Monroe s02e03 Episode Script

I've been told I can only keep one registrar.
I have to let one of you go.
We've got a bleeder.
We're gonna have to stop.
How much have you got out? Not enough.
We have to leave most of the tumour in there.
I'm sorry but I think we may have caused serious damage to her brain.
I think that we should go and talk to someone.
About us.
Our problems.
I'd like to offer you the registrar position.
I'm not ready.
I could stay on my current grade.
I just want you to be sure you can live with the consequences.
It's yours if you want it.
If I want it? Of course I want it.
Registrar.
Who wouldn't want it? You'd be surprised.
Every so often something goes wrong and it won't go away.
It just won't go away.
Is it so bad that it's stopping you from doing your job properly? I'll only know when I'm staring at someone's brain and I have to start cutting.
Doesn't that scare you? It would scare me if you hadn't noticed I was the best man for the job.
Now, that would scare me.
You get to make your own mistakes now.
Are you sure you're in the right shape to do your job properly? I don't know.
I really don't know.
You did what? You turned down registrar? What did you do that for? I've been through this with Monroe.
I'll know when I'm ready.
Why do you suppose he's going to offer you the chance again? You had thought about that, hadn't you? Hi.
Hi.
Erm Don't exactly know how to say this cos I've never done it before but I think we both know we've messed up and it won't happen again.
Oh, cos there was me thinking we'd done a good thing.
I was about to suggest we jump into a cupboard for a quick Boris Becker.
How are you going to handle working for Springer? I won't be working for Springer.
I'll be working with Springer.
You think so? Morning! Well at least he isn't wearing a monocle.
Give him time.
Good morning.
Morning! I'll come and talk to you later.
Tell your mum I will only be a sec, OK? You waited till the night shift then you sneaked in and admitted a child on to my ward.
There were no beds in Paediatrics.
There are other paediatric wards in other hospitals.
OK, the dad died in the floods in Pakistan two years ago.
They lived in a refugee camp for 18 months and made it to family in Leeds.
I think with that effort they deserve Bremner.
Who deserves me, Mullery? He thinks you've gone soft on admissions since having a baby.
It's a test case.
I think she's crouching because she's got right ventricular outflow tract obstruction and that's the only way to force oxygenated blood into her lungs.
I'm thinking Fallot's.
You see, Mullery, deep down you know you want to come back to cardio.
How's her English? Both girls already speak broad Yorkshire.
You're going to let me down, aren't you? I don't want this to be uncomfortable.
Me neither.
I'm sure I only just edged it.
I'm sure you did.
Springer.
Good to see it hasn't gone to your head.
What have you got? Alex Schofield.
25.
Went to the doctor with poor motor skills in hands and constant back pain.
MRI scan shows suspected ependymoma high on his neck.
C4 to C7.
One of my top least favourite locations for surgery.
Are you sure you want to go on the ward dressed like that? Of course.
Why not? Just when I thought the day couldn't get any better.
What have you come as? You were warned.
One - tie.
Bacteria risk.
Tuck it in your shirt or I'll circumcise it.
Two - sleeves.
Infection risk.
Get them rolled up.
Three - briefcase.
Needless clutter.
Get rid.
Four - you look like a knob.
We'll operate and take a biopsy.
It's likely to be one of two things.
An astrocytoma or an ependymoma.
If it's an ependymoma, we'll remove as much of it as we can.
What if it's not? If it's an astrocytoma we'll sew you up and the operation won't take place.
So I'm having an operation to see if I need an operation? Yes.
And the operation will have risks I need to talk to you about.
Let me show you something.
Come forward.
Oh, I know.
Silly bugger.
Hand on heart, do you find that attractive in any shape or form? Er It's not really my kind of thing.
See? There you are.
Another lovely girl you've ruled out, in't it? We don't need to worry about the tattoo right now.
The growth is in the substance of Alex's spinal cord.
If the spinal cord gets damaged when we remove the growth then everything from here down would be paralysed.
Paralysed? How do you mean? It's all right, Mum.
It'll be all right.
They know what they're doing.
It's only fair I tell you that risk, but you should also know that if we just leave it, it'll grow and then, I'm afraid, it definitely would paralyse you.
