk right now.
'Sorry, I know you've got the investigation today,
'but Jakub Wozniak is back with another chest infection.
'They're asking for you. Wh-What shall I...?'
I-I'm on my way.
It's not appropriate for you to be here.
We agreed restricted duties for your own sake.
I mean, it is visiting hours, so I could just wander in there.
He's not responded to three rounds of antibiotics.
- A line for the fourth has just gone. - Can I go in?
I mean, where do we stand legally if I treat him?
Maryam...
I don't think there's very much clinically
that you can still do for him.
Even if we trialled a fifth round, he's got no veins left.
- We're not winning. - Well, let me try, at least.
Come in with me, and then we can say you did it.
Dobroho ronku. Zoya, Kateryna.
- Hi. - Hello.
Pryvit, Jakub.
That is a tiny vein.
Well done.
Dyakuyu.
Helen, where have you been? Didn't you get my messages?
Lars has just...
Helen?
Catherine, it's not time yet, is it?
Hi.
Have you seen him since they brought him in?
No. I'm the last person he wants to see.
Why wouldn't he want to see you?
- You saved his life. - He didn't want saving.
If Maggie had remembered his...
Fuck! I haven't dropped off Maggie's swimming costume!
Fuck...
I don't understand how things got so bad.
He got suspended, er, a couple of days ago for drinking on call.
Oh, God.
Well, how'd that happen? How'd they...?
I reported him.
You know, this isn't your fault.
He found out that I slept with someone...
..else.
Hiya. We can't get him onto HDU, he's on the Acute Ward.
- He can't be on his own ward! - There's no space anywhere.
He'll be with his patients, for God's sake.
No, it... it's fine. It's OK. Is he there now, or...?
- Yeah. - OK.
- I'll come with you, OK? - Yeah.
Settling in, then?
I officially start as Consultant yesterday.
As promised, new rota.
The trust waived my notice period so I can
- pitch in clearing the waiting lists. - Jack, I'm...
I'll be taking on an extra elective list
on a Saturday, where possible.
I'm either on call, on nights or on weekends the whole...
Three out of four weeks, I'm on call!
Yeah, well, with my promotion, it's...
It's what the department needs.
You're gonna have to look at this again. I can't...
You telling me you can't do the job that's required?
What?
I can't do any favours, Catherine.
Take some time with it.
Let me know tomorrow.
Did you hear about Guy Cavendish? Helen's husband.
He tried to take his own life this morning.
Have you seen her?
Can you give me something to do?
Is he gonna be OK?
Mm.
I'm so sorry.
Thank you.
I'm in love with him.
This is not your fault.
Whatever happened between the two of you...
..whatever he said
or he didn't say to you...
..what he did this morning is not your fault.
Do you hear what I'm saying?
You should go home.
No. No, I wanna...
I'd rather keep busy...
..like you.
Can I sit with him?
When he's well enough for visitors,
it will be his parents and his children.
Fuck! Fuck!
Helen.
Hey, stop!
Hey, hey, hey. Come on.
Hey.
Hey! It's OK. Oh, it's OK.
It's OK.
I keep thinking, this time yesterday...
If I could just go back and...
And, what, stop him?
This didn't start yesterday, though, did it?
I knew he'd been struggling.
I mean, we'd... we'd tried counselling
after he told me about Louise.
Fucking Louise!
- Not that I'm any better. - Don't.
Your judgement was so loud,
it was practically a speech bubble above your head.
I'm sorry.
- You know, right? - Yeah.
Did you tell him?
Yeah.
- What did he say? - Helen, go back and be with Guy.
I'm so angry with him. I feel like I could kill him myself.
You'd have to use your left hand.
And how could he do this to me?
How... How could he do it to the kids?
I mean, what the fuck am I supposed to tell them?
Life's never gonna be the same again, is it?
You'd tell your patients to take it one day at a time.
How did I let this happen? Ow, fuck!
- Sorry. - My hand's really sore.
I'm gonna be late for Maryam's meeting.
Oh, "Help." OK, erm... I'll be back.
Catherine...
..just look out for her.
Go back and sit with Guy.
Our recommendation for actions
may include changes to processes or systems,
or further training and support for individuals.
We can...
Excuse me.
We can offer stronger action against individuals
where there is a case for culpability.
So, shall we make a start?
Dr Afridi, as the lead physician treating Edward Williams,
what prevented you from administering antibiotics
within the recommended timeframe?
I gave what I believed to be a direct instruction to Dr Segman
to call Microbiology,
so that they could find an antibiotic
that Edward could tolerate.
But that call wasn't made.
Hm.
