Pulse (2017) s01e03 Episode Script
Episode 3
1 You need this heart to survive.
I'm just I'm not in a place to decide.
I'm just so exhausted.
Your heart, it is failing, and if you don't take this chance Zoe, good news.
The heart looks great.
We're good to go.
Okay.
You've just done 14 hours of theatre.
Thanks for the offer, Maggie, but I've got this.
ZOE: Hey, baby, you're going to look after Daddy while the doctors look after Mum, yeah? Yeah.
We'll be here when you wake up.
- All ready? - Okay.
- Let's take her off.
- Stop! Do not unclamp.
- What's the issue? - There's a loose stitch.
Check it.
What's your call, resident? I must have been mistaken.
Right.
Let's start her up.
- (MACHINE BEEPS) - Good job.
BERGER: Prognosis.
It's a brain tumour.
Benign? It's glioblastoma multiforme.
What would you say to the patient? Don't buy too many green bananas.
Who's the patient? (SIREN WAILS) Open my lungs Move your hands inside my chest Cut me deep beneath my skin I'm ready to fall out My body's caving in Hold me down So that I can feel the heat Cut me with the sharpest knife I'm ready for the pain.
MAN: Go on.
One more drink.
FRANKIE: Mm, no, thanks.
I don't want to get soused.
- I am a cheap drunk.
- (CHUCKLES) That's a shame.
I'd like to see that.
- What? - An image.
You in a nurse's uniform.
Nurse, huh? Your profile said you were a healthcare professional.
Oh, yeah, it's an easy mistake.
Woman, health care - Oh, you're a doctor.
- Yep.
- Okay.
- (PHONE RINGS) I kept it vague, because friends suggested that some men have trouble with the whole authority thing.
Yeah.
Yeah, so That's awkward, huh? So, you want to save lives, huh? Cool.
That's the idea, yep.
Why don't you get that? I'll get this and, um, we can call it a day, yeah? Yeah.
These came from radiology.
It's addressed to Dr Berger, but there's no patient number on it.
Oh, we'll be with you in just a moment, Connie.
Connie Capitano's back.
- And this just came in.
- Yeah.
Was there something else? (MACHINE BEEPS) Um, I saw that Dr Berger's here.
He's unavailable at the moment.
A boy or a girl? Um, well, my husband swears blind he can see a penis on the ultrasound, but I think he's just getting mixed up with the large intestine.
- It's wishful thinking, I guess.
- (CHUCKLES) There's something wrong, isn't there? Oh, on the contrary.
Your blood pressure is normal.
Everything's looking good.
What about my protein levels? Uh, slightly elevated, but nothing to worry about.
(SIGHS) This is what happened last time.
Slightly.
I'm talking one plus.
That's something to watch.
If it was four plus, then I would worry.
Look, I'd really like a second opinion.
I know you had a difficult time with your first pregnancy.
He's just in there.
If you're still worried, then maybe you should book in with your obstetrician.
No, I've just been with my obstetrician and she told me to come and see Dr Berger.
Look, I know that you all think I'm just being paranoid, but everything was going perfectly fine last time, and then You know that I'm a transplant recipient, right? I can't I can't lose this baby.
- No one is going to let that happen.
- Well - Everything all right out here? - Dr Berger.
Hello, Connie.
How's things? Well, that's what I'd like to talk to you about.
Dr Bell here said that you weren't available.
I can't think why she'd say that.
I'm always available for my patients.
Why don't you take a seat in my office? Sure.
Thank you.
All of her results are normal.
She is panicking unnecessarily.
Connie lost her first baby six weeks out from full term.
It's understandable if she's nervous.
- I get that, but - You are a mere resident.
You don't get to edit my patient list.
It's not your job.
Do we understand each other? Trouble in paradise? This patient, Shane Wozniak, came in from ED with ischaemic-sounding chest pain and a cough.
Care to comment on this X-ray? Sure, this is a mobile chest X-ray taken in the ED.
It shows a moderate-sized unilateral pleural effusion on the right.
The left lung field is clear.
There are no other obvious abnormalities.
Good.
Good.
There's something odd here.
Can you see how the overlaying soft tissue is less dense on this side? Do we know what the underlying aetiology is? Jury's still out on that.
You mean you don't know.
And if you don't know, just say so.
What would be your differentials? Infection, trauma, malignancy, hepatic hydrothorax? Okay.
Hi, Shane.
I'm Dr Steele.
- I'm the consult on.
- (COUGHS) And how long have you had this cough? Ah, about a month, maybe more.
My GP gave me a script for antibiotics, but I still can't shake it.
Look, I think the most likely thing is you have pneumonia, and fluid has built up between your lung and the chest wall.
Now, we're going to pop a drain in there, take out the fluid.
Should have you feeling better pretty quickly.
Dr Patel will perform the procedure here on the ward.
Now, he's going to put a local anaesthetic in your skin, and then he's going to insert a tube into the space between your lung and the chest wall.
Once we have the drain in, we'll be able to send some fluid off to the lab for testing.
And that should tell us why you have this effusion.
- Any questions? - Can't you do it? It's a very straightforward procedure.
Dr Patel can handle it.
He would have done it many times in the past, and he'll be supervised by my registrar.
Rest assured, you're in safe hands.
FRANKIE: Levels are fine.
CAROL: Yep, yep, looking good.
All looking good.
Oh! Hi, buddy! I wasn't expecting you guys so soon.
Yeah, it's been like Christmas at our place.
This little guy's been up since the sparrow's fart.
- How's Zo? - She's doing great.
No, really, we're weaning her off the sedatives and we expect to be extubating her soon.
- Great.
- Hey, you want to see Mum? - Yeah.
- Yeah? We just have to check the balloons and the beautiful flowers in with Carol though, okay? There's no flowers in ICU, I'm afraid.
It's okay, mate.
But when Mum comes out to the ward, we can give them to her then, yeah? I promise I won't let anybody steal them.
Okay.
Let's bust a move.
Hey, so, heads up.
Mum has a big tube coming out of her mouth.
It looks like she's swallowed a vacuum cleaner.
But it's actually helping her to breathe, so we like the tube.
The tube's good, okay? I need you to be brave.
You too, Dad.
So, Mum's just resting.
It's the best way her body has to heal itself.
So, we keep her asleep until we think she's ready.
- All right? - Yeah.
I don't know if that's a good idea, mate.
He's fine.
Still can't get my head around the idea there's another person's heart in her.
Thank you.
You don't need to thank me.
The surgeons did an amazing job.
I was just the ground staff.
No, no, no.
Zo was ready to give up.
It was you who gave her the courage to go for it.
Hey, what's this? Five hearts.
You, Mum, me, the person who gave Mum the heart, and Frankie.
Thanks, matey.
- MONICA: Hey.
- Mitri's taken me off his list.
Oh, you're with the best, Cutter.
Does he take residents off his list often? He's the surgical boss.
He makes a call, you suck it up.
Don't waste your time with Mitri.
I just wanted to clarify that I've never actually done a chest drain before.
Yeah, well, good news, today the training wheels come off.
Maybe they need to stay on for one more lap.
Patel, what were you in a previous life? - Oh, you mean, like, career-wise? - Mm-hm.
I was a chef.
Chef? That's a first.
What kind of chef? Like, where were you in the pecking order? - I was a general hand.
- Oh.
Guess I don't need to go after all.
Patel, there's two types of doctors in my experience.
There's coat-tailers and there's doers.
Now, coat-tailers, they're always around when you don't need them, never around when you do.
Now, doers we try to weed out coat-tailers before their first year's out.
Do not be a coat-tailer on my watch.
I'll shadow you in there, but you need to take the running.
You understand? (WHISTLES) (SIGHS) So, did they teach you anything? CUTTER: What have I got to learn? Ah, you're back with us.
You're not Mitri's favourite anymore? - I'm assisting you today.
