Monroe s01e03 Episode Script

Episode 3

Still here? I thought we agreed you weren't cut out for this.
I never agreed to that.
She's told Nick you've split up.
You have.
But she hasn't mentioned my affair.
Your pathological need to be loved has been made worse by your wife ditching you.
I have a date.
Do I know her? No.
Sounds like I know her.
Give me some slack! I lost my daughter! (ALARM BLEEPS) (SIGHS) What? If there are signs of sepsis, let's try antibiotics before a lumbar puncture.
Let's try and steer clear of repeated aspirations.
In six months, you'll be wondering what you had to be depressed about.
I take it this new and nauseatingly upbeat attitude is down to the fact that you finally got some action.
She's been hurt in the past.
We both have.
So we're taking it slow.
If she wants to take it slow at the start, then you really have got problems.
Sex decreases with time.
If she isn't wanting alarm-bell sex" at the beginning, then you are in for a life of bitter tears and masturbation.
'Alarm-bell sex?' OK, check her obs and if her stats go below 70, I'll need to know.
Judith Warbin? She had mitral valve repair five years ago.
Referred by her GP with a faulty - Thanks, Mullery.
I know all about Mrs Warbin.
Hello, Judith.
Sharon.
Hello, Jenny.
Still being mean to your students? Morning.
Morning.
Mr Grant Lungs, liver and kidney struggling.
I to check cardiac function and may need MRI to check viability.
We might be looking at a repeat operation to replace or repair mitral and tricuspid valves.
You can tell all that just by looking at me? No sense of humour loss.
That's one for the plus box.
Have you found a nice chap yet? I will come and talk to you when I've done all the tests.
All right? Not a word of that conversation to anyone, understood? Understood.
Got an admission through from A&E - David Foster.
Fell off a wall on his way home from a party.
He walked into A&E and waited for two hours to be seen.
High GCS.
Talking.
Good response to listening.
Good motor control.
Then told us he'd taken ketamine at a party.
Ketamine? He's conscious.
He's coherent.
He sounds fine.
Why are you telling me about him? Because of his scan.
OK.
It's subdural and it could be bleeding.
But he's tolerating it.
Springer, tell me why we want to operate.
Could be brain damage, increased pressure in the brain, stem the bleeding.
Wilson, tell me why we don't.
If the swelling is too great, we might not get the dura closed again.
All true.
All true.
I think it's too big to leave.
Fortune, scrub the first elective of the day.
Springer, you can scrub in.
Ketamine, eh? The drug that's simply too good for horses.
Stupid, I know.
My registrar tells me you're ex-army.
Well, that explains the stupidity.
I'm going to be straight with you.
You've got a blood clot on your brain from the fall, and even though you're coping well, I think it would be safer to operate to take it out.
Fair enough.
Have you anything you want to ask me? No.
Anybody you want me to contact? No.
Mum and Dad? Wife? Children? None that I want to contact.
It's no fun facing this on your own.
I'm not married, I don't have any kids.
And let's just say I'm not in the mood for the pained expression on my mum and dad's faces right now.
OK.
I'm going to change my timetable and operate as soon as I can.
OK? Yeah.
Just get it done.
A replacement valve? At her age? You have to question whether Lady Bremner has got this right.
What would YOU suggest? Leave Judith to die on a hillside? Manage it with medication.
Happens all the time in the States.
Are we looking at one valve or two? Doctors? I was wondering whether it was ethical to operate at all, given her health and age.
It might be better managed with medication.
Oh And what medication might that be, Mullery? I don't know.
Exactly.
I don't look to you for moral guidance, Mullery.
I look to you to display very, very basic surgical knowledge.
And you manage to disappoint me even in that.
Wilson, Springer, talk me through it.
Incision.
Drill two holes.
Craniotome to open the bone flap.
Lift the bone flap, expose the dura.
Open the dura.
Suck out the clot.
Close him up.
Bob's your knob.
You're very quiet, Wilson.
I was just thinking about that thing you said.
What thing I said? I say many things.
The thing about medicine being what we do to keep a patient entertained whilst nature takes its course.
Voltaire wouldn't have said it if he'd this kit.
OK.
I shall go and anaesthetise him.