The instruction to call Microbiology wasn't in Edward's notes
at the time of his death.
Er, that was an oversight on my part.
- It was an extremely busy shift. - And your first full shift back
after, what, 28 months of maternity leave.
In an acute setting,
which was in breach of Dr Afridi's return-to-work plan.
Did you raise concerns about being given pagers
or being placed in CAU?
I definitely tried to say something to Dr Fisher.
- We were by the hand-dryers. - And you felt fit to practise?
Yes.
Let's make an exception and give him more time.
All right.
Matt?
- Was that Psychiatry? - Yeah, erm...
I... Basically, I told them he's not fit to be assessed.
Do you think they'll section him?
Erm... if it's what he needs, then, yeah.
I keep...
..thinking back over our conversations, trying to find the...
the language, or the tells.
I think I knew he was struggling.
He left a... a note.
Do you think I...
I should read it, or give it to Psychiatry, or...?
Shit, Helen, I don't... I don't know. I'm so sorry.
Thank God you found him.
What was the return-to-work plan
you put in place with the training director?
We agreed we'd spend my first week in a non-acute setting,
and then assess my readiness to return to full duties.
But you were pulled out of an IT induction by Dr Fisher
on day one to carry the labour ward pager?
I'm struggling to find staff to meet the MINIMUM requirements
across our services,
never mind meet guidelines.
Was Dr Afridi given the opportunity
to come off the acute and on-call rotas
that she shouldn't have been on in the first place,
immediately following Edward's death?
No, she...
No.
What support was she offered, Dr Fisher?
Perhaps, and I regret this assumption now,
I saw Dr Afridi as a fresh pair of legs.
- My team are exhausted. - I understand that Dr Afridi
has recently been placed on restricted duties.
We both agreed that she should be away from acute settings
until the conclusion of this investigation, yes.
Do you think, in hindsight, Dr Afridi,
that you might have come back too early from maternity leave?
My instruction to Simon wasn't clear.
This is to call Microbiology?
But I assumed he'd hear it was for him, because...
..when I was an F1, I wrote down every syllable my reg said.
I checked, I double checked, I asked if I wasn't sure.
That was my training. You show up, you arrive early, you leave late.
No matter how insurmountable the challenge,
you... always find a way to make it work.
You don't make mistakes, but if you do,
you take responsibility for them.
That's the standard I've held myself to my whole career.
Well, we appreciate your candour, Dr Afridi.
Were there other instructions
Dr Afridi gave you during the day that you understood WERE for you?
- Yeah, sure. - Like...?
Edward's urine dip?
- Yeah. - But you didn't carry out that instruction.
I thought she meant that I could ask a nurse to do it.
Can I ask, Dr Afridi, what did you think
coming back after maternity leave was going to be like?
I knew we were short-staffed.
I'd heard a lot about burnout.
I knew we were struggling to meet the challenges
children were facing in their health and development.
And in yourself?
You said you felt fit to practise,
but did you feel confident coming back?
No.
I felt tired.
I felt scared about being tired.
I felt rusty.
I hadn't cannulated a patient in over two years.
I felt...
I couldn't remember the doctor I was before I had children.
- I feel changed. - Changed how?
I feel like all the pieces of who I was
have been thrown up in the air, and...
..some of them still haven't landed.
'Woman' by Rosie Lowe ♪ I don't expect you to understand
♪ You can't imagine how I'm feeling
♪ I can't admit it to myself
♪ So where would I even begin?
♪ Cos I'm a proud woman... ♪
Rather than asking someone to judge themselves in hindsight
on their readiness to return to front-line medicine
after maternity leave,
perhaps it would be more useful to consider
why they weren't given the support they needed
to ensure they were ready.
Why Dr Afridi wasn't offered the support
to process the trauma of Edward's death.
I'd like to bring us back to the question
of why the sepsis guidelines were not followed.
My clinical understanding of Edward's condition
is that it was against the odds that Microbiology
would have found an antibiotic within the hour
that didn't send him into anaphylactic shock.
And even if they had, we don't know if he would have lived.
- I think Edward was let down. - Yes, I agree.
Edward was let down by the same systems
that let Dr Afridi down.
I understand the urge to pin that failure on an individual.
Oh, it's so much easier
than fighting for real change in a system.
Besides, Dr Afridi's right.
We keep finding ways in the NHS, don't we?
Somehow, we make it work.
We try and hold it all on our shoulders
because we're the ones who have to look patients
and their families in the eye and let them down.
It costs us something to hold ourselves
to those incredibly high standards.
And when we're pushed to maintain those standards
in impossible circumstances, it costs us everything.