- Lucky for us.
Oh, I've got some new tracks.
- Do you want to - I better like them.
So, I bet vet world is looking pretty good, right now.
Scalpel.
Let's get funky, people.
COMPUTER: The patient should be positioned laying down on their back in order to have the best position for insertion.
- Create a large - Hey, get a move on, Dr Google.
and make the incision.
It can be very painful for the patient, so make sure that the area is adequately SHANE: No, nothing serious.
This chest cough thing that won't budge.
Doctors just reckon I need to rest up.
Oh, no, I'll be back on deck next week.
No other issues, boss.
No, it's okay.
Thank you, sir.
Yeah.
Do you want to check that I've got everything? - Have you? - Mm-hm.
Off you go, then.
Mr Wozniak, can I get you to pop back on the bed for me please? Thank you.
And just untie your gown as well.
Could you untie your gown and place your right hand behind your neck for me, thanks? Mr Wozniak, we need an ultrasound image to determine the best possible insertion site for the drain.
If I miss and get the wrong spot, I could cause your lung to collapse.
Hitting the right spot sounds like a plan.
Give us a hand.
That's quite a scar you got there, mate.
Yeah, I had cancer.
Did you? It says nothing about that in your notes here.
I'm in remission.
What kind of cancer are we talking about here? Just cancer.
Just cancer.
Might have a quick chat to you, is that all right? It's okay.
You're okay.
I know it's hard, but you need to try and relax.
(GAGS) I know it's hard, but you need to try and relax.
(GAGS) Zoe, you need to try and relax.
I know it's hard.
Don't grab at it.
The nurse will take the tube out, but you need to try and relax.
Deep breaths, gentle breaths.
- Deep breaths, gentle breaths.
- (GAGS) (PANTS) Hey.
Welcome back.
So, that was a mastectomy scar, right? That's pretty rare in men.
First for me too, actually.
Do you think the pleural effusion is related? Not good news for him if it is.
Hey, listen, before you go back in there, if you're going to do this, you need to act like you know what you're doing.
Yeah.
Yeah, yeah, yeah.
Hi, Shane.
How you going? All right, I'm just going to check your chest, all right? Can you talk about the cancer treatment you had in the past? - Did it spread to your lymph nodes? - Yeah, I had them cut out too.
Right.
Okay, it's going to be a little bit cold, all right? Did you have chemo? How about, uh, are you on any medications now? Why all the questions? Look, a pleural effusion can mean the cancer has spread.
I'm not saying it definitely has.
We won't know for sure until we get the fluid off for testing.
How you doing over there? You all right? Yeah.
All right, you're going to feel a little bit of a prick, okay? And just a minute to let the anaesthetic get to work.
Was that a yes to the medication? No, I stopped taking my meds, all right? Look, are we going to do this, or what? Yeah.
What the hell are you doing? - What? - You want to do this procedure or not? Dr Patel, are you comfortable doing this procedure or would you like me to take over? Yes, I said I'd do it.
- Then do it right.
- Okay, all right.
Maybe you should do this one.
I'll watch and do the next one.
Sorry, Mr Wozniak, my intern must have had a little stage fright.
I'll take over if that's okay.
Sam and Zac came by earlier.
They're still around waiting to see you, soon as you're ready.
The donor and I made the cut too.
You know, until I met you, my biological clock ran on silent.
Now there is this very faint tick-tock and, frankly, that is a problem, not just because I don't have a partner.
There's a bit of a man drought at the moment.
But guys find out I'm a doctor and they just run the other way.
Either that or no one's told me that I have really skanky breath.
I'm sorry.
I'm sorry.
Sorry.
No laughing.
Your SAT levels are good.
How about I track down those boys of yours? (SOFTLY) Thank you.
Okay, Shane, I'm done here.
You did well.
We'll send this off for testing, get you some answers.
And you should find that your breathing settles down a fair bit too.
When can I go home? That just depends on how quickly this drains.
Look, I'd bank on at least an overnight, all right? As soon as we get the results, we'll let you know.
Hey, Eli, thanks.
I just wasn't ready, you know, but next Are you a doctor or are you not? Are you? (ALARM BEEPS) Move.
Come on.
Oh, shit! MONICA: What's happening? I was assessing a patient.
She's dropped her BP.
We need some help in here.
Come on, Zoe, stay with us.
- Talk to me.
- She's got no air entry.
- PATEL: Checking.
No output either.
- Start chest compressions.
- CAROL: Who's running this? - I am.
Set up over here.
Strapping her head down.
Monica, can you get on airway for me? Great.
I'm going to need blood.
O negative if there's no cross-match.
Two units, all right? Check out this drain.
She's bleeding out.
Keep up with those chest compressions.
While we're waiting on that, let's get two bags of normal saline, stat.
And two, continue compressions.
I need one mil of adrenaline IV with a flush.
It's time for a rhythm check, guys.
Charge the defibrillator.
- Charging.
- Everybody clear? - Clear.
- Shocking.
- (MONITOR BEEPS) - She's still VF.
- Recharge.
Restart compressions.
- One, two We're never going to stabilise her while she's bleeding like this.
Even if we bring her back, she's just gonna keep crashing.
Okay, what's your call? - The theatre's ready for us? - MAN: Yeah, just prepping.
All right, we crack her chest back open, see if we can resew whatever's bleeding.
Get ready to move her, everybody.
- Let's go.
- All right, get those bags.
- Hop up there, yeah? - Yep.
- Okay, brakes off.
- Keep giving compression.
Get ready to move her, all right? Bags in the hand? We're going to work her as we go, okay.
You ready? - Yes, yes.
- Let's get her out.
Put the sides up.
- Got the bags.
- Move it quick.
- Let's do this.
Okay? - Up, up, up, come on.
16, 17, 18, 19, 20 Zoe Mendoza's gone into arrest.
She's bleeding out.
ELI: How are her obs? MONICA: Uh, no cardiac output, and the drain's still going.
- Right.
Update.
- PATEL: 22, 23 - How's her BP? Any change? - 25, 26, 27, 28, 29, 30.
And breath one, breath two.
Everybody in? All right, call the theatre.
five, six, seven, eight, nine, 10, 11, 12 They must have moved her already.
Come on.
Let's go find her.
- Still no pulse.
- Charge at 200.
Everyone clear.
- Charging.
- Two breaths.
One, two - Shocking.
- Clear.
- (MONITOR BEEPS) - Sinus rhythm.
Right, she's back.
Get ready to move her.
On your call.
CUTTER: Okay, everyone not on my team, out of my theatre now.
Go, go, go.
- All right, let's go.
Come on.
- We're ready.
One, two Do you think maybe she was bumped to a different level? - What's going on? - Zoe arrested.
I was just with her.
She was fine.
They're opening her back up as we speak.
Frankie? Mr Mendoza, your wife has experienced some post-operative complications that the surgical team are currently working to fix.
She's back in theatre? - That's correct.
- Why? What the hell happened? - What kind of complications? - We're not sure.
As soon as we are, you will be the first to know.
Sam, um Zac.
- Let's go get some air, yeah? - Yeah.
CUTTER: Okay, more suction.
More suction.
- We need better hands in here.
- The anastomosis is leaking.
Well, do you want me to oversew or do you want to do it? Get out of my way.
Get that aorta clamped.
3-0 Prolene.
Suction.
Shit! Tissue's shot.
- I think I got it.
She's all right.
- (MONITOR BEEPS QUICKLY) Oh, shit.
She's arrested again.
Okay, charging.
Paddles.
Clear.
She's still VF.
Compressions, directly.
Get your hand in there, that's it.
That's it, keep it up.
One, two, three, four, five, six, seven, eight Her SATS and BP were all good, so how could she just crash like that? PATEL: She was bleeding into the drain.
- What? - Eli ran the code.
I did the CPR.
