Monroe s02e02 Episode Script

It's better to have a surgeon like Gilliespie in charge than some non-medic.
I don't think we're in the job of giving people false hope.
Jenny Bremner, you made it to the other side.
I can barely smell the baby sick.
We did all right here, didn't we? This is my dad.
This is Donna.
We're gonna get married.
I will not do the mother and baby talk.
It's a promise I made myself.
You could almost earn my grudging respect.
Hey, don't fight it.
It was inevitable.
You're going to have to lose one of your team.
Springer or Wilson.
How does the old saying go? 'A change is gonna come.
' OK.
Basic stages of inserting a shunt.
Hockey-stick scalp incision, strip pericranium then burr hole.
Langenbecks in to expose the peritoneum.
Tunnel, pass the peritoneal catheter.
Secure valve Connect the catheter to valve, check CSF flow.
Drop distal catheter into the peritoneal cavity and close with 2-0 Vicryl and clips to skin.
Brilliant.
Both of you.
Thank you.
Thanks.
Pity your patient dies of an infection within three months.
What? You didn't prepare the shunt by priming it and soaking it in Gentamicin.
Therefore I can only assume you didn't do it.
What's all this about? All this testing.
You know we know this stuff.
I can't think of a better way to decide which one I sack.
No, really.
What's it about? I've been told I can only keep one registrar.
I have to let one of you go.
Let's try and stay civil about this situation.
Yeah, well we've always been in competition.
Nothing's really changed.
Passive aggressive.
So that's how you want to play it.
I'm glad to see the healthy eating policy is making inroads.
I'm no more than 100 yards from cardiology.
There can't be a safer place in the world to eat a fried breakfast.
How are they coping? Well, er Wilson is trying to win through increased dedication and practice.
And Springer is trying to win by killing Wilson.
Mm.
An elegant solution.
Murder.
Did you not express before you come out? My missus was exactly the same.
Only had to hear a baby cry she'd be like Vesuvius.
Very tricky time for a woman.
You want to be more sensitive, mate.
Two years ago, Lynn Monkford had a low-grade glioma maximally debulked.
Now it has come back as a much more aggressive malignant tumour in the medial temporal region.
She's young, otherwise healthy.
I've spoken with Oncology and I think we should operate, remove what we can, give her some quality of life for her last 12 months.
Does she understand what this means? That she's gonna die of cancer within a year? Yeah, she gets it.
Only too well.
You're sure about that? She's a very strong woman.
Very clear-headed.
She will have understood.
She'll need to be strong.
Poor her.
Wilson, Springer.
Risks of surgery? Potential complications can be divided into early and late, local and systemic.
Let's cut to the chase.
Increased risk owing to residual scar tissue from previous operations.
Thank you.
Causing distortions in the Yes, well that's obvious Yes.
Thank you.
Both of you.
Hope you're happy with the battle you've unleashed between my trainees.
Junior surgeons with a competitive attitude? I'm not sure you can lay that one at my door.
Jill.
Thanks for backing me up in there.
Gillespie sometimes needs his card marking.
Just because he annoys us both, love, don't think that gives us a bonding moment.
I do love you.
You know that, don't you? If you were more of a man, I'd sue for sexual harassment.
Jenny! Jenny! I'm so sorry.
About before.
I really don't want to discuss it.
I gave the secret signal.
What? I'm just saying.
I gave the secret signal.
Thank you.
So, Graham, you all set? Bit nervous, you know.
He's having a bypass.
Then he'll be able to come fishing again.
Well, I er hope he'll be up to something a little bit more strenuous than fishing.
You've never been fishing with our Geoffrey.
Well, you're up first, so you won't have too long to wait.
All right? I'm good for the bypass, by the way.
I'm sure you are.
Which is why I shall enjoy working on it with you.
I did fly solo on a bypass while you were on maternity leave.
