Monroe s01e06 Episode Script

Oh, shit! It's my fault she had a haemorrhage.
Shall I scrub in, too? No, no, I think Dr Wilson has this one.
We're all holding out for some miracle in the end.
Not me.
It's better if we stop seeing each other.
Again? Agh! Is it Lion King 2: Simba's Pride? Brain surgeon's daughter dies of a brain tumour - long odds by anybody's book.
If you leave this house, it doesn't mean you're leaving Charlotte.
Nick? (MOBILE RINGS) Hello? Well, I know it's not there.
Well, what do you suggest I do, you cheeky little bollocks? (SLOW APPLAUSE) Wow.
Why don't you just wave a flag that says "midlife crisis" on it? Nick's borrowed the car.
You do realise it's the afternoon, don't you? What time did you set off? Very funny (!) I'm covering Fortune's on-call.
That's just sad.
I know.
I think you should change your rota and join me.
What? Let's face it, you've nothing else to do with your nights, have you? Don't do that, Mullery.
It diminishes you and embarrasses me.
Erm, blood tests good.
Started her on IV heparin yesterday.
Due a stair test with the physio today.
The patient passed a regular solid stool last night at around 2am.
Thank you, Mullery.
An admirable and dispassionate eye for detail.
How you feeling? Any lingering pain's been blocked out by acute embarrassment.
Yeah, well, unfortunately I can't treat you for that.
How's your left side? I'm going down to physio this afternoon.
Hoping it'll be good news.
Feel free to hit Mullery if you think it might help.
Assessments.
That time of year already.
I hate them! Planning, dexterity, teamwork, how to cope under pressure.
What pressure? I'm hardly allowed to bully them any more.
You bully them all the time.
No, that's just good-natured verbal humiliation.
Speaking of which, how is it with you when you bump into Bremner? Like avoiding the sixth-former who dumped you at the disco.
Just go up to her and say, "You can mend all the hearts in the worldapart from mine.
" You'll get over Bremner, just try to avoid crying in front of her.
There's a better way of getting over her.
Uh-huh? I'm leaving.
Leaving?! You'll never leave! Mrs Graves.
Due for a coronary artery bypass today.
Originally due for surgery six weeks ago, then last week got cancelled for the second time.
Er, acute angina - And now dying of starvation.
Mrs Graves, we're sorry we're running a bit late.
We'll have you down to surgery within the hour.
I look forward to it (!) One of you can harvest the vein for the bypass, but I don't know which one of you yet.
I don't understand.
Is it part of the assessment? I don't believe in assessments, Dr Witney, I believe in competition.
Normally I get my theatre nurse to do this, but as Wickens hates you, I thought it'd put you at an unfair disadvantage.
I know you'd have got rid of me if you thought I was completely hopeless.
Have you any idea how hard it is to sack anyone round here? Especially underprivileged minorities like yourself.
Like I say, the hardest thing you can be these days is white, middle class and male.
Comments like that have earned you an A+ for minority awarenesss.
Really? No, not really.
Still plenty of points to play for.
Excuse me for a moment.
Oi! Here, you! You're not serious about leaving, are you? This Bremner stuff has taught me I need a change.
Lawrence Shepherd, you're loser.
Wherever you go, you'll be a loser, so why not be a loser where you are at least respected? I'm serious! I've had enough.
OK, Dr Witney, tell me your plans for harvesting Mrs Graves' vein.
Clean incision with a 23 blade.
Problems, Mullery? Risks creating flaps if the course of the vein deviates.
Any thoughts on exposure? Start one finger breadth anterior to the medial malleolus.
Give me one reason why you should harvest the vein and not Witney.
I can tie better surgical knots and bad ligatures can cause bleeding, leading to resternotomy.
Ah! We'll to have to watch this one, Dr Witney.
I think love has made him ruthless.
Congratulations, Mullery, you get to harvest the vein.
Better be as good as you say you are.
See you in theatre in a hour.
Go on.
OK, if I was going to die of a high-grade glioma, how would you go about telling me? Try not to smile whilst imagining it.
I wouldn't leave you waiting.
I'd be factual but sympathetic - Bremner, ten minutes - I'll liaise about Fortune after the weekend.
Notes are by her bed.
It isn't about Fortune.
I'm excited about tonight.
Are you excited about tonight? Er, is this part of the assessment? Wilson, you worry too much.
That's my assessment of you.
You have great knowledge, your decision-making is spot-on, you've the stitching skills of a child sweatshop worker, so why are you not more confident? I think there might be a bit of a bullying culture in surgery.