♪ It's too painful To even think about... ♪
♪ So it would kill me To say it out loud... ♪
Hello. Hi! How are you? Are you OK?
I wore Ariana's spare swimming costume!
Did you? Aw.
- Er, she's not staying for after-school club today. - OK.
- Mummy, it had Nemo on it. - Did it?
Oh, can I have a cuddle?
♪ And stay a proud woman... ♪
Good afternoon, Dr Cavendish. You're on AMU. Naloxone infusion.
No intubation.
- Here. - Oh...
Don't look too cogent, Psychiatry have been round.
- Don't. - Er, don't what, mate?
We didn't look after them properly.
We should've done better.
♪ I can't be a mad woman
♪ I have analysed Every single inch of my skin
♪ And comparisons I can't seem To break in my daily routine
♪ I-I-I find myself obsessing Imperfections that only I see
♪ Break free
♪ And I know it's such a waste But the pressure is getting to me
♪ I don't expect You to understand. ♪
I expected to feel this wave of relief.
I feel like I got away with it.
I've thought about him every day since he died.
I know I could have done better.
That doesn't sound like getting away with it to me.
I don't know what to do with myself.
I didn't expect to still be a doctor.
I think the question is, do you still want to be a doctor?
Are you on call?
- No, but I think I have to scrub in anyway. - Hm.
Holding yourself to impossible standards.
Catherine.
Thank you.
Call you later.
Did the line hold?
No.
I, erm... I know them best.
I'm OK, honestly.
Swab.
He's just fucking hosing. I can't see anything.
Can someone sort the fucking lights?
Blood pressure still dropping.
- Mind if I assist? - What are you doing here?
Fourteen year old hit by a car, ruptured spleen.
Have you divided the retroperitoneal attachments?
I can't get to them.
Blood pressure still dropping. We need some more blood.
Jack.
Jack?
Yeah.
Can you get to them?
I can't see the splenophrenic or the splenorenal.
No, still can't see them.
When it's bleeding like this...
you need to feel for them instead.
Scissors, please.
Run your scissors along your fingers like this.
OK. Roberts, please.
Second Roberts.
Blood pressure stabilising.
Hold the tray up a bit higher for me. Thank you.
Spleen out.
- Ligate or transfix? - Always transfix. Stitch, please.
Some scissors, please.
- Yes? - Uh-huh.
Thank you.
Clamp off slowly.
OK, let's tidy him up.
- More warm wash, please. - No. No. That's enough.
Catherine, can you close him up? Great work, everyone.
And, er, don't forget the drains.
I think this might be the time to consider
that he may not survive this.
Sometimes, our job as doctors...
..is to accept there are things that we can't fix.
So I think the best thing for Jakub,
for you,
is to give him a death with some dignity.
I can't.
- I can't tell her. - You can.
I just saved that boy's life in there,
not to mention your arse.
- Don't speak to me like I'm... - What? My junior?
Whatever's going on between you and Helen,
you need to stop it.
What's coming next for her is gonna be long and hard and messy,
and you're not really up for that.
- I care about Helen. - Then leave her alone.
I'm not your boyfriend any more, Catherine, I'm your boss.
Then fire me.
But you might want to consider
having at least one decent surgeon around.
His blood pressure is very low.
Things are slowing down.
Matt said that you've been talking.
Maybe you don't want to look at me.
I wouldn't blame you.
Hello.
I'm here.
I love you.
Whatever you need to say, I'm... I'm here to listen.
I'm sorry.
Me, too.
Do you need me for something?
I couldn't do what you just did.
Everyone thinks it's about the heroics and the saves, but...
..this is what it means to be a doctor.
For me.
You'll find out what it means for you.
I don't think I'm cut out for paediatrics.
What you got next?
Er, orthopaedics.
- People don't die of bad knees very often, do they? - Hm.
Are you on today?
Yep. Come in!
Have you been here all night?
I can't do this any more.
- Catherine, is it? - Yes.
Great.
Myofascial release therapy is a massage technique
that breaks down the scar tissue on your perineum
caused by birth trauma,
releasing the tension in the web of muscles
that holds your vagina and other pelvic organs.
This picture...
I know where everything is, I'm a surgeon.
I just want to be able to have sex again.
OK. Why don't you just take everything on your lower half off
and hop up so I can take a look?
I'll just warm the jelly up for you.
Now, it can be quite an intense sensation,
so if you do need a break at any point,
- just tell me to stop. - I'll be fine, thank you.
OK. Here we go, then.
Oh.
Ah.
Ow.
Ow, ow.
Aah!
Ohh!
- Are you OK? - Erm, fine. Never better.