If you wanted to check I don't need reminding that I was on maternity leave and I don't need reminding that I'm answerable to Mr Gillespie.
But perhaps you need reminding that you're answerable to me.
Are you clear that this operation won't cure you? Yes.
Yes, I am.
We hope it will extend your life but the operation itself still carries some risks.
The tumour is not in a great place We know the risks.
But you know, Mr Monroe, what have I got to lose, really, when all's said and done? OK.
Let's get it done.
My thoughts exactly.
All right, then, Geoffrey Right, now, listen.
I want you to eat stuff that's good for you.
All right? I will.
Yes.
Hey! Hey! No fretting.
Now, promise me.
OK.
Geoffrey.
This is a no-fret zone, love.
Why don't I get someone to show you the canteen? Yeah? Graham! They've got a canteen.
I'll get you a sandwich, for when you come round.
Right.
Come on, love.
Shelley Maxwell, superstar.
How long has it been? Three months.
This is Springer.
Don't laugh.
Shelley is 15 years old.
Erm, repeated shunt failures.
Infections.
And this time she has a blockage and would seem a suitable candidate for ETV.
- Elaborate.
- We make a small hole in the floor of the third ventricle to bypass the obstruction, meaning she doesn't need a shunt any more.
Meaning we don't have to see Shelley ever, ever again! Which I call win-win.
Have you got any questions? Yeah.
Can someone help me with my biology homework? I think Dr Wilson is who you need.
I got an A at GCSE.
Ooh! Your lesson for today, Shelley.
Never trust a grown man who can remember his grades.
By the way, I got an A in English when A still meant something.
See you later.
The parents only ever meet by the hospital bed, so try and be tactful if that's possible.
I'm middle class.
We invented the messy divorce.
Hm.
See that? We've got rapport.
You can't buy that.
Used to come up here last time around.
Well, as you can see, we've had it upgraded since.
I haven't told anybody what's happening.
My mother.
Her mother.
Her kids.
Well, I say kids but they're all grown up.
They think she's just come in for a checkup.
That's up to you.
The more people I tell, the more true it is.
And I don't want it to be true.
What about Lynn? What does she want? Why isn't she scared? I'd be scared.
I am scared.
I can't answer that.
If you were gonna die, would you want to know? No, thank you! Nah.
All that stuff about letting your loved ones say goodbye.
Well, unlucky them.
They get to live.
So whatever their emotional problems are, they still get the best part of the deal.
So that makes us a pair of cowards.
Oh, I've known that for a long time.
Are you only just getting there? Best get back.
She'll be accusing me of neglecting her.
Hey, Mike.
You might be scared but erm you're a brave bastard.
You should know that.
Just doing my best.
Shouldn't one of us answer that? It's Witney's.
Don't look at me.
I'm not authorised to answer a registrar's phone.
And it's disturbing my ward.
Hello.
It's Mullery.
Right.
Well, her phone was ringing out.
Yeah.
I'll come now.
Right now.
So tell me.
How would you position the heart to do the LAD graft? Slide my hand under the heart, palm up, lift the ventricles up and rotate them towards the right so that the LAD comes into view.
Right, come on, then.
I thought you didn't trust me with this.
Well, you talk a good operation, Miss Witney.
I want to see you live up to your opinion of yourself.
Right.
Oh, fine.
As I'm the one with the free hands.
Theatre two.
Hang on.
Hello? Bremner.
Forceps and damp swabs, please.
Hand deep in Mr Birdwell's chest, I'm afraid.
Hey.
It's your lucky day.
Bremner and Witney are in theatre and this clever boy has got himself shot by a nail gun.
We have a fast, thready pulse and no recordable blood pressure.
Suggestions? Tamponade? Quickly.
Get on with it.
He's arrested.
Hang on, Mullery.
He's arrested.
Can we get him to theatre in time? He'd die on the way.
Tell me the procedure for a clamshell.
Bilateral thoracotomies.