A bullying culture? I realise you're a rarity in surgery.
That's wrong, I try to acknowledge that.
It's not me I'm worried about.
It's Springer.
I think you pick on him.
Of course I do, he's Springer.
I think you do it for my benefit, to reassure me you aren't favouring the white public school boy.
I don't need reassuring on that front.
Wilson, Wilson! You don't express an opinion in six months, now they all come out at once and they're all wrong.
Sorry.
Maybe it's a generational thing.
Ahem.
This can mean only one thing.
You're getting strength back in your left side or you're very, very bored indeed.
What do you think? Good, eh? I think it's the best news I've had all week.
Want to scrub in? You know I would if you'd let me.
Good news is you can still be involved in the frontline work of the neurosurgery department trainee assessments.
26 sections from clinical judgments to breaking bad news.
Be good for your fine motor skills, turning those pages, ticking all those boxes.
Just so you know, I'll be giving Springer all excellents.
He'll be rated so highly, you'll never be able to shake him off.
What cruel and unnatural revenge.
Take as much time as you want, you know.
I'm not going to replace you.
Why do you think I'm covering your night shift? That's for me? How sweet.
I thought it was because you were sad and lonely.
We want the patient to make a rapid recovery.
Easier to do if her leg isn't mauled by bad blade work.
OK, Mayo scissors.
Are you happy with the light? Shouldn't I be? Hmthere is no right or wrong, Dr Mullery, there is judgment.
It's your call.
Would you bring the light down a litte, Dr Witney, thank you? Even through a mask, I can detect attitude, Dr Witney.
Can we have a little less, please? Swab in, please, Dr Witney.
Smaller scissors.
I don't want to talk about it any more.
So you sailed through your assessment, then? He didn't treat it as a big deal.
Didn't he? Because he's made up his mind already.
What?! You must have heard.
Mullery pissed off Bremner and has been getting in with Monroe.
He'll join our team and one of us will be out in the cold.
No guesses for who.
Why do you assume it'll be you he gets rid of? (LAUGHS) Well, I'm sorry, but I mean Without wishing to be offensive, you do have some advantages in these politically correct times.
I spent most of my assessment defending you to Monroe, and you turn round and you say that? That's a worry.
If you're defending me, that means he's already decided to sack me.
Great (!) OK, that's the last of the grafts done.
Cut there, please.
OK, let's get the clamp off, see if we've done any good in there.
Looking good.
Good.
Is there something wrong? No.
I'm just enjoying watching the heart do what it's supposed to do.
(DISTANT SIREN) Bremner, can I have ten minutes that might change your life? Is this about a mutual colleague? I swear, if you hear me out I'll never mention Shepherd again and we'll return to our previous state of hostility and suspicion.
There's this brain imaging thing they're doing in neuroscience now.
When people who've been blind all their lives read Braille, the occipital area, here at the back of the brain, lights up.
The same area that lights up when the sighted are reading.
Your point being? I think the area of your brain that lights up when you're in love still lights up, but you've lost the ability to show it.
Ah, a neurological explanation for my mysterious desire to make my own choices.
Can't argue with science.
Every working hour I argue with science.
And so do you.
You're both damaged, you could make one great big damaged thing.
Like a good car welded together from two write-offs.
(LAUGHS) Did I make you laugh? Is it some kind of breakthrough? He is lovely.
He's funny, he's bright, he's considerate.
He's just wrong.
You're making excuses because you're fundamentally afraid of intimacy.
So? So, why? I can't think of a single good reason to tell you that.
Why are we walking round in circles? I'm trying to shake you off.
Just think about what I said, eh? Nick.
I leave you for five minutes and you're chasing women round the hospital.
They don't come any stranger, believe me.
Thought you might need these.
Thank you.
For the record, that pneumatic woman that disappeared into the lift is Shepherd's lust object, not mine.
For the record, I'm your son, not your mate.
For future reference, I'd rather you didn't talk about sex, drugs or rap music.
Not even Joe Dolce's Shaddap You Face? That's a dad joke.
Come on.
You are gonna be all right on your own in the house? Course I am.
An HD screen and toastie maker - what more could a man want? It's not your job to worry about me.
It's my job to worry about you.
Here, just so I've got something else to worry about Take them.
I want you to have the car.
Really.
I think you should.
Go on.
The car? Is this another dad joke? Just take it before I change my mind.
He's leaving, you're giving away your possessions.
Not sure I can take this much uncertainty.
I kept my bike.
I'm always telling patients regular exercise will add two years to their life.
