Maternal (2023) s01e05 Episode Script

Sorry. Er, Professor!
Professor Thomas! Sorry.
It's about
the consultant interviews.
We had, a a meeting,
for the consultant interviews.
I'm one of the candidates.
- Catherine MacDiarmid.
- I know who you are.
You were late.
And where do you see yourself
in ten years' time, Jack?
Clinical Director of Surgery.
But I find myself
increasingly humble about planning.
My day's been like dominoes.
One delay to surgery this morning,
and I'm
Oh, just seven minutes late.
Nice shot, Alan.
Could I buy you a cup of tea, perhaps?
Hadn't you better answer that?
I'd love the opportunity to tell you
what I have to offer the trust.
Besides punctuality
Planning is all well and good,
but what the last few years
have taught me is adaptability.
- That's what it's all about.
- I couldn't agree more.
Good work, Jack!
What is it, Lars?
Just to say that the
flight's all on time.
Great.
Jesus Christ.
Go on, in you go.
Yes, you can watch TV.
Hello! How was Grandma's? Hello!
That's a lovely picture.
Oh, my gosh,
there's glitter everywhere.
How was Grandma's?
48 hours is definitely
everyone's limit.
Could you just look after them for
half an hour while I have a shower?
Yeah, sure. Actually, er, no.
Can we just have a quick chat?
- Yeah, sure.
- Thanks. Do you mind?
Raz!
Hello. How are you, mate?
Just give me a sec.
Maz. Have you slept at all today?
Oh, you were going in to fix me.
Less Ibadat, more like
an appointment at the Genius Bar?
I needed to speak to someone,
I didn't know where else to go.
I am not having this
conversation in the street.
- Fine. Let's go home and have it.
- I can't, I've gotta go to work.
You can't keep going in, Maz,
you're not well.
Don't be another person
telling me how I feel.
Then you tell me. Talk to me.
Why are you still going to work?
It's not just the job.
You've never understood.
I really struggle with
the saviour complex, Maz.
- What?!
- There are other doctors!
The whole thing won't come
crashing down if you're not there.
You've not seen the
gaps in the rota this week.
Look, I understand
you're punishing yourself
for what happened
to that little boy.
Edward. His name was Edward.
You can say no to
being kind to yourself,
to me, to our children,
to that baby girl,
but you can't say no
to that place, can you?
- I don't understand that.
- I haven't said no to her.
I've said I need
to get past the investigation.
They need an answer, Maz.
I'm not having this conversation
in the street.
You can't keep choosing
to be a doctor
at the expense
of everything else, Maz. Please.
Maz?
What is it?
The other night,
when I called you from work.
I know that you'd been
- Mummy!
- Yes, Maggie.
Can you just watch
TV for a minute, please?
- Can I have my hot milk?
- Yeah, in a minute.
Guy, I
I know that you'd been drinking.
- Mummy, I want a hot milk!
- Yes, in a minute!
It was half a glass of wine.
I think you need to ask yourself,
what is this, really?
- Mummy, hot milk!
- I'm making it!
You're lying.
- I'm sorry?
- Your mother told me
she can't drink at the moment
because she's on warfarin.
Plus, you need to learn
to empty the recycling!
You weren't fit to be on call, Guy.
Mummy, it's the scary bit.
- Please can you watch it with us?
- Yeah, course.
Look, here's your hot milk, OK?
Come on, I'll forward it on.
Guy
Just talk to me, please.
You need help.
I do NOT need help.
It's OK. Just don't.
Just leave it.
- What was that, Mummy?
- Fuck's sake.
It's all right, Mags. Can you
just stay up there, please?
You done?
Flight RY35 from Shannon
is now delayed by 25 minutes.
Hi!
Oh, hi.
Hi! Aw, look!
- Everything OK?
- Oh, yeah, yeah, yeah.
Yeah, we had a great time.
Aw, I'm so pleased.
You heading straight back?
Well, half an hour.
So
You all ready for tomorrow?
Absolutely. Mama's gonna smash it!
For protracted ileus,
mechanical obstruction
should be excluded by CT scan
and underlying electrolyte abnorm
Come on.
Come closer.
Would you?
Oh. No.
Oh!
Bronch.
- Bronch is RSV.
- Just trying to liven things up.
Can I leave you with
the labour ward bleep?
Who's eaten half of these?
Susan,
I can't do this tonight.
Well, Xavi's not sleeping.
You're not still breast-feeding,
are you?
If you stop breast-feeding him,
he will sleep through the night.