No! Don't say that.
Mum.
Go and get us some tea, will you? We're going to need it.
I thought you were nil by mouth.
Well, you can drink yours, I'll look at mine.
Can somebody, please? No, I don't Mrs Summerfield Shall we get that tea? Go on.
Listen.
Whatever you tell me, tell me straight.
I don't need protecting.
But my mum? It's a different matter.
You've seen what she's like.
I don't want her worried.
She's had enough worries over the years.
She's got nothing to worry about.
Neither of you have.
This man's the best.
Just in case you've got hold of the wrong end of the CUSA, I am not Butch and you are not Sundance.
You are my registrar! You're not my partner.
You don't interrupt me when I'm talking to a patient! And do something about the suit.
You look like a bookie's runner.
Well, well, well.
Someone knows there's a new stag in the forest.
Stick your tongue out for me.
OK, let's have a look at your hands.
Will you tell your mum Husna needs an operation, it's quite a serious one.
It's to repair a hole in her heart.
She knows.
Husna was diagnosed in Pakistan, but they couldn't do the operation there.
Fallot's.
Ooh, hold the doors! We're going to need a translator, Miss Witney.
Informed consent can't be taken through an 11-year-old.
I'll get on to it.
So does Louis have any favourite bedtime songs yet? Erm A Team by Ed Sheeran.
Oh, a song about a crack-addicted teenage prostitute.
Cute.
Oh! His playlist.
That's not mine.
Give over.
He likes to pretend he doesn't like Simply Red but I catch him singing along to it in the car.
It really isn't mine.
Make a hash of that and he won't even be breathing on his own.
Which is why I am taking the precaution of having Shepherd use neuromonitoring.
It will help my decision-making.
What? I thought you argued that machines make a surgeon too conservative.
It's not replacing him.
Just telling him how close he is to the spinal cord.
He doesn't want to damage it, does he? "The more equipment we use, the more we learn to distrust our expertise.
" You said that.
Springer.
Back off.
Do you want me to spell it out? What? We're using a machine because right now I need it.
Why? Because last week I crippled a patient.
I wasn't saying I need it to give me the confidence in this operating theatre where, as you point out, one slip and it's wheelchair time for Alex.
Forgive me for being dull but this patient's needs trump your desire for blood sports! Are you scrubbing in or what? Oh.
Can I help you? No.
Sorry.
Sorry.
OK, so neonatal Is my neurophysiologist happy with his new toy? Neuromonitor up and running.
Happy with the patient and happy with the new-found tone of respect.
OK.
Let's get a biopsy and see if we need to do this operation.
There you go.
Urdu, Pashto and South Yorkshire.
I've already tried him.
Oh, my God! What's gone wrong? Nothing at all.
The biopsy confirmed it's an ependymoma.
And we're going to operate to remove it.
I hear you're looking for an Urdu translator.
Do you know one? You're looking at him.
You? What can I say? I've got hinterland.
Come with me.
I'm hard as nails.
So don't spare me any details.
I can take it.
It's good news.
We know what the problem is and we're going to do our best to get rid of it.
No promises, then.
What? You don't make promises, do you? I'm a good listener.
The bingo years, you see.
And I've been listening to you and you never make promises.
You're right.
I don't.
But this operation needs to happen.
He's all I've got.
Unbelievable.
There you go.
Thank you.
So, come on, where did you learn Urdu? Five-card stud, Asian cabbies.
Can you stimulate the patient? Tell me what Metal Mickey thinks of my efforts so far.
Running motor check.
Amber, mostly amber.
Good.
You are still in the safe zone.
Again? We've still got waveforms but now most of the channels have gone red.
Careful.
OK? The margins between the cord and tumour are blurring.
Try again.
The same.
It's red.
We're going to stop there.
Are you sure? I'm sure.
We're going to stop there.
Close him up, Springer.
Still got tumour to debulk.
I know.
Totally lost his nerve.
I've a mind to reconsider my position as registrar unless he snaps out of it.
Right.
I mean it.
I'm a flair player.
That's what surgery's about for me and the old Monroe.