I just hope I've got enough drugs to knock him out.
How do you mean? He's drunk eight pints, he's taken ketamine and got a subdural clot, and he's still awake.
He's practically indestructible.
Shepherd.
Hang on.
We're not going to operate.
Stop! Take David back to the ward and I'll get ITU to free up a bed.
I'm not going to operate.
What? David, I'm sorry to put you through this.
I've had another look at the scan and I don't think you necessarily need an operation.
I'll go through it with you back on the ward.
Are you sure? Yes, I'm sure.
This will come as no surprise, but I might have to replace both the valves.
Or I could re-repair one.
Either way, it won't be an easy operation.
How difficult is it? Again, I won't lie to you.
The risks are always greater at a repeat operation.
If I have the op and it goes all right, will I be right for my granddaughter's wedding? What can I do with her? It's all she'll talk about.
Is that the only reason you want to go ahead with this operation? Can you think of a better one? Fortune.
You cover electives.
Wilson, Springer, you cover admissions, referrals and A&E.
I don't want to be in theatre unless I can help it.
I want to monitor this young man and don't trust anybody else.
If I'm honest, I don't even trust myself.
All right.
So You're conscious.
You haven't any impaired movement.
You're not slurring your words.
Which, given you banged your head and took horse tranquiliser, is perhaps an indication that you are what we call born survivor.
Maybe it's the ketamine that's keeping me alive.
It might be the alcohol.
It shrinks your brain and leaves more room for it to swell.
But there is a blood clot? There is a blood clot.
I won't lie.
And a couple of hours ago you were telling me you needed to operate.
It's big enough to worry about.
But then the scan tells me is one thing and you are telling me another.
You're talking.
You're coherent.
You're passing all these tests.
Which makes me think we should wait and see if it goes away.
Do blood clots ever just go away? Sometimes.
Sometimes? Sometimes I have operated on a clot and the release of pressure has made the brain jump out to meet me.
Which I don't think either of us wants to happen.
Do we? Don't we? Look, I'm going to monitor you myself most of the time.
I understand it's a bit scary.
I'm not afraid.
I've got nothing to lose.
Why should I be afraid? OK.
Are you absolutely certain you want to play it this way? I know you like to knock 'em out, but you won't go short of work, I promise.
You do an operation and the patient dies, everybody believes you've done your very best.
If you do nothing and the patient dies, nobody believes that's your best.
Yeah, but I'd know.
So what changed? Instinct.
It just doesn't feel right to operate.
Are you going to fit a pressure monitor? What'll that tell me that his behaviour won't? Will you be using any technology or shall I just book leeches? (LAUGHS) I hear you just bullied yourself an ITU bed for your patient.
Not bullied.
Charmed.
You should exercise YOUR charm muscle some time.
It gives you a warm glow inside.
Has she fallen off the ambulance? Well, she must be somewhere! I can't leave the hospital.
She can't have got far attached to two drips and a heart monitor! I'm monitoring a blood clot.
Strange case.
An estate agent got hit over the head with his own 'For Sale' sign.
And I haven't heard from Nick, so Look, just call before you come in.
Give me time to prepare my civilised face.
(CHUCKLES) Oh, I'm sorry.
My mother.
That was a joke.
Monroe, by the way.
(EASTERN EUROPEAN ACCENT) Tatiana.
Great coffee.
I don't make it.
The machine does! But you have to refill the machine.
When I refill the coffee machine, my background really helps.
East European? No.
Biochemistry.
Did you know that that snack-trolley girl is a biochemist? Tatiana? Yeah, everyone knows that.
Just phone the referring hospital again.
I did.
The consultant's gone home already.
Please! Sorry.
Is there anything you want to ask me about tomorrow? No, love.
You lot keep on inventing all this stuff to make us live longer.
We do indeed.
Be a bit rude to turn it down, wouldn't it? Now you can do all these marvellous things.
I hope you're not having the op so as not to appear ungrateful.
I just want it to be over.
You know, all this.
Whatever your decision, I'll support you.
It isn't my decision, though, is it? What if it was just you, on your own? What would you do then? I can't let them down, can I? They need me.
You know I can't.
(FOOTSTEPS APPROACHING) Hi, Gran! Was she saying what I think she was? I don't know.