Deep skin incision.
As I cut through the muscle, keep the knife away from the lungs.
Crack rib cage using heavy scissors.
Open up using rib spreaders.
Get access to all areas.
Yep.
Off you go.
What? Here? It doesn't have to be pretty.
It just has to be quick.
Size seven gloves.
Now tent the pericardium using the forceps and get the scissors in.
Scissors.
Got a pulse yet? Yep.
Well done, Mr Mullery.
His heart is beating again.
Get that clot out of the way.
There's the nail.
Got it.
OK, now you've found the hole in the ventricle, you need to get your finger and some gauze over it.
Got it.
Good.
Let's get him to theatre.
Hey! Why are you looking so glum? You just saved his life.
Clamshell incision.
Witney will kill me when she finds out.
That's fascinating.
By the way, your patient is waking up and you've got your hand in his heart.
He might get a bit distressed about that.
Anaesthetist.
Oh, no, no, no! No.
I think you'll find hospital regulations forbid offensive banners.
That's my faith.
Respect it.
So, is there anything you want to ask me about the operation? Erm, well if anything happens, you know, goes wrong, like you will keep an eye on Mike for me, won't you? Of course.
I'm I'm not as tough as I pretend to be, you know.
Do you think I don't know that? It's Mike.
I can't let him see.
I can't put him through that.
I know.
I know.
A clamshell? I can't believe you did a clamshell? Rather well.
You must miss him, Jenny.
I take it you had good reason and it wasn't just a boy thing.
Penetrating nail gun injury to the chest with no cardiac output.
Quick and ugly surgery - the daily burden of A&E.
When I got his heart restarted, he actually woke up for a few seconds.
Unbelievable.
That's so lucky.
I've waited for ever to do one.
If Jill McHeath hadn't made me answer your phone, I might've missed out.
My phone? It was my clamshell? Yeah, but you were already in theatre and I'm sure you'll get to do one soon.
Yeah.
Yeah, I'm sure I will.
We get about one a year.
Oops.
Hey, Shelley.
All set? Are my strange family still following me? Don't worry.
We've got armed guards beyond the double doors.
Shoot to kill.
OK.
Right frontal incision and burr hole.
5 millimetre endoscope.
Travel through the foramen of Monro - appropriately enough before encountering the mammillary bodies - every schoolboy's dream and the fornix named after the Roman arches where prostitutes saw clients.
And that is relevant, why? Altogether now.
That's the area of the brain which gets screwed.
Aren't you scrubbing in? No.
Not unless you need me.
And you don't.
Time for you two to grow up.
All right.
I'll start you off.
Then you really are on your own.
Lights.
You OK? He's doing well.
He won't like any of the sandwiches you've got so I bought him Rolos.
Did the social worker come and talk to you? About finding you somewhere to stay while Graham's in here? Yes.
I I didn't fancy it.
I'm all right here.
Excellent job, you two.
Do you feel up to closing her up? Don't push it, Springer.
We have to support him.
Why? Why is there this fetish for supporting your children when what they're doing is wrong? He's too young.
They both are.
Are you going to tell him that? Of course I am.
That's exactly what I'll tell him.
I'm delighted for you both.
Really, I am.
Good.
Is that why you both wanted to see me on my own? Or was it to ask if Donna's pregnant? She isn't, by the way.
Look We both know we've really given you a shit time.
Splitting up.
Dragging you into it.
And we're really sorry.
Thanks.
But I'm not getting married to get my own back.
We're not saying you're doing it on purpose but subconsciously, perhaps I just want to be with her.
And she wants to be with me.
We can talk about anything and we make each other happy.
And we're in love.
Which is all really great.
But why the rush to get married? Why the delay? Be Hi.
Hi.
Hi, Gabriel.
Hi, Anna.
It was like we thought.
They were trying to bring me to my senses.
- But I put them right.
- No, no, not at all Are we having starters? Are you on a very early shift or a very late one? Neither.