You went in hard, yeah, with the compressions? Yeah, of course, I mean, as hard as I could, given that she had a heart transplant.
Shit.
Just keep me posted, yeah? No word yet.
28, 29, 30.
One, two, three, four, five We need to call this.
- No, we can keep going.
- Oh, bullshit! It's hopeless.
Zoe Mendoza, time of death, 17:06.
12, 13, 14 - Lou.
Lou, hey, hey - 16 - Hey.
- (PANTS) Okay.
So, how did this happen? Hm? How did this girl die? - I mean, how is that even possible? - Nothing went wrong.
The surgery was fine.
Nothing went wrong at my end.
This is a SAC 1.
It's going to be investigated.
(PHONE CHIMES) ELI: CU extubated her two hours ago.
She seemed stable and fine.
Then she lost consciousness, started bleeding out through the operation site.
She went into cardiac arrest, a code was called.
I ran that code.
We immediately started compressions.
We managed to get her back into sinus rhythm in the theatre, at which point, the surgical team took over.
STEELE: Monica, were you in this? Um, yeah, I was involved in the code, bagging, masking, and then again in theatre when we tried opening her up.
Was resuscitation performed correctly? As far as I'm concerned, we did everything appropriately.
She died because the anastomosis leaked.
We don't know what happened.
Okay, no one's passing judgement here.
I just need to get a handle on what happened.
I tried to oversew, but the tissue was shot.
I tried to patch it up as best I could, but she bled out.
Was there anything else we missed? Could we have done anything more? No.
We need to get an apology to the family.
They need to understand what's happened.
- You up for that? - Of course, boss.
Okay.
Does anyone else know the family? Right.
Remember that we're here to say sorry that Zoe has died, and that we want to work out why this has happened.
To inform him to make sure that it doesn't happen again.
Don't get drawn into giving any reasons we don't have answers for yet, okay? (KNOCK AT DOOR) Mr Mendoza, I believe that you know everyone here.
Yeah.
Like to take a seat? Would you like some water? Mr Mendoza, your wife, as you know, was recovering from a heart transplant operation when she had a bleed.
She had to go back into surgery because she had a cardiac arrest.
It was during this process, unfortunately, that we found out she was bleeding from the operation site.
We were unable to resuscitate her.
Your wife died.
We're really very sorry.
I know this is a huge loss for you.
Okay.
Uh (STAMMERS) you'd better get going.
It's six o'clock already.
You don't want to be late.
Conference conference call.
Oh, right.
Look, we're going to stop now.
I think that's a lot for you to take on.
But rest assured, the hospital will be running a thorough inquiry into how your wife died.
We will be in contact.
In the meantime, feel free to call anytime.
Aw, you shouldn't have, Frankie.
She got the heart.
She should have lived.
Shit happens.
We do what we can.
Why did you tell me? Like, why did you pull me into your shit, and then - push me away? - I made a mistake.
I shouldn't have told you.
I'd only just found out myself.
So, the MRI confirms it? Mm.
Glioblastoma.
Grade four.
So, that means I've got between six months and two years.
So, you were right about the green bananas.
- I am so sorry.
- Like I said shit happens.
What was the surgeon's advice? Or the oncologist's? - What do those pricks know? - You have seen someone.
The only two people that know are you and the radiographer, and that's the way I want it.
I want to keep working.
I don't want anyone in this place weighing in.
I've got far too much work to get on with.
Okay, well, they're going to weigh in when you have seizures.
And you can get down off that high horse.
What is this? Is this blackmail? Yeah? You have my secret and I have yours.
Something like that.
TABB: I really don't think I can make it in cardio.
Just don't have the bladder for it.
God, you should have seen Eli.
That guy's got like, camel parts or something.
You know, I had a male patient today, breast cancer.
We're talking, like, full mastectomies You mind? Can we get through dinner without mentioning medicine? I'd just like to pretend for one moment we are normal people who talk about normal things.
What about anal anecdotes though? Are you sure that you went in hard enough with the compressions? (MUTTERING) What is syndrome? Hyperthyroidism.
Hyperthyroidism.
Describe Graves' Disease.
Okay, okay disease.
(TAPS ON DOOR) I'm sorry.
Two codes in two weeks.
People are going to start calling you shit magnet.
They already have.
How come on ER they always manage to bring them back? Because George Clooney is God.
(LAUGHS) (PAGER BEEPS) Okay, speak to me.
Shane Wozniak's prelim cytology reports are here.
His cancer's back.
Okay, we'd better tell him.
I'll tell him.
Shane, your cytology reports are here.
The cancer is back.
But all we know at this stage is that the cancer has metastasised and we won't know the extent of the spread until we do a CT and a PET scan.
An oncology reg will come by later to discuss your treatment options as well, okay? Is there anything else you wanted to ask me? I'm sorry.
I know this is not the news you wanted to hear.
I'm going to die of breast cancer, aren't I? So, what happened the other day? You know, the Mendoza woman's transplant operation.
What do you mean? Well, you were in the thick of it, weren't you? - How'd it go? - What have you heard? Just a simple question.
Hey, we're up.
We need to say something, Monica.
About what? We don't know what caused her to bleed out.
(SCOFFS) You might think you do.
It's not the same thing.
You know what, hon? If you want to be a surgeon, I would shut up in this meeting, if I were you.
Let the senior people talk, take your cues from them, because you really can't afford to make a big deal about this right now.
Come on.
Say E E Oh, great.
All right.
I'm all right to go? (SCOFFS) No, we need you in bed for at least another four hours minimum.
Then, we need to get you an X-ray, and then, we need to get you into oncology.
Oh, screw oncology.
My gran died of this, so did my mum.
Look, there have been huge technological advancements in drug medication in recent years, you know.
If I just walked out of here right now, how long have I got? No treatment.
If you did nothing months.
Maybe six months, tops.
But treatment can help push that out to years.
Look, the bad news is you have breast cancer, but that's also the good news, in terms of new drug protocols.
(COUGHS) The other doctor yesterday asked if I was still taking my meds.
Would that have made a difference? It's my fault it's back.
You can't afford to think like that.
Excuse me.
Okay.
I'll see you soon.
You ran an anaesthetic assessment.
Any concerns? Zoe presented with a viral infection two weeks ago, that damaged her heart.
We were concerned, obviously, but outside the cardiac situation, she was a fit, young, strong female.
And she was haemodynamically stable pre, during and post-op of the entire heart transplant.
So, you were happy.
From my end, yeah.
Mitri? From my end, all fine.
I was happy with how things went in surgery that day.
Of course, I wasn't there for her extubation, obviously.
And I'm in no way commenting on that process work, but there wasn't much time between her extubation and her code arrest.
There might be a link there.
I don't know.
I can't explain why she bled out, boss.
I wish I could.
Could have been her blood pressure.
Yeah, well, we all know that heart transplant surgery is a complex part of medicine.
We can never know what happened.
Thank you, Monica.
Does anyone have anything else to add? Okay.
Well, there will be an autopsy of course.
And, as I said earlier, a root cause analysis will be undertaken into Zoe's death.
(PANTS) CAROL: We have a problem.
He pulled his IV tube out.
I couldn't stop him.
- Shane! - Where do you think you're going? I haven't even discharged you yet, mate.
You're bleeding.
Shane, Just come back out and let me fix you up, okay? Please.
I don't want to die.
Come on.
Is there anyone we can call? Family, or that girl you mentioned? Shane, you need some support, some people around you.
Who helped you the first time around? No one.
No one knows.
So how did you manage the doctor's visits? The surgery, chemo? Took leave off work, shifted stations stayed out of the locker rooms, worked solo.
Holy crap.
Can I get you to hold that for me, please? Cut my finger, I have to tell the whole world.
Maybe you should give people the benefit of the doubt this time around.
I'm not having treatment.
Well, at least find out what you're saying no to.
Hi, could I please speak to Dr Erin Phipps there? Thank you.