I don't know what you were thinking.
I didn't even know you could think! Hang on in there, Mullery.
That's flirting where she comes from.
Oh, right You wouldn't be smiling if you worked for him.
The more I see, the more I think the family is a very over-rated institution.
People talk about it as though it's this big support network, but it's not really, is it? I mean, what is it, really? A group of people connected by biology, cemented together due to the power of association.
It has no inherent moral worth.
It's just a structure, like any other.
On the other hand, who else is going to play Cluedo with you? Don't undercut with humour.
You sound like Monroe.
Right.
Sorry.
Do you want to get something to eat? If it's all the same to you, I'd rather not.
OK.
Sure It's been a long day.
What I would really like is for us to find a suitable venue for sexual intercourse.
Right.
We'll eat later.
(SIREN) So why doesn't the ex-squaddie want you to contact his family? Bit fishy, in my view.
He's very isolated and whatever he says, he's very frightened.
He's probably done something terrible out in Afghanistan and can't live with the guilt.
He's probably a war criminal.
He's not a war criminal.
He's just confused.
Well, he looks like a war criminal with the haircut you've given him.
He'll need a lot of monitoring and support to get through the night and you're going to help me hold his hand.
I think the Hague Tribunal would class that as collaboration.
He plays poker.
I will raise youfour.
So what made you want to neck ketamine? Don't answer that.
He's trying to distract you.
Trying to forget something.
I'll call.
Folding.
Must have seen some bad things out there.
Yeah, especially when they flew Jim Davidson out to entertain us.
Four of a kind.
Two pair.
I've got Muck.
Don't you have other stuff to do? I have a highly trained team who are rising to the occasion.
Something you did, was it? The thing you were trying to forget? No, mate.
Something I DIDN'T do.
Looks like one of your highly trained team needs her hand holding.
It's a lumbar puncture.
It's a basic procedure.
Did you try Fortune first? She's in surgery.
Springer's panicking.
Next time, unless Springer has a brain in a bucket that he can't get back into a skull, it is not an emergency! You feel the give in the dura.
And then it's all about touch.
Think of Paul Scholes.
Paul who? No pain in your legs, Mr Ashton? No, no.
Thanks for that, Mr Monroe.
Sorry for any discomfort.
The lad's got to learn.
Indeed he has.
This is where, if I was a better man, I'd put my hand on your shoulder, look at you kindly and say, 'We've all been there.
' Sadly, I'm not a better man.
(MOUTHS) That was your chance.
It's different for you.
He likes you.
So, how was it? After all this time.
Did you remember where everything went? Why would you imagine that I would tell you anything? Oh, I get it! You went to bed, but she just wanted you to hold her.
And you said that's fine because you haven't made love yet and holding her is still exciting.
Then she fell asleep and so did your arm as you lay there watching the sun come through her thin girlie blinds.
Remind me why any of this is your business.
I care about you.
I hate to think of you being disappointed or humiliated in any way.
Yeah.
MONROE: The future of neurosurgery! I fully expect you'll be wrong, but which is the best approach? Witney? A transseptal approach to the mitral valve gives good access to the tricuspal valve as well.
Right.
You've been reading books rather than playing cards.
Don't look so pleased with yourself for doing what's expected of you.
Are you ready? How long do you think you can hold off surgery? He has no headache, his pupils aren't dilated, his GCS is fine.
And last night he bluffed his way to the pot with a straight run.
You're playing cards for money with a brain-damaged patient? I've got a feeling there are rules about that.
He wanted to play.
Patient choice.
It's part of the charter.
Dissolve, you bastard! She's really got it in for me.
She? Anna, the blood clot.
Nick.
Will you give me a call some time soon? Even if it's to shout abuse at me.
Thanks, mate.
Mr Monroe? Yes.
Tim Foster.
And this is Ann.
David Foster's mum and dad.
Oh, yes.
Good to meet you.
I don't know how - Good news.
We've been on the internet.
We've solved David's problem! You can go in up David's nose and not touch the top of his head! There's bore holes and a saline drain.
We've got the YouTube link.
Mr Foster.
Mrs Foster.
I know this is hard, but David has just spent an OK night and he seems to be coping well.