All my paperwork got knocked back by Mullery's clamshell.
Ah.
Yeah.
What about you? RTA.
The helicopter never arrived.
What happened to it? Don't worry.
It wasn't shot down by BUPA or anything.
It just went to Oldham Spinal Unit instead.
Come on.
I'll give you a lift home.
Anyone who laughs at my jokes, they get a lift home.
It's just a rule I have.
Put like that Thank you.
Something not right there.
I know something's not right there.
I don't know how to fix it.
He's my son.
Never mind your son.
It's not right you're on good terms with your ex-wife.
I don't have much choice.
Wouldn't happen in Bramley.
I know that much.
Do you think it ever goes? The jealousy.
I still get jealous of her first husband even now.
Even here.
I think that sounds very healthy indeed.
You're taking the piss now, aren't you? A little.
But here, listen.
You should feel exactly the same about her because then you'll treat her exactly the same.
She would hate it if you treated her any differently.
You're not wrong.
I know we found each other late, but thank God we did, like.
She's amazing.
Of course she is.
She really is.
I'd say more about her, but since you've told me about your jealousy issues I think I'll leave it there.
So what made you want to become an anaesthetist? I didn't.
I wanted to be an engine driver but I didn't get the grades.
Really? I just chose another job that deals in pressure and gauges and steam.
And, you know, playing second fiddle to surgeons cos that's the real bonus of the job.
Mm.
Is that true? Do all anaesthetists secretly hate us? Yes.
Yes, we do.
We do.
We have secret meetings and everything.
One day we will rise up as one and sedate you.
I thought as much.
You know, Jenny thinks the world of you.
She just Isn't very good at showing it.
No, she's not.
Oh, God.
Don't let me become 'self-pity man'.
You couldn't become 'self-pity man' if you tried.
You're a great guy.
A great guy? What? A great guy.
Sounds like something they say about a sacked DJ.
Thanks for cheering me up.
Mmm.
It's It's borderline inappropriate.
Yeah? But I think we got away with it.
Yeah? Mm.
Good.
Thanks for the lift.
Mm-hm.
See ya.
You're my lovely boy.
Yes, you are.
Ah.
Yes, you are.
So Louis is the other man, is he? You're early.
Yeah.
They were diverted to Oldham.
Are you taking him up? Five minutes.
I just miss him so much when I'm at work.
Well, who wouldn't? I've been thinking.
I think that we should go and talk to someone.
Talk to someone? About the milk thing? Don't you think you're overreacting? No, not about the milk thing.
About us.
Well How about How about you just get a sense of humour instead? I think that comment proves my point.
I just think that at the moment we're not making each other very happy, are we? Do you know what? I'm not having that.
'We' don't have a problem, Jenny.
You do.
Can I have a minute? Listen to me.
I always listen to you.
I don't get any choice.
I love you.
And I'll be here for you afterwards.
I should bloody well hope so.
I love you, too.
By the way.
Something you ought to know.
I've booked us a holiday.
Where? I'll tell you when you come round.
Well, if it's a caravan in Wales, I'm leaving you.
Thank you.
Go on.
All of you.
Let the girl have some rest.
There's still a worry about Geoffrey.
Graham will be in for at least a week.
I thought Lizzie was looking into that.
I left you a message on your phone.
Didn't you get it? Miss Witney doesn't always answer her phone.
Oh.
You're enjoying this, aren't you? I can enjoy anything if I put my mind to it.
So my husband tells me.
The next time you need an urgent bed for one of your patients, you might regret making an enemy of Sister McHeath.
She doesn't like me.
She makes a point of not liking me.
You make it very easy for her.
Morning, Miss Witney.
How did it go clearing up Mullery's clamshell? Fine.
Yes.
Yeah.
Um I hate to be too demanding but with my Head of Clinical Services hat on, I might need just a bit more to go on.
Sorry.