If those two years are spent doing exercise, where's the advantage? I think you did it to upset Anna.
No, I wouldn't do that.
Nick reminded you that she's seeing other men, you gave him the car.
Just warped revenge.
Nick never said she was seeing other men.
Only a matter of time, though.
Good-looking woman.
They get their second wind about her age.
We've split up, you know.
I no longer have the right to feel anything about her love life.
Apart from gnawing jealousy and heart-churning insecurity.
That's a good 'un.
Somebody else wants her and now you want her, too.
You see it all the time in bookmaking.
Odds shorten on some unfancied nag, everybody throws their money at it.
Thank you for that touching and sensitive image (!) (TEXT SIGNAL) Right on time.
That'll be Anna, ready and waiting for me.
Very funny.
What you doing? I'm having a kip before an emergency arrives.
I sometimes suspect you're abusing my hospitality.
Well, switch the light off on your way out, eh? Ah Well, I have to say, I didn't see this coming.
I don't do preamble.
I know.
So I'm going to tell you something, then you're going to understand.
When I was 16, my fatherleft us.
Oh.
His business failed and all he saw before him was more failure, so he took a decision.
Decisive and brutal for all of us.
Well, I can see why you ended up becoming a surgeon.
You're probably right.
It confirmed some other things, too.
Male idiocy, the perils of love and the dependency that comes with that.
Just because you had some bad luck with men doesn't necessarily mean you should give up.
Yes, I thought you'd say that.
Well, I'm nothing if not predictable.
When I said that he left, what I meant was that he really left.
He killed himself.
Why didn't you tell me that before? Because I thought that if you knew, you'd set out to cure me.
I know your type.
You're kind, you're a rescuer.
And I don't need rescuing.
There I said you'd understand.
Hey.
How did the assessment go? Mullery seems to have snatched my crown.
How about you? I'm behind on points and there's not much left in the locker.
I can hardly play the ethnic card.
Theethnic card? Well, yeah.
Maybe I should try that.
You're not "ethnic" ethnic.
Oh! Mullery's dating Fortune, so working the ethnic angle by association.
(LAUGHS) I'm not sure Mullery's working on any angle where Fortune's concerned.
How naive are you? He's ruthless.
He'll hoover us all up.
You really spend your nights thinking this stuff up, don't you? LookI'd love to give you more advice, but I've got an admission to take.
SPRINGER: Monroe? Monroe? Monroe UhSpringer.
Is this an emergency, or did I die and go to hell? It's emergency.
Does the patient in any way resemble Debbie Harry? Wellit's not exactly Debbie Harry.
On the other hand, the disc is completely obliterating the CSF space.
It is an emergency and I get to use a big stick.
The Cobbs elevator? Sometimes.
Sometimes just any old stick we can lay our hands on.
Face down, tied to a table.
Does the patient's position remind you of your assessment, Springer? I haven't seen the size of instruments yet.
(LAUGHS) Oh, you got a laugh out of Shepherd.
you really must be coming on.
Isn't Wilson srcubbing in? She's down at A&E, picking up the crumbs.
If I thought badly of you, I'd suspect you hadn't told her of this.
Frowning for a reason, Dr Witney? I was just wondering about my assessment.
I didn't get to harvest the vein and I was Here.
You fill in the assessment, I'll sign it in the morning.
I never had any doubts about you, Dr Witney.
That's the reason why you didn't get to harvest the vein.
Oh, man make fire.
(MONROE LAUGHS) Fire is good.
No other surgeon in the world would laugh at your jokes like I do.
(WHOOPS) OK, swab.
When do we check the spinal level? When we've cleaned the remaining tissue from the bone.
What a night, eh? We've had fire, we've used a big stick.
Any more macho, we'd be in orthopaedics.
Any more testosterone and we'd make someone pregnant.
You see what you've done there, Springer? You've taken it too far.
You've let yourself down.
(PHONE) Somebody do the honours, please.
Hello? Ah, Wilson.
How nice to hear from you.
Right Go on.
Go ahead, go ahead.
Tell me.
WILSON: '13-year-old girl.
RTA.
Hit by an oncoming car as a pedestrian.
GCS is 3.
Both pupils blown.
Her father's here.
' OK.
Send through the scan immediately you get it.
Tell the father you'll talk to him after I've seen the scan.
Come up and have a look at it with me.
Wilson .
.
prepare him for bad news, OK? Sodid she land a good case? Can't be better than this one, can it? OK, let's get on with doing some good, can we? Saline, please.
Left-sided, frontoparetial.
Wilson? Subdural haematoma.