But the tumour's still there! Not a tumour.
A blood clot.
That's not the same thing.
You don't bring a patient to a hospital just so the hospital can do nothing.
Is it because of the drugs? Is he at the bottom of the waiting list? You do know he's a war hero? Not just some druggie.
That is not the reason I'm not operating.
It isn't because I disapprove of what he's done.
I should think not.
Listen, this up-the-nose thing.
It's still early days.
It'd be like painting your front hall by putting a roller through the letter box.
Well, how else are we supposed to help? Just be here for him.
Emotional support.
He won't see us, Mr Monroe.
He won't even talk to us.
He will once he knows you're here.
He DOES know we're here.
He won't see us.
OK.
We have extensive anterior chordal rupture, thickened leaflet and leaflet perforation with the whole valve leaking.
Risk of valve replacement? Damage to the circumflex artery? Good.
Witney? Damage to the coronary sinus, entrapment of the non-coronary cusp over the aortic valve.
AV dehiscence on lifting the heart, oversizing the valve Yeah, thank you.
That's enough disadvantages to be getting on with.
Let's get the old valve out before we all lose hope, shall we? Scissors, please.
You know your mum and dad are here? A nurse told me.
You don't want to see them? No.
Why not? Is that any of your business? No.
But I'm a bit bored talking about your blood clot.
I was doing Stag one time out in Sangin, Helmand Province.
And this towelhead came down the street, smiling, pushing a sofa.
Pushing it.
Dragging it.
Inches at a time.
Then he stopped, like, right in front of me.
I'm giving it all, 'Wruq Sha! Wruq Sha!' And he reaches inside his pocket and I thinkhe's going for a gun.
But I don't fire.
And he pulls out a cigarette packand smiles.
Not a tooth in his head.
Then he sits on the sofa, lights up, you know, like winding me up.
And all the time I've got my gun on him, sweat running off me.
In my eyes, down the back of my neck.
And all the time he's just looking at me.
Well, he finishes his cigarette, gets up and carries on like nothing had happened.
And he was right.
Nothing happened.
That was the problem.
I don't get it.
I wanted something to happen.
So would you have felt better about yourself if you'd shot the Afghan fella's head off or he'd blown you up? At least then I would have mattered.
Is that why you won't see your mum and dad? Like I say, their disappointment It's like this bloody great weight that they put on me.
Listen, can I tell you a secret? Everybody feels that way about their parents.
As excuses go, it's a none-starter.
Then they disguise their disappointment and that makes it ten times worse.
So it's not their disappointment you can't take, it's their kindness disguising it? Bloody hell! There's no pleasing you, is there? My dad was the reason I joined the army.
He wanted it more than me.
I don't know what he thought it would turn me into, but I'm pretty sure it wasn't this.
What are you thinking about? My son.
Is this a good time? Probably not.
I meant a good time for us to talk.
See my first answer.
Hello! Hello.
You realise that coffee is always destined to taste disappointing, don't you? It is in this hospital.
It will always smell better than it tastes.
It's the contrast between orthonasal smell and retronasal smell.
But you know that.
Basic neurology.
You are the point at which coffee and neuroscience intersect.
Does that woman know you? She keeps looking at you.
What woman? Oh Thanks.
Can you get Nick to call me the next time he calls you? He's angry.
Who isn't? She was pretty.
Who? The girl you were flirting with like a sixth-former.
Tatiana, yeah.
She's interesting.
She pushes a tea trolley, but she's better qualified than most of our pathologists.
Well, there you go, then.
A girl who needs rescuing.
Your perfect match.
Shall we have this argument now or shall we take it home for later? I'm sorry.
I should have told you I was putting the house on the market.
I didn't think they'd put up the sign so early.
I haven't had a chance to think about any of this stuff.
I'm not even sure we split up! Of course we've split up.
You know we have.
Are you seeing someone else? Of course not.
I want to stay in the house.
For now, at least.
Why? Why would you? Because that's where we lived with our daughter and I'm not ready to leave her even if you are! You cheap bastard! The ventricle's distended.
OK, heart isn't going to beat by itself.
Any suggestions other than trying again? Insert a balloon? Good, yes.
How long have we been on this? About four hours.
OK, let's have those pacing wires.