I'll order another MRI scan, yeah? Yes.
You do that.
What did I tell you? You didn't want me to make you a doctor's appointment, now look at you.
As good as new! Erm Can you erm Can you just push against me? Good.
Good.
How are you feeling? A bit sore, but Great.
Really.
Hands feel like new.
I didn't realise how bad they'd got.
I thought I was just getting cack-handed, you know.
Like a dodgy keeper.
Squeeze as hard as you can.
Good.
Good.
Arm-wrestling back on.
Darts may take a few days.
Thanks, Mr Monroe.
Thanks for everything.
Oh.
Thank you.
Thank you! So there was his mum, hugging me and thanking me.
And I knew I hadn't done the job I set out to do.
Knew I could safely have taken more.
Knew I should have taken more.
So what stopped you? Fear.
I'm frightened.
Frightened of what I've done and what I might do.
We met at work.
Erm started dating.
Got more serious.
Unplanned pregnancy and then we moved in together.
Then Louis was born.
And now we're both back at work.
And Terrified we've got nothing in common now the adrenaline's gone.
So when you had the bad outcome Lynn.
Her name was Lynn.
This happened before.
It's part of the job.
Why did this one get to you? I don't know.
A connection maybe.
A face.
Or maybe you're feeling particularly raw right now.
So? So the only place you can redeem yourself is the operating theatre.
And that doesn't happen, so Hold on.
Hold on.
Don't you agree with me? Oh, no, I agree with you.
I just want a pen to write it all down.
Is there anything outside your relationship that might be having an impact on it? Like? Like what? Work? Family history? Health? Oh.
All of the above.
That's very honest.
Well, we're good at being honest.
That's something we do a little bit too well, I think.
I could talk to someone from work, but I feel if I do they'll always be watching me.
Oh, yes.
I was forgetting.
No weakness permitted damage the Monroe brand.
That's why I choose to talk to you.
I come to you for naked mockery.
Just mockery these days.
We're divorced.
So we are.
Oh.
So, what time are you meeting Dave? Ten minutes ago.
I'm sorry.
You'll be fine, you know.
Yeah, I know.
Go on.
You crazy kids go and enjoy yourselves! I think I'll make espresso my drink of choice now I'm registrar.
It's a more important kind of coffee.
What, latte's for losers? You see.
We think the same.
Which is why you should let me buy you a drink sometime.
You don't know what you're missing.
Do you know, it was uncanny.
It was like she knew all about me and was waiting for me to say it out loud.
You're cured now, are you? Not after one session, no.
Not how it works.
I remember taking my car to a garage once.
I only wanted the alternator replacing.
But, you know, once he fixed one thing it made another thing break.
I had to go back the next week, week after that.
This is relationship counselling, it's not some dodgy car repair shop.
I'm just saying.
I cut my losses in the end.
Sold it for scrap.
We need to talk.
Larry, I don't think we do.
We need to talk.
Can one of you two get me a large black coffee to take away, please? Sure.
No suit today? I feel overdressed now.
I'm laughing inside and that's the important thing.
I'm glad you ditched the suit.
It made you look like you were overcompensating.
For what? You don't know, do you? You weren't first choice to be registrar.
Wilson was offered it and turned it down.
What? No.
Wilson would have told me.
No, she wouldn't.
Because she's far too nice.
Unlike me, as it turns out.
It doesn't matter really, does it? I mean, you're doing the job now.
Close your eyes.
OK, now put your hands down.
I stopped the operation too soon.
I left too much of the tumour in there.
You took a clinical decision based on the evidence available.
Have you heard of Wilder Penfield? Yes.
I've heard of Wilder Penfield.
Neurosurgeon, epilepsy pioneer and, most surprisingly of all, Canadian.
One operation he did in the 1930s - when he got into it he saw that this malignant tumour had spread, really aggressive.
He took it all out along with a massive part of the patient's cortex.
His colleagues were against it but he said it wouldn't have any side effects.
And it didn't.
Do you know why that story is remembered? Because it's the exception.
No.
It's remembered because he was operating on his sister.
His own sister.
That's the story that made me want to be a brain surgeon.
Maybe he just didn't like his sister very much.