Oh, hi, Erin.
It's Dr Tabb Patel here from City West Public.
How are you today? Great.
Look, I have a breast cancer patient that has failed conventional therapy, and I believe you're running a trial.
So, I was just wondering whether you're still recruiting.
Great.
Yeah, his name is Shane Wozniak, male.
Yeah, yeah, I get that it's unusual, but could you make an exception? Okay, all right, thank you.
Yes, look, I appreciate that you don't want to throw your study out, but is there any way we can Okay, thank you.
Hi, yes, I'm just calling about our conversation earlier today.
This is Dr Tabb Patel.
Okay, all right.
No, I understand that.
But what about compassionate access to the drugs? Right, okay.
Yeah, thank you.
Hello, Dr Patel speaking.
Yeah, his name is Shane Wozniak.
Yeah, he's BRCA, actually.
His mother had it and his grandmother.
Oh, yes.
Uh-huh.
Perfect.
Thank you so much.
All right, bye.
Okay, Mr Heritage, we'll see you in a month.
Oh, hi, Connie.
You're back so soon.
We weren't expecting you for another week.
My BP is up and my urine levels are rising.
How do you know this, Connie? I bought a test.
It's two plus.
Look, something's wrong.
- Something's really, really wrong.
- Okay, well, we went over this.
And your blood pressure is normal, so you're fine.
I wish I was as healthy as you.
Oh, God! Over here, over here, Connie.
You're okay, come this way.
Hold onto me.
- You're all right.
- I'm sorry.
That's okay.
No worries.
Look, it's a trial.
There are no guarantees that you'll benefit from this treatment, and I can't really tell you that it will extend your quality of life, but it's a good hospital and they're a good team with a great track record in this kind of cancer research.
So, if I was you that's where I'd be going.
Royal Women's? And one man.
Thanks.
So, have you got transport sorted, or do you want me to flag a cab or something for you? No, I'm all good.
Shane.
- Hey.
- Shit news, mate.
Come on.
Yeah, well, it makes sense, really A pacemaker for VT.
(CAN DROPS) Yeah, look, I think Thursday we've got an echo booked in, so see how that goes, okay? Thanks.
(GAGS) Oh, God! Somebody help me.
Could we have knocked her kidney with the medication that we gave her? No, she'd be sicker than that.
It's just a gastro bug or something.
Connie BERGER: What's going on? Uh, it's weird.
She's, like, vomiting at regular intervals.
Let me see.
(GROANS) She's in labour, you pair of quokkas.
What? - She can't be! - She can't be! No, I can't be! I'm I've still got six weeks until I'm due.
Connie, I'm going to need to examine you.
Can you lie down, please? Frankie, call an Obs code.
That's it.
Good girl.
Yeah, it's renal out-patients.
We need an OB reg up here now.
There's a patient.
She's in labour.
It's maybe an emergency caesarean.
There's no reg.
- Who else is on? - Who else is on? We just need to get someone up here.
Which one of you is going to go catcher? 'Cause this baby's coming out now.
I'll go get a midwife.
- No, no! - Frankie.
It's all right, stay there.
Stay, stay, stay, Connie.
- Whoa, whoa, whoa - No! Here, sweetheart.
Look here.
Listen.
Listen, Connie.
Now, listen to me, Connie.
I need you to try and relax, and the next contraction that comes, you're going to push that baby's head out.
Okay, now, are you with me, Connie? Okay.
Okay.
That's it.
Good girl.
You can do this.
You can do this, okay? (SCREAMS) Good girl.
(SCREAMS) Ah! Push.
(SCREAMS) That's it.
Push! Push, Connie.
- (SCREAMS) - Push.
Well done.
- That's it.
Lie down.
- What's happening? It's all right.
Lie down.
Lie down on the bed.
There you are.
We've just taken him away.
We're going to give him a bit of a kick-start.
Is my baby alive? Tell me.
Just relax.
(BABY CRIES) - There.
- (LAUGHS) Is he okay? - He's all right.
- He's fine.
He's absolutely fine.
- (CRIES) - (LAUGHS) Clucky? As if.
Oh, come on, not even a little bit? Well, when would I fit it in? In my reg year? That's impossible.
When I specialise Hey, aren't you getting a bit ahead of yourself? You haven't been accepted on my program yet.
If there's a window, any window at all, it's now, so I don't think it's going to happen.
I've started taking dexamethasone to control the swelling.
You prescribed that.
The only symptoms I've got, Frankie, are the headaches.
Thanks to the dex, they are subsiding.
I feel totally normal.
Oh, come on.
Do you think I would really carry on working in this place if I thought there was any real threat? You can't make that call.
Your judgement is impaired.
That's why you showed me the CT scan, because I'm supposed to monitor you.
- Yeah.
That's one of the reasons.
- (ALARM BEEPS) 'Cause I trust you.
- I want your car keys.
- What? If we're doing this, I have a couple of rules, and one of them is that you can't drive.
Frankie.
The other is that you see a surgeon, and get this bloody tumour looked at independently.
Until you are given treatment, and are given the all clear that your motor skills are okay, you can't drive.
Those are my conditions.
All right.
And I have some conditions too.
You never come to work again with a temperature higher than 38.
2.
38.
8.
Actually, 38.
Fine.
You can drive me home.
LOU: Bust of Napoleon.
TABB: Oh, come on, that's like an urban myth or something.
It's true.
Just wanted to see what all the fuss was about.
(LAUGHTER) Washing machine agitator.
No! - Yeah.
- Really? What, front or top loader? - Top.
- What? And the paramedics had to cut him out.
Apparently, the guy was like, reaching for a cupboard or something.
(LAUGHS) "Fell" on his date.
- Oh, ouch.
- Yeah.
What about you, Frankie? - Hair dryer.
- Oh.
No, no, no, with the the - the curling attachment.
- Oh, God! - (PHONE RINGS) - That's massive! That's that's huge.
You have one of those.
I do.
I haven't used it for that yet though.
- Hello.
- SAM: Frankie.
Sam, is that you? Did someone fuck up, Frankie? I don't know what happened to Zoe.
Did someone fuck up here? I just I don't I don't have anything to tell you.
What is everyone hiding? There is a process if you want to make a complaint.
Just tell me! Did someone fuck up? I'm so sorry.
I don't know what happened.
I'm so sorry.
Well, the heart was from a marginal donor, so it was always line-ball.
It's just that she looked to me to advise her, they both did.
And I wanted to believe that that heart was going to be okay, because I wanted it to be, so I encouraged her.
The truth was that the alternative was that she probably would have died waiting, and I wasn't ready for that to happen.
I wasn't ready.
All I managed to do was drag out the pain for her poor family.
You know, it may not have been the heart.
I mean, the anastomosis did leak.
I was worried in the operation, so I called it.
What do you mean you called it? Actually, don't worry about it.
Worry about what? I don't I don't understand.
Forget it, forget it, Frankie.
What do you mean, you called it? - What what went on in there? - Just ignore me.
I'm I'm drunk.
I don't know what I just said.
Lou, this is me.
What exactly did you see? The stitching looked loose.
But it mustn't have been, I mean, it held right.
She bled out.
Not straightaway.
We don't know that that was related.
Okay, so you told Mitri in the operation, and he did what? Oh, I shouldn't be having this conversation.
Lou? Frankie, I told you this in confidence.
You can't tell anyone.
Tell anyone what? Just let it just let it all play out, please.
Quality or quantity, Frankie.
I'm going for quality.
Just talk it over with your wife.
We've already agreed.
My life, my choice.
This vasano go 'pough' All of the time.
Synechia.
That's Chrissy's word for a defibrillator.
We do not tell patients what they're signing up for when they agree to this kind of intervention.
WOMAN: It's your decision, Mama.
But whatever you decide, I'll support it.
I'm sorry for how I treated you in the OT, Lou.
It wasn't cool.