Crescentic and hyperdense.
Significant midline shift.
Some acute subdural blood on the right side, too.
Can you explain to the father her chances of survival are very poor? If she did survive, she would do so withmassive brain damage.
Can you handle it? Yeah.
Good.
I thought so.
You've done the right thing.
Love, you've got to call me back right away.
Soon as you get this, just call me, right? Do you have kids, love? No.
If it's all the same to you, I'd rather talk to somebody who has kids.
Clinically, it doesn't look good, I'm afraid.
I have to talk to somebody who has kids.
When would you have him walking, Springer? Three to four days.
Three to four days if you suture him to the bed.
Tomorrow.
(PHONE) Somebody get that, please.
Hello? I'm sorry, who's this? I'm sorry, Mr Fraser, but I thought I got Dr Wilson to explain.
I can do that, yes.
I can do that, of course I can.
I'll come and talk to you soon as I can.
That was the father of the RTA girl.
Wilson put him on.
I've got to go and talk to him.
Springer, I want you to continue closing up.
Bury the knots in the subcutaneous layer and close the skin using a subcuticular continuous stitch.
I can do that.
Good man.
Mr Fraser, I'm Mr Monroe.
I'm I know who you are.
The surgeon.
If I operate on your daughter I think that she will either die, or her brain damage will be such that her quality of live will beseverely compromised.
That's what the other doctor said, the young girl.
I wanted to hear it from you.
Absolutely.
Of course.
(SIGHS) Her mother's away, with work.
In Spain.
Tasha was on the phone to her and I was telling her off for staying on too long.
Worrying about her homework.
She started tying her school tie in one of them great big fat knots.
They all do it.
Drives me mad.
It was just this morning.
Little things I know.
I know what's likely to happen .
.
but I'm saying to you, I don't want to take that risk.
I want you to try and save her life and I'll take the consequences.
You have to ask yourself if she'd want her life saving if it was going to be no life at all.
She's a 13-year-old girl.
All she has is life, all she has is potential.
Well, in that case, then, it's up to you and me.
Her scans indicate that the pressure in her brain is extremely high.
Her pupils are both fixed and dilated, which means the brain is so badly damaged she's lost the ability to constrict her pupils in response to light.
I think that tells us that we are far too late, Mr Fraser.
I'm sorry.
All the signs suggest that there's no hope.
I have hope.
Let me worry about hope.
I know it's hard to think of anything but the here and now but in a year's time, with your daughter in a vegetative state In ten years Are you saying that you can't save her or you won't save her? I'm telling you that, in my opinion, there is a very small chance of saving her.
And the work that we would need to do in order to save her life won't be worth the suffering it will cause.
But that's not for you to judge, is it? I'm asking you to operate.
I'm asking you to give her one last chance at life.
Not for me.
For her.
I have to fight for her.
That's all I'm asking, that you help me fight.
(MONITORS BEEP) Don't tell me you're having second thoughts.
When I decide not to operate, I ask myself this - can I explain that decision rationally and clearly to a loved one? And can I stick by that decision in the face of their grief and their wishes? I talked to her dad.
And you know what? I couldn't do that.
So, yes, I am having second thoughts.
A 13-year-old girl and a grieving father.
Come on, if I can see the similarities, I'm sure you can.
It has nothing to do with Charlotte.
This won't bring her back.
I'm making a clinical decision based on emotion, but her father's emotion, not mine.
I don't believe you.
My beautiful daughter is dead.
I know this, I never forget this, it is never not with me.
Why would I confuse that father's grief with my own? You're just prolonging the agony for her dad.
He has a lifetime of agony ahead of him! The one thing that might help him get through that is that he knows everything was done that could've been done.
Everything has been done - I'm going to operate and I don't need your approval, I need your help.
Are you going to help? Craniotomy and evacuation of acute subdural haematoma.
Agreed? When I've washed out the clot, Wilson, you can help me insert the intercranial monitor.
OK? OK.
Are you all right with that? Yeah.
Be nice if you still fainted once in a while, Wilson.
We badly need some light relief.
I could say something tactless and offensive if that would help.
No response to painful stimulus.
Pupils nonreactive to light.
No gagging or coughing reflex present.
No signs of breathing on her own.
We did everything we could.
She sustained a lot of damage throughout her brain.
We managed to remove the clot and that helped to reduce the pressure.
Shepherd and I have just done the first set of tests and she's showing no responses.
She isn't likely to do so.
I'm sorry.
Thank you.
What happens now? In a couple of hours we'll do the tests again.