Yes.
Chest drains coming out this morning and transferred from ITU.
Thank you so much.
You know, she reminds me of someone.
I can't think who.
This operation is not about making life viable.
This is about making life bearable.
To work on a patient who is dying, that is our duty and our privilege as surgeons.
This is about matching our patient's courage with our own.
Oh, thanks.
See you in a bit.
If there is scarring and brain tissue stuck to the inner table of the bone, we may rip a cortical artery.
We don't want to do that because? If the artery is near Broca's area, you'll wreck the patient's speech.
Correct.
Right, let's develop a plane between the brain and the bone flap.
Elevator.
More saline, Wilson.
Easy does it.
You OK? Got everything you need? I think so.
Anything you want to ask? You know, if Romeo and Juliet had BBM, do you think it would have still worked out that way? Cheeky.
Any other pressing matters? Do you think my mum and dad will still see each other when I don't have to come in here every six months? When they don't have a reason.
Have you told them you're worried about that? Teenager tells her parents things.
Hm.
There's a thought.
Well I could always tell them.
I don't have to say you mentioned it.
I could make it look as though I thought it might be an issue.
So if they think it's stupid, then it's you they think is stupid.
That's my job.
I'm your stupidity decoy.
Oh, right.
I wondered what you did.
Oh.
Wash.
Hello.
This is Geoffrey.
What? We're short on relatives' accommodation.
It's not a guesthouse.
Wash.
Are you OK? I don't know.
Micro scissors.
More scar tissue.
Shit! Got a bleeder.
What? We have to stop, Larry.
How much have you got out? Not nearly enough.
But I think I nicked a striate vessel.
You think you have? Covered in scar tissue, how can you tell? I know I have.
We'll cauterise it to control the bleeding then we have to stop.
We'll have to leave most of the tumour in there.
How bad is it? Come on! Wash.
More wash.
Springer, come on! Come on! Wash! Jesus! Wash! Right Close her up.
Hello, Lynn.
Do you know where you are? I I Do you know what this is? I I It's OK.
It's OK.
It's early days.
Don't worry.
Can you squeeze my fingers for me? Good.
And now this one.
It was a difficult operation and it didn't go well.
And it didn't go well.
We didn't get all of the tumour out.
I'm sorry.
Yeah, but she was slow getting back to speed last time.
I'm sorry, but I think we may have caused serious damage to her brain.
I don't think she'll get her speech back and I don't think she'll recover any movement on the right side of her body.
But you've got to say all this stuff, haven't you? I mean, legally, you know.
Health and safety.
Worst-case scenario and all that.
I mean, you're the man.
We just have to wait, don't we? We'll wait.
But I want you to prepare yourself, Mike.
Lynn isn't going to make a full recovery.
Isn't going to make a full recovery.
Do you understand what I've just told you? Yeah, of course I do.
We just have to wait.
Expressive dysphasia and very little anti-gravity function on her right side.
She's unlikely to recover that.
How's her husband? Hasn't sunk in yet.
And how are you? My first year as a registrar, I had a patient who got a post-op infection and it tore him apart bit by bit.
He came in here walking and talking, handsome.
And he left in a wheelchair with a book on sign language and a crooked smile on his face.
Why? Cos I didn't pick up the infection soon enough.
My mistake.
The first time you wreck someone that's hard.
The first time.
But this wasn't the first time.
You don't have to do this tough nut stuff for my benefit, you know.
You asked me how I'm doing and I told you.
Why don't you go and polish your platitudes? Oh Erm So you were right, by the way.
About talking to someone.
I think we should probably do that.
Great, that's good.
Good.
Good.
I've booked us an appointment with Relate next Thursday.
I've checked your shifts.
We're both free so You see that That right there.
Maybe that's something we could talk about.
What? Efficiency? Control.
You lucky sod.
You're not taking advantage of that poor man, are you, Geoffrey? I've got something for you.