Hm.
Surgeons with superpowers.
It's a myth.
Stop trying to live up to it.
It's hurting you.
I don't know.
Maybe I need a break.
Is that such a terrible idea? Tell her? This is insane! Why would you ruin your life? Why would you ruin mine? Do you hate me that much? I don't hate you.
I really don't.
I just realised that I can't ever mend what I've got with Jenny when I'm keeping this secret.
And you think telling her that you slept with me is going to do the trick, do you? I am so sorry.
If there was a way of keeping you out of it Larry, I am begging you not to do this.
We made a terrible mistake and we need to put it behind us.
But, please, if you tell her This is what I love doing.
Please don't take it away from me.
Monroe needs you.
Got a great happy hour special in from A & E.
I was thinking we normally only see babies with this condition.
Husna's five years old so You were thinking that as she was older you might be able to do the operation? Well, I'm afraid the answer to that is "No".
If she dies during the operation, which is very possible, I want her family to know the most experienced surgeon was operating.
Do you understand? Of course.
I know, you hate me for refusing.
But one day you won't.
That is some insult.
It's practically defamation.
Is he conscious? He was when he walked in.
He's losing blood.
He walked into A & E like that? Did A & E send up drug and alcohol screens? He wasn't drinking.
He walked down Briggate with a knife in his head? He walked over the road to try and stop a fight.
His 12-year-old boy brought him in.
Hello, Finn.
This is Mr Monroe who I was telling you about.
You're going to make him better, aren't you? Yes.
I'm going to try my best.
I wrapped his scarf round his head.
Good lad.
That was the right thing to do.
And leaving the knife in, that was right too.
We did it at school.
First aid? No.
The Sword In The Stone.
It was like The Sword In The Stone.
You know what? We give special milk shakes to brave lads round here.
All right? I've got to go and help your dad out now, OK? Come on, Finn.
One stab wound inner leg stitched, for what it's worth.
Strictly small time.
Knife's gone straight into the sagittal sinus.
Knife's acting as a plug.
It's going to get messy.
Nothing we can't handle, eh, Skipper? You call me Skipper ever again and I will break you like a twig.
Blood pressure's falling.
The sooner we get on with it the better, Skipper.
Anything you observe about the heart, Miss Witney? Enlarged.
Very weak beat.
Textbook.
Absolutely.
Shit, shit! Stop.
Everybody stop.
The coronary artery's in the wrong place.
It's at the junction of the right ventricle and MPA.
My God, I'd have killed her.
Yes.
She's going to need a homograft.
Make a few calls, and I'll go and speak to Mrs Sahni.
Of course.
And tell them it's urgent.
Because it is.
Very.
Do you understand? I'm looking for a homograft for a five-year-old girl.
What smaller sizes do you have? 17 millimetres? There's been a complication and the operation is going to take a little longer than we thought.
Thank you.
Thank you so much.
OK.
Yalda.
Now I want you to tell her what I really said.
I can't.
It's too hard for her.
I know, I know that it's hard, but I need you to be a brave girl.
I don't want to be a brave girl anymore.
I dropped it in the car park but I rinsed it off under a tap.
Perfect fit.
He's dropping again.
We need to get a move on now.
You OK with this, Springer? Me? You can do it, nice and smooth.
We can't wait.
Monroe, we can't wait! Take the suction, Springer.
Ahh I'll do it.
One, two, three Ah BP's not BP's not too bad.
Thank you.
OK, everybody? Reduce the flow and remove the aortic clamp, please.
Flow up.
Come on, Husna.
You're a survivor, I know you are.
Come on.
Come on! Good.
OK.
Good.
Miss Witney.
Agitate the ventricles, please, and let's prepare to fill the heart, thank you.
Your dad's out of his operation.
He's still asleep, but he's going to be fine.
I knew he would be.
I knew it! Lizzie here will take you up to him when he comes round.
OK, fella? Thanks.
The er blood soaked through my scrubs.
My erm pants too.
So I'm gonna have to go commando for the rest of the shift.
Is that really what you came here to tell me? Er Did you ask Wilson to be registrar before me? Yes.