If the results are the same, we'll take her off the ventilator for a few minutes.
If she can't breathe on her own then we'll agree that Natasha is dead.
We'll let you say goodbye before turning off the ventilator for the last time.
You understand? I understand.
The thing is, I don't know when's the right time to say this She was always on at me to carry a donor card.
What about Tasha? I'll get someone from the donor team to come and talk to you.
She's a good girl.
She'd never hurt anybody.
How can she be dead .
.
when there's so many bad buggers alive? I really don't know.
It's very unfair.
You did your best.
Hi.
Hello.
How are you? What are you doing here? Is it Nick? No! No, you called me in the middle of the night.
Remember? You rang and told me there was a girl the same age as Charlotte and you needed to see me.
Did I? Yes.
Yes, you did.
When Charlotte died .
.
I couldn't think of anything to say to you.
I remember standing in the corner of the room, watching you cry .
.
and not feeling anything but my own pain.
I couldn't share mine with you and I didn't want yours.
Because I knew if I did .
.
if I let all that sorrow in really let it in .
.
it would just fucking bury me .
.
and I'd never survive.
I know thatthat was the beginning of the end for us.
Never mind the affair, never mind the years after.
I couldn't share my pain with you and I'm sorry.
You don't have to tell me this.
I was there.
And that girl today seeing her .
.
made me want to say all of this stuff to you.
Yeah.
So are you going to do something about the grief? Like what? Well, you could talk to someone.
Someone professional.
What, a therapist? There's an idea.
Well, I was pretty sceptical, too.
But I found it really helps.
You've been going to therapy? Really? Well, can't you tell? Don't you think I'm a living, breathing picture of mental health? I was wondering how mad you'd be if you hadn't done therapy.
(LAUGHS) I'm glad we talked about this.
I'm glad you said what you said.
Me, too.
I've got to go to work.
Look after yourself, eh? Is it time? Yes.
It's time.
When I held her, when she was born, I could .
.
rest her head on my hand.
'Days like today are what the job is really about.
You will always fail more than you succeed .
.
and you'll always secretly be thankful when a patient with that much brain damage is allowed to pass away.
' Because the dying you will get used to .
.
the dying you'll be able to live with .
.
but the wrecking someone .
.
that you will never get used to.
Tomorrow somebody else will come through those doors with a loved one that you have to operate on.
They won't care about the little girl that we just lost.
And you won't, either.
You justget on with what is in front of you.
You need four things to become a surgeon.
Memory, manual dexterity, decision-making and, most of all, the strength to come through those doors and do it all again after it's gone wrong.
You come back for more tomorrow morning and that's your assessment.
Because the rest .
.
is just so much bullshit.
All right, that's more than enough of being nice.
Go and write it up.
I'm sorry, about the girl.
Me, too.
Have the transplant team spoken to you, the parents were keen.
Yeah, we will get on to that at the end of the day.
We never should have tried to save her in the first place.
I disagree.
I think we're here to make life viable.
That surprises me, coming from you.
There are two ways to drive yourself insane doing this job.
One of them is to question the morality of every operation.
And the other is not to.
Erm If you ever want to talk You know, justtalk.
I'm sorry.
About the girl.
Hm.
What's this, a farewell drink? I hope we can run to better than that.
You all right? The thing that breaks your heart is that he was so fucking nice about it, so grateful.
Why couldn't he just get angry with me? Well, not everyone's like you.
You think I'm angry? I think you're furious.
I think you wake up and if you're not angry you check for vital signs.
Anybody who wakes up in the morning and isn't angry .
.
is an idiot.
Got any plans for the rest of the day? Thought I'd go home and sleep for a week.
You've not forgotten it's poker night? Poker? Nah, not tonight.
(DOORBELL) WILLY MASON: We Can Be Strong I'm in for a fiver.
I'll raise it by three.
I'll call.
If I call, it's costing me more to stay in than Wickens or Shepherd.
Correct.
I may as well call, then.
I'll call because Springer's not a good enough actor to run that bluff.
Signed myself out today Sent a letter far away I said, baby, I'll be good someday I earned house colours for bridge at my school.
Hang on, are you telling me that bridge was a school sport? Just when I thought I was starting to like you, you drag me back to the foothills of class hatred.
I couldn't take that sterile place In those rooms I lost my face And in the end they couldn't sell me grace Money goes to money every time.
I hate you, Springer.
Sorry.
(PHONE) I've just got to get this.
Hello.
No, no, nothing important.
We can be strong Strong Strong We can be strong Springeryou're sitting with the big boys now.