Look, I'm a reg down on the rota.
I can't cover every
hole in the rota.
Well, the only other option's Mae,
and, honestly,
I think it's too much
responsibility for her.
She doesn't have
the neonatal experience.
- You have to tell someone.
- I can't.
You have to speak to his manager.
He's putting people at risk.
This isn't an interview
scenario, Jack.
When it comes out -
and it always comes out -
and when they find out
you've been covering
I'm not I'm not covering for him.
you'll be the one
facing disciplinary action.
He'll get rehab, and
a weekly appointment
with Occupational Health.
He's my husband.
If he gets suspended,
then who pays our mortgage?
Who explains to my five-year-old
why Mummy and Daddy aren't
living together any more?
- But he can't keep drinking.
- I know.
I-I know that.
Oh, I don't know what to do.
Sorry, I
I don't think he's left you
with much choice.
I know. I know.
I know. Oh, come on, Elis.
Come on, sweetie pie.
Fine. Fine. I know.
I know.
Her temperature is still 39.
OK, Catherine,
like I said before, it's RSV.
If she's struggling to breathe,
then bring her in.
Can I bring her in
so YOU can tell me
if she's struggling for breath?
Look, I know this is scary
but you're doing brilliantly.
Can I push the Calpol
to, like, every two hours?
No.
Mae, can you come with me
to the labour ward?
If you're going, I need
to stay. Take Simon.
Don't touch me!
I don't want any of you touching me!
Calm down now.
Let's get these on you.
Let us help you, Layla.
Oh, God.
- I want her to stay in me!
- What's your management plan?
- Can you feel another contraction coming?
- Er
Layla?
I know what you're doing.
I know what you're doing!
Let NICU know to expect
a premmie with prenatal drug use.
Er, suspected NAS?
So that they can start monitoring
a-and the other stuff.
- I don't want this!
- Which is what?
- Stop touching me!
- Depends on the monitoring.
Stop fighting us, Layla. You're
gonna hurt yourself and the baby.
What baby's would be L
- Lipsitz?
- Lipsitz scores are.
If they shows signs
of opioid withdrawal,
- treat with morphine.
- I'm gonna be a good mother.
You missed an immediate start
on antibiotics
due to maternal risk factor
of substance abuse.
We don't know what the substance is.
So call the NICU,
look up the NAS guidelines.
Here comes another one, Layla.
Big push now.
Nearly there, one more big push.
Let me hold her!
Don't Don't take her away!
- Calm down.
- Just give her back!
Please just let me have her.
I'll do better this time.
Please!
Just let me hold her, please!
You know we can't do that, Layla.
Shall we try oxygen?
- Yep.
- I'm her mother!
Who takes a baby from their mother?!
- You bitch!
- OK, increase the pressure a bit.
- Just get off me!
- That's it.
Bitch!
- She's breathing.
- Well done, love.
- Get the lines in.
- You did this! You took her!
And you!
I will NEVER forgive you.
Please, please
Get the NAS scores.
What, do you mean
go with her now, or
wait for 72 hours?
Dr Afridi?
Er, Dr Afridi,
do you mean go now, or?
Maryam?
Hello?
It's Laura from Theatres.
Just letting you know
I've squeezed in an
appendicectomy at nine,
- just in case you were aiming for
- Laura, what, sorry?
No, I'm not working today.
I requested it as holiday.
No, you're on today,
and you have an appendicectomy
from the CEPOD list.
No, I filled out the holiday form.
I sent it to you.
I'm sure I got a response. Hold on.
Laura, help.
I'm so sorry, it didn't
Look, I can't work today.
It's interview day,
my interview's at four.
They put you last, then?
Please,
someone else has got to take it.
You've been begging me
for the surgical hours.
Yes, just not today!
There isn't anyone else,
so unless you're ill
I'm really ill. Horribly ill.
I'll tell them you can't make
your interview, then, shall I?
Hello?
How long's the list?
You should be done by three.
See you in an hour.
I need you to pull it together.
You can't be ill today.
She was up a bit in the night,
she's a bit tired.
Not temperature, or anything,
probably just teething.
You know I'm a doctor, right?
Great. Yeah. OK, well, bye.
Bye, Elis!
She's got a temperature.
I know that.
I know that, Mum. I really would
Yeah. Yeah.
You hold her
till I find someone else,
or you remove an
appendix. Your call.
Mum?
Yeah, Mum. I'm begging you.
Please get on that train now.
Is there enough
milk in that for you?