So it's time for you to decide just what side you're on, princess.
I'm just I'm not in a place to decide.
I'm just so exhausted.
Your heart, it is failing, and if you don't take this chance Zoe, good news.
The heart looks great.
We're good to go.
Okay.
You've just done 14 hours of theatre.
Thanks for the offer, Maggie, but I've got this.
ZOE: Hey, baby, you're going to look after Daddy while the doctors look after Mum, yeah? Yeah.
We'll be here when you wake up.
- All ready? - Okay.
- Let's take her off.
- Stop! Do not unclamp.
- What's the issue? - There's a loose stitch.
Check it.
What's your call, resident? I must have been mistaken.
Right.
Let's start her up.
- (MACHINE BEEPS) - Good job.
BERGER: Prognosis.
It's a brain tumour.
Benign? It's glioblastoma multiforme.
What would you say to the patient? Don't buy too many green bananas.
Who's the patient? (SIREN WAILS) Open my lungs Move your hands inside my chest Cut me deep beneath my skin I'm ready to fall out My body's caving in Hold me down So that I can feel the heat Cut me with the sharpest knife I'm ready for the pain.
MAN: Go on.
One more drink.
FRANKIE: Mm, no, thanks.
I don't want to get soused.
- I am a cheap drunk.
- (CHUCKLES) That's a shame.
I'd like to see that.
- What? - An image.
You in a nurse's uniform.
Nurse, huh? Your profile said you were a healthcare professional.
Oh, yeah, it's an easy mistake.
Woman, health care - Oh, you're a doctor.
- Yep.
- Okay.
- (PHONE RINGS) I kept it vague, because friends suggested that some men have trouble with the whole authority thing.
Yeah.
Yeah, so That's awkward, huh? So, you want to save lives, huh? Cool.
That's the idea, yep.
Why don't you get that? I'll get this and, um, we can call it a day, yeah? Yeah.
These came from radiology.
It's addressed to Dr Berger, but there's no patient number on it.
Oh, we'll be with you in just a moment, Connie.
Connie Capitano's back.
- And this just came in.
- Yeah.
Was there something else? (MACHINE BEEPS) Um, I saw that Dr Berger's here.
He's unavailable at the moment.
A boy or a girl? Um, well, my husband swears blind he can see a penis on the ultrasound, but I think he's just getting mixed up with the large intestine.
- It's wishful thinking, I guess.
- (CHUCKLES) There's something wrong, isn't there? Oh, on the contrary.
Your blood pressure is normal.
Everything's looking good.
What about my protein levels? Uh, slightly elevated, but nothing to worry about.
(SIGHS) This is what happened last time.
Slightly.
I'm talking one plus.
That's something to watch.
If it was four plus, then I would worry.
Look, I'd really like a second opinion.
I know you had a difficult time with your first pregnancy.
He's just in there.
If you're still worried, then maybe you should book in with your obstetrician.
No, I've just been with my obstetrician and she told me to come and see Dr Berger.
Look, I know that you all think I'm just being paranoid, but everything was going perfectly fine last time, and then You know that I'm a transplant recipient, right? I can't I can't lose this baby.
- No one is going to let that happen.
- Well - Everything all right out here? - Dr Berger.
Hello, Connie.
How's things? Well, that's what I'd like to talk to you about.
Dr Bell here said that you weren't available.
I can't think why she'd say that.
I'm always available for my patients.
Why don't you take a seat in my office? Sure.
Thank you.
All of her results are normal.
She is panicking unnecessarily.
Connie lost her first baby six weeks out from full term.
It's understandable if she's nervous.
- I get that, but - You are a mere resident.
You don't get to edit my patient list.
It's not your job.
Do we understand each other? Trouble in paradise? This patient, Shane Wozniak, came in from ED with ischaemic-sounding chest pain and a cough.
Care to comment on this X-ray? Sure, this is a mobile chest X-ray taken in the ED.
It shows a moderate-sized unilateral pleural effusion on the right.
The left lung field is clear.
There are no other obvious abnormalities.
Good.
Good.
There's something odd here.
Can you see how the overlaying soft tissue is less dense on this side? Do we know what the underlying aetiology is? Jury's still out on that.
You mean you don't know.
And if you don't know, just say so.
What would be your differentials? Infection, trauma, malignancy, hepatic hydrothorax? Okay.
Hi, Shane.
I'm Dr Steele.
- I'm the consult on.
- (COUGHS) And how long have you had this cough? Ah, about a month, maybe more.
My GP gave me a script for antibiotics, but I still can't shake it.
Look, I think the most likely thing is you have pneumonia, and fluid has built up between your lung and the chest wall.
Now, we're going to pop a drain in there, take out the fluid.
Should have you feeling better pretty quickly.
Dr Patel will perform the procedure here on the ward.
Now, he's going to put a local anaesthetic in your skin, and then he's going to insert a tube into the space between your lung and the chest wall.
Once we have the drain in, we'll be able to send some fluid off to the lab for testing.
And that should tell us why you have this effusion.
- Any questions? - Can't you do it? It's a very straightforward procedure.
Dr Patel can handle it.
He would have done it many times in the past, and he'll be supervised by my registrar.
Rest assured, you're in safe hands.
FRANKIE: Levels are fine.
CAROL: Yep, yep, looking good.
All looking good.
Oh! Hi, buddy! I wasn't expecting you guys so soon.
Yeah, it's been like Christmas at our place.
This little guy's been up since the sparrow's fart.
- How's Zo? - She's doing great.
No, really, we're weaning her off the sedatives and we expect to be extubating her soon.
- Great.
- Hey, you want to see Mum? - Yeah.
- Yeah? We just have to check the balloons and the beautiful flowers in with Carol though, okay? There's no flowers in ICU, I'm afraid.
It's okay, mate.
But when Mum comes out to the ward, we can give them to her then, yeah? I promise I won't let anybody steal them.
Okay.
Let's bust a move.
Hey, so, heads up.
Mum has a big tube coming out of her mouth.
It looks like she's swallowed a vacuum cleaner.
But it's actually helping her to breathe, so we like the tube.
The tube's good, okay? I need you to be brave.
You too, Dad.
So, Mum's just resting.
It's the best way her body has to heal itself.
So, we keep her asleep until we think she's ready.
- All right? - Yeah.
I don't know if that's a good idea, mate.
He's fine.
Still can't get my head around the idea there's another person's heart in her.
Thank you.
You don't need to thank me.
The surgeons did an amazing job.
I was just the ground staff.
No, no, no.
Zo was ready to give up.
It was you who gave her the courage to go for it.
Hey, what's this? Five hearts.
You, Mum, me, the person who gave Mum the heart, and Frankie.
Thanks, matey.
- MONICA: Hey.
- Mitri's taken me off his list.
Oh, you're with the best, Cutter.
Does he take residents off his list often? He's the surgical boss.
He makes a call, you suck it up.
Don't waste your time with Mitri.
I just wanted to clarify that I've never actually done a chest drain before.
Yeah, well, good news, today the training wheels come off.
Maybe they need to stay on for one more lap.
Patel, what were you in a previous life? - Oh, you mean, like, career-wise? - Mm-hm.
I was a chef.
Chef? That's a first.
What kind of chef? Like, where were you in the pecking order? - I was a general hand.
- Oh.
Guess I don't need to go after all.
Patel, there's two types of doctors in my experience.
There's coat-tailers and there's doers.
Now, coat-tailers, they're always around when you don't need them, never around when you do.
Now, doers we try to weed out coat-tailers before their first year's out.
Do not be a coat-tailer on my watch.
I'll shadow you in there, but you need to take the running.
You understand? (WHISTLES) (SIGHS) So, did they teach you anything? CUTTER: What have I got to learn? Ah, you're back with us.
You're not Mitri's favourite anymore? - I'm assisting you today.
- Lucky for us.
Oh, I've got some new tracks.