If nothing else comes of this, at least you'll have learned something You don't sound hopeful.
I'm not.
And nor was the patient.
I admitted the two electives this morning and an emergency from Harrogate from overnight.
Springer? Are you going to call or raise on the hand of Wilson's? Erm, there's one admission I'm struggling with a little.
You're going to have to be a bit more specific.
I can't actually find her.
You've lost her? Since when? Since yesterday.
I've got all her paperwork.
Thank God for that.
As long as her paperwork's bang up to date! See the way it's sitting over the right hemisphere? Crescentic.
Are you still here, Springer? That's another minute your lost patient is closer to death.
I'm sorry.
I knew about the missing patient last night.
I should have told you earlier.
Don't worry.
I knew too.
Bradley, chief porter, found her in the ambulance bay.
She's being monitored on General Surgical until a bed becomes free.
Shouldn't we Shouldn't someone tell Springer? Now, Wilson, where would the fun be in that? She's come through the operation.
Thank God.
Oh, thank God! We tried to take her off the bypass machine, but her heart wouldn't pump without it.
Well, that will take a while, won't it, what with the No, what I'm saying is this.
She's still very sick.
She's not wake-upable at the moment.
And we've put in a temporary device to help her heart out.
So when will you be able to wake her up? We don't know.
We just have to hope that her heart starts to work independently.
Are you sayingyou don't know when she'll recover? No, Sharon.
I'm saying I don't know IF she'll recover.
(SOBS) Where have you been for the last hour? He doesn't call, he doesn't text Mm-hm Sorry.
Didn't know anyone was in here.
I'm nearly done.
Tubes in, tubes out.
Can't take that long.
Indeed.
Shepherd! (MANCUNIAN ACCENT) It's turning into a party.
Are you staying all night? Yes.
That's what constant monitoring is.
It's a pity, that, because er I'm not busyat alltonight.
I'm completely free, in fact.
OK, well, maybe there's some football on the telly! Yeah.
Yeah.
I'll be at home on my own all night if you want to just give me a call.
Well, I'll bear that in mind.
Cool.
Hm He's a very needy boy.
Can't really do anything without me.
I was thinking of going for a coffee.
Do you want one? No, thank you.
Are you going to be here all night? I'm on call, so it depends.
So, did I tell you my wife put my house up for sale without telling me? I'm not really all that interested.
I'm just reaching out.
How are her obs? Pulse 130.
BP ropey.
Gotcha.
I knew you wanted to make small talk.
What do you want to talk about? Why don't we start with the one that got away? It was always going to be touch and go.
She wanted to see her granddaughter get married.
Well, her daughter wanted her to see it.
And her choice would have been? She more or less told me she'd had enough.
But nobody really wants to die, do they? I mean, we're all holding out for some miracle in the end.
Not me.
Just so as I'm clear, should the occasion arise, you'd want me to smother you with a pillow? It would be the right thing to do.
I've often thought so.
The only reason we don't want to die is that we can't imagine the world existing without us.
Well, it might not.
We'll be dead.
So we'll never know.
(PAGER BLEEPS) Do you ever stop writing? I daren't.
If I kill you, then I have to have written evidence that I did it with good reason.
Do you want me to sign some kind of insurance waiver? Nothing to lose.
Nothing to lose? Why's that? Because you're not dead or maimed? What? Well, the way you tell it, other lads died out there, other lads got maimed or blinded, but not you, and you feel jealous of them.
I feel guilty, not jealous! As the Dalai Lama says, 'Let's agree that life is useless and disappointing and then go out and enjoy the good shit.
' I feel a bit better.
You see! No, I mean, I feel better.
I feel a bit lessclaggy, you know.
Claggy? Must have been off med school that day.
Your pulse is dropping, which is promising.
Unless it stops altogether, of course.
I hear from my colleagues in cardiac that that's not good.
Mwah! You don't have to stop.
Stop what? No change? No change.
So what do you do next? Make sure I don't make the same mistake again.
Come on, it's just unlucky.
We can't make decisions based on experience and then blame luck when it goes wrong.
But you can when it goes right? I take it his scan was good.
His clot seems to be dissolving, yes.
Don't hold back on your usual smugness on my account.
It's night.