We could, er
We could go to the funeral place
tomorrow if you're free?
Can we, like
What's the word?
burn her?
Not, like,
burn her like she's a witch.
I was thinking
we need to contact her dad.
Your dad. Tell him.
I'm not speaking to him.
He needs to know. He was her dad.
She wouldn't want him there.
It's not about what she wants
any more, is it?
OK, I don't want him there.
It wasn't your mum's fault.
Yeah, it were. We tried to help her.
You tried, I tried my whole life,
did nothing but try.
OK, but your mum was like she was
because our dad was like he was.
It's just cycles of this bullshit.
Exactly. It wasn't just her life
she was tearing up, was it?
I can't believe
this is happening to me!
Jessica?
I'm Catherine MacDiarmid.
I'm your surgeon today.
I see you're struggling
with the pain.
I'm meant to be getting
married in 60 hours!
I'm literally meant to be
at the tanning place now.
Do you have insurance?
No!
We're never gonna
get the '90s band again!
Two years we've been planning this.
It's the biggest day of my life!
It's not. Most expensive, maybe.
But I'm gonna have a scar!
It's keyhole surgery.
But you'll see it
when I'm in my dress.
Oh, no, it will just be here,
just a tiny incision
You'll see what you had for lunch
in that.
I wanna die!
OK, Jessica, that's enough!
You're gonna man up,
we're gonna put you under,
and I'm gonna have you
out of here by tomorrow
with some decent painkillers.
Those and a glass of Champagne,
and it might just be
the best day of your life.
We can still get married?
I've got my lucky pants on.
You OK?
Please don't say anything to anyone.
Hi. You've reached
Catherine MacDiarmid.
I can't take your call just
Hi, Mum, it's me again.
Be good to know where you are.
Hopefully, you're in a tunnel.
I have a meeting now.
The interview is in an hour.
I'm not operating, fair enough,
but I am an important cog
in this wheel
of patient quality and care.
She's lovely, but it's also
very hard to get anything done.
No, really
OK, you're tired.
Good luck in there.
Be nice to have more
women in charge.
Thank you, you've been lovely. Oh!
Oh, dear, how are you feeling, huh?
Oh, no. Oh, Elis, no!
Looking very dapper!
- Just had my interview for consultant.
- Oh. Go well?
- Yeah, I think so.
- Well, you certainly look the part.
I'm sorry, by the way.
For your loss.
What's that?
For, erm
Sorry, I'm confusing you with
Never mind, way too much
"trust priorities
and leadership strategies"
running through my head.
Don't worry, you can forget about
those almost immediately.
Well, ignore me. Sorry.
I know.
Is that what
you were wearing before?
- She puked over it.
- Oh.
Take her.
- Catherine, I can't, my inbox is
- My mum is on her way.
Please, please, Laura.
I'm up any minute.
I will never give you a hard time
about a list ever, ever again.
Ever?
You're on the panel, aren't you?
Can we talk about this later?
I'm just on my way in.
- Why would you do something so stupid?
- I'm trying to help.
I honestly don't think you've
got anything to worry about.
It's the classic Swiss Cheese
model of accident causation.
You know that "learning from
the no-blame culture" stuff
is bollocks, don't you?
No, I honestly think
it was systems failures.
Right. Which system in particular?
The childcare system,
staff shortages,
the public school system, austerity,
or just the patriarchy in general?
Or are they gonna throw
someone under the bus?
I'm not throwing you
under any buses.
I need this to stop.
I just need all of this to stop.
Maz, breathe.
Come on, calm.
- Breathe.
- Miss MacDiarmid?
- I have to go.
- Please.
Please take your name off the panel.
I can't, it's too late.
I'm sorry, I've got to go.
Can you call someone?
Or could you could you wait?
Maz?
I need to report that my
consultant
has been drinking on call.
Guy.
Guy has been drinking on call.
Bitch!
Is there anyone here
you haven't met?
I think I got around to everybody,
just about.
Even if briefly.
I understand
you had a list this morning?
Two appendixes,
two hernias and some gallstones.
My pager is on, I'm afraid.
Well, then, we'd better get started.
So, how does your training
meet the needs of this post?
I was lucky enough to
sub-specialise in trauma surgery
in addition to my general surgery
pathway training,
and I spent six months
Miss MacDiarmid?
I had the opportunity
to spend six months
at a county hospital in Oklahoma.
I think it demonstrated not only
how keen my surgical instincts are,
the procedure itself was executed
perfectly and saved the boy's life,
but how well I react
to the unexpected.