Your shunt.
For old times' sake.
That would be really sweet, if it wasn't so gross.
Cute.
I'm just there for people.
It's the little touches that Monroe appreciates.
I wish I could say the same about Bremner.
Look, if If you ever want to talk about stuff stuff you're finding difficult - I'm good, you know.
They used to call me the Agony Aunt at uni.
That's very sweet.
I'll bear it in mind.
Great.
I'll pick you up at eight.
Nothing exclusive at this stage, obviously, but we'll see how it plays out.
Most girls tend to want me to themselves once they've sampled the wares.
Oh, you're good, Springer.
Very good.
You're cheering me up already.
Mike.
I've been looking for you! Isn't our Shelley doing brilliant! Thank you so much, Mr Monroe.
Thank you! It's a pleasure.
I didn't know what to get you.
The hospital shop is full of tat, so, anyhow, you do drink, don't you? Cheers.
Take a seat.
It's been difficult trying to choose between you and Springer.
Perhaps I should explain something.
But I'd like to offer you the registrar position.
Thank you.
But I don't want it.
Not yet.
Not yet? You're practically doing the job anyway! I'm not ready.
I say you are ready.
In Lynn's operation when it went wrong I just wanted to run away.
Here's the secret.
So did I.
But you didn't.
You carried on.
And you're back at work and ready to go again.
Not me.
That's how I know I'm not ready.
I'm not asking you to be me.
I'm asking you to be my registrar.
I could stay on my current grade.
One registrar, one trainee.
Isn't that how it goes? Come on.
What? And have Springer as your boss? I can handle that.
You know that Springer would kill to be sitting there? That's why you should give it to him.
Well it makes the decision easier, that's for sure.
I just don't get it.
They're a different generation.
More thoughtful.
Or more cowardly.
Is that what you really think? Wilson's a coward? Maybe it's a better quality than I gave it credit for.
I heard about your patient.
I'm sorry.
I did the operation to give her a better quality of life for whatever time she has left.
Instead I don't know about you, but as a definition of savage irony, I think that takes some beating.
These things happen.
Oh, God, not you as well.
Surely you can do better than that? You made the call.
You made the cut.
You take all the blame.
See how far that gets you.
Hustled by a patient.
Bang goes another get-rich-quick scheme.
You've got more than one? I'm still working on designer clothes for the religiously devout.
Is this the Burberry burka thing? I don't think it's ever gonna work.
Boyfriend? No.
No.
Er just a stalker.
A brilliant way of trying to find out if a woman has a boyfriend.
I don't think anyone saw through that.
Right, who am I giving a lift to? Me.
Not me.
On my bike.
Brought the car, love.
Me, too.
Um Any chance you get, big me up, yeah? I live to big you up.
Nice.
Thank you.
For what? For rescuing me from Springer.
Oh, you could do worse than Springer.
Trust me.
He's got good prospects.
That's true.
Hm.
Not exactly spoiled for choice.
What? Oh, come on.
Look at you.
You're amazing.
Thank you.
You too.
I know.
I moisturise.
God.
There you go again.
I wish we didn't get on so well.
Why? Well, if I say why, then we'll stop getting on so well.
Well, then your wish would have come true.
You're gonna make me say it, aren't you? It's looking that way.
Well, erm I think you're lovely and and I wish things were different.
All right? Happy now? No, not really.
I mean, yes.
Yes, I'm very Very.
So what do we do now? Um You're gonna go inside.
I'm gonna sit here count to 100 and pretend that that didn't happen.
Yeah.
Yeah.
Registrar? Who wouldn't want it? I'm sure I only just edged it.
I'm sure you did.
I'm frightened what I've done, what I might do.
I won't be working for Springer.
I'll be working with Springer.
I'm terrified we've got nothing in common.
The blood soaked through my scrubs.
I'll have to go commando for the rest of the shift.
Tell her? I am begging you not to do this.