Triumphalism doesn't play at night.
What? I mean, it's like, during the day we're in control of the hospital, but during the night the hospital is in control of US.
I know you agree with me.
If it wasn't night, would you and me be talking like this? That's true.
It would take the fear of death to do that.
You're a lost cause, Bremner.
(MOBILE RINGS) (HUM OF CHATTER AND ACTIVITY) Hello? Hello? (PLAYFULLY) Oh, Bremner! Your phone.
It was in the cardigan you tucked round me.
Must have fallen out during the night.
Thank you.
Was last night a dream? Do you feel ashamed that we shared intimacies? I need to focus on the job in hand.
I know your way is to do all this, but I don't have the time or the energy to humour you right now.
You're behaving as though we slept together.
Did we sleep together? Stop.
Stop.
I don't know what significance you want to attach to last night, but I cannot play along with it.
What can I say? What can I say? You are a genius! You are a genius! I know, I know.
Thank you.
Thank you so much.
Well, he's a remarkable young man.
No doubt about it.
Thank God he was in your care.
Thank God.
Have you just been to see him? Oh, no.
We wouldn't do that.
One of the nurses told us.
We wouldn't go and see him.
Not unless he said we could.
I'll give you evens on Spirit of Sahara.
That's as far as I go.
You know what I think? I think Bremner's got a crush on me.
That would certainly account for her hostility.
No, no, no.
She's fighting her own feelings for me by putting up a shield of hatred.
My missus does that a lot.
It's YOU that's obsessed with HER.
You really think she's speculating right now about your crooked heart? My crooked heart? You're my only friend in the world! Have you ever asked yourself why that might be? Push.
Push! Good.
Arms.
Turn.
Back.
Clench.
That's all looking good.
You are a lucky man.
We need to check the bleeding has stopped, but the clot is dissolving and the intracranial pressure seems to be dropping.
Is that good? That's very good.
Thank you.
You had a narrow escape with this, you know.
So So how do I put this with the right degree of subtlety? You nearly died.
You got lucky.
You owe it to fate to put some of the shit in your life right.
OK? Is this about my mum and dad? They need you.
Doesn't that count for something? Right.
Springer will soon enlighten me! I've found the admission! Great! Dead or alive? Alive.
She was in General Surgical for observation until a bed became available.
I know.
You know? How do you know? I always knew.
Don't go home without taking a full history off her and writing it up, will you? Bastard.
There's no change.
She isn't any better and she isn't any worse.
I'm sorry.
But you can do something, can't you? Not at the moment, no.
We can monitor her.
And what if she stays like she is? What then? Then we have to think about what Judith might want.
What she might have wanted if she'd known it would turn out like this.
She'll come through She always does.
She'll come through.
(ROLLING STONES TRACK PLAYS) If it's sex you're after as an apology, you've come to the right place! Yoo! The estate agent just wanted to show some people around.
Hello.
Hi there.
Do you think it's a good time to put it on the market? Well, I think it's the best thing to do.
And not just for me.
For the both of us.
Is that what the estate agent told you to say? I want you to be happy.
But I can't see that in this house.
These memories Deep down you know it too.
You won't agree with me because it's me saying it.
That's me all over.
I'm a cheap bastard, remember? No, I'm not going back over this argument.
But you did deserve that one.
OK.
You're right.
Maybe I did deserve it.
But I just .
.
didn't want to close the door on that part of our life.
If you leave this house, it doesn't mean you're leaving Charlotte.
It really doesn't.
I want to buy the house off you.
What? Get three buyers' offers.
I'll match the average price.
You don't need a house this size! You'll go mad here on your own.
Just say you'll think about it! What have you go to lose by that? All right.
I'll think about it Thanks.
YEAH YEAH YEAHS: Little Shadow Patience, shadow With all your sight there's no sight to see Little shadow Little shadow To the night, will you follow me? Pardon, shadow Hold on tight to your darkened key Little shadow Little shadow (SOUNDLESS) What if I tell you that God is talking to me? Why would he stop because you had a tumour removed? He's testing me! Is everything OK? No.
Everything is not OK.
Rosario's? Pardon? I hear you went to Rosario's last night.
You don't want me to be happy! Are we er, OK?
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