And most surgery is clean,
calm, controlled.
When we're in charge,
we have time to prep, to plan.
But the step up from
registrar to consultant is,
in addition to surgical
competency, about management.
Managing human beings,
fighting for your patients
and your department.
That can be a far less
controllable, much messier business.
And one I'm absolutely ready for.
So, apart from
the clamshell thoracotomy,
which we've heard a lot about today,
which experiences
outside of medicine
have proved useful
in your surgical career?
Like my hobbies?
Oh.
Oh, well, my academic record,
and work ethic
haven't left much room for
distractions.
Nothing else in your life, then?
Can you tell us about
a serious complication
and how you dealt with it?
I'm sorry, would you mind
repeating the question?
Can you tell us about
a serious complication
and how you dealt with it?
Yes.
A few weeks ago,
I delivered a baby at 32 weeks,
rather unexpectedly,
after a gall bladder removal.
And was that a complication
or a coincidence?
- Did your procedure actuate labour?
- No.
Well I don't know,
the causes of pre-term labour
after abdominal surgery
are still largely unknown.
I'm aware. Thank you.
How's baby doing now?
It was fine when I handed it
to the obstetrician.
To the paediatrician, surely?
Thank you, Professor,
you're right.
That wasn't a clear case
of a complication.
Oh, last year, I had a
- Nothing more recent?
- No, because I was on
The pandemic's caused such
disruption to elective surgeries.
Mm.
A VTE in a 40-year-old male.
Oh, can I get your help
with this referral?
You'll have to ask
someone else, I'm afraid.
- Why, where are you going?
- I've been suspended.
I What's happened?
Guy, what can I do?
- Was it because of us?
- There is no "us", Louise.
Did Helen find out?
Guy
I told Helen
almost as soon as it happened
because it was the
biggest mistake of my life.
Just leave me alone.
Floor two.
- This lift is going down.
- Well What do I
What do I tell everyone
about where you are?
- Doors closing.
- Guy?
Doors opening.
And, yeah, the sides.
Missed a bit.
Those lucky pants
did the trick, then?
Sorry.
Babes, it's done. No, it's all out.
It's like nothing ever happened.
I had the most amazing surgeon.
Yes!
"With zigzag lightning,
flashing and frightening,"
"the tiny snail
on the tail of the whale"
"and she gazed at the sky,
the sea, the land"
"the waves and the caves
and the golden sand."
"She gazed and gazed,
amazed by it all,"
"and she said to the whale"
"I feel so small."
This is Dr Maryam Afridi on CAU.
I was just following up on a baby
I treated in the delivery suite
last night, baby Kalpar.
Could someone check the latest
NAS scores for me, please?
She's scoring fives and sixes.
So far.
No. That's OK, thanks.
Thank you.
So, are they going to give
her a big whack of morphine?
It's a rough start.
Listen, Simon,
about last night
I'm not gonna say anything.
I think I think you need to.
She was making this horrible noise
when she breathed in.
God, I don't know what to do.
- All the germs on the plane.
- Or a protest at going away.
How is making me feel guilty
a useful thing right now?
- What's her temperature?
- 39.2.
Is that wheezing
or struggling to breathe?
Like that, listen.
Shit, we need to take her to A&E.
No, no, stay calm.
Come on, let her calm down.
It's okay.
That's croup.
Isn't that a card game?
It's a respiratory infection,
you had it.
Look, go and stand outside with her,
get her some cool air.
I'll get some steam going
in the bathroom.
I think we should call 111.
If you like, but describe
that cough to them.
Go and stand on
the doorstep with her.
OK, I'm going. We are going.
Don't wait up.
We can talk in the morning
when you've sobered up.
I'm gonna be in the guest room.
I told them where to stick it.
Yeah. Yeah, no, I heard.
You must be feeling
very pleased with yourself.
My sister died.
St Harry's called
me at work to tell me,
and I couldn't go and be with her
because you weren't fit
to come in and cover for me.
- How does Jack know?
- What?
Jack.
He said he was sorry for my loss.
Jack drove me to St
Harry's in the morning.
And then I went back to
his place and I fucked him.
Now you know how it feels.
Five-week-old came in 30 minutes ago
in respiratory distress.
Resps are 81, oxygen is 90
Intercostal
and subcostal recession.
Baby's tiring.
- Put out a RESUS call.
- But you're here.
So your baby is going to need
some help breathing,
she's not getting enough oxygen.