Well done. When you're ready,
swing your legs round and stand up for me.
I will step outside
so you can get yourself back together.
You OK?
Erm...
Sorry, I...
It just feels good...
I feel like I'm in my body again.
Good. You're OK.
- Do you want a glass of water? - Mm-hm.
I can't let you take her.
I appreciate what a generous offer it is.
You and Brigitta are great parents,
and Sweden sounds like a wonderful place to grow up,
but I can't do it. My body won't let me.
So are you gonna change jobs?
I don't know.
I'm gonna take it one day at a time
for a little while longer, I suppose.
Yeah. Not sure that's good enough.
It's going to have to be.
I'll come by the flat later and see her?
Maybe we can talk some more.
I'm sure Elis would love to see you.
There's not much more to say, is there?
This... This, erm...
This arrangement that we have,
it's not sustainable.
- It's post-natal depression. - Is it?
Cos whatever it is,
I need to find a way to work through it.
Have you thought it might be PTSD?
Would it make you feel better to give it a label?
You're a doctor, I'm just trying to...
I'm so tired of people telling me how I must be feeling.
- What do you want me to do? - Listen to me.
I'm listening.
I'm in no fit state to take on another baby.
Don't. Please don't say it, Maz, please.
This is the hardest thing I have ever done.
If I don't put myself first, I'm going to end up like Guy.
I mean, could they give us more time?
There's another family.
That's why they're pushing us so hard for a decision.
'Work' by Charlotte Day Wilson
I'm sorry.
♪ It's gonna take a little time
♪ But with you by my side
♪ I won't let go
♪ Till I've got what's mine
♪ Ooh-ooh
♪ Ooh-ooh... ♪
- Hi. - Hi.
How is he? Sorry, how are you?
How are you both?
He, er...
He's fit to assess,
according to Psychiatry.
I just wanted to say, er,
thank you for yesterday morning...
..for stepping up and taking such good care of him.
It was really impressive.
I should go and be with him.
Oh, you know, they were saying yesterday,
they're gonna need a locum or someone to act up as consultant.
Yeah. Yeah. He's gonna be off indefinitely, so...
Did they mention any names or...?
Right, I think they assumed the most qualified person
wouldn't be up for it, so...
you have to let them know if you were.
Thanks, Tessa.
♪ It's gonna take a bit of work
♪ Oh-oh, work
♪ Now that you're here
♪ Whoa-oh, work
♪ It's gonna take a bit of work
♪ Oh-oh, work
♪ Now that you're here... ♪
Mummy, catch the bubbles.
♪ Oh-oh, work... ♪
Er... Fast asleep.
Are you sure?
Yes.
I need to, erm... check dates.
I don't know when I can get back over here again.
I don't wanna leave her.
There has to be a better way to work this.
- Can you move to Sweden? - No, I can't.
Well...
..there has to be some way to help you to...
- I... I don't know. - Me neither.
There must be a better solution.
'Like A Hunger' by Wilma Archer
♪ I can't wait
♪ Any longer
♪ For me to feel your body
♪ Am I going insane?
♪ It's like a hunger
♪ It leaves your body
♪ I can't wait Come on over now, baby
♪ The touch is driving me crazy
♪ I can't wait... ♪
When do you start?
Erm... I will be acting up as consultant
as soon as I'm ready to come back.
So, I don't know, maybe next week.
A junior doctor no more. You've made it.
Congratulations. Well deserved.
Slightly dark circumstances, but... thanks.
When are you coming back?
- I dunno. - Give it a while. I might have to wait
till Professor Thomas dies, and I don't want to be the last.
- I'll keep an eye on the obituaries. - Mm.
And all thoughts on alternative surgical specialties welcome.
- Boobs. - Very mature.
No, breast surgery. They have these fellowships.
Because women do women's bits?
No, because it's all elective, so the hours are decent.
Take as much time as you need, though, Maryam.
It's really important.
- Oh, er... how was the fanny witch? - Oh, yeah.
Well, her power is real,
so, regrettably, we'll have to burn her.
Does this mean you can have sex again?
Yeah. Hypothetically.
- Oh... - Make good choices.
Mm-hm.
Do boobs pay well enough to cover childcare?
You just paid someone like 50 quid to get fingered.
And she said I still need three more sessions, so...
What?
Oh, wow.
You and vaginas, honestly.
♪ The touch is driving me crazy
♪ Am I going insane?
♪ Do I need to be loved? Yeah
♪ Would I need you? I can't wait
♪ I can't wait
♪ Am I going insane?
♪ I can't wait
♪ Am I going insane? ♪