- Do you want to - I better like them.
So, I bet vet world is looking pretty good, right now.
Scalpel.
Let's get funky, people.
COMPUTER: The patient should be positioned laying down on their back in order to have the best position for insertion.
- Create a large - Hey, get a move on, Dr Google.
and make the incision.
It can be very painful for the patient, so make sure that the area is adequately SHANE: No, nothing serious.
This chest cough thing that won't budge.
Doctors just reckon I need to rest up.
Oh, no, I'll be back on deck next week.
No other issues, boss.
No, it's okay.
Thank you, sir.
Yeah.
Do you want to check that I've got everything? - Have you? - Mm-hm.
Off you go, then.
Mr Wozniak, can I get you to pop back on the bed for me please? Thank you.
And just untie your gown as well.
Could you untie your gown and place your right hand behind your neck for me, thanks? Mr Wozniak, we need an ultrasound image to determine the best possible insertion site for the drain.
If I miss and get the wrong spot, I could cause your lung to collapse.
Hitting the right spot sounds like a plan.
Give us a hand.
That's quite a scar you got there, mate.
Yeah, I had cancer.
Did you? It says nothing about that in your notes here.
I'm in remission.
What kind of cancer are we talking about here? Just cancer.
Just cancer.
Might have a quick chat to you, is that all right? It's okay.
You're okay.
I know it's hard, but you need to try and relax.
(GAGS) I know it's hard, but you need to try and relax.
(GAGS) Zoe, you need to try and relax.
I know it's hard.
Don't grab at it.
The nurse will take the tube out, but you need to try and relax.
Deep breaths, gentle breaths.
- Deep breaths, gentle breaths.
- (GAGS) (PANTS) Hey.
Welcome back.
So, that was a mastectomy scar, right? That's pretty rare in men.
First for me too, actually.
Do you think the pleural effusion is related? Not good news for him if it is.
Hey, listen, before you go back in there, if you're going to do this, you need to act like you know what you're doing.
Yeah.
Yeah, yeah, yeah.
Hi, Shane.
How you going? All right, I'm just going to check your chest, all right? Can you talk about the cancer treatment you had in the past? - Did it spread to your lymph nodes? - Yeah, I had them cut out too.
Right.
Okay, it's going to be a little bit cold, all right? Did you have chemo? How about, uh, are you on any medications now? Why all the questions? Look, a pleural effusion can mean the cancer has spread.
I'm not saying it definitely has.
We won't know for sure until we get the fluid off for testing.
How you doing over there? You all right? Yeah.
All right, you're going to feel a little bit of a prick, okay? And just a minute to let the anaesthetic get to work.
Was that a yes to the medication? No, I stopped taking my meds, all right? Look, are we going to do this, or what? Yeah.
What the hell are you doing? - What? - You want to do this procedure or not? Dr Patel, are you comfortable doing this procedure or would you like me to take over? Yes, I said I'd do it.
- Then do it right.
- Okay, all right.
Maybe you should do this one.
I'll watch and do the next one.
Sorry, Mr Wozniak, my intern must have had a little stage fright.
I'll take over if that's okay.
Sam and Zac came by earlier.
They're still around waiting to see you, soon as you're ready.
The donor and I made the cut too.
You know, until I met you, my biological clock ran on silent.
Now there is this very faint tick-tock and, frankly, that is a problem, not just because I don't have a partner.
There's a bit of a man drought at the moment.
But guys find out I'm a doctor and they just run the other way.
Either that or no one's told me that I have really skanky breath.
I'm sorry.
I'm sorry.
Sorry.
No laughing.
Your SAT levels are good.
How about I track down those boys of yours? (SOFTLY) Thank you.
Okay, Shane, I'm done here.
You did well.
We'll send this off for testing, get you some answers.
And you should find that your breathing settles down a fair bit too.
When can I go home? That just depends on how quickly this drains.
Look, I'd bank on at least an overnight, all right? As soon as we get the results, we'll let you know.
Hey, Eli, thanks.
I just wasn't ready, you know, but next Are you a doctor or are you not? Are you? (ALARM BEEPS) Move.
Come on.
Oh, shit! MONICA: What's happening? I was assessing a patient.
She's dropped her BP.
We need some help in here.
Come on, Zoe, stay with us.
- Talk to me.
- She's got no air entry.
- PATEL: Checking.
No output either.
- Start chest compressions.
- CAROL: Who's running this? - I am.
Set up over here.
Strapping her head down.
Monica, can you get on airway for me? Great.
I'm going to need blood.
O negative if there's no cross-match.
Two units, all right? Check out this drain.
She's bleeding out.
Keep up with those chest compressions.
While we're waiting on that, let's get two bags of normal saline, stat.
And two, continue compressions.
I need one mil of adrenaline IV with a flush.
It's time for a rhythm check, guys.
Charge the defibrillator.
- Charging.
- Everybody clear? - Clear.
- Shocking.
- (MONITOR BEEPS) - She's still VF.
- Recharge.
Restart compressions.
- One, two We're never going to stabilise her while she's bleeding like this.
Even if we bring her back, she's just gonna keep crashing.
Okay, what's your call? - The theatre's ready for us? - MAN: Yeah, just prepping.
All right, we crack her chest back open, see if we can resew whatever's bleeding.
Get ready to move her, everybody.
- Let's go.
- All right, get those bags.
- Hop up there, yeah? - Yep.
- Okay, brakes off.
- Keep giving compression.
Get ready to move her, all right? Bags in the hand? We're going to work her as we go, okay.
You ready? - Yes, yes.
- Let's get her out.
Put the sides up.
- Got the bags.
- Move it quick.
- Let's do this.
Okay? - Up, up, up, come on.
16, 17, 18, 19, 20 Zoe Mendoza's gone into arrest.
She's bleeding out.
ELI: How are her obs? MONICA: Uh, no cardiac output, and the drain's still going.
- Right.
Update.
- PATEL: 22, 23 - How's her BP? Any change? - 25, 26, 27, 28, 29, 30.
And breath one, breath two.
Everybody in? All right, call the theatre.
five, six, seven, eight, nine, 10, 11, 12 They must have moved her already.
Come on.
Let's go find her.
- Still no pulse.
- Charge at 200.
Everyone clear.
- Charging.
- Two breaths.
One, two - Shocking.
- Clear.
- (MONITOR BEEPS) - Sinus rhythm.
Right, she's back.
Get ready to move her.
On your call.
CUTTER: Okay, everyone not on my team, out of my theatre now.
Go, go, go.
- All right, let's go.
Come on.
- We're ready.
One, two Do you think maybe she was bumped to a different level? - What's going on? - Zoe arrested.
I was just with her.
She was fine.
They're opening her back up as we speak.
Frankie? Mr Mendoza, your wife has experienced some post-operative complications that the surgical team are currently working to fix.
She's back in theatre? - That's correct.
- Why? What the hell happened? - What kind of complications? - We're not sure.
As soon as we are, you will be the first to know.
Sam, um Zac.
- Let's go get some air, yeah? - Yeah.
CUTTER: Okay, more suction.
More suction.
- We need better hands in here.
- The anastomosis is leaking.
Well, do you want me to oversew or do you want to do it? Get out of my way.
Get that aorta clamped.
3-0 Prolene.
Suction.
Shit! Tissue's shot.
- I think I got it.
She's all right.
- (MONITOR BEEPS QUICKLY) Oh, shit.
She's arrested again.
Okay, charging.
Paddles.
Clear.
She's still VF.
Compressions, directly.
Get your hand in there, that's it.
That's it, keep it up.
One, two, three, four, five, six, seven, eight Her SATS and BP were all good, so how could she just crash like that? PATEL: She was bleeding into the drain.
- What? - Eli ran the code.
I did the CPR.
You went in hard, yeah, with the compressions? Yeah, of course, I mean, as hard as I could, given that she had a heart transplant.