Don't worry, she's in safe hands.
Dr Afridi?
Shit.
I need you to look at this baby,
I don't know what's wrong.
- What do you mean?
- I can't do it.
- Please, you have to come.
- OK. I'll call you back.
What's wrong with this baby, Maryam?
Five-week-old
in respiratory distress.
RSV. Bronchiolitis.
She needs intubating.
No, it's OK. We've got this.
We just need to help
your baby to breathe, OK?
- PICU been called?
- Yes.
Colour change on the capnograph.
Anaesthetist is here.
That's much better.
Simon, stay with her.
Right, call me if oxygen levels
don't keep rising
and when PICU get here. Good job.
You'd better come with me.
I knew what that baby needed
and I knew how to do it.
It was just like my body
wouldn't let me go through with it.
And what do you think
your body's telling you?
That if I treat another child
and it dies, I won't survive it.
So how do you feel now?
Stupid.
Ashamed.
Scared.
I had a panic attack in the toilets
when I came back
from the labour ward last night.
And is that the first one of those
you've had since you got back?
When Sami arrived with us
I stopped sleeping.
When he slept, I had to keep
watching him breathing
cos I was so scared
he was gonna die.
And then I was pregnant again,
just waiting to miscarry again.
And then when Xavi was born,
it took them a minute
to get him to breathe
and I thought,
"Oh, THIS is how we lose him."
And then the whole vigil thing
all over again with him.
It's like I'm just waiting for it.
I'm seeing all the ways they
might die play out in here.
And how do you feel
about the future?
Just this dread.
This isn't you, Maryam.
- You're not well.
- Please don't sign me off.
Not until the
investigation concludes.
Let me go in there a doctor.
Please, Susan.
- Hi.
- Hi. I've just had an offer.
Congratulations, Jack.
I didn't wanna spend the day
at work pretending to you.
- I'm delighted for you, really.
- I'll see you there.
Yeah. OK. Bye.
Bastards.
Yeah.
What am I gonna do now, Mum?
Jesus!
I'm just taking the kids
to school and, er, nursery.
Guy?
- Daddy?
- Yeah, he's fine, honey.
We're gonna go to school now,
darling.
We're gonna go to school, OK?
Daddy's just a bit tired,
everything's all right.
Mummy, but Mummy,
we haven't had breakfast.
Yeah, I know. We can go to a cafe!
Shall we do that?
That'd be an adventure, won't it?
Come on, you two.
Out you come. Yay for adventures
Come on. Good boy. Out you go.
It's just my childcare
is like three-dimensional chess
so a rota sneak preview
would be much appreciated.
- I'm kind of your line manager.
- Good luck with that.
Thanks.
Have you spoken to Helen,
by the way?
- Cavendish? No. Should I have?
- Maybe just check in with her.
Off to get my terms
and conditions in writing.
- Thank you.
- Thank YOU.
Dr Maryam Afridi?
This is Clare from the adoption
team at social services.
We have an update on Sami's sister.
She was born very prematurely
the night before last.
She's currently in
the Neonatal Intensive Care Unit
At City General.
Don't take her away!
So we're gonna need to know
what it is you want to do.
Dr Afridi?
Dr Afridi, are you there?
I'm sorry about last night.
I didn't mean to tell you
about Debbie or Jack like that.
What did Marco say exactly?
Are you suspended
or taking some time or?
I think you need to talk to someone
about how you got here, Guy.
They're offering to help you.
Just take the help.
Please.
I'm done.
Clare just called again.
Just let me get through today.
Are you sure you don't want me
to come with you?
I'll be fine.
Come on. Quick as you can!
Hey, just, just be quiet, guys.
Daddy must still be sleeping.
You two, just be quiet. Good boy.
Come on. Out we go.
Come on. Grab your bag, we're late!
Come on. Quick! Quick! Quick!
- Mummy, it's swimming today!
- Well, you can't Well
I'm sorry, darling,
we haven't got your swimming kit.
Please, Mummy,
please go home and get it!
I can't spend the whole day
just chasing after you, Maggie!
Mummy, I can't go
if I don't have it! Please, Mummy!
OK, Maggie. Stop!
Do not shout at me!
I will drop it off at reception.
- Now in you go.
- Thank you, Mummy.
- Love you.
- Love you, too.
This is Dr Guy Cavendish,
please leave a message.
Guy?
Guy?
No No, no Guy? Guy?
Guy, can you hear me?
Fuck, fuck, fuck!
Fuck!
Please, please, please