Is that it? "Yes"? Do you know what I'm going to do tomorrow? I'm going to remove the rest of Alex's tumour.
Have you told her everything this time? Yes.
That's why she's crying.
Grown-ups always cry when they're happy.
Good.
Thank you.
I told you she was strong.
Dad died but she was meant to live.
Yeah, she was.
I really think she was.
Good day? Yes.
You? Very.
You know how it is in our trade.
One day you're Jesus, the next day you're Job.
Beautifully put.
If a tad self-aggrandising.
You ready? There you are.
We were looking for you, weren't we, Louis? Hello, hello, hello! Good night.
And well done for today.
Thank you.
He's lovely, by the way, Louis.
He's lovely.
Yes, he is.
Thank you.
You are lovely, aren't you? You are lovely.
Do you think we should discuss what we talked about in Relate at some stage? Are we allowed? I don't know what the rules are.
Did I hurt your feelings? Some of the stuff that I said? No.
No.
I thought you were very honest.
I sometimes wonder if there can be a little too much honesty in a relationship.
What? What is it? I'm sorry.
What for? For everything.
For hurting you.
Yes, I'm sorry too.
For hurting you.
When did you hurt me? Well, at Relate.
That's what you meant, isn't it? All the stuff we said to each other in there.
And even though it it's can seem very painful that doesn't mean it's not worth saving, does it? I mean, we are worth saving aren't we? Yes.
Of course we are.
It's better that we do another operation now before scar tissue forms.
If we leave it, we'll be doing the same operation in a year but riskier.
Yesterday you were thinking of taking some time off.
That was before I'd pulled a knife out of a man's head.
No time to think.
That's what's been holding me back - time to think.
That's thinking taken care of then.
Seriously, though.
I've been going into operations thinking about past failures.
It's been making me overcautious.
It was because I was overcautious I let Alex down.
He has just had a serious spine operation.
You really think he is going to give his consent again? If we don't take it all out he is on a steady road to full paralysis.
Erm just to put your mind at rest.
I'm not going to tell Jenny.
I'm sorry for all that stuff I put you through yesterday.
You were right.
You know something? I don't give a shit what you do.
Oh.
OK.
I decided I wasn't going to torture myself worrying about what you would or wouldn't say.
I know that's what men like you get off on.
When did I stop being a great guy and start being "a man like you"? Are you still up for that drink tonight? Actually, I'm up for dinner.
OK.
Great.
Did you hear that? Yes.
We all heard it.
I know this little Italian.
Is it Frankie Dettori? She was just waiting for me to be made registrar until she succumbed.
Yes.
That will almost definitely be it.
I'm all singing, all dancing, all moving.
I'm feeling better than yesterday and tomorrow I'll be better still.
I know you don't want to worry your mum.
I love my mum to bits but you don't really think that's the reason I'm saying no, do you? Go on.
Dangerous operation, you said.
One-off.
And you asked me to trust you.
And I did.
And now, all of a sudden, you want to do it all over again.
Trust you again.
And the thing I worry about is this: If you're so bloody good then why didn't you do it right the first time? The tumour will grow if we leave it in there.
And there will be side effects.
You don't know that.
Not for certain.
One side effect is that you will be impotent.
Impotent? Is that true? No, no.
It's something I say to men to convince them to have operations they don't need.
Yes.
It's true.
You're 25 years of age, maybe you've done all the riding you want to already OK.
OK.
OK.
Where do I sign? We OK? Yeah.
Green across all channels.
All good.
Motor responses working.
Won't be for long if he carries on listening to this shite.
I preferred your mother's stuff, Alex.
He was six months old when his dad buggered off.
I cried for a week and then I rolled up my sleeves and I said, "Right.
It's the two of us now.
" And it's always been that way.
You're his mum.
You've got every right to be protective.
God, if it was my daughter in the same boat I'd be exactly the same.
And I know he should be standing on his own two feet by now but you know? You'll miss him if he goes.
I will, yeah.
But I have to let him go, haven't I? You don't have to say it.
I know.
I do know.
What does the monitor say now? Amber.
Mostly amber.
Already? Yep.
Try again.
You're actually in the red now.