Shit.
Just keep me posted, yeah? No word yet.
28, 29, 30.
One, two, three, four, five We need to call this.
- No, we can keep going.
- Oh, bullshit! It's hopeless.
Zoe Mendoza, time of death, 17:06.
12, 13, 14 - Lou.
Lou, hey, hey - 16 - Hey.
- (PANTS) Okay.
So, how did this happen? Hm? How did this girl die? - I mean, how is that even possible? - Nothing went wrong.
The surgery was fine.
Nothing went wrong at my end.
This is a SAC 1.
It's going to be investigated.
(PHONE CHIMES) ELI: CU extubated her two hours ago.
She seemed stable and fine.
Then she lost consciousness, started bleeding out through the operation site.
She went into cardiac arrest, a code was called.
I ran that code.
We immediately started compressions.
We managed to get her back into sinus rhythm in the theatre, at which point, the surgical team took over.
STEELE: Monica, were you in this? Um, yeah, I was involved in the code, bagging, masking, and then again in theatre when we tried opening her up.
Was resuscitation performed correctly? As far as I'm concerned, we did everything appropriately.
She died because the anastomosis leaked.
We don't know what happened.
Okay, no one's passing judgement here.
I just need to get a handle on what happened.
I tried to oversew, but the tissue was shot.
I tried to patch it up as best I could, but she bled out.
Was there anything else we missed? Could we have done anything more? No.
We need to get an apology to the family.
They need to understand what's happened.
- You up for that? - Of course, boss.
Okay.
Does anyone else know the family? Right.
Remember that we're here to say sorry that Zoe has died, and that we want to work out why this has happened.
To inform him to make sure that it doesn't happen again.
Don't get drawn into giving any reasons we don't have answers for yet, okay? (KNOCK AT DOOR) Mr Mendoza, I believe that you know everyone here.
Yeah.
Like to take a seat? Would you like some water? Mr Mendoza, your wife, as you know, was recovering from a heart transplant operation when she had a bleed.
She had to go back into surgery because she had a cardiac arrest.
It was during this process, unfortunately, that we found out she was bleeding from the operation site.
We were unable to resuscitate her.
Your wife died.
We're really very sorry.
I know this is a huge loss for you.
Okay.
Uh (STAMMERS) you'd better get going.
It's six o'clock already.
You don't want to be late.
Conference conference call.
Oh, right.
Look, we're going to stop now.
I think that's a lot for you to take on.
But rest assured, the hospital will be running a thorough inquiry into how your wife died.
We will be in contact.
In the meantime, feel free to call anytime.
Aw, you shouldn't have, Frankie.
She got the heart.
She should have lived.
Shit happens.
We do what we can.
Why did you tell me? Like, why did you pull me into your shit, and then - push me away? - I made a mistake.
I shouldn't have told you.
I'd only just found out myself.
So, the MRI confirms it? Mm.
Glioblastoma.
Grade four.
So, that means I've got between six months and two years.
So, you were right about the green bananas.
- I am so sorry.
- Like I said shit happens.
What was the surgeon's advice? Or the oncologist's? - What do those pricks know? - You have seen someone.
The only two people that know are you and the radiographer, and that's the way I want it.
I want to keep working.
I don't want anyone in this place weighing in.
I've got far too much work to get on with.
Okay, well, they're going to weigh in when you have seizures.
And you can get down off that high horse.
What is this? Is this blackmail? Yeah? You have my secret and I have yours.
Something like that.
TABB: I really don't think I can make it in cardio.
Just don't have the bladder for it.
God, you should have seen Eli.
That guy's got like, camel parts or something.
You know, I had a male patient today, breast cancer.
We're talking, like, full mastectomies You mind? Can we get through dinner without mentioning medicine? I'd just like to pretend for one moment we are normal people who talk about normal things.
What about anal anecdotes though? Are you sure that you went in hard enough with the compressions? (MUTTERING) What is syndrome? Hyperthyroidism.
Hyperthyroidism.
Describe Graves' Disease.
Okay, okay disease.
(TAPS ON DOOR) I'm sorry.
Two codes in two weeks.
People are going to start calling you shit magnet.
They already have.
How come on ER they always manage to bring them back? Because George Clooney is God.
(LAUGHS) (PAGER BEEPS) Okay, speak to me.
Shane Wozniak's prelim cytology reports are here.
His cancer's back.
Okay, we'd better tell him.
I'll tell him.
Shane, your cytology reports are here.
The cancer is back.
But all we know at this stage is that the cancer has metastasised and we won't know the extent of the spread until we do a CT and a PET scan.
An oncology reg will come by later to discuss your treatment options as well, okay? Is there anything else you wanted to ask me? I'm sorry.
I know this is not the news you wanted to hear.
I'm going to die of breast cancer, aren't I? So, what happened the other day? You know, the Mendoza woman's transplant operation.
What do you mean? Well, you were in the thick of it, weren't you? - How'd it go? - What have you heard? Just a simple question.
Hey, we're up.
We need to say something, Monica.
About what? We don't know what caused her to bleed out.
(SCOFFS) You might think you do.
It's not the same thing.
You know what, hon? If you want to be a surgeon, I would shut up in this meeting, if I were you.
Let the senior people talk, take your cues from them, because you really can't afford to make a big deal about this right now.
Come on.
Say E E Oh, great.
All right.
I'm all right to go? (SCOFFS) No, we need you in bed for at least another four hours minimum.
Then, we need to get you an X-ray, and then, we need to get you into oncology.
Oh, screw oncology.
My gran died of this, so did my mum.
Look, there have been huge technological advancements in drug medication in recent years, you know.
If I just walked out of here right now, how long have I got? No treatment.
If you did nothing months.
Maybe six months, tops.
But treatment can help push that out to years.
Look, the bad news is you have breast cancer, but that's also the good news, in terms of new drug protocols.
(COUGHS) The other doctor yesterday asked if I was still taking my meds.
Would that have made a difference? It's my fault it's back.
You can't afford to think like that.
Excuse me.
Okay.
I'll see you soon.
You ran an anaesthetic assessment.
Any concerns? Zoe presented with a viral infection two weeks ago, that damaged her heart.
We were concerned, obviously, but outside the cardiac situation, she was a fit, young, strong female.
And she was haemodynamically stable pre, during and post-op of the entire heart transplant.
So, you were happy.
From my end, yeah.
Mitri? From my end, all fine.
I was happy with how things went in surgery that day.
Of course, I wasn't there for her extubation, obviously.
And I'm in no way commenting on that process work, but there wasn't much time between her extubation and her code arrest.
There might be a link there.
I don't know.
I can't explain why she bled out, boss.
I wish I could.
Could have been her blood pressure.
Yeah, well, we all know that heart transplant surgery is a complex part of medicine.
We can never know what happened.
Thank you, Monica.
Does anyone have anything else to add? Okay.
Well, there will be an autopsy of course.
And, as I said earlier, a root cause analysis will be undertaken into Zoe's death.
(PANTS) CAROL: We have a problem.
He pulled his IV tube out.
I couldn't stop him.
- Shane! - Where do you think you're going? I haven't even discharged you yet, mate.
You're bleeding.
Shane, Just come back out and let me fix you up, okay? Please.
I don't want to die.
Come on.
Is there anyone we can call? Family, or that girl you mentioned? Shane, you need some support, some people around you.
Who helped you the first time around? No one.
No one knows.
So how did you manage the doctor's visits? The surgery, chemo? Took leave off work, shifted stations stayed out of the locker rooms, worked solo.
Holy crap.
Can I get you to hold that for me, please? Cut my finger, I have to tell the whole world.
Maybe you should give people the benefit of the doubt this time around.
I'm not having treatment.
Well, at least find out what you're saying no to.
Hi, could I please speak to Dr Erin Phipps there? Thank you.
Oh, hi, Erin.