You know what? Turn the bloody thing off.
Are you sure? Turn it off.
It's stopping me doing my job.
Good call.
Thank you, Wilson.
I can get this.
Hey.
How did it go? Oh, it went well, yeah.
Just have to wait and see now, like always.
Thanks for your concern.
It's almost as if you didn't trust me.
Hey! You don't get it, do you? I am accountable for every decision you make.
So I think that entitles me to ask about the outcome of an operation when the surgeon himself has previously been questioning his own abilities.
All right.
You're right.
I'm sorry.
I'm back in arrogant prick mode.
Surely that's reassuring.
I took this job because I thought it would be better if a surgeon was in charge of Surgery.
I took this job for the best possible reasons.
I know.
You don't have to tell me that.
Well, maybe, once in a while, you and Bremner and all the others could give me some credit for fighting your corner.
Yes.
Right.
Message understood.
You OK? It's Gillespie you should be worried about.
He seems to think he's in charge.
How are you? I've made a full recovery.
Motor responses are good.
BP slightly raised.
You know what I mean.
We were in counselling and I was thinking, "If this is what it's come to, if we can't even talk to each other without a referee in the room, then what's the point?" That's not a relationship I want to be in.
You've had one session.
Jesus, Larry, give it a fair crack at least.
One! A bit of short-term advice to tide you over.
If this alludes to unhygienic sexual practices I don't want to hear it.
Go home.
Give her a hug.
Tell her you love her.
And that's going to solve everything? You'd be surprised.
And back rubs.
Women love back rubs.
Here's the main trick.
You pretend you don't expect it's going to lead anywhere.
Thank you.
No, no, no, no.
You pretend it's not going to lead anywhere and it always does.
"I love you.
" Remember? I love you.
Alex has come round on the ward.
Thought you might want to know.
Why did you have to go again? Look at him.
He was doing really well.
We've got all the tumour out this time.
He won't have to come back.
He's not talking.
Mm-hm.
Alex, can you hear me? Can you lift your right arm? Mm-hm.
Excuse me.
Right, Alex, wiggle your toes.
Come on, Alex, try harder.
Your toes.
Come on, try harder.
Wiggle your toes.
Come on, Alex, you've an audience here - your toes! Good! Good! Good boy! That's great.
Great! Right, you can stop wiggling.
Don't want to tire yourself out.
I think he's going to be all right.
Ooh! I love you.
Oh, well what's brought this on? I was just being spontaneous.
Right.
I'm not I'm not very good at spontaneous at the moment.
Sorry.
I can give you a back rub later if you want? Yes, that would be lovely.
As long as you don't think it will lead to mad, passionate love-making.
I'll need to be a tiny bit more conscious for that.
No, it's just a back rub.
No ulterior motive.
Well, that would be nice.
Well, well, well, Miss Witney.
But you're beautiful.
What? It's a line.
They always use it in films.
What films? Well, now you're putting me on the spot.
Shall we get to the restaurant? You know what? Do you mind if we don't go to your Italian? There's this other place I think you'll enjoy more.
Where are we going with this? I'm folding.
You only play premium hands.
That's so management.
I'll raise it a fiver.
Take it to the river.
I'll pawn my wedding ring this time round.
I hope you've got an understanding husband.
I'm not married.
I just wear the ring for work.
What? Keeps lechery at bay.
I wear a ring for much the same reason.
Why's that funny? Ace-high flush.
You've only got yourself to blame.
Ah, hello.
He's gonna lose his hand.
Aye-aye.
More the merrier.
Get your money out! You know how to treat a girl, Springer.
You cheapskate, Springer.
What can I say? Lady's prerogative.
Full house.
Did she keep her hands on the table when I was at the door? Cheeky.
Unbelievable! How much am I in? Dream over.
I was just wondering about tonight or tomorrow or any night really.
What the hell are you doing here? All right, Dad? What the hell are you doing here? Why don't we get married? We are hardly happy as we are, how would marrying help? If there's no hope for us then why the hell am I even here? You are the best registrar I've ever had.
You can tell me.
How bad can it be? I slept with someone else.
Are you sure this wasn't a dream you had?