It's Dr Tabb Patel here from City West Public.
How are you today? Great.
Look, I have a breast cancer patient that has failed conventional therapy, and I believe you're running a trial.
So, I was just wondering whether you're still recruiting.
Great.
Yeah, his name is Shane Wozniak, male.
Yeah, yeah, I get that it's unusual, but could you make an exception? Okay, all right, thank you.
Yes, look, I appreciate that you don't want to throw your study out, but is there any way we can Okay, thank you.
Hi, yes, I'm just calling about our conversation earlier today.
This is Dr Tabb Patel.
Okay, all right.
No, I understand that.
But what about compassionate access to the drugs? Right, okay.
Yeah, thank you.
Hello, Dr Patel speaking.
Yeah, his name is Shane Wozniak.
Yeah, he's BRCA, actually.
His mother had it and his grandmother.
Oh, yes.
Uh-huh.
Perfect.
Thank you so much.
All right, bye.
Okay, Mr Heritage, we'll see you in a month.
Oh, hi, Connie.
You're back so soon.
We weren't expecting you for another week.
My BP is up and my urine levels are rising.
How do you know this, Connie? I bought a test.
It's two plus.
Look, something's wrong.
- Something's really, really wrong.
- Okay, well, we went over this.
And your blood pressure is normal, so you're fine.
I wish I was as healthy as you.
Oh, God! Over here, over here, Connie.
You're okay, come this way.
Hold onto me.
- You're all right.
- I'm sorry.
That's okay.
No worries.
Look, it's a trial.
There are no guarantees that you'll benefit from this treatment, and I can't really tell you that it will extend your quality of life, but it's a good hospital and they're a good team with a great track record in this kind of cancer research.
So, if I was you that's where I'd be going.
Royal Women's? And one man.
Thanks.
So, have you got transport sorted, or do you want me to flag a cab or something for you? No, I'm all good.
Shane.
- Hey.
- Shit news, mate.
Come on.
Yeah, well, it makes sense, really A pacemaker for VT.
(CAN DROPS) Yeah, look, I think Thursday we've got an echo booked in, so see how that goes, okay? Thanks.
(GAGS) Oh, God! Somebody help me.
Could we have knocked her kidney with the medication that we gave her? No, she'd be sicker than that.
It's just a gastro bug or something.
Connie BERGER: What's going on? Uh, it's weird.
She's, like, vomiting at regular intervals.
Let me see.
(GROANS) She's in labour, you pair of quokkas.
What? - She can't be! - She can't be! No, I can't be! I'm I've still got six weeks until I'm due.
Connie, I'm going to need to examine you.
Can you lie down, please? Frankie, call an Obs code.
That's it.
Good girl.
Yeah, it's renal out-patients.
We need an OB reg up here now.
There's a patient.
She's in labour.
It's maybe an emergency caesarean.
There's no reg.
- Who else is on? - Who else is on? We just need to get someone up here.
Which one of you is going to go catcher? 'Cause this baby's coming out now.
I'll go get a midwife.
- No, no! - Frankie.
It's all right, stay there.
Stay, stay, stay, Connie.
- Whoa, whoa, whoa - No! Here, sweetheart.
Look here.
Listen.
Listen, Connie.
Now, listen to me, Connie.
I need you to try and relax, and the next contraction that comes, you're going to push that baby's head out.
Okay, now, are you with me, Connie? Okay.
Okay.
That's it.
Good girl.
You can do this.
You can do this, okay? (SCREAMS) Good girl.
(SCREAMS) Ah! Push.
(SCREAMS) That's it.
Push! Push, Connie.
- (SCREAMS) - Push.
Well done.
- That's it.
Lie down.
- What's happening? It's all right.
Lie down.
Lie down on the bed.
There you are.
We've just taken him away.
We're going to give him a bit of a kick-start.
Is my baby alive? Tell me.
Just relax.
(BABY CRIES) - There.
- (LAUGHS) Is he okay? - He's all right.
- He's fine.
He's absolutely fine.
- (CRIES) - (LAUGHS) Clucky? As if.
Oh, come on, not even a little bit? Well, when would I fit it in? In my reg year? That's impossible.
When I specialise Hey, aren't you getting a bit ahead of yourself? You haven't been accepted on my program yet.
If there's a window, any window at all, it's now, so I don't think it's going to happen.
I've started taking dexamethasone to control the swelling.
You prescribed that.
The only symptoms I've got, Frankie, are the headaches.
Thanks to the dex, they are subsiding.
I feel totally normal.
Oh, come on.
Do you think I would really carry on working in this place if I thought there was any real threat? You can't make that call.
Your judgement is impaired.
That's why you showed me the CT scan, because I'm supposed to monitor you.
- Yeah.
That's one of the reasons.
- (ALARM BEEPS) 'Cause I trust you.
- I want your car keys.
- What? If we're doing this, I have a couple of rules, and one of them is that you can't drive.
Frankie.
The other is that you see a surgeon, and get this bloody tumour looked at independently.
Until you are given treatment, and are given the all clear that your motor skills are okay, you can't drive.
Those are my conditions.
All right.
And I have some conditions too.
You never come to work again with a temperature higher than 38.
2.
38.
8.
Actually, 38.
Fine.
You can drive me home.
LOU: Bust of Napoleon.
TABB: Oh, come on, that's like an urban myth or something.
It's true.
Just wanted to see what all the fuss was about.
(LAUGHTER) Washing machine agitator.
No! - Yeah.
- Really? What, front or top loader? - Top.
- What? And the paramedics had to cut him out.
Apparently, the guy was like, reaching for a cupboard or something.
(LAUGHS) "Fell" on his date.
- Oh, ouch.
- Yeah.
What about you, Frankie? - Hair dryer.
- Oh.
No, no, no, with the the - the curling attachment.
- Oh, God! - (PHONE RINGS) - That's massive! That's that's huge.
You have one of those.
I do.
I haven't used it for that yet though.
- Hello.
- SAM: Frankie.
Sam, is that you? Did someone fuck up, Frankie? I don't know what happened to Zoe.
Did someone fuck up here? I just I don't I don't have anything to tell you.
What is everyone hiding? There is a process if you want to make a complaint.
Just tell me! Did someone fuck up? I'm so sorry.
I don't know what happened.
I'm so sorry.
Well, the heart was from a marginal donor, so it was always line-ball.
It's just that she looked to me to advise her, they both did.
And I wanted to believe that that heart was going to be okay, because I wanted it to be, so I encouraged her.
The truth was that the alternative was that she probably would have died waiting, and I wasn't ready for that to happen.
I wasn't ready.
All I managed to do was drag out the pain for her poor family.
You know, it may not have been the heart.
I mean, the anastomosis did leak.
I was worried in the operation, so I called it.
What do you mean you called it? Actually, don't worry about it.
Worry about what? I don't I don't understand.
Forget it, forget it, Frankie.
What do you mean, you called it? - What what went on in there? - Just ignore me.
I'm I'm drunk.
I don't know what I just said.
Lou, this is me.
What exactly did you see? The stitching looked loose.
But it mustn't have been, I mean, it held right.
She bled out.
Not straightaway.
We don't know that that was related.
Okay, so you told Mitri in the operation, and he did what? Oh, I shouldn't be having this conversation.
Lou? Frankie, I told you this in confidence.
You can't tell anyone.
Tell anyone what? Just let it just let it all play out, please.
Quality or quantity, Frankie.
I'm going for quality.
Just talk it over with your wife.
We've already agreed.
My life, my choice.
This vasano go 'pough' All of the time.
Synechia.
That's Chrissy's word for a defibrillator.
We do not tell patients what they're signing up for when they agree to this kind of intervention.
WOMAN: It's your decision, Mama.
But whatever you decide, I'll support it.
I'm sorry for how I treated you in the OT, Lou.
It wasn't cool.
So it's time for you to decide just what side you're on, princess.